المؤلفون: Arrarte Terreros, Nerea, Stolp, Jeffrey, Bruggeman, Agnetha A E, Swijnenburg, Isabella S J, Lopes, Ricardo R, van Meenen, Laura C C, Groot, Adrien E D, Kappelhof, Manon, Coutinho, Jonathan M, Roos, Yvo B W E M, Emmer, Bart J, Beenen, Ludo F M, Dippel, Diederik W J, van Zwam, Wim H, van Bavel, Ed, Marquering, Henk A, Majoie, Charles B L M

المصدر: Arrarte Terreros , N , Stolp , J , Bruggeman , A A E , Swijnenburg , I S J , Lopes , R R , van Meenen , L C C , Groot , A E D , Kappelhof , M , Coutinho , J M , Roos , Y B W E M , Emmer , B J , Beenen , L F M , Dippel , D W J , van Zwam , W H , van Bavel , E , Marquering , H A , Majoie , C B L M & MR CLEAN Registry ....

مصطلحات موضوعية: acute ischemic stroke, early recanalization, endovascular treatment, intravenous thrombolysis, transferred patients

الوصف: The early management of transferred patients with a large vessel occlusion (LVO) stroke could be improved by identifying patients who are likely to recanalize early. We aim to predict early recanalization based on patient clinical and thrombus imaging characteristics. We included 81 transferred anterior-circulation LVO patients with an early recanalization, defined as the resolution of the LVO or the migration to a distal location not reachable with endovascular treatment upon repeated radiological imaging. We compared their clinical and imaging characteristics with all (322) transferred patients with a persistent LVO in the MR CLEAN Registry. We measured distance from carotid terminus to thrombus (DT), thrombus length, density, and perviousness on baseline CT images. We built logistic regression models to predict early recanalization. We validated the predictive ability by computing the median area-under-the-curve (AUC) of the receiver operating characteristics curve for 100 5-fold cross-validations. The administration of intravenous thrombolysis (IVT), longer transfer times, more distal occlusions, and shorter, pervious, less dense thrombi were characteristic of early recanalization. After backward elimination, IVT administration, DT and thrombus density remained in the multivariable model, with an AUC of 0.77 (IQR 0.72-0.83). Baseline thrombus imaging characteristics are valuable in predicting early recanalization and can potentially be used to optimize repeated imaging workflow.

العلاقة: https://cris.maastrichtuniversity.nl/en/publications/5b162b6a-f8e5-4425-ad99-e3516396c12eTest

الإتاحة: https://doi.org/10.3390/jcdd11040107Test
https://cris.maastrichtuniversity.nl/en/publications/5b162b6a-f8e5-4425-ad99-e3516396c12eTest

المؤلفون: van Voorst, Henk, Hoving, Jan W, Koopman, Miou S, Daems, Jasper D, Peerlings, Daan, Buskens, Erik, Lingsma, Hester F, Beenen, Ludo F M, de Jong, Hugo W A M, Berkhemer, Olvert A, van Zwam, Wim H, Roos, Yvo B W E M, van Walderveen, Marianne A A, van den Wijngaard, Ido, Dippel, Diederik W J, Yoo, Albert J, Campbell, Bruce C V, Kunz, Wolfgang G, Emmer, Bart J, Majoie, Charles B L M, van Oostenbrugge, Robert Jan, Truijman, Martine, Staals, Julie, Goldhoorn, Robert-Jan, ten Cate, Hugo, Hinsenveld, Wouter, Pirson, Anne-France, Olthuis, Susanne, Vranken, Jeannique R. R. A., Verheesen, Sabrina, Postma - Jacobi, Linda, Jeurrissen, D., Berkhemer, Olvert A., de Ridder, Inger, van der Leij, Christiaan, Brans, Rutger, Pinckaers, Floor

المصدر: van Voorst , H , Hoving , J W , Koopman , M S , Daems , J D , Peerlings , D , Buskens , E , Lingsma , H F , Beenen , L F M , de Jong , H W A M , Berkhemer , O A , van Zwam , W H , Roos , Y B W E M , van Walderveen , M A A , van den Wijngaard , I , Dippel , D W J , Yoo , A J , Campbell , B C V , Kunz , W ....

