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unruptured internal aneurysms

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https://www.readbyqxmd.com/read/29764206/management-of-incidental-aneurysms-comparison-of-single-centre-multi-disciplinary-team-decision-making-with-the-unruptured-incidental-aneurysm-treatment-score
#1
Alex Smedley, Nate Yusupov, Alaa Almousa, Thomas Solbach, Ahmed K Toma, Joan P Grieve
OBJECTIVE: To compare multidisciplinary team (MDT) decision making at our centre with the suggested management from the recently published Unruptured Intracranial Aneurysm Treatment Score (UIATS), with particular focus on disagreements between the two bodies of expert opinion. DESIGN: A retrospective audit of local practice. SUBJECTS: Adult patients with incidental cerebral saccular aneurysms referred to The National Hospital for Neurology and Neurosurgery Neurovascular MDT...
May 15, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29749361/risk-factors-for-ruptured-intracranial-aneurysms
#2
Guang-Xian Wang, Dong Zhang, Zhi-Ping Wang, Liu-Qing Yang, Hua Yang, Wen Li
Background & objectives: The treatment of unruptured intracranial aneurysms (IAs) remains controversial; the ability to predict the risk of rupture for an aneurysm would be of clinical value. The aim of this study was to determine and evaluate the predictive value of the risk factors of IA rupture. Methods: This retrospective study involved 379 consecutive patients with 441 aneurysms between August 2011 and July 2014. Based on clinical data and computed tomography angiography findings, the potential of risk factors to predict the aneurysmal rupture was assessed using statistical methods...
January 2018: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/29726776/the-25th-anniversary-of-the-retrograde-suction-decompression-technique-dallas-technique-for-the-surgical-management-of-paraclinoid-aneurysms-historical-background-systematic-review-and-pooled-analysis-of-the-literature
#3
Bruno C Flores, Jonathan A White, H Hunt Batjer, Duke S Samson
OBJECTIVE Paraclinoid internal carotid artery (ICA) aneurysms frequently require temporary occlusion to facilitate safe clipping. Brisk retrograde flow through the ophthalmic artery and cavernous ICA branches make simple trapping inadequate to soften the aneurysm. The retrograde suction decompression (RSD), or Dallas RSD, technique was described in 1990 in an attempt to overcome some of those treatment limitations. A frequent criticism of the RSD technique is an allegedly high risk of cervical ICA dissection...
May 4, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29725569/nontraumatic-acetabular-fracture-sustained-during-convulsive-seizure-following-surgery-for-an-unruptured-intracranial-aneurysm-a-case-report
#4
Hirofumi Iwamoto, Kazuhiro Nakamura, Daisuke Watanabe, Kiyoyuki Yanaka, Takeshi Ainoya, Tetsuya Yamamoto
Acetabular fracture usually is related to high-energy traumatic injury or falls from heights and directly caused by seizures without trauma is extremely rare. We report a 71-years-old man who sustained a left acetabular fracture secondary to generalized seizure after clipping of an unruptured aneurysm without trauma and any risk for fracture. The patient had an aneurysm was arising from the bifurcation of the left internal carotid artery and the posterior communicating artery. After the clipping, the patient had three times tonic-clonic seizures for 1 min and resulted in an acetabular fracture...
April 2018: NMC case report journal
https://www.readbyqxmd.com/read/29712525/analysis-of-cerebrovascular-aneurysm-treatment-cost-retrospective-cohort-comparison-of-clipping-coiling-and-flow-diversion
#5
Spencer Twitchell, Hussam Abou-Al-Shaar, Jared Reese, Michael Karsy, Ilyas M Eli, Jian Guan, Philipp Taussky, William T Couldwell
OBJECTIVE With the continuous rise of health care costs, hospitals and health care providers must find ways to reduce costs while maintaining high-quality care. Comparing surgical and endovascular treatment of intracranial aneurysms may offer direction in reducing health care costs. The Value-Driven Outcomes (VDO) database at the University of Utah identifies cost drivers and tracks changes over time. In this study, the authors evaluate specific cost drivers for surgical clipping and endovascular management (i...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29691597/preoperative-digital-subtraction-angiography-in-incidental-unruptured-intracranial-aneurysms-how-much-is-too-much
#6
Moriz Herzberg, Robert Forbrig, Christian Schichor, Hartmut Brückmann, Franziska Dorn
PURPOSE: Digital subtraction angiography (DSA) is deemed necessary to precisely visualize intracranial aneurysms and define individual treatment strategies. In patients with unruptured intracranial aneurysms (UIA) who were diagnosed by MRI, a four-vessel DSA is usually performed to detect additional aneurysms. This study aimed to evaluate whether the evaluation of all vessels beyond the aneurysm-harboring artery is really necessary. MATERIAL AND METHODS: Patients with an UIA that was detected on MRA (TOF/ceMRA) were prospectively included...
