Pub Date : 1997-09-01DOI: 10.1097/00006123-199709000-00056
J. Reul, U. Spetzger, J. Weis, S. von Buelow, A. Ince, A. Thron
SUMMARY To investigate the early intraluminal thrombotic events after endovascular treatment of terminal aneurysms with detachable coils, and to assess the biological changes over the first three weeks, terminal arterial bifurcation aneurysms were produced microsurgically in 20 rabbits. After a healing period of three weeks, transfemoral angiography was performed and all aneurysms were occluded with Guglielmi Detachable Coils (GDC). Complete (i.e. 100%) occlusion was achieved in ten aneurysms. About 95% occlusion (only a small neck remnant) was seen in eight cases. In two cases, occlusion was about 70 - 80%. Half of the animals were treated by anticoagulation during and continuously two days after occlusion therapy. Angiographic studies and histological analysis were done for four aneurysms (two without and two with anticoagulation) after 24 - 48 hours, 3 - 4 days, 6 - 7 days, 14 days, and 21 days after the treatment. On macroscopic examination, complete occlusion of the aneurysms by early thrombus formation was found in all cases during the first two days. After three to seven days, recanalization and fibrinolysis were observed, leading to a reopening of the neck, and part of the dome. After three weeks recanalization was found in six out of eight aneurysms, regardless of whether the animal was under anticoagulation. In nine cases, the degree of occlusion was overestimated by angiography compared to the pathological findings. During the early phase after occlusion of an aneurysm with platinum coils, extensive clot formation is induced. Over time due to the natural fibrinolysis, continuous recanalization beginning at the neck takes place. These findings can explain the clinical phenomenon of early thromboembolic complications, and the reopening and regrowth of aneurysms occluded with metallic coils observed at later stages.
{"title":"The nature of early intraluminal thrombosis in terminal aneurysms occluded with guglielmi detachable coils.","authors":"J. Reul, U. Spetzger, J. Weis, S. von Buelow, A. Ince, A. Thron","doi":"10.1097/00006123-199709000-00056","DOIUrl":"https://doi.org/10.1097/00006123-199709000-00056","url":null,"abstract":"SUMMARY\u0000To investigate the early intraluminal thrombotic events after endovascular treatment of terminal aneurysms with detachable coils, and to assess the biological changes over the first three weeks, terminal arterial bifurcation aneurysms were produced microsurgically in 20 rabbits. After a healing period of three weeks, transfemoral angiography was performed and all aneurysms were occluded with Guglielmi Detachable Coils (GDC). Complete (i.e. 100%) occlusion was achieved in ten aneurysms. About 95% occlusion (only a small neck remnant) was seen in eight cases. In two cases, occlusion was about 70 - 80%. Half of the animals were treated by anticoagulation during and continuously two days after occlusion therapy. Angiographic studies and histological analysis were done for four aneurysms (two without and two with anticoagulation) after 24 - 48 hours, 3 - 4 days, 6 - 7 days, 14 days, and 21 days after the treatment. On macroscopic examination, complete occlusion of the aneurysms by early thrombus formation was found in all cases during the first two days. After three to seven days, recanalization and fibrinolysis were observed, leading to a reopening of the neck, and part of the dome. After three weeks recanalization was found in six out of eight aneurysms, regardless of whether the animal was under anticoagulation. In nine cases, the degree of occlusion was overestimated by angiography compared to the pathological findings. During the early phase after occlusion of an aneurysm with platinum coils, extensive clot formation is induced. Over time due to the natural fibrinolysis, continuous recanalization beginning at the neck takes place. These findings can explain the clinical phenomenon of early thromboembolic complications, and the reopening and regrowth of aneurysms occluded with metallic coils observed at later stages.","PeriodicalId":126264,"journal":{"name":"Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences","volume":"125 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1997-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129740594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Takigawa, Kensuke Suzuki, Y. Sugiura, R. Suzuki, I. Takano, Nobuyuki Shimizu, Yoshihiro Tanaka, Akio Hyodo
Here we describe the case of a patient with a wide-necked unruptured aneurysm arising at origin of a persistent primitive trigeminal artery (PTA) variant from the right internal carotid artery (ICA), supplying the territory of the right superior cerebellar artery and the anterior inferior cerebellar artery. To preserve the ICA and the PTA variant, coil embolization of the aneurysm was performed using a double-balloon remodeling technique (HyperForm™ and HyperGlide™ Occlusion Balloon Systems; ev3 Endovascular Inc., Irvine, CA, USA). The association of a PTA variant with an aneurysm is very rare. To our knowledge, this is the first description of the use of coil embolization using double-balloon remodeling to treat a PTA variant aneurysm. This technique permits complete embolization and reduces the risk of cerebral and cerebellar ischemia.
