Endovascular treatment of ruptured intracranial aneurysms

Pruvo, J. P.; Leclerc, Xavier; Arès, G. Soto; Lejeune, Jean‐Paul; Leys, D.

doi:10.1007/s004150050342

Cited by 12 publications

(2 citation statements)

References 22 publications

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“…This aneurysm filling by coils was recently confirmed to occur in real cases [29]. The first coils generate a frame near the aneurysm wall, while coils added later fill the aneurysm core as previously speculated [10], [37]. Similar to real treatment, virtual coils are evenly distributed along the longitudinal axis.…”

Section: Discussionmentioning

confidence: 55%

A Virtual Coiling Technique for Image-Based Aneurysm Models by Dynamic Path Planning

Morales

Larrabide

Geers

et al. 2013

IEEE Trans. Med. Imaging

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Computational algorithms modeling the insertion of endovascular devices, such as coil or stents, have gained an increasing interest in recent years. This scientific enthusiasm is due to the potential impact that these techniques have to support clinicians by understanding the intravascular hemodynamics and predicting treatment outcomes. In this work, a virtual coiling technique for treating image-based aneurysm models is proposed. A dynamic path planning was used to mimic the structure and distribution of coils inside aneurysm cavities, and to reach high packing densities, which is desirable by clinicians when treating with coils. Several tests were done to evaluate the performance on idealized and image-based aneurysm models. The proposed technique was validated using clinical information of real coiled aneurysms. The virtual coiling technique reproduces the macroscopic behavior of inserted coils and properly captures the densities, shapes and coil distributions inside aneurysm cavities. A practical application was performed by assessing the local hemodynamic after coiling using computational fluid dynamics (CFD). Wall shear stress and intra-aneurysmal velocities were reduced after coiling. Additionally, CFD simulations show that coils decrease the amount of contrast entering the aneurysm and increase its residence time.

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Section: Discussionmentioning

confidence: 55%

A Virtual Coiling Technique for Image-Based Aneurysm Models by Dynamic Path Planning

Morales

Larrabide

Geers

et al. 2013

IEEE Trans. Med. Imaging

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“…Thromboembolic complications are reported in 5-10% of patients treated endovascularly 2,12,14,16,17,23) , though permanent deficit are less frequent with rates of 1-5% 5,8,9) . Associations between the development of thrombosis, the size of the catheter/introducer, and the duration of the procedure have been established.…”

Section: Discussionmentioning

confidence: 99%

Types of Thromboembolic Complications in Coil Embolization for Intracerebral Aneurysms and Management

Kim

Hwang

Kim

2009

J Korean Neurosurg Soc

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Objective : We describe our clinical experiences and outcomes in patients who had thromboembolic complications occurring during endovascular treatment of intracerebral aneurysms with a review of the literature. The types of thromboembolic complications were divided and the treatment modalities for each type were described. Methods : Between August 2004 and March 2009 we performed endovascular embolization with Guglielmi detachable coils for 173 patients with 189 cerebral aneurysms, including ruptured and unruptured aneurysms at our hospital. Sixty-eight patients were males and 105 patients were females. The age of patients ranged from 22-82 years (average, 58.8 years). We retrospectively evaluated this group with regard to complication rates and outcomes. The types of thromboembolic complications were classified into the following three categories: mechanical obstruction, distal embolic stroke, and stent-induced complications, which corresponded to types I, II, and III, respectively. A comparison of the clinical results was made for each type of complication. Results : Only eight patients had a thromboembolic complication during or after a procedure (4.6%). Of the eight patients, two had a mechanical obstruction as the causative factor; the other three patients had distal embolic stroke as the causative factor. The remaining three patients had stent-induced complications. In cases of mechanical obstruction, recanalization occurred due to the use of intra-arterial thrombolytic agents in one of two patients. Nevertheless, a poor prognosis was seen. In the cases of stent-induced complications, in one of three patients in whom a thrombus developed following stent insertion, a middle cerebral artery territory infarct developed with a poor prognosis despite the use of wiring and an intra-arterial thrombolytic agent. In the cases of distal embolic stroke, all three patients achieved good results following the use of antiplatelet agents. Conclusion : Treatment for thromboemboic complications due to mechanical obstruction and stent-induced complications include antiplatelet and intra-arterial thrombolytic agents; however, this cannot guarantee a sufficient extent of effectiveness. Therefore, active treatments, such as balloon angioplasty, stent insertion, and clot extraction, are helpful.

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Subarachnoid Hemorrhage Coiling and Intervention

Aliyar¹,

Mohamed²

2021

Management of Subarachnoid Hemorrhage

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Endovascular treatment of ruptured intracranial aneurysms

Cited by 12 publications

References 22 publications

A Virtual Coiling Technique for Image-Based Aneurysm Models by Dynamic Path Planning

A Virtual Coiling Technique for Image-Based Aneurysm Models by Dynamic Path Planning

Types of Thromboembolic Complications in Coil Embolization for Intracerebral Aneurysms and Management

Subarachnoid Hemorrhage Coiling and Intervention

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