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https://www.readbyqxmd.com/read/29783870/safety-and-efficacy-of-a-new-outreach-distal-access-catheter-tactics-for-coil-embolization-of-unruptured-intracranial-aneurysms
#1
Toshinori Matsushige, Shigeyuki Sakamoto, Daizo Ishii, Katsuhiro Shinagawa, Koji Shimonaga, Masahiro Hosogai, Tomohiro Kawasumi, Junpei Oshita, Takahito Okazaki, Kaoru Kurisu
Background and purpose Current large-bore catheters can be easily and safely placed in the intracranial vessels for the stabilization of microcatheters in several neurointervention scenarios. We considered that a novel 3.4 French catheter (TACTICS, Technorat Corporation, Aichi, Japan) might be useful for intermediate/distal access in a triaxial system. Here, we present our initial experience using the TACTICS catheter for treatment of intracranial aneurysms. Materials and methods A total of 35 endovascular coils were placed to embolize unruptured intracranial aneurysms of the anterior circulation using the TACTICS catheter between December 2016 and November 2017...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29781370/re-treatment-of-an-unruptured-anterior-communicating-artery-aneurysm-using-the-new-pconus-2-device-description-of-a-case
#2
Marco Varrassi, Sergio Carducci, Aldo V Giordano, Carlo Masciocchi
Endovascular approach represents today the first option in treatment of ruptured and unruptured cerebral aneurysms. Nevertheless, wide-neck bifurcation aneurysms still represent a technical challenge for endovascular treatment due to the need to protect vessels arising next to the aneurysmal neck. A variety of devices have been implemented to ensure adequate assistance for coiling of these lesions. Among these devices, the new pCONus 2 represents an evolution of the well-known pCONus; compared to the previous one in fact, it allows a degree of articulation and flexibility between the shaft and the distal part (crown), making it more suitable for treatment of aneurysms presenting an angle between the longitudinal axis of the dome and parent vessel...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29778996/stent-and-flow-diverter-assisted-treatment-of-acutely-ruptured-brain-aneurysms
#3
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/29778598/relevance-of-antiplatelet-therapy-duration-after-stent-assisted-coil-embolization-for-unruptured-intracranial-aneurysms
#4
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/29775150/computer-aided-analysis-of-middle-cerebral-artery-tortuosity-association-with-aneurysm-development
#5
Kornelia M Kliś, Roger M Krzyżewski, Borys M Kwinta, Krzysztof Stachura, Marek Moskała, Krzysztof A Tomaszewski
OBJECTIVE Blood vessel tortuosity may play an important role in the development of vessel abnormalities such as aneurysms. Currently, however, there are no studies analyzing the impact of brain blood vessel tortuosity on the risk of aneurysm formation. Therefore, the authors performed a computer-aided analysis of middle cerebral artery (MCA) tortuosity, especially among patients diagnosed with MCA aneurysms. METHODS Anatomy of the MCAs of 54 patients with unruptured MCA aneurysms was retrospectively analyzed, as was that of 54 sex-, age-, and vessel side-matched control patients without MCA aneurysms...
May 18, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29768963/the-woven-endobridge-web-as-primary-treatment-for-unruptured-intracranial-aneurysms
#6
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/29767773/aneurysm-size-is-the-strongest-risk-factor-for-intracranial-aneurysm-growth-in-the-eastern-finnish-population
#7
Joel Björkman, Juhana Frösen, Olli Tähtinen, Terhi Huttunen, Jukka Huttunen, Mitja I Kurki, Mikael von Und Zu Fraunberg, Timo Koivisto, Hannu Manninen, Juha E Jääskeläinen, Antti E Lindgren
BACKGROUND: Saccular intracranial aneurysm (sIA) growth during follow-up is associated with high risk for subsequent rupture. Finnish patients have been suggested to have higher risk for subarachnoid hemorrhage, but follow-up studies of sIA growth in the Finnish population are scarce. OBJECTIVE: To identify the strongest risk factors for sIA growth in Eastern Finnish population by studying 205 patients with 350 unruptured sIAs with angiographic follow-up imaging...
