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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/29783014/comparison-of-micro-clamping-stent-retriever-thrombectomy-with-conventional-stent-retriever-thrombectomy-in-intracranial-large-vessel-embolism
#2
Zhen-Sheng Liu, Gang Deng, Long-Jiang Zhou, Yong Sun, Xin-Jiang Zhang, Xiong-Wei Kuang, Yong-Lin Qin, Jia-Xiang Wang, Qing Shan
OBJECTIVE: To evaluate the effectiveness of micro-clamping stent-retriever thrombectomy (MSRT) in acute ischemic stroke patients with intracranial large vessel embolism (ILVE), and compare the same with conventional stent-retriever thrombectomy (CSRT). MATERIALS AND METHODS: We retrospectively evaluated a total of 108 ILVE patients treated by MSRT (n=52) and CSRT (n=56) from the two participating institutions between January 2016 and November 2017. The rates of successful (mTICI 2b or 3) and complete reperfusion (mTICI 3), time from guide catheter placement to reperfusion, rates of first-pass success, and the number of passes for reperfusion were compared between the MSRT and CSRT groups...
May 18, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29778598/relevance-of-antiplatelet-therapy-duration-after-stent-assisted-coil-embolization-for-unruptured-intracranial-aneurysms
#3
Tackeun Kim, Chang Hyeun Kim, Si-Hyuck Kang, Seung Pil Ban, O-Ki Kwon
BACKGROUND: The optimal duration of dual antiplatelet therapy (DAPT) for preventing delayed thromboembolic events (DTEs) remains unclear. We aimed to determine whether longer DAPT provides improved protection against delayed DTEs. METHODS: This retrospective cohort study included 507 stent-assisted coil embolization procedures using a single stent for unruptured intracranial aneurysms. We performed coarsened exact matching according to the duration of maintenance DAPT...
May 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29768963/the-woven-endobridge-web-as-primary-treatment-for-unruptured-intracranial-aneurysms
#4
Sanne Bt van Rooij, Willem Jan van Rooij, Jo P Peluso, Menno Sluzewski
Purpose The intrasaccular flow disruptor Woven EndoBridge (WEB) device is developed for the treatment of wide-necked aneurysms without supportive devices. We used the WEB as primary treatment for unruptured aneurysms suitable for the device, regardless of neck size. Methods Between February 2015 and June 2017, 59 aneurysms in 51 patients were selectively treated with the WEB. There were 15 men and 36 women with a mean age of 59 years. Mean aneurysm size was 7.0 mm (range 3-22 mm). Of 59 aneurysms, 45 (76%) had a wide neck defined as ≥4 mm or dome-neck ratio ≤1...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29768352/effectiveness-of-trevo-stent-retriever-in-acute-ischemic-stroke-comparison-with-solitaire-stent
#5
Ho Jun Yi, Dong Hoon Lee, Sang Uk Kim
Recently, mechanical thrombectomy with stent retriever has achieved faster and higher rates of recanalization for intracranial major vessel occlusion. However, comparative studies of the most widely used Solitaire and Trevo stents have been rarely published.The authors retrospectively reviewed a total of 200 patients who performed mechanical thrombectomy at our center during 4 years and divided patients into 2 groups: mechanical thrombectomy with Solitaire stent (Group 1: Solitaire) and mechanical thrombectomy with Trevo stent (Group 2: Trevo)...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29765397/lvis-jr-device-for-y-stent-assisted-coil-embolization-of-wide-neck-intracranial-aneurysms-a-multicenter-experience
#6
Edgar A Samaniego, Aldo A Mendez, Thanh N Nguyen, Vladimir Kalousek, Waldo R Guerrero, Sudeepta Dandapat, Guilherme Dabus, Italo Linfante, Ameer E Hassan, Alexander Drofa, Evgueni Kouznetsov, David Leedahl, David Hasan, Alberto Maud, Santiago Ortega-Gutierrez
Background and Purpose: Complex wide-neck intracranial aneurysms are challenging to treat. We report a multicenter experience using the LVIS Jr stent for "Y-stent"-assisted coiling embolization of wide-neck bifurcation aneurysms. Methods: Seven centers provided retrospective data on patients who underwent Y-stenting. Technical complications, immediate posttreatment angiographic results, clinical outcomes, and imaging follow-up were assessed. Results: Thirty patients/aneurysms were treated: 15 basilar tip, 8 middle cerebral artery, 4 anterior communicating artery, 1 pericallosal, and 2 posterior inferior cerebellar artery aneurysms...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29764034/-application-of-low-profile-visualized-intraluminal-support-lvis-stents-in-assisting-coil-embolization-of-intracranial-aneurysms
#7
D C Xu, J Li, Z Q Jiang
Objective: To evaluate the safety and effectiveness of application of LVIS stent-assisted coiling endovascular procedures in cerebral aneurysms . Methods: The clinical data of 41 patients with intracranial aneurysms , which were performed in LVIS stent-assisted coiling endovascular therapies from June 2015 to October 2017 in The First Affiliated Hospital of Bengbu Medical College were analyzed retrospectively. 13 patients were unruptured and 28 patients were ruptured. Immediate angiography outcomes and follow-up angiography outcomes were assessed by DSA...
