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ESTUDIOS


18 agosto 2011

AMERICAN JOURNAL OF NEURORADIOLOGY. Percutaneous and Open Retrograde Endovascular Stenting of Symptomatic High-Grade Innominate Artery Stenosis: Technique and Follow-Up

P. Mordasini, J. Gralla, D.-D. Do, J. Schmidlic, B. Keserü, M. Arnold, U. Fischer, G. Schroth and C. Brekenfeld

BACKGROUND AND PURPOSE: Angioplasty and stenting of the IA have been reported with high technical and clinical success rates, low complication rates and good mid-term patency rates. Different antegrade or retrograde endovascular catheter-based approaches and combinations with surgical exposure of the CCA are used. The purpose of this study was to determine safety, efficacy and mid-term clinical and radiological outcome of the stent-assisted treatment of atherosclerotic stenotic disease of the IA with special focus on the different technical approaches.

11 agosto 2011

AMERICAN JOURNAL OF NEURORADIOLOGY. Preoperative Onyx Embolization of Meningiomas Fed by the Ophthalmic Artery: A Case Series

F. Trivelatto, G.S. Nakiri, M. Manisora, R. Riva, M. Al-Khawaldeh, I. Kessler and C. Mounayer

SUMMARY: Embolization of head and neck hypervascular tumors is a well-established therapeutic technique. Preoperative embolization reduces intraoperative blood loss, shortens the length of surgery, and decreases surgical morbility and mortality. This study assesses the safety and efficacy of preoperative embolization of meningiomas fed by the OPH by using Onyx liquid embolic agent.

04 agosto 2011

AMERICAN JOURNAL OF NEURORADIOLOGY. Vascular Geometry Change Because of Endovascular Stent Placement for Anterior Communicating Artery Aneurysms

Q.-H. Huang, Y.-F. Wu, Y. Xu, B. Hong, L. Zhang and J.-M. Liu

BACKGROUND AND PURPOSE: Hemodynamics have been shown to play an important role in the initiation and progress of intracranial aneurysms, and are considered well-related to vascular configuration. The purpose of this study was to quantify the vascular geometry change due to intracranial stent placement and to discuss its potential effects on hemodynamics.

04 agosto 2011

AMERICAN JOURNAL OF NEURORADIOLOGY. Parent Vessel Size and Curvature Strongly Influence Risk of Incomplete Stent Apposition in Enterprise Intracranial Aneurysm Stent Coiling

R.S. Heller and A.M. Malek

BACKGROUND AND PURPOSE: Flexible microstents, such as the closed-cell EN, have facilitated adjunctive coiling of intracranial aneurysms. Little data are available on the ability of the stent struts to maintain vessel-wall apposition once deployed in the tortuous cerebral vasculature and the prevalence of ISA. The purpose of this study was to evaluate the relationship between geometric features of the parent vessel at the stent deployment site and prevalence of ISA.

17 octubre 2011

INTERVENTIONAL NEURORADIOLOGY. Acute Endovascular Treatment (< 48 Hours) of Uncoilable Ruptured Aneurysms at Non-Branching Sites Using Silk Flow-Diverting Devices

F. Causin, R. Pascarella, G. Pavesi, R. Marasco, G. Zambon, R. Battaglia, and M. Munari

A blood blister-like (BBL) or dissecting aneurysm should be carefully considered if located at a non-branching site of the supra-clinoid internal carotid artery (ICA). Several surgical and endovascular treatment methods have been proposed but they all carry a relatively high risk of morbidity and mortality.

18 julio 2011

AMERICAN JOURNAL OF NEURORADIOLOGY. Mechanical Thrombectomy in Acute Ischemic Stroke: Catch Device

I. Mourand, H. Brunel, V. Costalat, C. Riquelme, K. Lobotesis, D. Milhaud, C. Héroum, C. Arquizan, M. Moynier and A. Bonafé

BACKGROUND AND PURPOSE: Mechanical thrombectomy presents today a promising alternative to traditional stroke therapies. Our aim with this study was to evaluate the safety and efficacy of the Catch mechanical thrombectomy device in the treatment of acute stroke and report the angiographic results and clinical outcomes.

01 enero 2013

JACC: CARDIOVASCULAR INTERVENTIONS. Carotid Artery Stenting of a Contralateral Occlusion and In-Hospital Outcomes. Results From the CARE (Carotid Artery Revascularization and Endarterectomy) Registry

Nestor Mercado, MD, PhD; David J. Cohen, MD, MSc; John A. Spertus, MD, MPH; Paul S. Chan, MD, MSc; John House, MS; Kevin Kennedy, MS; Ralph G. Brindis, MD; Christopher J. White, MD; Kenneth A. Rosenfield, MD; Steven P. Marso, MD

Objectives: The authors sought to study the characteristics and outcomes of patients with contralateral carotid artery occlusions (CCOs) undergoing elective carotid artery stenting (CAS).

