Subject(s)
Pulmonary Disease, Chronic Obstructive , Takotsubo Cardiomyopathy , Electrocardiography , Female , Humans , Middle AgedABSTRACT
Endovascular treatment of broad-necked bifurcation aneurysms remains challenging. Stent-assisted coiling has been successful but requires catheterization of the branches off the parent vessel. We present the case of a patient who failed primary and stent-assisted coiling of a large basilar tip aneurysm because the morphology of the aneurysm precluded successful distal catheterization of the posterior cerebral artery (PCA) branches. Using the PulseRider device, which does not require catheterization of bifurcation branches, we were able to treat the aneurysm successfully.
Subject(s)
Embolization, Therapeutic/instrumentation , Intracranial Aneurysm/therapy , Stents , Treatment Failure , Aged , Arteries , Catheterization , Cerebral Angiography , Female , Humans , Imaging, Three-Dimensional , Incidental Findings , Intracranial Aneurysm/diagnostic imaging , Postoperative Complications/diagnostic imaging , Postoperative Complications/therapy , Retreatment , Treatment OutcomeABSTRACT
Endovascular treatment of broad-necked bifurcation aneurysms remains challenging. Stent-assisted coiling has been successful but requires catheterization of the branches off the parent vessel. We present the case of a patient who failed primary and stent-assisted coiling of a large basilar tip aneurysm because the morphology of the aneurysm precluded successful distal catheterization of the posterior cerebral artery (PCA) branches. Using the PulseRider device, which does not require catheterization of bifurcation branches, we were able to treat the aneurysm successfully.
Subject(s)
Embolization, Therapeutic/instrumentation , Endovascular Procedures/instrumentation , Intracranial Aneurysm/diagnostic imaging , Intracranial Aneurysm/surgery , Aged , Angiography , Female , Humans , Posterior Cerebral ArteryABSTRACT
OBJECTIVES: Even after evolution of computerized tomography and improved surgical measures, treatment of intraarticular calcaneal fractures remains a controversy. Hence this study was carried out to compare functional outcomes of displaced intraarticular calcaneal fractures, treated with operative management with plating and conservative management with cast. MATERIAL AND METHODS: This study was carried out as a prospective, comparative study. Twenty nine (30 fractures) patients with acute, displaced intraarticular fractures of calcaneum aged 18-50 years, were enrolled in the study. Open fractures and fractures older than two weeks were excluded. 30 fractures were divided into two groups (operative and conservative; n = 15 in each). Evaluation in form of post treatment restoration of Bohler's angle, heel varus angle and with Creighton-Nebraska (C-N) score for functional outcome was done at the end of 12 months. RESULTS: When we consider the clinical evaluation under the C-N score, the results of operatively managed calcaneal fractures are slightly better than those of the conservative group. But this did not have any statistical significance. Also, there was significant difference in pre and post treatment Bohler's angle and heel varus angle in operative group. Three cases of plating suffered from post-operative wound dehiscence. CONCLUSION: A relatively better functional outcome was observed in displaced and comminuted fractures in plating, provided that the Bohler's angle was restored. In conservative group, functional outcome of minimally displaced fractures were better than displaced comminuted fractures. Post treatment Bohlers angle has prognostic importance in functional outcome.