Parent artery stenting as a rescue management for stretched coils during cerebral aneurysms embolization: Report of three cases and review of literature.

BACKGROUND: Displacement of a stretched coil into the parent artery during intracranial aneurysm coiling is a challenging situation where the risk of acute intravascular thrombosis might be a life-threatening condition. The usual way of management is coil snaring, yet in some cases, it might not be feasible to retrieve the coil. Parent artery rescue stenting had already been described as a way of management in acutely thrombosed parent arteries during aneurysm coiling. CASE REPORTS: We present three cases with an inadvertent displacement of the unraveled coils into the parent artery for which rescue stenting was carried out to crush the coil against the vessel wall aiming to eliminate its thrombogenic effect. Our preliminary experience is that rescue stenting of the parent artery for stretched coil could be a convenient effective option particularly in case of failed/risky snaring with no notable immediate or long-term complications. REVIEW AND DISCUSSION: We review the reported cases of stretched coils with or without further unraveling and fracture and discuss the possible consequences, salvage methods, and clinical outcomes. Neurointerventionists should be aware of this complication and get acquainted with bailout strategies.

Role of computed tomography in diagnosis of appendicitis and its complications

Background: Appendicitis and its complications are the most commonly acute abdominal pain that require surgical intervention. Patients may present with a wide variety of clinical manifestation. The clinical diagnosis is based primarily on the patient history, physical examinations and white blood cell count. Clinical diagnosis mostly straight forward in patients presenting with classic signs and symptoms, while diagnostic confusion and delay in treatment may occur in patients with atypical presentations. MSCT is a highly accurate means for establishing the diagnosis. Objective: The aim of the work is to describe the value and role of Multi-slice computed tomography in diagnosing appendicitis and its complications. Methods: This study retrospective study was conducted on patients with right lower quadrant or right flank pain. The study was conducted in Health Insurance hospitals Radiology department on Fifteen patients with right lower quadrant pain or right flank pain. Results: In the present study, we concentrate on continuity and thickness of the appendiceal wall. The normal appendix thickness is less than 1 mm. When appendix got inflamed, it usually appears thickened, asymmetric and enhancing with i.v. contrast from 1 to 3 mm thickness. Conclusion: MSCT is helpful for accurate and prompt diagnosis in suspected cases of appendicitis & its complications and conditions that mimic appendicitis