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Efficacy and Safety of Flow-Diverter Therapy for Recurrent Aneurysms after Stent-Assisted Coiling.
Park, K Y; Yeon, J Y; Kim, B M; Jeon, P; Kim, J-H; Jang, C K; Kim, D J; Lee, J W; Kim, Y B; Chung, J; Song, D H; Park, H G; Park, J S.
Afiliación
  • Park KY; From the Department of Neurosurgery (K.Y.P., C.K.J., J.W.L., Y.B.K., J.C.), Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Yeon JY; Department of Neurosurgery (J.Y.Y.), Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
  • Kim BM; Department of Radiology (B.M.K., J.-H.K., D.J.K., D.H.S., H.G.P., J.S.P.), Severance Stroke Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea bmoon21@hanmail.net bmoon21@yuhs.ac.
  • Jeon P; Department of Radiology (P.J.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
  • Kim JH; Department of Radiology (B.M.K., J.-H.K., D.J.K., D.H.S., H.G.P., J.S.P.), Severance Stroke Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Jang CK; From the Department of Neurosurgery (K.Y.P., C.K.J., J.W.L., Y.B.K., J.C.), Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Kim DJ; Department of Radiology (B.M.K., J.-H.K., D.J.K., D.H.S., H.G.P., J.S.P.), Severance Stroke Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Lee JW; From the Department of Neurosurgery (K.Y.P., C.K.J., J.W.L., Y.B.K., J.C.), Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Kim YB; From the Department of Neurosurgery (K.Y.P., C.K.J., J.W.L., Y.B.K., J.C.), Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Chung J; From the Department of Neurosurgery (K.Y.P., C.K.J., J.W.L., Y.B.K., J.C.), Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Song DH; Department of Radiology (B.M.K., J.-H.K., D.J.K., D.H.S., H.G.P., J.S.P.), Severance Stroke Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Park HG; Department of Radiology (B.M.K., J.-H.K., D.J.K., D.H.S., H.G.P., J.S.P.), Severance Stroke Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Park JS; Department of Radiology (B.M.K., J.-H.K., D.J.K., D.H.S., H.G.P., J.S.P.), Severance Stroke Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
AJNR Am J Neuroradiol ; 41(4): 663-668, 2020 04.
Article en En | MEDLINE | ID: mdl-32165365
BACKGROUND AND PURPOSE: Flow-diverter treatment for previously stented aneurysms has been reported to be less effective and prone to complications. In this study, we evaluated the effectiveness and safety of flow diverters for recurrent aneurysms after stent-assisted coiling. MATERIALS AND METHODS: Patients who underwent flow-diverter placement for recurrent aneurysms after stent-assisted coiling between March 2015 and March 2019 were recruited. Clinical and radiographic characteristics and clinical and angiographic outcomes were retrospectively evaluated. RESULTS: Among 133 patients who underwent flow-diverter insertion, 17 (male/female ratio = 5:12; mean age, 53.8 years) were treated for recurrent aneurysms after stent placement with (n = 16) or without (n = 1) coiling. Eight patients initially presented with subarachnoid hemorrhage; 7, with headache; and 2, with visual field defects. Angiographic morphology included large/giant saccular in 12 patients, dissecting in 2, fusiform in 1, traumatic pseudoaneurysm in 1, and ruptured blood blister-like aneurysm in 1. The duration between the first treatment and flow-diverter placement ranged from 2 weeks to 15 months (median, 6 months). Flow-diverter placement was successful in all cases without any complications. All patients had favorable outcomes (mRS, 0-2), without any newly appearing symptoms. Aneurysms were followed up with conventional angiography at least once in 6-18 months. Sixteen aneurysms showed complete occlusion, and 1 aneurysm was enlarged. CONCLUSIONS: Results from this case series investigating flow-diverter placement for recurrent aneurysms after stent-assisted coiling suggested that the procedure is safe and effective. Further study in a larger population may be warranted.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Reoperación / Prótesis Vascular / Aneurisma Intracraneal / Embolización Terapéutica / Procedimientos Endovasculares Tipo de estudio: Observational_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: AJNR Am J Neuroradiol Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Reoperación / Prótesis Vascular / Aneurisma Intracraneal / Embolización Terapéutica / Procedimientos Endovasculares Tipo de estudio: Observational_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: AJNR Am J Neuroradiol Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos