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Unruptured cerebral aneurysm

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https://www.readbyqxmd.com/read/29775150/computer-aided-analysis-of-middle-cerebral-artery-tortuosity-association-with-aneurysm-development
#1
Kornelia M Kliś, Roger M Krzyżewski, Borys M Kwinta, Krzysztof Stachura, Marek Moskała, Krzysztof A Tomaszewski
OBJECTIVE Blood vessel tortuosity may play an important role in the development of vessel abnormalities such as aneurysms. Currently, however, there are no studies analyzing the impact of brain blood vessel tortuosity on the risk of aneurysm formation. Therefore, the authors performed a computer-aided analysis of middle cerebral artery (MCA) tortuosity, especially among patients diagnosed with MCA aneurysms. METHODS Anatomy of the MCAs of 54 patients with unruptured MCA aneurysms was retrospectively analyzed, as was that of 54 sex-, age-, and vessel side-matched control patients without MCA aneurysms...
May 18, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29768963/the-woven-endobridge-web-as-primary-treatment-for-unruptured-intracranial-aneurysms
#2
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/29767773/aneurysm-size-is-the-strongest-risk-factor-for-intracranial-aneurysm-growth-in-the-eastern-finnish-population
#3
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/29765397/lvis-jr-device-for-y-stent-assisted-coil-embolization-of-wide-neck-intracranial-aneurysms-a-multicenter-experience
#4
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/29764206/management-of-incidental-aneurysms-comparison-of-single-centre-multi-disciplinary-team-decision-making-with-the-unruptured-incidental-aneurysm-treatment-score
#5
Alex Smedley, Nate Yusupov, Alaa Almousa, Thomas Solbach, Ahmed K Toma, Joan P Grieve
OBJECTIVE: To compare multidisciplinary team (MDT) decision making at our centre with the suggested management from the recently published Unruptured Intracranial Aneurysm Treatment Score (UIATS), with particular focus on disagreements between the two bodies of expert opinion. DESIGN: A retrospective audit of local practice. SUBJECTS: Adult patients with incidental cerebral saccular aneurysms referred to The National Hospital for Neurology and Neurosurgery Neurovascular MDT...
May 15, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29764034/-application-of-low-profile-visualized-intraluminal-support-lvis-stents-in-assisting-coil-embolization-of-intracranial-aneurysms
#6
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/29760311/postoperative-subdural-air-collection-is-a-risk-factor-for-chronic-subdural-hematoma-after-surgical-clipping-of-cerebral-aneurysms
#7
Shuhei Kawabata, Shoichi Tani, Hirotoshi Imamura, Hidemitsu Adachi, Nobuyuki Sakai
The precise mechanism of the development of chronic subdural hematoma (CSDH) as a postoperative complication after aneurysmal clipping remains unclear. The purpose of this study was to identify the independent risk factors for CSDH after craniotomy for aneurysmal clipping and to elucidate the relationship between CSDH and subdural air (SDA) collection immediately after surgery. The medical records and radiologic data of 344 patients who underwent surgical clipping of unruptured aneurysms from July 2010 to July 2016 were retrospectively evaluated...
May 11, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29749361/risk-factors-for-ruptured-intracranial-aneurysms
#8
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
#9
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/29741225/prediction-of-vascular-abnormalities-on-ct-angiography-in-patients-with-acute-headache
#10
Imanda M E Alons, Ben F J Goudsmit, Korné Jellema, Marianne A A van Walderveen, Marieke J H Wermer, Ale Algra
OBJECTIVES: Patients with acute headache increasingly undergo CT-angiography (CTA) to evaluate underlying vascular causes. The aim of this study is to determine clinical and non-contrast CT (NCCT) criteria to select patients who might benefit from CTA. METHODS: We retrospectively included patients with acute headache who presented to the emergency department of an academic medical center and large regional teaching hospital and underwent NCCT and CTA. We identified factors that increased the probability of finding a vascular abnormality on CTA, performed multivariable regression analyses and determined discrimination with the c-statistic...
May 9, 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29729990/quantitative-proteomics-analysis-of-differentially-expressed-proteins-in-ruptured-and-unruptured-cerebral-aneurysms-by-itraq
#11
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/29719303/acute-obstructive-hydrocephalus-due-to-a-giant-posterior-cerebral-artery-aneurysm-in-a-pediatric-patient
#12
Can Sarica, Bahattin Tanrikulu, Yener Sahin, Adnan Dağçınar, Feyyaz Baltacioglu, Yasar Bayri
INTRODUCTION: Intracranial aneurysms are very rare in children. Although subarachnoidal hemorrhage (SAH) is by far the most common presentation of aneurysms in the majority of the pediatric case series, it is not rare for an unruptured aneurysm to present with a mass effect. Acute hydrocephalus is a common finding following aneurysmal SAH. However, this malady may develop even in the absence of SAH but secondary to direct obstruction by a giant aneurysm. This situation is extremely rare in children, with only a few known case reports in the literature...
