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Fusiform aneurysms

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https://www.readbyqxmd.com/read/28589068/endovascular-treatment-of-large-unruptured-fusiform-fenestrated-vertebrobasilar-junction-aneurysm
#1
Saeed A Alqahtani, Daniel R Felbaum, Alex Tai, Ai-Hsi Liu, Rocco A Armonda
Fenestrated vertebrobasilar junction aneurysms are rare vascular lesions. Microsurgical intervention is extremely difficult due to the complex anatomy in the vicinity of these aneurysms. Endovascular neurosurgery appears to be safe and should be considered as the first modality of treatment. This case study details the treatment of an unruptured fusiform fenestrated vertebrobasilar junction aneurysm with endovascular occlusion with stent-assisted coiling. The optimal angiographic exposure and selective microcatheterization of the aneurysm were challenging due to the patient's body habitus, and the aneurysm was large with one dominant fenestrated limb...
May 3, 2017: Curēus
https://www.readbyqxmd.com/read/28588807/eosinophilic-angiitis-presenting-with-a-true-fusiform-temporal-artery-aneurysm
#2
Megan MacDiarmid, Dmitri Nepogodiev, Alok Tiwari, Martin Duddy, Martyn Carey, Paresh Jobanputra
Temporal artery aneurysm is a rare cause of temporal artery swelling in the absence of preceding trauma. Vasculitis other than giant cell arteritis, such as eosinophilic granulomatosis with polyangiitis, should be considered in such cases and a careful assessment of other medium-sized arteries undertaken.
June 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28578117/pipeline-embolization-device-in-treatment-of-50-unruptured-large-and-giant-aneurysms
#3
Nimer Adeeb, Christoph J Griessenauer, Hussain Shallwani, Hakeem Shakir, Paul M Foreman, Justin M Moore, Adam Dmytriw, Raghav Gupta, Adnan H Siddiqui, Elad I Levy, Kenneth Snyder, Mark R Harrigan, Christopher S Ogilvy, Ajith J Thomas
INTRODUCTION: Treatment of large (≥ 20 mm) and giant (≥ 25 mm) intracranial aneurysms is challenging, and can be associated with a high rate of morbidity and mortality. The Pipeline Embolization Device (PED) has been effectively used for the treatment of intracranial aneurysms achieving a high rate of complete occlusion. However, its safety and efficacy in treatment of large and giant aneurysms has not been fully evaluated. METHODS: A retrospective analysis of consecutive aneurysms treated with PED between 2009 and 2016 at three academic institutions within the United States was performed...
May 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28575128/neurofibromatosis-type-1-is-not-associated-with-subarachnoid-haemorrhage
#4
Arttu Kurtelius, Roope A Kallionpää, Jukka Huttunen, Terhi J Huttunen, Katariina Helin, Timo Koivisto, Juhana Frösen, Mikael von Und Zu Fraunberg, Sirkku Peltonen, Juha Peltonen, Juha E Jääskeläinen, Antti E Lindgren
BACKGROUND: The prevalence of intracranial aneurysms (IAs) has been proposed to be elevated in the patients with neurofibromatosis type 1 (NF1). Our aims were to determine the prevalence of NF1 in a large Finnish population based cohort of IA patients and, on the other hand, the occurrences of subarachnoid haemorrhage and unruptured intracranial aneurysms in a nationwide population-based cohort of NF1 patients and its matched ten-fold control cohort. METHODS: The Kuopio IA Database (www...
