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Flow diverter OR flow diverting OR flow diversion AND aneurysm

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https://www.readbyqxmd.com/read/28712903/multimodality-treatment-of-posterior-inferior-cerebellar-artery-aneurysms
#1
Justin R Mascitelli, Kurt Yaeger, Daniel Wei, Christopher P Kellner, Thomas J Oxley, Reade A De Leacy, Johanna T Fifi, Aman B Patel, Thomas P Naidich, Joshua B Bederson, J Mocco
OBJECT: Posterior inferior cerebellar artery (PICA) aneurysms are heterogeneous, uncommon lesions that can be treated in many fashions. Many previous series have focused on a specific aneurysm subset or treatment paradigm. The aim of this study was to present a comprehensive approach for all PICA aneurysms and analyze outcomes by PICA location. METHODS: All PICA aneurysms treated from 2012 until present were reviewed retrospectively and classified by location. Angiographic and clinical outcome were assessed...
July 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28710081/use-of-a-next-generation-multi-durometer-long-guide-sheath-for-triaxial-access-in-flow-diversion-experience-in-95-consecutive-cases
#2
Li-Mei Lin, Matthew T Bender, Geoffrey P Colby, Narlin B Beaty, Bowen Jiang, Jessica K Campos, Judy Huang, Rafael J Tamargo, Alexander L Coon
BACKGROUND: Intracranial access techniques in modern neurointerventions have shifted towards more robust access platforms. The long guide sheath is one of the building blocks of triaxial systems used in intracranial embolizations. Here we present our experience with the AXS Infinity LS long sheath in the triaxial platform for the implantation of the Pipeline embolization device (PED). METHODS: We retrospectively identified patients who underwent PED Flex treatment with the AXS Infinity LS at a single institution...
July 14, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28692909/pipeline-embolization-of-posterior-communicating-artery-aneurysms-associated-with-a-fetal-origin-posterior-cerebral-artery
#3
Adam N Wallace, Yasha Kayan, Matthew J Austin, Josser E Delgado Almandoz, Mudassar Kamran, DeWitte T Cross, Christopher J Moran, Joshua W Osbun, Akash P Kansagra
BACKGROUND AND PURPOSE: Flow diversion may have advantages in the treatment of posterior communicating artery (PComA) aneurysms associated with a fetal origin posterior cerebral artery (PCA), which can be challenging to treat with conventional techniques. However, a PComA incorporated into the aneurysm may prevent or delay aneurysm occlusion. Also, coverage of a fetal origin PCA risks infarction of a large vascular territory. The purpose of this study was to examine the safety and effectiveness of using the Pipeline Embolization Device (PED) to treat PComA aneurysms associated with a fetal origin PCA...
June 27, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28611839/utilization-of-a-novel-multi-durometer-intracranial-distal-access-catheter-nuances-and-experience-in-110-consecutive-cases-of-aneurysm-flow-diversion
#4
Geoffrey P Colby, Li-Mei Lin, Risheng Xu, Narlin Beaty, Matthew T Bender, Bowen Jiang, Judy Huang, Rafael J Tamargo, Alexander L Coon
BACKGROUND: Coaxial catheter support systems provide a safe and stable foundation in endovascular treatment of intracranial aneurysms. Increasingly, robust distal intracranial support is sought during complex neurointerventions. The AXS Catalyst 5 distal access catheter (Cat5) is a new intracranial catheter designed for improved trackability and stability. We report the first experience using Cat5 for aneurysm treatment by flow diversion. METHODS: A single-center aneurysm database was reviewed for cases of aneurysm treatment with the Pipeline embolization device (PED) that utilized Cat5...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28611831/salvage-of-herniated-flow-diverters-using-stent-and-balloon-anchoring-techniques-a-technical-note
#5
Bharathi D Jagadeesan, Divyajot Sandhu, Kim Jae Hong, Sara Roshan Khanipour, Andrew W Grande, Ramachandra P Tummala
