Download Neuroendovascular Surgery (Progress in Neurological Surgery) by Michael S. Horowitz, Elad I. Levy PDF

By Michael S. Horowitz, Elad I. Levy

Over the last many years many surgical subspecialties have moved from usually open tactics in the direction of minimally invasive techniques. With the arrival of more suitable know-how and smaller extra maneuverable units extra tender techniques were built. during this quantity, the commonest neuroendovascular strategies at the moment practiced are mentioned. themes comprise administration of intracranial aneurysms, arteriovenous malformations, tumors, intracranial and extracranial arterial stenoses, and arterial fistulas. This book offers neurosurgeons, radiologists, neurologists, and trial legal professionals with a concise reference that explains the historical past, in addition to symptoms, and methods for appearing the most typical neuroendovascular systems.

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Extra resources for Neuroendovascular Surgery (Progress in Neurological Surgery)

Sample text

Sixty-nine of these cases were performed using stents. The authors chose to conduct 136 of their procedures using distal balloon occlusion (‘protection’) to reduce the chance of distal emboli during balloon inflation and plaque manipulation. A 13% incidence of neurologic complications occurred after angioplasty without ‘protection’ while a 0% complication rate followed angioplasty with ‘protection’. Unprotected stent placement was accompanied by a 1% complication rate and a 0% complication rate when using proximal balloon occlusion.

CAS is an attractive theoretical alternative for these patients. An endovascular approach affords the opportunity to combine intra-arterial thrombolysis with CAS. In addition, antiplatelet agents [such as glycoprotein (GP) IIb–IIIa inhibitors] can be administered to patients who experience embolization of carotid artery thrombus into the intracranial circulation during the endovascular procedure; this may not be an option during CEA because of potential bleeding complications. Contralateral Carotid Occlusion Patients with recent symptoms referable to severe carotid artery stenosis and coexistent contralateral carotid artery occlusion have a high risk of ipsilateral ischemic stroke [33].

Stents may provide a means of covering an aneurysm neck to allow for coil deposition within the fundus without the fear of parent vessel occlusion or stenosis. In 1997 Higashida et al. [23] successfully placed a Palmaz-Schatz PS 1540 articulated stent (Johnson & Johnson Interventional Systems) across the neck of a ruptured fusiform basilar aneurysm and used the stent to hold coils in the aneurysm fundus and out of the basilar artery lumen. In 1998, Lanzino et al. , USA) in the management of a paraclinoidal aneurysm.

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