bluuebunny/crossref_metadata_2025_split huggingface dataset:
Local Intraarterial Thrombolysis in the Carotid Territory
Authors: Theron J. , Coskun O. , Huet H. , Oliveira G. , Toulas P. , Payelle G. 
Published: January 2017

A new series of 142 patients treated by local intraarterial thrombolysis is presented. After haemorrhage was ruled out by CT, all patients had an emergency angiogram. Patients with occlusion of the lenticulostriate arteries were not treated after the sixth hour (79 cases). Patients without involvement of these arteries were treated up to the 12th hour (61 cases). This selection led to a dramatic reduction of pos-thrombolysis intraparenchymatous haemorrhage (0.7%) compared to other series. All deaths (7 cases) were related to vasogenic oedema due to incomplete reduction of infarcted cerebral volume, in most cases (4 cases) in intracerebral extension of a cervical internal carotid occlusion. Digitized parenchymography proved to be a reliable technique to document the exact location and extent of brain ischaemia before and after thrombolysis. It also allows a prognosis of spontaneous recovery without using thrombolysis. By reducing the infarcted cerebral volume, local intraarterial thrombolysis seems beneficial to the patient as long as a strict selection based on the angiographic location of the occlusion and the time delay is respected.
Embolisation of Ruptured Cerebral Aneurysms with Interlocking Detachable Coils in Acute Stage
Authors: Manabe H. , Fujita S. , Hatayama T. , Ohkuma H. , Suzuki S. , Yagihashi S. 
Published: January 2017

Twelve cases of ruptured cerebral aneurysm were treated in acute stage with interlocking detachable coils (IDC, Target Therapeutics, Fremont, California) and the outcome was assessed. IDCs were placed intra-aneurysm for intra-aneurysmal occlusion, or intra-artery for proximal occlusion. Cases: age 36–84 (mean; 60) y.o., 11 females and 1male; 1, 5, 4 and 2 patients were categorised (Hunt and Hess) as grades 1, 2, 3 and 4 respectively. An intra-aneurysmal occlusion in ten cases and a proximal occlusion in two were performed on day 1–11 (mean 4). On angiograms and CT findings, the ruptured point seemed to have occluded in all cases. The occlusion rate was 100% in five cases, 95% in two, 90% in three, 80% in one, and less than 50% in one. There were two cases of technical complication, one a coil migration and the other an aneurysmal perforation with IDC. Their Glasgow Outcome Scale six months after embolisation was graded as good recovery in four cases, moderately disabled state in two, severely disabled state in one, and dead in five. Follow-up angiograms taken four to six months after embolisation showed an intra-aneurysmal coil compaction in five cases. Two of these were treated by a second embolisation or by neck clipping followed by aneurysmal resection, but another two were observed without any treatment and the last one died of rebleeding. Histological examination of the resected embolised aneurysm revealed slight organization around coils but no endothelialisation over the aneurysmal orifice. In our experience, coil embolisation with IDC for acute ruptured aneurysm is a promising means of preventing rerupture during subacute stage.
Characteristics of a New Liquid Material for Arteriovenous Malformations (HEMA-MMA)
Authors: Kazekawa K. , Tomonaga M. , Iwata H. , Kawano T. , Kawaguchi T. , Honma T. , Kaneko Y. , Dosaka A. , Koizumi T. , Morikawa N. , Matsuda S. , Ikada Y. 
Published: January 2017

Characteristics of a newly developed liquid material for embolization of AVM and its clinical experiments are reported. This liquid is composed of dissolving poly (2-hydroxyethyl methacrylate-co-methyl methacrylate) in Iopamiron with adding a small amount of ethyl alcohol. Thirty-two cases of AVM and 5 cases of spinal AVM were embolized with this liquid with good results. This liquid material is of low viscosity, not adhesive and not cytotoxic, therefore, it can be easily injected through a microcatheter, and can safely and effectively occlude AVM.
Covered Stent Placement for Artificial Cervical Carotid Aneurysms
Authors: Mase M. , Banno T. , Yamada K. , Katano H. , Sasaki S. , Kitase M. , Matsumoto T. 
Published: January 2017

