scholarly journals Cerebral foreign body reaction after carotid aneurysm stenting

2015 ◽  
Vol 22 (1) ◽  
pp. 53-57 ◽  
Author(s):  
Anastasia Orlova Lorentzen ◽  
Terje Nome ◽  
Søren Jacob Bakke ◽  
David Scheie ◽  
Vidar Stenset ◽  
...  
Keyword(s):  
Foreign Body ◽  
Internal Carotid ◽  
Foreign Body Reaction ◽  
Artery Aneurysm ◽  
Brain Biopsy ◽  
Flow Diverter ◽  
Left Internal Carotid Artery ◽  
Hydrophilic Polymer ◽  
Carotid Artery Aneurysm ◽  
Internal Carotid Artery Aneurysm

Flow diverter stents are new important tools in the treatment of large, giant, or wide-necked aneurysms. Their delivery and positioning may be difficult due to vessel tortuosity. Common adverse events include intracranial hemorrhage and ischemic stroke, which usually occurs within the same day, or the next few days after the procedure. We present a case where we encountered an unusual intracerebral complication several months after endovascular treatment of a large left internal carotid artery aneurysm, and where brain biopsy revealed foreign body reaction to hydrophilic polymer fragments distally to the stent site. Although previously described, embolization of polymer material from intravascular equipment is rare. We could not identify any other biopsy verified case in the literature, with this particular presentation of intracerebral polymer embolization – a multifocal inflammation spread out through the white matter of one hemisphere without hemorrhage or ischemic changes.

scholarly journals Mid-term follow-up of staged bilateral internal carotid artery aneurysm treatment with Pipeline embolization

2019 ◽  
Vol 25 (6) ◽  
pp. 664-670
Author(s):  
Juan G Tejada ◽  
Gloria VV Lopez ◽  
Jerry ME Koovor ◽  
Kalen Riley ◽  
Mesha Martinez
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Flow Diverter ◽  
Imaging Data ◽  
Carotid Artery Aneurysm ◽  
Common Location ◽  
Internal Carotid Artery Aneurysm

Background Endovascular treatment of large complex morphology aneurysms is challenging. High recanalization rates have been reported with techniques such as stent-assisted coiling and balloon-assisted coiling. Flow diverter devices have been introduced to improve efficacy outcomes and recanalization rates. Thromboembolic complications and in-device stenosis are certainly more worrisome when treatment of bilateral internal carotid arteries has been performed. This study aimed to report our experience with mid-term imaging follow-up of staged bilateral Pipeline embolization device placement for the treatment of bilateral internal carotid artery aneurysms. Methods We reviewed the clinical, angiographic, and follow-up imaging data in all consecutive patients treated with bilateral internal carotid artery aneurysms who underwent elective Pipeline embolization. Results Six female patients were treated, harboring a total of 13 aneurysms. Of these, 60% were asymptomatic. Diplopia and headache were the most common symptoms. The most common location was the paraclinoid segment (6/13), including by cavernous segment (4/13) and ophthalmic segment (2/13). Successful delivery of the device was achieved in 12 cases. Difficult distal access precluded the deployment of the device in one case. The treatment was always staged with at least eight weeks' difference between the two procedures. All aneurysm necks were covered completely. There were no periprocedural complications. Angiographic follow-up ranged between 3 and 12 months, and computed tomography angiogram follow-up ranged between 2 and 24 months. Complete aneurysm occlusion was achieved in all cases. Conclusion In our series, Pipeline deployment for the treatment of bilateral internal carotid artery aneurysms in a staged fashion is safe and feasible. Mid-term imaging follow-up showed permanent occlusion of all the treated aneurysms.

A New Virtual Coiling Method and its Use in Evaluation of Combining Coiling and Flow-Diversion Treatment in a Patient-Specific Aneurysm

2014 ◽  
Author(s):  
Robert Damiano ◽  
Jianping Xiang ◽  
Elad Levy ◽  
Hui Meng
Keyword(s):  
Internal Carotid ◽  
Thrombus Formation ◽  
Artery Aneurysm ◽  
Flow Diverter ◽  
Patient Specific ◽  
Test Case ◽  
Carotid Artery Aneurysm ◽  
Internal Carotid Artery Aneurysm ◽  
Single Flow ◽  
Packing Densities

A new realistic finite element method (FEM) based endovascular coil deployment technique was developed to explore the hemodynamic modifications of coiling in addition to flow diverter (FD) treatment. A patient-specific internal carotid artery aneurysm was used as a test case, and a single flow diverter was deployed using a previously developed method [1], along with several coils using the new method. Results showed fluctuations in hemodynamic parameters at low packing densities (1–3 coils) which are unexpected. At high packing density however (6 coils), results were consistent with expectations. These results suggest that adding coils at low packing densities to FD treatment may not cause significant additional flow reduction into the aneurysm sac, but may provide a scaffold for aneurysmal thrombus formation.

Extracranial internal carotid artery aneurysm presenting as pharyngeal mass with dysphagia

2005 ◽  
Vol 120 (2) ◽  
pp. 1-3 ◽  
Author(s):  
Bruno Sergi ◽  
Vittorio Alberti ◽  
Gaetano Paludetti ◽  
Francesco Snider
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Left Internal Carotid Artery ◽  
Extracranial Internal Carotid Artery ◽  
Carotid Artery Aneurysm ◽  
Internal Carotid Artery Aneurysm

Aneurysms of the extracranial portion of the internal carotid artery are rare. Generally, they occur just at the level of, or above, the bifurcation. Here we report a case of a left internal carotid artery aneurysm presenting as an oropharyngeal mass causing dysphagia.

scholarly journals Treatment of an internal carotid artery aneurysm with a flow diverter through a double lumen balloon catheter

2017 ◽  
Vol 23 (3) ◽  
pp. 255-259
Author(s):  
José M Amorim ◽  
Santiago Rosati ◽  
Ronit Agid ◽  
Vítor Mendes Pereira ◽  
Timo Krings
Keyword(s):  
Carotid Artery ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Flow Diverter ◽  
Double Lumen ◽  
Carotid Artery Aneurysm ◽  
Internal Carotid Artery Aneurysm ◽  
Procedural Complications ◽  
Wall Apposition ◽  
Flow Diverters

Background Double lumen balloon catheters (DLBCs) are currently used in the treatment of intracranial aneurysms, especially when involving balloon or stent-assisted coiling. The existing DLBCs allow the delivery of self-expandable stents but do not offer the possibility to deploy flow-diverters. Despite the increasing use and success of flow-diverters, there have been numerous reports of procedural complications such as early in-stent thrombosis or delayed distal embolization. It seems that these complications can be avoided by correct stent positioning and adequate wall apposition, achieved either by manoeuvres with the microguidewire and/or microcatheter or by performing balloon angioplasty following an exchange guidewire manoeuvre. Objective Report the use of a new DLBC able to deliver a flow-diverter. Methods A 41-year-old woman presented to our hospital with binocular horizontal diplopia for two weeks and reduced visual acuity. A left internal carotid artery aneurysm involving the cavernous and ophthalmic segments was found, with a maximum height of 19 mm and a broad 8 mm neck. It presented extra- and intra-dural components and the parent vessel was significantly narrowed. A decision was made to perform endovascular treatment of the aneurysm with placement of a flow diverter through a DLBC. Results Patency and adequate expansion of the flow diverter with evident intra-aneurysmal contrast stasis was observed in the final angiogram. No peri-procedural complications were observed. Conclusion This is a technical note demonstrating the feasibility of a new device to deploy a flow diverter, aiming to improve wall apposition and stent configuration without the need of additional devices or exchange manoeuvres.

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