The effectiveness of Penumbra 400 micro-coils in the embolization of large cerebral aneurysms

Background: The objective of this work is to analyze the effectiveness of Penumbra 400 micro -coils in the embolization of large cerebral aneurysms. Material and methods: A retrospective analysis has been conducted in a group of 32 patients at the average age of 54.5 years (30-84) for whose embolization the P400 micro-coils (P400) have been used. A control group consisted of 44 patients at the average age of 52.7 years (24–82) in whose aneurysm embolization the 18 micro-coils (MC) have been utilized. Results: The respective percentages of micro-coil packing density in aneurysm sacs were 31.5% for P400 and 29% for MC. The average P400 fluoroscopy time was 21 min, and 34 min in case of MC. The average number of used micro-coils was 3.9 for P400 and 5.6 for MC. The radiation dose received by a patient was 1.7 Gy/2.2 Gy, respectively. The recanalization of P400 has occurred in 14/31 cases (45%), and for MC it has occurred in 23/44 (52%) patients. One patient died due to early recanalization after P400 aneurysm embolization. Conclusion: Procedures with use of the P400 demonstrate minimally higher effectiveness of large aneurysms embolization in comparison with the MS with a not much shorter duration and reduction of a radiation dose that a patient receives

The effectiveness of Penumbra 400 micro-coils in the embolization of large cerebral aneurysms

Background The objective of this work is to analyze the effectiveness of Penumbra 400 micro-coils in the embolization of large cerebral aneurysms. Material and methods A retrospective analysis has been conducted in a group of 32 patients at the average age of 54.5 years (30–84) for whose embolization the P400 micro-coils (P400) have been used. A control group consisted of 44 patients at the average age of 52.7 years (24–82) in whose aneurysm embolization the 18 micro-coils (MC) have been utilized. Results The respective percentages of micro-coil packing density in aneurysm sacs were 31.5% for P400 and 29% for MC. The average P400 fluoroscopy time was 21min, and 34min in case of MC. The average number of used micro-coils was 3.9 for P400 and 5.6 for MC. The radiation dose received by a patient was 1.7Gy/2.2Gy, respectively. The recanalization of P400 has occurred in 14/31 cases (45%), and for MC it has occurred in 23/44 (52%) patients. One patient died due to early recanalization after P400 aneurysm embolization. Conclusion Procedures with use of the P400 demonstrate minimally higher effectiveness of large aneurysms embolization in comparison with the MS with a not much shorter duration and reduction of a radiation dose that a patient receives

Endovascular treatment of middle cerebral artery aneurysms : single-centre results

Purpose: The middle cerebral artery (MCA) is the second most common location of intracerebral aneurysms. Traditionally, they are treated by microsurgical clipping, but with the development of new techniques and devices endovascular embolisation is gaining more importance. The aim of this study was to summarise six years of experience of our department in endovascular treatment of MCA aneurysms. Material and methods: Forty patients with 41 MCA aneurysms treated in a single centre were included in this study. Data on patients' comorbidities, aneurysm morphology, and treatment course were collected, with special emphasis on complications. Results: There were no statistically significant differences in terms of aneurysm morphology between males and females and between ruptured and unruptured aneurysms. None of the diseases analysed in the current study were linked with significantly increased risk of SAH. Unruptured aneurysms were significantly more frequently treated by stent-assisted coiling (30.4% vs. 5.6%, p = 0.0388) than were ruptured aneurysms, while ruptured aneurysms were treated more frequently by coiling alone (77.8% vs. 34.8%, p = 0.0062). After an initial course of treatment 63.4% (n = 26) of patients had class I in Raymond-Roy occlusion classification, 22% (n = 9) had class II, and 14.6% (n = 6) had class III. Complications of the procedure were observed in 17.5% (n = 7) of patients: 22.2% (n = 4) with ruptured and 13.6% (n = 3) with unruptured aneurysms. Conclusions: Endovascular treatment of MCA aneurysms is feasible, and our results are convergent with other studies. Ruptured MCA aneurysms may be treated endovascularly with similar effects as unruptured MCA aneurysms. The complication rate of such treatment is low

Mechanical thrombectomy in acute stroke – Five years of experience in Poland

Objectives Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. Methods and results We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. Results Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250±99min. 90.3% of the studied patients had MT within 6h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% – emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization – in 30.7%, mRS of 0–2 – in 31.4% and mRS of 6 in 22% of cases. Conclusion Our results can help harmonize standards for MT in Poland according to international guidelines