The Experts below are selected from a list of 7887 Experts worldwide ranked by ideXlab platform

Michael T. Lawton - One of the best experts on this subject based on the ideXlab platform.

  • Anterior Cerebral Artery bypass for complex aneurysms an experience with intracranial intracranial reconstruction and review of bypass options
    Journal of Neurosurgery, 2014
    Co-Authors: Adib A Abla, Michael T. Lawton
    Abstract:

    Object The authors describe their experience with intracranial-to-intracranial (IC-IC) bypasses for complex Anterior Cerebral Artery (ACA) aneurysms with giant size, dolichoectatic morphology, or intraluminal thrombus; they determine how others have addressed the limitations of ACA bypass; and they discuss clinical indications and microsurgical technique. Methods A consecutive, single-surgeon experience with ACA aneurysms and bypasses over a 16-year period was retrospectively reviewed. Bypasses for ACA aneurysms reported in the literature were also reviewed. Results Ten patients had aneurysms that were treated with ACA bypass as part of their surgical intervention. Four patients presented with subarachnoid hemorrhage and 3 patients with mass effect symptoms from giant aneurysms; 1 patient with bacterial endocarditis had a mycotic aneurysm, and 1 patient's meningioma resection was complicated by an iatrogenic pseudoaneurysm. One patient had his aneurysm discovered incidentally. There were 2 precommunicatin...

  • the azygos Anterior Cerebral Artery bypass double reimplantation technique for giant Anterior communicating Artery aneurysms
    Journal of Neurosurgery, 2011
    Co-Authors: Zaman Mirzadeh, Nader Sanai, Michael T. Lawton
    Abstract:

    The authors introduce the azygos Anterior Cerebral Artery (ACA) bypass as an option for revascularizing distal ACA territories, as part of a strategy to trap giant Anterior communicating Artery (ACoA) aneurysms. In this procedure, the aneurysm is exposed with an orbitozygomatic-pterional craniotomy and distal ACA vessels are exposed with a bifrontal craniotomy. The uninvolved contralateral A2 segment of the ACA serves as a donor vessel for a short radial Artery graft. The contralateral pericallosal Artery (PcaA) and the callosomarginal Artery (CmaA) are connected to the graft in the interhemispheric fissure using the double reimplantation technique. Three anastomoses create an azygos system supplying the entire ACA territory, enabling the surgeon to trap the aneurysm incompletely. Retrograde flow from the CmaA supplies the ipsilateral recurrent Artery of Heubner, and the aneurysm lumen thromboses. The azygos bypass was successfully performed to treat a 47-year-old woman with a giant, thrombotic ACoA aneur...

  • the azygos Anterior Cerebral Artery bypass double reimplantation technique for giant Anterior communicating Artery aneurysms
    Journal of Neurosurgery, 2011
    Co-Authors: Zaman Mirzadeh, Nader Sanai, Michael T. Lawton
    Abstract:

    The authors introduce the azygos Anterior Cerebral Artery (ACA) bypass as an option for revascularizing distal ACA territories, as part of a strategy to trap giant Anterior communicating Artery (ACoA) aneurysms. In this procedure, the aneurysm is exposed with an orbitozygomatic-pterional craniotomy and distal ACA vessels are exposed with a bifrontal craniotomy. The uninvolved contralateral A(2) segment of the ACA serves as a donor vessel for a short radial Artery graft. The contralateral pericallosal Artery (PcaA) and the callosomarginal Artery (CmaA) are connected to the graft in the interhemispheric fissure using the double reimplantation technique. Three anastomoses create an azygos system supplying the entire ACA territory, enabling the surgeon to trap the aneurysm incompletely. Retrograde flow from the CmaA supplies the ipsilateral recurrent Artery of Heubner, and the aneurysm lumen thromboses. The azygos bypass was successfully performed to treat a 47-year-old woman with a giant, thrombotic ACoA aneurysm supplied by the A(1) segment of the left ACA, with left PcaA and CmaA originating from the aneurysm base. The authors conclude that the azygos ACA bypass is a novel option for revascularizing PcaA and CmaA, as part of the overall treatment of giant ACoA aneurysms.

