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Flow diverter OR flow diverting OR flow diversion AND aneurysm

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https://www.readbyqxmd.com/read/29765391/abciximab-reopro-dosing-strategy-for-the-management-of-acute-intraprocedural-thromboembolic-complications-during-pipeline-flow-diversion-treatment-of-intracranial-aneurysms
#1
Li-Mei Lin, Bowen Jiang, Jessica K Campos, Narlin B Beaty, Matthew T Bender, Rafael J Tamargo, Judy Huang, Geoffrey P Colby, Alexander L Coon
Background: Flow diversion with the Pipeline embolization device (PED) is an effective neuro-endovascular method and increasingly accepted for the treatment of cerebral aneurysms. Acute in situ thrombosis is a known complication of PED procedures. There is limited experience in the flow diversion literature on the use of abciximab (ReoPro) for the management of acute thrombus formation in PED cases. Methods: Data were collected retrospectively on patients who received intra-arterial (IA) ReoPro with or without subsequent intravenous (IV) infusion during PED flow diversion treatment of intracranial aneurysms...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29754516/acute-retinal-hemorrhage-after-pipeline-embolization-device-placement-for-treatment-of-ophthalmic-segment-aneurysm-a-case-report
#2
Nimer Adeeb, Justin Moore, Christoph J Griessenauer, Raghav Gupta, Ahad A Fazelat, Christopher S Ogilvy, Ajith J Thomas
Introduction Ophthalmic segment aneurysms may present with visual symptoms due to direct compression of the optic nerve. Treatment of these aneurysms with the Pipeline embolization device (PED) often results in visual improvement. Flow diversion, however, has also been associated with occlusion of the ophthalmic artery and visual deficits in a small subset of cases. Case report A 49-year-old Caucasian female presented with subarachnoid hemorrhage due to a ruptured anterior communicating artery aneurysm. On follow-up imaging, the patient was found to have a right asymptomatic ophthalmic segment aneurysm...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29751179/treatment-of-small-and-tiny-aneurysms-before-and-after-flow-diversion-era-a-single-center-experience-of-409-aneurysms
#3
Yuxiang Zhang, Yupeng Zhang, Feng Guo, Fei Liang, Peng Yan, Shikai Liang, Chuhan Jiang
OBJECT: To explore whether we should use PED as primary treatment modality for small and tiny aneurysms at anterior circulation. METHOD: This retrospective study included 409 cases of small and tiny aneurysms including aneurysms treated by PED (n=77), coiling (n=51) and SAC (n=281). We also made a comparison regarding the safety and efficacy among these treatment modality. RESULTS: A total of 55 patients with 77 small aneurysms was treated with PEDs...
May 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29726768/pipeline-embolization-of-posterior-circulation-aneurysms-a-multicenter-study-of-131-aneurysms
#4
Christoph J Griessenauer, Christopher S Ogilvy, Nimer Adeeb, Adam A Dmytriw, Paul M Foreman, Hussain Shallwani, Nicola Limbucci, Salvatore Mangiafico, Ashish Kumar, Caterina Michelozzi, Timo Krings, Vitor Mendes Pereira, Charles C Matouk, Mark R Harrigan, Hakeem J Shakir, Adnan H Siddiqui, Elad I Levy, Leonardo Renieri, Thomas R Marotta, Christophe Cognard, Ajith J Thomas
OBJECTIVE Flow diversion for posterior circulation aneurysms performed using the Pipeline embolization device (PED) constitutes an increasingly common off-label use for otherwise untreatable aneurysms. The safety and efficacy of this treatment modality has not been assessed in a multicenter study. METHODS A retrospective review of prospectively maintained databases at 8 academic institutions was performed for the years 2009 to 2016 to identify patients with posterior circulation aneurysms treated with PED placement...
May 4, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29719553/47-consecutive-cases-of-pipeline-flex-flow-diversion-utilizing-a-novel-large-bore-intracranial-intermediate-catheter-nuances-and-institutional-experience-with-the-syphontrak
#5
Li-Mei Lin, Bowen Jiang, Matthew T Bender, Erick M Westbroek, Jessica K Campos, Rafael J Tamargo, Judy Huang, Alexander L Coon, Geoffrey P Colby
Background: The increasing complexity of modern neurointerventions has necessitated a shift in intracranial access techniques towards more robust distal support platforms. Here we present our experience with the Syphontrak Support Catheter (Codman Neuro, Raynham, MA, USA) in the triaxial platform for the implantation of the second-generation Pipeline Flex embolization device (PED Flex; Medtronic Neurovascular, Irvine, CA, USA). Methods: We retrospectively identified patients who underwent PED Flex treatment utilizing the Syphontrak at a single institution...