May 15, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29765397/lvis-jr-device-for-y-stent-assisted-coil-embolization-of-wide-neck-intracranial-aneurysms-a-multicenter-experience
#8
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/29764285/expressions-of-eotaxin-3-interleukin-5-and-eosinophil-derived-neurotoxin-in-chronic-subdural-hematoma-fluids
#9
Reo Kawaguchi, Koji Osuka, Masahiro Aoyama, Shigeru Miyachi, Masakazu Takayasu
Eosinophils induce inflammation by releasing cytokines and cytotoxic granule proteins. Infiltration of eosinophilic granulocytes occurs in the outer membrane of chronic subdural hematomas (CSDHs). Eosinophils play an important role in the growth of CSDHs. However, the manner in which eosinophils accumulate within CSDH fluid remains undetermined. In the current study, we assessed the expression of eosinophil chemoattractants in CSDH fluids according to the growth stage of the CSDHs and examined the correlation between the two...
May 15, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29764206/management-of-incidental-aneurysms-comparison-of-single-centre-multi-disciplinary-team-decision-making-with-the-unruptured-incidental-aneurysm-treatment-score
#10
Alex Smedley, Nate Yusupov, Alaa Almousa, Thomas Solbach, Ahmed K Toma, Joan P Grieve
OBJECTIVE: To compare multidisciplinary team (MDT) decision making at our centre with the suggested management from the recently published Unruptured Intracranial Aneurysm Treatment Score (UIATS), with particular focus on disagreements between the two bodies of expert opinion. DESIGN: A retrospective audit of local practice. SUBJECTS: Adult patients with incidental cerebral saccular aneurysms referred to The National Hospital for Neurology and Neurosurgery Neurovascular MDT...
May 15, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29764034/-application-of-low-profile-visualized-intraluminal-support-lvis-stents-in-assisting-coil-embolization-of-intracranial-aneurysms
#11
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/29760311/postoperative-subdural-air-collection-is-a-risk-factor-for-chronic-subdural-hematoma-after-surgical-clipping-of-cerebral-aneurysms
#12
Shuhei Kawabata, Shoichi Tani, Hirotoshi Imamura, Hidemitsu Adachi, Nobuyuki Sakai
The precise mechanism of the development of chronic subdural hematoma (CSDH) as a postoperative complication after aneurysmal clipping remains unclear. The purpose of this study was to identify the independent risk factors for CSDH after craniotomy for aneurysmal clipping and to elucidate the relationship between CSDH and subdural air (SDA) collection immediately after surgery. The medical records and radiologic data of 344 patients who underwent surgical clipping of unruptured aneurysms from July 2010 to July 2016 were retrospectively evaluated...
May 11, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29749361/risk-factors-for-ruptured-intracranial-aneurysms
#13
Guang-Xian Wang, Dong Zhang, Zhi-Ping Wang, Liu-Qing Yang, Hua Yang, Wen Li
Background & objectives: The treatment of unruptured intracranial aneurysms (IAs) remains controversial; the ability to predict the risk of rupture for an aneurysm would be of clinical value. The aim of this study was to determine and evaluate the predictive value of the risk factors of IA rupture. Methods: This retrospective study involved 379 consecutive patients with 441 aneurysms between August 2011 and July 2014. Based on clinical data and computed tomography angiography findings, the potential of risk factors to predict the aneurysmal rupture was assessed using statistical methods...
January 2018: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/29741656/differences-in-pressure-within-the-sac-of-human-ruptured-and-nonruptured-cerebral-aneurysms
#14
Yiping Li, Mark Corriveau, Beverly Aagaard-Kienitz, Azam Ahmed, David Niemann
BACKGROUND: Hemodynamics plays a critical role in the development, growth, and rupture of intracranial aneurysms. This data could be vital in determining individual aneurysm rupture risk and could facilitate our understanding of aneurysms. OBJECTIVE: To present the largest prospective cross-sectional cohort study of intrasaccular pressure recordings of ruptured and nonruptured intracranial aneurysms and describe the hemodynamic differences that exist between ruptured and nonruptured aneurysms...
May 8, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29741225/prediction-of-vascular-abnormalities-on-ct-angiography-in-patients-with-acute-headache
#15
Imanda M E Alons, Ben F J Goudsmit, Korné Jellema, Marianne A A van Walderveen, Marieke J H Wermer, Ale Algra
OBJECTIVES: Patients with acute headache increasingly undergo CT-angiography (CTA) to evaluate underlying vascular causes. The aim of this study is to determine clinical and non-contrast CT (NCCT) criteria to select patients who might benefit from CTA. METHODS: We retrospectively included patients with acute headache who presented to the emergency department of an academic medical center and large regional teaching hospital and underwent NCCT and CTA. We identified factors that increased the probability of finding a vascular abnormality on CTA, performed multivariable regression analyses and determined discrimination with the c-statistic...
