http://www.ruralneuropractice.com/text.asp?2014/5/1/11/127864





ABSTRACT
Context: Endovascular neurointervention (interventional neuroradiology) is a highly demanding science requiring deep understanding of disease, anatomy, clinical skills and manual dexterity, consequently with a long learning curve and thus posing significant challenges to a physician entering new into the competitive arena. Aim: To evaluate the procedural success, complications and outcome in the first year of independent endovascular neurointervention practice in a suburban hospital. Materials and Methods: Retrospective analysis of prospectively maintained data of all
diagnostic and therapeutic neurointerventional cases performed by the author between the period of January 02, 2012 and December 31, 2012. Results: A total of 61 procedures were performed. The performance success rate of the diagnostic procedures was 100% (38/38) and that of therapeutic procedures was 82.6% (19/23). The periprocedural complication rates were nil and 13%, respectively, for diagnostic and therapeutic procedures. The 3‑month patient outcome for therapeutic procedures was good outcome (Modified Rankin Scale <2 13="" 1="" 3="" 87="" a="" acceptable="" and="" br="" cases="" comparable="" complication="" conclusion:="" dead="" debilitated="" endovascular="" existing="" first="" for="" had="" high="" in="" literature.="" modified="" neurointerventionalist="" of="" outcome="" patient="" poor="" practice="" procedural="" rankin="" rate="" rates="" scale="" success="" the="" to="" trained="" well="" with="" year="">Key words: Acute stroke, aneurysm coiling, cerebral angiography, combined lysis of thrombus in brain ischemia using transcranial ultrasound and systemic tissue plasminogen activator, sonothrombolysis, embolization, endovascular neurointervention

Subhash Kumar, Shailesh B. Gaikwad, and Nalini Kant Mishra, “3D Rotational Angiography in Follow-Up of Clipped Intracranial Aneurysms,” ISRN Radiology, vol. 2014, Article ID 935280, 5 pages, 2014. doi:10.1155/2014/935280




http://www.hindawi.com/isrn/radiology/2014/935280/
 

http://link.springer.com/article/10.1007/s00276-013-1232-z


We describe a rare constellation of variant anatomy of the aortic arch branches, seen on a magnetic resonance angiographic examination during the course of investigation for recent onset memory loss in a 52-year-old patient. There was a common origin of both the common carotid arteries (CCA), the common trunk being the first major branch of the aortic arch, the right vertebral artery arising from the right CCA and the right subclavian artery arising as the last branch of the arch. In isolation, the three components of this constellation have been reported with different frequencies, but as per the authors’ knowledge, this entire constellation has been rarely reported. We review the literature and propose an embryological mechanism for this variant anatomy.

kellert et al have published a very important article...which is seen in day to day practice....and which I have kept telling to anyone I meet and cares to listen to me....which is "DO ONLY MECH THROMBECTOMY AND DONT MIX UP DIFFERENT TECHNIQUES OF RECANALISATION"

Abstract

Background and Purpose—To investigate the relationship between severe bleeding complications and outcome after mechanical thrombectomy with or without glycoprotein-IIb/IIIa inhibitor tirofiban treatment.

Methods—The study included prospectively collected data of consecutive patients with acute ischemic stroke in whom mechanical thrombectomy was perfomed in the years 2006 to 2011.

Results—Of 162 patients, 128 patients had anterior circulation stroke, and 34 patients had posterior circulation stroke. Additional treatment with tirofiban was given to 30 of 128 patients with anterior circulation stroke and to 20 of 34 patients with posterior circulation stroke. Treatment with tirofiban did not influence recanalization rates. Fatal intracerebral hemorrhage occurred more frequently in tirofiban-treated patients in the entire cohort (12.0% vs 2.7%; P=0.03) and in tirofiban-treated patients with anterior circulation stroke (13.3% vs 3.1%; P=0.05). Logistic regression found age (odds ratio, 1.17; 95% confidence interval, 1.00–1.37; P=0.05) and tirofiban treatment (odds ratio, 3.03; 95% confidence interval, 1.50–4.05; P=0.04) to be independent predictors for fatal intracerebral hemorrhage. Tirofiban treatment was also an independent predictor for poor outcome (odds ratio, 6.60; 95% confidence interval, 1.06–41.52; P=0.04) in addition to National Institute of Health Stroke Scale (odds ratio, 1.08; 95% confidence interval, 1.00–1.17; P=0.05).

Conclusions—In endovascular stroke therapy, additional treatment with the glycoprotein-IIb/IIIa inhibitor tirofiban is associated with increased risk of fatal intracerebral hemorrhage and poor outcome.

 

 

 

folks, I was relocating to a new place, 1000 KM away in this vast country called INDIA, hence could not add any posts for two months.
I shall restart posting now.
But no cases...for now...because the department is not set...shall be at least another 6 months.