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Flow diverter

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https://www.readbyqxmd.com/read/29659995/the-importance-of-wall-apposition-in-flow-diverters
#1
René Aquarius, Antonius de Korte, Debby Smits, Matthew Gounis, Kiek Verrijp, Léon Driessen, William Leenders, Joost de Vries
BACKGROUND: It is assumed that high pore densities in flow diverters (FDs) are beneficial for intracranial aneurysm (IA) healing. However, various animal studies are not conclusive on the issue, suggesting that other factors are in play. One important factor might be wall apposition. OBJECTIVE: To (1) determine the relationship between FD pore density and aneurysm occlusion, and (2) determine the relationship between FD wall apposition and aneurysm occlusion. METHODS: Saccular aneurysms were microsurgically created in the aorta of 36 Wistar rats...
April 4, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29653275/safety-and-efficacy-of-flow-diverter-treatment-for-aneurysm-in-small-cerebral-vessels-a-systematic-review-and-meta-analysis
#2
REVIEW
Yazhou Yan, Deyuan Zhu, Haishuang Tang, Qinghai Huang
PURPOSE: To clarify the safety and efficacy of flow diverter (FD) treatment for aneurysm in small cerebral vessels, we conducted a systematic review of the literature analyzing perioperative and long-term clinical and angiographic outcomes. METHODS: A comprehensive review of the up-to-date literature for studies with ≥10 patients related to FD treatment of small vessel aneurysms published was performed. Random-effects meta-analysis was used to pool the following outcomes: complete occlusion, technical procedural success, perioperative mortality, perioperative stroke, procedure-related morbidity and mortality, all complications, long-term mortality, and overall good outcome...
April 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29651585/ruptured-fusiform-aneurysm-of-the-anterior-spinal-artery-successful-treatment-with-flow-diverter-stent-placed-in-the-feeding-vertebral-artery
#3
C P Simon-Gabriel, H Urbach, S Meckel
No abstract text is available yet for this article.
April 12, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29650785/surpass-streamline-flow-diverter-embolization-device-for-treatment-of-iatrogenic-and-traumatic-internal-carotid-artery-injuries
#4
M Ghorbani, H Shojaei, K Bavand, M Azar
Iatrogenic and traumatic cerebral internal carotid artery injuries are uncommon but potentially lethal complications. Direct surgical repair of ICA injuries may be difficult in an acute setting. However, endovascular treatment with a flow-diverter embolization device is a feasible alternative technique that we experienced. In this clinical report, we describe demographic data, radiographic images, lesion characteristics, endovascular procedure notes, postprocedural hospital course, and follow-up digital subtraction angiography of 5 patients...
April 12, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29650782/treatment-of-distal-anterior-cerebral-artery-aneurysms-with-flow-diverter-stents-a-single-center-experience
#5
F Cagnazzo, M Cappucci, C Dargazanli, P-H Lefevre, G Gascou, C Riquelme, A Bonafe, V Costalat
BACKGROUND AND PURPOSE: Flow diversion for aneurysms beyond the circle of Willis is still debated. Our aim was to evaluate the safety and efficacy of flow diversion treatment of distal anterior cerebral artery aneurysms. MATERIALS AND METHODS: Consecutive patients with distal anterior cerebral artery aneurysms treated from January 2014 to October 2017 were evaluated retrospectively with prospectively maintained data. Treatment was performed only for unruptured or recanalized aneurysms after coiling...
April 12, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29644398/stent-placement-in-patients-with-acute-subarachnoid-haemorrhage-when-is-it-justified
#6
Andrew G Murchison, Victoria Young, Tanja Ddjurdjevic, Martino Cellerini, Rufus Corkill, Wilhelm Küker
PURPOSE: Endovascular stents are widely used for the elective treatment of cerebral aneurysms. Acute stenting is performed in the management of dissections, pseudo-aneurysms, broad-based aneurysms or as a 'bail out' measure after coil migration. The purpose of this study is to review the safety of using stents in acute subarachnoid haemorrhage. METHODS: The stent registry of our institution was reviewed for procedures in patients with acute subarachnoid haemorrhage...
