Comparison of Flow Diversion and Coiling for the Treatment of Unruptured Intracranial Aneurysms

Xin, Wenqiang; Xin, Qi-qiang; Yuan, Yan; Chen, Shi; Gao, Xiangyang; Zhao, Yan; Zhang, Hao; Li, Wenkui

doi:10.1016/j.wneu.2019.05.149

Cited by 6 publications

(7 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Yet other authors used a cutoff of ≥ 10% positivity of tumor cells staining, but only considered staining intensity of 2+ or greater as truly positive [13]. On the other hand, negative staining was considered by some authors to be weak or focal [13,19,22,28]. Others considering weak (1+) staining as positive, but did not have a cutoff value for the number of positively staining tumor cells [15,35].…”

Section: Immunohistochemistry Methods and Scoringmentioning

confidence: 99%

“…The reason for exclusion of the six studies included the use of a non-commercially available BRAF V600E antibody clone in 4 studies [9,16,27,31], one study using a non-VE1 clone [37], and one study using only core needle biopsy specimens [36]. The majority of the studies used the anti-human BRAF V600E (clone VE1) monoclonal antibody by Spring Bioscience (Spring Bioscience Pleasanton, CA, USA) [11, 13-15, 18, 21, 25, 26, 28-30, 32, 39, 40] or Ventana medical systems (Ventana Medical Systems, Roche Diagnostics Indianapolis, IN, USA) [12,17,19,20,22,[33][34][35]. Only one study used a BRAF V600E antibody from GBI Biotechnology (Beijing Zhongshan-GBI Biotechnology Co., Beijing, China) [24].…”

Section: Study Selection and Characteristic Reviewmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of Molecular Methods and BRAF Immunohistochemistry (VE1 Clone) for the Detection of BRAF V600E Mutation in Papillary Thyroid Carcinoma: A Meta-Analysis

Parker

White

2020

Head and Neck Pathol

View full text Add to dashboard Cite

The evaluation of surgically resected papillary thyroid carcinomas (PTC) by immunohistochemistry (IHC) for BRAF mutation has diagnostic, prognostic and therapeutic implications. The goal of this meta-analysis was to perform a systematic review of studies using the VE1 clone (specific for detection of the BRAF V600E mutation) on formalin-fixed paraffin embedded (FFPE) thyroid surgical resection specimens for primary papillary thyroid carcinoma. The authors' molecular techniques, immunohistochemistry protocols, and scoring methods for VE1 immunostaining were also evaluated. This study included 4079 PTCs representing data from 23 studies. The results extracted from each study were split into two different groups, direct sequencing group or PCR group, based on the molecular "gold standard" method used to compare VE1 IHC staining. In the direct sequencing group, the IHC sensitivity was 100% (95% CI 0.97-1.00) and specificity 84% (95% 0.72-0.91). In the PCR group the sensitivity was 98% (95% CI 0.96-0.99) and specificity 89% (95% CI 0.82-0.94). Although immunohistochemical procedures varied by author, the overall performance of the VE1 clone shows that it is highly sensitive and relatively specific for detecting the BRAF V600E mutation in surgical resection specimens. However, standardization of immunohistochemical procedural method and scoring/interpretation criteria may improve the reliability and reproducibility for the use of VE1 clone for future practice.

show abstract

Section: Immunohistochemistry Methods and Scoringmentioning

confidence: 99%

Section: Study Selection and Characteristic Reviewmentioning

confidence: 99%

Comparison of Molecular Methods and BRAF Immunohistochemistry (VE1 Clone) for the Detection of BRAF V600E Mutation in Papillary Thyroid Carcinoma: A Meta-Analysis

Parker

White

2020

Head and Neck Pathol

View full text Add to dashboard Cite

show abstract

“…Ruptured and unruptured aneurysms were also involved in our study. Currently, most studies comparing the effect and safety of stent-assisted coiling vs. flow diversion involved only unruptured ( 23 , 24 ) or ruptured ( 25 ) aneurysms, posterior ( 26 ) or anterior ( 27 ) circulation, small or tiny aneurysms ( 28 ). In the procedure-related complications, the stent-assisted coiling involved more complications than those with flow diversion even though there were no significant differences (11.5 vs. 1.9%).…”

Section: Discussionmentioning

confidence: 99%

Effects of stent-assisted coiling in comparison with flow diversion on intracranial aneurysms

Guo

Liu

et al. 2022

Front. Neurol.

