scholarly journals Stent-assisted coil placement for unruptured cerebral aneurysms

2004 ◽  
Vol 17 (5) ◽  
pp. 1-4 ◽  
Author(s):  
Pascal Jabbour ◽  
Christopher Koebbe ◽  
Erol Veznedaroglu ◽  
Ronald P. Benitez ◽  
Robert Rosenwasser
Keyword(s):  
Anticoagulation Therapy ◽  
Cerebral Aneurysms ◽  
Antiplatelet Agents ◽  
Challenging Problem ◽  
Parent Vessel ◽  
New Era ◽  
Occlusion Rate ◽  
Unruptured Cerebral Aneurysms ◽  
Placement Procedure

Object The treatment of wide-necked cerebral aneurysms represents a challenging problem for neurosurgeons. The recent development of stents has provided clinicians with the ability to treat these aneurysms while keeping the parent vessel patent. The long-term occlusion rate of aneurysms treated with stent-assisted coil placement has yet to be investigated. The authors report the use of a new intracranial stent—the Neuroform microstent—in the treatment of unruptured wide-necked cerebral aneurysms. Methods Thirty-two patients harboring unruptured wide-necked intracranial aneurysms underwent a stent-assisted coil placement procedure. Patients were pretreated with antiplatelet agents, and a stent was positioned across the neck of the aneurysm. The next step was the insertion of coils into the aneurysm cavity. Patients received anticoagulation therapy for 24 hours after the procedure. All 32 patients with unruptured wide-necked cerebral aneurysms were suitable candidates for this procedure. Occlusion of at least 90% of the aneurysm was achieved in 24 patients (75%) and 0% occlusion was observed in five patients (15%). Two patients experienced thromboembolic events, one of which was directly related to the stent. The overall complication rate was 6.3%. Conclusions Intracranial stents will be used more frequently in the new era of endovascular management of wide-necked cerebral aneurysms. With some technical improvements and more data on long-term occlusion rates, this new modality should improve the occlusion of wide-necked cerebral aneurysms while protecting the parent vessel.

scholarly journals Long-Term Results and Follow-Up Examinations after Endovascular Embolization for Unruptured Cerebral Aneurysms

2019 ◽  
Vol 40 (7) ◽  
pp. 1191-1196 ◽  
Author(s):  
T. Murakami ◽  
T. Nishida ◽  
K. Asai ◽  
Y. Kadono ◽  
H. Nakamura ◽  
...  
Keyword(s):  
Cerebral Aneurysms ◽  
Endovascular Embolization ◽  
Long Term Results ◽  
Unruptured Cerebral Aneurysms

scholarly journals Advances in endovascular aneurysm management: coiling and adjunctive devices

2020 ◽  
Vol 5 (1) ◽  
pp. 14-21
Author(s):  
Jessica K Campos ◽  
Brian V Lien ◽  
Alice S Wang ◽  
Li-Mei Lin
Keyword(s):  
Cerebral Aneurysms ◽  
Next Generation ◽  
Coil Embolisation ◽  
Interventional Techniques ◽  
Technological Advances ◽  
Aneurysm Occlusion ◽  
Unruptured Cerebral Aneurysms ◽  
Endovascular Coils

Endovascular coil embolisation continues to evolve and remains a valid modality in managing ruptured and unruptured cerebral aneurysms. Technological advances in coil properties, adjunctive devices and interventional techniques continue to improve long-term aneurysm occlusion rates. This review elaborates on the latest advances in next-generation endovascular coils and adjunctive coiling techniques for treating cerebral aneurysms.

scholarly journals Long-term Follow-up after Treatment for Cerebrovascular Disease. Semi-long-term Follow-up Results for the Treatment of the Unruptured Cerebral Aneurysms.

