Brain aneurysms and arteriovenous malformations: advancements and emerging treatments in endovascular embolization
UMass Chan Affiliations
Department of Radiology, Division of Neuroimaging and InterventionDocument Type
Journal ArticlePublication Date
2007-02-27Keywords
CatheterizationCerebral Arteries
Cerebral Hemorrhage
Cyanoacrylates
Embolization, Therapeutic
Humans
Intracranial Aneurysm
Intracranial Arteriovenous Malformations
Polyethylenes
Prostheses and Implants
Vascular Surgical Procedures
Life Sciences
Medicine and Health Sciences
Metadata
Show full item recordAbstract
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.Source
Stroke. 2007 Apr;38(4):1411-7. Epub 2007 Feb 22. Link to article on publisher's siteDOI
10.1161/01.STR.0000259824.10732.bbPermanent Link to this Item
http://hdl.handle.net/20.500.14038/38491PubMed ID
17322071Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1161/01.STR.0000259824.10732.bb