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At least 487 records · Page 27Linked to original sources
PubMed2002

Endoscopic fenestration of posterior fossa arachnoid cyst for the treatment of presyrinx myelopathy--case report.

A 32-year-old man presented with an arachnoid cyst of the posterior fossa manifesting as cervical syringomyelic myelopathy. Magnetic resonance (MR) imaging demonstrated edematous enlargement and T2 prolongation of the cervical spinal cord, indicating a "presyrinx" state. MR imaging showed the inferior wall of the cyst, which disturbed cerebrospinal fluid (CSF) pulsatile movement between the intraspinal and intracranial subarachnoid spaces. The cyst wall was fenestrated with a neuroendoscope. The presyrinx state and the CSF movement improved. Posterior fossa arachnoid cyst, as well as Chiari malformation, can cause CSF flow disturbance at the craniocervical junction and syringomyelia. Endoscopic fenestration is less invasive than foramen magnum decompression and should be the procedure of choice.

Adult↗
PubMed2003

Microsurgically critical anomaly of the anterior communicating artery complex during the pterional approach to a ruptured aneurysm: double fenestration of the proximal A2 segments.

A 50-year-old man presented with a ruptured aneurysm of the anterior communicating artery (ACoA) complex anomaly with the neck of the aneurysm located in the upper ACoA. The right pterional approach was performed 2 days after admission. Retraction of the frontal lobe exposed the lower half of the ACoA complex consisting of the origins of the bilateral A2 segments, and the apparent neck of the aneurysm was clipped. However, further exposure of the bilateral A2 segments revealed double fenestration of the proximal A2 segments, a subtype of duplication of the ACoA accompanied by a bridging artery between the upper and lower ACoA. The limited visualization of this ACoA complex anomaly with an aneurysm had led to the proximal origin of the bridging artery being mistaken for the neck of the aneurysm. Such double fenestration of the proximal A2 segments is a microsurgically critical anomaly of the ACoA complex, because the bridging artery mimics the neck of an aneurysm when visualized by the pterional approach.

Aneurysm, Ruptured↗
PubMed2004

Neuroendoscopic basket dilation technique for the fenestration of the ventricular wall or intracranial cysts--technical note.

A basket dilation technique has been developed for fenestration of ventricular or cystic walls, using a basket type widely used in the urological field to collect renal or ureteric stones. This technique allows deep-seated structures to be visualized directly through the expanded basket during dilation and the thinnest part of ventricular wall to easily be pierced, cut, and dilated. Fine control can be exerted over expansion pressure through the hand piece directly connected to the basket tip. In addition, the basket can be rotated to cut the floating tissue that must be removed around the stoma. This basket dilation technique is safer than the balloon inflation technique currently used because it allows visualization of deep-seated structures that cannot be seen through the balloon, and should therefore prove useful in third ventriculostomy, plasty of the sylvian aqueduct, and fenestration of intracranial cystic lesions.

Brain Diseases↗
PubMed1992

The retinal pigment epithelium induces fenestration of endothelial cells in vivo.

Rodent photoreceptor dystrophies are characterized by late stage ingrowth of retinal blood vessels into the retinal pigment epithelium (RPE) where they proliferate. Some of these vessels develop the fenestrated phenotype of the choriocapillaris (CC). To determine if development of fenestrae in these endothelial cells is a function of the duration of time the endothelial cell had been encapsulated by the RPE, we did an ultrastructural morphometric study of these vessels in urethane induced photoreceptor degeneration in Long-Evans rats. Retinas of animals aged 20, 24, 40 and 56 weeks were studied. The fraction of vessel profiles within the RPE that had fenestrated endothelial cells increased from 10% to 90% between 20 to 56 weeks. The average number of fenestrae per vessel increased approximately 25 fold between 20 and 24 weeks but stabilized after that, despite a decrease in the number of vessels present at 56 weeks. A large number of degenerated retinal vessel profiles were seen in the RPE at 40 weeks. These facts support the idea that the presence of the RPE induces endothelial cell fenestrae, and also show that a complex process of remodelling including proliferation and degeneration is occurring in these vessels. Analogies between the basic cell biology of neovascularization occurring in these rodent models and that of proliferative diabetic retinopathy and age-related macular degeneration are discussed.

