scholarly journals Applications of the Columbus steerable guidewire

2021 ◽  
pp. neurintsurg-2021-018120
Author(s):  
Alexander von Hessling ◽  
Tomás Reyes del Castillo ◽  
Lutz Lehmann ◽  
Justus Erasmus Roos ◽  
Grzegorz Karwacki
Keyword(s):  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Curvature Radius ◽  
Content Type ◽  
Complex Aneurysm ◽  
Media Player ◽  
First Case ◽  
Great Support ◽  
Basilar Tip Aneurysm ◽  
Video Player

The Columbus steerable guidewire (Rapid Medical, Israel) is a 0.014 inch guidewire with a remotely controlled deflectable tip intended for neuronavigational purposes. 1 The tip can be shaped by pulling or pushing the handle. Pulling the handle decreases the radius (from 4 mm to 2 mm) and curves the tip, while pushing the handle increases the curvature radius and straightens the tip until it bends in the opposite direction. The amount of deflection is at the discretion of the operator. Video 1 The response of the Columbus guidewire to rotational movements is inferior to that of standard wires, and the tip is very soft and malleable but brings great support when bent. We present two cases where the Columbus guidewire was used. In the first case, the Columbus enabled us to probe a posterior cerebral artery arising from a giant basilar tip aneurysm without wall contact. In the second case, the Columbus was used as a secondary wire to help cannulate the pericallosal artery in a patient with a recurrent anterior complex aneurysm; this subsequently permitted successful stent-assisted coiling of the aneurysm.Video 1

De novo giant posterior cerebral artery aneurysm developing 25 years after basilar bifurcation aneurysm treatment using a Drake tourniquet: case report and implications for aneurysm follow-up

2018 ◽  
Vol 128 (4) ◽  
pp. 1028-1031
Author(s):  
Rafael Martinez-Perez ◽  
David M. Pelz ◽  
Stephen P. Lownie
Keyword(s):  
Cerebral Artery ◽  
De Novo ◽  
Posterior Cerebral Artery ◽  
Rare Complication ◽  
Young Patients ◽  
Artery Aneurysm ◽  
First Case ◽  
Bifurcation Aneurysm ◽  
De Novo Aneurysm

The objective of this paper was to report a rare complication of basilar artery (BA) tourniquet treatment of a giant basilar tip aneurysm, and to discuss possible causes for the formation of a de novo giant posterior cerebral artery (PCA) aneurysm. A 34-year-old woman underwent satisfactory treatment of a ruptured giant basilar bifurcation aneurysm by BA ligation (Drake tourniquet) in 1985. She presented 25 years later with a new aneurysm in the left PCA, successfully treated by coil embolization. To the authors’ knowledge, this is the first case of de novo aneurysm formation on a PCA, and the first de novo aneurysm reported as a complication of BA ligation therapy by Drake tourniquet. Long-term follow-up is necessary in patients with treated cerebral aneurysms, particularly those occurring in young patients, those with multiple aneurysms, those with complex posterior circulation aneurysms, and those undergoing flow diversion or flow-altering therapies.

Republished: Treatment of wide-necked basilar tip aneurysm not amenable to Y-stenting using the PulseRider device

2015 ◽  
Vol 8 (9) ◽  
pp. e37-e37 ◽  
Author(s):  
Sunil A Sheth ◽  
Nirav S Patel ◽  
Ameera F Ismail ◽  
Dena Freeman ◽  
Gary Duckwiler ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Parent Vessel ◽  
Basilar Tip Aneurysm

Endovascular treatment of broad-necked bifurcation aneurysms remains challenging. Stent-assisted coiling has been successful but requires catheterization of the branches off the parent vessel. We present the case of a patient who failed primary and stent-assisted coiling of a large basilar tip aneurysm because the morphology of the aneurysm precluded successful distal catheterization of the posterior cerebral artery (PCA) branches. Using the PulseRider device, which does not require catheterization of bifurcation branches, we were able to treat the aneurysm successfully.

scholarly journals Optional Endovascular Therapy of Dissecting Posterior Cerebral Artery Aneurysm

2017 ◽  
Vol 6 (3-4) ◽  
pp. 219-228 ◽  
Author(s):  
Mohamed Wael Osman ◽  
Krzysztof Kadziolka ◽  
Laurent Peirot
Keyword(s):  
Ischemic Stroke ◽  
Cerebral Artery ◽  
Endovascular Therapy ◽  
Posterior Cerebral Artery ◽  
Artery Aneurysm ◽  
Occurrence Rate ◽  
Parent Artery ◽  
Safe Method ◽  
First Case ◽  
History Of

