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Intracranial stent

Srikanth Boddu, Marc Dinkin, Maria Suurna, Kelly Hannsgen, Xem Bui, Athos Patsalides
OBJECTIVE: Evaluate the role of venous sinus stenting in the treatment of pulsatile tinnitus among patients with Idiopathic Intracranial Hypertension (IIH) and significant venous sinus stenosis. SUBJECTS AND METHODS: A written informed consent approved by the Weill Cornell institutional review board was signed and obtained from the study participants. Thirty-seven consecutive patients with IIH and venous sinus stenosis who were treated with venous sinus stenting between Jan...
2016: PloS One
W-Y Guo, C-C J Lee, C-J Lin, H-C Yang, H-M Wu, C-C Wu, W-Y Chung, K-D Liu
BACKGROUND AND PURPOSE: Sinus stenosis occasionally occurs in dural arteriovenous fistulas. Sinus stenosis impedes venous outflow and aggravates intracranial hypertension by reversing cortical venous drainage. This study aimed to analyze the likelihood of sinus stenosis and its impact on cerebral hemodynamics of various types of dural arteriovenous fistulas. MATERIALS AND METHODS: Forty-three cases of dural arteriovenous fistula in the transverse-sigmoid sinus were reviewed and divided into 3 groups: Cognard type I, type IIa, and types with cortical venous drainage...
October 20, 2016: AJNR. American Journal of Neuroradiology
Sami Al Kasab, Michael J Lynn, Tanya N Turan, Colin P Derdeyn, David Fiorella, Bethany F Lane, L Scott Janis, Marc I Chimowitz
BACKGROUND: An American Heart Association/American Stroke Association (AHA/ASA) writing committee has recently recommended that tissue evidence of cerebral infarction associated with temporary symptoms (CITS) lasting <24 hours should be considered a stroke. We analyzed the impact of considering CITS as equivalent to stroke on the results of the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial. METHODS: We compared outcomes in the medical (n = 227) and stenting (n = 224) groups in SAMMPRIS using the following primary end point (new components in bold): any stroke, CITS, or death within 30 days after enrollment or within 30 days after a revascularization procedure for the qualifying lesion during follow-up; or ischemic stroke or CITS in the territory of the qualifying artery beyond 30 days...
October 17, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Jacques Sedat, Yves Chau, Jean Gaudart, Marina Sachet, Stephanie Beuil, Michel Lonjon
BACKGROUND: Thromboembolic complications are the main problem in stent-assisted coil embolization of unruptured intracranial aneurysms. The combination of aspirin and clopidogrel is generally used to decrease these complications, but some patients do not respond to clopidogrel and have a higher risk of stent thrombosis. In cardiology, clinical trials have shown that prasugrel reduced the incidence of ischaemic events in patients with acute coronary syndrome compared with clopidogrel but, according to several authors, prasugrel would produce an increased risk of cerebral haemorrhagic complications...
October 19, 2016: Interventional Neuroradiology
Marcus D Mazur, Philipp Taussky, Joel D MacDonald, Min S Park
BACKGROUND AND IMPORTANCE: As the use of flow-diverting stents (FDSs) for intracranial aneurysms expands, a small number of case reports have described the successful treatment of blister aneurysms of the internal carotid artery with flow diversion. Blister aneurysms are uncommon and fragile lesions that historically have high rates of morbidity and mortality despite multiple treatment strategies. We report a case of rebleeding after treatment of a ruptured blister aneurysm with deployment of a single FDS...
November 2016: Neurosurgery
Gregory M Weiner, Rafey Feroze, David M Panczykowski, Amin Aghaebrahim, William Ares, Nitin Agarwal, John Enis, Xiao Zhu, Andrew F Ducruet
INTRODUCTION: Tandem occlusion resulting in acute ischemic stroke (AIS) is associated with high morbidity and mortality and a poor response to thrombolytic therapy. The use of endovascular strategies for tandem stroke cases results in an improved outcome for this subgroup of patients. We present two cases with a pattern of tandem occlusion consisting of proximal obstruction at the origin of the common carotid artery (CCA) with concomitant intracranial occlusion treated by endovascular techniques...
