Neurosurgery Department, School of Medicine, Loma Linda University, Loma Linda, CA, USA.
Published: October 2019
AI Article Synopsis
Article Abstract
Cerebral revascularization was pioneered half a century ago. Gradual improvements in microsurgical instrumentation and training in microsurgical techniques have allowed significant changes that improved outcomes in neurosurgery, extrapolating this knowledge to other neurosurgical diseases (brain tumor, aneurysms, and skull base tumor surgery). But the popularity of cerebral bypass procedures was followed by their decline, given the lack of clear benefit of bypass surgery in chronic cerebrovascular ischemia after the EC-IC bypass studies. Over the last couple of decades, the formidable advance of neuro-endovascular techniques for revascularization has lessened the need for application of open cerebral revascularization procedures, either for flow augmentation or flow replacement. However, there is still a select group of patients with chronic cerebral ischemia, for whom open cerebral revascularization with flow augmentation is the only treatment option available, and this will be the objective of our current review.
Cognitive dysfunction is common in Moyamoya disease (MMD). However, current knowledge of cognitive impairment in MMD is inadequate. In this review, we explored the characteristics of altered cognitive function associated with MMD and offered recommendations aimed at guiding potential research endeavors into the cognitive dysfunction in MMD.
Background: Delirium in the post-anesthesia care unit (PACU) may be associated with worse outcomes in children with moyamoya disease (MMD). This retrospective study aimed to describe the prevalence of PACU delirium in children with MMD and investigate its risk factors.
Methods: Patients with MMD aged < 15 years who underwent indirect revascularization between January 2014 and October 2023 were included in this study.
Background: Complete clot ingestion (CCI) is defined as full ingestion of the clot into the catheter or pump canister without any external clot remnants at the catheter tip. The aim of this study was to demonstrate that using the CCI metric in vitro, partially ingested ('corked') clots pose a higher risk of distal emboli given distal emboli may exist in the setting of Thrombolysis In Cerebral Infarction 3 (TICI 3) revascularization.
Methods: Thrombectomies using an in vitro synthetic clot analog were conducted across six catheters using the novel ALGO Smart Pump with Adaptive Pulsatile Aspiration (APA) (Von Vascular Inc, Sunrise, FL) and compared against the Penumbra static Engine Pump (Alameda, CA).
We encountered a patient who had undergone a transposition procedure, which encompassed the performance of subclavian-common carotid arterial end-to-side anastomosis before a thoracic endovascular aortic repair (TEVAR) when carrying out Stanford type B aortic dissection. A 50-year-old man was admitted to our hospital with a diagnosis of chronic Stanford type B aortic dissection that tended to expand. Transposition was performed in advance of zone 2 TEVAR.
Background: Moyamoya disease (MMD) is a rare cerebrovascular disorder marked by internal carotid artery narrowing, collateral neovascularization, and symptomatic cerebral ischemia. Select patients can benefit from direct bypass (STA-MCA bypass) by restoring blood flow to hypoperfused territories. Symptomatic contralateral stroke (CS) following STA-MCA bypass is a devastating, poorly understood complication.
