Aneurysm Formation, Growth, and Rupture: The Biology and Physics of Cerebral Aneurysms

Texakalidis, Pavlos; Sweid, Ahmad; Mouchtouris, Nikolaos; Peterson, Eric C.; Sioka, Chrissa; Rangel-Castilla, Leonardo; Reavey‐Cantwell, John; Jabbour, Pascal

doi:10.1016/j.wneu.2019.07.093

Cited by 89 publications

(62 citation statements)

References 106 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4,81,82 It is generally considered that genetic, environmental, and atherosclerotic risk factors play an important role in aneurysm formation, although the exact pathogenic process remains unknown. 2,[82][83][84][85] In several operative series, atherosclerosis has been most frequently recognized as the main cause of the aneurysms 12,86 ; nonetheless, a previous systematic review, reporting on 117 and 107 cases treated with stent and other endovascular strategies, receptively, provided evidence that post-traumatic ECAAs accounted for approximately half of the published cases overall. 4 Similarly, in our study, including overall 162 patients treated with primary stenting, trauma was responsible for aneurysm formation in 54.3% (n ¼ 38/70) of the cases.…”

Section: Discussionmentioning

confidence: 99%

Εndovascular Repair of Extracranial Carotid Artery Aneurysms: A Systematic Review

Giannopoulos

Trinidad

Aronow

et al. 2020

Vasc Endovascular Surg

View full text Add to dashboard Cite

Objective: Both true and false extracranial carotid artery aneurysms (ECAA) are a potential source of morbidity and mortality. While ECAA have historically been treated surgically, endovascular reconstruction with stenting is an emerging treatment option. The aim of our study was to report clinical/radiologic outcomes following endovascular repair of ECAAs. Methods: A comprehensive systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Results: A total of 68 case reports and case series, comprising 162 patients, were included. Most patients presented with at least one symptom or sign related to the ECAA (89.5%; N = 145/162). In 42.6% (N = 69/162) and 46.3% (N = 75/162) of the cases polytetrafluoroethylene covered and uncovered stents were deployed respectively. Immediate post-procedural imaging demonstrated complete aneurysm exclusion in 86.4% (N = 140/162) of the cases and minimal filling of the aneurysm sack in 10.5% (N = 17/162) of all cases. Perioperative adverse event rates were 3.1% for stroke, 1.2% for transient ischemic attack (TIA) and 4.3% for mortality. During a mean follow-up of 21.8months, there were additionally observed one stroke, two TIAs and three deaths. Overall 88.6 % of the patients (N = 117/132) remained asymptomatic, partially recovered or at least did not suffer from new neurologic deficits during follow up, with no signs of stenosis or occlusion of the carotid artery. Conclusions: Endovascular stenting for the treatment of ECAAs is feasible with acceptable short- and long-term clinical and radiologic outcomes. Prospective real-world studies are needed to further validate the safety and the long-term patency of endovascular repair.

show abstract

Section: Discussionmentioning

confidence: 99%

Εndovascular Repair of Extracranial Carotid Artery Aneurysms: A Systematic Review

Giannopoulos

Trinidad

Aronow

et al. 2020

Vasc Endovascular Surg

View full text Add to dashboard Cite

show abstract

“…For each technique, details of the animal model, localization, time for creation, size of the aneurysm, patency rate, and morbidity and mortality are outlined in Supplementary Tables. We defined five main groups of aneurysm models as (1) sidewall, (2) terminal, (3) bifurcation stump, (4) natural and artificial bifurcation, and (5) complex aneurysm models ( Figure 2).…”

Section: Resultsmentioning

confidence: 99%

“…The sidewall aneurysm model, described by German and Black, is the oldest microsurgical technique to produce experimental aneurysms (Figure 4, A1). 13 The two variations of this technique have used (1) an isolated vein graft sutured end-to-side onto the parent artery (Supplementary Figure A1A) and (2) an arteriovenous fistula created by end-to-side or side-to-side suturing of a vein onto the parent artery followed by immediate or delayed ligation of the fistula (Supplementary Figure A1B). 14,15 Modifications include weakening of the parent artery with the use of nitrogen mustard, elastase, or mechanical destruction and subsequent aneurysmal outpouching at the site of the damaged vessel segment.…”

Section: Sidewall Aneurysm Modelmentioning

confidence: 99%

“…Despite rapid advances in the development of endovascular treatment, complete and long-lasting aneurysm occlusion remains a challenge, and the biological mechanisms that predispose brain aneurysms to grow and recanalize are not yet fully understood. 1,2 Although strong histological similarity exists between the cerebral arteries of humans and animals, the prevalence of naturally developed cerebral aneurysms in animals is extremely low. 3,4 Models with artificial induction of aneurysm formation are therefore needed for preclinical studies of the pathobiology of human brain aneurysms as well as to evaluate and invent novel endovascular devices and medical therapies that prevent rupture and recurrence after endovascular therapy.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Preclinical extracranial aneurysm models for the study and treatment of brain aneurysms: A systematic review

