bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Nature of Early Intraluminal Thrombosis in Terminal Aneurysms Occluded with Guglielmi Detachable Coils
Authors: Reul J. , Spetzger U. , Weis J. , Von Buelow S. , Ince A. , Thron A. 
Published: January 2017

To investigate the early intraluminal thrombotic events after endovascular treatment of terminal aneurysms with detachable coils, and to assess the biological changes over the first three weeks, terminal arterial bifurcation aneurysms were produced microsurgically in 20 rabbits. After a healing period of three weeks, transfemoral angiography was performed and all aneurysms were occluded with Guglielmi Detachable Coils (GDC). Complete (i.e. 100%) occlusion was achieved in ten aneurysms. About 95% occlusion (only a small neck remnant) was seen in eight cases. In two cases, occlusion was about 70–80%. Half of the animals were treated by anticoagulation during and continuously two days after occlusion therapy. Angiographic studies and histological analysis were done for four aneurysms (two without and two with anticoagulation) after 24 – 48 hours, 3 – 4 days, 6 – 7 days, 14 days, and 21 days after the treatment. On macroscopic examination, complete occlusion of the aneurysms by early thrombus formation was found in all cases during the first two days. After three to seven days, recanalization and fibrinolysis were observed, leading to a reopening of the neck, and part of the dome. After three weeks recanalization was found in six out of eight aneurysms, regardless of whether the animal was under anticoagulation. In nine cases, the degree of occlusion was overestimated by angiography compared to the pathological findings. During the early phase after occlusion of an aneurysm with platinum coils, extensive clot formation is induced. Over time due to the natural fibrinolysis, continuous recanalization beginning at the neck takes place. These findings can explain the clinical phenomenon of early thromboembolic complications, and the reopening and regrowth of aneurysms occluded with metallic coils observed at later stages.
Aneurysm on a Persisting Primitive Trigeminal Artery Occluded with Guglielmi Detachable Coils
Authors: Nepper-Rasmussen J. , Bjerre P. , Andersen P. 
Published: January 2017

A persisting primitive trigeminal artery (PPTA) is present in 0.2 – 0.6% of all cerebral angiographies. 27 cases of PPTA aneurysms have been reported. We present a case with sixth cranial nerve palsy due to a non ruptured aneurysm on a persisting primitive trigeminal artery. The aneurysm was successfully occluded with Guglielmi Detachable Coils with preservation of the parent artery. The cranial nerve palsy resolved and recovery was uneventful.
Mechanical Intracranial Embolectomy
Authors: Wikholm G. 
Published: January 2017

Cerebral ischaemia due to thrombo-embolic complications of intracranial endovascular therapy remains one of the more obvious hazards of this otherwise rather gentle treatment. In this connection the time factor is usually well controlled and the possibility to achieve a good result from thrombolysis are possibly better7. To directly extract an embolus mechanically would be an attractive alternative. This has so far been hampered by the lack of suitable tools. The use of a microsnare intended for intravascular retrieval of foreign bodies like displaced coils or broken catheters shown here must further encourage development of specially designed “thrombectomy devices” for intracranial use. Such a tool may well have an impact on the treatment of noniatrogenic emboli as well.
Aneurysms Found after Attempted Fibrinolytic Therapy of Occluded Arteries
Authors: Matsumaru Y. , Hyodo A. , Okazaki M. , Nose T. 
Published: January 2017

Three patients with angiographically invisible aneurysms found after attempted fibrinolytic therapy are presented. One aneurysm bled during the procedure with a tragic result. All of aneurysms were located distal to the occluded arteries. Aneurysms were preexisting and invisible distal to the occluded artery, or they developed rapidly after the fibrinolysis. These aneurysms were at a risk for rupture during and after fibrinolytic therapy.
Percutaneous Transluminal Angioplasty for Atherosclerotic Stenosis of the Intracranial Cerebral Arteries
Authors: Hyodo A. , Matsumaru Y. , Anno I. , Sato H. , Kato N. , Nakai Y. , Nose T. 
Published: January 2017

