Electronic Database for Documentation of Microsurgical and Endovascular Treatment of Intracranial Aneurysms: Technical Note

2001 ◽  
Vol 44 (2) ◽  
pp. 92-94 ◽  
Author(s):  
A. Gruber ◽  
M. Killer ◽  
G. Bavinzski ◽  
B. Richling
Keyword(s):  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Technical Note ◽  
Electronic Database

scholarly journals Technical Note on VDS

2002 ◽  
Vol 8 (2) ◽  
pp. 197-200 ◽  
Author(s):  
H. Henkes ◽  
P. Drepper ◽  
J. Speder ◽  
S. Felber ◽  
H. Monstadt ◽  
...  
Keyword(s):  
Stainless Steel ◽  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Technical Note ◽  
Coil Occlusion ◽  
Platinum Coil ◽  
Continuous Current ◽  
Detachment Time ◽  
Platinum Coils ◽  
New System

A new system was deviced that allows the electrolytical detachment of platinum microcoils at variable lengths for the endovascular treatment of intracranial aneurysms. The detachment element consists of two short platinum coil segments, which are connected by a threat of stainless steel. The steel threat is interrupted by electrolysis, using a continuous current with 1–2 mA at a voltage of 4–8 Volt. The average detachment time in heparinized blood is about 30–40 sec. The detachment elements can be used to connect either an insertion wire with a platinum coil or to connect several segments of platinum coils with variable helices and lengths. If several detachment elements are integrated in a coil, electrolysis interrupts only the element, which is next beyond the distal tip of the catheter. The electrolytical process does not affect the detachment elements proximal and distal to the element adjacent to the tip of the catheter. Single or several coil segments can be pulled back into the microcatheter if necessary. The system is expected to allow a faster and more complete endovascular coil occlusion of intracranial aneurysms. The principles described in this paper are claimed by the German pending patent DE 100 10840 A1.

scholarly journals MR susceptibility artefact associated with the use of Barricade coils for treatment of intracranial aneurysms

2015 ◽  
Vol 21 (2) ◽  
pp. 188-190 ◽  
Author(s):  
Vamsi Gontu ◽  
Norman McConachie
Keyword(s):  
Magnetic Resonance ◽  
Image Quality ◽  
Magnetic Resonance Angiography ◽  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Technical Note ◽  
Digital Subtraction ◽  
Susceptibility Artefact

Magnetic resonance angiography (MRA) is commonly used to follow up patients after endovascular treatment for intracranial aneurysms. Magnetic resonance artefacts from coil constructs may impair image quality and jeopardise the evaluation of the effectiveness of treatment and review of adjacent vasculature. We present here a technical note on the usage of Barricade coils recently introduced at our institution. The MRA artefacts associated with these coils may make it impossible to ascertain aneurysm closure and anatomy. Hence these patients would need to be recalled for digital subtraction angiograms for a complete neuroradiological follow-up.

125 Staged Endovascular Treatment of Ruptured Intracranial Aneurysms: Acute Coiling Followed By Delayed Flow Diversion

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 228-228
Author(s):  
Erick Michael Westbroek ◽  
Matthew Bender ◽  
Narlin B Beaty ◽  
Bowen Jiang ◽  
Risheng Xu AB ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Complication Rate ◽  
Coil Embolization ◽  
Intracranial Aneurysms ◽  
Major Complication ◽  
Flow Diversion ◽  
Neurological Deficits ◽  
Major Complication Rate ◽  
Ruptured Intracranial Aneurysms

