Abstract:
BACKGROUND:Dissecting aneurysms of the vertebral artery (VA) are difficult to treat using current surgical and endovascular techniques. OBJECTIVE:To analyze retrospectively the efficacy and safety of flow diverters in the treatment of dissecting aneurysms of the vertebral artery. METHODS:We identified six patients with six unruptured VA dissecting aneurysms either arising from the V4 or V3-V4 junction that were treated with the Pipeline embolization device (PED) at our institution between July 2012 and February 2015. Among other parameters, technical feasibility of the procedure, procedure-related complications, angiographic results, and clinical outcome were evaluated. RESULTS:PED placement was achieved in all cases and immediate angiography follow-up demonstrated intra-aneurysmal contrast stasis with parent artery preservation. A temporary episode of dysarthria was noted in one patient. Major procedure-related complications were not observed. The 6-month follow-up (n=6) demonstrated complete/near-complete aneurysm obliteration in five patients and partial obliteration in one. At the 1-year follow-up (n=5) stable complete aneurysm occlusion was seen in two patients. Two cases showed progression from near complete occlusion and partial occlusion at 6 months to complete occlusion and near complete occlusion. One cases showed unchanged near complete occlusion. No aneurysmal bleeding, in-stent stenosis or thromboembolic complication was seen. National Institutes of Health Stroke Scale and modified Rankin scale scores remained unchanged from admission to discharge. CONCLUSIONS:Our preliminary experience with the use of PED for the treatment of intradural VA dissecting aneurysms shows promising short-term results, making this technique a feasible and safe treatment option in patients suitable for this approach. However, long-term and larger cohort studies are needed to validate these results.
journal_name
J Neurointerv Surgjournal_title
Journal of neurointerventional surgeryauthors
Kühn AL,Kan P,Massari F,Lozano JD,Hou SY,Howk M,Gounis MJ,Wakhloo AK,Puri ASdoi
10.1136/neurintsurg-2015-012028subject
Has Abstractpub_date
2016-10-01 00:00:00pages
1048-51issue
10eissn
1759-8478issn
1759-8486pii
neurintsurg-2015-012028journal_volume
8pub_type
杂志文章abstract:OBJECTIVES:We sought to determine whether the timing of carotid artery stenting (CAS) affects peri-procedural outcomes in recently symptomatic patients. BACKGROUND:Early carotid endarterectomy following a stroke lowers the risk of recurrent ischemic events but has been associated with an increased risk of intracerebra...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/jnis.2009.000901
更新日期:2010-03-01 00:00:00
abstract:INTRODUCTION:Atraumatic convexity subarachnoid hemorrhage is a subtype of spontaneous subarachnoid hemorrhage that often presents a diagnostic challenge. Common etiologies include cerebral amyloid angiopathy, vasculopathies, and coagulopathy; however, aneurysm is rare. Given the broad differential of causes of convexit...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2019-014781
更新日期:2019-12-01 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:PURPOSE:Although the anatomic course of the posterior interior cerebellar artery (PICA) is variable, it is thought to be very rare for the artery to cross midline, with an estimated incidence of 0.1%. Bihemispheric PICA crosses midline and typically serves both PICA territories. METHODS:We present 11 cases of bihemisp...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2012-010527
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND AND AIM:During endovascular procedures for acute ischemic stroke, catheter access to the occluded vessel may be technically difficult or impossible. The aim of this study was to access the impact of difficult catheter access to target the carotid artery on clinical outcome. METHODS:Anterior circulation stro...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2012-010438
更新日期:2013-05-01 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: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::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:Intra-arterial therapy (IAT) is increasingly used to treat patients with acute stroke with large vessel occlusions. There are minimal data and guidelines for treatment indications and performance standards. We aimed to gain a better understanding of real-world practice patterns for IAT. METHODS:An internet-...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2012-010565
更新日期:2013-05-01 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:BACKGROUND:Aneurysms at the posterior communicating artery (PCOM) origin represent the most common location on the internal carotid artery (ICA), and are associated with greater recurrence following endovascular treatment. We evaluate the association between ICA angulation in three-dimensional (3D) space and PCOM aneur...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2020-015883
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Complete occlusion of an intracranial aneurysm (IA) after the deployment of a flow-diverter stent is currently unpredictable. The aim of this study was to develop a predictive occlusion score based on pretreatment clinical and angiographic criteria. METHODS:Consecutive patients with ≥6 months follow-up were...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2020-016748
更新日期:2020-11-20 00:00:00
abstract:BACKGROUND:Experience with the endovascular treatment of cerebral aneurysms by flow diverter devices (FDDs) is limited to four devices (Pipeline, Covidien; FRED, Microvention; Silk, Balt Extrusion; Surpass, Stryker), as reported in different studies. OBJECTIVE:To describe the initial experience and the technical innov...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-011743
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:The degree of stenosis of carotid arteries is recognized as an important risk factor for ischemic stroke. However, high-grade stenosis does not always cause cerebrovascular events, whereas low- to moderate-grade stenosis may often cause strokes. It has been reported that there is an association between carot...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011317
更新日期:2016-02-01 00:00:00
abstract::Component coding is the method NeuroInterventionalists have used for the past 20 years to bill procedural care. The term refers to separate billing for each discrete aspect of a surgical or interventional procedure, and has typically allowed billing the procedural activity, such as catheterization of vessels, separate...
