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Ruptured cerebral aneurysm

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https://www.readbyqxmd.com/read/29781370/re-treatment-of-an-unruptured-anterior-communicating-artery-aneurysm-using-the-new-pconus-2-device-description-of-a-case
#1
Marco Varrassi, Sergio Carducci, Aldo V Giordano, Carlo Masciocchi
Endovascular approach represents today the first option in treatment of ruptured and unruptured cerebral aneurysms. Nevertheless, wide-neck bifurcation aneurysms still represent a technical challenge for endovascular treatment due to the need to protect vessels arising next to the aneurysmal neck. A variety of devices have been implemented to ensure adequate assistance for coiling of these lesions. Among these devices, the new pCONus 2 represents an evolution of the well-known pCONus; compared to the previous one in fact, it allows a degree of articulation and flexibility between the shaft and the distal part (crown), making it more suitable for treatment of aneurysms presenting an angle between the longitudinal axis of the dome and parent vessel...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29775770/treatment-of-ruptured-vertebral-artery-dissection-and-abdominal-hemorrhage-associated-with-segmental-arterial-mediolysis-using-endovascular-coil-embolization-va-dissection-associated-with-sam
#2
Taiki Isaji, Tomotaka Ohshima, Sigeru Miyachi, Naoki Matsuo, Reo Kawaguchi, Masakazu Takayasu
BACKGROUND: Segmental arterial mediolysis is a rare disease characterized by idiopathic noninflammatory vasculopathy involving small to medium arteries. Here, we report a case of ruptured cerebral and abdominal aneurysms, which were successfully treated using emergency endovascular coil embolization. CASE DESCRIPTION: A 45-year-old male suffered subarachnoid hemorrhage caused by the rupture of the right vertebral artery dissecting aneurysm, which was treated using emergency endovascular coiling...
May 15, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29768963/the-woven-endobridge-web-as-primary-treatment-for-unruptured-intracranial-aneurysms
#3
Sanne Bt van Rooij, Willem Jan van Rooij, Jo P Peluso, Menno Sluzewski
Purpose The intrasaccular flow disruptor Woven EndoBridge (WEB) device is developed for the treatment of wide-necked aneurysms without supportive devices. We used the WEB as primary treatment for unruptured aneurysms suitable for the device, regardless of neck size. Methods Between February 2015 and June 2017, 59 aneurysms in 51 patients were selectively treated with the WEB. There were 15 men and 36 women with a mean age of 59 years. Mean aneurysm size was 7.0 mm (range 3-22 mm). Of 59 aneurysms, 45 (76%) had a wide neck defined as ≥4 mm or dome-neck ratio ≤1...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29768961/a-rare-case-of-ruptured-aneurysm-of-the-paramedian-artery-of-percheron
#4
Gianvincenzo Sparacia, Francesco Agnello, Massimo Midiri, Alberto Iaia
Introduction The artery of Percheron is a rare anatomic variant supplying bilateral medial thalamic nuclei and a variable portion of the rostral part of midbrain. Case report A 48-year-old female with massive subarachnoid hemorrhage due to a ruptured aneurysm of the paramedian artery of Percheron presented to the emergency room. Because of significant risk of recurrent intracranial hemorrhage, it was decided to proceed with endovascular embolization of the aneurysm. The patient was ultimately sent to a rehabilitation center and her presenting neurologic deficits showed significant improvements in the weeks following endovascular embolization treatment...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29767773/aneurysm-size-is-the-strongest-risk-factor-for-intracranial-aneurysm-growth-in-the-eastern-finnish-population
#5
Joel Björkman, Juhana Frösen, Olli Tähtinen, Terhi Huttunen, Jukka Huttunen, Mitja I Kurki, Mikael von Und Zu Fraunberg, Timo Koivisto, Hannu Manninen, Juha E Jääskeläinen, Antti E Lindgren
BACKGROUND: Saccular intracranial aneurysm (sIA) growth during follow-up is associated with high risk for subsequent rupture. Finnish patients have been suggested to have higher risk for subarachnoid hemorrhage, but follow-up studies of sIA growth in the Finnish population are scarce. OBJECTIVE: To identify the strongest risk factors for sIA growth in Eastern Finnish population by studying 205 patients with 350 unruptured sIAs with angiographic follow-up imaging...