2017: PloS One
https://www.readbyqxmd.com/read/28565985/endovascular-management-of-fusiform-aneurysms-in-the-posterior-circulation-the-era-of-flow-diversion
#5
Ahmed J Awad, Justin R Mascitelli, Reham R Haroun, Reade A De Leacy, Johanna T Fifi, J Mocco
Fusiform aneurysms are uncommon compared with their saccular counterparts, yet they remain very challenging to treat and are associated with high rates of rebleeding and morbidity. Lack of a true aneurysm neck renders simple clip reconstruction or coil embolization usually impossible, and more advanced techniques are required, including bypass, stent-assisted coiling, and, more recently, flow diversion. In this article, the authors review posterior circulation fusiform aneurysms, including pathogenesis, natural history, and endovascular treatment, including the role of flow diversion...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28565978/off-label-uses-of-the-pipeline-embolization-device-a-review-of-the-literature
#6
Purvee D Patel, Nohra Chalouhi, Elias Atallah, Stavropoula Tjoumakaris, David Hasan, Hekmat Zarzour, Robert Rosenwasser, Pascal Jabbour
The Pipeline embolization device (PED) is the most widely used flow diverter in endovascular neurosurgery. In 2011, the device received FDA approval for the treatment of large and giant aneurysms in the internal carotid artery extending from the petrous to the superior hypophyseal segments. However, as popularity of the device grew and neurosurgeons gained more experience, its use has extended to several other indications. Some of these off-label uses include previously treated aneurysms, acutely ruptured aneurysms, small aneurysms, distal circulation aneurysms, posterior circulation aneurysms, fusiform aneurysms, dissecting aneurysms, pseudoaneurysms, and even carotid-cavernous fistulas...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28543389/coexistence-of-a-permanent-form-of-a-junctional-reciprocating-tachycardia-and-coronary-sinus-aneurysm-a-case-report
#7
Yuki Shimizu, Osamu Inaba, Masahiko Goya, Kenzo Hirao
A 58-year-old man with a long R-P' narrow QRS tachycardia underwent an electrophysiological study. The tachycardia was diagnosed as permanent form of junctional reciprocating tachycardia (PJRT), and the earliest atrial activation site during tachycardia was coronary sinus (CS) ostium. Radiofrequency ablation at the site was initially not successful because the tip impedance and temperature were unstable. After changing of the ablation catheter to that with contact force sensor, the accessory pathway was immediately ablated and the PJRT was no longer induced...
May 24, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28521345/superficial-temporal-artery-distal-posterior-cerebral-artery-bypass-through-the-subtemporal-approach-technical-note-and-pilot-surgical-cases
#8
Akitsugu Kawashima, Hugo Andrade-Barazarte, Behnam Rezai Jahromi, Minna Oinas, Ahmed Elsharkawy, Juri Kivelev, Yuichi Kubota, Takakazu Kawamata, Juha A Hernesniemi
BACKGROUND: Posterior cerebral artery (PCA) aneurysms are rare and the majority are fusiform in shape. Proximal occlusion of PCA represents a treatment option for these lesions. However, this procedure carries a high risk of ischemic complications. OBJECTIVE: To describe the technique of trapping a fusiform PCA aneurysm and revascularization of the distal PCA using a superficial temporal artery (STA) graft through the same microsurgical approach. METHODS: From September 2012 to October 2014, we retrospectively identified 3 patients harboring a fusiform PCA aneurysm (P2 segment aneurysm) who underwent trapping of the aneurysm and reconstruction of the distal PCA through the same subtemporal approach...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28488626/surgery-for-superior-hypophyseal-artery-aneurysms-a-new-classification-and-surgical-considerations
#9
Chaitanya Godbole, Sanjay Behari, Kamlesh K Bhaisora, Jayesh Sardhara, Arun Srivastava, Anant Mehrotra, Kuntal Kanti Das, Raj Kumar, Awadhesh K Jaiswal
BACKGROUND: Superior hypophyseal artery (SHA) aneurysms form a unique subgroup of paraclinoid aneurysms having a propensity to grow to a large size in the suprasellar region resulting in compression of the optic nerve, chiasma, and/or tract. AIM: A new classification of SHA aneurysms is proposed that helps in identifying the surgical issues encountered during surgical clipping of these medially directed aneurysms located at different segments of the medial surface of the internal carotid artery (ICA)...
May 2017: Neurology India
https://www.readbyqxmd.com/read/28488025/in-stent-stenosis-after-p64-flow-diverter-treatment
#10
M Aguilar Pérez, P Bhogal, E Henkes, O Ganslandt, H Bäzner, H Henkes
PURPOSE: There is limited information available on the incidence of in-stent stenosis (ISS) secondary to the use of flow-diverting stents in the intracranial vasculature. We sought to determine the incidence, severity, and clinical course of ISS on angiographic follow-up after treatment of saccular aneurysms with p64. METHODS: We retrospectively reviewed all patients who underwent treatment of a saccular (ruptured and unruptured) intracranial aneurysm with ≥1 p64 between 2011 and 2015...
