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Pipeline stent

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https://www.readbyqxmd.com/read/29628950/safety-assessment-of-endovascular-treatment-of-cerebral-aneurysms-in-patients-with-fibromuscular-dysplasia
#1
Matthew T Bender, Christopher Hurtado, Bowen Jiang, Jessica K Campos, Judy Huang, Rafael J Tamargo, Li-Mei Lin, Alexander L Coon, Geoffrey P Colby
Background: The prevalence of cerebral aneurysms is increased in fibromuscular dysplasia (FMD). The presence of FMD may serve as discouragement to elective endovascular aneurysm treatment. Outcomes of endovascular intervention for aneurysms through vessels affected by FMD have not been reported. Methods: A prospectively maintained database of patients undergoing intracranial embolization was reviewed for patients with FMD who underwent endovascular aneurysm treatment...
February 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29624153/occlusion-rates-of-intracranial-aneurysms-treated-with-the-pipeline-embolization-device-the-role-of-branches-arising-from-the-sac
#2
Felipe Padovani Trivelato, Marco Túlio Salles Rezende, Alexandre Cordeiro Ulhôa, Luis Henrique de Castro-Afonso, Guilherme Seizem Nakiri, Daniel Giansante Abud
OBJECTIVE The aim of this study was to compare the clinical and angiographic outcomes of intracranial aneurysms with and without branches arising from the sac after Pipeline embolization device (PED) treatment. METHODS This retrospective 2-center comparative study included 116 patients with 157 aneurysms that were treated with PEDs. Aneurysms were divided into 2 groups: one group had branches arising from the sac and the other group did not. Study end points included total aneurysm occlusion assessed by angiography at 6 and 12 months, death or stroke, technical complications, in-stent stenosis, patency of covered branches, and transient ischemia...
April 6, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29605278/rare-case-of-diffuse-spinal-arachnoiditis-following-a-complicated-vertebral-artery-dissection
#3
Elias Atallah, Sophia Dang, Sage Rahm, James Feghali, Chalouhi Nohra, Stavropoula Tjoumakaris, Robert H Rosenwasser, Hekmat Zarzour, Nabeel Herial, Michael Reid Gooch, Pascal Jabbour
Spinal arachnoiditis (SA) is an extremely rare and delayed complication of subarachnoid hemorrhage (SAH). Little is known about its underlying pathogenesis and subsequent clinical course. A middle-aged patient presented with the worst headache of her life and a grade 3 SAH of the basal-cisterns and posterior fossa was identified on Computed Tomography scans (CT). Angiography revealed a ruptured dissecting aneurysm of the left vertebral artery (VA-V4), as well as an unruptured left Anterior Cerebral Artery (ACA-A1) aneurysm...
March 28, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29600915/predictors-of-cerebral-aneurysm-persistence-and-occlusion-after-flow-diversion-a-single-institution-series-of-445-cases-with-angiographic-follow-up
#4
Matthew T Bender, Geoffrey P Colby, Li-Mei Lin, Bowen Jiang, Erick M Westbroek, Risheng Xu, Jessica K Campos, Judy Huang, Rafael J Tamargo, Alexander L Coon
OBJECTIVE Flow diversion requires neointimal stent overgrowth to deliver aneurysm occlusion. The existing literature on aneurysm occlusion is limited by heterogeneous follow-up, variable antiplatelet regimens, noninvasive imaging modalities, and nonstandard occlusion assessment. Using a large, single-center cohort with low attrition and standardized antiplatelet tapering, the authors evaluated outcomes after flow diversion of anterior circulation aneurysms to identify predictors of occlusion and aneurysm persistence...
March 30, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29563212/unexpected-early-radiographic-findings-associated-with-a-ruptured-blister-like-carotid-wall-aneurysm
#5
James L West, Jasmeet Singh, Stacey Q Wolfe, Kyle M Fargen
A 33-year-old man presented with aneurysmal subarachnoid hemorrhage from a ruptured, blister-type sidewall internal carotid artery (ICA) aneurysm. Balloon-assisted coiling was performed with residual neck. He subsequently developed severe vasospasm requiring intra-arterial therapies on multiple occasions, during which it was noted that despite widespread vasospasm, a focal segment of the ICA at the site of the aneurysm showed no significant spasm, suggesting underlying vessel abnormality. He was discharged without deficit and scheduled for flow diversion given concern over this potentially pathologic segment of vessel...