Zaman Mirzadeh - One of the best experts on this subject based on the ideXlab platform.

  • the azygos Anterior Cerebral Artery bypass double reimplantation technique for giant Anterior communicating Artery aneurysms
    Journal of Neurosurgery, 2011
    Co-Authors: Zaman Mirzadeh, Nader Sanai, Michael T. Lawton
    Abstract:

    The authors introduce the azygos Anterior Cerebral Artery (ACA) bypass as an option for revascularizing distal ACA territories, as part of a strategy to trap giant Anterior communicating Artery (ACoA) aneurysms. In this procedure, the aneurysm is exposed with an orbitozygomatic-pterional craniotomy and distal ACA vessels are exposed with a bifrontal craniotomy. The uninvolved contralateral A2 segment of the ACA serves as a donor vessel for a short radial Artery graft. The contralateral pericallosal Artery (PcaA) and the callosomarginal Artery (CmaA) are connected to the graft in the interhemispheric fissure using the double reimplantation technique. Three anastomoses create an azygos system supplying the entire ACA territory, enabling the surgeon to trap the aneurysm incompletely. Retrograde flow from the CmaA supplies the ipsilateral recurrent Artery of Heubner, and the aneurysm lumen thromboses. The azygos bypass was successfully performed to treat a 47-year-old woman with a giant, thrombotic ACoA aneur...

  • the azygos Anterior Cerebral Artery bypass double reimplantation technique for giant Anterior communicating Artery aneurysms
    Journal of Neurosurgery, 2011
    Co-Authors: Zaman Mirzadeh, Nader Sanai, Michael T. Lawton
    Abstract:

    The authors introduce the azygos Anterior Cerebral Artery (ACA) bypass as an option for revascularizing distal ACA territories, as part of a strategy to trap giant Anterior communicating Artery (ACoA) aneurysms. In this procedure, the aneurysm is exposed with an orbitozygomatic-pterional craniotomy and distal ACA vessels are exposed with a bifrontal craniotomy. The uninvolved contralateral A(2) segment of the ACA serves as a donor vessel for a short radial Artery graft. The contralateral pericallosal Artery (PcaA) and the callosomarginal Artery (CmaA) are connected to the graft in the interhemispheric fissure using the double reimplantation technique. Three anastomoses create an azygos system supplying the entire ACA territory, enabling the surgeon to trap the aneurysm incompletely. Retrograde flow from the CmaA supplies the ipsilateral recurrent Artery of Heubner, and the aneurysm lumen thromboses. The azygos bypass was successfully performed to treat a 47-year-old woman with a giant, thrombotic ACoA aneurysm supplied by the A(1) segment of the left ACA, with left PcaA and CmaA originating from the aneurysm base. The authors conclude that the azygos ACA bypass is a novel option for revascularizing PcaA and CmaA, as part of the overall treatment of giant ACoA aneurysms.

Akira Uchino - One of the best experts on this subject based on the ideXlab platform.

  • bilateral carotid Anterior Cerebral Artery anastomoses associated with bilateral ophthalmic arteries arising from the anastomotic arteries diagnosed by magnetic resonance angiography a case report
    Surgical and Radiologic Anatomy, 2017
    Co-Authors: Akira Uchino, Naoko Saito, Norio Tanahashi
    Abstract:

    Anastomosis between the ophthalmic segment of the internal carotid Artery and the A1-A2 junction of the Anterior Cerebral Artery (ACA), described as carotid-ACA anastomosis or infraoptic course of the ACA, is rare and known to demonstrate right-sided predominance. We report a case of bilateral carotid-ACA anastomoses associated with bilateral ophthalmic arteries arising from the sphenoidal branch of the middle meningeal Artery that were diagnosed by magnetic resonance (MR) angiography. Identification of rare arterial variations on MR angiography requires careful scrutiny of source images.

