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Flow diverte stent

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https://www.readbyqxmd.com/read/28416090/clipping-in-awake-surgery-as-end-stage-in-a-complex-internal-carotid-artery-aneurysm-after-failure-of-multimodal-endovascular-and-extracranial-intracranial-bypass-treatment
#1
Delia Cannizzaro, Simone Peschillo, Cristina Mancarella, Biagia La Pira, Emanuela Rastelli, Emiliano Passacantilli, Antonio Santoro
BACKGROUND: Intracranial carotid artery aneurysm can be treated via microsurgical or endovascular techniques. The optimal planning is the result of the careful patient selection through clinical, anatomic, and angiographic analysis. CLINICAL PRESENTATION: We present a case of ruptured internal carotid artery (ICA) aneurysm that became a complex aneurysm after failure of multi-endovascular and surgery treatment. We describe complete trapping in awake craniotomy after failure of coiling, stenting, and bypassing...
April 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28391744/malignant-stroke-in-a-ticagrelor-non-responder-as-a-complication-following-aneurysm-treatment-with-the-pipeline-embolization-device%C3%A2
#2
Pegah Ghamasaee, Kevin Carr, Jeremiah Johnson, Ramesh Grandhi
The Pipeline Embolization Device™ (PED; Covidien Neurovascular Inc, Irvine, CA, USA) is a flow-diverting stent often used for the endovascular treatment of large or giant, wide-necked intracranial aneurysms of the internal carotid artery. Because of the inherent thrombogenicity of intracranial stents, dual-antiplatelet therapy is initiated after placement, which has been shown to decrease morbidity and mortality related to perioperative ischemic events in neurointerventional procedures. However, in some series, as much as 50% of patients demonstrate clopidogrel non-responsiveness...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28383672/cerebral-revascularization-for-aneurysms-in-the-flow-diverter-era
#3
David C Straus, Harley Brito da Silva, Lynn McGrath, Michael R Levitt, Louis J Kim, Basavaraj V Ghodke, Jason K Barber, Laligam N Sekhar
BACKGROUND: Cerebral bypass has been an important tool in the treatment of complex intracranial aneurysms. The recent advent of flow-diverting stents (FDS) has expanded the capacity for endovascular arterial reconstruction. OBJECTIVE: We investigated how the advent of FDS has impacted the application and outcomes of cerebral bypass in the treatment of intracranial aneurysms. METHODS: We reviewed a consecutive series of cerebral bypasses during aneurysm surgery over the course of 10 years...
April 5, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28374616/treatment-of-barrow-type-b-carotid-cavernous-fistulas-with-flow-diverter-stent-pipeline
#4
Carlos Castaño, Sebastián Remollo, Rosa García-Sort, Carlos Domínguez, Mikel Terceño
Background Carotid cavernous fistulas (CCFs) Barrow type 'B' are dural shunts between the meningeal branches of the internal carotid artery and the cavernous sinus. The symptoms include vision deterioration, ophthalmoplegia with diplopia, exophthalmos, conjunctival injection, chemosis, ocular bruit, seizures, or neurological deficit. Endovascular treatment remains the gold standard for treatment through the transvenous or transarterial routes. The transvenous approaches have been proved to be the first option...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28333907/the-effect-of-placing-flow-diverting-stents-in-intracranial-collateral-arteries-of-miniature-pig
#5
Jiwei Wang, Yanan Ding, Qiuxia Wang, Yanan Wang, Shiqing Mu, Lixin Bi, Youxiang Li
BACKGROUND Flow-diverting stent (FDS) has been suggested as an effective intracranial aneurysm treatment. However, the effects of FDS on collateral branches of an aneurysm parent artery still remain unknown. Thus, the present study aimed to comprehensively evaluate the effects of placing a FDS in the intracranial collateral artery, using a miniature pig animal model. MATERIAL AND METHODS Ten healthy miniature pigs were included in the study: one pig was reserved as a control and the remaining nine pigs were placed in three experimental groups: FDS (i...