April 11, 2018: Neuroradiology
https://www.readbyqxmd.com/read/29619421/influence-of-spontaneous-splenorenal-shunts-on-clinical-outcomes-in-decompensated-cirrhosis-and-after-liver-transplantation
#7
Karen Saks, Kyle K Jensen, Joel McLouth, Justine Hum, Joseph Ahn, Atif Zaman, Michael F Chang, Alice Fung, Barry Schlansky
Cirrhosis and portal hypertension can lead to the formation of a spontaneous splenorenal shunt (SSRS) that may divert portal blood flow to the systemic circulation and reduce hepatic perfusion. Our aims were to evaluate SSRSs as an independent prognostic marker for mortality in patients with decompensated cirrhosis and the influence of SSRSs on liver transplantation (LT) outcomes. We retrospectively analyzed adult patients with decompensated cirrhosis undergoing LT evaluation from January 2001 to February 2016 at a large U...
April 2018: Hepatology communications
https://www.readbyqxmd.com/read/29608747/pharmacy-mediated-antiplatelet-management-protocol-compared-to-one-time-platelet-function-testing-prior-to-pipeline-embolization-of-cerebral-aneurysms-a-propensity-score-matched-cohort-study
#8
Christoph J Griessenauer, Abhi Jain, Alejandro Enriquez-Marulanda, Raghav Gupta, Nimer Adeeb, Justin M Moore, Stacey A Grassi, Shamsher S Dalal, Christopher S Ogilvy, Ajith J Thomas, Clemens M Schirmer
BACKGROUND: There is ongoing controversy regarding the optimal antiplatelet regimen, and extent or even need for platelet function testing surrounding Pipeline flow diverter (Medtronic Inc, Dublin, Ireland) embolization of cerebral aneurysms. OBJECTIVE: To compare a unique pharmacy-mediated antiplatelet medication management protocol to a 1-time platelet function testing strategy prior to Pipeline placement. METHODS: A retrospective review of patients with cerebral aneurysms who underwent Pipeline embolization at 2 academic institutions was performed...
March 27, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29599505/ocean-convection-linked-to-the-recent-ice-edge-retreat-along-east-greenland
#9
Kjetil Våge, Lukas Papritz, Lisbeth Håvik, Michael A Spall, G W K Moore
Warm subtropical-origin Atlantic water flows northward across the Greenland-Scotland Ridge into the Nordic Seas, where it relinquishes heat to the atmosphere and gradually transforms into dense Atlantic-origin water. Returning southward along east Greenland, this water mass is situated beneath a layer of cold, fresh surface water and sea ice. Here we show, using measurements from autonomous ocean gliders, that the Atlantic-origin water was re-ventilated while transiting the western Iceland Sea during winter...
March 29, 2018: Nature Communications
https://www.readbyqxmd.com/read/29599173/parent-artery-reconstruction-for-large-or-giant-cerebral-aneurysms-using-the-tubridge-flow-diverter-a-multicenter-randomized-controlled-clinical-trial-parat
#10
J-M Liu, Y Zhou, Y Li, T Li, B Leng, P Zhang, G Liang, Q Huang, P-F Yang, H Shi, J Zhang, J Wan, W He, C Liang, G Zhu, Y Xu, B Hong, X Yang, W Bai, Y Tian, H Zhang, Z Li, Q Li, R Zhao, Y Fang, K Zhao
BACKGROUND AND PURPOSE: Although flow diverters have been reported with favorable clinical and angiographic outcomes in various literatures, randomized trials determining their true effectiveness and safety are still in lack. The Parent Artery Reconstruction for Large or Giant Cerebral Aneurysms Using the Tubridge Flow Diverter (PARAT) trial was designed to evaluate the safety and efficacy of the Tubridge flow diverter in the treatment of large or giant aneurysms in comparison with Enterprise stent-assisted coiling...
