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Basilar aneurysm coil

Soumya Mukherjee, Arun Chandran, Anil Gopinathan, Mani Putharan, Tony Goddard, Paul R Eldridge, Tufail Patankar, Hans-Christean Nahser
OBJECTIVE The goal of this study was to assess the safety and feasibility of PulseRider, a novel endovascular stent, in the treatment of intracranial bifurcation aneurysms with wide necks. The authors present the initial results of the first 10 cases in which the PulseRider device was used. METHODS Patients whose aneurysms were intended to be treated with the PulseRider device at 2 institutions in the United Kingdom were identified prospectively. Patient demographics, procedural details, immediate neurological and clinical status, and immediate angiographic outcomes and 6-month clinical and imaging follow-up were recorded prospectively...
September 30, 2016: Journal of Neurosurgery
Shin-Ichiro Sugiyama, Kuniyasu Niizuma, Kenichi Sato, Sherif Rashad, Misaki Kohama, Hidenori Endo, Toshiki Endo, Yasushi Matsumoto, Makoto Ohta, Teiji Tominaga
BACKGROUND AND PURPOSE: Hemodynamic forces may play a role in the recanalization of coiled aneurysms. The purpose of this study was to investigate the influence of presurgical hemodynamics on the efficacy of coil embolization for basilar tip aneurysms. METHODS: We identified 82 patients who underwent endovascular coil embolization for basilar tip aneurysms with a follow-up of >1 year. Presurgical hemodynamics were investigated using computational fluid dynamics with 3-dimensional data derived from rotational angiography...
October 2016: Stroke; a Journal of Cerebral Circulation
Gordhan Ajeet, Dickinson John
Aneurysms of the persistent trigeminal artery (PTA) trunk are exceptionally rare and have a high risk for rupture. Dual stent placement through each internal carotid and basilar artery for endovascular coil embolization of a fusiform aneurysm arising from the PTA has not been described in the literature. A 44-year-old female with a history of chronic headache was identified to have a fusiform aneurysm arising from medially coursing adult type, Saltzman type 3 PTA trunk. Sacrifice of the PTA trunk inclusive of the aneurysm was performed with dual stent placement through each basilar and internal carotid artery across their respective junctions with the PTA...
September 2016: Neurointervention
Grzegorz Turek, Andrzej Lewszuk, Jan Kochanowicz, Tomasz Lyson, Justyna Zielinska-Turek, Krzysztof Gorbacz, Zenon Mariak
BACKGROUND: We still lack reliable data on the outcomes of endovascular coiling for ruptured cerebral aneurysms. As this is still an evolving technique, the outcomes of the procedures performed in the past and more recently cannot be directly compared. We present the early outcomes of endovascular coiling in a relatively large group of patients with ruptured intracranial aneurysms. METHOD: The study included 190 consecutive patients (a total of 216 aneurysms) subjected to endovascular coiling in 2006-2013 (127 women aged 56±13 years and 63 men aged 50± 15 years)...
2016: Neurologia i Neurochirurgia Polska
Vistasp J Daruwalla, Furqan H Syed, Ali H Elmokadem, Michael C Hurley, Ali Shaibani, Sameer A Ansari
Basilar perforator aneurysms are rare and a communication between a basilar perforator and a separate pseudoaneurysm cavity is extremely rare. We describe a case presenting with high grade subarachnoid hemorrhage which on further investigation delineated a 2-3 mm dissecting basilar perforator aneurysm communicating superiorly into a contained 6 mm pseudoaneurysm cavity. This case illustrates an unusual neurovascular pathology with low potential for successful endovascular treatment such as coil embolization or intracranial flow diverter stenting...
August 2, 2016: Interventional Neuroradiology
Thomas P Madaelil, Adam N Wallace, Arindam N Chatterjee, Gregory J Zipfel, Ralph G Dacey, DeWitte T Cross, Christopher J Moran, Colin P Derdeyn
BACKGROUND: Ruptured intracranial dissecting aneurysms must be secured quickly to prevent re-hemorrhage. Endovascular sacrifice of the diseased segment is a well-established treatment method, however postoperative outcomes of symptomatic stroke and re-hemorrhage rates are not well reported, particularly for the perforator-rich distal vertebral artery or proximal posterior inferior cerebellar artery (PICA). METHODS: We retrospectively reviewed cases of ruptured distal vertebral artery or PICA dissecting aneurysms that underwent endovascular treatment...
