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Flow diverte stent

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https://www.readbyqxmd.com/read/27904445/endovascular-treatment-of-unruptured-aneurysms-of-cavernous-and-ophthalmic-segment-of-internal-carotid-artery-with-flow-diverter-device-pipeline
#1
Marko Jevsek, Charbel Mounayer, Tomaz Seruga
BACKGROUND: Intra-arterial treatment of aneurysms by redirecting blood flow is a newer method. The redirection is based on a significantly more densely braided wire stent. The stent wall keeps the blood in the lumen of the stent and slows down the turbulent flow in the aneurysms. Stagnation of blood in the aneurysm sac leads to the formation of thrombus and subsequent exclusion of the aneurysm from the circulation. The aim of the study was to evaluate flow diverter device Pipeline for broad neck and giant aneurysm treatment...
December 1, 2016: Radiology and Oncology
https://www.readbyqxmd.com/read/27884881/testing-stenting-and-flow-diversion-using-a-surgical-elastase-induced-complex-fusiform-aneurysm-model
#2
R Fahed, T E Darsaut, I Salazkin, J-C Gentric, M Mazighi, J Raymond
BACKGROUND AND PURPOSE: Rabbit elastase-induced saccular aneurysms have been commonly used for preclinical testing of endovascular devices, including flow diverters. However, all tested devices have been shown to be capable of aneurysm occlusion with this model. We aimed to create a more challenging model to test and discriminate among neurovascular devices of varying efficacies. MATERIALS AND METHODS: With a surgical approach that included elastase infusion and balloon dilation, we attempted the creation of complex fusiform aneurysms in 16 rabbits, with standard saccular carotid aneurysms created in 15 other animals...
November 24, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/27836994/treatment-of-posterior-circulation-non-saccular-aneurysms-with-flow-diverters-a-single-center-experience-and-review-of-56-patients
#3
REVIEW
P Bhogal, M Aguilar Pérez, O Ganslandt, H Bäzner, H Henkes, S Fischer
BACKGROUND AND PURPOSE: Non-saccular aneurysms of the posterior fossa are an uncommon pathology with no clear treatment strategy. The use of flow-diverting stents (FDS) has had mixed results. We sought to evaluate our experience of FDS for the treatment of this pathology. METHODS: We retrospectively reviewed our database of prospectively collected information for all patients treated only with flow diversion for an unruptured non-saccular aneurysm of the posterior circulation between February 2009 and April 2016...
November 11, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27810105/does-the-gravity-orientation-of-saccular-aneurysms-influence-hemodynamics-an-experimental-study-with-and-without-flow-diverter-stent
#4
Kamil J Chodzyński, Omer F Eker, Axel E Vanrossomme, Daniel Ribeiro de Sousa, Grégory Coussement, Luc Vanhamme, Frank Dubois, Alain Bonafé, Bastien Chopard, Guy Courbebaisse, Karim Zouaoui Boudjeltia
Most intracranial aneurysms morphologic studies focused on characterization of size, location, aspect ratio, relationship to the surrounding vasculature and hemodynamics. However, the spatial orientation with respect to the gravity direction has not been taken into account although it could trigger various hemodynamic conditions. The present work addresses this possibility. It was divided in two parts: 1) the orientations of 18, 3D time-of-flight MRI (3D TOF MRI), scans of saccular aneurysms were analyzed. This investigation suggested that there was no privileged orientation for cerebral aneurysms...
October 18, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27801399/-the-modern-role-of-microsurgery-in-treatment-of-large-and-giant-aneurysms-of-the-internal-carotid-artery
#5
O D Shekhtman, Sh Sh Eliava, S B Yakovlev, Yu V Pilipenko, An N Konovalov
INTRODUCTION: Large (1.5-2.5 cm) and giant (>2.5 cm in diameter) aneurysms of the internal carotid artery (ICA) remain one of the complex neurosurgical pathologies in terms of microsurgery. In recent years, endovascular techniques for treatment of paraclinoid aneurysms, in particular ICA reconstruction using flow-diverting stents, have become a priority. However, surgery of flow stents has a number of limitations, therefore the choice of treatment in each case is individual. PURPOSE: To analyze the results of direct surgery in patients with large and giant aneurysms of the ICA and to determine the role and place of modern microsurgical techniques in the treatment of this vascular disease...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/27799376/thrombogenicity-of-flow-diverters-in-an-ex-vivo-shunt-model-effect-of-phosphorylcholine-surface-modification
#6
Matthew W Hagen, Gaurav Girdhar, John Wainwright, Monica T Hinds
BACKGROUND: Flow diverters offer a promising treatment for cerebral aneurysms. However, they have associated thromboembolic risks, mandating chronic dual antiplatelet therapy (DAPT). Shield Technology is a phosphorylcholine surface modification of the Pipeline Embolization Device (PED) flow diverter, which has shown significant reductions in material thrombogenicity in vitro. OBJECTIVE: To compare the thrombogenicity of PED, PED with Shield Technology (PED+Shield), and the Flow-Redirection Endoluminal Device (FRED)-with and without single antiplatelet therapy and DAPT-under physiological flow...