In order to evaluate the midterm patency and the effectiveness of Dacron-covered self-expanding metallic stent in the treatment of cervical carotid aneurysm, we made wide-necked carotid aneurysms with a technique of vein pouch end-to-side anastomosis, and implanted the stents percutaneously to occlude the aneurysms in dogs. The patency was angiographically followed up for 3 months with anticoagulation and antiplatelet medications. The Dacron-covered stent could make the aneurysms disappear angiographically within ten minutes if it was implanted in the correct place. The acute thrombotic obstruction was seen in one of the five regions. The delayed stenosis was seen in two of the five regions in two weeks. Only one of the five regions was patent three months after the stent placement without stenosis, in this case, no cerebral infarction of the brain was found histologically. The Dacron-covered stent can make wide-necked aneurysms occlude quickly. However, the short or midterm patency was poor, suggesting that it is not safe enough to be used clinically in carotid lesions. Further study should be needed to improve the materials for a covered stent before clinical applications.
Pitfalls in Endovascular Treatment of Dural Arteriovenous Fistulas Involving the Cavernous Sinus
Authors: Kuwayama N. , Endo S. , Kubo M. , Akai T. , Takaku A. 
Published: January 2017

Angiographic changes of the sylvian veins, superior ophthalmic vein (SOV), and superior petrosal sinus (SPS) before and after endovascular treatment were determined for 18 patients with dural arteriovenous fistulas (AVFs) involving the cavernous sinus, and pitfalls of endovascular treatment, especially regarding venous drainage routes, for 3 of the patients were reported. Case 1: 57-year-old woman who presented with right abducens nerve palsy had a Barrow type D fistula in the right cavernous sinus draining into the bilateral inferior petrosal sinuses (IPS). One of the ipsilateral sylvian veins that had drained antegradely before treatment was occluded, and a small lacunar infarction in the corona radiata developed after transvenous embolization (TVE) of the right cavernous sinus. Case 2: 72-year-old woman who presented with symptoms of right ocular hypertension had a type D fistula in the right cavernous sinus draining into only the ipsilateral SOV. Conjunctival hyperemia persisted and was aggravated after angioanatomical obliteration of the fistula by transarterial embolization. Case 3: 55-year-old man who presented with left abducens nerve palsy had a type D fistula in the left cavernous sinus draining into the ipsilateral IPS and sylvian vein. The dural AVF was obliterated once with TVE, but recurred 1 week later with retrograde drainage into the ipsilateral SPS and mesencephalic veins. A second TVE resulted in complete obliteration of the fistula. In conclusion, detailed analysis of drainage routes is necessary for planning of treatment of patients with dural AVF, and prompt treatment is needed when redistribution of drainage routes develops during or after TVE.
Transvenous Embolizations of Venous Compartments of Dural Arteriovenous Fistulas within Venous Sinus Walls
Authors: Nakamura M. , Hara Y. , Nagashima T. , Morikawa M. , Minami H. , Tamaki N. 
Published: January 2017

Transvenous embolization of venous compartments within the venous sinus wall was the method initially attempted for closing dural arteriovenous fistulas in 15 patients (22 sinuses). The venous channel, separate from the sinus lumen and located in the venous sinus wall, could be embolized in 6 lesions (3 patients), including 3 superior sagittal sinus fistulas, 2 transverse sinus fistulas, and 1 straight sinus fistula. This technique resulted in closure of the fistulas and preservation of sinus patency as well as immediate improvement of clinical symptoms. The embolizable venous compartment of the fistula within the venous sinus wall could be detected by preoperative angiography, magnetic resonance imaging, and intraoperative venography. This unique drainage of dural arteriovenous fistulas may develop concurrently with more obvious portions of the fistula. Transvenous embolization of these venous compartments can close the fistulas and normalize impaired sinus function.
Intracranial Aneurysm Embolization Using Interlocking Detachable Coils
Authors: Satoh K. , Matsubara S. , Hondoh H. , Nagahiro S. 
Published: January 2017

The relationship between volume embolization ratio and coil compaction on the intracranial aneurysm occluded using interlocking detachable coils (IDCs) was determined. From February 1994 to October 1996, 7 intracranial aneurysms were embolized using IDCs. Aneurysm capacity (volume) was calculated assuming that aneurysms are ellipsoid of the diameter in 3 planes. Coil volume was calculated assuming that IDCs are cylinders of primary coil. Coil compaction was observed in aneurysms embolized at a volume embolization ratio under 25%. There was no coil compaction in aneurysms embolized at a volume embolization ratio of over 25%. Measurement of the volume embolization ratio is useful to predict coil compaction. Intracranial aneurysms should be embolized at a volume embolization ratio of 25–33%.
Results of 55 AVM Cases Treated by Embolization and/or Surgery
Authors: Hattori T. , Negoro M. , Bundou M. , Iwakoshi T. , Fukui K. , Fukasaku K. , Takayasu M. , Shibuya M. , Yoshida J. 
Published: January 2017