Background: Posterior cerebral artery aneurysms are uncommon, with an occurrence rate of less than 1% of intracranial aneurysms. They have various shapes, including saccular and fusiform. Dissecting aneurysms may occur in distal posterior cerebral artery and they may affect the whole artery. Endovascular therapy is considered as a safe method of treatment and there are different techniques for endovascular therapy. Summary: Posterior cerebral artery aneurysms are uncommon. Endovascular therapy is considered as a safe method of treatment and there are different techniques for endovascular therapy. We present here three cases collected from Maison Blanche Hospital (Intervention Neuroradiology Department, CHU Reims, France) during 2011-2012; they were females, at a young age and the affected side was on the right. The first case was affected at the P2-P3 segment, the aneurysm was fusiform in shape and she presented with ischemic stroke, while the second and third cases were affected at the P2 segment, the aneurysms being saccular in shape; one of them presented with subarachnoid hemorrhage with a history of migraine and the other patient presented with ischemic stroke. All of them had no history of trauma, hypertension or other diseases. One patient was treated by coiling and sacrificing the parent artery, the second patient was treated with stent-assisted coils, and the third one was treated by coiling without sacrificing the parent artery.

scholarly journals MeVO SAVE technique: initial experience with the 167 cm long NeuroSlider 17 for a combined approach in medium vessel occlusions (MeVOs)

2020 ◽  
pp. neurintsurg-2020-016763
Author(s):  
Carlos Pérez-García ◽  
Santiago Rosati ◽  
Carlos Gómez-Escalonilla ◽  
Alfonso López-Frías ◽  
Juan Arrazola ◽  
...  
Keyword(s):  
Mechanical Thrombectomy ◽  
Functional Independence ◽  
Stent Retriever ◽  
Initial Experience ◽  
Combined Approach ◽  
Content Type ◽  
Media Player ◽  
Low Profile ◽  
Inner Diameter ◽  
Video Player

Goyal et al described occlusions in M2/3, A2/3 and P2/3 as medium vessel occlusions (MeVOs); the only available controlled data of mechanical thrombectomy (MT) in MeVOs is limited to the middle cerebral artery M2 segment, suggesting that MT may be effective and safe with high functional independence and recanalization rates. The Stent retriever Assisted Vacuum-locked Extraction (SAVE) technique in mechanical thrombectomy consists of the simultaneous use of a stent retriever and a distal aspiration catheter (DAC), with the removal of both as a unit when performing the thrombectomy pass; however, so far the low-profile (0.035 inch distal inner diameter) DACs were longer (160 cm) than conventional 0.017 inch microcatheters for MeVOs. We present a case of a combined approach MT in MeVO with the use of the new 167 cm long NeuroSlider 17 (Acandis, Pforzheim, Germany) 0.0165 inch microcatheter and 3MAX (Penumbra, Alameda, CA) through the SAVE technique—the MeVO SAVE technique. (video 1).video 1.

Fusiform posterior cerebral artery aneurysm treated with excision and end-to-end anastomosis

1986 ◽  
Vol 64 (3) ◽  
pp. 501-504 ◽  
Author(s):  
Han Soo Chang ◽  
Takanori Fukushima ◽  
Shinichiro Miyazaki ◽  
Teruaki Tamagawa
Keyword(s):  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Cerebral Aneurysms ◽  
Artery Aneurysm ◽  
Fusiform Aneurysm ◽  
Pertinent Literature ◽  
Content Type ◽  
End To End ◽  
Cerebral Artery Aneurysm ◽  
Fine Print

✓ A case of a ruptured fusiform aneurysm of the posterior cerebral artery is reported. The aneurysm was excised and end-to-end anastomosis was carried out between the two ends of the posterior cerebral artery. There is no previous report of a posterior cerebral artery aneurysm treated with this technique. The pertinent literature is reviewed and the significance of this technique in the treatment of unclippable cerebral aneurysms is discussed.

Treatment and outcome in 30 patients with posterior cerebral artery aneurysms

2003 ◽  
Vol 99 (1) ◽  
pp. 15-22 ◽  
Author(s):  
Christopher L. Taylor ◽  
Thomas A. Kopitnik ◽  
Duke S. Samson ◽  
Phillip D. Purdy
Keyword(s):  
Visual Field ◽  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Underlying Disease ◽  
Neurological Deficits ◽  
Content Type ◽  
Ruptured Aneurysms ◽  
The Mean ◽  
Poor Outcomes ◽  
Fine Print

Object. The records of 30 patients with posterior cerebral artery (PCA) aneurysms treated during a 12-year period were reviewed to determine outcome and the risk of visual field deficit associated with PCA sacrifice. Methods. Clinical data and treatment summaries for all patients were maintained in an electronic database. The Glasgow Outcome Scale (GOS) and modified Rankin Scale (mRS) scores were determined by an independent registrar. Visual field changes were determined by review of medical records. Twenty-eight patients were treated with open surgery, one of them after an attempt at detachable coil embolization failed. Two patients underwent successful endovascular PCA sacrifice. The mean GOS and mRS scores in 18 patients with unruptured aneurysms were 4 and 2, respectively, at discharge. Subarachnoid hemorrhage (SAH) from other aneurysms and neurological deficits caused by the PCA lesion or underlying disease contributed to poor outcomes in this group. The mean GOS and mRS scores in 12 patients with ruptured aneurysms were 4 and 4, respectively, at discharge. One patient died of severe vasospasm. Neurological deficits secondary to SAH and, in one patient, treatment of a concomitant arteriovenous malformation contributed to poor outcomes in the patients with ruptured aneurysms. Seven patients with normal visual function preoperatively underwent PCA occlusion. One patient (14%) developed a new visual field deficit. Conclusions. Optimal treatment of PCA aneurysms is performed via one of several surgical approaches or by endovascular therapy. The approach is determined, in part, by the anatomical location and size of the aneurysm and the presence of underlying disease and neurological deficits.

