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Neuro endovascular

Shamik Chakraborty, Christopher G Filippi, Jan-Karl Burkhardt, Sherese Fralin, Ashley Ray, Tamika Wong, Rafael Ortiz, David J Langer, John A Boockvar
BACKGROUND: Bevacizumab (BV) has been used to treat recurrent glioblastoma with a progression free survival of approximately 3-3.5 months. Typically, it is administered intravenously every 2-3 weeks at dosages ranging from 5-15 mg/kg. Serious side effects include GI tract perforations, hematologic disorders, intracranial hemorrhage, and malignant hypertension. We hypothesized that selective intracranial intra-arterial infusion (SIACI) of BV following blood/brain barrier disruption (BBBD) with mannitol may allow for reduced dosage, lower toxicity, and equivalent or superior progression free survival (PFS)...
November 2016: Journal of Experimental Therapeutics & Oncology
Sumedh S Shah, Brian M Snelling, Samir Sur, Alexandra R Ramnath, Emmalee S Bandstra, Dileep R Yavagal
INTRODUCTION: Scalp congenital hemangiomas (CHs) are rare vascular malformations among infants; they can be associated with an array of complications, including cardiac and cosmetic issues. Here, we report the endovascular treatment of a premature infant with a suspected large right parietal scalp hemangioma and associated high-output cardiac failure. CASE DESCRIPTION: A two-day-old female premature infant (29 weeks gestational age; 1330 g birth weight) was referred by the neonatologists to our department for consultation and potential treatment of a large right parietal CH causing abrupt hypotension and high-output cardiac failure...
October 27, 2016: Interventional Neuroradiology
Asaf Honig, Ruth Eliahou, Roni Eichel, Ari Aharon Shemesh, Tamir Ben-Hur, Eitan Auriel
Bilateral thalamic infarction (BTI) typically presents as a sleep-like coma (SLC) without localizing signs, posing a diagnostic challenge that may lead the treating physician to search for toxic or metabolic causes and delay treatment. We review our experience with BTI of different etiologies, and emphasize the critical role of timely imaging, diagnosis, and management in a series of 12 patients with a presentation of SLC and acute BTI who were managed in our Medical Centers from 2006-2015. In 11/12, urgent head CT scans showed normal brain tissue, while diffusion-weighted (DWI) MRI revealed symmetric bilateral thalamic hyperintense lesions with variable degrees of brainstem involvement...
September 1, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Qiang Zhang, Zhiqiang Zhang, Jiakang Yang, Qi Sun, Yongchun Luo, Tonghui Shan, Hao Zhang, Jingfeng Han, Chunyang Liang, Wenlong Pan, Chuanqi Gu, Gengsheng Mao, Ruxiang Xu
Digital subtracted angiography (DSA) remains the gold standard for diagnosis of cerebral vascular diseases and provides intraprocedural guidance. This practice involves extensive usage of x-ray and iodinated contrast medium, which can induce side effects. In this study, we examined the accuracy of 3-dimensional (3D) registration of magnetic resonance angiography (MRA) and DSA imaging for cerebral vessels, and tested the feasibility of using preprocedural MRA for real-time guidance during endovascular procedures...
August 2016: Medicine (Baltimore)
Ning Guan, Shiqing Mu, Linyuan Wang, Xiaochuan Huo, Yuhua Jiang, Xianli Lv, Youxiang Li
BACKGROUND: Cavernous carotid aneurysms (CCAs) are characterized by pain and neuro-ophthalmologic deficits. The optimal treatment remains unclear, especially for asymptomatic CCAs. This study investigated the efficacy of endovascular treatment for CCAs in our center. METHODS: Data obtained from patients who underwent endovascular treatment for CCAs from July 2011 to July 2014 were reviewed. A retrospective analysis was conducted regarding the general condition, clinical presentation, aneurysm characteristics, therapeutic strategy, and prognosis of CCA patients...
August 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Badih Daou, Nohra Chalouhi, Stavropoula Tjoumakaris, David Hasan, Guilherme Barros, Robert H Rosenwasser, Pascal Jabbour
OBJECTIVE: Data regarding the role of alternative access routes in neuro-endovascular interventions is limited. Our aim is to evaluate the safety and efficacy of alternative access in endovascular management of cerebrovascular diseases. METHODS: 29 patients who underwent endovascular interventions using alternative access techniques including transradial, transcervical with carotid cutdown and access through the superior ophthalmic vein (SOV) to manage various intracranial pathologies were retrospectively identified...
