AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · May 2002
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialN-butyl cyanoacrylate embolization of cerebral arteriovenous malformations: results of a prospective, randomized, multi-center trial.
Liquid N-butyl cyanoacrylate (n-BCA) use for the treatment of arteriovenous malformations (AVM) in the brain has become part of medical practice. However, no study has led to the Food and Drug Administration's approval of n-BCA for intravascular use. The purpose of this study was to verify the effectiveness and safety of an n-BCA/Tantalum Powder/Ethiodized Oil mixture, compared with conventional treatment (Trufill polyvinyl alcohol [PVA]) for preoperative embolization of cerebral AVM. ⋯ This prospective, randomized trial showed that n-BCA is equivalent to PVA as a preoperative embolic agent for treatment of cerebral AVM as determined by percent of nidus reduction and number of feeding pedicles embolized.
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AJNR Am J Neuroradiol · May 2002
Case ReportsEndovascular treatment of unruptured intracranial aneurysms.
Intracranial aneurysms are common, with an overall frequency ranging from 0.8% to 10%. Because prognosis after subarachnoid hemorrhage is still very poor, treatment of unruptured aneurysms, either neurosurgically or endovascularly, has been advocated. However, risk of rupture and subsequent subarachnoid hemorrhage needs to be considered against the risks of elective treatment. We analyzed the technical feasibility, safety, and efficacy of endovascular treatment of a consecutive series of unruptured cerebral aneurysms. ⋯ Endovascular embolization of unruptured cerebral aneurysms is an effective therapeutic alternative to neurosurgical clipping and is associated with low morbidity and mortality rates. For the management of unruptured aneurysms, endovascular treatment should be considered.
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Three patients with internal carotid artery thrombus and thrombolysis in myocardial infarction (TIMI) 0-1 flow were treated by using intraarterial (IA) suction thrombectomy a mean of 4.2 hours after stroke onset. After catheterization with a 7F guide-catheter, thrombus was aspirated by using a 60-mL syringe. ⋯ The median National Institutes of Health Stroke Scale score decreased from 22 (range, 12-23) to 4 (range, 2-22) at 3 months. IA suction thrombectomy may be safe and feasible in patients with acute stroke.
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AJNR Am J Neuroradiol · May 2002
Case Reports Retracted PublicationParadoxical cerebral arterial embolization of cement during intraoperative vertebroplasty: case report.
Paradoxical cerebral embolism of cement occurred in a 78-year-old woman after cement-assisted transpedicular spinal fixation surgery. Multiple pulmonary emboli of polymethylmethacrylate precipitated pulmonary hypertension and right-to-left shunting into the systemic circulation through a patent foramen ovale. This rare complication occurred because of failure to recognize venous migration of cement during the procedure and the injection of multiple levels in one setting. Although this was an open procedure, the technical aspects were the same as for vertebroplasty and the precautions should be applied to percutaneous vertebroplasty.
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AJNR Am J Neuroradiol · Apr 2002
Comparative StudyRelationship between findings of conventional and contrast-enhanced transcranial color-coded real-time sonography and angiography in patients with basilar artery occlusion.
Contrast-enhanced transcranial color-coded real-time sonography (TCCS) is a promising tool for the evaluation of brain circulation. The purpose of the present study was to assess the diagnostic ability of conventional and contrast-enhanced TCCS in patients with acute stroke and basilar artery occlusion and to compare the findings with those of angiography. ⋯ Contrast-enhanced TCCS is more sensitive in imaging basilar artery flow than is conventional TCCS. When examined with contrast-enhanced TCCS, a combination of absent basilar artery flow and the reversed basilar artery flow sign may be a diagnostic indicator of basilar artery occlusion.