Journal of neurointerventional surgery
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Case Reports
Over-the-catheter retrieval of a retained microcatheter following Onyx embolization: a technical report.
Brain arteriovenous malformations are vascular lesions that are increasingly being treated with endovascular embolization. A potential complication with endovascular embolization is microcatheter entrapment within the embolic material. In the present report, a novel technique for the retrieval of microcatheters retained during Onyx embolization of intracranial lesions is described. ⋯ A novel technique, which may be useful in the removal of retained microcatheters during Onyx embolization of Brain arteriovenous malformations, is presented.
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Case Reports
Endovascular management of symptomatic vertebral artery origin stenosis in the presence of an acute thrombus.
A woman in her early 60s with hypertension and hyperlipidemia was undergoing investigations for anemia of unknown etiology. She developed a sudden reduction in visual acuity and bilateral visual field impairment. MRI and angiography revealed acute infarcts in the posterior circulation and severe narrowing of the left vertebral artery origin. ⋯ She was discharged to a rehabilitation facility 4 days later without worsening or new neurological deficits. A search of the literature yielded a similar report managed with anticoagulation and subsequent VOAS after complete lysis of the thrombus. Our report highlights the technique, safety and feasibility of VOAS in the presence of a thrombus using a flow reversal technique and distal protection.
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Stent assisted coiling of unruptured wide necked intracranial aneurysms require antiplatelets to prevent stent thrombosis. The effect of the loading dose of antiplatelets prior to the stent coiling procedure in an unsecured wide necked ruptured intracranial aneurysm is not known. ⋯ In our series of carefully selected patients, therapeutic dual antiplatelet loading prior to stent assisted coiling of ruptured wide necked intracranial aneurysm was not associated with increased bleeding complications. However, thromboembolic events remain the main challenge. Further study is required to confirm the safety of antiplatelet loading in stent assisted ruptured intracranial aneurysm coiling.
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Randomized Controlled Trial
Effects of a music intervention on patients undergoing cerebral angiography: a pilot study.
To test the effect of a music intervention on procedural anxiety, stress response and medication requirements in participants with a cerebral aneurysm or arteriovenous malformation (AVM) undergoing cerebral angiography. ⋯ A music intervention on participants with a brain aneurysm or AVM undergoing cerebral angiography did not have a statistically significant impact on reducing the stress response, anxiety or medication requirements. Interestingly, participants in the control group had significantly less anxiety after their angiogram than did participants in the experimental group. This pilot study sets the stage for future research to further examine these findings.