May 2, 2018: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29712525/analysis-of-cerebrovascular-aneurysm-treatment-cost-retrospective-cohort-comparison-of-clipping-coiling-and-flow-diversion
#13
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/29712518/unruptured-aneurysms-in-the-elderly-perioperative-outcomes-and-cost-analysis-of-endovascular-coiling-and-surgical-clipping
#14
Nicole A Silva, Belinda Shao, Michael J Sylvester, Jean Anderson Eloy, Chirag D Gandhi
OBJECTIVE Observation and neurosurgical intervention for unruptured intracranial aneurysms (UIAs) in the elderly population is rapidly increasing. Cerebral aneurysm coiling (CACo) is favored over cerebral aneurysm clipping (CAC) in elderly patients, yet some elderly individuals still undergo CAC. The cost-effectiveness of treating UIAs requires further exploration. Understanding the effect of intervention on hospital charges and length of stay (LOS) as well as perioperative mortality and complications can further shed light on its economic impact...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29689406/hyperperfusion-syndrome-after-trapping-with-high-flow-bypass-for-a-giant-paraclinoid-internal-carotid-artery-aneurysm
#15
Masanao Mohri, Toshiya Ichinose, Naoyuki Uchiyama, Kouichi Misaki, Iku Nambu, Yasushi Takabatake, Mitsutoshi Nakada
BACKGROUND: Hyperperfusion syndrome associated with aneurysm surgery is rare. The occurrence of the syndrome after trapping with high-flow bypass has not been described previously. Herein, we present a case of the syndrome occurring after trapping with high-flow bypass of an unruptured giant paraclinoid internal carotid artery (ICA) aneurysm. CASE DESCRIPTION: The patient was a 68-year-old woman with progressive loss of vision in her left eye. After a diagnosis of a left giant ICA aneurysm, she underwent successful trapping with high-flow bypass...
April 21, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29686163/-coil-embolization-for-very-small-intracranial-aneurysms-with-diameter-less-than-3mm-a-case-series-of-14-patients-and-literature-review
#16
Kazushi Maeda, Ryota Motoie, Satoshi Karashima, Ryosuke Otsuji, Nice Ren, Shintaro Nagaoka, Yoshiaki Ikai, Junji Uno, Hidefuku Gi
INTRODUCTION: Many studies describe aneurysms measuring ≤3mm as "very small" or "tiny, " with a risk of intraoperative rupture higher than that of most cerebral aneurysms. We evaluated the results of endovascular coil embolization for very small aneurysms with diameter ≤3mm. MATERIAL AND METHODS: The same interventional neurosurgeon performed coil embolization for 14 tiny aneurysms in 14 patients(8male and 6 females)at our institution between May 2015 and June 2017...
April 2018: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29685416/phases-score-applied-to-a-prospective-cohort-of-aneurysmal-subarachnoid-hemorrhage-patients
#17
Paul M Foreman, Philipp Hendrix, Mark R Harrigan, Winfield S Fisher, Nilesh A Vyas, Robert H Lipsky, Beverly C Walters, R Shane Tubbs, Mohammadali M Shoja, Christoph J Griessenauer
The treatment of unruptured intracranial aneurysms remains controversial. The PHASES score was developed to predict the 5-year risk of aneurysm rupture. We have assigned PHASES scores to a cohort of aneurysmal subarachnoid hemorrhage (aSAH) patients to assess the distribution of scores and its ability to predict outcome. In this study, the PHASES score was applied to a prospective cohort of aSAH patients that were enrolled in the Cerebral Aneurysm Renin Angiotensin System (CARAS) study. The CARAS study enrolled patients from two academic institutions in the United States from 2012 to 2015...
April 20, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29685412/posterior-fossa-avms-increased-risk-of-bleeding-and-worse-outcome-compared-to-supratentorial-avms
#18
Nazife Dinc, Johannes Platz, Stephanie Tritt, Johanna Quick-Weller, Michael Eibach, Robert Wolff, Joachim Berkefeld, Volker Seifert, Gerhard Marquardt
Infratentorial AVMs are often considered as potentially hazardous as they are thought to present more often with hemorrhage, may harbor AVM-associated aneurysms more frequently and to be associated with poor outcome. The aim of our study is to compare features of supratentorial and infratentorial AVMs. We retrospectively analyzed 316 consecutive patients with cerebral AVM presenting to our neurovascular center between 2005 and 2015. Location and angioarchitecture of the AVM including AVM-associated aneurysms, bleeding events, and outcome during follow up were analyzed...
April 20, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29682071/intraoperative-rupture-cerebral-aneurysm-and-computational-flow-dynamics
#19
Ilya Senko, Anton Shatokhin, Ishu Bishnoi, Yasuhiro Yamada, Riki Tanaka, Daisuke Suyama, Tukasa Kawase, Yoko Kato
Intraoperative aneurysmal rupture (IAR) is the most fearsome complication of aneurysm surgery. IAR associates with high morbidity and mortality. In recent years, we have many studies regarding using computational fluid dynamics (CFD) in aneurysm surgery. CFD helps in calculating the velocity of blood flowing in the aneurysm sac, the pressure in the aneurysm sac, and wall shear stress (WSS). CFD also helps in predicting nature of aneurysm wall and thus may warn about different intraoperative microscopy findings in aneurysms...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29676694/keyhole-strategy-aiming-at-minimizing-hospital-stay-for-surgical-clipping-of-unruptured-middle-cerebral-artery-aneurysms
#20
Kentaro Mori, Kojiro Wada, Naoki Otani, Arata Tomiyama, Terushige Toyooka, Satoru Takeuchi, Takuji Yamamoto, Yasuaki Nakao, Hajime Arai
OBJECTIVE Aneurysms of the middle cerebral artery (MCA) are still most often treated by clipping through standard craniotomy, but a longer hospital stay is one of the main drawbacks of this treatment. The authors developed a pterional keyhole clipping strategy for unruptured MCA aneurysms with the intention of minimizing hospital stay. In this paper, they report on their experience with this approach and analyze the long-term neurological and radiological outcomes. METHODS A total of 160 relatively small unruptured MCA aneurysms (mean 6...
April 20, 2018: Journal of Neurosurgery
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