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Flow diverte stent

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https://www.readbyqxmd.com/read/28819696/what-are-the-treatment-options-for-blister-like-aneurysms
#1
REVIEW
Torstein R Meling
Treatment of blood blister-like aneurysms (BBAs) of the supraclinoidal internal carotid artery (ICA) is challenging and the optimal treatment is yet to be defined. The treatment options for ICA BBAS are microsurgery, endovascular therapy, or a combination of the two. The microsurgical armamentarium consists mainly of direct aneurysm clipping with or without protective EC-IC bypass, clip-wrapping, or trap ligation with ICA sacrifice with or without EC-IC bypass. The endovascular treatment options are mainly endovascular ICA ligation, multiple overlapping stents (≥ 3) with or without coiling, covered stents, or flow diverters...
August 17, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28818824/clinical-impact-of-flat-panel-volume-ct-angiography-in-evaluating-the-accurate-intraoperative-deployment-of-flow-diverter-stents
#2
F Clarençon, F Di Maria, J Gabrieli, E Shotar, V Degos, A Nouet, A Biondi, N-A Sourour
BACKGROUND AND PURPOSE: The deployment of flow-diverter stents may be difficult to analyse on regular DSA. The purpose of our study was to investigate the clinical impact of stent-dedicated flat panel volume CT angiography to evaluate intraoperatively the satisfactory deployment of flow-diverter stents. MATERIALS AND METHODS: From January 2009 to April 2015, 83 consecutive patients (mean age, 51 years; 62 women) were treated in our institution with flow-diverter stents...
August 17, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28782689/flow-diverter-treatment-of-tandem-intracranial-aneurysms
#3
Seby John, Mark Bain, Russell Cerejo, Andrew Bauer, Thomas Masaryk, Muhammad S Hussain, Peter Rasmussen, Gabor Toth
OBJECTIVE: The application of flow diversion (FD) for treatment of multiple, tandem intracranial aneurysms has not been well studied. We sought to assess technical success, and clinical and imaging outcomes of FD treatment for tandem intracranial aneurysms. METHODS: Retrospective analysis of patients treated with FD for tandem intracranial aneurysms. RESULTS: Twenty female patients were included with a mean (± SD) age of 60 ±12 years. Only one patient was treated after subarachnoid hemorrhage...
August 3, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28758550/treatment-of-ruptured-blood-blister-aneurysms-using-primary-flow-diverter-stenting-with-considerations-for-adjunctive-coiling-a-single-centre-experience-and-literature-review
#4
Cunli Yang, Agnes Vadasz, István Szikora
Objective The objective of this article is to conduct a single-centre evaluation and quick literature review of the effectiveness of primary flow-diverter (FD) treatment of ruptured blood blister aneurysms (BBAs), with additional relevance of adjunctive coiling. Methods Patients presenting with subarachnoid haemorrhage (SAH) due to ruptured BBAs and subsequently treated with FDs were retrospectively selected from June 2010 to January 2017. Treatment techniques, angiographic data on occlusion rates and procedural success as well as clinical outcomes using the modified Rankin Scale (mRS) were collated...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28754807/balloon-assisted-coil-embolization-and-large-stent-delivery-for-cerebral-aneurysms-with-a-new-generation-of-dual-lumen-balloons-copernic-2l
#5
Adrien Guenego, Jean-Baptiste Zerlauth, Francesco Puccinelli, Steven Hajdu, David C Rotzinger, Felix Zibold, Eike I Piechowiak, Pasquale Mordasini, Jan Gralla, Tomas Dobrocky, Roy T Daniel, René Chapot, Pascal J Mosimann
INTRODUCTION: Dual coaxial lumen balloon microcatheters through which small stents can be delivered have recently been described. We report a series of a new type of dual lumen balloon catheter with a parallel lumen design enabling enhanced inflation and deflation properties through which larger stents may be deployed, including flow diverters (FD). METHODS: All aneurysms that were treated with a Copernic 2L (COP2L) dual lumen balloon catheter at our institution between February 2014 and December 2016 were assessed...
