target bp prior to obliteration of aneurysm

#Target bp prior to obliteration of aneurysm series#

In situations in which the 2 investigators disagreed on aspects of the angiographic data, discrepancies were reconciled in a blinded fashion by a third investigator. Two investigators who were not involved in the procedures independently reviewed all preprocedure and postprocedure angiographic data, including aneurysm location, number of PEDs deployed, and patency of anterior circulation branch vessels (i.e., OphA, PCoA, AChA, and anterior cerebral artery ). Medical records from consecutive patients with anterior circulation aneurysms treated with the PED between 20 were reviewed retrospectively from a prospectively maintained database to obtain demographic data (including age, sex, and medical comorbidities) as well as clinical data regarding complications and outcome. The protocol for this study had the approval of the University at Buffalo institutional review board. 2, 3, 10, 14 In this study, we evaluated the rate of branch vessel patency following PED placement in aneurysms in 82 patients treated at our institution.

#Target bp prior to obliteration of aneurysm series#

Recently, authors of small patient series have sought to elucidate this widespread concern, evaluating the rates of ophthalmic artery (OphA), posterior communicating artery (PCoA), and anterior choroidal artery (AChA) integrity following PED placement. The rate and clinical consequence of branch vessel occlusion after treatment with PEDs remains poorly defined. Similarly, concern for branch vessel integrity has resulted in widespread reluctance toward PED use in the posterior circulation where small perforating arteries serve critical brainstem structures. This prompted the FDA to approve the PED for use only in the internal carotid artery (ICA) from the petrous to the superior hypophyseal segments. There are theoretical concerns that this flow stagnation may also occur in branch vessels covered by the PED, particularly in small perforating arteries, resulting in branch vessel thrombosis. Disrupted flow into the aneurysm causes flow stagnation, thrombosis, and sealing of the ostium of the aneurysm through endothelialization and neointimal proliferation across the device struts. 6, 8 Flow diverters disrupt flow into the aneurysm sac while maintaining normal blood flow through parent and branch vessels. 3–9, 12 The Pipeline Embolization Device (PED, Covidien) is a flow-diversion device made of 25% platinum tungsten and 75% cobalt chromium.

F low diversion is increasingly recognized as an important tool in the treatment of intracranial aneurysms.