Hemodynamics Analysis of Several Stent Treatments of a Patient Specific Anterior Communicating Artery Aneurysm

2012 ◽  
Author(s):  
S. Cito ◽  
J. Pallarés ◽  
A. Vernet ◽  
A. J. Geers ◽  
I. Cuesta
Keyword(s):  
Cerebral Aneurysms ◽  
Artery Aneurysm ◽  
The Other ◽  
Patient Specific ◽  
Anterior Communicating Artery ◽  
Flow Conditions ◽  
Real Patient ◽  
Open Cell ◽  
Anterior Communicating Artery Aneurysm ◽  
Closed Cell

CFD predictions of the flow in cerebral aneurysms can help to analyze the mechanisms of growth and rupture and the degree of stress for a given flow conditions and to compare and to propose different stenting treatments. In this work we simulated the flow in a model of cerebral aneurysms of a real patient in six different conditions. One case corresponds to the flow conditions in the aneurysm without treatment and the other five cases correspond to different options or strategies of treatment with open cell stents (OCS) and closed cell stents (CCS) to hold the coil. The aneurysm is located in the anterior communicating artery (AComA). The effect of the treatment on the hemodynamics is quantified and reported.

scholarly journals A patient with neurofibromatosis type 1 presenting with bilateral frontal lobe infarctions following anterior communicating artery aneurysm rupture

2019 ◽  
Vol 7 ◽  
pp. 2050313X1984115
Author(s):  
HMMTB Herath ◽  
Nilukshana Yogendranathan ◽  
Aruna Kulatunga
Keyword(s):  
Cerebral Aneurysms ◽  
Artery Aneurysm ◽  
Neurofibromatosis Type ◽  
Frontal Lobes ◽  
Aneurysm Rupture ◽  
Anterior Communicating Artery ◽  
Sri Lankan ◽  
Vascular Abnormalities ◽  
Anterior Communicating Artery Aneurysm ◽  
First Case

Neurofibromatosis is a neurocutaneous genetic condition with dysplasia of the mesodermal and ectodermal tissues. Vascular abnormalities are well recognized in neurofibromatosis and cerebral aneurysms are rarely reported in literature. Here, we present a 20-year-old Sri Lankan female presented with headache, altered personality, disinhibited behaviour, and urinary incontinence. On imaging, she was found to have infarctions of both frontal lobes and evidence of a ruptured anterior communicating artery aneurysm with a small subarachnoid haemorrhage. Another small middle cerebral artery aneurysm was also seen in the angiogram. She was managed conservatively and gradually recovered. Because aneurysms in neurofibromatosis are usually asymptomatic and as rupture of such an aneurysm is rare, regular vascular screening is not recommended to all patients with neurofibromatosis. This is the first case report in literature in which a patient with neurofibromatosis presented with infarctions of both frontal lobes due to rupture of an anterior communicating artery aneurysm.

Comparison of figural intrusion errors in three amnesic subgroups

1995 ◽  
Vol 1 (6) ◽  
pp. 561-567 ◽  
Author(s):  
Jeffrey S. Kixmiller ◽  
Mieke Verfaellie ◽  
Kenneth A. Chase ◽  
Laird S. Cermak
Keyword(s):  
Artery Aneurysm ◽  
Executive Dysfunction ◽  
Memory Deficits ◽  
The Other ◽  
Anterior Communicating Artery ◽  
Wechsler Memory Scale ◽  
Anterior Communicating Artery Aneurysm ◽  
Immediate Recall ◽  
Intrusion Errors ◽  
Prior Item

AbstractTo examine the contribution of memory deficits and executive dysfunction to the production of prior-item intrusion errors, Korsakoff, mesial temporal amnesic, and anterior communicating artery aneurysm (ACoA) patients’ performance on the Visual Reproduction subtest of the Wechsler Memory Scale-Revised (WMS-R) was assessed. The Korsakoff patients were matched to the mesial temporal group in terms of severity of amnesia, while the ACoA group, which was less severely amnesic, was matched to the Korsakoff group in their performance on executive tests. Results indicated that at immediate recall, Korsakoff patients made significantly more intrusions than mesial temporal and ACoA patients. Conversely, after a delay, ACoA patients tended to make more intrusions than the other groups. Findings suggest that intrusions are due to a combination of deficient memory and executive dysfunction. A further comparison of a subgroup of ACoA patients matched to the Korsakoff patients in terms of severity of amnesia, however, revealed differences in the pattern of intrusions of these two groups, suggesting that different mechanisms may underlie Korsakoff and ACoA patients’ susceptibility to interference. (JINS, 1995, 1, 561–567.)

