Stent-assisted aneurysm coil embolization: safety and efficacy at a low-volume center.

BACKGROUND AND PURPOSE: To compare safety and efficacy of cerebral aneurysm embolization with and without Neuroform stent placement at a low procedural volume center. METHODS: Retrospective cohort study of unruptured aneurysm coil embolization with and without Neuroform stent assistance over a period of 53 months at a center performing 14.4 interventions per year. Neuroform stent-assisted embolization was performed for 26 aneurysms in 25 patients (mean age: 61.3 years). Twelve patients (mean age: 64.3 years) with 12 unruptured aneurysms were treated without stent support. Comparative analysis of complications, angiographic findings, and clinical outcomes was performed. RESULTS: Procedural complications for the Neuroform stent group was 7.69% (2/26) versus 8.34% (1/12) for aneurysms without (P=0.7; OR: 1.1; CI: 0.09-13.35).The Modified Rankin Scale (MRS) and Glasgow Outcome Scale (GOS) scores for all patients in the stent and non-stent groups were 0 and 5, respectively. Three out of 20 aneurysms (15%) were retreated for major recurrence in the stent group and two of 10 (20%) in the non-stent group (P=0.55; OR: 1.42; 95% CI: 0.20-10.23). At a mean follow-up of 16.9 months, persistent complete occlusion was observed in 36.8% (7/19) of aneurysms with stent support. At a mean of 15.9-month follow-up in 10 non-stented aneurysms, persistent complete occlusion was observed in 50% of aneurysms (P=0.69; OR=2.3; 95% CI: 0.38-14.2). CONCLUSION: Neuroform stent-assisted coil embolization at a low volume center is efficacious and does not increase procedural risk with optimal operator experience.

Quality of life issues for South Africans with acne vulgaris.

The adverse effects of acne on the psyche have been established in patients from 'first world' countries. There has been no in depth study in predominantly black patients from Africa addressing this issue. This was a prospective cross-sectional study of acne patients attending a dermatology unit in KwaZulu-Natal, South Africa. A questionnaire was completed and acne graded by the Global Acne Grading scale. Psychological morbidity and quality of life (QOL) were assessed by the General Health Questionnaire and Dermatology Specific Quality of Life Questionnaires, respectively. We found that clinical severity was not associated with patient perception or psychological distress. The QOL measures such as feelings, social activities, performance at work or school, activities of daily living and overall mental health were found to be associated with distress with associated P-values of 0.0002, 0.0168, 0.0032, 0.033 and < 0.0001, respectively. The severity of acne was not associated with psychological distress. Painful and bleeding lesions were associated with distress levels; P = 0.042 and P = 0.019, respectively. In conclusion, South African patients with acne vulgaris suffer significant psychological distress, which affects the quality of their lives.