May 15, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29766928/parent-artery-sacrifice-for-ruptured-aneurysms-in-acute-and-chronic-phases-a-systematic-review
#6
REVIEW
Xianli Lv, Wei Li, Huijian Ge, Hengwei Jin, Hongwei He, Chuhan Jiang, Youxiang Li
Background: Experience with respect to parent vessel sacrifice (PVS) for unclippable/uncoilable ruptured aneurysms is limited. Objective: The aim of the present systematic review was to evaluate the risk of PVS for unclippable/uncoilable ruptured aneurysms. Materials and Methods: The PUBMED and SCIENCEDIRECT databases were searched using "parent vessel occlusion OR parent artery occlusion" AND "acute subarachnoid hemorrhage" till December 27, 2015, and 1 journal was searched from November 1995 to April 2016 for relevant results...
May 2018: Neurology India
https://www.readbyqxmd.com/read/29765397/lvis-jr-device-for-y-stent-assisted-coil-embolization-of-wide-neck-intracranial-aneurysms-a-multicenter-experience
#7
Edgar A Samaniego, Aldo A Mendez, Thanh N Nguyen, Vladimir Kalousek, Waldo R Guerrero, Sudeepta Dandapat, Guilherme Dabus, Italo Linfante, Ameer E Hassan, Alexander Drofa, Evgueni Kouznetsov, David Leedahl, David Hasan, Alberto Maud, Santiago Ortega-Gutierrez
Background and Purpose: Complex wide-neck intracranial aneurysms are challenging to treat. We report a multicenter experience using the LVIS Jr stent for "Y-stent"-assisted coiling embolization of wide-neck bifurcation aneurysms. Methods: Seven centers provided retrospective data on patients who underwent Y-stenting. Technical complications, immediate posttreatment angiographic results, clinical outcomes, and imaging follow-up were assessed. Results: Thirty patients/aneurysms were treated: 15 basilar tip, 8 middle cerebral artery, 4 anterior communicating artery, 1 pericallosal, and 2 posterior inferior cerebellar artery aneurysms...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29764034/-application-of-low-profile-visualized-intraluminal-support-lvis-stents-in-assisting-coil-embolization-of-intracranial-aneurysms
#8
D C Xu, J Li, Z Q Jiang
Objective: To evaluate the safety and effectiveness of application of LVIS stent-assisted coiling endovascular procedures in cerebral aneurysms . Methods: The clinical data of 41 patients with intracranial aneurysms , which were performed in LVIS stent-assisted coiling endovascular therapies from June 2015 to October 2017 in The First Affiliated Hospital of Bengbu Medical College were analyzed retrospectively. 13 patients were unruptured and 28 patients were ruptured. Immediate angiography outcomes and follow-up angiography outcomes were assessed by DSA...
May 8, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29758371/comparative-cost-analysis-for-the-surgical-and-endovascular-treatment-of-ruptured-intracranial-aneurysms-in-taiwan-a-nationwide-population-based-cohort-study
#9
Jian-Han Chen, Chih-Yuan Huang, Yi-Che Lee, Kuo-Wei Wang, Po-Chou Liliang, Cheng-Loong Liang, Kang Lu, Han-Jung Chen, Yuan-Ting Sun, Hao-Kuang Wang
OBJECTIVE: Using a database that enabled longitudinal follow-up, the authors assessed the cost, outcome, complications, and readmission rate of ruptured cerebral aneurysms repaired by surgical clipping and endovascular coiling. METHODS: This study was a retrospective review of data from a series of patients who underwent surgical clipping or endovascular coiling of ruptured cerebral aneurysms between 1996 and 2013. The medical records and hospital cost data were all examined...
May 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29753899/co-adjuvant-treatment-of-vasospasm-in-ruptured-unsecured-cerebral-aneurysms-with-aggressive-angioplasty-intra-arterial-nimodipine-and-aneurysm-embolization
#10
Ching-Chang Chen, Alvin Yi-Chou Wang, Chun-Ting Chen, Po-Chuan Hsieh
BACKGROUND: Vasospasm is a major cause of morbidity and mortality in patients following aneurysmal subarachnoid hemorrhage (SAH). Although early treatment of ruptured aneurysms is advocated, delayed intervention complicates the treatment strategy and leading to significant vasospasm and a poor prognosis. We report our experience of endovascular protocol for occlusion of the unsecured aneurysm and angioplasty for vasospasm in a single session. METHODS: A total of 24 cases with significant vasospasm and unsecured ruptured cerebral aneurysm were reviewed among 660 aneurysmal SAH patients between January 2011 and May 2017...
