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https://www.readbyqxmd.com/read/28210239/flow-diversion-for-the-treatment-of-mca-bifurcation-aneurysms-a-single-centre-experience
#1
Pervinder Bhogal, Muhammad AlMatter, Hansjörg Bäzner, Oliver Ganslandt, Hans Henkes, Marta Aguilar Pérez
BACKGROUND: Intracranial aneurysms located at the bifurcation of the middle cerebral artery (MCA) can often be challenging for the neurointerventionalist. We aimed to evaluate the efficacy and safety of flow diverting stents (FDS) in the treatment of these aneurysms. MATERIALS AND METHODS: We retrospectively reviewed our prospectively maintained database to collect information for all patients with unruptured saccular bifurcation MCA aneurysms treated with FDS between January 2010 and January 2016...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28194477/maximizing-first-pass-complete-reperfusion-with-save
#2
Volker Maus, Daniel Behme, Christoph Kabbasch, Jan Borggrefe, Ioannis Tsogkas, Omid Nikoubashman, Martin Wiesmann, Michael Knauth, Anastasios Mpotsaris, Marios Nikos Psychogios
BACKGROUND: Endovascular techniques for treatment of large vessel occlusions (LVO) in patients with acute ischemic stroke (AIS) have advanced in recent years. We report a multicenter experience using a combined aspiration and stent retriever technique for mechanical thrombectomy (MT). METHODS: We retrospectively analyzed 32 consecutive MT patients using a novel, combined approach of Stent retriever Assisted Vacuum-locked Extraction (SAVE) by 3 operators at 3 stroke centers...
February 13, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28184345/y-configuration-stent-assisted-coil-embolization-for-wide-necked-intracranial-bifurcation-aneurysms
#3
Kwangho Lee, Hyun Park, Insung Park, Sukh Que Park, O-Ki Kwon, Jongwoo Han
OBJECTIVE: The objective of this study was to determine the efficiency and safety of Y configuration stent-assisted coiling with double-closed stents for wide-necked intracranial aneurysms located at arterial bifurcations thorough analysis of a multicenter case series. MATERIALS AND METHODS: A retrospective chart review was done on 10 patients who underwent endovascular treatment of wide-necked intracranial aneurysms with Y-configuration stent-assisted coil embolization in three centers from August 2011 to March 2014...
December 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/28184261/dual-antiplatelet-therapy-and-non-cardiac-surgery-evolving-issues-and-anesthetic-implications
#4
REVIEW
Jong Wook Song, Sarah Soh, Jae-Kwang Shim
Dual antiplatelet therapy (DAPT) consisting of aspirin plus a P2Y12 inhibitor (clopidogrel, prasugrel, or ticagrelor) is imperative for the treatment of acute coronary syndrome, particularly during the re-endothelialization period after percutaneous coronary intervention (PCI). When patients undergo surgery during this period, the consequences of stent thrombosis are far more serious than those of bleeding complications, except in cases of intracranial surgery. The recommendations for perioperative DAPT have changed with emerging evidence regarding the improved efficacy of non-first-generation drug (everolimus, zotarolimus)-eluting stents (DES)...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28178166/headache-improvement-after-intracranial-endovascular-procedures-in-chinese-patients-with-unruptured-intracranial-aneurysm-a-prospective-observational-study
#5
Linjing Zhang, Yunxia Wang, Qingkui Zhang, Wei Ge, Xiancong Wu, Hai Di, Jun Wang, Xiangyu Cao, Baomin Li, Ruozhuo Liu, Shengyuan Yu
The aim of this study was to investigate whether there is a long-term improvement in headache of patients with unruptured intracranial aneurysms (UIAs) treated with intracranial endovascular procedures.Using a prospective design, consecutive patients with UIAs with neuroendovascular treatment from January 2014 to December 2014 were asked to participate. Headache outcomes were established before aneurysm treatment and for 6 months following treatment. Factors associated with different headache outcomes were investigated...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28175371/110%C3%A2-noninferiority-of-a-direct-aspiration-first-pass-technique-vs-stent-retriever-thrombectomy-in-emergent-large-vessel-intracranial-occlusions
#6
Christopher J Stapleton, Collin M Torok, Aman B Patel
No abstract text is available yet for this article.
August 1, 2016: Neurosurgery
https://www.readbyqxmd.com/read/28163497/successful-endovascular-neurosurgical-practice-in-resource-poor-exclusive-rural-neuro-hospital-setup
#7
Kamble Jayaprakash Harsha
AIM: The aim of this study to evaluate the feasibility of establishing endovascular neurosurgery in remote resource-poor neuro-hospital setup and evaluate its outcome. MATERIALS AND METHODS: Retrospective analysis of diagnostic and therapeutic endovascular neurosurgical procedures performed during September 2013-June 2016. RESULTS: A total of 174 diagnostic cerebral and spinal digital subtraction angiograms and 70 major endovascular neurosurgeries were performed during the period...
