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Ronak Dholakia, Chandramouli Sadasivan, David Fiorella, Henry Woo, B Barry Lieber
Cerebral aneurysms are pathological focal evaginations of the arterial wall at and around the junctions of the circle of Willis. Their tenuous walls predispose aneurysms to leak or rupture leading to hemorrhagic strokes with high morbidity and mortality rates. The endovascular treatment of cerebral aneurysms currently includes the implantation of fine-mesh stents, called flow diverters, within the parent artery bearing the aneurysm. By mitigating flow velocities within the aneurysmal sac, the devices preferentially induce thrombus formation in the aneurysm within hours to days...
October 11, 2016: Journal of Biomechanical Engineering
Joseph R Linzey, Julius Griauzde, Zhe Guan, Nicole Bentley, Joseph J Gemmete, Neeraj Chaudhary, B Gregory Thompson, Aditya S Pandey
BACKGROUND: Stent-assisted coiling is commonly used to treat wide-necked and fusiform cerebral aneurysms. We evaluated our institutional experience with stent-assisted coiling of cerebral aneurysms to elucidate potential risk factors for recurrence. METHODS: A retrospective analysis of patients undergoing stent-assisted coiling of cerebral aneurysms from 2005 to 2012 resulted in 122 patients with 122 aneurysms. Demographic, peri-procedural, medical comorbidity, and follow-up data were collected...
October 3, 2016: Journal of Neurointerventional Surgery
Jun Wang, Yongping Liang, Baomin Li, Xinfeng Liu, Sheng Li, Xiangyu Cao, Ruozhuo Liu
OBJECTIVE: To evaluate the feasibility, safety, clinical, and angiographic follow-up of only overlapping stents therapy for intracranial vertebral artery dissection aneurysms (VADA). METHODS: Eight consecutive patients (6 men, 2 women; mean age 46.8 years ranging from 34 to 62 years) with intracranial VADA admitted to Department of Neurology, Chinese People's Liberation Army General Hospital from June 2008 to June 2014 were retrospectively reviewed. All patients were diagnosed intracranial VADA by MRI or digital subtraction angiography (DSA)...
May 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Mina G Safain, Marie Roguski, Robert S Heller, Adel M Malek
BACKGROUND AND PURPOSE: Flow diversion using the Pipeline Embolization Device is reported as a safe treatment of aneurysms. Complete aneurysm occlusion, however, occurs in a delayed fashion with initial persistent filling of the aneurysm dome. We hypothesized that this transflow across metallic struts may be associated with thromboembolic events. METHODS: Forty-one consecutive patients undergoing aneurysm treatment with the Pipeline Embolization Device and a comparison group of 78 Neuroform stent-mediated embolizations were studied...
March 2016: Stroke; a Journal of Cerebral Circulation
Baomin Li, Yongping Liang, Xinfeng Liu, Jun Wang, Sheng Li, Xiangyu Cao, Aili Ge, Huimin Feng
OBJECTIVE: To investigate the feasibility,safety and follow-up results of multiple stents parallel placement and reconstruction technique for treating giant vertebrobasilar dissecting aneurysms. METHODS: Five consecutive patients with giant fusiform vertebrobasilar dissecting aneurysms in Department of Neurology,Chinese People's Liberation Army General Hospital were retrospectively reviewed from April 2011 to October 2013. All patients were diagnosed vertebrobasilar dissecting aneurysms by MRI and digital subtraction angiography (DSA), the aneurysm size ranged 8...
August 1, 2015: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Anna Luisa Kühn, Samuel Y Hou, Ajit S Puri, Christine F Silva, Matthew J Gounis, Ajay K Wakhloo
BACKGROUND: Stent-assisted coil embolization (SACE) is a viable therapeutic approach for wide-neck intracranial aneurysms. However, it can be technically challenging in small cerebral vessels (≤2 mm). OBJECTIVE: To present our experience with stents approved for SACE in aneurysms with small parent arteries. METHODS: All patients who underwent stent-assisted aneurysm treatment with either a Neuroform or an Enterprise stent device at our institution between June 2006 and October 2012 were identified...
