scholarly journals Coil Knotting during Endovascular Coil Embolization for Ruptured MCA Aneurysm

2008 ◽  
Vol 14 (3) ◽  
pp. 331-334
Author(s):  
S.C. Kwon ◽  
I.U. Lyo ◽  
S.H. Shin ◽  
J.B. Park ◽  
Y. Kim
Keyword(s):  
Coil Embolization ◽  
Present Report ◽  
Cerebral Aneurysms ◽  
Thromboembolic Events ◽  
Related Complication ◽  
Parent Vessel ◽  
Aneurysmal Rupture ◽  
Hemorrhagic Complications ◽  
Endovascular Coil Embolization ◽  
Mca Aneurysm

Complications during coil embolization of cerebral aneurysms include thromboembolic events, hemorrhagic complications related to procedural aneurysmal rupture and parent vessel perforation, and coil-related complications. The present report describes a rare coil-related complication involving spontaneous coil knotting.

scholarly journals Thromboembolic Events during Endovascular Coil Embolization of Cerebral Aneurysms

2006 ◽  
Vol 12 (1_suppl) ◽  
pp. 112-116 ◽  
Author(s):  
T. Ishibashi ◽  
Y. Murayama ◽  
T. Saguchi ◽  
M. Ebara ◽  
K. Irie ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adverse Event ◽  
Coil Embolization ◽  
Diffusion Weighted Imaging ◽  
Cerebral Aneurysms ◽  
Thromboembolic Events ◽  
Diffusion Weighted ◽  
Endovascular Coil Embolization ◽  
Intracerebral Aneurysm

Thromboembolic events was most important adverse event for coil embolization for intracerebral aneurysm. The present study investigated possible risk factors for thromboembolic events during coil embolization using diffusion-weighted imaging (DWI), comparing unruptured and ruptured lesions.

scholarly journals Acutely ruptured basilar artery bifurcation aneurysm, treated with simultaneous Cascade and Comaneci temporary-assisted coiling

2020 ◽  
pp. neurintsurg-2020-016320
Author(s):  
Alexander Sirakov ◽  
Radoslav Raychev ◽  
Pervinder Bhogal ◽  
Stanimir Sirakov
Keyword(s):  
Basilar Artery ◽  
Coil Embolization ◽  
Cerebral Aneurysms ◽  
Content Type ◽  
Compliant Structure ◽  
Bifurcation Aneurysm ◽  
Vessel Patency ◽  
Endovascular Coil Embolization ◽  
Video Player ◽  
Temporary Stent

Temporary stent-assisted coiling is an eligible approach for the treatment of acutely ruptured complex cerebral aneurysms. Improved material properties and industrial advances in braiding technology have led to the introduction of new stent-like devices to augment endovascular coil embolization. Such technology includes the Cascade and Comaneci neck-bridging devices. Both devices are manually controlled, non-occlusive and fully retrievable neck-bridging temporary implants. The braided nature and the ultra-thin wire, compliant structure of their bridging meshes helps maintain target vessel patency during coil embolization. In this video (video 1) we demonstrate the straightforward combination of two temporary neck-bridging devices for the embolization of an acutely ruptured aneurysm of the basilar artery. Technical success and complete embolization of the aneurysm were recorded at the final angiography. In this technical video we discuss the technical nuances of the Comaneci and Cascade coil embolization.Video 1

Abciximab Treatment Modalities for Thromboembolic Events Related to Aneurysm Coiling

2010 ◽  
Vol 67 (suppl_2) ◽  
pp. ons503-ons508 ◽  
Author(s):  
Mohamed Aggour ◽  
Laurent Pierot ◽  
Krisztof Kadziolka ◽  
Philippe Gomis ◽  
Jean-Pierre Graftieaux
Keyword(s):  
Scale Score ◽  
Coil Embolization ◽  
Treatment Modalities ◽  
Parent Artery ◽  
Thromboembolic Events ◽  
Modified Rankin Scale ◽  
Thromboembolic Complications ◽  
Unruptured Aneurysms ◽  
Hemorrhagic Complications ◽  
Flow Restoration

ABSTRACT BACKGROUND: Thromboembolic complications are the most common cause of periprocedural morbidity associated with the endovascular treatment of intracranial aneurysms with detachable coils. OBJECTIVE: To estimate the safety and efficacy of using combined intra-arterial and intravenous abciximab to treat thrombi complicating endovascular cerebral aneurysm coil embolization. METHODS: In a retrospective analysis of 390 aneurysmal coiling procedures, we identified 39 patients (10.0%) with thromboembolic events related to the procedure. As the first line of treatment in 23 of these patients, abciximab was administered intra-arterially as a bolus followed by intravenous infusion over a 12-hour period. Eleven of the 23 patients were treated for ruptured aneurysms, 9 for unruptured aneurysms, and 3 for aneurysmal recanalization. Flow restoration and neurological outcome were evaluated. RESULTS: Amelioration as measured by the Thrombolysis in Myocardial Infarction flow grade score was achieved in 17 of 23 patients (73.9%), and no change was observed in 6 of 23 patients (26.1%). Complete recanalization was achieved in 13 patients (56.5%). A greater response to abciximab was noted for thrombi at the coil–parent artery interface, and a lesser response was noted for distal thrombi. No hemorrhagic complications were noted for any of the patients, whereas 11 patients (47.8%) showed ischemic lesions. A modified Rankin Scale score of 2 or less was achieved in 17 of 23 patients (73.9%), whereas 6 of 23 patients (26.1%) had a modified Rankin Scale score of more than 2. CONCLUSION: Combined intra-arterial/intravenous administration of abciximab is safe and effective for treating thromboembolic complications that occur during aneurysmal coil embolization with no hemorrhagic complications.

