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Flow diverter

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https://www.readbyqxmd.com/read/27932668/quantitative-flow-measurement-after-placing-a-flow-diverter-for-a-distal-internal-carotid-artery-aneurysm
#1
Chien-Wei Chen, Ho-Fai Wong, Yu-Ling Ye, Yao-Liang Chen, Wei-Liang Chen, Chang-Hsien Ou, Yuan-Hsiung Tsai
OBJECTIVES: To evaluate the differences in arterial flow after flow diverter placement using quantitative flow measurements based on digital subtraction angiography (DSA). METHODS: Between November 2013 and November 2015, all patients who had flow diverters placed for distal internal carotid artery (ICA) aneurysms were reviewed. Patients in whom the stent was placed across the ostia of the ophthalmic artery (OphA) and anterior choroidal artery (AChA) were enrolled...
December 8, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27913801/the-pressure-reduction-coefficient-a-new-parameter-to-assess-aneurysmal-blood-stasis-induced-by-flow-diverters-disruptors
#2
Gregory Gascou, Riccardo Ferrara, Dominique Ambard, Mathieu Sanchez, Kyriakos Lobotesis, Franck Jourdan, Vincent Costalat
BACKGROUND AND PURPOSE: Pore density (PD), surface metal coverage (SMC) and the number of wires are all different parameters which can influence the efficacy of a flow disruptor/diverter. Nevertheless, the relative importance of a parameter to induce intra-aneurysmal blood stasis is still poorly evaluated. Therefore, comparison between devices based on a unique value is not reliable. The aim of this study was to propose a new bench top parameter (the pressure reduction coefficient (PRC; ξ)) in order to assess the global haemodynamic effect of each flow diverter/disruptor to slow flow...
December 2, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27904445/endovascular-treatment-of-unruptured-aneurysms-of-cavernous-and-ophthalmic-segment-of-internal-carotid-artery-with-flow-diverter-device-pipeline
#3
Marko Jevsek, Charbel Mounayer, Tomaz Seruga
BACKGROUND: Intra-arterial treatment of aneurysms by redirecting blood flow is a newer method. The redirection is based on a significantly more densely braided wire stent. The stent wall keeps the blood in the lumen of the stent and slows down the turbulent flow in the aneurysms. Stagnation of blood in the aneurysm sac leads to the formation of thrombus and subsequent exclusion of the aneurysm from the circulation. The aim of the study was to evaluate flow diverter device Pipeline for broad neck and giant aneurysm treatment...
December 1, 2016: Radiology and Oncology
https://www.readbyqxmd.com/read/27888218/diverting-cert-mediated-ceramide-transport-to-mitochondria-triggers-bax-dependent-apoptosis
#4
Amrita Jain, Oliver Beutel, Katharina Ebell, Sergey Korneev, Joost C M Holthuis
A deregulation of ceramide biosynthesis in the ER is frequently linked to induction of mitochondrial apoptosis. While in vitro studies suggest that ceramides may initiate cell death by acting directly on mitochondria, their actual contribution to the apoptotic response in living cells is unclear. In here, we analyzed the consequences of targeting the biosynthetic flow of ceramides to mitochondria using a ceramide transfer protein equipped with an outer mitochondrial membrane anchor, mitoCERT. Cells expressing mitoCERT import ceramides into mitochondria and undergo Bax-dependent apoptosis...
November 25, 2016: Journal of Cell Science
https://www.readbyqxmd.com/read/27884881/testing-stenting-and-flow-diversion-using-a-surgical-elastase-induced-complex-fusiform-aneurysm-model
#5
R Fahed, T E Darsaut, I Salazkin, J-C Gentric, M Mazighi, J Raymond
BACKGROUND AND PURPOSE: Rabbit elastase-induced saccular aneurysms have been commonly used for preclinical testing of endovascular devices, including flow diverters. However, all tested devices have been shown to be capable of aneurysm occlusion with this model. We aimed to create a more challenging model to test and discriminate among neurovascular devices of varying efficacies. MATERIALS AND METHODS: With a surgical approach that included elastase infusion and balloon dilation, we attempted the creation of complex fusiform aneurysms in 16 rabbits, with standard saccular carotid aneurysms created in 15 other animals...
