Experience with FRED junior flow diverter in treatment of cerebral aneurysms at or distal to the circle of Willis
Publication date: Available online 23 August 2019Source: Journal of Clinical NeuroscienceAuthor(s): Rajeev Sivasankar, Manish Shrivastava, Uday S. LimayeAbstractThis retrospective study was aimed at assessing our results of endovascular management using the FRED junior flow diverter in cerebral aneurysms at or distal to the circle of Willis. 12 patients with 15 small cerebral vessel aneurysms at or distal to the circle of Willis underwent endovascular treatment using the FRED junior flow diverter at two tertiary care centres in Mumbai, India. 12 of the 15 aneurysms were unruptured, one was treated in an acutely ruptured setting, while two, which had presented with SAH were initially treated with balloon assisted coiling and later treated in a staged manner with a flow diverter. Technical success was 100% in all 15 deployments. Deployments were made across angles ranging from 45° to 180°. There was no stroke/TIA/death in any of the cases, which were unruptured. The O’Kelly-Marotta (OKM) staging was used to analyze angiographic follow up (at least one post procedure angiogram) which was available in 8 patients (10 aneurysms). OKM D &C was seen in 80% of the aneurysms on follow up angiograms. The treatment of small vessel cerebral aneurysms at or distal to the Circle of Willis using a dedicated flow diverter (FRED Jr.) is both technically feasible and highly efficacious.
With advances in neurointerventional device technology and increased experience with aneurysm embolization, endovascular treatment (EVT) has become a widely accepted modality to treat intracranial aneurysms (IAs) . During EVT of IAs, aneurysms are packed as densely as possible, which makes it exceedingly difficult to implant coils while ensuring safety and complete occlusion [2,3]. However, there appears to be a paradoxical challenge for small ruptured aneurysms (SRAs,
CONCLUSIONS: PulseRider is being used in both on- and off-label cases following FDA approval. The clinical and radiographic outcomes are comparable in real-world experience to the outcomes observed in earlier studies. Further experience is needed with the device to determine its role in the neurointerventionalist's armamentarium, especially with regard to its off-label use. PMID: 31703202 [PubMed - as supplied by publisher]
AbstractPurposeTo investigate the long-term clinical and angiographic outcomes and their related predictors in endovascular treatment (EVT) of small (
Conclusion: Oral nimodipine administration improved clinical outcome of patients after aSAH and should be administered routinely for such patients.
CONCLUSION: TPCoA aneurysms are rare and challenging lesions with high rupture rate in literatures. Endovascular treatment may be a feasible alternative for TPCoA aneurysms. Primary coiling, as well as adjunctive strategies, such as stent-assisted coiling or dual catheter techniques may be considered. Further study in a larger population is necessary. PMID: 31488022 [PubMed - as supplied by publisher]
Conclusion: The SKEN members have been responsible for the major role of endovascular treatments in South Korea for the recent 5 years. This was achieved through the perseverance of senior members who started out in the midst of hardship, the establishment of standards for the training/certification of endovascular neurosurgery, and the enthusiasm of current SKEN members who followed. To provide better treatment to patients, we will have to make further progress in SKEN. PMID: 31288507 [PubMed - as supplied by publisher]
Bin Sheng1†, Degang Wu1†, Jinlong Yuan1†, Shanshui Xu1, Zhenbao Li1, Jin Dong2, Niansheng Lai1* and Xinggen Fang1* 1Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China 2Department of Nursing, The First Affiliated Hospital of Wannan Medical College, Wuhu, China Objective: To investigate the hemodynamic features before and after embolization of paraclinoidal aneurysms using hemodynamic numerical simulation and the influence of embolization on recurrence after embolization. Methods: From January 2016 to December 2017, we enrolled a total of 113 para...
Publication date: Available online 7 February 2019Source: Interdisciplinary NeurosurgeryAuthor(s): Kamil Zeleňák, Martin Vorčák, Ján Sýkora, Zuzana Trabalková, Jana Zeleňáková, Ema Kantorová, Vladimír NosáľAbstractA 55-year-old woman with acute ischaemic stroke was referred for endovascular treatment after unsuccessful intravenous thrombolysis. Her initial National Institutes of Health Stroke Score (NIHSS) was 20. The right carotid artery stenting was performed because of the inappropriate result of angioplasty of the right internal carotid artery st...
Abstract Remarkable developments in the field of endovascular neurosurgery have been witnessed in the last decade. The success of endovascular therapy for ischemic stroke treatment is now irrefutable, making it an accepted standard of care. Endovascular treatment of cerebral aneurysms is no longer limited to primary coiling but now includes options such as stent or balloon assistance and flow diversion and applications utilizing neck reconstruction, intrasaccular, and bifurcation-specific devices. Balloons, liquid embolic agents, and flow-directed catheters have revolutionized the treatment of arteriovenous malfor...
Conclusions: Active reperfusion hemorrhage involving perforator arteries was observed to correlate with the CT “spot sign” and to be associated with poor outcomes.Intervent Neurol 2018;7:370 –377