Faculty of Medicine
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Item type:Publication, IMPACT OF TIME-TO-TREATMENT AND THROMBECTOMY TECHNIQUE ON OUTCOMESINACUTEISCHEMICSTROKE:ASINGLE-CENTERCOHORTANALYSIS(Macedonian Association of Anatomists and Morphologists, 2025-06); ; ; ; Introduction:Mechanical thrombectomy (MT) is the standard of care for acute ischemic stroke (AIS) secondary to large vessel occlusion (LVO). Time-to-reperfusion is the most critical determinant of patient outcome. This study aimed to conduct a comprehensive analysis of key time metrics and the efficacy of MT at our institution, evaluating their impact on both angiographic and clinical results to identify areas for process optimization.Methods:We conducted a retrospective analysis of a cohort of 17 consecutive patients treated with MT for LVO stroke. We analyzed demographics, baseline clinical status (mRS), occlusion location, detailed time-to-treatment intervals, procedural techniques, and outcomes. The primary angiographic endpoint was successful reperfusion, defined as an extended Thrombolysis in Cerebral Infarction (eTICI) score of ≥2b. Clinical endpoints included functional outcome at 3 months, measured by the mRS, and the rate of symptomatic intracranial hemorrhage (sICH).Results:The mean patient age was 60.9 years, with a significant male predominance (70.6%). All patients presented with severe stroke (initial mRS 4-5), indicating a high-acuity cohort. The mean time from symptom onset to final reperfusion was prolonged at 505 minutes (8 hours 25 minutes). Despite this, a high rate of successful reperfusion (eTICI ≥2b) was achieved in 85.7% of patients, with complete reperfusion (eTICI ≥2c/3) in 57.1%. However, this technical success did not fully translate to clinical recovery, as a good functional outcome (mRS 0-2) at 3 months was achieved in only 30.8% of patients. The rate of sICH was 15.4%.Conclusion:Our center achieves high rates of technical success in reperfusion (85.7% eTICI ≥2b), comparable to international benchmarks. However, prolonged treatment delays are significantly attenuating clinical outcomes, with only 30.8% of patients achieving functional independence. This analysis underscores that procedural excellence alone is insufficient; optimizing system-wide time-to-treatment protocols isthe critical next step to improve patient recovery. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Origin of the right vertebral artery examined with CTA(Македонска академија на науките и уметностите, Одделение за медицински науки = Macedonian Academy of Sciences and Arts, Section of Medical Sciences/ Sciendo, 2025-12-06); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ARTERIAL THROMBOSIS IN A COVID-19 PATIENT(Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2022); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Size, Localization and Risk Factors in Ruptured and Unruptured Brain Aneurysms(SciVision Publishers LLC, 2025-01-06); ; ; Brain aneurysm is a pathological focal enlargement of an artery in the brain, that is, of the inner muscle layer of the blood vessels. The vessel expands in the form of a balloon from varying degrees, where the wall of the aneurysm can become thin and rupture without warning. Brain aneurysms can form and not rupture. They are often discovered incidentally during the examination of other pathological health conditions. Aim: To assess the incidence of brain aneurysms in relation to sex and age, as well as in relation to localization, size and type, that is, bleeding and non-bleeding brain aneurysms. The study also analyzes risk factors for the occurrence and outcome of brain aneurysms. Material and Methods: In the study, 80 patients with symptoms of brain aneurysm were analyzed, and diagnostic procedures were performed to prove the brain aneurysm and establish an indication for further treatment. Results: Of the analyzed patients, 48 (60%) were women, and 32 (40%) were men. In terms of age, the patients had an average age of 56.1 ± 10.3 (31-84 years). In patients with ruptured and unruptured aneurysms, there was a statistically insignificant difference in the average age between these two groups of patients 55.8 ± 9.5 vs 56.8 ± 12.3 years. Ruptured aneurysms were significantly more often diagnosed in male patients 84.38% vs 62.5% in the female population. A statistically significant difference was detected in the distribution of small, large, and giant aneurysms between the groups of ruptured and unruptured aneurysms, where it was shown that small aneurysms were insignificantly more often bleeding 77.19% vs 56.52%, large aneurysms were insignificantly more often non-bleeding 26.09% vs 21.05%, giant aneurysms were significantly more often non-bleeding 