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Interventional Neuroradiology

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https://www.readbyqxmd.com/read/28304208/issues-with-vertebral-artery-dissections
#1
Marc A Bronson, Stephen M Perle, Peter Tuchin
No abstract text is available yet for this article.
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304207/dural-venous-sinus-stenting-for-medically-and-surgically-refractory-idiopathic-intracranial-hypertension
#2
Sudhakar R Satti, Lakshmi Leishangthem, Alejandro Spiotta, M Imran Chaudry
Background Idiopathic intracranial hypertension (IIH) is a syndrome defined by elevated intracranial hypertension without radiographic evidence of a mass lesion in the brain. Dural venous sinus stenosis has been increasingly recognized as a treatable cause, and dural venous sinus stenting (DVSS) is increasingly performed. Methods A 5 year single-center retrospective analysis of consecutive patients undergoing DVSS for medically refractory IIH. Results There were 43 patients with a mean imaging follow-up of 6...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304206/restenosis-after-stenting-in-symptomatic-vertebral-arterial-orifice-disease-and-considerations-for-better-outcome
#3
Jun Young Chang, Hyun Park, Oki Kwon, Moon-Ku Han
We have performed stenting in 11 patients with symptomatic vertebral arterial orifice stenosis refractory to medical treatment or impairment in anterior circulation. Three of the 11 patients experienced asymptomatic severe in-stent restenosis or occlusion. Bare metal stents were used in those three patients, two of whom received revascularization therapy. Development of sufficient cervical collateral channels reconstituting the distal vertebral artery was the common feature in patients with asymptomatic in-stent restenosis...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304205/stenting-of-the-cervical-internal-carotid-artery-in-acute-stroke-management-the-karolinska-experience
#4
Anastasios Mpotsaris, Christoph Kabbasch, Jan Borggrefe, Vamsi Gontu, Michael Soderman
Background Emergency stent placement in the extracranial internal carotid artery in combination with anterior circulation thrombectomy is a routine procedure. Yet, precise indications and clinical safety in this setting remains controversial. Present data for mechanical thrombectomy include few studies with acute stenting of tandem occlusions. We evaluated the feasibility, safety and clinical outcome of this endovascular treatment in a retrospective analysis of all consecutive cases at a comprehensive stroke centre...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304204/changes-in-contrast-transit-times-on-digital-subtraction-angiography-post-pipeline-embolization-device-deployment
#5
Ahmed E Hussein, Andreas Linninger, Sophia F Shakur, Fady T Charbel, Chih-Yang Hsu, Fady T Charbel, Ali Alaraj
It is postulated that hemodynamic changes occur in the distal vascular bed post-deployment of Pipeline Embolization Devices (PEDs). In this paper, we evaluate changes in the contrast transit times (TTs) on digital subtraction angiography (DSA) post-PED interventions. DSA films were analyzed using custom-made software for the time-density relationship at baseline and compared to post-PED deployment. All analyses were performed within the middle cerebral artery (MCA) M1 segment. Analyses included TT10%-100% (time needed for the contrast to change from 10% image intensity to 100%), TT100%-10%, and TT25%-25%...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304203/manual-aspiration-thrombectomy-using-a-penumbra-catheter-in-patients-with-acute-migrated-mca-occlusion
#6
Sung Hyun Baik, Hyo Sung Kwak, Seung Bae Hwang, Gyung Ho Chung
Background We retrospectively assessed the efficacy and safety of manual aspiration thrombectomy (MAT) using a Penumbra catheter in patients with acute migrated middle cerebral artery (MCA) occlusion. Methods We conducted a retrospective review of patients who underwent MAT using Penumbra 4 or 5 MAX reperfusion catheters for the treatment of acute MCA occlusion between January 2012 and December 2015. A migrated thrombus was defined as distal migration greater than ≥1 cm on initial cerebral angiography compared with preprocedural angiographic findings...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304201/evaluation-of-the-characteristics-of-various-types-of-finishing-coils-for-the-embolization-of-intracranial-aneurysms-in-an-experimental-model-with-radiolucent-coils
#7
Keisuke Ota, Noriaki Matsubara, Shigeru Miyachi, Takashi Izumi, Masashi Ito, Takumi Asai, Takashi Yamanouchi, Toshihiko Wakabayashi
In endovascular coil embolization of intracranial aneurysms, very soft coils, often called "finishing coils," are usually selected in the final stage of coil embolization. The authors developed a radiolucent coil made of thin nylon thread to evaluate the performance of coils under a situation simulating the course of embolization. The characteristics of various types of finishing coils were investigated using radiolucent coils. Experimental embolization was performed with a silicone aneurysm filled with radiolucent coils simulating the final stage of embolization...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304200/advance-an-effective-and-feasible-technique-in-acute-stroke-treatment
