scholarly journals Clearance of Subarachnoid Clots after GDC Embolization for Acutely Ruptured Cerebral Aneurysm

2001 ◽  
Vol 7 (1_suppl) ◽  
pp. 57-60 ◽  
Author(s):  
S. Kobayashi ◽  
A. Satoh ◽  
Y. Koguchi ◽  
M. Wada ◽  
H. Tokunaga ◽  
...  
Keyword(s):  
Cerebral Aneurysm ◽  
Intrathecal Administration ◽  
Acute Stage ◽  
Guglielmi Detachable Coils ◽  
Mortality And Morbidity ◽  
Symptomatic Vasospasm ◽  
Group 12 ◽  
Cisternal Irrigation ◽  
Detachable Coils ◽  
Causes Of Mortality

It is apparent that subarachnoid clots play an important role in the development of delayed vasospasm that is one of the major causes of mortality and morbidity in patients with acutely ruptured cerebral aneurysm. The purpose of this study is to compare the clearance of subarachnoid clots in the acute stage after the treatment with Guglielmi detachable coils (GDC) and after treatment with direct surgery. Forty-nine patients were treated by GDC embolization within four days of the ictus. After GDC embolization, adjunctive therapies, such as ventricular and/or spinal drainage (67%), intrathecal administration of urokinase (41%), continuous cisternal irrigation (16%), and external decompression (16%), were performed. Seventy-four surgically treated patients were subsequently treated by continuous cisternal irrigation with mock-CSF containing ascorbic acid for ten days. The clearance of subarachnoid clots was assessed by the Hounsfield number serial changes on the CT scans taken on days 0, 4, 7, 10 after subarachnoid hemorrhage. The incidence of symptomatic vasospasm was lower in the GDC group (6%) than in the surgery group (12%). The clearance of subarachnoid clots from both the basal cistern and the Sylvian fissure was more rapid in the GDC cases than in the surgery cases in the first four days. Intrathecal administration of urokinase accelerated the clearance significantly. GDC embolization followed by intrathecal administration of thrombolytic agents accelerates the reduction of subarachnoid clots and favorably acts to prevent delayed vasospasm.

scholarly journals Endovascular Treatment with GDC for Severe Acute SAH: Comparison with Early Direct Surgery

2000 ◽  
Vol 6 (1_suppl) ◽  
pp. 79-84 ◽  
Author(s):  
S. Kobayashi ◽  
A. Satoh ◽  
Y. Koguchi ◽  
T. Yamauchi ◽  
S. Itoh ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Neurological Status ◽  
Intrathecal Administration ◽  
Acute Stage ◽  
Symptomatic Vasospasm ◽  
Acute Rupture ◽  
Cisternal Irrigation ◽  
Detachable Coils ◽  
The Difference ◽  
The Brain

The purpose of this study was to evaluate the effect of endovascular treatment with Guglielmi detachable coils (GDC) on the outcome of severe subarachnoid hemorrhage (SAH) caused by acute rupture of a cerebral aneurysm and on the incidence of symptomatic vasospasm. Thirty-five patients with aneurysmal SAH were treated in the acute stage using GDC. Fifteen out of 17 patients in Hunt & Kosnik grades I, II, and III showed good recovery (GR) at discharge, while one was moderately disabled (MD) and one was severely disabled (SD). Among 16 patients in poor neurological condition (GCS was ⩽ 9 on admission), the outcome was GR in 5 cases (31%), MD in 2 (13%), and SD in 9 (56%). These results were better than those for surgically treated patients with the same neurological status. The difference in outcome between endovascular treatment and surgery may have been related to the difference in the insult to the brain caused by each modality. The incidence of symptomatic vasospasm was lower in the GDC group (5.7%) than in the surgical group (12%). In the patients treated with GDC and intrathecal administration of urokinase, subarachnoid clots were cleared more rapidly than in those treated surgically with continuous cisternal irrigation. The accelerated clearance of subarachnoid clots in the GDC group might have helped to prevent delayed vasospasm. The long-term efficacy of GDC embolization in preventing subsequent bleeding has not yet been determined. However, this method seems to be less traumatic for the brain and may be suitable for treatment of patients with severe SAH.

scholarly journals Angiographical Change of Guglielmi Detachable Coils

2004 ◽  
Vol 10 (1_suppl) ◽  
pp. 161-166 ◽  
Author(s):  
Y. Nakai ◽  
M. Sonobe ◽  
T. Takigawa ◽  
T. Yamazaki ◽  
S. Okamoto ◽  
...  
Keyword(s):  
Cerebral Aneurysm ◽  
Medical Condition ◽  
Cerebral Aneurysms ◽  
Acute Stage ◽  
Guglielmi Detachable Coils ◽  
Unruptured Aneurysms ◽  
Detachable Coils

