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https://www.readbyqxmd.com/read/29783867/virtual-stenting-of-intracranial-aneurysms-a-pilot-study-for-the-prediction-of-treatment-success-based-on-hemodynamic-simulations
#1
Philipp Berg, Sylvia Saalfeld, Gábor Janiga, Olivier Brina, Nicole M Cancelliere, Paolo Machi, Vitor M Pereira
Endovascular treatment of intracranial aneurysms using flow-diverting devices has revolutionized the treatment of large and complex lesions due to its minimally invasive nature and potential clinical outcomes. However, incomplete or delayed occlusion and persistent intracranial aneurysm growth are still an issue for up to one-third of the patients. We evaluated two patients with intracranial aneurysm located at the internal carotid artery who were treated with flow-diverting devices and had opposite outcomes...
May 1, 2018: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29778996/stent-and-flow-diverter-assisted-treatment-of-acutely-ruptured-brain-aneurysms
#2
José E Cohen, J Moshe Gomori, Ronen R Leker, Sergey Spektor, Hosni Abu El Hassan, Eyal Itshayek
OBJECTIVE: We present our experience with stent techniques in the management of acutely ruptured aneurysms, focusing on aneurysm occlusion rates, intraprocedural complications, and late outcomes. METHODS: We retrospectively reviewed the clinical records of patients treated by stent techniques during the early acute phase of aneurysmal rupture, from June 2011 to June 2016. Patients who underwent stenting for the management of unruptured aneurysms, or in a delayed fashion for a ruptured lesion, were excluded...
May 19, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29720021/silk-flow-diverter-stent-for-the-treatment-of-complex-intracranial-aneurysms-a-one-year-follow-up-multicenter-study
#3
G Foa Torres, F Roca, A Noguera, J Godes, S Petrocelli, I Aznar, S Ales, P Muszynski, R Maehara, M Vicente, J M Pumar
Background Flow-diverter stents have been successfully used in the treatment of complex aneurysms with limited therapeutic alternatives. We report our experience using the Silk flow diverter (SFD; Balt Extrusion, Montmorency, France) for the treatment of complex aneurysms in four Argentine centers. Methods We conducted a retrospective review of 246 consecutive patients who were treated with the SFD at four Argentine centers between January 2009 and January 2017. The patient and aneurysm characteristics, as well as the details of the procedure, were analyzed...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29719554/pipeline-flex-embolization-of-flow-related-aneurysms-associated-with-arteriovenous-malformations-a-case-report
#4
Narlin B Beaty, Jessica K Campos, Geoffrey P Colby, Li-Mei Lin, Matthew T Bender, Risheng Xu, Alexander L Coon
Background: An estimated 0.1% of the population harbors brain arteriovenous malformations (AVMs). Diagnosis and workup of AVMs include thorough evaluation for characterization of AVM angioarchitecture and careful assessment for concomitant aneurysms. The presence of coexisting aneurysms is associated with an increased risk of intracranial hemorrhage, with a published risk of 7% per year compared to patients with AVMs alone with a risk of 3%. Comprehensive AVM management requires recognition of concomitant aneurysms and prioritizes treatment strategies to mitigate the aggregate risk of intracranial hemorrhage associated with AVM rupture in patients with coexisting aneurysms...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29712525/analysis-of-cerebrovascular-aneurysm-treatment-cost-retrospective-cohort-comparison-of-clipping-coiling-and-flow-diversion
#5
Spencer Twitchell, Hussam Abou-Al-Shaar, Jared Reese, Michael Karsy, Ilyas M Eli, Jian Guan, Philipp Taussky, William T Couldwell
OBJECTIVE With the continuous rise of health care costs, hospitals and health care providers must find ways to reduce costs while maintaining high-quality care. Comparing surgical and endovascular treatment of intracranial aneurysms may offer direction in reducing health care costs. The Value-Driven Outcomes (VDO) database at the University of Utah identifies cost drivers and tracks changes over time. In this study, the authors evaluate specific cost drivers for surgical clipping and endovascular management (i...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29698879/use-of-pipeline%C3%A2-embolization-device-for-the-treatment-of-traumatic-intracranial-pseudoaneurysms-case-series-and-review-of-cases-from-literature
#6
Mairaj T Sami, Domenico A Gattozzi, Hesham M Soliman, Alan R Reeves, Christopher J Moran, Paul J Camarata, Koji C Ebersole
OBJECTIVE: Intracranial traumatic pseudoaneurysms (PSA) are a rare but dangerous subtype of cerebral aneurysm. Reports documenting use of flow-diverting stents to treat traumatic intracranial PSAs are few and lack long-term follow-up. To our knowledge, this is the largest case-series to date demonstrating use of Pipeline Endovascular Device (PED) for traumatic intracranial PSAs. PATIENTS AND METHODS: Retrospective review of 8 intracranial traumatic PSAs in 7 patients treated using only PED placement...
