bluuebunny/crossref_metadata_2025_split huggingface dataset:
Glubran 2®: A New Acrylic Glue for Neuroradiological Endovascular Use
Authors: Leonardi M. , Cenni P. , Simonetti L. , Bozzao A. , Romano A. , Bonamini M. , Fantozzi L.M. , Fini G. 
Published: January 2017

Two Landrace Large White swine underwent angiography by the femoral route. In both cases, the superior left renal artery was embolized by injection of 2 ml of Glubran 2®, diluted with Lipiodol 1:1 thereby excluding the superior left kidney poles from blood flow. During the follow-up period, neither pig presented any clinical symptom correlated to the embolization procedure. Case 1 was sacrificed after 30 days and case 2 after 60 days. Macroscopic and microscopic analysis was performed in both animals. Long-term follow-up of the two cases after endovascular injection of Glubran 2® showed that the embolization procedure was well-tolerated by the swine in terms of clinical symptoms and histological findings. Arterial occlusion was stable and a reasonable quantity of scar tissue appeared between 30 and 60 days, surrounding the ischaemic tissue. This follow-up experimental study offers further evidence that Glubran 2® is a safe embolizing material for human use as far as its chemical activity is concerned.
Simultaneous Bilateral Vertebral Artery 3D Rotational Angiography: Technical Report of Two Cases
Authors: Reavey-Cantwell J. F. , Lewis S. B. , Firment C. 
Published: January 2017

We describe the first reported use of simultaneous bilateral vertebral artery rotational angiography to visualize an aneurysm. Images acquired from 3D rotational angiography with a single vertebral injection provided insufficient anatomic detail in two cases with vertebrobasilar junction aneurysms associated with fenestration. Therefore, simultaneous bilateral vertebral artery 3D rotational runs were performed. Anatomic detail was superior with the simultaneous injection and this allowed for the appropriate plan of care to be instituted. In the rare cases of vertebrobasilar junction aneurysm associated with fenestration, simultaneous bilateral vertebral artery 3D rotational angiography may provide the most useful anatomic detail when evaluating a patient for possible endovascular intervention.
Application of the Liquid Coil as an Embolic Material for Arteriovenous Malformations
Authors: Kurata A. , Suzuki S. , Ozawa H. , Yuzawa I. , Yamda M. , Fujii K. , Kan S. , Kitahara T. , Ohmomo T. , Miyasaka Y. 
Published: January 2017

The purpose of this paper is to clarify advantages and disadvantages of platinum liquid coils as an embolic material for AVMs. During the last eight years, 50 endovascular procedures using liquid coils were conducted in our institute for 19 cases with AVMs, 15 of which were located in the eloquent area. All but one presented with haemorrhage, the exception demonstrating repeated ischemic symptoms. Only liquid coils were used as the embolic material to obliterate the nidus and feeders. In ten of the 15 patients with AVMs located in the eloquent area and one case rejecting surgery, liquid coil embolization was applied one to 11 times (average 3.5 times) to achieve decrease in size and this was then followed by radiosurgery. The remaining eight AVM patients underwent total removal after liquid coil embolization. No complications were encountered during the peri-embolization period. In all cases, the purpose of embolization was to diminish the size to facilitate radiosurgery and decrease bleeding during surgery. The liquid coil has advantages as a material for embolization of AVMs; it is non-toxic and bioinart material; it seldom occludes normal minute vascular channels; when it used in a nidus, it seldom to migrates in the venous direction, and it has good radio-opacity and offers good marking for surgery. Appropriate applications include preoperative embolization or pre-radiosurgical embolization of AVMs, especially when staged embolizations are performed to reduce risk of perfusion pressure breakthrough in patients which are large or located in the eloquent area.
The Influence of Aneurysm Configuration on Intra-Aneurysmal Pressure and Flow
Authors: Sorteberg A. , Farhoudi D. 
Published: January 2017

