Abstract:
BACKGROUND AND PURPOSE:Little is known about the safety of long-term anticoagulation in patients with unruptured saccular intracranial aneurysms, although case reports of anticoagulation in patients with fusiform and saccular aneurysms have been published. The goal of this study was to estimate the rate of subarachnoid hemorrhage (SAH) due to aneurysm rupture in patients with intracranial saccular aneurysms receiving therapeutic doses of anticoagulation. METHODS:This was a retrospective case series of patients with intradural aneurysms receiving therapeutic doses of anticoagulation (defined as a dose that achieves a target INR >2.0 or the equivalent dose of another anticoagulant). The primary outcome was SAH due to aneurysm rupture while receiving anticoagulation treatment. The rate of SAH due to aneurysm rupture was calculated among patients with aneurysms documented on imaging. RESULTS:42 patients with 48 intradural aneurysms on anticoagulation were identified. Their mean age was 67 years (range 40-83) and 28 (67%) were women. The mean aneurysm size was 5.1±3.6 mm and 40 (83%) aneurysms were in the anterior circulation. The mean±SD follow-up was 495±749 days per patient. Twelve patients had their aneurysms coiled, clipped or surgically wrapped before the period of anticoagulation. Three patients had clipping or coiling of their aneurysms during the period of anticoagulation. Six patients had a history of aneurysm rupture prior to anticoagulation, of which two were treated by coiling and four by clipping. Among the 48 aneurysms, 32 were never coiled or clipped prior to anticoagulation. No anticoagulated patients with known aneurysms developed SAH during 57 patient-years of follow-up. The patients with untreated aneurysms had 31 patient-years of follow-up and those who underwent clipping, coiling or surgical wrapping of their aneurysms had 26 patient-years of follow-up while receiving anticoagulation (for a combined total of 57 years of follow up). CONCLUSIONS:The risk of aneurysm rupture is not increased in patients receiving systemic anticoagulation. However, these results should be interpreted with caution given the small sample size in this study and the need for a prospective study to confirm these findings.
journal_name
J Neurointerv Surgjournal_title
Journal of neurointerventional surgeryauthors
Tarlov N,Norbash AM,Nguyen TNdoi
10.1136/neurintsurg-2012-010359subject
Has Abstractpub_date
2013-09-01 00:00:00pages
405-9issue
5eissn
1759-8478issn
1759-8486pii
neurintsurg-2012-010359journal_volume
5pub_type
杂志文章abstract:INTRODUCTION:ADAPT (a direct aspiration first pass technique) has been shown to be fast, cost-effective, and associated with excellent angiographic and clinical outcomes in the treatment of acute ischemic stroke (AIS). OBJECTIVE:To identify any and all preoperative factors that are associated with successful revascula...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2016-012439
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Combining non-contrast CT (NCCT), CT angiography (CTA), and CT perfusion (CTP) imaging (referred to as a CT stroke study, CTSS) provides a rapid evaluation of the cerebrovascular axis during acute ischemic stroke. Iodinated contrast-enhanced CT imaging is not without risk, which includes renal injury. If a p...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-012118
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:There is a discrepancy in clinical outcomes and the achieved recanalization rates with stent retrievers in the endovascular treatment of ischemic stroke. It is our hypothesis that procedural release of embolic particulate may be one contributor to poor outcomes and is a modifiable risk. The goal of this stud...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011491
更新日期:2016-02-01 00:00:00
abstract:PURPOSE:Three-dimensional (3D) scans with flat detector angiographic systems are widely used for neurointerventions by providing detailed vascular information. However, its associated radiation dose and streak metal artifact generated by implanted treatment devices remain issues. This work evaluates the feasibility and...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2018-013886
更新日期:2019-02-01 00:00:00
abstract:INTRODUCTION:Prior studies of aneurysmal subarachnoid hemorrhage (SAH) have shown that treatment at teaching institutions and decreased time to surgery are factors that correlate with improved patient outcome. We aimed to individually evaluate the effect of teaching institution treatment on rates of surgical clipping o...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011642
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Intracranial blister aneurysms are rare lesions that are notoriously more difficult to treat than typical saccular aneurysms. High complication rates associated with surgery have sparked considerable interest in endovascular techniques, though not well-studied, to treat blister aneurysms. OBJECTIVE:To evalu...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011443
更新日期:2016-01-01 00:00:00