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
#6
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/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/29660038/external-ventricular-drain-and-hemorrhage-in-aneurysmal-subarachnoid-hemorrhage-patients-on-dual-antiplatelet-therapy-a-retrospective-cohort-study
#8
Joseph S Hudson, Benjamin S Prout, Yasunori Nagahama, Daichi Nakagawa, Waldo R Guerrero, Mario Zanaty, Nohra Chalouhi, Pascal Jabbour, Sudeepta Dandapat, Lauren Allan, Santiago Ortega-Gutierrez, Edgar A Samaniego, David Hasan
BACKGROUND: Stenting and flow diversion for aneurysmal sub arachnoid hemorrhage (aSAH) require the use of dual antiplatelet therapy (DAPT). OBJECTIVE: To investigate whether DAPT is associated with hemorrhagic complication following placement of external ventricular drains (EVD) in patients with aSAH. METHODS: Rates of radiographically identified hemorrhage associated with EVD placement were compared between patients who received DAPT for stenting or flow diversion, and patients who underwent microsurgical clipping or coiling and did not receive DAPT by way of a backward stepwise multivariate analysis...
April 11, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29650782/treatment-of-distal-anterior-cerebral-artery-aneurysms-with-flow-diverter-stents-a-single-center-experience
#9
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/29628950/safety-assessment-of-endovascular-treatment-of-cerebral-aneurysms-in-patients-with-fibromuscular-dysplasia
#10
Matthew T Bender, Christopher Hurtado, Bowen Jiang, Jessica K Campos, Judy Huang, Rafael J Tamargo, Li-Mei Lin, Alexander L Coon, Geoffrey P Colby
Background: The prevalence of cerebral aneurysms is increased in fibromuscular dysplasia (FMD). The presence of FMD may serve as discouragement to elective endovascular aneurysm treatment. Outcomes of endovascular intervention for aneurysms through vessels affected by FMD have not been reported. Methods: A prospectively maintained database of patients undergoing intracranial embolization was reviewed for patients with FMD who underwent endovascular aneurysm treatment...
February 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29626682/patterns-predictors-and-outcomes-of-post-procedure-delayed-hemorrhage-following-flow-diversion-for-intracranial-aneurysm-treatment
#11
A C White, D A Kumpe, C D Roark, D E Case, J Seinfeld
PURPOSE: To evaluate patterns, predictors, and outcomes of post procedure delayed hemorrhage (PPDH) following flow diversion therapy for intracranial aneurysm. METHODS: 50 patients with 52 aneurysms were treated from 2012-2016 with the Pipeline Embolization Device (PED; Medtronic, Minneapolis, MN). PED placement was performed as a standalone therapy or with adjunctive coil embolization. Patients underwent dual antiplatelet therapy (DAT) for 6 months following treatment...
April 4, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29608702/flow-diversion-of-posterior-circulation-cerebral-aneurysms-a-single-institution-series-of-59-cases
#12
Matthew T Bender, Geoffrey P Colby, Bowen Jiang, Li-Mei Lin, Jessica K Campos, Risheng Xu, Erick M Westbroek, Chau D Vo, David A Zarrin, Justin M Caplan, Judy Huang, Rafael J Tamargo, Alexander L Coon
BACKGROUND: Posterior circulation cerebral aneurysms are at higher risk of rupture and are more symptomatic than those in the anterior circulation. Existing treatments carry significant morbidity. Early reports of flow diversion for posterior circulation aneurysms have suggested high complication and low occlusion rates. OBJECTIVE: To report safety and efficacy of flow diversion with the pipeline embolization device (ev3, Medtronic Inc, Dublin, Ireland) for aneurysms located throughout the posterior circulation...
March 28, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29605278/rare-case-of-diffuse-spinal-arachnoiditis-following-a-complicated-vertebral-artery-dissection
#13
Elias Atallah, Sophia Dang, Sage Rahm, James Feghali, Chalouhi Nohra, Stavropoula Tjoumakaris, Robert H Rosenwasser, Hekmat Zarzour, Nabeel Herial, Michael Reid Gooch, Pascal Jabbour
Spinal arachnoiditis (SA) is an extremely rare and delayed complication of subarachnoid hemorrhage (SAH). Little is known about its underlying pathogenesis and subsequent clinical course. A middle-aged patient presented with the worst headache of her life and a grade 3 SAH of the basal-cisterns and posterior fossa was identified on Computed Tomography scans (CT). Angiography revealed a ruptured dissecting aneurysm of the left vertebral artery (VA-V4), as well as an unruptured left Anterior Cerebral Artery (ACA-A1) aneurysm...