Aneurysm rupture may occur in conjunction with swift pressure increases like heavy lifting. We therefore investigated the transmission of pressure waves as well as local flow rates in various types of experimental aneurysms and their parent arteries. 0.014-inch guidewires containing a combined pressure and thermistor sensor were inserted into both the dome and the parent artery of idealized silicone aneurysms mounted in a pulsatile flow phantom. Intravascular pressure and thermodilution responses to injections of room-temperatured normal saline at a rate of 5cc.s−1 over two seconds were recorded simultaneously at both sites. Flow was evaluated semiquantitatively applying the thermodilution principle. We found that the propagation of pressure was attenuated at the dome of the aneurysms compared to their respective parent arteries. This difference was more distinct in side-wall aneurysms than in bifurcational aneurysms. The attenuation of traveling pressure in the aneurysm was most effective at low systemic pressures. The intraaneurysmal flow rate was unique, always lower than in the respective parent arteries and highly dependent on the configuration of the aneurysm. We observed considerably higher flow rates in bifurcational aneurysms compared to side-wall aneurysms. Bifurcational aneurysms were hence characterized by a relatively high pressure transmission and high flow rates which may represent a stimulus for enlargement of untreated aneurysms and promote coil compaction in endovascularly treated lesions.
Percutaneous Transluminal Angioplasty and Stenting for Chronic Total Occlusion of Intracranial Carotid Artery
Authors: Ishihara H. , Sakai N. , Kuroiwa T. , Sakaguchi M. , Morizane A. , Sakai C. , Yano T. , Kajikawa R. , Yamagami H. , Kobayashi J. 
Published: January 2017

Chronic total occlusion of cerebrovascular lesions is regarded as a contraindication to revascularization. We describe a case of chronic total occlusion of intracranial internal carotid artery that iwass successfully recanalized by endovascular treatment. A 72-year-old man who presented with slight right hemiparesis was proved to have chronic total occlusion of the left intracranial internal carotid artery. Percutaneous transluminal angioplasty/stenting was achieved using reversal of flow with the Parodi Anti-Embolic System. The present case indicates that percutaneous transluminal angioplasty/stenting can be an effective therapeutic option in selected patients with chronic total occlusion of cerebrovascular lesions.
Leo Stent for Endovascular Treatment of Broad-Necked and Fusiform Intracranial Aneurysms
Authors: Juszkat R. , Nowak S. , Smóal S. , Kociemba W. , Blok T. , Zarzecka A. 
Published: January 2017

The advent of intracranial stents has widened the indications for endovascular treatment of broad-necked and fusiform aneurysms. Leo stent is a self-expandable, nitinol, braided stent dedicated to intracranial vessels. The aim of this study is to present our experience in endovascular treatment of broad-necked and fusiform intracranial aneurysms using self-expanding, nitinol Leo stents. Between February 2004 and November 2006, 25 broad-necked and three fusiform aneurysms in 28 patients were treated using Leo stents in our centre. There were 18 patients who experienced acute subarachnoid haemorrhage due to aneurysm rupture, two patients who experienced SAH at least 12 months ago and in eight patients aneurysms were found incidentally. Aneurysms were located as follows: internal carotid artery, basilar artery, basilar tip, posterior inferior cerebral artery, M1/M2 segment, A2 segment and vertebral artery. There were no difficulties with stent deployment and delivery. All patients after acute SAH (n=18) underwent stent implantation and coil embolization in one procedure. The remaining patients underwent coil embolization in a staged procedure. Immediate aneurysm occlusion of more than 95% was achieved in all patients who underwent stent placement and coil embolization in one procedure. There were three thromboembolic complications encountered in patients in an acute setting of SAH, preloaded only on acetylsalicylic acid. Use of abciximab led to patency within the stent and parent vessel. However, one of these patients presented rebleeding from the aneurysm during administration of abciximab and died. Application of Leo stents in cases of broad-necked and fusiform intracranial aneurysms is safe and effective with a low complication rate.
Periprocedural Monitoring with Regional Cerebral Oxygen Saturation in Carotid Artery Stenting
Authors: Kamii H. , Sato K. , Matsumoto Y. , Furui E. , Ezura M. , Takahashi A. 
Published: January 2017

