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Flow diverter

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https://www.readbyqxmd.com/read/28531340/in-reply-rerupture-of-a-blister-aneurysm-after-treatment-with-a-single-flow-diverting-stent
#1
Marcus D Mazur, Philipp Taussky, Joel D MacDonald, Min S Park
No abstract text is available yet for this article.
May 22, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28521024/pipeline-embolization-device-for-pericallosal-artery-aneurysms-a-retrospective-single-center-safety-and-efficacy-study
#2
Katyucia De Macedo Rodrigues, Anna Luisa Kühn, Takamitsu Tamura, Guilherme Dabus, Peter Kan, Miklos G Marosfoi, J Diego Lozano, Mary Perras, Christopher Brooks, Mary C Howk, Samuel Y Hou, David E Rex, Francesco Massari, Matthew J Gounis, Ajay K Wakhloo, Ajit S Puri
BACKGROUND: Pericallosal artery aneurysm treatment may be challenging using traditional endovascular techniques. OBJECTIVE: To demonstrate the feasibility, efficacy, and safety of endovascular treatment of pericallosal artery aneurysm using flow diverters. METHODS: We performed a retrospective review of our institutional database from July 2013 through July 2016 and identified 7 subjects with a pericallosal artery aneurysm treated with the Pipeline embolization device (ev3 Neurovascular, Medtronic, Dublin, Ireland) and at least 1 follow-up angiogram...
May 17, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28515570/association-between-hemodynamic-modifications-and-clinical-outcome-of-intracranial-aneurysms-treated-using-flow-diverters
#3
Nikhil Paliwal, Robert J Damiano, Jason M Davies, Adnan H Siddiqui, Hui Meng
Treatment of intracranial aneurysms (IAs) has been revolutionized by the advent of endovascular Flow Diverters (FDs), which disrupt blood flow within the aneurysm to induce pro-thrombotic conditions, and serves as a scaffold for endothelial ingrowth and arterial remodeling. Despite good clinical success of FDs, complications like incomplete occlusion and post-treatment rupture leading to subarachnoid hemorrhage have been reported. In silico computational fluid dynamic analysis of the pre- and post-treated geometries of IA patients can shed light on the contrasting blood hemodynamics associated with different clinical outcomes...
February 11, 2017: Proceedings of SPIE
https://www.readbyqxmd.com/read/28508297/adaptation-to-stochastic-temporal-variations-in-intratumoral-blood-flow-the-warburg-effect-as-a-bet-hedging-strategy
#4
Curtis A Gravenmier, Miriam Siddique, Robert A Gatenby
While most cancers promote ingrowth of host blood vessels, the resulting vascular network usually fails to develop a mature organization, resulting in abnormal vascular dynamics with stochastic variations that include slowing, cessation, and even reversal of flow. Thus, substantial spatial and temporal variations in oxygen concentration are commonly observed in most cancers. Cancer cells, like all living systems, are subject to Darwinian dynamics such that their survival and proliferation are dependent on developing optimal phenotypic adaptations to local environmental conditions...
May 15, 2017: Bulletin of Mathematical Biology
https://www.readbyqxmd.com/read/28506004/relationships-between-geometrical-parameters-and-mechanical-properties-for-a-helical-braided-flow-diverter-stent
#5
Takashi Suzuki, Hiroyuki Takao, Soichiro Fujimura, Chihebeddine Dahmani, Toshihiro Ishibashi, Hiroya Mamori, Naoya Fukushima, Yuichi Murayama, Makoto Yamamoto
BACKGROUND: Although flow diversion is a promising procedure for aneurysm treatment, the safety and efficacy of this strategy have not been sufficiently characterized. Both mechanical properties and flow reduction effects are important factors in the design of an optimal stent. OBJECTIVE: We aimed to clarify the contributions of strut size and pitch to the mechanical properties (radial stiffness and longitudinal flexibility) and geometric characteristics (porosity and pore density) related to flow reduction effects...
