Technical challenges to surgical clipping of aneurysmal regrowth with coil herniation following endovascular treatment – a case report

In recent years, technical developments have made endovascular procedures attractive therapeutic options and enabled the endovascular surgeon to redefine the management of cerebral aneurysms. However, as the number of aneurysms undergoing endovascular therapy has grown, so has the number of patients with incompletely treated aneurysms who are presenting for further management. In cases of failure of endovascular treatment caused by either incomplete occlusion or regrowth of the aneurysm, a complementary treatment is often necessary. Surgical treatment of these patients is challenging. We present a case of a ruptured posterior cerebral artery aneurysm treated initially with endovascular coiling that left behind significant residual aneurysmal sac. Regrowth of the aneurysm documented on follow-up was treated surgically. At surgery, the coil was found to have herniated through the aneurysmal sac into the subarachnoid space, and the aneurysm was successfully clipped without removing the coils. We review the regrowth of aneurysms following endovascular therapy and potential problems and challenges of surgically managing these lesions

Enhancement of Rydberg-mediated single-photon nonlinearities by electrically tuned Förster resonances

We demonstrate experimentally that Stark-tuned Förster resonances can be used to substantially increase the interaction between individual photons mediated by Rydberg interaction inside an optical medium. This technique is employed to boost the gain of a Rydberg-mediated single-photon transistor and to enhance the non-destructive detection of single Rydberg atoms. Furthermore, our all-optical detection scheme enables high-resolution spectroscopy of two-state Förster resonances, revealing the fine structure splitting of high-n Rydberg states and the non-degeneracy of Rydberg Zeeman substates in finite fields. We show that the ∣50S1/2,48S1/2⟩↔∣49P1/2,48P1/2⟩ pair state resonance in 87Rb enables simultaneously a transistor gain G>100 and all-optical detection fidelity of single Rydberg atoms F>0.8. We demonstrate for the first time the coherent operation of the Rydberg transistor with G>2 by reading out the gate photon after scattering source photons. Comparison of the observed readout efficiency to a theoretical model for the projection of the stored spin wave yields excellent agreement and thus successfully identifies the main decoherence mechanism of the Rydberg transistor

Dissociation and the development of spatial correlation in a molecular ultracold plasma.

Penning ionization initiates the evolution of a dense molecular Rydberg gas to plasma. This process selects for pairs of excited molecules separated by a distance of two Rydberg orbital diameters or less. The deactivated Penning partners predissociate, depleting the leading edge of the distribution of nearest-neighbor distances. For certain density and orbital radii, this sequence of events can form a plasma in which large distances separate a disproportionate fraction of the ions. Experimental results and model calculations suggest that the reduced potential energy of this Penning lattice significantly affects the development of strong coupling in an ultracold plasma

Recanalization after endovascular treatment of intracerebral aneurysms

INTRODUCTION: The aim of this study was to evaluate the risks of endovascular therapy, aneurysm regrowth, recanalization and the need for reembolization. METHOD: A prospective analysis was performed on 211 aneurysms treated endovascularly from February 2000 to December 2003. Of these 211 aneurysms, 81 were asymptomatic and 130 were ruptured. The risks of endovascular therapy, aneurysm regrowth, recanalization and the need for reembolization were evaluated. RESULTS: The mean observation time was 10 months (ranging from 178 to 830 days). Complete occlusion (100%) in the initial intervention was achieved in 171 of 201 aneurysms (85%), 80-95% occlusion in 24 aneurysms (12%), and <80% occlusion in 6 aneurysms (3%). Recanalization had occurred at the first follow-up in 34 of all 153 aneurysms reassessed (22.2%). Of 133 aneurysms with initial 100% occlusion, 107 (80.4%) remained completely occluded, 17 (12.7%) showed recanalization, and 9 (6.7%) showed neck regrowth. Among those with 80-95% occlusion, 20 were reassessed, and of these 2 showed spontaneous occlusion, 10 (50%) still showed the initial neck, and 8 (40%) showed increased recanalization. One aneurysm which initially showed <80% occlusion remained unchanged, and another showed showed recanalization. Of the 153 aneurysms, 12 (7.8%) were recoiled, 2 initially <80% occluded, 7 initially 80-95% occluded and 3 initially totally occluded. CONCLUSION: In spite of low morbidity and mortality, one in four aneurysms will show recurrence. The initial degree of occlusion seems to have an influence on the likelihood of recanalization