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Venous sinus stenting

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https://www.readbyqxmd.com/read/29274029/endovascular-stent-based-revascularization-of-malignant-superior-vena-cava-syndrome-with-concomitant-implantation-of-a-port-device-using-a-dual-venous-approach
#1
Susanne Anton, T Oechtering, E Stahlberg, F Jacob, M Kleemann, J Barkhausen, J P Goltz
PURPOSE: The aim of this paper is to evaluate the safety and efficacy of endovascular revascularization of malignant superior vena cava syndrome (SVCS) and simultaneous implantation of a totally implantable venous access port (TIVAP) using a dual venous approach. MATERIALS AND METHODS: Retrospectively, 31 patients (mean age 67 ± 8 years) with malignant CVO who had undergone revascularization by implantation of a self-expanding stent into the superior vena cava (SVC) (Sinus XL®, OptiMed, Germany; n = 11 [Group1] and Protégé ™ EverFlex, Covidien, Ireland; n = 20 [Group 2]) via a transfemoral access were identified...
December 22, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29245300/treatment-of-the-superior-sagittal-sinus-and-transverse-sinus-thrombosis-associated-with-intracranial-hemorrhage-with-the-mechanical-thrombectomy-and-thrombolytics-case-report
#2
Yuchun Liu, Keqin Li, Yi Huang, Jie Sun, Xiang Gao
RATIONALE: The superior sagittal sinus (SSS) and transverse sinus are the major dural sinuses that receive a considerable amount of venous drainage. The occlusion of them has been suggested to cause intracranial hypertension, hemorrhage, and lead to potentially fatal consequences. PATIENT CONCERNS: We reported a 35-year-old woman with headache presented to our emergency department with a decreased level of consciousness and epileptic seizures. The examination of speech, higher mental function, and cranial nerve were normal...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29243076/pta-stent-of-dural-sinuses-in-brain-davf-a%C3%A2-report-of-4-cases
#3
Leonardo Renieri, Caterina Michelozzi, Waleed Brinjikji, Jean Darcout, Adrien Guenego, Ivan Vukasinovic, Philippe Tall, Fabrice Bonneville, Anne-Christine Januel, Christophe Cognard
BACKGROUND AND PURPOSE: Type I and IIa dural arteriovenous fistulas (DAVFs) have a low hemorrhagic risk, but are often the cause of debilitating tinnitus that requires treatment. While Onyx® and PHIL™ (Precipitating hydrophobic injectable liquid) transarterial embolization represent the first endovascular option, there are occasional cases where performing angioplasty and stenting of the affected sinus may lead to satisfactory results. MATERIAL AND METHODS: We retrospectively analyzed four consecutive cases of patients with DAVF-induced pulsatile tinnitus secondary to type I and II DAVFs who were treated with angioplasty and stenting of the sinus only...
December 14, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29204038/venous-sinus-stenting-using-transcranial-access-for-the-treatment-of-idiopathic-intracranial-hypertension-in-a-pediatric-patient
#4
Thomas J Buell, Robert M Starke, Dale Ding, Harry R Hixson, Daniel M S Raper, Ching-Jen Chen, Kenneth C Liu
A 4-year-old male with headaches, papilledema, intracranial hypertension, and bilateral transverse sinus (TS) stenosis underwent attempted percutaneous placement of a right TS stent. Stent deployment was not technically feasible due to the stiffness of the stent and tortuosity of the patient's jugular bulb. Therefore, the patient underwent hybrid endovascular stenting of the right TS using neuronavigation and direct access of the TS following a single burr hole craniectomy. Two Express 8 mm × 17 mm balloon-mounted stents were deployed into the right TS, which resulted in obliteration of the preexisting trans-stenosis pressure gradient and decreased intracranial parenchymal pressure as monitored through an intracranial pressure bolt...
October 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29175828/retrograde-3d-rotational-venography-3drv-for-venous-sinus-stent-placement-in-idiopathic-intracranial-hypertension
#5
Christopher C Young, Ryan P Morton, Basavaraj V Ghodke, Michael R Levitt
BACKGROUND: Dural venous sinus stenting has emerged as an effective and durable treatment for idiopathic intracranial hypertension (IIH). Improved visualization of the venous sinuses can improve stent placement. METHODS: We present two cases of IIH treated with venous sinus stenting in which retrograde three-dimensional rotational venography (3DRV) provided superior anatomical details of the venous sinuses for optimal sizing and positioning of stent. RESULTS: Comparison of pre-stent 3DRV with post-stent contrast-enhanced flat panel detector CT allowed confirmation of stent placement and the result of stenosis dilation...
