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At least 1,567 records · Page 87Linked to original sources
PubMed1989

Outcome following aneurysm wrapping: a 10-year follow-up review of clipped and wrapped aneurysms.

One hundred and eighty-one patients with single aneurysms involving the anterior circulation were treated either by wrapping (60 cases) or clipping (121 cases), and 96.1% of them were followed for 10 years. The rate of early rebleeding (less than 6 months) from wrapped aneurysms was 8.6% (confidence interval 1.4% to 15.8%) and the late rebleeding (6 months to 10 years) rate was 1.5% per annum (confidence interval 0.3% to 2.5%/yr). Wrapping an aneurysm offers some protection from rebleeding, particularly during the first 6 months when the risk of rebleeding is high.

Adolescent↗
PubMed1991

Transoral transclival clipping of anterior inferior cerebellar artery aneurysm using new rotating applier. Technical note.

A large, partly calcified aneurysm buried in the pons and arising from the junction of the basilar artery and the anterior inferior cerebellar artery was successfully occluded using a variangle aneurysm clip with a new rotating pistol-grip applier which allowed transoral access. The authors believe that the new applier, used in association with the current techniques for dural closure, allows for safe transoral surgery for basilar aneurysms.

Adult↗
PubMed2002

Neurological deterioration after coil embolization of a giant basilar apex aneurysm with resolution following parent artery clip ligation. Case report and review of the literature.

The authors present the case of a patient who suffered from progressive cranial nerve dysfunction, radiographically documented brainstem compression, and peduncular hallucinosis after undergoing endosaccular coil placement in a giant basilar apex aneurysm. Symptom resolution was achieved following clip ligation of the basilar artery. The pathogenesis of aneurysm mass effect due to coil placement is discussed and the pertinent literature is reviewed.

Basilar Artery↗
PubMed1985

Effect of chronic infusion of synthetic atrial natriuretic factor (ANF 8-33) in conscious two-kidney, one-clip hypertensive rats.

Conscious two-kidney, one-clip hypertensive rats were chronically infused during 7 days with synthetic ANF (8-33) (1 microgram/hr/rat) by means of osmotic minipumps. The initial blood pressure of 183 +/- 4 mmHg gradually decreased to 116 +/- 5 mmHg the last 2 days of infusion. Pressure diuresis returned to normal and pressure natriuresis was attenuated. PRA was significantly lower (1.81 +/- 0.41 AI ng/ml/hr) than in not treated hypertensive rats (8.56 +/- 3.75 AI ng/ml/hr). A partial regression in cardiac hypertrophy was observed in the treated group. We suggest that the hypotensive response to ANF may be mainly due to vasodilatation, but the possibility that the decrease in PRA may play a partial role in lowering blood pressure, cannot be excluded.

Animals↗
PubMed1986

Atrial natriuretic factor inhibits the sympathetic nervous activity in one-kidney, one-clip hypertension in the rat.

The one-kidney, one-clip model of rat hypertension was found to have an increased natriuresis following chronic infusion of atrial natriuretic factor (ANF). We have now found that this natriuretic effect of ANF is associated with a suppression of the initially elevated urinary excretion of norepinephrine and epinephrine and increase of the excretion of the main dopamine metabolite-dihydroxyphenylacetic acid as well as of the urinary dopamine to norepinephrine ratio. These data are compatible with the hypothesis that ANF suppresses the increased sympathetic activity in this model of hypertension and this action combined with opposite changes of dopamine may contribute to the natriuretic effect of ANF.

Animals↗
PubMed2005

Treatment of a duodenal perforation secondary to an endoscopic sphincterotomy with clips.

Perforation is one of the most serious complications of endoscopic sphincterotomy (ES) necessitating immediate surgical intervention. We present a case of successful management of such a complication with endoclipping. A 85-year-old woman developed duodenal perforation after ES. The perforation was identified early and its closure was achieved using three metallic clips in a single session. There was no procedure-related morbidity or complications and our patient was discharged from hospital 10 d later. Endoclipping of duodenal perforation induced by ES is a safe, effective and alternative to surgery treatment.

Aged, 80 and over↗
PubMed1994

Impairement of endothelium-dependent relaxation in chronic two-kidney, one clip hypertensive rats.