  • carotid Anterior Cerebral Artery anastomosis on mr angiography a university hospital based study
    Neuroradiology, 2012
    Co-Authors: Akira Uchino, Naoko Saito, Yoshitaka Okada, Kaiji Inoue
    Abstract:

    Rarely in the Anterior circulation, an anastomosis of the carotid and Anterior Cerebral arteries occurs when an anomalous branch arises from the ophthalmic segment of the internal carotid Artery and anastomoses with the A1–A2 junction of the Anterior communicating Artery. Right-side predominance is known. To our knowledge, the incidence of carotid–Anterior Cerebral Artery anastomosis has not been reported, so we researched cases in our institution records to determine incidence and investigated characteristic features of the condition on magnetic resonance (MR) angiography. To isolate such cases, we retrospectively reviewed cranial MR angiographic images of 3,491 consecutive patients in our institution. We found three cases with carotid–Anterior Cerebral Artery anastomosis (two men, one woman), representing an incidence of 0.086%. The anastomosis was on the right in all three cases. A normal A1 segment of the Anterior Cerebral Artery (ACA) was present in two cases but could not be identified in the remaining case on MR angiographic images that included source images. Two of the three patients demonstrated associated arterial variations in their carotid systems. On MR angiography, we observed a 0.086% incidence of carotid–Anterior Cerebral Artery anastomosis in our institution and reaffirmed the right-side predominance of this anomaly. We found a high frequency of other associated arterial variations in the carotid system.

  • Anterior Cerebral Artery variations detected by mr angiography
    Neuroradiology, 2006
    Co-Authors: Akira Uchino, Keita Nomiyama, Yukinori Takase, Sho Kudo
    Abstract:

    Introduction From anatomical and angiographic studies, it is well known that there are several variations of the Anterior Cerebral Artery (ACA). However, ACA variations have rarely been studied by magnetic resonance (MR) angiography. The purpose of this study was to investigate not only the type, location, configuration, and incidence of ACA variations, but also coexisting arterial pathology such as aneurysms detected by cranial MR angiography.

  • Anterior Cerebral Artery variations detected by mr angiography
    Neuroradiology, 2006
    Co-Authors: Akira Uchino, Keita Nomiyama, Yukinori Takase, Sho Kudo
    Abstract:

    From anatomical and angiographic studies, it is well known that there are several variations of the Anterior Cerebral Artery (ACA). However, ACA variations have rarely been studied by magnetic resonance (MR) angiography. The purpose of this study was to investigate not only the type, location, configuration, and incidence of ACA variations, but also coexisting arterial pathology such as aneurysms detected by cranial MR angiography. We retrospectively reviewed cranial MR angiography images of 891 patients at our institution. All images were obtained with one of two 1.5-T scanners using the three-dimensional time-of-flight technique. Maximum intensity projection (MIP) images in the horizontal rotation view were displayed stereoscopically. We reviewed these horizontal MIP images, inferosuperior MIP images, and source images, and identified variations of the ACA. We found 50 instances (5.6%) of unilateral A1 segment aplasia, 27 (3.0%) of three A2 segments, 18 (2.0%) of an unpaired A2 segment, and 11 (1.2%) fenestrations of the A1 and/or A2 segment. Seven Anterior communicating Artery (ACoA) aneurysms and one ACA territory embolic infarction were found among the 50 patients with unilateral A1 segment aplasia. One ACoA aneurysm and one pericallosal infarction were found in the 27 patients with three A2 segments. Two distal ACA aneurysms were detected among the 18 patients with an unpaired A2 segment. No associated aneurysm was seen at the fenestrations. Although the clinical significance of ACA variations is usually minor, an associated aneurysm is found relatively frequently. Thus, recognizing ACA variations during the interpretation of cranial MR angiograms is important.

