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Linjing Zhang, Yunxia Wang, Qingkui Zhang, Wei Ge, Xiancong Wu, Hai Di, Jun Wang, Xiangyu Cao, Baomin Li, Ruozhuo Liu, Shengyuan Yu
The aim of this study was to investigate whether there is a long-term improvement in headache of patients with unruptured intracranial aneurysms (UIAs) treated with intracranial endovascular procedures.Using a prospective design, consecutive patients with UIAs with neuroendovascular treatment from January 2014 to December 2014 were asked to participate. Headache outcomes were established before aneurysm treatment and for 6 months following treatment. Factors associated with different headache outcomes were investigated...
February 2017: Medicine (Baltimore)
Ashish Sonig, Elad I Levy
No abstract text is available yet for this article.
August 1, 2016: Neurosurgery
José E Cohen, John Moshe Gomori, Gustavo Rajz, Iddo Paldor, Samuel Moscovici, Eyal Itshayek
BACKGROUND: Galenic dural arteriovenous fistulas (DAVF) are rare; however, they are the most frequent type of DAVF to manifest aggressive clinical behavior and usually represent a diagnostic and therapeutic challenge for clinicians. METHODS: We retrospectively reviewed clinical and imaging data of patients managed with neuroendovascular techniques for the treatment of galenic DAVFs from 2000 to 2016. We searched the 2000-2016 English-language literature for papers discussing neuroendovascular management of galenic DAVFs, with or without companion surgical procedures...
January 31, 2017: Acta Neurochirurgica
Mónica Echeverry-Rendon, Lisa M Reece, Fernando Pastrana, Sandra L Arias, Akshath R Shetty, Juan Jose Pavón, Jean Paul Allain
Current treatments for brain aneurysms are invasive, traumatic, and not suitable in most patients with increased risks. A new alternative method is using scaffold stents to create a local and focal attraction force of cells for an in situ reconstruction of the tunica media. For this purpose, a nanostructured bioactive coating is designed to render an asymmetric region of the stent scaffold magnetic and biomimetic, which utilizes bacterial nanocellulose (BNC) as a platform for both magnetic and cell attraction as well as proliferation...
January 24, 2017: Macromolecular Bioscience
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
Linjing Zhang, Xiancong Wu, Hai Di, Tao Feng, Yunxia Wang, Jun Wang, Xiangyu Cao, Baomin Li, Ruozhuo Liu, Shengyuan Yu
BACKGROUND: Two editions of the International Classification of Headache Disorders (ICHD) diagnostic criteria for "Headache attributed to an intracranial endovascular procedure" have been published, in 2004 and 2013.(1,2) Despite studies that have suggested that the former is not very practical, the ICHD-3 beta did not contain major changes. Moreover, so far no consensus exists regarding characteristics of headache after intracranial endovascular procedure. Thus, there is a need for sound suggestions to improve the ICHD-3 beta diagnostic criteria...
December 19, 2016: Headache
Donald R Ricci, Thomas R Marotta, Howard A Riina, Martina Wan, Joost De Vries
Training has been important to facilitate the safe use of new devices designed to repair vascular structures. This paper outlines the generic elements of a training program for vascular devices and uses as an example the actual training requirements for a novel device developed for the treatment of bifurcation intracranial aneurysms. Critical elements of the program include awareness of the clinical problem, technical features of device, case selection, and use of a simulator. Formal proctoring, evaluation of the training, and recording the clinical outcomes complement these elements...
2016: Journal of Market Access & Health Policy
Raghav Gupta, Nimer Adeeb, Justin M Moore, Rouzbeh Motiei-Langroudi, Christoph J Griessenauer, Apar S Patel, Christopher S Ogilvy, Ajith J Thomas
OBJECTIVE: Endovascular embolization, though initially approved as an adjunctive therapy for surgical excision of cerebral arteriovenous malformations (AVMs), has found extensive use in the management of these lesions. A number of systems have been proposed to stratify AVMs by the procedural risk of embolization, including the Buffalo score and AVM Neuroendovascular grade. An external validity assessment of these systems has not been performed. PATIENTS AND METHODS: A retrospective review of all patients who underwent embolization of cerebral AVMs at a single institution, between 2010 and 2016, was performed...
