111 research outputs found
The retreatment: Indications, technique and results
No full textDurability of endovascular treatment of intracranial aneurysms has always been an issue and a very strong point of criticism. Although studies on long-term results have made it clear that endovascular treatment safe and effective they, nonetheless showed retreatment after endovascular treatment is nearly 5-10 times more frequent than surgical clipping. Risk factors predisposing high probability of retreatment are aneurysm with dissecting nature, incomplete coiling, sac size larger than 10 mm and localization at the bifurcations such as basilar tip. The indications for retreatment after endovascular treatment are not clear yet, although certain morphologic criteria can be used. Retreatment appears not to negate the initial advantage of endovascular treatment over surgical treatment and can be performed very small morbi-mortality numbers. (C) 2013 Elsevier Ireland Ltd. All rights reserved
Re: Vertebrobasilar junction aneurysms associated fenestration: experience of five cases treated with Guglielmi detachable coils. Surg Neurol 2004;61 : 248-54
No full textFlow Redirection Endoluminal Device (FRED) with or without Adjunctive Coiling in Treatment of Very Large and Giant Cerebral Aneurysms
No full textPurpose Flow diverter stents are gaining wider use in the treatment of complex intracranial aneurysms; however, there are limited data on occlusion and complication rates of flow diverters in very large and giant aneurysms. This study assessed the safety and efficacy of flow redirection endoluminal device (FRED) and FRED Jr. stents in aneurysms >= 20 mm. Methods We retrospectively analyzed all aneurysms >= 20 mm treated with FRED/FRED Jr. between January 2010 and June 2020 from three centers. Endpoints for clinical safety were absence of major stroke, aneurysmal rupture, or death and complete or near-complete occlusion for efficacy. Results A total of 45 patients with very large (28 cases) and giant aneurysms (17 cases) were treated with FRED (41 cases), and FRED Jr. (4 cases) stents. The majority of the aneurysms (40/45, 88.9%) were in the anterior circulation. Adjunctive aneurysm coiling was performed in 21 aneurysms (46.7%). Technical complications were encountered in 4 procedures (8.9%). Ischemic and hemorrhagic complication rates were 6.7% and 8.9%, respectively. There was no case with major stroke. The mortality rate was 8.9%, and all cases were due to hemorrhagic complications from aneurysmal rupture. Median angiographic follow-up was 21.5 months (range 3-60 months). Complete occlusion was achieved in 32 aneurysms (71.1%), and near-complete occlusion in 5 cases (11.1%). Conclusion The use of FRED/FRED Jr. for the treatment of aneurysms >= 20 mm achieved a long-term aneurysm occlusion rate and a safety profile comparable to the large series reported with other flow diverter stents
Letter to the Editor. Is it time to evaluate multiple familial cavernous malformations with ultra–high resolution flat-detector CT angiography?
No full textCerebral Abscess Following Endovascular Treatment of Aneurysm: Report of 2 Cases and Review of the Literature
No full textINTRODUCTION: Endovascular treatment is growing in popularity globally as an important treatment option for intracranial aneurysms. Cerebral infection as a complication of endovascular treatment of aneurysms is sufficiently rare that only 6 isolated cerebral abscess cases have been reported thus far. CASE REPORT: In this report, we present 2 cerebral abscesses from 3 institutions, which developed after coil embolization of anterior communicating artery and middle cerebral artery aneurysms. CONCLUSION: This report was written to discuss the possible mechanisms underlying cerebral abscess after endovascular treatment of aneurysms and to suggest potential treatment and prevention methods
Does measurement of the jugular foramen diameter on MRI help to differentiate transverse sinus thrombosis from unilateral transverse sinus hypoplasia?