01 febrero 2012

CIRCULATION. Downregulation of TMEM16A Calcium-Activated Chloride Channel Contributes to Cerebrovascular Remodeling During Hypertension by Promoting Basilar Smooth Muscle Cell Proliferation

Mi Wang, MD, PhD*; Hui Yang, MD, PhD*; Ling-Yun Zheng, PhD*; Zheng Zhang, MD, PhD*; Yong-Bo Tang, MD, PhD; Guan-Lei Wang, MD, PhD; Yan-Hua Du, MD, PhD; Xiao-Fei Lv, MSc; Jie Liu, BSc; Jia-Guo Zhou, MD, PhD; Yong-Yuan Guan, MD

Background—The Ca2+-activated chloride channel (CaCC) plays an important role in a variety of physiological functions. In vascular smooth muscle cells, CaCC is involved in the regulation of agonist-stimulated contraction and myogenic tone. The physiological functions of CaCC in blood vessels are not fully revealed because of the lack of specific channel blockers and the uncertainty concerning its molecular identity.

28 junio 2011

AMERICAN JOURNAL OF NEURORADIOLOGY. Transvenous Embolization of Intracranial Dural Arteriovenous Shunts through Occluded Venous Segments: Experience in 51 Patients

E. Lekkhong, S. Pongpech, K. ter Brugge, P. Jiarakongmun, R. Willinsky, S. Geibprasert, and T. Krings

BACKGROUND AND PURPOSE: DAVFs with cortical venous reflux carry a high risk of morbidity and mortality. Endovascular treatment options include transarterial embolization with a liquid embolic agent or transvenous access with occlusion of the involved venous segment, which may prove difficult if the venous access route is thrombosed. The aim of this article is to describe the technique and results of the transvenous approach via thrombosed venous segments for occlusion of DAVFs.

17 octubre 2011

INTERVENTIONAL NEURORADIOLOGY. Intracranial Aneurysms Associated with a Double Origin of the Posterior Inferior Cerebellar Artery

F. Padovani Trivelato, M.T. Salles Rezende, R. Brito Santos, T. Hilton Vieira Madeira, R. Cardoso Campos, and A. Cordeiro Ulhûa

The posterior inferior cerebellar artery (PICA) frequently has a variable course and target territory. However, double origin PICA is a rare finding. Its significance is uncertain, but it has been associated with intracranial aneurysms localized at the PICA proper or at a distant site. The presence of this variation imposes specific challenges.

01 febrero 2013

NEURORADIOLOGY. Quantitative comparison of the dynamic flow waveform changes in 12 ruptured and 29 unruptured ICA–ophthalmic artery aneurysms

Aichi Chien, James Sayre, Fernando Viñuela

Introduction: Studies have reported a correlation between blood flow dynamics in the cardiac cycle and vascular diseases, but research to analyze the dynamic changes of flow in cerebral aneurysms is limited. This quantitative study investigates the temporal changes in flow during a cardiac cycle (flow waveform) in different regions of aneurysms and their association with aneurysm rupture.

01 febrero 2013

JOURNAL OF NEUROSURGERY. Potential intracranial applications of magnetic resonance–guided focused ultrasound surgery

Stephen Monteith, M.D., Jason Sheehan, M.D., Ph.D., Ricky Medel, M.D., Ph.D., Max Wintermark, M.D., Matthew Eames, Ph.D., John Snell, Ph.D., Neal F. Kassell, M.D., and W. Jeff Elias, M.D.

Magnetic resonance–guided focused ultrasound surgery (MRgFUS) has the potential to create a shift in the treatment paradigm of several intracranial disorders. High-resolution MRI guidance combined with an accurate method of delivering high doses of transcranial ultrasound energy to a discrete focal point has led to the exploration of noninvasive treatments for diseases traditionally treated by invasive surgical procedures. In this review, the authors examine the current intracranial applications under investigation and explore other potential uses for MRgFUS in the intracranial space based on their initial cadaveric studies.

70 2012

STROKE. Flow Diversion for Intracranial Aneurysms

Pietro I. D Urso, MD; Giuseppe Lanzino, MD; Harry J. Cloft, MD, PhD; David F. Kallmes, MD

The introduction of flow diverters for treatment of intracranial aneurysms represents a major paradigm shift in the treatment of these lesions. The theoretical hallmark of flow diverters is the treatment of the diseased segment harboring the aneurysm instead of treating the aneurysm itself. Flow diverters are designed to induce disruption of flow near the aneurysm neck while preserving flow into parent vessel and adjacent branches. After flow diversion, intra-aneurysmal thrombosis occurs, followed by shrinkage of the aneurysmal sac as the thrombus organizes and retracts. Preliminary clinical series document effective treatment of wide-neck and/or large and giant aneurysms with acceptable complication rates. However, several questions remain unanswered related to the incidence and mechanisms of aneurysm rupture after treatment with flow diverters, fate of small perforating vessels, and long-term patency rates.

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