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Stent-assisted coiling

S Fischer, A Weber, A Carolus, F Drescher, F Götz, W Weber
BACKGROUND: Endovascular treatment of wide-necked aneurysms remains challenging without the use of adjunctive devices to preserve the parent artery. OBJECTIVE: To present our initial experience with a temporary bridging device, the Comaneci (Rapid Medical, Israel). The compliant remodeling mesh protects the parent artery during coil occlusion without flow arrest in the distal vasculature. Permanent dual antiplatelet therapy is not required since the device is fully removed at the end of the procedure...
October 14, 2016: Journal of Neurointerventional Surgery
Jian Liu, Linkai Jing, Ying Zhang, Ying Song, Yang Wang, Chuanhui Li, Yanmin Wang, Shiqing Mu, Nikhil Paliwal, Hui Meng, Italo Linfante, Xinjian Yang
BACKGROUND: Intracranial vertebral artery dissecting aneurysms (VADAs) tend to recur despite successful stent-assisted coil embolization (SACE). Hemodynamics is useful in evaluating aneurysmal formation, growth and rupture. Our aim was to evaluate the hemodynamic patterns of VADA's recurrence. METHODS: Between September 2009 and November 2013, all consecutive patients with recurrent VADAs after SACE in our institutions were enrolled. Recurrence was defined as recanalization and/or regrowth...
October 11, 2016: World Neurosurgery
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
Christoph J Griessenauer, Matthew R Fusco, Lucy He, Michelle Chua, Sarah Sieber, Abd A Mazketly, Arra S Reddy, Christopher S Ogilvy, Ajith J Thomas
BACKGROUND: The configuration of the anterior communicating artery (AcomA) complex is important in the endovascular treatment of AcomA complex aneurysms. In cases of codominant anterior cerebral arteries (ACA), coil embolization may result in inadvertent occlusion of the contralateral ACA due to poor visualization. A second diagnostic catheter in the contralateral carotid artery may help with visualization of this angiographic blind spot. To our knowledge, the safety and efficacy of this dual diagnostic catheter technique have never been assessed...
2016: Surgical Neurology International
Joseph R Linzey, Julius Griauzde, Zhe Guan, Nicole Bentley, Joseph J Gemmete, Neeraj Chaudhary, B Gregory Thompson, Aditya S Pandey
BACKGROUND: Stent-assisted coiling is commonly used to treat wide-necked and fusiform cerebral aneurysms. We evaluated our institutional experience with stent-assisted coiling of cerebral aneurysms to elucidate potential risk factors for recurrence. METHODS: A retrospective analysis of patients undergoing stent-assisted coiling of cerebral aneurysms from 2005 to 2012 resulted in 122 patients with 122 aneurysms. Demographic, peri-procedural, medical comorbidity, and follow-up data were collected...
October 3, 2016: Journal of Neurointerventional Surgery
Soumya Mukherjee, Arun Chandran, Anil Gopinathan, Mani Putharan, Tony Goddard, Paul R Eldridge, Tufail Patankar, Hans-Christean Nahser
OBJECTIVE The goal of this study was to assess the safety and feasibility of PulseRider, a novel endovascular stent, in the treatment of intracranial bifurcation aneurysms with wide necks. The authors present the initial results of the first 10 cases in which the PulseRider device was used. METHODS Patients whose aneurysms were intended to be treated with the PulseRider device at 2 institutions in the United Kingdom were identified prospectively. Patient demographics, procedural details, immediate neurological and clinical status, and immediate angiographic outcomes and 6-month clinical and imaging follow-up were recorded prospectively...
September 30, 2016: Journal of Neurosurgery
Jeffrey Steinberg, Vincent Cheung, Gunjan Goel, J Scott Pannell, Javan Nation, Alexander Khalessi
Although there have been reports of carotid artery pseudoaneurysm formation after adenoidectomy and/or tonsillectomy secondary to iatrogenic injury, there are no case reports of successful endovascular reconstruction of the injured artery in the pediatric population. In most pediatric cases, the internal carotid artery (ICA) is sacrificed. The authors report on a 6-year-old girl who presented with odynophagia, left-sided Horner's syndrome, hematemesis, and severe anemia 6 months after a tonsillectomy. On examination she was found to have a pulsatile mass along the left posterior lateral oropharynx, and imaging demonstrated a dissection of the extracranial left ICA and an associated pseudoaneurysm...
