AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Nov 2008
Clinical TrialFrequency and outcome of pulmonary polymethylmethacrylate embolism during percutaneous vertebroplasty.
During percutaneous polymethylmethacrylate (PMMA) vertebroplasty (PV), PMMA cement may migrate into the venous system and subsequently be transported to the pulmonary arteries. Frequency, outcome, and imaging findings of PMMA pulmonary embolism are poorly understood. We retrospectively assessed the frequency and outcome of PMMA embolism during PV in a large patient cohort and evaluated the relationship of the volume of injected PMMA to the occurrence of pulmonary PMMA embolism. ⋯ Pulmonary PMMA embolism during PV is an infrequent complication without permanent clinical sequelae. After 1 year, no pulmonary reaction was seen on CT. No definite relationship of PMMA emboli with injected cement volume could be established.
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AJNR Am J Neuroradiol · Nov 2008
Comparative Study3D time-resolved MR angiography (MRA) of the carotid arteries with time-resolved imaging with stochastic trajectories: comparison with 3D contrast-enhanced Bolus-Chase MRA and 3D time-of-flight MRA.
Time-resolved MR angiography (MRA) offers the combined advantage of large anatomic coverage and hemodynamic flow information. We applied parallel imaging and time-resolved imaging with stochastic trajectories (TWIST), which uses a spiral trajectory to undersample k-space, to perform time-resolved MRA of the extracranial internal carotid arteries and compare it to time-of-flight (TOF) and high-resolution contrast-enhanced (HR) MRA. ⋯ The TWIST technique consistently obtained pure arterial phase images while providing dynamic information. It is rapid, uses a low dose of contrast, and may be useful in specific circumstances, such as in the acute stroke setting. However, it does not yet have spatial resolution comparable with standard contrast-enhanced MRA.
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Major neurologic morbidity and mortality with vertebroplasty are rare. We describe a 71-year-old woman who had a stroke approximately 30 minutes after vertebroplasty. ⋯ Emergency embolectomy was attempted but was unsuccessful. This report emphasizes the need to be aware that intracranial embolization of polymethylmethacrylate can occur and describes management strategies to consider.
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AJNR Am J Neuroradiol · Oct 2008
Review Meta Analysis Comparative StudySafety and efficacy of adjunctive balloon remodeling during endovascular treatment of intracranial aneurysms: a literature review.
Concurrent temporary inflation of a nondetachable balloon in the parent artery has been reported to be useful during endovascular coiling of complex, wide-neck aneurysms, facilitating truer coil reconstruction of the native vessel. Nevertheless, there exists concern that adjunctive use of balloon assistance may lead to increased adverse events during aneurysm coiling. ⋯ This largest-to-date literature review and meta-analysis did not demonstrate a higher incidence of thromboembolic events or iatrogenic rupture with the use of adjunctive balloon remodeling compared with unassisted coiling. Balloon remodeling appears to result in higher initial and follow-up aneurysm occlusion rates.