scholarly journals Antiplatelet Premedication for Stent-Assisted Coil Embolization of Intracranial Aneurysms: Low-Dose Prasugrel vs Clopidogrel

Neurosurgery ◽  
2017 ◽  
Vol 83 (5) ◽  
pp. 981-988 ◽  
Author(s):  
Hyun Ho Choi ◽  
Jung Jun Lee ◽  
Young Dae Cho ◽  
Moon Hee Han ◽  
Won-Sang Cho ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Intracranial Aneurysms ◽  
Low Dose ◽  
Significant Risk ◽  
Cerebral Aneurysms ◽  
Significant Risk Factor ◽  
Thromboembolic Events ◽  
Antiplatelet Medication ◽  
Unruptured Intracranial Aneurysms ◽  
Significant Difference

Abstract BACKGROUND The use of antiplatelet medications to prevent thrombosis in the treatment of cerebral aneurysms with stents has become widely emphasized. OBJECTIVE To compare low-dose prasugrel with clopidogrel in stent-assisted coil embolization of intracranial aneurysms. METHODS This is a retrospective review of 311 aneurysms from 297 patients who underwent stent-assisted endovascular coil embolization of unruptured intracranial aneurysm between November 2014 and March 2017. Thromboembolic and hemorrhagic adverse events were compared between 207 patients who received low-dose prasugrel (PSG group) and 90 patients who received clopidogrel (CPG group). RESULTS P2Y12 reaction unit (PRU) values were significantly lower in the PSG group (PSG group vs CPG group, 132.3 ± 76.9 vs 238.1 ± 69.1; P < .001); the percentage of inhibition was also statistically higher in the PSG group (54.0 ± 26.0% vs 20.8 ± 18.6%; P < .001). Thromboembolic events occurred less frequently in the PSG group than in the CPG group (0.9% vs 6.4%; P = .01), whereas there was no significant difference in the percentage of hemorrhagic complications (0.5% vs 2.2%; P = .22). In the multivariate analysis, clopidogrel as the antiplatelet medication was the sole significant risk factor for thromboembolism in this series of patients undergoing stent-assisted coil embolization. CONCLUSION Use of low-dose PSG as an antiplatelet premedication is quick, effective, and safe for stent-assisted coil embolization of unruptured intracranial aneurysms. Prasugrel premedication significantly lowered the frequency of thromboembolic events without increasing the risk of hemorrhage.

scholarly journals Treatment of wide-necked cerebral aneurysms with the Neuroform2 Treo stent

2005 ◽  
Vol 18 (2) ◽  
pp. 1-5 ◽  
Author(s):  
Sepehr Sani ◽  
Kirk W. Jobe ◽  
Demetrius K. Lopes
Keyword(s):  
Coil Embolization ◽  
Intracranial Aneurysms ◽  
Cerebral Aneurysms ◽  
Technical Difficulty ◽  
Neurological Complications ◽  
Clinical Effects ◽  
Parent Vessel ◽  
Cerebral Angiogram ◽  
Aneurysm Neck

Object Until recently, wide-necked aneurysms were not considered amenable to treatment with coil embolization. The recent introduction of intracranial stents has provided a method of preventing coil migration out of wide-necked aneurysms. The Neuroform2 Treo is a modification of the Neuroform stent; the new version has a higher metal/artery ratio. The authors' initial experience with the use of this stent in combination with coil embolization to treat wide-necked intracranial aneurysms is reported and technical considerations are discussed. Methods The authors' first 10 consecutive patients with wide-necked intracranial aneurysms were included in this study. Inclusion criteria restricted the group to adult patients with wide-necked intracranial aneurysms (ruptured and unruptured lesions). A wide neck was defined as a dome/neck ratio of less than 2 or a neck that was 4 mm or wider as measured on angiograms. Immediate postprocedure angiography studies were performed to determine successful coil occlusion of the aneurysm as well as patency of the parent vessel. Six-month follow-up angiograms were obtained in all patients. Ten aneurysms with poor dome/neck ratios (< 2) were studied in 10 patients. In all cases the stent was delivered to the aneurysm site and positioned without difficulty. No branch artery compromise was observed. A technical difficulty occurred in one case, with prolapse of a coil into the parent vessel, which was successfully corrected with no adverse clinical effects. There were no clinical or neurological complications associated with endovascular treatment of aneurysms in this series. One patient required further coil embolization because of findings on the 6-month follow-up cerebral angiogram. Conclusions The Neuroform2 Treo navigates similarly to the Neuroform2, with the advantage of increased aneurysm neck coverage. This feature may lower the retreatment rates for wide-necked cerebral aneurysms.

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