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Flow diverter OR flow diverting OR flow diversion AND aneurysm

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https://www.readbyqxmd.com/read/28439656/-management-of-paraophthalmic-aneurysms-review-of-endovascular-treatment-strategies
#1
P Bhogal, M Aguilar Pérez, G Sauder, H Bäzner, O Ganslandt, H Henkes
BACKGROUND: Aneurysms of the cerebral vessels are relatively common and aneurysms of the ophthalmic segment of the internal carotid artery (ICA) represent approximately 10% of intradural aneurysms. ANATOMICAL ASPECTS: The ophthalmic segment of the ICA extends from the origin of the ophthalmic artery to the origin of the posterior communicating artery. Aneurysms can originate from the ophthalmic artery itself or directly from the ICA at a distance from the ophthalmic artery...
April 24, 2017: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/28433850/surgical-resection-and-histopathological-analysis-of-a-thrombosed-giant-fusiform-mca-aneurysm-after-initial-treatment-with-a-flow-diversion-construct
#2
Jayson Sack, Vincent Cheung, Deirdre Amaro, Arvin R Wali, David R Santiago-Dieppa, J Scott Pannell, Alexander A Khalessi
BACKGROUND: We describe the histopathology of an un-ruptured, giant calcified left MCA fusiform aneurysm initially treated with endovascular flow diversion. The flow diversion construct underwent post-operative in-stent thrombosis, necessitating surgical resection of the aneurysm to eliminate mass effect. METHODS: A 75-year-old woman with a known left MCA aneurysm presented to the Emergency Department with moderate right hemibody weakness. Due to the clinical and radiographic progression of the aneurysm, the patient was offered treatment...
April 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28411263/use-of-platelet-function-testing-before-pipeline-embolization-device-placement-a-multicenter-cohort-study
#3
Nimer Adeeb, Christoph J Griessenauer, Paul M Foreman, Justin M Moore, Hussain Shallwani, Rouzbeh Motiei-Langroudi, Abdulrahman Alturki, Adnan H Siddiqui, Elad I Levy, Mark R Harrigan, Christopher S Ogilvy, Ajith J Thomas
BACKGROUND AND PURPOSE: Thromboembolic complications constitute a significant source of morbidity after neurointerventional procedures. Flow diversion using the pipeline embolization device for the treatment of intracranial aneurysms necessitates the use of dual antiplatelet therapy to reduce this risk. The use of platelet function testing before pipeline embolization device placement remains controversial. METHODS: A retrospective review of prospectively maintained databases at 3 academic institutions was performed from the years 2009 to 2016 to identify patients with intracranial aneurysms treated with pipeline embolization device placement...
April 14, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28402491/matched-comparison-of-flow-diversion-and-coiling-in-small-noncomplex-intracranial-aneurysms
#4
Nohra Chalouhi, Badih Daou, Guilherme Barros, Robert M Starke, Ameet Chitale, George Ghobrial, Richard Dalyai, David Hasan, L Fernando Gonzalez, Stavropoula Tjoumakaris, Robert H Rosenwasser, Pascal Jabbour
BACKGROUND: Flow diversion is typically reserved for large, giant, or morphologically complex aneurysms. Coiling remains a first-line treatment for small, morphologically simple aneurysms. OBJECTIVE: To compare coiling and flow diversion in small, uncomplicated intracranial aneurysms (typically amenable to coiling). METHODS: Forty patients treated with the pipeline embolization device (PED) for small (<10 mm), morphologically simple aneurysms that would have also been amenable to coiling were identified...
April 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28383672/cerebral-revascularization-for-aneurysms-in-the-flow-diverter-era
#5
David C Straus, Harley Brito da Silva, Lynn McGrath, Michael R Levitt, Louis J Kim, Basavaraj V Ghodke, Jason K Barber, Laligam N Sekhar
BACKGROUND: Cerebral bypass has been an important tool in the treatment of complex intracranial aneurysms. The recent advent of flow-diverting stents (FDS) has expanded the capacity for endovascular arterial reconstruction. OBJECTIVE: We investigated how the advent of FDS has impacted the application and outcomes of cerebral bypass in the treatment of intracranial aneurysms. METHODS: We reviewed a consecutive series of cerebral bypasses during aneurysm surgery over the course of 10 years...
