ABSTRACT
Treatment of motor disorders by MRI-guided focused ultrasound is an alternative to neuro- and radiosurgery such as stereotactic radiofrequency ablation and thalamotomy with a gamma knife. However, safety, efficacy and feasibility of this technology for intracranial neoplasms are still unclear. The authors report successful hypothalamic hamartoma dissection by MRI-guided focused ultrasound in a 32-year-old woman with drug-resistant gelastic epilepsy and violent laughter and crying attacks. Magnetic resonance imaging revealed type II hypothalamic hamartoma. The last one was detached from surrounding brain tissue by MRI-guided focused ultrasound without side effects. Symptoms regressed immediately after surgery. No laughter and crying attacks were observed throughout 6-month follow-up.
Subject(s)
Drug Resistant Epilepsy , Hamartoma , Hypothalamic Diseases , Female , Humans , Adult , Hypothalamic Diseases/diagnostic imaging , Hypothalamic Diseases/surgery , Hamartoma/diagnostic imaging , Hamartoma/surgery , Magnetic Resonance Imaging , RussiaABSTRACT
OBJECTIVE: To show that effective and safe bilateral MR-guided focused ultrasound (MRgFUS) treatment of essential tremor (ET) is achievable. MATERIAL AND METHODS: Four male patients underwent bilateral thalamotomy. Two patients underwent staged thalamotomy, with the ≥12 month interval between operations. Two patients underwent simultaneous bilateral thalamotomy. RESULTS: After six months, all patients noted a significant reduction in symptoms on both sides: when assessing tremors with the Clinical Rating Scale for Tremor, the severity of hyperkinesis decreased by 57.5-69.7%. We did not observe any complications in any of the cases. CONCLUSION: Our experience indicates that simultaneous bilateral MRI-guided focused ultrasound treatment of ET can be performed safely and effectively. Further research is necessary to estimate the effectiveness and adverse effect rates.
Subject(s)
Essential Tremor , Humans , Male , Essential Tremor/diagnostic imaging , Essential Tremor/surgery , Treatment Outcome , Thalamus/diagnostic imaging , Thalamus/surgery , Tremor , Magnetic Resonance ImagingABSTRACT
A series of studies demonstrated comparability of the incidence rate of major adverse cardiac events (MACE) in the middle-term postoperative period following implantation of last-generation drug-coated stents and biodegradable intravascular scaffolds. It was noted observed that these complications may be associated with malposition and inadequate inappropriate preparation of the lesion. We carried out a total of 16 percutaneous coronary interventions (PCI) with implantation of absorbable vascular scaffolds (Absorb, Abbott Vascular) under the guidance of optical coherent tomography. Besides, a further 16 PCIs were performed without intravascular visualization (control group). As experience was gathered, the algorithm of carrying out optical coherent tomography was subjected to changes, resulting in proposal of an optimal algorithm for choice of intraoperative policy based on the findings obtained in optical coherent tomography.
Subject(s)
Absorbable Implants/adverse effects , Blood Vessel Prosthesis Implantation , Blood Vessel Prosthesis/adverse effects , Coronary Stenosis , Drug-Eluting Stents/adverse effects , Percutaneous Coronary Intervention/instrumentation , Radiography, Interventional/methods , Tomography, Optical Coherence/methods , Adult , Algorithms , Blood Vessel Prosthesis Implantation/adverse effects , Blood Vessel Prosthesis Implantation/instrumentation , Blood Vessel Prosthesis Implantation/methods , Comparative Effectiveness Research , Coronary Angiography/methods , Coronary Stenosis/diagnostic imaging , Coronary Stenosis/surgery , Decision Support Techniques , Equipment Failure Analysis , Female , Humans , Male , Percutaneous Coronary Intervention/methods , Perioperative Period/methods , Prosthesis Design , RussiaABSTRACT
OBJECTIVE: To study the results of stenting the left coronary artery trunk and to determine the possibility of using Empira dilatation balloon catheters for kissing dilatation. SUBJECT AND METHODS: The left coronary artery trunk was stented in 47 patients, which constituted 1.39% of the total number of the stented patients. Bifurcation stenting was performed in 48.9%. T and crush stenting procedures were used in 4 and 2 patients, respectively. Stenting of the left coronary artery trunk with transition to the orifice of the anterior interventricular artery or the circumflex artery was carried out in 12 and 5 patients, respectively. RESULTS: The angiographic success rate was 100%; there were no fatal outcomes. After endovascular treatment, 20 (42.5%) patients belonged to Functional Class (FC) 0-I angina; 24 (51.1%) and 3 (6.4%) were diagnosed with FC II and III, respectively. CONCLUSION: It was ascertained that it was expedient to use the Empira dilatation balloon catheters for kissing dilatation. The left coronary artery trunk can be successfully stented if the patent is carefully prepared for the intervention.