scholarly journals Morphologic and Haemodynamic Changes after Stent Placement for Experimental Carotid Aneurysm

2004 ◽  
Vol 10 (1_suppl) ◽  
pp. 153-154 ◽  
Author(s):  
H. Tenjin
Keyword(s):  
Blood Flow ◽  
Digital Subtraction Angiography ◽  
Stent Placement ◽  
Carotid Arteries ◽  
Parent Artery ◽  
Digital Subtraction ◽  
Thin Slices ◽  
Before And After ◽  
Haemodynamic Changes ◽  
Plastic Resin

We investigated and compared the morphologic and haemodynamic changes between before and after stent placement when several different kinds of stents were applied to experimental aneurysms. Experimental aneurysms in eight pig carotid arteries were used. Stents were placed covering the aneurysm orifice. Five Cordis stents (coil stent), two GFXs (multilink stent), and one Multilink (tube stent) were used in this study. After stent placement, the arteries were perfused with 70% ethanol, the specimens were embedded in polyester plastic resin and thin slices were stained with hemtoxilin-eosin. Blood flow in the aneurysm was measured using digital subtraction angiography. The parent artery was stretched in multilink stent (GFX) cases, and was most markedly stretched by use of the tube stent (Multilink). Stent placement with any type of stent decreased intra-aneurysmal blood flow.

scholarly journals Morphologic and Hemodynamic Changes after Stent Placement for Experimental Carotid Aneurysm

2002 ◽  
Vol 8 (2) ◽  
pp. 143-149 ◽  
Author(s):  
H. Tenjin ◽  
Y. Ohshita ◽  
R. Daimon
Keyword(s):  
Blood Flow ◽  
Stent Placement ◽  
Carotid Arteries ◽  
Parent Artery ◽  
Digital Subtraction ◽  
Hemodynamic Changes ◽  
Thin Slices ◽  
Before And After ◽  
Plastic Resin ◽  
Hematoxylin Eosin

Stent assisted coil embolization is useful in treating broad neck aneurysms, and there are many kinds of stents that can be applied in the cerebral artery, however their characteristics are not well known. We investigated and compared morphologic and hemodynamic changes before and after stent placement when several different kinds of stents were applied to experimental aneurysms. Experimental aneurysms in eight pig carotid arteries were used. Stents were placed covering the aneurysm orifice. Five Cordis stents (coil stent), two GFXs (multilink stent), and one Multilink (tube stent) were used in this study. After coil placement, the arteries were perfused with 70% ethanol, the specimens were embedded in polyester plastic resin and thin slices were stained with hematoxylin-eosin. Blood flow in the aneurysm was measured using digital subtraction angiography. The parent artery was stretched in multilink stent (GFX) cases, and was most markedly stretched by use of the tube stent (Multilink). Stent placement with any type of stent decreased intra-aneurysmal blood flow.

Contribution of the straightening effect of the parent artery to decreased recanalization in stent-assisted coiling of large aneurysms

2017 ◽  
Vol 127 (5) ◽  
pp. 1063-1069 ◽  
Author(s):  
Akira Ishii ◽  
Hideo Chihara ◽  
Takayuki Kikuchi ◽  
Daisuke Arai ◽  
Hiroyuki Ikeda ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Parent Artery ◽  
Digital Subtraction ◽  
Stent Group ◽  
Unruptured Aneurysms ◽  
Angle Change ◽  
Angular Change ◽  
Significant Difference ◽  
Before And After ◽  
The Difference

OBJECTIVEThe durability of embolization of large aneurysms is enhanced by use of the neck-bridging stent. However, it remains unclear what factors contribute to decreased recanalization. The purpose of this study was to demonstrate the contribution of the straightening effect of the parent artery to the durability of stent-assisted coiling for large aneurysms.METHODSOf the 182 aneurysms treated by embolization since the introduction of the neurovascular stent, 82 consecutive unruptured aneurysms with a diameter greater than 7 mm were selected. There were 52 aneurysms treated with a stent (Group S) and 30 treated without a stent (Group NS). Occlusion status was evaluated 12 months after embolization with digital subtraction angiography. The vascular angle of the parent artery was measured before, immediately after, and 12 months after embolization. The rates of recanalization were compared between Group S and Group NS. In Group S, the rates of recanalization were further compared between those aneurysms with and without a significant angle change.RESULTSThe rate of major recanalization was 9.6% in Group S and 26.7% in Group NS. The volume embolization ratio was 32.6% in Group S and 31.6% in Group NS, with no statistically significant difference. However, the angulation change before and after coiling was significantly higher in Group S (10.6°) than in Group NS (0.9°). The difference in the angulation was more evident 12 months after coiling (19.1° in Group S and 1.5° in Group NS). In Group S, recanalization was found in 14.3% of 35 stented aneurysms without a significant angular change when a significant angular change was defined as more than 20°. In contrast, all 17 aneurysms with ≥ 20° of angular change remained occluded.CONCLUSIONSSignificant angular change of ≥ 20° most likely leads to decreased recanalization following stent-assisted embolization of large aneurysms.

