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https://www.readbyqxmd.com/read/29331948/lvis-blue-as-a-low-porosity-stent-and-coil-adjuvant
#1
Matthew J Koch, Christopher J Stapleton, Scott B Raymond, Susan Williams, Thabele M Leslie-Mazwi, James David Rabinov, Aman B Patel
INTRODUCTION: The LVIS Blue is an FDA-approved stent with 28% metallic coverage that is indicated for use in conjunction with coil embolization for the treatment of intracranial aneurysms. Given a porosity similar to approved flow diverters and higher than currently available intracranial stents, we sought to evaluate the effectiveness of this device for the treatment of intracranial aneurysms. METHODS: We performed an observational single-center study to evaluate initial occlusion and occlusion at 6-month follow-up for patients treated with the LVIS Blue in conjunction with coil embolization at our institution using the modified Raymond-Roy classification (mRRC), where mRRC 1 indicates complete embolization, mRRC 2 persistent opacification of the aneurysm neck, mRRC 3a filling of the aneurysm dome within coil interstices, and mRRC 3b filling of the aneurysm dome...
January 13, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29327997/mechanical-thrombectomy-in-basilar-artery-occlusion-influence-of-reperfusion-on-clinical-outcome-and-impact-of-the-first-line-strategy-adapt-vs-stent-retriever
#2
Benjamin Gory, Mikael Mazighi, Raphael Blanc, Julien Labreuche, Michel Piotin, Francis Turjman, Bertrand Lapergue
OBJECTIVE Several randomized trials have been focused on patients with anterior circulation stroke, whereas few data on posterior circulation stroke are available. Thus, new mechanical thrombectomy (MT) strategies, including a direct-aspiration first-pass technique (ADAPT), remain to be evaluated in basilar artery occlusion (BAO) patients. The authors here assessed the influence of reperfusion on outcome in BAO patients and examined whether ADAPT improves the reperfusion rate compared with stent retriever devices...
January 12, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29325955/endovascular-patch-embolization-for-blood-blister-like-aneurysms-in-the-dorsal-segment-of-the-internal-carotid-artery
#3
Xudong Hao, Guilin Li, Jian Ren, Jingwei Li, Chuan He, Hong-Qi Zhang
OBJECTIVE: Blood blister-like aneurysms (BBAs) in the dorsal segment of the internal carotid artery (ICA) are fragile and difficult to treat, and the optimal treatment for BBAs is still controversial. We report clinical and angiographic results with procedural details for the treatment of BBA by using the endovascular patch embolization method. METHODS: We retrospectively reviewed patients who presented with subarachnoid hemorrhage(SAH) caused by ICA-BBAs and were treated with the endovascular patch embolization method in our center from October 2011 to March 2015...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29325952/endovascular-treatment-of-intracranial-aneurysms-concomitant-with-severe-adjacent-atherosclerotic-stenosis
#4
Bu-Lang Gao, Zhao-Shuo Li, Tian-Xiao Li, Jiang-Yu Xue, Guang Feng, Zi-Liang Wang, Wei-Xing Bai, Tong-Yuan Zhao, Xiao-Dong Liang
PURPOSE: To investigate the effect and safety of endovascular treatment of intracranial aneurysms concomitant with severe adjacent atherosclerotic stenosis. MATERIALS AND METHODS: Twenty-six patients with aneurysms and adjacent stenosis were prospectively enrolled. The characteristics of the aneurysm, parent artery, atherosclerotic stenosis and endovascular treatment methods were analyzed. RESULTS: All aneurysms were successfully embolized (100%), with stent-assisted coiling in forteen (53...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29322232/mechanical-thrombectomy-using-the-new-solitaire%C3%A2-platinum-stent-retriever-reperfusion-results-complication-rates-and-early-neurological-outcome
#5
Johannes Pfaff, Stefan Rohde, Tobias Engelhorn, Arnd Doerfler, Martin Bendszus, Markus Alfred Möhlenbruch
BACKGROUND AND PURPOSE: The application of radiopaque markers to the Solitaire™ stent-retriever for better visibility during mechanical thrombectomy (MT) has the potential to alter the well-known characteristics of the device; however, it is uncertain whether this adjustment influences efficacy or safety of the enhanced stent-retriever. METHODS: Retrospective analysis of stroke databases of three comprehensive stroke centers. Our investigation was focused on technical and angiographic parameters, including procedure times, reperfusion results (thrombolysis in cerebral infarction, TICI), periprocedural complications and favorable early neurological recovery at discharge (modified Rankin scale ≤2 or National Institutes of Health Stroke Scale, NIHSS = 0 or ∆NIHSS ≥ 10), from consecutive patients with acute anterior circulation ischemic stroke treated with a Solitaire™ Platinum stent-retriever between October 2016 and March 2017...
