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Background: Optimal maternal nutrition is associated with better pregnancy and infant outcomes. Culinary nutrition programmes have potential to improve diet quality during pregnancy. Therefore, this research aimed to understand the experiences of cooking and the wants and needs of pregnant women regarding a cooking and food skills programme in the United Kingdom (UK) and Republic of Ireland (ROI). Methods: Online focus group discussions with pregnant women and those who had experienced a pregnancy in the UK or ROI were conducted between February and April 2022. Two researchers conducted a thematic analysis. Seven focus groups with ROI participants (n = 24) and six with UK participants (n = 28) were completed. Results: Five themes were generated. These were (1) cooking during pregnancy: barriers, motivators and solutions; (2) food safety, stress and guilt; (3) need for cooking and food skills programmes and desired content; (4) programme structure; (5) barriers and facilitators to programme participation. Overall, there was support for a programme focusing on broad food skills, including planning, food storage, using leftovers and to manage pregnancy‐specific physiological symptoms such as food aversions. Participants emphasised the importance of inclusivity for a diverse range of people and lifestyles for programme design and content. Conclusions: Current findings support the use of digital technologies for culinary nutrition interventions, potentially combined with in‐person sessions using a hybrid structure to enable the development of a support network. Highlights: Thirteen online focus group discussions were conducted across the UK and Ireland.Five themes were generated around cooking during pregnancy and the content and structure of a cooking and food skills programme.There was support for an inclusive cooking programme that included a wide range of food‐related skills.Participants believed the programme should be supported by the health services.There was support for the use of digital technologies, potentially combined with in‐person sessions using a hybrid structure. [ABSTRACT FROM AUTHOR]

Abstract Background The Square Stepping Exercise (SSE) is an exercise training program that integrates physical exercise and cognitive elements and can be conducted in a group setting. The potential of SSE in delaying cognitive decline in older adults is promising. However, the coronavirus pandemic has made it more difficult for older adults worldwide to exercise together in person. To address this issue, this study conducted a wholistic evaluation of the effects of a center-based hybrid SSE trial on cognitive, physical, psychological, and group functioning in sedentary older adults. Methods A total of 93 older adults (19 men, 74 women) participated in the study. Fifty-eight participants (9 men, 49 women) completed center-based hybrid SSE sessions over 12 weeks under coronavirus pandemic circumstances, whereas other 35 participants in the control group maintained their current level of daily activities. Cognitive functions focused on executive functions assessed by the Stroop Color-Word Test (inhibition) and the Trail Marking Test (TMT) (set-shifting). Psychological and group functioning were assessed by the Subjective Vitality Scale and the Physical Activity Group Environment Questionnaire. Physical function was evaluated by measuring gait speeds. A repeated ANOVA was conducted on the measured variables separately for the intervention and control groups to focus on the change of participant’s performance over data collection points. Results Outcomes of the Stroop Color-Word Test and the TMT revealed that the hybrid SSE was highly effective in improving executive function. Stroop performance (correct trials) was significantly improved in the incongruent condition, as well as both TMT-A and -B over the intervention period in the intervention group. The hybrid SSE was also beneficial to improve physical (gait speed at usual pace and at the maximum pace) as well as psychological functioning (subjective vitality). Furthermore, SSE participants reported increased engagement with the SSE task, social communication, and increased bonding and closeness with their group members through the hybrid SSE. Conclusions In this study, hybrid SSE was found to be effective in enhancing cognitive, physical, psychological, and group functioning in sedentary older adults. The findings of this study are crucial to provide older adults with a safer and efficient option to exercise.