April 24, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29689406/hyperperfusion-syndrome-after-trapping-with-high-flow-bypass-for-a-giant-paraclinoid-internal-carotid-artery-aneurysm
#7
Masanao Mohri, Toshiya Ichinose, Naoyuki Uchiyama, Kouichi Misaki, Iku Nambu, Yasushi Takabatake, Mitsutoshi Nakada
BACKGROUND: Hyperperfusion syndrome associated with aneurysm surgery is rare. The occurrence of the syndrome after trapping with high-flow bypass has not been described previously. Herein, we present a case of the syndrome occurring after trapping with high-flow bypass of an unruptured giant paraclinoid internal carotid artery (ICA) aneurysm. CASE DESCRIPTION: The patient was a 68-year-old woman with progressive loss of vision in her left eye. After a diagnosis of a left giant ICA aneurysm, she underwent successful trapping with high-flow bypass...
April 21, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29676694/keyhole-strategy-aiming-at-minimizing-hospital-stay-for-surgical-clipping-of-unruptured-middle-cerebral-artery-aneurysms
#8
Kentaro Mori, Kojiro Wada, Naoki Otani, Arata Tomiyama, Terushige Toyooka, Satoru Takeuchi, Takuji Yamamoto, Yasuaki Nakao, Hajime Arai
OBJECTIVE Aneurysms of the middle cerebral artery (MCA) are still most often treated by clipping through standard craniotomy, but a longer hospital stay is one of the main drawbacks of this treatment. The authors developed a pterional keyhole clipping strategy for unruptured MCA aneurysms with the intention of minimizing hospital stay. In this paper, they report on their experience with this approach and analyze the long-term neurological and radiological outcomes. METHODS A total of 160 relatively small unruptured MCA aneurysms (mean 6...
April 20, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29675480/pituitary-dysfunction-from-an-unruptured-ophthalmic-internal-carotid-artery-aneurysm-with-improved-2-year-follow-up-results-a-case-report
#9
Meng Qi, Ming Ye, Meng Li, Peng Zhang
Internal carotid artery (ICA) supraclinoid segment aneurysms extending into the sellar region and leading to pituitary dysfunction are a rare occurrence. To date, long-term follow up of pituitary function 2 years post-treatment has never been reported. Herein, we present a case of pituitary dysfunction due to an unruptured ophthalmic segment internal carotid artery aneurysm and report improved 2-year follow-up results. A 76-year-old male presented with disturbed consciousness due to hyponatremia, which was caused by hypoadrenocorticism resulting from pituitary dysfunction complicated by hypogonadism and hypothyroidism...
2018: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/29624149/detection-rates-and-sites-of-unruptured-intracranial-aneurysms-according-to-sex-and-age-an-analysis-of-mr-angiography-based-brain-examinations-of-4070-healthy-japanese-adults
#10
Yohichi Imaizumi, Tohru Mizutani, Katsuyoshi Shimizu, Yosuke Sato, Junichi Taguchi
OBJECTIVE The purpose of this study was to evaluate the detection rate and occurrence site according to patient sex and age of unruptured intracranial aneurysms detected through MRI and MR angiography (MRA). METHODS A total of 4070 healthy adults 22 years or older (mean age [± SD] 50.6 ± 11.0 years; 41.9% women) who underwent a brain examination known as "Brain Dock" in the central Tokyo area between April 2014 and March 2015 were checked for unruptured saccular aneurysm using 3-T MRI/MRA. The following types of cases were excluded: 1) protrusions with a maximum diameter < 2 mm at locations other than arterial bifurcations, 2) conical protrusions at arterial bifurcations with a diameter < 3 mm, and 3) cases of suspected aneurysms with unclear imaging of the involved artery...