journal_title:Journal of neurointerventional surgery
pub_type: 历史文章,杂志文章
doi:10.1136/neurintsurg-2012-010606
更新日期:2013-11-01 00:00:00
abstract:INTRODUCTION:Mechanical thrombectomy (MT) has transformed the treatment of ischemic stroke. However, patient access to MT may be limited due to a shortage of doctors specifically trained to perform MT. The studies reported here were done to (1) develop, operationally define, and seek consensus from procedure experts on...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2018-014510
更新日期:2019-08-01 00:00:00
abstract:SUMMARY:The first known use of Onyx delivered via a dual lumen balloon catheter is reported. A mandibular arteriovenous malformation was successfully embolized with Onyx via an Ascent balloon catheter. CASE PRESENTATION:A teenage girl presented with facial deformity and episodes of oral bleeding. Angiogram showed an e...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2011-010179
更新日期:2013-03-01 00:00:00
abstract:INTRODUCTION:Venous outflow obstruction is recognized as a contributing factor in a subset of patients with idiopathic intracranial hypertension (IIH). Little is known about venous sinus waveform morphology or how it changes after stenting. METHODS:Fifteen patients with IIH underwent waveform recording during catheter...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2018-013858
更新日期:2018-11-01 00:00:00
abstract::The endovascular management of giant aneurysms often proves difficult with standard techniques. Obtaining distal access to allow catheter reduction is often key to approaching these aneurysms, but several anatomic challenges make this task unsafe and not feasible. Obtaining distal anchor points and performing catheter...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011336.rep
更新日期:2016-07-01 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 AND PURPOSE:Adjunctive devices are commonly employed in the treatment of wide necked cerebral aneurysms. Balloon remodeling and permanent stent implantation may lead to thromboembolic complications or the need for antiplatelet use. A temporary stent that does not lead to complete flow arrest may be beneficia...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011518
更新日期:2016-02-01 00:00:00
abstract::We present our initial patient experience with an innovative temporary bridging device, the Comaneci (Rapid Medical, Israel), to assist in the coiling of cerebral aneurysms. The Comaneci device confers the same benefits as balloon remodeling but without the risks of parent artery occlusion. This alleviates time pressu...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-011726.rep
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:To elucidate the early detachment of the Solitaire stent during mechanical thrombectomy, we tested the stent in vitro under various conditions and evaluated with microscopy. METHODS:A total of five stents were tested. Using a dynamic mechanical analysis machine, we calculated the tensile force needed for sep...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2013-010942
更新日期:2015-02-01 00:00:00
abstract:AIM:To present the long-term angiographic and subjective results of patients with head and neck arteriovenous malformations (HNAVMs) after endovascular treatment. METHODS:We retrospectively analyzed the medical files of 14 patients with HNAVM who were treated between 2000 and 2014. The treatment of choice was a transa...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2016-012570
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Cavernous carotid artery aneurysms (CCAs) represent a unique subset of intracranial aneurysms due to their distinct natural history and the anatomy of the cavernous sinus. Enlarging CCAs can cause elastic compression of the parent internal carotid artery (ICA). We suggest defining aneurysms that cause lumina...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,多中心研究
doi:10.1136/neurintsurg-2018-014562
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Different endovascular modalities have been applied to the treatment of vertebral artery dissecting aneurysms, the most commonly used being internal trapping and stent-assisted coiling, although the ideal treatment remains controversial. OBJECTIVE:To perform a meta-analysis to study clinical outcomes of pat...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,meta分析
doi:10.1136/neurintsurg-2016-012309
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The rabbit small clot embolic model for large vessel occlusion (LVO) is well established, yet has limitations. Blind introduction of autologous thrombus often fails to completely occlude a target vessel and, when successful, the precise timing of occlusion and revascularization is difficult to co...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2013-011063
更新日期:2015-05-01 00:00:00
abstract::This report describes a patient who presented with subarachnoid hemorrhage and extensive right posterior inferior cerebellar artery territory infarct secondary to a dissecting aneurysm of the right intracranial vertebral artery. Urgent endovascular treatment was undertaken with plans for trapping of the diseased segme...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/jnis.2011.004952
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Stent assisted coiling of unruptured wide necked intracranial aneurysms require antiplatelets to prevent stent thrombosis. The effect of the loading dose of antiplatelets prior to the stent coiling procedure in an unsecured wide necked ruptured intracranial aneurysm is not known. OBJECTIVE:To report any pot...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2011-010035
更新日期:2012-07-01 00:00:00
abstract::Flow diversion for the management of intracranial aneurysms represents a paradigm shift in how aneurysms are managed. The Pipeline embolization device (PED) is, to date, the only flow diverter approved for use in the USA by the Food and Drug Administration. Limitations and complications with new treatment strategies a...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011548.rep
更新日期:2016-02-01 00:00:00