Horizontal deployment of an intracranial stent via an antegrade approach for coil embolization of a basilar apex aneurysm: technical note

2011 ◽  
Vol 3 (4) ◽  
pp. 355-357 ◽  
Author(s):  
P. Yashar ◽  
P. T. Kan ◽  
E. I. Levy
Neurosurgery ◽  
2000 ◽  
pp. 248-253 ◽  
Author(s):  
Richard D. Fessler ◽  
Andrew J. Ringer ◽  
Adnan I. Qureshi ◽  
Lee R. Guterman ◽  
L. Nelson Hopkins

2017 ◽  
Vol 6 (3-4) ◽  
pp. 263-267 ◽  
Author(s):  
James D. Rossen ◽  
Edgar A. Samaniego ◽  
Mishelle Paullus ◽  
Santiago Ortega-Gutierrez

Acute basilar artery (BA) occlusion has a very poor prognosis. Recanalization can be challenged by bilateral vertebral artery (VA) occlusions, arterial dissection, or advanced atherosclerotic disease. We describe a case in whom the BA was accessed and recanalized through a retrograde-antegrade approach from the anterior circulation using a large posterior communicating artery (PCOM). Once the BA had been crossed retrogradely through the PCOM, another microcatheter was advanced antegradely through the VA into the BA and right posterior cerebral artery using the “buddy-wire” technique. In this way the BA was recanalized and reconstructed with stents. This technical note demonstrates a new approach to BA treatment when the antegrade access is hampered by advanced VA/BA disease or dissection.


Neurosurgery ◽  
2000 ◽  
Vol 46 (1) ◽  
pp. 248-253 ◽  
Author(s):  
Richard D. Fessler ◽  
Andrew J. Ringer ◽  
Adnan I. Qureshi ◽  
Lee R. Guterman ◽  
L. Nelson Hopkins

2003 ◽  
Vol 99 (1) ◽  
pp. 23-30 ◽  
Author(s):  
Patrick P. Han ◽  
Felipe C. Albuquerque ◽  
Francisco A. Ponce ◽  
Christopher I. Mackay ◽  
Joseph M. Zabramski ◽  
...  

Object. Intracranial stent placement combined with coil embolization is an emerging procedure for the treatment of intracranial aneurysms. The authors report their results using intracranial stents for the treatment of intracranial aneurysms. Methods. A prospectively maintained database was reviewed to identify all patients with intracranial aneurysms that were treated with intracranial stents. Ten lesions, including eight broad-based aneurysms and two dissecting aneurysms, were treated in 10 patients. Four lesions were located in the cavernous segment of the internal carotid artery, two at the vertebrobasilar junction, two at the basilar trunk, one at the basilar apex, and one in the intracranial vertebral artery. Attempts were made to place stents in 13 patients, but in three the stents could not be delivered. Altogether, intracranial stents were placed in 10 patients for 10 lesions. Results that were determined to be satisfactory angiographically were achieved in all 10 lesions. Two patients suffered permanent neurological deterioration related to stent placement. In two patients, the aneurysm recurred after stent-assisted coil embolization. In one case of recurrence a second attempt at coil embolization was successful, whereas in the second case of recurrence parent vessel occlusion was required and well tolerated. Conclusions. Intracranial stents can be a useful addition to coil embolization by providing mechanical, hemodynamic, and visual benefits in the treatment of complex, broad-based aneurysms.


2015 ◽  
Vol 21 (6) ◽  
pp. 738-741 ◽  
Author(s):  
Dale Ding ◽  
Robert M Starke ◽  
David Manka ◽  
R Webster Crowley ◽  
Kenneth C Liu

Spinal arteriovenous fistulas (AVFs) completely isolated to the epidural compartment are exceedingly rare. As such, the optimal management of these lesions is poorly defined. The aim of this technical note is to describe our endovascular technique for the occlusion of a purely epidural AVF of the thoracic spine associated with cord compression from an associated enlarging venous varix. A 40-year-old male presented with severe right-sided back pain and anterior thigh numbness after a sports-related back injury six months previously. Spinal magnetic resonance imaging (MRI) showed an enhancing, extradural mass lesion at T12. Spinal angiography revealed an epidural AVF supplied by a radicular branch of the right T12 subcostal artery and draining into the paravertebral lumbar veins, as well as an adjacent 20 × 13 mm2 contrast-filling sac, compatible with a dilated venous varix. There was no evidence of intradural venous drainage. We elected to proceed with endovascular treatment of the lesion. At the time of embolization five days later, the venous varix had enlarged to 26 × 16 mm2. The T12 epidural AVF was completely occluded with two coils, without residual or recurrent AVF on follow-up angiography one month later. The patient made a full recovery, and complete resolution of the venous varix and cord compression were noted on MRI at three months follow-up. Endovascular coil embolization can be successfully employed for the treatment of appropriately selected spinal epidural AVFs. Cord compression from an enlarging venous varix can be treated concurrently with endovascular occlusion of an associated spinal epidural AVF.


2010 ◽  
Vol 3 (2) ◽  
pp. 172-176 ◽  
Author(s):  
E. F. Hauck ◽  
R. G. Tawk ◽  
N. S. Karter ◽  
M. J. Binning ◽  
A. A. Khalessi ◽  
...  

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