May 9, 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29730098/subdural-fluid-collection-after-the-clipping-of-unruptured-intracranial-aneurysms-its-clinical-course-and-significance
#16
Jeong-Han Kang, Seung Kon Huh, Jinna Kim, Keun Young Park, Joonho Chung
OBJECT: We evaluated the clinical course and significance of postoperative subdural fluid collection (SFC), and identified the patients who were at risk of developing postoperative chronic subdural hematoma (CSDH) after the clipping of unruptured intracranial aneurysms (UIAs). METHODS: Between January 2012 and June 2014, we retrospectively reviewed 298 patients with UIAs treated by microsurgical clipping. Among them, 257 patients were enrolled in the present study...
May 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29729990/quantitative-proteomics-analysis-of-differentially-expressed-proteins-in-ruptured-and-unruptured-cerebral-aneurysms-by-itraq
#17
Pengjun Jiang, Jun Wu, Xin Chen, Bo Ning, Qingyuan Liu, Zhengsong Li, Maogui Li, Fan Yang, Yong Cao, Rong Wang, Shuo Wang
The underlying pathophysiological mechanisms involved in cerebral aneurysms rupture remain unclear. This study was performed to investigate the differentially expressed proteins between ruptured and unruptured aneurysms using quantitative proteomics. The aneurysmal walls of six ruptured aneurysms and six unruptured aneurysms were collected during the surgical operation. The isobaric tags for relative and absolute quantification (iTRAQ) were used to identify the differentially expressed proteins and western blotting was performed to validate the expression of the proteins of interest...
May 3, 2018: Journal of Proteomics
https://www.readbyqxmd.com/read/29726776/the-25th-anniversary-of-the-retrograde-suction-decompression-technique-dallas-technique-for-the-surgical-management-of-paraclinoid-aneurysms-historical-background-systematic-review-and-pooled-analysis-of-the-literature
#18
Bruno C Flores, Jonathan A White, H Hunt Batjer, Duke S Samson
OBJECTIVE Paraclinoid internal carotid artery (ICA) aneurysms frequently require temporary occlusion to facilitate safe clipping. Brisk retrograde flow through the ophthalmic artery and cavernous ICA branches make simple trapping inadequate to soften the aneurysm. The retrograde suction decompression (RSD), or Dallas RSD, technique was described in 1990 in an attempt to overcome some of those treatment limitations. A frequent criticism of the RSD technique is an allegedly high risk of cervical ICA dissection...
May 4, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29725569/nontraumatic-acetabular-fracture-sustained-during-convulsive-seizure-following-surgery-for-an-unruptured-intracranial-aneurysm-a-case-report
#19
Hirofumi Iwamoto, Kazuhiro Nakamura, Daisuke Watanabe, Kiyoyuki Yanaka, Takeshi Ainoya, Tetsuya Yamamoto
Acetabular fracture usually is related to high-energy traumatic injury or falls from heights and directly caused by seizures without trauma is extremely rare. We report a 71-years-old man who sustained a left acetabular fracture secondary to generalized seizure after clipping of an unruptured aneurysm without trauma and any risk for fracture. The patient had an aneurysm was arising from the bifurcation of the left internal carotid artery and the posterior communicating artery. After the clipping, the patient had three times tonic-clonic seizures for 1 min and resulted in an acetabular fracture...
April 2018: NMC Case Report Journal
https://www.readbyqxmd.com/read/29719303/acute-obstructive-hydrocephalus-due-to-a-giant-posterior-cerebral-artery-aneurysm-in-a-pediatric-patient
#20
Can Sarica, Bahattin Tanrikulu, Yener Sahin, Adnan Dağçınar, Feyyaz Baltacioglu, Yasar Bayri
INTRODUCTION: Intracranial aneurysms are very rare in children. Although subarachnoidal hemorrhage (SAH) is by far the most common presentation of aneurysms in the majority of the pediatric case series, it is not rare for an unruptured aneurysm to present with a mass effect. Acute hydrocephalus is a common finding following aneurysmal SAH. However, this malady may develop even in the absence of SAH but secondary to direct obstruction by a giant aneurysm. This situation is extremely rare in children, with only a few known case reports in the literature...
May 2, 2018: Pediatric Neurosurgery
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