October 31, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27798327/effects-on-vessel-measurement-accuracy-and-subsequent-occlusion-after-calcium-channel-blocker-infusion-during-treatment-of-cerebral-aneurysms-with-the-pipeline-embolization-device
#7
M D Alexander, A D Nicholson, R J Darflinger, F Settecase, D L Cooke, C F Dowd, M R Amans, R T Higashida, S W Hetts, V V Halbach
INTRODUCTION/PURPOSE: To achieve aneurysm occlusion, flow diverters (FDs) must be accurately sized to maximize coverage over the neck and induce thrombosis. Catheterization for diagnostic angiography can cause vasospasm that may affect vessel measurements. This study evaluates impacts of intra-arterial infusion of a calcium channel blocker (CCB) on angiographic measurements in patients treated with FDs to determine effects on final diameter of the FD and subsequent occlusion. MATERIALS AND METHODS: Pre-treatment measurements were recorded for diameter of the distal and proximal landing zones and maximum and minimum diameters between these segments...
October 26, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27789789/use-of-flow-diverters-in-the-treatment-of-unruptured-saccular-aneurysms-of-the-anterior-cerebral-artery
#8
REVIEW
P Bhogal, R Martinez Moreno, O Ganslandt, H Bäzner, H Henkes, M Aguilar Perez
BACKGROUND: Few publications have dealt exclusively with the use of flow diverter stents for the treatment of aneurysms of the anterior cerebral artery (ACA). OBJECTIVE: To determine the efficacy of flow-diverting stents in the treatment of small, unruptured aneurysms of the ACA. METHODS: We retrospectively reviewed our database of prospectively collected information for all patients treated with flow diversion for an unruptured saccular aneurysm of the ACA between September 2009 and July 2016...
October 27, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27780870/virtual-flow-diverter-treatment-planning-the-effect-of-device-placement-on-bifurcation-aneurysm-haemodynamics
#9
Thomas Peach, Katerina Spranger, Yiannis Ventikos
Bifurcation aneurysms account for a large fraction of cerebral aneurysms and often present morphologies that render traditional endovascular treatments, such as coiling, challenging and problematic. Flow-diverter stents offer a potentially elegant treatment option for such aneurysms, but clinical use of these devices remains controversial. Specifically, the deployment of a flow-diverter device in a bifurcation entails jailing one or more potentially vital vessels with a low-porosity mesh designed to restrict the flow...
October 25, 2016: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/27760885/prasugrel-versus-clopidogrel-in-stent-assisted-coil-embolization-of-unruptured-intracranial-aneurysms
#10
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
https://www.readbyqxmd.com/read/27760832/an-outcomes-based-grading-scale-for-the-evaluation-of-cerebral-aneurysms-treated-with-flow-diversion
#11
Min S Park, Marcus D Mazur, Karam Moon, Michael J Nanaszko, John R W Kestle, Lubdha M Shah, Blair Winegar, Felipe C Albuquerque, Philipp Taussky, Cameron G McDougall
OBJECT: Despite the popularity of flow-diverting stents for the treatment of cerebral aneurysms, there is no widely accepted scale for the characterization of results. We present an outcomes-based grading scale that considers factors related to failure of flow diversion. METHODS: The grading scale was developed using the results from consecutive patients at two institutions who were treated with flow diversion for a cerebral aneurysm. The initial treatment results were graded on patient, aneurysm, and treatment characteristics...
October 19, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27759680/rerupture-of-a-blister-aneurysm-after-treatment-with-a-single-flow-diverting-stent
#12
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
https://www.readbyqxmd.com/read/27738098/endovascular-reconstruction-of-internal-carotid-artery-dissection-in-patients-with-acute-ischemic-stroke-using-the-wingspan-stent
#13
Eduardo Murias Quintana, Pedro Vega Valdés, Edison Morales Deza, Alberto Gil Garcia, Hugo Cuellar Saenz, Alba L Salgado Bernal, María Cadenas Rodríguez, Lorena Benavente Fernández, Montserrat González Delgado, Nuria Riesco Pérez, Davinia Larrosa Campo, Sergio Calleja Puerta
OBJECTIVE: The purpose of this study is to demonstrate our experience in endovascular reconstruction of carotid dissections using the Wingspan Stent System™ (Boston Scientific, Natick, MA, USA), a device we use because of its high radial force and its navigation in extreme curves. METHODS: We treated 11 consecutive patients with acute ischemic stroke due to carotid dissection with the Wingspan stent, in the cervical carotid artery. RESULTS: Functional evaluation revealed that 10 of the 11 patients were independent at 3 months post surgery and that the 11 stents used were found to be patent at the 6-month follow-up digital subtraction angiography (DSA)...