May 8, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29762775/combination-superficial-temporal-artery-middle-cerebral-artery-bypass-and-m2-m2-reanastomosis-with-trapping-of-a-stented-distal-middle-cerebral-artery-aneurysm-3-dimensional-operative-video
#8
Jan-Karl Burkhardt, Sonia Yousef, Halima Tabani, Arnau Benet, Roberto Rodriguez Rubio, Michael T Lawton
Distal middle cerebral artery (MCA) aneurysms often have non-saccular morphology and cannot be clipped, requiring revascularization and trapping instead. Combination bypasses are needed when 2 arteries exit the aneurysm, and extracranial-intracranial and intracranial-intracranial bypasses can be used. This video demonstrates a combination bypass used to treat a previously stented distal MCA aneurysm with both a superficial temporal artery (STA)-to-MCA bypass and an M2-to-M2 reanastomosis. This 56-yr-old man presented with distal left-sided MCA aneurysm 2 years earlier and attempted stent-assisted coiling was aborted after the aneurysm was perforated with stenting alone...
May 12, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29761220/transcriptomic-analysis-of-the-harvested-endothelial-cells-in-a-swine-model-of-mechanical-thrombectomy
#9
Nasren Jaff, Rikard Grankvist, Lars Muhl, Arvin Chireh, Mikael Sandell, Stefan Jonsson, Fabian Arnberg, Ulf Eriksson, Staffan Holmin
PURPOSE: In mechanical thrombectomy (MT) for ischemic stroke, endothelial cells (ECs) from intracranial blood vessels adhere to the stent retriever device and can be harvested. However, understanding the molecular biology and the role of the endothelium in different pathological conditions remains insufficient. The purpose of the study was to characterize and analyze the molecular aspect of harvested ECs using cell culture and transcriptomic techniques in an MT swine model relevant to clinical ischemic stroke...
May 14, 2018: Neuroradiology
https://www.readbyqxmd.com/read/29761219/intracranial-rescue-stent-angioplasty-after-stent-retriever-thrombectomy-multicenter-experience
#10
Robert Forbrig, Hannah Lockau, Fabian Flottmann, Tobias Boeckh-Behrens, Christoph Kabbasch, Maximilian Patzig, Anastasios Mpotsaris, Jens Fiehler, Thomas Liebig, Goetz Thomalla, Oezguer A Onur, Silke Wunderlich, Kornelia Kreiser, Moriz Herzberg, Frank A Wollenweber, Sascha Prothmann, Franziska Dorn
PURPOSE: Stent-retriever thrombectomy (SRT) for acute intracranial large artery occlusion (LAO) may not result in permanent recanalization in rare cases, e.g. due to an underlying stenosis or dissection. In this specific patient group, rescue stent angioplasty (RSA) may be the only treatment option to achieve permanent vessel patency and potentially a good clinical outcome. To date, the experience with RSA is limited. METHODS: In this retrospective analysis, interventional and clinical data of patients with acute intracranial LAO of the anterior and posterior circulation who underwent RSA after SRT due to an underlying lesion between 2012-2017 in four neurovascular centers were studied...