March 29, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29584923/rescue-therapy-for-procedural-complications-associated-with-deployment-of-flow-diverting-devices-in-cerebral-aneurysms
#11
Fawaz Al-Mufti, Krishna Amuluru, Eric R Cohen, Vikas Patel, Mohammad El-Ghanem, Ethan Wajswol, Vincent Dodson, Sarmad Al-Marsoummi, Neil Majmundar, Neha S Dangayach, Rolla Nuoman, Chirag D Gandhi
Flow diverting devices (FDDs) have revolutionized the treatment of morphologically complex intracranial aneurysms such as wide-necked, giant, or fusiform aneurysms. Although FDDs are extremely effective, they carry a small yet significant risk of intraprocedural complications. As the implementation of these devices increases, the ability to predict and rapidly treat complications, especially those that are iatrogenic or intraprocedural in nature, is becoming increasingly more necessary.Our objective in this paper is to provide a descriptive summary of the various types of intraprocedural complications that may occur during FDDs deployment and how they may best be treated...
March 22, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29574426/delayed-neurological-deficits-after-endovascular-placement-of-a-pipeline-embolisation-device-clinical-manifestation-and-treatment
#12
Naveen Sablani, Maryam Mumtaz Hasan, Ashik Shrestha, Jeffrey Farkas
Endovascular treatment has been the mainstay of therapy for repair of both ruptured and unruptured cerebral aneurysms. Flow diverter devices offer a new option for the treatment of complex aneurysms that were previously not amenable to coiling. Procedural adverse effects include intracranial haemorrhage and ischaemic stroke, which usually occur on the same day. Delayed complications are rare. We report a case of a patient who underwent placement of a pipeline embolisation device and developed delayed neurological deficits, which were thought to be an inflammatory reaction to the hydrophilic coating used in guidewires and microcatheters...
March 23, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29572267/long-term-visual-outcome-in-patients-treated-by-flow-diversion-for-carotid-ophthalmic-aneurysms
#13
Romain Touzé, Valérie Touitou, Eimad Shotar, Joseph Gabrieli, Mehdi Drir, Bertrand Mathon, Nader-Antoine Sourour, Frédéric Clarençon
BACKGROUND: Flow-diverter stents (FDSs) are an upgrade in the treatment of intracranial aneurysms. However, complications concerning covered branches have been reported, especially the ophthalmic artery (OA). The purpose of our study was to evaluate the long-term ophthalmic complication rate of carotid-ophthalmic aneurysms (COA) without visual pathways compression, treated by a FDS covering the OA by performing an exhaustive ophthalmic examination. MATERIAL AND METHODS: Retrospective analysis of a single-center database screening the patients treated from October 2009 to April 2015 for an intracranial aneurysm with a FDS...
March 23, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29570011/clipping-as-re-treatment-strategy-after-treatment-of-a-cerebral-aneurysm-with-the-woven-endobridge-embolization-device-case-report
#14
Gregor Durner, Yigit Özpeynirci, Bernd Schmitz, Christian Rainer Wirtz, Ralph König, Andrej Pala
Recently, treatment of cerebral aneurysms with the Woven EndoBridge (WEB) device has become an established endovascular strategy. However, over time, neurosurgeons and neuroradiologists will be confronted with the challenge of how to treat aneurysm recanalization. The authors report the case of a 49-year-old woman who underwent re-treatment with clipping after the recanalization of a 4 × 3-mm anterior communicating artery aneurysm that had previously been treated using a 4 × 3 WEB device. In contrast to the authors' prior experiences with clipping of previously coiled aneurysms, the WEB device was found to have a responsive softness during clip placement, and the aneurysm was more maneuverable...
March 23, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29569259/varicocele-is-the-root-cause-of-bph-destruction-of-the-valves-in-the-spermatic-veins-produces-elevated-pressure-which-diverts-undiluted-testosterone-directly-from-the-testes-to-the-prostate
#15
M Goren, Y Gat
In varicocele, there is venous flow of free testosterone (FT) directly from the testes into the prostate. Intraprostatic FT accelerates prostate cell production and prolongs cell lifespan, leading to the development of BPH. We show that in a large group of patients presenting with BPH, bilateral varicocele is found in all patients. A total of 901 patients being treated for BPH were evaluated for varicocele. Three diagnostic methods were used as follows: physical examination, colour flow Doppler ultrasound and contact liquid crystal thermography...