June 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29695603/intermediate-catheter-placement-distal-to-the-cerebral-aneurysm-during-flow-diversion-embolization-with-the-surpass-device
#7
Osman Melih Topcuoglu, Anil Arat, Ahmet Peker, Basar Sarikaya
PURPOSE: We present the preliminary angiographic and clinical results of the combined utilization of an AXS Catalyst 5 (Cat5) distal access catheter and a Surpass flow diverter (SFD) for the endovascular treatment of intracranial aneurysms. MATERIALS AND METHODS: Interventional neuroradiology case records were evaluated retrospectively to identify patients treated with an SFD in combination with Cat5. Demographic data, technical success, location of the catheter tip, aneurysm occlusion rate, and procedure-related morbidity and mortality were noted...
April 25, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29684517/nickel-related-adverse-reactions-in-the-treatment-of-cerebral-aneurysms-a-literature-review
#8
REVIEW
Anderson Chun On Tsang, Patrick Nicholson, Vitor Mendes Pereira
BACKGROUND: Nickel is the most common metal allergen and predominantly affects women. It is also the ubiquitous component in the alloys used to manufacture intracranial devices for aneurysm treatments, including aneurysm clips, self-expanding stents, flow-diverting stents and endosaccular occlusion devices. Adverse events related to nickel-allergy after deployment of such devices are uncommon but can be severe, resulting in dilemmas in the choice of treatment strategies and devices in managing nickel-sensitive patients with intracranial aneurysms...
April 20, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29682009/the-effect-of-stents-in-cerebral-aneurysms-a-review
#9
REVIEW
Kenan Alkhalili, Jack Hannallah, Mary Cobb, Nohra Chalouhi, Jessica L Philips, Angela B Echeverria, Pascal Jabbour, M Haithem Babiker, David H Frakes, L Fernando Gonzalez
The etiology of up to 95% of cerebral aneurysms may be accounted for by hemodynamically-induced factors that create vascular injury. The purpose of this review is to describe key physical properties that stents have and how they affect cerebral aneurysms. We performed a two-step screening process. First, a structured search was performed using the PubMed database. The following search terms and keywords were used: "Hemodynamics," "wall shear stress (WSS)," "velocity," "viscosity," "cerebral aneurysm," "intracranial aneurysm," "stent," "flow diverter," "stent porosity," "stent geometry," "stent configuration," and "stent design...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29675721/fenestration-of-the-supraclinoid-segment-of-the-ica-and-associated-aneurysms-a-case-report-with-literature-review
#10
Alessandro Sgreccia, Oguzhan Coskun, Federico Di Maria, Georges Rodesch, Arturo Consoli
The supraclinoid ICA fenestration (SIF) is considered an extremely rare congenital anomaly. However, most of the reported cases of SIF are associated with intracranial aneurysms either ruptured or unruptured. We report the case of a 55-year-old patient with a right SIF and an unruptured, large, wide-necked aneurysm located on the larger limb of the fenestration and a second small aneurysm distal to the SIF. The aneurysms were treated with a Pipeline flow-diverter stent, achieving the complete reconstruction of the anatomy of the carotid siphon...