July 28, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28748748/outcome-study-of-the-pipeline-embolization-device-for-treatment-of-intracranial-aneurysms-at-a-single-uk-institution
#6
Shih-Hung Yang, Timothy Hampton, Naga Kandasamy, Jonathan Hart, Jonathan Ashmore, Daniel C Walsh, Christos M Tolias, Thomas C Booth
BACKGROUND: The introduction of flow-diverting stents in the last decade provides an alternative endovascular treatment choice in selected intracranial aneurysms. This retrospective analysis of a UK centre's experience provides insight into clinical and radiographic outcomes. METHODS: Electronic patient records, diagnostic and procedural images and written procedural records for patients treated with the PED between August 2009 and April 2014 were reviewed. Follow-up TOF MRA was performed after treatment...
July 27, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28689955/flow-diverting-stent-in-the-treatment-of-cervical-carotid-dissection-and-pseudoaneurysm-review-of-literature-and-case-report
#7
REVIEW
Anna Paula Weinhardt Baptista-Sincos, Aline Bigatão Simplício, Igor Rafael Sincos, Alex Leaderman, Fernando Saliture Neto, Adjaldes Moraes, Ricardo Aun
BACKGROUND: The endovascular technique has been recommended over the past few years to extracranial carotid dissection and pseudoaneurysm with promising results, specially after medical therapy failure. Flow-diverting stents are an alternative for complex cases. These stents have proven to be effective treatment devices for intracranial aneurysms. OBJECTIVE: To find out all cases of flow-diverting stents in the treatment of extracranial carotid dissection with or without pseudoaneurysm and compare to our case report...
July 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28689183/acute-thrombus-formation-on-phosphorilcholine-surface-modified-flow-diverters
#8
Miklos Marosfoi, Frederic Clarencon, Erin T Langan, Robert M King, Olivia W Brooks, Takamisu Tamura, John M Wainwright, Matthew J Gounis, Srinivasan Vedantham, Ajit S Puri
PURPOSE: Thromboembolic complications remain a limitation of flow diverting stents. We hypothesize that phosphorilcholine surface modified flow diverters (Pipeline Flex with Shield Technology, sPED) would have less acute thrombus formation on the device surface compared with the classic Pipeline Embolization device (cPED). METHODS: Elastase-induced aneurysms were created in 40 rabbits and randomly assigned to receive cPED or sPED devices with and without dual antiplatelet therapy (DAPT) (four groups, n=10/group)...
July 8, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28687502/endovascular-treatment-of-distal-tears-located-in-the-reno-viseceral-segment-with-bare-metal-stents-and-coils-in-a-complicated-type-b-aortic-dissection
#9
Qingsheng Lu, Yanqing Chen, Yongxue Zhang, Hongfei Wang, Hanyan Li, Jiaxuan Feng, Huajuan Mao, Zaiping Jing
PURPOSE: To provide an endovascular strategy of treating patent re-entries adjacent to visceral branches in the management of aortic dissections. CASE REPORT: A 45-year-old male who had received endovascular treatment for a type B aortic dissection was again admitted for his intermittent abdominal pain. Distal tears located in the reno-visceral segment was left untreated in the initial procedure, and was thought to be related to the expansion of the false lumen during follow-up...
July 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28685380/intracranial-aneurysms-treated-by-flow-diverting-stents-long-term-follow-up-with-contrast-enhanced-magnetic-resonance-angiography
#10
Maximilian Patzig, Robert Forbrig, Lorenz Ertl, Hartmut Brückmann, Gunther Fesl
PURPOSE: Long-term data on aneurysm treatment with flow-diverting stents are still sparse, and follow-up protocols differ widely between institutions. We present long-term results, with a focus on the usefulness of contrast-enhanced MR angiography (ceMRA). MATERIALS AND METHODS: Interventions and follow-up imaging of patients with aneurysms treated by flow-diverting stents ("Pipeline," "Silk" and "FRED" models) without additional coiling were analyzed. All MRI scans included dedicated two-phase ceMRA...