abstract:INTRODUCTION:Various large-bore catheters can be employed for manual aspiration thrombectomy (MAT); clinical differences are rarely explored. METHODS:Prospectively collected demographic, angiographic, and clinical data for patients with acute internal carotid artery, middle cerebral artery M1, or basilar occlusions un...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2018-014633
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Brain arteriovenous malformations (AVMs) are a rare pathology, and their treatment is discussed. The development of techniques and materials in endovascular, radiosurgical, and neurosurgical fields led to higher rates of complete occlusions and good clinical outcomes. MATERIALS AND METHODS:84 patients (52 m...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2013-010869
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:The formation of de novo pseudoaneurysms after stent implantation has not been well characterized after stenting of intracranial vessels. Its clinical significance is unknown, resulting in a difficult decision making process with regard to its treatment. METHODS:The database of patients treated at the Bapti...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2012-010443
更新日期:2013-09-01 00:00:00
abstract::We report two cases of delayed post-embolectomy stenosis--that is, a new stenosis in the vascular bed of a previous endovascular embolectomy. The first case was discovered incidentally in a patient returning after embolectomy for evaluation of cerebral aneurysms. The second case was discovered on an MR angiogram obtai...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011136.rep
更新日期:2015-05-01 00:00:00
abstract::Spinal arteriovenous malformations (sAVMs) are rare vascular lesions whose natural history remains incompletely defined. Several classification schemes for sAVMs have evolved based on an improved understanding of the anatomic characteristics as well as pathophysiologic behavior of these arteriovenous shunts. Advances ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,评审
doi:10.1136/neurintsurg-2012-010487
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:A study was undertaken to determine the typical length, diameter and taper of vessels in the anterior cerebral circulation. METHODS:The sample size was calculated at 100 patients based on similar measurements in the literature and divided into cohorts based on gender and side. These patients were consecutiv...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2012-010314
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVE:To identify clinical, morphological, and hemodynamic independent characteristic factors that discriminate posterior communicating artery (PCoA) aneurysm rupture status. METHODS:173 patients with single PCoA aneurysms (108 ruptured, 65 unruptured) between January 2012 and June 2014 were retrospectively collec...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-011865
更新日期:2016-08-01 00:00:00
abstract::Idiopathic intracranial hypertension (IIH) is characterized by headache, papilledema, visual field changes and tinnitus with elevated cerebral spinal fluid opening pressures on lumbar puncture. Left untreated, this condition can lead to permanent visual loss. Previous treatment modalities include medical management, t...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,评审
doi:10.1136/neurintsurg-2012-010468
更新日期:2013-09-01 00:00:00
abstract::Intravascular foreign bodies are a known complication of medical and dental procedures. Dental anesthetic needles may be broken off and retained in the oropharynx. These needles have occasionally been reported to migrate through the oral mucosa in to deeper structures. Here we present the case of a 57-year-old man who...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2016-012771.rep
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Recent reports suggest that placement of a venous sinus stent improves symptoms in selected patients with idiopathic intracranial hypertension (IIH). We report our evaluation of the long-term patency of venous stents placed for IIH. METHODS:We retrospectively reviewed our clinical database for 30 patients (...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2013-010691
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Mechanical thrombectomy using a stent retriever has become the standard of care for acute large-vessel occlusions in the anterior circulation. Clots that are refractory to single stent retriever thrombectomy remain a challenge for neurointerventionalists. OBJECTIVE:To assess the efficacy and safety of doubl...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2018-014288
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Deconstructive approaches may be necessary to treat a variety of neurovascular pathologies. Recently, a new device has become available for endovascular arterial occlusion that may have unique applications in neurovascular disease. The Micro Vascular Plug (MVP, Reverse Medical, Irvine, California, USA) has b...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011306
