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Your search keyword '"Payner, T."' showing total 3 results
Start Over Author "Payner, T." Topic aneurysm, ruptured
3 results on '"Payner, T."'

1. Artificial intelligence aneurysm measurement tool finds growth in all aneurysms that ruptured during conservative management.

Author

Sahlein DH, Gibson D, Scott JA, DeNardo A, Amuluru K, Payner T, Rosenbaum-Halevi D, and Kulwin C

Subjects
Humans, Prospective Studies, Artificial Intelligence, Conservative Treatment, Risk Factors, Aneurysm, Ruptured diagnostic imaging, Aneurysm, Ruptured therapy, Aneurysm, Ruptured complications, Intracranial Aneurysm diagnostic imaging, Intracranial Aneurysm therapy, Intracranial Aneurysm complications, Aneurysm, False
Abstract

Background: Cerebral aneurysm rupture is associated with high rates of morbidity and mortality. Detecting aneurysms at high risk of rupture is critical in management decision making. Rupture risk has traditionally been associated with size-measured as a maximum dimension. However, aneurysms are morphologically dynamic, a characteristic ignored by large prospective aneurysm risk studies. Manual measurement is challenging and fraught with error. We used an artificial intelligence (AI) measurement tool to study aneurysms that ruptured during conservative management to detect changes in size not appreciated by manual linear measurement., Methods: A single practice database with >5000 aneurysms was queried. Patients followed conservatively for an unruptured aneurysm were identified using appropriate diagnosis codes. This cohort was screened for subsequent rupture using procedure codes. Only patients with two vascular imaging studies before rupture were included., Results: Five patients met the criteria. All patients had aneurysm enlargement, two of which were not detected from manual linear measurements, including adjudication and analysis, during a multidisciplinary neurovascular conference in a high volume practice. Maximum dimension increased at a minimum of 1.8% (range 1.8-63.3%) from the first scan to the last, and aneurysm volume increased at a minimum of 5.9% (5.9-385.5%), highlighting the importance of volumetric measurement., Conclusions: AI-enabled volumetric measurements are more sensitive to changes in size and detected enlargement in all aneurysms that ruptured during conservative management. This finding has major implications for clinical practice and methods used for interval aneurysm measurement in patients being conservatively followed., Competing Interests: Competing interests: DHS: consultant for Medtronic, Microvention and Phenox, grant from Microvention, payment or honoraria for lectures from Medtronic and Microvention, support for attending meetings from Microvention and Medtronic. DPG: data support and consultant for iSchemaView. KA: consultant for Medtronic., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2023
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2. Analysis of intraoperative rupture in the surgical treatment of 1694 saccular aneurysms.

Author

Leipzig TJ, Morgan J, Horner TG, Payner T, Redelman K, and Johnson CS

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Aneurysm, Ruptured etiology, Humans, Incidence, Infant, Intracranial Aneurysm complications, Intraoperative Complications etiology, Male, Middle Aged, Retrospective Studies, Subarachnoid Hemorrhage epidemiology, Subarachnoid Hemorrhage etiology, Treatment Outcome, Aneurysm, Ruptured epidemiology, Intracranial Aneurysm surgery, Intraoperative Complications epidemiology
Abstract

Objective: Intraoperative rupture (IOR) of an aneurysm is a known risk in the surgical management of intracranial aneurysms. The purpose of this study was to determine the incidence of IOR in a modern surgical series and to assess which factors bear upon it., Methods: This study retrospectively examined 1269 patients with saccular aneurysms treated surgically between 1986 and 1998. Three vascular neurosurgeons performed 1435 operations on 1694 aneurysms. Multiple factors, including the magnitude and time of occurrence of IOR, aneurysm location, subarachnoid hemorrhage, timing of surgery, and use of temporary occlusion, were analyzed., Results: There were 113 instances of IOR (7.9% per surgery; 6.7% per aneurysm; 8.9% per patient). If the 59 "minor leaks" are excluded (as in previously published reports), the incidence becomes 3.8% per surgery, 3.2% per aneurysm, and 4.3% per patient. Posteroinferior cerebellar artery and anterior and posterior communicating artery aneurysms were more liable to rupture intraoperatively. The IOR rate was greater in ruptured than unruptured aneurysms (10.7 versus 1.2%, P < 0.0001). There was a lower rate of IOR in operations using temporary arterial occlusion (3.1 versus 8.6%, P < 0.0001). The occurrence of IOR for early surgery was not significantly higher than for surgery performed more than 3 days after subarachnoid hemorrhage (11.1 versus 10.0%, P = 0.6234)., Conclusion: The rate of significant IOR can be kept low. Aneurysm location, subarachnoid hemorrhage, and temporary arterial occlusion seem to be important factors affecting the incidence of IOR.

