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Yasuyuki Yamashita - One of the best experts on this subject based on the ideXlab platform.

  • Endovascular Management of Visceral Artery Pseudoaneurysms: Transcatheter Coil Embolization Using the Isolation Technique
    CardioVascular and Interventional Radiology, 2010
    Co-Authors: Osamu Ikeda, Yoshitaka Tamura, Yutaka Nakasone, Yasuyuki Yamashita
    Abstract:

    Purpose To describe our experiences with treatment of visceral artery pseudoaneurysms (VAPA) by transcatheter Coil Embolization using an isolation technique and to propose indications for treating VAPA with this method. Materials and Methods We treated 37 patients with VAPA endovascularly: There were 15 pancreaticoduodenal arcade, 10 hepatic, 5 renal, 3 splenic, and 1 each left gastric, gastroepiploic, adrenal, and superior mesenteric artery pseudoaneurysms. Preprocedure computed tomography (CT) and/or angiographic studies confirmed the presence of VAPA in all 37 patients. Using the isolation technique, we embolized vessels at sites distal and proximal to the pseudoaneurysm. Results Transcatheter Coil Embolization with the isolation technique was technically successful in 33 (89%) of 37 patients, and angiogram confirmed the complete disappearance of the VAPA in 32 patients. No major complications occurred during the procedures. In a patient with a pancreaticoduodenal arcade artery pseudoaneurysm, we were unable to control hemorrhage. In 30 of 32 patients who recovered after transcatheter Coil Embolization using the isolation technique, follow-up CT scan showed no flow in VAPA; they survived without rebleeding. Two of the 32 patients (6%) with confirmed complete disappearance of VAPA on angiogram and CT scan obtained the day after the procedure manifested rebleeding during follow-up. Conclusion Transcatheter Coil Embolization using the isolation technique is an effective alternative treatment in patients with VAPA. In combination with Coil Embolization, the isolation technique is particularly useful in patients whose pseudoaneurysms present surgical difficulties.

  • endovascular management of visceral artery pseudoaneurysms transcatheter Coil Embolization using the isolation technique
    CardioVascular and Interventional Radiology, 2010
    Co-Authors: Osamu Ikeda, Yoshitaka Tamura, Yutaka Nakasone, Yasuyuki Yamashita
    Abstract:

    To describe our experiences with treatment of visceral artery pseudoaneurysms (VAPA) by transcatheter Coil Embolization using an isolation technique and to propose indications for treating VAPA with this method. We treated 37 patients with VAPA endovascularly: There were 15 pancreaticoduodenal arcade, 10 hepatic, 5 renal, 3 splenic, and 1 each left gastric, gastroepiploic, adrenal, and superior mesenteric artery pseudoaneurysms. Preprocedure computed tomography (CT) and/or angiographic studies confirmed the presence of VAPA in all 37 patients. Using the isolation technique, we embolized vessels at sites distal and proximal to the pseudoaneurysm. Transcatheter Coil Embolization with the isolation technique was technically successful in 33 (89%) of 37 patients, and angiogram confirmed the complete disappearance of the VAPA in 32 patients. No major complications occurred during the procedures. In a patient with a pancreaticoduodenal arcade artery pseudoaneurysm, we were unable to control hemorrhage. In 30 of 32 patients who recovered after transcatheter Coil Embolization using the isolation technique, follow-up CT scan showed no flow in VAPA; they survived without rebleeding. Two of the 32 patients (6%) with confirmed complete disappearance of VAPA on angiogram and CT scan obtained the day after the procedure manifested rebleeding during follow-up. Transcatheter Coil Embolization using the isolation technique is an effective alternative treatment in patients with VAPA. In combination with Coil Embolization, the isolation technique is particularly useful in patients whose pseudoaneurysms present surgical difficulties.

  • Nonoperative management of unruptured visceral artery aneurysms: Treatment by transcatheter Coil Embolization
    Journal of vascular surgery, 2008
    Co-Authors: Osamu Ikeda, Yoshitaka Tamura, Yutaka Nakasone, Yasuhiko Iryou, Yasuyuki Yamashita
    Abstract:

