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Stent cerebral aneurysm

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https://www.readbyqxmd.com/read/27920207/vascular-angular-remodeling-by-kissing-y-stenting-in-wide-necked-intracranial-bifurcation-aneurysms
#1
Katharina Melber, Dan Meila, Philipp Draheim, Dominik Grieb, Björn Greling, Martin Schlunz-Hendann, Friedhelm Brassel
INTRODUCTION: Single stent deployment leads to a change in vascular geometry in wide necked bifurcation aneurysms. In some complex cases, the use of the single stent technique might not be sufficient or may not be feasible. The kissing-Y stenting technique appears to be an alternative endovascular treatment option. The aim of this study was to evaluate the effects of the kissing-Y stenting technique on vascular angular remodeling. METHODS: 21 patients with wide necked intracranial bifurcation aneurysms at different sites (10 anterior communicating artery, 6 middle cerebral artery, 3 basilar artery, 1 vertebral artery/posterior inferior cerebellar artery, 1 internal carotid artery/posterior communicating artery) were treated with 44 closed cell stents (follow-up 2012-2016) using the kissing-Y stenting technique...
December 5, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27913802/combined-use-of-a-pconus-and-a-solitaire-stent-report-of-two-cases
#2
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/27903923/stent-assisted-coil-embolization-of-a-recurrent-posterior-cerebral-artery-aneurysm-following-surgical-clipping
#3
Tomonori Takeshita, Tomoaki Nagamine, Kohei Ishihara, Yasuhiko Kaku
Posterior cerebral artery (PCA) aneurysms are rare, and direct surgery of these is considered difficult. Coil embolization of PCA aneurysms is becoming popular. However, it is difficult to completely obliterate the aneurysm while preserving the flow of the parent artery in large or giant PCA aneurysms with a wide neck with this technique. We report a case of a large and wide-necked PCA aneurysm with multiple recurrences following successful surgical clipping and coil embolization.A 77-year-old man with a large unruptured right PCA (P2) aneurysm was successfully treated by surgical clipping...
November 30, 2016: Neuroradiology Journal
https://www.readbyqxmd.com/read/27890754/endovascular-treatment-of-spontaneous-intracranial-fusiform-and-dissecting-aneurysms-outcomes-related-to-imaging-classification-of-309-cases
#4
Yisen Zhang, Zhongbin Tian, Binbin Sui, Yang Wang, Jian Liu, Miao Li, Youxiang Li, Chuhan Jiang, Xinjian Yang
OBJECTIVE: This study aimed to propose a modified classification of spontaneous intracranial dissecting aneurysms (IDAs) and to guide the treatment for IDAs. METHODS: Between January 2010 and December 2015, 3183 consecutive patients were referred to our department for endovascular treatment of a cerebral aneurysm and 309 patients harboring 323 spontaneous IDAs were identified from them. Based on a modified imaging classification, spontaneous IDAs were classified into four subtypes: classic dissecting aneurysm, segmental ectasia, dolichoectatic dissecting aneurysm, and large mural bleeding ectasia...
November 24, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27856649/the-barrel-stent-new-treatment-option-for-stent-assisted-coiling-of-wide-necked-bifurcation-aneurysms-results-of-a-single-center-study
#5
Ruben Mühl-Benninghaus, Andreas Simgen, Wolfgang Reith, Umut Yilmaz
PURPOSE: The Barrel stent is a laser cut stent designed for stent-assisted coil embolization of wide-necked bifurcation or branch aneurysms with a single device, with the purpose of lowering the metal-to-artery ratio and its inherent risk of thromboembolic complications of multiple stents. We report our early experiences with this device in 17 patients in this retrospective single-center analysis. MATERIALS AND METHODS: 17 consecutive patients who underwent stent-assisted coil embolization of wide-necked bifurcation aneurysms with the Barrel stent were retrospectively identified...
November 17, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27856436/diffusion-weighted-imaging-detected-ischemic-lesions-following-endovascular-treatment-of-cerebral-aneurysms-a-systematic-review-and-meta-analysis
#6
K M Bond, W Brinjikji, M H Murad, D F Kallmes, H J Cloft, G Lanzino
BACKGROUND AND PURPOSE: Endovascular treatment of intracranial aneurysms is associated with the risk of thromboembolic ischemic complications. Many of these events are asymptomatic and identified only on diffusion-weighted imaging. We performed a systematic review and meta-analysis to study the incidence of DWI positive for thromboembolic events following endovascular treatment of intracranial aneurysms. MATERIALS AND METHODS: A comprehensive literature search identified studies published between 2000 and April 2016 that reported postprocedural DWI findings in patients undergoing endovascular treatment of intracranial aneurysms...