مصطلحات موضوعية: Diagnosis, Four-dimensional computed tomography, Health Care Economics and Organizations, Ischemic stroke, Thrombectomy

الوصف: Objectives: CT perfusion (CTP) has been suggested to increase the rate of large vessel occlusion (LVO) detection in patients suspected of acute ischemic stroke (AIS) if used in addition to a standard diagnostic imaging regime of CT angiography (CTA) and non-contrast CT (NCCT). The aim of this study was to estimate the costs and health effects of additional CTP for endovascular treatment (EVT)–eligible occlusion detection using model-based analyses. Methods: In this Dutch, nationwide retrospective cohort study with model-based health economic evaluation, data from 701 EVT-treated patients with available CTP results were included (January 2018–March 2022; trialregister.nl:NL7974). We compared a cohort undergoing NCCT, CTA, and CTP (NCCT + CTA + CTP) with a generated counterfactual where NCCT and CTA (NCCT + CTA) was used for LVO detection. The NCCT + CTA strategy was simulated using diagnostic accuracy values and EVT effects from the literature. A Markov model was used to simulate 10-year follow-up. We adopted a healthcare payer perspective for costs in euros and health gains in quality-adjusted life years (QALYs). The primary outcome was the net monetary benefit (NMB) at a willingness to pay of €80,000; secondary outcomes were the difference between LVO detection strategies in QALYs (ΔQALY) and costs (ΔCosts) per LVO patient. Results: We included 701 patients (median age: 72, IQR: [62–81]) years). Per LVO patient, CTP-based occlusion detection resulted in cost savings (ΔCosts median: € − 2671, IQR: [€ − 4721; € − 731]), a health gain (ΔQALY median: 0.073, IQR: [0.044; 0.104]), and a positive NMB (median: €8436, IQR: [5565; 11,876]) per LVO patient. Conclusion: CTP-based screening of suspected stroke patients for an endovascular treatment eligible large vessel occlusion was cost-effective. Clinical relevance statement.: Although CTP-based patient selection for endovascular treatment has been recently suggested to result in worse patient outcomes after ischemic stroke, an alternative CTP-based screening for ...

العلاقة: https://cris.maastrichtuniversity.nl/en/publications/67e91dee-1147-4d97-b45f-60aadbbb4eadTest

الإتاحة: https://doi.org/10.1007/s00330-023-10119-yTest
https://cris.maastrichtuniversity.nl/en/publications/67e91dee-1147-4d97-b45f-60aadbbb4eadTest

المؤلفون: Fakkert, Raoul A., Koopman, Miou S., Scheerder, Maeke J., Beenen, Ludo F. M., Weber, Nina C., Preckel, Benedikt, van Hulst, Robert A., Weenink, Robert P.

المصدر: Fakkert , R A , Koopman , M S , Scheerder , M J , Beenen , L F M , Weber , N C , Preckel , B , van Hulst , R A & Weenink , R P 2024 , ' Computer tomography perfusion patterns in iatrogenic cerebral arterial gas embolism : A retrospective cohort study ' , European Journal of Radiology , vol. 170 , 111242 . https://doi.org/10.1016/j.ejrad.2023.111242Test