Abstract INTRODUCTION ISAT demonstrated that coiling is effective for aneurysm treatment in subarachnoid hemorrhage (SAH); however, complete occlusion of wide-necked aneurysms frequently requires adjuvants relatively contraindicated in SAH. As such, a limited “dome occlusive” strategy is often pursued in the setting of SAH. We report a single institution series of coiling of acutely ruptured aneurysms followed by delayed flow diversion for definitive, curative occlusion. METHODS A prospectively collected IRB-approved database was screened for patients with aneurysmal SAH who were initially treated by coil embolization followed by planned flow diversion at a single academic medical institution. Peri-procedural outcomes, complications, and angiographic follow-up were analyzed. RESULTS >50 patients underwent both acute coiling followed by delayed, planned flow diversion. Average aneurysm size on initial presentation was 9.5 mm. Common aneurysm locations included Pcomm (36%), Acomm (30%), MCA (10%), ACA (10%), and vertebral (5%). Dome occlusion was achieved in all cases following initial coiling. Second-stage implantation of a flow diverting stent was achieved in 49/50 cases (98%). Follow-up angiography was available for 33/50 patients (66%), with mean follow-up of 11 months. 27 patients (82%) had complete angiographic occlusion at last follow up. All patients with residual filling at follow-up still had dome occlusion. There were no mortalities (0%). Major complication rate for stage I coiling was 2% (1 patient with intra-procedural aneurysm re-rupture causing increase in a previous ICH). Major complication rate for stage 2 flow diversion was 2% (1 patient with ischemic stroke following noncompliance with dual antiplatelet regimen). Minor complications occurred in 2 additional patients (4%) with transient neurological deficits. CONCLUSION Staged endovascular treatment of ruptured intracranial aneurysms with acute dome-occlusive coil embolization followed by delayed flow diversion is a safe and effective treatment strategy.

A novel endovascular clip system for the treatment of intracranial aneurysms: technology, concept, and initial experimental results

2008 ◽  
Vol 108 (6) ◽  
pp. 1230-1240 ◽  
Author(s):  
Thomas R. Marotta ◽  
Thorsteinn Gunnarsson ◽  
Ian Penn ◽  
Donald R. Ricci ◽  
Ian Mcdougall ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Delivery System ◽  
Intracranial Aneurysms ◽  
Balloon Catheter ◽  
Cerebral Aneurysms ◽  
Histopathological Analysis ◽  
Parent Vessel ◽  
Flow Models ◽  
Aneurysm Neck ◽  
Novel Device

Object The authors describe a novel device for the endovascular treatment of intracranial aneurysms, the endovascular clip system (eCLIPs). Descriptions of the device and its delivery system as well as the results of flow model tests and the treatment of experimental aneurysms are provided. Methods The eCLIPs comprises a flexible hybrid implantable device (an anchor and a covered leaf) and a balloon catheter delivery system, designed to be positioned and activated in the parent vessel in such a way that the covered portion will abut the aneurysm neck. The eCLIPs was subjected to testing in glass, elastomeric, and cadaveric flow models to determine its navigability, orientation, and activation compared with commercially available stents. In a second experiment, 8 carotid artery sidewall aneurysms in swine were treated using eCLIPs. The degree of occlusion was observed on angiography immediately following and 30 days after device activation, and a histological analysis was performed at 30 days. Results The device could navigate tortuous glass models and human cadaveric vessels. Compared with commercially available stents, the eCLIPs performed well. It could be navigated, oriented, and activated easily and reliably. With regard to the 8 porcine experimental aneurysms, immediate postactivation angiograms confirmed complete occlusion of 4 lesions and near occlusion of the other 4. Angiographic follow-up at 30 days postactivation showed occlusion of all 8 aneurysms and patency of all parent vessels. Histopathological analysis revealed aneurysm healing, with smooth-muscle cells growing across the lesion neck to allow reendothelialization. Conclusions Aneurysm occlusion with a single extrasaccular endovascular device has potential advantages. The authors believe that eCLIPs may prove to be a useful tool in the endovascular treatment of cerebral aneurysms. The system should reduce risks associated with coiling, procedure time, costs, and radiation exposure. The device satisfactorily occluded 8 experimental sidewall aneurysms. The observed healing pattern is similar to that seen after microsurgical clipping.

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