Posts Tagged ‘Intracranial aneurysm’
Objective: To investigate the impact of angular remodeling in aneurysms treated with single stent-assisted coiling using computational fluid dynamic (CFD) techniques.
Methods: Fourteen patients (7 women, mean age 55) who underwent stent-coiling of 14 wide-necked bifurcation aneurysms were included based on availability of high-resolution three-dimensional rotational angiography. Pre-treatment datasets underwent virtual aneurysm removal to isolate the effect of stenting. Wall shear stress (WSS) and pressure profiles obtained from constant flow input CFD analysis were analyzed for apical hemodynamic changes.
Objective: To investigate the immediate and delayed effects of Y-stenting using self-expanding microstents on basilar bifurcation architecture and hemodynamics.
Methods: Fifteen patients underwent basilar Y-stent-coiling and imaging with rotational angiography. Vascular angles were measured between proximal P1 segments of the posterior cerebral arteries ([alpha]), and between the basilar artery and each P1 segment ([beta]1,2) in the anteroposterior and ([gamma]1,2) sagittal planes. Patient-specific computational fluid dynamic (CFD) analysis was used to estimate wall shear stress (WSS) changes with treatment.
Background: The variable definition of Size Ratio (SR) for sidewall (SW) vs. bifurcation (BIF) aneurysms raises confusion for lesions harboring small branches such as carotid ophthalmic or posterior communicating locations. These aneurysms are considered SW by many clinicians, while SR methodology classifies them as BIF.
Objective: To evaluate the effect of ignoring small vessels and SW vs. stringent BIF labeling on SR ruptured aneurysm detection performance in borderline aneurysms with small branches, and to reconcile SR-based labeling with clinical SW/BIF classification.
Methods: Catheter rotational angiographic datasets of 134 consecutive aneurysms (60 ruptured) were automatically measured in 3-D. Stringent BIF labeling was applied to clinically labeled aneurysms, with 21 aneurysms switching label from SW to BIF. Parent vessel size was evaluated both taking into account, and ignoring, small vessels. SR was defined accordingly, as the ratio between aneurysm and parent vessel sizes. Univariate and multivariate statistics identified significant features. The square of the correlation coefficient (R-square) was reported for bivariate analysis of alternative SR calculations.
Objective: To report early postmarket results with the PED.
Methods: This study was a prospective registry of patients treated with PEDs at 7 American neurosurgical centers subsequent to Food and Drug Administration approval of this device. Data collected included clinical presentation, aneurysm characteristics, treatment details, and periprocedural events. Follow-up data included degree of aneurysm occlusion and delayed (> 30 days after the procedure) complications.