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Intracranial stenting

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https://www.readbyqxmd.com/read/28318953/mechanical-thrombectomy-in-wake-up-strokes-a-case-series-using-alberta-stroke-program-early-ct-score-aspects-for-patient-selection
#1
Angelos Aristeidis Konstas, Artin Minaeian, Ian B Ross
BACKGROUND: There is lack of published studies on mechanical thrombectomy with stent retrievers for wake-up stroke (WUS). OBJECTIVE: To report the outcomes of WUS patients with large vessel occlusions, selected for intervention based on Alberta Stroke Program Early CT Score (ASPECTS) and treated with stent retrievers or primary aspiration thrombectomy. METHODS: Data were collected retrospectively for each consecutive WUS patient undergoing mechanical thrombectomy with a stent retriever or primary aspiration catheter between February 2015 and September 2016...
March 15, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28304207/dural-venous-sinus-stenting-for-medically-and-surgically-refractory-idiopathic-intracranial-hypertension
#2
Sudhakar R Satti, Lakshmi Leishangthem, Alejandro Spiotta, M Imran Chaudry
Background Idiopathic intracranial hypertension (IIH) is a syndrome defined by elevated intracranial hypertension without radiographic evidence of a mass lesion in the brain. Dural venous sinus stenosis has been increasingly recognized as a treatable cause, and dural venous sinus stenting (DVSS) is increasingly performed. Methods A 5 year single-center retrospective analysis of consecutive patients undergoing DVSS for medically refractory IIH. Results There were 43 patients with a mean imaging follow-up of 6...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304205/stenting-of-the-cervical-internal-carotid-artery-in-acute-stroke-management-the-karolinska-experience
#3
Anastasios Mpotsaris, Christoph Kabbasch, Jan Borggrefe, Vamsi Gontu, Michael Soderman
Background Emergency stent placement in the extracranial internal carotid artery in combination with anterior circulation thrombectomy is a routine procedure. Yet, precise indications and clinical safety in this setting remains controversial. Present data for mechanical thrombectomy include few studies with acute stenting of tandem occlusions. We evaluated the feasibility, safety and clinical outcome of this endovascular treatment in a retrospective analysis of all consecutive cases at a comprehensive stroke centre...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304199/jailed-double-microcatheter-technique-following-horizontal-stenting-for-coil-embolization-of-intracranial-wide-necked-bifurcation-aneurysms-a-technical-report-of-two-cases
#4
Takahiro Kitahara, Taketo Hatano, Makoto Hayase, Etsuko Hattori, Akinori Miyakoshi, Takehiko Nakamura
The horizontal stenting technique facilitates endovascular treatment of wide-necked bifurcation intracranial aneurysms. Previous literature shows, however, that subsequent coil embolization at initial treatment results in incomplete obliteration in many cases. The authors present two consecutive cases of wide-necked large bifurcation aneurysms to describe an additional coil embolization technique following horizontal stenting. The patients were a 53-year-old female with an unruptured internal carotid artery terminus aneurysm and a 57-year-old female with a recurrent basilar artery tip aneurysm...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304190/the-second-generation-eclips-endovascular-clip-system-initial-experience
#5
Albert H Chiu, Joost De Vries, Cian J O'Kelly, Howard Riina, Ian McDougall, Jonathan Tippett, Martina Wan, Airton Leonardo de Oliveira Manoel, Thomas R Marotta
OBJECTIVE Treatment of wide-necked intracranial aneurysms is associated with higher recanalization and complication rates; however, the most commonly used methods are not specifically designed to work in bifurcation lesions. To address these issues, the authors describe the evolution in the design and use of the eCLIPs (Endovascular Clip System) device, a novel hybrid stent-like assist device with flow diverter properties that was first described in 2008. METHODS A registry was established covering 13 international centers at which patients were treated with the second-generation eCLIPs device...