OBJECTIVES: Hypertension is commonly associated with an endothelial dysfunction that may contribute to the rise in blood pressure. Little information has been available so far on the role of endothelium-derived nitric oxide(EDNO) in renin-dependent, 2-kidney, 1 clip(2KIC) hypertension. The present study was aimed to determine a role for EDNO in the development and maintenance of 2KIC hypertension. METHODS: The effects of blocking synthesis or supplementation with precursor of EDNO on the development of hypertension were determined in 2KIC rats. Vascular responses to acetylcholine, nitroprusside, atrial natriuretic peptide and nifedipine were examined in 7- and 12-week hypertensive 2KIC rats. RESULTS: NG-nitro-L-arginine-methyl ester caused a sustained increase of blood pressure in normal rats, while it was only partially associated with a more pronounced increase of blood pressure in the developmental phase of hypertension in 2KIC rats. In 7-week and 12-week hypertensive rats, phenylephrine-induced contraction of the isolated thoracic aortic rings was more sensitive compared with control. Their acetylcholine-induced relaxation was attenuated while the responses to nitroprusside or atrial natriuretic peptide were unaltered. Although their blood pressure did not differ between 7-week and 12-week hypertensive groups, the attenuation in the acetylcholine-induced relaxation was more prominent in the latter with a longer duration of hypertension. Indomethacin did not affect the attenuated relaxation to acetylcholine. The relaxation response to nifedipine was more pronounced in 2KIC rats. CONCLUSION: These results indicate that ENDO has little influence of the 2KIC hypertension, at least during its developmental phase, which is associated with an activated reninangiotensin system. The chronic stage of 2KIC hypertension, however, is associated with an endothelial dysfunction which may contribute to the enhanced vasoconstriction and sustained high blood pressure.

Acetylcholine↗
PubMedDate not supplied

Local cortical blood flow and oxygen consumption during isoflurane-induced hypotension. Results in patients undergoing intracranial aneurysm clipping.

Cerebral cortical blood flow (lCoBF) and metabolic rate for oxygen (lCoMRO2) were studied in eight patients undergoing intracranial aneurysm clipping. The patients were anesthetized with fentanyl 10 micrograms/kg and 70% nitrous oxide combined with 30% oxygen. Hypotension was induced with isoflurane. A thermal diffusion probe was used to measure lCoBF, and arterial and cerebral venous blood samples were obtained for measurement of arterio-cerebral venous O2 content difference. Measurements were made prior to hypotension, during hypotension (to mean arterial pressure approximately 50 mmHg), and posthypotension. Mean lCoBF decreased from 69 +/- 20 mL/100 g/min at normotension to 59 +/- 13 mL/100 g/min during hypotension (P less than .03, NS) and was 61 +/- 18 mL/100 g/min upon return to normotension (all values mean +/- 1 SD). The lCoMRO2 averaged 3.9 +/- 1.6 mL/100 g/min and 3.1 +/- 1.5 mL/100 g/min, respectively (P less than .03, NS) for normotension upsilon hypotension. Values for cerebral venous PO2 and O2 saturation also did not differ significantly between study periods. These results indicate that isoflurane-induced hypotension during fentanyl-nitrous oxide anesthesia allows maintenance of a constant lCoBF and oxygen delivery.

Adult↗
PubMedDate not supplied

Postoperative assessment of surgical clip position in 16 dogs with cancer: a pilot study.

Metallic hemoclips or surgical staples were inserted in 16 tumor-bearing dogs at the time of surgical resection of the tumor. Orthogonal radiographs were taken immediately postoperatively and after wound healing to visualize the location and number of hemoclips or metallic staples. A shift in hemoclip/staple position was identified in nine dogs, mainly from positioning during radiography. In three dogs, an absolute shift in marker position was identified. Based on this study, it appears that the placement of surgical clips is potentially useful in identifying the tumor bed, which may be of benefit in establishing radiation treatment fields.

Animals↗
PubMed2002

Prognosis of hypercholesterolemic patients taking pravastatin for five years: the Chiba Lipid Intervention Program (CLIP) Study.

The Chiba Lipid Intervention Program (CLIP) Study was designed to clarify the prognosis of Japanese hypercholesterolemic patients taking pravastatin for 5 years. Hypercholesterolemic patients (n = 2,529) with a total cholesterol level > or = 220 mg/dl and without histories of ischemic coronary heart disease and/or cerebral infarction were administered pravastatin (10-20 mg/day). Among them, 2,131 took pravastatin fully (Pravastatin-continued group), and 398 discontinued the treatment (Discontinued group). The baseline total cholesterol level was 264.3 +/- 34.7 mg/dl (mean +/- standard deviation). The mean reduction rates of total cholesterol and low-density lipoprotein (LDL) cholesterol were 18.0% and 27.2%, respectively. Mild and moderate adverse events occurred in 86 cases (3.6%). Serious adverse events were not observed. Death rates of the pravastatin-continued group and of the discontinued group were 2.6 and 16.0/1,000 persons/year, respectively. Cardiac events (fatal and nonfatal myocardial infarction, cardiac death, angina pectoris) in all, occurred in 35 patients (incidence rate = 2.77/1,000 persons/year). In the pravastatin continued group, 9 causes of fatal and nonfatal myocardial infarction occurred (0.84/1,000 persons/year), whereas in the discontinued group, 4 cases occurred (2.06/1,000 persons/ year). The risk ratio for cardiac events was correlated with the number of risks. In the low-risk group (< or = 1 risk), decreased rates of LDL-cholesterol were less in the cardiac event group than the non-cardiac event group (LDL-cholesterol; 16% vs 25%, p = 0.04). These results suggested the following; 1) Pravastatin maintained a cholesterol lowering effect long-term without serious complications. 2) Pravastatin administration might reduce the mortality rate and myocardial infarction. 3) The combination of multiple risks is a strong factor for a cardiac event in addition to hypercholesterolemia.