June 2016: Journal of Neurointerventional Surgery
Andrew Kelly Johnson, Stephan A Munich, Lee A Tan, Daniel Mark Heiferman, Kiffon Marie Keigher, Demetrius Klee Lopes
OBJECT: Stent-assisted embolization (SAE) has broadened the scope of endovascular cerebral aneurysm treatment. The risks associated with stent selection and configuration are poorly defined. In this study, the authors aimed to characterize the risk factors that contribute to complications in SAE of intracranial aneurysms. METHODS: Over a 10-year period, a single surgeon treated 486 aneurysms with SAE in which open-cell Neuroform or closed-cell Enterprise stents were used...
August 2015: Journal of Neurosurgery
Erol Akgul, Tugsan Balli, Erol H Aksungur
In Y-stenting, stabilization of the first stent may be problematic as in some cases it migrates during second stent insertion. This report evaluates the safety and effectiveness of the technique and presents the long-term results of hybrid, Y-configured, dual stent-assisted coil embolization in the treatment of wide-necked bifurcation aneurysms. We retrospectively evaluated the patients treated endovascularly due to cerebral aneurysms. Twenty patients treated with hybrid Y-stent-assisted coil embolization were enrolled in the study...
February 2015: Interventional Neuroradiology
Jun Kyeung Ko, In Ho Han, Won Ho Cho, Byung Kwan Choi, Seung Heon Cha, Chang Hwa Choi, Sang Weon Lee, Tae Hong Lee
OBJECTIVE: Double stenting in a Y-configuration is a promising therapeutic option for wide-necked cerebral aneurysms not amenable to reconstruction with a single stent. We retrospectively evaluated the efficacy and safety of the crossing Y-stent technique for coiling of wide-necked bifurcation aneurysms. METHODS: By collecting clinical and radiological data we evaluated from January 2007 through December 2013, 20 wide-necked bifurcation aneurysms. RESULTS: Twelve unruptured and eight ruptured aneurysms in 20 patients were treated with crossing Y-stent-assisted coiling...
May 2015: Clinical Neurology and Neurosurgery
Jean-Christophe Gentric, Alessandra Biondi, Michel Piotin, Charbel Mounayer, Kyriakos Lobotesis, Alain Bonafé, Vincent Costalat
BACKGROUND: Endovascular treatment of wide-necked and complex aneurysms may require stent-assisted coiling, either as primary stenting or combined with the balloon remodeling technique (BRT). OBJECTIVE: To compare the angiographic results and clinical outcomes of both strategies in the Safety and Efficacy of Neuroform for Treatment of intracranial Aneurysms (SENAT) registry. METHODS: SENAT was a prospective, multicenter registry that allowed BRT in conjunction with stenting and coiling with bare platinum coils...
April 2015: Neurosurgery
Brent King, Sasha Vaziri, Amit Singla, Kyle M Fargen, J Mocco
INTRODUCTION: The most widely used intracranial stents for stent-assisted coiling are Neuroform (NEU) and Enterprise stents (ENT). This study compares published outcomes between the ENT and NEU coil-assist systems and comments on the published safety and efficacy of stent-assisted coiling in general. METHODS: A literature search was performed through PubMed for all published series of ENT or NEU stent-assisted coiling of cerebral aneurysms from 2004 to 2014. All studies including 10 or more published cases of stent-assisted coiling with ENT or NEU were included...
December 2015: Journal of Neurointerventional Surgery
C R Durst, P Khan, J Gaughen, J Patrie, R M Starke, P Conant, K C Liu, M E Jensen, A J Evans
AIM: To compare the complications and outcomes of Neuroform and Enterprise stents in the treatment of unruptured wide-necked aneurysms. MATERIALS AND METHODS: Under the auspices of the institutional review board, a review of a prospectively collected patient log identified 130 patients who underwent elective stent-assisted coil embolization of a wide-necked aneurysm, including 53 patients treated with an Enterprise stent and 77 patients treated with a Neuroform stent...
December 2014: Clinical Radiology
Kenichi Kono, Aki Shintani, Tomoaki Terada
It is necessary to consider possibility of recanalization and retreatment after coil embolization for cerebral aneurysms. There is concern that retreatment for recanalized aneurysms after Y-stent-assisted coil embolization may be difficult because of double stents, especially in Y-stents with double closed-cell stents owing to narrowed structures. However, no detailed reports of retreatment after Y-stent have been reported. Between July 2010 and June 2013, we treated four aneurysms with Y-stent-assisted coil embolization using Enterprise closed-cell stents...
