BACKGROUND: Experience with endoluminal flow diversion for the treatment of posterior circulation aneurysms is limited. PURPOSE: We sought to investigate factors associated with the safety and efficacy of this treatment by collecting disaggregated patient-level data from the literature. DATA SOURCES: PubMed, EMBASE, and Ovid were searched up through 2019 for articles reporting flow diversion of posterior circulation aneurysms. STUDY SELECTION: Eighty-four studies reported disaggregated data for 301 separate posterior circulation aneurysms. DATA ANALYSIS: Patient, aneurysm, and treatment factors were collected for each patient. Outcomes included the occurrence of major complications, angiographic occlusion, and functional outcomes based on the mRS.DATA SYNTHESIS: Significant differences in aneurysm and treatment characteristics were seen among different locations. Major complications occurred in 22%, angiographic occlusion was reported in 65% (11.3 months of mean follow-up), and good functional outcomes (mRS 0-2) were achieved in 67% (13.3 months of mean follow-up). Multivariate analysis identified age, number of flow diverters used, size, and prior treatment to be associated with outcome measures. Meta-analysis combining the current study with prior large nondisaggregated series of posterior circulation aneurysms treated with flow diversion found a pooled incidence of 20% (n ¼ 712 patients) major complications and 75% (n ¼ 581 patients) angiographic occlusions. LIMITATIONS:This study design is susceptible to publication bias. Use of antiplatelet therapy was not uniformly reported. CONCLUSIONS:Endoluminal flow diversion is an important tool in the treatment of posterior circulation aneurysms. Patient age, aneurysm size, prior treatment, and the number of flow diverters used are important factors associated with complications and outcomes.ABBREVIATIONS: aOR ¼ adjusted OR; FD ¼ flow diverter; PCA ¼ posterior cerebral artery; VBJ ¼ vertebrobasilar junction E ndoluminal flow diversion is a well-established treatment for cerebral aneurysms, but most flow diverters (FDs) have been approved for the treatment of anterior circulation aneurysms. 1 Posterior circulation aneurysms comprise 10%-15% of all cerebral aneurysms, 2 and some of the first cases of flow diversion in the
Table 1 outlines VAS pain outcomes as related to the procedure, both preoperative and postoperative. There was a significant difference between improvement of resting pain (2.63 point improvement, <0.000001), as well as a significant difference between improvement of worst pain before and after the SpineJack procedure (1.88 point improvement, <0.0001). Conclusions These results support the safety and efficacy of the SpineJack procedure as related to current conventional treatments in the setting of vertebral fractures.
within a neurosurgery department to uncover undocumented patient variables which negatively affects LOS quality metrics. Methods Vizient software was used to analyze DRGs and expected LOS for 53 SAH patients between August 2020 and August 2021. Chart reviews for all procedures were conducted to discover variables missed by the documenting provider or coder. Results Chart reviews of 53 SAH cases from August 2020 to August 2021 revealed at least one new variable coding for LOS in 49 cases (92%). An average of 3 (2.89) new variables were found per chart (maximum of 8). Expected LOS, recalculated with undocumented variables, increased by an average of 6.46 days (maximum increase of 74.22 days). Most common variables missed were ventriculostomy (17), fluid & electrolyte disorders (15), obesity (14), and Medicaid status (11). Conclusion Inadequate documentation causes omission of variables coded; in turn, leading to misrepresentation of the quality of patient care being provided. Efforts to guide providers to document their care accurately can improve their quality metrics such as LOS, mortality, and cost estimates.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.