Animals↗
PubMed1975

Peroperative effect of fenestration upon intraosseous pressure in patients with osteoarthritis of the hip.

In nine patients with osteoarthritis of the hip who suffered from pain at rest, intraosseous pressure was measured in both the femoral head and neck before and immediately after fenestration in the lateral aspect of the greater trochanter. A small but significant drop in intraosseous pressure in both the femoral neck and head was registered as a result of the fenestration procedure.

Adult↗
PubMed1991

Endoscopic ventricular fenestration using a "saline torch".

The fiberoptic endoscope has never gained popularity among neurosurgeons although it is ideally suited for navigating within the cerebral ventricles. Recent advances in optics and miniaturization make the application of endoscopy in neurosurgery more practical. The authors report eight children who underwent ventriculoscopic fenestration of symptomatic loculated cerebrospinal fluid (CSF) collections. These CSF collections were either isolated ventricular cysts or trapped lateral ventricles secondary to obstruction at the foramen of Monro. Cyst wall dissection was carried out with a "saline torch" dissector which was introduced through a working channel in the ventriculoscope. The torch was used to coagulate vessels and to sculpt large windows in cyst walls or in the septum pellucidum. Ventriculoscope-guided cyst fenestration can be performed safely and easily under direct vision. The technique may permit simplification of shunt systems in some patients and elimination of shunts in others.

Brain Diseases↗
PubMed2003

Magnetic resonance imaging-guided percutaneous fenestration of a cervical intradural cyst. Case report.

The authors describe the case of a high cervical, intradural extramedullary cyst located anterior to the spinal cord in a 13-year-old boy. The lesion was fenestrated percutaneously by using real-time magnetic resonance (MR) imaging guidance and a local anesthetic agent. The patient's symptom, severe exercise-induced headache, immediately resolved after treatment. Nine months later, complete disappearance of the cyst was confirmed on MR imaging and computerized tomography myelography. Magnetic resonance imageing-guided fenestration can be considered a minimally invasive option for intradural cystic lesions.

Adolescent↗
PubMed1999

The role of endoscopic fenestration procedures for cerebral arachnoid cysts.

Recently, endoscopic procedures have been recommended as the first surgical option for cerebral arachnoid cyst (AC). The author reports seven ACs treated endoscopically and discuss the role of endoscopic fenestration. The age of the patients ranged from two to 62 years. Three ACs were located in the posterior cranial fossa, two in the suprasellar area, one in the middle cranial fossa, and one in the convexity. All cases were examined by cine magnetic resonance (MR) flow study. The patient's symptoms included headache, vomiting, dizziness, problems in balance, visual disturbance, and seizure. The author performed a cysto-cisternostomy or cysto-ventriculostomy via a single burr hole. The follow-up periods ranged from six to 18 months. There was no mortality or morbidity except one case of intracisternal bleeding during endoscopic procedure. Symptoms were relieved in all seven patients. Follow-up imaging studies revealed a decrease in the size or disappearance of the cysts. The results support that the minimal fenestration procedure as possibly as preserving the internal environment is valuable for the management of ACs.

Adolescent↗
PubMed1996

Protein-losing enteropathy after the Fontan operation: successful treatment by percutaneous fenestration of the atrial septum.

Protein-losing enteropathy (PLE) after the Fontan operation is a life-threatening complication that may be refractory to medical therapy. Herein we describe a percutaneous atrial fenestration that was performed in a 42-year-old man with a double-inlet left ventricle who had undergone a Fontan operation 9 years earlier. Severe PLE developed, and despite frequent infusions of protein, his albumin level was 1.8 g/dL. The diagnosis of PLE was confirmed by an alpha(1)-antitrypsin clearance of 425 mL in 24 hours (normal 27 or less). Percutaneous atrial fenestration resulted in dramatic clinical improvement and resolution of the PLE. At 5-month follow-up, the patient's albumin level was 4.2 g/dL, his alpha(1)-antitrypsin clearance was normal, and he was free of ascites and edema.