July 6, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28675349/novel-solution-for-luminal-access-loss-into-the-double-layered-lvis-blue%C3%A2-construct
#11
Evgueni Kouznetsov, Thomas Haldis, Michael Manchak, Alexander Drofa
We described a novel solution for a challenging case of double-layered LVIS Blue™ (LB) stent construct retraction into a large cavernous aneurysm. The double-layered LB stent construct was used as a flow diverter for treatment of a large cavernous aneurysm. Our solution comprised a balloon angioplasty and placement of balloon-mounted cardiac-stent construct through the side wall of the LB construct, with eventual placement of a Pipeline Flex inside of the final conduit.
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28647659/flow-diverters-as-a-useful-adjunct-to-traditional-endovascular-techniques-in-the-treatment-of-direct-carotid-cavernous-fistulas
#12
Christopher S Ogilvy, Rouzbeh Motiei-Langroudi, Mohammad Ghorbani, Christoph J Griessenauer, Abdulrahman Y Alturki, Ajith J Thomas
BACKGROUND: Direct carotid-cavernous sinus fistulas (CCF) are high flow arteriovenous shunts that are typically the result of a severe head injury. The endovascular treatment of these lesions includes the use of detachable balloons, coils, liquid embolic agents, and covered stents. To minimize the chance of treatment failure and subsequent complications, endoluminal reconstruction using a flow-diverting stent may be added to the treatment construct . METHODS: We present 3 cases and review the existing literature...
June 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28611831/salvage-of-herniated-flow-diverters-using-stent-and-balloon-anchoring-techniques-a-technical-note
#13
Bharathi D Jagadeesan, Divyajot Sandhu, Kim Jae Hong, Sara Roshan Khanipour, Andrew W Grande, Ramachandra P Tummala
BACKGROUND: The pipeline embolization device (PED; Medtronic, MN, USA) can sometimes herniate into the aneurysmal sac in an unexpected manner during or shortly after its deployment due to device foreshortening. In this report, we describe 2 endovascular techniques, which can be used to reposition a herniated PED construct into a more favorable alignment. SUMMARY: In a 67-year-old patient who had an intraprocedural herniation of a PED device into a giant cavernous aneurysm, a stent anchor technique was used to reverse the herniation, reorient the PED construct, and achieve successful flow diversion...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28604183/treatment-of-an-internal-carotid-artery-aneurysm-with-a-flow-diverter-through-a-double-lumen-balloon-catheter
#14
José M Amorim, Santiago Rosati, Ronit Agid, Vítor Mendes Pereira, Timo Krings
Background Double lumen balloon catheters (DLBCs) are currently used in the treatment of intracranial aneurysms, especially when involving balloon or stent-assisted coiling. The existing DLBCs allow the delivery of self-expandable stents but do not offer the possibility to deploy flow-diverters. Despite the increasing use and success of flow-diverters, there have been numerous reports of procedural complications such as early in-stent thrombosis or delayed distal embolization. It seems that these complications can be avoided by correct stent positioning and adequate wall apposition, achieved either by manoeuvres with the microguidewire and/or microcatheter or by performing balloon angioplasty following an exchange guidewire manoeuvre...
June 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28598274/evaluation-of-ischemic-lesion-prevalence-after-endovascular-treatment-of-intracranial-aneurysms-as-documented-by-3-t-diffusion-weighted-imaging-a-2-year-single-center-cohort-study
#15
Christina Iosif, Jean-Christophe Lecomte, Eduardo Pedrolo-Silveira, George Mendes, Marie-Paule Boncoeur Martel, Suzana Saleme, Charbel Mounayer
OBJECTIVE Even though published data exist concerning the prevalence of ischemic lesions detected by diffusion-weighted imaging (DWI) following endovascular treatment of intracranial aneurysms, a single-center cross-evaluation of the different endovascular techniques has been lacking. The authors sought to prospectively evaluate the prevalence and clinical significance of ischemic lesions occurring after endovascular treatment of intracranial aneurysms and to compare the safety and effectiveness of a broad spectrum of currently accepted endovascular techniques in a single-center setting...