Published
2005
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3. Unruptured intracranial aneurysms--risk of rupture and risks of surgical intervention

Author

Wiebers, D., Whisnant, J., Forbes, G., Meissner, I., Brown, R., Piepgras, D., Huston, J., Nichols, D., O Fallon, W., Peacock, J., Jaeger, L., Kassell, N., Kongable-Beckman, G., Torner, J., Rajput, M., Drake, C., Kurtzke, J., Marler, J., Walker, M., Meyer, F., Atkinson, J., Marsh, W., Thielen, K., Ferguson, G., Barr, H., Lownie, S., Hachinski, V., Fox, A., Sahjpaul, R., Parrent, A., Mayer, C., Lindsay, K., Teasdale, E., Bone, I., Fatukasi, J., Lindsay, M., Cail, W., Sagher, O., Davis, M., Sengupta, R., Bates, D., Gholkar, A., Murdy, J., Wilson, S., Praharaj, S., Partridge, G., Reynolds, C., Hind, N., Ogilvy, C., Crowell, R., Gress, D., Schaefer, P., Choi, I., Buckley, D., Sloan, K., King, D., Giannotta, S., Ameriso, S., Teitelbaum, T., Thomson, E., Fishback, D., Vajda, J., Nyary, I., Czirjak, S., Horvath, M., Szikora, I., Pasztor, E., Varady, P., Erdos, A., Edner, G., Wahlgren, N., Lindqvist, M., Antonsson, A., Da Pian, R., Pasqualin, A., Chioffi, F., Beltramello, A., Zampieri, G., Benati, A., Rossi, G., Ronkainen, A., Hernesniemi, J., Vapalahti, M., Rinne, J., Luukkonen, M., Vihavainen, M., Savolainen, S., Koivisto, T., Leivo, S., Helin, K., Steinberg, G., Marks, M., Vanefsky, M., Norbash, A., Thompson, R., Bell, T., Marcellus, M., Meyer, A., Kerr, R., Adams, C., Molyneux, A., Vinden, S., Bacon, F., Shrimpton, J., Parker, S., Day, A., Nadeau, S., Stachniak, J., Friedman, W., Fessler, R., Peters, K., Jacob, R., Roper, S., Smith, A., Lafrentz, P., Howard, M., Loftus, C., Adams, H., Crosby, D., Rogers, M., Broderick, J., Tew, J., Brott, T., Loveren, H., Yeh, H., Zuccarello, M., Tomsick, T., Gaskill-Shipley, M., Minneci, L., Mcmahon, N., Castel, J., Orgogozo, J., Loiseau, H., Bourgeois, P., Berge, J., Dousset, V., Cuny, E., Richard, M., Agbi, C., Hugenholtz, H., Benoit, B., Morrish, W., Wee, R., Grahovac, S., Pratt, L., Mortensen, M., Andreoli, A., Testa, C., Comani, V., Trevisan, C., Limoni, P., Carlucci, F., Leonardi, M., Sturiale, C., Pendl, G., Eder, H., Klein, G., Eder, M., Leber, K., Horner, T., Leipzig, T., Payner, T., Denardo, A., Scott, J., Redelman, K., Fisher, W., Rosner, M., Vitek, G., Hand, M., Flack, Wf, Sichez, J., Pertuiset, B., Fohanno, D., Marsault, C., Casasco, A., Biondi, A., Capelle, L., Duffau, H., Winn, H., Grady, M., Newell, D., Longstreth, W., Thompson, P., Bybee, H., Jones, D., Findlay, J., Petruk, K., Steinke, D., Ashforth, R., Stenerson, P., Schindel, D., Vanderhoven, H., Neves, J., Zager, E., Flamm, E., Raps, E., Hurst, R., Parrott, S., Sellers, M., Torchia, M., Anderson, B., West, M., Fewer, D., Hill, N., Sutherland, G., Ross, I., Mcclarty, B., Brownstone, R., Williams, O., Narotam, P., Christane, L., Mcginn, G., Gladish, D., Kirkpatrick, P., Pickard, J., Antoun, N., Simpson, D., Higgins, N., Turner, C., Tebbs, S., Holness, R., Malloy, D., Phillips, S., Maloney, W., Molina-De-Orozco, V., Baxter, B., Connolly-Campbell, K., Macdougall, A., Gentili, F., Wallace, M., Ter Brugge, K., Willinsky, R., Tymianski, M., Rickards, L., Tucker, W., Lambert, C., Montanera, W., Rychlewski, C., Flood, C., Villani, R., Sganzerla, E., Tomei, G., Bettinelli, A., Ceccarelli, G., Righini, A., Bello, L., Marras, C., Nelson, R., Lewis, T., Renowden, C., Clarke, Y., Varian, L., Chyatte, D., Sila, C., Perl, J., Masaryk, T., Porterfield, R., Shaw, M., Foy, P., Nixon, T., Dunn, L., Clitheroe, N., Smith, T., Eldridge, P., Humphrey, P., Wiseman, J., Hawkins, K., Owen, L., Ost, K., Saminaden, S., Mohr, G., Schondorf, R., Carlton, J., Maleki, M., Just, N., Brien, S., Entis, S., Tampieri, D., Simons, N., Mooij, J., Metzemackers, J., Hew, J., Beks, J., Veen, A., Bosma, I., Sprengers, M., Rinkel, G., Gijn, J., Ramos, L., Tulleken, C., Greebe, P., Vliet, F., Borgesen, S., Jespersen, B., Boge-Rasmussen, T., Willumsen, L., Homer, D., Eller, T., Carpenter, J., Meyer, J., Munson, R., Small, B., Nussbaum, E., Heros, R., Latchaw, R., Camarata, P., Lundgren, J., Mattsen, N., Whittle, I., Sellar, R., O Sullivan, M., Steers, A., Statham, P., Malcolm, G., Price, R., Hoffman, B., Yonas, H., Wechsler, L., Thompson-Dobkin, J., Jungreis, C., Kassam, A., Kirby, L., Parent, A., Lewis, A., Azordegan, P., Smith, R., Alexander, L., Gordon, D., Russell, W., Benashvili, G., Perry, R., Scalzo, D., Mandybur, G., Morgan, C., Karanjia, P., Madden, K., Kelman, D., Gallant, T., Vanderspek, H., Choucair, A., Neal, J., Mancl, K., Saveland, H., Brandt, L., Holtas, S., Trulsson, B., Macdonald, R., Weir, B., Mojtahedi, S., Amidei, C., Vermeulen, M., Bosch, D., Hulsmans, F., Albrecht, K., Roos, Y., Vet, A., Gorissen, A., Mechielsen, M., Martin, N., Gobin, Y., Saver, J., Vinuela, F., Duckwiler, G., Kelly, D., Frazee, J., Da Graca, R., Gravori, T., Illingworth, R., Richards, P., Wade, J., Colquhoun, I., Bashir, E., Shortt, S., Weaver, J., Fisher, M., Stone, B., Chaturvedi, S., Davidson, R., Davidson, K., Giombini, S., Solero, C., Boiardi, A., Cimino, C., Valentini, S., Antonio Silvani, Alberts, M., Friedman, A., Gentry, A., Hoffman, K., Hughes, R., Lillihei, K., Earnest, M., Nichols, J., Kindt, G., Anderson, A., Levy, S., Breeze, R., Noonan, V., Dowd, C., Vanwestrop, J., Wilson, C., Berger, M., Hannegan, L., Marcos, J., Ugarte, L., Kitchen, N., Taylor, W., Kumar, M., Grieve, J., Durity, F., Boyd, M., Fairholm, D., Griesdale, D., Honey, C., Redekop, G., Toyota, B., Turnbull, I., Woodhurst, W., Zwimpfer, T., Teal, P., Grabe, D., Brevner, A., Piepgras, A., Schmiedek, P., Schwartz, A., Weber, T., Biller, J., Brem, S., Cybulski, G., Chadwick, L., Bronstein, K., Pietila, T., Brock, M., Krug, D., Krznaric, I., and Kivisaari, R.