April 6, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29608473/cavernous-sinus-aneurysm-associated-with-cerebellar-hemangioblastoma-in-an-adult-with-von-hippel-lindau-disease
#11
Hui Zhou, Shuo Sun, Hui Shi, Kui Ma
A case of cerebellar hemangioblastoma with von Hippel-Lindau disease and an aneurysm of the cavernous sinus segment of the internal carotid artery is presented here. A 60-year-old woman presented with a cerebellar solid tumor manifesting as headache of 4 months, progressive vomiting, and ataxia of half a month. Four-vessel angiography revealed a high stain mass tumor located in the posterior fossa; an aneurysm on the cavernous sinus segment of the internal carotid artery was demonstrated at the same time. The ipsilateral anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar artery (PICA) branches were the main feeding vessels of the hemangioblastoma...
March 30, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29602477/flow-instability-detected-in-ruptured-versus-unruptured-cerebral-aneurysms-at-the-internal-carotid-artery
#12
Lijian Xu, Fuyou Liang, Lixu Gu, Hao Liu
Flow instability has emerged as a new hemodynamic metric hypothesized to have potential value in assessing the rupture risk of cerebral aneurysms. However, diverse findings have been reported in the literature. In the present study, high-resolution hemodynamic simulations were performed retrospectively on 35 aneurysms (10 ruptured & 25 unruptured) located at the internal carotid artery (ICA). Simulated hemodynamic parameters were statistically compared between the ruptured and unruptured aneurysms, with emphasis on examining the correlation of flow instability with the status of aneurysm rupture...
March 15, 2018: Journal of Biomechanics
https://www.readbyqxmd.com/read/29538687/spinal-cord-infarction-in-the-region-of-the-posterior-spinal-artery-after-embolization-for-vertebral-artery-dissection
#13
Wataro Tsuruta, Tetsuya Yamamoto, Go Ikeda, Masayuki Sato, Yoshiro Ito, Tomoji Takigawa, Aiki Marushima, Yasunobu Nakai, Yuji Matsumaru, Akira Matsumura
BACKGROUND: Endovascular surgery for vertebral artery dissections (VADs) carries the risk of spinal cord infarction (SCI). Although SCI in the region of the anterior spinal artery (ASA) has been reported, SCI in the region of the posterior spinal artery (PSA) is rare. OBJECTIVE: To investigate PSA infarction after endovascular surgery for VAD. METHODS: Infarction in the region of the PSA after endovascular surgery for VADs carried out in consecutive 21 cases was investigated...
March 9, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29519788/long-term-outcomes-of-patients-with-stent-tips-embedded-into-internal-carotid-artery-branches-during-aneurysm-coiling
#14
S P Ban, O-K Kwon, S U Lee, J S Bang, C W Oh, H J Jeong, M J Cho, E-A Jeong, T Kim
BACKGROUND AND PURPOSE: During stent-assisted coiling of ICA aneurysms, stent tips are sometimes unintentionally embedded into ICA branches. Stent tips can be visualized because they have radiopaque markers. Concerns regarding stent tip misplacement include risks of artery perforation and occlusion. The aim of this study was to evaluate the long-term outcomes of ICA branches with embedded stent tips. MATERIALS AND METHODS: ICA branches with embedded stent tips were identified among 35 patients with unruptured ICA aneurysms treated with stent-assisted coiling between November 2003 and November 2014...
May 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29518864/-clinical-features-and-risk-factors-of-internal-carotid-artery-stenosis-coexisting-with-unruptured-intracranial-aneurysm
#15
H Y Zhao, Z C Jia, D S Fan
Objective: To analyze the incidence of intracranial unruptured aneurysms in patients with internal carotid artery (ICA) stenosis (≥30%), the characteristics of aneurysms and risk factors in patients with ICA stenosis and intracranial aneurysm. Methods: Clinical data of patients receiving digital subtraction angiography (DSA) at Peking University Third Hospital between January 2012 and June 2015 were retrospectively reviewed to identify patients with ICA stenosis and unruptured intracranial aneurysm. Results: Among 247 patients with ICA stenosis, 16 patients (6...
