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Flow diverter stent

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https://www.readbyqxmd.com/read/28108500/ophthalmic-artery-occlusion-after-pipeline-embolization-device-placement-with-reconstitution-of-flow-via-an-endoleak-a-report-of-two-cases
#1
Michael L Adix, Ian A Kaminsky, In Sup Choi
The Pipeline Embolization Device (PED) is a flow diverting stent used in the treatment of a wide variety of intracranial aneurysms. The device differs from traditional stents used in stent-assisted coil embolization in that it has a tighter lattice structure with smaller cell sizes designed specifically to disrupt blood flow into aneurysms rather than only to retain coils within aneurysms. While the PED has been shown to be safe and effective, it has a unique risk profile that includes side branch and perforator vessel occlusion...
January 20, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28100649/incidence-of-delivery-wire-recapture-failure-with-the-pipeline-flex-device
#2
Michael A Mooney, Karam Moon, Bradley A Gross, Andrew F Ducruet, Felipe C Albuquerque
BACKGROUND: The Pipeline Flex embolization device has several advantages over the first-generation Pipeline embolization device (Covidien, Dublin, Republic of Ireland). Despite these advantages, we have observed frequent difficulty in recapturing the device's delivery wire. OBJECTIVE: To prospectively document the incidence of failure to recapture the delivery wire. METHODS: We tracked our experience in patients undergoing endovascular treatment with a flow-diverting stent for cerebral aneurysms between 1 May and 30 September 2016...
January 18, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28057633/compacting-a-single-flow-diverter-versus-overlapping-flow-diverters-for-intracranial-aneurysms-a-computational-study
#3
R J Damiano, V M Tutino, N Paliwal, D Ma, J M Davies, A H Siddiqui, H Meng
BACKGROUND AND PURPOSE: Locally compacting the mesh of a flow diverter by a dynamic push-pull technique can accelerate intracranial aneurysm healing. We asked how this deployment strategy compares with overlapping 2 flow diverters for aneurysmal flow reduction. MATERIALS AND METHODS: Using a high-fidelity virtual stent placement method, we simulated 3 flow-diverter strategies (single noncompacted, 2 overlapped, and single compacted) in 3 aneurysms (fusiform, large saccular, and medium saccular)...
January 5, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28048545/we-de-207a-04-advances-in-radiological-neuro-endovascular-interventional-imaging
#4
S Rudin
: 1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048454/we-de-207a-00-advances-in-image-guided-neurointerventions-clinical-pull-and-technology-push
#5
Jeffrey Siewerdsen, Rebecca Fahrig
: 1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047800/we-de-207a-01-parallels-in-the-evolution-of-x-ray-angiographic-systems-and-devices-used-for-minimally-invasive-endovascular-therapy
#6
C Strother
: 1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047144/we-de-207a-02-advances-in-cone-beam-ct-anatomical-and-functional-imaging-in-angio-suite-to-enable-one-stop-shop-stroke-imaging-workflow
#7
G Chen
: 1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046482/we-de-207a-03-recent-advances-in-devices-used-in-neuro-interventions
#8
M Gounis
: 1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28029187/off-label-uses-for-flow-diversion-in-intracranial-aneurysm-management
#9
Fawaz Al-Mufti, Krishna Amuluru, Gomez Francisco, Vincent Dodson, Mohammad El-Ghanem, Charles J Prestigiacomo, Chirag D Gandhi
Treatment of complex aneurysms using microsurgical and other conventional neuroendovascular techniques remains challenging. As a result, stent- and balloon-assisted coiling are instead performed to treat morphologically complex aneurysms, which include giant, wide-necked, and fusiform aneurysms. While these techniques have had success in treating these complex aneurysms, recanalization rates associated with these techniques are still problematic. In the constant effort to improve the outcome of complex aneurysm treatment, flow-diverting stents (FDSs) have emerged in recent years as the preferred treatment...