BACKGROUND: The pipeline embolization device (PED; Medtronic, MN, USA) can sometimes herniate into the aneurysmal sac in an unexpected manner during or shortly after its deployment due to device foreshortening. In this report, we describe 2 endovascular techniques, which can be used to reposition a herniated PED construct into a more favorable alignment. SUMMARY: In a 67-year-old patient who had an intraprocedural herniation of a PED device into a giant cavernous aneurysm, a stent anchor technique was used to reverse the herniation, reorient the PED construct, and achieve successful flow diversion...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28610970/internal-maxillary-artery-bypass-with-radial-artery-graft-treatment-of-giant-intracranial-aneurysms
#6
Long Wang, Shuaibin Lu, Hai Qian, Xiang'en Shi
BACKGROUND: Giant intracranial aneurysms (GIAs) can be approached via microsurgical and endovascular techniques. Utilization of flow diversion devices (FDDs) has yielded favorable outcomes, and indications for cerebral revascularization have dramatically decreased. OBJECTIVE: To evaluate the safety and validity of using internal maxillary artery (IMA) bypass with an interposed graft to treat GIAs. METHODS: During a 6-year period, high-flow IMA bypass procedures were performed in 32 patients with GIAs at our institute...
June 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28604187/in%C3%A2-vitro-digital-subtraction-angiographic-evaluation-of-flow-diverters-in-a-patient-specific-aneurysm
#7
Liang-Der Jou
Background The importance of both porosity and pore density of a flow diverter is well recognized in treatment of intracranial aneurysms; however, understanding of the effect of individual wire (wire number and size) is critical in improving device design and use. Methods A total of 10 multi-layered flow diverters with different wire numbers (32, 48, 56, and 72) and sizes (30, 35, and 40 µm) were implanted into identical patient-specific middle cerebral artery aneurysm models. Digital subtraction angiography was acquired at 30 f/s and X-ray signals at three selected regions of interest were compared to determine the amount of intra-aneurysmal flow...
June 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28600012/flow-diversion-after-aneurysmal-subarachnoid-hemorrhage
#8
REVIEW
Sabareesh K Natarajan, Hussain Shallwani, Vernard S Fennell, Jeffrey S Beecher, Hakeem J Shakir, Jason M Davies, Kenneth V Snyder, Adnan H Siddiqui, Elad I Levy
Flow diversion after aneurysmal subarachnoid hemorrhage (SAH) is the last treatment option for aneurysm occlusion when other methods of aneurysm treatment cannot be used because of the need for dual antiplatelet therapy. The authors' general protocol for treatment selection after aneurysmal SAH is provided to share with readers our approach to securing the aneurysm before embarking flow diversion for primary treatment or delayed adjunctive treatment to primary coiling. The authors' experience with flow diversion after aneurysmal SAH, review of pertinent literature, and the future of flow diversion after aneurysmal SAH are discussed...
July 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28598274/evaluation-of-ischemic-lesion-prevalence-after-endovascular-treatment-of-intracranial-aneurysms-as-documented-by-3-t-diffusion-weighted-imaging-a-2-year-single-center-cohort-study
#9
Christina Iosif, Jean-Christophe Lecomte, Eduardo Pedrolo-Silveira, George Mendes, Marie-Paule Boncoeur Martel, Suzana Saleme, Charbel Mounayer
OBJECTIVE Even though published data exist concerning the prevalence of ischemic lesions detected by diffusion-weighted imaging (DWI) following endovascular treatment of intracranial aneurysms, a single-center cross-evaluation of the different endovascular techniques has been lacking. The authors sought to prospectively evaluate the prevalence and clinical significance of ischemic lesions occurring after endovascular treatment of intracranial aneurysms and to compare the safety and effectiveness of a broad spectrum of currently accepted endovascular techniques in a single-center setting...