Acute angiographical changes for preventing acute rebleeding on GDC treated cerebral aneurysms were evaluated. From December 2000 to November 2002, 48 total aneurysms in 44 consecutive patients with acute SAH. Acute angiographical evaluations were carried out in 46 aneurysms, including 42 ruptured and 4 unruptured aneurysms. Two cases were excluded because of poor medical condition. In this series, there were no rebleeding cases in acute stage. In the initial embolization for the 46 aneurysms, CO was achieved in eight aneurysms, NR in 15 aneurysms and BF in 23 aneurysms. Acute angiographical observations showed progressive thrombosis in 17 aneurysms (37%). No changes were observed in remaining 29. No recanalization was observed in this series. Only one case of BF, inside the aneurysm bleb was still observed during follow up. Additional embolization was carried out. Progressive thrombosis was frequently observed in GDC treated cerebral aneurysms during acute stage. This angiographical finding seems to show prevention of rebleeding, which is considered important for the management of GDC treatment in acutely ruptured cerebral aneurysm.

The Embolization of Ruptured Aneurysms in Acute Stage with Guglielmi Detachable Coils

1999 ◽  
Vol 5 (1_suppl) ◽  
pp. 191-193 ◽  
Author(s):  
Y. Matsumaru ◽  
M. Sonobe ◽  
R. Masuda ◽  
M. Yasuda ◽  
E. Hori ◽  
...  
Keyword(s):  
Acute Stage ◽  
Long Term Results ◽  
Morbidity Rate ◽  
Guglielmi Detachable Coils ◽  
Ruptured Aneurysms ◽  
Symptomatic Vasospasm ◽  
Detachable Coils ◽  
Promising Treatment ◽  
Permanent Morbidity

We have treated 43 ruptured aneurysms in 42 patients with Guglielmi Detachable Coils (GDC) in acute period. Thirty-one patients (74%) were independent on discharge. Among the patients of Hunt and Hess Grade I, II and III, 27 patients (84%) were independent. Acute rerupture occurred in two elderly patients with insufficient embolization and another patient experienced rerupture 45 days after the embolization. Symptomatic vasospasm was reported in 16% of patients and its permanent morbidity rate resulted in 3.1%. Although the long term results remain to be determined, embolization with GDC is a safe and promising treatment for acutely ruptured aneurysms.

scholarly journals The Embolization of Ruptured Aneurysms in Acute Stage

2001 ◽  
Vol 7 (1_suppl) ◽  
pp. 53-56
Author(s):  
M. Sonobe ◽  
Y. Nakai ◽  
Y. Matsumaru ◽  
K. Sugita
Keyword(s):  
Acute Stage ◽  
Long Term Results ◽  
Morbidity Rate ◽  
Ruptured Aneurysms ◽  
Symptomatic Vasospasm ◽  
Detachable Coils ◽  
Promising Treatment ◽  
Permanent Morbidity

We have treated 93 ruptured aneurysms with Guglielmi Detachable Coils (GDC) in acute period. Seventy-three patients (78%) were independent on discharge. Among the patient of Hunt and Hess Grade I, II and III, 59 patients (88%) were independent. Acute re-rupture occurred in two elderly patients with insufficient embolization and two patients experienced re-rupture in the follow up period. Symptomatic vasospasm was reported in 17.6% of patients. The permanent morbidity rate is 4.4% and one patient died (1.5%). Although the long-term results remain to be determined, embolization with GDC is a safe and promising treatment for acutely ruptured aneurysms.

Embolization of Ruptured Cerebral Aneurysms with GDC in Acute Stage

1998 ◽  
Vol 4 (1_suppl) ◽  
pp. 93-95
Author(s):  
K. Onizuka ◽  
M. Sonobe ◽  
K. Sugita ◽  
Y. Matsumaru ◽  
S. Takahashi
Keyword(s):  
Cerebral Aneurysms ◽  
Acute Stage ◽  
Guglielmi Detachable Coils ◽  
Detachable Coils ◽  
Occlusion Rate ◽  
Primary Hemorrhage

21 cases of 22 ruptured cerebral aneurysms were treated in acute stage with Guglielmi detachable coils and the outcome was assesed. GDCs were placed intra-aneurysm for intra-aneurysmal occlusion. Cases: age 42–80 (mean; 59) y. o., 7 male and 14 female; 4, 6, 8 and 3 patients were categorized (Hunt and Hess) as grades 1, 2, 3 and 4 respectively. GDC embolization was performed within 24 hours of primary hemorrhage in 11 patients, within 2 to 3 days in 4 patients and 5 to 19 days in 6 patients. The occlusion rate was 100% in 7 ANs, more than 75% in 9 ANs and less than 75% in 6 ANs. There were 7 cases of complications, two coil deposits, one embolism and 4 reruptures.

