Treatment of symptomatic fusiform aneurysm in basilar artery by stenting following coiling technique.

AIM: The present stent-assisted coil technique has many limitations especially in treating fusiform aneurysms. We aimed to introduce stenting following coiling technique to treat fusiform aneurysms. MATERIAL AND METHODS: From January 2009 to December 2010, we treated 6 patients with fusiform aneurysms in basilar artery (BA) by stenting following coiling technique. The 6 patients included four men and two women (age from 20 to 78 years, mean age 51 years). Two patients had subarachnoid hemorrhage, whereas 4 had unruptured aneurysms with progressive brainstem symptoms. In the procedure of endovascular treatment, the stent was delivered after coiling to compress the coils against the aneurysm wall and form a lumen in basilar artery. RESULTS: Five patients had an excellent recovery with a satisfactory clinical result with an average 15.4 months follow-up. Four patients received follow-up angiographic imaging with an average 13 months, whereas 3 patients demonstrated complete aneurysm occlusion with reconstructive BA patency. Re-growth occurred in one patient, although clinically stable. None had angiographic evidence of in-stent stenosis. CONCLUSION: Stenting following coiling technique may be a feasible and effective method to reshape parent arteries and to embolize fusiform aneurysms safely. However, this technique may be considered in selected patients.

Early treatment of ruptured intracranial aneurysms / 国际脑血管病杂志

The rebleeding rate,morbidity and mortality of the ruptured intracranial aneurysms are very high.Early treatment is very important to reduce the rebleeding rate.However,there are still a lot of controversies for its indications.The early treatment modalities of the ruptured intracranial aneurysms are mainly including craniotomy and interventional treatment.This article reviews the indications of early treatment of ruptured intracranial aneurysms and the selection of treatment modalities.

Combined Stent and Coils for the Treatment of Middle Cerebral Artery Bifurcation Wide-necked Aneurysms: 15 Cases Report / 中国康复理论与实践

@#Objective To summarize the technique of stent combined with coils to treat middle cerebral artery bifurcation wide-necked aneurysms. Methods 15 patients were reported. Results 11 of 15 aneurysms were completely occluded and 4 were incompletely (>95%) occluded. Transient ischemia of cerebral occurred in a case. 8 aneurysms were followed up for 6～12 months, 1 presented neck remnant growth. Conclusion It is satisfied to use the stent combined with coils to treat middle cerebral artery bifurcation wide-necked aneurysm, which may protect the parent artery.

Transvenous embolization of cavernous sinus dural arteriovenous fistula with onyx-18 and platinum coils. A technical note.

We describe a patient with dural arterial venous fistula of the cavernous sinus causing occulomotor palsy and chemosis. The fistula was successfully treated via transvenous approach with Onyx-18 and detachable platinum coils.

Transarterial embolization of dural arteriovenous fistulas of the anterior cranial fossa using onyx-18. A case report.

We describe the first case of a dural arteriovenous fistula of the anterior cranial fossa successfully treated with transarterial embolization using Onyx-18.

Trigeminocardiac reflex in transvenous packing of the cavernous sinus with onyx for dural arteriovenous fistula. A case report.

Paper Withdrawn Because Already Published in AJNR American Journal of Neuroradiology 28: 1769 - 70 - October 2007.

Early-stage mini-traumatic operation in treatment of hypertensive intracerebral hemorrhage(HIA) / 中华急诊医学杂志

Objective To explore the effects of mini-traumatic operation in treatment of HIH. Methods A retrospective analysis of 140 patients with HIH was carried out,who were treated with mini-traumatic operation or only medicine.Results The mortality in operation group was 14.3%,and in medicine group was 34.3%.80% patients in operation group recovered well,and 52% patients in medicine group recovered well.Conclusion Mini-traumatic operation is more effective than only treated with medicine.Six to 48 hours after onset is a good period for mini-traumatic operation.