May 1, 2017: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/28499020/letter-rerupture-of-a-blister-aneurysm-after-treatment-with-a-single-flow-diverting-stent
#6
Leonardo B C Brasiliense, Christina M Walter, Mauricio J Avila, Travis M Dumont
No abstract text is available yet for this article.
May 11, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28498701/fast-low-to-high-confinement-mode-bifurcation-dynamics-in-a-tokamak-edge-plasma-gyrokinetic-simulation
#7
C S Chang, S Ku, G R Tynan, R Hager, R M Churchill, I Cziegler, M Greenwald, A E Hubbard, J W Hughes
Transport barrier formation and its relation to sheared flows in fluids and plasmas are of fundamental interest in various natural and laboratory observations and of critical importance in achieving an economical energy production in a magnetic fusion device. Here we report the first observation of an edge transport barrier formation event in an electrostatic gyrokinetic simulation carried out in a realistic diverted tokamak edge geometry under strong forcing by a high rate of heat deposition. The results show that turbulent Reynolds-stress-driven sheared E×B flows act in concert with neoclassical orbit loss to quench turbulent transport and form a transport barrier just inside the last closed magnetic flux surface...
April 28, 2017: Physical Review Letters
https://www.readbyqxmd.com/read/28494622/presence-of-inflammatory-proteins-s100a8-and-s100a9-in-a-giant-intracranial-aneurysm-after-flow-diverter-treatment
#8
Antonius M de Korte, René Aquarius, Frederick J A Meijer, Peter van Lent, Hieronymus D Boogaarts, Joost de Vries
We demonstrate the presence of S100A8 and S100A9 proteins in the wall and thrombosed lumen of an enlarged intracranial aneurysm after flow diverter treatment. These proteins have shown to play an important role in vascular inflammation and may serve as a biomarker and potential therapeutic target for intracranial aneurysms.
May 12, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28490608/expanding-the-use-of-flow-diverters-beyond-their-initial-indication-treatment-of-small-unruptured-aneurysms
#9
J M Pumar, A Mosqueira, H Cuellar, B Dieguez, L Guimaraens, J Masso, S Miralbes, M Blanco-Ulla, M Souto-Bayarri, F Vazquez-Herrero
BACKGROUND: Experience with the endovascular treatment of unruptured small intracranial aneurysms by flow diverter devices is still limited. OBJECTIVE: To assess the safety and efficacy of the SILK flow diverter (SFD) in the treatment of small unruptured cerebral aneurysms (<10 mm). METHODS: We performed a retrospective review of a prospectively maintained database of patients treated with a SFD between July 2008 and December 2013 at 4 institutions in Spain to identify all patients with small unruptured aneurysms (<10 mm)...
May 10, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28488025/in-stent-stenosis-after-p64-flow-diverter-treatment
#10
M Aguilar Pérez, P Bhogal, E Henkes, O Ganslandt, H Bäzner, H Henkes
PURPOSE: There is limited information available on the incidence of in-stent stenosis (ISS) secondary to the use of flow-diverting stents in the intracranial vasculature. We sought to determine the incidence, severity, and clinical course of ISS on angiographic follow-up after treatment of saccular aneurysms with p64. METHODS: We retrospectively reviewed all patients who underwent treatment of a saccular (ruptured and unruptured) intracranial aneurysm with ≥1 p64 between 2011 and 2015...
May 9, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28487360/ultrasound-for-the-evaluation-of-stenosis-after-flow-diversion
#11
Cameron M McDougall, Khurshid Khan, Maher Saqqur, Andrew Jack, Jeremy Rempel, Carol Derksen, Yin Xi, Michael Chow
BACKGROUND AND PURPOSE: Flow diversion is a relatively new strategy used to treat complex cerebral aneurysms. The optimal method for radiographic follow-up of patients treated with flow diverters has not been established. The rate and clinical implications of in-stent stenosis for these devices is unclear. We evaluate the use of transcranial Doppler ultrasound (TCD) for follow-up of in-stent stenosis. MATERIALS AND METHODS: We analyzed 28 patients treated with the Pipeline embolization device (PED) over the course of 42 months from January 2009 to June 2012...
