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We report our two-year experience in the endovascular treatment of brain aneurysms in relation to their parent artery wall. We prospectively recorded patients with intracranial aneurysms (107 ruptured - 38 unruptured) treated with coiling during a two-year period: 145 patients, 94 females and 51 males - mean age 56 years. The aneurysms were divided into side-wall (A) and bifurcation (B) groups. A total occlusion rate was noted in post-embolization angiograms in 101 aneurysms (70%) with a morbidity of 4%. No angiographic recurrence arose in the six-month follow-up. The two groups had a similar total occlusion rate (68.31% and 71.8% respectively), while the complication rate was 3% in group A and 4.7% in group B. Significant differences between the two groups were noted in the number of assisted coiling cases: 28 out of 60 cases (46.7%) in group A - 14 out of 85 cases (16.5%) in group B. Further statistical analysis showed strong dependencies for the type of endovascular procedure between the ruptured and unruptured aneurysms in both groups (p 0.000<0.05), but no dependencies between the aneurysm occlusion rate and the ruptured or non-ruptured aneurysms, or between the occlusion rate and the type of endovascular procedure (p 0.552>0.05 and 0.071>0.05 respectively). In conclusion, the anatomic relation of the aneurysm sac with the wall of the parent artery is important, as significant differences in endovascular practice, devices and techniques were noted between side-wall and bifurcation aneurysms. [ABSTRACT FROM AUTHOR]

Background:Minimally invasive surgical techniques are a revolutionary and innovative approach to the practice of surgery. Endovascular aneurysm repair (EVAR) may offer a number of significant advantages in comparison with conventional open surgical repair.Aim:The purpose of this study was to compare regional anaesthesia (RA) and general anaesthesia (GA) in EVAR, and to describe the surgical nursing interventions.Methods:This included a retrospective analysis of 160 consecutive patients (age 55 to 96 years) who underwent EVAR under: epidural anaesthesia (EDA = 60 patients), combined spinal and epidural anaesthesia (Combined = 40 patients) and GA = 60 patients.Results:Results were successful in all patients and no mortality was noticed. Among the GA group, 11 patients needed ICU support while only 5 from the other 2 groups. Furthermore, a statistically significant difference regarding median hospital stay was also noticed in favour of the regional group.Conclusion:In conclusion, RA is a safe and effective anaesthetic method for endovascular repair of abdominal aneurysms, offering several advantages including simplicity, haemodynamic stability, less need for ICU management and reduced hospital stay. The anaesthetic nurse can play a major role in the management of this anaesthesia throughout the procedure. [ABSTRACT FROM PUBLISHER]

PurposeThe aim of this study was to evaluate neuron specific enolase (NSE) as prognostic factor for CNS disorders developed in relation to cardiac surgery.Patients and methodsA cohort of 92 patients were divided into two groups; the experimental group consisted of patients undergoing open-heart bypass surgery (50 patients) and the control group consisting of 42 patients undergoing general surgery procedures. The blood levels of NSE were measured in both groups before and 24 h after the operation and have been related to the incidence of the postoperative brain damage as well as to the duration of the extracorporeal circulation (ECC).ResultsThe analysis of our results showed that the changes of blood NSE levels, before and immediately after ECC in open-heart surgery have been related to the incidence of postoperative brain dysfunction according to a specific mathematical equation. This incidence was raised also in relation to the age of the patient and the duration of ECC. On the contrary, NSE seems to have no prognostic value in general surgery.ConclusionNSE can be used in cardiac surgery as a simple and reliable prognostic factor to predict postoperative brain dysfunction. [ABSTRACT FROM PUBLISHER]