In order to build a data base for future comparison, we summarized the treatment results of cerebral arteriovenous malformation (AVM) patients in our hospital. Fifty five AVM patients who had been treated at Nagoya University Hospital from 1988 to 1995 were enrolled in the study. The patient characteristics were nearly the same as other reported series. Trend of treatment modality was changing in this period and embolization was increasing in its role. Karnofsky score was used to follow the patients' clinical status. It was useful to assess pretreatment clinical status and post treatment status. The results showed the improvement of the embolization procedure.
Matters to Be Attended to in Intra-Aneurysmal GDC Embolization for Aneurysms with No Hemorrhage or Hemorrhage in Chronic Stage
Authors: Ezura M. , Takahashi A. , Yoshida M. , Takahashi N. , Nishimura S. , Yoshimoto T. 
Published: January 2017

Sixty-two aneurysms with no hemorrhage or hemorrhage in chronic stage were treated by intra-aneurysmal GDC embolization in 69 sessions. The embolizations were performed under local anesthesia, systemic heparinization, 6F introducing catheter and double-markered microcatheter. Systemic heparinization was performed during the procedure and continued 48 hours afterwards except for the first 4 sessions in which only during the procedure. Activating clotting time (ACT) was maintained 2 to 2.5 times as long as base line value. Angiographic results were complete in 30, neck remnant in 27, and body filling in 12. Symptomatic embolism distal to the aneurysm were observed in two cases out of the first 4 cases without post-embolization heparinization. In the last 65 sessions, persistent symptomatic complications were observed in 4 patients, parent artery occlusion in 1 and embolism distal to the aneurysm in 3. Asymptomatic or transient complication was observed in 7 cases (parent artery occlusion or stenosis). Complications related to systemic heparinization were observed in 5 cases. Difficulty of complete neck closure and recanalization of aneurysmal cavity mainly due to coil compaction are two main problems on GDC embolization. To avoid these two problems, it is be extremely important for GDC embolization to embolize the aneurysmal cavity as tightly as possible. On the other hand, the more tightly the aneurysmal cavity is embolized, the more frequently thromboembolic complications occur. Thus, systemic heparinization after the embolization is essential. However, one should been in mind that systemic heparinization itself carries a potential risk of hemorrhage. To overcome this dilemma, we use a special device for immediate and complete closure of the puncture site of the introducing sheath.
Transarterial Embolization of Cerebrospinal Lesions with Liquid Coils
Authors: Hara Y. , Nakamura M. , Ehara K. , Tamaki N. 
Published: January 2017

We report our experience with endovascular embolization using liquid coils. Twenty-two transarterial embolization procedures were performed with these coils in 20 patients with cerebrospinal vascular or neoplastic lesions. The coils were delivered into the target vessels under fluoroscopic monitoring through a microcatheter by manual injection and flushing with saline. Subsequent surgical resections of embolized lesions were performed in 14 cases, and radiosurgery for two. Complete obliteration of the target vessels were accomplished in all cases without complications. Passage through the microcatheter and delivery of the coil was smooth. Proximal protrusion of the coil occurred during the procedure, and a combination of other embolic materials was necessary to completely occlude large vessels in 9 cases. The embolized lesions were easily resected in the following neurosurgery. Liquid coils were safe and effective as an embolic material in use prior to surgery or radiosurgery.
Embolization of Aneurysms with a Liquid Material: An Experimental Study
Authors: Koizumi T. , Kawano T. , Kazekawa K. , Kawaguchi T. , Honma T. , Kaneko Y. , Dosaka A. , Tabuchi K. , Iwata H. , Morikawa N. , Matsuda S. , Ikada Y. , Inoue T. 
Published: January 2017