2002 ◽  
Vol 30 (2) ◽  
pp. 83-87 ◽  
Author(s):  
Katsumi MATSUMOTO ◽  
Katsuhito AKAGI ◽  
Makoto ABEKURA ◽  
Tateo SAKAGUCHI ◽  
Takahiro TOMISHIMA ◽  
...  
Keyword(s):  
Cerebrovascular Disease ◽  
Cerebral Aneurysms ◽  
Long Term Follow Up ◽  
Unruptured Cerebral Aneurysms

scholarly journals Mid- to Long-term Prognosis of Patients with Clip-ligated Asymptomatic Unruptured Cerebral Aneurysms: De Novo and Untreated Aneurysms

2021 ◽  
Vol 49 (6) ◽  
pp. 447-452
Author(s):  
Shunsuke KAWAMOTO ◽  
Shunsuke FUKAYA ◽  
Yoshihiro ABE ◽  
Kanae OKUNUKI ◽  
Takuma SUMI ◽  
...  
Keyword(s):  
De Novo ◽  
Cerebral Aneurysms ◽  
Long Term Prognosis ◽  
Unruptured Cerebral Aneurysms

Abstract 1122‐000103: FlowDiverter:A Study Safety and Efficacy in a Consecutive Group of 53 Patient and 60 Aneurysm

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Marcelo Bolcato ◽  
ana Carolina Dalmonico ◽  
Leo Ditzel ◽  
Savio Machareti ◽  
Thiago Yoshida ◽  
...  
Keyword(s):  
Cerebral Aneurysms ◽  
Flow Diverter ◽  
Consecutive Series ◽  
Safety And Efficacy ◽  
Grading Scale ◽  
Aneurysm Occlusion ◽  
Occlusion Rate ◽  
Flow Diverters

Introduction : Endovascular flow diverters are increasingly used for the treatment of cerebral aneurysms. We assessed the safety and efficacy of the Flow Diverters in a consecutive series of 53 patients and 60 aneurysms. Methods : Inclusion criteria were wide‐neck, blister‐like, or fusiform aneurysms independent of size, treated with the FRED, PIPELINE and SILK between December 2014 and Junho 2021. Assessment criteria were aneurysm occlusion, manifest ischemic stroke, bleeding, or death. The occlusion rate was assessed at 6 months and 1 year with DSA by using the Raymond classification and the O'Kelly‐Marotta grading scale. Results : Fifty three patients (mean age 54.3 years;81.1% female) with 60 aneurysms were treated with 9 Silk, 38 FREDs and 13 Pipeline. Aneurysm size ranged from 2.5 to 30 mm. Deployment of the Flow diverters was successful in 52 aneurysms. Three patient developed mild stroke symptoms that fully receded within days, 4 patients occlusion total carotid because resistant antiagregation and another patient’s development Swelling syndrome. There has been one death. Initial follow‐up at 6 months showed complete occlusion in 90% of the overall study group and 93,33% at 1 year. Conclusions : The flow diverter is a safe device for the treatment of cerebral aneurysms of various types. Our data reveal high occlusion rates at 6 months and 1 year. Long‐term occlusion rates are expected.

The Role of Blood Impulse in Cerebral Aneurysm Coil Compaction: Effect of Aneurysm Neck Size

2003 ◽  
Author(s):  
Baruch B. Lieber ◽  
Chander Sadasivan ◽  
Matthew J. Gounis ◽  
Ajay K. Wakhloo
Keyword(s):  
Cerebral Aneurysms ◽  
Momentum Equation ◽  
Parent Vessel ◽  
Neck Size ◽  
Aneurysm Neck ◽  
Hemodynamic Forces ◽  
Sigmoid Curve ◽  
Detachable Coils ◽  
Aneurysm Volume