November 24, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/27878693/is-medicines-parallel-trade-regulatory-arbitrage
#6
Joan Costa-Font
Parallel trade (PT) is a phenomenon that takes place at the distribution level, when a patented product is diverted from the official distribution chain to another one where it competes as a parallel distributor. Although some research regards PT in Europe as a 'common' form of arbitrage, there are reasons to believe that it is a type of 'regulatory arbitrage' that does not necessarily produce equivalent welfare effects. We draw upon a unique dataset that contains source country records of parallel imported medicine sales to the Netherlands for one therapeutic group (statins), that accounts for 5 % of the market at the time of study and it faced no generic competition...
December 2016: Int J Health Econ Manag
https://www.readbyqxmd.com/read/27836994/treatment-of-posterior-circulation-non-saccular-aneurysms-with-flow-diverters-a-single-center-experience-and-review-of-56-patients
#7
REVIEW
P Bhogal, M Aguilar Pérez, O Ganslandt, H Bäzner, H Henkes, S Fischer
BACKGROUND AND PURPOSE: Non-saccular aneurysms of the posterior fossa are an uncommon pathology with no clear treatment strategy. The use of flow-diverting stents (FDS) has had mixed results. We sought to evaluate our experience of FDS for the treatment of this pathology. METHODS: We retrospectively reviewed our database of prospectively collected information for all patients treated only with flow diversion for an unruptured non-saccular aneurysm of the posterior circulation between February 2009 and April 2016...
November 11, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27813461/editorial-fiat-flow-diverters-and-establishing-the-role-of-new-technology
#8
Peter S Amenta, Ricky Medel, Aaron S Dumont
No abstract text is available yet for this article.
November 4, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27811135/treatment-of-intra-and-extracranial-aneurysms-using-the-flow-redirection-endoluminal-device-multicenter-experience-and-follow-up-results
#9
F Drescher, W Weber, A Berlis, S Rohde, A Carolus, S Fischer
BACKGROUND AND PURPOSE: Flow diversion emerged as a crucial treatment option for intracranial aneurysms. We report a multicenter retrospective analysis of the safety and efficacy in the treatment of intracranial aneurysms with the Flow-Redirection Endoluminal Device (FRED) flow diverter, a dual-layer flow-modulation device. MATERIALS AND METHODS: All intracranial aneurysms treated with the FRED between March 2013 and February 2016 at 4 neurovascular centers were included...
November 3, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/27810105/does-the-gravity-orientation-of-saccular-aneurysms-influence-hemodynamics-an-experimental-study-with-and-without-flow-diverter-stent
#10
Kamil J Chodzyński, Omer F Eker, Axel E Vanrossomme, Daniel Ribeiro de Sousa, Grégory Coussement, Luc Vanhamme, Frank Dubois, Alain Bonafé, Bastien Chopard, Guy Courbebaisse, Karim Zouaoui Boudjeltia
Most intracranial aneurysms morphologic studies focused on characterization of size, location, aspect ratio, relationship to the surrounding vasculature and hemodynamics. However, the spatial orientation with respect to the gravity direction has not been taken into account although it could trigger various hemodynamic conditions. The present work addresses this possibility. It was divided in two parts: 1) the orientations of 18, 3D time-of-flight MRI (3D TOF MRI), scans of saccular aneurysms were analyzed. This investigation suggested that there was no privileged orientation for cerebral aneurysms...
October 18, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27801399/-the-modern-role-of-microsurgery-in-treatment-of-large-and-giant-aneurysms-of-the-internal-carotid-artery
#11
O D Shekhtman, Sh Sh Eliava, S B Yakovlev, Yu V Pilipenko, An N Konovalov
INTRODUCTION: Large (1.5-2.5 cm) and giant (>2.5 cm in diameter) aneurysms of the internal carotid artery (ICA) remain one of the complex neurosurgical pathologies in terms of microsurgery. In recent years, endovascular techniques for treatment of paraclinoid aneurysms, in particular ICA reconstruction using flow-diverting stents, have become a priority. However, surgery of flow stents has a number of limitations, therefore the choice of treatment in each case is individual. PURPOSE: To analyze the results of direct surgery in patients with large and giant aneurysms of the ICA and to determine the role and place of modern microsurgical techniques in the treatment of this vascular disease...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/27799376/thrombogenicity-of-flow-diverters-in-an-ex-vivo-shunt-model-effect-of-phosphorylcholine-surface-modification
#12
Matthew W Hagen, Gaurav Girdhar, John Wainwright, Monica T Hinds
BACKGROUND: Flow diverters offer a promising treatment for cerebral aneurysms. However, they have associated thromboembolic risks, mandating chronic dual antiplatelet therapy (DAPT). Shield Technology is a phosphorylcholine surface modification of the Pipeline Embolization Device (PED) flow diverter, which has shown significant reductions in material thrombogenicity in vitro. OBJECTIVE: To compare the thrombogenicity of PED, PED with Shield Technology (PED+Shield), and the Flow-Redirection Endoluminal Device (FRED)-with and without single antiplatelet therapy and DAPT-under physiological flow...
October 31, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27798327/effects-on-vessel-measurement-accuracy-and-subsequent-occlusion-after-calcium-channel-blocker-infusion-during-treatment-of-cerebral-aneurysms-with-the-pipeline-embolization-device
#13
M D Alexander, A D Nicholson, R J Darflinger, F Settecase, D L Cooke, C F Dowd, M R Amans, R T Higashida, S W Hetts, V V Halbach
INTRODUCTION/PURPOSE: To achieve aneurysm occlusion, flow diverters (FDs) must be accurately sized to maximize coverage over the neck and induce thrombosis. Catheterization for diagnostic angiography can cause vasospasm that may affect vessel measurements. This study evaluates impacts of intra-arterial infusion of a calcium channel blocker (CCB) on angiographic measurements in patients treated with FDs to determine effects on final diameter of the FD and subsequent occlusion. MATERIALS AND METHODS: Pre-treatment measurements were recorded for diameter of the distal and proximal landing zones and maximum and minimum diameters between these segments...
October 26, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27789789/use-of-flow-diverters-in-the-treatment-of-unruptured-saccular-aneurysms-of-the-anterior-cerebral-artery
#14
REVIEW
P Bhogal, R Martinez Moreno, O Ganslandt, H Bäzner, H Henkes, M Aguilar Perez
BACKGROUND: Few publications have dealt exclusively with the use of flow diverter stents for the treatment of aneurysms of the anterior cerebral artery (ACA). OBJECTIVE: To determine the efficacy of flow-diverting stents in the treatment of small, unruptured aneurysms of the ACA. METHODS: We retrospectively reviewed our database of prospectively collected information for all patients treated with flow diversion for an unruptured saccular aneurysm of the ACA between September 2009 and July 2016...
October 27, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27780870/virtual-flow-diverter-treatment-planning-the-effect-of-device-placement-on-bifurcation-aneurysm-haemodynamics
#15
Thomas Peach, Katerina Spranger, Yiannis Ventikos
Bifurcation aneurysms account for a large fraction of cerebral aneurysms and often present morphologies that render traditional endovascular treatments, such as coiling, challenging and problematic. Flow-diverter stents offer a potentially elegant treatment option for such aneurysms, but clinical use of these devices remains controversial. Specifically, the deployment of a flow-diverter device in a bifurcation entails jailing one or more potentially vital vessels with a low-porosity mesh designed to restrict the flow...