Subjects
Adult, Male, medicine.medical_specialty, International Subarachnoid Aneurysm Trial, Adolescent, Rupture rate, Aneurysm, Ruptured, Risk Factors, Intervention (counseling), Unruptured cerebral aneurysm, Medicine, Humans, Prospective Studies, Aged, Probability, Retrospective Studies, Aged, 80 and over, Rupture, Spontaneous, business.industry, Age Factors, Intracranial Aneurysm, General Medicine, Middle Aged, Subarachnoid Hemorrhage, Emergency medicine, Female, business, Vascular Surgical Procedures
Abstract

The management of unruptured intracranial aneurysms requires knowledge of the natural history of these lesions and the risks of repairing them.A total of 2621 patients at 53 participating centers in the United States, Canada, and Europe were enrolled in the study, which had retrospective and prospective components. In the retrospective component, we assessed the natural history of unruptured intracranial aneurysms in 1449 patients with 1937 unruptured intracranial aneurysms; 727 of the patients had no history of subarachnoid hemorrhage from a different aneurysm (group 1), and 722 had a history of subarachnoid hemorrhage from a different aneurysm that had been repaired successfully (group 2). In the prospective component, we assessed treatment-related morbidity and mortality in 1172 patients with newly diagnosed unruptured intracranial aneurysms.In group 1, the cumulative rate of rupture of aneurysms that were less than 10 mm in diameter at diagnosis was less than 0.05 percent per year, and in group 2, the rate was approximately 11 times as high (0.5 percent per year). The rupture rate of aneurysms that were 10 mm or more in diameter was less than 1 percent per year in both groups, but in group 1, the rate was 6 percent the first year for giant aneurysms (or =25 mm in diameter). The size and location of the aneurysm were independent predictors of rupture. The overall rate of surgery-related morbidity and mortality was 17.5 percent in group 1 and 13.6 percent in group 2 at 30 days and was 15.7 percent and 13.1 percent, respectively, at 1 year. Age independently predicted surgical outcome.The likelihood of rupture of unruptured intracranial aneurysms that were less than 10 mm in diameter was exceedingly low among patients in group 1 and was substantially higher among those in group 2. The risk of morbidity and mortality related to surgery greatly exceeded the 7.5-year risk of rupture among patients in group 1 with unruptured intracranial aneurysms smaller than 10 mm in diameter.

Published
1998

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