| 1. |
- Alves, JV, et al.
(författare)
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Subarachnoid Haemorrhage from a Large Cerebral Aneurysm Visible only on Repeat Angiography
- 2005
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Ingår i: Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences. - : SAGE Publications. - 1591-0199. ; 11:1, s. 59-62
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Tidskriftsartikel (refereegranskat)abstract
- We report the case of a 49-year-old woman with a massive subarachnoid haemorrhage in conjunction with trauma. The initial cerebral angiography was normal. Three weeks later she had a second subarachnoid haemorrhage. A repeat angiography demonstrated an eight mm aneurysm of the internal carotid artery bifurcation, a region clearly normal in the previous angiography.
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| 2. |
- Andersson, T, et al.
(författare)
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Regression of a Flow-Related Ophthalmic Artery Aneurysm After Treatment of a Frontal DAVS. A Case Report
- 2004
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Ingår i: Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences. - : SAGE Publications. - 1591-0199. ; 10:3, s. 265-268
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Tidskriftsartikel (refereegranskat)abstract
- We report a case of a frontal dural arteriovenous shunt or fistula (DAVS) adjacent to the left side of the cribriform plate, with bilateral supply from multiple arteries, the most prominent being the dural branches originating from the anterior ethmoidal artery coming from the left ophthalmic artery. Before treatment there was an eight mm flow-related arterial aneurysm proximally on the left ophthalmic artery. After transarterial embolization of the DAVS with N-butyl cyanoacrylate and polyvinyl alcohol, minimal shunting still remained. At follow-up angiography six months after the treatment, the shunt was obliterated and the ophthalmic artery aneurysm had regressed completely. Our case illustrates that complete obliteration of a DAVS may be achieved even though arteriovenous shunting remains at the end of the procedure. Furthermore, a flow-related arterial aneurysm, may not warrant any specific treatment. Elimination of the high flow situation can lead to complete regression of these aneurysms.
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| 3. |
- Bhogal, P, et al.
(författare)
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Normal pio-dural arterial connections
- 2015
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Ingår i: Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences. - : SAGE Publications. - 1591-0199. ; 21:6, s. 750-758
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Tidskriftsartikel (refereegranskat)abstract
- The arterial blood supply to the dura mater is rich, complex and is derived from both the internal and external carotid systems. Endovascular management of a variety of intracranial diseases necessitates a thorough understanding of the dural arterial network. In this article we review the normal contributions of the pial arteries to the blood supply of the dura mater and discuss some aspects of its role in the supply of dural arteriovenous shunts (DAVS).
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| 4. |
- Bhogal, P, et al.
(författare)
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The Medina Embolic Device: Karolinska experience
- 2018
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Ingår i: Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences. - : SAGE Publications. - 2385-2011. ; 24:1, s. 4-13
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to report our single centre experience with the Medina Embolic Device (MED). Methods We performed a retrospective analysis of prospectively collected data to identify all patients treated with the MED. A total of 14 aneurysms (non-consecutive), in 13 patients, were treated including one ruptured and one partially thrombosed aneurysm. Fundus diameter was ≥5 mm in all cases. We evaluated the angiographic appearances, the clinical status, complications, and the need for adjunctive devices or repeat treatments. Results Aneurysm location was cavernous internal carotid artery (ICA; n = 1), supraclinoid ICA ( n = 1), terminal ICA ( n = 2), anterior communicating artery (AComA; n = 4), A2–3 ( n = 1), M1–2 junction ( n = 1), posterior communicating artery (PComA; n = 1), superior cerebellar artery (SCA; n = 1), and basilar tip ( n = 2). The average aneurysm fundus size was 8.6 mm (range 7–10 mm) and average neck size 3.75 mm (range 1.9–6.9 mm). Immediate angiographic results were modified Raymond–Roy occlusion classification (mRRC) I n = 2, mRRC II n = 1, mRRC IIIa n = 2, mRRC IIIb n = 2, the remaining 7 aneurysms showed complete opacification. At follow-up angiography (mean 5 months) mRRC I n = 5, mRRC II n = 5, mRRC IIIa n = 3, and persistent filling was seen in 1 aneurysm. Overall, four patients had repeat treatment and one is pending further treatment. Of the aneurysms treated with more than one MED, 75% showed complete occlusion at 6-month follow up whereas only one aneurysm treated with a single device showed complete occlusion. Overall, three patients had temporary complications and there were no deaths. Conclusions The MED is an intra-saccular flow-diverting device with satisfactory angiographic results and an acceptable safety profile. Use of a single MED cannot be recommended and further longer term studies are needed prior to widespread clinical use.
