15 FLOW DIVERTERS FOR BRAIN ANEURYSM TREATMENT: INTRAPROCEDURAL COMPLICATIONS AND MANAGEMENT

Author(s):  
Brian P. Walcott ◽  
Ki-Eun Chang ◽  
Robin Babadjouni ◽  
William J. Mack

Neurosurgery ◽  
2019 ◽  
Vol 86 (Supplement_1) ◽  
pp. S36-S45 ◽  
Author(s):  
Bree Chancellor ◽  
Eytan Raz ◽  
Maksim Shapiro ◽  
Omar Tanweer ◽  
Erez Nossek ◽  
...  

Abstract Flow diverters (FDs) have changed the management of brain aneurysms; not only for complex aneurysms (giant, fusiform and blister) refractory to conventional therapies, but also for unruptured lesions previously managed by traditional surgical or coil-based endovascular methods. Since 2011 when the PipelineTM Embolization Device (Medtronic) was cleared by the Food and Drug Administration for adults with large or giant wide-neck intracranial aneurysms of the internal carotid artery proximal to the posterior communicating segment, the role of flow diversion for aneurysm treatment has expanded—supported by favorably low complication and high cure rates compared with alternative treatments. Here we review the key clinical trials and the long term outcomes that have demonstrated safety and efficacy of minimized porosity endoluminal devices in the treatment of cerebral aneurysms.


Neurosurgery ◽  
2014 ◽  
Vol 74 (3) ◽  
pp. E341-E342 ◽  
Author(s):  
Pascal Jabbour ◽  
Nohra Chalouhi

Author(s):  
V Pereira ◽  
O Brina ◽  
N Cancelliere ◽  
J Bracken ◽  
F Nijnatten ◽  
...  

Author(s):  
Akihiko Ichikawa ◽  
Takahiro Ito ◽  
Kouhei Shimogaito ◽  
Takashi Kubo ◽  
Toshio Fukuda

2019 ◽  
Vol 12 (9) ◽  
pp. e230687 ◽  
Author(s):  
Ichiro Yuki ◽  
Toshihiro Ishibashi ◽  
Chihebeddine Dahmani ◽  
Naoki Kato ◽  
Ayako Ikemura ◽  
...  

We introduce a new imaging technique to improve visualisation of stent apposition after endovascular treatment of brain aneurysms employing high-resolution cone beam CT and three-dimensional digital subtraction angiography. After performing a stent-assisted coil embolisation of brain aneurysm, the image datasets were processed with a metal artefact reduction software followed by the automated image fusion programmes. Two patients who underwent aneurysm coiling using a Neuroform stent were evaluated. The reconstructed 3D images showed a detailed structure of the stent struts and identified malappositions of the deployed stents. Case 1 showed good apposition on the outer curvature side of the carotid siphon, while the inner curvature side showed prominent malapposition. Case 2, with multiple aneurysms, showed good apposition on both outer and inner curvature sides, although inward prolapse of the struts was observed. This new imaging technique may help evaluate stent apposition after the endovascular aneurysm treatment.


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