October 14, 2016: World Neurosurgery
Youssef Al Said, Khalil Kurdi, Saleh S Baeesa, Ahmed Najjar, Mohammed Almekhlafi, Ahmed Hassan
OBJECTIVE: To present our local experience with intracranial angioplasty and stenting used for the treatment of symptomatic intracranial stenosis to assess its safety, efficacy, and outcome. METHODS: This is a retrospective review of all the patients with symptomatic intracranial atherosclerotic disease who underwent endovascular treatment in King Faisal Specialist Hospital and research center, Jeddah, Kingdom of Saudi Arabia from January 2003 to December 2014. Clinical, procedural, and outcome variables were gathered...
October 2016: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
Rustum Karanjia, Alfredo A Sadun, Angelos A Konstas
Severe visual loss may occur in patients with pseudotumor cerebri (PTC), also known as idiopathic intracranial hypertension. Transverse sinus stenosis is 1 cause of PTC syndrome. Although the role of transverse sinus stenosis in the pathogenesis of the disease remains controversial, recent case series of transverse sinus stenting have reported very high rates of symptom response and resolution of papilledema with improvement or at least stabilization of the visual fields and visual acuity (Ahmed et al., 2011)...
October 12, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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
Tibor Becske, Matthew B Potts, Maksim Shapiro, David F Kallmes, Waleed Brinjikji, Isil Saatci, Cameron G McDougall, István Szikora, Giuseppe Lanzino, Christopher J Moran, Henry H Woo, Demetrius K Lopes, Aaron L Berez, Daniel J Cher, Adnan H Siddiqui, Elad I Levy, Felipe C Albuquerque, David J Fiorella, Zsolt Berentei, Miklós Marosföi, Saruhan H Cekirge, Peter K Nelson
OBJECTIVE The long-term effectiveness of endovascular treatment of large and giant wide-neck aneurysms using traditional endovascular techniques has been disappointing, with high recanalization and re-treatment rates. Flow diversion with the Pipeline Embolization Device (PED) has been recently used as a stand-alone therapy for complex aneurysms, showing significant improvement in effectiveness while demonstrating a similar safety profile to stent-supported coil treatment. However, relatively little is known about its long-term safety and effectiveness...
October 14, 2016: Journal of Neurosurgery
Daisuke Wajima, Shuta Aketa, Ichiro Nakagawa, Katsuya Masui, Taiji Yonezawa, Tomomi Enami, Fukuko Nishida, Hiroyuki Nakase
OBJECTIVE: Although short-term clinical outcomes after basilar artery stent placement have been reported previously, effectiveness of intracranial stenting for vertebro-basilar artery occlusion in acute phase of ischemic stroke is unclear. METHODS: We clinically investigated 8 patients with intracranial percutaneous trans-luminal angioplasty (PTA) or stenting as our protocol for symptomatic atherosclerotic vertebra-basilar artery occlusion (age range 54-80, mean 69±11 years; 6 male and 2 female) who were admitted to our hospital between August 2013 and December 2015...
October 8, 2016: World Neurosurgery
Ichiro Deguchi, Takeshi Hayashi, Hiroaki Neki, Fumitaka Yamane, Shoichiro Ishihara, Norio Tanahashi, Masaki Takao
We herein report three ischemic stroke patients who underwent emergency carotid artery stenting after receiving intravenous tissue plasminogen activator (t-PA) treatment. All patients received antiplatelet medications immediately before stent placement for loading as well as dual antiplatelet therapy after stenting. Under high-dose and dual antiplatelet therapy, none of the three patients showed symptomatic intracranial hemorrhaging. However, one case showed reocclusion of the placed stent after acute thrombosis...