January 10, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29318353/the-barrel-vascular-reconstruction-device-a%C3%A2-retrospective-observational-multicentric-study
#6
C Kabbasch, A Mpotsaris, V Maus, J C Altenbernd, C Loehr
BACKGROUND AND PURPOSE: The Barrel device is an electrolytically detachable laser cut, closed-cell microstent that is used for neck reconstruction in wide-necked bifurcation and branching aneurysms to support coiling. The key feature is a barrel section that herniates over the aneurysmal ostium. The objective was to evaluate the safety, feasibility and the immediate and mid-term occlusion results of this new device. MATERIAL AND METHODS: The databases of two tertiary care centers were screened for all Barrel-based stent-assisted intracranial coil embolization of wide-necked aneurysms between June 2015 and September 2016...
January 9, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29317468/radiation-exposure-and-procedure-and-fluoroscopy-times-in-endovascular-treatment-of-intracranial-aneurysms-a-methodological-comparison
#7
Nicholas K Cheung, Michelle Boutchard, Michael W Carr, Jens J Froelich
BACKGROUND: Limited data are available for radiation exposure, and procedure and fluoroscopy times in neuroendovascular treatment (NET) strategies. OBJECTIVE: This study establishes and compares related parameters between coil embolization (COIL), balloon assisted coil embolization (BAC), stent assisted coil embolization (SAC), and flow diverting technology (FDT) in NET of intracranial aneurysms. MATERIALS AND METHODS: Between 2010 and 2017, 249 consecutive intracranial aneurysms underwent NET at a single center, all performed by the same operator...
January 9, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29301051/antiplatelet-premedication-for-stent-assisted-coil-embolization-of-intracranial-aneurysms-low-dose-prasugrel-vs-clopidogrel
#8
Hyun Ho Choi, Jung Jun Lee, Young Dae Cho, Moon Hee Han, Won-Sang Cho, Jeong Eun Kim, Sang Joon An, Jong Hyeon Mun, Dong Hyun Yoo, Hyun-Seung Kang
BACKGROUND: The use of antiplatelet medications to prevent thrombosis in the treatment of cerebral aneurysms with stents has become widely emphasized. OBJECTIVE: To compare low-dose prasugrel with clopidogrel in stent-assisted coil embolization of intracranial aneurysms. METHODS: This is a retrospective review of 311 aneurysms from 297 patients who underwent stent-assisted endovascular coil embolization of unruptured intracranial aneurysm between November 2014 and March 2017...
December 29, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29296999/safety-and-efficacy-of-a-3-dimensional-stent-retriever-with-aspiration-based-thrombectomy-vs-aspiration-based-thrombectomy-alone-in-acute-ischemic-stroke-intervention-a-randomized-clinical-trial
#9
Raul G Nogueira, Donald Frei, Jawad F Kirmani, Osama Zaidat, Demetrius Lopes, Aquilla S Turk, Donald Heck, Brian Mason, Diogo C Haussen, Elad I Levy, Siddhart Mehta, Marc Lazzaro, Michael Chen, Arnd Dörfler, Albert J Yoo, Colin P Derdeyn, Lee Schwamm, David Langer, Adnan Siddiqui
Importance: The treatment effects of individual mechanical thrombectomy devices in large-vessel acute ischemic stroke (AIS) remain unclear. Objective: To determine whether the novel 3-dimensional (3-D) stent retriever used in conjunction with an aspiration-based mechanical thrombectomy device (Penumbra System; Penumbra) is noninferior to aspiration-based thrombectomy alone in AIS. Design, Setting, and Participants: This randomized, noninferiority clinical trial enrolled patients at 25 North American centers from May 19, 2012, through November 19, 2015, with follow-up for 90 days...