在此，我们描述了一例宽颈未破裂动脉瘤的病例，该动脉瘤起源于右颈内动脉(ICA)的持久原始三叉动脉(PTA)变体，该变体供应右小脑上动脉和小脑前下动脉的区域。为了保留ICA和PTA变体，使用双球囊重塑技术(HyperForm™和HyperGlide™闭塞球囊系统)对动脉瘤进行线圈栓塞;ev3 Endovascular Inc.， Irvine, CA, USA)。PTA变异与动脉瘤的关联是非常罕见的。据我们所知，这是首次使用双球囊重构线圈栓塞治疗PTA变异动脉瘤。该技术允许完全栓塞并降低脑和小脑缺血的风险。
{"title":"Double-balloon remodeling for coil embolization of a primitive trigeminal artery variant aneurysm. A case report.","authors":"T. Takigawa, Kensuke Suzuki, Y. Sugiura, R. Suzuki, I. Takano, Nobuyuki Shimizu, Yoshihiro Tanaka, Akio Hyodo","doi":"10.15274/NRJ-2014-10053","DOIUrl":"https://doi.org/10.15274/NRJ-2014-10053","url":null,"abstract":"Here we describe the case of a patient with a wide-necked unruptured aneurysm arising at origin of a persistent primitive trigeminal artery (PTA) variant from the right internal carotid artery (ICA), supplying the territory of the right superior cerebellar artery and the anterior inferior cerebellar artery. To preserve the ICA and the PTA variant, coil embolization of the aneurysm was performed using a double-balloon remodeling technique (HyperForm™ and HyperGlide™ Occlusion Balloon Systems; ev3 Endovascular Inc., Irvine, CA, USA). The association of a PTA variant with an aneurysm is very rare. To our knowledge, this is the first description of the use of coil embolization using double-balloon remodeling to treat a PTA variant aneurysm. This technique permits complete embolization and reduces the risk of cerebral and cerebellar ischemia.","PeriodicalId":126264,"journal":{"name":"Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125852988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Tsuura, T. Terada, H. Matsumoto, O. Masuo, T. Itakura, G. Hyoutani, Y. Nakamura, T. Nishiguchi, H. Moriwaki, S. Hayashi
SUMMARY Total 89 patients with cervical ICA stenosis were treated by stenting. In 74 cases of stenting, we used our blocking balloon systems to prevent distal embolism. The morbidity and the mortality rate was 4.5% and 0%, respectively.Two(3%) of 74 cases showed distal embolism when blocking balloon catheter systems(BBCS) were used, while distal embolism occurred in four (27%) of 15 cases of stenting without BBCS. On diffusion- weighted MRI (DWI), hyperintense areas were detected in seven (47%) of 15 lesions when we used BBCS only during postdilatation. On the other hand, use of BBCS during predilatation as well as postdilatation reduced hyperintense areas on DWI, which were detected in three (25%) of 12 patients. Our blocking balloon catheter system is a useful device to reduce the risk of distal embolism, especially when we use it during not only postdilatation but predilatation.
{"title":"Clinical results of stenting for cervical internal carotid stenoses.","authors":"M. Tsuura, T. Terada, H. Matsumoto, O. Masuo, T. Itakura, G. Hyoutani, Y. Nakamura, T. Nishiguchi, H. Moriwaki, S. Hayashi","doi":"10.2335/SCS.31.129","DOIUrl":"https://doi.org/10.2335/SCS.31.129","url":null,"abstract":"SUMMARY\u0000Total 89 patients with cervical ICA stenosis were treated by stenting. In 74 cases of stenting, we used our blocking balloon systems to prevent distal embolism. The morbidity and the mortality rate was 4.5% and 0%, respectively.Two(3%) of 74 cases showed distal embolism when blocking balloon catheter systems(BBCS) were used, while distal embolism occurred in four (27%) of 15 cases of stenting without BBCS. On diffusion- weighted MRI (DWI), hyperintense areas were detected in seven (47%) of 15 lesions when we used BBCS only during postdilatation. On the other hand, use of BBCS during predilatation as well as postdilatation reduced hyperintense areas on DWI, which were detected in three (25%) of 12 patients. Our blocking balloon catheter system is a useful device to reduce the risk of distal embolism, especially when we use it during not only postdilatation but predilatation.","PeriodicalId":126264,"journal":{"name":"Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115073171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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