May 9, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28484550/distal-posterior-cerebral-artery-revascularization-for-a-fusiform-pca-aneurysm-a-lesson-learned
#11
Gavin W Britz, Ali Zomorodi, Ciaran J Powers
The need for revascularization with proximal posterior cerebral artery occlusion in the treatment of giant and fusiform aneurysms is unclear. While early series demonstrated only about a 10% chance of infarction following posterior cerebral artery occlusion, recently several authors have advocated a bypass prior to parent vessel sacrifice in all cases. We present the case of an adult man with a fusiform aneurysm of the right posterior cerebral artery at the P2-P3 junction. He clinically failed a balloon test occlusion preoperatively and therefore underwent an occipital artery to distal posterior cerebral artery bypass with subsequent endovascular occlusion of the parent vessel and aneurysm...
April 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28479183/numerous-fusiform-and-saccular-cerebral-aneurysms-in-central-nervous-system-lupus-presenting-with-ischemic-stroke
#12
Shahram Majidi, Christopher R Leon Guerrero, Shreya Gandhy, Kathleen M Burger, Dimitri Sigounas
Central nervous system (CNS) involvement occurs in up to 50% of patients with systemic lupus erythematosus (SLE). Cerebral aneurysm formation is a rare complication of CNS lupus. The majority of these patients present with subarachnoid hemorrhage. We report a patient with an active SLE flare who presented with a recurrent ischemic stroke and was found to have numerous unruptured fusiform and saccular aneurysms in multiple vascular territories. He was treated with high-dose steroid and rituximab along with aspirin and blood pressure control for stroke prevention...
May 4, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28473431/first-us-experience-with-pipeline-flex-with-shield-technology-using-aspirin-as-antiplatelet-monotherapy
#13
Ricardo A Hanel, Pedro Aguilar-Salinas, Leonardo Bc Brasiliense, Eric Sauvageau
Flow diversion has revolutionised the treatment of intracranial aneurysms, and the Pipeline Embolization Device (PED) remains the only flow diverter (FD) approved in the USA. However, thromboembolic events remain an issue for FDs. Attempting to minimise these incidents, a newer PED has been developed with the use of covalent bonding of phosphorylcholine onto the Pipeline device that has been known as Shield Technology (PED Shield), which in vitro has demonstrated a significant reduction in material thrombogenicity...
May 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28461281/interrater-agreement-in-the-radiologic-characterization-of-ruptured-intracranial-aneurysms-based-on-computed-tomography-angiography
#14
Nicolai Maldaner, Martin N Stienen, Philippe Bijlenga, Davide Croci, Daniel W Zumofen, Donato Dalonzo, Serge Marbacher, Rodolfo Maduri, Roy Thomas Daniel, Carlo Serra, Giuseppe Esposito, Marian Christoph Neidert, Oliver Bozinov, Luca Regli, Jan-Karl Burkhardt
OBJECTIVE: To determine interrater agreement in the initial radiologic characterization of ruptured intracranial aneurysms based on computed tomography angiography (CTA) with special emphasis on the rater's level of experience. METHODS: One junior and one senior rater of 5 high-volume neurovascular tertiary centers evaluated anonymized CTA images of 30 consecutive patients with aneurysmal subarachnoid hemorrhage. Each rater described location, side, size, and morphology in a standardized manner...
April 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28456735/aneurysms-of-the-proximal-segment-of-the-anterior-cerebral-artery-a-new-classification-system-with-corresponding-therapeutic-options
#15
Xinmin Ding, Peyton Lubbock Nisson, Whitney S James, Michael T Lawton, Shaohua Ren, Lu Jia, Honging Ji
OBJECTIVE: This study aims to establish a new classification system for proximal anterior cerebral artery (A1) aneurysms and to offer treatment strategies, based on the lessons learned by studying the case reports of 41 patients with A1 aneurysms. METHODS: 2,332 consecutive patients with intracranial aneurysms were treated at a single medical center between June 2005 and May 2015. Forty-one patients with 42 A1 aneurysms were treated by surgical clipping or endovascular coiling...
