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Stent-assisted coiling

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https://www.readbyqxmd.com/read/28304190/the-second-generation-eclips-endovascular-clip-system-initial-experience
#1
Albert H Chiu, Joost De Vries, Cian J O'Kelly, Howard Riina, Ian McDougall, Jonathan Tippett, Martina Wan, Airton Leonardo de Oliveira Manoel, Thomas R Marotta
OBJECTIVE Treatment of wide-necked intracranial aneurysms is associated with higher recanalization and complication rates; however, the most commonly used methods are not specifically designed to work in bifurcation lesions. To address these issues, the authors describe the evolution in the design and use of the eCLIPs (Endovascular Clip System) device, a novel hybrid stent-like assist device with flow diverter properties that was first described in 2008. METHODS A registry was established covering 13 international centers at which patients were treated with the second-generation eCLIPs device...
March 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28304189/physiological-remodeling-of-bifurcation-aneurysms-preclinical-results-of-the-eclips-device
#2
Thomas R Marotta, Howard A Riina, Ian McDougall, Donald R Ricci, Monika Killer-Oberpfalzer
OBJECTIVE Intracranial bifurcation aneurysms are complex lesions for which current therapy, including simple coiling, balloon- or stent-assisted coiling, coil retention, or intrasaccular devices, is inadequate. Thromboembolic complications due to a large burden of intraluminal metal, impedance of access to side branches, and a high recurrence rate, due largely to the unmitigated high-pressure flow into the aneurysm (water hammer effect), are among the limitations imposed by current therapy. The authors describe herein a novel device, eCLIPs, and its use in a preclinical laboratory study that suggests the device's design and functional features may overcome many of these limitations...
March 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28279720/stent-assisted-coil-embolization-of-a-symptomatic-renal-artery-aneurysm-at-a-bifurcation-point
#3
Naiem Nassiri, Lauren A Huntress
PURPOSE: Symptomatic renal artery aneurysms at bifurcation points present challenging clinical scenarios rarely amenable to endovascular repair due to concerns regarding parenchymal loss following intervention. Herein, we add to the scant body of literature describing successful endovascular repair of a saccular, symptomatic renal artery aneurysm situated at a bifurcation point. METHODS: A 52 year-old woman with a 2.5 cm extra-parenchymal, saccular, symptomatic left renal artery aneurysm underwent self-expanding stent-assisted detachable platinum microcoil embolization...
March 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28264515/fabrication-and-optimal-design-of-biodegradable-polymeric-stents-for-aneurysms-treatments
#4
Xue Han, Xia Wu, Michael Kelly, Xiongbiao Chen
An aneurysm is a balloon-like bulge in the wall of blood vessels, occurring in major arteries of the heart and brain. Biodegradable polymeric stent-assisted coiling is expected to be the ideal treatment of wide-neck complex aneurysms. This paper presents the development of methods to fabricate and optimally design biodegradable polymeric stents for aneurysms treatment. Firstly, a dispensing-based rapid prototyping (DBRP) system was developed to fabricate coil and zigzag structures of biodegradable polymeric stents...
February 28, 2017: Journal of Functional Biomaterials
https://www.readbyqxmd.com/read/28264249/microguidewire-looping-to-traverse-stented-parent-arteries-of-intracranial-aneurysms
#5
Young Dae Cho, Jong Kook Rhim, Dong Hyun Yoo, Hyun-Seung Kang, Jeong Eun Kim, Moon Hee Han
OBJECTIVE: Stents are widely used in coil embolization of intracranial aneurysms, but on occasion, a microcatheter must traverse a stented segment of artery (so-called trans-cell technique) to select an aneurysm, or double stenting may necessary. In such situations, microguidewire passage and microcatheter delivery through a tortuous stented parent artery may pose a technical challenge. Described herein is a microguidewire looping technique to facilitate endovascular navigation in these circumstances...
