Clinical Study Endovascular Treatment of Intracranial Artery Dissection: Clinical and Angiographic Follow-Up

Background. Intracranial artery dissections are rare and many controversies exist about treatment options. The aim of this study was to evaluate the efficacy and safety of the endovascular approach in patients with an intracranial dissection presenting with different symptoms. Methods. We prospectively evaluated the clinical features and treatment outcomes of 30 patients who had angiographically confirmed nontraumatic intracranial dissections over 4 years. Patients were followed up for 17 months, and their final outcomes were assessed by the modified Rankin Score (mRS) and angiography. Results. Sixteen (53.3%) patients had a dissection of the anterior circulation, whereas 14 (46.7%) had a posterior circulation dissection. Overall, 83.3% of the patients suffered a subarachnoid hemorrhage (SAH). Grade IV Hunt and Hess score was seen in 32% of the SAH presenting cases. Parent artery occlusion (PAO) with coil embolization was used in 70% of the cases. The prevalence of overall procedural complications was 23.3%, and all were completely resolved at the end of follow-up. No evidence of in-stent occlusion/stenosis or rebleeding was observed in our cases during follow-up. Angiography results improved more frequently in the PAO with coil embolization group (100%) than in the stent-only-treated group (88.9%) ( = 0.310) and the unruptured dissection group (5/5, 100%) in comparison with the group that presented with SAH (95.8%) ( = 0.833). Conclusion. Favorable outcomes were achieved following an endovascular approach for symptomatic ruptured or unruptured dissecting aneurysms. However, the long-term efficacy and durability of these procedures remain to be determined in a larger series

Endovascular Treatment of Intracranial Artery Dissection: Clinical and Angiographic Follow-Up

Background. Intracranial artery dissections are rare and many controversies exist about treatment options. The aim of this study was to evaluate the efficacy and safety of the endovascular approach in patients with an intracranial dissection presenting with different symptoms. Methods. We prospectively evaluated the clinical features and treatment outcomes of 30 patients who had angiographically confirmed nontraumatic intracranial dissections over 4 years. Patients were followed up for 17 months, and their final outcomes were assessed by the modified Rankin Score (mRS) and angiography. Results. Sixteen (53.3%) patients had a dissection of the anterior circulation, whereas 14 (46.7%) had a posterior circulation dissection. Overall, 83.3% of the patients suffered a subarachnoid hemorrhage (SAH). Grade IV Hunt and Hess score was seen in 32% of the SAH presenting cases. Parent artery occlusion (PAO) with coil embolization was used in 70% of the cases. The prevalence of overall procedural complications was 23.3%, and all were completely resolved at the end of follow-up. No evidence of in-stent occlusion/stenosis or rebleeding was observed in our cases during follow-up. Angiography results improved more frequently in the PAO with coil embolization group (100%) than in the stent-only-treated group (88.9%) (P=0.310) and the unruptured dissection group (5/5, 100%) in comparison with the group that presented with SAH (95.8%) (P=0.833). Conclusion. Favorable outcomes were achieved following an endovascular approach for symptomatic ruptured or unruptured dissecting aneurysms. However, the long-term efficacy and durability of these procedures remain to be determined in a larger series

Effects of PM2.5 and NO2 on the 8-isoprostane and lung function indices of FVC and FEV1 in students of Ahvaz city, Iran

The aim of this study was to determine the correlation between PM2.5 and NO2 pollutants and oxidative stress marker (8-isoprostane) and lung function tests (FVC and FEV1) in healthy children who were living and studying in three different areas of Ahvaz city including A1: Naderi site with high traffic, A2: Alavi Alley site with average traffic, and A3: Ein 2 site with low traffic (a rural area on the suburb of Ahvaz). 30 students in the 12–13 year-old range were selected from each studied zone (1, 2 and 3 sites) during three months of year. Of each student, one sample was taken every two weeks to measure 8-isoprostane of exhaled breath condensate (EBC). Air pollution data were collected from three air quality monitoring stations. Also, the relationship between air pollution and 8-isoprostane as well as lung function tests were determined using generalized estimating equations (GEE). The mean concentration of PM2.5 and NO2 in A1, A2 and A3 areas were 116, 92 and 45 (μg/m3) also 77, 53 and 14 (ppb) respectively. Among all studied students, there was a significant correlation between the increase of mean concentration of PM2.5 and NO2 in 1–4 before sampling day, increased 8-isoprostane concentration and decreased FEV1, while there was no significant correlation between them and decreased FVC. In A1 site, an increase in IQR (13 μg/m3) PM2.5 and IQR (6.5 ppb) NO2 on 1–4 days before sampling was associated with 0.38 unit (95% CI: 0.11, 0.65) and 1.1 unit (95% CI: 0.85, 1.35) increase in 8-isoprostane concentration, also decreased 121 ml and 190 ml FEV1, respectively. Results showed that the short-term exposure to traffic-related air pollution can decrease the values of lung function indices and increase the oxidative stress. It may adversely affect children’s lungs. Keywords: Air pollution, Lung function, 8-Isoprostane, Traffic, Ahvaz, Ira

Assessment of incremental lifetime cancer risks of ambient air PM10-bound PAHs in oil-rich cities of Iran

This study investigates the concentrations of PM10-bound PAHs and their seasonal variations in three cities of Ahvaz, Abadan, and Asaluyeh in Iran. The mean concentrations of PM10 in two warm and cold seasons in Ahvaz were higher and in Abadan and Assaluyeh were lower than the national standard of Iran and the guidelines of the World Health Organization. The Σ16 PAHs concentration in ambient air PM10 during the cold season in Ahvaz, Abadan and Asaluyeh was 244.6, 633, and 909 ng m− 3, respectively, and during the warm season in Ahvaz, Abadan, and Asaluyeh was 242.1, 1570 and 251 ng m− 3, respectively. The high molecular weight PAHs were the most predominant components. The most abundant PAHs species were Pyr, Chr, B [ghi] P, and Flt. The results showed that the total PAHs concentration in the cold and warm seasons was dependent on industrial activities, particularly the neighboring petrochemical units of the city, vehicular exhausts, traffic and use of oil, gas, and coal in energy production. The total cancer risk values as a result of exposure to PAHs in ambient air PM10 in all three cities for children and adults and in both cold and warm seasons were between 1 × 10− 6 and 1 × 10− 4, and this indicates a potential carcinogenic risk. Therefore, considering the various sources of air pollutants and its role on people’s health, decision makers should adopt appropriate policies on air quality to reduce the ambient air PAHs and to mitigate human exposure