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Pipeline OR flow diverter OR flow diverting OR flow divertion AND aneurysm

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https://www.readbyqxmd.com/read/28624566/4d-phase-contrast-mri-protocol-optimization-using-patient-specific-3d-printed-replicas-for-in-vivo-imaging-before-and-after-flow-diverter-placement
#1
Christof Karmonik, Jeff R Anderson, Saba Elias, Richard Klucznik, Orlando Diaz, Y Jonathan Zhang, Robert G Grossman, Gavin W Britz
PURPOSE: Hemodynamics in cerebral aneurysms is currently investigated towards its clinical efficacy using non-standardized computational simulation techniques. At the same time, flow patterns and velocities are accessible by 4D phase contrast magnetic resonance imaging (4D pcMRI). Complexity of protocol design and imaging duration has limited the use of this technique in clinical imaging. A new approach is presented to overcome these limitations. MATERIAL AND METHODS: 3D replicas of two cerebral aneurysms were fabricated by fused deposition prototyping (3D printing) and imaged using 4D pcMRI while connected to an MRI compatible continuous flow loop...
June 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28611831/salvage-of-herniated-flow-diverters-using-stent-and-balloon-anchoring-techniques-a-technical-note
#2
Bharathi D Jagadeesan, Divyajot Sandhu, Kim Jae Hong, Sara Roshan Khanipour, Andrew W Grande, Ramachandra P Tummala
BACKGROUND: The pipeline embolization device (PED; Medtronic, MN, USA) can sometimes herniate into the aneurysmal sac in an unexpected manner during or shortly after its deployment due to device foreshortening. In this report, we describe 2 endovascular techniques, which can be used to reposition a herniated PED construct into a more favorable alignment. SUMMARY: In a 67-year-old patient who had an intraprocedural herniation of a PED device into a giant cavernous aneurysm, a stent anchor technique was used to reverse the herniation, reorient the PED construct, and achieve successful flow diversion...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28604187/in%C3%A2-vitro-digital-subtraction-angiographic-evaluation-of-flow-diverters-in-a-patient-specific-aneurysm
#3
Liang-Der Jou
Background The importance of both porosity and pore density of a flow diverter is well recognized in treatment of intracranial aneurysms; however, understanding of the effect of individual wire (wire number and size) is critical in improving device design and use. Methods A total of 10 multi-layered flow diverters with different wire numbers (32, 48, 56, and 72) and sizes (30, 35, and 40 µm) were implanted into identical patient-specific middle cerebral artery aneurysm models. Digital subtraction angiography was acquired at 30 f/s and X-ray signals at three selected regions of interest were compared to determine the amount of intra-aneurysmal flow...
June 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28604183/treatment-of-an-internal-carotid-artery-aneurysm-with-a-flow-diverter-through-a-double-lumen-balloon-catheter
#4
José M Amorim, Santiago Rosati, Ronit Agid, Vítor Mendes Pereira, Timo Krings
Background Double lumen balloon catheters (DLBCs) are currently used in the treatment of intracranial aneurysms, especially when involving balloon or stent-assisted coiling. The existing DLBCs allow the delivery of self-expandable stents but do not offer the possibility to deploy flow-diverters. Despite the increasing use and success of flow-diverters, there have been numerous reports of procedural complications such as early in-stent thrombosis or delayed distal embolization. It seems that these complications can be avoided by correct stent positioning and adequate wall apposition, achieved either by manoeuvres with the microguidewire and/or microcatheter or by performing balloon angioplasty following an exchange guidewire manoeuvre...
June 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28598274/evaluation-of-ischemic-lesion-prevalence-after-endovascular-treatment-of-intracranial-aneurysms-as-documented-by-3-t-diffusion-weighted-imaging-a-2-year-single-center-cohort-study
#5
Christina Iosif, Jean-Christophe Lecomte, Eduardo Pedrolo-Silveira, George Mendes, Marie-Paule Boncoeur Martel, Suzana Saleme, Charbel Mounayer
OBJECTIVE Even though published data exist concerning the prevalence of ischemic lesions detected by diffusion-weighted imaging (DWI) following endovascular treatment of intracranial aneurysms, a single-center cross-evaluation of the different endovascular techniques has been lacking. The authors sought to prospectively evaluate the prevalence and clinical significance of ischemic lesions occurring after endovascular treatment of intracranial aneurysms and to compare the safety and effectiveness of a broad spectrum of currently accepted endovascular techniques in a single-center setting...