Hemodynamic instability during and after carotid artery stenting (CAS) may reduce cerebral blood flow (CBF), leading to cerebral ischemia. To investigate changes in CBF in the periprocedural period, we continuously recorded the regional cerebral oxygen saturation (rSO2) using near-infrared spectroscopy. In 46 consecutive patients with carotid artery stenosis, rSO2 was continuously recorded during and after CAS. In addition, the patients underwent SPECT to evaluate a change in CBF on the next day after CAS. Introprocedural bradycardia (heart rate <50 bpm) occurred in 21 patients (46%) including one transient cardiac arrest. Intraprocedural hypotension (systolic blood pressure <80 mmHg) occurred in 18 patients (39%), and 16 of them showed prolonged hypotension. The rSO2 in patients with bradycardia/hypotension during CAS was significantly less than that in patients without them (p<0.01). Moreover, the SPECT on the next day after CAS demonstrated that the ipsilateral CBF in patients with bradycardia/hypotension during CAS significantly more than that in patients without them (p<0.05). Intraprocedural hemodynamic instability resulted in a significant decrease in rSO2, leading to a possible severe cerebral ischemia. In addition, intraprocedural bradycardia/hypotension might be related with postprodedural hyperperfusion, causing the morbidity and mortality after CAS.
Mechanisms of Perianeurysmal Edema following Endovascular Embolization of Aneurysms
Authors: Tomokiyo M. , Kazekawa K. , Onizuka M. , Aikawa H. , Tsutsumi M. , Ikoh M. , Kodama T. , Nii K. , Matsubara S. , Tanaka A. 
Published: January 2017

After coil embolization for an aneurysm, edema surrounding the aneurysm revealed by magnetic resonance imaging (MRI) is rarely seen and is usually associated with neurological symptoms. Perianeurysmal edema was found by postoperative MRI in three out of 182 patients with cerebral aneurysm, which was treated with Guglielmi Detachable Coil (GDC), and neurological symptoms developed simultaneously. In cases where neurological symptoms improved with conservative medical treatment, a temporary increase in the volume of an aneurysm, due to coil and thrombus formation, may result in edema. In cases where symptoms were not alleviated with conservative medical treatment, persistent water-hammer effect against the residual lumen of the aneurysm as well as an increase in the volume of aneurysm by hemorrhage in the aneurysmal wall may contribute to the development of perianeurysmal edema. Consideration of the mechanism of edema development by neurological symptoms, MRI findings, and angiographic findings is needed in order to select appropriate treatment.
Patterns of the Cranial Venous System from the Comparative Anatomy in Vertebrates
Authors: Aurboonyawat T. , Pereira V. , Kring T. , Toulgoat F. , Churojana A. , Lasjaunias P. 
Published: January 2017

Comparing the adult submammalian brain with the human embryonic brain, some patterns of venous drainage are quite similar. The veins lying on the lateral surface of the brain in sub-mammals resemble those of the human embryo. In addition, the new longitudinal venous anastomosis ventral to the brain vesicles occurring late in human embryonic development seems to be similar to the late appearance of the basal vein and the ventral brain stem venous plexus found in adult mammals including man. The evolution of the new structures of the brain vesicles throughout the vertebrate series may have an induction role on the appearance of the cranial venous system. This part of the article series focuses on the evolution of the lateral-ventral venous system of the five brain vesicles. Nevertheless, the limitation of this article is due in part to the paucity of circumstantial papers and different names used for the veins.
Preliminary Experience of Cerecyte Coils in the Treatment of Intracranial Aneurysms
Authors: Leonardi M. , Dall'Olio M. , Vasquez O. Ortiz , Quercetti C. 
Published: January 2017

Coil embolization of intracranial aneurysms is the first choice treatment in many centres worldwide. The ISAT study reported in favour of endovascular treatment even though coil embolization carries a higher risk of revascularization than surgical clipping. Bioactive coils boosting fibrosis within the aneurysm and neointimal production could counteract the tendency of embolized aneurysms to re-open. We reviewed our cohort in a retrospective study based on the following inclusion criteria: 1) Cerecyte coils (Micrus Endovascular, San Jose, Calif) were the only bioactive coils deployed. 2) Cerecyte coils were used in the first embolization procedure. Between July 2005 and December 2007 39 patients matched these inclusion criteria, 15 men and 24 women (average age 63.5 years) with 44 aneurysms. Treatment outcomes were: 30 aneurysms completed excluded from the circulation, 13 aneurysms almost completed excluded from the circulation, one incomplete aneurysm occlusion. Two aneurysms out of 44 recurred during follow-up (4.54%) and were re-embolized. The radio-opacity and conformational memory of the Cerecyte coils were satisfactory and they were easy to manoeuvre and detach.
Dural Arteriovenous Fistula at the Anterior Condylar Confluence
Authors: Miyachi S. , Ohshima T. , Izumi T. , Kojima T. , Yoshida J 
Published: January 2017

