Posts Tagged ‘aneurysm’
Background: Recent experimental evidence indicates that endogenous mechanisms against cerebral vasospasm can be induced via preconditioning (PC).
Objective: To determine whether these vascular protective mechanisms are also present in vivo in humans with aneurysmal subarachnoid hemorrhage (aSAH)
Methods: A multicenter retrospective cohort of aSAH patients was examined for ischemic PC stimulus: pre-existing steno-occlusive cerebrovascular disease and/or previous cerebral infarct (CVD). Generalized estimating equation models were performed to determine the effect of the PC stimulus on the primary endpoints: radiographic vasospasm, symptomatic vasospasm, and vasospasm-related delayed cerebral infarction, and the secondary endpoint: discharge modified Rankin Scale.
Advances and Innovations in Vascular Neurosurgery: Advances in Open Microsurgery for Cerebral Aneurysms
Background: Endovascular techniques introduced strong extrinsic forces that provoked reactive changes in aneurysm surgery. Microsurgery has become less invasive, more appealing to patients, lower risk, and efficacious for complex aneurysms, particularly those unfavorable for or failing endovascular therapy.
Objective: To review specific advances in open microsurgery for aneurysms.
Methods: A university-based, single-surgeon practice was examined for the use of minimally invasive craniotomies, surgical management of recurrence after coiling, the use of intracranial-intracranial bypass techniques, and cerebrovascular volume-outcome relationships.
Background: Aneurysmal subarachnoid hemorrhage is a disabling disease. Endovascular coiling provides minimally invasive, effective, and safe treatment of both ruptured and unruptured intracranial aneurysms. Intracranial stents have improved the endovascular treatment of complex aneurysms, but the long-term durability of this treatment modality needs clarification.
Objective: To elucidate the long-term success of intracranial stent use in the treatment of aneurysms.
Methods: Four hundred ten patients were treated with stent-assisted endovascular management of 464 aneurysms. Treatment of 363 small aneurysms, 88 large aneurysms, and 13 giant aneurysms was analyzed with respect to both long-term anatomical results using digital subtraction (DSA) and magnetic resonance angiography (MRA) over the follow-up period.
Objective: To assess the effect of stent compression on FDS porosity, evaluate the influence of single and overlapping implantation of FDS on intra-aneurysmal flow profiles, and correlate stent porosity with changes of static mean intra-aneurysmal pressure.
Methods: Intra-aneurysmal time-density curves were recorded in a pulsatile in vitro flow model before and after implantation of FDS (Pipeline Embolization Device; ev3) in seven different types of aneurysm models. Reduction of the maximum contrast inflow and time to maximum intra-aneurysmal contrast were calculated. Micro-CT was performed and compression-related FDS-porosity was measured. Influence of FDS placement on mean static intra-aneurysmal pressure was measured.