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cerebral aneurysm rupture risk

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https://www.readbyqxmd.com/read/29444617/hemodynamic-impingement-and-the-initiation-of-intracranial-side-wall-aneurysms
#1
Gerald J Riccardello, Abhinav R Changa, Fawaz Al-Mufti, I Paul Singh, Chirag Gandhi, Max Roman, Charles J Prestigiacomo
Objective The natural history intracranial aneurysms (IA) remains poorly understood despite significant morbidity and mortality associated with IA rupture. Hemodynamic impingement resulting in elevations in wall shear stress and wall shear stress gradient (WSSG) has been shown to induce aneurysmal remodeling at arterial bifurcations. We investigate the hemodynamic environment specific to side-wall pre-aneurysmal vasculature. We hypothesize that fluid impingement and secondary flow patterns play a role in side-wall aneurysm initiation...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29444616/endovascular-treatment-of-cerebral-aneurysm-after-renal-transplantation-in-polycystic-kidney-disease
#2
Zeferino Demartini, Jennyfer Galdino, Gelson L Koppe, Alexandre T Bignelli, Alexandre N Francisco, Luana Am Gatto
Background Patients with polycystic kidney disease have a higher prevalence of intracranial aneurysms and may progress to renal failure requiring transplantation. The endovascular treatment of intracranial aneurysms may improve prognosis, since rupture often causes premature death or disability, but the nephrotoxicity risk associated with contrast medium must be always considered in cases of renal impairment. Methods A 55-year-old female patient with polycystic kidney disease and grafted kidney associated with anterior communicant artery aneurysm was successfully treated by embolization...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29424648/association-of-plasma-d-dimer-level-with-thromboembolic-events-after-endovascular-coil-treatment-of-ruptured-cerebral-aneurysms
#3
Hitoshi Fukuda, Akira Handa, Masaomi Koyanagi, Benjamin Lo, Sen Yamagata
OBJECTIVE Although endovascular therapy is favored for acutely ruptured intracranial aneurysms, hematological factors associated with acute subarachnoid hemorrhage (SAH) may predispose to procedure-related ischemic complications. The aim of this study was to evaluate whether an elevated level of plasma D-dimer, a parameter of hypercoagulation in patients with acute SAH, is correlated with increased incidence of thromboembolic events during endovascular coiling of ruptured aneurysms. METHODS The authors analyzed data from 103 cases of acutely ruptured aneurysms (in 103 patients) treated with endovascular coil embolization at a single institution...
February 9, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29417290/secondary-coiling-after-incomplete-surgical-clipping-of-cerebral-aneurysms-a-rescue-strategy-or-a-treatment-option-for-complex-cases-institutional-series-and-systematic-review
#4
REVIEW
Giuseppe Maria Della Pepa, Federico Bianchi, Alba Scerrati, Alessio Albanese, Enrico Cotroneo, Alberto Delitala, Renato Gigli, Giuseppe La Rocca, Enrico Marchese, Alessandro Pedicelli, Alfredo Puca, Giovanni Sabatino, Alessando Olivi, Carmelo Lucio Sturiale
Residual and recurrent intracranial aneurysms after surgical clipping present a persistent risk of bleeding. Secondary coiling after incomplete clipping represents a strategy to occlude the residual sac: feasibility, bleeding risk and outcome were evaluated through a systematic review of literature along with the series of two tertiary referral neurovascular centres. Demographics, ruptured status, aneurysm morphology, topography, exclusion at surgery, timing of secondary coiling, complications, occlusion rate and outcome were analysed...
February 7, 2018: Neurosurgical Review
https://www.readbyqxmd.com/read/29404853/implantation-of-multiple-polytetrafluoroethylene-covered-stent-inside-drug-eluting-stent-to-rescue-purulent-coronary-artery-ectasia-with-giant-saccular-aneurysm
#5
Yusuke Namba, Toshiaki Yamanaka, Jun Ida, Takefumi Oka
A 79-year-old male with diabetes mellitus and old cerebral infarction was admitted to hospital due to fever and palpitation. Diagnosis of purulent pericarditis was established by pericardial effusion examination. The patient's general condition improved temporarily after drainage of the pericardial effusion. However, computed tomography demonstrated a saccular aneurysm arising from RCA have rapidly grown even larger, up to 63 × 51 mm on 7th hospital day. This indicated that the risk of rupture of the aneurysm was high...