March 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28264234/semi-jailing-technique-using-a-neuroform3-stent-for-coiling-of-wide-necked-intracranial-aneurysms
#6
Jun Kyeung Ko, Won Ho Cho, Seung Heon Cha, Chang Hwa Choi, Sang Weon Lee, Tae Hong Lee
OBJECTIVE: The semi-jailing technique (SJT) provides stent-assisted remodeling of the aneurysm neck during coil embolization without grasping the coil delivery microcatheter. We retrospectively evaluated the efficacy and safety of SJT using a Neuroform3 stent for coiling of wide-necked intracranial aneurysms. METHODS: We collected the clinical and radiological data between January 2009 and June 2015 of the wide-necked aneurysms treated with SJT using a Neuroform3 stent...
March 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28256168/multidisciplinary-management-for-the-treatment-of-proximal-posterior-inferior-cerebellar-artery-aneurysms
#7
Kwang-Chun Cho, Yong Bae Kim, Sang Hyun Suh, Jin Yang Joo, Chang-Ki Hong
OBJECTIVES: Aneurysms of the proximal posterior inferior cerebellar artery (PICA) are rare. The management of proximal PICA aneurysms is challenging with either surgical or endovascular treatment. We report our successful experience of treating PICA aneurysms with a multimodal approach. METHODS: Of 2382 treated aneurysms, 22 aneurysms in 21 patients (male:female 8:13, mean age 48.9 years) were enrolled from March 1998 to December 2015. We treated the aneurysms with a multimodal approach and performed angiography to examine aneurysm regrowth at the 12 months follow-up...
March 3, 2017: Neurological Research
https://www.readbyqxmd.com/read/28246277/ischemic-stroke-after-treatment-of-intraprocedural-thrombosis-during-stent-assisted-coiling-and-flow-diversion
#8
Nimer Adeeb, Christoph J Griessenauer, Justin M Moore, Paul M Foreman, Hussain Shallwani, Rouzbeh Motiei-Langroudi, Raghav Gupta, Carlos E Baccin, Abdulrahman Alturki, Mark R Harrigan, Adnan H Siddiqui, Elad I Levy, Christopher S Ogilvy, Ajith J Thomas
BACKGROUND AND PURPOSE: Intraprocedural thrombosis poses a formidable challenge during neuroendovascular procedures because the risks of aggressive thromboembolic treatment must be balanced against the risk of postprocedural hemorrhage. The aim of this study was to identify predictors of ischemic stroke after intraprocedural thrombosis after stent-assisted coiling and pipeline embolization device placement. METHODS: A retrospective analysis of intracranial aneurysms treated with stent-assisted coiling or pipeline embolization device placement between 2007 and 2016 at 4 major academic institutions was performed to identify procedures that were complicated by intraprocedural thrombosis...
February 28, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28238529/innovations-in-endovascular-treatment-strategies-for-large-carotid-cavernous-aneurysms-the-safety-and-efficacy-of-a-flow-diverter
#9
Shigeru Miyachi, Hiroyuki Ohnishi, Ryo Hiramatsu, Takashi Izumi, Noriaki Matsubara, Toshihiko Kuroiwa
BACKGROUND: The efficacy for the treatment of large carotid cavernous aneurysms (CCAs) was compared between conventional endovascular treatments, stent-assisted coiling (SAC), parent artery occlusion (PAO), and the flow diverter (FD). METHODS: Between January 2001 and December 2015, 49 patients with large, broad-necked, unruptured CCA underwent endovascular treatment at our institution. We performed PAO in 22 patients, SAC in 18 patients, and FD in 9 patients. Safety and efficacy were assessed in all patients by periodic clinical and radiological examinations during a 6-month follow-up...
