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https://www.readbyqxmd.com/read/28819696/what-are-the-treatment-options-for-blister-like-aneurysms
#1
REVIEW
Torstein R Meling
Treatment of blood blister-like aneurysms (BBAs) of the supraclinoidal internal carotid artery (ICA) is challenging and the optimal treatment is yet to be defined. The treatment options for ICA BBAS are microsurgery, endovascular therapy, or a combination of the two. The microsurgical armamentarium consists mainly of direct aneurysm clipping with or without protective EC-IC bypass, clip-wrapping, or trap ligation with ICA sacrifice with or without EC-IC bypass. The endovascular treatment options are mainly endovascular ICA ligation, multiple overlapping stents (≥ 3) with or without coiling, covered stents, or flow diverters...
August 17, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28818824/clinical-impact-of-flat-panel-volume-ct-angiography-in-evaluating-the-accurate-intraoperative-deployment-of-flow-diverter-stents
#2
F Clarençon, F Di Maria, J Gabrieli, E Shotar, V Degos, A Nouet, A Biondi, N-A Sourour
BACKGROUND AND PURPOSE: The deployment of flow-diverter stents may be difficult to analyse on regular DSA. The purpose of our study was to investigate the clinical impact of stent-dedicated flat panel volume CT angiography to evaluate intraoperatively the satisfactory deployment of flow-diverter stents. MATERIALS AND METHODS: From January 2009 to April 2015, 83 consecutive patients (mean age, 51 years; 62 women) were treated in our institution with flow-diverter stents...
August 17, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28808603/aneurysm-treatment-practice-patterns-for-newly-appointed-dual-trained-cerebrovascular-endovascular-neurosurgeons-comparison-of-open-surgical-to-neuroendovascular-procedures-in-the-first-2-years-of-academic-practice
#3
Bowen Jiang, Matthew T Bender, Bima Hasjim, Frank P K Hsu, Rafael J Tamargo, Judy Huang, Geoffrey P Colby, Alexander L Coon, Li-Mei Lin
BACKGROUND: The practice patterns of a hybrid open cerebrovascular/neuroendovascular (CVNV) neurosurgeon in early academic practice is unknown. METHODS: We performed a multi-institutional retrospective cohort study of patients with cerebral aneurysms that were treated within the first 24 months of the neurosurgeon's practice. RESULTS: A total of 533 aneurysms were treated by the three senior authors within the first 24 months of their academic practice...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28798217/multicenter-experience-with-fred-jr-flow-re-direction-endoluminal-device-for-intracranial-aneurysms-in-small-arteries
#4
M A Möhlenbruch, O Kizilkilic, M Killer-Oberpfalzer, F Baltacioglu, C Islak, M Bendszus, S Cekirge, I Saatci, N Kocer
BACKGROUND AND PURPOSE: Flow diverters are emerging as an endovascular treatment alternative for proximally located intracranial aneurysms. However, treatment of aneurysms at and beyond the circle of Willis is not well-established. We assessed the clinical safety and efficacy of the Flow Re-Direction Endoluminal Device Jr (FRED Jr) dedicated to small-vessel diameters between 2.0 and 3.0 mm. MATERIALS AND METHODS: This was a multicenter observational clinical study of 42 patients with 47 aneurysms treated by a flow-direction technique with the FRED Jr...
August 10, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28782689/flow-diverter-treatment-of-tandem-intracranial-aneurysms
#5
Seby John, Mark Bain, Russell Cerejo, Andrew Bauer, Thomas Masaryk, Muhammad S Hussain, Peter Rasmussen, Gabor Toth
OBJECTIVE: The application of flow diversion (FD) for treatment of multiple, tandem intracranial aneurysms has not been well studied. We sought to assess technical success, and clinical and imaging outcomes of FD treatment for tandem intracranial aneurysms. METHODS: Retrospective analysis of patients treated with FD for tandem intracranial aneurysms. RESULTS: Twenty female patients were included with a mean (± SD) age of 60 ±12 years. Only one patient was treated after subarachnoid hemorrhage...
August 3, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28765024/amd3100-accelerates-reendothelialization-of-neointima-in-rabbit-saccular-aneurysm-after-flow-diverter-treatment
#6
Zifu Li, Rui Zhao, Xinggen Fang, Jiahao Zhou, Guoquan Jiang, Qinghai Huang, Jianmin Liu
OBJECTIVE: To inspect the role of AMD3100 that acts as an antagonist of SDF-1/CXCR4 on the formation of neointima in rabbit saccular aneurysm after flow diverter (FD) treatment. METHODS: Twenty saccular aneurysm models were established by using porcine pancreatic elastase. Three weeks later, a FDs of Tubridge was implanted into the saccular aneurysm. All treated models were immediately divided into two groups: the AMD3100 group was subcutaneously injected with AMD3100 (5 mg/kg per day), while control group with saline...
July 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28758550/treatment-of-ruptured-blood-blister-aneurysms-using-primary-flow-diverter-stenting-with-considerations-for-adjunctive-coiling-a-single-centre-experience-and-literature-review
#7
Cunli Yang, Agnes Vadasz, István Szikora
Objective The objective of this article is to conduct a single-centre evaluation and quick literature review of the effectiveness of primary flow-diverter (FD) treatment of ruptured blood blister aneurysms (BBAs), with additional relevance of adjunctive coiling. Methods Patients presenting with subarachnoid haemorrhage (SAH) due to ruptured BBAs and subsequently treated with FDs were retrospectively selected from June 2010 to January 2017. Treatment techniques, angiographic data on occlusion rates and procedural success as well as clinical outcomes using the modified Rankin Scale (mRS) were collated...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28754807/balloon-assisted-coil-embolization-and-large-stent-delivery-for-cerebral-aneurysms-with-a-new-generation-of-dual-lumen-balloons-copernic-2l
#8
Adrien Guenego, Jean-Baptiste Zerlauth, Francesco Puccinelli, Steven Hajdu, David C Rotzinger, Felix Zibold, Eike I Piechowiak, Pasquale Mordasini, Jan Gralla, Tomas Dobrocky, Roy T Daniel, René Chapot, Pascal J Mosimann
INTRODUCTION: Dual coaxial lumen balloon microcatheters through which small stents can be delivered have recently been described. We report a series of a new type of dual lumen balloon catheter with a parallel lumen design enabling enhanced inflation and deflation properties through which larger stents may be deployed, including flow diverters (FD). METHODS: All aneurysms that were treated with a Copernic 2L (COP2L) dual lumen balloon catheter at our institution between February 2014 and December 2016 were assessed...
July 28, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28748748/outcome-study-of-the-pipeline-embolization-device-for-treatment-of-intracranial-aneurysms-at-a-single-uk-institution
#9
Shih-Hung Yang, Timothy Hampton, Naga Kandasamy, Jonathan Hart, Jonathan Ashmore, Daniel C Walsh, Christos M Tolias, Thomas C Booth
BACKGROUND: The introduction of flow-diverting stents in the last decade provides an alternative endovascular treatment choice in selected intracranial aneurysms. This retrospective analysis of a UK centre's experience provides insight into clinical and radiographic outcomes. METHODS: Electronic patient records, diagnostic and procedural images and written procedural records for patients treated with the PED between August 2009 and April 2014 were reviewed. Follow-up TOF MRA was performed after treatment...
July 27, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28726227/modelling-the-effects-of-water-diversion-and-combined-sewer-overflow-on-urban-inland-river-quality
#10
Xianyong Gu, Zhenliang Liao, Guangqian Zhang, Jiaqiang Xie, Jin Zhang
In order to assist and optimize the operation of a clean water diversion project for the medium-sized inland rivers in Chaohu, China, an integrated hydrodynamic and water quality model was used in this study. Sixteen diversion scenarios and five sewage interception scenarios were defined to assess the improvement of water quality parameters including ammonia nitrogen (NH3-N), total phosphorus (TP) and chemical oxygen demand (COD) under different diverted water flows, diverting times, diverting points, diverting routines and sewage interception proportions...
July 20, 2017: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/28712070/flow-diverter-in-radiation-induced-skull-base-carotid-blowout-syndrome-do-not-write-it-off
#11
Gopinathan Anil, Junwei Zhang, Yew Kwang Ong, Francis Hui
Post-radiotherapy carotid blowout syndrome (CBS) of the skull base is a rare but often catastrophic complication of head and neck malignancies. The existing literature on the treatment of this condition with flow-diverting devices (FDD) is extremely limited and disappointing. We present a case of impending CBS in a patient previously irradiated for nasopharyngeal cancer that was successfully treated with use of multiple FDDs, adjunctive endonasal packing and delayed reinforcement with pedicled naso-septal flap, yielding an excellent outcome at 14-months follow-up...
July 16, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28689955/flow-diverting-stent-in-the-treatment-of-cervical-carotid-dissection-and-pseudoaneurysm-review-of-literature-and-case-report
#12
REVIEW
Anna Paula Weinhardt Baptista-Sincos, Aline Bigatão Simplício, Igor Rafael Sincos, Alex Leaderman, Fernando Saliture Neto, Adjaldes Moraes, Ricardo Aun
BACKGROUND: The endovascular technique has been recommended over the past few years to extracranial carotid dissection and pseudoaneurysm with promising results, specially after medical therapy failure. Flow-diverting stents are an alternative for complex cases. These stents have proven to be effective treatment devices for intracranial aneurysms. OBJECTIVE: To find out all cases of flow-diverting stents in the treatment of extracranial carotid dissection with or without pseudoaneurysm and compare to our case report...
July 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28689183/acute-thrombus-formation-on-phosphorilcholine-surface-modified-flow-diverters
#13
Miklos Marosfoi, Frederic Clarencon, Erin T Langan, Robert M King, Olivia W Brooks, Takamisu Tamura, John M Wainwright, Matthew J Gounis, Srinivasan Vedantham, Ajit S Puri
PURPOSE: Thromboembolic complications remain a limitation of flow diverting stents. We hypothesize that phosphorilcholine surface modified flow diverters (Pipeline Flex with Shield Technology, sPED) would have less acute thrombus formation on the device surface compared with the classic Pipeline Embolization device (cPED). METHODS: Elastase-induced aneurysms were created in 40 rabbits and randomly assigned to receive cPED or sPED devices with and without dual antiplatelet therapy (DAPT) (four groups, n=10/group)...
July 8, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28687502/endovascular-treatment-of-distal-tears-located-in-the-reno-viseceral-segment-with-bare-metal-stents-and-coils-in-a-complicated-type-b-aortic-dissection
#14
Qingsheng Lu, Yanqing Chen, Yongxue Zhang, Hongfei Wang, Hanyan Li, Jiaxuan Feng, Huajuan Mao, Zaiping Jing
PURPOSE: To provide an endovascular strategy of treating patent re-entries adjacent to visceral branches in the management of aortic dissections. CASE REPORT: A 45-year-old male who had received endovascular treatment for a type B aortic dissection was again admitted for his intermittent abdominal pain. Distal tears located in the reno-visceral segment was left untreated in the initial procedure, and was thought to be related to the expansion of the false lumen during follow-up...
July 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28685380/intracranial-aneurysms-treated-by-flow-diverting-stents-long-term-follow-up-with-contrast-enhanced-magnetic-resonance-angiography
#15
Maximilian Patzig, Robert Forbrig, Lorenz Ertl, Hartmut Brückmann, Gunther Fesl
PURPOSE: Long-term data on aneurysm treatment with flow-diverting stents are still sparse, and follow-up protocols differ widely between institutions. We present long-term results, with a focus on the usefulness of contrast-enhanced MR angiography (ceMRA). MATERIALS AND METHODS: Interventions and follow-up imaging of patients with aneurysms treated by flow-diverting stents ("Pipeline," "Silk" and "FRED" models) without additional coiling were analyzed. All MRI scans included dedicated two-phase ceMRA...
July 6, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28675349/novel-solution-for-luminal-access-loss-into-the-double-layered-lvis-blue%C3%A2-construct
#16
Evgueni Kouznetsov, Thomas Haldis, Michael Manchak, Alexander Drofa
We described a novel solution for a challenging case of double-layered LVIS Blue™ (LB) stent construct retraction into a large cavernous aneurysm. The double-layered LB stent construct was used as a flow diverter for treatment of a large cavernous aneurysm. Our solution comprised a balloon angioplasty and placement of balloon-mounted cardiac-stent construct through the side wall of the LB construct, with eventual placement of a Pipeline Flex inside of the final conduit.
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28665866/intracranial-aneurysms-of-neuro-ophthalmologic-relevance
#17
Jonathan A Micieli, Nancy J Newman, Daniel L Barrow, Valérie Biousse
BACKGROUND: Intracranial saccular aneurysms are acquired lesions that often present with neuro-ophthalmologic symptoms and signs. Recent advances in neurosurgical techniques, endovascular treatments, and neurocritical care have improved the optimal management of symptomatic unruptured aneurysms, but whether the chosen treatment has an impact on neuro-ophthalmologic outcomes remains debated. EVIDENCE ACQUISITION: A review of the literature focused on neuro-ophthalmic manifestations and treatment of intracranial aneurysms with specific relevance to neuro-ophthalmologic outcomes was conducted using Ovid MEDLINE and EMBASE databases...
June 29, 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/28647659/flow-diverters-as-a-useful-adjunct-to-traditional-endovascular-techniques-in-the-treatment-of-direct-carotid-cavernous-fistulas
#18
Christopher S Ogilvy, Rouzbeh Motiei-Langroudi, Mohammad Ghorbani, Christoph J Griessenauer, Abdulrahman Y Alturki, Ajith J Thomas
BACKGROUND: Direct carotid-cavernous sinus fistulas (CCF) are high flow arteriovenous shunts that are typically the result of a severe head injury. The endovascular treatment of these lesions includes the use of detachable balloons, coils, liquid embolic agents, and covered stents. To minimize the chance of treatment failure and subsequent complications, endoluminal reconstruction using a flow-diverting stent may be added to the treatment construct . METHODS: We present 3 cases and review the existing literature...
June 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28624566/4d-phase-contrast-mri-protocol-optimization-using-patient-specific-3d-printed-replicas-for-in-vivo-imaging-before-and-after-flow-diverter-placement
#19
Christof Karmonik, Jeff R Anderson, Saba Elias, Richard Klucznik, Orlando Diaz, Y Jonathan Zhang, Robert G Grossman, Gavin W Britz
PURPOSE: Hemodynamics in cerebral aneurysms is currently investigated towards its clinical efficacy using non-standardized computational simulation techniques. At the same time, flow patterns and velocities are accessible by 4D phase contrast magnetic resonance imaging (4D pcMRI). Complexity of protocol design and imaging duration has limited the use of this technique in clinical imaging. A new approach is presented to overcome these limitations. MATERIAL AND METHODS: 3D replicas of two cerebral aneurysms were fabricated by fused deposition prototyping (3D printing) and imaged using 4D pcMRI while connected to an MRI compatible continuous flow loop...
June 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28619972/staged-curative-treatment-of-a-complex-direct-carotid-cavernous-fistula-with-a-large-arterial-defect-and-an-oversized-internal-carotid-artery
#20
Matthew T Bender, Li-Mei Lin, Alexander L Coon, Geoffrey P Colby
This is a case of a high-flow, post-traumatic direct carotid-cavernous fistula with a widened arterial defect and a large-diameter internal carotid artery (ICA). The unique aspect of this case is the oversized ICA, >8mm in diameter, which is both a pathological and a therapeutic challenge, given the lack of available neuroendovascular devices for full vessel reconstruction. We present a planned two-stage embolisation paradigm for definitive treatment. Transarterial coil embolisation is performed as the first stage to disconnect the fistula and normalise flow in the ICA...
June 14, 2017: BMJ Case Reports
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