Comparison of staged-stent and stent-assisted coiling technique for ruptured saccular wide-necked intracranial aneurysms: Safety and efficacy based on a propensity score-matched cohort study

BackgroundApplication of stent-assisted coiling and FD in acute phase of ruptured wide-necked aneurysms is relatively contraindicated due to the potential risk of ischemic and hemorrhagic complications. Scheduled stenting after initial coiling has emerged as an alternative paradigm for ruptured wide-necked aneurysms. The objective of this study is to evaluate the safety and efficacy of a strategy of staged stent-assisted coiling in acutely ruptured saccular wide-necked intracranial aneurysms compared with conventional early stent-assisted coiling strategy via propensity score matching in a high-volume center.MethodsA retrospective review of patients with acutely ruptured saccular wide-necked intracranial aneurysms who underwent staged stent-assisted coiling or conventional stent-assisted coiling from November 2014 to November 2019 was performed. Perioperative procedure-related complications and clinical and angiographic follow-up outcomes were compared.ResultsA total of 69 patients with staged stent-assisted coiling and 138 patients with conventional stent-assisted coiling were enrolled after 1:2 propensity score matching. The median interval time between previous coiling and later stenting was 4.0 weeks (range 3.5–7.5 weeks). No rebleeding occurred during the intervals. The rate of immediate complete occlusion was lower with initial coiling before scheduled stenting than with conventional stent-assisted coiling (21.7 vs. 60.9%), whereas comparable results were observed at follow-up (82.5 vs. 72.9%; p = 0.357). The clinical follow-up outcomes, overall procedure-related complications and procedure-related mortality between the two groups demonstrated no significant differences (P = 0.232, P = 0.089, P = 0.537, respectively). Multivariate analysis showed that modified Fisher grades (OR = 2.120, P = 0.041) were independent predictors for overall procedure-related complications and no significant predictors for hemorrhagic and ischemic complications.ConclusionsStaged stent-assisted coiling is a safe and effective treatment strategy for acutely ruptured saccular wide-necked intracranial aneurysms, with comparable complete occlusion rates, recurrence rates at follow-up and overall procedure-related complication rates compared with conventional stent-assisted coiling strategy. Staged stent-assisted coiling could be an alternative treatment option for selected ruptured intracranial aneurysms in the future

Review: Collins, Luke C. (2019). Corpus linguistics for online communication: A guide for research. Routledge

Corpus Linguistics for Online Communication: A Guide for Research, published by Routledge, is a practical handbook for corpus-based online communication research. This volume introduces corpus-based online communication research methods for a variety of research topics with empirical case studies. The volume blends theoretical progress with practical application, making it a useful resource for researchers and scholars in online communication and related fields

3D hodge decompositions of edge- and face-based vector fields

We present a compendium of Hodge decompositions of vector fields on tetrahedral meshes embedded in the 3D Euclidean space. After describing the foundations of the Hodge decomposition in the continuous setting, we describe how to implement a five-component orthogonal decomposition that generically splits, for a variety of boundary conditions, any given discrete vector field expressed as discrete differential forms into two potential fields, as well as three additional harmonic components that arise from the topology or boundary of the domain. The resulting decomposition is proper and mimetic, in the sense that the theoretical dualities on the kernel spaces of vector Laplacians valid in the continuous case (including correspondences to cohomology and homology groups) are exactly preserved in the discrete realm. Such a decomposition only involves simple linear algebra with symmetric matrices, and can thus serve as a basic computational tool for vector field analysis in graphics, electromagnetics, fluid dynamics and elasticity