الوصف: Purpose: Cerebral arterial gas embolism (CAGE) occurs when air or medical gas enters the systemic circulation during invasive procedures and lodges in the cerebral vasculature. Non-contrast computer tomography (CT) may not always show intracerebral gas. CT perfusion (CTP) might be a useful adjunct for diagnosing CAGE in these patients. Methods: This is a retrospective single-center cohort study. We included patients who were diagnosed with iatrogenic CAGE and underwent CTP within 24 h after onset of symptoms between January 2016 and October 2022. All imaging studies were evaluated by two independent radiologists. CTP studies were scored semi-quantitatively for perfusion abnormalities (normal, minimal, moderate, severe) in the following parameters: cerebral blood flow, cerebral blood volume, time-to-drain and time-to-maximum. Results: Among 27 patient admitted with iatrogenic CAGE, 15 patients underwent CTP within the designated timeframe and were included for imaging analysis. CTP showed perfusion deficits in all patients except one. The affected areas on CTP scans were in general located bilaterally and frontoparietally. The typical pattern of CTP abnormalities in these areas was hypoperfusion with an increased time-to-drain and time-to-maximum, and a corresponding minimal decrease in cerebral blood flow. Cerebral blood volume was mostly unaffected. Conclusion: CTP may show specific perfusion defects in patients with a clinical diagnosis of CAGE. This suggests that CTP may be supportive in diagnosing CAGE in cases where no intracerebral gas is seen on non-contrast CT.

العلاقة: https://research.vumc.nl/en/publications/f3a3f6b0-4794-4bc5-9880-b778721e4b23Test

الإتاحة: https://doi.org/10.1016/j.ejrad.2023.111242Test
https://research.vumc.nl/en/publications/f3a3f6b0-4794-4bc5-9880-b778721e4b23Test
http://www.scopus.com/inward/record.url?scp=85178112167&partnerID=8YFLogxKTest

المؤلفون: van Voorst, Henk, Hoving, Jan W., Koopman, Miou S., Daems, Jasper D., Peerlings, Daan, Buskens, Erik, Lingsma, Hester F., Beenen, Ludo F. M., de Jong, Hugo W. A. M., Berkhemer, Olvert A., van Zwam, Wim H., Roos, Yvo B. W. E. M., van Walderveen, Marianne A. A., van den Wijngaard, Ido, Dippel, Diederik W. J., Yoo, Albert J., Campbell, Bruce C. V., Kunz, Wolfgang G., Emmer, Bart J., Majoie, Charles B. L. M.

المصدر: van Voorst , H , Hoving , J W , Koopman , M S , Daems , J D , Peerlings , D , Buskens , E , Lingsma , H F , Beenen , L F M , de Jong , H W A M , Berkhemer , O A , van Zwam , W H , Roos , Y B W E M , van Walderveen , M A A , van den Wijngaard , I , Dippel , D W J , Yoo , A J , Campbell , B C V , Kunz , W ....

الوصف: Objectives: CT perfusion (CTP) has been suggested to increase the rate of large vessel occlusion (LVO) detection in patients suspected of acute ischemic stroke (AIS) if used in addition to a standard diagnostic imaging regime of CT angiography (CTA) and non-contrast CT (NCCT). The aim of this study was to estimate the costs and health effects of additional CTP for endovascular treatment (EVT)–eligible occlusion detection using model-based analyses. Methods: In this Dutch, nationwide retrospective cohort study with model-based health economic evaluation, data from 701 EVT-treated patients with available CTP results were included (January 2018–March 2022; trialregister.nl:NL7974). We compared a cohort undergoing NCCT, CTA, and CTP (NCCT + CTA + CTP) with a generated counterfactual where NCCT and CTA (NCCT + CTA) was used for LVO detection. The NCCT + CTA strategy was simulated using diagnostic accuracy values and EVT effects from the literature. A Markov model was used to simulate 10-year follow-up. We adopted a healthcare payer perspective for costs in euros and health gains in quality-adjusted life years (QALYs). The primary outcome was the net monetary benefit (NMB) at a willingness to pay of €80,000; secondary outcomes were the difference between LVO detection strategies in QALYs (ΔQALY) and costs (ΔCosts) per LVO patient. Results: We included 701 patients (median age: 72, IQR: [62–81]) years). Per LVO patient, CTP-based occlusion detection resulted in cost savings (ΔCosts median: € − 2671, IQR: [€ − 4721; € − 731]), a health gain (ΔQALY median: 0.073, IQR: [0.044; 0.104]), and a positive NMB (median: €8436, IQR: [5565; 11,876]) per LVO patient. Conclusion: CTP-based screening of suspected stroke patients for an endovascular treatment eligible large vessel occlusion was cost-effective. Clinical relevance statement.: Although CTP-based patient selection for endovascular treatment has been recently suggested to result in worse patient outcomes after ischemic stroke, an alternative CTP-based screening for ...

