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Interventional Neuroradiology

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https://www.readbyqxmd.com/read/28166669/microcatheter-shaping-using-intravascular-placement-during-intracranial-aneurysm-coiling
#1
Shinya Yamaguchi, Osamu Ito, Yuya Koyanagi, Katsuma Iwaki, Koichiro Matsukado
Background The selection of a pre-shaped microcatheter or a shaping method must be carefully considered for successful aneurysm coiling. The objective of this report is to verify the use of intravascular placement to establish an appropriate microcatheter shape. Methods Fifteen patients (15 aneurysms) were included in this study because of the predicted difficulty of microcatheter insertion and stabilisation. The SL-10 straight microcatheter was inserted into the parent artery until the tip of the catheter passed through the neck of the aneurysm...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28162027/retriever-wire-supported-carotid-artery-revascularization-rewised-care-in-acute-ischemic-stroke-with-underlying-tandem-occlusion-caused-by-an-internal-carotid-artery-dissection-technical-note
#2
Daniel Behme, Michael Knauth, Marios-Nikos Psychogios
We hereby report a novel technical approach for the treatment of acute stroke with underlying tandem occlusion. The so-called retriever wire supported carotid artery revascularization (ReWiSed CARe) technique, utilizing the wire of a stent-retriever as a guiding wire for carotid artery stenting, is technically feasible in tandem occlusions caused by an internal carotid artery (ICA) dissection or high grade ICA stenosis. This technique eliminates the need to use a long microwire in order to maintain the position inside the true lumen of a dissection...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28152631/construction-of-an-in%C3%A2-vivo-carotid-siphon-model-for-testing-endovascular-devices-for-neuro-interventions
#3
Bu-Lang Gao, Yong-Li Wang, Xue-Jing Zhang, Qiong-Ying Fan, Wei-Li Hao, Dong-Hai Zhang
Objective The aim of this study was to construct an in vivo carotid siphon model for testing neurovascular devices for endovascular interventions. Methods A model of a human carotid siphon was pre-shaped using a glass tube from a human cadaver and used to confine a segment of one side of the common carotid artery (CCA) in canines. This segment of CCA with the glass carotid siphon on was interposed end-to-end onto the contralateral CCA so as to simulate a human carotid artery siphon in vivo. Two weeks later, the siphon model was evaluated using computed tomography angiography and digital subtraction angiography, and the covered stent specially designed for intracranial vasculature was navigated through the siphon model for a longitudinal flexibility test...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28133987/ruptured-intracranial-vertebral-artery-dissecting-aneurysms-an-evaluation-of-prognostic-factors-of-treatment-outcome
#4
K Urasyanandana, P Withayasuk, D Songsaeng, T Aurboonyawat, E Chankaew, A Churojana
Objective Intracranial spontaneous vertebral artery dissecting aneurysms commonly occur in the third to fifth decades of life, and are mostly associated with hypertension. Patients present with intracranial haemorrhage or thromboembolic events. Patients who present with intracranial haemorrhage carry about a 70% risk of recurrent bleeding. Patients with a posterior-inferior cerebellar artery (PICA) or ipsilateral dominant vertebral artery involve selecting which parent vessel could not be sacrificed. Recent reconstructive techniques such as stent-assisted coiling embolisation and flow-diverting stents are effective treatments of choice...
January 1, 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
#5
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...
January 1, 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
#6
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...
December 12, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27956518/use-of-self-expanding-stents-for-better-intracranial-flow-diverter-wall-apposition
#7
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...
December 12, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27913802/combined-use-of-a-pconus-and-a-solitaire-stent-report-of-two-cases
#8
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...
December 2, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27913800/the-transvenous-pressure-cooker-technique-a-treatment-for-brain-arteriovenous-malformations
#9
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.
December 2, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27903925/onyx-extravasation-during-embolization-of-a-brain-arteriovenous-malformation
#10
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...
November 30, 2016: 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
#11
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
#12
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
https://www.readbyqxmd.com/read/27895243/contrast-less-stent-placement-for-vertebral-artery-origin-stenosis
#13
Shinzo Ota, Yoshinobu Sekihara, Takahiro Himeno, Yasue Tanaka, Tatsuya Ohtonari
We performed stent placement under intravascular ultrasound (IVUS), without the use of contrast medium, in a male patient in his 70s who had vertebral artery origin stenosis and decreased renal function. Satisfactory dilatation was achieved without complications, and the patient remained asymptomatic at 2 years of follow-up. We now report the details of this procedure. Stent placement under IVUS guidance may be useful in patients in whom contrast medium is contraindicated.