September 30, 2016: Journal of Neurosurgery. Pediatrics
C Herweh, S Nagel, J Pfaff, C Ulfert, M Wolf, M Bendszus, M Möhlenbruch
INTRODUCTION: Stent-assisted coiling of wide-necked intracranial aneurysms has become an established treatment and has significantly benefited from the introduction of compliant, self-expanding devices, such as the Enterprise VRD (EP-VRD). We report our experiences with the successor model, the Enterprise2 (EP2) stent in stent-assisted coiling as well as in the treatment of atherosclerotic stenosis. MATERIALS AND METHODS: In 11 consecutive patients 12 EP2 were used to treat 9 intracranial aneurysms and 2 stenoses...
September 27, 2016: Clinical Neuroradiology
Bradley A Gross, Karam Moon, Andrew F Ducruet, Felipe C Albuquerque
BACKGROUND/OBJECTIVE: The rarity of petrous internal carotid artery (ICA) aneurysms has largely precluded analyses of their presentation and management in case series format. METHODS: We performed a retrospective analysis of our endovascular database of patients treated from January 2001 to May 2016 to identify patients with petrous ICA aneurysms. We evaluated the treatment approach and results for patients managed in the era of dedicated intracranial stents and flow diverters, noting clinical and angiographic results...
September 26, 2016: Journal of Neurointerventional Surgery
Erol Akgul, Hasan Bilen Onan, Huseyin Tugsan Balli, Nuri Eralp Cetinalp
The frequency of multiple intracranial aneurysms seen in patients with or without subarachnoid hemorrhage is high. The advancement of the endovascular technique and devices has ensured that endovascular treatment of intracranial aneurysms is the first choice in most cases, especially in unruptured ones. Different combinations of treatment modalities and techniques can be used in the management of multiple aneurysms. But in selected patients without subarachnoid hemorrhage, treatment of all aneurysms in one or more sessions with endovascular techniques is less traumatic than that with surgery...
2016: Case Reports in Neurological Medicine
Kunpeng Chen, Lijun Wang, Daming Wang, Jiachun Liu, Jun Lu, Peng Qi
This study reports our experience of balloon-in-stent assisted coiling for the treatment of morphologically unfavorable aneurysms located in the internal carotid artery (ICA). From July 2007 to April 2014, twelve patients with twelve aneurysms located in the ICA were coil embolized by simultaneously using balloon and stent assistance. Five aneurysms were ruptured and seven were unruptured. All the aneurysms were overwide (dome-to-neck ratio ⩽1.2) and undertall (aspect ratio ⩽1.2) anatomically. The procedure-related adverse events, clinical and angiographic results were retrospectively analyzed...
September 19, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Hyoung Soo Byoun, Hyeong Joong Yi, Kyu Sun Choi, Hyoung Joon Chun, Yong Ko, Koang Hum Bak
OBJECTIVE: Subarachnoid hemorrhage (SAH) caused by rupture of an internal carotid artery (ICA) or vertebral artery (VA) dissecting aneuryesm is rare. Various treatment strategies have been used for ruptured intracranial dissections. The purpose of this study is to compare the clinical and angiographic characteristics and outcomes of endovascular treatment for ruptured dissecting aneurysms of the intracranial ICA and VA. METHODS: The authors retrospectively reviewed a series of patients with SAH caused by ruptured intracranial ICA and VA dissecting aneurysms from March 2009 to April 2014...
September 2016: Journal of Korean Neurosurgical Society
S G Aoun, B G Welch, L G Pride, J White, R Novakovic, K Hoes, R Sarode
BACKGROUND: Stent-assisted coiling of intracranial aneurysms is an efficient alternative treatment to surgical clipping but requires prolonged antiplatelet therapy. Some patients are non-responsive to aspirin and/or clopidogrel. OBJECTIVE: To analyze the implications of this assessment using the 'whole blood aggregometry (WBA) by impedance' technique. MATERIALS AND METHODS: The Southwestern Tertiary Aneurysm Registry was reviewed between 2002 and 2012 for patients with unruptured aneurysms treated with stent-assisted coiling...
September 20, 2016: Journal of Neurointerventional Surgery
Kefu Cai, Yunfeng Zhang, Lihua Shen, Yaohui Ni, Qiuhong Ji
OBJECTIVE: The purpose of this study was to compare the efficacy, stability, and safety of stent-assisted coiling (SAC) and balloon-assisted coiling (BAC) in the treatment of ruptured wide-necked aneurysms in the acute period. METHODS: Consecutive patients including 65 cases treated with SAC and 32 with BAC were reviewed at authors' institution between November 2011 and December 2014. The efficacy of these two approaches and the incidence of periprocedural complications were retrospectively evaluated...