Percutaneous transluminal angioplasty (PTA) was carried out 43 times for 40 lesions in 38 cases of atheroscrelotic stenosis of the intracranial or skull base cerebral arteries. The stenotic lesions involved the middle cerebral artery in 15 cases, the basilar artery in seven cases, the internal carotid artery (petrous-supraclinoid portion) in 14 cases, and the intracranial vertebral artery in four cases. Nearly all cases were symptomatic, such as TIA or stroke, and the degree of stenosis ranged from 70 to 99 percent, with a mean of 80 percent. PTA was performed using a STEALTH balloon angioplasty catheter. In these trials, PTA was successfully performed (as indicated by a residual stenosis under 50%) 36 times. The initial success rate was 84% and stenosis was reduced from 80% to 25%. Clinical follow-up was performed from 3 to 62 months with a mean of 40 months. During this period, death due to myocardial infarction or pneumonia occurred in four cases, stroke related to previous PTA occurred in one case (due to re-stenosis) and stroke unrelated to previous PTA occurred in two cases. Angiographic follow-up was performed in 30 cases after 36 successful PTA procedures. Re-stenosis was seen in 20% of the cases, symptomatic complication occurred in 7%, and asymptomatic complications occurred in 7% of the cases. There was no mortality in this series. From analysis of complicated cases, there are several characteristic findings on the stenotic lesion. These are the stenotic lesions that located near the bifurcation, involving long segment, or showing irregular shape which is including ulcer or dissection. It is important to keep a fundamental and safe technique to reduce the complication. And besides, it is very important to keep the strict indication and to avoid the high-risk patient from a morphological point of view.
Embolization of Cerebral Arteriovenous Malformations to Enhance the Success of Subsequent Radiosurgery
Authors: Miyachi S. , Tanaka T. , Kobayashi T. , Kida Y. , Negoro M. , Okamoto T. , Yoshida J. 
Published: January 2017

We studied angiographic changes in embolized arteriovenous malformations (AVMs) by comparing pre- and postembolization angiograms and angiograms preceding radiosurgery. This study sought factors determining the usefulness of embolization as a pretreatment to enhance the success of subsequent radiosurgery. Thirty patients with cerebral AVMs treated in this manner over 4 years were studied. In these cases AVMs were embolized with cyanoacrylate and were treated with Gamma-knife radiosurgery. The mean size of the AVM nidus was reduced by a fraction of seven following embolization. The subsequent angiogram for planning radiosurgery showed further nidus reduction in 10 AVMs, no change in 12, and regrowth in 8. In all size-reduction cases the nidus was sufficiently packed, and 2 AVMs had thrombosed completely before radiosurgery. All the regrowing AVMs were of diffuse type; 6 were associated with already-developed leptomeningeal channels, and the remaining 3 were fed by newly sprouted meningeal feeders. Five AVMs disappeared following radiosurgery, all representing size-reduction or no-change cases. Analysis of cases with regrowth showed increased risk of that event with feeder occlusion of a multi-axially supplied AVM, lack of reduction of shunt flow, or remaining meningeal feeders. On the other hand, when embolization as pretreatment prior to radiosurgery succeeds in producing a small, compacted, plexiform nidus with slow shunt flow, it furthers the likelihood of successful radiosurgery, Nidus embolization and occlusion of fistulous and meningeal feeders are mandatory, while proximal feeder occlusion and use of embolic materials which risk recanalization should be avoided to prevent nidus regrowth.
Embolism in the Superior Cerebellar Artery following Coil Embolization of Basilar Tip Aneurysms: Anatomy and Hemodynamics
Authors: Miyachi S. , Negoro M. , Bundo M. , Okamoto T. , Yoshida J. 
Published: January 2017

