Recasting Endovascular Coils to Seal Post-LAAO Leaks Recasting Endovascular Coils to Seal Post-LAAO Leaks
The novel approach shows promise, but questions persist as to why these leaks occur in the first place and whether their closure will mitigate stroke risk.Medscape Medical News
The incidence of stroke is high worldwide1 and is the leading cause of death in China presently.2,3 Subarachnoid hemorrhage caused by ruptured intracranial aneurysm is a subtype of severe stroke that occurs suddenly in seemingly healthy individuals with generally poor prognosis.4 Surgical clipping and endovascular coiling are effective treatment modalities for patients with aneurysmal subarachnoid hemorrhage (aSAH). Delayed cerebral ischemia (DCI) is a complication of aSAH, occurring in up to 30% of patients,5 and is an important cause of disability and death, often leading to deterioration of patients ’ condition or quality of life.
Data comparing the effect of age on outcomes of patients who underwent either endovascular coiling (EVC) or neurosurgical clipping (NSC) for ruptured intracranial aneurysms remains limited.
Endovascular coil embolization for cerebral aneurysms is widely performed to prevent hemorrhage or rebleeding, and it has low morbidity and mortality. However, recanalization which frequently arises during the follow-up period after coil embolization and occasionally leads to a catastrophic rupture remains a major limitation. A recanalization rate of 8.6 –27.4% has been reported in recent systematic reviews of studies that analyzed several thousands of cerebral aneurysms.1–3 A wide neck of aneurysms has been a key factor for recanalization.
ConclusionsThe stent-assisted coiling was successfully performed with acceptable range of ischemic events and without hemorrhage in all patients, including those who applied tailored medication. Low-dose prasugrel was effective for obtaining appropriate PRU values for initial medication as well as for clopidogrel-resistant patients. The genetic test did not provide reliable results in determining clopidogrel resistance.
We present a patient with a prior coronary artery bypass grafting who was referred for an incidental 3cm saccular ascending aortic pseudoaneurysm who was successfully treated with frame coiling under total cerebral embolic protection using the SENTINEL device.
CONCLUSION: This study describes the current status of acute stroke care in Korea. Despite quite acceptable quality of stroke care, it suggests regional and hospital disparities. Expansion of stroke units, stroke center certification or accreditation, and connections between stroke centers and emergency medical services are highly recommended. PMID: 32449325 [PubMed - in process]
Conclusion: This study suggests that IA embolisation may be performed by a recently trained INR with good clinical and anatomical outcomes. Published on 2020-05-06 10:29:10
Background and purpose: Coiling and flow diversion are established endovascular techniques for treatment of cavernous carotid aneurysms (CCAs). We performed a systematic review of published series on endovascular treatment of CCAs in order to assess the efficacy and safety between coiling and flow diversion. Methods: We conducted a computerized search of PubMed, MEDLINE, and Web of Science electronic databases for reports on endovascular treatment of CCAs from 1990 to 2019. Comparisons were made in complete occlusion rate, improvement of symptoms rate and intraoperative complication rate between coiling and flow diversion.
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: The effects of case volume and CSC capabilities on in-hospital mortality and short-term functional outcomes in SAH patients differed between patients undergoing clipping and those undergoing coiling. In the modern endovascular era, better outcomes of clipping may be achieved in facilities with high CSC capabilities. PMID: 32168489 [PubMed - as supplied by publisher]