العلاقة: https://research.vumc.nl/en/publications/196e9dfd-4c9e-44d1-87c9-7eb587c5ecf6Test

الإتاحة: https://doi.org/10.1007/s00330-023-10119-yTest
https://research.vumc.nl/en/publications/196e9dfd-4c9e-44d1-87c9-7eb587c5ecf6Test
http://www.scopus.com/inward/record.url?scp=85171598701&partnerID=8YFLogxKTest

المؤلفون: Koopman, Miou S., Hoving, Jan W., Tolhuisen, Manon L., Jin, Peng, Thiele, Frank O., Bremer-van der Heiden, Linda, van Voorst, Henk, Berkhemer, Olvert A., Coutinho, Jonathan M., Beenen, Ludo F. M., Marquering, Henk A., Emmer, Bart J., Majoie, Charles B. L. M.

المصدر: Koopman , M S , Hoving , J W , Tolhuisen , M L , Jin , P , Thiele , F O , Bremer-van der Heiden , L , van Voorst , H , Berkhemer , O A , Coutinho , J M , Beenen , L F M , Marquering , H A , Emmer , B J & Majoie , C B L M 2023 , ' Accuracy of Four Different CT Perfusion Thresholds for Ischemic Core Volume and Location Estimation Using IntelliSpace Portal ' , Journal of Cardiovascular Development and Disease , vol. 10 , ....

الوصف: Computed tomography perfusion (CTP) is frequently used in the triage of ischemic stroke patients for endovascular thrombectomy (EVT). We aimed to quantify the volumetric and spatial agreement of the CTP ischemic core estimated with different thresholds and follow-up MRI infarct volume on diffusion-weighted imaging (DWI). Patients treated with EVT between November 2017 and September 2020 with available baseline CTP and follow-up DWI were included. Data were processed with Philips IntelliSpace Portal using four different thresholds. Follow-up infarct volume was segmented on DWI. In 55 patients, the median DWI volume was 10 mL, and median estimated CTP ischemic core volumes ranged from 10–42 mL. In patients with complete reperfusion, the intraclass correlation coefficient (ICC) showed moderate-good volumetric agreement (range 0.55–0.76). A poor agreement was found for all methods in patients with successful reperfusion (ICC range 0.36–0.45). Spatial agreement (median Dice) was low for all four methods (range 0.17–0.19). Severe core overestimation was most frequently (27%) seen in Method 3 and patients with carotid-T occlusion. Our study shows moderate–good volumetric agreement between ischemic core estimates for four different thresholds and subsequent infarct volume on DWI in EVT-treated patients with complete reperfusion. The spatial agreement was similar to other commercially available software packages.

العلاقة: https://research.vumc.nl/en/publications/f3b52eab-cebd-4619-911f-3b27e0b6fd72Test

الإتاحة: https://doi.org/10.3390/jcdd10060239Test
https://research.vumc.nl/en/publications/f3b52eab-cebd-4619-911f-3b27e0b6fd72Test
http://www.scopus.com/inward/record.url?scp=85163791770&partnerID=8YFLogxKTest

المؤلفون: Goossen, Robin L, Verboom, Mariëlle, Blacha, Mariëlle, Smesseim, Illaa, Beenen, Ludo F M, Meenen, David M P van, Paulus, Frederique, Schultz, Marcus J

