Balloon-Assisted Coil Embolization and Balloon Angioplasty for Post Subarachnoid Hemorrhage Vasospasm: Initial Experience with Scepter Mini Balloon

Ioannidis Ioannis,Adamou Antonis,Nasis Nikolaos,Vlychou Marianna,Poullos Nektarios 대한신경중재치료의학회 2022 Neurointervention Vol.17 No.2

The scope of this technical note is to report our experience with balloon remodeling for wideneck aneurysms and balloon angioplasty of post-subarachnoid hemorrhage vasospasm using the novel Scepter Mini balloon (SMB). Five cases were treated with balloon remodeling for aneurysmal subarachnoid hemorrhage, 2 of which were additionally treated with angioplasty due to post-bleeding vasospasm. All patients had their aneurysm located on parent vessels with a diameter smaller than 2 mm. Complete occlusion was noted in all aneurysms, and the patients had no short-term complications attributed to the catheterization. Additionally, we confirm the previously reported smooth navigation of the balloon through vessels with tortuous anatomy without catheter-induced vasospasm. Based on our experience, the SMB can be a safe and efficient device for applying the balloon remodeling technique for distally located wide-neck aneurysms and distal balloon angioplasty.

The Incidence of Adjacent Segment Degeneration after the Use of a Versatile Dynamic Hybrid Stabilization Device in Lumbar Stenosis: Results of a 5–8-Year Follow-up

Mauro Dobran,Davide Nasi,Domenico Paolo Esposito,Maurizio Gladi,Massimo Scerrati,Maurizio Iacoangeli 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.2

Study Design: Retrospective study with long-term follow-up. Purpose: To evaluate the long-term incidence of adjacent segment degeneration (ASD) and clinical outcomes in a consecutive series of patients who underwent spinal decompression associated with dynamic or hybrid stabilization with a Flex+TM stabilization system (SpineVision, Antony, France) for lumbar spinal stenosis. Overview of Literature: The incidence of ASD and clinical outcomes following dynamic or hybrid stabilization with the Flex+TM system used for lumbar spinal stenosis have not been well investigated. Methods: Twenty-one patients with lumbar stenosis and probable post-decompressive spinal instability underwent decompressive laminectomy followed by spinal stabilization using the Flex+TM stabilization system. The indication for a mono-level dynamic stabilization was a preoperative magnetic resonance imaging (MRI) demonstrating evidence of severe disc disease associated with severe spinal stenosis. The hybrid stabilization (rigid–dynamic) system was used for multilevel laminectomies with associated initial degenerative scoliosis, first-grade spondylolisthesis, or rostral pathology. Results: The improvement in Visual Analog Scale and Oswestry Disability Index scores at follow-up were statistically significant (p <0.0001 and p <0.0001, respectively). At the 5–8-year follow-up, clinical examination, MRI, and X-ray findings showed an ASD complication with pain and disability in one of 21 patients. The clinical outcomes were similar in patients treated with dynamic or hybrid fixation. Conclusions: Patients treated with laminectomy and Flex+TM stabilization presented a satisfactory clinical outcome after 5–8 years of follow-up, and ASD incidence in our series was 4.76% (one patient out of 21). We are aware that this is a small series, but our long-term follow-up may be sufficient to contribute to the expanding body of literature on the development of symptomatic ASD associated with dynamic or hybrid fixation.

The Effect of Low-Temperature Annealing on a CdZnTe Detector

Kim, K. H.,Hwang, Seokjin,Fochuk, Petro,Nasi, L.,Zappettini, Andrea,Bolotnikov, A. E.,James, R. B. Professional Technical Group on Nuclear Science 2016 IEEE transactions on nuclear science Vol.63 No.4

<P>It is known that low temperature annealing at below 200 degrees C decreases the leakage current in a CdTe and CdZnTe (CZT) detector. However, only CZT detectors which have electrodes made by electroless method and low temperature annealing in the air showed diminished leakage current after annealing. With the aid of an in-situ annealing monitoring system, we measured the leakage current of a CZT detector while carrying out low-temperature annealing. A decrease in the leakage current resulted from the presence of thin insulating Te oxide layers, TeO2 and CdTeO3, instead of CZT/electrode interface enhancement by diffusion of Au. Other measurement results of Auger electron spectroscopy, micro TEM analysis, and pulse height spectrum were in good agreement with our new interpretation of the low temperature annealing effects of CZT.</P>