June 9, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28595811/acute-distal-migration-of-a-flow-diverting-stent
#6
David Dornbos, Ciarán J Powers
The introduction of flow diverting stents, particularly for treatment of petrous to supraclinoid internal carotid artery aneurysms, has greatly impacted endovascular treatment of intracranial aneurysms. Despite their high efficacy, complications, such as ischemic events, distal hemorrhage, or problems with stent deployment, remain a significant concern. We present the first reported case of acute distal migration of a Pipeline Embolization Device (PED). A 24-year old female underwent elective placement of a PED for treatment of a left paraclinoid internal carotid artery aneurysm...
June 5, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28592484/analysis-of-neointima-development-in-flow-diverters-using-optical-coherence-tomography-imaging
#7
Yoshikazu Matsuda, Joonho Chung, Demetrius K Lopes
BACKGROUND: Flow diverters are used for the treatment of intracranial aneurysms. Surface modification may decrease the thrombogenicity of flow diverters but the details are unknown. Optical coherence tomography (OCT) is an intravascular imaging test with high resolution which identifies neointimal growth over stents. We compared the development of neointima in a flow diverter and stents with and without surface modification in a swine model. METHODS: In this study we implanted four devices (two in each carotid artery) in four pigs...
June 7, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28591800/cerebral-revascularization-for-aneurysms-in-the-flow-diverter-era
#8
(no author information available yet)
No abstract text is available yet for this article.
June 7, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28584676/transradial-approach-to-treating-endovascular-cerebral-aneurysms-case-series-and-technical-note
#9
Javier Goland, Gustavo Fabián Doroszuk, Silvia Lina Garbugino, María Paula Ypa
BACKGROUND: Several benefits have been described over the years of the transradial versus femoral endovascular approach to cardiac interventions. Consequently, its use has become habitual at most centers that perform cardiac catheterizations. This paper details a right transradial approach, incorporating a variety of coils or flow diverters, which can be utilized for the endovascular treatment of different cerebral aneurysms. METHODS: From 2014 to 2016, we performed 40 endovascular procedures to treat cerebral aneurysms adopting the same right transradial approach...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28576622/haemodynamic-effects-of-stent-diameter-and-compaction-ratio-on-flow-diversion-treatment-of-intracranial-aneurysms-a-numerical-study-of-a-successful-and-an-unsuccessful-case
#10
Mingzi Zhang, Yujie Li, Xi Zhao, David I Verrelli, Winston Chong, Makoto Ohta, Yi Qian
BACKGROUND: Compacting a flow-diverting (FD) stent is an emerging technique to create a denser configuration of wires across the aneurysm ostium. However, quantitative analyses of post-stenting haemodynamics affected by the compaction level of different stent sizes remain inconclusive. OBJECTIVE: To compare the aneurysmal haemodynamic alterations after virtual FD treatments with different device diameters at different compaction ratios. METHODS: We virtually implanted three sizes of FD stent, with each size deployed at four compaction ratios, into two patient aneurysms previously treated with the Silk+FD-one successful case and the other unsuccessful...
May 16, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28565992/pipeline-flow-diversion-of-ruptured-blister-aneurysms-of-the-supraclinoid-carotid-artery-using-a-single-device-strategy
#11
Robert W Ryan, Amir S Khan, Rebecca Barco, Armen Choulakian
OBJECTIVE Ruptured blister aneurysms remain challenging lesions for treatment due to their broad, shallow anatomy and thin, fragile wall. Historical challenges with both open microsurgical approaches and intrasaccular endovascular approaches have led to increased use of flow diversion for management of these aneurysms. However, the optimum paradigm, including timing of treatment, use of dual antiplatelet therapy, and number of flow-diverter devices to use remains unknown. The authors describe their experience with ruptured blister aneurysms treated with flow diversion at their institution, and discuss rates of rebleeding and number of devices used...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28565988/postprocedural-midterm-and-long-term-results-of-cerebral-aneurysms-treated-with-flow-diverter-devices-7-year-experience-at-a-single-center
#12
Francesco Briganti, Giuseppe Leone, Luigi Cirillo, Oreste de Divitiis, Domenico Solari, Paolo Cappabianca
OBJECTIVE Flow diversion has emerged as a viable treatment option for selected intracranial aneurysms and recently has been gaining traction. The aim of this study was to evaluate the safety and effectiveness of flow-diverter devices (FDDs) over a long-term follow-up period. METHODS The authors retrospectively reviewed all cerebral aneurysm cases that had been admitted to the Division of Neurosurgery of the Università degli Studi di Napoli between November 2008 and November 2015 and treated with an FDD. The records of 60 patients (48 females and 12 males) harboring 69 cerebral aneurysms were analyzed...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28565984/novel-use-of-flow-diversion-for-the-treatment-of-aneurysms-associated-with-arteriovenous-malformations
