Evidence map›Paper›PMID 34982901›Full record

ArticleOperative neurosurgery (Hagerstown, Md.)2022

Encephaloduroarteriosynangiosis Operative Technique and Intraoperative Anesthesia Management: Treatment From Both Sides of the Curtain.

Julie L Chan, Miguel D Quintero-Consuegra, Robin M Babadjouni, Daniel Chang, Zachary R Barnard, Neil A Martin, Keren Ziv, Barbara M Van de Wiele, Nestor R Gonzalez

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Operative neurosurgery (Hagerstown, Md.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Observational
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Julie L ChanDepartment of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Miguel D Quintero-ConsuegraDepartment of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.ORCID 0000-0002-2190-1823
Robin M BabadjouniDepartment of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Daniel ChangDepartment of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Zachary R BarnardDepartment of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Neil A MartinDepartment of Neurosurgery, Pacific Neuroscience Institute, Los Angeles, California, USA.
Keren ZivDepartment of Anesthesiology and Perioperative Medicine, University of California Los Angeles, Los Angeles, California, USA.
Barbara M Van de WieleDepartment of Anesthesiology and Perioperative Medicine, University of California Los Angeles, Los Angeles, California, USA.
Nestor R GonzalezDepartment of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.ORCID 0000-0002-8277-6317

Funding

Surgical Indirect Revascularization For Symptomatic Intracranial Aterial StenosisK23NS079477 · NINDS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI GONZALEZ, NESTOR RAUL · 2013 to 2017
$842k
NINDS NIH HHS K23 NS079477
6 · The paper itself

Abstract

backgroundEncephaloduroarteriosynangiosis (EDAS) is a form of indirect revascularization for cerebral arterial steno-occlusive disorders. EDAS has gained growing interest as a technique applicable to pediatric and adult populations for several types of ischemic cerebral steno-occlusive conditions.

objectiveTo present a team-oriented, multidisciplinary update of the EDAS technique for application in challenging adult cases of cerebrovascular stenosis/occlusion, successfully implemented in more than 200 cases.

methodsWe describe and demonstrate step-by-step a multidisciplinary-modified EDAS technique, adapted to maintain uninterrupted intensive medical management of patients' stroke risk factors and anesthesia protocols to maintain strict hemodynamic control.

resultsA total of 216 EDAS surgeries were performed in 164 adult patients, including 65 surgeries for patients with intracranial atherosclerotic disease and 151 operations in 99 patients with moyamoya disease. Five patients with intracranial atherosclerotic disease had recurrent strokes (3%), and there was one perioperative death. The mean clinical follow-up was 32.9 mo with a standard deviation of 31.1. There was one deviation from the surgical protocol. There were deviations from the anesthesia protocol in 3 patients (0.01%), which were promptly corrected and did not have any clinical impact on the patients' condition.

conclusionThe EDAS protocol described here implements a team-oriented, multidisciplinary adaptation of the EDAS technique. This adaptation resides mainly in 3 points: (1) uninterrupted administration of intensive medical management, (2) strict hemodynamic control during anesthesia, and (3) meticulous standardized surgical technique.

Indexed as

AnesthesiaCerebral RevascularizationCerebrovascular DisordersIntracranial ArteriosclerosisMoyamoya DiseaseStrokeAdultChildHumansTreatment Outcome

Identifiers

PMID34982901
PMCPMC10602499

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.