May 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29749594/-non-aneurysmal-subarachnoid-haemorrhage-secondary-to-panarteritis-nodosa-at-paediatric-age-a-case-report
#11
L Salgado-Lopez, C de Quintana-Schmidt, I Catala-Antunez, J Aibar-Duran, L San Roman-Manzanera, J Molet-Teixido
INTRODUCTION: Polyarteritis nodosa is a necrotizing vasculitis that mainly affects small and medium-sized arteries in skin and internal organs. Neurological involvement is reported in around 25% of cases: ischemic stroke is relatively common, but haemorrhagic lesions are extremely rare. Subarachnoid haemorrhage in polyarteritis nodosa is an uncommon expression of this disease, mostly associated with aneurism rupture. To the best of the authors' knowledge, there is just one published case in pediatric age with polyarteritis nodosa and subarachnoid haemorrhage with no underlying aneurismal disease...
May 16, 2018: Revista de Neurologia
https://www.readbyqxmd.com/read/29749361/risk-factors-for-ruptured-intracranial-aneurysms
#12
Guang-Xian Wang, Dong Zhang, Zhi-Ping Wang, Liu-Qing Yang, Hua Yang, Wen Li
Background & objectives: The treatment of unruptured intracranial aneurysms (IAs) remains controversial; the ability to predict the risk of rupture for an aneurysm would be of clinical value. The aim of this study was to determine and evaluate the predictive value of the risk factors of IA rupture. Methods: This retrospective study involved 379 consecutive patients with 441 aneurysms between August 2011 and July 2014. Based on clinical data and computed tomography angiography findings, the potential of risk factors to predict the aneurysmal rupture was assessed using statistical methods...
January 2018: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/29741656/differences-in-pressure-within-the-sac-of-human-ruptured-and-nonruptured-cerebral-aneurysms
#13
Yiping Li, Mark Corriveau, Beverly Aagaard-Kienitz, Azam Ahmed, David Niemann
BACKGROUND: Hemodynamics plays a critical role in the development, growth, and rupture of intracranial aneurysms. This data could be vital in determining individual aneurysm rupture risk and could facilitate our understanding of aneurysms. OBJECTIVE: To present the largest prospective cross-sectional cohort study of intrasaccular pressure recordings of ruptured and nonruptured intracranial aneurysms and describe the hemodynamic differences that exist between ruptured and nonruptured aneurysms...
May 8, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29730271/intraventricular-extension-of-an-aneurysmal-subarachnoid-hemorrhage-is-an-independent-predictor-of-a-worse-functional-outcome
#14
Mario Zanaty, Daichi Nakagawa, Robert M Starke, Enrique C Leira, Edgar A Samaniego, Waldo R Guerrero, James Torner, Yasunori Nagahama, Olatilewa Awe, Jeremy Greenlee, Joseph S Hudson, Lauren Allan, Reem Elwy, Nohra Chalouhi, Pascal Jabbour, Royce Woodroffe, Anthony Piscopo, David Hasan
OBJECTIVE: The objective of this study is to determine the impact of intraventricular hemorrhage (IVH) on the cognitive prognosis of subarachnoid hemorrhage (SAH) due to ruptured cerebral aneurysm, independent of the presence of intraparenchymal hemorrhage, hydrocephalus or vasospasm. PATIENT AND METHODS: A Retrospective review of a prospectively collected database of patients with aneurysmal SAH from July 2009 to November 2016 was performed. Patients were included if they had a saccular aneurysm with a Hunt-Hess grade (HHG) 1-3...
April 30, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29729990/quantitative-proteomics-analysis-of-differentially-expressed-proteins-in-ruptured-and-unruptured-cerebral-aneurysms-by-itraq
#15
Pengjun Jiang, Jun Wu, Xin Chen, Bo Ning, Qingyuan Liu, Zhengsong Li, Maogui Li, Fan Yang, Yong Cao, Rong Wang, Shuo Wang
The underlying pathophysiological mechanisms involved in cerebral aneurysms rupture remain unclear. This study was performed to investigate the differentially expressed proteins between ruptured and unruptured aneurysms using quantitative proteomics. The aneurysmal walls of six ruptured aneurysms and six unruptured aneurysms were collected during the surgical operation. The isobaric tags for relative and absolute quantification (iTRAQ) were used to identify the differentially expressed proteins and western blotting was performed to validate the expression of the proteins of interest...