November 17, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/27847780/recurrent-carotid-cavernous-fistula-originating-from-a-giant-cerebral-aneurysm-after-placement-of-a-covered-stent
#7
Jung Wook Baek, Sung Tae Kim, Young Seo Lee, Young-Gyun Jeong, Hae Woong Jeong, Jin Wook Baek, Jung Hwa Seo
We report the case of a recurrent carotid cavernous fistula (CCF) originating from a giant cerebral aneurysm (GCA) after placement of a covered stent. A 47-year-old woman presented with sudden onset of severe headache, and left-sided exophthalmos and ptosis. Cerebral angiography revealed a CCF caused by rupture of a GCA in the cavernous segment of the left internal carotid artery. Two covered stents were placed at the neck of the aneurysm. The neurological symptoms improved at first, but were aggravated in the 6 months following the treatment...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27847767/the-benefits-of-navien%C3%A2-intracranial-support-catheter-for-endovascular-treatment
#8
Siwoo Lee, Tae-Sik Gong, Yong-Woo Lee, Hyo-Joon Kim, Chang-Young Kweon
OBJECTIVE: Endovascular treatment is one of the most important treatments along with open craniotomy for cerebrovascular surgery. The successful treatment of endovascular disease relies on appropriate instruments and the surgeon's skill. Endovascular treatment needs to provide safe and stable access to the catheter cavity. Additionally, it is important to maintain a round shape without changing to an oval shape. The catheter for endovascular treatment has to be flexible and accommodate at least 0...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27844157/stent-assisted-coiling-embolization-of-tiny-wide-necked-intracranial-aneurysms
#9
Yongtao Zheng, Yanbing Song, Dajun Liu, Yingjun Liu, Qiang Xu, Yanlong Tian, Bing Leng
BACKGROUND: Tiny, wide-necked intracranial aneurysms pose a significant therapeutic challenge for interventional neuroradiologists because of the small volume for microcatheterization and coil stabilization inside the aneurysm sac. We report our preliminary experience of stent-assisted coiling embolization of these aneurysms. METHODS: A total of 50 patients with 52 tiny, wide-necked aneurysms who were treated with stent-assisted coiling from January 2007 to December 2014 were reviewed retrospectively...
November 14, 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27833409/preoperative-coiling-of-coexisting-intracranial-aneurysm-and-subsequent-brain-tumor-surgery
#10
Keun Young Park, Byung Moon Kim, Dong Joon Kim
OBJECTIVE: Few studies have investigated treatment strategies for brain tumor with a coexisting unruptured intracranial aneurysm (cUIA). The purpose of this study was to evaluate the safety and efficacy of preoperative coiling for cUIA, and subsequent brain tumor surgery. MATERIALS AND METHODS: A total of 19 patients (mean age, 55.2 years; M:F = 4:15) underwent preoperative coiling for 23 cUIAs and subsequent brain tumor surgery. Primary brain tumors were meningiomas (n = 7, 36...
November 2016: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/27810105/does-the-gravity-orientation-of-saccular-aneurysms-influence-hemodynamics-an-experimental-study-with-and-without-flow-diverter-stent
#11
Kamil J Chodzyński, Omer F Eker, Axel E Vanrossomme, Daniel Ribeiro de Sousa, Grégory Coussement, Luc Vanhamme, Frank Dubois, Alain Bonafé, Bastien Chopard, Guy Courbebaisse, Karim Zouaoui Boudjeltia
Most intracranial aneurysms morphologic studies focused on characterization of size, location, aspect ratio, relationship to the surrounding vasculature and hemodynamics. However, the spatial orientation with respect to the gravity direction has not been taken into account although it could trigger various hemodynamic conditions. The present work addresses this possibility. It was divided in two parts: 1) the orientations of 18, 3D time-of-flight MRI (3D TOF MRI), scans of saccular aneurysms were analyzed. This investigation suggested that there was no privileged orientation for cerebral aneurysms...
October 18, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27799376/thrombogenicity-of-flow-diverters-in-an-ex-vivo-shunt-model-effect-of-phosphorylcholine-surface-modification
#12
Matthew W Hagen, Gaurav Girdhar, John Wainwright, Monica T Hinds
BACKGROUND: Flow diverters offer a promising treatment for cerebral aneurysms. However, they have associated thromboembolic risks, mandating chronic dual antiplatelet therapy (DAPT). Shield Technology is a phosphorylcholine surface modification of the Pipeline Embolization Device (PED) flow diverter, which has shown significant reductions in material thrombogenicity in vitro. OBJECTIVE: To compare the thrombogenicity of PED, PED with Shield Technology (PED+Shield), and the Flow-Redirection Endoluminal Device (FRED)-with and without single antiplatelet therapy and DAPT-under physiological flow...
October 31, 2016: Journal of Neurointerventional Surgery
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
#13
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...
October 26, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27789790/treatment-of-wide-necked-aneurysms-with-the-low-profile-visualized-intraluminal-support-lvis-jr-device-a-multicenter-experience
#14
J A Grossberg, R A Hanel, G Dabus, K Keigher, D C Haussen, E Sauvageau, I Linfante, D Gonsales, P Aguilar Salinas, M Bouslama, M Mayich, R G Nogueira, D K Lopes
BACKGROUND: The Low-profile Visualized Intraluminal Support (LVIS) Junior stent is newly approved for the treatment of wide-necked intracranial aneurysms. OBJECTIVE: To report our multicenter experience with use of the LVIS Jr device. METHODS: The neurointerventional databases of the participating institutions were retrospectively reviewed for aneurysms treated with LVIS Jr from the time of Food and Drug Administration approval until February 2016...