We aimed to identify anatomic factors favoring intra-aneurysmal clot embolization complicating coil embolization of basilar tip aneurysms. Thirty basilar tip aneurysm cases were classified angiographically into three types according to branching pattern of the superior cerebellar artery (SCA) and coil embolization complications were analyzed. The SCA may arise from the basilar artery (BA) just proximal to the origin of the posterior cerebral artery (PCA), initially coursing at an angle (more than 60°) relative to the BA, (type A). Alternatively the SCA may originate directly from the PCA at a sharp angle less than 30° relative to the BA (type C). Type B includes patterns intermediate between types A and C. Behavior of particles chosen to simulate intra-aneurysmal clots was also observed in a plastic tube model with pulsatile water flow simulating configurations A and C. Type C branching was seen in 35% (21/60) of SCA, being dominant on the left side and associated with large aneurysms and broad necks. All 3 of 24 coil embolization patients with ischemic complications in the SCA territory had large aneurysms and type C SCA branching, 2 aneurysms having broad necks. In the plastic model embolized “clots” more frequently lodged in type C than in type A SCA. “Clots” close to the orifice migrated more easily than those in the dome of the plastic aneurysm. Large basilar tip aneurysms with broad necks carry a risk of intra-aneurysmal clot migration into the SCA, during and after the embolization, especially in type C configurations, because pulsatile blood flow in the basilar artery may disperse clots between the coils and carry them into the sharply angulated SCA. Avoiding this complication requires meticulous coil packing to interrupt inflow into the aneurysm as well as appropriate anti-coagulation therapy.
Vertebral Arteriovenous Fistula Treated by Embolization Technique
Authors: Kinoshita Y. , Terada T. , Tanaka Y. , Yokote H. , Tsuura M. , Nakai E. , Nakai K. , Itakura T. , Hyoutani G. , Kamei I. 
Published: January 2017

Three patients with vertebral arteriovenous fistulae are described. Transarterial embolization by microcoils and balloons was used in each case and the fistula was completely occluded in one case immediately after embolization. Another two cases with partial obliteration of the fistula were followed and showed complete occlusion of the fistula after a one year follow-up. After embolization of the fistula, each patient improved in clinical signs and symptoms and showed no complications. Transarterial embolization for vertebral arteriovenous fistula is a safe and effective treatment.
Cost-Effectiveness of Percutaneous Automated Lumbar Nucleotomy
Authors: Dullerud R. , Lie H. , Magnæs B. 
Published: January 2017

This study was conducted in order to evaluate the cost-effectiveness of percutaneous automated lumbar nucleotomy in comparison with traditional macro-procedure discectomy in the treatment of herniated discs. Sixty-eight patients undergoing surgical procedures and 90 treated with nucleotomy were consecutively included. Both cohorts were assessed pre-operatively and at regular intervals for one year or more after treatment by independent observers, using a clinical overall scoring system (COS) with 0 being the best attainable result and 1000 the poorest conceivable status of the patients. There were better clinical results after surgery with 78% successes after one year compared to 62% after nucleotomy. By including subsequent operations and re-operations after failure to respond to the primary treatment, the success rates rose to 79% and 77%, respectively. The cost of surgical treatment was calculated to USD 6.119 per patient and the cost of a nucleotomy procedure was USD 1.252. Owing to an almost five times higher price of surgery than nucleotomy, the latter turned out to be 2.7 to 3.9 times more cost-effective, depending on whether secondary treatment was included or not. Due to the minimal difference in final outcome between the groups, however, the marginal cost per extra success in patients primarily treated with surgery was as high as USD 205.850. The study concludes that nucleotomy, as a mini-invasive procedure with low complication rates and the potential of a quick recovery, is more cost-effective than traditional surgical treatment for lumbar disc herniation.
Digital Subtraction and Conventional Blood Flow Studies in Porcine Experimental Aneurysms
Authors: Asakura F. , Tenjin H. , Matsumoto K. , Ueda S. , Urano M. 
Published: January 2017

Flow studies are important to understanding pathogenesis and treatment of cerebral aneurysms, but have not been possible in the clinical setting. We used experimental aneurysms established in and then removed from pigs to compare and correlate flow studies by high-speed video photography of introduced particles and by clinically applicable digital subtraction angiography. Venous pouches were used to create aneurysms in incised common carotid arteries. After aneurysms and parent arteries were removed, specimens were rendered translucent with solvents so they could be studied by video photography of introduced plastic particles in addition to digital subtraction angiography with iodinated contrast material. Regions of interest were studied individually. Mean transit time for contrast in the preparation correlated with videographically measured particle flow velocity (r = 0.616). Digital subtraction angiography should be useful in evaluation of flow in the clinical assessment and treatment of cerebral aneurysms, such as in endovascular therapy.
Transvenous Embolisation of Spontaneous Carotid-Cavernous Fistulas by Sequential Occlusion of the Cavernous Sinus
Authors: Cheng K.-M. , Chan C.-M. , Cheung Y.-L. , Liang C.-C. , Lee M.-K. , Leung C.-L. , Chiu H.-M. , Chan C.-H. 
Published: January 2017