June 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29659995/the-importance-of-wall-apposition-in-flow-diverters
#11
René Aquarius, Antonius de Korte, Debby Smits, Matthew Gounis, Kiek Verrijp, Léon Driessen, William Leenders, Joost de Vries
BACKGROUND: It is assumed that high pore densities in flow diverters (FDs) are beneficial for intracranial aneurysm (IA) healing. However, various animal studies are not conclusive on the issue, suggesting that other factors are in play. One important factor might be wall apposition. OBJECTIVE: To (1) determine the relationship between FD pore density and aneurysm occlusion, and (2) determine the relationship between FD wall apposition and aneurysm occlusion. METHODS: Saccular aneurysms were microsurgically created in the aorta of 36 Wistar rats...
April 4, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29653275/safety-and-efficacy-of-flow-diverter-treatment-for-aneurysm-in-small-cerebral-vessels-a-systematic-review-and-meta-analysis
#12
REVIEW
Yazhou Yan, Deyuan Zhu, Haishuang Tang, Qinghai Huang
PURPOSE: To clarify the safety and efficacy of flow diverter (FD) treatment for aneurysm in small cerebral vessels, we conducted a systematic review of the literature analyzing perioperative and long-term clinical and angiographic outcomes. METHODS: A comprehensive review of the up-to-date literature for studies with ≥10 patients related to FD treatment of small vessel aneurysms published was performed. Random-effects meta-analysis was used to pool the following outcomes: complete occlusion, technical procedural success, perioperative mortality, perioperative stroke, procedure-related morbidity and mortality, all complications, long-term mortality, and overall good outcome...
April 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29651585/ruptured-fusiform-aneurysm-of-the-anterior-spinal-artery-successful-treatment-with-flow-diverter-stent-placed-in-the-feeding-vertebral-artery
#13
C P Simon-Gabriel, H Urbach, S Meckel
No abstract text is available yet for this article.
April 12, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29650782/treatment-of-distal-anterior-cerebral-artery-aneurysms-with-flow-diverter-stents-a-single-center-experience
#14
F Cagnazzo, M Cappucci, C Dargazanli, P-H Lefevre, G Gascou, C Riquelme, A Bonafe, V Costalat
BACKGROUND AND PURPOSE: Flow diversion for aneurysms beyond the circle of Willis is still debated. Our aim was to evaluate the safety and efficacy of flow diversion treatment of distal anterior cerebral artery aneurysms. MATERIALS AND METHODS: Consecutive patients with distal anterior cerebral artery aneurysms treated from January 2014 to October 2017 were evaluated retrospectively with prospectively maintained data. Treatment was performed only for unruptured or recanalized aneurysms after coiling...
April 12, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29644398/stent-placement-in-patients-with-acute-subarachnoid-haemorrhage-when-is-it-justified
#15
Andrew G Murchison, Victoria Young, Tanja Ddjurdjevic, Martino Cellerini, Rufus Corkill, Wilhelm Küker
PURPOSE: Endovascular stents are widely used for the elective treatment of cerebral aneurysms. Acute stenting is performed in the management of dissections, pseudo-aneurysms, broad-based aneurysms or as a 'bail out' measure after coil migration. The purpose of this study is to review the safety of using stents in acute subarachnoid haemorrhage. METHODS: The stent registry of our institution was reviewed for procedures in patients with acute subarachnoid haemorrhage...
April 11, 2018: Neuroradiology
https://www.readbyqxmd.com/read/29608747/pharmacy-mediated-antiplatelet-management-protocol-compared-to-one-time-platelet-function-testing-prior-to-pipeline-embolization-of-cerebral-aneurysms-a-propensity-score-matched-cohort-study
#16
Christoph J Griessenauer, Abhi Jain, Alejandro Enriquez-Marulanda, Raghav Gupta, Nimer Adeeb, Justin M Moore, Stacey A Grassi, Shamsher S Dalal, Christopher S Ogilvy, Ajith J Thomas, Clemens M Schirmer
BACKGROUND: There is ongoing controversy regarding the optimal antiplatelet regimen, and extent or even need for platelet function testing surrounding Pipeline flow diverter (Medtronic Inc, Dublin, Ireland) embolization of cerebral aneurysms. OBJECTIVE: To compare a unique pharmacy-mediated antiplatelet medication management protocol to a 1-time platelet function testing strategy prior to Pipeline placement. METHODS: A retrospective review of patients with cerebral aneurysms who underwent Pipeline embolization at 2 academic institutions was performed...