Background: The Square Stepping Exercise (SSE) is an exercise training program that integrates physical exercise and cognitive elements and can be conducted in a group setting. The potential of SSE in delaying cognitive decline in older adults is promising. However, the coronavirus pandemic has made it more difficult for older adults worldwide to exercise together in person. To address this issue, this study conducted a wholistic evaluation of the effects of a center-based hybrid SSE trial on cognitive, physical, psychological, and group functioning in sedentary older adults. Methods: A total of 93 older adults (19 men, 74 women) participated in the study. Fifty-eight participants (9 men, 49 women) completed center-based hybrid SSE sessions over 12 weeks under coronavirus pandemic circumstances, whereas other 35 participants in the control group maintained their current level of daily activities. Cognitive functions focused on executive functions assessed by the Stroop Color-Word Test (inhibition) and the Trail Marking Test (TMT) (set-shifting). Psychological and group functioning were assessed by the Subjective Vitality Scale and the Physical Activity Group Environment Questionnaire. Physical function was evaluated by measuring gait speeds. A repeated ANOVA was conducted on the measured variables separately for the intervention and control groups to focus on the change of participant's performance over data collection points. Results: Outcomes of the Stroop Color-Word Test and the TMT revealed that the hybrid SSE was highly effective in improving executive function. Stroop performance (correct trials) was significantly improved in the incongruent condition, as well as both TMT-A and -B over the intervention period in the intervention group. The hybrid SSE was also beneficial to improve physical (gait speed at usual pace and at the maximum pace) as well as psychological functioning (subjective vitality). Furthermore, SSE participants reported increased engagement with the SSE task, social communication, and increased bonding and closeness with their group members through the hybrid SSE. Conclusions: In this study, hybrid SSE was found to be effective in enhancing cognitive, physical, psychological, and group functioning in sedentary older adults. The findings of this study are crucial to provide older adults with a safer and efficient option to exercise. [ABSTRACT FROM AUTHOR]

The article examines Russia’s foreign policy tools in Africa and analyses the Russian sphere of influence on the continental countries. In this context, it is discussed that Russia has exploited the foreign policy legacy left by the Union of Soviet Socialist Republics (USSR) in coordination with its intervention tools and has gradually increased its engagements in the continent. The abandonment of the Cold War strategy of leading the Communist parties and movements outside its borders paved the way for a period in which Russia prioritized state interests and redesigned its African policy accordingly. The article aims to analyse the hybrid intervention approach that brings together the soft and hard power elements of Russia increasing its interaction with the African countries to which it has given a different economic, political, and cultural importance due to the Ukraine war. In this direction, it is claimed that the hybrid model, which encompasses election interference, media and communication studies, trade relations, disinformation activities, and covert paramilitary formations, basically centres on Pan-Africanism, anti-Western approach, and economic expansionism. The study uses the literature review method. In terms of examining the effects of the economic, political, and security-based consequences of the Ukraine War on Russia’s tendencies and policies towards Africa, the study differs from the existing literature and provides a comprehensive framework for the perception of Russia in Africa.

Venous thrombosis is a frequent disorder. A distinction is made between an acute phase of the disease and a chronic manifestation, the postthrombotic syndrome. In particular, proximal venous thrombosis/pelvic vein thrombosis can cause a life-threatening pulmonary embolism during the acute phase of the disease. The postthrombotic syndrome is characterized by the remodeling of the affected venous section, which is often caused by inflammation. Locally, the typical clinical finding is caused by scarred stricture of the vein with restricted drainage and peripheral venous hypertension. Acute thrombosis should be primarily treated by therapeutic anticoagulation and compression therapy of the affected extremity. The duration of these measures depends on clinical presentation, cause (provoked, unprovoked) and risk factors for venous thrombosis/recurrent thrombosis. Venous revascularization procedures are important both in the acute phase of the disease and in the treatment of postthrombotic syndrome. The recanalization treatment is mostly carried out as an endovascular or hybrid intervention and venous bypass procedures are reserved for special situations. [ABSTRACT FROM AUTHOR]

The article examines Russia’s foreign policy tools in Africa and analyses the Russian sphere of influence on the continental countries. In this context, it is discussed that Russia has exploited the foreign policy legacy left by the Union of Soviet Socialist Republics (USSR) in coordination with its intervention tools and has gradually increased its engagements in the continent. The abandonment of the Cold War strategy of leading the Communist parties and movements outside its borders paved the way for a period in which Russia prioritized state interests and redesigned its African policy accordingly. The article aims to analyse the hybrid intervention approach that brings together the soft and hard power elements of Russia increasing its interaction with the African countries to which it has given a different economic, political, and cultural importance due to the Ukraine war. In this direction, it is claimed that the hybrid model, which encompasses election interference, media and communication studies, trade relations, disinformation activities, and covert paramilitary formations, basically centres on Pan-Africanism, anti-Western approach, and economic expansionism. The study uses the literature review method. In terms of examining the effects of the economic, political, and security-based consequences of the Ukraine War on Russia’s tendencies and policies towards Africa, the study differs from the existing literature and provides a comprehensive framework for the perception of Russia in Africa. [ABSTRACT FROM AUTHOR]