المصدر: The PRoVENT-Covid And PRoAcT-Covid Investigators , Goossen , R L , Verboom , M , Blacha , M , Smesseim , I , Beenen , L F M , Meenen , D M P V , Paulus , F & Schultz , M J 2023 , ' Incidence of Air Leaks in Critically Ill Patients with Acute Hypoxemic Respiratory Failure Due to COVID-19 ' , Diagnostics , vol. 13 , no. 6 , 1156 . https://doi.org/10.3390/diagnostics13061156Test

الوصف: Subcutaneous emphysema, pneumothorax and pneumomediastinum are well-known complications of invasive ventilation in patients with acute hypoxemic respiratory failure. We determined the incidences of air leaks that were visible on available chest images in a cohort of critically ill patients with acute hypoxemic respiratory failure due to coronavirus disease of 2019 (COVID-19) in a single-center cohort in the Netherlands. A total of 712 chest images from 154 patients were re-evaluated by a multidisciplinary team of independent assessors; there was a median of three (2-5) chest radiographs and a median of one (1-2) chest CT scans per patient. The incidences of subcutaneous emphysema, pneumothoraxes and pneumomediastinum present in 13 patients (8.4%) were 4.5%, 4.5%, and 3.9%. The median first day of the presence of an air leak was 18 (2-21) days after arrival in the ICU and 18 (9-22)days after the start of invasive ventilation. We conclude that the incidence of air leaks was high in this cohort of COVID-19 patients, but it was fairly comparable with what was previously reported in patients with acute hypoxemic respiratory failure in the pre-COVID-19 era.

وصف الملف: application/pdf

العلاقة: https://research.rug.nl/en/publications/a1b0aa68-9f86-4f94-9859-90e2717d857bTest

الإتاحة: https://doi.org/10.3390/diagnostics13061156Test
https://hdl.handle.net/11370/a1b0aa68-9f86-4f94-9859-90e2717d857bTest
https://research.rug.nl/en/publications/a1b0aa68-9f86-4f94-9859-90e2717d857bTest
https://pure.rug.nl/ws/files/829626264/diagnostics-13-01156-v2.pdfTest

المؤلفون: van der Steen, Wouter, van der Ende, Nadinda A M, Luijten, Sven P R, Rinkel, Leon A, van Kranendonk, Katinka R, van Voorst, Henk, Roosendaal, Stefan D, Beenen, Ludo F M, Coutinho, Jonathan M, Emmer, Bart J, van Oostenbrugge, Robert J, Majoie, Charles B L.M, Lingsma, Hester F, van der Lugt, Aad, Dippel, Diederik W J, Roozenbeek, Bob, on behalf of the MR CLEAN-NO IV, MR CLEAN-MED, and CONTRAST investigators

مصطلحات موضوعية: Ischemic stroke

الوصف: Background Intracranial hemorrhage (ICH) is a frequent complication after endovascular stroke treatment. Objective To assess the association of the occurrence and type of ICH after endovascular treatment (EVT) with functional outcome. Methods We analyzed data from the MR CLEAN-NO IV and MR CLEAN-MED trials. Both trials included adult patients with ischemic stroke with a large vessel occlusion in the anterior circulation, who were eligible for EVT. ICH was classified (1) as asymptomatic or symptomatic (concomitant neurological deterioration of ≥4 points on the NIHSS, or ≥2 points on 1 NIHSS item), and (2) according to the Heidelberg Bleeding Classification. We used multivariable ordinal logistic regression analyses to assess the association of the occurrence and type of ICH with the modified Rankin Scale score at 90 days. Results Of 1017 included patients, 331 (33%) had an asymptomatic ICH, and 90 (9%) had a symptomatic ICH. Compared with no ICH, both asymptomatic (adjusted common OR (acOR)=0.76; 95% CI 0.58 to 0.98) and symptomatic (acOR=0.07; 95% CI 0.04 to 0.14) ICH were associated with worse functional outcome. In particular, isolated parenchymal hematoma type 2 (acOR=0.37; 95% CI 0.14 to 0.95), combined parenchymal hematoma with hemorrhage outside infarcted brain tissue (acOR=0.17; 95% CI 0.10 to 0.30), and combined hemorrhages outside infarcted brain tissue (acOR=0.14; 95% CI 0.03 to 0.74) were associated with worse functional outcome than no ICH. Strength of the association of ICH with functional outcome depends on the type of ICH. Although the association is stronger for symptomatic ICH, asymptomatic ICH after EVT is also associated with worse functional outcome.

