Changing Aspects in Stroke Surgery: Aneurysms, Dissections, Moyamoya Angiopathy and EC-IC Bypass PDF
Preview Changing Aspects in Stroke Surgery: Aneurysms, Dissections, Moyamoya Angiopathy and EC-IC Bypass
Acta Neurochirurgica Supplements Editor: H.-J. Steiger Changing Aspects in Stroke Surgery: Aneurysms, Dissections, Moyamoya Angiopathy and EC-IC Bypass Edited by Y.Yonekawa, T. Tsukahara, A.Valavanis, and N. Khan Acta Neurochirurgica Supplement 103 SpringerWienNewYork Prof. Dr. Yasuhiro Yonekawa NeurochirurgieFMH,Zurich,Switzerland Dr. Tetsuya Tsukahara DepartmentofNeurosurgery,KyotoNationalHospital,Kyoto,Japan Prof. Dr. Anton Valavanis Institutf€uurNeuroradiologie,Universit€aatsspitalZurich,Zurich,Switzerland Dr. Nadia Khan NeurochirurgischeKlinik,Universit€aatsspitalZurich,Zurich,Switzerland Thisworkissubjecttocopyright. Allrightsarereserved,whetherthewholeorpartofthematerialisconcerned,speciallythoseoftranslation,reprinting,re-useof illustrations,broadcasting,reproductionbyphotocopyingmachinesorsimilarmeans,andstorageindatabanks. ProductLiability:Thepublishercangivenoguaranteeforalltheinformationcontainedinthisbook.Thisalsoreferstothatondrugdosage andapplicationthereof.Ineachindividualcasetherespectiveusermustchecktheaccuracyoftheinformationgivenbyconsultingother pharmaceuticalliterature.Theuseofregisterednames,trademarks,etc.inthispublicationdoesnotimply,evenintheabsenceofspecific statement,thatsuchnamesareexemptfromtherelevantprotectivelawsandregulationsandthereforefreeforgeneraluse. #2008Springer-Verlag=Wien PrintedinAustria SpringerWienNewYorkisapartofSpringerScienceþBusinessMedia springer.at Typesetting:ThomsonPress,Chennai,India PrintingandBinding:DruckereiTheissGmbH,St.Stefan,Austria,www.theiss.at Printedonacid-freeandchlorine-freebleachedpaper SPIN:12040858 LibraryofCongressControlNumber:2007940850 With 65 Figures (thereof 14 coloured) ISSN 0065-1419 ISBN978-3-211-76588-3SpringerWienNewYork ActaNeurochirSuppl(2008)103:V #Springer-Verlag2008 PrintedinAustria Preface This Supplement is an outline of the proceedings of the in Japan. Neurosurgical advances in this type of angio- 3rd European-Japanese Joint Conference for Cerebral pathy are discussed in detail in this issue. Stroke Surgery which was held in conjunction with the The role of EC–IC bypass surgery, with a history of 70th Anniversary of the Neurochirurgische Univer- now just 40 years since the pioneer work of Professors sit€aatsklinik Z€uurich founded by Prof. Krayenb€uuhl. Yasargil and Donaghy in 1967, with its extensive avail- Thismeetinghasbeenheldtwiceuntilnowunderthe ability in the field of stroke surgery to date, is also nameofSwiss-JapaneseJointconferencewiththeaimto elucidated. exchange recent knowledge and technical advances in Last butnot least, ongoing developments of endovas- thefieldofstroke surgeryanditsperioperativemanage- cular surgery in the treatment of stroke surgery along ment. with the introduction of the current randomised study This time we have focused especially on dissecting of unruptured brain AVM (ARUBA) by Prof. Mohr is aneurysms, where their epidemiology, pathophysiology, included. and management are still to be elucidated. In Japan, a This publication is partly sponsored by the Research nationwide survey on this topic is ongoing, and part of Grant for Cardiovascular Diseases (18C-5) by the Min- the results are presented in this issue. istry of Health, Labor and Welfare, Japan. Also, onewill find some local differences in the inci- Yasuhiro Yonekawa dence and pathophysiology of various vascular diseases Tetsuya Tsukahara like in the case of Moyamoya angiopathy, which pres- Anton Valavanis entlyalsohasa50-yearhistorysinceitsinitialdiscovery Nadia Khan Contents Part 1: Aneurysms, arteriovenous malformations and fistulas Mohr, J. P.: A randomized trial of unruptured brain arteriovenous malformations (ARUBA). . . . . . . . . . . . . . . . . . . . . . . 3 Manabe, H.: Ruptured cerebral aneurysms treated by stent-assisted GDC embolization – two case reports with long-term follow-up. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Takahashi, T., Suzaki, N., Tsugane, S., Yamauchi, K., Takada, S.: Suction decompression methods for giant internal carotid ophthalmic aneurysms by using revised double lumen balloon catheters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Kikuta, K., Takagi, Y., Nozaki, K., Hashimoto, N.: Introduction to tractography-guided navigation: using 3-tesla magnetic resonance tractography in surgery for cerebral arteriovenous malformations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Orakcioglu, B., Becker, K., Sakowitz, O. W., Unterberg, A., Schellinger, P. D.: Serial diffusion and perfusion MRI analysis of the perihemorrhagic zone in a rat ICH model . . . . . . . . . . . . 15 Baumann, F., Khan, N., Yonekawa, Y.: Patient and aneurysm characteristics in multiple intracranial aneurysms . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Otani, N., Fujioka, M., Oracioglu, B., Muroi, C., Khan, N., Roth, P., Yonekawa, Y.: Thalamic cavernous angioma: paraculminar supracerebellar infratentorial transtentorial approach for the safe and complete surgical removal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 El Beltagy, M., Muroi, C., Imhof, H.-G., Yonekawa, Y.: Peripheral large or giant fusiform middle cerebral artery aneurysm: report of our experience and review of literature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Part 2: Dissection of cerebral arteries Baumgartner, R. W.: Stroke prevention and treatment in patients with spontaneous carotid dissection. . . . . . . . . . . . . . . . . . . . . . 47 Satoh, A., Sugiyama, T., Hongo, K., Kakizawa, Y., Ishihara, S., Matsutani, M.: Nationwide surveillance of IC anterior (or dorsal) wall aneurysm: with special reference to its dissecting nature. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 Nishino, A., Suzuki, I., Utsunomiya, A., Suzuki, S., Uenohara, H., Sakurai, Y.: Clinical manifestation and treatment strategy for non hemorrhagic cerebral arterial dissection. . . . . . . . . . . . 57 VIII Contents Yonekawa, Y., Zumofen, D., Imhof, H.-G., Roth, P., Khan, N.: Hemorrhagic cerebral dissecting aneurysms: surgical treatment and results . . . . . . . . . . . . . . . . . . . . . . . . . 61 Part 3: Revascularisation procedures, EC–IC bypass revisited Mehdorn, H. M.: Cerebral revascularisation by EC-IC bypass–present status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 Inoue, T., Jinnouchi, J.: Changes in brain volume after EC-IC bypass surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 Kaku, Y., Watarai, H., Kokuzawa, J., Tanaka, T., Andoh, T.: Less invasive technique for EC-IC bypass . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 Alfieri, A., Bregy, A., Constantinescu, M., Stuker, F., Schaffner, T., Frenz, M., Banic, A., Reinert, M.: Tight contact technique during side-to-side laser tissue soldering of rabbit aortas improves tensile strength. . . 87 Krayenb€uuhl, N., Khan, N., Cesnulis, E., Imhof, H.-G., Yonekawa, Y.: Emergency extra–intracranial bypass surgery in the treatment of cerebral aneurysms . . . . . . . . . . . . . . . . . . 93 Zumofen, D., Khan, N., Roth, P., Samma, A., Yonekawa, Y.: Bonnet bypass in multiple cerebrovascular occlusive disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 Tsukahara, T., Hatano, T., Nakakuki, T., Tsuji, Y., Aoyama, T., Ogata, H.: Combined treatment using CEA and CAS for carotid arterial stenosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . 109 Part 4: Moyamoya angiopathy, history Iwama, T., Yoshimura, S.: Present status of Moyamoya disease in Japan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 H€aanggi, D., Mehrkens, J. H., Schmid-Elsaesser, R., Steiger, H.-J.: Results of direct and indirect revascularisation for adult European patients with Moyamoya angiopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119 Kikuta, K.: Experiences using 3-tesla magnetic resonance imaging in the treatment of Moyamoya disease . . . . . . . . . . 123 Khan, N., Yonekawa, Y: Moyamoya angiopathy in Europe: the beginnings in Zurich, practical lessons learned, increasing awareness and future perspectives. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127 Hernesniemi, J., Dashti, R., Mateo, O., Cancela, P., Karatas, A., Niemel€aa, M.: Historical landmarks invascular Neurosurgery ‘‘On July 10th 2006, at the 70th Anniversary of the Department of Neurosurgery of Z€uurich Medical School’’. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131 Author index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139 Index of keyword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 Listed in Current Contents Part 1: Aneurysms, arteriovenous malformations and fistulas ActaNeurochirSuppl(2008)103:3–4 #Springer-Verlag2008 PrintedinAustria A randomized trial of unruptured brain arteriovenous malformations (ARUBA) J. P. Mohr DorisandStanleyTananbaumStrokeCenter,NeurologicalInstituteColumbiaMedicalCenter,NewYork,NY,U.S.A. Summary equipoise’’ concerning whether to treat or not. Patients whose BAVM is deemed too daunting for eradica- Despitealmostacenturyofeffortsinthetreatmentofbrainarteriove- nousmalformations(BAVMs)noclinicaltrialhasyetbeenperformedto tion efforts are thus not subject to ethical equipoise. demonstrate the benefits of interventionversus conservative (medical) Patients with evidence of having bled are not eligible. managementforthosenotyetbled.Onlyinsufficientinformationonthe Thetrialofferstheopportunitytoassesshemorrhagic natural history of unbled BAVMs exists to certify that intervention is neededandthatsuchinterventionproducesabetterlong-termfunctional predictability for biomarkers such a TNF-(cid:1)-238G>A outcome. and MMP-9 [1, 4, 5, 12]. Support of this testing was Keywords: Brainarteriovenousmalformations;naturalhistory. applied for at NIH under a grant proposal entitled ‘‘BioMarkers for Hemorrhagic Risk ‘‘BARUBA’’ (WL Young, PI), review of which is currently in process. An Introduction applicationtoevaluatetheuseofMinocyclineorcompara- EffectivefromJanuary2006,theNINDSawardedGrant bleagentinaparallelclinicaltrialforthecurrentlyuntreat- 1U01 NS051483 for an international prospective, inter- able, very large lesions is in preparation as is a proposal net-basedrandomized (1:1)trial of800 patients toeval- for a registry of cases eligible for ARUBA, but who do uate the difference, if any, in the incidence of stroke, notacceptorarenotapproachedforrandomization. hemorrhage, death, and functional status over a period of five years for patients with brain arteriovenous Material and methods malformation (BAVM), which is deemed treatable by the local center, and to whom randomization is offered To date87 centers inthe U.S.,Europe,Canada, Australia, Braziland Puerto Rico have enrolled to participate in the trial. The trial has its with regard to conservative (medical management for clinicalcenterattheNeurologicalInstituteinNewYork(JPMohr,PI), non-hemorrhage symptoms) vs. any type, number, or theEuropeanCoordinatingCenterattheLaraboisiereinParis(CStapf, sequence of intervention intended to eradicate the Co-I, M-G Bousser, Service Chief), and the Statistical Center at the International center for Health Outcomes and innovation Research BAVM including surgery, endovascular, or radiotherapy (InCHOIR–www.inchoir.org)(AMoskowitzandAGelijns,Co-PIs). treatment(s). Subjects randomized to the conservative WhenBAVMscametoattentionbecauseofhemorrhageanddiagno- management arm are eligible for interventional treat- siswasbasedonangiogram,itwasnosurprisethatclinicianscameto mentshouldhemorrhageoccurduringthe5-yearcourse regardBAVMsaslethalalesionasananeurysm.Disappointingexperi- enceswithindividualcasesfullyjustifiedthisview[14].Littlewonder of follow-up. thatthosediscoveredpriortohemorrhagewereconsideredsuitablefor Patients to whom randomization should be offered intervention.Suchassumedsuitabilitymayexplainthefailureofallbut are those for whom the local treating team has ‘‘ethical themostrecentcaseseriesintheliteraturetohavesegregatedtreatment outcomesbasedonwhetherpatientshadbledornotpriortotreatment [3,13,15]. Basedontheliteraturefromthebeginningofthisfield,itseemsclear Correspondence:J. P. Mohr,Doris and Stanley TananbaumStroke thathemorrhagesetsinmotionaprocessthatraisestheriskofrecurrent Center, Neurological Institute Columbia Medical Center, 710 West hemorrhageinthenearfuture,andallworkers,includingthoseformu- 168thStreet,NewYork,NY10032,U.S.A. latingandplanningparticipationinARUBA[9,16]are committedto e-mail:[email protected] interventionforBAVMsoncehemorrhagehasoccurred.
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