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Flow diverter

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https://www.readbyqxmd.com/read/29223886/electrocatalytic-co2-reduction-catalyzed-by-nitrogenase-mofe-and-fefe-proteins
#1
Bo Hu, Derek F Harris, Dennis R Dean, T Leo Liu, Zhi-Yong Yang, Lance C Seefeldt
Nitrogenases catalyze biological dinitrogen (N2) reduction to ammonia (NH3), and also reduce a number of non-physiological substrates, including carbon dioxide (CO2) to formate (HCOO-) and methane (CH4). Three versions of nitrogenase are known (Mo-, V-, and Fe-nitrogenase), each showing different reactivities towards various substrates. Normally, electrons for substrate reduction are delivered by the Fe protein component of nitrogenase, with energy coming from the hydrolysis of 2 ATP to 2 ADP+2 Pi for each electron transferred...
December 5, 2017: Bioelectrochemistry
https://www.readbyqxmd.com/read/29214402/decision-making-and-neurosurgeons-agreement-in-the-management-of-aneurysmal-subarachnoid-haemorrhage-based-on-computed-tomography-angiography
#2
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...
December 7, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29209136/interaction-between-flow-diverter-and-parent-artery-of-intracranial-aneurysm-a-computational-study
#3
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
#4
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/29201581/contrast-enhancement-of-aneurysm-sac-post-pipeline-treatment-interpreted-as-recanalization
#5
Annie J Tsay, Sara Langan, Scott Simon
Multiple imaging modalities are available to evaluate aneurysms post-flow diverter (FD) placement. Though digital subtraction angiography (DSA) is the gold standard imaging modality post-FD placement, it is not perfect, and neither are other techniques, including contrast-enhanced magnetic resonance angiography (CE-MRA) and magnetic resonance imaging (MRI). We present a case of a 73-year-old woman with a right internal carotid artery (ICA) aneurysm treated with a pipeline embolization device (PED). Initial follow-up post-PED placement by three-dimensional time-of-flight (3D-TOF) MRA demonstrated aneurysm occlusion, which was confirmed by computed tomography angiography (CTA) and CE-MRA in subsequent follow-up appointments...
September 29, 2017: Curēus
https://www.readbyqxmd.com/read/29197751/dacron-graft-as-replacement-to-dissected-aorta-a-three-dimensional-fluid-structure-interaction-analysis
#6
R Jayendiran, B M Nour, A Ruimi
Aortic dissection (AD) is a serious medical condition characterized by a tear in the intima, the inner layer of the aortic walls. In such occurrence, blood is being diverted to the media (middle) layer and may result in patient death if not quickly attended. In the case where the diseased portion of the aorta needs to be replaced, one common surgical technique is to use a graft made of Dacron, a synthetic fabric. We investigate the response of a composite human aortic segment-Dacron graft structure subjected to blood flow using the three-dimensional fluid-structure-interaction (FSI) capability in Abaqus...
November 26, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/29197163/model-for-pressure-drop-and-flow-deflection-in-the-numerical-simulation-of-stents-in-aneurysms
#7
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/29174523/transvenous-coil-embolization-for-the-treatment-of-carotid-cavernous-fistula-after-pipeline-placement-a-case-report
#8
Ryuta Nakae, Masaya Nagaishi, Issei Takano, Yoshihiro Tanaka, Akio Hyodo, Kensuke Suzuki
The Pipeline embolization device (PED), a type of flow diverter, has become an appealing alternative treatment option for large or giant and wide-necked intracranial aneurysms. Carotid cavernous fistula (CCF) resulting from delayed aneurysmal rupture is a rare complication of PED placement with unknown pathophysiology. Here, we describe a case of CCF resulting from aneurysmal rupture following PED placement, and present the details of treatment by transvenous coil embolization. An 81-year-old woman was referred to our hospital for treatment of an 18...
November 22, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29170270/the-role-of-hemodynamics-in-intracranial-bifurcation-arteries-after-aneurysm-treatment-with-flow-diverter-stents
#9
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/29166295/nursing-care-of-infants-with-a-ventriculoperitoneal-shunt
#10
Rachel A Joseph, Michaela R Killian, Emily E Brady
BACKGROUND: Infants with congenital or posthemorrhagic hydrocephalus may require a ventriculoperitoneal (VP) shunt to divert the flow of cerebrospinal fluid, thus preventing increase in intracranial pressure. Knowledge on various aspects of caring for a child with a VP shunt will enable new and experienced nurses to better care for these infants and equip parents for ongoing care at home. PURPOSE: To review the nurses' role in care of infants with hydrocephalus, care after VP shunt placement, prevention of complications, and parental preparation for home care...
