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Stent-assisted coiling

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https://www.readbyqxmd.com/read/28931265/diagnostic-and-interventional-optical-angioscopy-in-ex-vivo-carotid-arteries
#1
Luis E Savastano, Neeraj Chaudhary, Carlos Murga-Zamalloa, Michael Wang, Thomas Wang, B Gregory Thompson
BACKGROUND: Angioscopy - or endovascular endoscopy - is a catheter-based technique employing a flexible fiberoptic angioscope to directly visualize arterial lumen. Poor resolution and excessive stiffness of pre-existent angioscopes limited their use clinically. Recent advances resulted in novel fused optical fiber bundle angioscopes with improved flexibility and imaging resolution. Use of these devices in endovascular neurosurgery is still largely unexplored. OBJECTIVE: To evaluate image quality and feasibility of optical angioscopes for diagnostic and interventional neuro-angioscopy in carotid arteries of human cadavers...
February 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28927208/observation-of-neointimal-coverage-around-the-aneurysm-neck-after-stent-assisted-coil-embolization-by-optical-frequency-domain-imaging-technical-case-report
#2
Rie Yako, Hiroyuki Matsumoto, Osamu Masuo, Naoyuki Nakao
BACKGROUND AND IMPORTANCE: Stent-assisted coil embolization has been established as a treatment option for wide-necked or complex aneurysms. However, concerns have been raised about the incidence of thromboembolic complications, which is higher for coil embolization without stent assistance. Long-term antiplatelet therapy is necessary to prevent acute or delayed ischemic events potentially associated with incomplete stent apposition after treatment with stent-assisted coil embolization...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28923428/staged-stenting-with-or-without-additional-coils-after-conventional-initial-coiling-of-acute-ruptured-wide-neck-intracranial-aneurysms
#3
Zhengzhe Feng, Qiao Zuo, Pengfei Yang, Qiang Li, Rui Zhao, Bo Hong, Yi Xu, Qinghai Huang, Jianmin Liu
BACKGROUND: Stent-assisted coiling technique has been more and more adopted in the treatment of intracranial aneurysms, and has been shown to improve long-term angiographic results, however, the treatment is relatively contraindicated in acutely ruptured aneurysms for its ischemic and hemorrhagic complications. Staged stenting after conventional coiling has emerged as a potential treatment strategy for ruptured wide-neck aneurysms. This study assessed the safety and efficacy of coiling in the acute phase followed by delayed stenting for ruptured wide-neck intracranial aneurysms...
September 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28919570/initial-clinical-experience-with-aview-a-clinical-computational-platform-for-intracranial-aneurysm-morphology-hemodynamics-and-treatment-management
#4
Jianping Xiang, Nicole Varble, Jason M Davies, Ansaar T Rai, Kenichi Kono, Shin-Ichiro Sugiyama, Mandy J Binning, Rabih G Tawk, Hoon Choi, Andrew J Ringer, Kenneth V Snyder, Elad I Levy, L Nelson Hopkins, Adnan H Siddiqui, Hui Meng
BACKGROUND: Intracranial aneurysm (IA) management is challenging. Clinicians often rely on varied and intuitively disparate ways of evaluating rupture risk that may only partially take into account complex hemodynamic and morphologic factors. We developed a prototype of a clinically-oriented, streamlined, computational platform, AView, for rapid assessment of hemodynamics and morphometrics in clinical settings. To show the potential clinical utility of AView, we report our initial multicenter experience highlighting the possible advantages of morphologic and hemodynamic analysis of IAs...
September 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28906352/clinical-and-angiographic-outcomes-following-endovascular-treatment-of-very-small-3%C3%A2-mm-or-smaller-intracranial-aneurysm-a-single-center-experience
#5
Yongsheng Liu, Feng Wang, Xiaochen Fu, Yongjian Liu, Guodong Zhang, Ke Xu
Treatments for very small (3 mm or smaller) intracranial aneurysms (VSAs) remain controversial. The aim of this study was to evaluate the efficacy of endovascular treatment for VSAs and to evaluate clinical risk factors associated with complications.This retrospective study enrolled 82 VSA patients who underwent coil embolization in our institution. Angiographic outcomes were assessed according to the Meyers classification. The clinical results were evaluated using the modified Rankin scale (mRS) immediately after coiling, at discharge, and during follow-up...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28860903/a-novel-flow-diverter-tubridge-for-the-treatment-of-recurrent-aneurysms-a-single-center-experience
#6
Yongxin Zhang, Qing-Hai Huang, Yibin Fang, Pengfei Yang, Yi Xu, Bo Hong, Jianmin Liu
OBJECTIVE: The Tubridge flow diverter (FD) is a novel device aimed at reconstructing the parent artery and occluding complex aneurysms. Retreatment of recurrent aneurysms using the FD is challenging. We report our initial experience in the repair of aneurysm recurrence with the FD. MATERIALS AND METHODS: A database was reviewed prospectively, and 8 patients with 8 recurrent aneurysms (mean size, 16.7 mm) were identified. Four aneurysms had previously ruptured. The previous aneurysm treatment consisted of coiling in 1 aneurysm and single-stent-assisted coiling in 7 aneurysms...
