Abstract:
BACKGROUND:The treatment of recurrent aneurysms after previous surgery or embolization is challenging. Little is known regarding the use of the Pipeline Embolization Device (PED) for recurrent aneurysms. OBJECTIVE:To analyze the safety and results of PED therapy for recurrent aneurysms. METHODS:Fifteen patients with recurrent intracranial aneurysms after previous embolization or surgical clipping were treated with the PED at our institution between 2011 and 2012. Procedural complications and clinical and angiographic outcomes were analyzed. RESULTS:Median aneurysm size was 12 mm. Previous aneurysm treatment consisted of coiling in eight patients, stent coiling in four, a telescoping stent technique in two and surgical clipping in one. Major procedural complications (leaving significant morbidity) occurred in one patient (6.7%) and minor procedural or technical complications (no or minor morbidity) occurred in four patients (26.7%). Fourteen of the 15 patients (93.3%) had a favorable outcome (modified Rankin Scale score 0-2). Of 14 patients with angiographic follow-up, nine (64.3%) had complete aneurysm occlusion (100%), four (28.6%) had near-complete occlusion (≥90%) and only one (7.1%) had incomplete occlusion (<90%). Four of the five patients with less than 100% occlusion at follow-up had a previous stent in situ. CONCLUSIONS:Treatment of recurrent aneurysms with the PED appears to be effective, but patients with a previous stent in situ may achieve lower obliteration rates. The morbidity rate associated with PED therapy may be higher than with more standard endovascular techniques using historical data. Larger studies are needed to assess this question better.
journal_name
J Neurointerv Surgjournal_title
Journal of neurointerventional surgeryauthors
Chalouhi N,Chitale R,Starke RM,Jabbour P,Tjoumakaris S,Dumont AS,Rosenwasser RH,Gonzalez LFdoi
10.1136/neurintsurg-2012-010612subject
Has Abstractpub_date
2014-01-01 00:00:00pages
19-23issue
1eissn
1759-8478issn
1759-8486pii
neurintsurg-2012-010612journal_volume
6pub_type
杂志文章abstract:OBJECTIVE:Early intervention is desirable in patients presenting with stroke or transient ischemic attack (TIA) referable to carotid artery stenosis because of the high incidence of recurrent ischemic events within 48 h post-ictus. However, the optimal timing of performing carotid angioplasty and stenting (CAS) in thes...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2013-010744
更新日期:2014-05-01 00:00:00
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...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2012-010359
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:A rare complication of neuroendovascular procedures is acute thromboembolism. In the setting of intraprocedural or periprocedural embolism, thrombolytics present a potentially useful therapeutic strategy. A series of patients in whom eptifibatide (a platelet glycoprotein IIb/IIIa receptor inhibitor) was used ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2012-010271
更新日期:2013-05-01 00:00:00
abstract::The lifetime risk of developing a cerebral aneurysm is about 5%. For some patients, aneurysms can be reasonably managed by conservative measures, including periodic clinical and imaging surveillance. However, the definitive treatment of cerebral aneurysm disease requires securing the aneurysm by surgically excluding i...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,评审
doi:10.1136/jnis.2009.000539
更新日期:2009-12-01 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:Despite several retrospective studies analyzing the safety and efficacy of transradial access (TRA) versus transfemoral access (TFA) for cerebral angiography, this transition for neurointerventional procedures has been gradual. Nonetheless, based on our positive initial institutional experience with TRA for ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2017-013584
更新日期:2018-09-01 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:Endovascular recanalization for medically refractory non-acute middle cerebral artery (MCA) occlusion remains a clinical dilemma, and limited data are available. We report the multicenter clinical results of endovascular recanalization for symptomatic non-acute MCA occlusion and propose a new angiographic cl...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2020-016692
更新日期:2020-10-29 00:00:00
abstract:BACKGROUND AND PURPOSE:Thrombelastography (TEG) is widely used for the measurement of platelet function. However, few studies have investigated the TEG parameters in patients receiving extracranial or intracranial artery stenting for ischemic cerebrovascular disease. This study sought to describe the association of TEG...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-011687
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:The optimal first-line mechanical thrombectomy (MT) method in cancer-related stroke (CRS) patients with emergent large vessel occlusion (ELVO) remains largely unknown. The aim of this study is to evaluate the efficacy and safety between contact aspiration (CA) first-line thrombectomy and stent retriever (SR)...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2020-016144
更新日期:2020-06-25 00:00:00
abstract::We describe a case where a complex unruptured basilar tip aneurysm was treated with a unique method of stent-assisted coil embolization. The aneurysm was considered to have a complex anatomy since both the left posterior cerebral artery and left superior cerebellar artery originated from the dome of the aneurysm. Also...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011288.rep
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The pCONus is a new stent featuring a distal end that opens like a blossoming flower with four petals. The device is implanted in the aneurysm sac at the level of the neck. We report our initial experience in a series of patients treated with this device. METHODS:This retrospective study was app...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-011898