September 16, 2016: World Neurosurgery
Alejandro M Spiotta, Kyle M Fargen, Jonathan Lena, Imran Chaudry, Raymond D Turner, Aquilla S Turk, Daniel Huddle, David Loy, Richard Bellon, Donald Frei
INTRODUCTION: Traditional platinum coils used for cerebral aneurysm embolization have a uniform degree of softness throughout an individual coil's length. Recently, SMART Coils (Penumbra Inc., Alameda, CA) have been developed, which transition in softness along the length of their coils. We report the initial clinical results with this technology. METHODS: A retrospective study of all patients undergoing aneurysm coiling with SMART Coils at two centers was performed to evaluate the safety and efficacy of this new technology...
September 15, 2016: World Neurosurgery
Huijian Ge, Xianli Lv, Hui Ren, Hengwei Jin, Yuhua Jiang, Hongwei He, Peng Liu, Youxiang Li
OBJECTIVE: To investigate the influence of CYP2C19 genetic polymorphisms on clinical outcomes of intracranial aneurysms treated with stent-assisted coiling. METHODS: Between September 2014 and October 2015, we prospectively recruited 215 patients with intracranial aneurysms who were treated with stent-assisted coiling. CYP2C19 genotypes were determined and clopidogrel response was tested. The primary endpoints included symptomatic or silent ischemic events, and bleeding events...
September 15, 2016: Journal of Neurointerventional Surgery
Mario Muto, Francesco Giurazza, Gennaro Ambrosanio, Pasquale Vassallo, Francesco Briganti, Mario Tecame, Emiliano Schena, Maurizio De Nicola, Alessandro Sgreccia, Mirko Giannoni, Simone Peschillo, Francesco Diana, Giulio Guidetti, Gianluigi Guarnieri
INTRODUCTION: The purpose of this study is to report on a multi-center experience of ruptured intracranial aneurysms treated in acute phase with stent-assisted coil embolization, including primary success rates and midterm follow-up results. MATERIALS AND METHODS: Retrospective analysis was performed on a sample of 40 patients (14 men, 26 women, mean age 59.7 years) affected by ruptured saccular aneurysms and treated by stent-assisted coiling in acute phase; double antiplatelet therapy with clopidogrel bisulphate and acetylsalicylic acid was started after the procedure...
September 8, 2016: La Radiologia Medica
Anthea H O'Neill, Ronil V Chandra, Leon T Lai
OBJECTIVE: Treatment outcomes for unruptured anterior communicating artery (ACoA) aneurysms are not well established. We aimed to investigate the safety and effectiveness of microsurgical clipping (MC), endovascular coiling (EC), and stent assisted coiling (SAC) of unruptured ACoA aneurysms to aid pretreatment clinical decisions. METHODS: A systematic review of the literature was conducted using the Ovid Medline and EMBASE electronic databases, encompassing all English language studies reporting treatment outcomes for unruptured ACoA aneurysms published between 2005 and 2015...
September 13, 2016: Journal of Neurointerventional Surgery
Gordhan Ajeet, Dickinson John
Aneurysms of the persistent trigeminal artery (PTA) trunk are exceptionally rare and have a high risk for rupture. Dual stent placement through each internal carotid and basilar artery for endovascular coil embolization of a fusiform aneurysm arising from the PTA has not been described in the literature. A 44-year-old female with a history of chronic headache was identified to have a fusiform aneurysm arising from medially coursing adult type, Saltzman type 3 PTA trunk. Sacrifice of the PTA trunk inclusive of the aneurysm was performed with dual stent placement through each basilar and internal carotid artery across their respective junctions with the PTA...
September 2016: Neurointervention
Keun Young Park, Byung Moon Kim, Dong Joon Kim
PURPOSE: To compare clinical and angiographic outcomes between balloon-assisted (BAC) and stent-assisted coiling for internal carotid artery unruptured aneurysms (ICA-UA). MATERIALS AND METHODS: A total of 227 ICA-UA in 190 patients were treated with BAC (120 patients, 141 ICA-UA) or SAC (70 patients, 86 ICA-UA. We compared characteristics of patients and ICA-UA, and clinical and angiographic outcomes between groups. RESULTS: Aneurysm size and neck diameter were greater for SAC than in BAC, but aneurysm volume and coil packing density were not different between groups...
September 2016: Neurointervention
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