Controversies in Neurological Surgery Neurovascular Diseases

www.MedLibrary.info Controversies in Neurological Surgery: Neurovascular Diseases American Association of Neurosurgeons \u2022 Rolling Meadows, Illinois www.MedLibrary.info www.MedLibrary.info Controversies in Neurological Surgery: Neurovascular Diseases Michael T . Lawton, M.D . Associate Professor Chief of Cerebrovascular Surgery , T ong-Po Kan Endowed Chair Department of Neurological Surgery University of California, San Francisco School of Medicine San Francisco, California Daryl R. Gress, M.D . Associate Professor L ynchburg General Hospital L ynchburg, V irginia Randall T . Higashida, M.D . Clinical Professor Department of Radiology , Neurological Surgery , Neurology , and Anesthesiology University of California, San Francisco School of Medicine San Francisco, California Thieme New Y ork \u2022 Stuttgart American Association of Neurosurgeons Rolling Meadows, Illinois www.MedLibrary.info Thieme Medical Publishers, Inc. American Association of Neurosurgeons (AANS)* 333 Seventh Ave. 5550 Meadowbrook Drive New Y ork, NY 10001 Rolling Meadows, Illinois 60008-3852 Associate Editor: Birgitta Brandenburg Executive Editor: Timothy Hiscock Vice-President, Production and Electronic Publishing: Anne T . Vinnicombe Production Editor: Shannon Kerner Associate Marketing Manager: V erena Diem Sales Director: Ross Lumpkin Chief Financial Officer: Peter van W oerden President: Brian D. Scanlan Compositor: Alden Pre-Press Ser vices Printer: Maple-V ail Book Manufacturing Group Cover illustration: © 2006 Chris Gralapp, M.A., C.M.I. * The acronym AANS refers to both the American Association of Neurological Surgeons and the American Association of Neurosurgeons Librar y of Congress Cataloging-in-Publication Data Controversies in neurological surger y : neurovascular diseases/[edited by] Michael T . Lawton, Dar yl R. Gress, Randall T . Higashida. p. ; cm. Includes bibliographical references and index. ISBN 1-58890-400-8 (TMP ISBN : hardcover : alk. paper) \u2014 ISBN 3-13-141881-8 (GTV ISBN : hardcover : alk. paper) 1. Ner vous system\u2013Surger y . [DNLM: 1. Cerebrovascular Disorders\u2013surger y . 2. V ascular Surgical Procedures. WL 355 C764 2006] I. Lawton, Michael T . II. Gress, Dar yl R. III. Higashida, Randall T . RD593.C66 2006 617.4 \u2032 8\u2014dc22 2006002264 Copyright © 2006 by Thieme Medical Publishers, Inc., and the American Association of Neurosurgeons. This book, including all pa rts thereof, is legally protected by copyright. Any use, exploitation, or commercialization outside the narrow limits set by copyright legislat ion without the publisher\u2019s consent is illegal and liable to prosecution. This applies in particular to photostat reproduction, copying, mimeog raphing or dupli- cation of any kind, translating, preparation of microfilms, and electronic data processing and storage. Important note: Medical knowledge is ever-changing. As new research and clinical experience broaden our knowledge, changes in treatment and dr ug therapy may be required. The authors and editors of the material herein have consulted sources believed to be reliable in their efforts to provide information that is complete and in accord with the standards accepted at the time of publication. However , in view of the possibility of human error by the authors, editors, or publisher of the work herein or changes in medical knowledge, neither the authors, editors, nor publisher , nor any other party who has been involved in the preparation of this work, war rants that the infor mation contained herein is in ever y respect accurate or complete, and they are not responsible for any errors or omissions or for the results obtained from use of such inf or mation. Readers are encouraged to confirm the infor mation contained herein with other sources. For example, readers are advised to check the pr oduct infor- mation sheet included in the package of each dr ug they plan to administer to be certain that the infor mation contained in this publication is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recomm endation is of particular importance in connection with new or infrequently used dr ugs. Some of the product names, patents, and registered designs referred to in this book are in fact registered trademarks or propri etar y names even though specific reference to this fact is not always made in the text. Therefore, the appearance of a name without designation as proprietar y is not to be constr ued as a representation by the publisher that it is in the public domain. Printed in the United States of America 5 4 3 2 1 TMP ISBN 1-58890-344-3 TMP ISBN 978-1-58890-344-0 GTV ISBN 3 13 141881-8 GTV ISBN 978-3-13-141881-4 www.MedLibrary.info T o Suzanne, for your steady love and suppor t T o Alexandra, Simone, and Blake, for reminding me always about balance Michael T . Lawton, M.D. Dedication CME Credit Information The AANS is accredited by the Accreditation Council for Continuing Medical Education to sponsor continuing medical education for physicians. The American Association of Neurosurgeons designates this continuing medical education activity for a maximum of 15 credits in Categor y I of the Physician\u2019s Recognition Award of the American Medical Association. The Home Study Examination is online on the AANS W eb site at http://www .aans.org/education/books/ controversy .asp Participants have until Febr uar y 28, 2009 to complete and pass the examination. No CME will be available after this date. For more infor mation on CME credits, visit the AANS W eb site http://www .aans.org/education/cme.asp or contact the Member Ser vices Depar tment of the AANS at Phone: (888) 566-AANS (2267) or (847) 378-0500 E-mail: memberser vices@aans.org www.MedLibrary.info www.MedLibrary.info Contents Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . x Rober t F . Spetzler Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi Michael T . Lawton Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii Section I T rends in Neurovascular Medicine 1 T rends in Neurovascular Surger y . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Brian A. O\u2019Shaughnessy , Richard J. Parkinson, Ber nard R. Bendok, Christopher C. Getch, and H. Hunt Batjer 2 T rends in Endovascular Surger y . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Demetrius K. Lopes, Andrew J. Ringer , Stanley H. Kim, Lee R. Guter man, and L. Nelson Hopkins 3 Novel Appr oaches to Neurovascular Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Michael Louis DiLuna, Katie Pricola, and Murat Gunel 4 Implications of T rends in the Marketplace for Neurovascular Diseases . . . . . . . . . . . . . . . . . . 44 Charles B. W ilson 5 Neuroendovascular Diseases: Past, Pr esent, and Future . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 Daniel T uden and Joseph M. Fitzgerald Section II Clinical Controversies A Unr uptured Aneur ysms 6 Unruptured Aneur ysms: A Neurological Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 Nerissa U. Ko and Dar yl R. Gress 7 Unruptured Aneur ysms: A Surgical Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Chirag D. Gandhi, Aman B. Patel, and Joshua B. Bederson B Anterior Circulation Aneur ysms 8 Surgical T reatment of Anterior Circulation Aneur ysms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 G. Edward V ates, Ganesh Shankar , and Ar thur L. Day vii www.MedLibrary.info 9 Endovascular T reatment of Anterior Circulation Aneur ysms . . . . . . . . . . . . . . . . . . . . . . . . . . 92 Reza Jahan, Gar y Duckwiler , and Fer nando V inuela C Posterior Circulation Aneur ysms 10 Surgical T reatment of Posterior Circulation Aneur ysms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 Howard A. Riina and Rober t F . Spetzler 11 Endovascular T reatment of Posterior Circulation Aneur ysms . . . . . . . . . . . . . . . . . . . . . . . . . 105 Italo Linfante, Cole B. Graham III and Ajay K. W akhloo D Arteriovenous Malfor mations 12 Surgical T reatment of Cerebral Arteriovenous Malfor mations . . . . . . . . . . . . . . . . . . . . . . . . 115 Andrew Jea, Mustafa K. Ba s ¸kaya, and Rober to C. Heros 13 Endovascular T reatment of Arteriovenous Malfor mations . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130 Gar y M. Nesbit, Geor ge Luh, Raymond Tien, and Stanley L. Barnwell 14 Radiosurgical T reatment of Arteriovenous Malfor mations . . . . . . . . . . . . . . . . . . . . . . . . . . . 139 Douglas Kondziolka, L. Dade Lunsford, and John C. Flickinger E Arteriovenous Fistulas 15 Surgical T reatment of Intracranial Dural Arteriovenous Fistulas . . . . . . . . . . . . . . . . . . . . . . . 150 Y . Jonathan Zhang, C. Michael Cawley, Jacques E. Dion, and Daniel Louis Bar row 16 Endovascular T reatment of Dural Arteriovenous Fistulas . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157 Y asunari Niimi, Alejandro Berenstein, Avi Setton, and Mark J. Kupersmith F Extracranial Theroscler otic Disease 17 Surgical T reatment of Extracranial V ascular Occlusive Disease . . . . . . . . . . . . . . . . . . . . . . . . 174 Brian E. Snell, Rober t J. W ienecke, and Christopher M. Loftus 18 Endovascular Revascularization of Carotid Arter y Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . 182 Philip M. Meyers, Sean D. Lavine, and Randall T . Higashida G Intracranial Atheroscler otic Disease 19 Diagnosis and Medical and Endovascular T reatment of Intracranial Atheroscler otic Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196 Hunaldo Villalobos, Alan S. Boulos, and Lee R. Guter man H Caver nous Malfor mations 20 Microsurgical T reatment of Caver nous Malfor mations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205 Mustafa K. Ba s ¸kaya, Andrew Jea, and Jacques J. Morcos 21 Obser vation of Caver nous Malfor mations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223 Dar yl R. Gress and V ineeta Singh Section III The Practice of Neurovascular Medicine A Practice Str uctures 22 The Departmental Model for Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231 Christopher S. Ogilvy , Bob S. Car ter , Christopher M. Putman, and Colin T . McDonald 23 The Institutional Model for Practice: An Inter ventional Neurovascular Program Within an Academic Neurological Surger y Department . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235 T . C. Origitano, Harish N. Shownkeen, Mar y T . Fitzgerald, and Patricia Cassidy 24 The Neurovascular Center Model for Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241 Edwin J. Cunningham and Marc R. Mayberg viii Contents www.MedLibrary.info Contents ix B Regionalization of Neurovascular Care 25 Regionalization of Neurovascular Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245 E. Sander Connolly Jr , Mitchell F . Ber man, and Rober t A. Solomon C Data Collection 26 Resolving Controversy and Uncertainty with Evidence in Neurovascular Medicine . . . . . . . . 250 S. Claibor ne Johnston D Residency and Fellowship T raining Objectives 27 Developing the Neurovascular Surgical Specialists of the Futur e . . . . . . . . . . . . . . . . . . . . . . 257 Charles Y . Liu, Michael Y . W ang, Ar un P . Amar , and Steven L. Giannotta 28 Developing the Endovascular and Neurovascular Specialists of the Futur e . . . . . . . . . . . . . . . 265 Cameron G. McDougall Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271 www.MedLibrary.info

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