Low-crystallinity hydroxyapatite (HAP) foam is an ideal material for bone substitutes and scaffolds for bone tissue regeneration, because its interconnected pores provide the space for cell growth and tissue penetration, and its composition induces excellent tissue response and good osteoconductivity. In this study, the feasibility of low-crystallinity HAP foam fabrication was evaluated based on the phase transformation reaction or the so-called dissolution-reprecipitation reaction of alpha-tricalcium phosphate (alpha-TCP) foam granules. When alpha-TCP foam granules were placed in water at 37 degrees C for 1 day, no reaction was observed. However, alpha-TCP foam granules set to form low-crystallinity HAP by treating it hydrothermally at 200 degrees C. The network of fully interconnected pores was retained, and porosity was as high as 82%. Pore size ranged from 50 to 300 mum with an average pore size of 160 mum. Compressive strength was 207 kPa. Although no setting reaction was observed at 37 degrees C, the setting reaction caused by the hydrothermal treatment of alpha-TCP foam granules allowed the fabrication of any shape of low-crystallinity HAP. Therefore, this method may be useful for the fabrication of bone substitutes and scaffolds in bone tissue regeneration.
An 87-year-old man hospitalized for subarachnoid hemorrhage showed a ruptured aneurysm arising from fenestration of the posterior inferior cerebellar artery. Endovascular treatment was selected and the aneurysm and superior limb were embolized completely using three coils. Fenestration of the posterior cerebellar artery is exceedingly rare. In addition, we present a first case of aneurysm as fenestration of the posterior inferior cerebellar artery that was definitively identified as a cause of bleeding.
Intraprocedural coil migration during endovascular treatment for an aneurysm that might carry serious ischemic complications is well known. On the other hand, delayed coil migration after endovascular treatment for an aneurysm is very rare. A 77-year-old woman was incidentally diagnosed with unruptured aneurysm associated with distal azygos anterior cerebral artery (ACA). The aneurysm was located at the distal bifurcation of the azygos ACA and was wide necked (approximately 7 mm in diameter). Endovascular coil embolization was selected and the aneurysm was occluded successfully, but 29 days after endovascular therapy, follow-up computed tomography (CT) and magnetic resonance (MR) angiography revealed distal coil migration in the peripheral portion of the ACA. In addition, CT on day 57 after therapy revealed the migrated coil had moved more distally. Fortunately, in the course of these events, the patient remained asymptomatic. To the best of our knowledge, this represents the first case of delayed distal coil migration associated with relatively rare azygos ACA aneurysm, and also the first report confirming more distal coil movement over time. In the future, a large number of patients could develop this complication as more aneurysms are aggressively treated with endovascular treatment. Knowledge regarding the possibility of delayed coil migration is thus important.
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