Journal of neurointerventional surgery
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Comparative Study
Endovascular treatment of unruptured wide-necked intracranial aneurysms: comparison of dual microcatheter technique and stent-assisted coil embolization.
Endovascular treatment of wide-necked aneurysms is challenging. Stent-assisted coiling (SAC) is associated with increased complications and requires dual antiplatelet therapy. ⋯ DMT and SAC are effective endovascular approaches for unruptured, wide-necked aneurysms; however, DMT may result in less morbidity. Further long-term studies are necessary to determine the optimal indications for these treatment options.
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Comparative Study
Conventional endovascular treatment of small intracranial aneurysms is not associated with additional risks compared with treatment of larger aneurysms.
Endovascular treatment of small intracranial aneurysms has historically been technically challenging and has been associated with high rates of complications and intraprocedural rupture. In this study, we compared complication and recurrence rates for treatment of small aneurysms (≤ 4 mm) versus large aneurysms in the context of the advent of improvements in endovascular techniques and technologies. ⋯ Treatment of small intracranial aneurysms via conventional endovascular coiling techniques is not inferior to endovascular treatment of larger aneurysms based on our single institution experience. While technically challenging, such aneurysms may be treated safely and effectively with acceptable rates of complications and recurrence.
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Comparative Study
Effect of aneurysm and ICA morphology on hemodynamics before and after flow diverter treatment.
Flow diverter (FD) treatment aims to slow down blood flow inside the aneurysm and increase the average time that blood resides in the aneurysm. ⋯ Although the change in intra-aneurysmal hemodynamics after FD treatment strongly depends on the morphology of the aneurysm, the hemodynamic effect of a FD is also linked to the parent vessel morphology and the position and orientation of the aneurysm with respect to it.
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Multicenter Study
Endovascular treatment for M2 occlusions in the era of stentrievers: a descriptive multicenter experience.
Patients with M2 middle cerebral artery (MCA) occlusions are not always considered for endovascular treatment. ⋯ Endovascular treatment of M2 MCA occlusion with stentrievers seems safe. Induced recanalization may double the chances of achieving a favorable outcome, especially for patients with moderate or severe deficit.
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Case Reports Multicenter Study
Endovascular treatment of tandem vascular occlusions in acute ischemic stroke.
Tandem vascular occlusions are an important cause of acute ischemic stroke (AIS) and present unique treatment challenges. We report our experience of managing a subset of AIS patients with extracranial vascular stenting/angioplasty and intracranial revascularization. ⋯ Our study shows preliminary data from three centers on recanalization of tandem occlusions in patients presenting with AIS. There was a preference to revascularize the proximal occlusion using a stent followed by distal recanalization with mechanical thrombectomy, intra-arterial thrombolysis or a combination of these. This approach has low periprocedural complications and can achieve an excellent angiographic and clinical outcome.