100 Interesting Case Studies in Neurointervention

Description:

Neurointervention is a fast-growing subspecialty, and recent trials have demonstrated its role in ischaemic and haemorrhagic stroke. This has generated tremendous interest among interventional neuroradiology, neurology and neurosurgery communities. Nevertheless, formal teaching programmes that provide the required experience are limited, and many early career practitioners are not exposed to the crucial technical details essential to safely performing the procedure before they start practising independently. The book presents 100 characteristic case studies to illustrate the salient technical and clinical issues in decision-making and problem solving during the procedure. This book conveys the “real-world” issues and solutions that are not addressed in detail in most books. As such it is a practical teaching book with useful “tips and tricks” on how to handle specific challenging situations, and is particularly useful for fellows in neurointervention training programmes..

Table of Contents:

Part I. Aneurysms

1. Basilar Top Aneurysm with Extreme Tortuosity: Triaxial Technique

2. Aneurysm Embolization in Patient with Tortuous Aorta

3. Cerebral Aneurysm with Tortuous Access: Distal Access Catheter Placement Using Coaxial Technique

4. Interrupted Aortic Arch: Access—Direct Carotid Puncture

5. Giant Cavernous Aneurysm: Parent Vessel Occlusion After Balloon Occlusion Test

6. Dual Microcatheter Technique

7. Balloon-Assisted and Dual Microcatheter Technique (Geometry Assessment and Catheter Shaping)

8. Embolization of Internal Carotid Artery (ICA) Aneurysm Incorporating Origin of Posterior Communicating Artery

9. Aneurysm with Probable Near the Neck Rupture: Endovascular Management

10. Small Lobulated Aneurysm: Balloon-Assisted Coiling

11. Balloon-Assisted Coiling of Large Internal Carotid Artery (ICA) Bifurcation Aneurysm: Assessment of Neck

12. Aneurysm with a Branch Arising from the Sac: Balloon over Inflation Technique

13. Multilobulated Broad-Neck Aneurysm: End-Hole Technique

14. ICA Bifurcation Aneurysm: Balloon Placement Through Anterior Communicating Artery

15. Double Balloon Technique for Wide-Neck Aneurysms

16. Dissecting Aneurysm of MCA: Stent-Assisted Coiling

17. Stent-Assisted Coiling of Dissecting Aneurysm of Posterior Cerebral Artery

18. Use of Open-Cell Nitinol Stents for Aneurysms with Branch at Base (Ophthalmic and Anterior Choroidal Artery Aneurysms, etc.)