Thrombolysis and Mechanical Fragmentation to Treat Massive Pulmonary Embolism in a Patient with an Anterior Communicating Artery Aneurysm

2003 ◽  
Vol 10 (2) ◽  
pp. 332-335 ◽  
Author(s):  
Ramazan Kutlu ◽  
Alpay Alkan ◽  
Ayhan Kocak ◽  
Kaya Sarac
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Arteries ◽  
Cerebral Aneurysms ◽  
Artery Aneurysm ◽  
Recombinant Tissue Plasminogen Activator ◽  
Massive Pulmonary Embolism ◽  
Anterior Communicating Artery ◽  
Anterior Communicating Artery Aneurysm ◽  
The Right ◽  
Mechanical Fragmentation

Purpose: To describe successful management of massive pulmonary embolism suffered by a patient with an unsecured intracranial aneurysm. Case Report: An anterior communicating artery aneurysm was found 10 days after a 50-year-old woman was admitted to the intensive care unit with subarachnoid hemorrhage. The patient developed severe acute dyspnea before planned surgery; imaging demonstrated thrombus in the right and left pulmonary arteries. Heparin was contraindicated, so an emergent coil embolization procedure was undertaken. In the same session, recombinant tissue plasminogen activator was administered directly into the thrombus. After 2 hours of thrombolysis and intermittent mechanical fragmentation, lung perfusion improved, and the patient's symptoms abated. Conclusions: Mechanical fragmentation together with fibrinolytic agent administration is a safe and effective treatment for pulmonary embolism after securing cerebral aneurysms.

scholarly journals Impacts of Internal Carotid Artery Revascularization on Flow in Anterior Communicating Artery Aneurysm: A Preliminary Multiscale Numerical Investigation

2019 ◽  
Vol 9 (19) ◽  
pp. 4143 ◽  
Author(s):  
Guang-Yu Zhu ◽  
Yuan Wei ◽  
Ya-Li Su ◽  
Qi Yuan ◽  
Cheng-Fu Yang
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Patient Specific ◽  
Anterior Communicating Artery ◽  
Cfd Simulations ◽  
Anterior Communicating Artery Aneurysm ◽  
Relative Residence Time ◽  
Revascularization Procedures

The optimal management strategy of patients with concomitant anterior communicating artery aneurysm (ACoAA) and internal carotid artery (ICA) stenosis is unclear. This study aims to evaluate the impacts of unilateral ICA revascularization on hemodynamics factors associated with rupture in an ACoAA. In the present study, a multiscale computational model of ACoAA was developed by coupling zero-dimensional (0D) models of the cerebral vascular system with a three-dimensional (3D) patient-specific ACoAA model. Distributions of flow patterns, wall shear stress (WSS), relative residence time (RRT) and oscillating shear index (OSI) in the ACoAA under left ICA revascularization procedure were quantitatively assessed by using transient computational fluid dynamics (CFD) simulations. Our results showed that the revascularization procedures significantly changed the hemodynamic environments in the ACoAA. The flow disturbance in the ACoAA was enhanced by the resumed flow from the affected side. In addition, higher OSI (0.057 vs. 0.02), prolonged RRT (1.14 vs. 0.39) and larger low WSS area (66 vs. 50 mm2) in ACoAA were found in the non-stenotic case. These acute changes in hemodynamics after revascularization may elevate the rupture risk of ACoAA. The preliminary results validated the feasibility of predicting aneurismal hemodynamics characteristics in revascularization procedures by using multiscale CFD simulations, which would benefit the management of this group of patients.