December 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27733966/stent-assisted-embolization-of-a-giant-aneurysm-of-the-middle-cerebral-artery-using-small-and-large-coils-penumbra-coil-400
#14
Edgar Gerardo Ordónez-Rubiano, Christian Von-Diemling, William Cortes-Lozano, Nelson Oswaldo Lobelo-Garcia
Giant aneurysms have been treated with endovascular approaches like general, balloon-assisted and stent-assisted coiling, and flow diverter stent-assisted techniques. Few cases have been reported to be treated with both normal and large coils. Despite the mass effect, an adequate revascularization has been reported. An initial use of these coils is being reported in the current study. This is a case which has been successfully treated using a stent-assisted coiling with both small and large coils i.e., Penumbra Coil 400 (Penumbra, Inc...
August 31, 2016: Curēus
https://www.readbyqxmd.com/read/27727400/hemodynamics-of-flow-diverters
#15
Ronak Dholakia, Chandramouli Sadasivan, David Fiorella, Henry Woo, B Barry Lieber
Cerebral aneurysms are pathological focal evaginations of the arterial wall at and around the junctions of the circle of Willis. Their tenuous walls predispose aneurysms to leak or rupture leading to hemorrhagic strokes with high morbidity and mortality rates. The endovascular treatment of cerebral aneurysms currently includes the implantation of fine-mesh stents, called flow diverters, within the parent artery bearing the aneurysm. By mitigating flow velocities within the aneurysmal sac, the devices preferentially induce thrombus formation in the aneurysm within hours to days...
October 11, 2016: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/27672098/a-rare-but-morbid-neurosurgical-target-petrous-aneurysms-and-their-endovascular-management-in-the-stent-flow-diverter-era
#16
Bradley A Gross, Karam Moon, Andrew F Ducruet, Felipe C Albuquerque
BACKGROUND/OBJECTIVE: The rarity of petrous internal carotid artery (ICA) aneurysms has largely precluded analyses of their presentation and management in case series format. METHODS: We performed a retrospective analysis of our endovascular database of patients treated from January 2001 to May 2016 to identify patients with petrous ICA aneurysms. We evaluated the treatment approach and results for patients managed in the era of dedicated intracranial stents and flow diverters, noting clinical and angiographic results...
September 26, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27668108/a-patient-with-eight-intracranial-aneurysms-endovascular-treatment-in-two-sessions
#17
Erol Akgul, Hasan Bilen Onan, Huseyin Tugsan Balli, Nuri Eralp Cetinalp
The frequency of multiple intracranial aneurysms seen in patients with or without subarachnoid hemorrhage is high. The advancement of the endovascular technique and devices has ensured that endovascular treatment of intracranial aneurysms is the first choice in most cases, especially in unruptured ones. Different combinations of treatment modalities and techniques can be used in the management of multiple aneurysms. But in selected patients without subarachnoid hemorrhage, treatment of all aneurysms in one or more sessions with endovascular techniques is less traumatic than that with surgery...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27646987/selection-of-helical-braided-flow-diverter-stents-based-on-hemodynamic-performance-and-mechanical-properties
#18
Takashi Suzuki, Hiroyuki Takao, Soichiro Fujimura, Chihebeddine Dahmani, Toshihiro Ishibashi, Hiroya Mamori, Naoya Fukushima, Makoto Yamamoto, Yuichi Murayama
BACKGROUND: Although flow diversion is a promising procedure for the treatment of aneurysms, complications have been reported and it remains poorly understood. The occurrence of adverse outcomes is known to depend on both the mechanical properties and flow reduction effects of the flow diverter stent. OBJECTIVE: To clarify the possibility of designing a flow diverter stent considering both hemodynamic performance and mechanical properties. MATERIALS AND METHODS: Computational fluid dynamics (CFD) simulations were conducted based on an ideal aneurysm model with flow diverters...
September 19, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27633810/does-arterial-flow-rate-affect-the-assessment-of-flow-diverter-stent-performance
#19
H G Morales, O Bonnefous, A J Geers, O Brina, V M Pereira, L Spelle, J Moret, I Larrabide
BACKGROUND AND PURPOSE: Our aim was to assess the performance of flow-diverter stents. The pre- and end-of-treatment angiographies are commonly compared. However, the arterial flow rate may change between acquisitions; therefore, a better understanding of its influence on the local intra-aneurysmal hemodynamics before and after flow-diverter stent use is required. MATERIALS AND METHODS: Twenty-five image-based aneurysm models extracted from 3D rotational angiograms were conditioned for computational fluid dynamics simulations...
September 15, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/27593785/endovascular-treatment-of-wide-necked-ruptured-saccular-aneurysms-with-flow-diverter-stent
#20
Enes Duman, İlker Çöven, Erkan Yildirim, Cem Yilmaz, Ulaş Pinar
AIM: Flow diverter (FD) stents have been used in the treatment of unruptured intracranial aneurysms. There are a few studies that report the use of these devices in ruptured blister-like aneurysms. We present 5 consecutive patients, who have ruptured intracranial wide necked or side branch close to the neck of saccular aneurysms, have no other treatment options, treated with FD stents and coil embolization. MATERIAL AND METHODS: Between September 2012 and April 2015, 139 ruptured aneurysms of 133 consequent patients were treated...
December 28, 2015: Turkish Neurosurgery
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