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Embolization flow

Paolo Centofanti
With advancements in mechanical circulatory support technology, and limitations in donor supply for heart transplantation, the use of left ventricular assist devices (LVADs) has increased significantly in recent years. Multiple studies have shown that minimally invasive cardiac surgery can improve outcomes, with shorter hospital stays, decreased morbidity, faster recovery and ambulation, and lower total hospital costs. The current generation of centrifugal continuous-flow pumps is miniaturized and makes minimally invasive approaches increasingly practicable...
December 4, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Matthew T Bender, Geoffrey P Colby, Alexander L Coon
No abstract text is available yet for this article.
December 13, 2018: Neurosurgery
Yasir J Khattak, Ayman A Sibaie, Muhammad Anwar, Raza Sayani
Subarachnoid hemorrhage due to a ruptured cerebral aneurysm is a disastrous event accounting for approximately 5%-15% of all stroke cases and has a high mortality rate. One of the major goals in the management of these patients is to prevent rebleeding by securing the aneurysm either surgically or by endovascular means. Endovascular treatment is considered the first line of treatment for intracranial aneurysms; however, wide-neck aneurysms (WNAs) are specifically difficult to treat by endovascular means due to the difficulty in achieving a stable coil mass inside the aneurysm sac...
October 5, 2018: Curēus
Christoph J Griessenauer, Ajith J Thomas, Alejandro Enriquez-Marulanda, Aviraj Deshmukh, Abhi Jain, Christopher S Ogilvy, Naci Kocer, Tobias Engelhorn, Markus Möhlenbruch, Markus Holtmannspötter, Hendrik Janssen, Thomas Finkenzeller, Wolfgang Reith, Michael Sonnberger, Jan-Hendrik Buhk, Clemens M Schirmer, Monika Killer-Oberpfalzer
BACKGROUND: Flow diversion has become an accepted endovascular treatment modality for intracranial aneurysms. Studies comparing different types of flow diverters are currently lacking. OBJECTIVE: To perform a propensity score-matched cohort study comparing the Pipeline Embolization Device (PED; Medtronic, Dublin, Ireland) and Flow Redirection Endoluminal Device (FRED; MicroVention, Aliso Viejo, California). METHODS: Aneurysms of the internal carotid artery proximal to the communicating segment treated with PED at 2 neurovascular centers in the United States were matched with aneurysms treated in the European FRED study using propensity scoring...
December 12, 2018: Neurosurgery
Denise Brunozzi, Sophia F Shakur, Ali Alaraj
Flow diversion technology has revolutionized the treatment of complex anterior circulation cerebral aneurysms. However, vessel tortuosity and atherosclerotic disease may hamper the standard transfemoral access used in these procedures. Percutaneous direct carotid puncture is a viable alternative, but adequate carotid closure must be achieved. Here, we present the first case of a giant partially thrombosed aneurysm of the cavernous internal carotid artery treated with Pipeline Embolization Device (PED; ev3 Neurovascular, Irvine, CA) via direct carotid puncture...
December 6, 2018: World Neurosurgery
Reza Jahan, J Pablo Villablanca, Robert J Harris, Sandra Duarte-Vogel, Christopher K Williams, Harry V Vinters, Neal Rao, Dieter R Enzmann, Benjamin M Ellingson
BACKGROUND: A reliable animal model of ischemic stroke is vital for pre-clinical evaluation of stroke therapies. We describe a reproducible middle cerebral artery (MCA) embolic occlusion in the French Lop rabbit characterized with multimodal MRI and histopathologic tissue analysis. NEW METHOD: Fluoroscopic-guided microcatheter placement was performed in five consecutive subjects with angiographic confirmation of MCA occlusion with autologous clot. Multimodal MRI was obtained prior to occlusion and up to six hours post after which repeat angiography confirmed sustained occlusion...
December 7, 2018: Journal of Neuroscience Methods
Daniel Kuetting, Hans H Schild, Claus C Pieper
PURPOSE: To evaluate polymerization of N-butyl cyanoacrylate (NBCA)/iodized oil mixtures for lymphatic interventions in vitro. MATERIALS AND METHODS: Polymerization times of different NBCA/iodized oil mixtures (ratios of 1:0-1:7) were investigated in a static and dynamic experimental setup (performed in a lymph flow model in a silicone tube). Eight lymphatic samples with different triglyceride (TG) concentrations (low TGs, < 50 mg/dL; medium TGs, approximately 100-400 mg/dL; high TGs, > 700 mg/dL) were investigated...