Papillary muscle rupture with severe acute mitral regurgitation is a rare complication of acute myocardial infarction (AMI) that causes pulmonary congestion and cardiogenic shock. Moreover, it has a poor prognosis. Surgical intervention, including revascularization, is indicated; however, surgical mortality remains high. We report the case of an 85-year-old woman with cardiogenic shock from severe acute mitral regurgitation, in whom a hybrid intervention, combining percutaneous coronary intervention with mitral valve replacement via minithoracotomy, was performed after post-infarction papillary muscle rupture. She was discharged in a favorable clinical condition. We describe a novel hybrid intervention for treating a rare complication of AMI, which could minimize surgical invasion in elderly patients, prevent disuse syndrome after the intervention, and improve prognosis. However, mitral valve surgery via minithoracotomy for emergency cases requires technical proficiency, as well as collaboration with other healthcare professionals, and the choice to perform this procedure requires careful consideration.

Extremist ideologies are proliferating nowadays in both political and social levels. Considering that youngsters are in a development stage where they are still conforming their own social identity, they become especially vulnerable to these ideologies’ influence. Therefore, it becomes critical to provide them with the psychological skills to rationalize and resist those influences. Video games, which are already a technology commonly consumed by these generations, provide a way to motivate and engage youngsters. Therefore, implementing these video games in interventions to increase psychological resilience represents an opportunity to create an innovative learning approach. Following this motivation, this paper has three main objectives: adapting a traditional emotional intelligence training program to a novel serious game based intervention, called YoungRes; providing a metric to measure the student’ evolution based on in-game behavioural patterns, instead of indirect measures; and evaluating the impact of the intervention itself after its implementation. To do so, an 11 sessions intervention was applied to 36 students from two primary schools in Spain. Quantitative and qualitative data was extracted from the experience, consisting on data extracted from the player’s behaviour and a final survey. A detailed statistical analysis carried out showed two main outcomes: first, the serious game based intervention was very appreciated by the students, specially by those who frequently play video games; second, the intervention allowed to improve several emotional intelligence competences, such as active listening and controlled breathing, as well as to promote knowledge about the Islamic culture. Finally, the authors discussed about how the game could be improved for future applications in schools.

This article describes an arts-based intervention program for seven care dyads of elderly persons and their caregivers who are foreign domestic workers (FDWs) in Singapore. The intervention aimed to introduce interdisciplinary tools of artmaking and mindfulness that could be used to improve the communication and relationship between the care dyad and to support the stress reduction and self-care of caregivers. Following a client-based approach, eight sessions were conducted, once weekly, over a 2-month period in hybrid structure, at the home of the care dyad and through the use of Google Meet. Qualitative data were collected in personal interviews, questionnaires, and visual data, and they were connected with art therapists fieldnotes and reflection journals. At the end of the program, an online feedback session was offered to the elderly participants family members, and their feedback was collected using a questionnaire. The data analysis confirms the impact of the artmaking intervention on the communication and relationship of the dyad. Participants reported that artmaking combined with mindfulness tools contributed to their understanding of their care-recipient (CR)/caregiver, improved their daily care activities, and helped caregivers explore new ways of self-care and stress relief. The hybrid model of implementation was effective and encouraged caregivers to explore and practice the tools learned independently between sessions. The results of this pilot program inform the development of intervention programs for care dyads as well as training programs for both caregivers, art therapists, and other care professionals. The intervention for care dyads highlights the importance of dyadic care as part of a holistic approach to caregiving. The inclusion of FDWs in the program suggests that both CRs and caregivers are one unit in which their well-being is interdependent. Further research may explore specific artmaking activities for other dyads of caregivers and CRs with differing care needs and backgrounds. Potential training activities and models could support the use of this intervention by therapists and other professionals.

