AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Feb 2008
Randomized Controlled Trial Multicenter StudyHydroCoil Endovascular Aneurysm Occlusion and Packing Study (HELPS trial): procedural safety and operator-assessed efficacy results.
Coated coils have been in clinical use for several years without robust evidence to determine their safety/efficacy. The HydroCoil Endovascular Aneurysm Occlusion and Packing Study (HELPS) addresses this deficiency for the HydroCoil embolic system. This article reports periprocedural safety/operator-assessed angiographic results from HELPS. ⋯ These HELPS results reinforce coiling as an effective treatment for aneurysms, with an excellent technical success rate. Hydrogel coils can be used in a wide spectrum of aneurysms with a risk profile equivalent to that of bare platinum.
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AJNR Am J Neuroradiol · Feb 2008
Multicenter Study Comparative Study Controlled Clinical TrialClinical outcome and ischemic complication after treatment of anterior choroidal artery aneurysm: comparison between surgical clipping and endovascular coiling.
Although coiling has been favorably comparable with clipping for treatment of most intracranial aneurysms, there is a controversy on which modality is safer for anterior choroidal artery (AchoA) aneurysm. We retrospectively evaluated the clinical outcomes and treatment-related complications after surgical clipping and endovascular coiling of AchoA aneurysms. ⋯ Coiling of AchoA aneurysms appears comparable with clipping in clinical outcome and prevention of rebleeding, with significantly lower incidence of AchoA infarction than clipping.
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AJNR Am J Neuroradiol · Feb 2008
Comparative StudyComparison of three different methods for measurement of cervical cord atrophy in multiple sclerosis.
Evidence is mounting that spinal cord atrophy significantly correlates with disability in patients with multiple sclerosis (MS). The purpose of this work was to validate 3 different measures for the measurement of cervical cord atrophy on high-resolution MR imaging in patients with MS and in normal control subjects (NCs). We also wanted to evaluate the relationship between cervical cord atrophy and clinical disability in the presence of other conventional and nonconventional brain MR imaging metrics by using a unique additive variance regression model. ⋯ 3D CCAV measurement showed the largest differences between NCs and MS patients and between different disease subtypes. Cervical cord atrophy measurement provides valuable additional information related to disability that is not obtainable from brain MR imaging metrics.
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AJNR Am J Neuroradiol · Feb 2008
Clinical TrialEndovascular treatment of intracranial dural arteriovenous fistulas with cortical venous drainage: new management using Onyx.
DAVFs (dural arteriovenous fistulas) represent one of the most dangerous types of intracranial AV shunts. Most of them are cured by arterial or venous embolization, but surgery/radiosurgery can be required in case of failure. Our goal was to reconsider the endovascular treatment strategy according to the new possibilities of arterial embolization using non polymerizing liquid embolic agent. ⋯ Based on this experience, we believe that Onyx may be the treatment of choice for many patients with intracranial dural arteriovenous fistula (ICDAVF) with direct cortical venous reflux (CVR). The applicability of this new embolic agent indicates the need for reconsideration of the global treatment strategy for such fistulas.
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AJNR Am J Neuroradiol · Feb 2008
Neurologic complications of arteriovenous malformation embolization using liquid embolic agents.
Embolization of arteriovenous malformations (AVMs) is commonly used to achieve nidal volume reduction before microsurgical resection or stereotactic radiosurgery. The purpose of this study was to examine the overall neurologic complication rate in patients undergoing AVM embolization and analyze the factors that may determine increased risk. ⋯ Embolization of brain AVMs can be performed with a high degree of technical success and a low rate of permanent neurologic complications.