There are two important pathological features associated with carotid-cavernous fistula (CCF): the retrograde cortical venous drainage that can cause intracranial haemorrhage and non haemorrhagic neurological deficit and the retrograde ophthalmic venous drainage that causes orbital venous congestion and visual impairment. We propose a sequential embolisation strategy by the selective occlusion of these two pathological features as the initial steps followed by occlusion of the rest of the cavernous sinus. Eight patients with spontaneous CCF were treated by transvenous embolisation using our embolisation strategy. The clinical features, angiographic findings, embolisation procedures, and clinical and angiographic outcomes were analyzed. The follow-up period ranged from one to 21 months. Clinical cure was achieved in six patients at one to two month follow-ups. One patient with bilateral CCFs had clinical cure of the right eye and clinical improvement of the left eye at three-month follow-up. Another patient had clinical cure at one-month follow-up except residual VI nerve palsy. Two patients had complete angiographic obliteration of the fistula immediately after the embolisation procedure. Another three patients underwent follow-up angiography at one to 16 months and all showed angiographic cure. There were no immediate or late complications. Our embolisation strategy offers a safe and effective option in the embolisation of spontaneous CCF as demonstrated by the clinical results of our eight patients.
Percutaneous Transluminal Angioplasty for Atherosclerotic Stenosis of the Intracranial Cerebral Arteries
Authors: Hyodo A. , Kato N. , Nakai Y. , Anno I. , Sato H. , Okazaki M. , Matsumaru Y. , Nose T. 
Published: January 2017

Percutaneous transluminal angioplasty (PTA) was carried out 52 times for 49 lesions in 47 cases of atheroscrelotic stenosis of the intracranial or skull base cerebral arteries. The stenotic lesions involved the middle cerebral artery in 21 cases, the basilar artery in eight cases, the internal carotid artery (petrous-supraclinoid portion) in 15 cases, and the intracranial vertebral artery in five cases. Nearly all cases were symptomatic, such as TIA or stroke, and the degree of stenosis ranged from 70 to 99 percent, with a mean of 80 percent. PTA was performed using a STEALTH balloon angioplasty catheter. In these trials, PTA was successfully performed (as indicated by a residual stenosis under 50%) 41 times. The initial success rate was 79% and stenosis was reduced from 80% to 25%. Clinical follow-up was performed from 7 to 84 months with a mean of 44 months. During this period, death due to myocardial infarction or pneumonia occurred in five cases, stroke related to previous PTA occurred in one case (due to re-stenosis) and stroke unrelated to previous PTA occurred in two cases. Angiographic follow-up was performed in 31 cases after 41 successful PTA procedures. Re-stenosis was seen in 20% of the cases, symptomatic complications occurred in 6%, and asymptomatic complications occurred in 6% of the cases. One case suffered severe subarachnoid hemorrhage just after the PTA due to preexisting aneurysm rupture and he died a week after the PTA. So mortality in this series was 2%. From the results described here, we may conclude that PTA of the intracranial or skull base cerebral artery is technically feasible, and it can be performed with relatively low risk. From our results, it may be a useful method and effective for long-term survival of patients. But results from a larger number of patients and more long-term follow-up data are still necessary in order to evaluate the safety and usefulness of this method.
Distal Flow Protection during Carotid Stenting
Authors: Sugiu K. , Martin J.B. , Pache J.C. , Guimaraens L. , Theron J. , Rüfenacht D.A. 
Published: January 2017

This study was conducted to evaluate presence of embolic debris during ICA stent procedures. Nine patients with severe carotid atheromatous stenosis were treated by stent implantation under distal flow protection using a non-detachable balloon. After stent implantation, the lumen of the ICA was cleaned by aspiration of 50 cc of blood before further flush cleaning and deflation of the protection balloon. The blood samples obtained from each patient were analyzed using a microscope to check quantity and aspect of embolic debris. Significant numbers of embolic debris were recovered from blood samples in all nine stenting cases, but very few were found in four out of the five control cases. This observation demonstrates the high risk of producing embolic debris during carotid stenting. Distal balloon occlusion and cleaning procedures are techniques to provide protection from thromboembolic complications to the brain.
Exploring musculoskeletal injuries in the podiatry profession: an international cross sectional study
Authors: Williams Cylie M. , Penkala Stefania , Smith Peter , Haines Terry , Bowles Kelly‐Ann 
Published: January 2017