December 6, 2018: Journal of Vascular and Interventional Radiology: JVIR
Kendra J Grubb, Vasa Jevremovic, Edgar G Chedrawy
BACKGROUND: Myxomas account for approximately half of all primary cardiac neoplasms. Most occur in the left atrium and only rarely are attached to the mitral valve, with just over 30 such cases reported in the literature. These neoplasms can manifest with a combination of obstruction of blood flow, systemic embolization, and constitutional symptoms. CASE DESCRIPTION: We present a case of a 32-year-old African American man presenting at an emergency department with symptoms of a transient ischemic attack...
December 8, 2018: Journal of Medical Case Reports
C R Harnsberger, K Alavi, J S Davids, P R Sturrock, M Zayaruzny, J A Maykel
BACKGROUND: Carbon dioxide (CO2 ) embolism is a rare but potentially devastating complication of minimally invasive abdominal and retroperitoneal surgery. Characterized by a decrease in end-tidal CO2 (ETCO2 ) and oxygen saturation (SpO2 ), CO2 emboli can cause rapid intraoperative hypotension and cardiovascular collapse. Transanal total mesorectal excision (taTME) is a novel surgical approach for rectal resection, which requires high flow CO2 insufflation in a low volume operative field...
December 6, 2018: Techniques in Coloproctology
Xuelei Zhang, Gang Luo, Baixue Jia, Dapeng Mo, Ning Ma, Feng Gao, Jingyu Zhang, Zhongrong Miao
BACKGROUND: Therapeutic strategies and outcomes vary with stroke subtypes for patients with acute vertebrobasilar occlusion (VBAO). This study aimed to compare characteristics and outcomes of VBAO due to intracranial atherosclerotic disease (ICAD) and embolisms and identify baseline predictors of ICAD. METHODS: Patients with VBAO who received endovascular therapy (EVT) were retrospectively analyzed. Participants fulfilling the criteria were classified as the ICAD group (focal stenosis of >70%, or fixed stenosis >50% in addition to either flow and perfusion impairment on angiography or an evident reocclusion tendency) and the embolism group (defined as no evidence of focal significant stenosis after thrombolysis or thrombectomy)...
December 4, 2018: Interventional Neuroradiology
Chetan Pasrija, Kristen M Mackowick, Maxwell Raithel, Douglas Tran, Francesca M Boulos, Kristopher B Deatrick, Michael A Mazzeffi, Raymond Rector, Si M Pham, Bartley P Griffith, Zachary N Kon
BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support can be associated with significant deconditioning due to the requirement for strict bedrest as a result of femoral arterial cannulation. In order to address this issue, we evaluated our experience with ambulation in patients with peripheral femoral cannulation for VA-ECMO. METHODS: All patients that were peripherally cannulated for VA-ECMO over a two year period were retrospectively reviewed...
November 30, 2018: Annals of Thoracic Surgery
Dominik Abt, Gautier Müllhaupt, Livio Mordasini, Sabine Güsewell, Stefan Markart, Valentin Zumstein, Thomas M Kessler, Hans-Peter Schmid, Daniel S Engeler, Lukas Hechelhammer
OBJECTIVES: To identify predictive parameters of different treatment outcomes after prostatic artery embolization (PAE) in the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia. PATIENTS AND METHODS: A post-hoc analysis of data derived from the 48 patients undergoing PAE in a randomized, open label, non-inferiority trial was performed. Relative changes in the International Prostate Symptoms Score (IPSS), absolute changes in maximum flow rate, and relative changes in MRI-assessed prostate volume from baseline to 12 weeks were defined as the outcomes measures of interest...
November 30, 2018: BJU International
(no author information available yet)
OBJECTIVEThe Medina embolization device (MED) is a novel, braided self-expanding endovascular device designed to occlude aneurysms by constructing an in situ intrasaccular flow diverter. Although a single device can be positioned at the neck of simple spherical in vitro aneurysms, the best way to occlude more complex in vivo aneurysms (using multiple MEDs or a combination of MEDs and platinum coils) is currently unknown.METHODSFifty-two aneurysms of 3 different types were created in 31 canines, yielding 48 patent aneurysms...
October 1, 2018: Journal of Neurosurgery
(no author information available yet)
OBJECTIVEVein of Galen aneurysmal malformations (VGAMs) in infancy have a poor natural history if left untreated. Their high-flow nature can preclude safe and accurate therapeutic vessel occlusion and the risk of inadvertent pulmonary embolism is predominant. The authors describe the technique of rapid cardiac ventricular pacing for inducing transient hypotension to facilitate the controlled embolization of VGAMs.METHODSInitial transjugular venous access was obtained for placing temporary pacing leads for rapid cardiac ventricular pacing immediately prior to embolization...
