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An unusual internal carotid artery compression as a possible cause of Eagle syndrome – A novel hypothesis and an innovative surgical technique

2019

Background: Eagle syndrome (ES) is a rare symptomatic condition generally caused by an elongated styloid process (SP) or calcification of the stylohyoid complex. On the diagnosis is made, its treatment remains subjective since the indications for surgical intervention are still not standardized. Although styloidectomy is the surgical treatment of choice, no consensus exists regarding the transcervical or/and transoral route. Here, we report our experience in a patient with bilateral internal carotid artery (ICA) dissection caused by ES, who underwent innovative surgical technique. Case Description: A 53-year-old man, with the right-sided middle cerebral artery acute stroke, underwent compu…

The use of a proximal protection system, a reperfusion catheter, and new-generation mesh stents in combined endovascular therapy for a long, symptoma…

2020

Blood flow velocity waveforms of the middle cerebral artery and abnormal neurological evaluations in live-born fetuses with absent or reverse end-dia…

1992

Abstract We studied 37 fetuses with absent or reverse end-diastolic flow velocities (AREDFV) of the umbilical arteries with respect to the mode of delivery, fetal acidosis, resistance index of the middle cerebral arteries, and abnormal neurological evaluation at the time of discharge from the department of pediatrics. A control group with normal umbilical artery flow velocity waveforms was matched for gestational age. Fetuses with AREDFV were delivered almost exclusively by cesarean section, in most cases due to fetal distress. Metabolic changes with decreased base excess values were found more often in fetuses with AREDFV, but no difference could be detected with respect to severe fetal ac…

Endovascular management of carotid and vertebral artery dissections with new generation double-mesh stent and protection systems – single-center earl…

2019

Introduction Symptomatic dissections (SD) of cervical arteries are still a therapeutic problem. Although endovascular management (EM) is currently a preferred method of treatment of SD, complications associated with this method of treatment in published reports are quite frequent (3-16%). Aim In this retrospective study we analyzed the results of EM with novel, double-mesh stent and protection systems (PS) for SD of the internal carotid (IC) or vertebral arteries (VA) that coexisted with hemodynamically significant stenosis or aneurysmatic dilatation of the dissected artery. Material and methods We evaluated the results of EM in 19 patients (men 15, median age: 55, range: 25-83), presenting…

Imaging-Based Preoperative Planning

2017

Liver resection in the treatment of colorectal liver metastases, as for any other primary or secondary liver tumor, needs to be oncologically effective and surgically safe. Both goals need equal consideration, and imaging-based preoperative planning is paramount for achieving each of them. Preoperative imaging should ideally identify all metastatic lesions in the liver, as well as extrahepatic disease. Furthermore, it should provide an anatomical roadmap with the exact localization of each lesion within the segmental hepatic anatomy, and its proximity to adjacent vasculo-biliary structures, to allow for proper resection leaving the patient with a sufficiently functioning liver remnant. This…

Should all intrahepatic cholangiocarcinomas receive neoadjuvant chemotherapy before resection?

2021

Dual lumen microcatheters for recanalisation of chronic total occlusions: A EuroCTO Club expert panel report

2021

Dual lumen microcatheters (DLMC) have become indispensable tools in the setting of percutaneous coronary intervention (PCI) of chronic total occlusion (CTO). Other than allowing preservation and treatment of bifurcated coronary branches within or in the proximity of the CTO-body, they enable the use of modified parallel wiring, antegrade dissection and re-entry, collateral selection and retrograde negotiation of the distal CTO-cap. This Euro-CTO consensus document describes current DLMCs and suggests a practical guide to anatomies and techniques in which these devices are applicable.

Leberresektionen können bei vorsichtiger Patientenselektion auch in Zirrhose sicher durchgeführt werden

2021

Zusammenfassung Hintergrund Das hepatozelluläre Karzinom (HCC) ist der häufigste maligne Lebertumor in einer Leberzirrhose. Neben der Lebertransplantation stellt die Leberresektion in kompensierter Zirrhose eine kurative Therapieoption dar, die jedoch mit einer höheren postoperativen Morbidität und Mortalität einhergeht. Patienten Es wurden 108 Patienten identifiziert, die mit einer Leberzirrhose im Zeitraum von Januar 2008 bis Dezember 2019 an der Universitätsmedizin Mainz eine Leberresektion erhalten haben. Im gleichen Zeitraum wurden 185 Resektionen wegen eines HCC in nicht zirrhotischer Leber durchgeführt. Als weitere Kontrollgruppe dienten 167 Resektionen wegen kolorektaler Lebermetast…

Awake Surgery: Skills of Neurosurgeon Matter but Those of Patient Too. How to Optimize Functional Brain Mapping by Improving Per-Operatory Testing?

2011

International audience; It is now possible to perform resections of slowgrowing tumors in awake patients. Using direct electrical stimulation (DES), real-time functional mapping of the brain can be used to prevent the resection of essential areas near the tumor. For now, simple clinical tests are performed on conscious patients and combined with DES in order to discriminate functional and non-functional areas invaded by the tumors. In this work we try to develop a simple device based on a simple technology to better quantify the performances of the patients during the surgery itself and give a real-time feedback to the neurosurgeon that will help to further guide the surgery by improving th…

Abordaje multidisciplinar de un carcinoma sebáceo anaplásico palpebral en una paciente de 40 años

2010

Caso clínico: Mujer de 40 años remitida a nuestro servicio por persistencia durante meses de un cuadro de blefaritis anterior de aspecto indolente con aparición de un nódulo indurado en el párpado superior derecho filiado como chalazion refractario al tratamiento convencional, asociado a adenopatía preauricular ipsilateral. La biopsia extemporánea se informó como carcinoma sebáceo. Procedimos a la exéresis completa de dicho párpado y a su reconstrucción con injerto de mucosa palatina y colgajo glabelar. Posteriormente se practicó un vaciamiento cervical radical por la presencia de adenopatías de aspecto necrótico en diversos territorios linfáticos. Se biopsió el párpado inferior que resultó…