March 23, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28327963/treatment-of-intracranial-aneurysms-with-the-silk-embolization-device-in-a-multicenter-study-a-retrospective-data-analysis
#6
José Manuel Pumar, Alexandra Banguero, Hugo Cuellar, Leopoldo Guimaraens, Javier Masso, Salvador Miralbes, Miguel Blanco-Ulla, Fernando Vazquez-Herrero, Miguel Souto, Miguel Gelabert-Gonzalez
BACKGROUND: Flow-diverter technology has become an important stent-based embolization tool in the treatment of complex cerebrovascular pathology. We report here the experience of 4 Spanish centers with using the SILK flow-diverter (SFD) device. OBJECTIVE: To evaluate the safety and efficacy of using the SFD in the endovascular treatment of intracranial aneurysms with complex morphology. METHODS: We retrospectively examined a prospectively maintained database of patients treated with SFD devices between July 2008 and December 2013 at 1 of 4 institutions in Spain...
January 28, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327931/flow-diverters-for-treatment-of-160-ophthalmic-segment-aneurysms-evaluation-of-safety-and-efficacy-in-a-multicenter-cohort
#7
Christoph J Griessenauer, Ronie L Piske, Carlos E Baccin, Benedito J A Pereira, Arra S Reddy, Ajith J Thomas, Thiago G Abud, Christopher S Ogilvy
BACKGROUND: Treatment of ophthalmic segment aneurysms (OSA) remains challenging. Flow diverter stents (FDS) have evolved as a promising endovascular treatment option for aneurysms of the internal carotid artery and are associated with high occlusion rates and a favorable morbidity and mortality profile. OBJECTIVE: To determine safety and efficacy of FDS for OSA in a large, multicenter cohort. METHODS: A retrospective analysis of prospectively maintained databases of 127 consecutive patients harboring 160 OSA treated with FDS was performed...
January 28, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28316868/a-case-of-ruptured-blood-blister-like-aneurysm-treated-with-pipeline-embolization-device-clinical-significance-of-fetal-type-posterior-communicating-artery
#8
Ki-Su Park, Dong-Hun Kang, Won-Soo Son, Jaechan Park, Young-Sun Kim, Byung Moon Kim
Blood-blister like aneurysms (BBAs) are challenging lesions because of their wide fragile neck. Flow-diverting stents (FDSs), such as the Pipeline Embolization Device (PED), have been applied to treat BBAs less amenable to more established techniques of treatment. However, the use of FDSs, including the PED, in acute subarachnoid hemorrhage (SAH) still remains controversial. We report a case of aneurysm regrowth following PED application for a ruptured BBA that overlapped the origin of the dominant posterior communicating artery (PCoA), which was successfully treated after coil trapping of the origin of the fetal-type PCoA...
March 2017: Neurointervention
https://www.readbyqxmd.com/read/28316865/treatment-of-intracranial-aneurysms-with-flow-re-direction-endoluminal-device-a-single-centre-experience-with-short-term-follow-up-results
#9
Neeraj Ramesh Mahboobani, Wing Ho Chong, Samuel Siu Kei Lam, Jimmy Chi Wai Siu, Chong Boon Tan, Yiu Chung Wong
PURPOSE: A flow diverter (FD) is an effective treatment option for intracranial aneurysms. The Flow Re-direction Endoluminal Device (FRED) is a relatively new flow diverter with a unique dual-layer design. We report our experience and short-term results with the FRED. MATERIALS AND METHODS: We did a retrospective review of all consecutive cases in which the FRED was used to treat intracranial aneurysms at a single institution from March 2014 till December 2015. Clinical parameters, aneurysm characteristics, technical results and short-term outcomes were reviewed...
