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Microsurgical management of tentorial dural arteriovenous fistula: an analysis from the Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR).
[OBJECTIVE] Dural arteriovenous fistulas (dAVFs) are rare cerebrovascular anomalies. Tentorial dAVFs (TDAVFs) have more aggressive features, making them prone to symptomatic presentations and hemorrhage. TDAVFs are heterogenous and require …
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How I do it: surgical resection of micro-arteriovenous malformations.
[BACKGROUND] Micro-arteriovenous malformations (AVMs) are a subgroup of AVMs with a nidus smaller than 1- cm. As such, intraoperative localization of micro-AVMs can be challenging. Once identified intraoperatively, however, treatment of the…
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Contemporary adverse event profile of microsurgery for intracranial unruptured aneurysms in high-volume microsurgical centers: the international PRAEMIUM study.
[OBJECTIVE] Objective values on procedural risk are essential to facilitate informed consent and optimize clinical decision-making in patients with unruptured intracranial aneurysms (UIAs). While robust heuristics, such as the PHASES (popul…
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Risk Models for Adverse Events in Microsurgery for Intracranial Unruptured Aneurysms.
[BACKGROUND AND OBJECTIVES] Preventive treatment of unruptured intracranial aneurysms (UIAs) requires assessment of treatment risks vs expected benefit. Although established scores exist to estimate rupture and growth risk, currently, no ex…
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Most Promising Approaches to Improve Brain AVM Management: ARISE I Consensus Recommendations.
Brain arteriovenous malformations (bAVMs) are complex, and rare arteriovenous shunts that present with a wide range of signs and symptoms, with intracerebral hemorrhage being the most severe. Despite prior societal position statements, ther…
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Microsurgical Treatment of Intracranial Dural Arteriovenous Fistulas: A Collaborative Investigation From the Multicenter Consortium for Dural Arteriovenous Fistula Outcomes Research.
[BACKGROUND AND OBJECTIVES] First-line therapy for most intracranial dural arteriovenous fistulas (dAVFs) is endovascular embolization, but some require microsurgical ligation due to limited endovascular accessibility, anticipated lower cur…
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Management of failed flow diversion for intracranial aneurysm beyond the first 6 months of follow-up: an international Delphi consensus.
[OBJECTIVE] The placement of flow-diverting devices has become a common method of treating unruptured intracranial aneurysms of the internal carotid artery. The progressive improvement of aneurysm occlusion after treatment-with low complica…
- Microsurgical Resection of a Vermian Hemangioblastoma Using the Occipital Interhemispheric Transtentorial Approach: 2-Dimensional Operative Video.
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Natural history, angiographic presentation and outcomes of anterior cranial fossa dural arteriovenous fistulas.
[BACKGROUND] Anterior cranial fossa dural arteriovenous fistulas (ACF-dAVFs) are aggressive vascular lesions. The pattern of venous drainage is the most important determinant of symptoms. Due to the absence of a venous sinus in the anterior…
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Dural arteriovenous fistulas without cortical venous drainage: presentation, treatment, and outcomes.
[OBJECTIVE] Current evidence suggests that intracranial dural arteriovenous fistulas (dAVFs) without cortical venous drainage (CVD) have a benign clinical course. However, no large study has evaluated the safety and efficacy of current trea…
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Principles and strategies for step-by-step AVM excision.
Arteriovenous malformations (AVMs) are some of the most challenging surgical entities. Like any challenging surgical procedure, AVM surgery is a series of basic but fundamental steps, each with its own nuances. Despite a myriad of published…
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Natural history and management of posterior cerebral artery aneurysms: a systematic review and meta-analysis of individual patient data.
We conducted a comprehensive review and meta-analysis to investigate clinical, radiographic characteristics, and treatment outcomes of posterior cerebral artery aneurysms (PCAA). We systematically reviewed English-language articles investig…
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Location-based treatment of intracranial aneurysms in moyamoya disease: a systematic review and descriptive analysis.
We conducted a systematic review of the literature to evaluate the efficacy of various treatment modalities for intracranial aneurysms (IA) in patients with moyamoya disease (MMD) based on anatomical location of IA. A comprehensive review o…
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Combined Endovascular and Microsurgical Management of Unruptured, Partially Thrombosed, Giant, Internal Carotid Artery Aneurysm: 2-Dimensional Operative Video.
Giant intracranial aneurysms still represent a serious threat because of high mortality and morbidity and an absence of a widely accepted treatment. Herein, we illustrate the case of a 54-yr-old woman with progressive neurological decline w…
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Intracranial Aneurysms in White Patients with Moyamoya Disease: A U.S. Single-Center Case Series and Review.
[BACKGROUND] Intracranial aneurysms (IA) are associated with moyamoya disease (MMD). There are no clinically tested treatment guidelines. Reporting of cases is vital to better understand the underlying pathophysiology and potential ethnic p…
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Development and validation of the Skills Assessment in Microsurgery for Brain Aneurysms (SAMBA) instrument for predicting proficiency in aneurysm surgery.
[OBJECTIVE] Surgical performance evaluation was first described with the OSATS (Objective Structured Assessment of Technical Skills) and modified for aneurysm microsurgery simulation with the OSAACS (Objective Structured Assessment of Aneur…
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The Flower Petal Training System in Microsurgery: Validation of a Training Model Using a Randomized Controlled Trial.
[INTRODUCTION] Despite hundreds of training models for microsurgery being available in the literature, very few of them are scientifically validated. We chose to validate our low-fidelity training model on flower petals by comparing it head…