January 2, 2018: JAMA Neurology
https://www.readbyqxmd.com/read/29289804/endovascular-management-of-multiple-dysplastic-aneurysms-in-a-young-male-with-an-unknown-underlying-etiology-a-case-report-and-review-of-the-literature
#10
Tyler Scullen, Mansour Mathkour, Joseph Lockwood, Leah Ott, Ricky Medel, Aaron S Dumont, Peter S Amenta
BACKGROUND: Intracranial aneurysms (IA) are the leading cause of non-traumatic subarachnoid hemorrhage and are most commonly associated with the anterior cerebral artery (ACA) and anterior communicating artery complex. We describe the presentation and management of a 27-year-old male with concurrent bilateral A1-2 junction aneurysms and fusiform intraorbital ophthalmic artery (OA) aneurysms. CASE DESCRIPTION: A 27-year-old male with no past medical history presented with three months of headaches...
December 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29284735/contact-aspiration-versus-stent-retriever-in-patients-with-acute-ischemic-stroke-with-m2-occlusion-in-the-aster-randomized-trial-contact-aspiration-versus-stent-retriever-for-successful-revascularization
#11
Benjamin Gory, Bertrand Lapergue, Raphael Blanc, Julien Labreuche, Malek Ben Machaa, Alain Duhamel, Gautier Marnat, Suzana Saleme, Vincent Costalat, Serge Bracard, Hubert Desal, Mikael Mazighi, Arturo Consoli, Michel Piotin
BACKGROUND AND PURPOSE: Middle cerebral artery M2-segment occlusions represent an important subgroup of patients with acute stroke with large-vessel occlusion. The safety of mechanical thrombectomy, especially contact aspiration (CA), in such distal intracranial occlusions is still under debate. We compared reperfusion, adverse events, neurological recovery, and functional outcome of patients with isolated M2 occlusions according to the first-line strategy mechanical thrombectomy devices (CA versus stent retriever [SR])...
December 28, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29279801/technical-factors-affecting-outcomes-following-endovascular-treatment-of-posterior-circulation-atherosclerotic-lesions
#12
Matthew D Alexander, Jeffrey M Rebhun, Steven W Hetts, Matthew R Amans, Fabio Settecase, Robert J Darflinger, Christopher F Dowd, Van V Halbach, Randall T Higashida, Daniel L Cooke
Background: Atherosclerotic disease of the vertebrobasilar system causes significant morbidity and mortality. All lesions require aggressive medical management, but the role of endovascular interventions remains unsettled. This study examines such endovascular interventions for vertebrobasilar atherosclerosis. Methods: Retrospective review was performed of prospectively maintained procedure logs at three hospitals with comprehensive neurointerventional services...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29279045/ticagrelor-for-neuroendovascular-procedures-a-case-series
#13
Kyle Davis, Christopher Morrison
BACKGROUND: The development of thromboembolism is one of the most common complications of neuroendovascular procedures. Although several small studies have deemed clopidogrel safe and effective in the prevention of intracranial stent thrombosis, ticagrelor has yet to be assessed in this setting. OBJECTIVE: The objective of this study was to retrospectively evaluate the safety and efficacy of ticagrelor in patients undergoing neuroendovascular procedures. METHODS: A retrospective review of patients receiving ticagrelor following neuroendovascular aneurysm repair...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29277587/the-use-of-flow-diverter-in-ruptured-dissecting-intracranial-aneurysms-of-the-posterior-circulation
#14
Volker Maus, Anastasios Mpotsaris, Franziska Dorn, Markus Möhlenbruch, Jan Borggrefe, Pantelis Stavrinou, Nuran Abdullayev, Utako Birgit Barnikol, Thomas Liebig, Christoph Kabbasch
OBJECTIVE: Acute dissecting aneurysms of the posterior circulation are a rare cause of SAH. Established endovascular treatment options include PAO and stent-assisted coiling, but appear to be associated with an increased risk of ischemic stroke. Vessel reconstruction with flow-diverters is an alternative treatment option, however, its safety and efficacy in the acute stage remains unclear. METHODS: Multi-centric retrospective analysis of 15 consecutive acutely ruptured dissecting posterior circulation aneurysms treated with flow-diverters...