November 24, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29095707/long-term-management-and-outcomes-after-repair-of-cerebrospinal-fluid-rhinorrhea-related-to-idiopathic-intracranial-hypertension
#6
Theodore A Schuman, Brent A Senior
PURPOSE OF REVIEW: To identify long-term management strategies and outcomes for the treatment of spontaneous cerebrospinal fluid (CSF) rhinorrhea related to idiopathic intracranial hypertension (IIH). RECENT FINDINGS: Adjuvant treatments following surgical repair of spontaneous CSF leaks are aimed at normalizing intracranial pressure (ICP) to minimize the risk of recurrence. IIH is closely linked to obesity, and growing evidence suggests that weight loss, both through conservative and surgical approaches, is effective at addressing the root cause of this disorder...
October 31, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/29067093/stent-retriever-thrombectomy-combined-with-local-thrombolytic-therapy-for-cerebral-venous-sinus-thrombosis-a-case-report
#7
Chengwei Chen, Qiujing Wang, Xifeng Li, Ziming Lu, Jian He, Qinrui Fang, Xunchang Ke, Chuanzhi Duan, Tielin Li
The present study reports the effect of successful treatment of cerebral venous sinus thrombosis (CVST) with stent retriever thrombectomy combined with local thrombolytic therapy. Medical records of 29 patients were retrospectively analyzed following a diagnosis of CVST with magnetic resonance venography (MRV) or digital subtraction angiography (DSA). Systemic anticoagulation was the initial treatment in all patients following admission. In group A, stent retriever thrombectomy combined with local thrombolytic therapy was performed on 14 patients who met the criteria of endovascular therapy...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29017198/aggressive-treatment-of-cerebral-venous-sinus-thrombosis-cvt-with-stent-retrievers-and-local-thrombolysis-why-we-need-a-registry
#8
Christina Maria Kowoll, Hannah Lockau, Franziska Dorn, Christian Dohmen
Purpose Anticoagulation is the first-line therapy for cerebral venous sinus thrombosis (CVT). Endovascular treatment is increasingly applied in patients deteriorating despite anticoagulation with extensive thrombosis or contraindications for anticoagulation. Experience with stent retrievers in CVT is limited. Results We present three cases of severe CVT treated with stent-retrievers, thrombus aspiration and local thrombolysis. In two patients with extensive thrombosis, a partial recanalization was achieved, but only one of them showed significant improvement...
October 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/28992723/severe-cerebellar-hemorrhage-following-transverse-sinus-stenting-for-idiopathic-intracranial-hypertension
#9
Pascale Lavoie, Marie-Ève Audet, Jean-Luc Gariepy, Martin Savard, Steve Verreault, Alain Gourdeau, Geneviève Milot, Sylvine Carrondo Cottin
We report a severe adverse event occurring in the course of a cohort study (ISRCTN13784335) aimed at measuring the efficacy and safety of venous stenting in the treatment of patients with medically refractory idiopathic intracranial hypertension (IIH). The patient was a 41-year-old woman who was not overweight, who presented with severe headache, grade 1 bilateral papilledema and transient tinnitus, refractory to medical treatment. Right transverse sinus stenting was successfully performed. Following surgery, the patient's state of consciousness decreased acutely with rapid and progressive loss of brainstem reflex...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28984521/idiopathic-intracranial-hypertension-120-day-clinical-radiological-and-manometric-outcomes-after-stent-insertion-into-the-dural-venous-sinus
#10
Hasan Asif, Claudia L Craven, Almas H Siddiqui, Syed N Shah, Samir A Matloob, Lewis Thorne, Fergus Robertson, Laurence D Watkins, Ahmed K Toma
OBJECTIVE Idiopathic intracranial hypertension (IIH) is commonly associated with venous sinus stenosis. In recent years, transvenous dural venous sinus stent (DVSS) insertion has emerged as a potential therapy for resistant cases. However, there remains considerable uncertainty over the safety and efficacy of this procedure, in particular the incidence of intraprocedural and delayed complications and in the longevity of sinus patency, pressure gradient obliteration, and therapeutic clinical outcome. The aim of this study was to determine clinical, radiological, and manometric outcomes at 3-4 months after DVSS in this treated IIH cohort...