February 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27895242/availability-of-endovascular-therapies-for-cerebrovascular-disease-at-primary-stroke-centers
#14
Mark J Alberts, Jean Range, William Spencer, Vicki Cantwell, M J Hampel
Background Endovascular therapies (EVTs) are useful for treating cerebrovascular disease. There are few data about the availability of such services at primary stroke centers (PSCs). Our hypothesis was that some of these services may be available at some PSCs. Methods We conducted an internet-based survey of hospitals certified as PSCs by the Joint Commission. The survey inquired about EVTs such as intra-arterial (IA) lytics, IA mechanical clot removal, coiling of aneurysms, and cervical arterial stenting, physician training, coverage models, hospital type, and outcomes...
February 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27895241/secular-pattern-of-aneurismal-rupture-with-the-lunar-cycle-and-season
#15
Jillian C Banfield, Mohamed Abdolell, Jai S Shankar
Background The lunar cycle and seasons may be associated with rates of rupture of intracranial aneurysms, but the literature is mixed. Studies of the association between the lunar cycle and rates of aneurysm rupture used the eight qualitative moon phases. The purpose of this study was to assess any association of aneurysm rupture with the lunar cycle and with the season. Materials and methods We retrospectively reviewed all cases of subarachnoid haemorrhage secondary to ruptured intracranial aneurysm treated with endovascular coiling in our institution over a 10-year period...
February 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27837112/endovascular-treatment-of-vein-of-galen-aneurysmal-malformation-using-rapid-ventricular-pacing-a-case-report
#16
Birgitta Ramgren, Olof Rask, Jan Gelberg, Petru Liuba, Per Undrén, Johan Wassélius
The treatment of choice of vein of Galen aneurysmal malformation (VGAM) involves endovascular procedures that can be difficult to perform in high-flow fistulas. We describe the use of rapid ventricular pacing (RVP), a well-known cardiologic technique, to safely treat a high-flow fistula in an infant with VGAM.
February 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27815339/should-future-interventional-neuroradiologists-be-screened-for-mutations-that-impair-radiation-induced-dna-repair
#17
Kieran Murphy, Adam Thakore, Marie Constance Lacasse, Danyal Z Khan
In our current medical practice, an increasing number of specialists now have access to radiology technical platforms in order to perform imaging-guided procedures. Although knowledge about the current guidelines and radiation protection devices is a pre-requisite for the use of radiation, the preventive measures are often more or less strictly followed, leading to chronic daily exposure to significant doses of radiation and large accumulated lifetime exposures. Aortic intervention, electrophysiology, and neuro intervention in particular can result in large doses to the operators...
February 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27798328/cerebral-venous-sinuses-thrombosis-in-both-transverse-sinus-and-torcula-multistep-endovascular-treatment-and-stenting
#18
G Cabral de Andrade, A Lesczynsky, V M Clímaco, E R Pereira, P O Marcelino, Aoc Franco, D F De Almeida
Purpose Cerebral venous sinus thrombosis (CVST) is an unusual and potentially life-threatening condition with variable and nonspecific clinical symptoms and high morbimortality rates. Standard therapy consists of systemic anticoagulation; although there is no clear evidence about the best choice for treatment, intravenous heparin is used as the first-line treatment modality. Intravenous sinus thrombolysis can be an effective and relatively safe treatment for acutely deteriorating patients who have not responded to conventional therapy...
February 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27798327/effects-on-vessel-measurement-accuracy-and-subsequent-occlusion-after-calcium-channel-blocker-infusion-during-treatment-of-cerebral-aneurysms-with-the-pipeline-embolization-device
#19
M D Alexander, A D Nicholson, R J Darflinger, F Settecase, D L Cooke, C F Dowd, M R Amans, R T Higashida, S W Hetts, V V Halbach
Introduction/Purpose To achieve aneurysm occlusion, flow diverters (FDs) must be accurately sized to maximize coverage over the neck and induce thrombosis. Catheterization for diagnostic angiography can cause vasospasm that may affect vessel measurements. This study evaluates impacts of intra-arterial infusion of a calcium channel blocker (CCB) on angiographic measurements in patients treated with FDs to determine effects on final diameter of the FD and subsequent occlusion. Materials and methods Pre-treatment measurements were recorded for diameter of the distal and proximal landing zones and maximum and minimum diameters between these segments...
February 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27798326/traumatic-arteriovenous-fistula-between-the-extracranial-middle-meningeal-artery-and-the-pterygoid-plexus-a-case-report-and-literature-review
#20
Jinlu Yu, Yunbao Guo, Zhongxue Wu, Kan Xu
The formation of a traumatic arteriovenous fistula (AVF) between the extracranial middle meningeal artery (MMA) and the pterygoid plexus (PP) is very rare, and understanding of this condition is limited. This paper reports the case of an 8-year-old who suffered minor injuries after a high fall four months prior to admission and showed good recovery after one month. However, the child gradually developed exophthalmos of the left eye and conjunctival redness one month prior to admission. Auscultation revealed an intracranial murmur near the left side of the face, in the temporal region...
February 2017: Interventional Neuroradiology
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