December 2016: Clinical Neurology and Neurosurgery
J Scott Pannell, David R Santiago-Dieppa, Arvin R Wali, Brian R Hirshman, Jeffrey A Steinberg, Vincent J Cheung, David Oveisi, Jon Hallstrom, Alexander A Khalessi
This study establishes performance metrics for angiography and neuroendovascular surgery procedures based on longitudinal improvement in individual trainees with differing levels of training and experience. Over the course of 30 days, five trainees performed 10 diagnostic angiograms, coiled 10 carotid terminus aneurysms in the setting of subarachnoid hemorrhage, and performed 10 left middle cerebral artery embolectomies on a Simbionix Angio Mentor™ simulator. All procedures were nonconsecutive. Total procedure time, fluoroscopy time, contrast dose, heart rate, blood pressures, medications administered, packing densities, the number of coils used, and the number of stent-retriever passes were recorded...
August 29, 2016: Curēus
Naoyuki Uchiyama, Kouichi Misaki, Masanao Mohri, Tomoya Kamide, Yuichi Hirota, Ryo Higashi, Hisato Minamide, Yukihiko Kohda, Takashi Asahi, Katsuo Shoin, Masayuki Iwato, Daisuke Kita, Yoshitaka Hamada, Yuya Yoshida, Mitsutoshi Nakada
Five recent multicenter randomized controlled trials (RCTs) have clearly shown the superiority of mechanical thrombectomy in large vessel occlusion acute ischemic stroke compared to systemic thrombolysis. Although 14 hospitals in Ishikawa prefecture have uninterrupted availability of systemic thrombolysis, mechanical thrombectomy is not available at all of these hospitals. Therefore, we established a Kanazawa mobile embolectomy team (KMET), which could travel to these hospitals and perform the acute reperfusion therapy...
December 15, 2016: Neurologia Medico-chirurgica
Kaiz S Asif, Ahsan Sattar, Marc A Lazzaro, Brian-Fred Fitzsimmons, John R Lynch, Osama O Zaidat
BACKGROUND: Small aneurysms located at the anterior communicating artery carry significant procedural challenges due to a complex anatomy. Recent advances in endovascular technologies have expanded the use of coil embolization for small aneurysm treatment. However, limited reports describe their safety and efficacy profiles in very small anterior communicating artery aneurysms. OBJECTIVE: We sought to review and report the immediate and long-term clinical as well as radiographic outcomes of consecutive patients with ruptured very small anterior communicating artery aneurysms treated with current endovascular coil embolization techniques...
June 2016: Interventional Neurology
Karen Chen, Srinivasan Paramasivam, Alejandro Berenstein
BACKGROUND: Intracranial vascular malformations in children are being addressed through a variety of treatment modalities including open surgery, external beam radiation, and image-guided neuroendovascular procedures. These patients often receive multiple treatments and incur serial exposures to ionizing radiation which has been linked to tumor development in population-based data. OBJECTIVE: This study quantifies the effect of collimation on exposures from single procedures and over patient lifetimes to estimate excess risk of lifetime tumor development...
September 5, 2016: Journal of Neurointerventional Surgery
Akash P Kansagra, James D McEachern, Thomas P Madaelil, Adam N Wallace, DeWitte T Cross, Christopher J Moran, Colin P Derdeyn
BACKGROUND: Abciximab is used to treat thromboembolic complications of neuroendovascular procedures, but outcomes of treatment are not well defined. OBJECTIVE: To examine the angiographic and clinical outcomes based on route of abciximab administration and degree of vessel recanalization. MATERIALS AND METHODS: A prospectively maintained database of neuroendovascular procedures performed between January 2004 and May 2015 was retrospectively reviewed to identify cases with thromboembolic complications treated with abciximab...
