Journal of neurointerventional surgery
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Endovascular neurosurgery, or interventional neuroradiology, has developed rapidly over the last 50 years and has posed a challenge to the established mode of open surgery. Alfred J Luessenhop, an American neurosurgeon, is credited with the first embolization of a cranial arteriovenous malformation and the first intracranial arterial catheterization to occlude an aneurysm. This review describes the life and work of the surgeon who can be regarded as the father of endovascular neurosurgery.
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Y-stent assisted coiling has been proposed for the treatment of wide-neck bifurcation aneurysms, but there are many technical variations. We report our single-center experience of Y-stent assisted coiling of bifurcation aneurysms with the closed cell Enterprise stent in order to evaluate the safety and long-term results of this technique. The literature on Y-stenting and its hemodynamic effects are reviewed. ⋯ Y-stent assisted coiling has a high immediate occlusion rate and very good long-term stability. The procedure is relatively safe, although the complication and mortality rates are not negligible. Two Enterprise stents can be safely used for Y-stenting and, indeed, offer the advantage of easier catheterization, delivery and deployment into distal and tortuous vessels than open cell stents.
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There is a discrepancy in clinical outcomes and the achieved recanalization rates with stent retrievers in the endovascular treatment of ischemic stroke. It is our hypothesis that procedural release of embolic particulate may be one contributor to poor outcomes and is a modifiable risk. The goal of this study is to assess various treatment strategies that reduce the risk of distal emboli. ⋯ The risk of distal embolization is affected by the catheterization technique and clot mechanics.