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Interventional Neuroradiology

Gerald J Riccardello, Abhinav R Changa, Fawaz Al-Mufti, I Paul Singh, Chirag Gandhi, Max Roman, Charles J Prestigiacomo
Objective The natural history intracranial aneurysms (IA) remains poorly understood despite significant morbidity and mortality associated with IA rupture. Hemodynamic impingement resulting in elevations in wall shear stress and wall shear stress gradient (WSSG) has been shown to induce aneurysmal remodeling at arterial bifurcations. We investigate the hemodynamic environment specific to side-wall pre-aneurysmal vasculature. We hypothesize that fluid impingement and secondary flow patterns play a role in side-wall aneurysm initiation...
January 1, 2018: Interventional Neuroradiology
Zeferino Demartini, Jennyfer Galdino, Gelson L Koppe, Alexandre T Bignelli, Alexandre N Francisco, Luana Am Gatto
Background Patients with polycystic kidney disease have a higher prevalence of intracranial aneurysms and may progress to renal failure requiring transplantation. The endovascular treatment of intracranial aneurysms may improve prognosis, since rupture often causes premature death or disability, but the nephrotoxicity risk associated with contrast medium must be always considered in cases of renal impairment. Methods A 55-year-old female patient with polycystic kidney disease and grafted kidney associated with anterior communicant artery aneurysm was successfully treated by embolization...
January 1, 2018: Interventional Neuroradiology
Simon Ammanuel, Matthew D Alexander, Bertil Damato, Daniel L Cooke, Van V Halbach, Matthew R Amans, Christopher F Dowd, Randall T Higashida, Steven W Hetts
Purpose The aim was to evaluate the impact of protocol changes in selective ophthalmic arterial infusion (SOAI) for treatment of retinoblastoma (Rb). Methods A retrospective review was completed of 35 patients with Rb who were treated with SOAI between March 2010 and January 2017. Treatment details were tabulated for each SOAI session. SOAI protocol was changed in June 2015, and differences before and after this change were evaluated using two-tail chi-square tests and independent sample t-tests to note any differences in technical complications, need for enucleation, and other outcome variables Results 125 SOAI sessions occurred...
January 1, 2018: Interventional Neuroradiology
Denise Brunozzi, Sophia F Shakur, Fady T Charbel, Ali Alaraj
Objective Pipeline embolization devices (PED) are commonly used for endovascular treatment of cerebral aneurysms but changes in intracranial hemodynamics after PED deployment are poorly understood. Here, we assess middle cerebral artery (MCA) and systemic blood pressure before and after PED treatment. Methods Records of patients with cerebral aneurysms proximal to the internal carotid artery terminus treated with PED at our institution between 2015 and 2017 were retrospectively reviewed. Patients were included if ipsilateral MCA pressure measurements were available...
January 1, 2018: Interventional Neuroradiology
Karanarak Urasyanandana, Dittapong Songsang, Taweesak Aurboonyawat, Ekawut Chankaew, Pattarawit Withayasuk, Anchalee Churojana
Methods Patients with cerebral artery dissections were reviewed in a hospital setting from 2008 to 2015. Clinical presentations, lesion locations, treatment modalities, functional outcomes, and mortality were reviewed. Parent artery occlusion was the first choice for surgery or endovascular treatment of a hemorrhagic dissecting cerebral artery. Endovascular or surgical reconstructive treatment was indicated in patients whose parent artery could not be occluded. Favorable functional outcomes were determined using modified Rankin Scale (mRS) scores of 0-2...
January 1, 2018: Interventional Neuroradiology
Christopher J Stapleton, Anoop P Patel, Brian P Walcott, Collin M Torok, Matthew J Koch, Thabele M Leslie-Mazwi, James D Rabinov, William E Butler, Aman B Patel
Background While technological advances have improved the efficacy of endovascular techniques for tentorial dural arteriovenous fistulae (DAVF), superior petrosal sinus (SPS) DAVF with dominant internal carotid artery (ICA) supply frequently require surgical intervention to achieve a definitive cure. Methods To compare the angiographic and clinical outcomes of endovascular and surgical interventions in patients with SPS DAVF, the records of all patients with tentorial DAVF from August 2010 to November 2015 were reviewed...