September 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/28858988/venous-diverticula-causing-pulsatile-tinnitus-treated-with-coil-embolization-and-stent-placement-with-resolution-of-symptoms-report-of-two-cases-and-review-of-the-literature
#7
Ravi K Shastri, Neeraj Chaudhary, Aditya S Pandey, Steven A Telian, Joseph J Gemmete
OBJECTIVE: To report two cases of pulsatile tinnitus caused by complex venous diverticula with successful treatment via coil embolization and stent placement followed by complete resolution of symptoms. We also review the literature pertaining to venous diverticula causing pulsatile tinnitus treated using endovascular techniques. PATIENTS: Two women patients, aged 27 and 29 years, presented to our institution with 3-month histories of pulsatile tinnitus. In each case, non-invasive imaging and conventional digital subtraction angiography (DSA) confirmed the presence of a complex right transverse-sigmoid sinus junction diverticulum...
October 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28834890/therapeutic-effect-of-enterprise-stent-assisted-embolization-for-very-small-ruptured-intracranial-aneurysms
#8
Feiyun Qin, Zhenbao Li, Xinggen Fang, Xintong Zhao, Jiaqiang Liu, Degang Wu, Niansheng Lai
Enterprise stent has been widespread used in wide-necked intracranial aneurysms and good efficacy has been achieved, but there are few reports on its applications in very small ruptured intracranial aneurysms in literatures. This study aimed to evaluate the safety and efficacy of Enterprise stent-assisted coiling embolization of very small ruptured intracranial aneurysms.We retrospectively reviewed the clinical and imaging data from 37 patients with very small ruptured intracranial aneurysms who had SAC using Enterprise stents performed from February 2012 to July 2016 in our department...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28832231/unruptured-intracranial-aneurysms-management-strategy-and-current-endovascular-treatment-options
#9
Laurent Pierot, Matthias Gawlitza, Sébastien Soize
Unruptured intracranial aneurysms (UIA) have a high prevalence (3.2%) and are increasingly diagnosed with modern imaging tools. The main risk of UIA is their rupture associated with intracranial bleeding with often severe clinical consequences. Areas covered: This review discusses the management strategy of UIAs, based on the large series of the literature (ISUIA, ATENA, UCAS, …), knowing that no randomized controlled trial is available to compare different strategies. The different endovascular treatments are described...
September 6, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28826708/occlusion-status-on-magnetic-resonance-angiography-is-associated-with-risk-of-delayed-ischemic-events-in-cerebral-aneurysms-treated-with-stent-assisted-coiling
#10
Takayuki Kikuchi, Akira Ishii, Hideo Chihara, Daisuke Arai, Mitsushige Ando, Yohei Takenobu, Tomohisa Okada, Yasushi Takagi, Susumu Miyamoto
OBJECTIVE: Management after stent-assisted coiling (SAC) for unruptured intracranial aneurysm is sometimes difficult because close monitoring for ischemic events for a long period of time after the procedure is necessary. The purpose of this study was to clarify the usefulness of magnetic resonance angiography (MRA) at follow-up after SAC. METHODS: Sixty-six consecutive cases of SAC for unruptured intracranial aneurysm in our institute and affiliated hospitals were retrospectively reviewed for a delayed ischemic event...