March 27, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29599173/parent-artery-reconstruction-for-large-or-giant-cerebral-aneurysms-using-the-tubridge-flow-diverter-a-multicenter-randomized-controlled-clinical-trial-parat
#17
J-M Liu, Y Zhou, Y Li, T Li, B Leng, P Zhang, G Liang, Q Huang, P-F Yang, H Shi, J Zhang, J Wan, W He, C Liang, G Zhu, Y Xu, B Hong, X Yang, W Bai, Y Tian, H Zhang, Z Li, Q Li, R Zhao, Y Fang, K Zhao
BACKGROUND AND PURPOSE: Although flow diverters have been reported with favorable clinical and angiographic outcomes in various literatures, randomized trials determining their true effectiveness and safety are still in lack. The Parent Artery Reconstruction for Large or Giant Cerebral Aneurysms Using the Tubridge Flow Diverter (PARAT) trial was designed to evaluate the safety and efficacy of the Tubridge flow diverter in the treatment of large or giant aneurysms in comparison with Enterprise stent-assisted coiling...
March 29, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29584923/rescue-therapy-for-procedural-complications-associated-with-deployment-of-flow-diverting-devices-in-cerebral-aneurysms
#18
Fawaz Al-Mufti, Krishna Amuluru, Eric R Cohen, Vikas Patel, Mohammad El-Ghanem, Ethan Wajswol, Vincent Dodson, Sarmad Al-Marsoummi, Neil Majmundar, Neha S Dangayach, Rolla Nuoman, Chirag D Gandhi
Flow diverting devices (FDDs) have revolutionized the treatment of morphologically complex intracranial aneurysms such as wide-necked, giant, or fusiform aneurysms. Although FDDs are extremely effective, they carry a small yet significant risk of intraprocedural complications. As the implementation of these devices increases, the ability to predict and rapidly treat complications, especially those that are iatrogenic or intraprocedural in nature, is becoming increasingly more necessary.Our objective in this paper is to provide a descriptive summary of the various types of intraprocedural complications that may occur during FDDs deployment and how they may best be treated...
March 22, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29574426/delayed-neurological-deficits-after-endovascular-placement-of-a-pipeline-embolisation-device-clinical-manifestation-and-treatment
#19
Naveen Sablani, Maryam Mumtaz Hasan, Ashik Shrestha, Jeffrey Farkas
Endovascular treatment has been the mainstay of therapy for repair of both ruptured and unruptured cerebral aneurysms. Flow diverter devices offer a new option for the treatment of complex aneurysms that were previously not amenable to coiling. Procedural adverse effects include intracranial haemorrhage and ischaemic stroke, which usually occur on the same day. Delayed complications are rare. We report a case of a patient who underwent placement of a pipeline embolisation device and developed delayed neurological deficits, which were thought to be an inflammatory reaction to the hydrophilic coating used in guidewires and microcatheters...
March 23, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29572267/long-term-visual-outcome-in-patients-treated-by-flow-diversion-for-carotid-ophthalmic-aneurysms
#20
Romain Touzé, Valérie Touitou, Eimad Shotar, Joseph Gabrieli, Mehdi Drir, Bertrand Mathon, Nader-Antoine Sourour, Frédéric Clarençon
BACKGROUND: Flow-diverter stents (FDSs) are an upgrade in the treatment of intracranial aneurysms. However, complications concerning covered branches have been reported, especially the ophthalmic artery (OA). The purpose of our study was to evaluate the long-term ophthalmic complication rate of carotid-ophthalmic aneurysms (COA) without visual pathways compression, treated by a FDS covering the OA by performing an exhaustive ophthalmic examination. MATERIAL AND METHODS: Retrospective analysis of a single-center database screening the patients treated from October 2009 to April 2015 for an intracranial aneurysm with a FDS...
March 23, 2018: Journal of Neurointerventional Surgery
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