August 18, 2016: Journal of Neurointerventional Surgery
Mark R Villwock, David J Padalino, Raghu Ramaswamy, Eric M Deshaies
BACKGROUND: The future of neuroendovascular treatment for intracranial atherosclerotic disease (ICAD) has been debated since the results of SAMMPRIS reflected poor outcomes following endovascular therapy. There is currently a large spectrum of current management strategies. We compared historical outcomes of patients with ICAD and stroke that were treated with angioplasty-alone versus stent placement. METHODS: We extracted a population from the Nationwide Inpatient Sample (NIS) (2005-2011) and the National Inpatient Sample (NIS) (2012) composed of patients with ICAD and infarction that were admitted nonelectively and received endovascular revascularization...
June 2016: Journal of Vascular and Interventional Neurology
Ashish Sonig, Elad I Levy
No abstract text is available yet for this article.
August 2016: Neurosurgery
Dong Seong Shin, Ali Yilmaz, Ayca Ozkul, Dong Kyu Yeo, Sun-Chul Hwang, Bum-Tae Kim
Objective The transfemoral approach is a common route for catheterization of the supra-aortic vessels in neuroendovascular therapy. However, in some cases, the patient's anatomy prevents transfemoral catheterization or distal access to the carotid s. In such cases, direct carotid exposure (DCE) for neuroendovascular approaches may be used to treat cerebrovascular diseases. Methods We present 11 cases in which we were unable to perform the distal approach and DCE was the preferred neuroendovascular treatment procedure...
November 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Koichi Arimura, Koji Iihara
Recently, several new randomized controlled trials have been reported which showed the efficacy of neuroendovascular therapy for acute ischemic stroke. Confirming the major vessel occlusion in the proximal anterior circulation, limited ischemic core and preserved ischemic penumbra, using stent retrievers to achieve successful reperfusion, and shortening the onset-to-reperfusion time were the essential factors to achieve good clinical outcome. With these new evidences, it has been proved that neuroendovascular therapy became one of the standard treatments for acute ischemic stroke...
April 2016: Nihon Rinsho. Japanese Journal of Clinical Medicine
Satoshi Inoue, Atsushi Fujita, Takashi Mizowaki, Yoshito Uchihashi, Ryuichi Kuroda, Seishirou Urui, Eiji Kurihara, Eiji Kohmura
We report a patient with Trousseau syndrome who presented with repeated acute middle cerebral artery (MCA) occlusion, which was successfully treated by performing mechanical thrombectomy. A 66-year-old man with a lung lesion and abdominal lymph node swelling experienced a sudden onset of left hemiparesis. Magnetic resonance angiography (MRA) revealed a right MCA occlusion. Perfusion-weighted imaging revealed reduced cerebral blood flow in the right MCA territory. Complete recanalization of the occluded vessel was achieved by performing mechanical thrombectomy, and his symptoms remarkably disappeared...
June 2016: No Shinkei Geka. Neurological Surgery
Fawaz Al-Mufti, Krishna Amuluru, Chirag D Gandhi, Charles J Prestigiacomo
Endovascular treatment of intracranial aneurysms with complex morphologies such as giant, wide-necked, or fusiform aneurysms is challenging. Stent-assisted coiling and balloon-assisted coiling are alternative techniques to treat such complex aneurysms, but studies have shown less-than-expected efficacy, as suggested by their high rate of recanalization. The management of complex aneurysms via microsurgery or conventional neuroendovascular strategies has traditionally been poor. However, over the last few years, flow-diverting stents (FDS) have revolutionized the treatment of such aneurysms...
July 2016: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
R Yasuda, M Maeda, M Umino, Y Nakatsuka, Y Umeda, N Toma, H Sakaida, H Suzuki
We describe a case series of suspected metallic embolism after coil embolization for intracranial aneurysms. Between January 2012 and December 2014, 110 intracranial aneurysms had been treated by coil embolization in our institution. In 6 cases, the postprocedural MR imaging revealed abnormal spotty lesions not detected on the preprocedural MR imaging. The lesions were also undetectable on the postprocedural CT scan. They were demonstrated as low-intensity spots on T1WI, T2WI, DWI, and T2*-weighted imaging...
September 2016: AJNR. American Journal of Neuroradiology
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