The Effects of High Porosity Stent Configurations on Cerebral Aneurysm Hemodynamics

2011 ◽  
Author(s):  
Haithem Babiker ◽  
Justin Ryan ◽  
L. Fernando Gonzalez ◽  
Felipe Albuquerque ◽  
Daniel Collins ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Cerebral Aneurysm ◽  
Coil Embolization ◽  
Cerebral Aneurysms ◽  
High Porosity ◽  
Incomplete Filling ◽  
Aneurysmal Neck ◽  
Treatment For Cerebral Aneurysms ◽  
Wide Neck

Coil embolization is the most common endovascular treatment for cerebral aneurysms at many centers [1]. Nevertheless, the coiling of wide-neck aneurysms is a challenge. Incomplete filling of the aneurysmal sac due to coil configuration challenges and aneurysmal growth can often lead to recurrence. To assist treatment with coils, clinicians may deploy a high porosity stent in a staged process to act as a supporting bridge for coils. The stent is first deployed across the aneurysmal neck, and multiple coils are then deployed into the aneurysmal sac 6–8 weeks later [2]. Under certain circumstances, coil deployment is not possible and high porosity stents alone are used for treatment [2–3].

Comparison of the Effects of Embolic Coils and a Low Porosity Stent on Cerebral Aneurysm Fluid Dynamics

2012 ◽  
Author(s):  
Haithem Babiker ◽  
Breigh Roszelle ◽  
L. Fernando Gonzalez ◽  
Felipe Albuquerque ◽  
Daniel Collins ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Cerebral Aneurysm ◽  
Coil Embolization ◽  
Cerebral Aneurysms ◽  
High Porosity ◽  
Period 2 ◽  
Incomplete Filling ◽  
The Stability ◽  
Embolic Coils ◽  
Wide Neck

Wide-neck cerebral aneurysms are difficult to treat with embolic coils. Concerns over the stability of coils within the aneurysmal sac often lead to incomplete filling of the sac, which may cause recurrence [1]. To overcome this challenge, clinicians may deploy a high porosity stent in a staged process to act as a supporting bridge for coils. The stent is commonly deployed 6–8 week prior to coil embolization, which lengthens the treatment period [2].

Intra-Aneurysmal Occlusion of Cerebral Aneurysms Using Detachable Coils: Correlation of Aneurysm Neck Size and Treatment Results

1997 ◽  
Vol 3 (2_suppl) ◽  
pp. 114-117
Author(s):  
K. Irie ◽  
W. Taki ◽  
I. Nakahara ◽  
N. Sakai ◽  
F. Isaka ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Cerebral Aneurysms ◽  
Treatment Results ◽  
Neck Size ◽  
Aneurysm Neck ◽  
Detachable Coils ◽  
Aneurysm Occlusion ◽  
Aneurysmal Neck ◽  
Wide Neck

The aneurysmal neck size seems to be an import ant factor in the endovascular treatment outcome4,5. The purpose of the present study was to measure aneurysm neck size on angiographic films, and compare the measured value with the extent of intra-aneurysmal occlusion performed with detachable coils. The subjects were 22 patients with intracranial aneurysms treated using detachable coils. The cases were divided into two groups according to the aneurysmal neck size, 4 mm being the discriminating value for small neck. The neck of the aneurysm was successfully occluded in 19 of 22 patients. Ten aneurysms had a small neck and 9 aneurysms had a wide neck. Complete aneurysm occlusion was observed in 70% of small neck aneurysms and 25% of wide neck aneurysms. The results support that the size of the aneurysm neck correlates well with the effectiveness of endovascular treatment.

scholarly journals Lyophilizing thrombin powder-based treatment for hemostasis during coil embolization of ruptured cerebral aneurysm: Two case reports