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Purpose: The purpose of this study was to evaluate the long-term outcomes of patients with centrally located renal cell carcinomas (RCC) measuring 3 cm or larger, treated by a standardized transarterial embolization protocol associated with percutaneous ablation.Materials and Methods: This retrospective study included 11 patients (73% male, mean age 73.4 ± 6.5 years) with RCC and contraindications for surgery. All patients underwent a single session combining transarterial embolization with iodized oil and subsequent thermal percutaneous ablation. Primary and secondary local tumor control were analyzed, defined as absence of any contrast enhancing nodular lesion in the treated area after a single or percutaneous re-treatment session, respectively.Results: Mean tumor size was 3.5 ± 0.3 cm (range 3-4 cm) with a mean R.E.N.A.L. nephrometry score ((R)adius; (E)xophytic, endophytic properties; (N)earness to the collecting system; (A)nterior, posterior; (L)ocation relative to the polar line) of 8 ± 0.9 (range 7-9). Nearness to the collecting system was 4-7 mm in two patients (18%) and ≤ 4 mm in nine patients (82%). After a mean follow-up of 5.2 ± 2.5 years primary and secondary local tumor control rate were 82% and 100%, respectively. No change in serum creatinine levels and glomerular filtration rate was observed compared to pre-treatment values.Conclusion: A combined treatment of selective transarterial embolization and percutaneous ablation of large centrally located RCC (> 3 cm) is safe, feasible and can achieve excellent oncological long-term results. Larger prospective studies are needed. [ABSTRACT FROM AUTHOR]

Copyright of Creative Arts in Education & Therapy is the property of Inspirees International B.V. 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.)

Introduction: Severe ilio-femoral occlusive disease can limit the endovascular treatment of aorto-iliac aneurysms. In high surgical risk patients, inventive and staged hybrid interventions can be the answer to achieve definitive treatment. Clinical Case: A 68-year-old male, with multiple comorbidities, presented with simultaneous occurrence of bilateral common iliac aneurysms and severe ilio-femoral occlusive disease associated with right critical limb-threatening ischemia. In order to exclude the iliac aneurysms, preserve pelvic flow and revascularize the threatened limb we decided for a three-staged hybrid intervention. First, we began with a right external iliac angioplasty with femoral endarterectomy to create adequate arterial access. In a second intervention, we implanted a bifurcated aortoiliac endograft through this access. In order to prevent pelvic ischemia, contralateral leg outflow was directed to the left internal iliac artery with a combination of self-expandable and balloon-expandable covered stents. Finally, a right femoro-posterior tibial artery bypass completed the revascularization. At 1,5-year follow-up, no complications are reported and the patient is asymptomatic. Conclusion: In patients with poor medical condition and complex aorto-iliac aneurysmal and occlusive disease, a staged hybrid approach like the one described in this case-report can be feasible and associated with durable midterm patency and excellent clinical outcome.

Objective Interventions for multilevel critical limb ischemia include endovascular and surgical bypass revascularization. A hybrid approach combining both techniques is progressively used worldwide. The present randomized study proposed to compare the postoperative and clinical outcomes of surgical bypass and hybrid approach in patients with multilevel critical lower limb ischemia. Patients and methods This clinical randomized study was conducted in the period from September 2014 through April 2019. The study included 52 patients with multilevel critical limb ischemia. Patients were subjected to open surgical bypass (n=29) or hybrid intervention (n=23). Assessment included clinical examination, ankle-brachial pressure index measurement, arterial duplex (including ankle peak systolic velocity), and computed tomography angiography. Postoperatively, patients were followed at 1, 3, 6, 12 months, and then annually. The primary outcome in the present study was patency (primary, primary assisted, and secondary). Other outcome parameters included technical success (residual stenosis <30%), postoperative complications, ICU admission, hospital stay, major amputation, and mortality. Results Technical success was achieved in all the studied patients in both groups. Patients in surgical bypass group had higher rate of ICU admission and significantly longer hospital stay. In addition, they experienced significantly higher rate of postoperative wound infection and seroma formation. However, no significant differences were found between the studied groups regarding primary patency (62.1 vs. 60.9%, P=0.93), primary assisted patency (75.9 vs. 69.6%, P=0.61), secondary patency (86.2 vs. 87.0%, P=0.94), major amputation (13.8 vs. 13.0%, P=0.94), and mortality (10.3 vs. 4.3%, P=0.42). Conclusion Hybrid intervention provides patency and limb salvage rates equivalent to Open surgery. Moreover, the hybrid approach is associated with lower need of ICU admission and shorter hospital stay, which can reduce the clinical resource utilization. [ABSTRACT FROM AUTHOR]

