Endovascular coiling of proximal middle cerebral artery aneurysms: is it safe and durable?

Baek, Jin Wook; Huh, Chae Wook; Heo, Young Jin; Yoo, Min Wook; Kwon, Soon Chan; Kwon, O-Ki; Jeong, Hae Woong; Jin, Sung-Chul

doi:10.1007/s00701-018-3707-5

Cited by 5 publications

(5 citation statements)

References 22 publications

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“…Flow diverters (FDs) have been used widely for the treatment of intracranial with good clinical results 1,3,6,7,9,10,16,24,29) . However, the exact healing mechanism of the flow diverter remains poor.…”

Section: Introductionmentioning

confidence: 99%

Healing of Aneurysm after Treatment Using Flow Diverter Stent : Histopathological Study in Experimental Canine Carotid Side Wall Aneurysm

Lee

Cho

Kang

et al. 2020

J Korean Neurosurg Soc

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Objective : Despite widespread use of flow diverters (FDs) to treat aneurysms, the exact healing mechanism associated with FDs remains poorly understood. We aim to describe the healing process of aneurysms treated using FDs by demonstrating the histopathologic progression in a canine aneurysm model. Methods : Twenty-one side wall aneurysms were created in common carotid artery of eight dogs and treated with two different FDs. Angiographic follow-ups were done immediately after placement of the device, 4 weeks and 12 weeks. At last follow-up, the aneurysm and the device-implanted parent artery were harvested. Results : Histopathologic findings of aneurysms at 4 weeks follow-up showed intra-aneurysm thrombus formation in laminating fashion, and neointimal thickening at the mid-segment of aneurysm. However, there are inhomogenous findings in aneurysms treated with the same type of FD showing same angiographic outcomes. At 12 weeks, aneurysms of complete and near-complete occlusion revealed markedly shrunken aneurysm filled with organized connective tissues with thin neointima. Aneurysms of incomplete occlusion at 12 weeks showed small amount of organized thrombus around fringe neck and large empty space with thick neointmal formation. Neointimal thickness and diameter stenosis was not significantly different between the groups of FD specification and follow-up period. Conclusion : Intra-aneurysmal thrombus formation and organization seem to be an important factor for the complete occlusion of aneurysms treated using the FD. Neointimal formation could occur along the struts of the FD independently of intra-aneurysmal thrombus formation. However, neointimal formation could not solely lead to complete aneurysm healing.

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Section: Introductionmentioning

confidence: 99%

Healing of Aneurysm after Treatment Using Flow Diverter Stent : Histopathological Study in Experimental Canine Carotid Side Wall Aneurysm

Lee

Cho

Kang

et al. 2020

J Korean Neurosurg Soc

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“…25 Although it rarely occurs in the distal segments of the TAs, especially in the presence of aneurysms of the TA branches that emerge as early branches, the neurovascular anatomical information of these structures is even more important. [33][34][35] The cortical branching arteries of this region, such as the TPA, ATA, and MTA, can also be proposed as a model for revascularisation-bypass operations. [36][37][38][39][40] This study was performed on isolated hemispheres; therefore, it was not possible to obtain data regarding the sex and age of the donors.…”

Section: Discussionmentioning

confidence: 99%

“…Briggs et al termed the PTA as ‘artery of aphasia’ in cases with verbal deficits observed after surgery according to infarct of the PTA 25 . Although it rarely occurs in the distal segments of the TAs, especially in the presence of aneurysms of the TA branches that emerge as early branches, the neurovascular anatomical information of these structures is even more important 33–35 . The cortical branching arteries of this region, such as the TPA, ATA, and MTA, can also be proposed as a model for revascularisation-bypass operations 36–40 …”

Section: Discussionmentioning

confidence: 99%

Temporal Artery and Temporal Region Supplied by the Middle Cerebral Artery: An Anatomical Study

Guler

Güner

Korkmaz³

et al. 2021

Journal of Craniofacial Surgery

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This study was conducted to describe in detail the branching patterns of cortical branches from the middle cerebral artery supplying the feeding of the temporal region, to define the arterial structure of temporal artery (TA) and to determine the effect of this arterial supply to the temporal region. The arteries of brains (n ¼ 22; 44 hemispheres) were prepared for dissection after filling them with colored latex. TA was defined, and its classification was described, specifying its relationship with other cortical branches. A new classification was defined related to TA terminology. TA was found in 95% of cadavers, and it originated as an early branch in 75% and from the inferior trunk in 24% of cadavers. TA was classified as Type 0: No TA, Type I: single branch providing two cortical branches, Type II: single branch providing three or more cortical branches and Type III: double TA. Type I-TA (45%) was the most common, and Type II-TA arterial diameter was significantly larger than that of other types. All cadavers showed the cortical branches of temporal region from middle cerebral artery, anterior TA , middle TA, posterior TA and temporooccipital artery, except temporopolar artery (81%). Temporopolar artery, anterior TA, and middle TA primarily originated from TA, an early branch, but posterior TA and temporooccipital artery primarily originated from the inferior trunk. Detailed knowledge about cortical branches together with TA and also this region's blood supply would enable increased prediction of complications, especially in cases with these region-related pathologies, and would make interventions safer.

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“…However, in cases of ruptured aneurysms, heparin was administered after microcatheter selection in the aneurysmal sac. Regardless of rupture, an additional 1000 IU bolus of heparin was administered if the procedural time was longer than 1 h [4]. Patients with unruptured aneurysms were administered 100 mg aspirin and 75 mg clopidogrel for one week prior to the procedure.…”

Section: Methodsmentioning

confidence: 99%

“…Coil embolization is considered a safe and rapid treatment option for cerebral aneurysms [1][2][3][4]. However, procedural thromboembolisms remain a major complication of coil embolization of cerebral aneurysms.…”

Section: Introductionmentioning

confidence: 99%

Association of aortic arch calcification on chest X-ray with procedural thromboembolism after coil embolization of cerebral aneurysm

Kim

Nam

Lee

et al. 2022

Journal of Clinical Neuroscience

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Endovascular coiling of proximal middle cerebral artery aneurysms: is it safe and durable?

Cited by 5 publications

References 22 publications

Healing of Aneurysm after Treatment Using Flow Diverter Stent : Histopathological Study in Experimental Canine Carotid Side Wall Aneurysm

Healing of Aneurysm after Treatment Using Flow Diverter Stent : Histopathological Study in Experimental Canine Carotid Side Wall Aneurysm

Temporal Artery and Temporal Region Supplied by the Middle Cerebral Artery: An Anatomical Study

Association of aortic arch calcification on chest X-ray with procedural thromboembolism after coil embolization of cerebral aneurysm

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