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Background and aim The importance of mechanical thrombectomy in acute stroke treatment has grown over recent years. Mechanical thrombectomy comprises many different techniques. Technical improvements in the catheter material have led to the development of large- bore distal access catheters which can enter tortuous intracranial vessels. This has promising applications for endovascular stroke treatment. This study evaluated the safety and success rate of ultra-distal access of the middle cerebral artery (MCA) M1 segment with the 5 Fr Navien 58 distal access catheter in the treatment of acute stroke in combination with stent retrievers. Methods We retrospectively analyzed 81 patients with an acute stroke of the anterior circulation in whom ultradistal access to the M1 segment was carried out using the Navien 58 catheter with an anchoring technique with a stent retriever for mechanical thrombectomy. Technical complications, success rates of catheter placement, success rates of thrombectomy using the modified Thrombolysis In Cerebral Infarction (mTICI) score, and the procedure times were evaluated. Results Ultra-distal access with the Navien 58 was successful in 75% (61/81) of cases. Recanalization success with a mTICI score of 2b and better was achieved in 83% overall (67/81), in 90% (55/61) of cases with successful ultra-distal access and in 60% (12/20) of cases without ultra-distal access. No severe adverse effects such as dissections or perforations occurred as a result of the ultra-distal catheter placement in the M1 segment. In 4% (3/81) of the cases a reversible MCA vasospasm occurred. Conclusions Ultra-distal placement of the Navien 58 distal access catheter into the M1 segment in acute anterior circulation stroke can be achieved consistently, is safe in practice, and results in good recanalization success rates. [ABSTRACT FROM AUTHOR]

Purpose: While today mechanical thrombectomy is an established treatment option for main branch occlusions in anterior circulation stroke, there is still an ongoing debate on the kind of anesthesia to be preferred. Introducing a simple method for head stabilization, we analyzed safety and duration of endovascular recanalization procedures under general anesthesia (GA) and conscious sedation (CS).Methods: We retrospectively identified 84 consecutive patients who underwent mechanical thrombectomy owing to acute anterior circulation stroke. Fifty-three were treated under GA and 31 under CS equipped with a standard cervical collar to reduce head movement. We evaluated recanalization results, in-house time to start recanalization, procedure times, technical and clinical complication rates, and conversion rates from CS to GA.Results: Recanalization of mTICI ≥2b was achieved in 80 % under CS and in 81 % under GA. Median in-house time to start recanalization for CS was 60 min (IQR 28; 44-72) and 77 min (IQR 23; 68-91) for GA (P = 0.001). Median procedure time under CS was 35 min (IQR 43; 69-25) and 41 min (IQR 43; 66-23) for GA (P = 0.9). No major complications such as ICH occurred in either group, and no conversions from CS to GA were necessary.Conclusion: Mechanical thrombectomy can be performed faster and safely under CS in combination with simple head immobilization using a standard cervical collar. [ABSTRACT FROM AUTHOR]

Introduction: Neurovascular compression (NVC) is the most common cause of trigeminal neuralgia (TN), leading to microstructural changes in the affected nerve detectable using diffusion tensor imaging (DTI). But TN may also emerge as a symptom of multiple sclerosis (MS). The aim of this study was to evaluate if patients with MS-related TN feature the same DTI characteristics as patients with TN caused by NVC. Methods: Twelve patients with MS-related TN, 12 age-matched patients with NVC-related TN, and 12 healthy controls were included. Using 3T-DTI, mean fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were calculated for each affected and contralateral trigeminal nerve in patients with MS and NVC-related TN as well as healthy controls. Furthermore, presence of NVC was evaluated for patients with TN. Results: There was no significant difference concerning FA or ADC when comparing the affected and the non-affected sides in patients with MS. FA was significantly lower and ADC higher in patients with MS on the TN affected as well as on the non-affected side compared to the non-affected side of patients with idiopathic TN or healthy controls. Likewise, FA was significantly lower on the affected side compared to the non-affected side in patients with idiopathic TN or healthy controls. NVC was evident in 41.7/0 % on the affected/contralateral side in MS patients and 100/8 % in the patients with NVC-related TN. Conclusion: In patients with MS-related TN, DTI reveals microstructural changes within the trigeminal nerve not only on the affected side but also on the clinically non-affected side. [ABSTRACT FROM AUTHOR]

Background and purpose Studies on the impact of infectious diseases affecting the nervous system are sparse. Methods All patients with neuroinfectious diseases ( NIDs) who were treated at our Department of Neurology from 2005 until 2009 were retrospectively analyzed. Results Patients with NIDs required treatment at the intensive care unit in 34.8%. The mortality rate of patients with NIDs was significantly higher than that of other inpatients with neurological diseases (5.1% vs. 3.0%, respectively, P = 0.018). Conclusion In summary, this study shows that patients with NIDs are severely ill and mortality is high. [ABSTRACT FROM AUTHOR]

Copyright of Der Chirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Diabetologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In January 2004, two EUROMET supplementary comparisons started, coordinated by Physikalisch-Technische Bundesanstalt (PTB): one for the radiation protection quantity 'personal dose equivalent' Hp(10) using X-radiation, and one for the quantity 'absorbed dose in tissue' Ht(0.07) using beta reference fields. The focus of both comparisons lies on calibrations using radiation qualities at which the dissemination of the quantities considered here is difficult. Within the scope of the two comparisons, an ionisation chamber shall be calibrated. Together with a transfer chamber optimised to measure Hp(10) and Ht(0.07), respectively, for each comparison a complete electronic measuring system is circulated. These transfer devices, as well as, a specially developed test procedure, which has to be carried out by each participant to check the instruments, are described. For both comparisons, the results of those participants who had finished their measurements and delivered the measuring protocol until February 2005 were evaluated. As the comparisons are still running these first results are shown in an anonymous form. A first assessment of the data will be given. [ABSTRACT FROM AUTHOR]