May 9, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28477214/the-new-double-layer-micromesh-stent-roadsaver-%C3%A2-use-in-endovascular-treatment-of-supraaortic-and-visceral-artery-aneurysms-and-pseudoaneurysms
#12
Koray Akkan, Erhan Ilgit, Kutlay Karaman, Baran Onal, Murat Dökdök, Elif Ersöz, Abdullah Özer, Bijen Nazliel
PURPOSE: This study was designed to present our preliminary experience with the Roadsaver(®) double-layer micromesh (DLM) stent in the endovascular treatment of supra-aortic and visceral aneurysms and to utilize the flow-diverting effect of this new design in the treatment of these aneurysms. METHODS: DLM stent (Roadsaver(®), Terumo, Tokyo, Japan) was used in five patients (median age 61.8 years; three men) for treating arterial aneurysms (one common carotid artery, one vertebral artery V1 segment, one superior mesenteric artery, and two renal artery aneurysms)...
May 5, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28475757/a-multicenter-cohort-comparison-study-of-the-safety-efficacy-and-cost-of-ticagrelor-compared-to-clopidogrel-in-aneurysm-flow-diverter-procedures
#13
Justin M Moore, Nimer Adeeb, Hussain Shallwani, Raghav Gupta, Apar S Patel, Christoph J Griessenauer, Roy Youn, Adnan Siddiqui, Christopher S Ogilvy, Ajith J Thomas
BACKGROUND: Thromboembolic and hemorrhagic complications are among the most feared adverse events in the endovascular treatment of aneurysms, and this is particularly the case for flow diverter devices. Dual antiplatelet therapy has become standard of care; however, the safety, efficacy, and cost profiles of newer antiplatelet agents are not well characterized in the neurovascular context. OBJECTIVE: To compare the safety, efficacy, and cost of one of these newer agents, ticagrelor, to the most frequently used agent, clopidogrel...
May 5, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28473431/first-us-experience-with-pipeline-flex-with-shield-technology-using-aspirin-as-antiplatelet-monotherapy
#14
Ricardo A Hanel, Pedro Aguilar-Salinas, Leonardo Bc Brasiliense, Eric Sauvageau
Flow diversion has revolutionised the treatment of intracranial aneurysms, and the Pipeline Embolization Device (PED) remains the only flow diverter (FD) approved in the USA. However, thromboembolic events remain an issue for FDs. Attempting to minimise these incidents, a newer PED has been developed with the use of covalent bonding of phosphorylcholine onto the Pipeline device that has been known as Shield Technology (PED Shield), which in vitro has demonstrated a significant reduction in material thrombogenicity...
May 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28472526/glycoprotein-iib-iiia-inhibitors-in-prevention-and-rescue-treatment-of-thromboembolic-complications-during-endovascular-embolization-of-intracranial-aneurysms
#15
David Dornbos, Joel S Katz, Patrick Youssef, Ciarán J Powers, Shahid M Nimjee
Thromboembolic complications remain a major risk of endovascular neurosurgery during the treatment of intracranial aneurysms, despite the use of therapeutic heparinization and oral antiplatelet therapy when indicated. Glycoprotein (GP) IIb/IIIa inhibitors target a nonredundant pathway of platelet aggregation following adhesion and activation. Initially established and implemented in the cardiovascular arena, this drug class has provided a new tool in the neurovascular armamentarium as well. Numerous case reports, case series, and retrospective reviews have evaluated the safety and efficacy of abciximab, eptifibatide, and tirofiban in the treatment of acute thromboembolic complications during the endovascular treatment of intracranial aneurysms...
