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  • 1
    Online Resource
    Online Resource
    Risk factors for coil protrusion into the parent artery and associated thrombo-embolic events following unruptured cerebral aneurysm embolization
    SAGE Publications ; 2015
    In:  Interventional Neuroradiology Vol. 21, No. 2 ( 2015-04), p. 178-183
    Details
    In: Interventional Neuroradiology, SAGE Publications, Vol. 21, No. 2 ( 2015-04), p. 178-183
    Abstract: Advances in vascular reconstruction devices and coil technologies have made coil embolization a popular and effective strategy for treatment of relatively wide-neck cerebral aneurysms. However, coil protrusion occurs occasionally, and little is known about the frequency, the risk factors and the risk of thrombo-embolic complications. Method We assessed the frequency and the risk factors for coil protrusion in 330 unruptured aneurysm embolization cases, and examined the occurrence of cerebral infarction by diffusion-weighted magnetic resonance imaging (DW-MRI). Result Forty-four instances of coil protrusion were encountered during coil embolization (13.3% of cases), but incidence was reduced to 33 (10% of cases) by balloon press or insertion of the next coil. Coil protrusion occurred more frequently during the last phase of the procedure, and both a wide neck (large fundus to neck ratio) (OR = 1.84, P = 0.03) and an inadequately stable neck frame (OR = 5.49, P = 0.0007) increased protrusion risk. Coil protrusions did not increase the incidence of high-intensity lesions (infarcts) on DW-MRI (33.3% vs 29% of cases with no coil protrusion). However, longer operation time did increase infarct risk ( P = 0.0003). Thus, tail or loop type coil protrusion did not increase the risk of thrombo-embolic complications, if adequate blood flow was maintained. Conclusion Coil protrusion tended to occur more frequently in cases of wide-neck aneurysms with loose neck framing. Moderate and less coil protrusion carries no additional thrombo-embolic risk, if blood flow is maintained, which can be aided by additional post-operative antiplatelet therapy.
    Type of Medium: Online Resource
    ISSN: 1591-0199 , 2385-2011
    URL: Article
    DOI: 10.1177/1591019915582375
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
    detail.hit.zdb_id: 2571161-1
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  • 2
    Online Resource
    Online Resource
    The safety and efficacy of preoperative embolization of meningioma with N-butyl cyanoacrylate
    SAGE Publications ; 2015
    In:  Interventional Neuroradiology Vol. 21, No. 5 ( 2015-10), p. 624-630
    Details
    In: Interventional Neuroradiology, SAGE Publications, Vol. 21, No. 5 ( 2015-10), p. 624-630
    Abstract: Preoperative embolization of meningioma is commonly performed; however, there is no consensus on the best embolic material to reduce intraoperative blood loss and surgery time. Method We retrospectively assessed the safety and efficacy of 56 cases of preoperative embolization of the middle meningeal artery with N-butyl cyanoacrylate (NBCA) in 105 cases of surgery for meningioma. We also defined a blood loss to tumor volume ratio to compensate for bias caused by tumor volume, and analyzed limited cases (the embolized group n = 52, the non-embolized group n = 21) of the convexity, the parasagittal region, the falx, and the sphenoidal ridge. Result The blood loss to tumor volume ratio was significantly less in the embolized group ( p  〈  0.007). Preoperative embolization could be useful for cases with the external carotid artery as the dominant feeder vessel ( p  〈  0.02); however, the efficacy decreased for cases with an internal carotid artery feeder. Transient complications occurred in four cases (hemiparesis secondary to edema: two cases; intratumoral bleeding: one case; trigeminal nerve disorder: one case). The cases that showed a postoperative increase in edema or intratumoral bleeding were large tumors with the early filling of veins. For such cases, surgeons should pay close attention to slow injection speed and higher NBCA viscosity, not to cause the occlusion of draining vessels. Conclusion Tumor embolization with NBCA can be safely performed, and the procedure significantly reduces intraoperative blood loss.
    Type of Medium: Online Resource
    ISSN: 1591-0199 , 2385-2011
    URL: Article
    DOI: 10.1177/1591019915590537
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
    detail.hit.zdb_id: 2571161-1
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  • 3
    Online Resource
    Online Resource
    Double Origin of the Posterior Inferior Cerebellar Artery Diagnosed by MR Angiography : A Report of Two Cases
    SAGE Publications ; 2015
    In:  The Neuroradiology Journal Vol. 28, No. 2 ( 2015-04), p. 187-189
    Details
    In: The Neuroradiology Journal, SAGE Publications, Vol. 28, No. 2 ( 2015-04), p. 187-189
    Abstract: The posterior inferior cerebellar artery (PICA) frequently arises from the fenestrated segment of the intracranial vertebral artery (VA), and this common variation can be misinterpreted as or confused with a PICA of double origin. Rarely, a PICA of true double origin occurs when two branches of the PICA arise separately from the intracranial VA and fuse to form an arterial ring. We discovered this rare variation incidentally while interpreting images of magnetic resonance (MR) angiography. This is the first report of MR angiographic findings of this rare variation.
