AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Jan 2017
Multicenter StudyTreatment of Intra- and Extracranial Aneurysms Using the Flow-Redirection Endoluminal Device: Multicenter Experience and Follow-Up Results.
Flow diversion emerged as a crucial treatment option for intracranial aneurysms. We report a multicenter retrospective analysis of the safety and efficacy in the treatment of intracranial aneurysms with the Flow-Redirection Endoluminal Device (FRED) flow diverter, a dual-layer flow-modulation device. ⋯ The FRED device offers an effective tool in the treatment of intracranial aneurysms. The dual-layer design promotes contemporary and stable long-term occlusion rates. Sufficient device expansion should be documented by angiographic CT. Further studies might help to identify a more optimal antiplatelet regimen to avoid thromboembolic complications during the follow-up period.
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AJNR Am J Neuroradiol · Jan 2017
Quantifying the Cerebral Hemodynamics of Dural Arteriovenous Fistula in Transverse Sigmoid Sinus Complicated by Sinus Stenosis: A Retrospective Cohort Study.
Sinus stenosis occasionally occurs in dural arteriovenous fistulas. Sinus stenosis impedes venous outflow and aggravates intracranial hypertension by reversing cortical venous drainage. This study aimed to analyze the likelihood of sinus stenosis and its impact on cerebral hemodynamics of various types of dural arteriovenous fistulas. ⋯ Sinus stenosis indicated dysfunction of venous drainage and is more often encountered in dural arteriovenous fistula with more aggressive types. Venoplasty ameliorates cortical venous drainage in dural arteriovenous fistulas and serves as a bridge treatment to stereotactic radiosurgery in most cases.
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AJNR Am J Neuroradiol · Dec 2016
Review Meta AnalysisEfficacy and Safety of the Woven EndoBridge (WEB) Device for the Treatment of Intracranial Aneurysms: A Systematic Review and Meta-Analysis.
Intrasaccular flow diverters are increasingly being used in the treatment of wide-neck and bifurcation aneurysms. We performed a systematic review and meta-analysis of existing literature on the Woven EndoBridge device in the treatment of intracranial aneurysms. ⋯ Early evidence derived from uncontrolled studies suggests that Woven EndoBridge treatment has a good safety profile and promising rates of adequate occlusion, especially given the complexity of aneurysms treated. Further prospective clinical trials are needed to confirm these results and better define the risks and benefits of use of the Woven EndoBridge device in treating wide-neck and wide-neck bifurcation aneurysms.
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AJNR Am J Neuroradiol · Dec 2016
Are Anatomic Results Influenced by WEB Shape Modification? Analysis in a Prospective, Single-Center Series of 39 Patients with Aneurysms Treated with the WEB.
Endovascular treatment with the flow-disrupter Woven EndoBridge aneurysm embolization system (WEB) is an innovative treatment for wide-neck bifurcation aneurysms. Prospective, multicenter studies have shown the high safety of this technique. Stability of aneurysm occlusion in long-term follow-up has been rarely studied. Moreover the "compression" phenomenon has been reported and seems to be associated with poor anatomic results. This prospective, single-center series analyzes the safety and efficacy of the WEB device in long-term follow-up in relation to WEB shape modification. ⋯ This prospective, single-center series with WEB devices used in 39 patients during 3.5 years confirms data from previous multicenter studies. Treatment can be accomplished with good safety and efficacy, with a high rate of adequate occlusion. Anatomic results were not worse in case of WEB shape modification.
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AJNR Am J Neuroradiol · Nov 2016
Optimized, Minimal Specific Absorption Rate MRI for High-Resolution Imaging in Patients with Implanted Deep Brain Stimulation Electrodes.
Obtaining high-resolution brain MR imaging in patients with a previously implanted deep brain stimulator has been challenging and avoided by many centers due to safety concerns relating to implantable devices. We present our experience with a practical clinical protocol at 1.5T by using 2 magnet systems capable of achieving presurgical quality imaging in patients undergoing bilateral, staged deep brain stimulator insertion. ⋯ An optimized MR imaging protocol that minimizes the specific absorption rate can be used to safely obtain high-quality images in patients with previously implanted deep brain stimulators, and these images are adequate for surgical guidance.