We reviewed the records of eight patients with a dural arteriovenous fistula (DAVF) close to the hypoglossal canal and determined the angioarchitecture of the clinical entity at the anterior condylar confluence. Eight patients with DAVF received endovascular treatment at our institute over the past five years. Imaging with selective three-dimensional angiography and thin-slice computed tomography were used to identify the fistula and evaluate the drainage pattern. Based on the angiographic findings, the ascending pharyngeal artery was the main feeder in all cases, and the occipital, middle meningeal, posterior auricular, and posterior meningeal arteries also supplied the DAVF to varying degrees. Contralateral contribution was found in five patients. The main drainage route was the external vertebral plexus via the lateral condylar veins in four patients, the inferior petrosal sinus in three patients, and the internal jugular vein via the connecting emissary veins in one patient. Selective angiography identified the shunt point at the anterior condylar confluence close to the anterior condylar vein. Shunt occlusion with transvenous coil packing was performed in all cases; transarterial feeder embolization was also used in three patients. Two patients treated with tight packing of the anterior condylar vein developed temporary or prolonged hypoglossal palsy. Based on our results, the main confluence of the shunt is located at the anterior condylar confluence connecting the anterior condylar vein and multiple channels leading to the extracranial venous systems. To avoid postoperative nerve palsy, the side of the anterior condylar vein in the hypoglossal canal should not be densely packed with coils. Evaluating the angioarchitecture using the selective three-dimensional angiography and tomographic imaging greatly helps to determine the target and strategy of endovascular treatment for these DAVF.
Endovascular Treatment for Dural Arteriovenous Fistula of the Anterior Condylar Confluence Involving the Anterior Condylar Vein
Authors: Abiko M. , Ikawa F. , Ohbayashi N. , Mitsuhara T. , Ichinose N. , Inagawa T. 
Published: January 2017

Anterior condylar confluence (ACC) dural arteriovenous fistula (AVF) is a rare anomaly. We describe two cases of ACC dural AVF involving the anterior condylar vein that were successfully treated with selective transvenous coil embolization. The first patient presented with headache and right pulse-synchronous tinnitus, and demonstrated abnormal flow medial to the jugular bulb within the right hypoglossal canal on source image of magnetic resonance angiography (MRA). Arterioangiography disclosed a dural AVF in this area, supplied mainly by the meningeal branches of the bilateral ascending pharyngeal artery. We diagnosed ACC dural AVF involving the anterior condylar vein and transvenous embolization was successfully performed. The second patient presented with right pulse-synchronous tinnitus. Views of source image of MRA and arterioangiography were similar to the first case and, again, transvenous embolization was successfully performed. ACC dural AVF is a rare condition and knowledge of the anatomy of the venous system around the craniocervical junction is required for successful treatment.
Operative Classification of Brain Arteriovenous Malformation
Authors: Beltramello A. , Ricciardi G.K. , Piovan E. , Zampieri P. , Pasqualin A. , Nicolato A. , Foroni R. , Sala F. , Bassi L. , Gerosa M. 
Published: January 2017

The most important issue when dealing with a patient with a brain AVM is the decision whether to treat or not. Only after this decision has been made, taking into consideration a number of factors depending on both the patient and the specific type of AVM, can the best option for treatment be chosen. An operative classification of brain AVMs, previously adopted in the Department of Neuroradiology and Neurosurgery of Verona (Italy) and published in this journal, was subjected to validation in a consecutive group of 104 patients clinically followed for at least three years after completion of treatment. This classification, slightly modified from the original version concerning the importance of some specific items, allowed us to assess the indication to treat in each case, whatever type of treatment was offered to the patient.
Spontaneous Closure of Cerebral Dural Arteriovenous Fistulas with Direct Cortical Venous Drainage
Authors: Voormolen M. , Geens K. , Van Den Hauwe L. , Parizel P.M. 
Published: January 2017

We describe two rare cases of spontaneous closure of cerebral dural arteriovenous fistulas (DAVFs) with a small nidus and draining directly in a single cortical vein with several ectasias. Eighteen previously published cases of spontaneous closure of cerebral DAVF comprised more benign fistula types. In literature, several explanations for DAVF occlusion have been proposed. We hypothesize that, in addition to the known causes, the specific contrast medium used during the diagnostic selective angiography might have played a role in the thrombosis and subsequent fistula closure.
In Vitro Reproduction of Device Deformation Leading to Thrombotic Complications and Failure of Flow Diversion
Authors: Estrade Laurent , Makoyeva Alina , Darsaut Tim E. , Ghostine Jimmy , Kouznetsov Evgueni , Salazkin Igor , Roy Daniel , Weill Alain , Raymond Jean 
Published: January 2017

