Journal of neurointerventional surgery
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Case Reports
Perforator aneurysms of the posterior circulation: case series and review of the literature.
Posterior circulation perforator artery aneurysms are sparsely reported in the literature. The natural history of these rare lesions remains unclear and their diagnosis and management are not well-defined. ⋯ Perforator aneurysms of the posterior circulation are diagnostic and therapeutic challenges. Both microsurgical and endovascular treatment of posterior circulation perforator aneurysms are technically difficult, necessitating comprehensive management by an experienced cerebrovascular team.
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We report the incidence and risk factors for contrast-induced nephropathy after the use of iodinated contrast for endovascular treatment of acute ischemic stroke. ⋯ The risk of developing CIN is low among patients with acute stroke who undergo emergency endovascular treatment. Treatment of acute stroke should be performed irrespective of Cr levels.
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Endovascular treatment of intracranial aneurysms relies on coaxial catheter support systems to provide safe and stable access. Large-bore distal intracranial catheters have become necessary for aneurysm treatment with flow diverting devices including the Pipeline embolization device (PED). These catheters must accommodate 0.027 inch microcatheters, be supple enough to track distally and be able to provide sufficient support for manipulations required for PED deployment. ⋯ The Navien intracranial catheter is an important component of the triaxial system for embolization of cerebral aneurysms with the PED. This catheter is highly trackable to distal positions, atraumatic and provides sufficient support for the microcatheter manipulations used during typical PED deployments.
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In this case report we describe a successful interdisciplinary approach (including flow redirection and endovascular occlusion) applied to a patient with a continuously growing extracranial giant aneurysm of the right internal carotid artery (ICA) due to known Ehlers-Danlos syndrome. ⋯ This case report describes a successful interdisciplinary approach for the treatment of a rare giant extracranial ICA aneurysm in a patient with Ehlers-Danlos syndrome. Treatment options for this type are few and carry high risks. Flow redirection via extracranial-intracranial bypass followed by endovascular occlusion appears to be a good treatment approach.
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Little is known about how much protection a flow diversion stent provides to a non-thrombosed aneurysm without the adjunctive use of coils. ⋯ The flow diversion effects of both stents were limited to flow velocity reduction. In a non-thrombosed aneurysm or an aneurysm with delayed thrombosis, the intra-aneurysmal pressure remains essentially unchanged regardless of the level of the intra-aneurysmal flow velocity reduction induced by the stents.