The authors evaluated the embolization effects on experimental aneurysm models with a liquid material. This material is a mixture of poly (HEMA-co-MMA), Iopamidol, water and a small amount of ethyl alcohol. We have satisfactorily treated over 30 cases of AVM with this material. Out of four solutions of different viscosity, we used the solution with the highest viscosity to prevent distal migration of the mixture. Glass models of aneurysms of 5 mm in diameter in pulsatile saline flow were embolized with the mixture under various conditions. When an IDC was placed in the aneurysm models, the mixture obliterated them completely and did not migrate out from the aneurysm models. In this experimental study, it is suggested that the liquid material appears to be useful in embolizing cerebral aneurysms safely.
Investigations of the Dose of Heparin and Whole Blood Coagulation Time during Endovascular Surgery
Authors: Nagai S. , Kurata A. , Tanaka R. , Irikura K. , Miyasaka Y. , Fujii K. 
Published: January 2017

We chronologically determined whole blood coagulation time during continuous heparin administration, and investigated optimal doses of heparin in thirty-seven vascular surgery cases. ACT was determined with Hemochron 401. Heparin (2000 IU) was administered by bolus injection at the beginning of intravascular surgery, which was followed by continuous injection of 20 to 160 IU/kg/h. ACT determined before and 30 minutes after heparin administration were compared. There were no complications. ACT was maintained at a nearly constant level by continuous heparin administration. The dose of heparin required to maintain ACT at a level 1.5 to 2 times the initial level was 20 to 60 IU/kg/h. ACT was prolonged by more than three times in two of the ten subjects who were given heparin at a dose of 70 IU/kg/h or more. Continuous administration of heparin allowed maintenance of ACT at a nearly constant level during intravascular surgery. ACT was maintained within the range which is believed to be effective for prevention of thrombus formation (approximately 1.5 to 2.0 times larger than the initial level) by continuous administration of 20 to 60 IU/kg/h of heparin. ACT was, however, prolonged to more than three times the initial level in some subjects who were given 70 IU/kg/h or higher doses, suggesting the risk of a bleeding tendency. Accordingly, it is ideal to continue heparin administration at appropriate doses, while measuring ACT. The results of our study should serve as a useful standard for meeting this goal.
Assessment of Complication Types and Rates Related to Diagnostic Angiography and Interventional Neuroradiologic Procedures
Authors: Horowitz M.B. , Dutton K. , Purdy P.D. 
Published: January 2017

We determined the types and rates of complications related to diagnostic angiography and neuroradiologic interventional procedures at a centre that carries out the full spectrum of angiographic procedures. The occurrence of immediate and delayed complications in 1929 neuroangiographic procedures (1358 diagnostic and 571 interventional) performed between the years 1993–1996 was prospectively identified and recorded on a daily basis. A retrospective review of all charts of patients having procedures conducted during the study period was also carried out to ensure that no complications were missed. The overall complication rate for diagnostic cerebral angiography was 2.2%. Puncture site complications ranged from 0 – 0.1%. Vessel injury distal to the puncture site ranged from 0.2 – 0.6%. The temporary neurologic complication rate was 0.3%, while the permanent rate was 0.4%. There were no contrast reactions. The death rate was 0.1%. Interventional procedures had higher incidences of complications with overall rates ranging from 5.3 – 33%. Temporary and permanent neurologic deficits occurred at a rate of 0 – 10.5% depending upon the procedure involved. Individual complication and death rates and complication categories are provided for arteriovenous malformation embolisation, tumour embolisation, temporary balloon occlusion tests, detachable balloon vessel sacrifice, urokinase infusion, angioplasty, papavarine infusion, GDC embolisation, and carotid cavernous fistula embolisation. When carried out in experienced hands, neuroangiography and neurointervention are relatively safe with low incidences of neurologic and non-neurologic complications. Knowledge of these rates is important when counselling patients prior to treatments or deciding upon the risk-benefit ratio of preoperative procedures.
[O-15]H2O Positron Emission Tomography Determination of Cerebral Blood Flow Reserve after Intravenous Acetazolamide during Balloon Test Occlusion of the Internal Carotid Artery
Authors: Murphy K.J. , Deveikis J.P. , Brunberg J.A. , Jamadar D.A. , Frey K.A. 
Published: January 2017

