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intracranial aneurysm

Jacques Sedat, Yves Chau, Jean Gaudart, Marina Sachet, Stephanie Beuil, Michel Lonjon
BACKGROUND: Thromboembolic complications are the main problem in stent-assisted coil embolization of unruptured intracranial aneurysms. The combination of aspirin and clopidogrel is generally used to decrease these complications, but some patients do not respond to clopidogrel and have a higher risk of stent thrombosis. In cardiology, clinical trials have shown that prasugrel reduced the incidence of ischaemic events in patients with acute coronary syndrome compared with clopidogrel but, according to several authors, prasugrel would produce an increased risk of cerebral haemorrhagic complications...
October 19, 2016: Interventional Neuroradiology
Marcus D Mazur, Philipp Taussky, Joel D MacDonald, Min S Park
BACKGROUND AND IMPORTANCE: As the use of flow-diverting stents (FDSs) for intracranial aneurysms expands, a small number of case reports have described the successful treatment of blister aneurysms of the internal carotid artery with flow diversion. Blister aneurysms are uncommon and fragile lesions that historically have high rates of morbidity and mortality despite multiple treatment strategies. We report a case of rebleeding after treatment of a ruptured blister aneurysm with deployment of a single FDS...
November 2016: Neurosurgery
Hao Li, Jizong Zhao, Wen Wang, Lu Zhang, Qing Lan, Jiangfei Wang, Yong Cao, Jizong Zhao
BACKGROUND: Intracranial aneurysm (IA) is a cerebrovascular disorder characterized by an abnormally bulged artery in the brain and subarachnoid hemorrhage caused by IA rupture with a high ratio of fatality and morbidity. However, the genetic etiology of IA remains largely unknown. MATERIALS AND METHODS: A dysregulated lncRNA-associated competing endogenous RNA (ceRNA) network was constructed by utilizing sample-matched microRNA (miRNA), long non-coding RNA (lncRNA) and mRNA expression profiles in 12 saccular IA samples and paired control arteries...
October 14, 2016: World Neurosurgery
Sirui Zhou, Amirthagowri Ambalavanan, Daniel Rochefort, Pingxing Xie, Cynthia V Bourassa, Pascale Hince, Alexandre Dionne-Laporte, Dan Spiegelman, Ziv Gan-Or, Cathy Mirarchi, Vessela Zaharieva, Nicolas Dupré, Hatasu Kobayashi, Toshiaki Hitomi, Kouji Harada, Akio Koizumi, Lan Xiong, Patrick A Dion, Guy A Rouleau
Intracranial aneurysms (IAs) are the result of focal weakness in the artery wall and have a complex genetic makeup. To date, genome-wide association and sequencing studies have had limited success in identifying IA risk factors. Distinct populations, such as the French-Canadian (FC) population, have increased IA prevalence. In our study, we used exome sequencing to prioritize risk variants in a discovery cohort of six FC families affected by IA, and the analysis revealed an increased variation burden for ring finger protein 213 (RNF213)...
September 30, 2016: American Journal of Human Genetics
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
Emma Hitchcock, William T Gibson
Here we review the current understanding of the genetic architecture of intracranial berry aneurysms (IBA) to aid in the genetic counseling of patients at risk for this condition. The familial subtype of IBA, familial intracranial aneurysms (FIA), is associated with increased frequency of IBA, increased risk of rupture, and increased morbidity and mortality after rupture. Family history is the strongest predictor for the development of IBA. However, a genetic test is not yet available to assess risk within a family...
October 14, 2016: Journal of Genetic Counseling
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
Wonhyoung Park, Jae Sung Ahn, Jung Cheol Park, Byung Duk Kwun, Deok Hee Lee
OBJECTIVE: Intracranial infectious aneurysms (IIAs) are a very rare but unique subtype of potentially life-threatening vascular lesion. However, there is no widely accepted standard protocol for their management. We reviewed our treatment experiences of IIAs from 2001 to 2015 and proposed a treatment strategy for future use. METHODS: We retrospectively reviewed 25 patients with 33 IIAs. All patients had predisposing infectious disease for which the causative organism had been identified...