June 9, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28576622/haemodynamic-effects-of-stent-diameter-and-compaction-ratio-on-flow-diversion-treatment-of-intracranial-aneurysms-a-numerical-study-of-a-successful-and-an-unsuccessful-case
#10
Mingzi Zhang, Yujie Li, Xi Zhao, David I Verrelli, Winston Chong, Makoto Ohta, Yi Qian
BACKGROUND: Compacting a flow-diverting (FD) stent is an emerging technique to create a denser configuration of wires across the aneurysm ostium. However, quantitative analyses of post-stenting haemodynamics affected by the compaction level of different stent sizes remain inconclusive. OBJECTIVE: To compare the aneurysmal haemodynamic alterations after virtual FD treatments with different device diameters at different compaction ratios. METHODS: We virtually implanted three sizes of FD stent, with each size deployed at four compaction ratios, into two patient aneurysms previously treated with the Silk+FD-one successful case and the other unsuccessful...
May 16, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28565992/pipeline-flow-diversion-of-ruptured-blister-aneurysms-of-the-supraclinoid-carotid-artery-using-a-single-device-strategy
#11
Robert W Ryan, Amir S Khan, Rebecca Barco, Armen Choulakian
OBJECTIVE Ruptured blister aneurysms remain challenging lesions for treatment due to their broad, shallow anatomy and thin, fragile wall. Historical challenges with both open microsurgical approaches and intrasaccular endovascular approaches have led to increased use of flow diversion for management of these aneurysms. However, the optimum paradigm, including timing of treatment, use of dual antiplatelet therapy, and number of flow-diverter devices to use remains unknown. The authors describe their experience with ruptured blister aneurysms treated with flow diversion at their institution, and discuss rates of rebleeding and number of devices used...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28565989/pipeline-embolization-device-for-recurrence-of-previously-treated-aneurysms
#12
David Dornbos, Constantine L Karras, Nicole Wenger, Blake Priddy, Patrick Youssef, Shahid M Nimjee, Ciarán J Powers
OBJECTIVE The utilization of the Pipeline embolization device (PED) has increased significantly since its inception and original approval for use in large, broad-necked aneurysms of the internal carotid artery. While microsurgical clipping and advances in endovascular techniques have improved overall efficacy in achieving complete occlusion, recurrences still occur, and the best modality for retreatment remains controversial. Despite its efficacy in this setting, the role of PED utilization in the setting of recurrent aneurysms has not yet been well defined...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28565988/postprocedural-midterm-and-long-term-results-of-cerebral-aneurysms-treated-with-flow-diverter-devices-7-year-experience-at-a-single-center
#13
Francesco Briganti, Giuseppe Leone, Luigi Cirillo, Oreste de Divitiis, Domenico Solari, Paolo Cappabianca
OBJECTIVE Flow diversion has emerged as a viable treatment option for selected intracranial aneurysms and recently has been gaining traction. The aim of this study was to evaluate the safety and effectiveness of flow-diverter devices (FDDs) over a long-term follow-up period. METHODS The authors retrospectively reviewed all cerebral aneurysm cases that had been admitted to the Division of Neurosurgery of the Università degli Studi di Napoli between November 2008 and November 2015 and treated with an FDD. The records of 60 patients (48 females and 12 males) harboring 69 cerebral aneurysms were analyzed...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28565985/endovascular-management-of-fusiform-aneurysms-in-the-posterior-circulation-the-era-of-flow-diversion
#14
Ahmed J Awad, Justin R Mascitelli, Reham R Haroun, Reade A De Leacy, Johanna T Fifi, J Mocco
Fusiform aneurysms are uncommon compared with their saccular counterparts, yet they remain very challenging to treat and are associated with high rates of rebleeding and morbidity. Lack of a true aneurysm neck renders simple clip reconstruction or coil embolization usually impossible, and more advanced techniques are required, including bypass, stent-assisted coiling, and, more recently, flow diversion. In this article, the authors review posterior circulation fusiform aneurysms, including pathogenesis, natural history, and endovascular treatment, including the role of flow diversion...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28565984/novel-use-of-flow-diversion-for-the-treatment-of-aneurysms-associated-with-arteriovenous-malformations
