def calculate_phases_score(aneurysm_size, age, hypertension, smoking): score = 0 # Calcola il punteggio in base alla dimensione dell'aneurisma if aneurysm_size <= 7: score += 1 elif aneurysm_size <= 15: score += 2 else: score += 3 # Calcola il punteggio in base all'età if age <= 60: score += 1 else: score += 2 # Calcola il punteggio in base all'ipertensione if hypertension: score += 2 # Calcola il punteggio in base al fumo if smoking: score += 3 return score # Esempio di utilizzo phases_score = calculate_phases_score(10, 65, True, True) print("Il phases score è:", phases_score) Delayed enhancing lesions after coil embolization of aneurysms: clinical experience and benchtop analyses – Lab Neurovascolare

Delayed enhancing lesions after coil embolization of aneurysms: clinical experience and benchtop analyses

Posted on by Francesco Diana
Oh SW1,2, Shin NY1,3, Lee HJ1, Kim BM1, Kim DJ1.

Abstract

BACKGROUND: Foreign body emboli during endovascular treatment (EVT) may cause delayed enhancing lesions (DELs).

OBJECTIVE: To report our experiences of this complication in patients treated for cerebral aneurysms and to investigate the cause of the lesions by benchtop analyses.

METHODS: Three patients with DELs on MRI after EVT were retrospectively investigated. Unusual friction had occurred in the midst of coil delivery in two patients. The imaging findings, cause of the lesions due to the devices used for the procedure, treatment, and follow-up results were assessed. Two benchtop analyses were performed. First, a microcatheter that showed similar unusual friction during coiling was retrieved and dissected at the point of friction. Second, the EVT procedure was simulated with multiple coil advancement and withdrawal maneuvers within an acutely angulated microcatheter to identify downstream foreign body material emboli.

RESULTS: The DELs were identified 27-37 days (mean 32.7) after the procedure. The patients presented with left arm weakness, headache, and no other symptoms. The lesions were located in the hemisphere corresponding to the treatment. The symptoms subsided after conservative therapy. The dissected microcatheter showed whitish semitransparent material adherent to the inner lumen. Similar material was sieved after multiple coil advancement and withdrawal maneuvers.

CONCLUSIONS: DELs may be caused by fragmentation and emboli of the inner coating wall of the microcatheter. Development of unusual friction during coil delivery may be a sign of damage of the microcatheter inner wall and the device should be discarded.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

doi: 10.1136/neurintsurg-2016-012833

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