October 11, 2016: World Neurosurgery
Jian Liu, Linkai Jing, Ying Zhang, Ying Song, Yang Wang, Chuanhui Li, Yanmin Wang, Shiqing Mu, Nikhil Paliwal, Hui Meng, Italo Linfante, Xinjian Yang
BACKGROUND: Intracranial vertebral artery dissecting aneurysms (VADAs) tend to recur despite successful stent-assisted coil embolization (SACE). Hemodynamics is useful in evaluating aneurysmal formation, growth and rupture. Our aim was to evaluate the hemodynamic patterns of VADA's recurrence. METHODS: Between September 2009 and November 2013, all consecutive patients with recurrent VADAs after SACE in our institutions were enrolled. Recurrence was defined as recanalization and/or regrowth...
October 11, 2016: World Neurosurgery
Tibor Becske, Matthew B Potts, Maksim Shapiro, David F Kallmes, Waleed Brinjikji, Isil Saatci, Cameron G McDougall, István Szikora, Giuseppe Lanzino, Christopher J Moran, Henry H Woo, Demetrius K Lopes, Aaron L Berez, Daniel J Cher, Adnan H Siddiqui, Elad I Levy, Felipe C Albuquerque, David J Fiorella, Zsolt Berentei, Miklós Marosföi, Saruhan H Cekirge, Peter K Nelson
OBJECTIVE The long-term effectiveness of endovascular treatment of large and giant wide-neck aneurysms using traditional endovascular techniques has been disappointing, with high recanalization and re-treatment rates. Flow diversion with the Pipeline Embolization Device (PED) has been recently used as a stand-alone therapy for complex aneurysms, showing significant improvement in effectiveness while demonstrating a similar safety profile to stent-supported coil treatment. However, relatively little is known about its long-term safety and effectiveness...
October 14, 2016: Journal of Neurosurgery
Daniel R Felbaum, Kyle Mueller, Ai-Hsi Liu, Rocco A Armonda
Preoperative embolization of meningiomas can be safely performed using a variety of embolic agents. Most commonly, the vascular supply from branches of the external carotid artery is the target of embolization. In our report, we detail the treatment of a patient with a parafalcine meningioma that received its supply via branches of the anterior cerebral artery. One of the feeder vessels appeared to contain a dysplastic aneurysmal dilatation of the vessel. Due to patient circumstances, embolization was performed using standard microcatheterization techniques to minimize intraoperative blood loss...
September 11, 2016: Curēus
Monika Gradzik, Mariusz Niemczyk, Marek Gołębiowski, Leszek Pączek
Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common genetic disorders caused by a single gene mutation. The disease usually manifests itself at the age of 30-40 years and is characterized by formation of renal cysts along with the enlargement of kidneys and deterioration of their function, eventually leading to renal insufficiency. Imaging studies (sonography, computed tomography, magnetic resonance imaging) play an important role in the diagnostics of the disease, the monitoring of its progression, and the detection of complications...
2016: Polish Journal of Radiology
Teng Hu, Dongdong Wang
OBJECTIVES: Posterior communicating artery aneurysms (PcoAA) account for 30-35% of intracranial aneurysms. The anatomical factors involved in the formation of PCoAA are poorly known. The study aimed to investigate the anatomical variations in the posterior communicating artery (PcoAs) and the presence of PCoAA. METHODS: All 154 patients hospitalized from January 2008 to December 2013 at the department of neurology of our hospital were included in this study; 76 were confirmed with PCoAA upon cerebral angiography and 78 were confirmed without cranial artery aneurysm (controls)...
October 12, 2016: Neurological Research
S Voß, S Glaßer, T Hoffmann, O Beuing, S Weigand, K Jachau, B Preim, D Thévenin, G Janiga, P Berg
Computational Fluid Dynamics is intensively used to deepen the understanding of aneurysm growth and rupture in order to support physicians during therapy planning. However, numerous studies considering only the hemodynamics within the vessel lumen found no satisfactory criteria for rupture risk assessment. To improve available simulation models, the rigid vessel wall assumption has been discarded in this work and patient-specific wall thickness is considered within the simulation. For this purpose, a ruptured intracranial aneurysm was prepared ex vivo, followed by the acquisition of local wall thickness using μCT...
2016: Computational and Mathematical Methods in Medicine
Chubin Ou, Wei Huang, Matthew Ming-Fai Yuen, Yi Qian
Hemodynamics has been recognized as an important factor in the development, growth, and rupture of cerebral aneurysms, and investigated by computational fluid dynamics techniques using a single phase approach. However, flow-dependent cell transport and interactions are usually ignored in single phase models, in which blood is usually treated as a single phase Newtonian fluid. For getting better insight into the underlying pathology of intracranial aneurysm, cell transport and interactions should be covered in hemodynamic studies...