更新日期:2016-09-01 00:00:00
abstract::The statistics for stroke in the USA reads like a familiar ad slogan cited in most papers pertaining to acute ischemic stroke (AIS). Stroke is the third leading cause of death in the USA. While stroke ranks third among all causes of death, behind diseases of the heart and cancer, it is the leading cause of serious lon...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,评审
doi:10.1136/jnis.2009.000117
更新日期:2009-07-01 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::Pseudomonas aeruginosa meningitis is an uncommon complication of neurosurgical procedures or head trauma. Here, a case of infectious mid basilar artery aneurysm from Pseudomonas meningitis, and its angiographic remission from timely antibiotic therapy, is reported. ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/jnis.2011.004747
更新日期:2012-05-01 00:00:00
abstract::Current clinical practice standards are addressed for the invasive interventional management of post-hemorrhagic cerebral vasospasm (PHCV) in patients with aneurysmal subarachnoid hemorrhage. The conclusions, based on an assessment by the Standards Committee of the Society of Neurointerventional Surgery, included a cr...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,评审
doi:10.1136/neurintsurg-2011-010248
更新日期:2012-05-01 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:INTRODUCTION:Completed randomized trials on endovascular thrombectomy (ET) did not independently assess the efficacy of ET in the elderly (≥80 years old) who were often excluded or under-represented in trials. There were also inconsistent criteria for patient selection in this population across the different trials. Th...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2018-013787
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Evaluation of flow diversion treatment of intracranial aneurysms is difficult owing to lack of knowledge of the target hemodynamic environment. OBJECTIVE:To identify hemodynamic conditions created after flow diversion that induce fast aneurysm occlusion. METHODS:Two groups of aneurysms treated with flow di...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2013-011080
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Open surgery and the retrograde endovascular approach via the distal left common carotid artery (LCCA) have some limitations in LCCA ostial stenosis treatment. The 'no touch' technique used in the renal artery was modified for this situation. METHODS:Fifteen selective LCCA stenosis patients were treated by ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2016-012544
更新日期:2017-02-01 00:00:00
abstract::The Massachusetts General Hospital Neuroradiology Division employed an experience and evidence based approach to develop a neuroimaging algorithm to best select patients with severe ischemic strokes caused by anterior circulation occlusions (ACOs) for intravenous tissue plasminogen activator and endovascular treatment...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,评审
doi:10.1136/neurintsurg-2013-010715
更新日期:2013-05-01 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::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:OBJECTIVE:We have previously developed three logistic regression models for discriminating intracranial aneurysm rupture status from 119 aneurysms based on hemodynamic-morphological parameters. In this study we exploit their use as a tool for predicting the risk of rupture of aneurysms with a defined Rupture Resemblanc...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011218
更新日期:2015-07-01 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::Basilar artery occlusion is an infrequent form of acute stroke; clinical outcomes are heterogeneous, but the condition can be fatal. There is a lack of randomized controlled trial data in this field. Case series suggest that patients who are recanalized have much better outcomes than those who are not, and it is gener...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,评审
doi:10.1136/neurintsurg-2011-010090
更新日期:2012-07-01 00:00:00
abstract:INTRODUCTION:Endovascular interventions for intracranial aneurysms have evolved substantially over the past several decades. A citation rank list is used to measure the scientific and/or clinical impact of an article. Our objective was to identify and analyze the characteristics of the 100 most cited articles in the fi...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2017-013688
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Stenting of symptomatic intracranial atherosclerosis remains under investigation, yet this option to potentially avert subsequent stroke has been offered at select centers under humanitarian device exemption and off-label use for several years. METHODS:Retrospective case series of consecutive patients under...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/jnis.2010.004523
更新日期:2012-01-01 00:00:00
abstract::Several anatomical variations of the radial artery have been described in the literature. Common variations include radial artery loop, recurrent branch, and anastomotic channels connecting the radial and brachial arteries. These variations can pose significant technical challenges to safe radial artery catheterizatio...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2019-015712
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Acute stroke from tandem extracranial carotid artery and intracranial large vessel occlusion poses challenges for emergency endovascular treatment. Establishing and maintaining patency of the carotid artery and avoiding intracranial hemorrhage are competing concerns. METHODS:Twenty-three consecutive cases o...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011224
更新日期:2015-03-01 00:00:00