Journal of neurointerventional surgery
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Cerebral arteriovenous malformations (AVMs) are vascular lesions that are amenable to various treatment modalities including stereotactic radiosurgery, fractionated radiotherapy, endovascular embolization, microsurgical obliteration or combined modality treatment. A potential complication of endovascular therapy with embolization material is microcatheter entrapment. We report on a patient for whom surgery was combined with endovascular embolization to obliterate an AVM and retrieve an entrapped endovascular microcatheter. ⋯ This demonstrates the first incidence of microcatheter removal after procedural entrapment in Onyx embolization material.
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Case Reports Comparative Study
Stent-assisted coiling of paraclinoid aneurysms: risks and effectiveness.
Stent assistance for treatment of wide-based aneurysms is becoming rapidly accepted. ⋯ Stent-assisted coiling of paraclinoid aneurysms did not add significantly to morbidity; overall effectiveness was comparable to that of bare coiling of paraclinoid aneurysms. These results require confirmation by a prospective controlled trial.
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Spinal dural arteriovenous fistulas (SDAVFs) represent the most frequent spinal arteriovenous malformation and have an ominous natural history if left untreated. In the present review, we describe the spinal vascular anatomy, pathophysiology and clinical manifestations of SDAVFs, and the current role of endovascular embolization in this type of lesion.
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Case Reports
The balloon anchor technique: a novel technique for distal access through a giant aneurysm.
A novel technique is reported that helps the operator in achieving reliable access to the distal parent vessel with a microcatheter for stent assisted aneurysm coiling. Distal parent vessel access was obtained by allowing the microwire to follow the local hemodynamics into a giant internal carotid artery aneurysm and around its dome. ⋯ In this technique, an over-the-wire balloon was inflated in the distal vessel followed by gentle retraction of the balloon catheter and microwire allowed only a wire bridge across the aneurysm neck, thereby allowing the stent catheter to be brought up in a standard fashion. This technique may facilitate the use of new stent technologies for the treatment of aneurysms that would otherwise be untreatable with endovascular therapies.