Summary:When dural arteriovenous fistula (DAVF) is associated with leptomeningeal venous drainage (LMVD), most cases have venous hypertension and concomitant venous congestion in the same areas due to reduced venous circulation. On the other hand, some cases in the DAVF with LMVD have no low-perfusion area. We studied this phenomenon. The subjects were 25 patients with DAVF. Of them, 16 cases had LMVD. Eleven had a low-perfusion area but 5 had no low-perfusion area. We analyzed this phenomenon in 5 cases. Two cases had anterior cranial fossa DAVF, 2 had tentorium DAVF, and 1 had transverse-sigmoid sinus DAVF. The characteristics of these DAVF are: 1) extra-sinusal type or pure leptomeningeal venous drainage, 2) low shunt flow, 3) existence of accessory route.
The safety and efficacy of the ultrasonic scalpel (Harmonic Scalpel; Ethicon Endo-Surgery, Cincinnati, OH) for carotid endarterectomy (CEA) were evaluated. Material and Methods: CEA was performed in 28 consecutive patients (27 men, 1 woman; mean age, 72 years) using the ultrasonic scalpel from April 2011 to October 2012. Eighteen cases involved high-position stenosis. Mean percentage stenosis was 78%. Complications were compared to those in 27 consecutive cases treated without the ultrasonic scalpel, performed prior to March 2011. Results: One patient treated using the ultrasonic scalpel suffered ischemic complication (not significant). No patient using the ultrasonic scalpel died (not significant). Five patients treated using the ultrasonic scalpel showed increased signal hyperintensity on postoperative diffusion-weighted magnetic resonance imaging (not significant). Four patients treated using the ultrasonic scalpel suffered transient hoarseness, including 1 patient with recurrent nerve paralysis (not significant). However, only 3 of the 18 patients treated using the ultrasonic scalpel with high-position stenosis suffered transient hoarseness, showing a significant decrease compared to the 6 of 11 patients with high-position stenosis treated without the ultrasonic scalpel (P<0.05). Discussion: The ultrasonic scalpel reportedly causes less heat injury to vessels than electrocautery, which may account for the reduced number of complications caused by temporary damage to the superior laryngeal nerve. Conclusion: The ultrasonic scalpel is a useful tool for CEA, particularly for high-position stenosis.
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.
customersupport@researchsolutions.com
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.