May 14, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29754068/contrast-enhanced-magnetic-resonance-venography-in-the-follow-up-evaluation-of-idiopathic-intracranial-hypertension-patients-with-cerebral-venous-sinus-stenting
#11
Srikanth R Boddu, Pierre Gobin, Cristiano Oliveira, Marc Dinkin, Athos Patsalides
PURPOSE: Role of contrast-enhanced magnetic resonance venography (CE-MRV) in the follow-up of venous sinus stenting (VSS) among the idiopathic intracranial hypertension (IIH) patients. MATERIALS AND METHODS: Prospective evaluation of VSS patients with CE-MRV, DRCV and DSA for follow-up of clinically suspected recurrent stenosis. CE-MRV was evaluated against DRCV and DSA. RESULTS: Ten patients with twelve episodes of recurrent symptoms. Sensitivity, specificity, PPV, NPV and accuracy of the CE-MRV for the detection of recurrent stenosis were: 100%, 33...
May 1, 2018: Clinical Imaging
https://www.readbyqxmd.com/read/29747323/-efficacy-of-bare-metal-stent-for-treating-focal-coronary-artery-aneurysm-complicating-with-severe-stenosis-in-single-coronary-artery
#12
S B Qiao, J Li, J G Cui, J S Yuan, S W Liu, J Zhao, F H Hu, W X Yang, H B Liu, Z W Sun, R L Gao
Objective: To investigate the efficacy of bare metal stent for treating focal coronary artery aneurysm complicating with severe stenosisin single coronary artery. Methods: This retrospective analysis was performed in 7 patients who were diagnosed as local coronary artery aneurysm complicating with severe stenosis(≥70%) in single coronary artery and treated with bare metal stent during the period from December 2012 to June 2015 in Fuwai Hospital. All 7 patients were male with age of (62±11) years old. During the interventional operation, the narrow parts were pre-expanded,and all patients received bare metal stents implantation to cover aneurysms...
April 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29739828/anterior-cerebral-artery-embolism-during-thrombectomy-increases-disability-and-mortality
#13
Vanessa Chalumeau, Raphaël Blanc, Hocine Redjem, Gabriele Ciccio, Stanislas Smajda, Jean-Philippe Desilles, Daniele Botta, Simon Escalard, William Boisseau, Benjamin Maïer, Julien Labreuche, Mickaël Obadia, Michel Piotin, Mikael Mazighi
OBJECTIVE: During thrombectomy, thromboembolic migration in previously unaffected territory may occur and is not systematically notified. We report our data on the incidence, predictors, and clinical outcome of anterior cerebral artery emboli (ACAE). METHODS: From a prospectively collected thrombectomy database of consecutive patients with anterior circulation stroke between January 2012 and December 2016, 690 angiographic images were analyzed to assess ACAE. The primary outcome was a favorable outcome, defined as a 3 month modified Rankin Scale score of 0-2 or equal to the pre-stroke score...
May 8, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29736426/stent-assisted-treatment-of-ruptured-intracranial-aneurysms-in-the-acute-phase-a-single-center-experience
#14
Michael J Ho, Sophia L Göricke, Petra Mummel, Christoph Mönninghoff, Karsten Wrede, Isabel Wanke
Introduction: The purpose of this study was to analyze the results of patients with ruptured aneurysms who were treated with a specific microstent in the acute phase of subarachnoid hemorrhage. Methods: Data from patients with acutely-ruptured intracranial aneurysm treated with the Neuroform stent in the period between 2003 and 2016 were retrospectively assessed, addressing aneurysm occlusion and clinical outcome with a focus on periprocedural complications. Results: Twenty-nine consecutive patients with ruptured intracranial aneurysms were included in the analysis...
