Abstract:
OBJECTIVE:The endovascular treatment of complex bifurcation aneurysms possessing a neck that incorporates multiple side branches remains a surgical challenge. Double-stent-assisted coiling techniques, such as those with stents in an X and Y configuration, enable the endovascular treatment of wide-necked complex intracranial bifurcation aneurysms. However, the intraluminal struts at the intersection point in X- and Y-stents are not amenable to endothelialization, which may lead to thromboembolic complications. Stenting in the T configuration is a relatively new double-stent coiling technique. T-stenting differs from X- or Y-stenting in that there are no overlapping or intersecting stent segments. Promising short-term results of T-stent-assisted coiling were recently reported. However, the long-term results have not yet been demonstrated. This retrospective study investigated the long-term angiographic and clinical results in patients with wide-necked complex intracranial bifurcation aneurysms treated with T-stent-assisted coiling. METHODS:A retrospective review was performed to identify patients with wide-necked complex intracranial bifurcation aneurysms treated with T-stent-assisted coiling at 4 institutions. The technical success and the initial and follow-up clinical and angiographic outcomes were assessed. Aneurysm filling status was assessed according to the Raymond classification. Periprocedural and delayed complications were reviewed. The neurological status of the patients was evaluated using the modified Rankin Scale (mRS). RESULTS:One hundred two aneurysms in 102 patients (54 females), whose mean age was 57.9 ± 13.0 years, were included in the study. T-stenting was performed successfully in all patients. Immediate postprocedural angiography revealed complete occlusion in 83.3% of patients. Periprocedural complications developed in 13.7%, resulting in permanent morbidity in 1.9% and death in 1%. Eighty patients (78.4%) had at least one follow-up DSA examination performed at 6 months or later following the endovascular procedure. The mean duration of angiographic follow-up was 30.0 ± 16.3 months. The last follow-up examinations showed complete occlusion in 90.0% of patients. During the follow-up period, only 1 patient (1.3%) required retreatment. Delayed thromboembolic complications were observed in 4 patients (3.9%) without permanent morbidity. The mRS scores of all patients at the last clinical follow-up were between 0 and 2. CONCLUSIONS:The short-term angiographic findings showed that T-stent-assisted coiling is a feasible and effective endovascular method to treat wide-necked complex bifurcation aneurysms. The long-term angiographic follow-up results suggest that T-stent-assisted coiling provides a durable treatment for wide-necked complex bifurcation aneurysms with favorable clinical outcomes, demonstrating the long-term safety of T-stent-assisted coiling.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Aydin K,Stracke CP,Barburoglu M,Yamac E,Berdikhojayev M,Sencer S,Chapot Rdoi
10.3171/2019.9.JNS191733subject
Has Abstractpub_date
2019-12-06 00:00:00pages
1-10eissn
0022-3085issn
1933-0693pii
2019.9.JNS191733pub_type
杂志文章abstract:OBJECT:Pituitary tumors are abnormal growths that develop in the pituitary gland. The Central Brain Tumor Registry of the United States (CBTRUS) contains the largest aggregation of population-based data on the incidence of primary CNS tumors in the US. These data were used to determine the incidence of tumors of the pi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.5.JNS131819
更新日期:2014-09-01 00:00:00
abstract:OBJECT:Prior attempts to define normal cerebellar tonsil position have been limited by small numbers of patients precluding analysis of normal distribution by age group. The authors' objective in the present study was to analyze cerebellar tonsil location in every age range. METHODS:Two thousand four hundred patients ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2013.5.JNS121825
更新日期:2013-09-01 00:00:00
abstract::The magnetic properties of 12 different types of aneurysm clip were investigated in order to identify which clips allow postoperative magnetic resonance (MR) imaging without risk. Clip-induced MR artifacts were also quantitatively studied using a geometrical phantom. Nonferromagnetic aneurysm clips like the Yaşargil P...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.70.3.0426
更新日期:1989-03-01 00:00:00
abstract::A laboratory technique that allows strain measurements of the skull is described. Holographic interferometry allows the entire surface displacement of the skull to be mapped within 1/10 of the wavelength of light. Holographic interferometric pictures are presented following various stress applications to the skull. Th...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.52.6.0825
更新日期:1980-06-01 00:00:00
abstract::Space-occupying lesions of the basal ganglia are a rare cause of extrapyramidal dysfunction in children. Metastatic pineal germinoma in both basal ganglia produced dystonia in a 12-year-old boy. The literature is reviewed. Extrapyramidal manifestations in the child are compared with previously reported cases of basal ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.48.1.0108
