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Patency of the posterior communicating artery following treatment with the Pipeline Embolization Device

Badih Daou, Edison P. Valle-Giler, Nohra Chalouhi, Robert M. Starke, Stavropoula Tjoumakaris, David Hasan, Robert H. Rosenwasser, Ryan Hebert, and Pascal Jabbour

objective of this study was to assess the patency of the posterior communicating artery (PCoA) following treatment of PCoA aneurysms using the PED. Methods Patient Selection The study protocol was approved by the Thomas Jefferson University institutional review board. Patients who had PCoA aneurysms treated with the PED between May 2011 and July 2014 were retrospectively identified from our prospectively maintained database of patients undergoing treatment using the PED. Thirty-six patients with PCoA aneurysms were identified, of whom 6 were excluded because of

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Patency of anterior circulation branch vessels after Pipeline embolization: longer-term results from 82 aneurysm cases

Leonardo Rangel-Castilla, Stephan A. Munich, Naser Jaleel, Marshall C. Cress, Chandan Krishna, Ashish Sonig, Kenneth V. Snyder, Adnan H. Siddiqui, and Elad I. Levy

consequence of branch vessel occlusion after treatment with PEDs remains poorly defined. Recently, authors of small patient series have sought to elucidate this widespread concern, evaluating the rates of ophthalmic artery (OphA), posterior communicating artery (PCoA), and anterior choroidal artery (AChA) integrity following PED placement. 2 , 3 , 10 , 14 In this study, we evaluated the rate of branch vessel patency following PED placement in aneurysms in 82 patients treated at our institution. Methods The protocol for this study had the approval of the University at

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Patency of the ophthalmic artery after flow diversion treatment of paraclinoid aneurysms

Clinical article

Ross C. Puffer, David F. Kallmes, Harry J. Cloft, and Giuseppe Lanzino

specifically focused on patency of the OphA may provide insight into the impact on branch vessels of single or multiple PED implantations. In this study we assessed the fate of the OphA and any change in angiographic flow in the artery immediately after placement of a flow-diverting stent and at angiographic follow-up in a consecutive series of 19 patients with 20 paraclinoid aneurysms. Methods The study was approved by the Institutional Review Board of the Mayo Clinic. Patients included in this study were treated as part of ongoing multicenter studies on the PED such

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Thermosensitive determination of patency in lumboperitoneal shunts

Technical note

Yusuke Ishiwata, Yasuhiro Chiba, Toshinori Yamashita, Gakuji Gondo, Kaoru Ide, and Takeo Kuwabara

A technique for thermosensitive determination of shunt patency was reported in 1980 by Chiba and Yuda 2 to evaluate ventriculoperitoneal (VP) shunts. The same technique is described here for use in patients with lumboperitoneal (LP) shunts. The flow of cerebrospinal fluid (CSF), and hence patency of the shunt, was indicated by a downward deflection of the recording trace (a decrease in temperature). By this method, the patency of LP shunts can be investigated without an invasive procedure. Our experience with 19 cases is reported. Technique The catheter

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Ultrasound determination of cerebrospinal fluid shunt patency

Technical note

Marc A. Flitter, William A. Buchheit, Frederick Murtagh, and Marc S. Lapayowker

T his is a preliminary report on the utilization of Doppler flow detection to determine cerebrospinal fluid (CSF) shunt patency. The technique has been particularly useful in the management of patients whose clinical picture suggests shunt malfunction despite an apparently patent shunt as determined by manipulation of the flushing device of the system. Doppler flow detection depends on the changes in the frequency of sound waves reflected from moving acoustical interfaces. In the Doppler device the ultrasound waves are produced by electrical stimulation of a

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Shunt system patency testing by lumbar infusion

Jack Woodford, Richard L. Saunders, and Ernest Sachs Jr.

C onclusive assurance of ventricular shunt patency is critical to an assessment of the results of hydrocephalus treatment, and several methods have been reported for such evaluation. 2, 5, 6, 8 We have found the lumbar infusion technique described in this paper to be valuable, safe, and expedient to test shunt patency in patients with communicating hydrocephalus. It gives a dynamic profile of shunt function. The infusion tests were done to evaluate a series of adult patients with “normal” pressure hydrocephalus. In this paper, we review our experience with

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Determination of CSF shunt patency with a lumbar infusion test

Hart Schutz, Karel G. Ter Brugge, Ming C. Chiu, Angele Mongul, and Ferelith Taylor

C linical status and computerized tomography (CT) scanning are the most convenient methods of assessing patency of a cerebrospinal fluid (CSF) shunt. When either of these methods is not conclusive, then other means of ascertaining shunt function may be necessary. Such methods include: injection of contrast medium or radioactive substances into the flushing device; 1, 2 digital compression of the flushing device to determine response; assessment of flow by Doppler ultrasound methods; 3 temperature change determinations in a flowing CSF column; 4 and a lumbar

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A new technique for percutaneous study of lumboperitoneal shunt patency

Technical note

Yusuke Ishiwata, Toshinori Yamashita, Kaoru Ide, Gakuji Gondo, Nobumasa Kuwana, and Takeo Kuwabara

P ercutaneous lumboperitoneal (LP) shunt placement has become accepted as a useful procedure for diversion of cerebrospinal fluid (CSF). 2 The structural simplicity of an LP shunt enables the operative procedure to be simpler, easier, and safer than placement of any other type of CSF shunt. On the other hand, this structural simplicity makes it technically difficult to confirm its patency. Conventional studies of patency are especially difficult to perform in a onepiece LP shunt system. A new technique of x-ray imaging for this LP shunt system involving

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Clinical factors influencing the development of extracranial-intracranial bypass graft for steno-occlusive cerebrovascular disease

Shunsuke Nomura, Koji Yamaguchi, Tatsuya Ishikawa, Akitsugu Kawashima, Yoshikazu Okada, and Takakazu Kawamata

-language journals). 8 Furthermore, other studies have also shown the long-term effectiveness of the ECIC bypass in the prevention of ischemic stroke. 2 , 4 , 10 These studies have reported good results or good patency with the bypass surgery. Effectively retaining the patency of the ECIC bypass should be one of the most important factors in improving long-term results; however, factors influencing bypass patency have not been discussed much. Understanding those factors would directly contribute to the improvement of long-term results. We investigated bypass patency in 49

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Middle cerebral artery dissecting aneurysm with persistent patent pseudolumen

Case report

Tohru Mizutani

dissecting aneurysm with a persistent patent pseudolumen and discuss the possible mechanisms. Case Report This 60-year-old woman was hospitalized on April 16, 1991, because of abrupt speech disturbance and right hemiplegia. She had had several episodes of transient aphasic attacks during the 3 months prior to admission. Neurological examination on admission revealed total global aphasia and right hemiplegia. Diagnostic Imaging Studies Computerized tomography (CT) scanning on the following day showed a low-density area in the distribution of the left