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) is a surface modification that inhibits platelet adhesion. OBJECTIVE:To present initial experience with the pCONUS HPC device as an adjunct to coil embolization for ruptured aneurysms using single antiplatelet therapy (SAPT). METHODS:All patients who were treated with the pCONUS HPC for ruptured aneurysms using SAPT were retrospectively identified. The occurrence of thromboembolic and hemorrhagic complications was recorded together with the angiographic and clinical follow-up details. RESULTS:Fifteen patients were identified (nine female) with a median age of 54 years (range 27-81). Six aneurysms were located at the anterior communicating artery, five at the middle cerebral artery bifurcation, two at the basilar artery bifurcation, one at the posterior communicating artery, and one involving the intradural internal carotid artery. Ten patients (66.6%) achieved modified Raymond-Roy classification I or II at post-treatment angiography, with 45.5% of patients having adequate occlusion (defined as complete occlusion or neck remnant) at follow-up. All patients received acetylsalicylic acid (ASA) as SAPT before and after the procedure. Intraprocedural thrombus formation was seen in three patients (20%), resolving in two patients after a bolus dose of eptifibatide, and one treated with mechanical aspiration. No clinical or radiological consequences were seen. There were no recurrent aneurysm ruptures. One patient died owing to cerebral vasospasm. CONCLUSION:This initial clinical experience highlights the possibility and limitations of using the pCONUS HPC device in the treatment of complex ruptured aneurysm with ASA as SAPT. Randomized trials with longer follow-up in larger cohorts are underway.
journal_name
J Neurointerv Surgjournal_title
Journal of neurointerventional surgeryauthors
Aguilar Perez M,AlMatter M,Hellstern V,Wendl C,Ganslandt O,Bäzner H,Henkes Hdoi
10.1136/neurintsurg-2019-015746subject
Has Abstractpub_date
2020-09-01 00:00:00pages
862-868issue
9eissn
1759-8478issn
1759-8486pii
neurintsurg-2019-015746journal_volume
12pub_type
杂志文章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::We report a case of a direct carotid-cavernous fistula (CCF) in a patient with Ehlers-Danlos syndrome type IV who presented with progressive chemosis and diplopia. To prevent potential lethal arterial wall injury due to the fragility of the arterial vessel wall, the ipsilateral carotid artery and internal jugular vein...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011414.rep
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Adequate dual antiplatelet (AP) therapy is imperative when performing neurovascular stenting procedures. Currently, no consensus for the ideal AP regimen exists. Thus the present study aimed to gain a better understanding of real world practice AP patterns by surveying neurointerventional surgeons. METHODS:...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2013-010954
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:To determine the relative effectiveness of proximal and distal protection in prevention of cerebral ischemic events during carotid artery stent (CAS) placement using diffusion-weighted MRI (DW-MRI). METHODS:We analyzed data from patients who had undergone DW-MRI before and within 24 hours of CAS for symptoma...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2016-012661
更新日期:2017-10-01 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: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 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: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: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: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:There has been no prospective evaluation of vertebroplasty using a validated instrument. We describe the pain and functional status of 72 patients before and after vertebroplasty, as prospectively evaluated by the Vertebral Compression Fracture Pain and Functional Disability Questionnaire. METHO...
journal_title:Journal of neurointerventional surgery
pub_type: 临床试验,杂志文章
doi:10.1136/jnis.2009.000158
更新日期:2009-07-01 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::Intracerebral hemorrhage (ICH) is a devastating form of stroke associated with a 40% mortality rate at 30 days and a 75% functional dependence rate at 6 months. The role of surgery to treat ICH remains controversial. Preclinical studies suggest minimally invasive clot evacuation following ICH may benefit patients by m...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2020-016553
更新日期:2020-09-08 00:00:00
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::Infectious intracranial aneurysms (IIAs) are a rare cerebrovascular complication of systemic infections induced by microbial infiltration and degradation of the arterial vessel wall. Studies on the epidemiology and management of IIAs are limited to case reports and retrospective single-center studies, and report a lar...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,评审
doi:10.1136/neurintsurg-2017-013603
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The purpose of this systematic review and meta-analysis was to determine whether carotid stenting patients with intraplaque hemorrhage (IPH) identified on preoperative MRI were more likely to suffer perioperative ischemic complications compared with patients without IPH. METHODS:We conducted a c...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1136/neurintsurg-2016-012593
更新日期:2017-09-01 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: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 AND PURPOSE:Symptomatic intracranial atherosclerosis has been associated with a high rate of recurrent stroke. The safety of treatment of more distal atheromatous lesions with angioplasty has not been systematically reported. METHODS:We retrospectively reviewed our institutional database for all patients tr...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/jnis.2009.001818
更新日期:2010-09-01 00:00:00
abstract:PURPOSE:Multiple scores have been described for the assessment of collateralization in acute ischemic stroke. Currently, there is no gold standard for collateral assessment by CT angiography (CTA). This study compared four frequently used collateral scores with regard to their correlation with early infarct core and mi...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-012101
更新日期:2016-11-01 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:OBJECTIVE:To determine whether drug-eluting (DE) stents offer any advantage over bare-metal (BM) stents in terms of restenosis rates and to identify indications for vertebral artery stenting (VAS) based on the current literature. METHODOLOGY:A retrospective analysis was performed for patients who underwent extracrania...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2011-010051
更新日期:2012-05-01 00:00:00
abstract::The purpose of this publication is to provide a comprehensive review on the techniques and tools used for vascular access in neurointerventional procedures. Using published literature, we reviewed data on access methods, sites, tools, and techniques for neurointerventions. Recommendations are provided based on quality...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2019-015573
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Idiopathic intracranial hypertension is a disease of raised intra-cranial pressure of unknown etiology. Lateral cerebral venous sinus stenosis (VSS) has been increasingly reported in these patients, and stenting has emerged as an alternative treatment for medically refractory symptoms. Treatment efficacy on ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2020-016550
更新日期:2020-09-07 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::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:BACKGROUND:Torcular dural sinus malformations (tDSMs) with arteriovenous shunts are rare congenital intracranial vascular malformations that carry a high rate of neurologic impairment and death in the neonatal, infant and young pediatric population. Their impact on brain venous drainage, especially the deep venous syst...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2020-016888
更新日期:2020-11-16 00:00:00
abstract:BACKGROUND:Trials of endovascular thrombectomy (EVT) mostly excluded patients with large core strokes so the safety and efficacy of EVT is not well established in such patients. Moreover, the definition of large core and its measurement differ between semi-quantitative (ASPECTS) and quantitative (core volume) imaging m...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,评审
doi:10.1136/neurintsurg-2019-015509
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:To examine the effect of stenting on progressive occlusion of small and incompletely occluded unruptured intracranial aneurysms (UIAs) ≤10 mm in size using a propensity score matched case controlled analysis. METHODS:715 small UIAs consecutively treated by coiling between 2008 and 2010 were eligible for stu...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-011947
更新日期:2016-10-01 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