February 5, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29362932/increased-rate-of-ventriculostomy-related-hemorrhage-following-endovascular-treatment-of-ruptured-aneurysms-compared-to-clipping
#6
Christian Scheller, Christian Strauss, Julian Prell, Sebastian Simmermacher, Silvio Brandt
OBJECTIVE: Acutely ruptured aneurysms can be treated by endovascular intervention or via surgery (clipping). After endovascular treatment, the risk of thromboembolic complications is reduced by the use of anticoagulative agents, which is not required after clipping. The aim of the study is to investigate the rate of ventriculostomy-related hemorrhage after endovascular treatment and clipping. METHODS: A consecutive series of 99 patients treated for a ruptured aneurysm which required an external ventricular drainage between 2010 and 2015 were included...
January 23, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29360591/current-perspectives-in-imaging-modalities-for-the-assessment-of-unruptured-intracranial-aneurysms-a-comparative-analysis-and-review
#7
REVIEW
Nefize Turan, Robert A Heider, Anil K Roy, Brandon A Miller, Mark E Mullins, Daniel L Barrow, Jonathan Grossberg, Gustavo Pradilla
BACKGROUND: Intracranial aneurysms (IA) are pathological dilatations of cerebral arteries. This systematic review summarizes and compares imaging techniques for assessing unruptured intracranial aneurysms (UIAs). This review also addresses their uses in different scopes of practice. Pathophysiologic mechanisms are reviewed to better understand the clinical utility of each imaging modality. METHODS: A literature review was performed using PubMed with these search terms: "intracranial aneurysm," "cerebral aneurysm," "magnetic resonance angiography (MRA)," computed tomography angiography (CTA)," "catheter angiography," "digital subtraction angiography," "molecular imaging" "ferumoxytol" and "myeloperoxidase"...
January 19, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29348119/cigarette-smoke-initiates-oxidative-stress-induced-cellular-phenotypic-modulation-leading-to-cerebral-aneurysm-pathogenesis
#8
Robert M Starke, John W Thompson, Muhammad S Ali, Crissey L Pascale, Alejandra Martinez Lege, Dale Ding, Nohra Chalouhi, David M Hasan, Pascal Jabbour, Gary K Owens, Michal Toborek, Joshua M Hare, Aaron S Dumont
OBJECTIVE: Cigarette smoke exposure (CSE) is a risk factor for cerebral aneurysm (CA) formation, but the molecular mechanisms are unclear. Although CSE is known to contribute to excess reactive oxygen species generation, the role of oxidative stress on vascular smooth muscle cell (VSMC) phenotypic modulation and pathogenesis of CAs is unknown. The goal of this study was to investigate whether CSE activates a NOX (NAPDH oxidase)-dependent pathway leading to VSMC phenotypic modulation and CA formation and rupture...
January 18, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/29338437/elderly-population-have-a-decreased-aneurysmal-subarachnoid-hemorrhage-incidence-rate-than-middle-aged-population-a-descriptive-analysis-of-8-144-cases-in-mainland-china
#9
Yì Xiáng J Wáng, Lihong Zhang, Lin Zhao, Jian He, Xian-Jun Zeng, Heng Liu, Yun-Jun Yang, Shang-Wei Ding, Zhong-Fei Xu, Yong-Ming He, Lin Yang, Lan Sun, Ke-Jie Mu, Bai-Song Wang, Xiao-Hong Xu, Zhong-You Ji, Jian-Hua Liu, Jin-Zhou Fang, Rui Hou, Feng Fan, Guang-Ming Peng, Yue-Qi Zhu, Sheng-Hong Ju, Wai S Poon
PURPOSE: Rupture of an intracranial aneurysm is a life-threatening acute cerebrovascular event. The purpose of this study was to investigate whether aneurysmal subarachnoid haemorrhage (SAH) incidence rate is higher or lower in elderly population than in middle aged population. MATERIALS AND METHODS: Aneurysmal SAH cases were collected retrospectively from the archives of 21 hospitals in Mainland China. All the cases were collected from September 2016 and backward consecutively for a period of time up to 8 years...
January 17, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29325471/intracranial-subarachnoid-hemorrhage-following-cervical-laminoplasty-a-report-of-two-cases
#10
Yuichi Kondo, Kazunari Fushimi, Makoto Takasawa, Shigeo Kanamori, Takaki Miyagawa, Kenji Kawashima, Kazutoshi Yokoyama, Haruhiko Akiyama
Intracranial hemorrhage is a rare complication of spinal surgery. Case 1 was a 58-year-old man who underwent cervical laminoplasty. No apparent iatrogenic dural rupture or cerebrospinal fluid leakage was observed. An hour after the surgery, the patient had convulsions and became restless thereafter. CT revealed an intracranial SAH. The patient recovered normal consciousness the next morning. Case 2 was a 68-year-old woman who underwent cervical laminoplasty without postoperative CSF leakage. Six days after the surgery, the patient continued to complain of nausea and headache...
