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Pradeep Kumar, Shashi K. Jain, Virendra D. Sinha and Trilochan Srivastava

Abstract

Introduction: Aneurysmal Subarachnoid Hemorrhage (aSAH) remains a devastating and often fatal form of stroke. The aneurysm is targeted for obliteration to prevent re-bleeding and to manage the possible complications from the event. Endovascular coiling has emerged as a less invasive alternative to conventional surgical clipping to treat aneurysms.

Patients and methods: This study was done in 50 cases of anterior communicating (Acommm) aneurysm presented in the department of neurosurgery, SMS medical college, Jaipur from November 2015 to August 2016 to evaluate the outcome of both modalities used in the treatment of ruptured Acommm aneurysm. 50 patients with Hunt and Hess (H&H) grade I, II or III were classified into two groups of microsurgical clipping and endovascular coiling.

Results: Mortality rate was comparable in both groups that were 21. 21% in the clipping group and 23. 52% in the coiling group. Good Glasgow outcome score (GOS) were found in 60. 60% of clipping and 58. 58% of coiling group. All the complications found to be more in clipping group but that were not statistically significant except for hyponatremia which was significantly higher in clipping group(P=0. 007).

Conclusion: There was no statistically significant difference in GOS at 6 month of follow up between the two groups. We recommend further interventional studies with larger sample sizes and longer follow up for better evaluation of the modalities.

Open access

Venko Filipce, Aleksandar Caparoski and Zoran Milosevic

Abstract

The management of intracranial aneurysms has changed dramatically in recent years. The science and technology advancement have resulted in new therapeutic options for their treatment. There is an increased interest among neurosurgeons to perform endovascular procedures for intracranial aneurysms. This has become a part of the neurosurgical residency in the US. We are presenting our first experience of ruptured aneurysm coiling using stent assisted technique.

Open access

A. Chiriac, B. Iliescu, N. Dobrin and I. Poeata

Abstract

Particular anatomical situation like wideneck aneurysms or a large neck/fundus ratio, located on an arterial bifurcation or a small artery, are still a challenge for endovascular coil occlusion. These are due to the risk of coil migration or coil protrusion into the parent vessels. In our study we describe the balloon assisted coiling technique regarding the efficacy and safety of its practice and the problems that could appear.

Open access

Mohammad Parsa Mahjoob, Isa Khaheshi and Mohammadreza Naderian

Abstract

The femoral artery pseudoaneurysm is a disturbing groin complication associated with the femoral arterial access site used for invasive cardiovascular interventions. We present a 39 year old man who developed a huge right common femoral artery pseudoaneurysm, following diagnostic coronary artery catheterization, which was successfully managed with stent-assisted coiling, an emerging and narrative option in invasive percutaneous approaches to femoral artery pseudoaneurysm.

Open access

Guru Dutta Satyarthee and A.K. Mahapatra

Abstract

The ventriculo-peritoneal (VP) shunt surgery in resource constrained centre still remains, most common form of treatment for hydrocephalus. The V. P. shunt complications can occur along entire course of shunt, distal complications are obstruction of catheter, cerebrospinal fluid ascites, abscess and ulceration of skin. However, total cranial migration and getting coiled in subgaleal space, of peritoneal catheter end is very rare occurrence and is reported in only seven cases as isolated case- report in western literature, further more rare is associated extrusion of ventricular catheter and rarer is subgaleal coiling of both peritoneal and ventricular end. Author reports a rare and unique case of complete migration of peritoneal catheter into subgaleal space in a 2-year old boy associated, with partial extrusion of ventricular end, the child was also given electric stimulation by untrained physiotherapist along the shunt tract, which might have facilitated cranial migration of distal catheter in our case. Pertinent literature is briefly reviewed

Open access

M. Zenteno, F. Viñuela, L.R. Moscote-Salazar, H. Alvis-Miranda, R. Zavaleta, A. Flores, A. Rojas and A. Lee

Abstract

Anatomical variations of the internal carotid artery are diverse. Abnormalities in their geometry and paths are commonly identified by ultrasonography and angiography. The surgical correction of symptomatic CAs is better in preventing stroke compared with best medical therapy, as well as it completely eliminates the symptoms in patients with nonhemispheric symptoms. The ICA anomalies may be dangerous and represent a risk factor for massive bleeding. Suture ligatures can penetrate and occlude torn vessels, scalpels or biting instruments can lacerate vessels, and indirectly conducted electric cauterization can burn the soft of bony tissues