Endovascular treatment of basilar tip aneurysms in the era of endosaccular flow disruption: a comparative study

PURPOSE This study aims to compare endosaccular flow disruptor (EFD) for treatment of basilar tip aneurysm (BTA) with coiling in terms of safety and efficacy. METHODS We retrospectively reviewed patients treated with an EFD for BTAs at our institution between 2013 and 2019 to standard coiling from the same period (control group). Patient demographics, aneurysm characteristics, procedural data, complications and clinical and angiographic outcome were compared between groups. RESULTS Twenty-three (56%) patients were treated with an EFD and eighteen (44%) patients were treated with coiling. Average aneurysm size was 8~mm in the EFD group and 6.9~mm in the coiling group, respectively (P = 0.2). Average fluoroscopy time, treatment DAP and air kerma were 33~min, 76 Gycm2 and 1.7~Gy in the EFD group and 81~min, 152 Gycm2 and 3.8~Gy in the coiling group, respectively (P < 0.001). In the EFD group, clinically relevant thromboembolic complications occurred in one patient (4%) vs. in 5 patients (28%) in the coiling group (P = 0.07). In each group, 4 patients had an unfavourable outcome at discharge (P = 0.7). Adequate occlusion rates were 96% in the EFD group and 100% and coiling group. Six (26%) patients were prescribed long-term antiplatelet therapy in the EFD group vs. eleven (61%) patients in the coiling group (P = 0.02). CONCLUSION Both treatment concepts provided similar technical success and safety. However, procedure time, radiation exposure and a need for long-term antiaggregation were lower with EFD

Acute basilar thrombosis: Recanalization following intravenous thrombolysis is dependent on thrombus length

Introduction We investigated whether thrombus length measured in Computed Tomography Angiography (CTA) is predictive of the success rate of intravenous thrombolysis (IVT) in acute basilar occlusion and whether recanalization can be achieved by additional mechanical endovascular thrombectomy. Methods In 51 patients with acute basilar thrombosis thrombus length was measured on CTA images before intravenous thrombolysis (IVT) with rt-PA was started. After 114 minutes on average success of IVT was evaluated either by CTA or DSA. Patients with persistent basilar occlusion and no major brainstem infarction on CT underwent endovascular recanalization. Results 87% of patients had no recanalization of basilar artery after IVT alone. The average thrombus length was 15 mm in patients with persistent basilar occlusion after IVT and 7 mm in patients with recanalization after IVT. Thrombi longer than 13 mm did not resolve after IVT alone and 80% of thrombi shorter than 13 mm did not resolve either. 41 patients were transferred to endovascular recanalization;endovascular therapy was performed successfully in 90% (37 / 41). Conclusions Recanalization rates in acute basilar occlusion after IVT alone are low and dependent on thrombus length. Additional mechanical endovascular thrombectomy showed to be a very successful recanalization therapy

Проект "Малая академия наук "Scientrium"" как пример организации исследовательской деятельности учащихся

Рассматривается исследовательская деятельность учащихся старших классов. Освещается реализация социально значимого проекта по вовлечению их в исследовательскую и околонаучную деятельность на базе Национального исследовательского Томского политехнического университета, Томской областной детской общественной организации «Хобби-центр» и Томского областного института повышения квалификации и переподготовки работников образования. Показан механизм формирования научных команд, позволяющий эффективно организовать исследовательскую работу учащихся старших классов под руководством сотрудников университета и студентов.The article discusses research activity of high schoolchild. Covers the implementation of socially significant project to engage them in research and allied activities in the framework of the National research Tomsk Polytechnic University, Tomsk regional children's public organization «Hobby-center» and the Tomsk regional Institute of advanced training and retraining of workers of education. The mechanism of formation of research teams to effectively organize the research work of senior students under the guidance of University staff and students

Radiomic Analysis Reveals Prognostic Information in T1-Weighted Baseline Magnetic Resonance Imaging in Patients With Glioblastoma

Objectives The aim of this study was to investigate whether radiomic analysis with random survival forests (RSFs) can predict overall survival from T1-weighted contrast-enhanced baseline magnetic resonance imaging (MRI) scans in a cohort of glioblastoma multiforme (GBM) patients with uniform treatment. Materials and Methods This retrospective study was approved by the institutional review board and informed consent was waived. The MRI scans from 66 patients with newly diagnosed GBM from a previous prospective study were analyzed. Tumors were segmented manually on contrast-enhanced 3-dimensional T1-weighted images. Using these segmentations, P = 208 quantitative image features characterizing tumor shape, signal intensity, and texture were calculated in an automated fashion. On this data set, an RSF was trained using 10-fold cross validation to establish a link between image features and overall survival, and the individual risk for each patient was predicted. The mean concordance index was assessed as a measure of prediction accuracy. Association of individual risk with overall survival was assessed using Kaplan-Meier analysis and a univariate proportional hazards model. Results Mean overall survival was 14 months (range, 0.8-85 months). Mean concordance index of the 10-fold cross-validated RSF was 0.67. Kaplan-Meier analysis clearly distinguished 2 patient groups with high and low predicted individual risk (P = 5.5 x 10(-5)). Low predicted individual mortality was found to be a favorable prognostic factor for overall survival in a univariate Cox proportional hazards model (hazards ratio, 1.038;95% confidence interval, 1.015-1.062;P = 0.0059). Conclusions This study demonstrates that baseline MRI in GBM patients contains prognostic information, which can be accessed by radiomic analysis using RSFs

Влияние диаметра центрального отверстия горизонтальных ребер емкости объемом 60 литров на ее среднюю производительность

В данной работе представлена математическая модель нестационарного процесса заполнения вертикальных погружных емкостей газообразным UF6. Приведены результаты расчетов средней производительности, степени и времени заполнения емкости объемом 6·10-2 м3 с горизонтальным оребрением при изменении диаметра центрального отверстия ребер. Показано, что емкость объемом 6·10-2 м3 имеет максимальную среднюю производительность и минимальное время заполнения при диаметре центрального отверстия горизонтальных ребер 6,4·10-2 м.The mathematical model of non-stationary filling of vertical submerged tanks with gaseous uranium hexafluoride is presented in the paper. There are calculations of the average productivity, heat exchange area, filling time of horizontal ribbing tank with volume 6·10-2 m3 with change central hole diameter of the ribs. We have demonstrated that maximum average productivity and a minimum filling time are reached for the tank with volume 6·10-2 m3 having central hole diameter of horizontal ribs 6,4·10-2 m