March 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28304189/physiological-remodeling-of-bifurcation-aneurysms-preclinical-results-of-the-eclips-device
#6
Thomas R Marotta, Howard A Riina, Ian McDougall, Donald R Ricci, Monika Killer-Oberpfalzer
OBJECTIVE Intracranial bifurcation aneurysms are complex lesions for which current therapy, including simple coiling, balloon- or stent-assisted coiling, coil retention, or intrasaccular devices, is inadequate. Thromboembolic complications due to a large burden of intraluminal metal, impedance of access to side branches, and a high recurrence rate, due largely to the unmitigated high-pressure flow into the aneurysm (water hammer effect), are among the limitations imposed by current therapy. The authors describe herein a novel device, eCLIPs, and its use in a preclinical laboratory study that suggests the device's design and functional features may overcome many of these limitations...
March 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28298139/emergent-carotid-stenting-and-intra-arterial-abciximab-in-acute-ischemic-stroke-due-to-tandem-occlusion
#7
Fawaz Al-Mufti, Krishna Amuluru, Nathan W Manning, Imad Khan, Lissa Peeling, Chirag D Gandhi, Charles J Prestigiacomo, Galyna Pushchinska, David Fiorella, Henry H Woo
OBJECTIVE: Acute occlusions of the extracranial internal carotid artery (ICA) and a major intracranial artery respond poorly to intravenous tissue plasminogen activator (tPA) and present an endovascular challenge. The aim of our study was to retrospectively delineate the feasibility of the combined use of emergent carotid stenting and intra-arterial (IA) Abciximab with intracranial revascularization in the setting of acute ischemic stroke and carotid occlusions at our institution. METHODS: Eleven patients with complete cervical carotid occlusion with or without concomitant intracranial ICA and/or MCA occlusion were identified from a single center, retrospective review of patients admitted to the Stroke unit...
March 15, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28280103/association-of-genetic-variant-and-platelet-function-in-patients-undergoing-neuroendovascular-stenting
#8
Xin-Gang Li, Ning Ma, Shu-Sen Sun, Zhe Xu, Wei Li, Yong-Jun Wang, Xin Yang, Zhong-Rong Miao, Zhi-Gang Zhao
INTRODUCTION: The risk of recurrent ischaemic events is related to platelet function, which is often assessed by thromboelastography (TEG). TEG has high interindividual variability. OBJECTIVE: To identify causal variants associated with TEG parameters in patients who receive aspirin and clopidogrel after intra- or extracranial stenting. METHODS: Patients who underwent stenting for extracranial or intracranial stenosis (70-99%) were recruited into the study...
March 9, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28275555/endovascular-stroke-treatment-now-and-then-procedural-and-clinical-effectiveness-and-safety-of-different-mechanical-thrombectomy-techniques-over-time
#9
Niels von Gadow, Omid Nikoubashman, Jessica Freiherr, Frank Block, Arno Reich, Gunther Fesl, Martin Wiesmann
BACKGROUND: The most essential development in endovascular stroke treatment (EST) was the shift from intra-arterial thrombolysis to endovascular thrombectomy with dedicated thrombectomy devices, most notably the introduction of stent-retrievers. We evaluated procedural and clinical effectiveness and safety of different EST techniques over time. METHODS: We retrospectively analyzed EST cases that were treated by the same interventionalist before (n=36) and after (n=50) stent-retrievers were established as the treatment device of first choice...
February 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28270000/retrograde-semi-retrieval-technique-for-combined-stentriever-plus-aspiration-thrombectomy-in-acute-ischemic-stroke
#10
Ming Wei, Zhiqiang Wei, Xin Li, Hong Li
The endovascular treatment of acute ischemic stroke has become a standard procedure. The combination of multiple neuroendovascular devices provides more possibilities for the improvement of the thrombectomy technique. We describe a modified retrieval technique using a distal intracranial catheter (DIC) for the semi-retrieval of stentriever during the thrombectomy procedure. The retrograde semi-retrieval technique involves completely unfolding the stent retriever by pulling a Navien catheter and the partial re-sheath of a retrievable stent forming a tapered configuration by pushing the Navien catheter, which results in the thrombi being embedded into the strut, securing the clot within the stent and there being a shorter distance for the clot to travel...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28265011/tourniquet-parent-artery-occlusion-after-flow-diversion
#11
Visish M Srinivasan, Maxim Mokin, Edward A M Duckworth, Stephen Chen, Ajit Puri, Peter Kan
BACKGROUND: The Pipeline Embolization Device (PED) is increasingly used for both on- and off-label purposes for treatment of intracranial aneurysms. The device gradually slows flow of blood into the aneurysm, but the high metal coverage of PED promotes endothelialization of the device. Occasionally, this leads to in-stent stenosis that is clinically well tolerated. We present a multi-institutional Pipeline series that includes three cases of gradual asymptomatic occlusion within the PED and parent vessel...
