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unruptured internal aneurysms

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https://www.readbyqxmd.com/read/28219914/nickel-associated-delayed-multiple-white-matter-lesions-after-stent-assisted-coil-embolization-of-intracranial-unruptured-aneurysm
#1
Hun Soo Park, Ichiro Nakagawa, Shohei Yokoyama, Daisuke Wajima, Takeshi Wada, Yasushi Motoyama, Kimihiko Kichikawa, Hiroyuki Nakase
Metal-induced encephalopathy after stent-assisted coil embolization is extremely rare. The present report describes two patients who presented with symptomatic intracranial parenchymal edematous lesions after stent-assisted coil embolization. A 64-year-old woman underwent stent-assisted coil embolization for a left internal carotid artery aneurysm; 21 days after the procedure she presented with right hand weakness and MRI revealed multifocal white matter lesions. Another woman aged 52 years underwent stent-assisted coil embolization for right vertebral artery aneurysm; 18 days after the procedure she presented with left-sided sensory disturbance and MRI demonstrated multiple white matter lesions...
February 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28216398/engaging-in-a-keyhole-concept-for-the-management-of-ruptured-and-unruptured-aneurysms
#2
Daniel D Cavalcanti, Roberto C de Paula, Paula L Alvarenga, Paulo José P da Mata, Paulo Niemeyer Filho
OBJECTIVE: Many new endovascular devices have been used under the guidance of the International Subarachnoid Aneurysm Trial (ISAT). Clipping still offers higher occlusion rates, and its technique continues to evolve, resulting in smaller exposures and reduced manipulation to brain tissue. We sought to evaluate the routine use of the minisphenoidal approach to manage intracranial aneurysms in a high-volume institution. METHODS: We retrospectively reviewed our database of aneurysm patients from October 2013 to May 2016...
February 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28209576/differences-in-hemodynamics-and-rupture-rate-of-aneurysms-at-the-bifurcation-of-the-basilar-and-internal-carotid-arteries
#3
R Doddasomayajula, B Chung, F Hamzei-Sichani, C M Putman, J R Cebral
BACKGROUND AND PURPOSE: Cerebral aneurysms in the posterior circulation are known to have a higher rupture risk than those in the anterior circulation. We sought to test the hypothesis that differences in hemodynamics can explain the difference in rupture rates. MATERIALS AND METHODS: A total of 117 aneurysms, 63 at the tip of the basilar artery (27 ruptured, 36 unruptured, rupture rate = 43%) and 54 at the bifurcation of the internal carotid artery (11 ruptured, 43 unruptured, rupture rate = 20%) were analyzed with image-based computational fluid dynamics...
February 16, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28184003/a-survey-of-intracranial-aneurysm-treatment-practices-among-united-states-physicians
#4
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/28006728/is-clipping-better-than-coiling-in-the-treatment-of-patients-with-oculomotor-nerve-palsies-induced-by-posterior-communicating-artery-aneurysms-a-systematic-review-and-meta-analysis
#5
REVIEW
Feng Zheng, Ying Dong, Peng Xia, Anastasios Mpotsaris, Pantelis Stavrinou, Gerrit Brinker, Roland Goldbrunner, Boris Krischek
OBJECTIVE: Posterior communicating artery aneurysms (PcomAAs) are the second most common aneurysm, accounting for 25% of all aneurysms and 50% of internal carotid artery aneurysms. It has been estimated that oculomotor nerve palsy (ONP) occurs in up to one-third of patients with posterior communicating artery (PcomA) aneurysms. Recent research showed a better outcome of ONP in patients with PcomAA after surgical clipping when compared to endovascular coiling. We compared the effect of clipping and coiling on recovery of ONP in the management of patients with PcomAAs...
