Electrically Induced Thrombosis in Intracranial Aneurysms

Mullan, Sean; Raimondi, Anthony J.; Dobben, Glen D.; Vailati, G; Hekmatpanah, Javad

doi:10.3171/jns.1965.22.6.0539

Cited by 83 publications

(27 citation statements)

References 2 publications

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“…Finally, nitinol coils have a potentially higher thrombogenicity when compared with the very inert platinum coils. 18 Therefore, thromboembolic events are of special concern, accepting that subarachnoid hemorrhage is known to induce a hypercoagulative state. 19 Recently, a multicenter study by Papagiannaki et al 20 of 87 aneurysms (mostly unruptured) in 85 patients was published, and the results were favorable for the WEB when compared with those of coil occlusion in the Analysis of Treatment by Endovascular Approach of Nonruptured Aneurysms (ATENA) trial and the Clinical and Anatomical Results In the Treatment of Ruptured Intracranial Aneurysms (CLARITY) study.…”

Section: Discussionmentioning

confidence: 99%

Intrasaccular Flow Disruption in Acutely Ruptured Aneurysms: A Multicenter Retrospective Review of the Use of the WEB

Liebig

Kabbasch

Strasilla

et al. 2015

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 99%

Intrasaccular Flow Disruption in Acutely Ruptured Aneurysms: A Multicenter Retrospective Review of the Use of the WEB

Liebig

Kabbasch

Strasilla

et al. 2015

AJNR Am J Neuroradiol

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“…Astedt and Liedholm 61 gave rats high doses of AMCA and found no effect of the drug on the fibrinolytic activity of the heart vessel wails. Mullan et aI, 41 and Patterson and Harpel 48 demonstrated that antifibrinolytic agents help secure the permanency of an experimental arterial aneurysmal clot. Khilko and Shklyarova ~s injected EACA and fibrin directly into the carotid artery in 23 patients with saccular aneurysms and AV malformations.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous thrombosis of ruptured intracranial aneurysms during treatment with tranexamic acid (AMCA)

Fodstad

Liliequist

1979

Acta neurochir

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Radiographically verified spontaneous disappearance of medium-sized arterial cerebral aneurysms is seldom reported, and only three times in connection with antifibrinolytic therapy (EACA). In our clinic repeat angiograms have shown non-filling of the aneurysms in three patients during treatment with tranexamic acid (AMCA) two, three, and four weeks respectively after primary bleeds. Initially, all three patients had severe radiological vasospasm associated with neurological deterioration. Follow-up angiograms have demonstrated partial reappearance of the aneurysm after one month in one patient and complete disappearance of the aneurysms in the other two patients after 9 and 22 months respectively. In two cases occlusion of cerebral arteries occurred. With regard to the higher risk of severe vasospasm and occlusion of cerebral arteries in our opinion it should not be a therapeutic goal to try to achieve a thrombosis of a ruptured aneurysm with antifibrinolytic drugs. The reason for spontaneous aneurysm thrombosis during treatment with AMCA may be a local inhibition of plasminogen activators in and around the aneurysm wall. It may also be related to the sympathomimetic property of the drug, with vasospasm and a subsequent flow-reduction inside the aneurysm or a possible interaction with other drugs and substances.

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“…Starting in the 1960s, he pursued various metals and electrical currents as means of enhancing intravascular thrombosis, and he developed aneurysm models in the dog femoral artery to test his concepts. 10,17 He first tested the technique in open exposed aneurysms during craniotomy, with successful obliteration, and later with stereotactically placed needles, all guided by intraoperative angiography. In 1974 he published results accumulated over a decade in 16 patients, and he candidly recommended abandoning the rudimentary endovascular approach for aneurysms in favor of clipping.…”

Section: Relentless Innovations and Impactmentioning

confidence: 99%