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| 5. |
- Bhogal, P, et al.
(författare)
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The role of angiogenesis in dural arteriovenous fistulae: the story so far
- 2018
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Ingår i: Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences. - : SAGE Publications. - 2385-2011. ; 24:4, s. 450-454
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Tidskriftsartikel (refereegranskat)abstract
- Intracranial dural arteriovenous fistulae are a commonly encountered pathology that can present with a variety of different clinical symptoms. Although there is a significant body of work relating to the natural history and treatment of dural arteriovenous fistulae the exact underlying pathogenesis remains elusive. Various different pathogenetic models have been put forward but there is now a growing body of evidence implicating angiogenesis and the involvement of angiogenetic factors. In this review we attempt to show how the various animal and human studies performed over the past two decades have contributed to the proposed hypothesis on the development of dural arteriovenous fistulae.
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| 6. |
- Borota, Ljubisa, et al.
(författare)
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Combined percutaneous and transarterial devascularisation of juvenile nasopharyngeal angiofibroma with protection of internal carotid artery : A modification of the technique
- 2015
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Ingår i: Interventional Neuroradiology. - : SAGE Publications. - 1591-0199 .- 2385-2011. ; 21:3, s. 390-396
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Tidskriftsartikel (refereegranskat)abstract
- Juvenile nasal angiofibroma (JNA) is a hypervascularised, benign, but locally aggressive tumour that grows in the posterior, upper part of the nasal cavity and invades surrounding anatomical structures. The treatment of choice is surgical removal, but complete resection of the tumour can be hampered because of profuse perioperative bleeding. Preoperative embolisation of the tumour has been proposed as an effective method for prevention of perioperative bleeding, thereby shortening of the time of the operation. In this report of five cases, we describe successful preoperative devascularisation of the tumour by applying a modified method of direct intratumoural injection of the liquid embolic agent Onyx combined with protection of the internal carotid artery. The control of bleeding during the embolisation and occlusion of the maxillary or sphenopalatine artery was achieved by using a bi-luminal balloon catheter. Such use of the dual-lumen catheter in treatment of JNA has not been reported so far in the medical literature.
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| 7. |
- Borota, Ljubisa, et al.
(författare)
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Endovascular treatment of type 1 and type 4 non-saccular aneurysms of cerebral arteries : a single-Centre experience
- 2021
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Ingår i: Interventional Neuroradiology. - : Sage Publications. - 1591-0199 .- 2385-2011. ; 27:3, s. 372-387
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Tidskriftsartikel (refereegranskat)abstract
- AIM OF THE STUDY: The aim of this study was to evaluate our results regarding treatment options, complications, and outcomes in patients with non-saccular aneurysms of cerebral arteries belonging to type 1 and type 4 according to Mizutani's classification.METHODS: A total of 26 aneurysms in 26 patients were treated between 2014 and 2019. There were 13 males (mean age 42.77 ± 11.73 years) and 13 females (mean age 50.84 ± 9.37 years). In 23 cases the onset was haemorrhagic and in three cases non-haemorrhagic. A combination of conventional stents and coils was used in 10 cases, conventional stents and flow diverters in three cases, flow diverters and coils in five cases, and flow diverters only were used in eight cases. Radiological results of treatment were assessed after eight months and clinical after one year.RESULTS: In 24 patients, aneurysms were occluded at the end of the follow-up period. An iatrogenic dissection and two haemorrhagic complications were registered. In three cases, parent arteries were occluded due to re-growth of the aneurysm, which caused middle cerebral artery infarction in one case. A favourable clinical outcome was registered in 19, patients, and non-favourable in five. Two patients died in the early postoperative period due to extensive damage to the brain parenchyma caused by initial bleeding.CONCLUSION: Our results indicate that treatment of type 1 and type 4 non-saccular aneurysms with various combination of stents and flow diverters, with or without coils, is promising, although very challenging and technically demanding.
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| 8. |
- Borota, Ljubisa, et al.