#8
Erdem Gurkas, Cetin Kursad Akpinar, Emrah Aytac
Background and purpose Different techniques regarding efficient utilization of thrombectomy devices have been reported. Here, we described a novel technique named ADVANCE that is based on advancing a distal access catheter over the stent retriever. In this study, we aimed to report our initial results with this novel thrombectomy technique. Methods and results Sixty-seven consecutive acute anterior circulation ischemic stroke patients (35 male, 32 female) between January 2015 and January 2016 who were treated by mechanical thrombectomy were included in this prospective study...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304199/jailed-double-microcatheter-technique-following-horizontal-stenting-for-coil-embolization-of-intracranial-wide-necked-bifurcation-aneurysms-a-technical-report-of-two-cases
#9
Takahiro Kitahara, Taketo Hatano, Makoto Hayase, Etsuko Hattori, Akinori Miyakoshi, Takehiko Nakamura
The horizontal stenting technique facilitates endovascular treatment of wide-necked bifurcation intracranial aneurysms. Previous literature shows, however, that subsequent coil embolization at initial treatment results in incomplete obliteration in many cases. The authors present two consecutive cases of wide-necked large bifurcation aneurysms to describe an additional coil embolization technique following horizontal stenting. The patients were a 53-year-old female with an unruptured internal carotid artery terminus aneurysm and a 57-year-old female with a recurrent basilar artery tip aneurysm...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304198/extracranial-vertebral-artery-rupture-likely-secondary-to-cupping-therapy-superimposed-on-spontaneous-dissection
#10
Jae Young Choi, Jae Il Lee
No abstract text is available yet for this article.
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304197/endovascular-treatment-of-a-dural-arteriovenous-fistula-in-a-patient-with-loeys-dietz-syndrome-a-case-report
#11
Rie Aoki, Kittipong Srivatanakul, Takahiro Osada, Kazuko Hotta, Takatoshi Sorimachi, Mitsunori Matsumae, Hiroko Morisaki
Background Loeys-Dietz syndrome (LDS) is a recently recognized autosomal dominant connective tissue disease. The manifestations of LDS include vascular tortuosity, scoliosis, craniosynostosis, aneurysm and aortic dissections. Clinical presentation A 35-year-old woman treated with Stanford type B aortic dissection and breast cancer was referred to us for Borden type II dural arteriovenous fistula (dAVF) draining to the vein of Galen, involving the midline of tentorium cerebelli. The dAVF was treated successfully by combined transarterial and transvenous embolization...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28156167/gamma-knife-radiosurgery-for-the-treatment-of-intracranial-dural-arteriovenous-fistulas
#12
Adam A Dmytriw, Michael L Schwartz, Michael D Cusimano, Vitor Mendes Pereira, Timo Krings, Michael Tymianski, Ivan Radovanovic, Ronit Agid
Background Intracranial dural arteriovenous fistulae (DAVF) may present a treatment challenge. Endovascular embolization is in most cases the first line of treatment but does not always achieve cure. Gamma Knife (GK) radiosurgery represents an alternative treatment option, and the purpose of this study was to further evaluate its utility. Methods We reviewed all cases of DAVF treated between 2009 and 2016 at our institution with GK radiosurgery independently, or following failed/refused endovascular or surgical management...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28133986/a-case-of-filum-terminale-arterial-venous-fistula-needed-a-long-arterial-access-for-trans-arterial-shunt-obliteration
#13
Daisuke Wajima, Ichiro Nakagawa, Hun-Soo Park, Takahide Haku, Takeshi Wada, Kimihiko Kichikawa, Hiroyuki Nakase
A 78-year-old man was referred to our institution with a predominantly progressive numbness of both legs, and bladder dysfunction with urinary retention. He was diagnosed as the symptomatic arteriovenous fistula of the filum terminale (AVFFT). A trans-arterial embolization (TAE) of the arteriovenous shunt was planned for his symptomatic AVFFT. The long distance between the origin of the radiculo meningeal artery (Th8) and the site of the fistula (S1) resulted in the first TAE having a feeder occlusion. The length of accessible feeder in the first TAE was the longest (about 40 cm) as the past reports of the endovascular therapy...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27956519/advancing-marksman-into-contralateral-vertebral-artery-in-the-treatment-of-intradural-vertebral-artery-dissecting-aneurysm-with-pipeline
#14
Yupeng Zhang, Shikai Liang, Chuhan Jiang
