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01-06-2021 | Edema | Original Article

Surgeons’ experience of venous risk with CPA surgery

Authors: Adam Alaoui-Ismaili, M. E. Krogager, A. S. Jakola, L. Poulsgaard, W. Couldwell, T. Mathiesen

Published in: Neurosurgical Review | Issue 3/2021

Abstract

The study aims to systematize neurosurgeons’ practical knowledge of venous sacrifice as applied to the posterior fossa region and to analyze the collected data to present and preserve relevant experience and expert knowledge for current and future practicing neurosurgeons. The venous structures assessed were the superior petrosal vein (SPV), sigmoid sinus (SS), and the tentorial veins (TV). The survey is constructed to obtain surgeons’ idea of assessed risk when sacrificing specific venous structures during posterior fossa surgery. They were asked how they prep for surgery, number of operations conducted, and their basis of knowledge. Collected data were mainly qualitative and analyzed with a mixed-method approach. A mean absolute deviation was calculated measuring rate of disagreement for a given substructure. Consensus existed among the participating surgeons that sacrificing the SPV and the TV was considered safe. Although, the risk of death when occluding major structures like the main trunk of the SPV, one of the SS’ and or a total occlusion of all TV yielded high risk of death. The risk of infarction was often too apparent to discredit even with low risk of death among an experienced class of surgeons. Our findings provide an overview of surgical risk associated with venous sacrifice. This will minimize cases where indispensable practical knowledge on safe handling veins in the cerebellopontine angle is either to be lost or taught among few when the neurosurgeons retire. This will lower the disagreement regarding risks and increase the quality of surgical decision-making.

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Title: Surgeons’ experience of venous risk with CPA surgery
Authors: Adam Alaoui-Ismaili
M. E. Krogager
A. S. Jakola
L. Poulsgaard
W. Couldwell
T. Mathiesen
Publication date: 01-06-2021
Publisher: Springer Berlin Heidelberg
Keyword: Edema
Published in: Neurosurgical Review / Issue 3/2021
Print ISSN: 0344-5607
Electronic ISSN: 1437-2320
DOI: https://doi.org/10.1007/s10143-020-01365-5

At a glance: The STEP trials

Springer Medicine

Surgeons’ experience of venous risk with CPA surgery

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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