Hemodynamic characteristics of stable and unstable vertebrobasilar dolichoectatic and fusiform aneurysms

Brinjikji, Waleed; Chung, BongJae; Ding, Yuqin; Wald, John T.; Mut, Fernando; Kadirvel, Ramanathan; Kallmes, David F.; Rouchaud, Aymeric; Lanzino, Giuseppe; Cebral, Juan R.

doi:10.1136/neurintsurg-2018-013756

Cited by 7 publications

(7 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other reports of the natural history of VBD had results similar to those of the Passero and Rossi (33) and Wolters et al (21,(34)(35)(36)(37). Did it mean the VBD had a malignant natural history?…”

Section: Natural Historymentioning

confidence: 73%

“…This is because the above previous studies were not randomized trials, and they did not fulfill the criteria to reduce the risk of bias. Therefore, the natural history of VBD needs further investigation (21,(33)(34)(35)(36)(37).…”

Section: Natural Historymentioning

confidence: 99%

“…A progressive VBD after seven years is shown in Figure 5 . In moderate and severe cases, VBD patients may be symptomatic and unstable, with stenosis, fusiform dilation or large aneurysms; cases of VBD associated with an aneurysm have a worse natural history ( Figure 6 ) ( 11 , 35 , 36 , 38 ).…”

Section: Natural Historymentioning

confidence: 99%

“…Highly selective moderate and severe VBD patients can be EVT candidates, such as those VBD patients with large aneurysms and a greater bleeding risk or those with lower flow conditions and lower velocity, vorticity, and more oscillatory flow ( 36 , 40 , 41 ). EVT for VBD should reconstruct the vertebrobasilar artery to improve blood flow, target the aneurysm to prevent rupture or rebleeding, or reduce the occupying effect.…”

Section: Evt Prospectsmentioning

confidence: 99%

See 3 more Smart Citations

Prospects and Dilemmas of Endovascular Treatment for Vertebrobasilar Dolichoectasia

Wang¹,

Yu²

2022

Front. Neurol.

View full text Add to dashboard Cite

Vertebrobasilar dolichoectasia (VBD) is characterized by significant expansion, elongation, and tortuosity of the basilar artery and vertebral artery. Certain highly selected cases of VBD can require intervention. Recent advances in endovascular treatment (EVT) have renewed hope for patients with VBD. However, which cases of VBD can benefit from EVT still needs to be determined. Currently, little is known regarding this matter. Therefore, we performed a review of the literature from a PubMed search and cataloged our experience regarding the classification and natural history of VBD and the prospects, prognosis and complications of EVT. The findings can be summarized as follows: for asymptomatic VBD, “wait and see” or medical management may be a reasonable strategy. EVT may only be effective in certain patients. For saccular aneurysms in VBD, especially ruptured aneurysms, EVT is reasonable. For fusiform aneurysms in VBD, EVT can carry high complication rates and should be recommended with caution. For stenting reconstruction in VBD, the effect is uncertain. For the future of EVT of VBD, randomized controlled trials and the development of neurointerventional products are worth pursuing, but EVT in VBD still has a long way to go.

show abstract

Section: Natural Historymentioning

confidence: 73%

Section: Natural Historymentioning

confidence: 99%

Section: Natural Historymentioning

confidence: 99%

Section: Evt Prospectsmentioning

confidence: 99%

See 2 more Smart Citations

Prospects and Dilemmas of Endovascular Treatment for Vertebrobasilar Dolichoectasia

Wang¹,

Yu²

2022

Front. Neurol.

View full text Add to dashboard Cite

show abstract

“…In prevalence, the IADE was found up to 12% of patients presenting stroke while 0.1%-6.5% in the general population [1,[4][5][6][7]. IADE can be asymptomatic but manifests as brain infarction [8,9], cerebral hemorrhage, subarachnoid hemorrhage [10], and compression syndrome of cranial nerve [11,12], brainstem, or third ventricle with hydrocephalus, resulting overall Ivyspring International Publisher five-year fatality of 36.2% [4,7,[13][14][15]. Brain infarction can be a coincidental finding of IADE, but possibly caused by distorting and obstructing perforating arteries arising from the dolichoectatic artery or producing in-situ thrombosis and emboli [4,16].…”

Section: Introductionmentioning

confidence: 99%

Melittin-loaded Iron Oxide Nanoparticles Prevent Intracranial Arterial Dolichoectasia Development through Inhibition of Macrophage-mediated Inflammation

Vu¹,

Huynh²,

Ryu³

et al. 2021

Int. J. Biol. Sci.

View full text Add to dashboard Cite

Rationale: In intracranial arterial dolichoectasia (IADE) development, the feedback loop between inflammatory cytokines and macrophages involves TNF-α and NF-κB signaling pathways and leads to subsequent MMP-9 activation and extracellular matrix (ECM) degeneration. In this proof-of-concept study, melittin-loaded L-arginine-coated iron oxide nanoparticle (MeLioN) was proposed as the protective measure of IADE formation for this macrophage-mediated inflammation and ECM degeneration. Methods: IADE was created in 8-week-old C57BL/6J male mice by inducing hypertension and elastase injection into a basal cistern. Melittin was loaded on the surface of ION as a core-shell structure (hydrodynamic size, 202.4 nm; polydispersity index, 0.158). Treatment of MeLioN (2.5 mg/kg, five doses) started after the IADE induction, and the brain was harvested in the third week. In the healthy control, disease control, and MeLioN-treated group, the morphologic changes of the cerebral arterial wall were measured by diameter, thickness, and ECM composition. The expression level of MMP-9, CD68, MCP-1, TNF-α, and NF-κB was assessed from immunohistochemistry, polymerase chain reaction, and Western blot assay. Results: MeLioN prevented morphologic changes of cerebral arterial wall related to IADE formation by restoring ECM alterations and suppressing MMP-9 expression. MeLioN inhibited MCP-1 expression and reduced CD68-positive macrophage recruitments into cerebral arterial walls. MeLioN blocked TNF-α activation and NF-κB signaling pathway. In the Sylvian cistern, co-localization was found between the CD68-positive macrophage infiltrations and the MeLioN distributions detected on Prussian Blue and T2* gradient-echo MRI, suggesting the role of macrophage harboring MeLioN. Conclusions:The macrophage infiltration into the arterial wall plays a critical role in the MMP-9 secretion. MeLioN, designed for ION-mediated melittin delivery, effectively prevents IADE formation by suppressing macrophage-mediated inflammations and MMP activity. MeLioN can be a promising strategy preventing IADE development in high-risk populations.

show abstract

Effects of abnormal vertebral arteries and the circle of Willis on vertebrobasilar dolichoectasia: A multi-scale simulation study

Liu

Xinmiao

Wang

et al. 2023

Clinical Biomechanics

View full text Add to dashboard Cite

Hemodynamic characteristics of stable and unstable vertebrobasilar dolichoectatic and fusiform aneurysms

Cited by 7 publications

References 31 publications

Prospects and Dilemmas of Endovascular Treatment for Vertebrobasilar Dolichoectasia

Prospects and Dilemmas of Endovascular Treatment for Vertebrobasilar Dolichoectasia

Melittin-loaded Iron Oxide Nanoparticles Prevent Intracranial Arterial Dolichoectasia Development through Inhibition of Macrophage-mediated Inflammation

Effects of abnormal vertebral arteries and the circle of Willis on vertebrobasilar dolichoectasia: A multi-scale simulation study

Contact Info

Product

Resources

About