Technical success, procedural safety, and efficacy of the Silk Vista Baby in the treatment of cerebral aneurysms over a mid-to-long-term follow-up.

Background: Long-term follow-up of cerebral aneurysms treated with the Silk Vista Baby (SVB) flow diverter is lacking. This study aimed to assess the technical success, procedural safety, and efficacy of the SVB (Balt, Montmorency, France) for the treatment of intracranial aneurysms in small cerebral vessels over a mid-to long-term follow-up. Methods: We retrospectively analyzed a prospectively maintained database of patients treated with the SVB between September 2018 and June 2021. Data regarding patient demographics, aneurysm characteristics, and technical procedures were also collected. Angiographic and clinical findings were recorded during the procedure and over a period of at least 12 months. Results: Angiographic and clinical follow-up data were available for 50 patients/50 aneurysms. The procedural complication rate was 8%. At 12 months, the final results showed a technical success rate of 100%, the re rupture rate was 0%, neuromorbidity and mortality rates of 4 and 0%, respectively, and an almost complete occlusion rate of 94%. Conclusion: Treatment of complex intracranial aneurysms with the SVB was safe and effective. Long-term results showed high rates of adequate and stable occlusions.

CT angiography for diagnosis of carotid near-occlusion: a digital subtraction angiography validation study.

INTRODUCTION: Carotid near-occlusion (CNO) is a variant of severe stenosis where there is a distal luminal collapse of the internal carotid artery (ICA) beyond a tight stenosis. This study aimed to validate new visual extracranial diagnostic CT angiography (CTA) criteria, for the diagnosis of CNO. The new criteria include distal ICA diameter smaller than contralateral ICA and distal ICA diameter less than or equal to the ipsilateral external carotid artery (ECA). We also assessed the previously described CTA criteria: stenosis ≤ 1.3 mm, ipsilateral distal ICA ≤ 3.5 mm, ipsilateral distal ICA/contralateral distal ICA ratio ≤ 0.87, ipsilateral distal ICA/ipsilateral ECA ≤ 1.27. METHODS: Fifty-eight patients with ICA stenosis (including the near-occlusion variant) or occlusion on digital subtraction angiography (DSA) were included. These patients had DSA and CTA studies completed within 30 days of each other. DSA was considered the reference test. Two neuroradiologists blinded to the DSA results assessed the CTA images and evaluated the new and previously published CNO diagnostic criteria. RESULTS: Twenty-eight CNO were identified with DSA. The "distal ICA diameter less than or equal to the ipsilateral ECA" criterion had 79% sensitivity and 83% specificity with excellent interobserver agreement (kappa = 0.80), while three or more of the previously published criteria reached 82% sensitivity and 90% specificity, with a good interobserver agreement (kappa = 0.64). CONCLUSIONS: CT angiography may be useful for CNO diagnosis. The new visual diagnostic criteria provide acceptable results of sensitivity and specificity with an excellent interobserver agreement. However, false-negative and positive results persist.

[Behaviors in response to the tuberculin skin test conversion in medical students from a university in Lima, Peru]. / Conductas frente al viraje de la prueba de tuberculina en estudiantes de medicina de una universidad de Lima, Perú.

The aim of this study was to determine the behaviors in response to tuberculin skin test (PPD) conversion and the reasons for starting or not starting treatment for latent tuberculosis infection (TILT) among medical students at a university in Lima, Peru. A total of 548 participants completed a questionnaire; of them, 6.7% tested positive on university admission and 11.1% were recent converters. A total of 55.7% did not start TILT and had no explanation. Of the recent converters, most students who did start TILT were >22 years old (p = 0.01) and correctly answered general knowledge questions (p = 0.04). It is important to note that the PPD conversion rate was higher than that reported in the literature and that most students did not follow the treatment prophylaxis because of a lack of information.

Conductas frente al viraje de la prueba de tuberculina en estudiantes de medicina de una universidad de Lima, Perú / Behaviors in response to the tuberculin skin test conversion in medical students from a university in Lima, Peru

RESUMEN El objetivo del estudio fue determinar las conductas frente al viraje de la prueba de tuberculina (PPD) y las razones del inicio o no del tratamiento de la infección latente tuberculosa (TILT) en estudiantes de Medicina en una Universidad de Lima, Perú; 548 participantes llenaron un cuestionario; se obtuvo que 6,7% fueron positivos al ingreso a la universidad y 11,1% fueron conversores recientes; de este grupo 55,7 % no iniciaron TILT y la principal razón fue "no hubo explicación". De los conversores recientes, la mayoría de alumnos que sí iniciaron el TILT, eran mayores de 22 años (p=0,01) y respondieron correctamente las preguntas sobre conocimientos generales (p=0,04). Es resaltante que la tasa de conversión de PPD fue más alta a la reportada en la literatura y que la mayoría de estudiantes no siguió la profilaxis por falta de información.

ABSTRACT The aim of this study was to determine the behaviors in response to tuberculin skin test (PPD) conversion and the reasons for starting or not starting treatment for latent tuberculosis infection (TILT) among medical students at a university in Lima, Peru. A total of 548 participants completed a questionnaire; of them, 6.7% tested positive on university admission and 11.1% were recent converters. A total of 55.7% did not start TILT and had no explanation. Of the recent converters, most students who did start TILT were >22 years old (p = 0.01) and correctly answered general knowledge questions (p = 0.04). It is important to note that the PPD conversion rate was higher than that reported in the literature and that most students did not follow the treatment prophylaxis because of a lack of information.