Usefulness of endoscope-assisted surgery under exoscopic view in skull base surgery: A technical note.

Background: The use of the exoscope has been increasing in the field of neurosurgery, as it can set the visual axis freely, enabling the surgeon to operate in a comfortable posture. Although endoscope-assisted surgery for compensation of insufficient surgical field is useful under the microscope, we report that using an endoscope in exoscopic surgery is safer and more useful.

Methods: The exoscope used was ORBEYE.

Intraprocedural prediction of hemorrhagic cerebral hyperperfusion syndrome after carotid artery stenting.

Hyperperfusion syndrome (HPS) is a rare but severe complication after carotid artery stenting (CAS). Reliable methods for predicting HPS remain to be developed. We aimed to establish a predictive value of hemorrhagic HPS after CAS.

Incidence of hemodynamic depression after carotid artery stenting using different self-expandable stent types.

The rates of hemodynamic depression (HD) and thromboembolism were compared in 95 carotid artery stenting (CAS) procedures performed in 87 patients with severe carotid artery stenosis using self-expandable braided Elgiloy stents (Wallstent) in 52 and slotted-tube Nitinol stents (Precise) in 43 procedures. The blood pressure, pulse rate, and neurological signs were recorded at short intervals during and after CAS. All patients underwent diffusion-weighted magnetic resonance imaging within 5 days after the procedure.

Angiographically confirmed stent over expansion in the internal carotid artery during stenting: incidence, predictors, and outcomes.

Introduction: Selection of the appropriate diameter of stent is difficult in patients with the size mismatch between the internal carotid artery (ICA) and the common carotid artery (CCA). Although stent overexpansion (SOE) in the ICA after carotid artery stenting (CAS) is suspected of producing restenosis, SOE has not been well established. We discuss its incidence, predictors, and outcomes.

Early ceasing of intra-aneurysmal contrast opacification during coil embolization in ruptured aneurysms compared with unruptured aneurysms.

Background: The difference between coil-embolized ruptured and unruptured aneurysms with respect to intra-aneurysmal thrombus formation remains to be determined.

Objective: We examined whether there was a difference between ruptured and unruptured coil-embolized aneurysms in the rate and timing of thrombus formation in the aneurysmal sac and discuss the effect of thrombus on the treatment outcome.

Methods: We evaluated 209 aneurysms with an aneurysmal dome smaller than 10 mm and a neck size less than 4 mm.

Intraprocedural changes in angiographic cerebral circulation time predict cerebral blood flow after carotid artery stenting.

Changes in the cerebral blood flow (CBF) are important for planning postoperative care in patients treated by carotid artery stenting (CAS). The relationship between intraprocedural changes in the angiographic cerebral circulation time (CCT) and perioperative CBF changes were retrospectively studied in 49 CAS procedures performed in 46 patients with carotid artery stenosis. The CCT, defined as the interval between the timing of maximal opacification at the terminal portion of the internal carotid artery and at the cortical vein, was determined by referring to time-density curves of data obtained from routine intraprocedural digital subtraction angiography.

Fragmentation of calcified plaque after carotid artery stenting in heavily calcified circumferential stenosis.

Introduction: We assessed the morphological change of calcified plaque after carotid artery stenting (CAS) in vessels with heavily calcified circumferential lesions and discuss the possible mechanisms of stent expansion in these lesions.

Methods: We performed 18 CAS procedures in 16 patients with severe carotid artery stenosis accompanied by plaque calcification involving more than 75% of the vessel circumference. All patients underwent multidetector-row computed tomography (MDCT) to evaluate lesion calcification before and within 3 months after intervention.