Visualization of novel microstents in patients with unruptured intracranial aneurysms with contrast-enhanced flat panel detector CT

Poncyljusz, Wojciech; Zwarzany, Łukasz; Safranow, Krzysztof

doi:10.1016/j.ejrad.2015.04.015

Cited by 4 publications

(5 citation statements)

References 20 publications

(40 reference statements)

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“…Additionally, other studies have been performed in patients using, for example, the addition of contrast medium to the irrigant, or the measurement of the concentration of inflammatory markers in periapical fluid [ 6 , 16 ]. Nevertheless, all contrast medium types may induce a potentially allergic reaction in some patients, and reproducibility of periapical radiography and interrater agreement in assessment of the quality and quantity of the bone is not high [ 17 , 18 ]. Theoretically, the use of cone beam computed tomography could prove helpful, but this is associated with unnecessary exposure to radiation [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Apical Extrusion of Debris during Root Canal Preparation with ProTaper Next, WaveOne Gold and Twisted Files

2021

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(1) Background: Apical extrusion of debris is an example of a complication that may arise during root canal treatment, and it has been proven to be an unavoidable occurrence during endodontic treatment by numerous authors. Even though it may not hinder the long-term outcome of treatment, it may lead directly to increased levels of postoperative pain and, therefore, lower levels of patient acceptance and satisfaction. The aim of the study was to assess the weight of apically extruded debris during root canal preparation with instruments that use different movement kinematics (rotary, reciprocating, and adaptive motion); (2) Methods: The study was performed using the Myers and Montgomery model. Sixty human premolar teeth were inserted into preweighed Eppendorf tubes and randomly classified into three groups. After manual glide-path preparation, teeth in each group were instrumented to working length set 1 mm short of the anatomical apex using the standard sequence provided by the manufacturers (for Group 1: ProTaper Next X1 & X2; for Group 2: WaveOne Gold Primary, for Group 3: Twisted Files SM1-SM3). Root canals were irrigated with 1 mL of 0.9% NaCl solution between each file insertion. The tubes with collected debris were stored in an incubator at 70 °C for 5 days in order to evaporate the liquid component. Measurement of the weight of extruded debris was performed by subtracting the preinstrumentation from the postinstrumentation weight of the tubes. The results were analyzed with Kruskal–Wallis ANOVA, with significance level set at 0.05; (3) Results: The weight of extruded debris was 0.337 mg (SD = 0.148) for Group 1, 0.305 mg (SD = 0.201) for Group 2, and 0.348 mg (SD = 0.135) for Group 3. (4) Conclusions: Engine-driven root canal preparation with the use of instruments ProTaper Next, WaveOne Gold and Twisted Files that use different movement kinematics (rotary, reciprocating, and adaptive motion) was associated with apical extrusion of debris to a similar extent.

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Section: Discussionmentioning

confidence: 99%

Apical Extrusion of Debris during Root Canal Preparation with ProTaper Next, WaveOne Gold and Twisted Files

2021

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“…VasoCT (Philips Healthcare, Best, the Netherlands) with diluted iodinated contrast medium was used to assess stent apposition to the arterial wall. 7,8…”

Section: Description Of Techniquementioning

confidence: 99%

Flow-Diversion Effect of LEO Stents: Aneurysm Occlusion and Flow Remodeling of Covered Side Branches and Perforators

Cagnazzo

Cappucci

Dargazanli

et al. 2018

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Flow diversion with intermediate-porosity stents (braided stents) has been recently reported for distally located small aneurysms. The aim of this study was to evaluate the flow-diversion effect of LEO stents on covered vessels and for aneurysms treated with sole stent-placement therapy. MATERIALS AND METHODS: We retrospectively evaluated the following outcomes: 1) remodeling of covered side branches and perforators (extra-aneurysmal flow remodeling), and 2) the occlusion rate of aneurysms treated with sole stent-placement therapy (intraaneurysmal flow remodeling). RESULTS: Seventy-six patients with 98 covered vessels were studied. Overall, 89 covered arteries (91%) were normal, 7 showed narrowing (7%), and 2 (2%) were occluded (1 posterior communicating artery and 1 MCA) without related complications (mean DSA follow-up, 14 months). Univariate and multivariate analyses highlighted smoking (P ϭ .03) and the length of follow-up (P ϭ .002) as factors associated with arterial remodeling. Of the 17 Sylvian (lenticulostriate arteries) and 7 basilar perforators, 1 (4%) group of Sylvian perforators covered with double stents had asymptomatic remodeling. Ten aneurysms (mean size, 3.5 mm) were treated with LEO stents as stent monotherapy (5 recanalized after coiling and 5 directly treated with the LEO). Complete occlusion (Raymond-Roy I) was achieved in 70% of aneurysms (mean follow-up, 14 months). The Raymond-Roy I occlusion rate among recanalized aneurysms and those directly treated with LEO stents was 80% and 60%, respectively (P ϭ .9). CONCLUSIONS: The rate of flow remodeling on the covered arteries and perforators was 9% and 4%, respectively, and was clinically irrelevant in all cases. Complete occlusion of aneurysms treated with sole stent-placement therapy was 70%. These data stress the flow-diversion properties of LEO stents.

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“…Since its early de-velopment, it has shown its potential to depict intraprocedural bleeding 12 and also to provide accurate imaging of endovascular implants. 13,14 The potential of FPV-CTA has been shown for the accurate visualization of intracranial stents (laser-cut 5,15,16 as well as braided stents 7 ). It helps to see precisely the struts of the stent and may allow the depiction of a kinking, twisting, or stent misopening.…”

Section: Discussionmentioning

confidence: 99%

“…Only scant data are available in the literature on the potential of FPV-CTA by intra-arterial 4,7 or IV 17 injection for the visualization of FDSs and its clinical impact. Such protocols have been used to evaluate the accuracy of the FDS deployment intraoperatively 4 and for follow-up imaging.…”

Section: Discussionmentioning

confidence: 99%

“…4 Indeed, despite the addition of radiopaque strands in the design of these stents, their visibility remains poor, hampering the visualiza-tion of their accurate deployment by the operator during the procedure. Flat panel volume CT angiography (FPV-CTA) is now increasingly used to evaluate the deployment of regular intracranial stents in cases of stent-assisted coiling, [5][6][7] and has shown its effectiveness to depict kinking/misdeployment. However, the potential of this technique has been poorly reported for FDSs.…”

mentioning

confidence: 99%

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Clinical Impact of Flat Panel Volume CT Angiography in Evaluating the Accurate Intraoperative Deployment of Flow-Diverter Stents

Clarençon

Maria

Gabrieli

et al. 2017

AJNR Am J Neuroradiol

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Visualization of novel microstents in patients with unruptured intracranial aneurysms with contrast-enhanced flat panel detector CT

Cited by 4 publications

References 20 publications

Apical Extrusion of Debris during Root Canal Preparation with ProTaper Next, WaveOne Gold and Twisted Files

Apical Extrusion of Debris during Root Canal Preparation with ProTaper Next, WaveOne Gold and Twisted Files

Flow-Diversion Effect of LEO Stents: Aneurysm Occlusion and Flow Remodeling of Covered Side Branches and Perforators

Clinical Impact of Flat Panel Volume CT Angiography in Evaluating the Accurate Intraoperative Deployment of Flow-Diverter Stents

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