2014: Turkish Neurosurgery
Chang-Young Lee, Seong-Ho Park, Chang-Hyun Kim, Goetz Benndorf
INTRODUCTION: Crossing Y-stent technique is a valid option for coiling wide-necked bifurcation aneurysms. Two main designs of stents, the closed- (CCS) and open-cell (OCS), are used in combination for a crossing Y-construct. This in vitro study was conducted to assess the mechanical characteristics of each stent-combination and to suggest an optimal combination for clinical practice. METHODS: The Enterprise and the Neuroform3 stents were used as closed-cell and open-cell stents, respectively...
August 2014: Neuroradiology
Sun Geon Yoon, Sung-Chul Jin, Seung Hwan Kim, Kyoung Dong Jeon, Doo Young Kim, Sun-Il Lee, Hae Woong Jeong
OBJECTIVE: An open cell stent system may offer better apposition of cell struts to vessel wall than a closed cell stent system in acute vasculature. The purpose of this study was to evaluate the feasibility of coiling using the jailing technique with the Neuroform EZ stent system. METHODS: The jailing technique using the open-cell stent system of the Neuroform EZ stent was planned in 22 consecutive patients with 22 cerebral aneurysms. We retrospectively evaluated the technical success of the jailing technique and the occurrence of interference between two microcatheters as well as the factors influencing this interference...
December 2013: Journal of Cerebrovascular and Endovascular Neurosurgery
Young-Joon Kim, Jung Ho Ko
A flow-diverting stent such as the Pipeline embolization device (PED, ev3 Endovascular, Plymouth, MN, USA) and Silk flow-diverting stent (Balt Extrusion, Montmorency, France) offers an acceptable alternative for the treatment of difficult aneurysms according to their morphologies, including giant, wide-necked, fusiform, and blister types. However, complications arising from the use of these stents have frequently been reported including several cases of branch artery occlusion and delayed occlusion of the stented parent vessel shortly after antiplatelet medications were discontinued, highlighting the potential need for long-term antiplatelet therapy, and disastrous bleeding complications in unruptured aneurysm...
January 2014: Interventional Neuroradiology
Dale Ding, Daniel M Raper, Anita J Carswell, Kenneth C Liu
Mycotic intracranial aneurysms (MIA) are a rare form of cerebrovascular pathology for which obliteration must be undertaken when they present with rupture or fail to respond to antibiotic therapy. Intracranial stents provide the unique ability to simultaneously preserve parent vessel integrity while obliterating the aneurysmal sac, but their use for the treatment of MIA has only been reported in a few instances for proximally located lesions. We report a patient with a MIA treated with endovascular stenting and review the literature for similar cases...
July 2014: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Jiayao Ma, Zhong You, James Byrne, Rafik R Rizkallah
Brain arterial aneurysms are localised dilatation in the wall of cerebral arteries that are common among adult population and associated with high incidence of morbidity and mortality. Using flow diverter stent alone to treat cerebral aneurysm is recognized as a safe and effective method. However, flow diverter stents currently available have limitations due to their braided structures. In this paper a novel flow diverter stent is proposed. It is made out of nitinol tubes that provide adequate radial stiffness and tailored surface coverage to overcome problems of currently available braided stents while retaining low porosity and excellent longitudinal flexibility...
May 2014: Annals of Biomedical Engineering
Ou Young Kwon, Chun-Sung Cho, Jin Kyung Kim, Young Jin Kim, Sang Koo Lee, Maeng Ki Cho, Young-Joon Kim
The Neuroform stent is a device specifically designed for use in cerebral vessels and is increasingly being used in the embolization of broad-necked aneurysms, but long-term results are unsatisfactory. Reconstructive treatments using stents improve the occlusion rate and protect parent vessels. Stent-assisted coiling of broad-necked cerebral aneurysms is a technique that has rendered most aneurysms amenable to coiling. Recently, the use of stent-assisted coiling with preservation of the parent vessel lumen has been described in some series...
December 31, 2007: Neuroradiology Journal
Chun-Sung Cho
The Neuroform stent is the first microcatheter delivered stent designed specifically for the treatment of cerebral aneurysms. Recently, some reports on unconventional uses of the Neuroform stent have provided intelligent technical solutions to difficult endovascular cases. A 43-year-old man presented with severe headache. Imaging studies revealed subarachnoid hemorrhage and a fusiform vessel dilatation with a small aneurysm arising from the communicating segment of the left internal carotid artery. We report here the case of a double Neuroform2 stent without coiling within a ruptured fusiform aneurysm of the internal carotid artery...
June 30, 2007: Neuroradiology Journal
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