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Objective To preliminarly investigate the application value of Pipeline embolization device ( PED ) in the endovascular interventional treatment of complex intracranial aneurysms. Methods From July 2015 to October 2016, the clinical data of 10 consecutive patients with complex intracranial aneurysm treated with PED at the Department of Neurosurgery, Guangdong General Hospital were enrolled retrospectively. Their surgical modalities,complications,and imaging findings were analyzed. Results Of the 10 patients,7 were females and 3 were males,their age was 32-68 years ( mean age 54 ± 12 years) . There were 8 patients with internal carotid artery aneurysm,1 with middle cerebral artery aneurysm,and 1 with vertebrobasilar artery aneurysm;there were 2 patients with ruptured aneurysm and 8 with unruptured aneurysm;there were 5 patients with saccular aneurysm ( 2 with wide-necked aneu-rysm) ,3 with fusiform aneurysm,2 with dissecting aneurysm;there were 2 patients with medium aneurysm ( diameter>5-15 mm) ,2 with large aneurysm ( diameter>15-25 mm) ,6 with giant aneurysm ( diameter>25 mm) ,and there were 2 patients with recurrent aneurysm. They were all single aneurysms. Three patients were treated with PED in combination with coil embolization,and 7 patients were treated with PED implantation alone. Nine patients were treated with one PED and 1 was treated with 3 PEDs. The immediate postoperative angiography revealed that the contrast agents in the aneurysm cavities were obviously stranded. One patient died after procedure and 1 had quadriplegia after procedure,and the remaining 8 patients had no PED-related complications. The modified Rankin scale score was 0 in 8 cases,5 in 1 case,and 6 in 1 case on the first post-operative day. They were followed up for 14 to 28 months. Conclusions The different types of intracranial aneurysms treated with PED implantation is relatively safe and effective,but there are also some risks of dis-ability and death. Strictly selecting the indications and developing the individualized treatment strategies are needed.
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Objective To compare the effect of Solitaire AB and Enterprise stent-assisted endovascular embolization of intracranial wide-necked aneurysms. Methods The clinical data 218 patients with intracranial aneurysm treated with Solitaire AB stent or Enterprise stent in Guangdong General Hospital from January 2012 to December 2014 were analyzed retrospectively. Seventy patients were treated with Solitaire AB stents and 148 were treated with Enterprise stents. They were followed up after procedure (2 months to 2 years). The Raymond grade and the modified Rankin scale (mRS)scores were used to compare the efficacy of the 2 kinds of stents. Results There were no significant differences in patients before procedure in the Hunt-Hess grade (Z = 1. 550,P = 0. 121),Fisher grade (Z =1. 537,P =0. 124),aneurysm size (Z =0. 192,P =0. 848),and position (χ2 = 0. 337,P = 0. 736)between the 2 stent groups,while there were no significant differences in patients after procedure in the instant Raymond grade (Z = 0. 682,P = 0. 495), follow-up Raymond grade (Z = 0. 206,P =0. 837),and mRS score (P =0. 662)between the 2 stent groups. Further multivariate Logistic regression analysis showed that the stent type (Solitaire AB stent or Enterprise stent),Raymond grade follow-up grade (OR,0. 029 ,95% CI 0. 126 - 0. 199,P = 0. 661 ),and postoperative mRS score (OR,2. 000,95% CI 0. 204 - 19. 603,P = 0. 552)had no influence on the prognosis. Conclusions In the assisted embolization of intracranial wide-necked aneurysms using the Solitaire AB and Enterprise stents,the effects of both stents are good in the assisted embolization of intracranial wide-necked aneurysms.
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<p><b>OBJECTIVE</b>To analyze the factors that affect oculomotor nerve function recovery time in patients receiving balloon embolization for oculomotor nerve palsy caused by traumatic carotid cavernous sinus fistula.</p><p><b>METHODS</b>The clinical data were collected from 87 patients undergoing balloon embolization for oculomotor nerve palsy due to traumatic carotid cavernous sinus fistula from July 2005 to July 2013 and the factors affecting oculomotor nerve function recovery time was analyzed using a self-made questionnaire.</p><p><b>RESULTS AND CONLUSION</b>Oculomotor nerve function recovery time ranged from 1 to 6 months (mean 33.32 ± 16.76 days) in these patients. Age, severity of preoperative oculomotor nerve paralysis, injury-to-treatment time, and number of balloon used were positively correlated with nerve function recovery time, and the flow volume of traumatic carotid cavernous sinus fistula was negatively correlated with the recovery time.</p>
Subject(s)
Humans , Balloon Occlusion , Carotid-Cavernous Sinus Fistula , Oculomotor Nerve , Oculomotor Nerve Diseases , Recovery of FunctionABSTRACT
Objective To investigate the efficacy, technical tip, safety and complication prevention of combining Neuroform stents and Guglielmi detachable coils for treating acute ruptured giant intracranial aneurysms. Methods Among 10 cases who were diagnosed with giant intracranial aneurysms,Neuroform stents were released for supporting the neck of aneurysms, then micro-catheters were inserted into aneurysms through lumina of stents and coils were implanted. Results All the operations were completed successfully. There was no complication in these cases. The aneurysms were packed totally in 9 cases and partly in 1 case.Eight postoperative cases were followed up by 6 to 17 months. Neither bleeding nor thrombus was found, and all the patients recovered well. Conclusion Combining Neuroform stents and Guglielmi detachable coils for treating acute ruptured giant intracranial aneurysms is a safe and effective method.
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Objective To observe the effect of contortrostafin on human glioma xengoraft model and explore its mechanism.Method Animal models were established on BALB/c nude mice with subcutaneously transplanted neoplasma of U87 glioma.The nude mice bearing withU87 slioma were devided randomly into two groups,which were treated without drugs or with doses of 40 μg/d.The dimension of xenografts was measured and the living state of nude mice with U87 glioma was observed.The protein expression of microvesel density(MVD),bFGF in each paraff in imbedded xenograft of nude mice bearing with U87 glioma were detected by immunohistochemistry staining.Result Contortrostafin inhibited the growth of xenografts in nude mice with U87 glioma(P＜0.05),and the tumor volume was reduced by 50%.Meanwhile the control group highly expressed bFGF at the level of protein,coupling with increase of MVD.Compared with the dissolvent control group,contortrostatin treated group showed lower expression of bFGF,(P＜0.01)and more decrease in MVD(P＜0.01).Conclusion Contortrostatin diffusa has significant inhibitive effect on human glioma xenograft.