Object: The authors report on their 11 years' experience with embolization of cerebral aneurysms using Guglielmi Detachable Coil (GDC) technology and on the attendant anatomical and clinical outcomes.
Methods: Since December 1990, 818 patients harboring 916 aneurysms were treated with GDC embolization at University of California at Los Angeles Medical Center. For comparative purposes, the patients were divided into two groups: Group A included their initial 5 years' experience with 230 patients harboring 251 aneurysms and Group B included the later 6 years' experience with 588 patients harboring 665 aneurysms. Angiographically demonstrated complete occlusion was achieved in 55% of aneurysms and a neck remnant was displayed in 35.4% of lesions. Incomplete embolization was performed in 3.5% of aneurysms, and in 5% occlusion was attempted unsuccessfully. A comparison between the two groups revealed a higher complete embolization rate in patients in Group B compared with that in Group A patients (56.8 and 50.2%, respectively). The overall morbidity/mortality rate was 9.4%. Angiographic follow ups were obtained in 53.4% of cases of aneurysms, and recanalization was exhibited in 26.1% of aneurysms in Group A and 17.2% of those in Group B. The overall recanalization rate was 20.9%. Note that recanalization was related to the size of the dome and neck of the aneurysm. Overall incidence of delayed aneurysm rupture was 1.6%, a rate that improved in the past 5 years to 0.5%. Ten of 12 delayed ruptures occurred in large or giant aneurysms.
Conclusions: The clinical and postembolization outcomes in patients treated with the GDC system have improved in the past 5 years. Aneurysm recanalization, however, is still a major limitation of current GDC therapy. Follow-up angiography is mandatory after GDC embolization of cerebral aneurysms. Further technical and device improvements are mandatory to overcome current GDC limitations.
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http://dx.doi.org/10.3171/jns.2003.98.5.0959 | DOI Listing |
World J Urol
January 2025
Department of Urology, Urooncology, Robot-assisted and Focal Therapy, University Hospital Magdeburg, Otto-von Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany.
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Colorectal Surgery Unit, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona UAB, Barcelona, Spain.
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January 2025
Stanford Medicine, Stanford, CA, USA.
Purpose: Subclinical peroneal neuropathy without overt foot drop has been linked to increased fall risk in adults, yet remains under reported due to subtle symptoms and lack of awareness. Patients with carpal tunnel syndrome (CTS) often experience other nerve entrapments, prompting this study to evaluate CTS (a proxy for peroneal nerve entrapment) as a significant predictor of time to first fall.
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Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.
Objectives: Fundoscopy is crucial in the emergency department to identify or rule out serious ocular and neurological conditions. Despite its clinical importance, fundoscopy is often omitted due to the technical challenges associated with traditional direct ophthalmoscopy, particularly for non-ophthalmologists. This study examines emergency physicians' practices, confidence levels, and training related to various modalities of fundoscopy including traditional direct ophthalmoscopes, binocular indirect ophthalmoscopes, panoptic ophthalmoscopes, slit lamp fundoscopy and fundus cameras; and explores the potential role of alternative modalities, such as fundus cameras, in Canadian emergency departments.
View Article and Find Full Text PDFSci Rep
January 2025
Division of National Control of Communicable Diseases, Ministry of Health, Asmara, Eritrea.
Real-world data on treatment outcomes or the quality of large-scale chronic hepatitis B (CHB) treatment programs in sub-Saharan Africa (SSA) is extremely difficult to obtain. In this study, we aimed to provide data on the prevalence and incidence of mortality, loss to follow-up (LFTU), and their associated factors in patients with CHB in three treatment centres in Eritrea. Additional information includes baseline clinical profiles of CHB patients initiated on nucleos(t)ide analogue (NUCs) along with a comparison of treatment with Tenofovir disoproxil fumarate (TDF) vs.
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