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Although the Woven EndoBridge (WEB) device is increasingly used for the treatment of wide-neck intracranial aneurysms, including in the acute rupture setting, comparative evidence assessing the impact of rupture status remains limited. This study compared angiographic, safety, and clinical outcomes between ruptured and unruptured intracranial aneurysms treated with WEB. We conducted a retrospective analysis of prospectively collected data from the multicenter cohort registry WorldWideWEB, including consecutive adult patients with intracranial aneurysms treated with the WEB. Patients were stratified into groups of ruptured and unruptured aneurysms. Propensity score matching was used to balance baseline characteristics between both groups. Retreatment rate was the primary outcome. Secondary outcomes included mRS, safety events (thromboembolic complications) and angiographic outcomes (periprocedurally and last follow-up). Among 1,220 patients, 342 (28.0
Middle meningeal artery embolization (MMAE) has emerged as a treatment for chronic subdural hematoma (cSDH), but comprehensive real-world safety data remain limited. We performed a multicenter retrospective analysis of 1781 consecutive patients undergoing MMAE for cSDH (2019–2025). The primary outcome was any procedure-related complication within 30 days. Inverse probability of treatment weighting (IPTW) assessed the association between technical success and complications, adjusting for demographic, clinical, and procedural confounders. Mean age was 72.8 ± 12.4 years; 68.1
Background/Objectives: Primary non-refluxing megaureters (PM) are common congenital anomalies of the urinary tract. While spontaneous resolution is frequent, reliable non-invasive predictors of outcome are scarce. Ureteral peristalsis is frequently regarded as a sign of functional maturation and favorable prognosis, although supporting clinical evidence is limited. This study aimed to evaluate whether sonographically visible ureteral peristalsis at initial diagnosis predicts spontaneous resolution, pyelonephritis, or the need for surgery in infants with PM. Methods: In this retrospective single-center study, infants diagnosed with primary non-refluxing megaureters before one year of age between 2012 and 2018 were analyzed. Patients with refluxing, secondary, syndromic, or ectopic megaureters were excluded. Sonographic detection of distal ureteral peristalsis at initial examination was recorded. Clinical outcomes included spontaneous resolution, episodes of pyelonephritis (including breakthrough infections under antibiotic prophylaxis), and surgical intervention. Univariate and multivariate logistic regression analyses were performed. Results: Sixty-three infants were included, with a median follow-up of 34 months. Peristalsis was detected in 52.3% at initial ultrasound. Complete spontaneous resolution occurred in 66% of patients, while 20.9% required surgical reimplantation. The presence of peristalsis at diagnosis was not associated with spontaneous resolution, time to resolution, occurrence of pyelonephritis, breakthrough infections, or surgical intervention. Multivariate analysis confirmed that initial peristalsis was not an independent predictor of outcome. Conclusions: Sonographically visible ureteral peristalsis is a transient and inconsistent finding in infants with primary non-refluxing megaureters and does not predict clinical outcome. Peristalsis observed on initial ultrasound should not be used as a decision-making parameter in the management of PM during the first year of life.
BackgroundWe evaluated the safety of endoscopic procedures in cancer patients with neutropenia and/or thrombocytopenia.MethodsWe collected data on patients with neutropenia and/or thrombocytopenia who underwent endoscopy between 2012 and 2022 at Roswell Park Comprehensive Cancer Center. Neutropenia was defined as absolute neutrophil count (ANC) <1500 cells/µL, and thrombocytopenia was defined as platelet count <50 x 10³/µL. The development of infectious AEs (fever within 3 days or positive blood cultures within 7 days following endoscopy) in neutropenic patients and bleeding AEs (new overt GI bleeding within 3 days following endoscopy) in thrombocytopenic patients were the primary outcome measures; 30-day mortality was a secondary outcome measure. Univariate and multivariate analyses by logistic regressions were used to evaluate for risk factors.ResultsA total of 234 patients who underwent 329 endoscopic procedures were identified. In neutropenic patients, 7.8% (8/103) developed infectious AEs. In thrombocytopenic patients, 5.8% (12/208) developed bleeding AEs. Use of granulocyte colony-stimulating factor (G-CSF) was associated with increased risk of infectious AEs (OR 5.79, p = 0.02). The severity of neutropenia or thrombocytopenia and risk level of endoscopy were not associated with AEs. Multivariate analyses showed that poor performance status (PS) was the greatest risk factor for increased 30-day mortality (OR 4.69, p = <0.01).ConclusionsEndoscopy in patients with neutropenia and thrombocytopenia is relatively safe and does not lead to significant morbidity. A careful risk-benefit analysis in cancer patients with poor PS should be conducted prior to endoscopy.
Background/Objectives: Prostate needle biopsy often underestimates tumor aggressiveness due to limited tissue sampling, leading to Gleason score upgrading after radical prostatectomy (RP). Phosphatase and Tensin Homolog (PTEN) loss is an established tissue-based marker of adverse prostate cancer biology. This study evaluated whether reduced or absent PTEN immunoreactivity in diagnostic biopsies is associated with subsequent Gleason score and International Society of Urological Pathology (ISUP) Grade Group upgrading in RP specimens. Methods: This retrospective study included 85 prostate cancer patients who underwent multiparametric magnetic resonance imaging (mpMRI)-guided biopsy and subsequent RP. PTEN expression on biopsy samples was assessed via immunohistochemistry. Patients were stratified into PTEN-preserved (PTEN+, n = 75) and PTEN-deficient (PTEN-, n = 10) groups. Results: Upgrading occurred in 70% (7/10) of PTEN-deficient cases compared with 20% (15/75) of PTEN-preserved cases. This difference was statistically significant (two-sided Fisher's exact p = 0.0024), with PTEN-deficient patients showing a 3.50-fold higher relative risk of upgrading (RR = 3.50, 95% CI: 1.91-6.43). Preoperative PSA levels (p = 0.91) and Prostate Imaging Reporting and Data System (PI-RADS) scores (p = 0.73) did not differ significantly between the groups. Conclusions: Reduced PTEN protein expression, as assessed by immunohistochemistry in prostate needle biopsies, was significantly associated with Gleason score/ISUP Grade Group upgrading at radical prostatectomy. PTEN immunohistochemistry warrants further evaluation as a potentially complementary tissue-based marker of biopsy undergrading. However, the observed unadjusted association does not establish PTEN immunoreactivity as an independent predictor of upgrading.