Posterior Titanium Screw Fixation without Debridement of Infected Tissue for the Treatment of Thoracolumbar Spontaneous Pyogenic Spondylodiscitis

Mauro Dobran,Maurizio Iacoangeli,Davide Nasi,Niccolo Nocchi,Alessandro Di Rienzo,Lucia di Somma,Roberto Colasanti,Carmela Vaira,Roberta Benigni,Valentina Liverotti,Massimo Scerrati 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.3

Study Design: Retrospective study. Purpose: The aim of our study was to analyze the safety and effectiveness of posterior pedicle screw fixation for treatment of pyogenic spondylodiscitis (PSD) without formal debridement of the infected tissue. Overview of Literature: Posterior titanium screw fixation without formal debridement of the infected tissue and anterior column reconstruction for the treatment of PSD is still controversial. Methods: From March 2008 to June 2013, 18 patients with PSD underwent posterior titanium fixation with or without decompression, according to their neurological deficit. Postero-lateral fusion with allograft transplantation alone or bone graft with both the allogenic bone and the autologous bone was also performed. The outcome was assessed using the visual analogue scale (VAS) for pain and the Frankel grading system for neurological status. Normalization both of C-reactive protein (CRP) and erythrocyte sedimentation rate was adopted as criterion for discontinuation of antibiotic therapy and infection healing. Segmental instability and fusion were also analyzed. Results: At the mean follow-up time of 30.16 months (range, 24–53 months), resolution of spinal infection was achieved in all patients. The mean CRP before surgery was 14.32±7.9 mg/dL, and at the final follow-up, the mean CRP decreased to 0.5±0.33 mg/ dL (p <0.005). Follow-up computed tomography scan at 12 months after surgery revealed solid fusion in all patients. The VAS before surgery was 9.16±1.29 and at the final follow-up, it improved to 1.38±2.03, which was statistically significant (p <0.05). Eleven patients out of eighteen (61.11%) with initial neurological impairment had an average improvement of 1.27 grades at the final follow-up documented with the Frankel grading system. Conclusions: Posterior screw fixation with titanium instrumentation was safe and effective in terms of stability and restoration of neurological impairment. Fixation also rapidly reduced back pain.

Letter: Does Obesity Affect the Severity of Exercise-Induced Muscle Injury? (J Obes Metab Syndr 2021;30:132-40)

Anna Vittoria Mattioli,Francesca Coppi,Milena Nasi,Marcello Pinti 대한비만학회 2021 The Korean journal of obesity Vol.30 No.3

Clinical Outcome of Patients Over 90 Years of Age Treated for Chronic Subdural Hematoma

Mauro Dobran,Alessandra Marini,Davide Nasi,Valentina Liverotti,Roberta Benigni,Martina Della Costanza,Fabrizio Mancini,Massimo Scerrati 대한신경외과학회 2022 Journal of Korean neurosurgical society Vol.65 No.1

Objective : Chronic subdural hematoma (CSDH) is one of the most common pathology in daily neurosurgical practice and incidence increases with age. The aim of this study was to evaluate the prognostic factors and surgical outcome of CSDH in patients aging over 90 years compared with a control group of patients aging under 90 years. Methods : This study reviewed 25 patients with CSDH aged over 90 years of age treated in our department. This group was compared with a younger group of 25 patients aged below their eighties. At admission past medical history was recorded concerning comorbidities (hypertension, dementia, ictus cerebri, diabetes, and heart failure or attack). History of alcohol abuse, anticoagulant and antiplatelet therapy, head trauma and seizures were analyzed. Standard neurological examination and Markwalder score at admission, 48 hours after surgery and 1–6 months follow-up, radiologic data including location and CSDH maximum thickness were also evaluated. Results : Their mean age was 92.8 years and the median was 92.4 years (range, 90–100 years). In older group, the Markwalder evaluation at one month documented the complete recovery of 24 patients out of 25 without statistical difference with the younger group. This data was confirmed at 6-month follow-up. One patient died from cardiovascular failure 20 days after surgery. The presence of comorbidities, risk factors (antiplatelet therapy, anticoagulant therapy, history of alcohol abuse, and head trauma), preoperative symptoms, mono or bilateral CSDH, maximum thickness of hematoma, surgical time and recurrence were similar and statistically not significant in both groups. Conclusion : In this study, we demonstrate that surgery for very old patients above 90 years of age affected by CSDH is safe and allows complete recovery. Comparing two groups of patients above and under 90 years old we found that complication rate and recovery were similar in both groups.