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Flow diverte stent

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https://www.readbyqxmd.com/read/29444328/influence-of-anatomic-changes-on-the-outcomes-of-carotid-siphon-aneurysms-after-deployment-of-flow-diverter-stents
#1
Eduardo Waihrich, Pierre Clavel, George Mendes, Christina Iosif, Iruena Moraes Kessler, Charbel Mounayer
BACKGROUND: Flow-diverter stent (FDS) deployment can cause morphological and hemodynamic changes in the carotid siphon (CS), influencing the occlusion rate of aneurysms in this location. OBJECTIVE: To evaluate morphological changes to the CS after FDS deployment and their relationship with the rate of occlusion of intracranial aneurysms. METHODS: A cohort of 183 patients with CS aneurysms were treated by deployment of Pipeline® FDS (Medtronic Inc, Dublin, Ireland)...
February 10, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29402066/development-of-new-endovascular-devices-for-aneurysm-treatment
#2
REVIEW
Zhen Yu Jia, Hai Bin Shi, Shigeru Miyachi, Sun Moon Hwang, Jae Jon Sheen, Yun Sun Song, Joong Goo Kim, Deok Hee Lee, Dae Chul Suh
Since the first use of the Guglielmi detachable coil system for cerebral aneurysm embolization in 1990, various endovascular methods have been developed to treat large numbers of aneurysms. The main strategic and technical modifications introduced to date include balloon-assisted coil embolization, stent-assisted coil embolization, flow diverters, and flow disrupters. The development and introduction of such devices have been so persistent and rapid that new devices are being approved worldwide even before the earlier ones become available in some countries...
January 2018: Journal of Stroke
https://www.readbyqxmd.com/read/29380260/long-term-follow-up-in-the-endovascular-treatment-of-intracranial-aneurysms-with-flow-diverter-stents-update-of-a-single-centre-experience
#3
Giuseppe Guzzardi, Carmelo Stanca, Paolo Cerini, Bruno Del Sette, Ignazio Divenuto, Emanuele Malatesta, Alessandro Carriero, Alessandro Stecco
INTRODUCTION: Flow-diverter stents are becoming a useful tool in treating patients with intracranial aneurysms with suitable anatomical feature. Purpose of this study was to evaluate effectiveness and safety of endovascular treatment with flow-diverting stents (FD) in unruptured intracranial aneurysms. METHODS: From May 2009 and May 2014, we treated 49 patients with a total of 58 aneurysms, with FD technique. All patients were treated electively, under general anesthesia and were administered single antiplatelet drug 5 days before the procedure and double antiplatelet therapy for 3 months afterwards...
January 30, 2018: La Radiologia Medica
https://www.readbyqxmd.com/read/29351652/early-results-in-flow-diverter-sizing-by-computational-simulation-quantification-of-size-change-and-simulation-error-assessment
#4
Ana Paula Narata, Jordi Blasco, Luis San Roman, Juan Miguel Macho, Hector Fernandez, Raquel Kale Moyano, Renaud Winzenrieth, Ignacio Larrabide
BACKGROUND: Sizing of flow diverters (FDs) stent in the treatment of intracranial aneurysms is a challenging task due to the change of stent length after implantation. OBJECTIVE: To quantify the size change and assess the error in length prediction in 82 simulated FD deployments. METHODS: Eighty-two consecutive patients treated with FDs were retrospectively analyzed. Implanted FD length was measured from angiographic images and compared to the nominal sizes of the implanted device...
January 17, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29349370/endovascular-treatment-with-flow-diverting-stents-of-symptomatic-superior-mesenteric-artery-after-dissection-aneurysm
#5
Giuseppe Baldino, Paolo Mortola, Marta Cambiaso, Alessandro Valdata, Amerigo Gori
Isolated and spontaneous superior mesenteric artery dissection is a rare cause of acute abdominal pain. Whereas there is widespread consensus on conservative treatment of asymptomatic forms, revascularization would seem indicated in symptomatic complicated cases. A 73-year-old man presented with worsening epigastric pain. A computed tomography scan revealed an isolated and spontaneous superior mesenteric artery dissection with aneurysmal evolution of the false lumen, involving multiple side branches. The postdissection aneurysm was treated by endovascular exclusion with flow-diverting stents...