January 12, 2018: International Journal of Neuroscience
https://www.readbyqxmd.com/read/29305915/intraventricular-hemorrhage-due-to-subarachnoid-hemorrhage-does-the-severity-matter
#11
Marvin Darkwah Oppong, Oliver Gembruch, Annika Herten, Roman Frantsev, Mehdi Chihi, Philipp Dammann, Nicolai El Hindy, Michael Forsting, Ulrich Sure, Ramazan Jabbarli
OBJECT: Aneurysm rupture might be accompanied by intraventricular hemorrhage (IVH) that is associated with poor outcome of subarachnoid hemorrhage (SAH). The aim of this study was to analyze risk factors and clinical impact of IVH severity. MATERIAL AND METHODS: 995 consecutive SAH patients treated at our institution between January 2003 and June 2016 were eligible for this study. Clinical and radiological findings were correlated with the presence and severity of IVH assessed with the original Graeb score...
January 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29258945/impacts-of-a-size-ratio-on-outcome-in-patients-with-surgically-treated-unruptured-non-dissecting-anterior-cerebral-artery-aneurysms
#12
Hidetoshi Matsukawa, Hiroyasu Kamiyama, Takanori Miyazaki, Yu Kinoshita, Kosumo Noda, Nakao Ota, Norihiro Saito, Rihee Takeda, Sadahisa Tokuda, Rokuya Tanikawa
BACKGROUND: Anterior cerebral artery aneurysms (ACAs) are characterized by higher rupture rate and small size at rupture. It was revealed that the aneurysm-to-vessel size ratio, and not the absolute size, might predict the risk of rupture in small unruptured intracranial aneurysms.The present study aimed to investigate the relationship between a size ratio and outcome in patients with unruptured non-dissecting ACA aneurysms (UNDAs). METHODS: Consecutive 187 patients with 12 A1 (6...
December 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29258940/predictors-of-occurrence-and-anatomic-distribution-of-multiple-aneurysms-in-patients-with-aneurysmal-subarachnoid-hemorrhage
#13
Michel Roethlisberger, Rita Achermann, Schatlo Bawarjan, Martin N Stienen, Christian Fung, Donato D'Alonzo, Nicolai Maldaner, Andrea Ferrari, Marco V Corniola, Daniel Schöni, Daniele Valsecchi, Rodolfo Maduri, Martin A Seule, Jan-Karl Burkhardt, Serge Marbacher, Philippe Bijlenga, Kristine A Blackham, Heiner C Bucher, Luigi Mariani, Raphael Guzman, Daniel W Zumofen
BACKGROUND: The literature on multiple intracranial aneurysms (MIA) in patients with aneurysmal subarachnoid hemorrhage (aSAH) focuses largely on risk factor analysis and consists essentially of retrospective cohort studies of limited sample size, or studies in populations outside Europe and North America. The purpose of this cohort study was to identify predictors for aneurysm multiplicity and to investigate the anatomic distribution of MIA in a representative Western cohort of patients with aSAH...
December 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29190810/aneurysmal-subarachnoid-haemorrhage-asah-five-consecutive-years-experience-of-fars-province-iran
#14
Abdolkarim Rahmanian, Mohammad Jamali, Kamran Bagheri Lankarani, Sulmaz Ghahramani
OBJECTIVE: Subarachnoid haemorrhage (SAH), caused by the rupture of intracranial aneurysms, is a devastating event with high rates of morbidity and mortality. Aneurysmal subarachnoid haemorrhage (aSAH) plays a critical role in the potential loss of life as its sufferers are usually of a young age. We aimed to investigate the incidence of aSAH along with the patients' characteristics over five consecutive years in Fars, a large province located in Southern Iran. METHODS: In this prospective study, anonymous data of all patients diagnosed with aSAH in Fars province were collected after patient admission and surgery...
2017: PloS One
https://www.readbyqxmd.com/read/29172205/-a-case-of-multiple-atherosclerotic-fusiform-cerebral-aneurysms-with-repeated-subarachnoid-hemorrhage
#15
Kotaro Oshio, Tetsuya Ikeda, Takashi Matsumori, Daisuke Wakui, Hidemichi Ito, Hiroshi Takasuna, Yuichiro Tanaka
Pure fusiform aneurysms without dissection are considered to have a low risk of rupture. Furthermore, aneurysm wall with atherosclerotic change tends to be less susceptible to rupture. We present a rare case of multiple atherosclerotic fusiform aneurysms associated with repeated subarachnoid hemorrhage(SAH)during a 9-year observation period. A 34-year-old woman was admitted to our hospital because of SAH. SAH with a temporal hematoma due to a fusiform aneurysm of the right middle cerebral artery(MCA)was detected using computed tomography(CT)...