August 2016: Journal of Neurointerventional Surgery
M Aguilar Pérez, P Bhogal, R Martinez Moreno, C Wendl, H Bäzner, O Ganslandt, H Henkes
INTRODUCTION: Coil embolization of ruptured aneurysms has become the standard treatment in many situations. However, certain aneurysm morphologies pose technical difficulties and may require the use of adjunctive devices. OBJECTIVE: To present our experience with the pCONus, a new neck bridging device, as an adjunct to coil embolization for acutely ruptured aneurysms and discuss the technical success, angiographic and clinical outcomes. METHODS: We conducted a retrospective review of our database of prospectively collected data to identify all patients who presented with acute subarachnoid hemorrhage that required adjunctive treatment with the pCONus in the acute stage...
July 13, 2016: Journal of Neurointerventional Surgery
Nimer Adeeb, Apar S Patel, Christoph Johannes Griessenauer, Justin M Moore, Paul M Foreman, Raghav Gupta, Mark R Harrigan, Christopher S Ogilvy, Ajith J Thomas
INTRODUCTION: Stent-coiling of bifurcation aneurysms has significantly expanded the spectrum of aneurysms amenable to endovascular therapy. A variety of techniques have evolved to deal with wide-necked bifurcation aneurysms such as Y-stenting and WEB embolization device. In our 2 institutions, we have primarily used a single stent coiling to treat most bifurcation aneurysms. We present a large series in which a single stent was utilized with angiographic and clinical outcomes. METHODS: Two academic institutions in the United States contributed prospectively maintained data on consecutive patients with bifurcation aneurysms treated with single stent coiling between 2007 and 2015...
August 2016: Neurosurgery
Shuta Aketa, Daisuke Wajima, Taekyun Kim, Rinsei Tei, Taiji Yonezawa
BACKGROUND: There is no published report of ruptured cerebral aneurysm accompanied by target vessel occlusion. We present a case of ruptured basilar tip aneurysm with concomitant basilar artery (BA) occlusion. CASE DESCRIPTION: A 53-year-old man presented to our emergency room with the acute onset of disturbance. Plain head computed tomography showed diffuse subarachnoid hemorrhage. Computed tomography angiography and digital subtraction angiography showed a BA tip aneurysm with BA trunk occlusion...
September 2016: World Neurosurgery
Masaaki Hokari, Ken Kazumara, Naoki Nakayama, Satoshi Ushikoshi, Taku Sugiyama, Katsunori Asaoka, Kazuki Uchida, Daisuke Shimbo, Koji Itamoto, Yuka Yokoyama, Masanori Isobe, Tetsuaki Imai, Toshiya Osanai, Kiyohiro Houkin
OBJECTIVE: There are no established treatment strategies for aneurysms that recur after clipping. In this study, we present cases of patients who experienced recurrent aneurysms after clipping and subsequently underwent surgical intervention. METHODS: Between 2004 and 2015, we surgically treated 23 aneurysms that recurred at a previously clipped site. Patient characteristics and clinical history were retrospectively reviewed. RESULTS: Patients included 19 women and 4 men 45-81 years old...
August 2016: World Neurosurgery
Peng Qi, Daming Wang, Jiachun Liu, Lijun Wang, Jun Lu
OBJECTIVE: To explore the feasibility, safety and efficacy of endovascular reconstructive treatment by multiple overlapping stents with or without coils. METHODS: Totally 17 patients of vertebrobasilar fusiform aneurysms treated by multiple overlapping stents with or without coils between September 2011 and September 2015 in Department of Neurosurgery, Beijing Hospital were retrospectively reviewed. There were 15 male and 2 female patients with mean age of (47±13) years...
May 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
V Rastogi, G Asaithambi, A Patel, K Park, S Bidari, V S Hedna
WHAT IS KNOWN AND OBJECTIVE: Endovascular embolization of basilar tip aneurysms (BTA) is performed to prevent rupture, but little is known regarding post-procedural vasospasm and its consequences. We relate management of post-procedural vasospasm found in cardiovascular literature on this rare post-procedural intracranial complication. CASE DESCRIPTION: A 52-year-old man develops ischaemic strokes after undergoing posterior cerebral artery (PCA) stent-assisted coil embolization of BTA...
April 6, 2016: Journal of Clinical Pharmacy and Therapeutics
Christopher J Stapleton, Jay I Kumar, Brian P Walcott, Collin M Torok, Pankaj K Agarwalla, Matthew J Koch, Aman B Patel
BACKGROUND: Arterial bifurcations are common locations for aneurysm development given the altered hemodynamic forces and shear stress variations present at these locations. Recent reports indicate that a wide basilar artery bifurcation angle is an independent predictor of aneurysm development, growth, and subsequent rupture. METHODS: To determine the effect of basilar artery bifurcation angle on rates of initial occlusion, recanalization, and retreatment of basilar artery apex aneurysms following coil embolization, the records of 46 patients with basilar artery apex aneurysms treated with endovascular coil embolization from 2007 to 2013 were analyzed...