2016: Internal Medicine
Marcin Wiącek, Rafał Kaczorowski, Jarosław Homa, Edward Filip, Janusz Darocha, Daniel Dudek, Wiesław Guz, Halina Bartosik-Psujek
BACKGROUND AND PURPOSE: Recently, positive data from several randomized controlled trials (RCTs) of endovascular therapy for acute ischemic stroke (AIS) has emerged. The aim of this retrospective study is to present our clinical experience in cerebral vessel occlusion treatment using retrievable intracranial stents. METHODS: Forty-three consecutive patients with ischemic stroke (median age 75, range 22-87) treated by stent retriever thrombectomy (Solitaire™ FR) between January 2013 and December 2015 were identified...
September 23, 2016: Neurologia i Neurochirurgia Polska
Chun Fang, Hua-Qiao Tan, Hong-Jie Han, Hao Feng, Ji-Chong Xu, Shuo Yan, Zhi-Yu Nie, Ling-Jing Jin, Fei Teng
OBJECTIVE: Intracranial blood blister-like aneurysm (BBA) is a rare type of aneurysm that lacks all layers of the arterial wall. These fragile aneurysms have the propensity to rupture with minimal manipulation, which makes them hazardous and difficult to treat. The present study evaluated the safety and feasibility of endovascular treatment of BBAs with the Willis covered stent. MATERIALS: Thirteen patients (7 men and 6 women, age range 28-68 years) who presented with ruptured BBAs and were treated with the Willis covered stent were retrospectively reviewed...
October 5, 2016: Journal of Neurointerventional Surgery
Sophia F Shakur, Victor A Aletich, Sepideh Amin-Hanjani, Ahmed E Hussein, Fady T Charbel, Ali Alaraj
BACKGROUND: Pipeline embolization devices (PEDs) are commonly used for endovascular treatment of cerebral aneurysms but can be associated with delayed ipsilateral intraparenchymal hemorrhage. Although intra-aneurysmal hemodynamic changes have been studied, parent vessel and intracranial hemodynamics after PED use are unknown. We examine the impact of flow diversion on parent artery and distal intracranial hemodynamics. METHOD: Patients with internal carotid cerebral aneurysms treated with PED who had flow volume rate, flow velocities, pulsatility index, resistance index, Lindegaard ratio, and wall shear stress (WSS) obtained after treatment using quantitative magnetic resonance angiography were reviewed...
October 4, 2016: Interventional Neuroradiology
Patrick M House, Stefan R G Stodieck
OBJECTIVE: Idiopathic intracranial hypertension (IIH) is characterized by elevated intracranial pressure without a space-occupying cerebral lesion, venous sinus thrombosis or hydrocephalus and with normally composited cerebrospinal fluid (CSF). Main symptoms are headache, sight disturbances and potential visual impairment. Weight loss, carbonic anhydrase inhibitors, lumbar punctures with CSF drain, CSF shunting, optic nerve sheath fenestration, and venous sinus stenting are common IIH therapies...
November 2016: Clinical Neurology and Neurosurgery
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
Maxim Mokin, Kyle M Fargen, Christopher T Primiani, Zeguang Ren, Travis M Dumont, Leonardo B C Brasiliense, Guilherme Dabus, Italo Linfante, Peter Kan, Visish M Srinivasan, Mandy J Binning, Rishi Gupta, Aquilla S Turk, Lucas Elijovich, Adam Arthur, Hussain Shallwani, Elad I Levy, Adnan H Siddiqui
BACKGROUND: Vessel perforation during stent retriever thrombectomy is a rare complication; typically only single instances have been reported. OBJECTIVE: To report on a series of patients whose stent retriever thrombectomy was complicated by intraprocedural vessel perforation and discuss its potential mechanisms, rescue treatment strategies, and clinical significance. METHODS: Cases with intraprocedural vessel perforation, where a stent retriever was used either as a primary treatment approach or as a part of a direct aspiration first pass technique (ADAPT), were included in the final analysis...
September 29, 2016: Journal of Neurointerventional Surgery
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
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