Cinematic Angiography for Measurements of Blood Flow in Cerebral Aneurysms With Stents

2007 ◽  
Author(s):  
Makoto Ohta ◽  
Naoko Fujimura ◽  
Luca Augsburger ◽  
Hasan Yilmaz ◽  
Daniel A. Ru¨fenacht
Keyword(s):  
Blood Flow ◽  
High Speed ◽  
Cerebral Aneurysms ◽  
Flow Speed ◽  
Circulation System ◽  
Parent Artery ◽  
Vortex Center ◽  
System A ◽  
Before And After ◽  
Movement Distance

Background and Purpose: The assessment of blood flow speed by imaging modalities is important for endovascular treatments, such as stent implantation, of cerebral aneurysms. The subtracted vortex centers path line method (SVC method) is one of the ways of determining flow speed quantitatively using the image sequence. And a cinematic angiography (CA) is a high speed image acquisition system using X-ray and contrast media integrated in Digital Subtraction Angiography (DSA) for endovascular therapy. The combination of SVC and CA may useful for determining the blood flow speed during the operation using DSA. In this study, we applied this combination to analyze hemodynamic changes before and after stenting. Methods: A transparent tubular model was constructed of silicone which included an aneurysm 10 mm in diameter and having a 5 mm neck on a straight parent artery with a diameter of 3.5 mm. The model was integrated into a pulsatile circulation system. A double layer stent was placed in the parent artery on the aneurysm. By CA, successive images at 25 frames per second with injection of contrast were obtained. Results and conclusion: Rotating vortexes of contrast, which advanced along the wall of the aneurysm, were observed in successive images of the aneurysm cavity. The movement distance of the vortex center was measured and the results show that the vortex speed decrease after stenting. This indicates the possibility of applying the SVC method to medical imaging equipment for analysis of the flow in aneurysms containing stent.

scholarly journals A Poorly Treated Carotid-Cavernous Fistula Rescued by Coils through a PComA Approach

2009 ◽  
Vol 15 (2) ◽  
pp. 197-201
Author(s):  
J. Yu ◽  
Z. Shi ◽  
M. Lv ◽  
X. Yang ◽  
Z. Wu
Keyword(s):  
Digital Subtraction Angiography ◽  
Temporal Bone ◽  
Cavernous Sinus ◽  
Ophthalmic Artery ◽  
Parent Artery ◽  
Maxillary Artery ◽  
Digital Subtraction ◽  
Carotid Cavernous Fistula ◽  
Puncture Wound ◽  
Cavernous Fistula

This study describes a case of traumatic carotid-cavernous fistula poorly treated with balloons and rescued by coils through a PComA approach. A six-year-old boy suffered a left temporal bone puncture wound. Digital subtraction angiography disclosed a left carotid cavernous fistula. Five balloons were implanted into the cavernous sinus and the parent artery was sacrificed unwillingly, but the residual fistula retro-engorged by the ophthalmic artery communicated with the maxillary artery and the post circle through the PComA. We finally occluded the residual fistula through the PComA with coils. Once the parent artery was sacrificed and the distal residual fistula still retro-engorged, another patent communicating artery may be a rescue approach.

scholarly journals Discrepancy between two-dimensional and three-dimensional digital subtraction angiography for the planning of endovascular coiling of small cerebral aneurysms <5 mm

2020 ◽  
Vol 26 (6) ◽  
pp. 733-740
Author(s):  
Te-Chang Wu ◽  
Yu-Kun Tsui ◽  
Tai-Yuan Chen ◽  
Ching-Chung Ko ◽  
Chien-Jen Lin ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Three Dimensional ◽  
Cerebral Aneurysms ◽  
Endovascular Coiling ◽  
Parent Artery ◽  
Two Dimensional ◽  
Digital Subtraction ◽  
Rotational Angiography ◽  
Treatment Choices ◽  
The Impact

Background To investigate the discrepancy between two-dimensional digital subtraction angiography and three-dimensional rotational angiography for small (<5 mm) cerebral aneurysms and the impact on decision making among neuro-interventional experts as evaluated by online questionnaire. Materials and methods Eight small (<5 mm) ruptured aneurysms were visually identified in 16 image sets in either two-dimensional or three-dimensional format for placement in a questionnaire for 11 invited neuro-interventionalists. For each set, two questions were posed: Question 1: “Which of the following is the preferred treatment choice: simple coiling, balloon remodeling or stent assisted coiling?”; Question 2: “Is it achievable to secure the aneurysm with pure simple coiling?” The discrepancies of angio-architecture parameters and treatment choices between two-dimensional-digital subtraction angiography and three-dimensional rotational angiography were evaluated. Results In all eight cases, the neck images via three-dimensional rotational angiography were larger than two-dimensional-digital subtraction angiography with a mean difference of 0.95 mm. All eight cases analyzed with three-dimensional rotational angiography, but only one case with two-dimensional-digital subtraction angiography were classified as wide-neck aneurysms with dome-to-neck ratio < 1.5. The treatment choices based on the two-dimensional or three-dimensional information were different in 56 of 88 (63.6%) paired answers. Simple coiling was the preferred choice in 66 (75%) and 26 (29.6%) answers based on two-dimensional and three-dimensional information, respectively. Three types of angio-architecture with a narrow gap between the aneurysm sidewall and parent artery were proposed as an explanation for neck overestimation with three-dimensional rotational angiography. Conclusions Aneurysm neck overestimation with three-dimensional rotational angiography predisposed neuro-interventionalists to more complex treatment techniques. Additional two-dimensional information is crucial for endovascular treatment planning for small cerebral aneurysms.

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