Neuroform Stent implantation for teatment of intracranial wide-necked aneurysms:preliminary outcome / 中国康复理论与实践

@# ObjectiveTo summarize the technique and preliminary outcome of Neuroform stent combined with Guglielmi detachable coil (GDC) to treat wide-necked intracranial aneurysms. Methods32 cases with aneurysms which underwent 32 endovascular procedures performed by using stent were retrospectively analyzed.The ratio of aneurysm neck/body is 1/2～1/1. Results24 aneurysms were completely occluded and other 8 were incompletely (>95%) occluded. Transient ischemia of cerebral occured in 2 cases. 14 aneurysms were followed up 0.5～1 year after. 2 aneurysms of them appeared neck remnant growth.ConclusionUsing Neuroform stent combined with GDC to treat wide-necked intracranial aneurysm may prevent the herniation of GDC into the artery and increase the outcome of wide-necked intacranial aneurysm.

Value of stent placement in treatment of fusiform aneurysms and dissecting aneurysm of vertebral artery / 介入放射学杂志

Objective To summarize the technique of stent placement in treatment of fusiform aneurysms and dissecting aneurysms of vertebral artery. Methods we report a retrospective analysis of 16 aneurysms which underwent stent placement ,9 fusiform aneurysms which performed by using stent and GDC;7 dissecting aneurysms which performed by using stent first, Stent placement was followed by coil placement in the 5 aneurysms. Results all patients were cured,2 of 11 aneurysm showed up transient ischemia of cerebral.Follow-up angiographic studies performed in 13 patients from 3 months to 24 months revealed no aneurysm regrowth and no incident of in-stent stenosis.Conclusions the treatment of fusiform aneurysms and dissecting aneurysm of vertebral artery is distinguishing, Using stent combined with GDC to treat fusiform and dissecting aneurysm may restore the patency of parent artery and become safe and effective treatment for fusiform and dissecting aneurysm of vertebral artery.

Treatment of CCFs with facial vein-superior ophthalmic vein approaches / 介入放射学杂志

Objective To evaluate the efficacy of facial vein-superior ophthalmic vein approach to embolize carotid-cavernous sinus fistulas.Metheds The involved cavernous sinus was catheterized through the femoral vein-facial vein- superior ophthalmic vein approach, GDC, EDC, free microcoil, or silk were used to pack the sinus and occlude the shunt. If therer was any difficulty in catheterizing the faical vein, facial vein was exposed surgically and punctured, and then, through the superior opthalmic vein, the cavernous sinus was packed. Results 16 cavernous sinuses in 14 CCF patients(5 traumatic CCFs, 9 dural CCFs) were catheterized through facial vein-superior ophthalmic vein approach, and the technical success was achieved in 15 cavernous sinuses. Immediate angiographic cure of the shunts was achieved in 11cases, residual shunts with inferior petral sinus drainage in 2. Facial vein occlusion was encountered in 1 patient during the facial vein catheterization, further packing of the cavernous sinus was not performed, but follow-up angiography at the 21 st day revealed the spontaneous cure of the shunt. The VI cranial nerve palsy present after balloon embolization in a type A CCF was not improved after the packing of the cavernous sinus. Ocular symptoms in other patients disappeared after tranvenous embolization. The clinical follow-up period ranged from 3 to 21 months, no recurrence of the symptoms was found. Follow-up angiography in 2 patients with residual shunting showed the unchanged shunts, no further embolization was performed. No follow-up angiography was performed in other patients.Conclusions The facial vein-superior ophthalmic vein approach can be chosen as an optimum treatment for dural CCFs, and an important alternative treatment for type A CCFs after the failure of the initial balloon embolization.