November 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29155706/comprehensive-endovascular-and-open-surgical-management-of-cerebral-arteriovenous-malformations
#16
Robert C Rennert, Jeffrey A Steinberg, Vincent J Cheung, David R Santiago-Dieppa, Jeffrey Scott Pannell, Alexander A Khalessi
Arteriovenious malformations (AVMs) are associated with significant morbidity and mortality, and have a rupture risk of ~3% per year. Treatment of AVMs must be tailored specifically to the lesion, with surgical resection being the gold standard for small, accessible lesions. Pre-operative embolization of AVMs can reduce nidal blood flow and remove high-risk AVM features such as intranidal or venous aneurysms, thereby simplifying a challenging neurosurgical procedure. Herein, we describe our approach for the staged endovascular embolization and open resection of AVMs, and highlight the advantages of having a comprehensively trained neurovascular surgeon leading a multi-disciplinary clinical team...
October 20, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29129762/risk-factors-for-the-rupture-of-intracranial-aneurysms-using-computed-tomography-angiography
#17
Guang-Xian Wang, Li Wen, Liu Yang, Qi-Chuang Zhang, Jin-Bo Yin, Chun-Mei Duan, Dong Zhang
OBJECTIVE: To study the clinical and morphologic characteristics associated with risk factors for the rupture of intracranial aneurysms (IAs). METHODS: A total of 1115 consecutive patients with 1282 IAs were reviewed from August 2011 to February 2016. The patients and IAs were divided into ruptured and unruptured groups. Based on the clinical and morphologic findings, the risk factors for IA rupture were assessed using statistical methods. RESULTS: Age, hypertension, diabetes mellitus, and cerebral atherosclerosis were associated with ruptured IAs...
November 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29125027/thromboembolic-complications-during-endovascular-treatment-of-ruptured-cerebral-aneurysms
#18
Motohiro Nomura, Kentaro Mori, Akira Tamase, Tomoya Kamide, Syunsuke Seki, Yu Iida, Kazutaka Shirokane, Eiichi Baba, Atsushi Tsuchiya, Hiroshi Shima
Background In cases of subarachnoid hemorrhage due to aneurysm rupture, the administration of an anticoagulant or antiplatelet agent involves the risk of rebleeding from the aneurysm. There is a possibility of inducing thromboembolic events during the endovascular embolization of ruptured cerebral aneurysms. Patients and methods From April 2006 to March 2017, we treated a total of 70 patients with ruptured cerebral aneurysms with an endovascular technique. Among them, five patients (7.1%) showed intra-arterial thrombus formation...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29107725/proximal-stenosis-is-associated-with-rupture-status-in-middle-cerebral-artery-aneurysms
#19
Alexei Antonov, Kenichi Kono, Kilian Greim-Kuczewski, James E Hippelheuser, Alexandra Lauric, Adel M Malek
BACKGROUND: Hemodynamic factors impact cerebral aneurysm development and progression. Parent vessel architectural features, such as caliber, curvature and angle can affect downstream pressure and shear stress. OBJECTIVE: Investigate the association between proximal parent vessel stenosis and aneurysm rupture status at the middle cerebral artery (MCA) bifurcation. METHODS: Catheter 3D rotational angiographic datasets from 69 Japanese patients with MCA aneurysms (58 unruptured/11 ruptured) were analyzed...
October 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29103932/incidence-and-prognostic-factors-related-to-major-adverse-cerebrovascular-events-in-patients-with-complex-aortic-diseases-treated-by-the-chimney-technique
#20
Michel J Bosiers, Kenneth Tran, Jason T Lee, Konstantinos P Donas, Frank J Veith, Giovanni Torsello, Felice Pecoraro, Konstantinos Stavroulakis
OBJECTIVE: Endovascular aneurysm repair (EVAR) with the chimney technique (ch-EVAR) has been used for the treatment of aortic aneurysms as an alternative approach to fenestrated endografting or open repair. Nonetheless, the need for an upper extremity arterial access may contribute to a higher risk for periprocedural cerebrovascular events. This study reports on the perioperative cerebral and major adverse cardiac and cerebrovascular events (MACCE) after ch-EVAR. METHODS: The PERICLES registry (PERformance of the chImney technique for the treatment of Complex aortic pathoLogiES) is an international, retrospective multicenter study evaluating the performance of ch-EVAR for the treatment of complex aortic pathologies...
November 2, 2017: Journal of Vascular Surgery
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