Practical Neuroangiography, Second Edition is a complete, concise, current, practical, and richly illustrated guide to diagnostic and interventional. Medical therapy may need to be adjusted for angiography. Patients with preexisting .. 8– Morris P. Practical neuroangiography. 2nd ed. The first edition of Practical Neuroangiography was written with the intention of being the textbook that I wished had been available at the beginning of my own.
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Practical Neuroangiography, Third Edition
While acknowledging that most of the practical neuroangiography aspects of practical neuroangiography a neurointerventionalist manual skills and decision-making ability come with experience, this book aims to give first-year neurointerventional fellows basic background knowledge essential to understanding all aspects of neurointerventional procedures.
As the author, Dr.
Morris, says in his preface, the information contained in this book is what he wished had been available at the start of his own practical neuroangiography. Also, alternative routes of arterial practical neuroangiography brachial or axillary with attendant catheter decisions practical neuroangiography not covered nor is there a discussion on single- vs double-wall needle puncture.
The purpose of this document is to summarize and suggest the guidelines of CAS which can be generally accepted in Korea.
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This document describes the indication, contraindication, eligibility of operator, and standard reporting system for the use of CAS in Korea.
Pre-Procedural considerations Patient practical neuroangiography Patients can be selected according to multiple factors such as degree of stenosis, presence of symptoms, patient age, and presence of factors related with high risk of complications from CAS [ 13 ].
Various endarterectomy and stent trials have defined symptomatic patients as those with symptoms of acute ischemic stroke or practical neuroangiography ischemic stroke within 90 to days of trial entry [ 131415 ]. For purpose of consistency, it is recommended that symptomatic patients be defined as those with neurological or ocular symptoms within 6 months days [ 14 ].
Therefore, the indication for CAS in Korea needs to be broadened to the patients without surgically high risk. In practical neuroangiography cases of flow disturbance due to dissection, arterio-venous fistula, practical neuroangiography pseudoaneurysm, CAS is included in the insurance coverage by HIRA regardless of stenosis degree.
In the asymptomatic carotid stenosis, the evidence does not show either CEA or CAS having a clear benefit compared practical neuroangiography treatment by medication alone. The only large, well-constructed, randomized, controlled trial published to date comparing surgical endarterectomy with medical therapy practical neuroangiography asymptomatic carotid stenosis is the Asymptomatic Carotid Atherosclerosis Study ACAS [ 1320 ].
In practical neuroangiography document, we followed the HIRA guideline in asymptomatic stenosis [ 21 ]. It is probably due to proportional relation between old age and unfavorable arterial pathoanatomy for CAS.
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In endarterectomy trials, patients at high risk for complications from the treatment have been identified [ 14 ]. In SAPPHIRE trial, clinically significant cardiac disease, severe pulmonary disease, contralateral carotid occlusion, contralateral laryngeal nerve palsy, previous radiation therapy or radical surgery of neck, recurrent stenosis after endarterectomy, and older than 80 years are categorized as high risk group of CEA [ 7 ].
CAS also has high risk group such as the patients who have a severely tortuous carotid artery which makes it diff icult practical neuroangiography pass the device for CAS or who have acute thrombi in practical neuroangiography stenotic site that can migrate during the passage of the CAS devices.
Inclusion and exclusion criteria must be reported practical neuroangiography age, categorization of patients as symptomatic or asymptomatic, type of symptom, degree of stenosis, technique for measuring the degree of stenosis, and presence and type of high-risk comorbidities.
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In the conclusion of patient selection, we recommend the following inclusion criteria for CAS. Laboratory tests pertaining to blood homeostasis, renal function, and cardiac enzyme within 72 hours before the procedure are required to practical neuroangiography included, the same standard applied to endarterectomy trials [ 13 ].
A baseline brain Practical neuroangiography or MRI scan should be obtained to document any preexisting infarction or intracranial hemorrhage.
Treatment Description Previous operator experience is needed in the procedure report. Medical therapy may need practical neuroangiography be adjusted for angiography.
Patients with preexisting renal disease may be admitted 1 day early practical neuroangiography intravenous hydration or vasodilator therapy [ 13 ].