وصف الملف: text/html

العلاقة: http://jnis.bmj.com/cgi/content/short/15/10/971Test; http://dx.doi.org/10.1136/jnis-2022-019474Test

الإتاحة: https://doi.org/10.1136/jnis-2022-019474Test
http://jnis.bmj.com/cgi/content/short/15/10/971Test

المؤلفون: Lecouffe, Natalie E., Treurniet, Kilian M., Kappelhof, Manon, Jansen, Ivo G. H., Boers, Merel, Marquering, Henk A., Beenen, Ludo F. M., Boiten, Jelis, van Zwam, Wim H., Yo, Lonneke S. F., Majoie, Charles B. L. M., Roos, Yvo B. W. E. M., Emmer, Bart J., Coutinho, Jonathan M.

المصدر: Lecouffe , N E , Treurniet , K M , Kappelhof , M , Jansen , I G H , Boers , M , Marquering , H A , Beenen , L F M , Boiten , J , van Zwam , W H , Yo , L S F , Majoie , C B L M , Roos , Y B W E M , Emmer , B J , Coutinho , J M & MR CLEAN Registry Investigators 2023 , ' Outcome of patients with multivessel occlusion stroke after endovascular treatment ' , European Stroke Journal . ....

مصطلحات موضوعية: Endovascular treatment, stroke, multivessel occlusions, ACUTE ISCHEMIC-STROKE

الوصف: Introduction: Little is known about the implications of multivessel occlusions (MVO) in large vessel occlusion stroke patients who undergo endovascular treatment (EVT).Patients and methods: We report data from the MR CLEAN Registry: a prospective, observational study on all stroke patients who underwent EVT in the Netherlands (March 2014-November 2017). We included patients with an intracranial target occlusion in the anterior circulation. An MVO was defined as an MCA occlusion (M1/M2) or intracranial ICA/ICA-T occlusion, with a concurrent second occlusion in the ACA or PCA territory confirmed on baseline CTA. To compare outcomes, we performed a 10:1 propensity score matching analysis with a logistic regression model including potential confounders. Outcome measures included 90-day functional outcome (modified Rankin Scale, mRS) and mortality.Results: Of 2946 included patients, 71 patients (2.4%) had an MVO (87% concurrent ACA occlusion, 10% PCA occlusion, 3% >= 3 occlusions). These patients were matched to 71 non-MVO patients. Before matching, MVO patients had a higher baseline NIHSS (median 18 vs 16, p = 0.001) and worse collateral status (absent collaterals: 17% vs 6%, p < 0.001) compared to non-MVO patients. After matching, MVO patients had worse functional outcome at 90 days (median mRS 5 vs 3, cOR 0.39; 95%CI 0.25-0.62). Mortality was higher in MVO patients (46% vs 27%, OR 2.11, 95%CI 1.24-3.57).Discussion and conclusion: MVOs on baseline imaging were uncommon in LVO stroke patients undergoing EVT, but were associated with poor functional outcome.