October 27, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27789789/use-of-flow-diverters-in-the-treatment-of-unruptured-saccular-aneurysms-of-the-anterior-cerebral-artery
#15
REVIEW
P Bhogal, R Martinez Moreno, O Ganslandt, H Bäzner, H Henkes, M Aguilar Perez
BACKGROUND: Few publications have dealt exclusively with the use of flow diverter stents for the treatment of aneurysms of the anterior cerebral artery (ACA). OBJECTIVE: To determine the efficacy of flow-diverting stents in the treatment of small, unruptured aneurysms of the ACA. METHODS: We retrospectively reviewed our database of prospectively collected information for all patients treated with flow diversion for an unruptured saccular aneurysm of the ACA between September 2009 and July 2016...
October 27, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27780870/virtual-flow-diverter-treatment-planning-the-effect-of-device-placement-on-bifurcation-aneurysm-haemodynamics
#16
Thomas Peach, Katerina Spranger, Yiannis Ventikos
Bifurcation aneurysms account for a large fraction of cerebral aneurysms and often present morphologies that render traditional endovascular treatments, such as coiling, challenging and problematic. Flow-diverter stents offer a potentially elegant treatment option for such aneurysms, but clinical use of these devices remains controversial. Specifically, the deployment of a flow-diverter device in a bifurcation entails jailing one or more potentially vital vessels with a low-porosity mesh designed to restrict the flow...
October 25, 2016: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/27773575/efficacy-of-a-newly-modified-technique-for-distal-limited-open-stenting-in-octogenarians-with-aortic-arch-aneurysm
#17
Mitsumasa Hata, Yukihiko Orime, Shinji Wakui, Tetsuya Nakamura, Rei Hinoura, Atsushi Harada, Kenji Akiyama
OBJECTIVE: We assessed the efficacy of distal limited open stenting procedure in octogenarians with distal aortic arch aneurysm. METHODS: During the last 5 years, 24 patients underwent distal limited open stenting. Mean patient age was 81.6 ± 2.5 years, ranging from 80 to 90 years. The hemicircumference of the anterior surface of the arch around the left common carotid artery was obliquely incised, and a J-Graft Open Stent (Japan Lifeline Co, Ltd, Tokyo, Japan) was inserted into the descending aorta...
September 24, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27760885/prasugrel-versus-clopidogrel-in-stent-assisted-coil-embolization-of-unruptured-intracranial-aneurysms
#18
Jacques Sedat, Yves Chau, Jean Gaudart, Marina Sachet, Stephanie Beuil, Michel Lonjon
BACKGROUND: Thromboembolic complications are the main problem in stent-assisted coil embolization of unruptured intracranial aneurysms. The combination of aspirin and clopidogrel is generally used to decrease these complications, but some patients do not respond to clopidogrel and have a higher risk of stent thrombosis. In cardiology, clinical trials have shown that prasugrel reduced the incidence of ischaemic events in patients with acute coronary syndrome compared with clopidogrel but, according to several authors, prasugrel would produce an increased risk of cerebral haemorrhagic complications...
October 19, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27760832/an-outcomes-based-grading-scale-for-the-evaluation-of-cerebral-aneurysms-treated-with-flow-diversion
#19
Min S Park, Marcus D Mazur, Karam Moon, Michael J Nanaszko, John R W Kestle, Lubdha M Shah, Blair Winegar, Felipe C Albuquerque, Philipp Taussky, Cameron G McDougall
OBJECT: Despite the popularity of flow-diverting stents for the treatment of cerebral aneurysms, there is no widely accepted scale for the characterization of results. We present an outcomes-based grading scale that considers factors related to failure of flow diversion. METHODS: The grading scale was developed using the results from consecutive patients at two institutions who were treated with flow diversion for a cerebral aneurysm. The initial treatment results were graded on patient, aneurysm, and treatment characteristics...
October 19, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27733966/stent-assisted-embolization-of-a-giant-aneurysm-of-the-middle-cerebral-artery-using-small-and-large-coils-penumbra-coil-400
#20
Edgar Gerardo Ordónez-Rubiano, Christian Von-Diemling, William Cortes-Lozano, Nelson Oswaldo Lobelo-Garcia
Giant aneurysms have been treated with endovascular approaches like general, balloon-assisted and stent-assisted coiling, and flow diverter stent-assisted techniques. Few cases have been reported to be treated with both normal and large coils. Despite the mass effect, an adequate revascularization has been reported. An initial use of these coils is being reported in the current study. This is a case which has been successfully treated using a stent-assisted coiling with both small and large coils i.e., Penumbra Coil 400 (Penumbra, Inc...
August 31, 2016: Curēus
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