January 1, 2018: Interventional Neuroradiology
Paloma Largo Flores, Felix Haglund, Pervinder Bhogal, Leonard Yeo Leong Litt, Michael Södermann
We describe two contrasting patients with multiple cerebral aneurysms and a previous history of resected cardiac myxomas with no cardiac recurrence on follow-up echocardiography. Both patients presented with stroke- like symptoms; one with a left visual defect and the other with right hemiplegia. Magnetic resonance imaging of the brain of both patients showed the presence of multiple cerebral aneurysms that was later confirmed on conventional angiography. Both patients' aneurysms were managed conservatively...
January 1, 2018: Interventional Neuroradiology
Ga Y Lee, Gi W Shin, Hyun S Jung, Jin W Baek, Young J Heo, Yoo J Lee, Hye J Choo, Hae W Jeong
Fenestration of the supraclinoid internal carotid artery is extremely rare and frequently associated with aneurysms at the fenestrated segment or other vascular anomalies. We present a rare case of fenestration of the right supraclinoid internal carotid artery in which a small fenestrated segment arose from the neck portion of the paraclinoid aneurysm and fused with the origin of the posterior communicating artery.
January 1, 2018: Interventional Neuroradiology
Akitake Okamura, Kazuhiko Kuroki, Katsuhiro Shinagawa, Naoto Yamada
Background In cases of acute ischemic stroke, manual aspiration of the thrombus is commonly performed with a balloon guiding catheter placed in the cervical segment of the internal carotid artery (ICA). However, most manual aspirations using a balloon guiding catheter are combined with inner catheters, as in the direct aspiration first pass technique (ADAPT). We experienced some cases of acute ischemic stroke with proximal ICA occlusion due to cardiogenic thrombus where we obtained sufficient recanalization by simple manual aspiration from inflated Optimo 9F balloon catheters (Tokai Medical Products, Japan) placed in the origin of the cervical segment of the ICA without any inner catheter or stent retriever...
January 1, 2018: Interventional Neuroradiology
Kirill Orlov, Dmitry Kislitsin, Nikolay Strelnikov, Vadim Berestov, Anton Gorbatykh, Timur Shayakhmetov, Pavel Seleznev, Anton Tasenko
Utilization of flow diverting devices is accompanied with dual antiplatelet therapy to reduce the risk of thromboembolic events, even though this increases the risk of hemorrhagic complications. The updated Pipeline Flex embolization device with Shield Technology has been created using a phosphorylcholine coating that reduces thrombogenicity and possibly reduces the need for dual antiplatelet therapy. However, because of the potential risk to patients of utilizing a pipeline embolization device without dual antiplatelet therapy, the pipeline embolization device with Shield Technology has not been tested in human subjects without dual antiplatelet therapy, and its contribution to preventing thromboembolic events is therefore unknown...
January 1, 2018: Interventional Neuroradiology
Soumik Das, Arun Kumar Gupta, Arvinda Hanumathapura Ramalingiah, Sarbesh Tiwari, Nishtha Yadav
We report a case of delayed migration of Squid 18 following treatment of a direct carotico-cavernous fistula.
January 1, 2018: Interventional Neuroradiology
Robert Juszkat, Bartosz Żabicki, Katarzyna Stanistawska, Karolina Szepelak, Bartosz Kądziołka, Piotr Sosnowski, Jarosław Kocięcki
Background Arteriovenous malformations are potentially serious vascular anomalies that are rarely encountered in the eyelid and require a multidisciplinary approach. Objectives We would like to describe the technical and clinical aspects related to the treatment of palpebral arteriovenous malformation with selective embolization, followed by surgical resection. Methods A 40-year-old patient presented with an isolated high-flow palpebral arteriovenous malformation. Transarterial embolization, using a liquid embolic agent (PHIL™), was performed in this patient...
January 1, 2018: Interventional Neuroradiology
Chae Wook Huh, Sung-Chul Jin
Hemorrhagic intracranial dissecting aneurysms are known to have a poor natural history and an increased tendency to rebleed. The communicating segment of the internal carotid artery (ICA) is an infrequent site of dissection that is difficult to manage using deconstructive endovascular treatment because of the need to preserve important vascular branches. We report two cases of ruptured dissecting aneurysms that occurred in communicating segments of the ICA and treated using a reconstructive endovascular technique involving stent-assisted coiling...
January 1, 2018: Interventional Neuroradiology
Kris E Radcliff, Greg Schroeder
No abstract text is available yet for this article.
January 1, 2018: Interventional Neuroradiology
Hui Guo, QianKun Yin, Peng Liu, Ning Guan, Xiaochuan Huo, Youxiang Li
Background and purpose Transvenous embolization (TVE) is widely utilized as an effective and safe treatment option for cavernous sinus dural arteriovenous fistula (CS-dAVF); however, detecting the exact location of the fistula is challenging. The present study identified the angiographic features of the fistulous point and evaluated the match with the microcatheter tip and fistulous point. Materials and methods An analysis cohort of 45 consecutive patients with CS-dAVF treated by TVE was analyzed retrospectively...
January 1, 2018: Interventional Neuroradiology
Ferdi Cay, Ahmet Peker, Anıl Arat
Objectives The Neuroform Atlas stent (AS) is the smallest intracranial stent with an open-cell design. This study reports the first clinical experience with AS. Methods All intracranial aneurysms treated by stent-assisted coiling using a single AS in a single institution were retrospectively evaluated. Patient demographics, aneurysm characteristics, angles between the parent artery and stented branch, technical success, and clinical and angiographic follow-up were analyzed. Results Fifty-five consecutive aneurysms treated with AS-assisted coiling were included...
January 1, 2018: Interventional Neuroradiology
Jay F Yu, Andrew D Nicholson, Jeffrey Nelson, Matthew D Alexander, Stephanie H Tse, Steven W Hetts, J Claude Hemphill, Helen Kim, Daniel L Cooke
Background and purpose Despite evidence regarding risk factors for brain arteriovenous malformation (bAVM)-associated spontaneous intracranial hemorrhage (ICH), few data exist describing the spectrum of clinical outcomes that bAVM-associated ICH may manifest. This study aimed to identify the demographical, clinical, and bAVM anatomical variables associated with ICH volume and the presence of intraventricular hemorrhage (IVH) of ruptured bAVMs, two indicators of worse clinical outcome, to help better predict outcome for unruptured bAVMs...
January 1, 2018: Interventional Neuroradiology
Sravani Kondapavulur, Daniel L Cooke, Andrew Kao, Matthew R Amans, Matthew Alexander, Robert Darflinger, Christopher F Dowd, Randall T Higashida, Bertil Damato, Van V Halbach, Katherine K Matthay, Steven W Hetts
Background and purpose The purpose of this article is to estimate the distribution of superselective intra-arterial chemotherapy (IAC) delivery to ocular target tissue using quantitative digital subtraction angiography (qDSA). Materials and methods From March 2010 to January 2016, 50 ophthalmic artery contrast DSAs obtained immediately prior to IAC infusions in 22 patients were analyzed. This study was conducted under a retrospective review IRB (no. 10-01862). Parametric color-coded DSAs (iFlow, Siemens Medical) were post-processed (MATLAB, The Mathworks Inc...
January 1, 2018: Interventional Neuroradiology
Shigeru Yamauchi, Taichiro Kawakami, Keiji Murata, Tomoya Ishiguro, Hidetoshi Ikeda, Akimasa Nishio
Background and importance Traditionally, it has been believed that the plexal segment of the anterior choroidal artery (AChoA) can be sacrificed safely. Here, we present a case of choroid plexus arteriovenous malformation (AVM) in which the capsulothalamic artery originated from distal plexal segment of the AChoA. Clinical presentation A 45-year-old man was diagnosed with arteriovenous malformation involving the left inferior horn in screening MRI. Preceding stereotactic radiosurgery, transarterial target embolization was performed...
February 2018: Interventional Neuroradiology
Jun Wang, Changyang Zhong, Yan Zhang, Yingnan Wei, Huili Liu, Chunli Wu, Yongxing Yan
Objective Endovascular stent-assistant angioplasty (ESAA) is a valid treatment for symptomatic vertebrobasilar artery stenosis (SVAS), but the long-term effect and the improvement of condition compared with medication treatment are unknown. This study investigated the long-term efficacy of ESAA in patients with moderate and severe SVAS, and compared the efficacy with medication treatment. Materials and methods We conducted a retrospective analysis of clinical data of 43 patients with moderate and severe SVAS hospitalized in our department...
February 2018: Interventional Neuroradiology
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