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 patients with vertebral artery dissecting aneurysms who were treated with internal trapping or stent-assisted coiling. MATERIALS AND METHODS:We conducted a meta-analysis of eight retrospective studies that compared internal trapping with stent-assisted coiling for the treatment of vertebral artery dissecting aneurysms. The primary outcomes of this study were immediate occlusion, long-term occlusion, good outcome ratio, perioperative mortality, and angiographic recurrence. Subgroup analyses were conducted of patients with ruptured versus unruptured vertebral artery dissecting aneurysms. RESULTS:Eight studies comprising a total of 188 patients were included in the analysis. For ruptured cases, in comparison with stent-assisted coiling groups, the patients treated with trapping techniques had a higher rate of immediate postoperative occlusion (OR=0.165; 95% CI 0.067 to 0.405; p<0.01), although there was no significant difference in long-term occlusion (OR=1.059; 95% CI 0.033 to 34.121; p=0.974), good clinical outcome rates, recurrence rates, and perioperative mortality. For unruptured cases, patients in the trapping groups also had higher immediate occlusion rates than those who underwent stent-assisted coiling (OR=0.175; 95% CI 0.043 to 0.709; p=0.015), while rates of both recurrence and good clinical outcome were similar between the two groups. CONCLUSIONS:Both internal trapping and stent-assisted coiling are technically feasible for ruptured vertebral artery dissecting aneurysms, with high rates of good long-term neurologic outcomes and low recurrence and mortality rates. For unruptured aneurysms, conservative treatment is recommended. When a posterior inferior cerebellar artery (PICA) origin is involved, bypass surgery or vertebral artery-to-PICA stent placement plus coil embolization should be considered.
journal_name
J Neurointerv Surgjournal_title
Journal of neurointerventional surgeryauthors
Guan J,Li G,Kong X,He C,Long J,Qin H,Zhang H,Wang Rdoi
10.1136/neurintsurg-2016-012309subject
Has Abstractpub_date
2017-06-01 00:00:00pages
558-563issue
6eissn
1759-8478issn
1759-8486pii
neurintsurg-2016-012309journal_volume
9pub_type
杂志文章,meta分析abstract:BACKGROUND:The Low-profile Visualized Intraluminal Support (LVIS) Junior stent is newly approved for the treatment of wide-necked intracranial aneurysms. OBJECTIVE:To report our multicenter experience with use of the LVIS Jr device. METHODS:The neurointerventional databases of the participating institutions were retr...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,多中心研究
doi:10.1136/neurintsurg-2016-012687
更新日期:2017-11-01 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...
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abstract:BACKGROUND:The existence of spinal cord watershed territories was suggested in the 1950s. Segmental infarcts within the junctional territories of adjacent radiculomedullary contributors and isolated spinal gray matter ischemia constitute two well-recognized types of watershed injury. This report describes the existence...
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abstract:BACKGROUND:Coil occlusion has become the standard treatment for many ruptured aneurysms. However, specific aneurysm structures pose technical difficulties and may require the use of adjunctive neck-bridging devices, which necessitate the use of dual antiplatelet therapy. The hydrophilic polymer coating (pHPC, phenox) i...
journal_title:Journal of neurointerventional surgery
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doi:10.1136/neurintsurg-2019-015746
更新日期:2020-09-01 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
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journal_title:Journal of neurointerventional surgery
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abstract::We present a 56-year-old man who presented with bilateral vertebral artery occlusions and recurrent transient ischemic attacks and strokes despite maximal medical therapy. A long-segment extracranial right vertebral occlusion was noted and successfully reconstructed with four drug-eluting stents. The patient has been ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/jnis.2009.002139
更新日期:2011-03-01 00:00:00
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journal_title:Journal of neurointerventional surgery
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journal_title:Journal of neurointerventional surgery
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pub_type: 杂志文章
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journal_title:Journal of neurointerventional surgery
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abstract:INTRODUCTION:Stroke is a leading cause of adult death and disability. Although acute ischemic stroke (AIS) in pregnancy is rare, it has devastating consequences on the life of the mother and fetus. Pregnancy was an exclusion criterion in endovascular thrombectomy (EVT) trials and so there are no evidence-based treatmen...
journal_title:Journal of neurointerventional surgery
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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
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journal_title:Journal of neurointerventional surgery
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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::A patient with a giant symptomatic vertebrobasilar aneurysm was treated by endoscopic third ventriculostomy for obstructive hydrocephalus followed by treatment of the aneurysm by flow diversion using a Pipeline Embolization Device. After an uneventful procedure and initial periprocedural period, the patient experience...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011325.rep
更新日期:2015-11-01 00:00:00
abstract::The recognition of sacral insufficiency fractures continues to be poor, and diagnosis is often delayed resulting in significant morbidity. Percutaneous sacroplasty is an image guided procedure that is safe and potentially effective for treating the pain and disability related to these fractures. Several cohort studies...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,评审
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abstract:BACKGROUND AND OBJECTIVE:The HydroCoil Endovascular Aneurysm Occlusion and Packing Study clinical trial, comparing HydroCoil with platinum coils, reported an 8.6% reduction in significant recurrence following cerebral aneurysm coil embolization. We sought to better understand the mechanism of aneurysmal healing followi...
journal_title:Journal of neurointerventional surgery
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更新日期:2020-04-01 00:00:00
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journal_title:Journal of neurointerventional surgery
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journal_title:Journal of neurointerventional surgery
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更新日期:2020-06-29 00:00:00
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journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
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更新日期:2016-11-01 00:00:00
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journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,多中心研究
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更新日期:2017-06-01 00:00:00
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journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2017-013239
更新日期:2018-03-01 00:00:00
abstract::Acute hemorrhage relating to an expanding pseudoaneurysm of the carotid artery is referred to as carotid blowout syndrome (CBS). CBS is associated with a high morbidity and mortality. We describe the case of a patient who presented with dysphagia and a pulsatile mass in the neck. Imaging revealed a pseudoaneurysm orig...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
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更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Debate exists as to whether patients with acute ischemic stroke who are undergoing mechanical thrombectomy should receive general anaesthesia or conscious sedation during the procedure. Using a multihospital administrative database, we compared outcomes and complications of patients receiving mechanical thro...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
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更新日期:2015-11-01 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
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更新日期:2019-03-01 00:00:00
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journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
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更新日期:2017-03-01 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