Periprocedural management of acute ischemic stroke intervention.

Periprocedural medical management is an important aspect in optimizing the outcome of patients who undergo endovascular treatment for acute ischemic stroke. Blood pressure, fluid hydration, and antithrombotics are some of the elements that need to be tailored carefully to the patient according to the patency of his or her cerebral vasculature, the extent of his or her infarct, and the potential for hemorrhagic transformation. This article reviews the medical care of acute stroke patients before and after endovascular therapy.

Cerebral collateral circulation in carotid artery disease.

Carotid artery disease is common and increases the risk of stroke. However, there is wide variability on the severity of clinical manifestations of carotid disease, ranging from asymptomatic to fatal stroke. The collateral circulation has been recognized as an important aspect of cerebral circulation affecting the risk of stroke as well as other features of stroke presentation, such as stroke patterns in patients with carotid artery disease.

Intravascular tissue reactions induced by various types of bioabsorbable polymeric materials: correlation between the degradation profiles and corresponding tissue reactions.

Introduction: Several different bioabsorbable polymeric coil materials are currently used with the goal of improving treatment outcomes of endovascular embolization of intracranial aneurysms. However, little is known about the correlation between polymer degradation profiles and concomitant tissue responses in a blood vessel. The authors describe in vitro degradation characteristics of nine different polymeric materials and their corresponding tissue responses induced in rabbit carotid arteries.

A rabbit model for efficacy evaluation of endovascular coil materials.

Background: To investigate biomaterials seeking for their possible use for aneurysm treatment, in vivo screening tests using a number of potential materials are required. However, there is no established animal model that is suitable for such purpose. Some models require special preparation of tested materials for transcatheter delivery and others are inappropriate in view of their cost-effectiveness.

Immediate and midterm outcomes of patients with cerebral aneurysms treated with Matrix1 and Matrix2 coils: a comparative analysis based on a single-center experience in 250 consecutive cases.

Objective: Recanalization after coil embolization of cerebral aneurysms remains a limitation of this progressively accepted modality. The Matrix detachable bioabsorbable coil (Boston Scientific Neurovascular, Natick, MA) was developed to overcome this limitation. We report a single-center experience using first- and second-generation Matrix coils.

Thrombus organization and healing in the swine experimental aneurysm model. Part I. A histological and molecular analysis.

Object: The authors describe the process of thrombus organization in the swine surgical aneurysm model.

Methods: Lateral carotid artery aneurysms with immediately induced thrombosis were created in 31 swine for a time-course study. Aneurysms were evaluated at 1, 3, 7, 14, 30, and 90 days after they were created.

Initial clinical experience with matrix detachable coils for the treatment of intracranial aneurysms.

Object: The Matrix detachable coil is a new bioactive, bioabsorbable coil used in the endovascular embolization of intracranial aneurysms. It has a platinum core covered with a bioactive, bioabsorbable polymer (polyglycolic acid/lactide). The authors report on their initial midterm clinical experience with the first-generation Matrix detachable coil.

Visualization and quantification of flow and velocity fields in intracranial arteriovenous malformations using phase-contrast MR angiography.

Objective: The objective of this study was to describe postprocessing tools for MR phase-contrast flow quantification images and apply those tools to cerebral arteriovenous malformations (AVMs) to visualize blood flow dynamics noninvasively.

Conclusion: Inflow and outflow zones were clearly depicted at different regions in the AVM. The processed images showed flow patterns including vortical flow and variations in velocity over the cardiac cycle.

Intraaneurysmal flow visualization by using phase-contrast magnetic resonance imaging: feasibility study based on a geometrically realistic in vitro aneurysm model.

Object: The aim of this study was to evaluate the feasibility of complex intraaneurysmal flow visualization with the currently available phase-contrast magnetic resonance (MR) imaging modality.

Methods: A geometrically realistic in vitro aneurysm model, in which detailed flow velocity analysis had already been conducted using laser Doppler velocimetry was used for this in vitro hemodynamic simulation, so that the results of phase-contrast velocity measurements could be compared with the previous reliable results. On a 1.

Treatment of unruptured aneurysms with GDCs: clinical experience with 247 aneurysms.

Background And Purpose: The GDC system is a valuable therapeutic alternative to surgical treatment of intracranial aneurysms. We present our clinical experience with the GDC technique used to treat unruptured cerebral aneurysms.

Methods: This is a retrospective review of 217 patients with 247 unruptured intracranial aneurysms who underwent embolization with GDCs between August 1991 and June 2000.

Guglielmi detachable coil embolization of cerebral aneurysms: 11 years' experience.

Object: The authors report on their 11 years' experience with embolization of cerebral aneurysms using Guglielmi Detachable Coil (GDC) technology and on the attendant anatomical and clinical outcomes.

Methods: Since December 1990, 818 patients harboring 916 aneurysms were treated with GDC embolization at University of California at Los Angeles Medical Center. For comparative purposes, the patients were divided into two groups: Group A included their initial 5 years' experience with 230 patients harboring 251 aneurysms and Group B included the later 6 years' experience with 588 patients harboring 665 aneurysms.