Coating of intracranial aneurysms: A long-term follow-up study of 34 cases

Calenbergh, Frank Van; Buyse, Gunnar; Goffin, Jan; Plets, Christiaan

doi:10.1007/bf01411436

Cited by 10 publications

(3 citation statements)

References 27 publications

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“…4,11,12) However, experimental and clinical studies have shown direct vascular and neural toxicity from cyanoacrylate. Cyanoacrylate may cause chronic inflammation, necrosis of the vascular media, and thickening of the arterial wall due to fibrosis in both the media and adventitia, resulting in occlusive arterial lesions.…”

Section: Discussionmentioning

confidence: 99%

Cranial Nerve Pareses Following Wrapping of a Ruptured Dissecting Vertebral Artery Aneurysm: A Possible Complication of Cyanoacrylate Glue. Case Report.

Kuroki

Aoki

et al. 2003

Neurol. Med. Chir.(Tokyo)

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A 51-year-old female with a ruptured dissecting vertebral artery aneurysm underwent an uneventful wrapping technique using Biobond-soaked gauze through a unilateral suboccipital transcondyle approach. On the 3rd postoperative day, she developed pareses of the ipsilateral VII through XII cranial nerves. Daily intravenous administration of 300 mg of hydrocortisone was started. This treatment was continued and dosage was tapered until the 10th postoperative day. The cranial nerve pareses deteriorated until the 8th postoperative day, but slowly resolved by 3 weeks after surgery. The patient was discharged with slight hoarseness and dysphasia 5 weeks after surgery. She had only slight hoarseness at 6 months. This complication was probably due to a neural toxic response to the Biobond.

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Section: Discussionmentioning

confidence: 99%

Cranial Nerve Pareses Following Wrapping of a Ruptured Dissecting Vertebral Artery Aneurysm: A Possible Complication of Cyanoacrylate Glue. Case Report.

Kuroki

Aoki

et al. 2003

Neurol. Med. Chir.(Tokyo)

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“…These medical results raise the possibility of providing critical, additional protection to surgically treated patients (i.e., besides protecting those patients who have been treated by medical means alone). This additional safeguard is needed because surgically treated patients, regardless of technique used (clipping [2], coating [19,31], etc.) along with patients treated by interventional radiologic (endovascular) [4,5] methods, remain at some, as yet not quantified, risk of recurrent hemorrhage in long-term follow-up.…”

Section: Discussionmentioning

confidence: 99%

Unexpected results in long-term medically treated ruptured intracranial aneurysm including data on 14 patients followed more than 30 years each

1997

Acta neurochir

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This is the longest reported follow-up of patients with ruptured intracranial aneurysms treated entirely medically with hypotension. Patients with ruptured brain aneurysms, untreated except for plain bedrest, are at a well-recognized risk of recurrent hemorrhage. Some surgically treated patients also remain at risk of recurrent hemorrhage in follow-up. This is a review of results in patients whose active but entirely medical (hypotensive) treatment was started in the first 10 years of a 40-year study. It suggests a way of reducing risks in both of the above 2 groups. 53 consecutive patients with proven ruptured brain aneurysm(s) were treated as early as possible with medical-hypotensive therapy alone by the author and followed, personally, until death or, if they survived, for at least 30 years each (or until lost to follow-up). The patients included many considered to have been poor operative risks with some having been designated inoperable by the referring neurosurgeons. As part of the long-term follow-up, magnetic resonance angiography (MRA) has been begun. Long-term follow-up was defined as the time beginning after 9 weeks from (admission) hemorrhage. 9 patients had died during the earlier stages of hemorrhage (and treatment) i.e., before the 9 weeks period had elapsed; their data was presented previously. This yielded 44 patients for long-term follow-up. Only 2 patients (both had multiple aneurysms) on this regimen have died of either proven hemorrhage (1 patient) or presumed hemorrhage (1 patient). Most patients survived and maintained an excellent condition. Medical-hypotensive therapy of ruptured intracranial aneurysms has produced much better long-term results than expected. This is significant for (1) patients requiring medical treatment alone and (2) surgically treated patients who may benefit from additional long-term protection.

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“…11 Smith et al (1985) also reported that ethyl 2-cyanoacrylate adhesive could induce acute and chronic granulomatous inflammation of the meninges and evidence of severe vascular damage, including vessel wall necrosis, inflammation, thrombosis, and occasionally hemorrhage in cats. 12 In fact, postoperative complications, including narrowing and occlusion of the parent artery 7,8,11,[13][14][15] and recurrent hemorrhage after total coating 2,7,8,16 have been reported. Thus, the development of a new coating material is urgently required for safe and effective surgery.…”

Section: Introductionmentioning

confidence: 99%

A novel coating biomaterial for intracranial aneurysms: Effects and safety in extra‐ and intracranial carotid artery

et al. 2005

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Methyl-2-cyanoacrylate, a widely used material for coating cerebral aneurysm, was recently withdrawn. The aim of the present study was to develop an alternative coating material for cerebral aneurysm, which is safe, effective and stable within the brain. In the first experiment, an aneurysm model of the common carotid artery was produced in a rabbit by the local application of elastase. The aneurysm produced was covered by no material (Group A), a cellulose cotton sheet and conventional methyl-2-cyanoacrylate (Group B), a newly produced polyglycolic acid felt and fibrin glue (Group C), or a cellulose cotton sheet and fibrin glue (Group D). Histological examination showed that the materials resulted in the formation of tight connective tissue around the artery, and that the material was completely replaced by the connective tissue after 12 weeks. This change was found exclusively in Group C, but not in Group A or the other materials, although a temporary thickening of the intima was also observed at the site of the elastase application in Group C. In Group D, a long-term, marked thickening of the intima was observed. In the second experiment, using an intracranial internal carotid artery from a beagle, the applied polyglycolic acid felt and fibrin glue to the intracranial artery induced the formation of connective tissue around the artery that was completely absorbed 16 weeks after surgery. There were no signs of intimal thickening or of adverse reactions in nervous tissue. The present results suggest that polyglycolic acid felt and fibrin glue is a possible candidate for a safe, effective biomaterial to wrap or coat cerebral aneurysm.

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Coating of intracranial aneurysms: A long-term follow-up study of 34 cases

Cited by 10 publications

References 27 publications

Cranial Nerve Pareses Following Wrapping of a Ruptured Dissecting Vertebral Artery Aneurysm: A Possible Complication of Cyanoacrylate Glue. Case Report.

Cranial Nerve Pareses Following Wrapping of a Ruptured Dissecting Vertebral Artery Aneurysm: A Possible Complication of Cyanoacrylate Glue. Case Report.

Unexpected results in long-term medically treated ruptured intracranial aneurysm including data on 14 patients followed more than 30 years each

A novel coating biomaterial for intracranial aneurysms: Effects and safety in extra‐ and intracranial carotid artery

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