Bilateral Thalamic Infarcts Complicating Basilar Tip Aneurysm Coil Embolisation

1997 ◽  
Vol 3 (4) ◽  
pp. 325-328
Author(s):  
H.J. Cloft ◽  
D.F. Kallmes ◽  
G. Lanzino ◽  
M.E. Jensen ◽  
J.E. Dion
Keyword(s):  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Artery Stenosis ◽  
Partial Occlusion ◽  
Guglielmi Detachable Coils ◽  
Coil Embolisation ◽  
Detachable Coils ◽  
Basilar Tip Aneurysm ◽  
Thalamic Infarcts

We report a case of bilateral thalamic infarcts with no apparent cause other than unilateral partial occlusion of the P1 segment of the posterior cerebral artery caused by Guglielmi detachable coils in a basilar tip aneurysm. This case demonstrates that bilateral thalamic infarctions can result from a unilateral posterior cerebral artery stenosis or occlusion, and does not necessarily imply bilateral posterior cerebral artery abnormality.

Cerebral revascularization using omental transplantation for childhood moyamoya disease

1993 ◽  
Vol 79 (2) ◽  
pp. 192-196 ◽  
Author(s):  
Jun Karasawa ◽  
Hajime Touho ◽  
Hideyuki Ohnishi ◽  
Susumu Miyamoto ◽  
Haruhiko Kikuchi
Keyword(s):  
Moyamoya Disease ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Cerebral Arteries ◽  
Neurological Deficits ◽  
Content Type ◽  
Collateral Vessels ◽  
Neurological State ◽  
Fine Print

✓ Between January, 1986, and October, 1990, 30 children with moyamoya disease, aged from 2 to 17 years, underwent omental transplantation to either the anterior or the posterior cerebral artery territory. The mean follow-up period was 3.8 years, ranging from 1.6 to 6.4 years. Seventeen patients had symptoms of monoparesis, paraparesis, and/or urinary incontinence and were treated using unilateral or bilateral omental transplantation to the anterior cerebral artery territory. Eleven patients had visual symptoms and were treated with unilateral or bilateral omental transplantation to the posterior cerebral artery territory. Two patients had symptoms associated with both the anterior and the posterior cerebral arteries, and were treated with dual omental transplantations. All 19 patients treated with omental transplantation to the anterior cerebral artery and 11 (84.6%) of the 13 treated with omental transplantation to the posterior cerebral artery showed improvement in their neurological state. Patients with more collateral vessels via the omentum had more rapid and complete improvement in their neurological state. Patients with severe preoperative neurological deficits associated with the posterior cerebral artery had persistence of their symptoms.

Embolic posterior cerebral artery occlusion secondary to spondylitic vertebral artery compression

1975 ◽  
Vol 43 (5) ◽  
pp. 618-622 ◽  
Author(s):  
Humbert G. Sullivan ◽  
John W. Harbison ◽  
Frederick S. Vines ◽  
Donald Becker
Keyword(s):  
Vertebral Artery ◽  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Artery Occlusion ◽  
Clinical Syndrome ◽  
Content Type ◽  
X Ray ◽  
Vertebral Artery Compression ◽  
Cerebral Artery Occlusion ◽  
Fine Print

✓ The authors report a case of isolated homonymous hemianopsia secondary to embolic occlusion of the posterior cerebral artery. The cause of embolism was demonstrated to be spondylitic vertebral artery compression. The importance of arteriography is emphasized since the clinical syndrome may be nonspecific and myelographic or plain x-ray changes may be minimal. Surgical therapy is also discussed.

Spontaneous thrombosis of posterior cerebral artery aneurysm with angiographic reappearance

1993 ◽  
Vol 79 (3) ◽  
pp. 434-437 ◽  
Author(s):  
John L. D. Atkinson ◽  
John I. Lane ◽  
Harold J. Colbassani ◽  
D. Mark E. Llewellyn
Keyword(s):  
Mr Imaging ◽  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Brain Infarction ◽  
Artery Aneurysm ◽  
Parent Vessel ◽  
Spontaneous Thrombosis ◽  
Vessel Occlusion ◽  
Content Type ◽  
Parent Vessel Occlusion

✓ The case is presented of a 23-year-old man suffering ischemic brain infarction from spontaneous thrombosis of a left posterior cerebral artery P1–P2 junction aneurysm. Vasospasm and/or partial parent vessel occlusion were documented by magnetic resonance (MR) imaging and angiography. Repeat cerebral angiography and MR imaging 3 months later revealed patency of the posterior cerebral artery and luminal filling of a 1-cm fusiform aneurysm, which was successfully trapped at surgery.

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