October 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28951386/development-of-an-intracranial-dural-arteriovenous-fistula-after-venous-sinus-stenting-for-idiopathic-intracranial-hypertension
#11
Thomas J Buell, Daniel M Raper, Dale Ding, Ching-Jen Chen, Kenneth C Liu
We report a case in which an intracranial dural arteriovenous fistula (DAVF) developed after endovascular treatment of a patient with idiopathic intracranial hypertension with venous sinus stenting (VSS). The pathogenesis may involve hemodynamic alterations secondary to increased poststenting venous sinus pressure, which may cause new arterial ingrowth into the fistulous sinus wall without capillary interposition. Despite administration of dual antiplatelet therapy, there may also be subclinical cortical vein thrombosis that contributed to DAVF formation...
September 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28944707/combined-use-of-stent-retriever-and-aspiration-thrombectomy-for-cerebral-venous-sinus-thrombosis-involving-the-straight-sinus-a-case-report
#12
Syunsuke Taniguchi, Kei Harada, Masahito Kajihara, Kozo Fukuyama
Cerebral venous sinus thrombosis (CVST) is generally treated with anticoagulation therapy, however, endovascular therapy is considered for refractory cases. A 42-year-old woman presented with a progressive disturbance in consciousness, and diagnosed CVST in the straight sinus (SS). Recanalization of SS was achieved by emergent thrombectomy using aspiration catheter and stent-retriever system, and her level of consciousness improved immediately. The combined use of them aided the removal of the thrombus located in the SS...
December 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28934871/idiopathic-intracranial-hypertension-vision-venous-intervention-versus-shunting-in-iih-for-optic-nerve-disc-swelling-trial-patient-perspective-questionnaire
#13
Arun Chandran, Heinke Pulhorn, Catherine McMahon
INTRODUCTION: Headaches, visual problems and tinnitus are symptoms of Idiopathic Intracranial Hypertension (IIH) which resolve with reduction of CSF pressure. Impaired cranial venous outflow has been implicated in the pathogenesis and there is evidence of good treatment results in IIH using venous sinus stenting. We are currently initiating a multi-centre randomised controlled trial, the VISION study (Venous Intervention versus Shunting in IIH for Optic Disc Swelling) comparing radiological (venous sinus stenting) to surgical intervention (CSF shunting)...
September 21, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28922875/stent-placement-for-disabling-pulsatile-tinnitus-caused-by-a-lateral-sinus-stenosis-a-retrospective-study
#14
Stéphanie Lenck, Marc-Antoine Labeyrie, Fabrice Vallee, Jean-Pierre Saint-Maurice, Antoine Guillonnet, Anne-Laure Bernat, Pierre Vironneau, Emmanuel Houdart
BACKGROUND: Lateral sinus stenosis is a little-known cause for pulsatile tinnitus (PT). In several small series, stenting has been described as an effective treatment for disabling PT linked with this type of stenosis. OBJECTIVES: To describe the clinical, radiological, and manometric characteristics of patients treated for disabling PT by lateral sinus stenosis. Assessment of the efficacy of stenting for this indication. METHODS: Retrospective study of patients treated for isolated PT by stenting of a lateral sinus stenosis in our institution, between 2009 and 2015...
October 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28858988/venous-diverticula-causing-pulsatile-tinnitus-treated-with-coil-embolization-and-stent-placement-with-resolution-of-symptoms-report-of-two-cases-and-review-of-the-literature
#15
Ravi K Shastri, Neeraj Chaudhary, Aditya S Pandey, Steven A Telian, Joseph J Gemmete
OBJECTIVE: To report two cases of pulsatile tinnitus caused by complex venous diverticula with successful treatment via coil embolization and stent placement followed by complete resolution of symptoms. We also review the literature pertaining to venous diverticula causing pulsatile tinnitus treated using endovascular techniques. PATIENTS: Two women patients, aged 27 and 29 years, presented to our institution with 3-month histories of pulsatile tinnitus. In each case, non-invasive imaging and conventional digital subtraction angiography (DSA) confirmed the presence of a complex right transverse-sigmoid sinus junction diverticulum...
