Interv Neuroradiol
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Case Reports
A retained guidewire fractured with subsequent pericardial tamponade two years after endovascular neurointervention.
Entrapment of aneurysm embolization hardware is an extremely rare complication of endovascular neurointerventional procedures. We describe a case of a retained guidewire in a 42-year-old male during an aneurysm embolization. After unsuccessful attempts at removal via interventional methods, we decided to leave the guidewire within the vessel. ⋯ The fragments in the aorta were removed via interventional and surgical methods. We advocate early surgical management of the retained guidewires after unsuccessful retractions via interventional methods. Meticulous and gentle maneuvering is necessary to prevent such serious complications.
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Peripheral anterior inferior cerebellar artery (AICA) aneurysms are rare and commonly associated with vascular malformations, such as cerebellar arteriovenous malformations (AVMs). We present a case wherein multiple AICA feeding aneurysms on the subarcuate artery as a feeding artery of a Borden type I transverse-sigmoid dural arteriovenous fistula (dAVF) manifested as subarachnoid hemorrhage. ⋯ A rare case of multiple ruptured aneurysms on the subarcuate artery was reported in a patient with a Borden type I dAVF at the transverse-sigmoid sinuses manifesting as subarachnoid hemorrhage. Onyx embolization of the parent artery occlusion was feasible and useful in treating this type of feeding artery aneurysm of the AICA with a dAVF.
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Stent-assisted coil embolization of anterior communicating artery aneurysms using the LVIS Jr stent.
This retrospective study evaluates the safety and mid-term and long-term effectiveness of stent-assisted coil embolization of anterior communicating artery (Acomm) aneurysms treated with the LVIS Jr stent. ⋯ Complex, wide-necked Acomm aneurysms can be effectively treated with stent-assisted embolization using LVIS Jr stents.
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Case Reports Comparative Study
Microsurgical clipping and endovascular flow diversion of ruptured anterior circulation blood blister-like aneurysms.
Detection and treatment of blister-like intracranial aneurysms as a source of subarachnoid hemorrhage (SAH) can be challenging. In the past the results of both microsurgical and endovascular treatment were difficult. We present our experience with the treatment of blister-like aneurysms in the acute phase of SAH using microsurgical clipping, endovascular parent vessel occlusion or flow diversion. ⋯ Endovascular flow diversion is a viable option in the acute phase after SAH due to the rupture of a blister aneurysm. Implants with reduced thrombogenicity, obviating dual-platelet function inhibition, and flow diverters for vessel bifurcations would extend the indications for this treatment modality.
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Comparative Study
Microsurgical clipping and endovascular treatment of middle cerebral artery aneurysms in an interdisciplinary treatment concept: Comparison of long-term results.
Treatment of middle cerebral artery (MCA) aneurysms has been historically considered as the almost exclusive domain of microsurgical clipping. This retrospective single-center study assesses whether microsurgical clipping or endovascular treatment (i.e. coiling and/or stenting) for MCA aneurysms yielded better occlusion rates and clinical outcome. ⋯ Both treatment modalities are associated with excellent clinical and radiological outcome if applied within an interdisciplinary treatment concept. Endovascular aneurysm repair appears to be an attractive treatment alternative compared to clipping with low complication rates for well-selected patients.