October 25, 2016: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/27777479/acquired-portosystemic-collaterals-anatomy-and-imaging
#16
Andréa Farias de Melo Leite, Américo Mota, Francisco Abaeté Chagas-Neto, Sara Reis Teixeira, Jorge Elias Junior, Valdair Francisco Muglia
Portosystemic shunts are enlarged vessels that form collateral pathological pathways between the splanchnic circulation and the systemic circulation. Although their causes are multifactorial, portosystemic shunts all have one mechanism in common-increased portal venous pressure, which diverts the blood flow from the gastrointestinal tract to the systemic circulation. Congenital and acquired collateral pathways have both been described in the literature. The aim of this pictorial essay was to discuss the distinct anatomic and imaging features of portosystemic shunts, as well as to provide a robust method of differentiating between acquired portosystemic shunts and similar pathologies, through the use of illustrations and schematic drawings...
July 2016: Radiologia Brasileira
https://www.readbyqxmd.com/read/27765738/flow-diverters-in-the-treatment-of-pediatric-cerebrovascular-diseases
#17
M Barburoglu, A Arat
BACKGROUND AND PURPOSE: There is very limited data concerning utilization of flow diverters in children. Our aim is to report results for the treatment of complex intracranial aneurysms and carotid cavernous fistulas by using flow diverters in children. MATERIALS AND METHODS: Retrospective review of children (17 years of age or younger) treated with flow diverters between May 2011 and July 2014 was performed. Clinical and laboratory data and angiographic findings were extracted...
October 20, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/27760885/prasugrel-versus-clopidogrel-in-stent-assisted-coil-embolization-of-unruptured-intracranial-aneurysms
#18
Jacques Sedat, Yves Chau, Jean Gaudart, Marina Sachet, Stephanie Beuil, Michel Lonjon
BACKGROUND: Thromboembolic complications are the main problem in stent-assisted coil embolization of unruptured intracranial aneurysms. The combination of aspirin and clopidogrel is generally used to decrease these complications, but some patients do not respond to clopidogrel and have a higher risk of stent thrombosis. In cardiology, clinical trials have shown that prasugrel reduced the incidence of ischaemic events in patients with acute coronary syndrome compared with clopidogrel but, according to several authors, prasugrel would produce an increased risk of cerebral haemorrhagic complications...
October 19, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27760832/an-outcomes-based-grading-scale-for-the-evaluation-of-cerebral-aneurysms-treated-with-flow-diversion
#19
Min S Park, Marcus D Mazur, Karam Moon, Michael J Nanaszko, John R W Kestle, Lubdha M Shah, Blair Winegar, Felipe C Albuquerque, Philipp Taussky, Cameron G McDougall
OBJECT: Despite the popularity of flow-diverting stents for the treatment of cerebral aneurysms, there is no widely accepted scale for the characterization of results. We present an outcomes-based grading scale that considers factors related to failure of flow diversion. METHODS: The grading scale was developed using the results from consecutive patients at two institutions who were treated with flow diversion for a cerebral aneurysm. The initial treatment results were graded on patient, aneurysm, and treatment characteristics...
October 19, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27759680/rerupture-of-a-blister-aneurysm-after-treatment-with-a-single-flow-diverting-stent
#20
Marcus D Mazur, Philipp Taussky, Joel D MacDonald, Min S Park
BACKGROUND AND IMPORTANCE: As the use of flow-diverting stents (FDSs) for intracranial aneurysms expands, a small number of case reports have described the successful treatment of blister aneurysms of the internal carotid artery with flow diversion. Blister aneurysms are uncommon and fragile lesions that historically have high rates of morbidity and mortality despite multiple treatment strategies. We report a case of rebleeding after treatment of a ruptured blister aneurysm with deployment of a single FDS...
November 2016: Neurosurgery
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