Mechanical Detachment of Guglielmi Detachable Coils after Failed Electrolytic Detachment: Rescue from a Technical Complication

2008 ◽  
Vol 63 (suppl_4) ◽  
pp. ONSE293-ONSE294
Author(s):  
Chang-Young Lee ◽  
Man-Bin Yim ◽  
Goetz Benndorf
Keyword(s):  
Cerebral Aneurysm ◽  
Cerebral Aneurysms ◽  
Ruptured Aneurysm ◽  
In Vitro Tests ◽  
Guglielmi Detachable Coils ◽  
Detachable Coils ◽  
The Wire ◽  
Technical Complication

Abstract Objective: We describe the mechanical detachment of 2 Guglielmi detachable coils (GDC) that had been placed in a ruptured aneurysm and that failed to detach by electrolysis. Methods: Mechanical detachment was attempted by continuously rotating the delivery wire. The feasibility and reproducibility of this maneuver was tested by conducting additional in vitro tests. Results: Two GDCs that had been positioned in a ruptured cerebral aneurysm and had failed to detach by electrolysis were separated from the delivery wire by rotating the wire until the weakest segment of the coils broke. GDCs tested in vitro with correct detachment positioning could be separated from the microcatheter tip by approximately 15 rotations of the delivery wire without coil loop movement inside the aneurysm. Conclusion: Mechanical detachment of an electrolytic GDC by rotating the delivery wire until a break occurs can be safely performed in a potentially risky situation caused by detachment failure during GDC embolization of cerebral aneurysms.

Chitosan-Based Hydrogel Nanoparticles for Cancer Therapy

2017 ◽  
Vol 7 (04) ◽  
Author(s):  
Azadi A. ◽  
Khazaei M. ◽  
Ashrafi H.
Keyword(s):  
Drug Delivery ◽  
Cancer Therapy ◽  
Recent Decade ◽  
Reticuloendothelial System ◽  
Malignant Neoplasms ◽  
Mortality And Morbidity ◽  
Hydrogel Nanoparticles ◽  
Tissue Invasion ◽  
Causes Of Mortality ◽  
Nanoparticulate Systems

Cancer, an uncontrollable growth of cells, is among the leading causes of mortality and morbidity throughout the world. Malignant neoplasms are difficult to treat diseases because of their single in kind characteristics such as tissue invasion, metastasis, evading reticuloendothelial system (RES) and so forth. In recent decade polymeric nanoparticulate systems has gained special attention in drug delivery and targeting among all biocompatible nanoforms. Among these systems, chitosan-based hydrogel nanoparticles have been wildly utilized for drug delivery purposes. The usage of chitosan nanogels in cancer therapy significantly improved in recent years. The various cancers were the target of chitosan nanogels. Also, modification of other delivery systems with chitosan were much reported. The aim of this study is the review and update of the recent studies on chitosan nanogels applications in cancer therapy by focus on cancer based classification.

scholarly journals Are Lipids Possible Markers of Suicide Behaviors?

2021 ◽  
Vol 10 (2) ◽  
pp. 333
Author(s):  
Agnieszka Kułak-Bejda ◽  
Grzegorz Bejda ◽  
Magdalena Lech ◽  
Napoleon Waszkiewicz
Keyword(s):  
Suicide Risk ◽  
Biological Marker ◽  
Low Density Lipoproteins ◽  
Low Density ◽  
Lipid Levels ◽  
Mortality And Morbidity ◽  
Additional Tool ◽  
Cholesterol Levels ◽  
Causes Of Mortality ◽  
Suicide Behaviors

Suicides and suicidal behaviors are very important causes of mortality and morbidity and have become a serious global problem. More than 800,000 people die from suicide every year. Previous researches have established that lipids play an important role in the pathogenesis of suicide. Moreover, lipid levels might be a biological marker of suicide. A lot of researchers have tried to identify biological markers that might be related to depressive disorder, bipolar disorder or schizophrenia and suicidal behavior. It was also important to consider the usefulness of an additional tool for prevention actions. Metabolic deregulation, particularly low total cholesterol and low-density lipoproteins-cholesterol levels may cause higher suicide risk in patients with these psychiatric disorders.

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