Migration of Enterprise stent in treatment of intracranial aneurysms: a report of two cases

BackgroundThe purpose of the study was the presentation of findings and diagnostic imaging in patients with traumatic pseudoaneurysms of the thoracic aorta, as a rare consequence of road traffic accidents.Patients and methodsIn 22 years we have found 8 traumatic pseudoaneurysms of the thoracic aorta, out of which 7 (87.5%) in male and 1 (12.5%) in female patients. At the time of accidents the youngest patient was 21 and the oldest was 55 (mean age 33.8 years), and at the moment of diagnosing a pseudoaneurysm they were 26 and 55 years old, respectively (mean age 38.7 years). In all patients chest radiography was performed as well as CT scan, in 6 (75%) patients intra-venous digital subtraction angiography was performed (i.v. DSA) and in 1 (12.5%) MRI. CT was performed with the application of 120 ml, and i.v. DSA with 60 ml of contrast medium, respectively.ResultsIn 8 (100%) patients, who suffered a road traffic accident, and whose chest radiograph showed the enlargement of the aortic knob and widening of the mediastinum, CT, i.v. DSA and MRI revealed a traumatic pseudoaneurysm of the thoracic aorta. Periods of time between the accidents and the initial diagnosis of the pseudoaneurysm varied from 7 days to 18 years (median 2.0 years). The diameter of the pseudoaneurysm was from 4.5 to 9.2 cm (median 5.5 cm). In 7 (87.5%) isthmus was involved, and in 1 (12.5%) descending thoracic aorta, respectively. The chest radiograph revealed marginal calcifications in 4 (50%), and on the CT in 5 (62.5%) patients. Intraluminal thrombosis was found by CT in 2(25%) traumatized patients.ConclusionsTraumatic pseudoaneurysm should be taken into consideration in blunt chest trauma, where a chest radiograph shows suspicious regions. A multislice CT is a diagnostic method of choice.

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“… 13 The endovascular stent graft, is a very useful method in managing the aneurism as a minimally invasive procedure. 14 …”

Section: Discussionmentioning

confidence: 99%

Diagnostic imaging of traumatic pseudoaneurysm of the thoracic aorta

Beslić¹,

Bešlić²,

Beslic³

et al. 2010

Radiology and Oncology

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“…The aspect ratio of the aneurysm, the ratio of depth to neck width, will prove to be crucial [18][19][20]. Another clinical concern is stent migration [21][22][23]. Dynamics of flow diversion and prospect of delaying rupture were also investigated [24][25][26].…”

Section: Introductionmentioning

confidence: 99%

Influence of the aspect ratio on the endovascular treatment of intracranial aneurysms: A computational investigation

Tang¹,

Lai²,

Leung³

et al. 2012

JBiSE

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Intracranial aneurysm, a localized dilation of arterial blood vessels in the Circle of Willis and its branches, is potentially life threatening, due to massive bleeding in the subarachnoid space upon rupture. In clinical practice, one minimally invasive surgical procedure is the implantation of a metallic stent to cover the aneurysm neck. This flow diverting device can reduce the flow into the aneurysm and enhance the prospect of thrombosis, a condition expected to reduce the risk of growth and rupture. The biomechanical and haemodynamic factors in stented and nonstented situations are studied by computational fluid dynamics. Unlike earlier models with straight or curved parent blood vessels, the aneurysm is now located near an arterial bifurcation. The influence of the aspect (depth to neck) ratio of the aneurysm on the flow dynamics will be emphasized, especially in the post-operation stages. More precisely, the maximum flow velocity, the variations of wall shear stress, the risk of stent migration and volumetric flow rate after endovascular treatment will be studied. Aneurysms with larger aspect ratios (i.e. smaller neck sizes for constant depth) generally pose a greater risk in terms of these flow parameters. These results will assist the applications and design of stents in future neurosurgical therapy. The approach is limited to a nonelastic model, without taking into account of questions like stent expansion and interaction with tissue.

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Stent-assisted coiling for aneurysms and the phenomenon of stent migration: is it worth it?

Prestigiacomo¹

2010

J NeuroIntervent Surg

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Migration of Enterprise stent in treatment of intracranial aneurysms: a report of two cases

Cited by 4 publications

References 15 publications

Diagnostic imaging of traumatic pseudoaneurysm of the thoracic aorta

Diagnostic imaging of traumatic pseudoaneurysm of the thoracic aorta

Influence of the aspect ratio on the endovascular treatment of intracranial aneurysms: A computational investigation

Stent-assisted coiling for aneurysms and the phenomenon of stent migration: is it worth it?

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