October 1, 2018: Journal of Neurosurgery. Pediatrics
Sang Hun Lee, Jae Hyung Cha, Il Eok Jung, Sung Wook Yu, Ju Sun Moon, Kyung Hee Cho, Kyung Mi Oh, Chi Kyung Kim, Jin-Man Jung
BACKGROUND: In patients with unilateral posterior inferior cerebellar artery (PICA) territory infarction, the absence of relevant vessel stenosis may make it difficult to determine the etiology of the infarction. The incidence of cardioembolic (CE) infarction and the factors associated with infarction in such patients remains largely unknown. We hypothesized that the PICA angle would affect the flow direction of embolic sources. Thus, we analyzed the association between high-risk CE sources and the PICA angle...
November 24, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Idriss Haffaf, Frédéric Clarençon, Eimad Shotar, Claudia Rolla-Bigliani, Saskia Vande Perre, Bertrand Mathon, Mehdi Drir, Nader-Antoine Sourour
BACKGROUND AND PURPOSE: The Medina embolization device (MED) is a new flow disruption device combining the design of a detachable coil with an intrasaccular flow disrupter. Safety and short-term angiographic effectiveness of this device have recently been reported. However, long-term angiographic results are lacking. We report herein the 18 months' angiographic outcome in patients treated for a wide-neck intracranial aneurysm with the MED. MATERIALS AND METHODS: Nineteen patients (17 female, mean age 50 years) with 20 wide-neck intracranial aneurysms (six ruptured; 14 unruptured) were treated by the MED between January 2015 and June 2016...
November 24, 2018: Journal of Neurointerventional Surgery
Mazen A Juratli, Yulian A Menyaev, Mustafa Sarimollaoglu, Alexander V Melerzanov, Dmitry A Nedosekin, William C Culp, James Y Suen, Ekaterina I Galanzha, Vladimir P Zharov
Blood clotting is a serious clinical complication of many medical procedures and disorders including surgery, catheterization, transplantation, extracorporeal circuits, infections, and cancer. This complication leads to high patient morbidity and mortality due to clot-induced pulmonary embolism, stroke, and in some cases heart attack. Despite the clear medical significance, little progress has been made in developing the methods for detection of circulating blood clots (CBCs), also called emboli. We recently demonstrated the application of in vivo photoacoustic (PA) flow cytometry (PAFC) with unfocused ultrasound transducers for detection of CBCs in small vessels in a mouse model...
November 1, 2018: Biomedical Optics Express
Takeshi Hara, Takashi Sadatomo, Kiyoharu Shimizu, Hideo Oba, Kiyoshi Yuki, Shigeyuki Sakamoto, Takahito Okazaki, Katsuhiro Shinagawa, Kaoru Kurisu
Traumatic carotid cavernous fistula(CCF)is known to present a direct connection between the cavernous segment of the internal carotid artery(ICA)and the cavernous sinus(CS). In rare cases, the fistula is formed between the intradural internal carotid artery(ICA)and the cavernous sinus(CS)via a pseudoaneurysm(pAN), requiring appropriate management and aggressive surgical treatment. We describe a 58-year-old man who sustained a severe head injury diagnosed as traumatic CCF treated with an intradural pAN procedure and transarterial coil embolization combined with a Low-profile Visualized Intraluminal Support(LVIS)stent...
November 2018: No Shinkei Geka. Neurological Surgery
A Sweid, E Atallah, N Herial, H Saad, N Mouchtouris, G Barros, M R Gooch, S Tjoumakaris, H Zarzour, D Hasan, N Chalouhi, R H Rosenwasser, P Jabbour
BACKGROUND AND PURPOSE: Flow-diversion therapy (FDT) for large and complex intracranial aneurysms is effective and considered superior to primary coil embolization. Data evaluating common treatment with both FDT and coiling continues to emerge, but information on outcomes remains scarce. This study aims to examine further the efficiency and outcomes correlated with joint FDT using pipeline embolization device (PED) and coiling compared to PED-alone in treating intracranial aneurysms. MATERIALS AND METHODS: Comparative review and analysis of aneurysm treatment with PED in 416 subjects were conducted...
December 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
François Michaud, Ning Li, Rosalie Plantefève, Zeynab Nosrati, Charles Tremblay, Katayoun Saatchi, Gerald Moran, Alexandre Bigot, Urs O Häfeli, Samuel Kadoury, An Tang, Pierre Perreault, Sylvain Martel, Gilles Soulez
PURPOSE: To demonstrate the feasibility of using a custom gradient sequence on an unmodified 3T magnetic resonance imaging (MRI) scanner to perform magnetic resonance navigation (MRN) by investigating the blood flow control method in vivo, reproducing the obtained rheology in a phantom mimicking porcine hepatic arterial anatomy, injecting magnetized microbead aggregates through an implantable catheter, and steering the aggregates across arterial bifurcations for selective tumor embolization...
November 19, 2018: Medical Physics
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