Publications by authors named "Charlotte Chung"

Background: Data about the safety and the efficacy of flow diversion for distal anterior cerebral artery (DACA) aneurysms are limited. We present the largest multicenter analysis evaluating the outcomes of flow diversion in unruptured DACA aneurysm treatment.

Methods: Databases from 39 centers were retrospectively reviewed for unruptured DACA aneurysms treated with flow-diverting stents.

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Background And Objectives: Superficial temporal artery to middle cerebral artery (STA-MCA) bypass is the workhorse for flow augmentation surgery. Although either interrupted or running sutures can be used to complete the anastomosis with high intraoperative patency rates, no previous study in the cranial bypass literature has compared long-term patency and maturity of end-to-side STA-MCA anastomoses. We compared STA-MCA anastomoses performed with running vs interrupted sutures by evaluating bypass flow and anastomotic maturation on follow-up vascular imaging.

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Background: Hypoglossal canal dural arteriovenous fistulas (HCDAVFs) are a relatively rare subtype of dural arteriovenous fistula (dAVF), representing 3%-5% of all dAVFs. The complex angio- and venous architecture predisposed to numerous anastomoses and nearby anatomical structures, including the posterior fossa sinuses and cranial nerves, can complicate both the diagnosis and treatment of these lesions.

Observations: The authors describe the case of HCDAVF in a 74-year-old male who presented with pulsatile tinnitus (PT) lasting 3 months and significant fatigue, headaches, and dizziness.

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The anatomy of vertebrobasilar perforators has been widely studied in human cadavers, with most reports found in the neurosurgical literature. These arterial perforators are extremely hard to visualize consistently with traditional two-dimensional digital subtraction angiography, but are reliably visible with cross sectional cone beam CT techniques. A clear understanding of this specific neurovascular anatomy and pathology is essential for informed treatment decisions.

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  • The study aimed to identify the optimal sizes for middle cerebral artery (MCA) bifurcation aneurysms that are most suitable for treatment with the Woven EndoBridge (WEB) device, focusing on aneurysm width and neck dimensions.
  • Using a large retrospective database, the researchers analyzed unruptured MCA bifurcation aneurysms and established ideal cutoff values of 6.1 mm for width and 4.6 mm for neck size regarding treatment effectiveness.
  • Findings indicated that aneurysms smaller than these cutoff values had significantly higher rates of occlusion (93% for width and 90% for neck) and lower retreatment rates compared to larger aneurysms, highlighting the importance of
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Background And Objectives: Iatrogenic cerebrovascular injury can cause intracranial hemorrhage and pseudoaneurysm formation, putting patients at high risk for postoperative bleeding. No consensus for management exists. This study describes endovascular treatment of these acute injuries with flow diverter stents.

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  • * Initial treatments such as transvenous embolization were ineffective, and traditional methods weren't viable due to the importance of the patient's right sigmoid sinus for brain drainage.
  • * A successful alternative treatment used a pipeline embolization device (PED) to block the dAVF while keeping the sigmoid sinus functional, leading to improved blood flow and drainage confirmed in follow-up imaging.
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  • Diagnosing spinal vascular conditions is tough due to small structures, long imaging tests, and overlapping features.
  • The authors provide strategies to help radiologists identify these conditions by focusing on vascular anatomy and imaging results.
  • Three main types of abnormalities are discussed: infarcts, anomalies, and tumors, to assist in accurate diagnosis.
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  • - The study aimed to create a predictive calculator to determine the chances of achieving adequate occlusion (Raymond-Roy classification 1 or 2) when using the woven endobridge (WEB) device for intracranial aneurysms, drawing from a large dataset.
  • - Analyzed data from 356 patients across 30 centers worldwide revealed that larger aneurysm neck size and partial thrombosis were linked to lower chances of successful occlusion, while the calculator showed good predictive accuracy.
  • - The newly developed tool offers a valuable resource for clinicians to better estimate the success of using the WEB device in treating intracranial aneurysms, helping to enhance patient care.
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  • - The Woven EndoBridge (WEB) device is used for treating wide-neck intracranial bifurcation aneurysms smaller than 10 mm, but there's limited data on its effectiveness for larger aneurysms.
  • - A study reviewed data from the WorldWide WEB Consortium involving 898 patients to compare outcomes between small and large aneurysms, using propensity score matching (PSM) for accuracy.
  • - Results showed that large aneurysms had significantly lower rates of adequate occlusion and higher rates of retreatment compared to small aneurysms, suggesting that these findings could influence treatment choices and patient discussions in the future.
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  • The Woven EndoBridge (WEB) device is being studied as a new treatment for intracranial aneurysms, particularly its effectiveness for off-label uses which require further investigation.
  • A study of 162 patients utilizing machine learning developed predictive models for successful occlusion after off-label WEB treatment, analyzing various factors linked to outcomes.
  • Findings indicated that larger neck diameter and the presence of daughter sacs significantly predicted poorer occlusion results, emphasizing the need for further validation to refine patient selection and treatment strategies.
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Background: Although the burden of alcohol-associated hepatocellular carcinoma (HCC) is increasing with rising alcohol consumption, clinical presentation and outcomes of alcohol-associated HCC have not been systematically assessed. We aimed to determine the prevalence, clinical characteristics, surveillance rates, treatment allocation, and outcomes of alcohol-associated HCC.