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Reversible cerebral vasoconstriction syndromes (RCVS) represent a heterogeneous group of cerebrovascular disease characterized by acute presentations and transient segmental narrowing of the distal intracranial arteries. A series of patients with RCVS were studied to better understand the clinica...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/jnis.2010.004242
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Flow-diverter stent (FDS) placement for treatment of intracranial aneurysms can cause flow changes in the covered branches. OBJECTIVE:To assess the impact of the treatment of carotid siphon aneurysms with FDS on the posterior communicating artery (PComA) flow. MATERIALS AND METHODS:Between February 2011 an...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2016-012443
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:In recent years, implantation of flow diverters has emerged as an option for the endovascular treatment of intracranial aneurysms. One complication of treatment with flow diverters is the occurrence of in-stent stenosis, which has been reported to be partially reversible. The purpose of our study...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2018-013975
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We compared outcomes between endovascular (EV) therapy and intravenous (IV) thrombolysis in large vessel strokes. METHODS:223 patients who had received either IV (n=100) or EV (n=123) therapy were analyzed. Only patients with strokes involving the internal carotid artery terminus (ICA-T, n=45), ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2012-010429
更新日期:2013-09-01 00:00:00
abstract::We report a rare case of metal-induced dermatitis after coil embolization for cerebral aneurysm. A 51-year-old woman experienced a rash around the lips and neck 3 weeks after coil embolization. Judging from the clinical course and results of several patch tests, platinum coils were considered to have induced the derma...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-011981.rep
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVE:To audit our institutional mechanical thrombectomy (MT) outcomes for acute anterior circulation stroke and examine the influence of workflow time metrics on patient outcomes. METHODS:A database of 100 MT cases was maintained throughout May 2010-February 2015 as part of a statewide service provided across two...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,多中心研究
doi:10.1136/neurintsurg-2016-012304
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The goal of this article is to provide consensus recommendations for reporting standards, terminology, and written definitions when reporting on the radiological evaluation and endovascular treatment of intracranial, cerebral aneurysms. These criteria can be used to design clinical trials, to pro...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,实务指引
doi:10.1136/jnis.2010.002337
更新日期:2010-12-01 00:00:00
abstract:PURPOSE:To determine if lumbar synovial cyst rupture in symptomatic patients results in improved clinical outcome when using direct tandem and/or coaxial percutaneous CT guided techniques. MATERIALS AND METHODS:20 patients with unilateral lower extremity radiculopathy and/or low back pain underwent CT guided percutane...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2013-010891
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Moyamoya disease (MMD) is a rare cerebrovascular disease usually characterized by progressive bilateral distal internal carotid artery stenosis or occlusion and its consequences. Direct (ie, extracranial-intracranial bypass) or indirect cerebral revascularization procedures are the most established and effec...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/jnis.2010.003004
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Expansion of the endovascular and surgical workforce in the USA might lead to carotid revascularization procedures being carried out at low volume centers. OBJECTIVE:To evaluate trends in the treatment of carotid stenosis at high volume centers in the USA and compare outcomes by hospital volume. METHODS:Us...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011180
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Treatment of dural arteriovenous fistula involving the transverse-sigmoid region with cortical reflux is complex and treatment options may require sacrifice of the fistulous segment of the sinus. OBJECTIVE:To review our results in this subset of patients and describe current endovascular decision-making and...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2012-010497
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:The rates of recanalization and reinterventions after endovascular treatment (EVT) of intracranial aneurysms are unknown. Various risk factors have been suggested including the configuration of the aneurysm and the endovascular technique. Recently, an increasing number of patients have received antiplatelet ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2011-010111
更新日期:2012-09-01 00:00:00