Flow diverters (FDs) are increasingly used for complex intracranial aneurysms. As these self-expanding devices are deployed across an aneurysm neck, they can undergo deformations. The potential clinical consequences of FD deformations remain unclear. We describe an immediate thrombotic complication attributed to a stereotypical stenotic deformation of an FD extremity that can occur when landing zones are of insufficient length. This case is supplemented with in vitro studies showing the relationship between i) the length of the landing zones and ii) discrepancies between the diameter of the device and recipient vessel, and the severity of FD stenosis. In vitro, a shorter landing zone was associated with a progressive stenotic deformation of the terminal ends of all FDs studied. This deformation was more pronounced when the diameter of the device was oversized compared to the size of the recipient tube. In our clinical case, the presence of this deformation led to an immediate thrombotic complication, requiring deployment of a second stent to correct the observed stenosis. In addition, treatment failure ultimately led to a fatal rupture, a failure that can be explained by residual flows through a more porous transition zone, another characteristic FD deformation which occurs when they are oversized as compared to the parent vessel, but free to expand at the level of the aneurysm. Proper selection of device diameter and length of the landing zone is important, and may decrease the incidence of deformation-related complications.
Susceptibility-Weighted Imaging in Carotido-Cavernous Fistulas
Authors: Harsha Kamble Jayaprakash , Basti Ram Shenoy , Kesavadas Chandrasekharan , Thomas Bejoy 
Published: January 2017

This study determined the utility and accuracy of susceptibility-weighted MRI (SWI) for the detection of carotid cavernous fistulas. We retrospectively compared SWI images in nine patients (Group 1, case group) of DSA-proved carotid cavernous fistula (CCF) and 19 DSA negative cases for CCF as a control group (Group 2). Group 1 was again sub-grouped into direct and indirect types. Using uniform region-of-interest measurements, signal intensity within the superior ophthalmic vein (SOV) and the superior sagittal sinus (SSS) were measured on magnitude images of SWI. The SOV/SSS signal intensity ratio was calculated in each case and the mean values of the two groups were compared. Eleven SOV/SSS signal intensity ratios in Group 1 (7 unilateral and two bilateral CCF), 38 in Group 2 (both sides in 19 control subjects) were included. Median ± interquartile range of SOV/SSS ratios for Group 1, Group 2, indirect and direct type CCFs were 1.07 ± 0.43, 0.39 ± 0.23, 0.83 ±0.29, 1.4 ±0.38 respectively. Mann-Whitney test between Groups 1 and 2 was statistically significant with P<0.0001. All cases and controls were reliably distinguished with SOV/SSS signal intensity ratio of 0.64 as cut-off. Direct CCF cases had consistently higher ratios than indirect CCF. SWI was highly sensitive for detection and differentiation of both direct and indirect CCF. Only one case of corticovenous reflux was missed by SWI. SWI is useful for detection of CCF and to differentiate between direct and indirect CCF.
Occlusion of the Internal Carotid Artery Based on a Simple Tolerance Test
Authors: Numi Y. , Berenstein A. , Setton A. , Kupersmith M.J. 
Published: January 2017

In order to evaluate the safety of the internal carotid artery (ICA) occlusion based on our simple tolerance test, we reviewed 142 consecutive tolerance tests. Permanent endovascular ICA occlusion was performed on 99; a tolerance test only was performed on the remaining 43. Our assessment consisted of: 1) angiographic evaluation of collateral circulations without and with ICA test occlusion, 2) evaluation of clinical tolerance to balloon ICA occlusion for 15–20 minutes. Complications of test and permanent ICA occlusion were retrospectively analyzed. Complications related to test occlusion occurred in 2 cases (1.4%) without causing permanent deficits. Complications related to permanent occlusion occurred in 16 cases (16%) including 2 technical, 10 temporary (10%) and 4 permanent (4%). Complications were significantly decreased after introduction of stringent postoperative care to prevent hypotension in 1987. Since 1988, we performed 47 permanent ICA occlusion and experienced no technical, 3 temporary (6%) and no permanent complications. Our method to evaluate tolerance to ICA occlusion is simple and safe. Reliability of the results is comparable to other more complicated methods of assessing ICA occlusion.