Endovascular treatment of intracranial aneurysms using the Derivo Embolization Device: a multicenter experience.

BACKGROUND: Flow diversion is the first-line treatment for several types of intracranial aneurysms. We report on a large series of patients treated with the Derivo Embolization Device who underwent a 1-year angiographic control follow-up. METHODS: We performed a multicenter retrospective analysis of prospectively collected data, designed to evaluate the clinical and angiographic results of treatment of intracranial aneurysms with the Derivo Flow Diverter. The primary endpoint was complete occlusion of the aneurysm within 12 months, which was evaluated using DSA. The secondary endpoint was the absence of any serious adverse events. Univariate and multivariate logistic regression analyses were performed to analyze the data. RESULTS: The study was conducted from December 2016 to September 2019 and enrolled 127 patients with 177 intracranial aneurysms, treated at three different centers. Efficacy at 6 months was 70.1% (122/174) for total occlusion and 87.3% (152/174) for favorable occlusion and, at 12 months, it was 83.3% (145/174) for total occlusion and 97.7% (170/174) for favorable occlusion. Regarding safety concerns, 97.6% (124/127) of patients did not experience severe adverse effects during the follow-up period of 12 months, and there was no procedure-related mortality. CONCLUSIONS: The Derivo Embolization Device, achieving a total occlusion rate of 83.3% and a favorable occlusion rate of 97.7% in a 1-year angiographic control study of 174 aneurysms with minor morbidity and no intervention-related mortality, is a safe and effective treatment for intracranial aneurysms.

Percutaneous treatment of an intraorbital arteriovenous malformation using a transvenous approach: A case report.

Intraorbital arteriovenous malformations (AVMs) are extremely rare, and their actual prevalence is unknown. There is no consensus regarding the best treatment options, and the treatment is usually challenging, involving endovascular and other surgical procedures. Herein, we report the case of a patient diagnosed with an intraorbital AVM, presenting with thrombosis and hemorrhage, with rapidly progressive proptosis, chemosis, ophthalmoparesis, and vision loss. Treatment was performed with a transorbital puncture targeting a venous aneurysm of the superior ophthalmic vein, and closure of the AVM was possible with the use of coils and Onyx. We obtained anatomical occlusion of the lesion, and the patient showed progressive improvement of chemosis, vision acuity, and ophthalmoparesis. At six-month' follow-up, only mild proptosis was noted, and a control digital subtraction angiography confirmed complete closure of the AVM, with no residual lesion. To date, this is the first case of an intraorbital AVM treated with transorbital direct puncture.

[Hospitalizations for primary care-sensitive conditions in a Southern Brazilian municipality]. / Internações por condições sensíveis à atenção primária em município do sudeste do Brasil.

OBJECTIVE: To study the most frequent causes of hospitalizations for primary care-sensitive conditions (HPCSC) in the city of Juiz de Fora, MG, Brazil, by age group and gender, over the periods of 2002 to 2005 and of 2006 to 2009. METHODS: This was a descriptive study, with data collected from the Hospital Information System of the Unified Health System (Sistema de Informação Hospitalar do Sistema Único de Saúde - SIH-SUS) and from population projections by the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística - IBGE). HPCSC rates were calculated for 1,000 inhabitants, and the most frequent causes were studied by gender and age group, comparing both periods. RESULTS: HPCSP showed rates of 7.74/1,000 between 2002 and 2005 and 8.81/1,000 between 2006 and 2009. The main causes were heart failure, cerebrovascular diseases, angina pectoris, pulmonary diseases, and kidney and urinary tract infections, which together represented 4.9/1,000 in the first period and 5.6/1,000 in the second period. The evolution of the rates between both periods occurred differently by age group and gender. CONCLUSION: The study did not exhibit any remarkable differences in HPCSC rates between the periods. Regarding the most frequent causes, reduced hospitalization rates for gastroenteritis, asthma, high blood pressure, and cerebrovascular diseases were observed, as well as increased hospitalizations for heart failure, pulmonary diseases, epilepsies, and kidney and urinary tract infections; these hospitalizations occurred differently by gender and age group. The results showed that a deep reflection regarding the determinants of hospitalizations for avoidable causes is needed.

Internações por condições sensíveis à atenção primária em município do sudeste do Brasil / Hospitalizations for primary care-sensitive conditions in a Southern Brazilian municipality

OBJETIVO: Analisar as causas mais frequentes de internações por condições sensíveis à atenção primária (ICSAP) em Juiz de Fora, MG, Brasil, por faixa etária e sexo, nos períodos de 2002 a 2005 e 2006 a 2009. MÉTODOS: Trata-se de um estudo descritivo a partir dos dados provenientes do Sistema de Informação Hospitalar (SIH-SUS) e das projeções populacionais do Instituto Brasileiro de Geografia e Estatística (IBGE). As taxas de ICSAP foram calculadas para mil habitantes e as causas mais frequentes analisadas por sexo e faixa etária, comparando-se os dois períodos. RESULTADOS: As internações por condições sensíveis à atenção primária em Juiz de Fora apresentaram taxas de 7,74/mil hab. no período entre 2002 e 2005 e 8,81/mil hab. entre 2006 e 2009. As principais causas foram insuficiência cardíaca, doenças cerebrovasculares, angina pectoris, doenças pulmonares e infecções de rins e trato urinário que, em conjunto, representaram 4,9/mil hab. no primeiro período e 5,6/mil hab. no segundo período. A evolução das taxas entre os dois períodos ocorreu de forma distinta por faixa etária e sexo. CONCLUSÃO: O estudo não revelou diferença expressiva na taxa de ICSAP entre os dois períodos. Quanto às causas mais frequentes, foi verificada diminuição das taxas de internações por gastroenterites, asma, hipertensão e doenças cerebrovasculares e incremento das internações por insuficiência cardíaca, doenças pulmonares, epilepsias e infecções de rins e trato urinário que ocorreram de forma distinta por sexo e faixa etária. Os resultados evidenciam a necessidade de se aprofundar a reflexão sobre os determinantes das hospitalizações por causas evitáveis.

OBJECTIVE: To study the most frequent causes of hospitalizations for primary care-sensitive conditions (HPCSC) in the city of Juiz de Fora, MG, Brazil, by age group and gender, over the periods of 2002 to 2005 and of 2006 to 2009. METHODS: This was a descriptive study, with data collected from the Hospital Information System of the Unified Health System (Sistema de Informação Hospitalar do Sistema Único de Saúde - SIH-SUS) and from population projections by the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística - IBGE). HPCSC rates were calculated for 1,000 inhabitants, and the most frequent causes were studied by gender and age group, comparing both periods. RESULTS: HPCSP showed rates of 7.74/1,000 between 2002 and 2005 and 8.81/1,000 between 2006 and 2009. The main causes were heart failure, cerebrovascular diseases, angina pectoris, pulmonary diseases, and kidney and urinary tract infections, which together represented 4.9/1,000 in the first period and 5.6/1,000 in the second period. The evolution of the rates between both periods occurred differently by age group and gender. CONCLUSION: The study did not exhibit any remarkable differences in HPCSC rates between the periods. Regarding the most frequent causes, reduced hospitalization rates for gastroenteritis, asthma, high blood pressure, and cerebrovascular diseases were observed, as well as increased hospitalizations for heart failure, pulmonary diseases, epilepsies, and kidney and urinary tract infections; these hospitalizations occurred differently by gender and age group. The results showed that a deep reflection regarding the determinants of hospitalizations for avoidable causes is needed.