April 5, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28357169/low-profile-visualized-intraluminal-support-junior-device-for-the-treatment-of-intracranial-aneurysms
#6
Mihir Gupta, Vincent J Cheung, Peter Abraham, Arvin R Wali, David R Santiago-Dieppa, Brandon C Gabel, Abdulrahman Almansouri, J Scott Pannell, Alexander A Khalessi
OBJECTIVE: Early case series suggest that the recently introduced Low-profile Visualized Intraluminal Support Junior (LVIS Jr.) device (MicroVention-Terumo, Inc., Tustin, CA) may be used to treat wide-necked aneurysms that would otherwise require treatment with intrasaccular devices or open surgery. We report our single-center experience utilizing LVIS Jr. to treat intracranial aneurysms involving 1.8-2.5 mm parent arteries. METHODS: We retrospectively reviewed records of patients treated with the LVIS Jr...
February 17, 2017: Curēus
https://www.readbyqxmd.com/read/28279774/conscious-sedation-versus-general-anesthesia-for-the-treatment-of-cerebral-aneurysms-with-flow-diversion-a-matched-cohort-study
#7
Christoph J Griessenauer, Hussain Shallwani, Nimer Adeeb, Raghav Gupta, Leonardo Rangel-Castilla, Adnan H Siddiqui, Elad I Levy, Myles D Boone, Ajith J Thomas, Christopher S Ogilvy
INTRODUCTION: Flow diversion has become a popular treatment option for a variety of cerebral aneurysms. We sought to compare conscious sedation and general anesthesia for flow diverter placement in a matched cohort study. MATERIALS AND METHODS: Patients who underwent flow diverter placement under conscious sedation were matched on the basis of age, sex, American Society of Anesthesiologists (ASA) classification, aneurysm location, and aneurysm size with patients who received general anesthesia...
March 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28265011/tourniquet-parent-artery-occlusion-after-flow-diversion
#8
Visish M Srinivasan, Maxim Mokin, Edward A M Duckworth, Stephen Chen, Ajit Puri, Peter Kan
BACKGROUND: The Pipeline Embolization Device (PED) is increasingly used for both on- and off-label purposes for treatment of intracranial aneurysms. The device gradually slows flow of blood into the aneurysm, but the high metal coverage of PED promotes endothelialization of the device. Occasionally, this leads to in-stent stenosis that is clinically well tolerated. We present a multi-institutional Pipeline series that includes three cases of gradual asymptomatic occlusion within the PED and parent vessel...
March 6, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28246277/ischemic-stroke-after-treatment-of-intraprocedural-thrombosis-during-stent-assisted-coiling-and-flow-diversion
#9
Nimer Adeeb, Christoph J Griessenauer, Justin M Moore, Paul M Foreman, Hussain Shallwani, Rouzbeh Motiei-Langroudi, Raghav Gupta, Carlos E Baccin, Abdulrahman Alturki, Mark R Harrigan, Adnan H Siddiqui, Elad I Levy, Christopher S Ogilvy, Ajith J Thomas
BACKGROUND AND PURPOSE: Intraprocedural thrombosis poses a formidable challenge during neuroendovascular procedures because the risks of aggressive thromboembolic treatment must be balanced against the risk of postprocedural hemorrhage. The aim of this study was to identify predictors of ischemic stroke after intraprocedural thrombosis after stent-assisted coiling and pipeline embolization device placement. METHODS: A retrospective analysis of intracranial aneurysms treated with stent-assisted coiling or pipeline embolization device placement between 2007 and 2016 at 4 major academic institutions was performed to identify procedures that were complicated by intraprocedural thrombosis...