December 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28162904/bilateral-internal-carotid-artery-aneurysms-at-the-subpetrosal-portion-with-unilateral-lower-cranial-nerve-palsies-review-and-consideration-of-surgical-strategy
#8
Kei Noguchi, Takachika Aoki, Rokudai Sakamoto, Kimihiko Orito, Yasuharu Takeuchi, Masaru Hirohata, Motohiro Morioka
BACKGROUND: Symptomatic bilateral extracranial internal carotid artery (ICA) aneurysms at the subpetrosal portion are extremely rare, and their treatment strategy remains unknown. CLINICAL PRESENTATION: A 42-year-old man presented to our hospital with a 2-month history of sudden onset of hoarseness, dysarthria, and dysphagia. Magnetic resonance imaging, magnetic resonance angiography, and computed tomography angiography revealed extracranial bilateral ICA aneurysms at the subpetrosal portion...
February 2, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28157748/large-artery-atherosclerotic-occlusive-disease
#9
John W Cole
PURPOSE OF REVIEW: Extracranial or intracranial large artery atherosclerosis is often identified as a potential etiologic cause for ischemic stroke and transient ischemic attack. Given the high prevalence of large artery atherosclerosis in the general population, determining whether an identified atherosclerotic lesion is truly the cause of a patient's symptomatology can be difficult. In all cases, optimally treating each patient to minimize future stroke risk is paramount. Extracranial or intracranial large artery atherosclerosis can be broadly compartmentalized into four distinct clinical scenarios based upon the individual patient's history, examination, and anatomic imaging findings: asymptomatic and symptomatic extracranial carotid stenosis, intracranial atherosclerosis, and extracranial vertebral artery atherosclerotic disease...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28157744/treatment-of-acute-ischemic-stroke
#10
Alejandro A Rabinstein
PURPOSE OF REVIEW: This article provides an update on the state of the art of the emergency treatment of acute ischemic stroke with particular emphasis on the alternatives for reperfusion therapy. RECENT FINDINGS: The results of several randomized controlled trials consistently and conclusively demonstrating that previously functional patients with disabling strokes from a proximal intracranial artery occlusion benefit from prompt recanalization with mechanical thrombectomy using a retrievable stent have changed the landscape of acute stroke therapy...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28155683/towards-the-patient-specific-design-of-flow-diverters-made-from-helix-like-wires-an-optimization-study
#11
Mingzi Zhang, Hitomi Anzai, Bastien Chopard, Makoto Ohta
BACKGROUND: Flow diverter (FD) intervention is an emerging endovascular technique for treating intracranial aneurysms. High flow-diversion efficiency is desired to accelerate thrombotic occlusion inside the aneurysm; however, the risk of post-stenting stenosis in the parent artery is posed when flow-diversion efficiency is pursued by simply decreasing device porosity. For improving the prognosis of FD intervention, we develop an optimization method for the design of patient-specific FD devices that maintain high levels of porosity...
December 28, 2016: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28154128/lack-of-association-between-statin-use-and-angiographic-and-clinical-outcomes-after-pipeline-embolization-for-intracranial-aneurysms
#12
W Brinjikji, H Cloft, S Cekirge, D Fiorella, R A Hanel, P Jabbour, P Lylyk, C McDougall, C Moran, A Siddiqui, I Szikora, D F Kallmes
BACKGROUND AND PURPOSE: Use of statin medications has been demonstrated to improve clinical and angiographic outcomes in patients receiving endovascular stent placement for coronary, peripheral, carotid, and intracranial stenoses. We studied the impact of statin use on long-term angiographic and clinical outcomes after flow-diverter treatment of intracranial aneurysms. MATERIALS AND METHODS: We performed a post hoc analysis from pooled patient-level datasets from 3 Pipeline Embolization Device studies: the International Retrospective Study of the Pipeline Embolization Device, the Pipeline for Uncoilable or Failed Aneurysms Study, and the Aneurysm Study of Pipeline in an Observational Registry...
February 2, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28154100/stroke-caused-by-atherosclerosis-of-the-major-intracranial-arteries
#13
Chirantan Banerjee, Marc I Chimowitz
Our goal in this review is to discuss the pathophysiology, diagnosis, and treatment of stroke caused by atherosclerosis of the major intracranial arteries. References for the review were identified by searching PubMed for related studies published from 1955 to June 2016 using search terms intracranial stenosis and intracranial atherosclerosis. Reference sections of published randomized clinical trials and previously published reviews were searched for additional references. Intracranial atherosclerotic disease is a highly prevalent cause of stroke that is associated with a high risk of recurrent stroke...