May 3, 2018: Journal of Proteomics
https://www.readbyqxmd.com/read/29725567/one-stage-stent-assisted-coil-embolization-for-rupture-side-unknown-bilateral-vertebral-artery-dissecting-aneurysms-in-an-acute-stage-a-case-report
#16
Mio Terashima, Yoichi Miura, Fujimaro Ishida, Naoki Toma, Tomohiro Araki, Shinichi Shimosaka, Kenji Kanamaru, Hidenori Suzuki
Bilateral vertebral artery dissecting aneurysms (VADAs) with subarachnoid hemorrhage (SAH) are rare and their management is still challenging. In this report, we successfully performed one-stage stent-assisted coil embolization (SAC) for bilateral VADAs with SAH in an acute stage, because the ruptured side could not be diagnosed. A 47-year-old woman presented with a sudden onset of headache without laterality, and left-side dominant SAH with bilateral VADAs was noted on computed tomography (CT) scans. The size of aneurysmal dome and neck was similar between the two VADAs, and a bleb was observed only on the right VADA...
April 2018: NMC Case Report Journal
https://www.readbyqxmd.com/read/29718865/basal-ganglion-hematoma-evacuation-and-clipping-of-middle-cerebral-artery-aneurysm-by-neuroendoscopy-a-case-report
#17
Qiang Cai, Wenfei Zhang, Baowei Ji, Xiang Ding, Zhibiao Chen, Qianxue Chen
RATIONALE: Basal ganglia hematomas resulting from the rupture of aneurysms of the distal middle cerebral artery (MCA) are extremely rare and are usually treated by craniotomy. To date, only 5 cases of MCA aneurysm have been treated using neuroendoscopy, and none of these cases involved hematomas. For the first time, we report a special case in which neuroendoscopy was used to evacuate a hematoma and clip an aneurysm at the same time. PATIENT CONCERNS: A massive basal ganglia hematoma in a 60-year-old man was evacuated using neuroendoscopy, and a distal MCA aneurysm was discovered and clipped successfully under the neuroendoscopy during the operation...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29716803/pericallosal-aneurysm-coiling-with-a-hubbed-167-cm-0-013%C3%A2-headway-duo-via-a-transradial-approach
#18
Bradley A Gross, Cynthia L Kenmuir, William J Ares, Ashutosh P Jadhav, Tudor G Jovin, Brian T Jankowitz
Cerebral aneurysms in patients with extreme proximal tortuosity may contraindicate endovascular therapy as a result of both the approach and an inability to navigate a coil-compatible microcatheter into the aneurysm due to microcatheter length. We present a 72 year-old male with multiple medical comorbidities admitted with a grade 3, ruptured pericallosal aneurysm. Aortoiliac disease contraindicated a transfemoral approach and thus a 6 French 105 cm guide catheter was advanced through a 6 French short radial sheath into a bovine left common carotid artery...
April 28, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29712525/analysis-of-cerebrovascular-aneurysm-treatment-cost-retrospective-cohort-comparison-of-clipping-coiling-and-flow-diversion
#19
Spencer Twitchell, Hussam Abou-Al-Shaar, Jared Reese, Michael Karsy, Ilyas M Eli, Jian Guan, Philipp Taussky, William T Couldwell
OBJECTIVE With the continuous rise of health care costs, hospitals and health care providers must find ways to reduce costs while maintaining high-quality care. Comparing surgical and endovascular treatment of intracranial aneurysms may offer direction in reducing health care costs. The Value-Driven Outcomes (VDO) database at the University of Utah identifies cost drivers and tracks changes over time. In this study, the authors evaluate specific cost drivers for surgical clipping and endovascular management (i...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29701554/long-term-results-of-middle-cerebral-artery-aneurysm-clipping-in-the-barrow-ruptured-aneurysm-trial
#20
Michael A Mooney, Elias D Simon, Scott Brigeman, Peter Nakaji, Joseph M Zabramski, Michael T Lawton, Robert F Spetzler
OBJECTIVE A direct comparison of endovascular versus microsurgical treatment of ruptured middle cerebral artery (MCA) aneurysms in randomized trials is lacking. As endovascular treatment strategies continue to evolve, the number of reports of endovascular treatment of these lesions is increasing. Herein, the authors report a detailed post hoc analysis of ruptured MCA aneurysms treated by microsurgical clipping from the Barrow Ruptured Aneurysm Trial (BRAT). METHODS The cases of patients enrolled in the BRAT who underwent microsurgical clipping for a ruptured MCA aneurysm were reviewed...
April 27, 2018: Journal of Neurosurgery
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