March 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29331948/lvis-blue-as-a-low-porosity-stent-and-coil-adjuvant
#6
Matthew J Koch, Christopher J Stapleton, Scott B Raymond, Susan Williams, Thabele M Leslie-Mazwi, James David Rabinov, Aman B Patel
INTRODUCTION: The LVIS Blue is an FDA-approved stent with 28% metallic coverage that is indicated for use in conjunction with coil embolization for the treatment of intracranial aneurysms. Given a porosity similar to approved flow diverters and higher than currently available intracranial stents, we sought to evaluate the effectiveness of this device for the treatment of intracranial aneurysms. METHODS: We performed an observational single-center study to evaluate initial occlusion and occlusion at 6-month follow-up for patients treated with the LVIS Blue in conjunction with coil embolization at our institution using the modified Raymond-Roy classification (mRRC), where mRRC 1 indicates complete embolization, mRRC 2 persistent opacification of the aneurysm neck, mRRC 3a filling of the aneurysm dome within coil interstices, and mRRC 3b filling of the aneurysm dome...
January 13, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29317468/radiation-exposure-and-procedure-and-fluoroscopy-times-in-endovascular-treatment-of-intracranial-aneurysms-a-methodological-comparison
#7
Nicholas K Cheung, Michelle Boutchard, Michael W Carr, Jens J Froelich
BACKGROUND: Limited data are available for radiation exposure, and procedure and fluoroscopy times in neuroendovascular treatment (NET) strategies. OBJECTIVE: This study establishes and compares related parameters between coil embolization (COIL), balloon assisted coil embolization (BAC), stent assisted coil embolization (SAC), and flow diverting technology (FDT) in NET of intracranial aneurysms. MATERIALS AND METHODS: Between 2010 and 2017, 249 consecutive intracranial aneurysms underwent NET at a single center, all performed by the same operator...
January 9, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29277587/the-use-of-flow-diverter-in-ruptured-dissecting-intracranial-aneurysms-of-the-posterior-circulation
#8
Volker Maus, Anastasios Mpotsaris, Franziska Dorn, Markus Möhlenbruch, Jan Borggrefe, Pantelis Stavrinou, Nuran Abdullayev, Utako Birgit Barnikol, Thomas Liebig, Christoph Kabbasch
OBJECTIVE: Acute dissecting aneurysms of the posterior circulation are a rare cause of SAH. Established endovascular treatment options include PAO and stent-assisted coiling, but appear to be associated with an increased risk of ischemic stroke. Vessel reconstruction with flow-diverters is an alternative treatment option, however, its safety and efficacy in the acute stage remains unclear. METHODS: Multi-centric retrospective analysis of 15 consecutive acutely ruptured dissecting posterior circulation aneurysms treated with flow-diverters...
December 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29239687/open-cell-stent-and-use-of-cone-beam-ct-enables-a-safe-and-effective-coil-embolization-of-true-ophthalmic-artery-and-anterior-choroidal-artery-aneurysms-with-preservation-of-parent-vessel-clinical-and-angiographic-results
#9
Samuel Y Hou, Anna Luisa Kühn, Ajit S Puri, Ajay K Wakhloo
Background Treatment of true ophthalmic artery (OA) or anterior choroidal artery (AChA) aneurysms with preservation of the parent vessel may be challenging. Flow diverters have limitations when dealing with branch vessels arising from the aneurysm sac. Visual loss or AChA territory infarcts have been reported both for surgical and endovascular treatment. Methods We evaluated the safety and efficacy of an open-cell design, laser-cut, self-expanding Nitinol stent, and use of cone-beam computed tomography (CBCT) for stent-assisted coil embolization...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29239685/in%C3%A2-vitro-angiographic-comparison-of-the-flow-diversion-performance-of-five-neurovascular-stents
#10
Ronak J Dholakia, Ari D Kappel, Andrew Pagano, Henry H Woo, Baruch B Lieber, David J Fiorella, Chander Sadasivan
Background and purpose Data differentiating flow diversion properties of commercially available low- and high-porosity stents are limited. This in vitro study applies angiographic analysis of intra-aneurysmal flow to compare the flow-diversion performance of five neurovascular devices in idealized sidewall and bifurcation aneurysm models. Methods Five commercial devices (Enterprise, Neuroform, LVIS, FRED, and Pipeline) were implanted in silicone sidewall and bifurcation aneurysm models under physiological average flow of blood analog fluid...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29214402/decision-making-and-neurosurgeons-agreement-in-the-management-of-aneurysmal-subarachnoid-haemorrhage-based-on-computed-tomography-angiography
#11
Nicolai Maldaner, Jan-Karl Burkhardt, Martin Nikolaus Stienen, Johannes Goldberg, David Bervini, Philippe Bijlenga, Davide Croci, Daniel Zumofen, Donato D'Alonzo, Serge Marbacher, Rodolfo Maduri, Roy Thomas Daniel, Carlo Serra, Giuseppe Esposito, Marian C Neidert, Oliver Bozinov, Luca Regli
BACKGROUND: To determine the neurosurgeon's agreement in aneurysmal subarachnoid haemorrhage (aSAH) management with special emphasis on the rater's level of experience. A secondary aim was to analyse potential aneurysm variables associated with the therapeutic recommendation. METHOD: Basic clinical information and admission computed tomography angiography (CTA) images of 30 consecutive aSAH patients were provided. Twelve neurosurgeons independently evaluated aneurysm characteristics and gave recommendations regarding the emergency management and aneurysm occlusion therapy...
