Intracranial aneurysms are rarely diagnosed during pregnancy. If treatment is necessary, surgery was traditionally preferred over embolization in case of ongoing pregnancy, due to concerns regarding foetal radiation exposure. We present a case of 21 mm unruptured carotid-ophthalmic aneurysm diagnosed during pregnancy and treated with flow diversion. Foetal radiation dose was estimated between 1 and 5 mGy, well below recommended limits. Double antiplatelet therapy with prasugrel and aspirin was administered between week 17 and week 37, followed by uneventful vaginal delivery at 39 weeks. The new-born infant did not present any clinical abnormalities. Post-natal angiography showed complete aneurysm occlusion. To our knowledge, this is the first report of flow diverter stent placement during ongoing pregnancy. Although a good outcome was observed in this case, this result should be interpreted with caution. Further studies are needed in order to better define the safety profiles of intracranial stents and double antiplatelet therapies during pregnancy.
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http://dx.doi.org/10.1007/s00234-020-02474-0 | DOI Listing |
Eur Radiol Exp
January 2025
Department of Neuroradiology, University hospital RWTH Aachen, Aachen, Germany.
Background: To define optimal parameters for the evaluation of vessel visibility in intracranial stents (ICS) and flow diverters (FD) using photon-counting detector computed tomography angiography (PCD-CTA) with spectral reconstructions.
Methods: We retrospectively analyzed consecutive patients with implanted ICS or FD, who received a PCD-CTA between April 2023 and March 2024. Polyenergetic, virtual monoenergetic, pure lumen, and iodine reconstructions with different keV levels (40, 60, and 80) and reconstruction kernels (body vascular [Bv]48, Bv56, Bv64, Bv72, and Bv76) were evaluated by two radiologists with regions of interests and Likert scales.
Neurosurg Rev
January 2025
Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
Ticagrelor has become the standard drug for the treatment of intracranial aneurysms (IAs) with flow diverters (FDs), but the dosage has not been standardized. The effect of platelet function on clinical and imaging prognosis remains unclear. This study aimed to show the effects of different doses of ticagrelor and platelet aggregation function on the clinical and imaging prognosis after FDs treatment of aneurysms.
View Article and Find Full Text PDFJ Neurointerv Surg
January 2025
Department of Neurosurgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
Background: Early literature on the Woven EndoBridge (WEB) device reported 80-90% adequate aneurysm occlusion but low complete occlusion (40-55%). It is uncertain whether residual or recurrent aneurysms require re-treatment to prevent future rupture.
Objective: To systematically review the literature to meta-analyze occlusion and complication rates after re-treatment of these aneurysms.
Acute Med Surg
January 2025
Department of Emergency and Critical Care Medicine Institute of Medicine, University of Tsukuba Hospital Tsukuba Ibaraki Japan.
Background: Traumatic intracranial aneurysms (TICAs) can be fatal if ruptured. We report a case of a TICA, distant from facial bone fractures, successfully treated with flow diverter (FD) before rupture.
Case Presentation: A 20-year-old woman was admitted following a car accident.
Brain Sci
January 2025
Department of Diagnostic and Interventional Neuroradiology, School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany.
The p48 MW HPC is a novel low-profile flow diverter covered by a hydrophilic polymer coating with antithrombogenic properties, which may reduce ischemic complications and enable a single antiplatelet therapy after insertion of the stent. In this single-center experience, we describe the efficacy of this device, focusing on the illustration of different therapeutic indications and the outcome in various clinical settings with regard to vessel anatomy, bleeding state, and aneurysm configuration. We retrospectively reviewed our database for all patients being treated with a p48 MW HPC flow diverter between February 2019 and July 2021.
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