Objectives. The aim of the study was to analyze the existing data and evidence, regarding chronically threatened limb ischemia and the role of hybrid vascular interventions. Materials and methods. Google Scholar and PubMed search engines were used to find data and evidence regarding chronically threatened limb ischemia and the role of hybrid vascular treatment. The following keywords were used for search: hybrid vascular interventions, multilevel atherosclerotic disease, critical limb ischemia. Results. There were identified 84 publications that showed actual data and evidence regarding chronically threatened limb ischemia and the role of hybrid vascular treatment. Conclusions. There is a limited body of data and evidence regarding chronically threatened limb ischemia and the role of hybrid vascular treatment, thus further new studies are needed to strengthen the already existing evidence. Some of the future research priorities are: refinement of risk factors in patients with chronically threatened limb ischemia, conduct comparative effectiveness studies directly comparing strategies, technics and specific technologies of revascularization in well-defined subgroups of patients.

Background. In early 2020, the novel coronavirus pandemic forced communities around the globe to shut down and isolate. Routine graduate medical education activities have also been suspended as resident and fellow physicians-in-training have been re-deployed to support critical patient care services. Innovation. We developed a two-part hybrid telesimulation model to teach COVID-19 ventilator management strategies while physically separating a group of learners and an instructor from one another. Learners consisted of non-ICU health care providers with limited experience in ventilator management being redeployed to manage ICU level COVID-19 infected patients. In the first week, the video tutorial has been viewed over 500 times and we have facilitated 14 telesimulation sessions, including 48 participants comprised of hospitalists, emergency medicine physicians and physician assistants, pediatric residents, nurses, and a nurse educator. Conclusion. We believe that the combination of a video tutorial followed by an interactive telesimulation was successful in providing timely education during a coronavirus pandemic. Furthermore, it reinforced the value and flexibility in which simulation education could continue conveniently for learners despite significant restrictions in place during the coronavirus pandemic. Research is needed to assess the efficacy of this hybrid intervention in preparing healthcare workers and to determine if the knowledge is successfully transferred to the clinical setting. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the long-term results of patients who underwent thoracic stent grafting. Material and Method: We retrospectively evaluated 25 patients with a mean age of 67.1 (20-82) with thoracic aortic pathology treated with a stent graft or the hybrid method (endovascular intervention after surgery) in our clinic. Results: 23 patients were treated electively and 2 of them were treated urgently. Type 1A endoleak was observed in 5 patients in control imaging. Additional intervention was performed in 3 of these patients. In one patient, the endoleak spontaneously regressed during follow-up. One patient died on the 6th postoperative day due to MI. A total of 7 patients underwent hybrid procedures. One of the debranching patients developed major complications during endovascular procedure. In the type B dissection patients, neurological complications were observed during post-procedure controls in 1 of the 7 patients who underwent hybrid intervention. Conclusion: Endovascular thoracic stent grafting is performed with high technical success and survival rates in thoracic aortic pathologies. Hybrid intervention is preferred in patients with non-suitable anatomy for TEVAR alone. [ABSTRACT FROM AUTHOR]

Axillary artery blowout is a rare life- and limb-threatening condition. The traditional surgical approach of ligation and extra-anatomic bypass is associated with a high morbidity and mortality. We present a case report of a 65-year-old male with axillary artery hemorrhage secondary to an irradiated squamous cell cancer. We propose a staged hybrid approach for the treatment of this unusual clinical entity consisting of emergent stent grafting followed by planned elective extra-anatomic bypass, debridement, and a course of specific antimicrobial therapy. [ABSTRACT FROM AUTHOR]

This study describes the results from a feasibility study of an innovative indicated prevention intervention with hybrid face-to-face and web-based components for preadolescent youth. This intervention includes a considerably briefer set of face-to-face sessions from the evidence-based Coping Power program and a carefully integrated internet component with practice and teaching activities and cartoon videos for children and for parents. The Coping Power – Internet Enhanced (CP-IE) program introduces a set of cognitive-behavioral skills in 12 small group sessions for children delivered during the school day and 7 group sessions for parents. Eight elementary schools were randomly assigned to CP-IE or to Control, and six children at each school were identified each year based on 4th grade teacher ratings of aggressive behavior. Path analyses of teacher-rated disruptive behavior outcomes for 91 fifth grade children, across two annual cohorts, indicated Control children had significantly greater increases in conduct problem behaviors across the 5th grade year than did CP-IE children. This much briefer version of Coping Power provided beneficial preventive effects on children's behavior in the school setting similar to the effects of the longer version of Coping Power. The website materials appeared to successfully engage children, and parents' use of the website predicted children's changes in conduct problems across the year. [ABSTRACT FROM AUTHOR]