Marbacher

Strange

Frösén

et al. 2020

J Cereb Blood Flow Metab

View full text Add to dashboard Cite

Animal models make an important contribution to our basic understanding of the pathobiology of human brain aneurysms, are indispensable in testing novel treatment approaches, and are essential for training interventional neuroradiologists and neurosurgeons. Researchers are confronted with a broad diversity of models and techniques in various species. This systematic review aims to summarize and categorize extracranial aneurysm models and their characteristics, discuss advantages and disadvantages, and suggest the best use of each model. We searched the electronical Medline/PubMed database between 1950 and 2020 to identify main models and their refinements and technical modifications for creation of extracranial aneurysms. Each study included was assessed for aneurysm-specific characteristics, technical details of aneurysm creation, and histological findings. Among more than 4000 titles and abstracts screened, 473 studies underwent full-text analysis. From those, 68 different techniques/models in five different species were identified, analyzed in detail, and then grouped into one of the five main groups of experimental models as sidewall, terminal, stump, bifurcation, or complex aneurysm models. This systematic review provides a compact guide for investigators in selecting the most appropriate model from a range of techniques to best suit their experimental goals, practical considerations, and laboratory environment.

show abstract

“…Intracranial aneurysms always occur in the bifurcations of the arteries that formed the circle of Willis, where the vessel wall is mostly affected by hemodynamic force. [ 1 ] Among them, posterior communicating artery aneurysms (PcomAA) account for about 45.9% of all intracranial aneurysms, which is a common type of intracranial aneurysms. [ 2 ] Spontaneous subarachnoid hemorrhage (SAH) and oculomotor nerve palsy (ONP) are common complications of PcomAA due to the adjacent anatomical relationships.…”

Section: Introductionmentioning

confidence: 99%

Comparison of surgical clipping and endovascular coiling in the treatment of oculomotor nerve palsy caused by posterior communicating artery aneurysm

et al. 2020

View full text Add to dashboard Cite

Oculomotor nerve palsy (ONP) caused by posterior communicating aneurysm (PcomAA) is mainly treated by surgical clipping or endovascular coiling. However, there are still some controversies about which treatment method could provide the more beneficial prognosis. This study aimed to compare ONP recovery rate between surgical clipping and endovascular coiling in patients diagnosed as PcomAA combined with ONP, and explore the potential risk factors of ONP recovery. The clinical data of 152 patients with ONP caused by PcomAA were retrospectively analyzed. Diameter of aneurysm, different treatment methods (surgical clipping or endovascular coiling), subarachnoid hemorrhage (SAH), degree of preoperative ONP, time from ONP onset to treatment, as well as degree of ONP symptom recovery were collected from medical records. All patients were followed up for at least 1 year. One hundred twelve patients underwent surgical clipping and 40 patients received endovascular coiling. There were no significant differences in age, gender, aneurysm diameter, hypertension, dyslipidemia, time from ONP symptom onset to treatment, SAH, and preoperative ONP degree between the 2 groups (all P > .05). Time to complete or partial recovery was 86.7 ± 35.7 days for patients receiving surgical clipping and 132.6 ± 37.5 days for patients receiving endovascular coiling, respectively (Log rank test, P < .001). The recovery rate was 94.6% in the surgical clipping group and 65.0% in the endovascular coiling group. The difference between the two groups was statistically significant (P < .001). Postoperative ONP recovery in the surgical clipping group was significantly superior to that of patients in the endovascular coiling group (HR, 2.625; 95% CI: 1.423–4.841; P = .002). Time from ONP symptom onset to treatment exerted the obvious effect on the ONP prognosis (HR, 0.572; 95% CI: 0.384–0.852; P = .006). In addition, the ONP recovery in patients with SAH before surgery was also independently associated with ONP prognosis (HR, 1.276; 95% CI, 1.043–1.562; P = .018). There was no treatment-related death in either group, and postoperative complications were within the manageable range. The recovery rate and recovery degree of ONP after surgical clipping was significantly better than that of endovascular coiling in PcomAA patients combined with ONP. The postoperative ONP recovery was associated with preoperative spontaneous SAH and time from ONP onset to treatment.

show abstract

Aneurysm Formation, Growth, and Rupture: The Biology and Physics of Cerebral Aneurysms

Cited by 89 publications

References 106 publications

Εndovascular Repair of Extracranial Carotid Artery Aneurysms: A Systematic Review

Εndovascular Repair of Extracranial Carotid Artery Aneurysms: A Systematic Review

Preclinical extracranial aneurysm models for the study and treatment of brain aneurysms: A systematic review

Comparison of surgical clipping and endovascular coiling in the treatment of oculomotor nerve palsy caused by posterior communicating artery aneurysm

Contact Info

Product

Resources

About