1.Flow Diverter Treatment for Non-Ruptured Carotid Aneurysms: Efficacy and Safety
Orlando LÓPEZ-CALLEJAS ; Andres F. ORTIZ-GIRALDO ; Daniela D. VERA ; Diego A. RAMIREZ-ROJAS ; Ana B. VILLAMIZAR-BARAHONA ; Carlos A. FERREIRA-PRADA ; Melquizidel GALVIS ; Oliverio VARGAS-PÉREZ ; Sergio SERRANO-GÓMEZ ; Adriana REYES-GONZALEZ ; Daniel MANTILLA
Neurointervention 2023;18(1):23-29
Purpose:
Internal carotid artery (ICA) aneurysm treatment with a flow diverter (FD) has shown an adequate efficacy and safety profile, presenting high complete occlusion or near occlusion rates with low complications during follow-up. The purpose of this study was to evaluate the efficacy and safety of FD treatment in non-ruptured internal carotid aneurysms.
Materials and Methods:
This is a retrospective, single-center, observational study evaluating patients diagnosed with unruptured ICA aneurysms treated with an FD between January 1, 2014, and January 1, 2020. We analyzed an anonymized database. The primary effectiveness endpoint was complete occlusion (O’Kelly–Marotta D, OKM-D) of the target aneurysm through 1-year follow-up. The safety endpoint was the evaluation of modified Rankin Scale (mRS) 90 days after treatment, considering a favorable outcome an mRS 0-2.
Results:
A total of 106 patients were treated with an FD, 91.5% were women; the mean follow- up was 427.2±144.8 days. Technical success was achieved in 105 cases (99.1%). All patients included had 1-year follow-up digital subtraction angiography control; 78 patients (73.6%) completed the primary efficacy endpoint by achieving total occlusion (OKM-D). Giant aneurysms had a higher risk of not achieving complete occlusion (risk ratio, 3.07; 95% confidence interval, 1.70 - 5.54]). The safety endpoint of mRS 0-2 at 90 days was accomplished in 103 patients (97.2%).
Conclusion
Treatment of unruptured ICA aneurysms with an FD showed high 1-year total occlusion results, with very low morbidity and mortality complications.
2.Risk of Cognitive Impairment in Patients With Parkinson’s Disease With Visual Hallucinations and Subjective Cognitive Complaints
Diego SANTOS-GARCÍA ; Teresa de Deus FONTICOBA ; Carlos Cores BARTOLOMÉ ; Maria J. Feal PAINCEIRAS ; Jose M. Paz GONZÁLEZ ; Cristina Martínez MIRÓ ; Silvia JESÚS ; Miquel AGUILAR ; Pau PASTOR ; Lluís PLANELLAS ; Marina COSGAYA ; Juan García CALDENTEY ; Nuria CABALLOL ; Ines LEGARDA ; Jorge Hernández VARA ; Iria CABO ; Lydia López MANZANARES ; Isabel González ARAMBURU ; Maria A. Ávila RIVERA ; Víctor Gómez MAYORDOMO ; Víctor NOGUEIRA ; Víctor PUENTE ; Julio Dotor GARCÍA-SOTO ; Carmen BORRUÉ ; Berta Solano VILA ; María Álvarez SAUCO ; Lydia VELA ; Sonia ESCALANTE ; Esther CUBO ; Francisco Carrillo PADILLA ; Juan C. Martínez CASTRILLO ; Pilar Sánchez ALONSO ; Maria G. Alonso LOSADA ; Nuria López ARIZTEGUI ; Itziar GASTÓN ; Jaime KULISEVSKY ; Marta Blázquez ESTRADA ; Manuel SEIJO ; Javier Rúiz MARTÍNEZ ; Caridad VALERO ; Mónica KURTIS ; Oriol de FÁBREGUES ; Jessica González ARDURA ; Ruben Alonso REDONDO ; Carlos ORDÁS ; Luis M. López DÍAZ L ; Darrian MCAFEE ; Pablo MARTINEZ-MARTIN ; Pablo MIR ;
Journal of Clinical Neurology 2023;19(4):344-357
Background:
and Purpose Visual hallucinations (VH) and subjective cognitive complaints (SCC) are associated with cognitive impairment (CI) in Parkinson’s disease. Our aims were to determine the association between VH and SCC and the risk of CI development in a cohort of patients with Parkinson’s disease and normal cognition (PD-NC).
Methods:
Patients with PD-NC (total score of >80 on the Parkinson’s Disease Cognitive Rating Scale [PD-CRS]) recruited from the Spanish COPPADIS cohort from January 2016 to November 2017 were followed up after 2 years. Subjects with a score of ≥1 on domain 5 and item 13 of the Non-Motor Symptoms Scale at baseline (V0) were considered as “with SCC” and “with VH,” respectively. CI at the 2-year follow-up (plus or minus 1 month) (V2) was defined as a PD-CRS total score of <81.
Results:
At V0 (n=376, 58.2% males, age 61.14±8.73 years [mean±SD]), the frequencies of VH and SCC were 13.6% and 62.2%, respectively. VH were more frequent in patients with SCC than in those without: 18.8% (44/234) vs 4.9% (7/142), p<0.0001. At V2, 15.2% (57/376) of the patients had developed CI. VH presenting at V0 was associated with a higher risk of CI at V2 (odds ratio [OR]=2.68, 95% confidence interval=1.05–6.83, p=0.039) after controlling for the effects of age, disease duration, education, medication, motor and nonmotor status, mood, and PD-CRS total score at V0. Although SCC were not associated with CI at V2, presenting both VH and SCC at V0 increased the probability of having CI at V2 (OR=3.71, 95% confidence interval=1.36–10.17, p=0.011).
Conclusions
VH were associated with the development of SCC and CI at the 2-year follow-up in patients with PD-NC.
3.Preclinical models of idiosyncratic drug-induced liver injury (iDILI): Moving towards prediction.
Antonio SEGOVIA-ZAFRA ; Daniel E DI ZEO-SÁNCHEZ ; Carlos LÓPEZ-GÓMEZ ; Zeus PÉREZ-VALDÉS ; Eduardo GARCÍA-FUENTES ; Raúl J ANDRADE ; M Isabel LUCENA ; Marina VILLANUEVA-PAZ
Acta Pharmaceutica Sinica B 2021;11(12):3685-3726
Idiosyncratic drug-induced liver injury (iDILI) encompasses the unexpected harms that prescription and non-prescription drugs, herbal and dietary supplements can cause to the liver. iDILI remains a major public health problem and a major cause of drug attrition. Given the lack of biomarkers for iDILI prediction, diagnosis and prognosis, searching new models to predict and study mechanisms of iDILI is necessary. One of the major limitations of iDILI preclinical assessment has been the lack of correlation between the markers of hepatotoxicity in animal toxicological studies and clinically significant iDILI. Thus, major advances in the understanding of iDILI susceptibility and pathogenesis have come from the study of well-phenotyped iDILI patients. However, there are many gaps for explaining all the complexity of iDILI susceptibility and mechanisms. Therefore, there is a need to optimize preclinical human