February 24, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28235953/nickel-associated-delayed-multiple-white-matter-lesions-after-stent-assisted-coil-embolization-of-intracranial-unruptured-aneurysm
#10
Hun Soo Park, Ichiro Nakagawa, Shohei Yokoyama, Daisuke Wajima, Takeshi Wada, Yasushi Motoyama, Kimihiko Kichikawa, Hiroyuki Nakase
Metal-induced encephalopathy after stent-assisted coil embolization is extremely rare. The present report describes two patients who presented with symptomatic intracranial parenchymal edematous lesions after stent-assisted coil embolization. A 64-year-old woman underwent stent-assisted coil embolization for a left internal carotid artery aneurysm; 21 days after the procedure she presented with right hand weakness and MRI revealed multifocal white matter lesions. Another woman aged 52 years underwent stent-assisted coil embolization for right vertebral artery aneurysm; 18 days after the procedure she presented with left-sided sensory disturbance and MRI demonstrated multiple white matter lesions...
February 24, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28228899/stent-assisted-modified-coil-protection-technique-for-bilobulated-aneurysm-technical-note
#11
Yunsuk Her, Jin Pyeong Jeon, Hyuk Jai Choi, Yong Jun Cho
Endovascular treatment of deeply located bilobulated aneurysms in elderly patients is still challenging because of the acute angulation of the carotid siphon and poor microcatheter support. In particular, generating a frame coil to cover each lobe is difficult in bilobulated aneurysms with narrow isthmus in the fused portion. Here, we report a successfully treated bilobulated aneurysm using a modified coil protection technique with stent assistance.
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28219914/nickel-associated-delayed-multiple-white-matter-lesions-after-stent-assisted-coil-embolization-of-intracranial-unruptured-aneurysm
#12
Hun Soo Park, Ichiro Nakagawa, Shohei Yokoyama, Daisuke Wajima, Takeshi Wada, Yasushi Motoyama, Kimihiko Kichikawa, Hiroyuki Nakase
Metal-induced encephalopathy after stent-assisted coil embolization is extremely rare. The present report describes two patients who presented with symptomatic intracranial parenchymal edematous lesions after stent-assisted coil embolization. A 64-year-old woman underwent stent-assisted coil embolization for a left internal carotid artery aneurysm; 21 days after the procedure she presented with right hand weakness and MRI revealed multifocal white matter lesions. Another woman aged 52 years underwent stent-assisted coil embolization for right vertebral artery aneurysm; 18 days after the procedure she presented with left-sided sensory disturbance and MRI demonstrated multiple white matter lesions...
February 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28184347/intra-arterial-thrombolysis-for-central-retinal-artery-occlusion-after-the-coil-embolization-of-paraclinoid-aneurysm
#13
Minwook Yoo, Sung-Chul Jin, Hae Yu Kim, Byeong-Sam Choi
The most common complication of coil embolization for cerebral aneurysms is thrombo-embolic stroke; in rare cases, these strokes, can present with central retinal artery occlusion. At our institution, a 53-year-old woman underwent stent-assisted coiling of the aneurysm. The patient's vision was improved immediately after intra-arterial thrombolysis and had further improved 8 months later. This report describes our experience of a rare case of central retinal artery occlusion after coil embolization that was successfully treated by intra-arterial thrombolysis...
December 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/28184345/y-configuration-stent-assisted-coil-embolization-for-wide-necked-intracranial-bifurcation-aneurysms
#14
Kwangho Lee, Hyun Park, Insung Park, Sukh Que Park, O-Ki Kwon, Jongwoo Han
OBJECTIVE: The objective of this study was to determine the efficiency and safety of Y configuration stent-assisted coiling with double-closed stents for wide-necked intracranial aneurysms located at arterial bifurcations thorough analysis of a multicenter case series. MATERIALS AND METHODS: A retrospective chart review was done on 10 patients who underwent endovascular treatment of wide-necked intracranial aneurysms with Y-configuration stent-assisted coil embolization in three centers from August 2011 to March 2014...
December 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/28178166/headache-improvement-after-intracranial-endovascular-procedures-in-chinese-patients-with-unruptured-intracranial-aneurysm-a-prospective-observational-study
#15
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)
https://www.readbyqxmd.com/read/28163518/double-barrel-y-configuration-stenting-for-flow-diversion-of-a-giant-recurrent-basilar-apex-aneurysm-with-the-pipeline-flex-embolization-device
#16
Dale Ding, Robert M Starke, Ben McGuinness, Stefan Brew
Giant basilar apex aneurysms are extremely challenging to successfully manage. The Pipeline Flex embolization device (PFED) is a new generation flow-diverting stent with a modified delivery system which allows resheathing of the stent after partial deployment. We describe a case of double-barrel Y-configuration stenting of a giant, recurrent basilar apex aneurysm using the PFED. A 73-year-old male was previously treated for an unruptured 11-mm basilar apex aneurysm with stent-assisted coiling using a Neuroform stent...