November 20, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29163748/transradial-approach-for-deployment-of-a-flow-diverter-for-an-intracranial-aneurysm-in-a-patient-with-a-type-3-aortic-arch
#11
Geoffrey W Peitz, Bhavani Kura, Jeremiah N Johnson, Ramesh Grandhi
Background: Flow diversion with the Pipeline embolization device (PED) is an effective treatment for giant and wide-neck intracranial aneurysms, but the standard transfemoral approach may not be feasible in patients with Type-3 aortic arches. Case Report: An 84-year-old woman presented with a right internal carotid artery (ICA) giant aneurysm and a Type-3 aortic arch, necessitating a transradial approach for access to the right common carotid artery. A triaxial catheter system made for a stable platform for the deployment of two telescoping PEDs to treat the patient's right ICA giant aneurysm...
October 2017: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/29140523/sequential-coiling-assisted-deployment-of-flow-diverter-for-treatment-of-fusiform-middle-cerebral-artery-aneurysms
#12
Abdulrahman Y Alturki, Philip G R Schmalz, Christopher S Ogilvy, Ajith J Thomas
BACKGROUND AND IMPORTANCE: Fusiform intracranial aneurysms remain challenging lesions to treat. These aneurysms have historically required bypass procedures or clip remodeling constructs for cure. Recently, endovascular specialists have reported experience with flow diversion for complex fusiform aneurysms of the vertebrobasilar system, with mixed results. Vascular anatomy for anterior circulation fusiform aneurysms may make these lesions more amenable to flow diversion and embolization procedures; however, published experience with these techniques is lacking...
November 11, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29127197/communicating-malapposition-of-flow-diverters-assessed-with-optical-coherence-tomography-correlates-with-delayed-aneurysm-occlusion
#13
Robert M King, Olivia W Brooks, Erin T Langan, Jildaz Caroff, Frédéric Clarençon, Takamitsu Tamura, John Michael Wainwright, Matthew J Gounis, Miklós Marosfői, Ajit S Puri
BACKGROUND: Optical coherence tomography (OCT) is a high resolution intravascular imaging method that allows visualization of flow diverter struts and the vessel wall. In this study, malapposition of the flow diverter that continues into the neck of the aneurysm, named communicating malapposition (CM), was investigated as a potential factor for delayed aneurysm healing. METHODS: 40 New Zealand White rabbits underwent elastase induced aneurysm creation, and were subsequently assigned to one of four treatment groups based on flow diverter type and administration of antiplatelet therapy...
November 10, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29125895/impact-of-preserved-collateral-veins-on-small-for-size-grafts-in-living-donor-liver-transplantation
#14
Seong Hoon Kim, Eung Chang Lee, Sang Jae Park
AIM: Graft size is a critical issue in living donor liver transplantation (LDLT). We hypothesized that too much portal flow could possibly be diverted into pre-existing collateral veins, alleviating small-for-size syndrome (SFSS) in LDLT. This study evaluated the impact of the preserved collateral veins in the outcomes of LDLT using a small-for-size graft (SFSG). METHODS: For patient safety, a graft-to-recipient weight ratio (GRWR) < 0.8% was strictly confined to patients with collateral veins (group A), and the patient group was compared in a 1:3 ratio to a matched group of patients with GRWR ≥ 0...
November 10, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
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
#15
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
#16
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
#17
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/29104748/resource-allocation-and-outpatient-appointment-scheduling-using-simulation-optimization
#18
Carrie Ka Yuk Lin, Teresa Wai Ching Ling, Wing Kwan Yeung
This paper studies the real-life problems of outpatient clinics having the multiple objectives of minimizing resource overtime, patient waiting time, and waiting area congestion. In the clinic, there are several patient classes, each of which follows different treatment procedure flow paths through a multiphase and multiserver queuing system with scarce staff and limited space. We incorporate the stochastic factors for the probabilities of the patients being diverted into different flow paths, patient punctuality, arrival times, procedure duration, and the number of accompanied visitors...
2017: Journal of Healthcare Engineering
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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