March 6, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28264249/microguidewire-looping-to-traverse-stented-parent-arteries-of-intracranial-aneurysms
#12
Young Dae Cho, Jong Kook Rhim, Dong Hyun Yoo, Hyun-Seung Kang, Jeong Eun Kim, Moon Hee Han
OBJECTIVE: Stents are widely used in coil embolization of intracranial aneurysms, but on occasion, a microcatheter must traverse a stented segment of artery (so-called trans-cell technique) to select an aneurysm, or double stenting may necessary. In such situations, microguidewire passage and microcatheter delivery through a tortuous stented parent artery may pose a technical challenge. Described herein is a microguidewire looping technique to facilitate endovascular navigation in these circumstances...
March 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28264234/semi-jailing-technique-using-a-neuroform3-stent-for-coiling-of-wide-necked-intracranial-aneurysms
#13
Jun Kyeung Ko, Won Ho Cho, Seung Heon Cha, Chang Hwa Choi, Sang Weon Lee, Tae Hong Lee
OBJECTIVE: The semi-jailing technique (SJT) provides stent-assisted remodeling of the aneurysm neck during coil embolization without grasping the coil delivery microcatheter. We retrospectively evaluated the efficacy and safety of SJT using a Neuroform3 stent for coiling of wide-necked intracranial aneurysms. METHODS: We collected the clinical and radiological data between January 2009 and June 2015 of the wide-necked aneurysms treated with SJT using a Neuroform3 stent...
March 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28258802/endovascular-stroke-treatment-of-acute-tandem-occlusion-a-single-center-experience
#14
Fabrizio Sallustio, Caterina Motta, Giacomo Koch, Silvia Pizzuto, Bruce C V Campbell, Marina Diomedi, Barbara Rizzato, Alessandro Davoli, Giorgio Loreni, Daniel Konda, Matteo Stefanini, Sebastiano Fabiano, Enrico Pampana, Paolo Stanzione, Roberto Gandini
PURPOSE: To evaluate outcomes and prognostic factors in patients with acute ischemic stroke caused by tandem internal carotid artery/middle cerebral artery occlusion undergoing endovascular treatment. MATERIALS AND METHODS: Characteristics of consecutive patients with tandem occlusion (TO) were extracted from a prospective registry. Collateral vessel quality on pretreatment computed tomographic (CT) angiography was evaluated on a 4-point grading scale, and patients were dichotomized as having poor or good collateral flow...
February 28, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28256418/high-resolution-magnetic-resonance-imaging-evidence-for-intracranial-vessel-wall-inflammation-following-endovascular-thrombectomy
#15
Yangchun Li, Tanya N Turan, Imran Chaudry, Alejandro M Spiotta, Aquilla S Turk, Raymond D Turner, Arindam Rano Chatterjee
Intracranial high-resolution vessel wall magnetic resonance imaging evidence of vessel wall inflammation is present following stent retriever manipulation but absent following aspiration thrombectomy. This is presented in a case of rotatory vertebral artery compression causing multiple posterior circulation infarctions requiring multiple separate aspiration and stent retriever thrombectomies.