更新日期:1978-01-01 00:00:00
abstract::Although in several histological studies of arteriovenous malformation (AVM) nidi the presence of compartments has been documented, no clinical study has been published. The present study was conducted to determine the presence of nidus compartments in clinical cases by using a new radiographic method. Two patients wi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2002.96.4.0770
更新日期:2002-04-01 00:00:00
abstract:OBJECTIVE:Both endovascular coiling and the Pipeline embolization device (PED) have been shown to be safe and clinically effective for treatment of small (< 10 mm) aneurysms. The authors conducted a comparative effectiveness analysis to compare the utility of these treatment methods in terms of health benefits. METHOD...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.8.JNS181080
更新日期:2019-01-11 00:00:00
abstract:OBJECT:Hemangioblastomas (HBs) occur sporadically or as a manifestation of von Hippel-Lindau (VHL) disease. In the majority of VHL-related HBs, inactivation of the VHL tumor suppressor gene (TSG), which is located on chromosome 3p25-26, is found. The VHL gene is assumed to be involved also in the development of sporadi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2002.97.4.0977
更新日期:2002-10-01 00:00:00
abstract::The theory of immune surveillance postulates that one function of the immune system is to eliminate small numbers of malignant cells that arise spontaneously within the organism. Although there has been a great deal of both clinical and experimental evidence in favor of thistheory as it applies to general oncology, th...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.49.1.0084
更新日期:1978-07-01 00:00:00
abstract::This 61-year-old man with a right-sided tentorial dural arteriovenous fistula (DAVF) was initially treated with staged stereotactic radiosurgery and transarterial embolization. Results of follow-up cerebral angiography performed 4 years later demonstrated complete obliteration of the dAVF and development of a previous...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.93.6.1058
更新日期:2000-12-01 00:00:00
abstract:OBJECT:The authors investigated the causes for surgical reexploration in patients with complex regional pain syndrome Type II who received initial relief of pain from implantation of a peripheral nerve stimulator (PNS). METHODS:The authors reviewed the charts of 11 consecutive patients who underwent a total of 27 PNS-...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2007.106.3.388
更新日期:2007-03-01 00:00:00
abstract::A consecutive series of 82 acromegalic patients who underwent transsphenoidal surgery during a 5-year period is presented. Preoperative and postoperative values for human growth hormone (HGH) were available in 80 cases. Microadenomas were present in 18 patients with a mean preoperative HGH value of 25.2 ng/ml, diffuse...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.50.4.0454
更新日期:1979-04-01 00:00:00
abstract::The authors report on a 17-year-old boy who suffered from slowly progressive and long-standing symptoms of ataxia, neck pain, and headache. Computerized tomography (CT) and magnetic resonance (MR) imaging revealed a tumor arising from the floor of the fourth ventricle that resulted in a moderate hydrocephalus. A parti...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1999.91.3.0506
更新日期:1999-09-01 00:00:00
abstract::An unusual case of complete anatomical compartmentalization of the cavernous sinus in a patient with bilateral Type D cavernous dural arteriovenous fistulae is described. This anatomical anomaly isolated the anterior cavernous sinus and orbital venous system, which was primarily responsible for the patient's clinical ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.79.4.0592
更新日期:1993-10-01 00:00:00
abstract:OBJECT:Appropriate management of hemorrhage after Gamma Knife surgery (GKS) for arteriovenous malformations (AVMs) of the brain is poorly understood, although a certain proportion of patients suffer from hemorrhage. METHODS:Among 500 patients observed for 1 to 183 months (median 70 months) after GKS, 32 patients (6.4%...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/sup.2006.105.7.52
更新日期:2006-12-01 00:00:00
abstract::Injury to the spinal column and spinal cord occurs relatively infrequently in the pediatric population. A review of 174 pediatric patients is presented, representing 5.4% of all patients admitted with spinal injury. Spinal cord injury was present in 45% of patients. A distinct injury profile, explained by anatomical a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1992.77.5.0700
更新日期:1992-11-01 00:00:00
abstract::OBJECTIVE High-grade glial brain tumors are often characterized by an elevated expression of the tumorigenic epidermal growth factor receptor variant III ( EGFRvIII). The authors sought to establish a clinically adaptive protocol as a noninvasive diagnostic tool for EGFRvIII detection through serum exosomes. METHODS P...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.11.JNS161187
更新日期:2018-04-01 00:00:00
