ObjectiveAn open cell stent system may offer better apposition of cell struts to vessel wall than a closed cell stent system in acute vasculature. The purpose of this study was to evaluate the feasibility of coiling using the jailing technique with the Neuroform EZ stent system.MethodsThe jailing technique using the open-cell stent system of the Neuroform EZ stent was planned in 22 consecutive patients with 22 cerebral aneurysms. We retrospectively evaluated the technical success of the jailing technique and the occurrence of interference between two microcatheters as well as the factors influencing this interference.ResultsThe jailing technique was successful in 19/22 patients (86.4%), and interference between two microcatheters occurred in 6/21 (28.6%). The jailing technique failed in 3/22 patients, with problems that included failure of the stent delivery system to advance into the positioned microcatheter in one, interference between the microcatheters during the advancement of the stent delivery system in one, and failure of microcatheter insertion into the aneurysm sac in the remaining patient. Interference between the two microcatheters developed during the advance of the stent delivery system into the positioned microcatheter in all cases. One factor that influences interference between two microcatheters more than expected by chance is the carotid siphon angle (p = 0.019).ConclusionThe acuteness of the carotid siphon angle influences the interference between two microcatheters. Therefore, the jailing technique using the Neuroform EZ stent should be performed carefully in cerebral aneurysms with an acute carotid siphon angle because the procedure may possibly fail.
ObjectiveThe aims of this study are to identify interpersonal differences in defining coordinates and to figure out the degree of distortion of the MRI and compare the accuracy between CT, 1.5-tesla (T) and 3.0T MRI.MethodsWe compared coordinates in the CT images defined by 2 neurosurgeons. We also calculated the errors of 1.5T MRI and those of 3.0T. We compared the errors of the 1.5T with those of the 3.0T. In addition, we compared the errors in each sequence and in each axis.ResultsThe mean difference in the CT images between the two neurosurgeons was 0.48±0.22 mm. The mean errors of the 1.5T were 1.55±0.48 mm (T1), 0.75±0.38 (T2), and 1.07±0.57 (FLAIR) and those of the 3.0T were 2.35±0.53 (T1), 2.18±0.76 (T2), and 2.16±0.77 (FLAIR). The smallest mean errors out of all the axes were in the x axis : 0.28-0.34 (1.5T) and 0.31-0.52 (3.0T). The smallest errors out of all the MRI sequences were in the T2 : 0.29-0.58 (1.5T) and 0.31-1.85 (3.0T).ConclusionThere was no interpersonal difference in running the Gamma Plan® to define coordinates. The errors of the 3.0T were greater than those of the 1.5T, and these errors were not of an acceptable level. The x coordinate error was the smallest and the z coordinate error was the greatest regardless of the MRI sequence. The T2 sequence was the most accurate sequence.
ObjectiveThe surgical clipping of paraclinoid segment internal carotid artery aneurysms is considered difficult because of the complex anatomical location and important neighboring structures. Our experiences of pterional craniotomy and extradural anterior clinoidectomy (EAC) to clip paraclinoid aneurysms are reported herein.MethodsWe present two patients with paraclinoid aneurysms who underwent surgical clipping using pterional craniotomy and EAC. The clinical results and operative techniques were reviewed from the patients' medical records.ResultsEAC improves the surgical field in the suprasellar and periclinoid regions. Clinically, a good outcome was obtained in both cases. No surgical complications directly resulting from the EAC were observed.ConclusionFavorable surgical results can be obtained with pterional craniotomy and EAC for the clipping of paraclinoid aneurysms. EAC is advocated for the clipping of paraclinoid aneurysms.
There are few observation papers regarding the natural history of an aneurysm. We report on a case of a completely occluded middle cerebral artery (MCA) aneurysm. A 47-year-old female patient presented with a headache and was diagnosed with rupture of a right MCA aneurysm. Due to a high risk of direct neck clipping, she received conservative treatment after craniotomy and wrapping of her aneurysm. The patient's condition showed improvement, with complete occlusion of the aneurysm and considerable reduction of the aneurysm in size after approximately three years. This is a rare case of an aneurysm of MCA that showed spontaneous resolution. Finally, on the angiogram, characteristics of an aneurysm to occlude spontaneously will be presumed based on literature reviews.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.