Publications by authors named "Juri Kivelev"
Importance: During the past decade, spinal surgical procedures have been increasingly performed on an ambulatory basis, a change in clinical practice supported only by observational evidence thus far. There have been no randomized clinical trials (RCTs) comparing ambulatory care with inpatient care after any spinal surgery.
Objective: To assess whether ambulatory care is noninferior to overnight hospital surveillance in functional outcome, as measured by Neck Disability Index (NDI), in adults after anterior cervical decompression and fusion (ACDF) for cervical radiculopathy.
The role of complex network analysis in patients with diagnosis of unruptured intracranial aneurysm is unexplored. The objective of this study is to assess the applicability of this methodology in aneurysm patients. We retrospectively analyze comprehensive unbiased local digital data of a large number of patients treated for any reason between January 2004 and July 2019.
View Article and Find Full Text PDFArticle Synopsis
- - The study aims to assess the feasibility of using PET imaging (specifically with 18F-FDG and 68Ga-DOTANOC tracers) to evaluate inflammation in the walls of unruptured intracranial aneurysms (UIA) prior to surgical treatment.
- - Patients scheduled for surgery will undergo a series of imaging tests and sample collections to measure the uptake of the tracers in aneurysms and relate it to various clinical and histological factors.
- - The research has received ethical approval and intends to share its findings through scientific publications and conferences, contributing to the understanding of UIA and arterial inflammation.
Article Synopsis
- A low ankle-brachial index (ABI) is linked to increased systemic inflammation and a higher risk of cardiovascular events, prompting investigation into its association with unruptured intracranial aneurysms (IAs).
- A study of 776 patients found a significant correlation between low ABI values and higher prevalence rates of unruptured IAs, indicating that lower ABI scores may suggest greater risk for these conditions.
- The findings suggest that ABI measurements could be useful for identifying individuals more likely to have unruptured IAs, potentially guiding further screening and prevention strategies.
Article Synopsis
- - The study aimed to assess trends in the detection rates of asymptomatic unruptured intracranial aneurysms (UIAs) using brain CTA/MRA from 2005 to 2019, revealing a notable increase in detection frequencies during this period.
- - Analysis of data from over 81,000 scans indicated a significant rise in new UIA cases, with a detection rate growth from 1.7% (2005-2009) to 3.4% (2015-2019), particularly among older age groups.
- - The findings suggest a trend toward increased identification of smaller UIAs, specifically less than 5 mm, raising important considerations for the management of these asymptomatic conditions in clinical practice.*
Background: Aneurysmal subarachnoid hemorrhage (aSAH) is a neurological emergency, affecting a younger population than individuals experiencing an ischemic stroke; aSAH is associated with a high risk of mortality and permanent disability. The noble gas xenon has been shown to possess neuroprotective properties as demonstrated in numerous preclinical animal studies. In addition, a recent study demonstrated that xenon could attenuate a white matter injury after out-of-hospital cardiac arrest.
View Article and Find Full Text PDFBackground: Cerebrovascular involvement of Kawasaki disease (KD) is poorly studied. White matter hyperintensities (WMH) indicate cerebral small vessel disease and increase the risk for stroke.
Purpose: To investigate whether childhood KD is associated with WMHs and other cerebrovascular findings later in adulthood.
Background: Perimesencephalic and nonperimesencephalic nonaneurysmal subarachnoid hemorrhage (PM-naSAH and NPM-naSAH) have a different bleeding pattern and clinical course. The etiology and risk factors for PM-naSAH and NPM-naSAH are unclear. The objective of this study was to compare risk factors and triggering events between PM-naSAH and NPM-naSAH.
View Article and Find Full Text PDFGiven the rareness of available data, we performed a systematic review and meta-analysis on therapeutic strategy microsurgical resection and stereotactic radiosurgery (SRS) for brainstem cavernous malformations (BSCMs) and assessed mortality, permanent neurological deficits (PNDs), rebleeding rate, and patients who require reintervention to elucidate the benefits of each treatment modality. Preferred reporting items for systematic reviews and meta-analyses (PRISMA) were used for protocol development and manuscript preparation. After applying all inclusion and exclusion criteria, six remaining articles were included in the final manuscript pool.
View Article and Find Full Text PDFObjective: Indication for surgery in brainstem cavernous malformations (BSCMs) is based on many case series, few comparative studies, and no randomized controlled trials. The objective of this study was to seek consensus about surgical management aspects of BSCM.
Methods: A total of 29 experts were invited to participate in a multistep Delphi consensus process on the surgical treatment of BSCM.
Background And Aims: Patients with intracranial aneurysms (IA) have excess mortality for cardiovascular diseases, but little is known on whether atherosclerotic manifestations and IA coexist. We investigated abdominal aortic calcification index (ACI) association with unruptured and ruptured IAs.
Methods: This retrospective case-control study reviews all tertiary centers patients (n = 24,660) who had undergone head computed tomography angiography (CTA), magnetic resonance angiography (MRA) or digital subtraction angiography (DSA) for any reason between January 2003 and May 2018.
