BACKGROUND: Although rare, de novo intracranial aneurysms (DNIAs) may develop in patients with a history of intracranial aneurysms (IAs).
BACKGROUND: Contralateral aneurysm clipping can be applied to bilateral intracranial aneurysms of the anterior circulation and to selected aneurysms on the medial wall of the internal carotid artery (ICA).
BACKGROUND: Treatment of wide-necked internal carotid artery aneurysms is frequently associated with incomplete occlusion and high recurrence rates. Furthermore, platinum coils cause strong beam-hardening artifacts, hampering subsequent image analyses.
BACKGROUND: There is an increasing tendency to treat spinal dural arteriovenous fistulas (SDAVFs) endovascularly despite the lack of clear evidence favoring embolization over surgery.
BACKGROUND: Carotid blowout syndrome (CBS) is a life-threatening emergency resulting from compromise of the carotid artery caused by malignancy in the head and neck.
BACKGROUND: With increasing use of endovascular techniques in the treatment of ruptured and unruptured aneurysms, the issue of obliteration efficacy has become increasingly important. We have previously reported the Aneurysm Recanalization Stratification Scale, which uses accessible predictors including aneurysm-specific factors (size, rupture, and intraluminal thrombosis) and treatment-related features (treatment modality and immediate angiographic result) to predict retreatment risk after endovascular therapy.
BACKGROUND: Although a transvenous route via the ipsilateral inferior petrosal sinus (IPS) is preferred in treating cavernous sinus dural arteriovenous fistula (CSdAVF), this option may be limited if an occluded ipsilateral IPS undermines microcatheter delivery to the cavernous sinus.
BACKGROUND: The availability of stents has widened the indications of endovascular intervention for cerebral aneurysms.
BACKGROUND: Stent-assisted coiling has been used in both unruptured and ruptured aneurysms, but the safety and efficacy still remain controversial.
BACKGROUND: Endovascular stenting is an effective treatment for patients with clinically significant cerebral venous sinus stenosis. Traditionally, stenting is indicated in elevated intravenous pressures on conventional venography; however, noninvasive monitoring is more desirable. Quantitative magnetic resonance angiography is an imaging modality that measures blood flow noninvasively. Established in the arterial system, applications to the venous sinuses have been limited.
INTRODUCTION: Intracranial-atherosclerotic disease (ICAD) accounts for approximately 10% of ischemic-strokes. The recent SAMMPRIS study displayed a high incidence of perioperative complications (15%) for treatment of ICAD with stenting. Although the incidence of stroke was lower in the medical arm, recurrent stroke was found in 12% of patients despite aggressive medical management, suggesting that intervention may remain a viable option for ICAD if perioperative risk is minimized. Angioplasty without stenting represents an alternative and understudied revascularization treatment for ICAD. Submaximal angioplasty limits the thromboembolism risk, vessel perforation, and reperfusion hemorrhage. We conducted a prospective phase I trial designed to assess the safety of submaximal angioplasty in patients with symptomatic ICAD.
INTRODUCTION: Differences between centers in patient outcome after subarachnoid hemorrhage (SAH) from ruptured intracranial aneurysms could be of relevance for the design of multicenter studies, particularly randomized clinical trials (RCTs), and standardization of management practices for improved quality of care for all patients. This study was aimed at investigating whether differences in outcome exist between centers enrolling patients into RCTs in SAH, and, if so, quantifying such center effect.
INTRODUCTION: In patients undergoing interventional treatment for acute ischemic stroke (AIS), proximal arterial stenosis may hinder access to the arterial occlusive lesion (AOL), compromise inflow during the intervention and prolong events leading to cerebral reperfusion. We examined proximal arterial stenosis in the Interventional Management of Stroke (IMS)-III trial, hypothesizing that it would impede successful endovascular therapy for AIS and worsen outcomes.
OBJECT: Vasopressor-induced hypertension (VIH) is an established treatment for patients with aneurysmal subarachnoid hemorrhage (SAH) who develop vasospasm and delayed cerebral ischemia (DCI). However, the safety of VIH in patients with coincident, unruptured, unprotected intracranial aneurysms is uncertain.
OBJECT: Pediatric cerebral arteriovenous fistulas (AVFs) are rare but potentially lethal vascular lesions. Management strategies for these lesions have undergone considerable evolution in the last decade with the advent of new endovascular, surgical, and radiosurgical technologies. This study sought to review current treatment strategies and long-term clinical outcomes at a high-volume cerebrovascular institute.
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