February 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27991669/characteristics-of-headache-after-an-intracranial-endovascular-procedure-a-prospective-observational-study
#6
Linjing Zhang, Xiancong Wu, Hai Di, Tao Feng, Yunxia Wang, Jun Wang, Xiangyu Cao, Baomin Li, Ruozhuo Liu, Shengyuan Yu
BACKGROUND: Two editions of the International Classification of Headache Disorders (ICHD) diagnostic criteria for "Headache attributed to an intracranial endovascular procedure" have been published, in 2004 and 2013.(1,2) Despite studies that have suggested that the former is not very practical, the ICHD-3 beta did not contain major changes. Moreover, so far no consensus exists regarding characteristics of headache after intracranial endovascular procedure. Thus, there is a need for sound suggestions to improve the ICHD-3 beta diagnostic criteria...
December 19, 2016: Headache
https://www.readbyqxmd.com/read/27956171/endovascular-parent-artery-occlusion-of-large-or-giant-unruptured-internal-carotid-artery-aneurysms-a-long-term-single-center-experience
#7
Kampei Shimizu, Hirotoshi Imamura, Yohei Mineharu, Hidemitsu Adachi, Chiaki Sakai, Shoichi Tani, Koichi Arimura, Mikiya Beppu, Nobuyuki Sakai
The development of stent-like devices has increased treatment options for complex internal carotid artery (ICA) aneurysms, but the optimal treatment remains unclear. The purpose of this study was to evaluate the safety and efficacy of endovascular parent-artery occlusion (PAO) for ICA aneurysms. We retrospectively reviewed 28 patients with unruptured ICA aneurysms ⩾10mm treated with PAO between April 2002 and March 2015 at our institution. Patients who developed neurologic symptoms or with venous-phase delay >2s during balloon test occlusion were not treated by PAO...
March 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27904445/endovascular-treatment-of-unruptured-aneurysms-of-cavernous-and-ophthalmic-segment-of-internal-carotid-artery-with-flow-diverter-device-pipeline
#8
Marko Jevsek, Charbel Mounayer, Tomaz Seruga
BACKGROUND: Intra-arterial treatment of aneurysms by redirecting blood flow is a newer method. The redirection is based on a significantly more densely braided wire stent. The stent wall keeps the blood in the lumen of the stent and slows down the turbulent flow in the aneurysms. Stagnation of blood in the aneurysm sac leads to the formation of thrombus and subsequent exclusion of the aneurysm from the circulation. The aim of the study was to evaluate flow diverter device Pipeline for broad neck and giant aneurysm treatment...
December 1, 2016: Radiology and Oncology
https://www.readbyqxmd.com/read/27891269/unruptured-basilar-tip-aneurysm-with-internal-septation-coiling-implications
#9
Ayman Khalil, Hong Kuan Kok, Mark Schembri, Paul Brennan, Mohsen Javadpour, John Thornton, Alan O'Hare, Hamed Asadi
An internal septum within a basilar artery aneurysm is an infrequent anomaly and is very rarely reported in the literature. We report a 62-year-old lady that was incidentally diagnosed with basilar tip aneurysm. Further imaging with magnetic resonance imaging (MRI) revealed internal septation within this aneurysm which was later confirmed with digital subtraction angiography (DSA). She underwent coil embolisation, which involved technical manipulation of the microcatheter and the balloon to enable coiling of each separate aneurysm compartment...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27858574/quantitative-anatomical-analysis-and-clinical-experience-with-mini-pterional-and-mini-orbitozygomatic-approaches-for-intracranial-aneurysm-surgery
#10
Kaan Yagmurlu, Sam Safavi-Abbasi, Evgenii Belykh, M Yashar S Kalani, Peter Nakaji, Albert L Rhoton, Robert F Spetzler, Mark C Preul
OBJECTIVE The aim of this investigation was to modify the mini-pterional and mini-orbitozygomatic (mini-OZ) approaches in order to reduce the amount of tissue traumatization caused and to compare the use of the 2 approaches in the removal of circle of Willis aneurysms based on the authors' clinical experience and quantitative analysis. METHODS Three formalin-fixed adult cadaveric heads injected with colored silicone were examined. Surgical freedom and angle of attack of the mini-pterional and mini-OZ approaches were measured at 9 anatomical points, and the measurements were compared...
November 18, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27847767/the-benefits-of-navien%C3%A2-intracranial-support-catheter-for-endovascular-treatment
#11
Siwoo Lee, Tae-Sik Gong, Yong-Woo Lee, Hyo-Joon Kim, Chang-Young Kweon
OBJECTIVE: Endovascular treatment is one of the most important treatments along with open craniotomy for cerebrovascular surgery. The successful treatment of endovascular disease relies on appropriate instruments and the surgeon's skill. Endovascular treatment needs to provide safe and stable access to the catheter cavity. Additionally, it is important to maintain a round shape without changing to an oval shape. The catheter for endovascular treatment has to be flexible and accommodate at least 0...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27847763/preliminary-experience-with-vascular-plugs-for-parent-artery-occlusion-of-the-carotid-or-vertebral-arteries
#12
Woosung Lee, Yong Sam Shin, Kyung Hyun Kim, Yong Bae Kim, Chang-Ki Hong, Joonho Chung
OBJECTIVE: The purpose of this study was to report the authors' preliminary experience using the Amplatzer Vascular Plug (AVP) (St. Jude Medical, Plymouth, MN, USA) for parent artery occlusion of the internal carotid artery (ICA) or vertebral artery (VA). MATERIALS AND METHODS: Between September 2008 and December 2015, we performed 52 therapeutic parent artery occlusions (PAOs) by an endovascular technique. Among them, 10 patients underwent PAO of the carotid or vertebral arteries using AVPs...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27833409/preoperative-coiling-of-coexisting-intracranial-aneurysm-and-subsequent-brain-tumor-surgery
#13
Keun Young Park, Byung Moon Kim, Dong Joon Kim
OBJECTIVE: Few studies have investigated treatment strategies for brain tumor with a coexisting unruptured intracranial aneurysm (cUIA). The purpose of this study was to evaluate the safety and efficacy of preoperative coiling for cUIA, and subsequent brain tumor surgery. MATERIALS AND METHODS: A total of 19 patients (mean age, 55.2 years; M:F = 4:15) underwent preoperative coiling for 23 cUIAs and subsequent brain tumor surgery. Primary brain tumors were meningiomas (n = 7, 36...
November 2016: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/27801397/-tactics-of-surgical-treatment-of-patients-with-unruptured-asymptomatic-cerebral-aneurysms
#14
A S Kheireddin, Sh Sh Eliava, S B Yakovlev, Yu M Filatov, A N Kaftanov, O B Belousova, I A Sazonov, S R Arustamyan, K G Mikeladze, E Yu Bukharin, P S Dorokhov
AIM: To clarify the indications for surgical treatment and the principles for choosing a surgical technique for patients with unruptured asymptomatic aneurysms (UAAs) based on the results of direct and endovasal operations performed at the Burdenko Neurosurgical Institute and on the literature data. MATERIAL AND METHODS: The study included 694 UAA patients (481 females (69.3%) and 213 males (30.7%)) operated on at the Burdenko Neurosurgical Institute from 1997 to 2013...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/27767401/-awake-clipping-of-cerebral-aneurysms-report-of-initial-series
#15
Saleem I Abdulrauf, Peter Vuong, Ritesh Patel, Raghu Sampath, Ahmed M Ashour, Lauren M Germany, Jonathon Lebovitz, Colt Brunson, Yuvraj Nijjar, J Kyle Dryden, Maheen Q Khan, Mihaela G Stefan, Evan Wiley, Ryan T Cleary, Connor Reis, Jodi Walsh, Paula Buchanan
OBJECTIVE Risk of ischemia during aneurysm surgery is significantly related to temporary clipping time and final clipping that might incorporate a perforator. In this study, the authors attempted to assess the potential added benefit to patient outcomes of "awake" neurological testing when compared with standard neurophysiological testing performed under general anesthesia. The procedure is performed after the induction of conscious sedation, and for the neurological testing, the patient is fully awake. METHODS The authors conducted an institutional review board-approved prospective study of clipping unruptured intracranial aneurysms (UIAs) in 30 consecutive adult patients who underwent awake clipping...