December 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29273960/stent-assisted-coiling-of-intracranial-aneurysms-using-leo-stents-long-term-follow-up-in-153-patients
#15
Jacques Sedat, Yves Chau, Jean Gaudart, Marina Sachet, Stephanie Beuil, Michel Lonjon
PURPOSE: Coiling associated with placement of a self-expandable intracranial stent has improved the treatment of intracranial wide-necked aneurysms. Little is known, however, about the durability of this treatment. The purpose of this report is to present our experience with the LEO stent and to evaluate the complications, effectiveness, and long-term results of this technique. METHODS: We analyzed the records of 155 intracranial unruptured aneurysms that were treated by stent-assisted coiling with a LEO stent between 2008 and 2012...
December 23, 2017: Neuroradiology
https://www.readbyqxmd.com/read/29250025/procedure-related-complication-of-willis-covered-stent-in-the-treatment-of-blood-blister-like-aneurysm-stent-detachment-from-dilating-balloon
#16
Yuxiang Zhang, Yupeng Zhang, Fei Liang, Chuhan Jiang
The use of Willis covered stent (WCS) for intracranial aneurysms has increased based on the promising results of previous studies about its safety and effectiveness. With the accumulation of cases, reports about peri-procedural complications are emerging. In our department, 25 patients were treated with WCS during December 2015 to March 2017. We here reported an unexpected technical complication occurred in the treatment with the WCS for a blood blister-like aneurysm (BBA). During the procedure, the distal end of the stents detached from the dilating balloon partially or as a whole...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29246908/long-term-follow-up-of-aneurysms-treated-electively-with-woven-stent-assisted-coiling
#17
Nicholas Kiu Cheung, Albert Hy Chiu, Andrew K Cheung, Jason David Wenderoth
BACKGROUND: Preliminary short-term results for stent-assisted coil embolization (SACE) using woven/braided stents have been promising. However, evidence supporting mid- to long-term efficacy and durability is lacking. OBJECTIVE: To report the long-term results for the durability of elective intracranial aneurysms treated with woven stents. MATERIALS AND METHODS: Between May 2012 and May 2015, 98 consecutive patients with 103 aneurysms underwent elective woven SACE across three Australian neurovascular centres...
December 15, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29246906/comparison-of-the-efficacy-and-safety-of-thrombectomy-devices-in-acute-stroke-a-network-meta-analysis-of-randomized-trials
#18
Hamidreza Saber, Gary B Rajah, Riyad Y Kherallah, Ashutosh P Jadhav, Sandra Narayanan
INTRODUCTION: Mechanical thrombectomy (MT) is increasingly used for large-vessel occlusions (LVO), but randomized clinical trial (RCT) level data with regard to differences in clinical outcomes of MT devices are limited. We conducted a network meta-analysis (NMA) that enables comparison of modern MT devices (Trevo, Solitaire, Aspiration) and strategies (stent retriever vs aspiration) across trials. METHODS: Relevant RCTs were identified by a systematic review. The efficacy outcome was 90-day functional independence (modified Rankin Scale (mRS) score 0-2)...
December 15, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29245300/treatment-of-the-superior-sagittal-sinus-and-transverse-sinus-thrombosis-associated-with-intracranial-hemorrhage-with-the-mechanical-thrombectomy-and-thrombolytics-case-report
#19
Yuchun Liu, Keqin Li, Yi Huang, Jie Sun, Xiang Gao
RATIONALE: The superior sagittal sinus (SSS) and transverse sinus are the major dural sinuses that receive a considerable amount of venous drainage. The occlusion of them has been suggested to cause intracranial hypertension, hemorrhage, and lead to potentially fatal consequences. PATIENT CONCERNS: We reported a 35-year-old woman with headache presented to our emergency department with a decreased level of consciousness and epileptic seizures. The examination of speech, higher mental function, and cranial nerve were normal...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29242362/feasibility-of-permanent-stenting-with-solitaire-fr-as-a-rescue-treatment-for-the-reperfusion-of-acute-intracranial-artery-occlusion
#20
H G Woo, L Sunwoo, C Jung, B J Kim, M-K Han, H-J Bae, Y J Bae, B S Choi, J H Kim
BACKGROUND AND PURPOSE: The Solitaire FR can be used not only as a tool for mechanical thrombectomy but also as a detachable permanent stent. Our aim was to assess the feasibility and safety of permanent stent placement with the Solitaire FR compared with other self-expanding stents for intracranial artery recanalization for acute ischemic stroke. MATERIALS AND METHODS: From January 2011 through January 2016, we retrospectively selected 2979 patients with acute ischemic stroke...
December 14, 2017: AJNR. American Journal of Neuroradiology
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