View full text Add to dashboard Cite

ObjectiveThe aim of this study was to investigate the efficacy and complications of stent-assisted coiling in comparison with flow diversion for wide-necked intracranial aneurysms.MethodsPatients with wide-necked intracranial aneurysms who were treated with stent-assisted coiling or flow diversion were respectively, enrolled into the stent-assisted coiling or flow diversion treatment group. The clinical and angiographic data were analyzed.ResultsA total of 61 patients with intracranial aneurysms underwent stent-assisted coiling, including 35 (57.4%) female and 26 (42.6%) male patients with 21 (34.4%) ruptured and 40 (65.6%) unruptured aneurysms. Also, 53 patients underwent deployment of flow-diverting devices, including 30 (56.6%) female and 23 (43.4%) male patients with 25 (47.2%) ruptured and 28 (52.8%) unruptured aneurysms. Stent-assisted coiling was performed successfully in 60 patients with 63 stents deployed, and immediate aneurysm occlusion was complete occlusion in 38 (62.3%) aneurysms, residual neck in 12 (19.7%), and residual aneurysm in 10 (16.4%). Procedure-related complications included in-stent thrombosis in three (4.9%) patients, coil protrusion in three (4.9%), and re-rupture of one (1.6%) aneurysm, with a total complication rate of 11.5%. In the flow diversion group, a pipeline embolization device alone was deployed in each of the 24 (45.3%) patients, adjunctive coiling combined with a pipeline device in 29 (54.7%), and double pipeline devices in each of the 6 (11.3%) patients. Immediately after treatment, complete occlusion was achieved in 3 (5.7%) patients with adjunctive coiling, residual neck in 3 (5.7%), and residual aneurysm in 47 (88.7%). Procedure-related complications included aneurysm rebleeding in one patient (1.9%). Clinical and angiographic follow-up was performed 13–49 months (median 29) after the procedure for 49 (80.3%) patients with stent-assisted coiling, with complete aneurysm occlusion in 27 (55.1%) aneurysms, residual neck in 3 (6.1%), residual aneurysm in 5 (10.2%), and recurrence in 14 (28.6%). Follow-up was performed for 14–37 (median 25) months in 45 (84.9%) patients with flow diversion treatment, with complete occlusion in 39 (86.7%) patients, residual neck in 5 (11.1%), residual aneurysm in 1 (2.2%), and no aneurysm recurrence.ConclusionsStent-assisted coiling comes with more complications but fewer permanent aneurysm occlusions than flow diverters, and flow diverters are superior to stent-assisted coiling in the treatment of wide-necked intracranial aneurysms, especially in the long-term effect.

show abstract

“…The flow diversion technique has revolutionized the treatment of large and complex IAs that were difficult (or even impossible) to treat with previous techniques. Compared with conventional techniques (i.e., coiling, stent-assisted coiling, parent vessel occlusion, or surgical clipping), FDSs showed higher rates of occlusion and lower rates of recurrence without increasing the rate of complications in the treatment of specific aneurysms, such as giant or complex aneurysms (3,4,15). Their efficacy relies on the ability to redirect the blood flow out of the aneurysmal sac, thus decreasing the intra-aneurysmal blood flow and the endothelization of the aneurysm neck, hence promoting thrombosis of the aneurysm and its regression (2).…”

Section: Frontiers Inmentioning

confidence: 99%

Effects of the flow diversion technique on nucleotide levels in intra-cranial aneurysms: A feasibility study providing new research perspectives

Lubicz

Cortese

Delporte

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

IntroductionThe flow diverter stent (FDS) has become a first-line treatment for numerous intra-cranial aneurysms (IAs) by promoting aneurysm thrombosis. However, the biological phenomena underlying its efficacy remain unknown. We proposed a method to collect in situ blood samples to explore the flow diversion effect within the aneurysm sac. In this feasibility study, we assessed the plasma levels of nucleotides within the aneurysm sac before and after flow diversion treatment.Materials and methodsIn total, 14 patients with unruptured IAs who were selected for FDS implantation were prospectively recruited from February 2015 to November 2015. Two catheters dedicated to (1) FDS deployment and (2) the aneurysm sac were used to collect blood samples within the parent artery (P1) and the aneurysm sac before (P2) and after (P3) flow diversion treatment. The plasma levels of adenosine monophosphate (AMP), adenosine diphosphate (ADP), and adenosine triphosphate (ATP) at each collection point were quantified with liquid chromatography and tandem mass spectrometry.ResultsThe aneurysms were extradural in nine (64.3%) patients and intra-dural in five (35.7%) patients. They presented an average diameter of 15.5 ± 7.1 mm, height of 15.8 ± 4.6 mm, and volume of 2,549 ± 2,794 ml. In all patients (100%), 16 FDS implantations and 42 in situ blood collections were performed successfully without any complications associated with the procedure. The ATP, ADP, and AMP concentrations within the aneurysm sac were decreased after flow diversion (p = 0.005, p = 0.03, and p = 0.12, respectively). Only the ATP levels within the aneurysm sac after flow diversion were significantly correlated with aneurysm volume (adjusted R2 = 0.43; p = 0.01).ConclusionIn situ blood collection within unruptured IAs during a flow diversion procedure is feasible and safe. Our results suggest that the flow diversion technique is associated with changes in the nucleotide plasma levels within the aneurysm sac.

show abstract

Comparison of Flow Diversion and Coiling for the Treatment of Unruptured Intracranial Aneurysms

Cited by 6 publications

References 33 publications

Comparison of Molecular Methods and BRAF Immunohistochemistry (VE1 Clone) for the Detection of BRAF V600E Mutation in Papillary Thyroid Carcinoma: A Meta-Analysis

Comparison of Molecular Methods and BRAF Immunohistochemistry (VE1 Clone) for the Detection of BRAF V600E Mutation in Papillary Thyroid Carcinoma: A Meta-Analysis

Effects of stent-assisted coiling in comparison with flow diversion on intracranial aneurysms

Effects of the flow diversion technique on nucleotide levels in intra-cranial aneurysms: A feasibility study providing new research perspectives

Contact Info

Product

Resources

About