  • bilateral Anterior Cerebral Artery territory infarction associated with unilateral hypoplasia of the a1 segment report of two cases
    Radiation Medicine, 2004
    Co-Authors: Ken Yamaguchi, Akira Uchino, Yukinori Takase, Akihiro Sawada, Yasuo Kuroda, Shou Kudo
    Abstract:

    We report two cases of bilateral Anterior Cerebral Artery (ACA) territory infarction. On magnetic resonance (MR) angiograms, the A1 segment of the ACA was unilaterally hypoplastic in both cases, suggesting that unilateral hypoplasia of A1 is a significant predisposing factor for this rare type of Cerebral infarction. When the contralateral A1 is dominant, embolic materials may enter into it more easily.

Nader Sanai - One of the best experts on this subject based on the ideXlab platform.

  • the azygos Anterior Cerebral Artery bypass double reimplantation technique for giant Anterior communicating Artery aneurysms
    Journal of Neurosurgery, 2011
    Co-Authors: Zaman Mirzadeh, Nader Sanai, Michael T. Lawton
    Abstract:

    The authors introduce the azygos Anterior Cerebral Artery (ACA) bypass as an option for revascularizing distal ACA territories, as part of a strategy to trap giant Anterior communicating Artery (ACoA) aneurysms. In this procedure, the aneurysm is exposed with an orbitozygomatic-pterional craniotomy and distal ACA vessels are exposed with a bifrontal craniotomy. The uninvolved contralateral A2 segment of the ACA serves as a donor vessel for a short radial Artery graft. The contralateral pericallosal Artery (PcaA) and the callosomarginal Artery (CmaA) are connected to the graft in the interhemispheric fissure using the double reimplantation technique. Three anastomoses create an azygos system supplying the entire ACA territory, enabling the surgeon to trap the aneurysm incompletely. Retrograde flow from the CmaA supplies the ipsilateral recurrent Artery of Heubner, and the aneurysm lumen thromboses. The azygos bypass was successfully performed to treat a 47-year-old woman with a giant, thrombotic ACoA aneur...

  • the azygos Anterior Cerebral Artery bypass double reimplantation technique for giant Anterior communicating Artery aneurysms
    Journal of Neurosurgery, 2011
    Co-Authors: Zaman Mirzadeh, Nader Sanai, Michael T. Lawton
    Abstract:

    The authors introduce the azygos Anterior Cerebral Artery (ACA) bypass as an option for revascularizing distal ACA territories, as part of a strategy to trap giant Anterior communicating Artery (ACoA) aneurysms. In this procedure, the aneurysm is exposed with an orbitozygomatic-pterional craniotomy and distal ACA vessels are exposed with a bifrontal craniotomy. The uninvolved contralateral A(2) segment of the ACA serves as a donor vessel for a short radial Artery graft. The contralateral pericallosal Artery (PcaA) and the callosomarginal Artery (CmaA) are connected to the graft in the interhemispheric fissure using the double reimplantation technique. Three anastomoses create an azygos system supplying the entire ACA territory, enabling the surgeon to trap the aneurysm incompletely. Retrograde flow from the CmaA supplies the ipsilateral recurrent Artery of Heubner, and the aneurysm lumen thromboses. The azygos bypass was successfully performed to treat a 47-year-old woman with a giant, thrombotic ACoA aneurysm supplied by the A(1) segment of the left ACA, with left PcaA and CmaA originating from the aneurysm base. The authors conclude that the azygos ACA bypass is a novel option for revascularizing PcaA and CmaA, as part of the overall treatment of giant ACoA aneurysms.

Giuseppe Lanzino - One of the best experts on this subject based on the ideXlab platform.