March 22, 2018: Andrologia
https://www.readbyqxmd.com/read/29567650/the-new-low-profile-web-17-system-for-treatment-of-intracranial-aneurysms-first-clinical-experiences
#16
S B T van Rooij, J P Peluso, M Sluzewski, H G Kortman, W J van Rooij
BACKGROUND AND PURPOSE: The Woven EndoBridge (WEB) is an intrasaccular flow diverter intended to treat wide-neck aneurysms. The latest generation WEBs needed a 0.021-inch microcatheter in the small sizes. Recently, a lower profile range of WEBs compliant with a 0.017-inch microcatheter (WEB 17) has been introduced. We present the first clinical results of treatment of both ruptured and unruptured aneurysms with the WEB 17. MATERIALS AND METHODS: Between December 2016 and September 2017, forty-six aneurysms in 40 patients were treated with the WEB 17...
March 22, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29545252/european-multicenter-study-for-the-evaluation-of-a-dual-layer-flow-diverting-stent-for-treatment-of-wide-neck-intracranial-aneurysms-the-european-flow-redirection-intraluminal-device-study
#17
M Killer-Oberpfalzer, N Kocer, C J Griessenauer, H Janssen, T Engelhorn, M Holtmannspötter, J H Buhk, T Finkenzeller, G Fesl, J Trenkler, W Reith, A Berlis, K Hausegger, M Augustin, C Islak, B Minnich, M Möhlenbruch
BACKGROUND AND PURPOSE: Endoluminal reconstruction with flow-diverting stents represents a widely accepted technique for the treatment of complex intracranial aneurysms. This European registry study analyzed the initial experience of 15 neurovascular centers with the Flow-Redirection Intraluminal Device (FRED) system. MATERIALS AND METHODS: Consecutive patients with intracranial aneurysms treated with the FRED between February 2012 and March 2015 were retrospectively reviewed...
March 15, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29545248/endovascular-treatment-of-very-large-and-giant-intracranial-aneurysms-comparison-between-reconstructive-and-deconstructive-techniques-a-meta-analysis
#18
F Cagnazzo, D Mantilla, A Rouchaud, W Brinjikji, P-H Lefevre, C Dargazanli, G Gascou, C Riquelme, P Perrini, D di Carlo, A Bonafe, V Costalat
BACKGROUND: The safety and efficacy of reconstructive and deconstructive endovascular treatments of very large/giant intracranial aneurysms are not completely clear. PURPOSE: Our aim was to compare treatment-related outcomes between these 2 techniques. DATA SOURCES: A systematic search of 3 data bases was performed for studies published from 1990 to 2017. STUDY SELECTION: We selected series of reconstructive and deconstructive treatments with >10 patients...
March 15, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29540732/continuous-flow-of-upper-labrador-sea-water-around-cape-hatteras
#19
Magdalena Andres, Mike Muglia, Frank Bahr, John Bane
Six velocity sections straddling Cape Hatteras show a deep counterflow rounding the Cape wedged beneath the poleward flowing Gulf Stream and the continental slope. This counterflow is likely the upper part of the equatorward-flowing Deep Western Boundary Current (DWBC). Hydrographic data suggest that the equatorward flow sampled by the shipboard 38 kHz ADCP comprises the Upper Labrador Sea Water (ULSW) layer and top of the Classical Labrador Sea Water (CLSW) layer. Continuous DWBC flow around the Cape implied by the closely-spaced velocity sections here is also corroborated by the trajectory of an Argo float...
March 14, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29538048/lymphatic-dysfunction-in-critical-illness
#20
Edmund Burke, Sanjeev A Datar
PURPOSE OF REVIEW: The essential role of the lymphatic system in fluid homeostasis, nutrient transport, and immune trafficking is well recognized; however, there is limited understanding of the mechanisms that regulate lymphatic function, particularly in the setting of critical illness. The lymphatics likely affect disease severity and progression in every condition, from severe systemic inflammatory states to respiratory failure. Here, we review structural and functional disorders of the lymphatic system, both congenital and acquired, as they relate to care of the pediatric patient in the intensive care setting, including novel areas of research into medical and procedural therapeutic interventions...
March 13, 2018: Current Opinion in Pediatrics
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