The management of complex skull base tumors that incorporate large intracranial vessels poses challenging questions. Patients who fail initial surgical resection and adjunctive therapies (i.e., radiosurgery) who present with tumor regrowth may be candidates for parent vessel occlusion and total tumor resection in combination with extracranial-to-intracranial (EC-IC) bypass to augment the sacrificed vessel territory. In this technical report, we delineate the surgical technique of performing an EC-IC bypass using a radial artery graft. Our protocol of simultaneous cranial, neck, and forearm dissections by the surgical team to perform this procedure is described in detail.
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http://dx.doi.org/10.1055/s-2005-872596 | DOI Listing |
J Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Kanto Rosai Hospital, Kanagawa, Japan.
Background: The presence of significant tortuosity in access routes to aneurysms can interfere with catheter guidance and manipulation and significantly impact treatment strategies.
Observations: In this report, the authors combined intentional staged aneurysm embolization with the construction of a new direct access route, which they call a "highway bypass," for a symptomatic posterior circulation cerebral aneurysm that was difficult to access with a catheter. Notably, the highway bypass is used for catheter passage, and technical tips should be considered.
J Soc Cardiovasc Angiogr Interv
December 2024
Division of Cardiovascular Medicine, Sulpizio Cardiovascular Center, University of California San Diego, San Diego, California.
Background: A minimum threshold activated clotting time (ACT) to guide heparin dosing during percutaneous coronary intervention (PCI) is associated with lower ischemic complications. However, data are variable regarding the risk of high ACT levels. The aim of this study was to assess the impact of peak procedural ACT on complications and mortality for transfemoral and transradial access PCI.
View Article and Find Full Text PDFInt J Cardiovasc Imaging
January 2025
Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Endovascular treatment (EVT) for patients with lower extremity artery disease is widely used as a less invasive alternative to surgical bypass. Recently, transradial artery intervention has gained popularity owing to its minimally invasive nature. The distance from the radial artery to the target vessel is critical for success; however, effective pre-assessment methods have not yet been established.
View Article and Find Full Text PDFFront Cardiovasc Med
December 2024
Chief of Cardiac Surgery, Peking Union Medical College Hospital, Beijing, China.
Introduction: Acute kidney injury (AKI) is notably prevalent after cardiac surgery for patients with active infective endocarditis. This study aims to create a machine learning model to predict AKI in this high-risk group, improving upon existing models by focusing specifically on endocarditis-related surgeries.
Methods: We analyzed medical records from 527 patients who underwent cardiac surgery for active infective endocarditis from January 2012 to December 2023.
J Extra Corpor Technol
December 2024
UPMC Presbyterian Perfusion, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
Oxygenator high-pressure (HPE) is a phenomenon that can occur during cardiopulmonary bypass (CPB) in which the oxygenator inlet pressure increases rapidly, thereby limiting flow. Most perfusionists globally do not use inlet oxygenator pressure monitoring and therefore HPE is not often recognized. HPE may occur for various reasons, and it is not fully understood.
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