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Stent-assisted coiling

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https://www.readbyqxmd.com/read/28087432/stenting-after-coiling-using-a-single-microcatheter-for-treatment-of-ruptured-intracranial-fusiform-aneurysms-with-parent-arteries-less-than-1-5-mm-in-diameter
#1
Jian Liu, Yisen Zhang, Yang Wang, Shiqing Mu, Xinjian Yang
BACKGROUND: Ruptured intracranial fusiform aneurysms involving small-diameter parent arteries are difficult to treat. Parent artery occlusion is a relatively simple and reliable treatment. However, occasionally, the parent arteries have to be retained. The arrival of the low-profile stent (LVIS(TM) Jr.) has made reconstructive endovascular treatment for fusiform aneurysms involving small-diameter parent arteries possible. CASE DESCRIPTION: This report describes an innovative method for stent-assisted coiling (stenting after coiling technique using only one microcatheter), and describes our initial experience and feasibility of this technique...
January 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28062369/stent-assisted-coiling-may-prevent-the-recurrence-of-very-small-ruptured-intracranial-aneurysms-a-multicenter-study
#2
Yisen Zhang, Ming Yang, Hongqi Zhang, Xiaolong Zhang, Youxiang Li, Chuhan Jiang, Jian Liu, Xinjian Yang
OBJECTIVE: To evaluate the safety and efficacy of endovascular treatments, including stent-assisted coiling, of very small (≤3 mm), ruptured intracranial aneurysms. METHODS: Ninety-three endovascularly treated patients with very small ruptured aneurysms were recruited from four high-volume centers between September 2010 and February 2014. Factors influencing procedural complications and outcomes were analyzed. RESULTS: Fifty-one (54.8%) aneurysms were treated by stent-assisted coiling, 41 (44...
January 3, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28059656/midterm-results-of-t-stent-assisted-coiling-of-wide-necked-and-complex-intracranial-bifurcation-aneurysms-using-low-profile-stents
#3
Kubilay Aydin, Serra Sencer, Mehmet Barburoglu, Mynzhylky Berdikhojayev, Yavuz Aras, Altay Sencer, Nail İzgi
OBJECTIVE Coiling of wide-necked and complex bifurcation aneurysms frequently requires implantation of double stents in various configurations. T-stent-assisted coiling involves the nonoverlapping implantation of 2 stents to protect the daughter vessels of bifurcation and is followed by coiling of the aneurysm. The authors studied the feasibility, efficacy, and safety of the T-stent-assisted coiling procedure as well as the midterm angiographic/clinical outcomes of patients with wide-necked bifurcation intracranial aneurysms treated using this technique...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28043886/microcatheter-looping-technique-mlt-facilitates-the-embolization-of-complex-intracranial-aneurysms-with-an-acute-angle-branch-incorporated-into-the-sac
#4
Zhang Xiaoxi, Cai Jing, Huang Qinghai, Liu Jianmin, Hong Bo, Dai Dongwei
PURPOSE: Intracranial aneurysms with an acutely angled parent vessel are difficult to enter using conventional techniques. This study examined the efficacy, safety, and technical aspects of the intraluminal, intra-aneurysmal, and in vitro microcatheter looping techniques. MATERIALS AND METHODS: Twenty-nine consecutive patients harboring intracranial aneurysms with an incorporated acute angle branch were treated with a microcatheter looping technique (MLT) after having failed treatment with conventional techniques...
December 30, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28029187/off-label-uses-for-flow-diversion-in-intracranial-aneurysm-management
#5
Fawaz Al-Mufti, Krishna Amuluru, Gomez Francisco, Vincent Dodson, Mohammad El-Ghanem, Charles J Prestigiacomo, Chirag D Gandhi
Treatment of complex aneurysms using microsurgical and other conventional neuroendovascular techniques remains challenging. As a result, stent- and balloon-assisted coiling are instead performed to treat morphologically complex aneurysms, which include giant, wide-necked, and fusiform aneurysms. While these techniques have had success in treating these complex aneurysms, recanalization rates associated with these techniques are still problematic. In the constant effort to improve the outcome of complex aneurysm treatment, flow-diverting stents (FDSs) have emerged in recent years as the preferred treatment...