February 27, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28255904/endovascular-treatment-of-idiopathic-intracranial-hypertension-retrospective-analysis-of-immediate-and-long-term-results-in-51-patients
#16
M Aguilar-Pérez, R Martinez-Moreno, W Kurre, C Wendl, H Bäzner, O Ganslandt, R Unsöld, H Henkes
PURPOSE: Idiopathic intracranial hypertension (IIH) is a disorder of increased intracranial pressure in the absence of any known causative factor. Sinus stenosis is common in these patients. Stenting of stenotic dural sinuses has gained popularity as a treatment option, since these stenoses may contribute to an obstruction of the venous return, and, thereby may contribute to IIH via an increase in venous sinus pressure. We evaluated the safety and efficacy of endovascular treatment in IIH with venous sinus stenosis...
March 2, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28251328/efficacy-and-safety-of-direct-aspiration-first-pass-technique-versus-stent-retriever-thrombectomy-in-acute-basilar-artery-occlusion-a-retrospective-single-center-experience
#17
Johannes C Gerber, Dirk Daubner, Daniel Kaiser, Kay Engellandt, Kevin Haedrich, Angela Mueller, Volker Puetz, Jennifer Linn, Andrij Abramyuk
INTRODUCTION: The study aimed to compare efficacy and safety of aspiration thrombectomy (AT) to stentriever thrombectomy (SRT) in patients with basilar artery (BA) occlusion (BAO). METHODS: We retrospectively included patients with the following characteristics: acute BAO or occlusion of the intracranial vertebral artery (ICVA) and endovascular therapy (EVT) with stentriever (SRT) or aspiration thrombectomy (AT). Additional extra- but not intracranial EVT and intravenous thrombolysis (IVT) were allowed...
March 1, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28251327/leo-stent-for-endovascular-treatment-of-intracranial-aneurysms-very-long-term-results-in-50-patients-with-52-aneurysms-and-literature-review
#18
Boris Lubicz, Alexandre Kadou, Ricardo Morais, Benjamin Mine
INTRODUCTION: The Leo stent was the first retrievable stent for endovascular treatment of intracranial aneurysms (IAs). We report our experience with this device with emphasis on very long-term follow-up. METHODS: This study was approved by authors' ethical committee. A retrospective review of our prospectively maintained database identified all patients treated for a saccular IA with this stent in our institution. Technical issues and immediate and long-term outcomes (at least 12 months) were evaluated...
March 1, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28246625/endovascular-management-of-a-combined-subclavian-and-vertebral-artery-injury-in-an-unstable-polytrauma-patient-case-report-and-literature-review
#19
Christian David Weber, Philipp Kobbe, Christian Herren, Andreas H Mahnken, Frank Hildebrand, Hans-Christoph Pape
While blunt trauma of the head and neck are a common pattern of injury, significant problems related to the prompt diagnosis and optimal management of traumatic artery injuries have been reported in the literature. While patients with major artery injuries might develop hemorrhagic shock very rapidly, patients with blunt cerebrovascular injuries (BCVI) can present asymptomatic, but complications like basilar territory infarction, cortical blindness and death may occur. We report the life- and limb-saving management in a 57-year-old hemodynamically unstable trauma patient...
January 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28246277/ischemic-stroke-after-treatment-of-intraprocedural-thrombosis-during-stent-assisted-coiling-and-flow-diversion
#20
Nimer Adeeb, Christoph J Griessenauer, Justin M Moore, Paul M Foreman, Hussain Shallwani, Rouzbeh Motiei-Langroudi, Raghav Gupta, Carlos E Baccin, Abdulrahman Alturki, Mark R Harrigan, Adnan H Siddiqui, Elad I Levy, Christopher S Ogilvy, Ajith J Thomas
BACKGROUND AND PURPOSE: Intraprocedural thrombosis poses a formidable challenge during neuroendovascular procedures because the risks of aggressive thromboembolic treatment must be balanced against the risk of postprocedural hemorrhage. The aim of this study was to identify predictors of ischemic stroke after intraprocedural thrombosis after stent-assisted coiling and pipeline embolization device placement. METHODS: A retrospective analysis of intracranial aneurysms treated with stent-assisted coiling or pipeline embolization device placement between 2007 and 2016 at 4 major academic institutions was performed to identify procedures that were complicated by intraprocedural thrombosis...
February 28, 2017: Stroke; a Journal of Cerebral Circulation
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