December 28, 2016: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/27979794/middle-cerebral-artery-bifurcation-aneurysms-treated-by-extrasaccular-flow-diverters-midterm-angiographic-evolution-and-clinical-outcome
#10
C Iosif, C Mounayer, K Yavuz, S Saleme, S Geyik, H S Cekirge, I Saatci
BACKGROUND AND PURPOSE: Flow diverters have been increasingly used lately in off-label, distal intracranial aneurysm treatments. Our aim was to evaluate the effectiveness of flow diverters in the treatment of middle cerebral artery bifurcation aneurysms and to analyze midterm angiographic patterns of regional flow modifications for safety and clinical outcomes. MATERIALS AND METHODS: Consecutive patients treated from January 2010 to December 2014 by the authors by using endovascular flow-diverting stents for MCA bifurcation aneurysms were evaluated retrospectively with prospectively maintained data...
December 15, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/27977003/single-stage-endovascular-treatment-of-multiple-intracranial-aneurysms-with-combined-endovascular-techniques-is-it-safe-to-treat-all-at-once
#11
Cagatay Andic, Fatih Aydemir, Ozgur Kardes, Murat Gedikoglu, Sule Akin
BACKGROUND AND PURPOSE: Multiple aneurysms have a high reported incidence, but the optimal treatment strategy is not clear. The aim of this study was to evaluate the safety and effectiveness of single-stage endovascular treatment of multiple aneurysms with a combination of various endovascular techniques. MATERIALS AND METHODS: Fifty-three consecutive patients with multiple intracranial aneurysms who underwent single-stage endovascular treatment for ≥2 aneurysms from June 2011 to May 2016 were included in the study...
November 14, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27956518/use-of-self-expanding-stents-for-better-intracranial-flow-diverter-wall-apposition
#12
Anna Luisa Kühn, Ajay K Wakhloo, Matthew J Gounis, Peter Kan, Katyucia de Macedo Rodrigues, J Diego Lozano, Miklos G Marosfoi, Mary Perras, Christopher Brooks, Mary C Howk, David E Rex, Francesco Massari, Ajit S Puri
BACKGROUND: Flow diverter (FD) malapposition is associated with stroke-related complications. We document the use of self-expanding nitinol stents to remove/reduce the ledge of a FD deployed for aneurysm treatment. METHODS: We identified five patients who were treated with the Pipeline embolization device (PED) in conjunction with a Neuroform EZ stent for inadequate wall apposition of the ends of the FD at our institution between May 2014 and July 2015. Among other parameters, angiographic results, cone-beam computed tomography assessment of wall apposition and patient clinical outcome were evaluated...
December 12, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27942770/management-of-unruptured-saccular-aneurysms-of-the-m1%C3%A2-segment-with-flow-diversion-a%C3%A2-single-centre-experience
#13
Pervinder Bhogal, Rosa Martinez, Oliver Gansladt, Hansjörg Bäzner, Hans Henkes, Marta Aguilar
PURPOSE: The optimal strategy for the treatment of M1 segment aneurysms has not yet been determined as both standard microneurosurgical and endovascular techniques can pose challenges. We sought to determine the efficacy of flow diverting stents to treat small, unruptured aneurysms of the M1 segment. METHODS: We retrospectively reviewed our database of prospectively collected information for all patients treated with flow diversion for an unruptured saccular aneurysm of the middle cerebral artery (MCA) between February 2009 and February 2016...
December 11, 2016: Clinical Neuroradiology
https://www.readbyqxmd.com/read/27932668/quantitative-flow-measurement-after-placing-a-flow-diverter-for-a-distal-internal-carotid-artery-aneurysm
#14
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/27904445/endovascular-treatment-of-unruptured-aneurysms-of-cavernous-and-ophthalmic-segment-of-internal-carotid-artery-with-flow-diverter-device-pipeline
#15
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/27884881/testing-stenting-and-flow-diversion-using-a-surgical-elastase-induced-complex-fusiform-aneurysm-model
#16
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/27836994/treatment-of-posterior-circulation-non-saccular-aneurysms-with-flow-diverters-a-single-center-experience-and-review-of-56-patients
#17
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/27810105/does-the-gravity-orientation-of-saccular-aneurysms-influence-hemodynamics-an-experimental-study-with-and-without-flow-diverter-stent
#18
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...
December 8, 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
#19
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
#20
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
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