June 2016: Clinical Neurology and Neurosurgery
(no author information available yet)
ContributorsAmerican Academy of Neurological Surgeons/ Congress of Neurological Surgeons (AANS/CNS): S.D. Lavine, K Cockroft, B Hoh, N Bambakidis, AA Khalessi, H Woo, H Riina. A. SiddiquiAmerican Society of Neuroradiology (ASNR): J. A. HirschAsian Australasian Federation of Interventional and Therapeutic Neuroradiology (AAFITN): W. ChongAustralian and New Zealand Society of Neuroradiology - Conjoint Committee for Recognition of Training in Interventional Neuroradiology (CCINR) representing the RANZCR (ANZSNR), ANZAN and NSA: H...
June 2016: Interventional Neuroradiology
Takumi Kuriyama, Nobuyuki Sakai, Norimitsu Niida, Masaki Sueoka, Mikiya Beppu, Chihebeddine Dahmani, Iwao Kojima, Chiaki Sakai, Hirotoshi Imamura, Katsuhiro Masago, Nobuyuki Katakami
PURPOSE: Flat panel detector (FD)-equipped angiography machines are increasingly used for neuro-angiographic imaging. During intracranial stent-assisted coil embolization procedures, it is very important to clearly and quickly visualize stent shape after deployment in the vessel. It is necessary to quickly visualize stents by cone-beam computed tomography (CBCT). The aim of this study was to compare CBCTs at 10 and 20 s, and to confirm that this method is useful for neuro-endovascular treatment procedures...
August 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
M Russ, R O'Hara, S V Setlur Nagesh, M Mokin, C Jimenez, A Siddiqui, D Bednarek, S Rudin, C Ionita
Minimally invasive endovascular image-guided interventions (EIGIs) are the preferred procedures for treatment of a wide range of vascular disorders. Despite benefits including reduced trauma and recovery time, EIGIs have their own challenges. Remote catheter actuation and challenging anatomical morphology may lead to erroneous endovascular device selections, delays or even complications such as vessel injury. EIGI planning using 3D phantoms would allow interventionists to become familiarized with the patient vessel anatomy by first performing the planned treatment on a phantom under standard operating protocols...
February 21, 2015: Proceedings of SPIE
P-L Sadigh, A Clifton, A Toma
INTRODUCTION: Epistaxis secondary to a ruptured cavernous-carotid aneurysm that has eroded into the sphenoid sinus is a life-threatening condition. When it is unilateral, balloon or coil embolization of the parent vessel should be considered. When bilateral, coiling the aneurysm to gain hemostasis followed by stent insertion after anticoagulation has been shown to be successful in achieving stabilization of the aneurysm wall whilst maintaining flow through the artery. CASE REPORT: We present a case of epistaxis secondary to giant bilateral cavernous-carotid aneurysm...
April 2016: European Annals of Otorhinolaryngology, Head and Neck Diseases
Ajeet Gordhan
INTRODUCTION: Endovascular trans-femoral access catheter aspiration of thrombus within the proximal subclavian, brachial, radial and ulnar arteries for symptomatic upper extremity ischemic pain has not been previously reported. We describe a case in which a successful clinical outcome was achieved using long length neuro-endovascular aspiration catheters. PRESENTATION OF CASE: A 45 year old female presented with diffuse left upper limb pain. Sonography revealed compromised upper extremity blood flow...
2016: International Journal of Surgery Case Reports
Maher A Al-Khawaldeh, Osama K Haddad, Ashraf O Alshabatat, Salil V Deo, Abeer Rababa'h, Salah E Altarabsheh
Ischemic stroke following cardiac surgery is one of the devastating complications that surgeons may encounter, and may lead to serious disabilities for the patient. The clinical course of such a complication may be prolonged if it is not treated properly. Making a quick decision when choosing a revascularization method is very helpful in this matter. Effective treatment options are usually limited. Neurointerventional maneuvers have recently emerged as a possible therapeutic modality in this field. We present the case of a 52-year-old woman who had open heart surgery in Queen Alia Heart Institute, Jordan, to replace a severely stenotic rheumatic mitral valve and repair a leaking tricuspid valve...