No full textBackground and Purpose The transverse sinus (TS) is a frequent location of cerebral venous thrombosis. However, unilateral TS hypoplasia is a frequent variation and radiological imaging pitfall in the diagnosis because it may mimic unilateral TS thrombosis. The purpose of this study is to find a cutoff value for bilateral jugular foramen (JF) diameter ratios on magnetic resonance imaging (MRI) for differentiating TS thrombosis from TS hypoplasia. Materials and Methods We retrospectively reviewed magnetic resonance venography results for 174 patients with reduced unilateral TS caliber resulting from either unilateral thrombosis (80 patients) or unilateral hypoplasia (94 patients). We calculated the ratio by proportioning the diameter of the JF ipsilateral to the TS with caliber reduction to the diameter of the contralateral JF. The Mann-WhitneyUtest was used to compare the ratios between thrombosis and hypoplasia groups, and the cutoff value was calculated by receiver-operating characteristic curve analysis. Results The ratio of bilateral JF diameters was lower in patients with hypoplasia than those with thrombosis (P < .01). The cutoff value to determine the diagnosis of TS hypoplasia with maximum accuracy was 0.638, with a sensitivity of 91.3% and specificity of 64.9%. Conclusion In equivocal cases, calculating the cutoff value by proportioning the diameter of JF ipsilateral to the TS with caliber reduction to the contralateral JF seems to be an efficient, quick, and straightforward method and valuable aid to differentiate TS thrombosis from TS hypoplasia
Tarımsal atık sulara bir hibrit ileri oksidasyon sisteminin uygulanabilirliği: Islak hava oksidasyonu ve mikrobiyal yakıt hücresi yöntemleri
No full textWithin the scope of this thesis, the main pollutants found in olive oil mill wastewaters were treated in the presence of walnut shell based catalysts by advanced oxidation methods and Microbial Fuel Cell (MFC) system. Advanced oxidation methods and Microbial Fuel Cell treatment were applied sequentially in a hybrid treatment system. The target olive olive mill wastewater contaminants were selected as succinic acid (SA) and fumaric acid (FA). This study was accomplished in two stages. The first part of study was performed in La Sapienza University Rome/Italy by the investigation of fumaric acid degradation in Microbial Fuel Cell. The second part of study was carried out in Ege University İzmir/Turkey by the application of a hybrid wastewater system including AOPs and MFC for succinic acid degradation which is the co-crystal of the fumaric acid. In the first step of the hybrid treatment system catalytic wet air oxidation or photo-Fenton-like oxidation method was applied whereas the wastewater obtained from advanced oxidation treatment was treated with microbial fuel cell in the second step.Bu tez kapsamında, zeytin karasuyunun ana kirleticilerinin ceviz kabuklarından hazırlanan katalizör varlığında çeşitli ileri oksidasyonu yöntemleri ve mikrobiyal yakıt hücresi ile arıtımı çalışılmıştır. İleri oksidasyon yöntemleri ve mikrobiyal yakıt hücresi sistemleri bir hibrit sistem olarak uygulanmıştır. Hedef zeytin karasuyu bileşikleri süksinik asit ve fumarik asit olarak seçilmiştir. Bu çalışma iki aşamada tamamlanmıştır. Çalışmanın ilk aşaması La Sapienza Üniversitesi Roma İtalya'da fumarik asit arıtımı mikrobiyal yakıt hücresi kullanılarak yapılmıştır. Çalışmanın ikinci aşaması Ege Üniversitesi İzmir Türkiye'de, ileri oksidasyon yöntemi ve mikrobiyal yakıt hücresi içeren hibrit sistem geliştirilmesi üzerine fumarik asidin eş-kristalı olan süksinik asit giderimi üzerinde tamamlanmıştır. Fumarik asit giderimi mikrobiyal yakıt hücresi ile incelenmiştir. Süksinik asit giderimi ise hibrit artıma sisteminin ilk aşaması olarak ileri oksidasyon yöntemlerinden katalitik ıslak hava oksidasyonu ve foto-Fenton benzeri oksidasyon yöntemleri ile incelenmiştir. Bu sistemin ikinci aşamasında mikrobiyal yakıt hücresi kullanılmıştır
Endovascular Treatment of Aneurysms Associated with Fenestrated A1 Segment of Anterior Cerebral Artery: Report of Two Cases
No full textFenestration in A1 segment of anterior cerebral artery is a rare entity. Treatment of aneurysms derived from a fenestrated artery may be more challenging because the fenestrations provide specific difficulties. A thorough radiologic work-up driven by high clinical suspicion is needed. Endovascular treatment, although it has been tried only once,7 appears to be the treatment of choice. We successfully treated 2 cases using endovascular techniques and can conclude that endovascular treatment is a safe and effective treatment of aneurysms associated with this rare variation in the A1 segment of ACA
Dissecting aneurysms of posterior communicating artery itself: anatomical, diagnostic, clinical, and therapeutical considerations
No full textPosterior communicating artery (PCoA) itself is an unusual location for intracranial aneurysms in that isolated dissections or dissecting aneurysms are extremely rare. In the way of correct diagnosis of dissecting aneurysms of PCoA itself, a proper understanding of (1) the anatomy of the PCoA and its perforator branches, (2) some particular diagnostic features, and (3) related clinical aspects is of significant importance. Although there are no established treatment strategies for this particular type of aneurysms, the endovascular approach might be considered as a plausible one. In this paper, our scope was to report five cases with dissecting aneurysm of the PCoA itself and to discuss this rare vascular pathology from anatomical, diagnostic, clinical, and therapeutical perspectives
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