Unruptured vertebral arteries dissecting aneurysms have a benign clinical course. The most common symptoms compromise headache, neck pain, dizziness and vomiting. The optimal endovascular treatment option remains controversial. Reconstructive techniques have many advantages over deconstructive ones since the advent of flow diverters such as the Pipeline embolization device (PED). Here, we present a case successfully treated with a PED through a combination of the radial access and advancement of the Marksman catheter into the contralateral vertebral artery due to the special angio-architecture of the patient...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27956518/use-of-self-expanding-stents-for-better-intracranial-flow-diverter-wall-apposition
#15
Anna Luisa Kühn, Ajay K Wakhloo, Matthew J Gounis, Peter Kan, Katyucia de Macedo Rodrigues, J Diego Lozano, Miklos G Marosfoi, Mary Perras, Christopher Brooks, Mary C Howk, David E Rex, Francesco Massari, Ajit S Puri
Background Flow diverter (FD) malapposition is associated with stroke-related complications. We document the use of self-expanding nitinol stents to remove/reduce the ledge of a FD deployed for aneurysm treatment. Methods We identified five patients who were treated with the Pipeline embolization device (PED) in conjunction with a Neuroform EZ stent for inadequate wall apposition of the ends of the FD at our institution between May 2014 and July 2015. Among other parameters, angiographic results, cone-beam computed tomography assessment of wall apposition and patient clinical outcome were evaluated...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27913802/combined-use-of-a-pconus-and-a-solitaire-stent-report-of-two-cases
#16
Pervinder Bhogal, Marta Aguilar Pérez, Rosa Martinez Moreno, Marcin Miś, Maciej Miś, Hans Henkes
Objective The aim of this study was to report our initial experience of the use of the pCONus neck protection device in conjunction with the Solitaire AB stent to assist in the endovascular management of complex intracranial aneurysms with arteries arising from both the neck and the dome of the aneurysm. Methods Two patients with unruptured aneurysms underwent elective endovascular management of their aneurysms, one arising from the middle cerebral artery bifurcation and one from the anterior communicating artery...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27913800/the-transvenous-pressure-cooker-technique-a-treatment-for-brain-arteriovenous-malformations
#17
Guang Zhang, Shiyi Zhu, Pei Wu, Shancai Xu, Huaizhang Shi
The treatment of brain arteriovenous malformations (AVMs) remains a significant challenge, especially hemorrhagic AVMs which are unsuitable for microsurgery or radiosurgery. We demonstrate an AVM located in the left basal ganglia area, supplied by slender arteries, and treated by the transvenous pressure cooker technique. Herein, we describe the procedure and outline the crucial points and indications for this technique.
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27903925/onyx-extravasation-during-embolization-of-a-brain-arteriovenous-malformation
#18
Hiroyuki Ikeda, Hirotoshi Imamura, Yuji Agawa, Yukihiro Imai, Shoichi Tani, Hidemitsu Adachi, Tatsuya Ishikawa, Yohei Mineharu, Nobuyuki Sakai
During Onyx embolization to treat brain arteriovenous malformation (AVM), carefully observing the penetration of Onyx to the nidus is important in order to avoid complications such as hemorrhage, ischemia, and difficulty with microcatheter removal. We encountered a case of Onyx extravasation during embolization of a cerebellar AVM confirmed by surgical resection and pathological analysis. The patient was a 44-year-old man with Spetzler-Martin grade I cerebellar AVM who underwent Onyx embolization prior to resection of the brain AVM...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27941133/letter-regarding-absence-of-skin-discoloration-after-transarterial-embolization-of-a-subcutaneous-auricular-arteriovenous-malformation-with-phil
#19
Rob Greene
No abstract text is available yet for this article.
February 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27913801/the-pressure-reduction-coefficient-a-new-parameter-to-assess-aneurysmal-blood-stasis-induced-by-flow-diverters-disruptors
#20
Gregory Gascou, Riccardo Ferrara, Dominique Ambard, Mathieu Sanchez, Kyriakos Lobotesis, Franck Jourdan, Vincent Costalat
Background and purpose Pore density (PD), surface metal coverage (SMC) and the number of wires are all different parameters which can influence the efficacy of a flow disruptor/diverter. Nevertheless, the relative importance of a parameter to induce intra-aneurysmal blood stasis is still poorly evaluated. Therefore, comparison between devices based on a unique value is not reliable. The aim of this study was to propose a new bench top parameter (the pressure reduction coefficient (PRC; ξ)) in order to assess the global haemodynamic effect of each flow diverter/disruptor to slow flow...
February 2017: Interventional Neuroradiology
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