March 2017: Neurointervention
https://www.readbyqxmd.com/read/28304190/the-second-generation-eclips-endovascular-clip-system-initial-experience
#10
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/28250282/a-single-center-experience-with-coil-embolization-for-cerebral-aneurysms-greater-than-10-mm-in-the-internal-carotid-artery
#11
Kensuke Suzuki, Ryotaro Suzuki, Tomoji Takigawa, Nobuyuki Shimizu, Yoshiyuki Matsumoto, Yoshiko Fujii, Yuki Inoue, Yoshiki Sugiura, Koji Hirata, Kyoji Tsuda, Yosuke Kawamura, Issei Takano, Ryuta Nakae, Masaya Nagaishi, Yoshihiro Tanaka, Akio Hyodo
We investigated endovascular treatment for 10 mm or larger aneurysms in the internal carotid artery (IC), including the cavernous portion, the paraclinoid portion, and the posterior communication artery (PC). Between 2011 and 2014 at our hospital, there were 35 cases of aneurysms that were 10 mm or larger in the carotid artery. We analyzed these 35 cases retrospectively based on the size and location of the aneurysms, method of treatment, number of coils implanted, use of a stent, complications, rupture after treatment, ophthalmologic symptoms, and need for re-treatment...
March 2, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28238529/innovations-in-endovascular-treatment-strategies-for-large-carotid-cavernous-aneurysms-the-safety-and-efficacy-of-a-flow-diverter
#12
Shigeru Miyachi, Hiroyuki Ohnishi, Ryo Hiramatsu, Takashi Izumi, Noriaki Matsubara, Toshihiko Kuroiwa
BACKGROUND: The efficacy for the treatment of large carotid cavernous aneurysms (CCAs) was compared between conventional endovascular treatments, stent-assisted coiling (SAC), parent artery occlusion (PAO), and the flow diverter (FD). METHODS: Between January 2001 and December 2015, 49 patients with large, broad-necked, unruptured CCA underwent endovascular treatment at our institution. We performed PAO in 22 patients, SAC in 18 patients, and FD in 9 patients. Safety and efficacy were assessed in all patients by periodic clinical and radiological examinations during a 6-month follow-up...
February 24, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28236050/endovascular-treatment-of-intracranial-aneurysms-with-the-p64-flow-diverter-stent-mid-term-results-in-35-patients-with-41-intracranial-aneurysms
#13
Ricardo Morais, Benjamin Mine, Pierre Julien Bruyère, Gilles Naeije, Boris Lubicz
INTRODUCTION: The p64 flow diverter (FD) device is a fully resheathable and detachable stent dedicated for endovascular treatment (EVT) of intracranial aneurysms (IAs). We report our mid-term experience with this device. METHODS: Between January 2015 and February 2016, we retrospectively identified, in our prospectively maintained database, all patients treated with p64 FDs in two institutions. Independent clinical follow-up was performed by a vascular neurologist...
February 24, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28217382/pipeline-embolization-device-as-primary-treatment-for-cervical-internal-carotid-artery-pseudoaneurysms
#14
Arthur Wang, Justin Santarelli, Michael F Stiefel
BACKGROUND: Limited data exists on the durability and occlusion rate of treating extracranial cervical internal carotid artery pseudoaneurysms using the pipeline embolization device (PED) flow-diverting stent. METHODS: Three patients presenting with dissecting cervical internal carotid artery pseudoaneurysms were treated with the PED as the sole treatment modality. RESULTS: In all three patients, successful aneurysmal occlusion and parent vessel reconstruction occurred on immediate angiography and continued on 6-month follow-up...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28210239/flow-diversion-for-the-treatment-of-mca-bifurcation-aneurysms-a-single-centre-experience
#15
Pervinder Bhogal, Muhammad AlMatter, Hansjörg Bäzner, Oliver Ganslandt, Hans Henkes, Marta Aguilar Pérez
BACKGROUND: Intracranial aneurysms located at the bifurcation of the middle cerebral artery (MCA) can often be challenging for the neurointerventionalist. We aimed to evaluate the efficacy and safety of flow diverting stents (FDS) in the treatment of these aneurysms. MATERIALS AND METHODS: We retrospectively reviewed our prospectively maintained database to collect information for all patients with unruptured saccular bifurcation MCA aneurysms treated with FDS between January 2010 and January 2016...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28163518/double-barrel-y-configuration-stenting-for-flow-diversion-of-a-giant-recurrent-basilar-apex-aneurysm-with-the-pipeline-flex-embolization-device
#16
Dale Ding, Robert M Starke, Ben McGuinness, Stefan Brew
Giant basilar apex aneurysms are extremely challenging to successfully manage. The Pipeline Flex embolization device (PFED) is a new generation flow-diverting stent with a modified delivery system which allows resheathing of the stent after partial deployment. We describe a case of double-barrel Y-configuration stenting of a giant, recurrent basilar apex aneurysm using the PFED. A 73-year-old male was previously treated for an unruptured 11-mm basilar apex aneurysm with stent-assisted coiling using a Neuroform stent...