Surgical indications for cerebral cavernous malformations remain significantly center- and surgeon-dependent. Available grading systems are potentially limited, as they do not include epileptological and radiological data. A novel grading system is proposed for supratentorial and cerebellar cavernomas: it considers neuroradiological features (bleeding, increase in size), neurological status (focal deficits and seizures), location of the lesion and age of the patient.
View Article and Find Full Text PDFObjective: We sought to examine the conservative treatment of symptomatic spinal cavernomas and evaluate the efficacy and safety of surgical management of spinal cord cavernous malformations.
Methods: This meta-analysis included articles comparing outcomes of conservative treatment and surgical management of spinal cavernomas, published in the full-text form (from 2000 to June 31, 2020). Collected variables included first author name, country, covered study period, publication year, the total number of patients and at follow-up, bleeding, motor weakness, pain, bladder and/or bowel dysfunction neurologic improvement or deterioration after discharge, and the need for reintervention after subtotal surgical resection or hemorrhage.
Background: Posterior cerebral artery (PCA) aneurysms are rare and the majority are fusiform in shape. Proximal occlusion of PCA represents a treatment option for these lesions. However, this procedure carries a high risk of ischemic complications.
View Article and Find Full Text PDFBackground: After occlusion of an aneurysm, a patient may experience aneurysm regrowth at the same site or develop de novo aneurysms. We present our experience in microsurgery of recurrent aneurysms with analysis of long-term results.
Methods: The senior authors (R.
Objective: Skull opening in occipital and suboccipital regions might be associated with risk of damage to the transverse venous sinus and the confluence of sinuses. We analyze the value of magnetic resonance (MR) imaging in localizing the venous sinuses in relation to the superior muscle insertion line (MIL) on the occipital bone.
Methods: We retrospectively analyzed head MR images of 100 consecutive patients imaged for any reason from 1 January 2013.
Objective: The presigmoid approach can be used to treat vertebrobasilar artery aneurysms when circumstances require more operative exposure. High morbidity and mortality in these cases have been reported. In this study, we describe our modified presigmoid approach for vertebrobasilar artery aneurysms and our clinical results.
View Article and Find Full Text PDFBackground: The lateral supraorbital approach (LSO) provides access to a variety of pathologies including anterior and some posterior circulation aneurysms, sellar and suprasellar lesions, and anterior fossa tumors. Technical modifications of LSO improve the surgical exposure of the skull base.
Methods: We retrospectively analyzed 73 consecutive patients treated by the senior author (Juha A.
Background: Ruptured cerebral aneurysms (ICAs) are the most common non-traumatic cause of subarachnoid hemorrhage (SAH) that is associated with life threatening complications such as Vasospasm, Infarction, and Hydrocephalus (HCP). The active participation of macrophage/monocyte-mediated inflammatory response in the pathogenesis of cerebral aneurysm as labeled with Monocyte Chemoattractant Protein-1 (MCP-1) is suggested.
Objective: To measure the serum level of MCP-1 in ruptured CAs in different time intervals.
Background: The basilar bifurcation aneurysm (BBA) is still considered to be one of the most challenging aneurysms for micro- and endovascular surgery. Classic surgical approaches, such as subtemporal, lateral supraorbital (LSO), and modified presigmoid, are still reliable and effective.
Objective: To analyze the clinical and radiological factors that affect the selection of these classic surgical approaches and their outcomes.
Background: The disadvantages of a contralateral approach (CA) include deep and narrow surgical corridors and inconsistent ability to achieve proximal control of the supraclinoid internal carotid artery (ICA). However, a CA remains as a microsurgical option for selected ICA-ophthalmic (opht) segment aneurysms.
Objective: To describe transient cardiac arrest induced by adenosine as an alternative tool to obtain proximal vascular control and soften the aneurysm sac in selected patients while performing a CA.
Background: Bilateral aneurysms located between the 2 middle cerebral artery (MCA) bifurcations may be approachable through a single unilateral approach.
Objective: To identify anatomic parameters based on imaging that would favor a contralateral approach.
Methods: From January 1998 to December 2013, we retrospectively identified 173 patients with bilateral intracranial aneurysms.
Background: We analyze our experience of using TachoSil® (Takeda Austria GmbH: Linz, Austria) in microneurosurgical procedures as a hemostat and also as a sealant to patch dural defects.
Materials And Methods: Beginning on January 1, 2012, we prospectively analyzed 100 consecutive surgeries where TachoSil was used. The patient group included 58 women (58 %) and 42 men (42 %); the mean age was 52 years (range, 3-85 years).
Background: Contralateral aneurysm clipping can be applied to bilateral intracranial aneurysms of the anterior circulation and to selected aneurysms on the medial wall of the internal carotid artery (ICA).
Objective: To identify anatomic and radiological parameters that would favor a contralateral microsurgical approach to ICA-ophthalmic segment (ICA-opht) aneurysms.
Methods: For the period January 1957 to December 2012, we retrospectively analyzed 268 patients with ICA-opht aneurysms treated in our institution.