#13
Craig Kilburg, Philipp Taussky, M Yashar S Kalani, Min S Park
The use of flow-diverting stents for intracranial aneurysms has become more prevalent, and flow diverters are now routinely used beyond their initial scope of approval at the proximal internal carotid artery. Although flow diversion for the treatment of cerebral aneurysms is becoming more commonplace, there have been no reports of its use to treat flow-related cerebral aneurysms associated with arteriovenous malformations (AVMs). The authors report the cases of 2 patients whose AVM-associated aneurysms were managed with flow diversion...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28565981/complications-associated-with-the-use-of-flow-diverting-devices-for-cerebral-aneurysms-a-systematic-review-and-meta-analysis
#14
Geng Zhou, Ming Su, Yan-Ling Yin, Ming-Hua Li
OBJECTIVE The objective of this study was to review the literature on the use of flow-diverting devices (FDDs) to treat intracranial aneurysms (IAs) and to investigate the safety and complications related to FDD treatment for IAs by performing a meta-analysis of published studies. METHODS A systematic electronic database search was conducted using the Springer, EBSCO, PubMed, Medline, and Cochrane databases on all accessible articles published up to January 2016, with no restriction on the publication year...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28565980/update-on-flow-diverters-for-the-endovascular-management-of-cerebral-aneurysms
#15
Gary Rajah, Sandra Narayanan, Leonardo Rangel-Castilla
Flow diversion has become a well-accepted option for the treatment of cerebral aneurysms. Given the significant treatment effect of flow diverters, numerous options have emerged since the initial Pipeline embolization device studies. In this review, the authors describe the available flow diverters, both endoluminal and intrasaccular, addressing nuances of device design and function and presenting data on complications and outcomes, where available. They also discuss possible future directions 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
#16
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/28565977/endovascular-treatment-of-blister-aneurysms
#17
Geoffrey W Peitz, Christopher A Sy, Ramesh Grandhi
Blister aneurysms are rare cerebrovascular lesions for which the treatment methods are reviewed here, with a focus on endovascular options. The reported pathogenesis of blister aneurysms varies, and hemodynamic stress, arterial dissection, and arteriosclerotic ulceration have all been described. There is consensus on the excessive fragility of blister aneurysms and their parent vessels, which makes clipping technically difficult. Open surgical treatment is associated with high rates of complications, morbidity, and mortality; endovascular treatment is a promising alternative...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28553172/current-status-of-the-treatment-of-blood-blister-like-aneurysms-of-the-supraclinoid-internal-carotid-artery-a-review
#18
REVIEW
Tiefeng Ji, Yunbao Guo, Xiuying Huang, Baofeng Xu, Kan Xu, Jinlu Yu
Currently, the treatment of blood blister-like aneurysms (BBAs) of the supraclinoid internal carotid artery (ICA) is challenging and utilizes many therapeutic methods, including direct clipping and suturing, clipping after wrapping, clipping after suturing, coil embolization, stent-assisted coil embolization, multiple overlapping stents, flow-diverting stents, covered stents, and trapping with or without bypass. In these therapeutic approaches, the optimal treatment method for BBAs has not yet been defined based on the current understanding of BBAs of the supraclinoid ICA...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28531340/in-reply-rerupture-of-a-blister-aneurysm-after-treatment-with-a-single-flow-diverting-stent
#19
Marcus D Mazur, Philipp Taussky, Joel D MacDonald, Min S Park
No abstract text is available yet for this article.
May 22, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28521024/pipeline-embolization-device-for-pericallosal-artery-aneurysms-a-retrospective-single-center-safety-and-efficacy-study
#20
Katyucia De Macedo Rodrigues, Anna Luisa Kühn, Takamitsu Tamura, Guilherme Dabus, Peter Kan, Miklos G Marosfoi, J Diego Lozano, Mary Perras, Christopher Brooks, Mary C Howk, Samuel Y Hou, David E Rex, Francesco Massari, Matthew J Gounis, Ajay K Wakhloo, Ajit S Puri
BACKGROUND: Pericallosal artery aneurysm treatment may be challenging using traditional endovascular techniques. OBJECTIVE: To demonstrate the feasibility, efficacy, and safety of endovascular treatment of pericallosal artery aneurysm using flow diverters. METHODS: We performed a retrospective review of our institutional database from July 2013 through July 2016 and identified 7 subjects with a pericallosal artery aneurysm treated with the Pipeline embolization device (ev3 Neurovascular, Medtronic, Dublin, Ireland) and at least 1 follow-up angiogram...
May 17, 2017: Operative Neurosurgery (Hagerstown, Md.)
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