Older adults represent the segment of the population that sits the most. This study evaluated the feasibility, acceptability, safety, and preliminary efficacy of an intervention to reduce sedentary behavior (SB) in older adults that can be disseminated broadly for limited cost and delivered by paraprofessionals with limited training. Senior centers in Central Pennsylvania were randomized to receive one of two healthy aging programs (i.e., intervention or comparison). Participants in both groups attended three 90-min meetings over 2 weeks. Behavior change content was delivered at the second session (i.e., day 7). Forty-two participants ( n = 25, n = 17) were recruited from five senior centers. Content for the intervention group focused on reducing SB while comparison group content focused on reducing social isolation. Self-reported SB was assessed on days 7 and 14. Repeated-measures ANOVA revealed a significant group × time interaction for total and weekday, but not weekend, SB. In the week following the delivery of group content, participants in the intervention group reported an average decrease in total SB of 837.8 min/week; however, the comparison group reported a nonsignificant average decrease of 263.0 min/week of total SB. Participants in the intervention group also reported an average decrease in weekday SB of 132.6 min/weekday ( d = −0.83) in the week following the delivery of group content; however, the comparison group reported a nonsignificant decrease of 24.0 min/weekday ( d = −0.16). There were no significant changes in weekend SB in either group in the week following the delivery of group content. Participants' attendance, measurement completion, and program ratings were high. Safety issues were minimal. This intervention was feasible to implement and evaluate, acceptable to older adults, and showed promise for reducing older adults' SB. [ABSTRACT FROM AUTHOR]

In the current era approximately 90% of infants born with tetralogy of Fallot (ToF) are expected to live beyond 40 years of age making it the fastest growing population amongst patients with congenital heart disease. One of the most common late consequences after repair of ToF, is pulmonary valve regurgitation (PVR). Significant PVR results in progressive dilatation and dysfunction of the right ventricle, decrease in exercise tolerance, arrhythmias, heart failure, and increased risk of sudden death. The conventional approach of dealing with this problem is to perform pulmonary valve replacement using cardiopulmonary bypass (CPB) and cardioplegic arrest. However, this approach is associated not only with long operative times but also side effects related to the use of CPB. Development of percutaneous approaches to valve disease is one of the most exciting areas of research and clinical innovation in cardiovascular research. The main development has been that of transcatheter pulmonary valve replacement for the rehabilitation of conduits between the right ventricle and pulmonary artery in patients after surgery for ToF. However, with the percutaneous technique, a limited size of prosthesis can be inserted. Moreover, the technique does not offer the opportunity of treating additional defects that are frequently associated with severe PR, such as pulmonary artery dilatation, and it cannot be used in the significantly dilated native right ventricular outlet tract (RVOT). The advent of the hybrid surgical options for treating cardiac disease has integrated the techniques of interventional cardiology with the techniques of cardiac surgery to provide a form of therapy that combines the respective strengths of both fields.In this review, we present and compare recent advances in procedures to replace the pulmonary valve in patients with ToF presenting with severe PVR and dilated RVOT.

Introduction: Aneurysms located at the middle cerebral artery bifurcation remain a clear neurosurgical indication. We detail here the steps necessary to enable safe surgery for Sylvian fissure aneurysms. Methods: An angiogram with 3D reconstruction is obtained and reviewed intraoperatively, just prior to the skin incision. During the exposure, the cistern is kept open by small cottonoids, thereby avoiding brain retraction. Continuous monitoring of MEPs along with ICG microscopic angio-fluorescence allows for detection of vascular compromise. Intraoperative angiography with 3D reconstruction allows for immediate correction of less than satisfactory surgical outcome. Conclusions: Careful planning of surgical strategy followed by a minimally invasive technique (with continuous neuro-monitoring) ensures safe surgery. The availability of intra-operative radiological guidance allows for optimal management. [ABSTRACT FROM AUTHOR]