December 28, 2016: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28009233/contribution-of-the-straightening-effect-of-the-parent-artery-to-decreased-recanalization-in-stent-assisted-coiling-of-large-aneurysms
#6
Akira Ishii, Hideo Chihara, Takayuki Kikuchi, Daisuke Arai, Hiroyuki Ikeda, Susumu Miyamoto
OBJECTIVE The durability of embolization of large aneurysms is enhanced by use of the neck-bridging stent. However, it remains unclear what factors contribute to decreased recanalization. The purpose of this study was to demonstrate the contribution of the straightening effect of the parent artery to the durability of stent-assisted coiling for large aneurysms. METHODS Of the 182 aneurysms treated by embolization since the introduction of the neurovascular stent, 82 consecutive unruptured aneurysms with a diameter greater than 7 mm were selected...
December 23, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28007767/usefulness-of-non-contrast-enhanced-mr-angiography-using-a-silent-scan-for-follow-up-after-y-configuration-stent-assisted-coil-embolization-for-basilar-tip-aneurysms
#7
N Takano, M Suzuki, R Irie, M Yamamoto, N Hamasaki, K Kamagata, K K Kumamaru, M Hori, H Oishi, S Aoki
BACKGROUND AND PURPOSE: Y-configuration stent-assisted coil embolization is used for treating wide-neck aneurysms. Noninvasive alternatives to x-ray DSA for follow-up after Y-configuration stent-assisted coil embolization treatment are required. This study aimed to assess the usefulness of non-contrast-enhanced MRA by using a Silent Scan (silent MRA) for follow-up after Y-configuration stent-assisted coil embolization for basilar tip aneurysms. MATERIALS AND METHODS: Seven patients treated with Y-configuration stent-assisted coil embolization for basilar tip aneurysms underwent silent MRA, 3D TOF-MRA, and DSA...
December 22, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/27977003/single-stage-endovascular-treatment-of-multiple-intracranial-aneurysms-with-combined-endovascular-techniques-is-it-safe-to-treat-all-at-once
#8
Cagatay Andic, Fatih Aydemir, Ozgur Kardes, Murat Gedikoglu, Sule Akin
BACKGROUND AND PURPOSE: Multiple aneurysms have a high reported incidence, but the optimal treatment strategy is not clear. The aim of this study was to evaluate the safety and effectiveness of single-stage endovascular treatment of multiple aneurysms with a combination of various endovascular techniques. MATERIALS AND METHODS: Fifty-three consecutive patients with multiple intracranial aneurysms who underwent single-stage endovascular treatment for ≥2 aneurysms from June 2011 to May 2016 were included in the study...
November 14, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27913802/combined-use-of-a-pconus-and-a-solitaire-stent-report-of-two-cases
#9
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/27908813/coil-embolization-assisted-thoracic-endovascular-aortic-repair-for-multiple-saccular-descending-aortic-aneurysms-with-insufficient-landing-zone
#10
Akito Imai, Tomomi Nakajima, Masataka Sato, Yasunori Watanabe, Shunichi Kondo, Motoo Osaka, Yuji Hiramatsu
We report a coil embolization-assisted thoracic endovascular aortic repair technique successfully applied to multiple saccular descending aortic aneurysms in a 74-year-old man. Because of the most distal aneurysm being located at the celiac trunk level and the distance between the superior mesenteric artery and the aneurysm being only 10 mm, a coil embolization of the distal saccular aneurysm was performed before stent delivery to secure a sufficient landing zone. Postoperative computed tomography showed an appropriate positioning of the endovascular devices without endoleak...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27903923/stent-assisted-coil-embolization-of-a-recurrent-posterior-cerebral-artery-aneurysm-following-surgical-clipping
#11
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
#12
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/27864325/a-technical-consideration-when-using-flow-diversion-for-recurrent-aneurysms-following-stent-assisted-coiling
#13
Justin R Mascitelli, Daniel Wei, Thomas J Oxley, Christopher P Kellner, Hazem Shoirah, Reade A De Leacy, J Mocco, Johanna T Fifi
Flow diversion (FD) is a treatment option for recurrent aneurysms including following stent-assisted coiling (SAC), although this approach is both 'off-label' and unproven. A technical challenge of FD placement may involve the microwire catching on the tines of the previously placed stent or potentially going 'in-out-in' from the central axis of the stent. We report a case and technique that assures the wire has safely remained within the central axis of the stent. The procedure was performed in standard fashion except that the intermediate catheter was passed completely through the previously placed stent after the microwire/microcatheter had crossed...