March 28, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29602477/flow-instability-detected-in-ruptured-versus-unruptured-cerebral-aneurysms-at-the-internal-carotid-artery
#14
Lijian Xu, Fuyou Liang, Lixu Gu, Hao Liu
Flow instability has emerged as a new hemodynamic metric hypothesized to have potential value in assessing the rupture risk of cerebral aneurysms. However, diverse findings have been reported in the literature. In the present study, high-resolution hemodynamic simulations were performed retrospectively on 35 aneurysms (10 ruptured & 25 unruptured) located at the internal carotid artery (ICA). Simulated hemodynamic parameters were statistically compared between the ruptured and unruptured aneurysms, with emphasis on examining the correlation of flow instability with the status of aneurysm rupture...
March 15, 2018: Journal of Biomechanics
https://www.readbyqxmd.com/read/29600915/predictors-of-cerebral-aneurysm-persistence-and-occlusion-after-flow-diversion-a-single-institution-series-of-445-cases-with-angiographic-follow-up
#15
Matthew T Bender, Geoffrey P Colby, Li-Mei Lin, Bowen Jiang, Erick M Westbroek, Risheng Xu, Jessica K Campos, Judy Huang, Rafael J Tamargo, Alexander L Coon
OBJECTIVE Flow diversion requires neointimal stent overgrowth to deliver aneurysm occlusion. The existing literature on aneurysm occlusion is limited by heterogeneous follow-up, variable antiplatelet regimens, noninvasive imaging modalities, and nonstandard occlusion assessment. Using a large, single-center cohort with low attrition and standardized antiplatelet tapering, the authors evaluated outcomes after flow diversion of anterior circulation aneurysms to identify predictors of occlusion and aneurysm persistence...
March 30, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29572267/long-term-visual-outcome-in-patients-treated-by-flow-diversion-for-carotid-ophthalmic-aneurysms
#16
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
https://www.readbyqxmd.com/read/29563212/unexpected-early-radiographic-findings-associated-with-a-ruptured-blister-like-carotid-wall-aneurysm
#17
James L West, Jasmeet Singh, Stacey Q Wolfe, Kyle M Fargen
A 33-year-old man presented with aneurysmal subarachnoid hemorrhage from a ruptured, blister-type sidewall internal carotid artery (ICA) aneurysm. Balloon-assisted coiling was performed with residual neck. He subsequently developed severe vasospasm requiring intra-arterial therapies on multiple occasions, during which it was noted that despite widespread vasospasm, a focal segment of the ICA at the site of the aneurysm showed no significant spasm, suggesting underlying vessel abnormality. He was discharged without deficit and scheduled for flow diversion given concern over this potentially pathologic segment of vessel...
March 21, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29548957/endovascular-treatment-of-posterior-inferior-cerebellar-artery-aneurysms-with-flow-diversion
#18
Adam Nathan Wallace, Mudassar Kamran, Thomas P Madaelil, Yasha Kayan, Joshua W Osbun, Anil K Roy, Josser E Delgado Almandoz, Christopher J Moran, Brian Howard, Junaid Yasin, Jonathan A Grossberg
No abstract text is available yet for this article.
March 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29545248/endovascular-treatment-of-very-large-and-giant-intracranial-aneurysms-comparison-between-reconstructive-and-deconstructive-techniques-a-meta-analysis
#19
F Cagnazzo, D Mantilla, A Rouchaud, W Brinjikji, P-H Lefevre, C Dargazanli, G Gascou, C Riquelme, P Perrini, D di Carlo, A Bonafe, V Costalat
BACKGROUND: The safety and efficacy of reconstructive and deconstructive endovascular treatments of very large/giant intracranial aneurysms are not completely clear. PURPOSE: Our aim was to compare treatment-related outcomes between these 2 techniques. DATA SOURCES: A systematic search of 3 data bases was performed for studies published from 1990 to 2017. STUDY SELECTION: We selected series of reconstructive and deconstructive treatments with >10 patients...
March 15, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29535900/kinking-of-flow-diverter-in-a-giant-wide-necked-supraclinoid-internal-carotid-artery-aneurysm
#20
Soumik Das, Arun Kumar Gupta, Arvinda Hanumathapura Ramalingiah
We report here a rare complication in the form of kinking of flow diverter in a case of giant wide-necked supraclinoid internal carotid artery (ICA) aneurysm 48 hours after the procedure. This 28-year female presented with giant wide-necked right supraclinoid ICA aneurysm which was managed by flow diversion. On 2nd post-op day, patient developed weakness of left side with altered sensorium - angiography and CT showed kinking of flow diverter at the neck of the aneurysm with poor distal flow. Eventually, the patient developed right middle cerebral artery infarct for which decompressive hemicraniectomy was done...
March 2018: Neurointervention
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