AbstractBackgroundWorkplace injury is an international costly burden. Health care workers are an essential component to managing musculoskeletal disorders, however in doing this, they may increase their own susceptibility. While there is substantial evidence about work‐related musculoskeletal disorders across the health workforce, understanding risk factors in specific occupational groups, such as podiatry, is limited.The primary aim of this study was to determine the prevalence and intensity of work related low back pain in podiatrists.MethodsThis was an international cross‐sectional survey targeting podiatrists in Australia, New Zealand and the United Kingdom. The survey had two components; general demographic variables and variables relating to general musculoskeletal pain in general or podiatry work‐related musculoskeletal pain. Multivariable regression analyses were used to identify factors associated with musculoskeletal stiffness and pain and low back pain intensity. Thematic analysis was used to group comments podiatrists made about their musculoskeletal health.ResultsThere were 948 survey responses (5% of Australian, New Zealand and United Kingdom registered podiatrists). There were 719 (76%) podiatrists reporting musculoskeletal pain as a result of their work practices throughout their career. The majority of injuries reported were in the first five years of practice (n = 320, 45%). The body area reported as being the location of the most significant injury was the low back (203 of 705 responses, 29%). Being female (p < 0.001) and working in private practice (p = 0.003) was associated with musculoskeletal pain or stiffness in the past 12 months. There were no variables associated with pain or stiffness in the past four weeks. Being female was the only variable associated with higher pain (p = 0.018). There were four main themes to workplace musculoskeletal pain: 1. Organisational and procedural responses to injury, 2. Giving up work, taking time off, reducing hours, 3. Maintaining good musculoskeletal health and 4. Environmental change.ConclusionsThe postures that podiatrists hold while treating patients appear to impact on musculoskeletal pain and stiffness. Recently graduated and female podiatrists are at higher risk of injury. There is a need for the profession to consider how they move and take care of their own musculoskeletal health.
Surgical Treatment of Buerger's Disease
Authors: Bozkurt A. Kürşat , Beşirli Kazim , Köksal Cengiz , Şirin Gökce , Yüceyar Lale , Tüzün Hasan , Sayin Ayla Gürel 
Published: January 2017

We aimed to evaluate the characteristics of 198 new patients with Buerger's disease treated surgically in the last decade. We also compared these results with our former series reported in 1993. The records of patients with Buerger's disease who were enrolled in an ongoing investigational protocol between 1991 and 2001 were reviewed. Sympathectomy was carried out in 161 patients and revascularization in 19 patients. The cumulative secondary patency rate was 57.9% for bypass grafts at a mean follow-up of 5.4 years. Clinical outcome following sympathectomy was considered improved in 52.3% of patients, stable in 27.8%, and worse in 19.8%. Seven major and 36 minor amputations were performed, with a limb salvage rate of 95.6%. The aggressiveness of the disease has increased compared with previous series, parallel to the expansion of cigarette consumption. Bypass surgery should be considered for patients with severe ischemia who have target vessels. Sympathectomy still has a role to improve distal flow.
L’avenir des sciences sociales Entre l’empirique et le normatif
Authors: Abbott Andrew 
Published: January 2017

Résumé
Ce texte prend appui sur la tradition processualiste afin d'identifier les facteurs susceptibles de produire rapidement un changement dans les sciences sociales. Le plus important est le décalage qui existe entre les dimensions empirique et normative des sciences sociales. L'article défend l'idée qu'un tel décalage entre la diversité des ontologies empiriques à notre disposition et l'éventail plus réduit des ontologies normatives sur lesquelles nous nous appuyons est problématique. De fait, la plupart des sciences sociales ont recours à un « contractualisme normatif ». Ontologie normative la plus courante dans les sciences sociales, ce dernier n'est cependant pas en mesure d'appréhender correctement les problèmes normatifs soulevés par les notions de « particularité », d'« historicité » et de « diversité des valeurs ». Pour conclure, ce texte appelle de ses voeux une analyse normative du monde social qui se démarque du contractualisme et pose les jalons d'une approche proprement processualiste.