August 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28791434/progressive-occlusion-of-small-saccular-aneurysms-incompletely-occluded-after-stent-assisted-coil-embolization-analysis-of-related-factors-and-long-term-outcomes
#11
Jeong Wook Lim, Jeongjun Lee, Young Dae Cho
PURPOSE: Incompletely occluded aneurysms after coil embolization are subject to recanalization but occasionally progress to a totally occluded state. Deployed stents may actually promote thrombosis of coiled aneurysms. We evaluated outcomes of small aneurysms (<10 mm) wherein saccular filling with contrast medium was evident after stent-assisted coiling, assessing factors implicated in subsequent progressive occlusion. METHODS: Between September 2012 and June 2016, a total of 463 intracranial aneurysms were treated by stent-assisted coil embolization...
August 8, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28754807/balloon-assisted-coil-embolization-and-large-stent-delivery-for-cerebral-aneurysms-with-a-new-generation-of-dual-lumen-balloons-copernic-2l
#12
Adrien Guenego, Jean-Baptiste Zerlauth, Francesco Puccinelli, Steven Hajdu, David C Rotzinger, Felix Zibold, Eike I Piechowiak, Pasquale Mordasini, Jan Gralla, Tomas Dobrocky, Roy T Daniel, René Chapot, Pascal J Mosimann
INTRODUCTION: Dual coaxial lumen balloon microcatheters through which small stents can be delivered have recently been described. We report a series of a new type of dual lumen balloon catheter with a parallel lumen design enabling enhanced inflation and deflation properties through which larger stents may be deployed, including flow diverters (FD). METHODS: All aneurysms that were treated with a Copernic 2L (COP2L) dual lumen balloon catheter at our institution between February 2014 and December 2016 were assessed...
July 28, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28751517/packing-density-necessary-to-reach-a-high-complete-occlusion-rate-in-circumferential-unruptured-intracranial-aneurysms-treated-with-stent-assisted-coil-embolization
#13
R T Tosello, U C Batista, B J A Pereira, R L Piske
BACKGROUND AND PURPOSE: This study is a homogeneous series of circumferential unruptured intracranial aneurysms with large necks treated with stent-assisted coil embolization. Our purpose was to demonstrate which value of packing density is required to produce a durable occlusion. MATERIALS AND METHODS: We retrospectively evaluated all patients with unruptured intracranial aneurysms who were treated with stent-assisted coil embolization having late angiographic control between 2004 and 2014, in a single large cerebrovascular referral center...
July 27, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28748256/bioresorbable-vascular-scaffolds-in-interventional-neuroradiology
#14
Anil Arat, Ergun Daglioglu, Ilkay Akmangit, Ahmet Peker, Murat Arsava, Mehmet Akif Topcuoglu, Deniz Belen
PURPOSE: Bioresorbable vascular scaffolds (BVS) have changed practice patterns in cardiology. These resorbable stents have not yet been utilized in the cerebrovascular circulation. We report the initial experiences with these devices in interventional neuroradiology. METHODS: A retrospective review of clinical presentations, imaging findings and follow-up results of all patients treated using a BVS by our neurovascular team was carried out using hospital electronic charts and the hospital radiographic archive system...
July 26, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28712903/multimodality-treatment-of-posterior-inferior-cerebellar-artery-aneurysms
#15
Justin R Mascitelli, Kurt Yaeger, Daniel Wei, Christopher P Kellner, Thomas J Oxley, Reade A De Leacy, Johanna T Fifi, Aman B Patel, Thomas P Naidich, Joshua B Bederson, J Mocco
OBJECT: Posterior inferior cerebellar artery (PICA) aneurysms are heterogeneous, uncommon lesions that can be treated in many fashions. Many previous series have focused on a specific aneurysm subset or treatment paradigm. The aim of this study was to present a comprehensive approach for all PICA aneurysms and analyze outcomes by PICA location. METHODS: All PICA aneurysms treated from 2012 until present were reviewed retrospectively and classified by location. Angiographic and clinical outcome were assessed...
July 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28706764/neuroradiological-endovascular-intervention-for-diplopia-in-a-case-of-aneurysmal-aberrant-regeneration-of-the-third-nerve
#16
Anupam C A Rao, Saumil A Shah, Benjamin W C Sim, Steven T H Yun, Neeranjali S Jain, Yashar Kalani, Ian C Francis
Aberrant regeneration of the third nerve occurs as a result of synkinetic 'miswiring' of the third nerve following its injury, such as in third cranial nerve palsy due to tumor, trauma, or aneurysm. The case presented is an elderly woman with new vertical diplopia, which led to a diagnosis of a third cranial nerve palsy, thought to be caused by a 5 mm blister aneurysm of the posterior communicating artery. However, neuro-ophthalmological evaluation diagnosed aberrant regeneration of the third nerve, with the cause of her new vertical diplopia being an ipsilateral fourth nerve palsy...