Multiple ruptured cerebral aneurysms in a child with Takayasu arteritis

2008 ◽  
Vol 1 (1) ◽  
pp. 83-87 ◽  
Author(s):  
Suresh N. Magge ◽  
H. Isaac Chen ◽  
Michael F. Stiefel ◽  
Linda Ernst ◽  
Ann Marie Cahill ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Aneurysm ◽  
Takayasu Arteritis ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Cerebral Aneurysms ◽  
Artery Aneurysm ◽  
Anterior Communicating Artery ◽  
Rare Presentation ◽  
Anterior Communicating Artery Aneurysm ◽  
Clip Application

✓The authors report the case of an 18-month-old girl who presented with a ruptured anterior communicating artery aneurysm, and who was later diagnosed with Takayasu arteritis. Her initial aneurysm was successfully treated with clip application. However, over a 6-month period she had multiple ruptures from new and rapidly recurring aneurysms adjacent to the clips. These aneurysms were treated with repeated craniotomy and clip application and then with endovascular coil placement. Aneurysmal subarachnoid hemorrhage is a rare presentation of Takayasu arteritis. To the authors' knowledge, this is the youngest reported patient with Takayasu arteritis to present with a ruptured cerebral aneurysm.

scholarly journals Re-treatment of an unruptured anterior communicating artery aneurysm using the new pCONus 2 device: Description of a case

2018 ◽  
Vol 24 (4) ◽  
pp. 379-382
Author(s):  
Marco Varrassi ◽  
Sergio Carducci ◽  
Aldo V Giordano ◽  
Carlo Masciocchi
Keyword(s):  
Cerebral Aneurysms ◽  
Artery Aneurysm ◽  
Longitudinal Axis ◽  
Anterior Communicating Artery ◽  
Parent Vessel ◽  
Anterior Communicating Artery Aneurysm ◽  
First Case ◽  
Endovascular Approach ◽  
Unruptured Cerebral Aneurysms ◽  
Aneurysmal Neck

Endovascular approach represents today the first option in treatment of ruptured and unruptured cerebral aneurysms. Nevertheless, wide-neck bifurcation aneurysms still represent a technical challenge for endovascular treatment due to the need to protect vessels arising next to the aneurysmal neck. A variety of devices have been implemented to ensure adequate assistance for coiling of these lesions. Among these devices, the new pCONus 2 represents an evolution of the well-known pCONus; compared to the previous one in fact, it allows a degree of articulation and flexibility between the shaft and the distal part (crown), making it more suitable for treatment of aneurysms presenting an angle between the longitudinal axis of the dome and parent vessel. We report our first case using pCONus 2 in the re-treatment of an unruptured anterior communicating artery aneurysm in a 57-year-old man, showing evident recanalization two years after coiling.

scholarly journals Minimally Invasive Mini-orbitozygomatic Approach for Clipping an Anterior Communicating Artery Aneurysm: Virtual Reality Surgical Planning

2020 ◽  
Author(s):  
Nicolás González Romo ◽  
Franco Ravera Zunino
Keyword(s):  
Virtual Reality ◽  
Minimally Invasive ◽  
Surgical Planning ◽  
Artery Aneurysm ◽  
Patient Specific ◽  
Anterior Communicating Artery ◽  
Imaging Data ◽  
Advantages And Disadvantages ◽  
Orbitozygomatic Approach ◽  
Skull Base Anatomy

AbstractVirtual reality (VR) has increasingly been implemented in neurosurgical practice. A patient with an unruptured anterior communicating artery (AcoA) aneurysm was referred to our institution. Imaging data from computed tomography angiography (CTA) was used to create a patient specific 3D model of vascular and skull base anatomy, and then processed to a VR compatible environment. Minimally invasive approaches (mini-pterional, supraorbital and mini-orbitozygomatic) were simulated and assessed for adequate vascular exposure in VR. Using an eyebrow approach, a mini-orbitozygomatic approach was performed, with clip exclusion of the aneurysm from the circulation. The step-by-step process of VR planning is outlined, and the advantages and disadvantages for the neurosurgeon of this technology are reviewed.

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