abstract::An audible, noisy cerebrospinal fluid flow is an uncommon sequela of ventriculoperitoneal shunting. Two cases presenting this phenomenon are described. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1987.67.3.0460
更新日期:1987-09-01 00:00:00
abstract:OBJECT:The transbasal approach (TBA) is an anterior skull base approach, which provides access to the anterior skull base, sellar-suprasellar region, and clivus. The TBA typically involves a bifrontal craniotomy with orbital bar and/or nasal bone osteotomies performed in 2 separate steps. The authors explored the feasi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.8.JNS132609
更新日期:2014-12-01 00:00:00
abstract:OBJECT:Despite the increasing use of immunotherapy in the treatment of metastatic melanoma, the effects of this therapy on the management of patients with associated brain metastases are not completely defined. The authors undertook this study to determine the effectiveness of resection and the effects of immunotherapy...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2011.3.JNS091107
更新日期:2011-07-01 00:00:00
abstract::Cerebrospinal fluid (CSF) leaks are relatively common following spinal surgery. A midline dural tear in the spine is readily repaired by direct application of sutures; however, far-lateral or ventral dural tears are problematic. Fat is an ideal sealant because it is impermeable to water. In this paper the author repor...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2002.96.2.0250
更新日期:2002-03-01 00:00:00
abstract::The authors demonstrate the use of cottonoid as a marker for ultrasound localization of a subcortical tumor. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.60.2.0438
更新日期:1984-02-01 00:00:00
abstract:OBJECT:In this paper the authors introduce a novel use of magnetoencephalography (MEG) for noninvasive mapping of language-specific cortex in individual patients and in healthy volunteers. METHODS:The authors describe a series of six experiments in which normative MEG data were collected and the reliability, validity,...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1999.90.1.0085
更新日期:1999-01-01 00:00:00
abstract::OBJECTIVE Many colloid cyst patients present with obstructive hydrocephalus that resolves after resection of the cyst. However, a proportion of patients with these cysts will require cerebrospinal fluid shunting after tumor resection, despite resolution of the obstruction at the foramina of Monro. The goal of this stu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2015.9.JNS151183
更新日期:2016-09-01 00:00:00
abstract::The search for the origin of the commonly held principle in current neurosurgery regarding the resectability of the anterior one third of the superior sagittal sinus unravels the many fascinating developments that occurred in neurosurgery during the early 20th century. All these occurrences can be traced back to, and ...
journal_title:Journal of neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.3171/jns.2003.99.4.0787
更新日期:2003-10-01 00:00:00
abstract::Cushing's experience with the surgical treatment of pituitary adenomas and other lesions producing the chiasmal syndrome is reviewed. The conclusion is that his ultimate rejection of the transsphenoidal route was not due to his dissatisfaction with this procedure, but rather came about because of the transfrontal rout...
journal_title:Journal of neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.3171/jns.1981.54.4.0448
更新日期:1981-04-01 00:00:00
abstract::Ten cases of meningioma of the pineal region were histologically verified at a single institution during an 8-year period. These represented 0.3% of 3061 intracranial meningiomas, as well as 6.2% of 164 pineal tumors. Patients were predominantly women. Symptoms and signs of increased intracranial pressure were most co...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.85.4.0586
更新日期:1996-10-01 00:00:00
abstract::Intracranial arteriovenous malformations (AVM's) have been classified as pure pial, pure dural, and mixed pial and dural. Dural AVM's are relatively uncommon, with 377 cases documented up to 1990. These lesions were believed to be situated within the walls of the sinuses, but during the last decade researchers discove...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.81.4.0620
更新日期:1994-10-01 00:00:00
abstract::OBJECTIVE Dysfunction of distributed neural networks underlies many brain disorders. The development of neuromodulation therapies depends on a better understanding of these networks. Invasive human brain recordings have a favorable temporal and spatial resolution for the analysis of network phenomena but have generall...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.11.JNS161162
更新日期:2018-02-01 00:00:00
abstract::Blood flow velocity was recorded from the middle or anterior cerebral and extracranial internal carotid arteries using transcranial Doppler sonography (TCD) in 121 unselected consecutive patients with acute aneurysmal subarachnoid hemorrhage (SAH). Recordings were made daily or every 2nd day after SAH for a 14-day per...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1993.78.2.0183
更新日期:1993-02-01 00:00:00