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Eung Koo Yeon, Young Dae Cho, Dong Hyun Yoo, Su Hwan Lee, Hyun-Seung Kang, Jeong Eun Kim, Won-Sang Cho, Hyun Ho Choi and Moon Hee Han

T he durability of a coiled aneurysm is a major concern for neurointerventionists. Regular follow-up evaluation of coiled aneurysms is essential and mandatory, because overall recanalization rates reported in coiled aneurysms have been relatively high (10.7%–33.6%). 14 , 24 However, the duration of required surveillance after coiling of aneurysms is also an important issue. Short-term follow-up of patients with stably occluded aneurysms does not guarantee that recanalization will not occur within a few years, but prolonged long-term surveillance raises cost

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Oliver G. S. Ayling, George M. Ibrahim, Brian Drake, James C. Torner and R. Loch Macdonald

A neurysmal subarachnoid hemorrhage (aSAH) occurs in 8–9 people per 100,000, 21 , 23 leading to significant morbidity 1 and mortality. 3 , 13 , 14 , 31 To reduce the risk of rehemorrhage, the ruptured aneurysm is treated either by neurosurgical clipping 29 or endovascular coiling. 16 , 28 , 30 Since publication of the International Subarachnoid Aneurysm Trial (ISAT) 30 in 2002, endovascular coiling has gained wide acceptance and has become the preferred treatment modality at many centers. 20 The most appropriate treatment modality for specific

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Nancy J. Edwards, Wesley H. Jones, Aditya Sanzgiri, Juan Corona, Mark Dannenbaum and Peng Roc Chen

F unctional outcomes for patients with aneurysmal subarachnoid hemorrhage (aSAH) have improved in the past 2 decades, likely due in part to the availability and refinement of neurosurgical and endovascular treatment options. 16 Because ruptured aneurysms are increasingly treated via coil embolization, preventing periprocedural complications will become more and more important. To date, the primary complication of coil embolization is a thromboembolic event (TEE). 5 , 8 , 12 , 19 In the multicenter, prospective Clinical and Anatomical Results in the Treatment

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Vincenzo Albanese, Antonio Spadaro, Fausto Iannotti, Piero Picozzi, Francesco Tomasello and Fernando Antonio Cioffi

K inking and coiling of the internal carotid artery (ICA) have been described as early as 1898, 8 but have only recently been associated with clinical symptoms of cerebral ischemia. 13, 16 Hemodynamic disturbances associated with neck movements, 2, 5, 14, 18–20 or atherosclerotic lesions located on the affected segment 11, 19 have been considered responsible for the cerebral ischemic episodes. While there have been many reports on the incidence, clinical symptoms, and treatment of kinking and coiling of the ICA, 2–4, 7, 11, 14, 18–20 very little is known

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David Hassanein Berro, Vincent L’Allinec, Anne Pasco-Papon, Evelyne Emery, Mada Berro, Charlotte Barbier, Henri-Dominique Fournier and Thomas Gaberel

I ntracranial aneurysms (IAs) can rupture and lead to subarachnoid hemorrhage (SAH), which is a very severe form of stroke. 3 IAs can be excluded from the intracranial circulation in two situations: prior to rupture to prevent primary bleeding or immediately after rupture to prevent rebleeding. 3 , 16 IA exclusions can be performed through two modalities: surgical clipping and endovascular coiling. There is much controversy surrounding the best treatment modality to use to exclude IAs. In ruptured IAs, when both treatment modalities are possible, endovascular

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Kubilay Aydin, Christian Paul Stracke, Mehmet Barburoglu, Elif Yamac, Mynzhylky Berdikhojayev, Serra Sencer and René Chapot

S tent-assisted coiling is an endovascular method that has been used for the treatment of wide-necked intracranial aneurysms. 3 , 24 , 26 The implantation of a stent across the wide neck of an aneurysm impedes the protrusion of coils from the aneurysm sac into the parent vessels. However, a single stent may not be enough to safely coil a wide-necked bifurcation aneurysm with a complex neck morphology. The involvement of more than one side branch of the bifurcation to the aneurysm neck may necessitate double-stent implantation to protect all the bifurcated

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Le-Bao Yu, Xin-Jian Yang, Qian Zhang, Shao-Sen Zhang, Yan Zhang, Rong Wang and Dong Zhang

, indicating an association between endovascular treatment and aneurysm rerupture in the current literature. 2–4 , 7 , 12 Aneurysm recurrence after coil embolization remains both a major shortcoming of endovascular treatment and a daunting challenge for neurosurgeons without optimal management strategies. 1 , 3 , 5 , 21 However, few data are available regarding the morphological changes of recurrent aneurysms and their management strategy. The modified Raymond scale or the original Raymond scale 8 , 15–17 , 19 is a well-known classification system for initial angiographic

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Kimon Bekelis, Daniel J. Gottlieb, Yin Su, A. James O'Malley, Nicos Labropoulos, Philip Goodney, Michael T. Lawton and Todd A. MacKenzie

C erebral aneurysms are a common cause of intracranial hemorrhage, stroke, and death. 3 , 8 Two treatment options are used in current practice. 3 , 25 Surgical clipping involves a craniotomy and clip placement on the blood vessel to exclude the weakened area, whereas endovascular coiling is a minimally invasive angiographic technique in which aneurysm obliteration is achieved from within the blood vessel. 3 , 8 Since the publication of the International Subarachnoid Aneurysm Trial (ISAT), 25 which focused on ruptured aneurysms, there has been a

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Spencer Twitchell, Hussam Abou-Al-Shaar, Jared Reese, Michael Karsy, Ilyas M. Eli, Jian Guan, Philipp Taussky and William T. Couldwell

diverter devices for complex aneurysm treatment has affected the cost of care for patients treated for aneurysms. Therefore, the aim of this study was to evaluate specific cost drivers for surgical clipping and endovascular management (i.e., coil embolization and flow diversion) of both ruptured and unruptured intracranial aneurysms using the VDO system. Methods The study was approved by the IRB at the University of Utah. The data were collected using the VDO database and the electronic medical record database to isolate elective and emergent patient cases in which

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Young Soo Kim, Sang Won Lee, Jeong A Yeom, Chang Hyo Yoon and Seung Kug Baik

E ndovascular treatment of intracranial aneurysms is a useful alternative to open clipping. A recent multicenter randomized trial demonstrated improved safety and clinical outcomes of endovascular treatment compared with neurosurgical clipping. Furthermore, an increasing trend toward endovascular treatment for aneurysm elimination is reported, and results from recent studies have shown that stent-assisted coil embolization (SACE) now accounts for about one-fourth to one-fifth of all endovascular treatments. 1 However, while most SACE studies appear to be