November 18, 2016: Journal of Neurointerventional Surgery
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
#14
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
#15
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/27854201/stent-assisted-detachable-coil-embolization-of-wide-necked-renal-artery-aneurysms
#16
Umberto Marcello Bracale, Donatella Narese, Ilaria Ficarelli, Mario De Laurentis, Flavia Spalla, Ettore Dinoto, Gaetano Vitale, Domenico Solari, Guido Bajardi, Felice Pecoraro
Renal artery aneurysms (RAAs) are rare with an estimated incidence of 0.1% in the general population, and they represent approximately 25% of all visceral aneurysms. The gold standard of treatment is open surgery, but it is associated with a high risk of nephrectomy, mortality, and morbidity. Less invasive endovascular therapies are becoming increasingly common for the treatment of RAAs. Here, we aimed to report three cases of wide-necked complex renal artery aneurysms treated endovascularly using stent-assisted coil embolization with self-expandable stent nitinol Solitaire AB and Concerto Axium coils...
November 17, 2016: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/27854091/images-diagnosis-and-emergent-endovascular-treatment-of-acute-hemorrhagic-basilar-artery-dissection-a-case-report
#17
Chia-Ju Lee, Kwo-Whei Lee, Wei-Liang Chen, Chun-Ching Chiu
PURPOSE: Basilar artery dissection (BAD) is a rare but possibly fatal disease with specific neuroimage findings. The management of BAD varies. This report describes a case with hemorrhagic BAD treated by endovascular stent-assisted coil embolization. CASE REPORT: We report an 82-year-old case of acute mid basilar artery dissection complicated with acute subarachnoid hemorrhage (SAH), intraventricular hemorrhage (IVH) and hydrocephalus, which was diagnosed by complete neuroimage surveys including computed tomography angiography (CTA), magnetic resonance angiography (MRA), and digital subtraction angiography (DSA)...
June 15, 2016: Acta Neurologica Taiwanica
https://www.readbyqxmd.com/read/27852655/a-technical-consideration-when-using-flow-diversion-for-recurrent-aneurysms-following-stent-assisted-coiling
#18
Justin R Mascitelli, Daniel Wei, Thomas J Oxley, Christopher P Kellner, Hazem Shoirah, Reade A De Leacy, J Mocco, Johanna T Fifi
Flow diversion (FD) is a treatment option for recurrent aneurysms including following stent-assisted coiling (SAC), although this approach is both 'off-label' and unproven. A technical challenge of FD placement may involve the microwire catching on the tines of the previously placed stent or potentially going 'in-out-in' from the central axis of the stent. We report a case and technique that assures the wire has safely remained within the central axis of the stent. The procedure was performed in standard fashion except that the intermediate catheter was passed completely through the previously placed stent after the microwire/microcatheter had crossed...
November 15, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27852380/-clinical-analysis-of-endovascular-strategies-in-the-treatment-of-vertebrobasilar-dissecting-aneurysms
#19
Y Z Zang, Z G Wang, C W Wang, Y Zhang, X Ding, X F Wang
Objective: To evaluate the efficacy and safety of endovascular strategies for vertebrobasilar dissecting aneurysm (VBDA) and analyze advantages and disadvantages of different endovascular methods for the treatment of VBDA through long-term follow-up. Methods: Retrospectively analyzing was used for the clinical information of 45 cases of vertebrobasilar dissecting aneurysms treated with endovascular methods in our department from January 2007 to December 2015. The treatment modalities were classified into reconstructive surgery and destructive surgery that were based on parent artery preservation...
November 8, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27847769/clinical-utility-of-angiographic-ct-with-a-flat-detector-angiographic-system-during-endovascular-procedure
#20
Seon Woong Choi, Kwang Wook Jo, Young Woo Kim, Seong Rim Kim, Ik Seong Park, Hoon Kim
OBJECTIVE: We evaluated the feasibility of angiographic computed tomography (ACT) for visualizing stent material in patients who underwent intracranial or extracranial stent placement to treat atherosclerotic lesions or stent assisted coil embolization. MATERIALS AND METHODS: We performed intrarterial and intravenous ACT on biplane angiography system equipped with flat panel detectors (Axiom Arits dBA; Siemens Medical Solutions, Forchheim, Germany). Vistipaque 320 was injected for contrast medium, total 150 mL at flow rate of 5 mL/s through artery and 77 mL at flow rate of 3...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
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