19. Microstent-Assisted Aneurysm Sac Catheterization

20. Microstent-Assisted Coiling of Dissecting Aneurysm of the Left MCA Bifurcation

21. Shelfing Technique for Stent-Assisted Coiling of Bifurcation Aneurysms

22. Y Stenting and Coil Embolisation of Broad-Based Aneurysm Using LVIS Jr. Stents

23. Balloon-Assisted Catheter Access in Large and Giant Aneurysms

24. Stent Retriever-Assisted Access

25. Quadri-axial Technique to Gain Access for Flow Diverter Deployment

26. Multiple Blister Aneurysm of ICA: Management by Pipeline Device

27. Long Flow Diverter (FD) in Partly Thrombosed Basilar Trunk Aneurysms

28. Pipeline Flex Embolization Device for Treatment of Pericallosal Artery Aneurysm

29. Feeding Artery Recurrent Aneurysm Treated with a p64 Flow Diverter

30. “Catheter Push” Technique to Open Flow Diverter

31. “Catheter Pull” Technique to Open Flow Diverter

32. “Balloon-Push” Technique to Open Flow Diverter

33. Endovascular Techniques for Achievement of Better Flow Diverter Wall Apposition: Telescopic Device Placement

34. pCONus Reconstruction for Basilar Top Aneurysm

35. Recurrent Wide-Necked Bifurcation Aneurysm: Treatment Using PulseRider® as an Adjunctive Device

36. Wide-Necked Bifurcation Aneurysm: Treatment with Woven EndoBridge (WEB) Device

37. Glue Occlusion of Dissecting Aneurysm After Induced Cardiac Asystole

38. Anterior Communicating (ACOM) Artery Aneurysm; Acute Angle Between A1 and A2: Microwire Shaping

39. Broad Neck Dysplastic Anterior Communicating Artery Aneurysm: Compartmental Packing

40. Broad Neck Basilar Top Aneurysm: Understanding the Neck

41. Aneurysm Rupture During Coiling: Key Actions

42. Aneurysm Rupture During Coiling: Use of Balloon

43. Coil Rupture During Balloon-Assisted Coiling

44. Aneurysm Rupture After Flow Diversion with a Braided Stent

45. Prolapse of Coil Loop: Balloon-Repositioning Technique

46. Coil Prolapse: Balloon-Repositioning and Coil Fixation Technique

47. Coil Prolapse: Emergency Stent Placement

48. Coil Migration During Coiling: Retrieval by Snare

49. Thrombus Formation During Coiling: Heparinization Protocol

50. Delayed Thromboembolism After Balloon-Assisted Coiling

51. Air Embolism During Coiling Procedure

52. Coil Retrieval: Stent-Assisted Retrieval Techniques

53. Wire Retrieval Method: Stent- and Snare-Based Retrieval Technique

54. Very Small (Less Than 2 mm) Aneurysm with Severe Vasospasm: Pretreatment Dilatation

55. Severe Diffuse Vasospasm: B/L Intraarterial Vasodilatation Followed by Coiling

56. Intraarterial Dilatation in Subarachnoid Haemorrhage-Induced Vasospasm

57. Continuous Intra-arterial Dilatation in Refractory/Malignant Vasospasm

58. CT Perfusion Imaging to Diagnose Vasospasm After Subarachnoid Hemorrhage

Part II. Arteriovenous Malformation

59. Cavernous Sinus Dural Arteriovenous Fistula (AVF): Trans-venous Approach Through Inferior Petrosal Sinus

60. Cavernous Dural Arteriovenous Fistula (AVF): Angio-CT-Guided Fistula Site Localization

61. Coil Embolization of Direct Carotid Cavernous Fistula (CCF)

62. Combined Trans-arterial and Balloon-Assisted Transvenous Onyx Embolization of Dural AVF

63. Dural AVF with Venous Aneurysm Causing Mass Effect: Management Strategy

64. Dural AVF Draining into an Isolated Sac: Embolization Technique

65. Dural AVF Embolization-Tortuous Access: Wire Loop Technique

66. Transvenous Onyx Embolization of the Dural AVF

67. Dural AVF with Progressive Edema and Mass Effect

68. Dural AVF Embolization Using Proximal Balloon Catheter Occlusion Technique

69. Small Cerebral AVM: Onyx Embolization

70. Cerebral Hematoma with a Micro-AVM: Intra-Arterial DynaCT Angiography-Guided Surgical Excision

71. AVM with Haematoma: Embolization and Surgery in Single Session

72. Cerebral Hematoma with AVM: Intra-Arterial DynaCT Angiography-Guided Targeted Embolization and Balloon-Assisted Catheterization

73. High-Flow Pial AVF: Safety Considerations—Detachable Tip Microcatheter and Proximal Balloon Occlusion Technique

74. Acutely Ruptured Arteriovenous Malformation (AVM) with Venous Aneurysm: En Passage Feeder—Endovascular Strategy

75. Cerebral AVM Embolization: Postoperative Bleeding Due to Draining Vein Occlusion – Part 1

76. Cerebral AVM Embolization: Postoperative Bleed Due to Draining Vein Occlusion—2

77. Vein of Galen Aneurysmal Malformation: Emergency Embolization for Cardiac Failure

78. Cerebral Proliferative Angiopathy: Differentiation from Arteriovenous Malformation (AVM)

79. Spinal Arteriovenous Fistula from Anterior Spinal Artery: Embolization Technique

80. Spinal Dural Arteriovenous Fistula (AVF)

Part III. Stroke and Carotid Disease

81. Acute Mechanical Thrombectomy Using Stent Retriever with Balloon Guide Catheter: Proximal Flow Arrest and Reversal

82. ADAPT Technique for Stroke Thrombectomy

83. Solumbra Technique

84. Aspiration Retriever Technique in Stroke (ARTS)

85. Terminal ICA Occlusion: The Utility of 6 mm × 30 mm Retrievable Stents

86. Atherosclerotic BA Occlusion: The Need to Detach the Stents

87. Anterior Cerebral Artery Branch Occlusion

88. Stroke in Evolution Due to Critical MCA Stenosis

89. Intracranial Atherosclerotic Disease (ICAD): Submaximal Angioplasty

90. Tandem Occlusions (Antegrade First Technique with Stent)

91. Intracranial Occlusion with Tandem Carotid Stenosis: Distal to Proximal Approach

92. Intracranial Occlusion with Tandem Carotid Stenosis: Retained Filter

93. Acute ICA Dissection: Stent-Assisted Recanalization

94. Extensive Stent Reconstruction for Long-Segment Symptomatic Dissections

95. Carotid Stenosis with Thrombus

96. Difficult to Cross Carotid Stenosis: Microcatheter Exchange Technique

97. Carotid Stenting with Tortuous Arch

98. Acute Thrombosis of Carotid Stent

99. Carotid Stenosis with Recurrent TIA’s: Emergency Stenting

100. Sub-occlusive Carotid Stenosis with Slow Flow in ICA with Dissection of Cervical ICA During the Procedure