August 2016: Interventional Neuroradiology
Daying Dai, Yong-Hong Ding, Michael Kelly, Ramanathan Kadirvel, David Kallmes
We report histopathological findings from a human cerebral aneurysm following treatment with a flow diverter. A 75-year-old male underwent flow diversion treatment (Pipeline Embolization Device (PED)) and coil embolization for treatment of an aneurysm at the basilar tip. At four months, angiography showed complete aneurysm occlusion; at 12 months angiography demonstrated that the aneurysm had reopened. The patient expired from brainstem compression. The aneurysm cavity was primarily filled with unorganized thrombus...
April 2016: Interventional Neuroradiology
Li Li, Tianxiao Li, Jiangyu Xue, Ziliang Wang, Weixing Bai, Liangfu Zhu, Guang Feng, Gangqin Xu, Bowen Yang
Basilar artery dissection is a rare disease with high morbidity and mortality. No well-established management strategy exists for this lesion. Endovascular reconstructive therapy using stents (with or without coiling) may be the optimum strategy.We describe our center's experience for this treatment strategy in 21 patients with basilar artery dissection from January 2009 to July 2014 (17 men, four women; age range, 18-70 years; median age, 56 years). We divided patients into two groups: Group 1 patients received stent-assisted coiling treatment, and Group 2 patients received stent-only treatment...
June 2016: Interventional Neuroradiology
Julian Maingard, Mark Brooks
Partially thrombosed aneurysms with circular flow dynamics around central thrombus pose a therapeutic dilema. We demonstrate the successful treatment of a patient with a large basilar donut aneurysm with a flow diverting stent without the use of embolisation coils in order to obviate the risk of further brainstem compression.
June 2016: Interventional Neuroradiology
Ryosuke Mori, Ichiro Yuki, Ikki Kajiwara, Yuichiro Nonaka, Toshihiro Ishibashi, Kostadin Karagiozov, Chiheb Dahmani, Yuichi Murayama
BACKGROUND: Intraventricular hemorrhages (IVHs) caused by ruptured cerebral aneurysms often have poor outcomes. Treatment challenges include comorbidities, increased intracranial pressure caused by IVH, and risk of rebleeding. CASE DESCRIPTION: Two cases of severe IVH accompanied by acute hydrocephalus caused by ruptured aneurysm were treated with coil embolization followed by endoscopic hematoma evacuation as a single treatment session in a hybrid operating room (OR) equipped with a multipurpose angio biplane system...
May 2016: World Neurosurgery
Yi-Chun Chiang, Chung-Hsih Lee, Wen-Hsien Chen, Yuang-Seng Tsuei
BACKGROUND: Paraplegia after intracranial aneurysmal subarachnoid hemorrhage (SAH) is a rare condition, and its pathogenesis is still unclear. CASE DESCRIPTION: We present a case of a ruptured basilar dissecting aneurysm treated with the stent-assisted coiling procedure. Progressive weakness of the lower limbs developed within 5 days postoperatively. Spinal magnetic resonance image showed SAH accumulation in the lumbosacral area. Emergency lumbar drainage was performed, and the patient's symptoms improved dramatically...
April 2016: World Neurosurgery
Marta Aguilar Pérez, Hans Henkes, Pierre Bouillot, Olivier Brina, Lee-Anne Slater, Vitor Mendes Pereira
BACKGROUND: Implantation of self-expanding stents from the parent artery into the sac of a bifurcation aneurysm is regularly used to facilitate endovascular coil occlusion with the so-called waffle cone technique (WCT). Self-expanding aneurysm bridging stents like Solitaire AB, can be used; however, bifurcation devices like pCONus and pCANvas are especially designed for WCT. These devices provide additional support for coil implantation owing to intraluminal nylon fibers (pCONus) or membranes (pCANvas) covering the intracranial aneurysm neck...
December 23, 2015: Journal of Neurointerventional Surgery
Robert Forbrig, Bernd Eckert, Lorenz Ertl, Maximilian Patzig, Christian Brem, Christian Vollmar, Joachim Röther, Niklas Thon, Hartmut Brückmann, Gunther Fesl
INTRODUCTION: Basilar artery (BA) perforator aneurysms may lead to severe subarachnoid hemorrhage (SAH). The acute management is uncertain. The anatomic approach is challenging both for coiling and clipping, and flow diverter stenting may be dangerous due to the required antiplatelet therapy. We report on our experiences in eight patients. METHODS: We retrospectively analyzed eight patients with ruptured BA perforator aneurysm, including clinical characteristics, imaging data, treatment regimen, clinical course, and long-term outcome...
March 2016: Neuroradiology
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