March 2018: ENeurologicalSci
https://www.readbyqxmd.com/read/29726291/management-of-acute-tandem-occlusions-stent-retriever-thrombectomy-with-emergency-stenting-or-angioplasty
#15
Wei Li, Zhonglun Chen, Zheng Dai, Rui Liu, Qin Yin, Huaiming Wang, Yonggang Hao, Yunfei Han, Zhongming Qiu, Yunyun Xiong, Wen Sun, Wenjie Zi, Gelin Xu, Xinfeng Liu
Objective To compare outcomes following intracranial stent retriever-based intracranial thrombectomy (SRT) with emergency extracranial internal carotid artery (EICA) stenting or angioplasty alone in patients presenting with acute stroke due to tandem occlusions of the ICA. Methods Consecutive patients with acute anterior tandem occlusion who received an endovascular intervention within 6h of symptom onset between January 2013 and June 2016 were included in this prospective study. Demographic, radiological, procedural and clinical outcome data were compared between the stenting and the angioplasty alone groups...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29720261/efficacy-and-safety-of-adding-rivaroxaban-to-the-anti-platelet-regimen-in-patients-with-coronary-artery-disease-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#16
Jun Yuan
BACKGROUND: Rivaroxaban, a direct factor Xa inhibitor, has seldom been used in patients with coronary artery disease. In this analysis, we aimed to systematically compare the efficacy and safety of rivaroxaban in addition to the anti-platelet regimen in patients with coronary artery disease. METHODS: Online databases (MEDLINE, EMBASE, Cochrane database, www.ClinicalTrials.gov and Google scholar were searched for randomized controlled trials which were exclusively based on patients with coronary artery disease; and which compared efficacy (cardiovascular outcomes) and safety (bleeding outcomes) outcomes with the addition of rivaroxaban to the other anti-platelet agents...
May 2, 2018: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29720021/silk-flow-diverter-stent-for-the-treatment-of-complex-intracranial-aneurysms-a-one-year-follow-up-multicenter-study
#17
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/29719557/stent-reconstruction-of-carotid-tonsillar-loop-dissection-using-telescoping-peripheral-stents
#18
Benjamin M Zussman, Bradley A Gross, William J Ares, Cynthia L Kenmuir, Gregory M Weiner, David M Panczykowski, Ashutosh P Jadhav, Tudor G Jovin, Brian T Jankowitz
Background: Endovascular treatment options for internal carotid artery (ICA) dissection with tandem intracranial occlusion are evolving. We report 2 cases of stent reconstruction of carotid loop dissections. Methods: Two patients with symptomatic ICA dissections of true 360° tonsillar loops and tandem intracranial occlusions were treated with manual aspiration thrombectomy (MAT) and telescoping Zilver self-expanding peripheral stents. Patient demographics, clinical presentations, endovascular techniques, and clinical outcomes were reviewed...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29706606/angioplasty-and-stenting-for-symptomatic-extracranial-non-tandem-internal-carotid-artery-occlusion
#19
Ashutosh Jadhav, David Panczykowski, Mouhammad Jumaa, Amin Aghaebrahim, Manasa Ranginani, Felix Nguyen, Shashvat M Desai, Ramesh Grandhi, Andrew Ducruet, Bradley A Gross, Brian Thomas Jankowitz, Tudor G Jovin
INTRODUCTION: Symptomatic internal carotid artery occlusion (ICAO) can lead to neurologic decline, recurrent stroke, and mortality. OBJECTIVE: We sought to evaluate the safety and feasibility of endovascular revascularization for ICAO without tandem intracranial large vessel occlusion (LVO). DESIGN, SETTING, AND PARTICIPANTS: This is a retrospective cohort analysis of all patients presenting to a single academic center with ischemic stroke and ipsilateral cervical ICAO from November 2003 through April 2016...
April 29, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29706296/stent-retriever-thrombectomy-for-acute-ischemic-stroke-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials-including-thrace
#20
M Barral, S Boudour, M Viprey, C Giroudon, G Aulagner, A-M Schott, F Turjman, X Armoiry, B Gory
BACKGROUND AND PURPOSE: Endovascular thrombectomy has become the reference therapy for patients with large vessel occlusion (LVO). However, no meta-analysis including the THRACE Trial has yet been reported. Thus, the present review assessed the outcomes of stent retriever thrombectomy added to medical care compared with medical care alone in LVO patients. MATERIALS AND METHODS: A systematic review was conducted of all randomized controlled trials (RCTs) examining stent retrievers added to medical care vs medical care alone in the MEDLINE, Embase and Web of Science databases...
April 26, 2018: Revue Neurologique
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