Objectives: We performed this study to report our experience using a stepwise stent deployment technique for the treatment of tandem intracranial aneurysms.
Methods: Patients with intracranial tandem aneurysms that were treated with a stepwise stent deployment technique between May 2009 and June 2013 were retrospectively reviewed.
Results: Twenty-one patients with 42 tandem aneurysms were identified (11 men, 10 women), with a mean age of 53.7 years (range, 17-82 years). Subarachnoid haemorrhage was confirmed in 12 patients using computed tomography at onset. Complete occlusion was achieved in 20 of the aneurysms (47.6%) after the procedure, neck remnant in 9 (21.4%), and aneurysm remnant in 13 (31.0%). The perioperative complications included in-stent thrombosis in one case and vasospasm in two cases, none of which left a permanent neurological deficit. The modified Rankin Scale (mRS) score at discharge was 0-2 in 20 cases and 3 in one case. The follow-up angiograms available for 17 patients showed complete occlusion in 26 aneurysms, improved in 4, and stable in 4. All of the patients had mRS scores of 0-1 during the clinical follow-up period.
Conclusions: The stepwise stent deployment technique is feasible and helpful in the treatment of intracranial tandem aneurysms.
Key Points: • Treating wide-necked intracranial aneurysms with stent-assisted coiling is preferable. • Tandem wide-necked intracranial aneurysms can be treated with a single stent. • Stepwise stent deployment is technically feasible for embolizing tandem intracranial aneurysms.
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http://dx.doi.org/10.1007/s00330-015-3823-z | DOI Listing |
Neurol Med Chir (Tokyo)
November 2024
Department of Neurosurgery, Yamaguchi University Graduate School of Medicine.
Staged angioplasty (SAP) is used as an alternative to preventing cerebral hyperperfusion syndrome (CHS) after carotid artery stenting (CAS), particularly among patients with compromised cerebral haemodynamics. Although SAP is presumed to prevent CHS by gradually restoring cerebral blood flow (CBF), few studies have examined haemodynamic changes, and none have evaluated CBF during the chronic phase of SAP. In the present study, in addition to the clinical outcome of SAP, we measured both resting CBF and cerebrovascular reactivity (CVR) throughout all stages of SAP, including the chronic phase, using quantitative N-isopropyl-p-[I-123] iodoamphetamine (I-IMP) single-photon emission computed tomography (SPECT) and evaluated the effects of SAP on cerebral haemodynamics.
View Article and Find Full Text PDFPediatr Pulmonol
October 2024
Pediatric Pulmonary & Sleep Unit, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Pediatric obstructive sleep apnea (OSA) is a common syndrome in children. While an adenotonsillectomy is effective for most, it may not be the treatment of choice for all, and possible alternative treatment options are briefly discussed herein. In obese children, in whom OSA is more prevalent, and has high rates of persistence after surgery, weight loss interventions may be recommended.
View Article and Find Full Text PDFWorld J Cardiol
September 2024
Department of Cardiology, Hippokration General Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece.
The evolution of coronary intervention techniques and equipment has led to more sophisticated procedures for the treatment of highly complex lesions. However, as a result, the risk of complications has increased, which are mostly iatrogenic and often include equipment failure. Stent dislodgement warrants vigilance for the early diagnosis and a stepwise management approach is required to either expand or retrieve the lost stent.
View Article and Find Full Text PDFSurg Endosc
November 2024
Department of General and Upper GI Surgery, Ninewells Hospital, Dundee, UK.
Introduction: Rates of subtotal cholecystectomy (STC) are increasing in response to challenging cases of laparoscopic cholecystectomy (LC) to avoid bile duct injury, yet are associated with significant morbidity. The present study identifies risk factors for STC and both derives and validates a risk model for STC.
Methods: LC performed for all biliary pathology across three general surgical units were included (2015-2020).
Pancreas
January 2025
From the Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
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