Transcervical access via direct neck exposure for neurointerventional procedures in the hybrid angiosuite
| العنوان: | Transcervical access via direct neck exposure for neurointerventional procedures in the hybrid angiosuite |
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| المؤلفون: | Seoung Woo Park, Jong-Hwa Park, Jong Young Lee, Hong Jun Jeon, Byung Moon Cho, Dae Young Yoon |
| المصدر: | Neuroradiology. 60:565-573 |
| بيانات النشر: | Springer Science and Business Media LLC, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, medicine.medical_treatment, Punctures, 030204 cardiovascular system & hematology, Balloon, Neurosurgical Procedures, Catheterization, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, medicine.artery, Occlusion, medicine, Humans, Radiology, Nuclear Medicine and imaging, Carotid-cavernous fistula, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Endovascular Procedures, Stent, Neck dissection, medicine.disease, Embolization, Therapeutic, Surgery, Cerebrovascular Disorders, Catheter, Stenosis, Treatment Outcome, Female, Stents, Neurology (clinical), Internal carotid artery, Cardiology and Cardiovascular Medicine, business, Neck, 030217 neurology & neurosurgery |
| الوصف: | A complicated course of the femoral route for neurointervention can prevent approaching the target. Thus, we determined whether transcervical access in the hybrid angiosuite is applicable and beneficial in real practice. From January 2014 to March 2017, this approach was used in 17 of 453 (3.75%) cases: 11 cerebral aneurysms (4 ruptured, 7 unruptured), 4 acute occlusions of the large cerebral artery, 1 proximal internal carotid artery (ICA) stenosis, and 1 direct carotid cavernous fistula (CCF). All patients were elderly (mean age, 78.1 years). The main cause was severe tortuosity of the supra-aortic course or the supra-aortic and infra-aortic courses (eight and five cases, respectively), orifice disturbance (three cases), and femoral occlusion (one case). Through neck dissection, 6–8Fr guiding catheters were placed via subcutaneous tunneling to enhance device stability and support. All cerebral aneurysms were embolized (eight complete and three neck remnants) using the combination of several additional devices. Mechanical stent retrieval with an 8Fr balloon guiding catheter was successfully achieved in a few runs (mean, 2 times; range, 1–3) within the proper time window (mean skin to puncture, 17 ± 4 min; puncture to recanalization, 25 ± 4 min). Each stent was satisfactorily deployed in the proximal ICA and direct CCF without catheter kick-back. All puncture sites were closed through direct suturing without complications. In the hybrid angiosuite, transcervical access via direct neck exposure is feasible in terms of device profile and support when the femoral route has an unfavorable anatomy. |
| تدمد: | 1432-1920 0028-3940 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0573b9f0c8f9f9caae27b89ab869d4aaTest https://doi.org/10.1007/s00234-018-1994-4Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....0573b9f0c8f9f9caae27b89ab869d4aa |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14321920 00283940 |
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