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  1. Article: Incomplete circle of Willis as a risk factor for intraoperative ischemic events during carotid endarterectomies performed under regional anesthesia - A prospective case-series.

    Gyöngyösi, Zoltán / Belán, Ivett / Nagy, Edit / Fülesdi, Zsófia / Farkas, Orsolya / Végh, Tamás / Hoksbergen, Arjan Willem / Fülesdi, Béla

    Translational neuroscience

    2023  Volume 14, Issue 1, Page(s) 20220293

    Abstract: Background: The role of the willisian collaterals during carotid endarterectomies (CEAs) is a debated issue. The aim of the present work was to test whether an incomplete or non-functional circle of Willis (CoW) is a risk factor for ischemic events ... ...

    Abstract Background: The role of the willisian collaterals during carotid endarterectomies (CEAs) is a debated issue. The aim of the present work was to test whether an incomplete or non-functional circle of Willis (CoW) is a risk factor for ischemic events during CEA.
    Patients and methods: CEAs were performed under local anesthesia. Patients were considered symptomatic (SY) if neurological signs appeared after the cross-clamping phase. In SY patients shunt insertion was performed. CoW on CT angiograms (CTa) were analyzed offline and categorized as non-functional (missing or hypoplastic collaterals) or functional collaterals by three neuroradiologists. Near-infrared spectroscopy (NIRS) was performed throughout the procedure.
    Results: Based on CTa, 67 incomplete circles were found, 54 were asymptomatic (ASY) and 13 were SY. No complete CoW was found among the SY patients. Significant differences could be detected between incomplete and complete circles between ASY and SY groups (Chi-square: 6.08;
    Conclusions: Collateral ability of the CoW may be a risk factor for ischemic events during CEAs. Further studies should delineate whether the preoperative assessment of collateral capacity may be useful in decision-making about shunt use during CEA.
    Language English
    Publishing date 2023-07-10
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2581219-1
    ISSN 2081-6936 ; 2081-3856
    ISSN (online) 2081-6936
    ISSN 2081-3856
    DOI 10.1515/tnsci-2022-0293
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Assessment of malformations, variations and diameters of vessels forming the circle of Willis - An autopsy study in a non-cerebrovascular cohort.

    Orosz, László / Gyöngyösi, Zoltán / Susán, Zsolt / Siró, Péter / Hoksbergen, Arjan Willem / Csiba, László / Fülesdi, Béla

    Translational neuroscience

    2022  Volume 13, Issue 1, Page(s) 398–406

    Abstract: Background a purpose: The collateral capacity of the circle of Willis (CoW) may play an important role in the development of ischemic strokes. The occurrence of classical polygon shows wide geographical variations and morphological data on diameters of ... ...

    Abstract Background a purpose: The collateral capacity of the circle of Willis (CoW) may play an important role in the development of ischemic strokes. The occurrence of classical polygon shows wide geographical variations and morphological data on diameters of the Willisian collaterals are scarce. We aimed to assess CoW variations and vessel diameters in a Central European cohort.
    Subjects and methods: CoWs were removed during routine autopsy. The morphological pattern of the circles was recorded. The prepared circles were then put between two glass plates and tightly compressed. The length of the vessels and half of the circumference were measured under a light microscope enabling measurement with an approximation of 0.1 mm. Vessel diameters were calculated from vessel circumference.
    Results: A total of 110 circles were analysed. Incomplete circles (missing one or two segments of CoW) were found in 25 cases (22.7%). Any forms of anatomical variations were detected in 14 cases (12.7%). When applying the <1 mm diameter threshold for analysis, 36 anterior communicating arteries (32.7%), 53 right posterior communicating arteries (48.2%), 73 left posterior communicating arteries (66.4%) and 18 posterior communicating arteries (16.3%) on both the sides were considered hypoplastic.
    Conclusions: In patients without stroke in their history, complete CoW may be present in >60% of the cases. Our diameter data may serve as reference values for the Central-European population.
    Language English
    Publishing date 2022-11-08
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2581219-1
    ISSN 2081-6936 ; 2081-3856
    ISSN (online) 2081-6936
    ISSN 2081-3856
    DOI 10.1515/tnsci-2022-0253
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Correlation between calcium, water contents and ultrasonographic appearance of atherosclerotic lesions of carotid artery lesions.

    Fülesdi, Béla / Farkas, Szabolcs / Gyöngyösi, Zoltán / Siró, Péter / Bereczki, Dániel / Bacsó, József / Csiba, László

    Translational neuroscience

    2020  Volume 11, Issue 1, Page(s) 269–276

    Abstract: Background: We tested the hypothesis whether there is a correlation between the echogenicity and calcium and water contents of carotid plaques.: Patients and methods: Ninety carotid befurcations from 45 deceased patients were removed during autopsy. ... ...

