UMMS Affiliation

Department of Radiology, Division of Neuroimaging and Intervention

Publication Date

2-27-2007

Document Type

Article

Subjects

Catheterization; Cerebral Arteries; Cerebral Hemorrhage; Cyanoacrylates; Embolization, Therapeutic; Humans; Intracranial Aneurysm; Intracranial Arteriovenous Malformations; Polyethylenes; Prostheses and Implants; Vascular Surgical Procedures

Disciplines

Life Sciences | Medicine and Health Sciences

Abstract

BACKGROUND AND PURPOSE: Brain aneurysms and vascular malformations can cause cerebral hemorrhages, with devastating consequences for the patients and their families. Since the development of microcatheters and materials used for endovascular embolization, we have witnessed a rapid advancement in the technology and in the number or patients treated with this approach. The aim of this review is to survey recent data relevant to new technologies and emerging treatment strategies in these areas. SUMMARY OF REVIEW: Clinical trials assessing the safety and efficacy of coil embolization for cerebral aneurysms were based on the use of bare platinum, helical coils. Since then, endovascular operators have been testing and using new materials such as bioactive coils, expandable coils, and complex-shaped coils. Based on the data so far obtained, third and fourth generation coil designs are rapidly emerging and will be ready for clinical application in the near future. Balloon- and stent-assisted coil embolization is enabling the treatment of complex, large-neck aneurysms and the vascular reconstruction of lesions previously considered not treatable. New open- and closed-cell designs allow the navigation and deployment of stents in extremely tortuous vessels. With regards to the embolization of vascular malformations, it is possible to safely navigate microcatheters and microwires through very small arteries previously considered not accessible. In addition, embolization materials such as n-butyl cyanoacrylate and ethylene-vinyl alcohol copolymer are now routinely injected to safely reduce or obliterate large and complex arteriovenous malformations and fistulae. CONCLUSIONS: Advancements in technology are rapidly improving the endovascular approach to the treatment of cerebral aneurysms and arteriovenous malformations.

Rights and Permissions

Citation: Stroke. 2007 Apr;38(4):1411-7. Epub 2007 Feb 22. Link to article on publisher's site

DOI of Published Version

10.1161/01.STR.0000259824.10732.bb

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Stroke; a journal of cerebral circulation

PubMed ID

17322071

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.