September 16, 2016: Journal of Biomechanics
Jian Guan, Michael Karsy, William T Couldwell, Richard H Schmidt, Philipp Taussky, Joel D MacDonald, Min S Park
OBJECTIVE The choice between treating and observing unruptured intracranial aneurysms is often difficult, with little guidance on which variables should influence decision making on a patient-by-patient basis. Here, the authors compared demographic variables, aneurysm-related variables, and comorbidities in patients who received microsurgical or endovascular treatment and those who were conservatively managed to determine which factors push the surgeon toward recommending treatment. METHODS A retrospective chart review was conducted of all patients diagnosed with an unruptured intracranial aneurysm at their institution between January 1, 2013, and January 1, 2016...
October 7, 2016: Journal of Neurosurgery
Chun Fang, Hua-Qiao Tan, Hong-Jie Han, Hao Feng, Ji-Chong Xu, Shuo Yan, Zhi-Yu Nie, Ling-Jing Jin, Fei Teng
OBJECTIVE: Intracranial blood blister-like aneurysm (BBA) is a rare type of aneurysm that lacks all layers of the arterial wall. These fragile aneurysms have the propensity to rupture with minimal manipulation, which makes them hazardous and difficult to treat. The present study evaluated the safety and feasibility of endovascular treatment of BBAs with the Willis covered stent. MATERIALS: Thirteen patients (7 men and 6 women, age range 28-68 years) who presented with ruptured BBAs and were treated with the Willis covered stent were retrospectively reviewed...
October 5, 2016: Journal of Neurointerventional Surgery
Miklos Marosfoi, Erin T Langan, Lara Strittmatter, Kajo van der Marel, Srinivasan Vedantham, Jennifer Arends, Ivan R Lylyk, Siddharth Loganathan, Gregory M Hendricks, Istvan Szikora, Ajit S Puri, Ajay K Wakhloo, Matthew J Gounis
BACKGROUND: Vascular remodeling in response to implantation of a tissue engineering scaffold such as a flow diverter (FD) leads to the cure of intracranial aneurysms. We hypothesize that the vascular response is dependent on FD design, and CD34+ progenitor cells play an important role in the endothelialization of the implant. METHODS: Sixteen rabbit aneurysms were randomly treated with two different single-layer braided FDs made of cobalt-chrome alloys. The FD-48 and FD-72 devices had 48 and 72 wires, respectively...
October 5, 2016: Journal of Neurointerventional Surgery
Shin-Ichiro Sugiyama, Hidenori Endo, Kuniyasu Niizuma, Toshiki Endo, Kenichi Funamoto, Makoto Ohta, Teiji Tominaga
This was a proof-of-concept computational fluid dynamics (CFD) study designed to identify atherosclerotic changes in intracranial aneurysms. We selected 3 patients with multiple unruptured aneurysms including at least one with atherosclerotic changes and investigated whether an image-based CFD study could provide useful information for discriminating the atherosclerotic aneurysms. Patient-specific geometries were constructed from three-dimensional data obtained using rotational angiography. Transient simulations were conducted under patient-specific inlet flow rates measured by phase-contrast magnetic resonance velocimetry...
2016: Computational and Mathematical Methods in Medicine
Sophia F Shakur, Victor A Aletich, Sepideh Amin-Hanjani, Ahmed E Hussein, Fady T Charbel, Ali Alaraj
BACKGROUND: Pipeline embolization devices (PEDs) are commonly used for endovascular treatment of cerebral aneurysms but can be associated with delayed ipsilateral intraparenchymal hemorrhage. Although intra-aneurysmal hemodynamic changes have been studied, parent vessel and intracranial hemodynamics after PED use are unknown. We examine the impact of flow diversion on parent artery and distal intracranial hemodynamics. METHOD: Patients with internal carotid cerebral aneurysms treated with PED who had flow volume rate, flow velocities, pulsatility index, resistance index, Lindegaard ratio, and wall shear stress (WSS) obtained after treatment using quantitative magnetic resonance angiography were reviewed...
October 4, 2016: Interventional Neuroradiology
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