February 3, 2017: Circulation Research
https://www.readbyqxmd.com/read/28152631/construction-of-an-in%C3%A2-vivo-carotid-siphon-model-for-testing-endovascular-devices-for-neuro-interventions
#14
Bu-Lang Gao, Yong-Li Wang, Xue-Jing Zhang, Qiong-Ying Fan, Wei-Li Hao, Dong-Hai Zhang
Objective The aim of this study was to construct an in vivo carotid siphon model for testing neurovascular devices for endovascular interventions. Methods A model of a human carotid siphon was pre-shaped using a glass tube from a human cadaver and used to confine a segment of one side of the common carotid artery (CCA) in canines. This segment of CCA with the glass carotid siphon on was interposed end-to-end onto the contralateral CCA so as to simulate a human carotid artery siphon in vivo. Two weeks later, the siphon model was evaluated using computed tomography angiography and digital subtraction angiography, and the covered stent specially designed for intracranial vasculature was navigated through the siphon model for a longitudinal flexibility test...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28144922/current-concepts-and-strategies-in-the-diagnosis-and-management-of-idiopathic-intracranial-hypertension-in-adults
#15
REVIEW
Jane W Chan
Since obesity has become an epidemic in industrialized nations, idiopathic intracranial hypertension (IIH) is now a more common neuro-ophthalmic disorder that causes visual loss and headaches. This review highlights the new diagnostic criteria for IIH and the new insights into the pathophysiologic mechanisms of IIH. Key diagnostic and monitoring techniques for papilledema include not only neuroimaging and the measurement of cerebrospinal fluid (CSF) pressure, but also perimetry, optical coherence tomography, and ocular sonography...
January 31, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28133987/ruptured-intracranial-vertebral-artery-dissecting-aneurysms-an-evaluation-of-prognostic-factors-of-treatment-outcome
#16
K Urasyanandana, P Withayasuk, D Songsaeng, T Aurboonyawat, E Chankaew, A Churojana
Objective Intracranial spontaneous vertebral artery dissecting aneurysms commonly occur in the third to fifth decades of life, and are mostly associated with hypertension. Patients present with intracranial haemorrhage or thromboembolic events. Patients who present with intracranial haemorrhage carry about a 70% risk of recurrent bleeding. Patients with a posterior-inferior cerebellar artery (PICA) or ipsilateral dominant vertebral artery involve selecting which parent vessel could not be sacrificed. Recent reconstructive techniques such as stent-assisted coiling embolisation and flow-diverting stents are effective treatments of choice...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28130545/risk-factors-of-subacute-thrombosis-after-intracranial-stenting-for-symptomatic-intracranial-arterial-stenosis
#17
Xuan Sun, Xu Tong, Wai Ting Lo, Dapeng Mo, Feng Gao, Ning Ma, Bo Wang, Zhongrong Miao
BACKGROUND AND PURPOSE: We aimed to explore the risk factors of subacute thrombosis (SAT) after intracranial stenting for patients with symptomatic intracranial arterial stenosis. METHODS: From January to December 2013, all symptomatic intracranial arterial stenosis patients who underwent intracranial stenting in Beijing Tiantan Hospital were prospectively registered into this study. Baseline clinical features and operative data were compared in patients who developed SAT with those who did not...
January 27, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28130502/optimal-first-coil-selection-to-avoid-aneurysmal-recanalization-in-endovascular-intracranial-aneurysmal-coiling
#18
Hiroaki Neki, Shinya Kohyama, Toshihiro Otsuka, Azusa Yonezawa, Shoichiro Ishihara, Fumitaka Yamane
BACKGROUND: Aneurysmal recanalization is a problem with endovascular coiling and one of its risk factors is the low volume embolization ratio (VER). The first coil VER (1st VER) is believed to be critical for obtaining a high VER. The main objective of this study was to evaluate factors potentially useful for selecting the optimal 1st VER for endovascular coiling. METHODS: 609 initial saccular aneurysmal treatments performed between January 2010 and December 2014 at our institution were included in this retrospective study...
January 27, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28123471/endovascular-treatment-of-irregular-and-complicated-intracranial-aneurysms-with-coils-using-double-microcatheter-technique
#19
Yang Zhang, Ge Gao, Yingjiu Chao, Yu Chen, Jian Yu, Daqun Gu, Jianjun Wei, Chaoshi Niu, Xianming Fu
Embolisation of irregular and complicated aneurysms is a great challenge for neuroradiologists. To overcome possible complications of endovascular treatment of these type of aneurysms, methods such as intracranial stents, balloon remodelling, and the double microcatheter technique have been developed. The aim of the study was to report our preliminary experience with endovascular treatment of irregular and complicated intracranial aneurysm with coils using double microcatheter technique, and evaluation of its feasibility and clinical advantages...
January 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28118796/mechanical-recanalization-for-acute-embolic-occlusion-at-the-origin-of-the-superior-mesenteric-artery
#20
Yoichi Miura, Tomohiro Araki, Mio Terashima, Junya Tsuboi, Yasuhiro Saito, Kenji Kanamaru, Hidenori Suzuki
PURPOSE: We report a combined technique consisting of thrombectomy and thromboaspiration for the treatment of acute embolic occlusion of the superior mesenteric artery (SMA) at the origin. CASE: A 90-year-old female with chronic atrial fibrillation had a sudden onset of abdominal pain and hematochezia due to acute embolic occlusion at the origin of the SMA. Computed tomographic findings showed reversible bowel wall ischemia. We performed mechanical thrombectomy using the Solitaire FR revascularization device, a self-expanding and fully retrievable stent-based thrombectomy system for acute intracranial large artery occlusion, combined with manual aspiration through a 6F guiding sheath placed at the SMA origin via a right brachial approach...
January 1, 2017: Vascular and Endovascular Surgery
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