May 3, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28462379/prolonged-absence-of-mechanoluminal-stimulation-in-human-intestine-alters-the-transcriptome-and-intestinal-stem-cell-niche
#16
Minna M Wieck, Christopher R Schlieve, Matthew E Thornton, Kathryn L Fowler, Mubina Isani, Christa N Grant, Ashley E Hilton, Xiaogang Hou, Brendan H Grubbs, Mark R Frey, Tracy C Grikscheit
BACKGROUND & AIMS: For patients with short-bowel syndrome, intestinal adaptation is required to achieve enteral independence. Although adaptation has been studied extensively in animal models, little is known about this process in human intestine. We hypothesized that analysis of matched specimens with and without luminal flow could identify new potential therapeutic pathways. METHODS: Fifteen paired human ileum samples were collected from children aged 2-20 months during ileostomy-reversal surgery after short-segment intestinal resection and diversion...
May 2017: Cellular and Molecular Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28458385/recent-trends-in-neuro-endovascular-treatment-for-acute-ischemic-stroke-cerebral-aneurysms-carotid-stenosis-and-brain-arteriovenous-malformations
#17
Yuji Matsumaru, Eiichi Ishikawa, Tetsuya Yamamoto, Akira Matsumura
The efficacy of mechanical thrombectomy with stent retrievers for emergent large vessel occlusion has been proved by randomized trials. Mechanical thrombectomy is increasingly being adopted in Japan since stent retrievers were first approved in 2014. An urgent clinical task is to offer structured systems of care to provide this treatment in a timely fashion to all patients with emergent large vessel occlusion. Treatment with flow-diverting stents is currently a preferred treatment option worldwide for large and giant unruptured aneurysms...
May 1, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28457861/comparison-of-3d-tof-mr-angiographic-accuracy-in-predicting-raymond-grade-of-flow-diverted-versus-coiled-intracranial-aneurysms
#18
Tamar R Binyamin, Brian C Dahlin, Ben Waldau
The accuracy of 3D time of Flight Magnetic Resonance Angiography (TOF MRA) has been studied extensively for following coiled intracranial aneurysms. It is used by many clinicians for non-invasive follow-up because of its adequate sensitivity in predicting aneurysmal recanalization compared to diagnostic cerebral angiography. The data on the accuracy of 3D TOF MRA for the Pipeline™ Embolization Device (PED) are sparse. In a retrospective chart review, we compared the accuracy of 3D TOF MRA of PED to coil embolization at our institution...
April 27, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28452658/resolution-of-giant-basilar-artery-aneurysm-compression-and-reversal-of-sensorineural-hearing-loss-with-use-of-a-flow-diverter-case-report
#19
Laila M Mohammad, Alexander L Coon, Andrew P Carlson
The authors present an unusual case of a 15-year-old boy in whom sensorineural hearing loss and disequilibrium developed in the setting of a giant basilar artery aneurysm. This patient was treated with a flow-diverting stent and had complete resolution of his clinical symptoms including hearing loss. This case demonstrates the efficacy of flow diversion in select pediatric patients with posterior circulation aneurysms. The features that are thought to result in successful treatment are discussed.
April 28, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28450438/large-basilar-apex-aneurysms-treated-with-flow-diverter-stents
#20
V Da Ros, J Caroff, A Rouchaud, C Mihalea, L Ikka, J Moret, L Spelle
BACKGROUND AND PURPOSE: The treatment of wide-neck, large basilar apex aneurysms is challenging with either an endovascular or a surgical approach. The aim of the present study was to report our experience treating basilar apex aneurysms with flow-diverter stents and to evaluate their efficacy and safety profile in this specific anatomic condition. MATERIALS AND METHODS: We retrospectively analyzed data from all consecutive patients treated with flow-diverter stents at our institution between January 2011 and January 2015...
April 27, 2017: AJNR. American Journal of Neuroradiology
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