Endovascular occlusion of cerebral aneurysms with bare platinum detachable coils is now recognized as preferable to surgical clipping (ISUIA Group, 2003, ISAT Group, 2002, Bavinzski et al, 1995, Thornton et al, 2002). Dependent on coil packing density (the ratio of the coil volume deposited in an aneurysm to that of the aneurysm volume), aneurysm location, size and neck width, coil compaction with recanalization of the aneurysm remains in the long-term a major concern. The aneurysm neck size is reported to be the main predictor for aneurysm recanalization (Fernandez-Zubillaga et al, 1994). The forces exerted on the coil mass at the aneurysm neck due to blood pulsatility are larger for wide neck aneurysms as compared to small neck aneurysms (Bavinzski et al, 1995). However, impingement forces have not been evaluated. We evaluated the force impinging on the aneurysm neck in a simplified aneurysm (basilar top) geometry utilizing the impulse-momentum equation and Womersley’s flow. Maximum impingement force as a function of aneurysm neck to parent lumen diameter ratio varies as a sigmoid curve. Analysis of the hemodynamic forces affecting coil compaction in cerebral aneurysms shows that the coil mass at the aneurysm neck may be subjected to cyclic impulse impingement due to redirection of blood momentum. Orientation of the aneurysm neck and the main axis of the aneurysm in relation to the oncoming parent vessel flow may help clinicians predict the risk of coil compaction and the location of subsequent aneurysm recanalization.

Retrospective analysis of intracranial aneurysms after flow diverter treatment including color-coded imaging (syngo iFlow) as a predictor of aneurysm occlusion

2021 ◽  
pp. 159101992110240
Author(s):  
Andreas Simgen ◽  
Christine Mayer ◽  
Michael Kettner ◽  
Ruben Mühl-Benninghaus ◽  
Wolfgang Reith ◽  
...  
Keyword(s):  
Cerebral Aneurysms ◽  
Flow Diverter ◽  
Complication Rates ◽  
Long Term Follow Up ◽  
Aneurysm Growth ◽  
Short And Long Term ◽  
Aneurysm Occlusion ◽  
Unruptured Cerebral Aneurysms

Purpose Flow Diverters (FD) have immensely extended the treatment of cerebral aneurysms in the past years. Complete aneurysm occlusion is a process that often takes a certain amount of time and is usually difficult to predict. Our aim was to investigate different syngo iFlow parameters in order to predict aneurysm occlusion. Methods Between 2014 and 2018 patients with unruptured cerebral aneurysms treated with a FD were reviewed. Aneurysm occlusion and complication rates have been assessed. In addition, various quantitative criteria were assessed using syngo iFlow before, after the intervention, and after short and long-term digital subtraction angiography (DSA). Results A total of 66 patients hosting 66 cerebral aneurysms were included in this study. 87.9% (n = 58) aneurysms in the anterior and 12.1% (n = 8) in the posterior circulation were treated. Adequate aneurysm occlusion at long-term follow-up (19.05 ± 15.1 months) was achieved in 90.9% (n = 60). Adequately occluded aneurysm revealed a significantly greater peak intensity delay (PI-D, p = 0.008) and intensity decrease ratio (ID-R, p < 0.001) compared to insufficiently occluded aneurysms. Increased intra-aneurysmal contrast agent intensity (>100%) after FD implantation resulted in an ID-R < 1, which was associated with aneurysm growth during follow-up DSA. Retreatment with another FD due to foreshortening and/or aneurysm growth was performed in 10.6% (n = 7). Overall morbidity and mortality rates were 1.5% (n = 1) and 0%. Conclusion The applied syngo iFlow parameters were found to be useful in predicting adequate aneurysm occlusion and foresee aneurysm growth, which might indicate the implantation of another FD.

scholarly journals Mid- to Long-term Durability of Clip-ligated Asymptomatic Unruptured Cerebral Aneurysms

2021 ◽  
Vol 49 (3) ◽  
pp. 186-190
Author(s):  
Shunsuke KAWAMOTO ◽  
Shunsuke FUKAYA ◽  
Yoshihiro ABE ◽  
Kanae OKUNUKI ◽  
Takuma SUMI ◽  
...  
Keyword(s):  
Cerebral Aneurysms ◽  
Unruptured Cerebral Aneurysms
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