2019 ◽  
Vol 25 (4) ◽  
pp. 454-459
Author(s):  
Changchun Jiang ◽  
Wei Wang ◽  
Baojun Wang ◽  
Yuechun Li ◽  
Guorong Liu ◽  
...  
Keyword(s):  
Cerebral Aneurysm ◽  
Coil Embolization ◽  
Case Reports ◽  
Balloon Catheter ◽  
Treatment Strategies ◽  
Cerebral Aneurysms ◽  
Interventional Therapy ◽  
Parent Artery ◽  
Clinical Practices ◽  
Detachable Coils

Background Rupture of cerebral aneurysm is an inevitable complication during embolization, followed by subsequent acute subarachnoid hemorrhage or intracranial hematoma, and results in the aggravation of a patient’s condition. In particular, for patients who have had a ruptured aneurysm, urgent treatment strategies are required during operation. The most common hemostatic methods seen in clinical practices are as follows: after lowering the blood pressure, we continue to embolize the aneurysms with detachable coils as soon as possible or inject with Glubran/Onyx embolization liquids, as well as use a balloon catheter to temporarily block the blood supply. If the conditions are permissible, a balloon guiding catheter may even be used to restrict the proximal blood flow. At times, due to limitations of these methods, neurosurgeons are requested to perform craniotomy to treat the hemostasis. However, the delayed transition often leads to rapid deterioration of the patient’s condition and even death due to cerebral hernia. Case description We herein presented two cases of ruptured cerebral aneurysms to provide an alternative method for hemostasis and to save the lives of patients as much as possible. In an extremely urgent situation (conventional treatment is ineffective), we successfully saved the patient’s life by injecting lyophilizing thrombin powder (LTP) solution into the aneurysmal sac and the parent artery through a microcatheter. Conclusions To our knowledge, this is the first report of successful hemostasis during coil embolization of ruptured cerebral aneurysm with LTP. Further prospective studies are needed to confirm the safety and efficacy of LTP in cerebrovascular interventional therapy.

Endovascular Treatment of Cerebral Aneurysms

2002 ◽  
Vol 15 (5) ◽  
pp. 537-548 ◽  
Author(s):  
G.B. Bradač ◽  
G. Stura ◽  
M. Bergui
Keyword(s):  
Endovascular Treatment ◽  
Cerebral Aneurysm ◽  
Essential Role ◽  
Cerebral Aneurysms ◽  
Balloon Occlusion ◽  
New Technique ◽  
Endovascular Techniques ◽  
Parent Vessel ◽  
Endovascular Approach

Balloon occlusion of parent vessel and direct coiling are the two endovascular techniques routinely used and commonly accepted as alternatives to surgery for treatment of the cerebral aneurysm in many patients. Based on our experience and what is reported in the literature, the various aspects concerning techniques, difficulties, risks, are described. In comparison to surgery, the endovascular approach is a relatively new technique, which is still in evolution. To date, there is no objective indication regarding the method to be used in a given case. The experience and attitude of the involved team still play an essential role.

Endovascular Treatment for Cerebral Aneurysms Using Stents

2010 ◽  
Vol 23 (6) ◽  
pp. 730-736 ◽  
Author(s):  
J. Zhang ◽  
M. Lv ◽  
X. Lv ◽  
C. Jiang ◽  
Y. Li ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Cerebral Aneurysms ◽  
Treatment For Cerebral Aneurysms

scholarly journals An Early Experience of Endovascular Treatment for Cerebral Aneurysms Harboring Blebs

2000 ◽  
Vol 6 (1_suppl) ◽  
pp. 89-93 ◽  
Author(s):  
Y. Matsumaru ◽  
M. Sonobe ◽  
R. Mashiko ◽  
Y. Nakai ◽  
S. Takahashi ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Treatment Strategy ◽  
Cerebral Aneurysms ◽  
Early Experience ◽  
Treatment For Cerebral Aneurysms

Re-rupture of cerebral aneurysms often occurs at their blebs, and the treatment of cerebral aneurysms harboring blebs has been considered difficult. To prevent rupture during embolization, the authors have tried to deliver coils only into aneurysm domes, without inserting coils, a microcatheter, or a microguidewire into the blebs. Here, to prove such a treatment strategy, the authors report early experience in 3 cases with cerebral aneurysms harboring blebs.

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