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Intracranial Fusiform aneurysm

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https://www.readbyqxmd.com/read/28265011/tourniquet-parent-artery-occlusion-after-flow-diversion
#1
Visish M Srinivasan, Maxim Mokin, Edward A M Duckworth, Stephen Chen, Ajit Puri, Peter Kan
BACKGROUND: The Pipeline Embolization Device (PED) is increasingly used for both on- and off-label purposes for treatment of intracranial aneurysms. The device gradually slows flow of blood into the aneurysm, but the high metal coverage of PED promotes endothelialization of the device. Occasionally, this leads to in-stent stenosis that is clinically well tolerated. We present a multi-institutional Pipeline series that includes three cases of gradual asymptomatic occlusion within the PED and parent vessel...
March 6, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28209313/the-arborization-bypass-sequential-intracranial-intracranial-bypasses-for-an-unruptured-fusiform-mca-aneurysm
#2
Jonathan J Russin
Revascularization techniques are being featured more prominently as endovascular treatments continue to select out complex cerebrovascular pathologies for open surgical management. The current healthcare environment requires decreased hospital stays and improved clinical outcomes despite the growing complexity of open surgical cases. Recent efforts to reduce operative room time and decrease risk for bypass surgery have focused on avoiding graft harvest and maintaining the entire bypass intracranial. The presented technique features an arborization bypass to serially anastomose the middle cerebral artery vessels allowing for proximal trapping of a complex aneurysm without graft harvest...
February 10, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28186451/techniques-and-outcomes-of-microsurgical-management-of-ruptured-and-unruptured-fusiform-cerebral-aneurysms
#3
Sam Safavi-Abbasi, M Yashar S Kalani, Ben Frock, Hai Sun, Kaan Yagmurlu, Felix Moron, Laura A Snyder, Randy J Hlubek, Joseph M Zabramski, Peter Nakaji, Robert F Spetzler
OBJECTIVE Fusiform cerebral aneurysms represent a small portion of intracranial aneurysms; differ in natural history, anatomy, and pathology; and can be difficult to treat compared with saccular aneurysms. The purpose of this study was to examine the techniques of treatment of ruptured and unruptured fusiform intracranial aneurysms and patient outcomes. METHODS In 45 patients with fusiform aneurysms, the authors retrospectively reviewed the presentation, location, and shape of the aneurysm; the microsurgical technique; the outcome at discharge and last follow-up; and the change in the aneurysm at last angiographic follow-up...
February 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28118952/the-only-case-of-mycotic-aneurysm-of-the-pica-clinical-radiological-remarks-and-review-of-literature
#4
Manolo Piccirilli, Emiliano Prizio, Delia Cannizzaro, Maria Pia Tropeano, Giulio Guidetti, Antonio Santoro
We present the first and only case, reported in literature, of a 67-years-old man with a mycotic aneurysm (MA) of the left posterior inferior cerebellar artery (PICA), caused by group B Streptococcus, that we surgically treated, performing neck aneurysm clipping, preserving patency of parent vessel. Moreover the peculiarity of this case is represented by the fact that the MA is originated from a tooth abscess, treated about two years before. To date, there have been only 10 cases of association between MA with either tooth pathologies or dental surgical procedures and our case is the only one originating from PICA...
April 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28087432/stenting-after-coiling-using-a-single-microcatheter-for-treatment-of-ruptured-intracranial-fusiform-aneurysms-with-parent-arteries-less-than-1-5-mm-in-diameter
#5
Jian Liu, Yisen Zhang, Yang Wang, Shiqing Mu, Xinjian Yang
BACKGROUND: Ruptured intracranial fusiform aneurysms involving small-diameter parent arteries are difficult to treat. Parent artery occlusion is a relatively simple and reliable treatment. However, occasionally, the parent arteries have to be retained. The arrival of the low-profile stent (LVIS Jr.) has made reconstructive endovascular treatment for fusiform aneurysms involving small-diameter parent arteries possible. CASE DESCRIPTION: This report describes an innovative method for stent-assisted coiling (stenting after coiling technique using only 1 microcatheter) and describes our initial experience and feasibility of this technique...