العلاقة: https://cris.maastrichtuniversity.nl/en/publications/ca7964eb-3916-478f-afce-6b6c34fa7feeTest

الإتاحة: https://doi.org/10.1177/23969873231216811Test
https://cris.maastrichtuniversity.nl/en/publications/ca7964eb-3916-478f-afce-6b6c34fa7feeTest

المؤلفون: Vespasiano, Valeria, Klop, Cornelis, Mulder, Catharina S., Koolstra, Jan H., Lobé, Nicolaas H. J., Beenen, Ludo. F. M, Nolte, Jitske W., Becking, Alfred G.

المصدر: Orthodontics & Craniofacial Research ; volume 26, issue 3, page 524-530 ; ISSN 1601-6335 1601-6343

الوصف: Objective To explore the normal variation of asymmetry in mandibles of children in the age group of 1 to 12 years. Materials and Methods The study group consisted of 92 cadaveric mandibles of children with a dental age of 1 to 12 years old in possession of ACTA (Academic Centre for Dentistry Amsterdam), Faculty of Dentistry, the Netherlands. 3D models of the mandibles were obtained from CT‐scans and hemimandibular volumes of all mandibles were calculated. The condylar height, ramus height, mandibular body length and the gonial angle were bilaterally determined using a novel landmark‐based method, and the degree of asymmetry was calculated. Results No relationship was found between dental age and asymmetry of the studied parameters ( P < .05). The highest degree of asymmetry was found in the ramus height, whereas the gonial angle presented the lowest degree of asymmetry. A positive correlation was found between the asymmetry of the hemimandibular volume vs the height of the ramus ( P < .05) and the length of the mandibular body ( P < .05). An inverse correlation was found between the asymmetry of the ramus height vs the condylar height ( P < .05), mandibular body length ( P < .05) and gonial angle ( P < .05). Conclusions Mandibular asymmetries in children did occur (9.8% of the included mandibles presented with a relevant overall asymmetry of ≥3%) and were unrelated to age. The different segments of the mandible seem to compensate for each other, in order to maintain a functional equilibrium.

الإتاحة: https://doi.org/10.1111/ocr.12639Test

المؤلفون: ten Hoope, Werner, Smulders, Pascal S. H., Baumann, Holger M., Hermanides, Jeroen, Beenen, Ludo F. M., Oostra, Roelof-Jan, Marhofer, Peter, Lirk, Philipp, Hollmann, Markus W.

المصدر: Scientific Reports ; volume 13, issue 1 ; ISSN 2045-2322

مصطلحات موضوعية: Multidisciplinary

الوصف: Whether the fascia iliaca compartment block (FICB) involves the obturator nerve (ON) remains controversial. Involvement may require that the injectate spreads deep in the cranial direction, and might thus depend on the site of injection. Therefore, the effect of suprainguinal needle insertion with five centimeters of hydrodissection-mediated needle advancement (S-FICB-H) on ON involvement and cranial injectate spread was studied in this radiological cadaveric study. Results were compared with suprainguinal FICB without additional hydrodissection-mediated needle advancement (S-FICB), infrainguinal FICB (I-FICB), and femoral nerve block (FNB). Seventeen human cadavers were randomized to receive ultrasound-guided nerve block with a 40 mL solution of local anesthetic and contrast medium, on both sides. Injectate spread was objectified using computed tomography. The femoral and lateral femoral cutaneous nerves were consistently covered when S-FICB-H, S-FICB or FNB was applied, while the ON was involved in only one of the 34 nerve blocks. I-FICB failed to provide the same consistency of nerve involvement as S-FICB-H, S-FICB or FNB. Injectate reached most cranial in specimens treated with S-FICB-H. Our results demonstrate that even the technique with the most extensive cranial spread (S-FICB-H) does not lead to ON involvement and as such, the ON seems unrelated to FICB. Separate ON block should be considered when clinically indicated.

الإتاحة: https://doi.org/10.1038/s41598-023-39041-5Test
https://www.nature.com/articles/s41598-023-39041-5.pdfTest
https://www.nature.com/articles/s41598-023-39041-5Test