Effect of Neck Size on the Inflow Magnitude Evaluated on 4D Flow MRI in Unruptured Internal Carotid Artery Aneurysms
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.
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.
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]
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]
Background: In the treatment of aneurysmal subarachnoid hemorrhage (aSAH), microsurgical clipping, and endovascular therapy (EVT) with coiling are modalities for securing the ruptured aneurysm. Little data is available regarding associated readmission rates. We sought to determine whether readmission rates differed according to treatment modality for ruptured intracranial aneurysms. Methods: The Nationwide Readmissions Database (NRD) was used to identify adults who experienced aSAH and underwent clipping or EVT.
Conclusion: Oral nimodipine administration improved clinical outcome of patients after aSAH and should be administered routinely for such patients.
Abstract Treatment of hemorrhagic strokes necessitates hospitalization in an accommodated hospital offering the possibility of a multidisciplinary approach. In this setting, over recent years interventional radiology has become increasingly important from the diagnostic as well as the therapeutic standpoint. In the context of subarachnoid hemorrhage by intracranial aneurysm rupture, the NICE (National Institute for Health and Clinical Excellence) and ASA (American Stroke Academy) recommendations suggest that endovascular coiling should be considered as an alternative to surgical clipping (class I, level of evidenc...
Abstract The risk of bleeding of unruptured aneurysms is increasing with aneurysm size. Small unruptured aneurysms can be treated conservatively with a regular MRI/MRA follow-up to detect a potential increase in size. If coiling is still the main endovascular technique for the treatment of unruptured aneurysms, several other techniques are now available including stent-assisted coiling, flow diversion, and flow disruption. After ARUBA study, there is no recommendation to treat unruptured brain AVMs. According to their hemorrhagic risk, dural arteriovenous fistulas with cortical venous drainage have to be treated, ...
CONCLUSIONSConsistent statin therapy was significantly associated with better prognosis after coil embolization or surgical clipping of cerebral aneurysms. PMID: 31125972 [PubMed - as supplied by publisher]
Conclusion: In Korea, age-related cerebral vascular diseases, such as RIA, ICH, and RAVM, demonstrated a declining trend in agestandardized incidence; meanwhile, UIA and UAVM demonstrated an increased trend in both crude incidence and age-standardized incidence for 9 years. The increase in the elderly population, management of hypertension, and development of diagnostic and endovascular techniques appear to have influenced this trend. PMID: 31064041 [PubMed - as supplied by publisher]
AbstractHydrocephalus is one of the most common sequelae after aneurysmal subarachnoid hemorrhage (aSAH), and it is a large contributor to the condition ’s high rates of readmission and mortality. Our objective was to quantify the healthcare resource utilization (HCRU) and health economic burden incurred by the US health system due to post-aSAH hydrocephalus. The Truven Health MarketScan® Research database was used to retrospectively quantify the prevalence and HCRU associated with hydrocephalus in aSAH patients undergoing surgical clipping or endovascular coiling from 2008 to 2015. Multivariable longitudinal ana...