    Abstract Background: We tested the hypothesis whether there is a correlation between the echogenicity and calcium and water contents of carotid plaques.
    Patients and methods: Ninety carotid befurcations from 45 deceased patients were removed during autopsy. Thirty-four plaques were categorized as homogenous echolucent (HEL), homogenous echogenic (HEG) and heterogenous (HE) plaques based on premortem B-mode image. Water content was expressed in % of wet weight. Ca was determined by proton-induced X-ray emission and expressed in ppm. Relative optical density of the B-mode images was analyzed offline using a computer program.
    Results: HEL plaques had lower Ca content (medians and IQRs: 6,145 [4,465-6,536 ppm]) compared to HEG (74,100 [15,300-1,44,500-ppm]),
    Conclusions: Echogenicity of carotid plaques increases along with their calcium content. Water content may be an important factor in differentiation of different plaques.
    Language English
    Publishing date 2020-08-24
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2581219-1
    ISSN 2081-6936 ; 2081-3856
    ISSN (online) 2081-6936
    ISSN 2081-3856
    DOI 10.1515/tnsci-2020-0115
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Clinical Experiences with the FRONT Formula for Pre-Operative Airway Assessment and Documentation: a Multi-Centre Study.

    Mitre, Calin / Mitre, Ileana / Gyöngyösi, Zoltán / Fülesdi, Béla / Zdrehus, Claudiu / Breazu, Caius / Biro, Peter

    Turkish journal of anaesthesiology and reanimation

    2017  Volume 45, Issue 4, Page(s) 225–230

    Abstract: Objective: The prediction of difficult airway is one of the most important challenges before general anaesthesia. This study aimed to assess the clinical usefulness of the FRONT score, a recently developed scoring system to predict and document airway ... ...

    Abstract Objective: The prediction of difficult airway is one of the most important challenges before general anaesthesia. This study aimed to assess the clinical usefulness of the FRONT score, a recently developed scoring system to predict and document airway difficulties.
    Methods: This multi-centre, inter-observer, prospective and double-blinded study included 976 patients from two university centres. The pre-operative evaluation of the patients was performed by a pre-operative team of anaesthesiologists (team A) who evaluated and scored the expected difficulty of airway management. An intra-operative team of evaluators (team B) working independently of team A, performed the actual instrumentation of the airway and scored the actual findings. Both teams used the FRONT scoring system and worked independently of each other to ensure blinded assessments. The statistical analysis of the pre- and intra-operative FRONT scores was performed in an off-line blinded manner.
    Results: Our results show a fair and promising association between pre-operative composite FRONT score and that observed at the induction phase (Spearman=0.43). Among the score components, the best correlation was observed for the F and R components (kappa=0.44 and 0.36, respectively), and the worse correlation was observed for the O and T components (kappa=0.25 and 0.24, respectively).
    Conclusion: The FRONT formula for the prediction and documentation of the airway status is a simple and effective method for assessing and defining airway management difficulties. Further prospective studies are required to assess the sensitivity and specificity of the system.
    Language English
    Publishing date 2017-08-01
    Publishing country Turkey
    Document type Journal Article
    ISSN 2667-677X
    ISSN 2667-677X
    DOI 10.5152/TJAR.2017.97992
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: VATS therapy of chylothorax caused by leiomyomatosis complicated with tuberous sclerosis complex.

    Csiszkó, Adrienn / Herr, György / Sz Kiss, Sándor / Hallay, Judit / Gyöngyösi, Zoltán / Szentkereszty, Zsolt

    Journal of minimal access surgery

    2012  Volume 9, Issue 2, Page(s) 84–86

    Abstract: Lymphangioleiomyomatosis with tuberous sclerosis complex is a rare disease. One of the most frequent complications of lymphangioleiomyomatosis is pleural effusion (chylothorax) wich can be treated with the use of VATS. Authors report a case of pulmonary ... ...

    Abstract Lymphangioleiomyomatosis with tuberous sclerosis complex is a rare disease. One of the most frequent complications of lymphangioleiomyomatosis is pleural effusion (chylothorax) wich can be treated with the use of VATS. Authors report a case of pulmonary lymphangioleiomyomatosis in a 56-year-old female patient with tuberous sclerosis complex with an 8-week history of recurrent chylothorax, dyspnea and debilitating weakness. By CT scan a flat tissue proliferation was seen in the site of the thoracic duct and it was supposed to be the reason for the pleural effusion. A VATS resection of this laesion and ligation of the thoracic duct was performed successfully. Chylothorax is often associated with pulmonary lymphangioleiomyomatosis. Lymphangioleiomyomatosis combined with tuberous sclerosis complex is extremely rare. In case of chylothorax VATS treatment is successful and may be the first choice.
    Language English
    Publishing date 2012-05-09
    Publishing country India
    Document type Case Reports
    ZDB-ID 2186884-0
    ISSN 1998-3921 ; 0972-9941
    ISSN (online) 1998-3921
    ISSN 0972-9941
    DOI 10.4103/0972-9941.110970
    Database MEDical Literature Analysis and Retrieval System OnLINE

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