scholarly journals Treatment Results of Combined Endovascular Coil Embolization Ruptured Anterior Communicating Artery Aneurysm and Endoscopic Surgery for Intracerebral and/or Intraventricular Hematoma

2014 ◽  
Vol 42 (1) ◽  
pp. 25-30 ◽  
Author(s):  
Tsutomu YOSHIOKA ◽  
Toshio HIGASHI ◽  
Mitsutoshi IWAASA ◽  
Kenji FUKUDA ◽  
Masakazu OHKAWA ◽  
...  
2019 ◽  
Vol 46 (Suppl_1) ◽  
pp. V8 ◽  
Author(s):  
Kunal Vakharia ◽  
Stephan A. Munich ◽  
Michael K. Tso ◽  
Muhammad Waqas ◽  
Elad I. Levy

Stent-assisted coiling offers a potential solution for coil embolization of broad-based aneurysms. Challenges associated with navigating a microcatheter beyond these aneurysms sometimes require looping the microcatheter within the aneurysm dome. Reducing microcatheter loops within domes can be difficult, and anchor techniques have been described, including balloon anchor, stent-retriever anchor, and stent anchor techniques. The authors present a patient requiring stent-assisted coiling of an anterior communicating artery aneurysm in whom a stent anchor technique was used to reduce a microcatheter loop within an aneurysm dome before coil embolization. Postembolization angiographic runs showed complete coil occlusion of the aneurysm with approximately 35% packing density.The video can be found here: https://youtu.be/zHR1ZOArUro.


Neurosurgery ◽  
2002 ◽  
Vol 50 (4) ◽  
pp. 899-902 ◽  
Author(s):  
Michael J. Alexander ◽  
Gary R. Duckwiler ◽  
Y. Pierre Gobin ◽  
Fernando Viñuela

Abstract OBJECTIVE AND IMPORTANCE: Thromboembolic complications after cerebral aneurysm treatment with Guglielmi detachable coils (Boston Scientific/Target, Fremont, CA) are not infrequent; in a University of California, Los Angeles institutional review of 720 treated aneurysms, thromboembolic complications occurred in 2.5% of cases. The development of intraluminal thrombus during the embolization procedure, however, may be diagnosed promptly and treated effectively with appropriate therapy. This report describes the use of intravenously administered abciximab for the treatment of intraprocedural arterial thrombus encountered during the coil embolization of a recently ruptured anterior communicating artery aneurysm. CLINICAL PRESENTATION: A 45-year-old man presented with severe headache 12 days before transfer to our institution. He had no neurological deficits at admission. Previous computed tomography of the brain demonstrated subarachnoid hemorrhage, and magnetic resonance angiography from the other institution demonstrated a 4-mm anterior communicating artery aneurysm. INTERVENTION: The patient underwent Guglielmi detachable coil embolization of the aneurysm under systemic heparinization. During the embolization, however, a thrombus developed in the proximal left A2 segment. The patient was given an intravenous infusion (20 mg) of abciximab for 10 minutes, and within 15 minutes dissolution of the thrombus was observed with no angiographic evidence of distal emboli. After reversal of general anesthesia, the patient exhibited minimal right leg weakness, which resolved within 1 hour. CONCLUSION: Abciximab may be a useful adjunct for endovascular treatment of patients with cerebral aneurysms in whom intraprocedural arterial thrombus is encountered.


2009 ◽  
Vol 37 (3) ◽  
pp. 162-166 ◽  
Author(s):  
Masanori TSUTSUMI ◽  
Hiroshi AIKAWA ◽  
Masanari ONIZUKA ◽  
Minoru IKO ◽  
Tomonobu KODAMA ◽  
...  

2019 ◽  
Vol 46 (Suppl_1) ◽  
pp. V12
Author(s):  
Visish M. Srinivasan ◽  
Aditya Vedantam ◽  
Peter Kan

We present a case of a patient with an anterior communicating artery aneurysm treated by PulseRider-assisted coil embolization. PulseRider is a new device, FDA approved for treatment of broad-necked aneurysms of the basilar apex or internal carotid artery terminus. The aneurysm was broad-necked and involved the anterior communicating artery and was considered for traditional stent-assisted coiling as well as PulseRider-assisted coiling. The authors present the treatment plan and strategy and then fluoroscopic recording of the PulseRider delivery and subsequent coiling phase. Nuances of technique for this new device used in a challenging setting are discussed.The video can be found here: https://youtu.be/ont7ggqgLH8.


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