#15
Craig Kilburg, Philipp Taussky, M Yashar S Kalani, Min S Park
The use of flow-diverting stents for intracranial aneurysms has become more prevalent, and flow diverters are now routinely used beyond their initial scope of approval at the proximal internal carotid artery. Although flow diversion for the treatment of cerebral aneurysms is becoming more commonplace, there have been no reports of its use to treat flow-related cerebral aneurysms associated with arteriovenous malformations (AVMs). The authors report the cases of 2 patients whose AVM-associated aneurysms were managed with flow diversion...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28565983/vision-outcomes-in-patients-with-paraclinoid-aneurysms-treated-with-clipping-coiling-or-flow-diversion-a-systematic-review-and-meta-analysis
#16
Michael A Silva, Alfred P See, Hormuzdiyar H Dasenbrock, Nirav J Patel, Mohammad A Aziz-Sultan
OBJECTIVE Patients with paraclinoid aneurysms commonly present with visual impairment. They have traditionally been treated with clipping or coiling, but flow diversion (FD) has recently been introduced as an alternative treatment modality. Although there is still initial aneurysm thrombosis, FD is hypothesized to reduce mass effect, which may decompress the optic nerve when treating patients with visually symptomatic paraclinoid aneurysms. The authors performed a meta-analysis to compare vision outcomes following clipping, coiling, or FD of paraclinoid aneurysms in patients who presented with visual impairment...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28565982/introduction-the-treatment-of-cerebral-aneurysms-flow-diversion-and-beyond
#17
Adam S Arthur, Philipp Taussky, Min S Park, Michael F Stiefel, Robert H Rosenwasser
No abstract text is available yet for this article.
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28565980/update-on-flow-diverters-for-the-endovascular-management-of-cerebral-aneurysms
#18
Gary Rajah, Sandra Narayanan, Leonardo Rangel-Castilla
Flow diversion has become a well-accepted option for the treatment of cerebral aneurysms. Given the significant treatment effect of flow diverters, numerous options have emerged since the initial Pipeline embolization device studies. In this review, the authors describe the available flow diverters, both endoluminal and intrasaccular, addressing nuances of device design and function and presenting data on complications and outcomes, where available. They also discuss possible future directions of flow diversion...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28565979/flow-diversion-of-tandem-cerebral-aneurysms-a-multi-institutional-retrospective-study
#19
Al-Wala Awad, Karam Moon, Nam Yoon, Marcus D Mazur, M Yashar S Kalani, Philipp Taussky, Cameron G McDougall, Felipe C Albuquerque, Min S Park
OBJECTIVE Flow diversion has proven to be an efficacious means of treating cerebral aneurysms that are refractory to other therapeutic means. Patients with tandem aneurysms treated with flow diversion have been included in larger, previously reported series; however, there are no dedicated reports on using this technique during a single session to treat this unique subset of patients. Therefore, the authors analyzed the outcomes of patients who had undergone single-session flow diversion for the treatment of tandem aneurysms...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28565977/endovascular-treatment-of-blister-aneurysms
#20
Geoffrey W Peitz, Christopher A Sy, Ramesh Grandhi
Blister aneurysms are rare cerebrovascular lesions for which the treatment methods are reviewed here, with a focus on endovascular options. The reported pathogenesis of blister aneurysms varies, and hemodynamic stress, arterial dissection, and arteriosclerotic ulceration have all been described. There is consensus on the excessive fragility of blister aneurysms and their parent vessels, which makes clipping technically difficult. Open surgical treatment is associated with high rates of complications, morbidity, and mortality; endovascular treatment is a promising alternative...
June 2017: Neurosurgical Focus
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