December 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28162904/bilateral-internal-carotid-artery-aneurysms-at-the-subpetrosal-portion-with-unilateral-lower-cranial-nerve-palsies-review-and-consideration-of-surgical-strategy
#17
Kei Noguchi, Takachika Aoki, Rokudai Sakamoto, Kimihiko Orito, Yasuharu Takeuchi, Masaru Hirohata, Motohiro Morioka
BACKGROUND: Symptomatic bilateral extracranial internal carotid artery (ICA) aneurysms at the subpetrosal portion are extremely rare, and their treatment strategy remains unknown. CLINICAL PRESENTATION: A 42-year-old man presented to our hospital with a 2-month history of sudden onset of hoarseness, dysarthria, and dysphagia. Magnetic resonance imaging, magnetic resonance angiography, and computed tomography angiography revealed extracranial bilateral ICA aneurysms at the subpetrosal portion...
February 2, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28133987/ruptured-intracranial-vertebral-artery-dissecting-aneurysms-an-evaluation-of-prognostic-factors-of-treatment-outcome
#18
K Urasyanandana, P Withayasuk, D Songsaeng, T Aurboonyawat, E Chankaew, A Churojana
Objective Intracranial spontaneous vertebral artery dissecting aneurysms commonly occur in the third to fifth decades of life, and are mostly associated with hypertension. Patients present with intracranial haemorrhage or thromboembolic events. Patients who present with intracranial haemorrhage carry about a 70% risk of recurrent bleeding. Patients with a posterior-inferior cerebellar artery (PICA) or ipsilateral dominant vertebral artery involve selecting which parent vessel could not be sacrificed. Recent reconstructive techniques such as stent-assisted coiling embolisation and flow-diverting stents are effective treatments of choice...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28130502/optimal-first-coil-selection-to-avoid-aneurysmal-recanalization-in-endovascular-intracranial-aneurysmal-coiling
#19
Hiroaki Neki, Shinya Kohyama, Toshihiro Otsuka, Azusa Yonezawa, Shoichiro Ishihara, Fumitaka Yamane
BACKGROUND: Aneurysmal recanalization is a problem with endovascular coiling and one of its risk factors is the low volume embolization ratio (VER). The first coil VER (1st VER) is believed to be critical for obtaining a high VER. The main objective of this study was to evaluate factors potentially useful for selecting the optimal 1st VER for endovascular coiling. METHODS: 609 initial saccular aneurysmal treatments performed between January 2010 and December 2014 at our institution were included in this retrospective study...
January 27, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28120064/giant-basilar-artery-aneurysm-involving-the-origin-of-bilateral-posterior-cerebral-and-superior-cerebellar-arteries-neck-reconstruction-with-pconus-assisted-coiling
#20
Francesco Signorelli, Carmelo Lucio Sturiale, Giuseppe La Rocca, Alessio Albanese, Francesco D'Argento, Pierpaolo Mattogno, Alfredo Puca, Massimiliano Visocchi, Enrico Marchese, Alessandro Pedicelli
Giant aneurysms of the basilar artery are rare and are frequently associated with obstructive hydrocephalus and brainstem compression. Treatment still remains a challenge both for neurosurgeons and for interventional neuroradiologists. Cases reported in the literature are anecdotal and, overall, their outcomes are poor. We present the case of a patient with a giant aneurysm of the basilar artery tip, involving the origin of both the posterior cerebral and superior cerebellar arteries, who underwent coiling and ventriculoperitoneal shunting for associated obstructive hydrocephalus...
2017: Acta Neurochirurgica. Supplement
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