17.39% vs 1.75%. Aneurysms were non- bleeding, that is, unruptured in 28.75%, bleeding, that is, ruptured aneurysms were diagnosed in 71.25% of patients. Risk factors were present in 69 (86.25%) patients, of which the most common risk factor was hypertension, which was present in 86.25% of the patients. Hyperlipidemia was present in 33.75% of patients, while diabetes was diagnosed in 13.75%. The risk factor of smoking was present in all patients. Conclusion: Timely diagnosis of brain aneurysms is important in determining the type of aneurysm, its localization, size, and the risk of rupture. Given that non-ruptured diagnosed aneurysms carry a high risk of rupture, the establishment of an indication for endovascular treatment is of particular importance. Control of risk factors, especially smoking and hypertension, is an important segment in the prevention of the occurrence and outcome of brain aneurysms. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Anatomical features and variations of the vertebrobasilar system(Firenze University Press, 2024-09-04); ; ; ; The posterior circulation of the brain constitutes the vertebrobasilar system and its branches, which are responsible for about 20% of the brain blood supply. The aim of this study was to describe the morphological characteristics of the vertebrobasilar system. We examined radiographs of 103 patients, 58 male and 45 females, age range from 25 - 82, mean age 58.4 years who had CT angiography undertaken for a variety of clinical reasons, performed as a part of their medical treatment at the University Institute for Radiology in Skopje, Macedonia. The left vertebral artery arose from the left subclavian artery in 94.17% and the right vertebral artery had origin from the right subclavian artery in 99.02%. Variable origin of the left vertebral artery from the aortic arch was noticed in 5.82% and in one patient (0.97%) we found atypical arisen of the right vertebral artery from the right common carotid artery. The diameter of the vertebral artery was 3.20 ± 0.74 mm on the right side and 3.33 ± 0.76 mm on the left side. The mean length of the basilar artery was 31.60 ± 5.1 mm (from 21.4 mm to 44.1 mm). The mean diameter of the basilar artery was 3.27 ± 0.52 mm (from 2.22 to 4.87 mm). Most of the SCA arise from the basilar artery as a single vessel. The most common variations of the SCA were duplication (frequency 1.94% on right and 0.97% on left) and origin from PCA (frequency 1.94% bilateral). In four patients (3.88%) we found fenestrations of posterior brain circulation, three fenestrations (2.91%) was on the basilar artery and one fenestration (0.97%) was on the vertebral artery. In one patient persistent trigeminal artery was found. A sound knowledge of vertebrobasilar system anatomy and variations is important during diagnostic, operative and endovascular procedures. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Origin of left common carotid artery examined with CTA(Faculty of Medicine, University of Nis Galaksijanis Nis, 2023-09-21); ; ; ; Introduction: The aortic arch usually gives rise to three major branches: the brachiocephalic trunk, the left common carotid artery and the left subclavian artery. The left common carotid artery is the second and longest branch of the aortic arch; it ascends from the apex of the arch to the left carotid bifurcation in the neck, which typically occurs between the third and fourth midcervical vertebral bodies. The aim of this study was to describe the variations in origin of left common carotid artery and to emphasize their clinical significance. Materials and methods: We examined radiographs of 103 patients who had CT angiography undertaken for a variety of clinical reasons, performed as a part of their medical treatment at the University Clinic for Radiology in Skopje, RN Macedonia. The study population included 103 patients, 58 male and 45 females, age range from 25 - 82, mean age 58.4 years. Results: The left common carotid artery arose from the aortic arch in 88 patients (85.43%). In 15 patients (14.56%) we found atypical arisen of the left common carotid artery from the brachiocephalic trunk. Conclusion: Although anatomically interesting, an awareness of the left common carotid artery anatomy and variations is clinically important. A sound knowledge of left common carotid artery anatomy and variations is important during diagnostic, endovascular and surgical procedures. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Anatomy and variations of the basilar artery examined with digital subtraction angiography(Balkan Society of Radiology, 2019-10-17); ; ; ; Introduction: The basilar artery is formed by the union of the vertebral arteries; it runs over the ventral surface of the pons and terminates at the upper border of the pons by dividing into the posterior cerebral arteries. It gives of many vital branches supplying various parts of the brain. The aim of this study was to determine origin and variations of branches of the basilar artery with DS angiography. Materials and methods: We examined radiographs of 55 patients who had DS angiography undertaken for a variety of clinical reasons, performed as a part of their medical treatment at the University Clinic for Radiology in Skopje. The study population included 27 male and 28 females, age range from 18-79, mean age 51.09 years. Results: The AICA originated from the proximal half of the basilar artery in all patients. Most of the SCA arise from the basilar artery as a single vessel (92.7% on right and 94.5% on left). The most common variations of the SCA were duplication (frequency 3.63% on right and 1.81% on left) and origin from PCA (frequency 3.63% bilateral). The PCA was evaluated in all cases. The adult configuration was present in 74.54% of the patients; fetal configuration was present in 20% of the patients and transitional configuration was present in 5.45% of the patients on the left side. On the right side adult configuration was present in 83.63% of the patients; fetal configuration was present in 14.54% of the patients and transitional configuration was present in 1.81% of the patients. Conclusion: A precise understanding of the basilar artery anatomy is fundamental for planning and performing endovascular procedures and neuro-interventions, as well as for the accurate interpretation of ischemic areas. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Radiological procedures in diagnosis and preoperative staging of testicular malignant tumors(SHMSHM - AAMD, 2008); ; ; Banev, Sasho - Some of the metrics are blocked by yourconsent settings
Item type:Publication, PERSISTENT TRIGEMINAL ARTERY - ANATOMICAL FEATURES AND CLINICAL SIGNIFICANCE(Macedonian Association of Anatomists and Morphologists, 2023); ; ; ; Persistent trigeminal artery is the most common primitive carotid basilar anastomosis that persists in adulthood. The overall incidence of persistent trigeminal artery is between 0.2 to 0.76%. PTA are known to be associated with a wide range of pathology. The aim of this study was to describe the morphological characteristics of the PTA and to emphasize its clinical significance. We examined radiographs from patients who had CT angiography undertaken for a variety of clinical reasons, performed as a part of their medical treatment at the University Institute for Radiology in Skopje, RN Macedonia. The study population included 234 patients, 130 male and 104 females, mean age 57.8 years. In one patient we found PTA with overall incidence of 0.42%. CTA revealed a left PTA that arise from the internal carotid artery and communicate with the basilar artery between the origin of the anterior inferior cerebellar artery and the superior cerebellar artery. Although anatomically interesting, an awareness of the anatomy and variations of the brain arteries is clinically important for radiologists and surgeons for save performance of procedures, and forensic pathologists since variants may have forensic consequences. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, RENAL LYMPHANGIECTASIA- AN UNUSUAL MIMICKER OF RENAL HYDRONEPHROSIS(Macedonian Association of Anatomists and Morphologists, 2021); ; Renal lymphangiectasia is a rare malformation of the renal lymphatics. It occurs in both children and adults and can be unilateral or bilateral with no gender predilection. It is a condition characterized by different degrees of dilatation of the lymphatic ducts. Because of the rarity, it can be easily misdiagnosed for other cystic masses, most commonly peripelvic cysts, renal cysts or hydronephrosis. Usually is asymptomatic and incidental finding, but in severe cases can lead to hypertension and renal failure. We report a case of unilateral renal lymphangiectasia in adult male patient with medical history of hydronephrosis and characteristic radiologic CT findings. From imaging methods, we conducted ultrasound (US), contrast enhanced computed tomography (CT) and CT angiography, because they have an important role as diagnostic procedures to recognize renal lymphangiectasia. Kidney cystic lesions revealed on ultrasound and confirmed on CT as hypodense intrarenal multiloculated findings, as well as fluid attenuation collections, not always go in favor of hydronephrosis. Knowledge of the radiological findings associated with renal lymphangiectasia can contribute to better differentiation from other conditions and with the right diagnosis, successful management and treatment can be provided for the patient.