ABSTRACT
BACKGROUND: The aim of this study was to assess the technical success and procedural safety of the new Silk Vista device (SV) by evaluating the intraprocedural and periprocedural complication rate after its use in several institutions worldwide. METHODS: The study involved a retrospective review of multicenter data regarding a consecutive series of patients with intracranial aneurysms, treated with the SV between September 2020 and January 2021. Clinical, intra/periprocedural and angiographic data, including approach, materials used, aneurysm size and location, device/s, technical details and initial angiographic aneurysm occlusion, were analyzed. RESULTS: 60 aneurysms were treated with SV in 57 procedures. 66 devices were used, 3 removed and 63 implanted. The devices opened instantaneously in 60 out of 66 (91%) cases and complete wall apposition was achieved in 58 out of 63 (92%) devices implanted. In 4 out of 66 (6%) devices a partial opening of the distal end occurred, and in 5 (8%) devices incomplete apposition was reported. There were 3 (5%) intraprocedural thromboembolic events managed successfully with no permanent neurological morbidity, and 4 (7%) postprocedural events. There was no mortality in this study. The initial occlusion rates in the 60 aneurysms were as follows: O'Kelly-Marotta (OKM) A in 34 (57%) cases, OKM B in 15 (25%) cases, OKM C in 6 (10%) cases, and OKM D in 5 (8%) cases. CONCLUSIONS: Our study demonstrated that the use of the new flow diverter Silk Vista for the treatment of intracranial aneurysms is feasible and technically safe.
Subject(s)
Endovascular Procedures , Intracranial Aneurysm , Humans , Intracranial Aneurysm/diagnostic imaging , Intracranial Aneurysm/surgery , Retrospective Studies , Silk , Stents , Treatment OutcomeABSTRACT
OBJECTIVE: This work provides a detailed description and differential diagnosis of a Pleistocene cave bear (Ursus spelaeus). MATERIALS: The specimen was recovered at the Cueva de Guantes archaeo- paleontological site, located in the North of the Iberian Peninsula and dated to more than 30k yr BP. METHODS: The study was carried out by macroscopic and radiological analysis. RESULTS: The specimen has unusual morphology, with two vertebrae (C6-C7) connected in the ventrodorsal projection by osseous tissue, without a space or disruption between them. However, a separation is visible in the dorsoventral projection. Moreover, C7 shows a "wedge-shape" conformation. CONCLUSIONS: The lack of clear radiological and macroscopic evidence of degenerative processes and trauma suggests a congenital anomaly or pathology. The short height of the ventral margin of the block and evidence of a radiological 'waist' lead us to propose congenital block vertebra (CBV) as the most likely diagnosis. SIGNIFICANCE: The Cueva de Guantes specimen would be the first reported evidence of CBV in a Pleistocene cave bear (Ursus spelaeus). LIMITATIONS: All diagnosis of archaeological animal remains should be undertaken with caution, especially when based on partial remains, as in this case. Moreover, this specimen lacks the neural arches of C6 and C7, preventing evaluation of the vertebral foramina. SUGGESTIONS FOR FURTHER RESEARCH: Intensive review of cave bear skeletal collections is advised to find new cases and perform an epidemiological approach to the palaeopathology of cave bears.
Subject(s)
Bone and Bones/pathology , Fossils/history , Tooth/pathology , Caves , Europe , History, Ancient , Humans , Paleontology/methods , Phylogeny , SpainABSTRACT
El angiosarcoma de mama es una entidad anatomopatológica excepcional. Presentamos un caso de esta entidad. Mujer de 19 años de edad con un aumento difuso de la mama derecha de evolución rápida. En el examen clínico se observa el aumento mamario unilateral y una tenue coloración azulada periareolar. La mamografía muestra el aumento mamario y mayor densidad que en la otra mama. En la ecografía se detectan ecos de mayor intensidad que pueden denotar hiperemia, que se confirma con Doppler-color, lo que unido a dos punciones con aguja fina, ciegas, totalmente hemáticas, hicieron sospechar patología vascular. Se realizó tomografía computarizada (TC) helicoidal sin y con contraste intravenoso no iónico. Las imágenes demuestran una vascularización patológica muy heterogénea y anárquica y probable afectación de la fascia del pectoral mayor. El análisis histológico, mediante biopsia quirúrgica, confirmó el diagnóstico. El tratamiento consistió en mastectomía total simple junto con extirpación del pectoral mayor. El análisis histológico confirmó el diagnóstico. Los hallazgos clínicos, radiológicos y anatomopatológicos se comparan con los descritos en distintas publicaciones de la bibliografía (AU)
