Patient with Recurrent Anterior Cerebral Artery Dissecting Aneurysm After Stent-Assisted Coil Embolization Successfully Treated with A3-A3 Anastomosis

Takahashi, Yoshiharu; Endo, Hidenori; Endo, Toshiki; Fujimura, Miki; Niizuma, Kuniyasu; Tominaga, Teiji

doi:10.1016/j.wneu.2017.09.128

Cited by 8 publications

(6 citation statements)

References 13 publications

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“…Dissecting aneurysms often undergo shape changes in the acute phase. Various responses to such changes after the initial endovascular treatment include switching to direct trapping with bypass, 3) and additional coiling and/or stenting. 6) …”

Section: Discussionmentioning

confidence: 99%

“… 1) The conventional treatment has been trapping with bypass, but endovascular treatment has recently been increasingly adopted. 2 , 3) Reconstructive endovascular treatment for intracranial dissecting aneurysms has the advantage of preserving the parent artery without challenging bypass techniques, 4 , 5) although curability remains a concern and management of antiplatelet agents is controversial after rupture.…”

Section: Introductionmentioning

confidence: 99%

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A Case of Ruptured Anterior Cerebral Artery Dissection Prevented from Re-rupture with Stenting and Modification of Antiplatelet Agents

OTAKI

Shimizu

Aihara

et al. 2021

NMC Case Report Journal

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A case of ruptured anterior cerebral artery (ACA) dissection was treated with multiple neck-bridge stents, with modification of antiplatelet administration according to changes in the shape of the aneurysm in the acute phase. A 67-year-old woman presented with severe subarachnoid hemorrhage and fusiform dilatation was observed in the left ACA between the A1 and A2 segments. The use of stents in the acute phase is associated with high risk of ischemic complications. Prasugrel administration, which is considered to have low drug resistance, may have allowed safe stent use in the acute phase.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Case of Ruptured Anterior Cerebral Artery Dissection Prevented from Re-rupture with Stenting and Modification of Antiplatelet Agents

OTAKI

Shimizu

Aihara

et al. 2021

NMC Case Report Journal

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“…The following patients were included: (Piotin et al, 2018) > 18 years; (Takahashi et al, 2018) Modified Rankin Scale (MRS) score < 3; (Bakhsheshian et al, 2018) Clinical symptoms of severe headache, unconsciousness and focal neurological deficits; (Takeshita et al, 2017) the IA identified with CTA.…”

Section: Methodsmentioning

confidence: 99%

“…The following excluding criteria were used: (Piotin et al, 2018) the patients had severe medical illness (such as myocardial infarction and psychiatric illness) and or severe sequelae of stroke; (Takahashi et al, 2018) the patients had a history of allergy to aspirin or clopidogrel, and or intracerebral hemorrhage; (Bakhsheshian et al, 2018) besides of aspirin or clopidogrel, the patients took other antiplatelet or anti-inflammatory drugs; and (Takeshita et al, 2017) the patients were pregnant or lactating women.…”

Section: Methodsmentioning

confidence: 99%

“…Intracranial aneurysm (IA) is a common cerebral disease, which involves various organs and becomes more prevalent with high-level morbidity and mortality (Piotin et al, 2018). With the development of medical devices, endovascular stents have been widely used in the prevention of IA (Bakhsheshian et al, 2018; Takahashi et al, 2018). Stent-assisted coil embolization (SCE) techniques are becoming popular and may be feasible and effective for such postoperatively complicated aneurysms (Takeshita et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

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Stent-Jailing Technique Reduces Aneurysm Recurrence More Than Stent-Jack Technique by Causing Less Mechanical Forces and Angiogenesis and Inhibiting TGF-β/Smad2,3,4 Signaling Pathway in Intracranial Aneurysm Patients

Meng

Liu

et al. 2019

Front. Physiol.

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Background: Stent-jailing and stent-jack are used for stent-assisted coil embolism (SCE) in intracranial aneurysm (IA) therapy, and cause different incidences of IA recurrence. Angiogenesis strongly correlates with aneurysm accumulation. Stent-jack causes higher mechanical forces in cerebral vessels than stent-jailing. Mechanical forces, as well as TGF-β/Smad2,3,4 signaling pathway, may play an important factor in IA recurrence by affecting angiogenesis.Methods: We explored the effects of stent-jailing or stent-jack technique on IA recurrence by investigating mechanical forces, TGF-β/Smad2,3,4 signaling pathway and the incidence of angiogenesis in IA patients. One-hundred-eighty-one IA patients were assigned into stent-jailing (n = 93) and stent-jacket groups (n = 88). The clinical outcome was evaluated using Glasgow Outcome Score (GOS) and aneurysm occlusion grades. The percentage of CD34+EPCs (releasing pro-angiogenic cytokines) in peripheral blood was measured by flow cytometer. Endothelial cells were separated from cerebral aneurysm and malformed arteries via immunomagnetic cell sorting. Angiogenesis was measured by microvessel density (MVD) using anti-CD34 monoclonal antibody staining before using the stent, immediately after surgery and 2 years later. Meanwhile, the mechanical forces in cerebral vessels were determined by measuring endothelial shear stress (ESS) via a computational method. TGF-β and Smad2,3,4 were measured by real-time qPCR and Western Blot. Tube formation analysis was performed to test the relationship between angiogenesis and TGF-β, and the effects of different techniques on angiogenesis.Results: After a 2-year follow-up, 85 and 81 patients from stent-jailing and stent-jack groups, respectively, completed the experiment. Stent-jailing technique improved GOS and reduced aneurysm occlusion grades higher than the stent-jack technique (P < 0.05). The counts of CD34+EPCs and MVD values in the stent-jailing group were lower than the stent-jack group (P < 0.05). ESS values in sent-jailing group were lower than the stent-jack group (P < 0.05), and positively correlated with MVD values (P < 0.05). TGF-β and Smad2,3,4 levels in sent-jailing group were also lower than the stent-jack group (P < 0.05). TGF-β was associated with angiogenesis incidence and stent-jack caused angiogenesis incidence more than stent-jailing.Conclusion: Stent-jailing technique reduces IA recurrence more than stent-jack by causing less mechanical forces, angiogenesis and inhibiting TGF-β/Smad2,3,4 signaling in IA patients.

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Fusiform aneurysms of anterior cerebral artery: center experience and systematic literature review

Conte,

Cagil,

Lanzino

et al. 2023

Neurosurg Rev

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Patient with Recurrent Anterior Cerebral Artery Dissecting Aneurysm After Stent-Assisted Coil Embolization Successfully Treated with A3-A3 Anastomosis

Cited by 8 publications

References 13 publications

A Case of Ruptured Anterior Cerebral Artery Dissection Prevented from Re-rupture with Stenting and Modification of Antiplatelet Agents

A Case of Ruptured Anterior Cerebral Artery Dissection Prevented from Re-rupture with Stenting and Modification of Antiplatelet Agents

Stent-Jailing Technique Reduces Aneurysm Recurrence More Than Stent-Jack Technique by Causing Less Mechanical Forces and Angiogenesis and Inhibiting TGF-β/Smad2,3,4 Signaling Pathway in Intracranial Aneurysm Patients

Fusiform aneurysms of anterior cerebral artery: center experience and systematic literature review

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