February 28, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28243686/flow-diversion-what-can-clinicians-learn-from-animal-models
#10
Robert Fahed, Tim E Darsaut, Jean-Christophe Gentric, Behzad Farzin, Igor Salazkin, Guylaine Gevry, Jean Raymond
INTRODUCTION: Flow diversion is increasingly used for treating intracranial aneurysms. This article aims to review the evidence obtained from animal models and summarizes the findings that might be of clinical interest. METHODS: From a systematic review of studies published between 2000 and 2016, we extracted the data on the following questions: What roles do aneurysm dimension, morphology, and vascular geometry have on success of flow diversion? What characteristics of a flow diverter can influence aneurysm occlusion? What are the risk factors for jailed branch occlusion? RESULTS: Flow diversion has been shown to be less effective in occluding large aneurysms with wide or undefined necks, as compared to smaller aneurysms with narrower necks...
February 27, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28210239/flow-diversion-for-the-treatment-of-mca-bifurcation-aneurysms-a-single-centre-experience
#11
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/28184003/a-survey-of-intracranial-aneurysm-treatment-practices-among-united-states-physicians
#12
Kyle M Fargen, Hector E Soriano-Baron, Julia T Rushing, William Mack, J Mocco, Felipe Albuquerque, Andrew F Ducruet, Maxim Mokin, Italo Linfante, Stacey Q Wolfe, John A Wilson, Joshua A Hirsch
BACKGROUND: Recent surveys have failed to examine cerebrovascular aneurysm treatment practices among US physicians. OBJECTIVE: To survey physicians who are actively involved in the care of patients with cerebrovascular aneurysms to determine current aneurysm treatment preferences. METHODS: A 25-question SurveyMonkey online survey was designed and distributed electronically to members of the Society of NeuroInterventional Surgery, Society of Vascular and Interventional Neurology, and the American Association of Neurological Surgeons/Congress of Neurological Surgeons Combined Cerebrovascular Section...
February 9, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28163518/double-barrel-y-configuration-stenting-for-flow-diversion-of-a-giant-recurrent-basilar-apex-aneurysm-with-the-pipeline-flex-embolization-device
#13
Dale Ding, Robert M Starke, Ben McGuinness, Stefan Brew
Giant basilar apex aneurysms are extremely challenging to successfully manage. The Pipeline Flex embolization device (PFED) is a new generation flow-diverting stent with a modified delivery system which allows resheathing of the stent after partial deployment. We describe a case of double-barrel Y-configuration stenting of a giant, recurrent basilar apex aneurysm using the PFED. A 73-year-old male was previously treated for an unruptured 11-mm basilar apex aneurysm with stent-assisted coiling using a Neuroform stent...
December 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28155683/towards-the-patient-specific-design-of-flow-diverters-made-from-helix-like-wires-an-optimization-study
#14
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/28130501/endovascular-flow-diversion-for-treatment-of-anterior-communicating-artery-region-cerebral-aneurysms-a-single-center-cohort-of-50-cases
#15
Geoffrey P Colby, Matthew T Bender, Li-Mei Lin, Narlin Beaty, Judy Huang, Rafael Tamargo, Alexander Coon
BACKGROUND: Flow diversion represents a novel but definitive treatment for recurrent and difficult-to-coil aneurysms of the anterior communicating artery (ACoA) region, of which reports are limited. OBJECTIVE: To determine the effectiveness of the Pipeline embolization device (PED) in treating aneurysms in the ACoA region. METHODS: We retrospectively reviewed an IRB-approved database of patients with an aneurysm at a single institution for patients with ACoA or A1-A2 aneurysms treated with PED...