(författare)
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Flexible lateral isocenter : A novel mechanical functionality contributing to dose reduction in neurointerventional procedures
- 2017
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Ingår i: Interventional Neuroradiology. - : SAGE Publications. - 1591-0199 .- 2385-2011. ; 23:6, s. 669-675
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Tidskriftsartikel (refereegranskat)abstract
- Aim of the study A new functionality that enables vertical mobility of the lateral arm of a biplane angiographic machine is referred to as the flexible lateral isocenter. The aim of this study was to analyze the impact of the flexible lateral isocenter on the air-kerma rate under experimental conditions. Material and methods An anthropomorphic head-and-chest phantom with anteroposterior (AP) diameter of the chest varying from 22 cm to 30 cm simulated human bodies of different body constitutions. The angulation of the AP arm in the sagittal plane varied from 35 degrees to 55 degrees for each AP diameter. The air-kerma rate (mGy/min) values were read from the system dose display in two settings for each angle: flexible lateral isocenter and fixed lateral isocenter. Results The air-kerma rate was significantly lower for all AP diameters of the chest of the phantom when the flexible lateral isocenter was used: (a) For 22 cm, the p value was 0.028; (b) For 25 cm, the p value was 0.0169; (c) For 28 cm, the p value was 0.01005 and (d) For 30 cm, the p value was 0.01703. Conclusion Our results show that the flexible lateral isocenter contributes significantly to the reduction of the air-kerma rate, and thus to a safer environment in terms of dose lowering both for patients and staff.
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| 9. |
- Borota, Ljubisa, et al.
(författare)
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Neuroform Atlas stent in treatment of iatrogenic dissections of extracranial internal carotid and vertebral arteries : a single-centre experience
- 2019
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Ingår i: Interventional Neuroradiology. - : SAGE Publications. - 1591-0199 .- 2385-2011. ; 25:4, s. 390-396
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Tidskriftsartikel (refereegranskat)abstract
- AIM OF THE STUDY: To present our experience in the treatment of iatrogenic dissections of extracranial internal carotid and vertebral arteries with the Neuroform Atlas stent.MATERIALS AND METHODS: Between January 2017 and February 2018 we treated iatrogenic dissections of three internal carotid arteries and three vertebral arteries. These iatrogenic dissections occurred during the endovascular treatment of ruptured and unruptured intracranial aneurysms. The indication for stenting was haemodynamically significant, flow-limiting dissection with threatening flow arrest. In all six cases, the dissections were treated by placement of Neuroform Atlas stents in the dissected segments of internal carotid or vertebral arteries. Deployment of the stent was followed by the usual dual antiplatelet regimen.RESULTS: Single or multiple Neuroform Atlas stents were deployed without any technical difficulties, and blood flow was restored immediately after placement of the stents in all six cases. Midterm follow-up (6-8 months) showed complete reconstruction of the shape and lumen of all treated arteries, with negligible intimal hyperplasia.CONCLUSION: Our results indicate that a favourable outcome can be achieved by treating iatrogenic dissections of extracranial internal carotid and vertebral arteries with the Neuroform Atlas stent.
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| 10. |
- Ericson, K, et al.
(författare)
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Volume Determination of Intracranial Arteriovenous Malformations prior to Stereotactic Radiosurgical Treatment
- 1996
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Ingår i: Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences. - : SAGE Publications. - 1591-0199. ; 2:4, s. 271-5
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Tidskriftsartikel (refereegranskat)abstract
- Exact dose planning for stereotactic radiosurgery was enabled in connection with diagnostic angiography or at the end of an endovascular procedure by simply placing a stereotactic localizing box onto the head of the patient while acquiring PA and lateral angiographic views. The fiducials engraved on the localizing box enabled the appropriate images to be scaled to the stereotactic space. Regular dose planning was then performed after estimating the size of the patient's head. A prediction of the chances of obliteration and the risks of complication could then be made immediately after the endovascular or diagnostic procedure, and further therapy could be selected much more confidently. This technique may also be used at centres without facilities for radiosurgical treatment if only the localizing box is available. The images may then be sent for evaluation to a unit with dose planning equipment. The technique is simple and involves little risk, significantly improving patient management. Digital subtraction angiography was used in this study. A correction algorithm was used to minimize the geometric distortion inherent to the digital technique.
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