The treatment of vertebral benign and malignant tumors with percutaneous vertebroplasty / 介入放射学杂志

Objective Vertebral benign and malignant tumors were intractable in the treatment. Previous treatment methods had their own deficiency. The introduction of percutaneous vertebroplasty brought a breakthrough in the treatment. The initial experience of the treatment of vertebral malignant and benign tumors with percutaneous vertebraplasty was analyzed in this clinical research.Methods and materials The treatment of seven cases of vertebral hemangiomas and 11 cases of vertebral malignant tumors were reported. Unipedicular or bipedicular approaches were used in 17 cases, and in one case of cervical hemangioma, the cervical anterior-lateral approach was adopted. 15-20% of bone cement was mixed and injected into the vertebral lesions and made to distribute and cast in the lesions. Results Good results were got in all the 18 cases. After 0.5-7ml of cement was injected into the lesions. The complete relief was got in 10 cases and sub-complete relief was achieved in 6 cases and medial relief was got in two cases. One to nine months of postoperative follow-ups found no recurrences.Conclusions The treatment of vertebral benign and malignant tumors with percutaneous vertebraplasty was mini-invasive, safe, and effective.

Comparison of cellulose acetate polymer and electrolytic detachable coils for treatment of canine aneurysmal models / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>Electrolytic detachable coils (EDC) have been the main embolic materials for intracranial aneurysms. Liquid aneurysmal embolic materials represented by cellulose acetate polymer (CAP) are still in controversy. In this research, the embolization results and pathological reactions after embolization of canine aneurysmal models with EDC or CAP were observed and compared.</p><p><b>METHODS</b>The canine aneurysmal models constructed by anastomosis of venous pouches were randomly grouped. The aneurysms were respectively occluded with CAP and electrolytic detachable coils that was named by Wu electrolytic detachable coil (WEDC) and made by us. Angiogram follow-ups were performed at 24-hour, 2-week, and 2-month after embolization. The occluded aneurysms were dissected in each stage for light microscopic, electron microscopic, and histochemical research.</p><p><b>RESULTS</b>The effect of embolization was significantly better with WEDC than that with CAP (chi2 = 5. 56, P < 0.05). Post-embolized complications such as aneurysm rupture and stenosis of parent arteries could only be found in CAP group. Pathological research showed that CAP mass could packed the aneurysms more densely than coils. Acute chemical damage of aneurysmal wall and inflammatory cell infiltration was prominently found in early stage after CAP-embolization. Organization of thrombus inside aneurysms and formation of endothelial tissue over the orifices of aneurysmal necks could be found in both groups 2 months after embolization. But parts of coils might be exposed outside endothelial layer.</p><p><b>CONCLUSIONS</b>EDC are still the most safe, efficient, and reliable instruments to embolize aneurysm. CAP should be improved further to solve the problem of strong chemical corrosion and difficulty in control before it is widely used.</p>

Endovascular treatment for wide-necked aneurysm with guglielmi detachable coi8l after goronary stent placement / 中国组织工程研究

To discuss treatment of wide-necked aneurysms.Methods Guglielmi detachable coil(GDC)after stent Pacement treat wide-necked aneurysm.Results Aneurysm was complete embolized,parent artery was intact.Conclusions Endovascular treatment of wide-necked aneurysms using and GDC is technically feasible.

Clinical Characteristics and Imaging Diagnosis of the Traumatic Carotid Cavernous Fistula(TCCF) with Hemorrhage / 实用放射学杂志

Objective To explore the clinical and imaging characteristics of traumatic carotid cavernous fistula(TCCF) with hemorrhage.Methods There were thirteen cases of TCCF underwent car accidents combined with epistaxis or intracranial hemorrhage between 1990 and 2000.Their clinical symptoms,CT,MR,and digital substract angiogram(DSA) were retrospectively analysed.Results There were special clinical and imaging characteristics in TCCF.Small amount of epistaxis and isolateral loss of sight might be found in cases with epistaxis at early stage,but delayed fatal and massive epistaxis occured at various time after trauma.Cranial base fracture and pseudoaneurysm were special imaging signs.In the TCCF cases with intracranial hemorrhage,prominent and tortuose cortical drainage veins might be found.And pseudoaneurysm at posterio-lateral wall of cavernous sinus might be another special imaging sign.Conclusion Small amount of epistaxis at early stage,cranial base fracture,pseudoaneurysm,prominence and tortuosity of cortical veins are characteristic diagnostic references for TCCF with hemorrhage.Emergent DSA examination at early stage should be regarded as a key step for diagnosis and treatment.