January 27, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28056454/collar-sign-in-incompletely-occluded-aneurysms-after-pipeline-embolization-evaluation-with-angiography-and-optical-coherence-tomography
#16
C J Griessenauer, R Gupta, S Shi, A Alturki, R Motiei-Langroudi, N Adeeb, C S Ogilvy, A J Thomas
BACKGROUND AND PURPOSE: Flow diversion with the Pipeline Embolization Device has emerged as an attractive treatment for cerebral aneurysms. Processes involved in aneurysm occlusion include changes in intra-aneurysmal hemodynamics and endothelialization of the device. Here, we call attention to a radiographic sign not previously reported that is detected in incompletely occluded aneurysms after treatment with the Pipeline Embolization Device at angiographic follow-up and referred to as the "collar sign...
November 10, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28029187/off-label-uses-for-flow-diversion-in-intracranial-aneurysm-management
#17
Fawaz Al-Mufti, Krishna Amuluru, Gomez Francisco, Vincent Dodson, Mohammad El-Ghanem, Charles J Prestigiacomo, Chirag D Gandhi
Treatment of complex aneurysms using microsurgical and other conventional neuroendovascular techniques remains challenging. As a result, stent- and balloon-assisted coiling are instead performed to treat morphologically complex aneurysms, which include giant, wide-necked, and fusiform aneurysms. While these techniques have had success in treating these complex aneurysms, recanalization rates associated with these techniques are still problematic. In the constant effort to improve the outcome of complex aneurysm treatment, flow-diverting stents (FDSs) have emerged in recent years as the preferred treatment...
December 28, 2016: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28017223/parent-vessel-occlusion-for-treatment-of-cerebral-aneurysms-is-there-still-an-indication-a-series-of-17-patients
#18
Nishant Ganesh Kumar, Travis R Ladner, Imad S Kahn, Scott L Zuckerman, Christopher B Baker, Marybess Skaletsky, Deborah Cushing, Matthew R Sanborn, J Mocco, Robert D Ecker
INTRODUCTION/PURPOSE: Flow diversion has allowed cerebrovascular neurosurgeons and neurointerventionalists to treat complex, large aneurysms, previously treated with trapping, bypass, and/or parent vessel sacrifice. However, a minority of aneurysms remain that cannot be treated endovascularly, and microsurgical treatment is too dangerous. However, balloon test occlusion (macro and micro), micro WADA testing, ICG, intra-angiography and intra-operative monitoring are all available to clinically test the hypothesis that vessel sacrifice is safe...
January 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28007770/flow-diversion-in-ruptured-intracranial-aneurysms-a-meta-analysis
#19
T P Madaelil, C J Moran, D T Cross, A P Kansagra
BACKGROUND: Flow diversion is now an established technique to treat unruptured intracranial aneurysms not readily amenable to endovascular coil embolization or open microsurgical occlusion. The role of flow-diverting devices in treating ruptured aneurysms is less clear. PURPOSE: To estimate rates of angiographic occlusion and good clinical outcome in patients with ruptured intracranial aneurysms treated with flow-diverting devices. DATA SOURCES: Systematic review of Ovid MEDLINE, PubMed, Cochrane databases, and EMBASE from inception to December 2015 for articles that included ruptured aneurysms treated with flow diversion...
December 22, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/27956252/clinical-features-management-considerations-and-outcomes-in-case-series-of-patients-with-parasellar-intracranial-aneurysms-undergoing-anterior-skull-base-surgery
#20
Daniel M Raper, Dale Ding, Elizabeth Evans, Robert M Starke, R Webster Crowley, Kenneth C Liu, Edward H Oldfield, John A Jane
BACKGROUND: The coincidence of parasellar aneurysms (IAs) and anterior skull base (ASB) lesions, while rare, presents a management challenge. IAs embedded within, or adjacent to, ASB lesions are at risk in the perioperative period and may have unique presentations, natural histories, and outcomes. The objective of this study was to outline management options and nuances in patients with coexisting IAs and ASB lesions. METHODS: We retrospectively evaluated all patients who presented for management of IAs and ASB lesions from January 2006 to January 2014...
March 2017: World Neurosurgery
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