June 9, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28595811/acute-distal-migration-of-a-flow-diverting-stent
#16
David Dornbos, Ciarán J Powers
The introduction of flow diverting stents, particularly for treatment of petrous to supraclinoid internal carotid artery aneurysms, has greatly impacted endovascular treatment of intracranial aneurysms. Despite their high efficacy, complications, such as ischemic events, distal hemorrhage, or problems with stent deployment, remain a significant concern. We present the first reported case of acute distal migration of a Pipeline Embolization Device (PED). A 24-year old female underwent elective placement of a PED for treatment of a left paraclinoid internal carotid artery aneurysm...
June 5, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28592484/analysis-of-neointima-development-in-flow-diverters-using-optical-coherence-tomography-imaging
#17
Yoshikazu Matsuda, Joonho Chung, Demetrius K Lopes
BACKGROUND: Flow diverters are used for the treatment of intracranial aneurysms. Surface modification may decrease the thrombogenicity of flow diverters but the details are unknown. Optical coherence tomography (OCT) is an intravascular imaging test with high resolution which identifies neointimal growth over stents. We compared the development of neointima in a flow diverter and stents with and without surface modification in a swine model. METHODS: In this study we implanted four devices (two in each carotid artery) in four pigs...
June 7, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28576622/haemodynamic-effects-of-stent-diameter-and-compaction-ratio-on-flow-diversion-treatment-of-intracranial-aneurysms-a-numerical-study-of-a-successful-and-an-unsuccessful-case
#18
Mingzi Zhang, Yujie Li, Xi Zhao, David I Verrelli, Winston Chong, Makoto Ohta, Yi Qian
BACKGROUND: Compacting a flow-diverting (FD) stent is an emerging technique to create a denser configuration of wires across the aneurysm ostium. However, quantitative analyses of post-stenting haemodynamics affected by the compaction level of different stent sizes remain inconclusive. OBJECTIVE: To compare the aneurysmal haemodynamic alterations after virtual FD treatments with different device diameters at different compaction ratios. METHODS: We virtually implanted three sizes of FD stent, with each size deployed at four compaction ratios, into two patient aneurysms previously treated with the Silk+FD-one successful case and the other unsuccessful...
May 16, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28565993/use-of-the-pipeline-embolization-device-in-the-treatment-of-iatrogenic-intracranial-vascular-injuries-a-bi-institutional-experience
#19
Julius Griauzde, Vijay M Ravindra, Neeraj Chaudhary, Joseph J Gemmete, Marcus D Mazur, Christopher D Roark, William T Couldwell, Min S Park, Philipp Taussky, Aditya S Pandey
OBJECTIVE Flow-diverting devices have been used for the treatment of complex intracranial vascular pathology with success, but the role of these devices in treating iatrogenic intracranial vascular injuries has yet to be clearly defined. Here, the authors report their bi-institutional experience with the use of the Pipeline embolization device (PED) for the treatment of iatrogenic intracranial vascular injuries. METHODS The authors reviewed a retrospective cohort of patients with iatrogenic injuries to the intracranial vasculature that were treated with the PED between 2012 and 2016...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28565984/novel-use-of-flow-diversion-for-the-treatment-of-aneurysms-associated-with-arteriovenous-malformations
#20
Craig Kilburg, Philipp Taussky, M Yashar S Kalani, Min S Park
The use of flow-diverting stents for intracranial aneurysms has become more prevalent, and flow diverters are now routinely used beyond their initial scope of approval at the proximal internal carotid artery. Although flow diversion for the treatment of cerebral aneurysms is becoming more commonplace, there have been no reports of its use to treat flow-related cerebral aneurysms associated with arteriovenous malformations (AVMs). The authors report the cases of 2 patients whose AVM-associated aneurysms were managed with flow diversion...
June 2017: Neurosurgical Focus
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