367 research outputs found
sj-docx-1-ine-10.1177_15910199221118148 - Supplemental material for Safety and efficacy of the surpass streamline for intracranial aneurysms (SESSIA): A multi-center US experience pooled analysis
No full textSupplemental material, sj-docx-1-ine-10.1177_15910199221118148 for Safety and efficacy of the surpass streamline for intracranial aneurysms (SESSIA): A multi-center US experience pooled analysis by Juan Vivanco-Suarez, Alan Mendez-Ruiz, Mudassir Farooqui, Kimon Bekelis, Justin A Singer, Kainaat Javed, David J Altschul, Johanna T Fifi, Stavros Matsoukas, Jared Cooper, Fawaz Al-Mufti, Bradley Gross, Brian Jankowitz, Peter T Kan, Muhammad Hafeez, Emanuele Orru, Andres Dajles, Milagros Galecio-Castillo, Cynthia B Zevallos, Ajay K Wakhloo and Santiago Ortega-Gutierrez in Interventional Neuroradiology</p
Tabish Khair in Conversation with Ajay K Chaubey
No full textBorn in Ranchi and educated up to his MA in Gaya, Tabish Khair, PhD (Copenhagen), DPhil (Aarhus), is a Professor of English in Denmark and the author of a number of acclaimed books. Winner of the All India Poetry Prize, Khair’s novels – The Bus Stopped (2004), Filming (2007) and The Thing About Thugs (2010) – have been shortlisted for awards including the Hindu Prize, Man Asian Prize, DSC Prize for South Asia. His last novel, How to Fight Islamist Terror from the Missionary Position, was dubbed the ‘best 9/11 novel’ by the New Republic and ‘unmissable’ by the Times. A study by Khair, The New Xenophobia, will be published by Oxford University Press in January 2016. Professor Khair, while being in Denmark, spoke to me through email promptly and positively on several aspects of diaspora, narratives of migration and rationale of ‘brain-drain’ and the theoretical contours of the Indian diaspora in the wake of multiple terrorist attacks in the West
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Angiographic Assessment of Flow Divertors as Treatment for Cerebral Aneurysms: Results in the Rabbit Elastase-Induced Aneurysm Model
No full textCerebral aneurysms are abnormal focal dilations of the cerebral vasculature that may rupture and cause a hemorrhagic stroke. More than a decade after seminal experimental studies showed the feasibility of successfully treating cerebral aneurysms by flow diversion, the potential of this modality is gradually being recognized in the clinical arena. A flow divertor is a metallic meshed tube that has its porosity (ratio of metal-free surface area to total surface area) and pore density (number of pores per unit surface area) optimized to facilitate occlusion of aneurysms. An appropriately designed flow divertor severely attenuates the flow exchange between the parent vessel and an aneurysm, resulting in the formation of intra-aneurysmal flow stasis zones which promote thrombosis. This study reports the results from implantation of three different configurations of a novel flow-diverting device in thirty elastase-induced aneurysm models in rabbits. Ten animals per device configuration were followed-up at 3 weeks (n=3), 3 months (n=3), and 6 months (n=4) and tissue explanted post-sacrifice was sent for histology. High-speed angiographic sequences were acquired before and immediately after device implantation, and at follow-up for each animal. Temporal variations in the angiographic contrast intensity within the aneurysms were recorded and subsequently corrected for respiratory motion. These aneurysmal contrast washout curves were fit to a mathematical model whose parameters served to quantify device performance. Angiographic quantification was supplemented by histomorphometric data to derive composite scores of the performance of each device configuration in effecting stable aneurysm occlusion. Performance scores showed that the device with a porosity of 70%, filament diameter of 38 microns, and pore density of 18 pores/mm^2 performed better than devices with 65% porosity, 51 micron filament diameter, 14 pores/mm^2 and 70% porosity, 51 micron filament diameter, 12 pores/mm^2 with relative efficacies of 100%, 86%, and 79%, respectively. Angiographic quantification further suggested a parameter, which could be employed to estimate long-term aneurysm occlusion probabilities immediately after treatment with any flow diversion device. A value of this parameter less than 30 predicts greater than 97% angiographic aneurysm occlusion over a period of six months with a sensitivity of 73% and specificity of 82%. Larger data sets are required to improve the validity of this test. The pore density of flow divertors, rather than porosity, was seen to be a critical modulating factor of device efficacy. Refinement of the best device configuration by further optimizing the pore density may yield yet better results.</p
Endovascular treatment of intracranial aneurysms: current status
No full textAlthough treatment of a ruptured aneurysm is accepted as an emergency, indication for treatment of unruptured intracranial aneurysms (IAs) is still being discussed
Brain aneurysms and arteriovenous malformations: advancements and emerging treatments in endovascular embolization
No full textBACKGROUND AND PURPOSE: Brain aneurysms and vascular malformations can cause cerebral hemorrhages, with devastating consequences for the patients and their families. Since the development of microcatheters and materials used for endovascular embolization, we have witnessed a rapid advancement in the technology and in the number or patients treated with this approach. The aim of this review is to survey recent data relevant to new technologies and emerging treatment strategies in these areas. SUMMARY OF REVIEW: Clinical trials assessing the safety and efficacy of coil embolization for cerebral aneurysms were based on the use of bare platinum, helical coils. Since then, endovascular operators have been testing and using new materials such as bioactive coils, expandable coils, and complex-shaped coils. Based on the data so far obtained, third and fourth generation coil designs are rapidly emerging and will be ready for clinical application in the near future. Balloon- and stent-assisted coil embolization is enabling the treatment of complex, large-neck aneurysms and the vascular reconstruction of lesions previously considered not treatable. New open- and closed-cell designs allow the navigation and deployment of stents in extremely tortuous vessels. With regards to the embolization of vascular malformations, it is possible to safely navigate microcatheters and microwires through very small arteries previously considered not accessible. In addition, embolization materials such as n-butyl cyanoacrylate and ethylene-vinyl alcohol copolymer are now routinely injected to safely reduce or obliterate large and complex arteriovenous malformations and fistulae. CONCLUSIONS: Advancements in technology are rapidly improving the endovascular approach to the treatment of cerebral aneurysms and arteriovenous malformations
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