April 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28433850/surgical-resection-and-histopathological-analysis-of-a-thrombosed-giant-fusiform-mca-aneurysm-after-initial-treatment-with-a-flow-diversion-construct
#16
Jayson Sack, Vincent Cheung, Deirdre Amaro, Arvin R Wali, David R Santiago-Dieppa, J Scott Pannell, Alexander A Khalessi
BACKGROUND: We describe the histopathology of an un-ruptured, giant calcified left MCA fusiform aneurysm initially treated with endovascular flow diversion. The flow diversion construct underwent post-operative in-stent thrombosis, necessitating surgical resection of the aneurysm to eliminate mass effect. METHODS: A 75-year-old woman with a known left MCA aneurysm presented to the Emergency Department with moderate right hemibody weakness. Due to the clinical and radiographic progression of the aneurysm, the patient was offered treatment...
April 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28433386/bilateral-fusiform-aneurysms-of-the-internal-carotid-arteries-presenting-with-subarachnoid-hemorrhage
#17
Sina Jelodar, Mohammad Shirani, Amin Tavallayi, Mehdi Ketabchi, Maysam Alimohamadi
Fusiform aneurysms of cerebral arteries are less prevalent than saccular aneurysms and are rarely associated with subarachnoid hemorrhage (SAH). In this article, we report SAH due to a rare case of bilateral fusiform aneurysm of the supraclinoid segment of the internal carotid arteries (ICAs) (C4 segment of the ICA).
April 19, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28430295/multiple-cerebral-fusiform-aneurysms-involving-the-posterior-and-anterior-circulation-including-the-anterior-cerebral-artery-a-case-report
#18
Sumit Das, Tibor Valyi-Nagy
<i>Multiple fusiform aneurysms occurring in a single patient are very uncommon. Fusiform aneurysms affecting the anterior circulation are extremely rare and reported cases involve the middle cerebral artery and internal carotid artery. We report here a case of a 55-year-old African American male who had a history of multiple strokes and who was found unresponsive prior to his latest hospital admission. Neuroimaging was remarkable for multiple fusiform aneurysms involving segments of the anterior, middle and posterior cerebral arteries as well as subarachnoid and intraparenchymal hemorrhage...
2017: Folia Neuropathologica
https://www.readbyqxmd.com/read/28411708/life-threatening-pulmonary-embolism-associated-with-multiple-venous-aneurysms
#19
Shogo Sakamoto, Toru Kataoka, Tsukasa Okai, Nanao Matsusaki, Masahiko Takagi, Minoru Yoshiyama
Popliteal venous aneurysms (PVAs) are often reported as a cause of pulmonary embolism. Previous reports documented the association between a single PVA and pulmonary embolism. We experienced a rare case with multiple venous saccular and fusiform aneurysms resulting in a nearly fatal pulmonary embolism. Surgical ligation is usually considered the first-line treatment for PVAs. In our patient, however, we selected inferior vena cava filter implantation and anticoagulant therapy to avoid the phlegmasia cerulea dolens caused by ligation of multiple aneurysms in both legs...
May 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28387624/dolichoectatic-aneurysms-of-the-vertebrobasilar-system-clinical-and-radiographic-factors-that-predict-poor-outcomes
#20
David S Xu, Michael R Levitt, M Yashar S Kalani, Leonardo Rangel-Castilla, Celene B Mulholland, Isaac J Abecassis, Ryan P Morton, John D Nerva, Adnan H Siddiqui, Elad I Levy, Robert F Spetzler, Felipe C Albuquerque, Cameron G McDougall
OBJECTIVE Fusiform dolichoectatic vertebrobasilar aneurysms are rare, challenging lesions. The natural history of these lesions and medium- and long-term patient outcomes are poorly understood. The authors sought to evaluate patient prognosis after diagnosis of fusiform dolichoectatic vertebrobasilar aneurysms and to identify clinical and radiographic predictors of neurological deterioration. METHODS The authors reviewed multiple, prospectively maintained, single-provider databases at 3 large-volume cerebrovascular centers to obtain data on patients with unruptured, fusiform, basilar artery dolichoectatic aneurysms diagnosed between January 1, 2000, and January 1, 2015...
April 7, 2017: Journal of Neurosurgery
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