June 12, 2017: Curēus
https://www.readbyqxmd.com/read/28697712/intravenous-administration-of-tirofiban-versus-loading-dose-of-oral-clopidogrel-for-preventing-thromboembolism-in-stent-assisted-coiling-of-intracranial-aneurysms
#17
Wang Zi-Liang, Liang Xiao-Dong, Li Tian-Xiao, Zhu Liang-Fu, Xue Jiang-Yu, Bai Wei-Xing, He Ying-Kun, Xu Gang-Qin, Shao Qiu-Ji, Li Li, Feng Guang, Li Zhao-Shuo
Background Thromboembolic complications after stenting of intracranial aneurysms may be affected by antiplatelet administration. Aims This retrospective study aimed to assess the safety of intravenous tirofiban versus loading dose of oral clopidogrel for preventing thromboembolism in stent-assisted coiling of intracranial aneurysms. Methods From January 2006 to December 2013, 281 patients with cerebral aneurysms were treated with stent-coiling using two antiplatelet strategies in comparison: the initial strategy (a loading dose of ≥300 mg clopidogrel followed by dual antiplatelet, clopidogrel group) and the modified strategy (intravenous administration of tirofiban 8 µg/kg over 3 min followed by a maintenance dose of 0...
July 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28687502/endovascular-treatment-of-distal-tears-located-in-the-reno-viseceral-segment-with-bare-metal-stents-and-coils-in-a-complicated-type-b-aortic-dissection
#18
Qingsheng Lu, Yanqing Chen, Yongxue Zhang, Hongfei Wang, Hanyan Li, Jiaxuan Feng, Huajuan Mao, Zaiping Jing
PURPOSE: To provide an endovascular strategy of treating patent re-entries adjacent to visceral branches in the management of aortic dissections. CASE REPORT: A 45-year-old male who had received endovascular treatment for a type B aortic dissection was again admitted for his intermittent abdominal pain. Distal tears located in the reno-visceral segment was left untreated in the initial procedure, and was thought to be related to the expansion of the false lumen during follow-up...
July 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28664029/endovascular-therapy-for-a-post-irradiated-cervical-pseudoaneurysm-at-the-carotid-stump-a-case-report
#19
Masayasu Arihara, Kei Miyata, Satoshi Iihoshi, Hiroyuki Yamaguchi, Kentaro Toyama, Katsuya Komatsu, Atsumu Hashimoto, Masahiko Wanibuchi, Nobuhiro Mikuni
A nearly 80-year-old man with a history of radiotherapy (RT) and total laryngectomy for laryngeal cancer 25 years previously presented with a rapidly growing mass on the right side of his neck. A huge pseudoaneurysm (pseudoAN) was detected at the right carotid bifurcation, though angiography performed four years previously had shown total occlusion of the internal carotid artery. Stent-assisted coil embolization enabled aneurysm sac shrinkage. Clinicians must be aware that the stump of an arterial occlusion associated with RT can change into a pseudoAN over the long term and must provide follow-up in such cases...
April 2017: NMC Case Rep J
https://www.readbyqxmd.com/read/28664025/traumatic-carotid-cavernous-fistula-with-a-connection-between-the-supraclinoid-internal-carotid-artery-and-cavernous-sinus-via-a-pseudoaneurysm-presenting-with-delayed-life-threatening-epistaxis
#20
Jun Kyeung Ko, Sang Weon Lee, Tae Hong Lee, Chang Hwa Choi
Traumatic carotid cavernous fistula (CCF) presents most commonly as a direct connection between the cavernous segment of internal carotid artery (ICA) and cavernous sinus (CS), and often accompanies basal skull fracture (BSF). The most frequently reported signs and symptoms are proptosis, chemosis, and bruit. Epistaxis is uncommon symptom of CCF. A 63-year-old man with a history of BSF due to blunt head trauma eight months previously was referred to our emergency room for massive epistaxis. Cerebral angiography demonstrated a high-flow CCF with a connection between the supraclinoid portion of left ICA and CS via a pseudoaneurysm, suggesting the life-threatening epistaxis had been caused by high-flow shunting, through the gap created by the BSF...
April 2017: NMC Case Rep J
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