Ruptured hidden intracranial aneurysm during mechanical thrombectomy: A case report

Nozaki, Toshiki; Noda, Masayuki; Ishibashi, Toshiyuki; Morita, Akio

doi:10.25259/sni_789_2020

Cited by 7 publications

(3 citation statements)

References 10 publications

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“…When patients use vital signs, healthy big data can obtain real human hemodynamic parameters, such as velocity, differential pressure, wall intercept stress, and particle motion. It is of great significance for cardiovascular system optimization, preoperative prediction, and clinical intervention evaluation [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic Analysis of Pipeline Embolization Device Stent for Treatment of Giant Intracranial Aneurysm under Unsupervised Learning Algorithm

Gao

You

et al. 2022

Journal of Healthcare Engineering

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To treat large intracranial aneurysms, pipeline embolization device (PED) stent with unsupervised learning algorithms was utilized. Unsupervised learning model algorithm was used to screen aneurysm health big data, find aneurysm blood flow and PED stent positioning characteristic parameters, and guide PED stent treatment of intracranial aneurysms. The research objects were 100 patients with intracranial large aneurysm admitted to X Hospital of X Province from June 2020 to June 2021, who were enrolled into two groups. One group used the prototype transfer generative adversarial network (PTGAN) model to measure mean blood flow and mean vascular pressure and guide the placement of PED stents (PTGAN group). The other group did not use the model to place PED (control group). The PTGAN model can learn feature information from horizontal and vertical directions, with smooth edges and prominent features, which can effectively extract the main morphological and texture features of aneurysms. Compared with the convolutional neural network (CNN) model, the accuracy of the PTGAN model increased by 8.449% (87.452%–79.003%), and the precision increased by 8.347% (91.23%–82.883%). The recall rate increased by 7.011% (87.231%–80.22%), and the F1 score increased by 8.09% (89.73%–81.64%). After the adoption of the PTGAN model, the average blood flow inside the aneurysm body was 0.22 (m/s). After the adoption of the CNN model, the average blood flow inside the aneurysm body was 0.21 (m/s), and the difference was 0.01 (m/s), which was considerable ( p < 0.05 ). Through this research, it was found that the PTGAN model was better than the CNN model in terms of accuracy, precision, recall, and F1 score values. The PTGAN model was better than the CNN model in detecting the average blood flow rate and average blood pressure after treatment, and the blood flowed smoothly. Postoperative complications and postoperative relief were also better than those of the control group. In summary, based on the unsupervised learning algorithm, the PED stent had a good adoption effect in the treatment of intracranial aneurysms and was suitable for subsequent treatment.

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Section: Introductionmentioning

confidence: 99%

Hemodynamic Analysis of Pipeline Embolization Device Stent for Treatment of Giant Intracranial Aneurysm under Unsupervised Learning Algorithm

Gao

You

et al. 2022

Journal of Healthcare Engineering

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“… 3 A few studies have also reported critical complications associated with rupture of hidden aneurysms due to mechanical stimulation of the stent retriever or thrombolysis. 4 , 5 Hidden cerebral aneurysms are frequently bifurcating (e.g., of the MCA and basilar artery tip), which is likely because blood flow is directed toward the aneurysms. 4 As such, sidewall-type hidden aneurysms are rare.…”

Section: Discussionmentioning

confidence: 99%

Mechanical thrombectomy for acute fetal posterior cerebral artery occlusion with a hidden unruptured cerebral aneurysm: illustrative case

Ishikawa

Endo

Shindo

et al. 2022

Journal of Neurosurgery: Case Lessons

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BACKGROUND Fetal posterior cerebral artery occlusion is rare and often presents with severe neurological symptoms. Although acute recanalization therapy is commonly used for cerebral vessel occlusion, unruptured cerebral aneurysms can be hidden distal to the occluded vessels. OBSERVATIONS An 87-year-old man presented with consciousness disturbance and right hemiparesis. The authors diagnosed left fetal posterior cerebral artery occlusion and performed mechanical thrombectomy. A stent retriever was deployed from the middle cerebral artery M1 segment across the mural thrombus of the internal carotid artery. After the first pass, the fetal posterior cerebral artery remained occluded, with confirmation of a contrast effect around the thrombus. Because the anatomical course of the fetal posterior cerebral artery was unidentified, the procedure was stopped. At 1-week recovery, magnetic resonance imaging revealed complete recanalization and a fetal posterior cerebral artery aneurysm hidden within the occluded site. Blood flow was directed to the aneurysm, and the thrombus within the aneurysm simultaneously occluded the fetal posterior cerebral artery. LESSONS To avoid critical complications following mechanical thrombectomy for fetal posterior cerebral artery occlusion, hidden aneurysms should be suspected when a “fried egg–like” contrast effect is observed around the thrombus.

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“…Ruptured hidden aneurysms can be treated by endovascular techniques immediately [130,131], but unruptured ones later, after the patient suffered from acute symptomatic thrombosis, with adequate antiplatelet pretreatment [132].…”

Section: Potential Hemorrhagic Procedural Complicationsmentioning

confidence: 99%

How to Improve the Management of Acute Ischemic Stroke by Modern Technologies, Artificial Intelligence, and New Treatment Methods

Zeleňák

Krajina

Meyer

et al. 2021

Life

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Stroke remains one of the leading causes of death and disability in Europe. The European Stroke Action Plan (ESAP) defines four main targets for the years 2018 to 2030. The COVID-19 pandemic forced the use of innovative technologies and created pressure to improve internet networks. Moreover, 5G internet network will be helpful for the transfer and collecting of extremely big databases. Nowadays, the speed of internet connection is a limiting factor for robotic systems, which can be controlled and commanded potentially from various places in the world. Innovative technologies can be implemented for acute stroke patient management soon. Artificial intelligence (AI) and robotics are used increasingly often without the exception of medicine. Their implementation can be achieved in every level of stroke care. In this article, all steps of stroke health care processes are discussed in terms of how to improve them (including prehospital diagnosis, consultation, transfer of the patient, diagnosis, techniques of the treatment as well as rehabilitation and usage of AI). New ethical problems have also been discovered. Everything must be aligned to the concept of “time is brain”.

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Ruptured hidden intracranial aneurysm during mechanical thrombectomy: A case report

Cited by 7 publications

References 10 publications

Hemodynamic Analysis of Pipeline Embolization Device Stent for Treatment of Giant Intracranial Aneurysm under Unsupervised Learning Algorithm

Hemodynamic Analysis of Pipeline Embolization Device Stent for Treatment of Giant Intracranial Aneurysm under Unsupervised Learning Algorithm

Mechanical thrombectomy for acute fetal posterior cerebral artery occlusion with a hidden unruptured cerebral aneurysm: illustrative case

How to Improve the Management of Acute Ischemic Stroke by Modern Technologies, Artificial Intelligence, and New Treatment Methods

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