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unruptured internal aneurysms

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...
October 12, 2016: World Neurosurgery
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
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...
September 27, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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...
September 19, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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
Naoki Otani, Kojiro Wada, Terushige Toyooka, Kazuya Fujii, Hideaki Ueno, Satoshi Tomura, Arata Tomiyama, Yasuaki Nakao, Takuji Yamamoto, Kentaro Mori
BACKGROUND: Surgical clipping of paraclinoid aneurysm can be very difficult because strong adhesions may hinder the dissection of the perforators and surrounding anatomical structures from the aneurysm dome. We describe our experience with using retrograde suction decompression during the clipping of paraclinoid aneurysms and discuss the relative advantages and pitfalls. MATERIALS AND METHODS: This study included 23 patients with large and giant paraclinoid aneurysms who underwent surgical treatment consisting of direct clipping with suction decompression between March 2004 and August 2014...
2016: Acta Neurochirurgica. Supplement
Ken-Ichiro Kikuta, Ryuhei Kitai, Toshihiko Kodera, Hidetaka Arishima, Makoto Isozaki, Norichika Hashimoto, Hiroyuki Neishi, Yoshifumi Higashino, Shinsuke Yamada, Munenori Yomo, Kousuke Awara
OBJECTIVE: To investigate the predictive factors for visual and ischemic complications after open surgery for paraclinoid aneurysms of the internal carotid artery (ICA). MATERIALS AND METHODS: Thirty-eight consecutive patients with unruptured paraclinoid aneurysms of ICA operated on between 2009 and 2013 were included in this study. The male:female ratio was 6:32 and the ages ranged from 33 to 81 (mean: 60 ± 2). Twenty cases were asymptomatic and 18 had ophthalmological symptoms...
2016: Acta Neurochirurgica. Supplement
Alex Alfieri, Lehel Török
No abstract text is available yet for this article.
November 2016: Acta Neurochirurgica
Keun Young Park, Byung Moon Kim, Dong Joon Kim
PURPOSE: To compare clinical and angiographic outcomes between balloon-assisted (BAC) and stent-assisted coiling for internal carotid artery unruptured aneurysms (ICA-UA). MATERIALS AND METHODS: A total of 227 ICA-UA in 190 patients were treated with BAC (120 patients, 141 ICA-UA) or SAC (70 patients, 86 ICA-UA. We compared characteristics of patients and ICA-UA, and clinical and angiographic outcomes between groups. RESULTS: Aneurysm size and neck diameter were greater for SAC than in BAC, but aneurysm volume and coil packing density were not different between groups...
September 2016: Neurointervention
Hyuk Won Chang, Shang Hun Shin, Sang Hyun Suh, Bum-Soo Kim, Myung Ho Rho
PURPOSE: The International Subarachnoid Aneurysm Trial (ISAT) revealed that in ruptured intracranial aneurysms (RA), endovascular coiling (EC) yields better clinical outcomes than neurosurgical clipping (NC) at 1 year. In unruptured aneurysms (UIA), EC is being increasingly used as an alternative to NC due to patients' preference. There is a lot of difference in treatment cost (EC vs. NC) between countries. There is one recently published study dealing with the comparative cost analysis only in UIAs in South Korea...
September 2016: Neurointervention
Xianli Lv, Huijian Ge, Hengwei Jin, Hongwei He, Chuhan Jiang, Youxiang Li
BACKGROUND AND PURPOSE: Endovascular treatment of unruptured posterior circulation intracranial aneurysms (UPCIAs) is limited in the International Study of Unruptured Intracranial Aneurysms (ISUIA). The aim of this study is to evaluate the periprocedural morbidity, mortality, and midterm clinical and angiographic follow-ups of endovascular treatment of UPCIAs. MATERIALS AND METHODS: Retrospective analysis of all patients treated in a 2-year period (89 patients: 10-78 years of age, mean: 45...
July 2016: Annals of Indian Academy of Neurology
K Ravishankar
The term "thunderclap headache" (TCH) was first coined in 1986 by Day and Raskin to describe headache that was the presenting feature of an underlying unruptured cerebral aneurysm. The term is now well established to describe the abrupt onset headache seen with many other conditions and is also now included in The International Classification of Headache Disorders 3(rd) edition beta version rubric 4.4. An essential to label an acute headache as "TCH" and differentiate it from other "sudden onset, severe headaches" is the arbitrary time frame of 1 min from onset to peak intensity for "TCH...
July 2016: Annals of Indian Academy of Neurology
Sook Young Sim, Jihye Song, Se-Yang Oh, Myeong Jin Kim, Yong Cheol Lim, Sang Kyu Park, Yong Sam Shin, Joonho Chung
OBJECTIVE: The purpose of this study was to investigate the incidence and characteristics of remote intracerebral hemorrhage (ICH) after endovascular treatment (EVT) of unruptured intracranial aneurysms (UIAs). METHODS: Between March 2007 and September 2015, 11 patients with remote ICH from a series of 2258 consecutive patients with 2597 UIAs treated via EVT were identified. Baseline demographic characteristics, medical history, radiological imaging data, characteristics of remote ICH, and clinical outcomes were retrospectively reviewed...