Methods: Medline and Embase were searched from inception to January 2023.

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Article Synopsis
  • Researchers aimed to identify factors predicting aneurysm occlusion and retreatment following WEB embolization due to limited existing studies.
  • The study reviewed data from 763 patients across 30 institutions, finding a 65.1% complete occlusion rate at follow-up and a 7.3% retreatment rate.
  • Key negative predictors for complete occlusion included smoking history, larger aneurysm size, and wall branch presence, while intraprocedural occlusion significantly improved long-term outcomes.
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  • A solid grasp of venous anatomy is crucial for diagnosing and treating various medical conditions, particularly those affecting the brain.
  • The venous system is gaining recognition for its potential in treating conditions like idiopathic intracranial hypertension, arteriovenous malformations, and pulsatile tinnitus.
  • The article breaks down the anatomy of the central nervous system's venous system into five sections: embryology, dural sinuses, cortical veins, deep veins, and spinal veins.
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  • This study examined how taking antiplatelet medications before and after procedures affects the risk of thromboembolic complications (TECs) in patients treated with the Woven EndoBridge (WEB) device for specific brain aneurysms.
  • It analyzed data from multiple centers, involving a total of 1412 patients, to determine if antiplatelet drugs reduce the likelihood of TECs, finding that those who took them before the procedure had a significantly lower risk.
  • The study concluded that while preprocedural antiplatelet use significantly lowers the chances of TECs, the effect does not carry over when the medication is taken post-procedure.
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Background And Purpose: Successful post-flow-diverter endoluminal reconstruction is widely believed to require endothelial overgrowth of the aneurysmal inflow zone. However, endothelialization/neointimal overgrowth is a complex process, over which we currently have very limited influence. Less emphasized is vascular remodeling of the target arterial segment, the dynamic response of the vessel to flow-diverter implantation.

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Background: The Woven EndoBridge (WEB) devices have been used for treating wide neck bifurcation aneurysms (WNBAs) with several generational enhancements to improve clinical outcomes. The original device dual-layer (WEB DL) was replaced by a single-layer (WEB SL) device in 2013. This study aimed to compare the effectiveness and safety of these devices in managing intracranial aneurysms.

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  • The Woven EndoBridge (WEB) device is effective for treating intracranial aneurysms, yet the postoperative use of aspirin shows varied practices among clinicians.
  • A multicenter study involving 1492 patients compared outcomes between those who took aspirin post-surgery and those who didn't, revealing that aspirin users had better functional outcomes and lower mortality rates but higher rates of retreatment.
  • The findings suggest that while aspirin may improve recovery and reduce death rates after WEB treatment, it also increases the likelihood of needing additional procedures, indicating a need for further research on optimal postoperative care.
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The scarcity of liver grafts has prompted developments in living donor liver transplantations (LDLT), with previous literature illustrating similar outcomes in recipients compared to deceased donor transplants. However, significant concerns regarding living donor morbidity and mortality have yet to be examined comprehensively. This study aims to provide estimates of the incidence of various outcomes in living liver donors.

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  • The study aimed to evaluate the role of carotid web (CW) and carotid bifurcation measurements in predicting stroke risk in patients.
  • Researchers analyzed data from 22 patients, focusing on specific anatomical angles associated with stroke risk and found that certain angles were significant predictors.
  • The findings suggest that detailed angioarchitectural data can help doctors assess an individual's stroke risk more accurately, leading to personalized patient care.
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  • * The case series highlights imaging findings related to the breakdown of the pharyngoesophageal wall and associated cervical spine infections, which often affect patients who have had previous dilations for benign strictures.
  • * Symptoms like neck pain, fever, or signs of infection should trigger a thorough evaluation for osteomyelitis-diskitis and possible breakdown of the neopharynx after dilation treatments.
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Background: Preliver transplant diabetes mellitus (pre-LT DM) is a common comorbidity in LT recipients associated with poorer post-transplant survival. However, its relationship with other important outcomes, including cardiovascular and renal outcomes, remains unclear. This meta-analysis aims to provide an updated analysis of the impact of pre-LT DM on key post-LT outcomes.

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Unlabelled: The superior hypophyseal arteries (SHAs) are well known in anatomical and surgical literature, with a well-established role in supply of the anterior hypophysis and superjacent optic apparatus. However, due to small size and overlap with other vessels, in vivo imaging by any modality has been essentially non-existent. Advances in high resolution cone beam CT angiography (CBCTA) now enables this deficiency to be addressed.

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  • The study investigates the long-term risks associated with metabolic dysfunction-associated steatotic liver disease (MASLD) by analyzing data from 129 original studies comparing MASLD patients to those without the condition.* -
  • Results indicate that individuals with MASLD have a higher risk of various complications, including cardiovascular issues, metabolic disorders (like diabetes and hypertension), chronic kidney disease, and certain cancers, with those having advanced liver disease at an even greater risk.* -
  • The findings highlight the need for comprehensive treatment approaches for MASLD due to its serious multisystem effects on health.*
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