Evaluation of the immediate and long-term results of endovascular treatment of ruptured vertebrobasilar artery aneurysms in an acute period of hemorrhage

2019 ◽  
Vol 20 (4) ◽  
pp. 31-37
Author(s):  
E. O. Ivankova ◽  
V. V. Darvin ◽  
M. A. Bessmertnykh
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Endovascular Treatment ◽  
Vegetative State ◽  
Good Condition ◽  
Artery Aneurysm ◽  
Long Term Results ◽  
Study Objective ◽  
Acute Period ◽  
Endovascular Occlusion ◽  
Vertebrobasilar Artery

The study objective is to evaluate the results of endovascular treatment of patients with subarachnoid hemorrhage due to rupture of the vertebrobasilar artery aneurysm.Materials and methods. From 2011 to 2017, 26 patients underwent endovascular occlusion of the ruptured vertebrobasilar artery aneurysm in an acute period of hemorrhage in Surgut Clinical Hospital for Traumatology.Results. Endovascular interventions were performed in 1–14 days after the episode of the primary subarachnoid hemorrhage. Among the patients 53.8 % were in good condition at admission (Hunt–Hess grade I–II), 46.2 % had moderate and severe neurologic disability (Hunt–Hess grade III–IV). A good and satisfactory degree of aneurysm occlusion was achieved in 18 (69.3 %). Favorable outcome (modified Rankin Scale (mRS) 0–2) was achieved in 21 (80.7 %); 1 (3.7 %) had severe disability (mRS 4), 2 (7.8 %) – vegetative state (mRS 5). Lethal outcome (mRS 6) occurred in 2 (7.8 %). Unfavorable outcomes were caused by a severe vasospasm.Conclusions. Endovascular occlusion of vertebrobasilar artery aneurysms in the acute period of hemorrhage is an effective and safe method of treatment in patients with Hunt–Hess grade I–IV.

scholarly journals Endovascular Occlusion of the Posterior Cerebral Artery in the Treatment of P2 Ruptured Aneurysms

2007 ◽  
Vol 13 (2) ◽  
pp. 127-132 ◽  
Author(s):  
E. Cotroneo ◽  
R. Gigli ◽  
G. Guglielmi
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Endovascular Treatment ◽  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Parent Vessel ◽  
Ruptured Aneurysms ◽  
Endovascular Occlusion ◽  
Platinum Coils

Four cases of posterior cerebral artery (PCA) aneurysms are described. The aneurysms were located at the P2 segment of PCA. All cases presented with a subarachnoid hemorrhage (SAH). Endovascular treatment was performed, with occlusion of the aneurysm and parent vessel, using platinum coils. Two patients developed a homonymus lateral hemianopia after treatment.

scholarly journals Anterior inferior cerebellar artery aneurysms: Segments and results of surgical and endovascular managements

2016 ◽  
Vol 22 (6) ◽  
pp. 643-648 ◽  
Author(s):  
Xianli Lv ◽  
Huijian Ge ◽  
Hongwei He ◽  
Chuhan Jiang ◽  
Youxiang Li
Keyword(s):  
Hearing Loss ◽  
Subarachnoid Hemorrhage ◽  
Surgical Treatment ◽  
Endovascular Treatment ◽  
Patient Outcomes ◽  
Facial Palsy ◽  
Artery Aneurysm ◽  
Anterior Inferior Cerebellar Artery ◽  
Cerebellar Artery ◽  
Cerebellar Symptoms

Background Anterior inferior cerebellar artery (AICA) aneurysms are rare and published clinical experience with these aneurysms is limited. Objective The objective of this article is to report angiographic characteristics and results associated with premeatal, meatal and postmeatal segments, surgical and endovascular therapies. Methods A literature review was performed through PubMed using “anterior inferior cerebellar artery aneurysm” through January 2016. Clinical data, angiograms, management techniques, and patient outcomes were reviewed for 47 collected cases in 30 previous reports. Results Of these aneurysms, 21 (44.7%) were associated with meatal segment, 10 (21.3%) were postmeatal and 16 (34.0%) were premeatal. Patients with meatal aneurysms are more likely to present with subarachnoid hemorrhage and hearing loss and facial palsy (77.8%). Patient outcomes of meatal aneurysms presented with more neuropathies (51.7%) and cerebellar symptoms (14.3%) ( p = 0.049). Four cases of meatal aneurysm with preoperative cranial nerve deficits (two VII and two VIII) showed improvement after surgery. Endovascular treatment achieved outcomes similar to surgical treatment ( p = 0.327). Conclusions AICA aneurysms have a predilection for meatal segment. Patients with meatal aneurysms are more likely to present with subarachnoid hemorrhage and hearing loss and facial palsy. Patient outcomes of meatal aneurysms presented with more neuropathies and cerebellar symptoms. Endovascular treatment achieved outcomes similar to surgical treatment.

scholarly journals Results of revascularizing operations performed in the acute period of subarachnoid hemorrhage

2021 ◽  
Vol 23 (2) ◽  
pp. 14-24
Author(s):  
V. A. Lukyanchikov ◽  
I. M. Shetova ◽  
V. D. Shtadler ◽  
N. E. Kudryashova ◽  
G. K. Guseynova ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Subarachnoid Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Long Term Results ◽  
Emission Computed Tomography ◽  
Acute Period ◽  
The Brain