March 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28064352/pipeline-embolization-device-for-the-treatment-of-a-traumatic-intracranial-aneurysm-in-a-child
#6
Felipe Padovani Trivelato, Marco Túlio Salles Rezende, Luiz Venâncio Fonseca, Lucas Eduardo Bonadio, Alexandre Cordeiro Ulhôa, Daniel Giansante Abud
INTRODUCTION: Traumatic intracranial aneurysms in children are rare and may occur as the result of closed or penetrating head trauma. Their natural history seems to be more aggressive. Most traumatic aneurysms have complex shape, tending to have a large neck or even a fusiform morphology. CASE REPORT: We present a case of a traumatic carotid artery aneurysm in a 9-year-old girl that was successfully treated with pipeline embolization device. DISCUSSION: Due to its dissecting nature, wall friability and lack of a substantial neck can make surgical clipping and selective coiling difficult and risky...
January 7, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28057633/compacting-a-single-flow-diverter-versus-overlapping-flow-diverters-for-intracranial-aneurysms-a-computational-study
#7
R J Damiano, V M Tutino, N Paliwal, D Ma, J M Davies, A H Siddiqui, H Meng
BACKGROUND AND PURPOSE: Locally compacting the mesh of a flow diverter by a dynamic push-pull technique can accelerate intracranial aneurysm healing. We asked how this deployment strategy compares with overlapping 2 flow diverters for aneurysmal flow reduction. MATERIALS AND METHODS: Using a high-fidelity virtual stent placement method, we simulated 3 flow-diverter strategies (single noncompacted, 2 overlapped, and single compacted) in 3 aneurysms (fusiform, large saccular, and medium saccular)...
March 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28029187/off-label-uses-for-flow-diversion-in-intracranial-aneurysm-management
#8
Fawaz Al-Mufti, Krishna Amuluru, Gomez Francisco, Vincent Dodson, Mohammad El-Ghanem, Charles J Prestigiacomo, Chirag D Gandhi
Treatment of complex aneurysms using microsurgical and other conventional neuroendovascular techniques remains challenging. As a result, stent- and balloon-assisted coiling are instead performed to treat morphologically complex aneurysms, which include giant, wide-necked, and fusiform aneurysms. While these techniques have had success in treating these complex aneurysms, recanalization rates associated with these techniques are still problematic. In the constant effort to improve the outcome of complex aneurysm treatment, flow-diverting stents (FDSs) have emerged in recent years as the preferred treatment...
December 28, 2016: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28003171/a-contralateral-transcondylar-fossa-approach-with-bilateral-v3-segment-exposure-for-repairing-complex-vertebral-artery-aneurysms
#9
Nakao Ota, Rokuya Tanikawa, Masataka Miyama, Takanori Miyazaki, Yu Kinoshita, Hidetoshi Matsukawa, Fumihiro Sakakibara, Norihiro Saito, Shiro Miyata, Kosumo Noda, Toshiyuki Tsuboi, Hiroyasu Kamiyama, Sadahisa Tokuda, Kyousuke Kamada
BACKGROUND AND IMPORTANCE: Microsurgical treatment for vertebral artery aneurysms can be approached through the lateral aspect of the brainstem and cerebellum. A contralateral approach may be selected in complex aneurysms with tortuous running and the intracranial vertebral artery distal to the aneurysm located in the contralateral cerebellopontine angle. When repairing the aneurysm, exposing the V3 segment before craniotomy is advantageous. We describe the detailed surgical procedures of the contralateral transcondylar fossa approach with bilateral V3 segment exposure for the repair of a complex vertebral artery aneurysm...
March 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27890754/endovascular-treatment-of-spontaneous-intracranial-fusiform-and-dissecting-aneurysms-outcomes-related-to-imaging-classification-of-309-cases
#10
Yisen Zhang, Zhongbin Tian, Binbin Sui, Yang Wang, Jian Liu, Miao Li, Youxiang Li, Chuhan Jiang, Xinjian Yang
OBJECTIVE: To propose a modified classification system for spontaneous intracranial dissecting aneurysms (IDAs) that can guide treatment decisions. METHODS: Between January 2010 and December 2015, 3183 consecutive patients were referred to our department for endovascular treatment of a cerebral aneurysm. Among this group, 309 patients harboring a total of 323 spontaneous IDAs were identified. Based on a modified imaging classification system, spontaneous IDAs were classified into 4 subtypes: classic dissecting aneurysm, segmental ectasia, dolichoectatic dissecting aneurysm, and large mural bleeding ectasia...
