scholarly journals Simple Classification of Anterior Communicating Artery Aneurysm Based on the Relation between A1 Direction and Aneurysm Projection: Angiographic Outcome after Coil Embolization

2015 ◽  
Vol 43 (2) ◽  
pp. 125-129
Author(s):  
Hiroyuki TOI ◽  
Kohei MATSUMURA ◽  
Hirotaka HAGINO ◽  
Hiroki TAKAI ◽  
Natsue KISHIDA ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Artery Aneurysm ◽  
Anterior Communicating Artery ◽  
Anterior Communicating Artery Aneurysm ◽  
Simple Classification

scholarly journals Coaxial Access for Microcatheter Stabilization During Aneurysm Coiling: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Miri Kim ◽  
Rachyl Shanker ◽  
Anthony Kam ◽  
Matthew Reynolds ◽  
Joseph C Serrone
Keyword(s):  
Artery Aneurysm ◽  
Anterior Communicating Artery ◽  
Distal Catheter ◽  
Anterior Communicating Artery Aneurysm ◽  
Class 1 ◽  
Previously Treated ◽  
Aneurysm Occlusion ◽  
Intracranial Circulation ◽  
Aneurysm Coiling

Abstract Coaxial support is a fundamental technique utilized by neurointerventionalists to optimize distal catheter control within the intracranial circulation. Here we present a 41-yr-old woman with a previously coiled ruptured anterior communicating artery aneurysm with progressive recurrence harboring tortuous internal carotid anatomy to demonstrate the utility of coaxial support. Raymond-Roy classification of initial aneurysm coiling of class 1 resulted as class 3b over the 21 mo from initial treatment.1 The patient consented to stent-assisted coiling for retreatment of this aneurysm. Coaxial support was advanced as distally as possible in the proximal vasculature to improve catheter control, reducing dead space within which the microcatheter could move, decreasing angulations within proximal vasculature, limiting the movement of the native vessels, and providing a surface of lower friction than the endothelium. As the risk of recurrent subarachnoid hemorrhage in previously treated coiled aneurysms approaches 3%, retreatment occurs in 16.4% within 6 yr2 and in 17.4% of patients within 10 yr.3 Rerupture is slightly higher in patients who underwent coiling vs clipping, with the rerupture risk inversely proportional to the degree of aneurysm occlusion,4 further substantiating that coaxial support provides technical advantage in selected patients where additional microcatheter control is necessary for optimal occlusion. Pitfalls of this technique include vasospasm and vascular injury, which can be ameliorated by pretreatment of the circulation with vasodilators to prevent catheter-induced vasospasm. This case and model demonstration illustrates the technique of coaxial access in the stent-assisted coiling of a recurrent anterior communicating artery aneurysm and identification and management of catheter-induced vasospasm.

scholarly journals Stent anchor technique to reduce microcatheter loop for stent-assisted coiling of anterior communicating artery aneurysm

2019 ◽  
Vol 46 (Suppl_1) ◽  
pp. V8 ◽  
Author(s):  
Kunal Vakharia ◽  
Stephan A. Munich ◽  
Michael K. Tso ◽  
Muhammad Waqas ◽  
Elad I. Levy
Keyword(s):  
Packing Density ◽  
Coil Embolization ◽  
Artery Aneurysm ◽  
Stent Retriever ◽  
Anterior Communicating Artery ◽  
Potential Solution ◽  
Link Type ◽  
Anterior Communicating Artery Aneurysm ◽  
Coil Occlusion

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.

Management of Intraprocedural Arterial Thrombus in Cerebral Aneurysm Embolization with Abciximab: Technical Case Report

Neurosurgery ◽  
2002 ◽  
Vol 50 (4) ◽  
pp. 899-902 ◽  
Author(s):  
Michael J. Alexander ◽  
Gary R. Duckwiler ◽  
Y. Pierre Gobin ◽  
Fernando Viñuela
Keyword(s):  
Cerebral Aneurysm ◽  
Coil Embolization ◽  
Artery Aneurysm ◽  
Neurological Deficits ◽  
Anterior Communicating Artery ◽  
Thromboembolic Complications ◽  
Anterior Communicating Artery Aneurysm ◽  
Guglielmi Detachable Coil ◽  
Aneurysm Embolization ◽  
Arterial Thrombus

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.

scholarly journals Coil Embolization for Tiny Ruptured Anterior Communicating Artery Aneurysm

2009 ◽  
Vol 37 (3) ◽  
pp. 162-166 ◽  
Author(s):  
Masanori TSUTSUMI ◽  
Hiroshi AIKAWA ◽  
Masanari ONIZUKA ◽  
Minoru IKO ◽  
Tomonobu KODAMA ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Artery Aneurysm ◽  
Anterior Communicating Artery ◽  
Anterior Communicating Artery Aneurysm

scholarly journals PulseRider treatment of an anterior communicating artery aneurysm

2019 ◽  
Vol 46 (Suppl_1) ◽  
pp. V12
Author(s):  
Visish M. Srinivasan ◽  
Aditya Vedantam ◽  
Peter Kan
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Coil Embolization ◽  
Internal Carotid ◽  
Treatment Plan ◽  
Artery Aneurysm ◽  
Anterior Communicating Artery ◽  
New Device ◽  
Link Type ◽  
Anterior Communicating Artery Aneurysm

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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