November 2015: Oman Medical Journal
S Stéphan, R Blanc, M Zmuda, C Vignal, M Barral, S Pistocchi, M Piotin, O Galatoire
INTRODUCTION: Carotid-cavernous fistulae are rare and affect visual prognosis. Their clinical presentation is varied and delayed diagnosis is common. They require rapid neuro-radio-ophthalmologic management. PURPOSE: The goal of this study was to evaluate the long-term efficacy and prognostic factors for treatment of carotid-cavernous fistulas by embolization. MATERIALS AND METHODS: A total of 60 patients with direct (10/60, 17%) or indirect (50/60, 83%) carotid-cavernous fistulae suspected during ophthalmological examination underwent cerebral angiography from December 2003 to October 2013...
January 2016: Journal Français D'ophtalmologie
Ahmed Hossain Chowdhury, Sharif Uddin Khan, Kazi Mohibur Rahman, A T M Hasibul Hasan, Swapon Kumar Ghose, Badrul Haque, Mansur Habib, Quazi Deen Mohammad
BACKGROUND: We have conducted this study to examine the clinical and morphological pattern of brain arteriovenous malformations (BAVMs) along with their treatment and short term outcome in a tertiary care hospital in Bangladesh. This retrospective chart review was carried out from the records of neuro-endovascular division at Department of Neurology, Dhaka Medical College Hospital (DMCH) from January 2010 to June 2013. A total 60 patients were evaluated. All the necessary information regarding the demographic, clinical, morphologic and treatment profile was gathered through a predesigned questionnaire...
2015: BMC Research Notes
Sang Hyuk Lee, Ji Hwan Jang, Kyu Hong Kim, Young Zoon Kim
We herein report on a patient with a cerebral aneurysm located at the petrous portion of the internal carotid artery (ICA). An 18-year-old male, previously diagnosed with neurofibromatosis, was referred to our emergency service complaining of severe headache, pulsatile tinnitus, nausea, and vomiting which occurred suddenly. Neuro-radiological studies including computed tomography and magnetic resonance imaging of the cerebral artery showed a large aneurysm arising from the petrous segment of the left ICA. He was treated with a neuro-interventional technique such as intra-arterial stenting and coil embolization for the aneurysm...
September 2015: Journal of Cerebrovascular and Endovascular Neurosurgery
J Perhac, J Spaltenstein, V M Pereira, K Schaller, O Brina, I Cabrilo, O Ratib
PURPOSE: Recent developments in interventional neuroradiology techniques, medical imaging modalities, endovascular stenting and embolization materials lead to an increasing number of patients with cerebral aneurysms and arteriovenous malformations that are eligible for endovascular treatment and have opened new perspectives for novel ways for patient treatment in general. In this paper, we describe a software tool for 3D image fusion of multi-modal acquisitions to assist endovascular treatment of cerebral malformations...
February 2016: International Journal of Computer Assisted Radiology and Surgery
Nabeel Alshafai, Olesya Falenchuk, Michael D Cusimano
BACKGROUND: The publication of the International Subarachnoid Aneurysm Trial rapidly changed the management of patients with subarachnoid hemorrhage. The present and perceived future trends of aneurysm management have significant implications for patients and how we educate future cerebrovascular specialists. OBJECTIVE: To determine present perceived competencies of final-year neurosurgical residents who have just finished their residencies and to relate those to what practitioners from a variety of continents expect of these persons...
September 2015: Acta Neurochirurgica
S Vijayan, V Rana, S Setlur Nagesh, Z Xiong, S Rudin, D Bednarek
PURPOSE: To determine the reduction of integral dose to the patient when using the micro-angiographic fluoroscope (MAF) compared to when using the standard flat-panel detector (FPD) for the techniques used during neurointerventional procedures. METHODS: The MAF is a small field-of-view, high resolution x-ray detector which captures 1024 x 1024 pixels with an effective pixel size of 35μm and is capable of real-time imaging up to 30 frames per second. The MAF was used in neuro-interventions during those parts of the procedure when high resolution was needed and the FPD was used otherwise...
June 2015: Medical Physics
M Russ, C Ionita, D Bednarek, S Rudin
PURPOSE: In endovascular image-guided neuro-interventions, visualization of fine detail is paramount. For example, the ability of the interventionist to visualize the stent struts depends heavily on the x-ray imaging detector performance. METHODS: A study to examine the relative performance of the high resolution MAF-CMOS (pixel size 75µm, Nyquist frequency 6.6 cycles/mm) and a standard Flat Panel Detector (pixel size 194µm, Nyquist frequency 2.5 cycles/mm) detectors in imaging a neuro stent was done using the Generalized Measured Relative Object Detectability (GM-ROD) metric...
June 2015: Medical Physics
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