    Type of Medium: Online Resource
    ISSN: 1971-4009 , 2385-1996
    URL: Article
    DOI: 10.1177/1971400915576659
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
    detail.hit.zdb_id: 2622347-8
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  • 4
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    Online Resource
    An Experience of Stereotactic Radiation Therapy for Primary Intracranial Choriocarcinoma
    SAGE Publications ; 2001
    In:  Tumori Journal Vol. 87, No. 3 ( 2001-05), p. 162-165
    Details
    In: Tumori Journal, SAGE Publications, Vol. 87, No. 3 ( 2001-05), p. 162-165
    Abstract: We report on a patient with choriocarcinoma in the pineal region who was successfully treated with stereotactic radiation therapy (SRT). The increased level of serum human chorionic gonadotropin (HCG) was lowered during chemotherapy with etoposide, cisplatin, and ifosfamide. However, HCG was not normalized and magnetic resonance images still showed an enhanced tumor mass with gadolinium. The patient underwent SRT of 40 Gy at an 80% isodose line per 10 fractions over'two weeks, followed by conventional craniospinal irradiation of 32.4 Gy. The level of HCG dropped below the detection limit. The patient has been in good condition for more than four years after the completion of treatment, without any signs of recurrence. We propose SRT as a valid treatment option for malignant germ cell tumors in the pineal region.
    Type of Medium: Online Resource
    ISSN: 0300-8916 , 2038-2529
    URL: Article
    DOI: 10.1177/030089160108700310
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2001
    detail.hit.zdb_id: 280962-X
    detail.hit.zdb_id: 2267832-3
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  • 5
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    Online Resource
    A comparison of estimation methods for computational fluid dynamics outflow boundary conditions using patient-specific carotid artery
    SAGE Publications ; 2013
    In:  Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine Vol. 227, No. 6 ( 2013-06), p. 663-671
    Details
    In: Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, SAGE Publications, Vol. 227, No. 6 ( 2013-06), p. 663-671
    Abstract: Computational fluid dynamics simulations can provide important hemodynamic insights for investigating the effectiveness of carotid artery stenting, but its accuracy is dependent on the boundary conditions such as the outflow pressure, which is difficult to obtain by measurements. Many computational fluid dynamics simulations assume that the outflow pressure is constant ( P = 0), but this method is likely to produce different results compared to clinical measurements. We have developed an alternative estimation method called the minimum energy loss method based on the concept of energy loss minimization at flow bifurcation. This new method has been tested on computational fluid dynamics simulation of two patients treated with carotid artery stenting, and its flow ratio at internal carotid artery and wall shear stress distribution was compared with the constant zero outlet pressure method. Three different procedure stages (prestent, poststent, and follow-up) were analyzed. The internal carotid artery flow ratio using the minimum energy loss method generally matched well with ultrasound measurements, but the internal carotid artery flow ratio based on zero outlet pressure method showed a large difference. Wall shear stress distributions varied between methods in response to the change in internal carotid artery flow rate. This study demonstrates the importance of accurate outlet boundary condition for assessing the long-term efficacy of carotid artery stenting and the risk of restenosis in treated patients.
    Type of Medium: Online Resource
    ISSN: 0954-4119 , 2041-3033
    URL: Article
    DOI: 10.1177/0954411913479540
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
    detail.hit.zdb_id: 2032763-8
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  • 6
    Online Resource
    Online Resource
    Cerebral Arterial Variations Associated with Moyamoya Disease Diagnosed by MR Angiography
    SAGE Publications ; 2014
    In:  The Neuroradiology Journal Vol. 27, No. 6 ( 2014-12), p. 697-701
    Details
    In: The Neuroradiology Journal, SAGE Publications, Vol. 27, No. 6 ( 2014-12), p. 697-701
    Abstract: Moyamoya disease is a rare progressive cerebrovascular steno-occlusive disease associated with different variations of the cerebral arteries. We evaluated the types and prevalence of such variations among patients with moyamoya disease. In our institution during the past seven years, we diagnosed 72 patients (24 male, 48 female; aged 6 to 75 years, mean, 42 years) with moyamoya disease by magnetic resonance (MR) angiography using either a 3-Tesla or one of two 1.5-T imagers and a standard time-of-flight technique without contrast media. An experienced neuroradiologist retrospectively reviewed the images. There were 15 cerebral arterial variations in 13 of 72 patients with moyamoya disease (18.1%), including four basilar artery fenestrations, three ophthalmic arteries arising from the middle meningeal artery, two intracranial vertebral artery fenestrations, two persistent first cervical intersegmental arteries, two persistent trigeminal arteries, one extracranial origin of the posterior inferior cerebellar artery, and one persistent stapedial artery. Although our number of patients was small, moyamoya disease was frequently associated with variations of the cerebral arteries, especially fenestrations in the vertebrobasilar system and persistent trigeminal artery.
    Type of Medium: Online Resource
    ISSN: 1971-4009 , 2385-1996
    URL: Article
    DOI: 10.15274/NRJ-2014-10093
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2014
    detail.hit.zdb_id: 2622347-8
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  • 7
    Online Resource
    Online Resource
    A patient with pulmonary arteriovenous fistulas (P-AVFs) in whom migraine disappeared after transcatheter coil embolization for the secondary prevention of paradoxical infarction. A case report
    SAGE Publications ; 2017
    In:  Cephalalgia Vol. 37, No. 3 ( 2017-03), p. 294-295
    Details
    In: Cephalalgia, SAGE Publications, Vol. 37, No. 3 ( 2017-03), p. 294-295
    Type of Medium: Online Resource
    ISSN: 0333-1024 , 1468-2982
    URL: Article
    DOI: 10.1177/0333102416644434
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
    detail.hit.zdb_id: 2019999-5
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