T o the E ditor: We read with interest the article by Sluzewski et al. (Sluzewski M, van Rooij WJ, Beute GN, et al: Balloon-assisted coil embolization of intracranial aneurysms: incidence, complications, and angiography results. J Neurosurg 105: 396–399, September, 2006). Sluzewski et al. presented their endovascular experience treating 757 patients with 827 intracranial aneurysms during a 10-year period. Balloon-assisted coil embolization was used to treat 71 patients; the rest received conventional CE with bare platinum coils. The parameter that led
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L. Fernando Gonzalez, Cameron G. McDougall, Felipe C. Albuquerque, Louis J. Kim, and Robert F. Spetzler
Hyun-Seung Kang, Bae Ju Kwon, O-Ki Kwon, Cheolkyu Jung, Jeong Eun Kim, Chang Wan Oh, and Moon Hee Han
and follow-up results of the use of endovascular coil embolization in patients with AChA aneurysms, including the treatment outcome of AChA-related oculomotor palsy. This study was approved by the Seoul National University Hospital Institutional Review Board (No. H-0806-075-248). Methods Patient Population Between July 1999 and March 2008, 2010 intracranial aneurysms in 1730 patients were occluded using coil embolization at our institutions. During the same period, 88 patients with 90 AChA aneurysms were treated with endovascular coil embolization in 91
Hiroshi Manabe, Seiichiro Fujita, Toru Hatayama, Shigeharu Suzuki, and Soroku Yagihashi
A lthough endovascular coil embolization therapy for cerebral aneurysms has been developed and can be performed safely, 1, 3–5, 13 the long-term outcome has not been evaluated, and its efficacy in preventing rerupture is still unknown. Although there have been some reports of rerupture of coil-embolized aneurysms, 3, 9 histopathological findings of a reruptured aneurysm after coil embolization have rarely been reported. We report a case with rerupture of recanalized aneurysm 8 months after embolization with interlocking detachable coils (IDCs). Case
Hiroki Kobayashi, Yukiko Enomoto, Tetsuya Yamada, Yusuke Egashira, Noriyuki Nakayama, Naoyuki Ohe, and Toru Iwama
Cyst formation in the perianeurysmal brain tissue after endovascular coil embolization is a rare complication and is termed a “perianeurysmal cyst.” Only 19 cases of perianeurysmal cyst have been reported. 1 We present a case of symptomatic perianeurysmal cyst in the brainstem that developed 6 years after endovascular coil embolization for a ruptured left vertebral artery–posterior inferior cerebellar artery (VA-PICA) aneurysm. Illustrative Case A 77-year-old woman had a history of subarachnoid hemorrhage (Hunt and Kosnik grade I) 6 years earlier
Kenji Fukutome, Shuta Aketa, Junji Fukumori, Takaaki Mitsui, Tsukasa Nakajima, Hiromichi Hayami, Ryuta Matsuoka, Rinsei Tei, Yasushi Shin, and Yasushi Motoyama
Several studies reported the development of cerebral vasospasm (CV) after clipping for unruptured cerebral aneurysms; 1–12 however, to date, only one study reported CV occurring after coil embolization. 13 Here we report a rare case of symptomatic vasospasm of the middle cerebral artery (MCA) after stent-assisted coil embolization for unruptured anterior communicating artery (AcomA) aneurysm. Illustrative Case A 58-year-old, left-handed woman with a history of hypertension was referred to our department because of an unruptured AcomA aneurysm, which
Menno Sluzewski, Willem Jan Van Rooij, Guus N. Beute, and Peter C. Nijssen
patient. Coil Insertion Procedure Coil embolization of aneurysms was performed while the patient was in a state of general anesthesia and receiving systemic heparinization. Heparin was continued intravenously or subcutaneously for 48 hours after the procedure and was followed by low-dose oral aspirin for 3 months thereafter. Coil insertion was performed using Guglielmi detachable coils (Boston Scientific, Fremont, CA) or Tru-Fill DCS coils (Cordis, Miami, FL). Some large aneurysms were embolized with very long mechanically detachable coils (Detach 18; Cook, Inc
Arnab K. Rana, Panos Koumellis, Timothy Jaspan, Maria Cartmill, and Norman S. Mcconachie
I ntracranial artery aneurysms are rare in pediatric patients, representing approximately 1.4% of the total cases. 6 Traditionally, these lesions have been treated with surgical clip application or excision or managed conservatively. 3 More recently, coil embolization treatment has been used in the pediatric age group, but this strategy is less commonly reported. 1 , 2 , 4 , 8 In children younger than 1 year of age, MCA aneurysms have been treated surgically, 3 , 6 , 7 , 12 , 14 but we have found no reports of embolization in such cases. Embolization
Christopher J. Stapleton, Brian P. Walcott, William E. Butler, and Christopher S. Ogilvy
E ndovascular coil embolization of ruptured intracranial aneurysms is an accepted treatment alternative to microsurgical clip obliteration. Since publication of the International Subarachnoid Aneurysm Trial (ISAT) and the Barrow Ruptured Aneurysm Trial (BRAT), coil embolization has become the dominant treatment modality for aneurysmal subarachnoid hemorrhage (aSAH) in many modern neurosurgical and neurointerventional practices. 1 , 15 , 16 In fact, a recent analysis of the Nationwide Inpatient Sample reported that 54% to 69% of all ruptured intracranial
Hyun Ho Choi, Young Dae Cho, Dong Hyun Yoo, Su Hwan Lee, Eung Koo Yeon, Hyun-Seung Kang, Won-Sang Cho, Jeong Eun Kim, and Moon Hee Han
E ndovascular coil embolization of anterior communicating artery (ACoA) aneurysms is technically challenging due to anatomical variations in bilateral A 1 /A 2 flow dynamics and critical perforators. In complex ACoA aneurysms with wide necks, a variety of techniques have been applied, including multicatheter utilization and use of stents or balloons. However, successful occlusion may still be difficult to achieve with only the usual techniques. Infringement on parent arteries during coil embolization is usually contraindicated, given the risk of severe ischemic
A novel pressure sensor with an optical system for coil embolization of intracranial aneurysms
Laboratory investigation
Noriaki Matsubara, Shigeru Miyachi, Yoshitaka Nagano, Tomotaka Ohshima, Osamu Hososhima, Takashi Izumi, Arihito Tsurumi, Toshihiko Wakabayashi, Masamichi Sakaguchi, Akihito Sano, and Hideo Fujimoto
I n recent years, neuroendovascular treatments have been widely used with a variety of improved devices such as microcatheters and microguidewires as well as an enhanced angiographic system. Coil embolization for intracranial aneurysms is one such treatment. Craniotomy with clipping of the aneurysm neck has been the most conventional therapeutic option for intracranial aneurysms. 16 However, with the reports of improved outcomes after coil embolization for ruptured aneurysms—such as those documented in the International Subarachnoid Aneurysm Trial (ISAT
