Anterior Communicating Artery Aneurysm: Previously Ruptured and Clipped Anterior Communicating Artery Aneurysm; Incidental Aneurysm Recurrence or Remnant; Endovascular Treatment with a Pipeline Embolization Device and Long-Term Follow-Up

2020 ◽  
pp. 711-723
Author(s):  
Pablo Albiña Palmarola ◽  
Rene Viso ◽  
Ivan Lylyk ◽  
Jorge Chudyk ◽  
Pedro Lylyk
Keyword(s):  
Endovascular Treatment ◽  
Artery Aneurysm ◽  
Anterior Communicating Artery ◽  
Pipeline Embolization Device ◽  
Anterior Communicating Artery Aneurysm ◽  
Long Term Follow Up

scholarly journals Radiological Changes in Infantile Dissecting Anterior Communicating Artery Aneurysm Treated Endovascularly

2014 ◽  
Vol 20 (6) ◽  
pp. 796-803 ◽  
Author(s):  
Kenji Yatomi ◽  
Hidenori Oishi ◽  
Munetaka Yamamoto ◽  
Yasuo Suga ◽  
Senshu Nonaka ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Blood Coagulation ◽  
Intracranial Aneurysms ◽  
Artery Aneurysm ◽  
Dissecting Aneurysm ◽  
Anterior Communicating Artery ◽  
Anterior Communicating Artery Aneurysm ◽  
Radiological Changes ◽  
Dissecting Aneurysms

Intracranial aneurysms are extremely rare in infants, and to our knowledge only seven infants treated for ruptured spontaneous dissecting aneurysms have been reported. Good outcomes have been achieved with endovascular treatment of infantile aneurysm. We the endovascular treatment of a one-month-old girl for ruptured dissecting aneurysm located in the anterior communicating artery, and the unique radiological changes that were observed during the perioperative and follow-up periods. These changes suggest that blood coagulation and fibrinolytic response play a part in the repair and healing processes of dissecting aneurysms. Careful neuroradiological surveys are needed for pediatric dissecting aneurysms treated endovascularly.

Republished: Pipeline embolization device thrombosis induced peri-construct collateral channels

2015 ◽  
Vol 8 (11) ◽  
pp. e47-e47 ◽  
Author(s):  
Albert Ho Yuen Chiu ◽  
Thomas R Marotta
Keyword(s):  
Anterior Cerebral Artery ◽  
Central Area ◽  
Artery Aneurysm ◽  
Biologically Active ◽  
Pipeline Embolization Device ◽  
Long Term Follow Up ◽  
Anterior Cerebral Artery Aneurysm ◽  
Cerebral Artery Aneurysm

More than half a decade of experience and follow-up has now been accumulated with regard to flow diversion as a treatment for intracranial aneurysms; however, many uncertainties, such as the nature of aneurysmal remnants and the meaning of non-regressed, non-perfused aneurysmal masses, are still unknown. Here we discuss a 22-year-old man who presented with a grade 1 subarachnoid hemorrhage secondary to a dissecting right anterior cerebral artery aneurysm who was subsequently treated with a Pipeline Embolization Device construct. After ceasing dual antiplatelet therapy himself, he was found on MRI to have an area of increased aneurysmal remnant reperfusion. This was found to connect to multiple channels which reconstituted flow within the distal construct on angiography. The central area of construct thrombosis could not be visualized on MRI. The finding suggests that non-opacified aneurysmal remnants that have not regressed are biologically active and raises concerns regarding using MRI for long term follow-up.

Very Late Thrombosis of a Pipeline Embolization Device Construct

2010 ◽  
Vol 67 (3) ◽  
pp. onsE313-onsE314 ◽  
Author(s):  
David Fiorella ◽  
Daniel Hsu ◽  
Henry H. Woo ◽  
Robert W. Tarr ◽  
Peter Kim Nelson
Keyword(s):  
Vertebral Artery ◽  
Artery Aneurysm ◽  
Left Vertebral Artery ◽  
Pipeline Embolization Device ◽  
Complete Occlusion ◽  
Brainstem Stroke ◽  
Long Term Follow Up ◽  
Late Thrombosis

Abstract BACKGROUND: The Pipeline embolization device (PED) is a new endoluminal construct designed to exclude aneurysms from the parent cerebrovasculature. We report the very late (>;1 year) thrombosis of a PED construct placed for the treatment of a left vertebral aneurysm. CLINICAL PRESENTATION: A patient with an occluded right vertebral artery and a large, fusiform intracranial left vertebral artery aneurysm was treated with PED and coil reconstruction. A durable, complete occlusion of the aneurysm was confirmed with control angiography at 1 year. The patient remained neurologically normal for 23 months until he experienced a transient visual disturbance followed weeks later by a minor brainstem stroke. INTERVENTION: Imaging evaluation showed thrombosis of the PED construct with complete occlusion of the left vertebral artery. After this stroke, he was initially treated with dual antiplatelet therapy and was then converted to warfarin. The patient remained neurologically stable for 5 months until he experienced progressive basilar thrombosis that ultimately resulted in a fatal stroke. CONCLUSION: The PED represents a promising new endovascular technology for the treatment of cerebral aneurysms; however, as an investigational device, long-term follow-up data are sparse at this point. The etiology of the very late thrombosis of the PED construct in this case remains unknown; however, this report underscores the need for a continued, careful systematic evaluation and close long-term follow-up of treated patients.

scholarly journals Follow-up of a Patient Treated by the Mechanical Detachable System (MDS) of Tungsten Spirals

2001 ◽  
Vol 7 (2) ◽  
pp. 111-114
Author(s):  
P. Kolasa ◽  
Z. Kaurzel
Keyword(s):  
Endovascular Treatment ◽  
Basilar Artery ◽  
Intracranial Aneurysms ◽  
Artery Aneurysm ◽  
Basilar Artery Aneurysm ◽  
Long Term Follow Up ◽  
Carotid Cavernous Fistulas

A case is presented of basilar artery aneurysm, to which endovascular treatment was applied, employing the mechanical detachable system (MDS) of tungsten spirals. The aim of the study was to demonstrate spiral disappearance in embolised aneurysm without recanalisation, following a long-term follow-up period — up to 42 months. During the years 1994 to 1999, about 100 intracranial aneurysms and carotid-cavernous fistulas were embolised by the use of MDS spirals. In one case, spiral disappearance was noted, that event not, however, affecting the patient's state in any way and confirmed by clinical and radiological evaluations.

Anticoagulation in addition to dual antiplatelet therapy has no impact on long-term follow-up after endovascular treatment of (sub)acute lower limb ischemia

VASA ◽  
2019 ◽  
Vol 48 (4) ◽  
pp. 321-329
Author(s):  
Mariya Kronlage ◽  
Erwin Blessing ◽  
Oliver J. Müller ◽  
Britta Heilmeier ◽  
Hugo A. Katus ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
Limb Ischemia ◽  
Bleeding Complications ◽  
Severe Bleeding ◽  
Short Term ◽  
Long Term Follow Up

Summary. Background: To assess the impact of short- vs. long-term anticoagulation in addition to standard dual antiplatelet therapy (DAPT) upon endovascular treatment of (sub)acute thrombembolic occlusions of the lower extremity. Patient and methods: Retrospective analysis was conducted on 202 patients with a thrombembolic occlusion of lower extremities, followed by crirical limb ischemia that received endovascular treatment including thrombolysis, mechanical thrombectomy, or a combination of both between 2006 and 2015 at a single center. Following antithrombotic regimes were compared: 1) dual antiplatelet therapy, DAPT for 4 weeks (aspirin 100 mg/d and clopidogrel 75 mg/d) upon intervention, followed by a lifelong single antiplatelet therapy; 2) DAPT plus short term anticoagulation for 4 weeks, followed by a lifelong single antiplatelet therapy; 3) DAPT plus long term anticoagulation for > 4 weeks, followed by a lifelong anticoagulation. Results: Endovascular treatment was associated with high immediate revascularization (> 98 %), as well as overall and amputation-free survival rates (> 85 %), independent from the chosen anticoagulation regime in a two-year follow up, p > 0.05. Anticoagulation in addition to standard antiplatelet therapy had no significant effect on patency or freedom from target lesion revascularization (TLR) 24 months upon index procedure for both thrombotic and embolic occlusions. Severe bleeding complications occurred more often in the long-term anticoagulation group (9.3 % vs. 5.6 % (short-term group) and 6.5 % (DAPT group), p > 0.05). Conclusions: Our observational study demonstrates that the choice of an antithrombotic regime had no impact on the long-term follow-up after endovascular treatment of acute thrombembolic limb ischemia whereas prolonged anticoagulation was associated with a nominal increase in severe bleeding complications.

scholarly journals Long-Term Follow-up Study of Endovascularly Treated Intracranial Aneurysms

2010 ◽  
Vol 16 (3) ◽  
pp. 231-239 ◽  
Author(s):  
L.M. Pyysalo ◽  
L.H. Keski-Nisula ◽  
T.T. Niskakangas ◽  
V.J. Kähärä ◽  
J.E. Öhman
Keyword(s):  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Bleeding Rate ◽  
Unruptured Aneurysms ◽  
Ruptured Aneurysms ◽  
Follow Up Study ◽  
Long Term Follow Up ◽  
Rebleeding Rate

Long-term follow-up studies after endovascular treatment for intracranial aneurysm are still rare and inconclusive. The aim of this study was to assess the long-term clinical and angiographic outcome of patients with endovascularly treated aneurysms. The clinical outcome of all 185 patients with endovascularly treated aneurysms were analyzed and 77 out of 122 surviving patients were examined with MRI and MRA nine to 16 years (mean 11 years) after the initial endovascular treatment. Sixty-three patients were deceased at the time of follow-up. The cause of death was aneurysm-related in 34 (54%) patients. The annual rebleeding rate from the treated aneurysms was 1.3% in the ruptured group and 0.1% in the unruptured group. In long-term follow-up MRA 18 aneurysms (53%) were graded as complete, 11 aneurysms (32%) had neck remnants and five aneurysms (15%) were incompletely occluded in the ruptured group. The occlusion grade was lower in the unruptured group with 20 aneurysms (41%) graded as complete, 11 (22%) had neck remnants and 18 (37%) were incomplete. However, only three aneurysms were unstable during the follow-up period and needed retreatment. Endovascular treatment of unruptured aneurysms showed incomplete angiographic outcome in 37% of cases. However, the annual bleeding rate was as low as 0.1%. Endovascular treatment of ruptured aneurysms showed incomplete angiographic outcome in 15% of cases and the annual rebleeding rate was 1,3%.

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