February 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27767401/-awake-clipping-of-cerebral-aneurysms-report-of-initial-series
#11
Saleem I Abdulrauf, Peter Vuong, Ritesh Patel, Raghu Sampath, Ahmed M Ashour, Lauren M Germany, Jonathon Lebovitz, Colt Brunson, Yuvraj Nijjar, J Kyle Dryden, Maheen Q Khan, Mihaela G Stefan, Evan Wiley, Ryan T Cleary, Connor Reis, Jodi Walsh, Paula Buchanan
OBJECTIVE Risk of ischemia during aneurysm surgery is significantly related to temporary clipping time and final clipping that might incorporate a perforator. In this study, the authors attempted to assess the potential added benefit to patient outcomes of "awake" neurological testing when compared with standard neurophysiological testing performed under general anesthesia. The procedure is performed after the induction of conscious sedation, and for the neurological testing, the patient is fully awake. METHODS The authors conducted an institutional review board-approved prospective study of clipping unruptured intracranial aneurysms (UIAs) in 30 consecutive adult patients who underwent awake clipping...
October 21, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27765738/flow-diverters-in-the-treatment-of-pediatric-cerebrovascular-diseases
#12
M Barburoglu, A Arat
BACKGROUND AND PURPOSE: There is very limited data concerning utilization of flow diverters in children. Our aim is to report results for the treatment of complex intracranial aneurysms and carotid cavernous fistulas by using flow diverters in children. MATERIALS AND METHODS: Retrospective review of children (17 years of age or younger) treated with flow diverters between May 2011 and July 2014 was performed. Clinical and laboratory data and angiographic findings were extracted...
October 20, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/27693822/flow-diversion-for-treatment-of-growing-a2-aneurysm-in-a-child-case-report-and-review-of-flow-diversion-for-intracranial-aneurysms-in-pediatric-patients
#13
Jay Ashok Vachhani, Christopher Michael Nickele, Lucas Elijovich, Paul Klimo, Adam Stephen Arthur
BACKGROUND: Intracranial flow diversion has gained increasing popularity since the approval of the Pipeline Embolization Device (PED). Although it is only approved for use in adult patients, the PED has been used to treat aneurysms in pediatric patients. We present the first reported case of the use of a PED in a pediatric patient to treat an unusual fusiform distal anterior cerebral artery aneurysm. CASE DESCRIPTION: A 12-year-old girl presented with new onset seizures and was found to have a distal left anterior cerebral artery aneurysm...
September 29, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27677627/spontaneous-and-unruptured-chronic-intracranial-artery-dissection-high-resolution-magnetic-resonance-imaging-findings
#14
Seung Chai Jung, Ho Sung Kim, Choong-Gon Choi, Sang Joon Kim, Sun U Kwon, Dong-Wha Kang, Jong S Kim
PURPOSE: The aim of this article is to present high-resolution magnetic resonance imaging (HR-MRI) findings of chronic stage spontaneous and unruptured intracranial artery dissection (ICAD). MATERIAL AND METHODS: From March 2012 to April 2016 a total of 29 patients (15 male and14 female, age range 37-68 years) with chronic stage spontaneous and unruptured ICAD (vertebral artery 27, posterior inferior cerebellar artery 1 and middle cerebral artery 1) were retrospectively enrolled...
September 27, 2016: Clinical Neuroradiology
https://www.readbyqxmd.com/read/27651862/comparison-of-endovascular-treatments-of-ruptured-dissecting-aneurysms-of-the-intracranial-internal-carotid-artery-and-vertebral-artery-with-a-review-of-the-literature
#15
Hyoung Soo Byoun, Hyeong Joong Yi, Kyu Sun Choi, Hyoung Joon Chun, Yong Ko, Koang Hum Bak
OBJECTIVE: Subarachnoid hemorrhage (SAH) caused by rupture of an internal carotid artery (ICA) or vertebral artery (VA) dissecting aneuryesm is rare. Various treatment strategies have been used for ruptured intracranial dissections. The purpose of this study is to compare the clinical and angiographic characteristics and outcomes of endovascular treatment for ruptured dissecting aneurysms of the intracranial ICA and VA. METHODS: The authors retrospectively reviewed a series of patients with SAH caused by ruptured intracranial ICA and VA dissecting aneurysms from March 2009 to April 2014...