The purpose of this paper was to evaluate the effects of acetazolamide on cerebral blood flow (CBF) measured by [O-15] H2O positron emission tomography (PET) during balloon test occlusion (BTO) of the internal carotid artery (ICA). [O-15] H2O PET cerebral blood flow studies were completed in 20 patients undergoing BTO. CBF determinations were obtained without carotid occlusion as a baseline, following balloon occlusion, and as a third scan with balloon occlusion after an intravenous acetazolamide bolus. The balloon was left deflated between scans, and was only inflated immediately before and during the 90 second period of time needed for CBF determination. Significance was determined at the P<0.05 level. Two of twenty studies were technical failures. Prior to acetazolamide there was a significant decrease in CBF (P<0.0007) ipsilateral to the occlusion. After acetazolamide administration there was no statistically significant change in flow on the occluded side (P<0.3047); however, there was a significant increase in cerebral blood flow (P<0.0002) on the non-occluded side. In this patient population, there was no acetazolamide-induced CBF decompensation (steal) phenomenon or haemodynamically significant risk in CBF ipsilateral to the occlusion.
Basilar Artery Fenestration Aneurysms Treated with Guglielmi Detachable Coils
Authors: Nakstad P.H. , Bakke S.J. , Dale L.G. , Moen G. 
Published: January 2017

Four patients with basilar artery fenestration aneurysms at the vertebro basilar junction were admitted after subarachnoid haemorrhage. In two of them attempted surgery failed. Subsequently, all four were embolised with Guglielmi Detachable Coils (GDC), three of them in the acute phase. In one case the initial embolisation was incomplete, but follow-up angiography demonstrated spontaneous total occlusion. In another, partial reopening was treated with further embolisation. Three patients recovered completely after treatment. One patient still has deficits related to surgery of an accompanying aneurysm at the middle cerebral artery. He is clinically improving but still not back at work. In two cases the fenestration was combined with a hypoplastic upper vertebral artery on one side. A hypoplastic veretebral artery on one side may frequently be part of the developmental anomaly of basilar fenestration aneurysms. The anatomical configuration and location of these aneurysms is such that their true nature is sometimes difficult to disclose at cerebral angiography and is only realised during embolisation. Treatment with GDC coils seems superior to surgery in basilar artery fenestration aneurysms.
Origin of the Perforating Arteries of the Interpeduncular Fossa in Relation to the Termination of the Basilar Artery
Authors: Brassier G. , Morandi X. , Fournier D. , Velut S. , Mercier P. 
Published: January 2017

We studied the perforating arteries of the interpeduncular fossa in 100 human brains which had previously been embalmed and injected with coloured intravascular neoprene latex. Three groups of perforating arteries were observed: the short interpeduncular arteries, a group of very fine arteries which can originate on every artery in the interpeduncular fossa and are destined to the cerebral peduncles and the oculomotor nerves (III); the diencephalic arteries, larger in diameter, most of which supply the mamillary bodies; only a few of them (one or two) penetrate the diencephalic floor and reach the posterior limb of the internal capsule and the anterior and medial thalamus; the diencephalic arteries are either individual branches of the P1 segment of the posterior cerebral arteries (PCA) or stem from the same segment of the PCA via a trunk common to the mesencephalic arteries; the latter supply the mesencephalic area medial to the pars reticularis of the black substance. Our study focusses on where the diencephalic and mesencephalic arteries originate, based on how both anterior longitudinal neural arteries merged into a basilar artery in the embryo. When merging was symmetrical, whether in the early stages or later, the origins are more or less equally distributed; however, when merging was asymmetrical, the great majority of the perforating diencephalic and mesencephalic arteries stem from the P1 segment on the side that merged earliest (cranially).
Multiple Spinal Perimedullary Arteriovenous Fistulae Associated with the Parkes-Weber Syndrome
Authors: Niimi Y. , Ito U. , Tone O. , Yoshida K. , Sato S. , Berenstein A. 
Published: January 2017

We present a rare case of multiple spinal perimedullary arteriovenous fistulae associated with the Parkes-Weber (PW) syndrome. A 31-year-old male known to have the PW syndrome involving the left leg since birth, presented with a 7-month-history of progressive myelopathy of the lower extremities and dysfunction of the bladder and bowel. Myelography demonstrated dilated intradural vessels. Angiography demonstrated two distinct single hole perimedullary arteriovenous fistulae near the conus at two different metameres. They were supplied by the left posterior spinal artery. The patient was treated by transarterial embolisation using polyvinyl alcohol particles, which resulted in venous side occlusion of the fistulae. After the treatment, the patient developed transient worsening of the spasticity of the lower extremities, and was treated by heparinization. After heparinization, the patient partially recovered from the pre-embolisation status of his myelopathy. The follow-up angiogram one year after the embolisation demonstrated persistent obliteration of both fistulae. At long-term follow-up, the patient can ambulate without assistance and work as a farmer.