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Transsphenoidal surgery carries the risk of carotid artery injury even for very experienced neurosurgeons. The computer-assisted neurosurgical (CANS) navigational system was used to obtain more precise guidance, based on the axial and coronal images during the transsphenoidal approach for nine pituitary adenomas. The CANS navigator consists of a three-dimensional digitizer, a computer, and a graphic unit, which utilizes electromagnetic coupling technology to detect the spatial position of a suction tube attached to a magnetic sensor. Preoperatively, the magnetic resonance images are transferred and stored in the computer and the tip of the suction tube is shown on a real-time basis superimposed on the preoperative images. The CANS navigation system correctly displayed the surgical orientation and provided localization in all nine patients. No intraoperative complications were associated with the use of this system. However, outflow of cerebrospinal fluid during tumor removal may affect the accuracy, so the position of the probe when the tumor is removed must be accurately determined. The CANS navigator enables precise localization of the suction tube during the transsphenoidal approach and allows safer and less-invasive surgery., Neurologia medico-chirurgica, 41(11), pp.565-569; 2001

We report here the successful use of endovascular stenting combined with coil embolization for dissective restenosis of the internal carotid artery after balloon angioplasty. The patient was a 76-year-old man was with a history of frequent transient right hemiparesis. Angiogram showed severe stenosis in the cervical portion of both internal carotid arteries. The left lesion was treated initially by percutaneous transluminal angioplasty, which resulted in satisfactory dilatation. However, three months later, angiogram revealed restenosis and subintimal dissection at the original region. Stent implantation was performed to reconstruct the true arterial lumen, then packed the false lumen with Guglielmi detachable coils through the stent mesh. Despite anticoagulation therapy, right leg monoparesis developed two days after coiling but disappeared after a week. Nine months later, complete obliteration of the false lumen and patency of the internal carotid artery were confirmed on angiogram. This combined technique may be useful to better manage dissecting restenosis in the cervical portion of the left internal carotid artery after balloon angioplasty., Acta medica Nagasakiensia. 2001, 46(1-2), p.73-76