Happy Easter – Smiling Aneurysm
Happy Easter from Neurovascolare Team. Francesco Diana, M.D. Francesco Biraschi, M.D. Simone Peschillo, M.D., Ph.D.
Author: Francesco Diana
Francesco Diana, M.D.,
Interventional Neuroradiology,
I.R.C.C.S. Neuromed,
Pozzilli (IS), Italy
A raised bar for aneurysm surgery in the endovascular era
Key points: Despite microsurgical treatment of cerebral aneurysms has a documented history, the impressive progression of endovascular technology, techniques and skills, and the results of the International Subarachnoid Aneurysm Trial (ISAT) and the Barrow Ruptured Aneurysm Trial (BRAT) has altered the paradigm for treating intracranial aneurysms. These neurointerventional option have raised the bar for aneurysm surgery, in an era when most Read more about A raised bar for aneurysm surgery in the endovascular era[…]
Collateral leptomeningeal arteries: where are the anastomosis?
Key point: More than 300 years ago, Willis T. characterized the arterial ring at the base of the brain and began debate concerning whether the circle functions primarily as a flow equalizer or as an anastomosis. Heubner O., in 1874, was the first to produce a well-documented study demonstrating the existence of LMA; he was trying to Read more about Collateral leptomeningeal arteries: where are the anastomosis?[…]
The Role of Catheter Angiography in the Diagnosis of Central Nervous System Vasculitis
Key points: The role of angiography in the diagnosis of primary central nervous system vasculitis (PCNSV) emerged in the mid-1960, when were recognized recurring but not specific angiographic pattens in the inflammatory conditions of the CNS. However the comprehension of the role of DSA in this cases was made difficult by the lack of a Read more about The Role of Catheter Angiography in the Diagnosis of Central Nervous System Vasculitis[…]
Intracranial Vessel Wall MRI: Principles and Expert Consensus Recommendations of the American Society of Neuroradiology
Key points: Conventional techniques for imaging the intracranial arteries can fail to fully characterize disease that resides within the vessel wall. For this reason, there is growing interest in direct visualization of the vessel wall with high-resolution intracranial vessel wall MR imaging (VW-MR imaging). The principal technical requirements for intracranial VW-MR imaging are the following: Clinical Read more about Intracranial Vessel Wall MRI: Principles and Expert Consensus Recommendations of the American Society of Neuroradiology[…]
Intravenous thrombolysis before endovascular therapy for large vessel strokes can lead to significantly higher hospital costs without improving outcomes
Key points: Nowadays there are a number of trials that have shown improved outcomes following endovascular therapy for LVO strokes compared with standard therapies alone, but only a little number of patients is treated without prior IV recombinant tissue plasminogen activator (rt-PA). For this reason the question of whether previous IV rt-PA really help the Read more about Intravenous thrombolysis before endovascular therapy for large vessel strokes can lead to significantly higher hospital costs without improving outcomes[…]
Optimal first coil selection to avoid aneurysmal recanalization in endovascular intracranial aneurysmal coiling
Key points: Coiling, simple or balloon-/stent-assisted, is an endosaccular technique of treatment and a long-term follow-up is mandatory: the problem of aneurysmal recanalization remains and according to a systematic review, recanalization occurs in 20.8% of patients. The volume embolization ratio (VER) has recently been reported to be associated with aneurysmal recanalization. It is a general Read more about Optimal first coil selection to avoid aneurysmal recanalization in endovascular intracranial aneurysmal coiling[…]
Multiple FD stents for treatment of large and giant aneurysms: is it really useful? Quantitative flow measurement after placing a flow diverter for a distal internal carotid artery aneurysm
Chen CW1, Wong HF2, Ye YL1, Chen YL3, Chen WL4, Ou CH5, Tsai YH1. Key points: As everyone knows the flow diverter stent (FDS) disrupts blood flow into the aneurysm sac, maintaining normal blood flow through the parent vessel; sometimes, there is a neointimal proliferation across the device strut, that contributes to the aneurysm closure. Read more about Multiple FD stents for treatment of large and giant aneurysms: is it really useful? Quantitative flow measurement after placing a flow diverter for a distal internal carotid artery aneurysm[…]
Headache and Treatment of Unruptured Intracranial Aneurysms
Arena JE1, Hawkes MA2, Farez MF1, Pertierra L1, Kohler AA1, Marrodán M1, Benito D3, Goicochea MT1, Miranda JC3, Ameriso SF4. Key points: Despite several studies have mentioned the presence of headache (cluster headache, hemicrania continua, and migraine) in subjects with UIAs, in 18%-34% of cases, in general practice chronic primary headache is not usually Read more about Headache and Treatment of Unruptured Intracranial Aneurysms[…]
A pilot study and novel angiographic classification for superior sagittal sinus stenting in patients with non-thrombotic intracranial venous occlusive disease
Raper DM, Buell TJ, Ding D, Pomeraniec IJ, Crowley RW, Liu KC. Key points: The majority of stenosis of an intracranial dural sinus, cause of intracranial hypertension (IIH) or chronic headache without IIH, involve the transverse (TS) and sigmoid (SS) sinuses. However, a subset of patients with intracranial venous occlusive disease (VOD) has SSS stenosis with Read more about A pilot study and novel angiographic classification for superior sagittal sinus stenting in patients with non-thrombotic intracranial venous occlusive disease[…]