The techniques used for treatment of intracranial aneurysms have progressed dramatically over the decades. The introduction of modern endovascular techniques and the continued refinement of progressively less invasive neurosurgical approaches have contributed to steadily improving clinical outcomes. Moreover, innovations such as flow-diverting stents have achieved dramatic success and have gained rapid widespread adoption. Particularly in lesions for which the application of conventional treatment techniques is difficult, flow diversion technology has revolutionized aneurysm management. This review provides a discussion on the morbidity and mortality encountered in the treatment of intracranial aneurysms in the modern era. Common adverse events faced in the management of these lesions with open surgery and various endovascular techniques are highlighted.
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http://dx.doi.org/10.1007/978-3-030-12887-6_11 | DOI Listing |
Acta Neurochir (Wien)
January 2025
Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street , Boston, MA, 02215, USA.
Background: Variability in long-term endovascular treatment outcomes for intracranial aneurysms has prompted questions regarding the effects of these treatments on aneurysm hemodynamics. Endovascular techniques disrupt aneurysmal blood flow and shear, but their influence on intra-aneurysmal pressure remains unclear. A better understanding of aneurysm pressure effects may aid in predicting outcomes and guiding treatment decisions.
View Article and Find Full Text PDFNeurosurg Rev
January 2025
Neurosurgical Service, Harvard Medical School, Beth Israel Deaconess Medical Center, 110 Francis Street, Boston, MA, 02215, USA.
Intracranial hemorrhages are highly concerning but underreported complications related to flow diversion (FD) treatment of intracranial aneurysms. Herein, we aimed to characterize these complications and the factors influencing their occurrence. We retrospectively reviewed patients treated with FD from 2013 to 2023 at a single U.
View Article and Find Full Text PDFNeuroradiol J
January 2025
Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, USA.
Flow diversion is a transformative approach in neurointerventional surgery for intracranial aneurysms that relies heavily on effective antiplatelet therapy. The ideal approach, including the timing of treatment, the use of dual antiplatelet therapy (DAPT), and the number of flow-diverter devices to use, remains unknown. DAPT, which combines aspirin with a thienopyridine like clopidogrel, prasugrel, or ticagrelor, is the standard regimen, balancing thromboembolic protection and hemorrhagic risk.
View Article and Find Full Text PDFPolymers (Basel)
December 2024
Department of Petroleum and Energy Engineering, School of Science and Engineering, The American University in Cairo, New Cairo 11835, Egypt.
One of the most challenging aspects of manipulating the flow of fluids in subsurfaces is to control their flow direction and flow behavior. This can be especially challenging for compressible fluids, such as CO, and for multiphase flow, including both water and carbon dioxide (CO). This research studies the ability of two crosslinked polymers, including hydrolyzed polyacrylamide and acrylic acid/hydrolyzed polyacrylamide crosslinked polymers, to reduce the permeability of both CO and formation water using different salinities and permeability values and in the presence of crude oil under different injection rates.
View Article and Find Full Text PDFDiagnostics (Basel)
December 2024
Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, 80131 Naples, Italy.
Objectives: This study aims to report on the application of degradable starch microspheres to provide flow diversion by means of temporary embolization of healthy tissues in oncological endovascular procedures when tumor feeding vessels are not selectively accessible.
Methods: This is a multicenter retrospective analysis of patients undergoing visceral embolization procedures of malignancies. The inclusion criteria were as follows: flow diversion performed by injection of degradable starch microspheres, visceral embolization procedures with unfeasible superselective catheterism of the target, and a malignant pathology.
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