March 21, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29511117/phosphorylcholine-surface-modified-flow-diverter-associated-with-reduced-intimal-hyperplasia
#6
Jildaz Caroff, Takamitsu Tamura, Robert M King, Pedro N Lylyk, Erin T Langan, Olivia W Brooks, Frédéric Clarençon, John Michael Wainwright, Laurent Spelle, Miklos Marosfoi, Matthew J Gounis, Ajit S Puri
BACKGROUND: Optical coherence tomography (OCT) is a high-resolution, intra-vascular diagnostic technique widely used for the characterization of vascular pathologies and optimization of stent implantation during percutaneous coronary intervention. OCT was used to investigate the in vivo vascular response to a new phosphorylcholine surface modified flow diverter (sPED). METHODS: In an in vivo rabbit aneurysmal model, we used two different types of flow diverters (classic Pipeline - cPED; and sPED) with or without dual antiplatelet therapy (four groups, n=10 per group)...
March 6, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29509490/management-of-ruptured-blister-aneurysm-with-pipeline-device-after-prasugrel-loading
#7
Rajsrinivas Parthasarathy, Vipul Gupta, Aditya Gupta
OBJECTIVES: Blister like aneurysm (BLA) is extremely challenging to treat; endoluminal reconstruction has emerged as the most promising treatment method. When to treat after the ictus, the timing of administration of antiplatelet and causal relationship between platelet function testing results and thromboembolism is unclear. We theorized that Prasugrel with a lower incidence of resistance may be a safe suitable alternative to clopidogrel in patients treated with a flow diverter. METHODS: Prospectively collected data from consecutive patients treated for a ruptured blister with a flow diverter was reviewed...
March 6, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29471704/flow-diverter-stents-for-endovascular-management-of-non-fetal-posterior-communicating-artery-aneurysms-analysis-on-aneurysm-occlusion-vessel-patency-and-patient-outcome
#8
Anna Luisa Kühn, Guilherme Dabus, Peter Kan, Ajay K Wakhloo, Ajit S Puri
Background Use of flow-diversion technology in the treatment of incidental and recanalized posterior communicating artery (PComA) aneurysms. Methods Patients treated with the Pipeline embolization device (PED) for PComA aneurysms were identified and included in our retrospective analysis. We evaluated aneurysm characteristics, modified Rankin Scale score (mRS) on admission, angiography follow-up, and patient clinical outcome at discharge, at three to nine months, and at 12-18 months. Results We included 56 patients with a mean age of 56 years...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29457589/short-term-efficacy-of-pipeline-embolization-device-for-treating-complex-intracranial-aneurysms
#9
NiZaMiDingJiang ReXiaTi, ReXiDan AiKeReMu, KaHeErMan KaDeEr, Yan-Dong Fan, Zhao-Hai Feng, Kai Wang, TeWuErBaTi SuErTanNiYa, Tao-Tao Dou, Hai-Qiang Wu, MaiMaiTiLi AiSha, Xiao-Jiang Cheng
OBJECTIVE: To observe the short-term efficacy of Pipeline embolization divice (PED) for the treatment of complex intracranial aneurysms. METHODS: The clinical data of 29 consecutive patients with 32 intracranial aneurysms treated with PED between April 2015 to September 2016 were analyzed retrospectively. There were 3 small aneurysm, 15 large aneurysms, 8 giant aneurysms, 5 fusiform ayneurysms and 1 recidivation. The vessels include 25 anterior circulation and 4 posterior circulation...
2018: Bio-medical Materials and Engineering
https://www.readbyqxmd.com/read/29444328/influence-of-anatomic-changes-on-the-outcomes-of-carotid-siphon-aneurysms-after-deployment-of-flow-diverter-stents
#10
Eduardo Waihrich, Pierre Clavel, George Mendes, Christina Iosif, Iruena Moraes Kessler, Charbel Mounayer
BACKGROUND: Flow-diverter stent (FDS) deployment can cause morphological and hemodynamic changes in the carotid siphon (CS), influencing the occlusion rate of aneurysms in this location. OBJECTIVE: To evaluate morphological changes to the CS after FDS deployment and their relationship with the rate of occlusion of intracranial aneurysms. METHODS: A cohort of 183 patients with CS aneurysms were treated by deployment of Pipeline® FDS (Medtronic Inc, Dublin, Ireland)...
February 10, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29289804/endovascular-management-of-multiple-dysplastic-aneurysms-in-a-young-man-with-an-unknown-underlying-cause-a-case-report-and-review-of-the-literature
#11
Tyler Scullen, Mansour Mathkour, Joseph Lockwood, Leah Ott, Ricky Medel, Aaron S Dumont, Peter S Amenta
BACKGROUND: Intracranial aneurysms are the leading cause of nontraumatic subarachnoid hemorrhage and are most commonly associated with the anterior cerebral artery (ACA) and anterior communicating artery complex. We describe the presentation and management of a 27-year-old man with concurrent bilateral A1-2 junction aneurysms and fusiform intraorbital ophthalmic artery (OA) aneurysms. CASE DESCRIPTION: A 27-year-old man with no past medical history presented with 3 months of headaches...
March 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29279045/ticagrelor-for-neuroendovascular-procedures-a-case-series
#12
Kyle Davis, Christopher Morrison
BACKGROUND: The development of thromboembolism is one of the most common complications of neuroendovascular procedures. Although several small studies have deemed clopidogrel safe and effective in the prevention of intracranial stent thrombosis, ticagrelor has yet to be assessed in this setting. OBJECTIVE: The objective of this study was to retrospectively evaluate the safety and efficacy of ticagrelor in patients undergoing neuroendovascular procedures. METHODS: A retrospective review of patients receiving ticagrelor following neuroendovascular aneurysm repair...
February 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29239685/in-vitro-angiographic-comparison-of-the-flow-diversion-performance-of-five-neurovascular-stents
#13
Ronak J Dholakia, Ari D Kappel, Andrew Pagano, Henry H Woo, Baruch B Lieber, David J Fiorella, Chander Sadasivan
Background and purpose Data differentiating flow diversion properties of commercially available low- and high-porosity stents are limited. This in vitro study applies angiographic analysis of intra-aneurysmal flow to compare the flow-diversion performance of five neurovascular devices in idealized sidewall and bifurcation aneurysm models. Methods Five commercial devices (Enterprise, Neuroform, LVIS, FRED, and Pipeline) were implanted in silicone sidewall and bifurcation aneurysm models under physiological average flow of blood analog fluid...
April 2018: Interventional Neuroradiology
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
#14
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/29118792/anchoring-pipeline-flow-diverter-construct-in-the-treatment-of-traumatic-distal-cervical-carotid-artery-injury
#15
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/29081013/emerging-technologies-in-flow-diverters-and-stents-for-cerebrovascular-diseases
#16
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
https://www.readbyqxmd.com/read/29065742/balloon-sandwich-technique-for-retrieval-of-fractured-delivery-wire-of-pipeline-stent
#17
Russell Cerejo, Mark Bain, Thomas Masaryk
Delivery wire fracture of flow-diverter stents are rare but have been described. We describe a video case of a successful technique to retrieve such a fractured delivery wire by using a balloon microcatheter and the intermediate catheter when other proven methods may fail.
February 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29054914/flow-diversion-for-the-treatment-of-posterior-inferior-cerebellar-artery-aneurysms-a-novel-classification-and-strategies
#18
Visish M Srinivasan, Michael George Zaki Ghali, Oleg E Reznik, Jacob Cherian, Maxim Mokin, Travis M Dumont, John R Gaughen, Ramesh Grandhi, Ajit S Puri, Stephen R Chen, Jeremiah N Johnson, Peter Kan
BACKGROUND: The pipeline embolization device (PED) is frequently used in the treatment of anterior circulation aneurysms, especially around the carotid siphon, with generally excellent results. However, treatment of posterior inferior cerebellar artery (PICA) aneurysms with flow diversion (FD) has not been specifically described or discussed. While there are reports of treating PICA aneurysms using placement of FD stents in the vertebral artery, there are no reports of treating these lesions by placement of flow diverting stents in the PICA vessel itself...
October 20, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29030499/unexpected-early-radiographic-findings-associated-with-a-ruptured-blister-like-carotid-wall-aneurysm
#19
James West, Jasmeet Singh, Stacey Q Wolfe, Kyle M Fargen
A 33-year-old man presented with aneurysmal subarachnoid hemorrhage from a ruptured, blister-type sidewall internal carotid artery (ICA) aneurysm. Balloon-assisted coiling was performed with residual neck. He subsequently developed severe vasospasm requiring intra-arterial therapies on multiple occasions, during which it was noted that despite widespread vasospasm, a focal segment of the ICA at the site of the aneurysm showed no significant spasm, suggesting underlying vessel abnormality. He was discharged without deficit and scheduled for flow diversion given concern over this potentially pathologic segment of vessel...
October 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28965108/meta-analysis-of-treatment-outcomes-of-posterior-circulation-non-saccular-aneurysms-by-flow-diverters
#20
Satoshi Kiyofuji, Christopher S Graffeo, Avital Perry, Mohammad Hassan Murad, Kelly D Flemming, Giuseppe Lanzino, Leonardo Rangel-Castilla, Waleed Brinjikji
INTRODUCTION: Non-saccular aneurysms of the posterior circulation are uncommon but highly dangerous lesions. Flow diverter stents have been demonstrated to be effective treatments of various anterior circulation aneurysms, particularly large and giant proximal internal carotid artery aneurysms. However, evidence regarding the treatment of non-saccular posterior circulation aneurysms with flow diverters is lacking. METHODS: A systematic literature review of the English language literature since 2007 was conducted using PubMed, MEDLINE, and Embase...
September 30, 2017: Journal of Neurointerventional Surgery
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