March 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29497785/transcervical-access-via-direct-neck-exposure-for-neurointerventional-procedures-in-the-hybrid-angiosuite
#16
Jong Young Lee, Jong-Hwa Park, Hong Jun Jeon, Dae Young Yoon, Seoung Woo Park, Byung Moon Cho
PURPOSE: A complicated course of the femoral route for neurointervention can prevent approaching the target. Thus, we determined whether transcervical access in the hybrid angiosuite is applicable and beneficial in real practice. METHODS: From January 2014 to March 2017, this approach was used in 17 of 453 (3.75%) cases: 11 cerebral aneurysms (4 ruptured, 7 unruptured), 4 acute occlusions of the large cerebral artery, 1 proximal internal carotid artery (ICA) stenosis, and 1 direct carotid cavernous fistula (CCF)...
May 2018: Neuroradiology
https://www.readbyqxmd.com/read/29384186/intentional-herniation-technique-with-the-neuroform-ez-stent-system-for-preservation-of-aneurysmal-neck-branch-a-case-report
#17
Yoji Kuramoto, Kazuyuki Mikami, Toshiaki Bando, Yasushi Ueno
PURPOSE: Endovascular treatment of bifurcation aneurysms is difficult and complicated because arterial branches may arise from the aneurysmal neck. We treat these cases with complex techniques such as Y or T stenting. In this report, we deployed one Neuroform EZ stent using the intentional herniation technique for the preservation of arterial branches. CASE PRESENTATION: A 78-year-old female presented with two unruptured aneurysms. One was an 8 mm aneurysm located at the bifurcation of the internal carotid artery and the posterior communicating artery (PcomA)...
December 6, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/29352057/feasibility-complications-morbidity-and-mortality-results-at-6-months-for-aneurysm-treatment-with-the-flow-re-direction-endoluminal-device-report-of-safe-study
#18
Laurent Pierot, Laurent Spelle, Jérôme Berge, Anne-Christine Januel, Denis Herbreteau, Mohamed Aggour, Michel Piotin, Alessandra Biondi, Xavier Barreau, Charbel Mounayer, Chrisanthi Papagiannaki, Jean-Paul Lejeune, Jean-Yves Gauvrit, Vincent Costalat
BACKGROUND AND PURPOSE: Flow diverters are increasingly used for the treatment of intracranial aneurysms. Evaluation of the first devices available for clinical use showed high efficacy of this treatment although safety results were worse compared with coiling or balloon-assisted coiling. The <u>S</u>afety and Efficacy <u>A</u>nalysis of <u>F</u>RED <u>E</u>mbolic Device in Aneurysm Treatment (SAFE) trial is a single-arm, multicenter, prospective study conducted to precisely analyze the safety and efficacy of the FRED and FRED Jr devices...
January 19, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29131823/prevalence-of-extracranial-carotid-artery-aneurysms-in-patients-with-an-intracranial-aneurysm
#19
V E C Pourier, C J H C M van Laarhoven, M D I Vergouwen, G J E Rinkel, Gert J de Borst
BACKGROUND AND PURPOSE: Aneurysms in various arterial beds have common risk- and genetic factors. Data on the correlation of extracranial carotid artery aneurysms (ECAA) with aneurysms in other vascular territories are lacking. We aimed to investigate the prevalence of ECAA in patients with an intracranial aneurysm (IA). METHODS: We used prospectively collected databases of consecutive patients registered at the University Medical Center Utrecht with an unruptured intracranial aneurysm (UIA) or aneurysmal Subarachnoid hemorrhage (SAH)...
2017: PloS One
https://www.readbyqxmd.com/read/29130668/-analysis-on-clinical-characteristic-and-risk-factors-of-patients-coexistence-of-cerebral-artery-stenosis-with-unruptured-intracranial-aneurysm
#20
Hai-Yan Zhao, Jin-Tao Han, Dong-Sheng Fan
OBJECTIVE: To analyze the incidence of intracranial unruptured aneurysms in patients with intracranial artery stenosis,clinical features,and investigate the risk factors for unruptured intracranial aneurysms. METHODS: Medical records from all patients performed with digital subtraction angiography (DSA) who had been treated at Peking University Third Hospital,China,from January 2012 to December 2015 were retrospectively reviewed to identify cases coexistence with cerebral artery stenosis and unruptured intracranial aneurysm...
September 2017: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
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