February 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29209136/interaction-between-flow-diverter-and-parent-artery-of-intracranial-aneurysm-a-computational-study
#12
Wenyu Fu, Qixiao Xia
To evaluate the influence of deployment strategy on the mechanical interaction between braided stent and parent artery of intracranial aneurysm (the elasticity of the arterial wall is considered), finite-element analyses are carried out by referring to computational models of flow-diverter device and arterial wall. Two implantation strategies are used to virtually implant the braided stent into the ideal intracranial aneurysm model. One is the noncompacted implantation method, and the other is the implantation method of using push-pull technique...
2017: Applied Bionics and Biomechanics
https://www.readbyqxmd.com/read/29204036/flow-diverting-stent-assisted-coil-embolization-of-a-ruptured-internal-carotid-artery-blister-aneurysm-with-the-pipeline-flex-embolization-device
#13
Dale Ding, Robert M Starke, Ayton Hope, Stefan Brew
Internal carotid artery (ICA) blister aneurysms are rare and challenging to successfully treat, using contemporary surgical or endovascular approaches, without partial or complete compromise of the parent vessel. We describe the use of a resheathable flow diverter, the Pipeline Flex Embolization Device (PFED) to perform stent-assisted coiling of a ruptured supraclinoid ICA blister aneurysm in a 56-year-old female who presented with a high-grade subarachnoid hemorrhage (SAH). The first PFED was deployed across the aneurysm neck to jail a microcatheter within the aneurysm dome, and then, two small coils were delivered into the aneurysm...
October 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29197163/model-for-pressure-drop-and-flow-deflection-in-the-numerical-simulation-of-stents-in-aneurysms
#14
S Li, J Latt, B Chopard
The numerical simulation of flow diverters like stents contributes to the development and improvement of endovascular stenting procedures, leading ultimately to an improved treatment of intracranial aneurysms. Due to the scale difference between the struts of flow diverters and the full artery, it is common to avoid fully resolved simulations at the level of the stent porosity. Instead, the effect of stents on the flow is represented by a heuristic continuum model. However, the commonly used porous media models describe the properties of flow diverters only partially, because they do not explicitly account for the deflection of the flow direction by the stent...
December 1, 2017: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/29170270/the-role-of-hemodynamics-in-intracranial-bifurcation-arteries-after-aneurysm-treatment-with-flow-diverter-stents
#15
A P Narata, F S de Moura, I Larrabide, C M Perrault, F Patat, R Bibi, S Velasco, A-C Januel, C Cognard, R Chapot, A Bouakaz, C A Sennoga, A Marzo
BACKGROUND AND PURPOSE: Treatment of intracranial bifurcation aneurysms with flow-diverter stents can lead to caliber changes of the distal vessels in a subacute phase. This study aims to evaluate whether local anatomy and flow disruption induced by flow-diverter stents are associated with vessel caliber changes in intracranial bifurcations. MATERIALS AND METHODS: Radiologic images and demographic data were acquired for 25 patients with bifurcation aneurysms treated with flow-diverter stents...
