login
  Password reminder
NeuroNews
Contact the editor Visit NeuroNews Twitter feed Visit NeuroNews Facebook page
 

Revolutionary impact of flow diversion/modification on treatment of certain aneuryms


Friday, 30 Sep 2011 11:45
Saruhan Çekirge
Saruhan Çekirge


Saruhan Çekirge, professor, Hacettepe University Hospitals, Ankara,Turkey, told delegates at the European Society of Minimally Invasive Neurological Therapy congress (ESMINT) held in Nice, France, that the impact of flow diversion/modification on the endovascular treatment of aneurysms with an important branch originating from the aneurysm sac was a “revolutionary change”.


He also told delegates: “In endovascular aneurysm treatment with flow diverters, there has been a strong consideration regarding the side branch or perforator patency. There have been anecdotal cases reporting perforating injury in the literature. In our experience, covering a segment, with branches coming off, with flow diverters especially with a single device, does not result in clinical consequence. If there is a flow demand, the vessel stays open; if not, it may close or become hypoplastic. This is most interesting that if there is a flow demand it stays open, so there is very intelligent behaviour.”


“Control studies have shown that flow diversion/modification treatment provides revolutionary changes not only for aneurysms which are large/giant and fusiform, for very small, difficult or impossible- to-coil ones and also for aneurysms with an important vessel coming off the sac which used to be the major limitation for endovascular treatment,” he added.


In the Hacettepe FD Pipeline/Silk series of 269 aneurysms in 211 patients, there was a subgroup of 46 aneurysms with a vessel originating from the aneurysm sac. In this group of 46 aneurysms with a vessel originating from the aneurysm sac, 23 aneurysms were in the internal carotid-anterior choroidal artery, 11 in the posterior communicating, four in the posterior inferior coronary artery, two in the distal anterior cerebral artery, one in the distal posterior communicating artery and five in the middle cerebral artery with important side branches originating .

 

“In 33 of these 46 aneurysms, six months and/or one year follow-up DSA was obtained. Investigators found that out of these 33 aneurysms which were controlled, all but one vessel (posterior communicating artery) originating from the aneurysm sac stayed open. Twenty aneurysms closed with perfect reconstruction and 13 aneurysm sacs were remodeled back. No clinical consequences developed except for one patient with an internal carotid-anterior choroidal aneurysm who stopped using clopidogrel after one week and had a transient ischaemic attack with a very small diffusion MR lesion in the territory. This patient returned to normal in 24 hours and a six-month control DSA revealed complete aneurysm occlusion with patency of the artery,” said Çekirge.




Add New Comment

Most popular


Better outcomes observed in MR CLEAN non-general anaesthesia subgroup in post-hoc analysis
Thursday, 02 Apr 2015
In a post-hoc analysis of the use of general anaesthesia in the MR CLEAN trial (Multicenter randomized clinical trial of endovascular treatment for acute ischemic stroke in the Netherlands) ... Better outcomes observed in MR CLEAN non-general anaesthesia subgroup in post-hoc analysis

Cover device proves more effective than guide catheter in stroke model
Wednesday, 18 Mar 2015
In an in vitro stroke model comparison, the use of the Cover accessory device (Lazarus Effect) in conjunction with a stent retriever resulted in higher successful recanalisation rates, no embolic ... Cover device proves more effective than guide catheter in stroke model

Evidence builds for endovascular treatment of acute ischaemic stroke
Friday, 17 Apr 2015
With the publication of two more stroke trials, the evidence in favour of endovascular treatment in patients with acute ischaemic stroke has reached new heights. Data from SWIFT PRIME and REVASCAT ... Evidence builds for endovascular treatment of acute ischaemic stroke

Features


New day in acute ischaemic stroke therapy
Friday, 17 Apr 2015
The newest generation of trials for acute ischaemic stroke, including MR CLEAN, ESCAPE, EXTEND IA and SWIFT PRIME, appear to have ushered in a new era in stroke therapy. Now, Joseph Broderick (... New day in acute ischaemic stroke therapy

Flow diverter technology for intracranial aneurysms
Tuesday, 31 Mar 2015
Gabor Toth writes for NeuroNews about the flow diverters that are currently available and the ongoing clinical trials that could have the potential to extend the indications of flow diverter therapy ... Flow diverter technology for intracranial aneurysms

Profiles


Joseph Broderick
Wednesday, 07 Jan 2015
Joseph Broderick speaks to NeuroNews about the future of neurology and his research, in particular, ... Joseph Broderick

Vladimír Beneš Jr
Tuesday, 30 Sep 2014
Vladimír Beneš Jr is professor and chair at the First Medical School, Charles University, P... Vladimír Beneš Jr

Cardiac Rhythm News Vascular News Cardiovascular News Interventional News Spinal News NeuroNews
BIBA Medical BIBA MedTech Insights CX Symposium ilegx
 
Password Reminder

BIBA Medical, 526 Fulham Road, Fulham, London, SW6 5NR.
TEL: +44 (0)20 7736 8788 FAX: +44 (0)20 7736 8283 EMAIL: 
info@bibamedical.com
© BIBA Medical Ltd is a company registered in England and Wales with company number 2944429.
VAT registration number 730 6811 50.
Site Map | Terms and Conditions