The study objective is an assessment of long-term results of cerebral revascularization performed in the acute period of subarachnoid hemorrhage due to rupture of cerebral aneurysms.Materials and methods. This cross-sectional study includes 74 patients, operated in N.V. Sklifosovsky Research Institute for Emergency Medicine in the acute period of aneurysmal subarachnoid hemorrhage. Patients were divided into two groups. The first group contained patients with EC—IC bypass performed in the acute period of aneurysmal subarachnoid hemorrhage. The Control group contained patients without bypass. In the long-term period, 11 patients were examined. Computed tomography of cerebral vessels, duplex ultrasound examination of the aortic arch, brachiocephalic arteries and intracranial vessels, transcranial Doppler ultrasonography with a breathing function test, single-photon emission computed tomography of the brain followed by stress test with acetazolamide, Modified Renkin Scale, Mini-Mental State Examination, Montreal Cognitive Assessment, Index Bartel, The Hospital Anxiety and Depression Scale, Holms-Rahe were performed. For descriptive results, a mathematical model was used.Results. The best treatment outcomes in severe patients with subarachnoid hemorrhage and cerebral ischemia were observed when performing simultaneous clipping of the aneurysm and EC-IC bypass (57.1 % versus 41.0 %) there was no statistically significant difference in outcomes. EC-IC bypass functioned in 37.5 % of cases. The rate and acceleration of the fall in volumetric blood flow and the passage of blood from the aortic bulb to the cerebral arterioles affect the perfusion values in the region of the brain concerned. Evaluation of long-term results of simultaneous interventions revealed persistent disturbances in the regulation of cerebral blood flow at the microcirculatory level. Patients with EC-IC bypass had a higher level of cognitive function and stress potential.Conclusion. The results of this study showed us the necessity for a comprehensive exploration of cerebral blood flow.

scholarly journals Endovascular Treatment of a Vertebral Artery Aneurysm via Puncture of the Surgically Exposed Vertebral Artery

2011 ◽  
Vol 17 (1) ◽  
pp. 74-77 ◽  
Author(s):  
F. Oka ◽  
H. Ishihara ◽  
S. Kato ◽  
M. Shinoyama ◽  
M. Suzuki
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Endovascular Therapy ◽  
Surgical Approach ◽  
Coil Embolization ◽  
Artery Aneurysm ◽  
Direct Access ◽  
Proximal Side ◽  
Femoral Route

We describe a case of subarachnoid hemorrhage due to a ruptured right vertebral artery (VA) aneurysm where endovascular therapy via a trans-femoral route was not feasible. Therefore we surgically exposed the VA and directly punctured it at the C4 level, followed by successful coil embolization. Direct access to the vertebral artery using an anterior surgical approach is an alternative in cases where the proximal side of the artery is occluded.

Endovascular Treatment of Ruptured Intradural Ophthalmic Artery Aneurysm

2011 ◽  
Vol 24 (6) ◽  
pp. 895-898
Author(s):  
L.S.P. Karanam ◽  
R. Saraf ◽  
U.S. Limaye
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Endovascular Treatment ◽  
Ophthalmic Artery ◽  
Artery Aneurysm ◽  
Review Of The Literature ◽  
Endovascular Technique ◽  
Unique Case ◽  
Antegrade Flow

We present a unique case of ruptured intradural ophthalmic artery aneurysm in a young man who presented with subarachnoid hemorrhage. By endovascular technique we successfully excluded the aneurysm from the circulation with preservation of antegrade flow in the ophthalmic artery. The presenting features and the technique of the treatment are described with a review of the literature.

scholarly journals Treatment of traumatic rupture of the thoracic aorta

2008 ◽  
Vol 136 (9-10) ◽  
pp. 498-504 ◽  
Author(s):  
Lazar Davidovic ◽  
Miroslav Markovic ◽  
Momcilo Colic ◽  
Nikola Ilic ◽  
Igor Koncar ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Mortality Rate ◽  
Endovascular Treatment ◽  
Thoracic Aorta ◽  
Good Condition ◽  
Long Term Results ◽  
Traumatic Rupture ◽  
Published Data ◽  
Aorta Rupture

INTRODUCTION Interest for traumatic thoracic aorta rupture stems from the fact that its number continually increases, and it can be rapidly lethal. OBJECTIVE The aim of this study is to present early and long term results as well as experiences of our team in surgical treatment of traumatic thoracic aorta rupture. METHOD Our retrospective study includes 12 patients with traumatic thoracic aorta rupture treated between 1985 and 2007. There were 10 male and two female patients of average age 30.75 years (18-74). RESULTS In six cases, primary diagnosis was established during the first seven days days after trauma, while in 6 more than one month later. In 11 cases, classical open surgical procedure was performed, while endovascular treatment was used in one patient. Three (25%) patients died, while two (16.6%) had paraplegia. Nine patients (75%) were treated without complications, and are in good condition after a mean follow-up period of 9.7 years (from one month to 22 years). CONCLUSION Surgical treatment requires spinal cord protection to prevent paraplegia, using cardiopulmonary by-pass (three of our cases) or external heparin-bonded shunts (five of our cases). Cardiopulmonary by-pass is followed with lower incidence of paraplegia, however it is not such a good solution for patients with polytrauma because of hemorrhage. The endovascular repair is a safe and feasible procedure in the acute phase, especially because of traumatic shock and polytrauma which contributes to higher mortality rate after open surgery. On the other hand, in chronic postrauamatic aortic rupture, open surgical treatment is connected with a lower mortality rate and good long-term results. There have been no published data about long-term results of endovascular treatment in the chronic phase.

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