Adult↗
PubMed1999

Antithrombotic activity of losartan in two kidney, one clip hypertensive rats. A study on the mechanism of action.

The potential antithrombotic action of losartan, an AT1 receptor antagonist, administered to two-kidney, one-clip rats (2K1C) in an experimental model of venous thrombosis was evaluated. The involvement of nitric oxide (NO) in this effect was also studied. Venous stasis was induced by ligation of the vena cava. Losartan after single dose (10 mg/kg, p.o.) significantly reduced the venous thrombus growth. The antithrombotic action of losartan in 2K1C rats was abolished by N(G)-nitro-L-arginine methyl ester (L-NAME, 30 mg/kg s.c.) and restored by L-arginine (1000 mg/kg s.c.). Platelet adhesion to fibrillar collagen significantly decreased after administration of losartan. No changes in primary hemostasis and platelet aggregation were observed. Moreover, coagulation parameters such as activated partial thromboplastin time, prothrombin time and euglobulin clot lysis time were found unchanged after losartan administration either in systemic circulation or at the place of thrombus formation. Our results indicate that antithrombotic activity of losartan in 2K1C rats is NO--dependent; observed inhibition of platelet adhesion could also play a role in this phenomenon.

Angiotensin Receptor Antagonists↗
PubMed1999

Reduction of aneurysm clip artifacts on CT angiograms: a technical note.

We describe a head tilt technique for use with CT angiography that reduces beam-hardening artifacts in patients with aneurysm clips. This simple maneuver directs the artifacts away from pertinent anatomy, thus increasing the chances for diagnostic accuracy. No significant changes in the CT angiographic protocol are required, and the maneuver can easily be combined with other artifact-minimizing strategies.

Artifacts↗
PubMed1999

Variceal ligation with bands and clips.

While endoscopic sclerotherapy is effective for management of variceal bleeding, significant local and systemic side effects promoted the development of alternative endoscopic therapies. Endoscopic band ligation has emerged as a technique with equal or greater efficacy and fewer local and systemic complications. New multibanded ligation systems have enhanced the speed and efficiency of endoscopic variceal ligation therapy and eliminated the need for an esophageal overtube. Endoscopic hemostatic clipping is another means of achieving directed, mechanical endoscopic hemostasis that has a limited role in variceal bleeding.

Acute Disease↗
PubMed1999

[Contralateral cerebellar infarction after aneurysmal clipping with pterional craniotomy: report of two cases].

A 77-year-old woman underwent right fronto-temporal craniotomy for a right ruptured IC-PC aneurysm (case 1), and a 44-year-old woman underwent right fronto-temporal craniotomy for a right ruptured BA-SCA aneurysm (case 2). They were clipped completely without any troubles during surgery. But postoperative CT scan demonstrated contralateral cerebellar infarction. We recognized left-hand tremor as a neurological deficit caused by cerebellar infarction in case 1. Concerning the mechanism of contralateral cerebellar infarction after pterional craniotomy, we think that it could be; --1) changing of venous blood flow by overdrainage of cerebrospinal fluid, 2) destruction of the bridging vein because of cerebral transformation with rapid decompression, 3) ischemia caused by brain retraction and compression during operation, 4) hypertension or hypoxia during operation, 5) crossed cerebellar diaschosis, and so on. In our 2 cases, we believe that perioperative CSF overdrainage caused the contralateral cerebellar infarction or CCD. To avoid this kind of infarction, we should try to take more protective and careful procedures as well as closer perioperative management.

Adult↗
PubMed2000

[Clipping of an aneurysm of the posterior cerebral artery via the transcortical transchoroidal-fissure approach: a case report].

A 65-year-old woman suddenly developed severe headache with nausea. Computed tomographic scans revealed a diffuse subarachnoid hemorrhage with thick hematoma of the left ambient cistern. Cerebral angiogram did not show any aneurysm. On the 7th day after admission, 3D-CT angiogram showed an aneurysm of the left posterior cerebral artery. On the 14th day, axial and coronal magnetic resonance images showed the aneurysm, surrounding structures and the choroidal fissure. On the 26th day after admission, successful neck clipping was performed through the temporal horn via the inferior temporal gyrus. The postoperative course was uneventful except for transient aphasia. This approach may be preferable in such cases, because it protects the brain from the detrimental effects of strong temporal retraction and provides a wider working space. In our case, thin slice MRI and MRA showing the aneurysm in the ambient cistern and the choroidal fissure were useful for deciding the appropriate approach.

Aged↗