236 research outputs found
sj-docx-1-ine-10.1177_15910199221118148 - Supplemental material for Safety and efficacy of the surpass streamline for intracranial aneurysms (SESSIA): A multi-center US experience pooled analysis
No full textSupplemental material, sj-docx-1-ine-10.1177_15910199221118148 for Safety and efficacy of the surpass streamline for intracranial aneurysms (SESSIA): A multi-center US experience pooled analysis by Juan Vivanco-Suarez, Alan Mendez-Ruiz, Mudassir Farooqui, Kimon Bekelis, Justin A Singer, Kainaat Javed, David J Altschul, Johanna T Fifi, Stavros Matsoukas, Jared Cooper, Fawaz Al-Mufti, Bradley Gross, Brian Jankowitz, Peter T Kan, Muhammad Hafeez, Emanuele Orru, Andres Dajles, Milagros Galecio-Castillo, Cynthia B Zevallos, Ajay K Wakhloo and Santiago Ortega-Gutierrez in Interventional Neuroradiology</p
Incidence of complications in gynaecological laparoscopic surgeries: a prospective study from a single tertiary care centre
No full textBackground: Laparoscopy is a widely utilized procedure in gynecology due to its minimally invasive nature, offering numerous benefits such as reduced postoperative pain, quicker recovery, and shorter hospital stays. However, as with all surgical procedures, complications may arise, particularly in more complex surgeries. This study aimed to evaluate the incidence of complications associated with gynecological laparoscopic surgeries performed at a single centre.
Methods: A total 248 patients undergoing laparoscopic gynecological procedures at the centre during the study period were included. Informed consent was obtained from each patient, outlining the risks and the possibility of conversion to laparotomy if necessary. The study evaluated patient demographics, surgical history, body mass index (BMI), types of procedures performed, hospital stay durations, and the incidence of major and minor complications.
Results: Mean age of 31.51±8.79 years. Diagnostic laparoscopy was performed in 39.51% of cases, while advanced procedures accounted for 27.01%. Complications occurred in 21 patients (8.47%), with major complications seen in 2 patients (0.80%) and minor complications in 12 patients (4.84%). Laparoscopic hysterectomy had the highest complication rate at 18.33%, and 6 patients required conversion to laparotomy. No complications were observed in diagnostic or minor surgeries.
Conclusions: Laparoscopic surgery in gynecology is generally safe, with an overall complication rate of 8.47%, which aligns with reported literature. Complications were more frequent in complex procedures and in patients with previous abdominal surgeries. Continued improvements in surgical techniques and patient selection are essential for further reducing complication rates and enhancing surgical outcomes
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Angiographic Assessment of Flow Divertors as Treatment for Cerebral Aneurysms: Results in the Rabbit Elastase-Induced Aneurysm Model
No full textCerebral aneurysms are abnormal focal dilations of the cerebral vasculature that may rupture and cause a hemorrhagic stroke. More than a decade after seminal experimental studies showed the feasibility of successfully treating cerebral aneurysms by flow diversion, the potential of this modality is gradually being recognized in the clinical arena. A flow divertor is a metallic meshed tube that has its porosity (ratio of metal-free surface area to total surface area) and pore density (number of pores per unit surface area) optimized to facilitate occlusion of aneurysms. An appropriately designed flow divertor severely attenuates the flow exchange between the parent vessel and an aneurysm, resulting in the formation of intra-aneurysmal flow stasis zones which promote thrombosis. This study reports the results from implantation of three different configurations of a novel flow-diverting device in thirty elastase-induced aneurysm models in rabbits. Ten animals per device configuration were followed-up at 3 weeks (n=3), 3 months (n=3), and 6 months (n=4) and tissue explanted post-sacrifice was sent for histology. High-speed angiographic sequences were acquired before and immediately after device implantation, and at follow-up for each animal. Temporal variations in the angiographic contrast intensity within the aneurysms were recorded and subsequently corrected for respiratory motion. These aneurysmal contrast washout curves were fit to a mathematical model whose parameters served to quantify device performance. Angiographic quantification was supplemented by histomorphometric data to derive composite scores of the performance of each device configuration in effecting stable aneurysm occlusion. Performance scores showed that the device with a porosity of 70%, filament diameter of 38 microns, and pore density of 18 pores/mm^2 performed better than devices with 65% porosity, 51 micron filament diameter, 14 pores/mm^2 and 70% porosity, 51 micron filament diameter, 12 pores/mm^2 with relative efficacies of 100%, 86%, and 79%, respectively. Angiographic quantification further suggested a parameter, which could be employed to estimate long-term aneurysm occlusion probabilities immediately after treatment with any flow diversion device. A value of this parameter less than 30 predicts greater than 97% angiographic aneurysm occlusion over a period of six months with a sensitivity of 73% and specificity of 82%. Larger data sets are required to improve the validity of this test. The pore density of flow divertors, rather than porosity, was seen to be a critical modulating factor of device efficacy. Refinement of the best device configuration by further optimizing the pore density may yield yet better results.</p
Role of laparoscopy in the diagnosis and management of benign adnexal masses
No full textBackground: Adnexal masses are frequent findings in women of all age groups. It consists of the ovaries, fallopian tubes and uterine ligaments. Women can present with various gynaecological complaints and adnexal masses could be detected while examining and investigating for these complaints. The aim was to study the role of laparoscopy in diagnosis and management of benign adnexal masses.Methods: The study was conducted on 48 women of reproductive age group. Per speculum examination was done and PAP smear was taken before bimanual examination was done. A complete per vaginum examination was done and the adnexal mass was assessed for its size, side, consistency, laterality and tenderness. Laparoscopy was done to confirm preoperative diagnosis and appropriate procedure done depending on diagnosis.Results: Pain in the lower abdomen was the commonest chief complaint seen in 87.5% cases. 41.67% cases were suspected to have endometriosis while on laparoscopy it was seen in 47.92%, 33.33% were suspected to have ovarian cyst which decreased to 25% on laparoscopy, ectopic pregnancy in 16.67% cases both pre-operative and on laparoscopic examination and tubo-ovarian mass in 8.33% cases pre-operatively and 2.08% on laparoscopy.Conclusions: This study has shown that if proper preoperative evaluation was done, author can select the appropriate patients for laparoscopic approach
Endovascular treatment of intracranial aneurysms: current status
No full textAlthough treatment of a ruptured aneurysm is accepted as an emergency, indication for treatment of unruptured intracranial aneurysms (IAs) is still being discussed
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