  • endovascular management of distal Anterior Cerebral Artery aneurysms a multicenter retrospective review
    World Neurosurgery, 2021
    Co-Authors: Guilherme B F Porto, Giuseppe Lanzino, Sami Al Kasab, Mithun G Sattur, Eyad Almallouhi, Orgest Lajthia, Michael A Casey, Robert M Starke, Christopher S Ogilvy, Ajith J Thomas
    Abstract:

    Introduction Distal Anterior Cerebral Artery aneurysms (DACAA) are a rare and difficult entity to manage. Endovascular treatment has evolved for safe and durable treatment of these lesions. The objective of this study is to report the safety, efficacy, and outcomes of endovascular treatment of DACAA. Methods A retrospective review of DACAA endovascularly treated at 5 different institutions was performed. Data included demographics, rupture status, radiographic features, endovascular technique, complication rates, and long-term angiographic and clinical outcomes. A primary endpoint was a good clinical outcome (modified Rankin scale 0–2). Secondary endpoints included complications and radiographic occlusion at follow-up. Results A total of 84 patients were reviewed. The mean age was 56, and 64 (71.4%) were female. Fifty-two (61.9%) aneurysms were ruptured. A good functional outcome was achieved in 59 patients (85.5%). Sixty (71.4%) aneurysms were treated with primary coiling, and the remaining 24 were treated with flow diversion. Adequate occlusion was achieved in 41 (95.3%) aneurysms treated with coiling, and 17 (89.5%) with flow diversion. There were total 11 (13%) complications. In the flow diversion category, there were 2, both related to femoral access. In the coiling category, there were 9: 5 thromboembolic, 3 ruptures, and 1 related to femoral access. Conclusion Endovascular treatment, and in particular, flow diversion for DACAA, is safe, feasible, and associated with good long-term angiographic and clinical outcomes.

  • progressive pure arterial malformations of the Anterior Cerebral Artery
    World Neurosurgery, 2019
    Co-Authors: He Yue, Wang Ling, Chen Hanmin, Ou Yibo, Guo Dongsheng, Giuseppe Lanzino
    Abstract:

    Background Pure arterial malformations (PAMs) are rare intracranial vascular anomalies. As recently reported, PAMs have a benign natural history and can be treated conservatively. However, their etiology, natural history, and treatment have not yet been fully elucidated. Methods We present a rare case of the progression of a PAM involving the Anterior Cerebral Artery. Magnetic resonance imaging showed a mass located in the suprasellar region associated with obstructive hydrocephalus. Digital subtraction angiography showed evolution of the arterial anomaly with progression compared with the studies 3 years earlier. Surgical trapping of the parent Artery with electrophysiological monitoring was performed. Combined with previous data, the clinical features and therapeutic strategies for this unusual entity are discussed. Results The patient recovered uneventfully after surgery. Postoperative digital subtraction angiography confirmed complete obliteration of the lesion. Axial computed tomography also showed shrinkage of the aneurysm, with improvement of the hydrocephalus. Our review of the reported data showed only 4 patients with a definite or probable PAM who had undergone surgery. To the best of our knowledge, the present case represents the first report of changes in the vascular architecture of a PAM during the follow-up period. Conclusion Whether the aneurysmal component of PAMs merits invasive treatment has remained controversial. The findings from our case raises the possibility of evolution for some patients with PAMs and stresses the importance of scheduled follow-up noninvasive imaging studies to rule out progression of these nosological entities, especially PAMs with an “aneurysm-like” component.

  • endovascular treatment of distal Anterior Cerebral Artery aneurysms single center experience and a systematic review
    American Journal of Neuroradiology, 2013
    Co-Authors: Carmelo Lucio Sturiale, Waleed Brinjikji, Mohammad Hassan Murad, Harry J Cloft, David F Kallmes, Giuseppe Lanzino
    Abstract:

    SUMMARY: In this study, a single center’s experience of 20 patients and a systematic review and a meta-analysis of 16 studies, including 279 patients/aneurysms, assessed the safety and efficacy of endovascular treatment of distal Anterior Cerebral Artery aneurysms. The authors conclude that endovascular treatment of distal Anterior Cerebral Artery aneurysms is associated with high angiographic occlusion rates, but the complication rates are higher compared with other aneurysms in the circle of Willis. ABBREVIATIONS: DACA distal Anterior Cerebral Artery; GOS Glasgow Outcome Scale