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https://www.readbyqxmd.com/read/28439656/-management-of-paraophthalmic-aneurysms-review-of-endovascular-treatment-strategies
#1
P Bhogal, M Aguilar Pérez, G Sauder, H Bäzner, O Ganslandt, H Henkes
BACKGROUND: Aneurysms of the cerebral vessels are relatively common and aneurysms of the ophthalmic segment of the internal carotid artery (ICA) represent approximately 10% of intradural aneurysms. ANATOMICAL ASPECTS: The ophthalmic segment of the ICA extends from the origin of the ophthalmic artery to the origin of the posterior communicating artery. Aneurysms can originate from the ophthalmic artery itself or directly from the ICA at a distance from the ophthalmic artery...
April 24, 2017: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/28438894/flow-diverter-treatment-of-intracranial-vertebral-artery-dissecting-pseudoaneurysms
#2
REVIEW
Russell Cerejo, Mark Bain, Nina Moore, Julian Hardman, Andrew Bauer, M Shazam Hussain, Thomas Masaryk, Peter Rasmussen, Gabor Toth
INTRODUCTION: Intracranial vertebral dissecting pseudoaneurysms are a rare, but increasingly recognized, cause of subarachnoid hemorrhage and ischemic stroke. The risks of aneurysm re-rupture and associated morbidity are high. The use of flow diverter stents for the treatment of these aneurysms has not been well studied. OBJECTIVE: To report our data and provide a summarized review of literature using flow diverter stents for the treatment of intracranial vertebral artery dissecting pseudoaneurysms...
April 24, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28438653/the-fate-of-side-branches-covered-by-flow-diverters-results-from-140-patients
#3
P Bhogal, O Ganslandt, H Bäzner, H Henkes, M Aguilar Perez
BACKGROUND: Flow diverter stents (FDS) are a recognised treatment option for intracranial aneurysms. There remain on-going concerns regarding the safety of FDS especially when it comes to the fate of covered side branches. We sought to report on the patency of side branches covered by FDS. METHODS: We retrospectively reviewed our database of prospectively collected information for all patients treated with FDS for an unruptured saccular aneurysm of the clinoid, ophthalmic, and terminating segments of the internal carotid artery between September 2009 and July 2016...
April 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28416090/clipping-in-awake-surgery-as-end-stage-in-a-complex-internal-carotid-artery-aneurysm-after-failure-of-multimodal-endovascular-and-extracranial-intracranial-bypass-treatment
#4
Delia Cannizzaro, Simone Peschillo, Cristina Mancarella, Biagia La Pira, Emanuela Rastelli, Emiliano Passacantilli, Antonio Santoro
BACKGROUND: Intracranial carotid artery aneurysm can be treated via microsurgical or endovascular techniques. The optimal planning is the result of the careful patient selection through clinical, anatomic, and angiographic analysis. CLINICAL PRESENTATION: We present a case of ruptured internal carotid artery (ICA) aneurysm that became a complex aneurysm after failure of multi-endovascular and surgery treatment. We describe complete trapping in awake craniotomy after failure of coiling, stenting, and bypassing...
April 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28401699/sling-scoop-squirter-anatomical-features-facilitating-prey-transport-processing-and-swallowing-in-rorqual-whales-mammalia-balaenopteridae
#5
Alexander J Werth, Haruka Ito
Much is known about lunge feeding in balaenopterid whales, but many key aspects of structure, function, and behavior have not yet been explained in detail, especially with regard to concentrating, positioning, and swallowing large aggregations of prey. We describe a novel system of three integrated structural components, all of which are involved in sequential feeding activities (intraoral transport, filtration, and swallowing of prey) that follow lunge-feeding engulfment of prey-laden water in rorquals: 1) a hammock-like muscular sling comprising extrinsic lingual musculature along the midline of the ventral pouch; 2) the flattened scoop-like arrangement of caudal-most baleen plates converging in the oropharynx adjacent to the esophageal opening; and 3) a flow-diverting flange at the posterior dorsum of the lip, by a flow channel at the angle of the mouth...
April 12, 2017: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
https://www.readbyqxmd.com/read/28391744/malignant-stroke-in-a-ticagrelor-non-responder-as-a-complication-following-aneurysm-treatment-with-the-pipeline-embolization-device%C3%A2
#6
Pegah Ghamasaee, Kevin Carr, Jeremiah Johnson, Ramesh Grandhi
The Pipeline Embolization Device™ (PED; Covidien Neurovascular Inc, Irvine, CA, USA) is a flow-diverting stent often used for the endovascular treatment of large or giant, wide-necked intracranial aneurysms of the internal carotid artery. Because of the inherent thrombogenicity of intracranial stents, dual-antiplatelet therapy is initiated after placement, which has been shown to decrease morbidity and mortality related to perioperative ischemic events in neurointerventional procedures. However, in some series, as much as 50% of patients demonstrate clopidogrel non-responsiveness...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28387623/flow-diverter-devices-in-ruptured-intracranial-aneurysms-a-single-center-experience
#7
Emilio Lozupone, Mariangela Piano, Luca Valvassori, Luca Quilici, Guglielmo Pero, Emiliano Visconti, Edoardo Boccardi
OBJECTIVE In this single-center series, the authors retrospectively evaluated the effectiveness, safety, and midterm follow-up results of ruptured aneurysms treated by implantation of a flow diverter device (FDD). METHODS The records of 17 patients (12 females, 5 males, average World Federation of Neurosurgical Societies score = 2.9) who presented with subarachnoid hemorrhage (SAH) due to the rupture of an intracranial aneurysm treated with an FDD were retrospectively reviewed. Of 17 ruptured aneurysms, 8 were blood blister-like aneurysms and the remaining 9 were dissecting aneurysms...
April 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28383672/cerebral-revascularization-for-aneurysms-in-the-flow-diverter-era
#8
David C Straus, Harley Brito da Silva, Lynn McGrath, Michael R Levitt, Louis J Kim, Basavaraj V Ghodke, Jason K Barber, Laligam N Sekhar
BACKGROUND: Cerebral bypass has been an important tool in the treatment of complex intracranial aneurysms. The recent advent of flow-diverting stents (FDS) has expanded the capacity for endovascular arterial reconstruction. OBJECTIVE: We investigated how the advent of FDS has impacted the application and outcomes of cerebral bypass in the treatment of intracranial aneurysms. METHODS: We reviewed a consecutive series of cerebral bypasses during aneurysm surgery over the course of 10 years...
April 5, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28374616/treatment-of-barrow-type-b-carotid-cavernous-fistulas-with-flow-diverter-stent-pipeline
#9
Carlos Castaño, Sebastián Remollo, Rosa García-Sort, Carlos Domínguez, Mikel Terceño
Background Carotid cavernous fistulas (CCFs) Barrow type 'B' are dural shunts between the meningeal branches of the internal carotid artery and the cavernous sinus. The symptoms include vision deterioration, ophthalmoplegia with diplopia, exophthalmos, conjunctival injection, chemosis, ocular bruit, seizures, or neurological deficit. Endovascular treatment remains the gold standard for treatment through the transvenous or transarterial routes. The transvenous approaches have been proved to be the first option...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28333907/the-effect-of-placing-flow-diverting-stents-in-intracranial-collateral-arteries-of-miniature-pig
#10
Jiwei Wang, Yanan Ding, Qiuxia Wang, Yanan Wang, Shiqing Mu, Lixin Bi, Youxiang Li
BACKGROUND Flow-diverting stent (FDS) has been suggested as an effective intracranial aneurysm treatment. However, the effects of FDS on collateral branches of an aneurysm parent artery still remain unknown. Thus, the present study aimed to comprehensively evaluate the effects of placing a FDS in the intracranial collateral artery, using a miniature pig animal model. MATERIAL AND METHODS Ten healthy miniature pigs were included in the study: one pig was reserved as a control and the remaining nine pigs were placed in three experimental groups: FDS (i...
March 23, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28332378/quantitative-computed-tomographic-volumetry-after-treatment-of-a-giant-intracranial-aneurysm-with-a-pipeline-embolization-device
#11
Woong Jae Lee, Jun Soo Byun, Jae Kyun Kim, Taek Kyun Nam
Recently developed flow diverters, such as the pipeline embolization device (PED), allow for safe and efficacious treatment of giant intracranial aneurysms, with high occlusion rates and a low incidence of complications. However, incomplete obliteration after PED treatment may lead to aneurysm regrowth and delayed rupture. Herein, we report a case of a partially thrombosed giant aneurysm of the cavernous internal carotid artery that showed progressive recanalization at 1-3 months after application of a PED...
May 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28327963/treatment-of-intracranial-aneurysms-with-the-silk-embolization-device-in-a-multicenter-study-a-retrospective-data-analysis
#12
José Manuel Pumar, Alexandra Banguero, Hugo Cuellar, Leopoldo Guimaraens, Javier Masso, Salvador Miralbes, Miguel Blanco-Ulla, Fernando Vazquez-Herrero, Miguel Souto, Miguel Gelabert-Gonzalez
BACKGROUND: Flow-diverter technology has become an important stent-based embolization tool in the treatment of complex cerebrovascular pathology. We report here the experience of 4 Spanish centers with using the SILK flow-diverter (SFD) device. OBJECTIVE: To evaluate the safety and efficacy of using the SFD in the endovascular treatment of intracranial aneurysms with complex morphology. METHODS: We retrospectively examined a prospectively maintained database of patients treated with SFD devices between July 2008 and December 2013 at 1 of 4 institutions in Spain...
January 28, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327931/flow-diverters-for-treatment-of-160-ophthalmic-segment-aneurysms-evaluation-of-safety-and-efficacy-in-a-multicenter-cohort
#13
Christoph J Griessenauer, Ronie L Piske, Carlos E Baccin, Benedito J A Pereira, Arra S Reddy, Ajith J Thomas, Thiago G Abud, Christopher S Ogilvy
BACKGROUND: Treatment of ophthalmic segment aneurysms (OSA) remains challenging. Flow diverter stents (FDS) have evolved as a promising endovascular treatment option for aneurysms of the internal carotid artery and are associated with high occlusion rates and a favorable morbidity and mortality profile. OBJECTIVE: To determine safety and efficacy of FDS for OSA in a large, multicenter cohort. METHODS: A retrospective analysis of prospectively maintained databases of 127 consecutive patients harboring 160 OSA treated with FDS was performed...
January 28, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28316868/a-case-of-ruptured-blood-blister-like-aneurysm-treated-with-pipeline-embolization-device-clinical-significance-of-fetal-type-posterior-communicating-artery
#14
Ki-Su Park, Dong-Hun Kang, Won-Soo Son, Jaechan Park, Young-Sun Kim, Byung Moon Kim
Blood-blister like aneurysms (BBAs) are challenging lesions because of their wide fragile neck. Flow-diverting stents (FDSs), such as the Pipeline Embolization Device (PED), have been applied to treat BBAs less amenable to more established techniques of treatment. However, the use of FDSs, including the PED, in acute subarachnoid hemorrhage (SAH) still remains controversial. We report a case of aneurysm regrowth following PED application for a ruptured BBA that overlapped the origin of the dominant posterior communicating artery (PCoA), which was successfully treated after coil trapping of the origin of the fetal-type PCoA...
March 2017: Neurointervention
https://www.readbyqxmd.com/read/28316865/treatment-of-intracranial-aneurysms-with-flow-re-direction-endoluminal-device-a-single-centre-experience-with-short-term-follow-up-results
#15
Neeraj Ramesh Mahboobani, Wing Ho Chong, Samuel Siu Kei Lam, Jimmy Chi Wai Siu, Chong Boon Tan, Yiu Chung Wong
PURPOSE: A flow diverter (FD) is an effective treatment option for intracranial aneurysms. The Flow Re-direction Endoluminal Device (FRED) is a relatively new flow diverter with a unique dual-layer design. We report our experience and short-term results with the FRED. MATERIALS AND METHODS: We did a retrospective review of all consecutive cases in which the FRED was used to treat intracranial aneurysms at a single institution from March 2014 till December 2015. Clinical parameters, aneurysm characteristics, technical results and short-term outcomes were reviewed...
March 2017: Neurointervention
https://www.readbyqxmd.com/read/28304190/the-second-generation-eclips-endovascular-clip-system-initial-experience
#16
Albert H Chiu, Joost De Vries, Cian J O'Kelly, Howard Riina, Ian McDougall, Jonathan Tippett, Martina Wan, Airton Leonardo de Oliveira Manoel, Thomas R Marotta
OBJECTIVE Treatment of wide-necked intracranial aneurysms is associated with higher recanalization and complication rates; however, the most commonly used methods are not specifically designed to work in bifurcation lesions. To address these issues, the authors describe the evolution in the design and use of the eCLIPs (Endovascular Clip System) device, a novel hybrid stent-like assist device with flow diverter properties that was first described in 2008. METHODS A registry was established covering 13 international centers at which patients were treated with the second-generation eCLIPs device...
March 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28279774/conscious-sedation-versus-general-anesthesia-for-the-treatment-of-cerebral-aneurysms-with-flow-diversion-a-matched-cohort-study
#17
Christoph J Griessenauer, Hussain Shallwani, Nimer Adeeb, Raghav Gupta, Leonardo Rangel-Castilla, Adnan H Siddiqui, Elad I Levy, Myles D Boone, Ajith J Thomas, Christopher S Ogilvy
INTRODUCTION: Flow diversion has become a popular treatment option for a variety of cerebral aneurysms. We sought to compare conscious sedation and general anesthesia for flow diverter placement in a matched cohort study. MATERIALS AND METHODS: Patients who underwent flow diverter placement under conscious sedation were matched on the basis of age, sex, American Society of Anesthesiologists (ASA) classification, aneurysm location, and aneurysm size with patients who received general anesthesia...
March 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28250282/a-single-center-experience-with-coil-embolization-for-cerebral-aneurysms-greater-than-10-mm-in-the-internal-carotid-artery
#18
Kensuke Suzuki, Ryotaro Suzuki, Tomoji Takigawa, Nobuyuki Shimizu, Yoshiyuki Matsumoto, Yoshiko Fujii, Yuki Inoue, Yoshiki Sugiura, Koji Hirata, Kyoji Tsuda, Yosuke Kawamura, Issei Takano, Ryuta Nakae, Masaya Nagaishi, Yoshihiro Tanaka, Akio Hyodo
We investigated endovascular treatment for 10 mm or larger aneurysms in the internal carotid artery (IC), including the cavernous portion, the paraclinoid portion, and the posterior communication artery (PC). Between 2011 and 2014 at our hospital, there were 35 cases of aneurysms that were 10 mm or larger in the carotid artery. We analyzed these 35 cases retrospectively based on the size and location of the aneurysms, method of treatment, number of coils implanted, use of a stent, complications, rupture after treatment, ophthalmologic symptoms, and need for re-treatment...
March 2, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28249880/the-bumper-technique-for-advancing-a-large-profile-microcatheter
#19
Christopher P Kellner, Alexander G Chartrain, Claire Schwegel, Thomas J Oxley, Hazem Shoirah, J Mocco
Operators commonly encounter difficulty maneuvering a microcatheter beyond the distal lip of wide neck aneurysms and aneurysms in challenging locations. Few techniques have been described to guide operators in these particular situations. In this case report of a 56-year-old woman with a 16 mm ophthalmic artery aneurysm, the microcatheter continually snagged the distal aneurysm lip, preventing delivery of a flow diverter into the distal parent vessel. In troubleshooting this obstacle, a second microguidewire was introduced alongside the microcatheter and was used to cover the distal lip of the aneurysm to prevent further snagging...
March 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28243686/flow-diversion-what-can-clinicians-learn-from-animal-models
#20
Robert Fahed, Tim E Darsaut, Jean-Christophe Gentric, Behzad Farzin, Igor Salazkin, Guylaine Gevry, Jean Raymond
INTRODUCTION: Flow diversion is increasingly used for treating intracranial aneurysms. This article aims to review the evidence obtained from animal models and summarizes the findings that might be of clinical interest. METHODS: From a systematic review of studies published between 2000 and 2016, we extracted the data on the following questions: What roles do aneurysm dimension, morphology, and vascular geometry have on success of flow diversion? What characteristics of a flow diverter can influence aneurysm occlusion? What are the risk factors for jailed branch occlusion? RESULTS: Flow diversion has been shown to be less effective in occluding large aneurysms with wide or undefined necks, as compared to smaller aneurysms with narrower necks...
February 27, 2017: Neuroradiology
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