December 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28155683/towards-the-patient-specific-design-of-flow-diverters-made-from-helix-like-wires-an-optimization-study
#17
Mingzi Zhang, Hitomi Anzai, Bastien Chopard, Makoto Ohta
BACKGROUND: Flow diverter (FD) intervention is an emerging endovascular technique for treating intracranial aneurysms. High flow-diversion efficiency is desired to accelerate thrombotic occlusion inside the aneurysm; however, the risk of post-stenting stenosis in the parent artery is posed when flow-diversion efficiency is pursued by simply decreasing device porosity. For improving the prognosis of FD intervention, we develop an optimization method for the design of patient-specific FD devices that maintain high levels of porosity...
December 28, 2016: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28154128/lack-of-association-between-statin-use-and-angiographic-and-clinical-outcomes-after-pipeline-embolization-for-intracranial-aneurysms
#18
W Brinjikji, H Cloft, S Cekirge, D Fiorella, R A Hanel, P Jabbour, P Lylyk, C McDougall, C Moran, A Siddiqui, I Szikora, D F Kallmes
BACKGROUND AND PURPOSE: Use of statin medications has been demonstrated to improve clinical and angiographic outcomes in patients receiving endovascular stent placement for coronary, peripheral, carotid, and intracranial stenoses. We studied the impact of statin use on long-term angiographic and clinical outcomes after flow-diverter treatment of intracranial aneurysms. MATERIALS AND METHODS: We performed a post hoc analysis from pooled patient-level datasets from 3 Pipeline Embolization Device studies: the International Retrospective Study of the Pipeline Embolization Device, the Pipeline for Uncoilable or Failed Aneurysms Study, and the Aneurysm Study of Pipeline in an Observational Registry...
February 2, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28133987/ruptured-intracranial-vertebral-artery-dissecting-aneurysms-an-evaluation-of-prognostic-factors-of-treatment-outcome
#19
K Urasyanandana, P Withayasuk, D Songsaeng, T Aurboonyawat, E Chankaew, A Churojana
Objective Intracranial spontaneous vertebral artery dissecting aneurysms commonly occur in the third to fifth decades of life, and are mostly associated with hypertension. Patients present with intracranial haemorrhage or thromboembolic events. Patients who present with intracranial haemorrhage carry about a 70% risk of recurrent bleeding. Patients with a posterior-inferior cerebellar artery (PICA) or ipsilateral dominant vertebral artery involve selecting which parent vessel could not be sacrificed. Recent reconstructive techniques such as stent-assisted coiling embolisation and flow-diverting stents are effective treatments of choice...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28108500/ophthalmic-artery-occlusion-after-pipeline-embolization-device-placement-with-reconstitution-of-flow-via-an-endoleak-a-report-of-two-cases
#20
Michael L Adix, Ian A Kaminsky, In Sup Choi
The Pipeline Embolization Device (PED) is a flow diverting stent used in the treatment of a wide variety of intracranial aneurysms. The device differs from traditional stents used in stent-assisted coil embolization in that it has a tighter lattice structure with smaller cell sizes designed specifically to disrupt blood flow into aneurysms rather than only to retain coils within aneurysms. While the PED has been shown to be safe and effective, it has a unique risk profile that includes side branch and perforator vessel occlusion...
January 20, 2017: Journal of Neurointerventional Surgery
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