Direct Carotid-Cavernous Fistula following Intracavernous Carotid Aneurysm Treatment with a Flow-Diverter Stent

Mustafa, Wessam; Kądziołka, Krzysztof; Anxionnat, René; Piérot, Laurent

doi:10.1177/159101991001600412

Cited by 33 publications

(28 citation statements)

References 8 publications

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“…Remarkably, no delayed aneurysm rupture or intracranial parenchymal hemorrhage was reported. 20,21 The present results also highlight the high quality of aneurysm occlusion obtained with this technique, confirming the data from 6-month follow-up in the WEBCAST and from an already published retrospective European series. 14,15,17 initial experience with WEB aneurysm treatment.…”

Section: Discussionsupporting

confidence: 78%

WEB Treatment of Intracranial Aneurysms: Clinical and Anatomic Results in the French Observatory

Piérot

Moret

Turjman

et al. 2015

AJNR Am J Neuroradiol

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119

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Section: Discussionsupporting

confidence: 78%

WEB Treatment of Intracranial Aneurysms: Clinical and Anatomic Results in the French Observatory

Piérot

Moret

Turjman

et al. 2015

AJNR Am J Neuroradiol

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119

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“…[76][77][78][79] However, most of those complications have occurred in large and giant aneurysms that have a high natural incidence of bleeding or were previously neither surgically or otherwise endovascularly treatable. From the Retrospective Analysis of Delayed Aneurysm Ruptures (RADAR) study analysis, delayed aneurysms rupture after FDs use occurred in 1.0% of patients.…”

Section: Strokementioning

confidence: 99%

Endovascular Treatment of Intracranial Aneurysms

Piérot

Wakhloo

2013

Stroke

239

162

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2046I n a recent systematic review and meta-analysis, the overall prevalence of unruptured intracranial aneurysms (IAs) is estimated as 3.2%. 1 The prevalence of IAs is higher in patients with autosomal dominant polycystic kidney disease or a positive family history of IAs of subarachnoid hemorrhage (SAH).1 From the same review, the size of unruptured IAs is <5 mm in 66%, 5 to 9 mm in 27%, and ≥10 mm in 7%; the site of IAs is internal carotid artery, including posterior communicating artery in 42%, middle cerebral artery in 35%, and anterior cerebral artery and anterior communicating artery in 18%.Most IAs are clinically silent until rupture, which is unpredictable and sometimes associated with SAH, intraparenchymal hematoma, and an intraventricular hemorrhage. The case fatality of IA rupture is high (from 27% to 44%), but has decreased during the past 3 decades because of the introduction of improved management strategies, including neurocritical care.2 The International Study of Unruptured Intracranial Aneurysms (ISUIA) showed an increased risk of IA rupture with aneurysm size and for posterior circulation aneurysms. Although treatment of a ruptured aneurysm is accepted as an emergency, indication for treatment of unruptured IAs is still being discussed. Decision for treatment is based on clinical and anatomic factors; among them, the most important being patient's age, family history of IA(s), associated conditions (autosomal dominant polycystic kidney disease), symptomatic aneurysms, aneurysm size, and location. The randomized International Subarachnoid Aneurysm Trial (ISAT) study has clearly demonstrated the superiority of endovascular treatment (EVT) of ruptured aneurysms using coil technology over surgery. 4 Since the publication of these results, EVT has rapidly evolved. Although for unruptured aneurysms a direct comparison between EVT and surgery is not available, EVT has been widely used in this subgroup as well. 5In fact the population presenting with IAs is quite heterogeneous, regarding their status at presentation (ruptured versus unruptured), aneurysm shape (fusiform versus saccular) and location (aneurysm geometry in relationship to parent artery), their size (small/large/giant), the size of their neck (small/ large), and other factors. The heterogeneity illustrates that various approaches have to be considered to treat all types of IAs by EVT. During the past >2 decades, different therapeutic modalities were developed for EVT of IAs, and the goal of the present review is to describe them and to analyze their role in the management of IAs. CoilingEVT of IAs was introduced by use of detachable latex balloons and pushable coils. Because their use was cumbersome and associated with high incidence of periprocedural complications, they were applied in a relatively limited number of patients who were difficult to treat with standard surgery. The development of coils with controlled detachable system was clearly the first important step for widespread use of EVT. 6,7 Initial large series showed accepta...

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“…[35][36][37][38][39][40][41][42][43] Only 5 studies were prospective, 26,30 -33 and 4 of them included patients enrolled in multicenter studies/registries. 26,30,32,33 Table 1 summarizes the results of the 5 prospective studies.…”

Section: Flow Diverters: Recent Clinical Studiesmentioning

confidence: 99%

Flow Diversion for Intracranial Aneurysms

D’Urso

Lanzino

Cloft

et al. 2011

Stroke

230

178

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Abstract-The introduction of flow diverters for treatment of intracranial aneurysms represents a major paradigm shift in the treatment of these lesions. The theoretical hallmark of flow diverters is the treatment of the diseased segment harboring the aneurysm instead of treating the aneurysm itself. Flow diverters are designed to induce disruption of flow near the aneurysm neck while preserving flow into parent vessel and adjacent branches. After flow diversion, intra-aneurysmal thrombosis occurs, followed by shrinkage of the aneurysmal sac as the thrombus organizes and retracts. Preliminary clinical series document effective treatment of wide-neck and/or large and giant aneurysms with acceptable complication rates. However, several questions remain unanswered related to the incidence and mechanisms of aneurysm rupture after treatment with flow diverters, fate of small perforating vessels, and long-term patency rates. (Stroke. 2011;42: 2363-2368.)

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Direct Carotid-Cavernous Fistula following Intracavernous Carotid Aneurysm Treatment with a Flow-Diverter Stent

Cited by 33 publications

References 8 publications

WEB Treatment of Intracranial Aneurysms: Clinical and Anatomic Results in the French Observatory

WEB Treatment of Intracranial Aneurysms: Clinical and Anatomic Results in the French Observatory

Endovascular Treatment of Intracranial Aneurysms

Flow Diversion for Intracranial Aneurysms

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