دورية أكاديمية
Delayed Stroke after Aneurysm Treatment with Flow Diverters in Small Cerebral Vessels: A Potentially Critical Complication Caused by Subacute Vasospasm
| العنوان: | Delayed Stroke after Aneurysm Treatment with Flow Diverters in Small Cerebral Vessels: A Potentially Critical Complication Caused by Subacute Vasospasm |
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| المؤلفون: | Schob, Stefan, Richter, Cindy, Scherlach, Cordula, Lindner, Dirk, Planitzer, Uwe, Hamerla, Gordian, Ziganshyna, Svitlana, Werdehausen, Robert, Struck, Manuel Florian, Schob, Bernd, Gaber, Khaled, Meixensberger, Jürgen, Hoffmann, Karl-Titus, Quäschling, Ulf |
| حالة النشر: | publishedVersion |
| بيانات النشر: | MDPI, 2019. |
| سنة النشر: | 2019 |
| المجموعة: | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Original Material: | urn:nbn:de:bsz:15-qucosa2-846407 |
| مصطلحات موضوعية: | flowdiversion, delayed ischemia, stroke, vasospasm, hemodynamic therapy, cerebral aneurysm, info:eu-repo/classification/ddc/610, ddc:610 |
| الوصف: | Flow diversion (FD) is a novel endovascular technique based on the profound alteration of cerebrovascular hemodynamics, which emerged as a promising minimally invasive therapy for intracranial aneurysms. However, delayed post-procedural stroke remains an unexplained concern. A consistent follow-up-regimen has not yet been defined, but is required urgently to clarify the underlying cause of delayed ischemia. In the last two years, 223 patients were treated with six different FD devices in our center. We identified subacute, FD-induced segmental vasospasm (SV) in 36 patients as a yet unknown, delayed-type reaction potentially compromising brain perfusion to a critical level. Furthermore, 86% of all patients revealed significant SV approximately four weeks after treatment. In addition, 56% had SV with 25% stenosis, and 80% had additional neointimal hyperplasia. Only 13% exhibited SV-related high-grade stenosis. One of those suffered stroke due to prolonged SV, requiring neurocritical care and repeated intra-arterial (i.a.) biochemical angioplasty for seven days to prevent territorial infarction. Five patients suffered newly manifested, transient hemicrania accompanying a compensatorily increased ipsilateral leptomeningeal perfusion. One treated vessel obliterated permanently. Hence, FD-induced SV is a frequent vascular reaction after FD treatment, potentially causing symptomatic ischemia or even stroke, approximately one month post procedure. A specifically early follow-up-strategy must be applied to identify patients at risk for ischemia, requiring intensified monitoring and potentially anti-vasospastic treatment. |
| Original Identifier: | oai:qucosa:de:qucosa:84640 |
| نوع الوثيقة: | Article |
| اللغة: | English |
| تدمد: | 2077-0383 |
| العلاقة: | 1649 |
| الإتاحة: | https://ul.qucosa.de/id/qucosa%3A84640Test https://ul.qucosa.de/api/qucosa%3A84640/attachment/ATT-0Test/ |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsndl.DRESDEN.oai.qucosa.de.qucosa.84640 |
| قاعدة البيانات: | Networked Digital Library of Theses & Dissertations |
Full Text Finder | تدمد: | 20770383 |
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