August 23, 2016: World Neurosurgery
V Gilard, L Grangeon, E Guegan-Massardier, M Sallansonnet-Froment, D Maltête, S Derrey, F Proust
BACKGROUND AND OBJECTIVES: The symptomatic status of unruptured aneurysms has to be looked for. The objective of this retrospective case-control study was to identify the headache semiologic characteristics of symptomatic aneurysms during the 3 months prior to patient admission. PATIENTS AND METHODS: The case cohort was composed of 40 consecutive patients admitted for the treatment of a ruptured intracranial aneurysm (IA) and able to answer a standardized questionnaire by the same neurologist...
August 12, 2016: Neuro-Chirurgie
R S Dzhindzhikhadze, O N Dreval', V A Lazarev, R L Kambiev
UNLABELLED: Progress in microneurosurgical techniques, neuroanesthesiology, and intraoperative imaging enables surgery using small incisions and craniotomy, in accordance with the keyhole surgery concept. Supraorbital craniotomy is the most widespread minimally invasive approach. There are a number of supraorbital craniotomy modifications, regarding different soft tissue incisions and the extent of craniotomy. We present the first results of using mini-orbitozygomatic craniotomy for aneurysms of the anterior circle of Willis and space-occupying lesions of the anterior and middle cranial fossae performed through an eyebrow incision...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Christoph J Griessenauer, Christopher S Ogilvy, Paul M Foreman, Michelle H Chua, Mark R Harrigan, Lucy He, Matthew R Fusco, J D Mocco, Christopher J Stapleton, Aman B Patel, Ashish Sonig, Adnan H Siddiqui, Ajith J Thomas
BACKGROUND: To date, the use of the flow-diverting Pipeline Embolization Device (PED) for small intracranial aneurysms (≤ 7 mm) has been reported only in single-center series. OBJECTIVE: To evaluate the safety and efficacy of the PED in a multicenter cohort. METHODS: Five major academic institutions in the United States provided data on patient demographics, aneurysm features, and treatment characteristics of consecutive patients with aneurysms ≤ 7 mm treated with a PED between 2009 and 2015...
August 1, 2016: Neurosurgery
Ji Hwa Kim, Sang Hyun Suh, Joonho Chung, Yeo-Jin Oh, Sung Jun Ahn, Kyung-Yul Lee
BACKGROUND AND PURPOSE: The prevalence of unruptured cerebral aneurysms (UCAs) in ischemic stroke patients is not clearly defined. This study aimed to measure the prevalence and characteristics of UCAs in patients with acute ischemic stroke (AIS) and to compare our findings with those of the general population. In addition, we investigated the factors associated with cerebral aneurysms in AIS patients. METHODS: We retrospectively reviewed the brain magnetic resonance angiography images of 955 patients with AIS and 2,118 controls who had received a brain magnetic resonance angiography as part of a health check-up...
September 2016: Journal of Stroke
Marta Aguilar Perez, Pervinder Bhogal, Rosa Martinez Moreno, Hansjörg Bäzner, Oliver Ganslandt, Hans Henkes
OBJECTIVE: To report our initial experience with the Medina Embolic Device (MED) in unruptured intracranial aneurysms either as sole treatment or in conjunction with additional devices. METHODS: 15 consecutive patients (6 women, 9 men) with unruptured aneurysms were treated between September 2015 and April 2016. The aneurysm fundus measured at least 5 mm. We evaluated the angiographic appearances of treated aneurysms at the end of the procedure and at follow-up, the clinical status, complications, and requirement for adjunctive devices...
August 2, 2016: Journal of Neurointerventional Surgery
Francesco Briganti, Giuseppe Leone, Lorenzo Ugga, Mariano Marseglia, Antonio Macera, Andrea Manto, Luigi Delehaye, Maurizio Resta, Mariachiara Resta, Nicola Burdi, Nunzio Paolo Nuzzi, Ignazio Divenuto, Ferdinando Caranci, Mario Muto, Domenico Solari, Paolo Cappabianca, Francesco Maiuri
BACKGROUND: Experience with the endovascular treatment of cerebral aneurysms using the p64 Flow Modulation Device is still limited. This study discusses the results and complications of this new flow diverter device. METHODS: 40 patients (30 women, 10 men) with 50 cerebral aneurysms treated in six Italian neurointerventional centers with the p64 Flow Modulation Device between April 2013 and September 2015 were retrospectively reviewed. RESULTS: Complete occlusion was obtained in 44/50 aneurysms (88%) and partial occlusion in 3 (6%)...
July 20, 2016: Journal of Neurointerventional Surgery
Lei Shi, Kan Xu, Xiaofeng Sun, Jinlu Yu
Among the variations of vertebral artery dissecting aneurysms (VDAs), VDAs involving the posterior inferior cerebellar artery (PICA), especially ruptured and high-risk unruptured aneurysms, are the most difficult to treat. Because the PICA is an important structure, serious symptoms may occur after its occlusion. Retained PICAs are prone to re-bleeding because VDAs are difficult to completely occlude. There is therefore confusion regarding the appropriate treatment for VDAs involving the PICA. Here, we used the PubMed database to review recent research concerning VDAs that involve the PICA, and we found that treatments for VDAs involving the PICA include (i) endovascular treatment involving the reconstruction of blood vessels and blood flow, (ii) occluding the aneurysm using an internal coil trapping or an assisted bypass, (iii) inducing reversed blood flow by occluding the proximal VDA or forming an assisted bypass, or (iv) the reconstruction of blood flow via a craniotomy...
2016: International Journal of Medical Sciences
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