October 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28841117/transient-resolution-of-venous-sinus-stenosis-after-high-volume-lumbar-puncture-in-a-patient-with-idiopathic-intracranial-hypertension
#16
Thomas J Buell, Daniel M S Raper, I Jonathan Pomeraniec, Dale Ding, Ching-Jen Chen, Davis G Taylor, Kenneth C Liu
Stenosis of the transverse sinus (TS) and sigmoid sinus (SS), with a trans-stenosis pressure gradient, has been implicated in the pathophysiology of idiopathic intracranial hypertension (IIH). MRI has shown improvement in TS and SS stenosis after high-volume lumbar puncture (HVLP) in a subset of patients with IIH. The authors present the first report of an IIH patient with immediate post-HVLP TS and SS trans-stenosis pressure gradient reduction and an attendant increase in TS and SS cross-sectional area confirmed using intravascular ultrasonography (IVUS)...
August 25, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28710082/accuracy-and-precision-of-venous-pressure-measurements-of-endovascular-microcatheters-in-the-setting-of-dural-venous-sinus-stenosis
#17
Michael B Avery, Sheryl Sambrano, Javed Khader Eliyas, Muneer Eesa, Alim P Mitha
INTRODUCTION: Dural venous sinus stenosis (DVSS) may lead to increased intracranial pressure, sometimes requiring a stent if a high pressure gradient exists. Many neuroendovascular physicians use microcatheters to measure gradients, yet there are no studies comparing the accuracies and precisions of modern day microcatheters. We examined pressure recordings from five commonly used microcatheters in an experimental DVSS model. METHODS: Using a programmable pump, dynamic flow was established in a closed circuit mimicking the venous sinus waveform...
July 14, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28698087/computational-fluid-dynamics-simulation-of-hemodynamic-alterations-in-sigmoid-sinus-diverticulum-and-ipsilateral-upstream-sinus-stenosis-after-stent-implantation-in-patients-with-pulsatile-tinnitus
#18
Yanjing Han, Qingqing Yang, Zeran Yang, Jun Xia, Tianhao Su, Jianan Yu, Long Jin, Aike Qiao
OBJECTIVE: To investigate the relationships between upstream venous sinus stenosis and pulsatile tinnitus (PT), and to assess the correlation with diverticulum growth and the effectiveness of stent implantation. METHODS: Patient-specific geometric models were constructed using computed tomography venography images from a patient with PT, with sigmoid sinus diverticulum, and with upstream transverse sinus stenosis, in whom stenting of the upstream sinus stenosis alone achieved complete remission of PT...
October 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28645586/venous-sinus-stenting-in-the-management-of-patients-with-intracranial-hypertension-manifesting-with-skull-base-cerebrospinal-fluid-leaks
#19
Rajiv R Iyer, David Solomon, Abhay Moghekar, C Rory Goodwin, C Matthew Stewart, Masaru Ishii, Philippe Gailloud, Gary L Gallia
BACKGROUND: A subset of patients with skull base cerebrospinal fluid (CSF) leaks are found to have elevated intracranial pressure (ICP). In these patients, elevated ICP is thought to contribute to both the pathophysiology of the leak and postoperative leak recurrences. Current strategies for postoperative ICP control include medical therapy and shunting procedures. The aim of this study is to report the use of venous sinus stenting (VSS) in the management of patients with skull base CSF leaks caused by elevated ICP...
October 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28637822/pattern-of-pressure-gradient-alterations-after-venous-sinus-stenting-for-idiopathic-intracranial-hypertension-predicts-stent-adjacent-stenosis-a-proposed-classification-system
#20
Daniel Raper, Thomas J Buell, Dale Ding, Ching-Jen Chen, Robert M Starke, Kenneth C Liu
OBJECTIVE: Venous sinus stenting (VSS) is a safe and effective treatment for idiopathic intracranial hypertension (IIH) with angiographic venous sinus stenosis. However, predictors of stent-adjacent stenosis (SAS) remain poorly defined. METHODS: We performed a retrospective review of 47 patients with IIH and intracranial venous stenosis who underwent VSS with pre- and post-stent venography. Patient characteristics, treatments and outcomes were reviewed. Changes in pressure gradient after VSS were classified according to pattern of gradient resolution into types I-III...
June 21, 2017: Journal of Neurointerventional Surgery
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