Adult↗
PubMed1999

[Concomitant mitral valvuloplasty and fenestrated total cavopulmonary connection: a case report].

A seven-year-old boy with tricuspid atresia successfully underwent a fenestrated total cavopulmonary connection and mitral valvuloplasty. Preoperative cardiac catheterization showed a mean pulmonary artery pressure of 16 mmHg. Pulmonary arteriography showed poor development of the branches (PA index: 180). Echocardiography revealed mild to moderate mitral valve incompetence due to prolapse of anterior leaflet. Mitral valve was exposed through the trans-septal approach. The excess chorda length was tucked into a longitudinal split in the top of the posterior papillary muscle. Then wedge resection of the redundant segment of the anterior leaflet and bilateral annuloplasty were performed. Finally, a total extracardiac cavopulmonary anastomosis with a 6 mm fenestration was completed. Postoperative clinical course was uneventful, and he is doing well with no recurrence of mitral incompetence 1 year after the operation.

Child↗
PubMed1998

Subtemporal suboccipital transpetrosal transsigmoidal approach to aneurysm of the basilar artery fenestration.

The aneurysm arising from the lower third of a basilar artery fenestration is a rare event. The traditional suboccipital or subtentorial transtentorial or transoral approach to this vascular malformation can be problematic. We report the case of a 52-year-old woman who suffered a Grade 4 subarachnoid hemorrhage from an aneurysm located at a fenestration of the proximal third of the basilar artery. This aneurysm was successfully clipped through a left subtemporal suboccipital translabyrinthine transsigmoidal approach. In the aneurysms of the proximal third of the basilar artery the transpetrosal approach with its variants (translabyrinthine and transsigmoidal) related to patient's clinical condition can be useful with undoubted advantages.

Basilar Artery↗
PubMed1976

Effect of corneal lens fenestration on edema and spectacle blur.

This paper is a clinical discussion of the effects of corneal lens fenestration on visible corneal edema and spectacle blur. Most of the discussion centers about photo slit lamp material selected to illustrate some of the author's experience with the subject. Although everyone does not benefit from fenestration, photographs show several cases in which visible corneal edema is reduced. Among patient impressions, the outstanding benefit is reduction of spectacle blur.

Contact Lenses↗
PubMedDate not supplied

[Fenestrated Fontan surgery in high risk patients].

A retrospective analysis is presented of all patients who had fenestrated Fontan procedure between january 1990 and may 1996. Surgery was indicated in the presence of anyone of the following risk factors: mean pulmonary pressure higher than 20 mmHg; pulmonary vascular resistance higher than 2 UW; ejection fraction less than 60%; systemic ventricular end diastolic pressure higher than 8 mmHg; Nakata index less than 200 mm2/m2, McGoon index less than 2. The diagnosis were: Absent right atrio-ventricular connection with concordance ventriculo-arterial connection 10 patients; pulmonary atresia with intact septum, 1 patient; Ebstein's malformation, 1 patient and absent left A-V connection with discordance VA connection, 1 patient. The mean of age was 6.7 years (range 2.5-11 years). Overall mortality was 23%. No significant difference in risk factors was found between survivals and no survivals. Nonsurvivors had between two an four risks factors. Postoperative complications were 1 patient with protein losing enteropathy and stroke (1 patient). The mean duration of pleural effusion was 16 days (range 4-45 days). We consider fenestrated Fontan procedure useful for patients with congenital heart disease with a one hypoplastic ventricle and one o more risks factors.

Child↗
PubMed1999

[Laparoscopic fenestration of the ovaries in sterility and the Stein-Leventhal syndrome--is it a modern fad or correct procedure].