November 23, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29125410/hemorrhage-associated-with-ventriculoperitoneal-shunt-placement-in-aneurysmal-subarachnoid-hemorrhage-patients-on-a-regimen-of-dual-antiplatelet-therapy-a-retrospective-analysis
#16
Joseph S Hudson, Yasunori Nagahama, Daichi Nakagawa, Robert M Starke, Brian J Dlouhy, James C Torner, Pascal Jabbour, Lauren Allan, Colin P Derdeyn, Jeremy D W Greenlee, David Hasan
OBJECTIVE Intracranial stenting and flow diversion require the use of dual antiplatelet therapy (DAPT) to prevent in-stent thrombosis. DAPT may significantly increase the risk of hemorrhagic complications in patients who require subsequent surgical interventions. In this study, the authors sought to investigate whether DAPT is a risk factor for hemorrhagic complications associated with ventriculoperitoneal (VP) shunt placement in patients with aneurysmal subarachnoid hemorrhage (aSAH). Moreover, the authors sought to compare VP shunt complication rates with respect to the shunt's location from the initial external ventricular drain (EVD) site...
November 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29118794/safety-and-efficacy-of-low-profile-self-expandable-stents-for-treatment-of-intracranial-aneurysms-initial-and-midterm-results-a-systematic-review-and-meta-analysis
#17
Su-Yeon Park, Jae-Sang Oh, Hyuk-Jin Oh, Seok-Mann Yoon, Hack-Gun Bae
Low-profile stents seem to be associated with a higher incidence of thromboembolic events compared with preexisting stents. We conducted a systematic review of 11 eligible reports and a meta-analysis of 7 reports with respect to the clinical efficacy and safety of low-profile stents. There were 217 intracranial aneurysms reported; 22% were ruptured aneurysms. In all, 72% were treated using single stenting, 19% were treated using overlapping stenting, and 6% were treated using balloon angioplasty followed by stenting; 3% were used to assess the flow diverter effect in a dissecting aneurysm or were treated using unexpected subtotal coil packing...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29118792/anchoring-pipeline-flow-diverter-construct-in-the-treatment-of-traumatic-distal-cervical-carotid-artery-injury
#18
Krishna Amuluru, Fawaz Al-Mufti, William Roth, Charles J Prestigiacomo, Chirag D Gandhi
Background: Traumatic extracranial internal carotid artery (ICA) dissections are uncommon and can be difficult to treat. Thinning of adventitia and dilatation may occur following arterial dissection, thus resulting in a fusiform pseudoaneurysm, which can subsequently cause bleeding, expanding, or pulsatile hematoma. Currently, medical management with anticoagulation remains the first line of treatment and yields good outcomes in 75% of cases with a mortality rate of 3-4%. Endovascular intervention is indicated with failure of medical therapy, progressive enlargement of a traumatic pseudoaneurysm, acute flow-related infarcts due to vessel occlusion, or when anticoagulation is contraindicated due to risk of pseudoaneurysm rupture and hemorrhage...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29099296/dual-antiplatelet-therapy-in-aneurysmal-subarachnoid-hemorrhage-association-with-reduced-risk-of-clinical-vasospasm-and-delayed-cerebral-ischemia
#19
Yasunori Nagahama, Lauren Allan, Daichi Nakagawa, Mario Zanaty, Robert M Starke, Nohra Chalouhi, Pascal Jabbour, Robert D Brown, Colin P Derdeyn, Enrique C Leira, Joseph Broderick, Marc Chimowitz, James C Torner, David Hasan
OBJECTIVE Clinical vasospasm and delayed cerebral ischemia (DCI) are devastating complications of aneurysmal subarachnoid hemorrhage (aSAH). Several theories involving platelet activation have been postulated as potential explanations of the development of clinical vasospasm and DCI. However, the effects of dual antiplatelet therapy (DAPT; aspirin and clopidogrel) on clinical vasospasm and DCI have not been previously investigated. The objective of this study was to evaluate the effects of DAPT on clinical vasospasm and DCI in aSAH patients...
November 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29081013/emerging-technologies-in-flow-diverters-and-stents-for-cerebrovascular-diseases
#20
REVIEW
Michael Karsy, Jian Guan, Andrea A Brock, Anubhav Amin, Min S Park
PURPOSE OF REVIEW: Stents and flow diverters have revolutionized the treatment of cerebrovascular disease. Guglielmi coils, flexible microcatheters, and first-generation intracranial stents, such as Neuroform (Stryker Neurovascular) and Enterprise stents (Codman/DePuy-Synthes), have paved the way for the development of the Pipeline Embolization Device (PED) (ev3/Covidien/Medtronic) and other endovascular approaches. RECENT FINDINGS: This review discusses the historical development of flow diverter technologies from the PED to similar devices, such as the Surpass stent (Stryker Neurovascular), the Flow-Redirection Endoluminal Device (FRED; MicroVention, Inc...
October 28, 2017: Current Neurology and Neuroscience Reports
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