October 21, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27744074/prevalence-of-asymptomatic-unruptured-intracranial-aneurysms-in-a-southeast-asian-population
#16
Ady Thien, Angela An Qi See, Samantha Ya Lyn Ang, Nishal Kishinchand Primalani, Mervyn Jun Rui Lim, Yew Poh Ng, Nicolas Kon Kam King
BACKGROUND: The prevalence of asymptomatic unruptured intracranial aneurysms (AUIA) in a Southeast Asian population has not been previously studied. Knowing the disease burden and population at risk can assist us in making informed decisions when managing AUIAs. We aimed to determine if the local prevalence of AUIAs differed from other populations in the published literature. METHODS: Magnetic resonance angiography radiology reports and images for 4572 patients between January 2013 and January 2014 were reviewed for AUIAs...
January 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27742747/coiling-of-wide-necked-carotid-artery-aneurysms-assisted-by-a-temporary-bridging-device-comaneci-preliminary-experience
#17
S Fischer, A Weber, A Carolus, F Drescher, F Götz, W Weber
BACKGROUND: Endovascular treatment of wide-necked aneurysms remains challenging without the use of adjunctive devices to preserve the parent artery. OBJECTIVE: To present our initial experience with a temporary bridging device, the Comaneci (Rapid Medical, Israel). The compliant remodeling mesh protects the parent artery during coil occlusion without flow arrest in the distal vasculature. Permanent dual antiplatelet therapy is not required since the device is fully removed at the end of the procedure...
October 14, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27692502/intraoperative-rupture-in-the-surgical-treatment-of-patients-with-intracranial-aneurysms
#18
S F Chen, Y Kato, A Kumar, G W Tan, D Oguri, J Oda, T Watabe, S Imizu, H Sano, Z X Wang
Intraoperative rerupture (IOR) during clipping of cerebral aneurysms is a difficult complication of microneurosurgery. The aim of this study was to evaluate the incidence of IOR and analyze the strategies for controlling profound hemorrhage. A total of 165 patients with unruptured intracranial aneurysms and 46 patients with subarachnoid hemorrhage (SAH) treated surgically between April 2010 and March 2011, were reviewed. The data were collected with regard to age, sex, presence of symptoms, confounding factors and strategy for controlling intraoperative hemorrhage was analyzed in terms of location of aneurysms, timing of rupture and severity of IOR...
December 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27658574/balloon-in-stent-assisted-coiling-for-treatment-of-intracranial-overwide-and-undertall-aneurysms
#19
Kunpeng Chen, Lijun Wang, Daming Wang, Jiachun Liu, Jun Lu, Peng Qi
This study reports our experience of balloon-in-stent assisted coiling for the treatment of morphologically unfavorable aneurysms located in the internal carotid artery (ICA). From July 2007 to April 2014, twelve patients with twelve aneurysms located in the ICA were coil embolized by simultaneously using balloon and stent assistance. Five aneurysms were ruptured and seven were unruptured. All the aneurysms were overwide (dome-to-neck ratio ⩽1.2) and undertall (aspect ratio ⩽1.2) anatomically. The procedure-related adverse events, clinical and angiographic results were retrospectively analyzed...
December 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27644699/unruptured-internal-carotid-artery-bifurcation-aneurysms-general-features-and-overall-results-after-modern-treatment
#20
Biagia La Pira, Waleed Brinjikji, Anthony M Burrows, Harry J Cloft, Roanna L Vine, Giuseppe Lanzino
BACKGROUND: Internal carotid artery bifurcation aneurysms (ICAbifAs) present unique challenges to endovascular and surgical operators, and little is known about their natural history. We reviewed our institution's experience with ICAbifAs studying outcomes of surgical and endovascular management and natural history. METHODS: Consecutive patients with unruptured ICAbifAs evaluated and/or treated over an 8-year interval were studied. Baseline demographics, neurovascular risk factors, aneurysm location and size, clinical presentation, treatment recommendations, and outcomes were prospectively collected and retrospectively analyzed...
November 2016: Acta Neurochirurgica
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