Journal of neurointerventional surgery
-
Comparative Study
Three dimensional CT angiography versus digital subtraction angiography in the detection of intracranial aneurysms in subarachnoid hemorrhage.
Ruptured intracranial aneurysms are responsible for over 90% of cases of spontaneous subarachnoid hemorrhage (SAH). Conventional digital subtraction angiography (DSA) remains the gold standard for diagnosing the source of SAH. A prospective study is presented wherein SAH patients underwent three dimensional CT angiography (CTA) prior to DSA in order to assess the specificity and sensitivity of this non-invasive modality to detect aneurysms. ⋯ Sensitivity and specificity were higher than previously reported, suggesting that CTA may be used as an initial screening tool in lieu of DSA. Further studies are necessary to determine if CTA can supplant DSA in ruling out all forms of vascular disease in idiopathic SAH.
-
Practice Guideline
Reporting standards for angioplasty and stent-assisted angioplasty for intracranial atherosclerosis.
Intracranial cerebral atherosclerosis causes ischemic stroke in a significant number of patients. Technological advances over the past 10 years have enabled endovascular treatment of intracranial atherosclerotic stenosis. The number of patients treated with angioplasty or stent-assisted angioplasty for this condition is increasing. Given the lack of universally accepted definitions, the goal of this document is to provide consensus recommendations for reporting standards, terminology, and written definitions when reporting clinical and radiological evaluation, technique, and outcome of endovascular treatment using angioplasty or stent-assisted angioplasty for stenotic and occlusive intracranial atherosclerosis. ⋯ In summary, the definitions proposed represent recommendations for constructing useful research data sets. The intent is to facilitate production of scientifically rigorous results capable of reliable comparisons between and among similar studies. In some cases, the definitions contained here are recommended by consensus of a panel of experts in this writing group for consistency in reporting and publication. These definitions should allow different groups to publish results that are directly comparable.
-
Case Reports
The balloon anchor technique: a novel technique for distal access through a giant aneurysm.
A novel technique is reported that helps the operator in achieving reliable access to the distal parent vessel with a microcatheter for stent assisted aneurysm coiling. Distal parent vessel access was obtained by allowing the microwire to follow the local hemodynamics into a giant internal carotid artery aneurysm and around its dome. ⋯ In this technique, an over-the-wire balloon was inflated in the distal vessel followed by gentle retraction of the balloon catheter and microwire allowed only a wire bridge across the aneurysm neck, thereby allowing the stent catheter to be brought up in a standard fashion. This technique may facilitate the use of new stent technologies for the treatment of aneurysms that would otherwise be untreatable with endovascular therapies.
-
To evaluate the efficacy of vertebral augmentation (VA) in cancer patients. ⋯ VA provides pain relief for a majority of ACFs and MCFs. Increasing age may be predictive of pain relief outcomes in MCFs. There are special planning, imaging and technical considerations (eg, needle placement) in using VA to treat cancer patients.