| Semi-jailing technique for coil embolization of complex, wide-necked intracranial aneurysms. | |
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MedLine Citation:
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PMID: 19934972 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Stent-assisted coiling of intracranial aneurysms is performed by placing a microcatheter through a stent's interstices or jailing the microcatheter between the stent and the artery. Both approaches impede manipulation of the microcatheter during coiling. We describe a modified jailing technique that improves catheter maneuverability and report the safety and efficacy of the method for the treatment of complex, wide-necked aneurysms. METHODS: The semi-jailing technique involves the partial deployment of a retrievable stent, bridging part of the aneurysm neck while leaving space to maneuver the microcatheter. Twenty-two complex, wide-necked aneurysms, including 3 ruptured and 5 dissecting, were treated using the semi-jailing technique (15 women; mean age, 55.2 years). RESULTS: The semi-jailing technique was successfully applied in all cases. Immediate posttreatment angiograms showed total occlusion of the aneurysm in 17 cases (77%), neck remnant in 3 cases (14%), and aneurysm dome filling in 2 cases (9%). Follow-up angiography available in 10 patients at an average of 8.5 months showed progressive occlusion in 1 aneurysm and 7 remained occluded. In 2 cases of dissecting aneurysms, retreatment was required. No permanent periprocedural morbidity was encountered. One patient died of complications secondary to intracranial hemorrhage 6 days after treatment. In 2 cases (9%), thromboembolic events after final stent placement were successfully treated with intraarterial thrombolysis. No delayed stent migration was seen. CONCLUSION: Semi-jailing is a safe and effective stent-assisted coiling technique that facilitates treatment of complex, wide-necked aneurysms. |
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Authors:
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Bo Hong; Neil V Patel; Matthew J Gounis; Michael J DeLeo; Italo Linfante; Joan C Wojak; Ajay K Wakhloo |
Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Neurosurgery Volume: 65 ISSN: 1524-4040 ISO Abbreviation: Neurosurgery Publication Date: 2009 Dec |
Date Detail:
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Created Date: 2009-11-25 Completed Date: 2010-02-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: United States |
Other Details:
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Languages: eng Pagination: 1131-8; discussion 1138-9 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Changhai Hospital, 2nd Military Medical University, Shanghai, People's Republic of China. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aspirin / therapeutic use Blood Vessel Prosthesis* Cerebral Angiography / methods Embolization, Therapeutic / instrumentation*, methods* Female Humans Intracranial Aneurysm / pathology, therapy* Male Microsurgery Middle Aged Platelet Aggregation Inhibitors / therapeutic use Prosthesis Design Stents* Ticlopidine / analogs & derivatives, therapeutic use Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin; 55142-85-3/Ticlopidine; 90055-48-4/clopidogrel |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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