September 2016: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/27570378/endovascular-treatment-of-unruptured-posterior-circulation-intracranial-aneurysms
#16
Xianli Lv, Huijian Ge, Hengwei Jin, Hongwei He, Chuhan Jiang, Youxiang Li
BACKGROUND AND PURPOSE: Endovascular treatment of unruptured posterior circulation intracranial aneurysms (UPCIAs) is limited in the International Study of Unruptured Intracranial Aneurysms (ISUIA). The aim of this study is to evaluate the periprocedural morbidity, mortality, and midterm clinical and angiographic follow-ups of endovascular treatment of UPCIAs. MATERIALS AND METHODS: Retrospective analysis of all patients treated in a 2-year period (89 patients: 10-78 years of age, mean: 45...
July 2016: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/27514698/the-derivo-embolization-device-in-the-treatment-of-intracranial-aneurysms-short-and-midterm-results
#17
Erol Akgul, Hasan Bilen Onan, Suha Akpinar, Huseyin Tugsan Balli, Erol Huseyin Aksungur
OBJECTIVE: The DERIVO embolization device (DED) is a new nitinol flow diverter stent manufactured for the treatment of intracranial aneurysms. In this study, we evaluated the safety and efficacy of the DED in the treatment of intracranial aneurysms and present the short- and midterm results. METHODS: We treated 34 aneurysms using 26 devices in 24 patients with wide-necked, mostly medium-sized, and fusiform aneurysms. Fourteen of the patients included in the study were women and the other 10 were men...
November 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27511816/the-insidious-appearance-of-the-dissecting-aneurysm-imaging-findings-and-related-pathophysiology-a-report-of-two-cases
#18
Valeria Onofrj, Maria Cortes, Donatella Tampieri
Intracranial dissecting aneurysms have been frequently reported to present with fairly challenging and time-variable imaging findings that can be mostly explained by the pathological mechanisms that underline the dissection. We present two cases of spontaneous dissecting aneurysm of the supraclinoid ICA, both clinically presenting with SAH, but characterized by different progression of clinical symptoms and imaging. However, in both cases an outpouch and a mild fusiform dilation of the supraclinoid ICA was present in the initial CTA performed after the occurrence of symptoms...
December 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27403217/auditory-hallucinosis-as-a-presenting-feature-of-interpeduncular-lipoma-with-proximal-p1-segment-fenestration-report-of-a-rare-case-and-review-of-literature-on-peduncular-hallucinosis
#19
Ashish Kulhari, Sunil Manjila, Gagandeep Singh, Kunal Kumar, Robert W Tarr, Nicholas Bambakidis
The authors present a unique case of intracranial lipoma in the interpeduncular cistern associated with proximal P1 segment fenestration. This patient is a 20-year-old male with extensive psychiatric history and complaints of recent auditory hallucinations. Cranial magnetic resonance imaging (MRI) (T1, T2, and FLAIR) showed a hyperintense lesion in the left aspect of interpeduncular cistern with a prominent flow void within the hyperintense lesion suggestive of a combined vascular-lipomatous lesion. Computed tomography (CT) angiography showed a high-riding large tortuous P1 segment on the left side with proximal fenestration, the ectatic posteromedial limb harboring a fusiform dilated segment...
June 2016: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/27402799/two-stage-reconstructive-overlapping-stent-leo-and-silk-for-treatment-of-intracranial-circumferential-fusiform-aneurysms-in-the-posterior-circulation
#20
Guilherme Cabral de Andrade, Helvercio P Alves, Valter Clímaco, Eduardo Pereira, Alexandre Lesczynsky, Michel E Frudit
Intracranial circumferential fusiform aneurysms of the posterior circulation involving arterial branches or perforating vessels are difficult to treat. This article shows an endovascular reconstruction technique not yet described, using a telescoping self-expandable stent (LEO+) and flow-diverter device (SILK) at different surgical times. Two patients with circumferential fusiform aneurysm, one being an aneurysm of the segments P2 and P3 of the posterior cerebral artery, diagnosed after a headache, and the other a partially thrombosed aneurysm of the lower basilar artery, diagnosed following ischemia of the brain stem...
October 2016: Interventional Neuroradiology
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