The treatment of the sterility due to the Stein-Leventhal syndrome has been always object of many discussions. Sometimes, the approach towards this disease in the different departments is diametrically different. Some offer only conservative therapy other-only surgical interventions and some-combination between the two. The authors of this study present the results of operative laparoscopy in the treatment of sterility and polycystic ovary syndrome, in the department of gynaecology to the Higher Medical Institute, Pleven. Object of observation were 33 women in whom was performed laparoscopic fenestration of the ovaries and 20 women in whom was made resectio cuneiformis ovariorum. Comparative analysis of the results for one year period after the surgical interventions was made. The conclusion of the authors is that after failure of the conservative approach, the laparoscopic fenestration of the ovaries remains the only right therapeutic intervention.

Adult↗
PubMed2001

Aneurysms of the fenestrated basilar artery treated with Gulielmi Detachabe Coils: case report.

Multiple aneurysms at the site of a basilar artery fenestration (BAF) are extremely rare. We report a case of BAF in association with two aneurysms successfully treated with Guglielmi Detachable Coils (GDCs). A 42-year-old male presented with subarachnoid hemorrhage and consciousness change. Angiograms of the vertebrobasilar artery demonstrated fenestration of the proximal basilar artery associated with two aneurysms. Embolization of aneurysms was done by using GDCs. Aneurysms were almost completely obliterated with preservation of the flow and lumen of the vertebrobasilar system. The patient remains asymptomatic at clinical follow-up of 18 months.

Adult↗
PubMedDate not supplied

The effect of fenestration procedure on liver regeneration in a case of polycystic liver disease.

We encountered a case of polycystic liver disease for which unroofing and fenestration procedures were performed. The patient was a 55-year-old Japanese female with epigastralgia and abdominal fullness. On computed tomography, millions of low-density areas were seen, particularly in S6, 7, where huge cysts 15 cm in diameter were observed. Magnetic resonance imaging showed a T1 low T2 high-intensity lesion, which was compatible with simple cysts. Unroofing for the cysts in S6, 7 and fenestration of other cysts were performed. Histological examination revealed cuboidal and flat monolayer epithelia with no dysplasia in the wall of the cysts. The postoperative course was uneventful, and the patient's abdominal symptoms remarkably improved. The percentage of the liver volume which was increased in relation to standard liver volume was reduced from 241% (3386 mL: liver parenchyma 750 mL, cysts 2636 mL) to 180% (2525 mL, 1566 mL, 959 mL, respectively) after surgery. The potent mitogen, hepatocyte growth factor, was rapidly increased after the operation and stayed high during the observation period. In this patient, since no liver resection was performed, liver regenerative stimulus was considered to be the loss of space. This phenomenon represents a model of liver regeneration in response to loss of occupied space in an absence of shear stress.

Cysts↗
PubMedDate not supplied

Periodontal plastic surgical technique for gingival fenestration closure.

Gingival fenestration is an opening through oral keratinized tissue, usually unattached, that is observed in thin gingiva with usually thick subgingival calculus deposits. This lesion is seen infrequently but may be more common than has been reported; lack of symptoms may inhibit patient awareness. Because surgical correction usually is not required, there are very few reports in the literature concerning this lesion. The following report describes a case of gingival fenestration and surgical treatment with a connective tissue/periosteal graft.

Adult↗
PubMed2002

Significance of distal fenestration in graft replacement for chronic aortic dissection.

It is recently controversial whether distal fenestration is necessary in graft replacement for chronic aortic dissection. Several groups started to try the exclusion of intimal entry by the insertion of a stent-graft as a treatment for chronic aortic dissection, while conventional surgical techniques consisted of graft replacement with distal anastomosis to both the true and false channels. It should be kept in mind that the resultant occlusion of the false lumen after obliteration of the false channel could promote spinal cord ischemia. We report a patient with delayed paraplegia after graft replacement without distal fenestration for chronic type B aortic dissection. It is possible that not all cases of chronic aortic dissection are good for stent-grafting.

Aortic Dissection↗