Effectiveness of premedication protocol using intravenous fentanyl to reduce pain associated with femoral artery closure device placement.

Aim: To test the effectiveness of a premedication protocol using intravenous bolus of 100 μg fentanyl to reduce pain associated with femoral artery closure device placement for neuro-endovascular procedures.

Materials And Methods: The severity of pain associated with femoral artery closure device placement was analysed using a numerical rating scale score ranging from 0 (no pain) to 10 (most severe pain) in two cohorts of consecutive adult patients (n=118), those who were (n=64) or were not (n=54) treated with premedication protocol. The primary endpoints were the proportion of patients with excellent (score ≤1) and failed pain control (score ≥8).

Femoral Neuropathy Following Transfemoral Neuroendovascular Procedures. An Analysis of a Prospective Registry.

Background And Purpose: Although femoral neuropathy is recognized as an adverse consequence following transfemoral neuroendovascular procedures, no reliable estimates are available. We analyzed data from a prospective registry to ascertain the frequency and characteristics of femoral neuropathy following transfemoral neuroendovascular procedures.

Methods: Consecutive patients who underwent neuroendovascular procedures through the transfemoral route were included.

Migraine and Non-Migraine Headaches Following Diagnostic Catheter-Based Cerebral Angiography.

Background And Objective: No reliable estimates of headaches following catheter-based cerebral angiography are available. We performed an observational cohort study to ascertain the frequency and type of headaches following catheter-based cerebral angiography.

Materials And Methods: Consecutive patients who underwent cerebral angiography through the transfemoral (or infrequently radial) route were included.

Effectiveness of Topical Lidocaine-Prilocaine Cream for Pain Control During Femoral Artery Catheterization in Adult Patients: A Prospective Study.

Objective: To test the effectiveness of topical EMLA cream (lidocaine 2.5% and prilocaine 2.5%) for pain control during femoral artery catheterization for neuro-endovascular procedures in adult patients.

Effect of Endovascular Treatment on Quality of Life in Patients with Recurrent Symptoms Associated with Vertebral, Subclavian, or Innominate Arterial Stenosis.

Background: Patients with vertebral, subclavian, or innominate arterial stenosis can present with recurrent symptoms that can adversely affect the quality of life (QOL). We aimed at determining the short-term effects of endovascular treatment (ET) on QOL in these patients.

Methods: European Quality of Life Five Dimension Scale (EQ-5D) utility index and visual analog scale (VAS) were ascertained before and within one month of ET in patients with vertebral, subclavian, or innominate arterial stenosis with recurrent episodes of vertigo, near syncope, and/or ataxia.

Effect of epidural blood injection on upright posture intolerance in patients with headaches due to intracranial hypotension: A prospective study.

Background: We performed a prospective study to quantify changes in various aspects of upright posture intolerance in patients with intracranial hypotension.

Methods: Six patients were provided a standard questionnaire before, immediately after epidural blood patch injection and at follow-up visit within 1 month after epidural blood injection inquiring: (a) How long can they stand straight without any support? (b) Do they feel any sense of sickness when they sit or lie down after standing? (c) How long do they have to wait before they are comfortable standing again after they have stood straight? (d) How effectively and fast can they get up from sitting or lying position to stand straight? and (e) Rate their activities in upright posture without support on a standard vertical visual analogue scale between 100 (can do everything) and 0 (cannot do anything).

Results: All patients responded that they could not stand straight for ≥30 min (four responding <5 min) on pretreatment evaluation.

Chest Pain as a Manifestation of Intracranial Hypotension: Report of Four Cases.

Background: Chest pain has not been recognized as a manifestation of intracranial hypotension secondary to cerebrospinal fluid leakage.

Case Report: We report on 4 patients with intracranial hypotension diagnosed by the pattern of headaches, temporal proximity to dural puncture, magnetic resonance imaging findings, and resolution of symptoms after epidural blood patch who presented with chest pain. The chest pain was episodic, located in the sternal and interscapular region for the first 3 patients, with no radiation to any other region and no clear relationship to exertion.

A New Technique for the Assessment of Cerebral Vasodilatory Capacity as Part of Catheter-Based Cerebral Angiography.

Background: Previous studies have demonstrated the value of cerebral vasodilatory capacity assessment for risk stratification in patients with extracranial arterial stenosis or occlusion. We describe a new method that assesses cerebral vasodilatory capacity as part of catheter-based cerebral angiography.

Methods: We assessed regional cerebral blood volume (rCBV) in the arterial distribution of interest using a controlled contrast injection through a diagnostic catheter placed in the common carotid or the subclavian artery.

Prolonged Microcatheter-Based Local Thrombolytic Infusion as a Salvage Treatment After Failed Endovascular Treatment for Cerebral Venous Thrombosis: A Multicenter Experience.

Background And Purpose: To determine the effectiveness of prolonged microcatheter-based local thrombolytic infusion in treatment of patients with cerebral venous thrombosis who achieved no or suboptimal recanalization with transvenous endovascular treatment.

Methods: Data collection: Prospectively registries supplemented by retrospective review.

Settings: Three hospitals with tertiary referral base.

Artery of Trigeminal Nerve Ganglion.

The artery to trigeminal nerve ganglion has been identified as a branch that arises from the extracranial segment of middle meningeal artery prior to entry into the foramen spinosum. The role of the artery in being the arterial supply to trigeminal nerve ganglion is supported by electrophysiological and clinical suppression of trigeminal nerve activity during selective intra-arterial injection of anesthetics.

Upright Catheter-Based Cerebral Angiography.

Background: Several studies using Doppler ultrasound have suggested cerebral venous drainage is through paravertebral venous plexus due to the collapse of internal jugular veins in an upright position.

Methods: We present a technique of acquiring venographic images during an upright position as part of catheter-based angiography to provide additional information regarding cerebral venous diseases. Angiographic images in anteroposterior projection were acquired in lying position and after patients were placed at 60° using radiolucent supporting wedges on angiographic table.

Intra-arterial Modulation of the Trigeminal Nerve Ganglion in Patients with Refractory Trigeminal Neuralgia.

Background And Purpose: Nerves and nerve ganglions are supplied by segmental arteries and the vasa nervorum, but the intra-arterial route has not been used for diagnostic or therapeutic purposes. We present the results of intra-arterial delivery of medication for modulating trigeminal nerve ganglion function in patients with refractory trigeminal neuralgia.

Methods: We administered intra-arterial lidocaine in doses up to 50 mg in the middle meningeal artery territory adjacent to the arterial branch that supplies the trigeminal nerve ganglion.