    Purpose To describe our experiences with the treatment of visceral artery aneurysms (VAA) by transcatheter Coil Embolization and to propose indications for treating VAA by this method. Methods We treated 22 patients with VAA by Coil Embolization; 9 had splenic-, 7 renal-, 4 pancreaticoduodenal arcade-, and 2 proper hepatic artery aneurysms. All nine splenic artery aneurysms patients presented with chronic hepatitis-C; four had hepatocellular carcinoma. Of the seven renal artery aneurysms patients, four were hypertensive and three had rheumatoid arthritis. Both pancreaticoduodenal arcade artery aneurysms patients manifested severe stenosis of the celiac axis. Our transcatheter Coil Embolization procedure includes Coil Embolization and Coil-packing of the aneurysmal sac, preserving the native arterial circulation. Results Transcatheter Coil Embolization with aneurysm packing was technically successful in 16 (72.7%) of the 22 patients and the native arterial circulation was preserved. Postprocedure angiograms confirmed complete disappearance of the VAA. In four of the nine splenic artery aneurysm patients, the native arterial circulation was not preserved. In one renal artery aneurysm patient, stenosis at the aneurysmal neck necessitated placement of a stent before transcatheter Coil Embolization. Magnetic resonance angiographs obtained during the follow-up period (mean 27 months) demonstrated complete thrombosis of the VAA in all 22 patients. Infarction occurred in one splenic- and two renal artery aneurysms patients; the latter developed flank pain and fever after the procedure. Conclusions Transcatheter Coil Embolization is an effective alternative treatment for patients with saccular and proximal VAA. In particular, the isolation technique using Coil Embolization is advantageous in splenic artery aneurysm patients.

Luc Dubois - One of the best experts on this subject based on the ideXlab platform.

  • Onyx versus Coil Embolization for the treatment of type II endoleaks.
    Journal of vascular surgery, 2020
    Co-Authors: Oonagh Scallan, Stewart Kribs, Adam H. Power, Guy Derose, Audra Duncan, Luc Dubois
    Abstract:

    Little evidence is available supporting the optimal treatment of type II endoleaks associated with aortic sac growth. Previous studies have lacked comparisons between treatment methods and long-term follow-up. The purpose of the present study was to review our center's experience with the treatment of type II endoleaks comparing Onyx (a liquid Embolization agent consisting of ethylene vinyl alcohol; Medtronic, Minneapolis, Minn) Embolization and Coil Embolization. A retrospective review of prospectively collected data from a vascular surgery database was performed to identify all patients who had undergone Embolization of a type II endoleak for aortic sac growth after endovascular aneurysm repair from 2005 to 2018. The Onyx and Coil Embolization groups were compared using univariate statistics. A total of 58 patients had undergone 77 Embolization procedures for type II endoleaks with either Onyx (27 patients; 37 procedures) or Coils (31 patients; 40 procedures). The average aneurysm size at Embolization was larger in the Onyx group (77.9 ± 15.1 mm) compared with Coil Embolization (73.4 ± 11.9 mm). The mean follow-up was 57 months for the Onyx group and 74 months for the Coil Embolization group. Of the 27 patients who had undergone Onyx Embolization, 2 (7.4%) had required graft explantation compared with 5 of the 31 patients (16.1%) who had undergone Coil Embolization (P = .33). The results of the per-patient analysis showed that the Coil Embolization group had a significantly greater rate of the need for further reintervention compared with the Onyx group (55% vs 19%; P < .01). Clinical success was observed in 13 patients (48%) in the Onyx Embolization group compared with 10 patients (32%) in the Coil Embolization group (P = .04). Two patients in each group had presented with secondary rupture of the aneurysm sac after attempted Embolization. Type II endoleaks associated with sac growth treated with Onyx were less likely to require further reinterventions than were those treated with Coil Embolization. A trend was found toward a greater need for endovascular aneurysm repair explant after Coil Embolization. With a high rate of further reintervention and potential for sac rupture, diligent follow-up is required after attempted type II Embolization, regardless of the technique used. Copyright © 2020 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  • Onyx versus Coil Embolization for the treatment of type II endoleaks.
    Journal of vascular surgery, 2020
    Co-Authors: Oonagh Scallan, Stewart Kribs, Adam H. Power, Guy Derose, Audra Duncan, Luc Dubois
    Abstract:

    Objective There is little evidence supporting the optimal treatment of type II endoleaks associated with aortic sac growth. Previous studies have lacked comparisons between treatment methods and long-term follow-up. The purpose of this study was to review our center's experience with the treatment of type II endoleaks comparing Onyx (a liquid Embolization agent consisting of ethylene vinyl alcohol) Embolization with Coil Embolization. Methods A retrospective review of a prospectively collected vascular surgery database was performed to identify all patients who underwent Embolization of a type II endoleak for aortic sac growth after EVAR between 2005 and 2018. Onyx and Coil Embolization groups were compared using univariate statistics. Results In total, 58 patients underwent 77 Embolizations for type II endoleaks with either Onyx (27 patients, 37 procedures) or Coils (31 patients, 40 procedures). The average aneurysm size at the time of Embolization was larger in the Onyx group (77.9mm±15.1) compared to Coil Embolization (73.4mm±11.9). Mean follow-up was 57 months in the Onyx group and 74 months in the Coil Embolization group. Among the 27 patients undergoing Onyx Embolization, two patients (7.4%) required graft explantation compared to five patients (16.1%) among the 31 patients undergoing Coil Embolization (p=.33). Based on per-patient analysis, the Coil Embolization group had a significantly higher rate of need for further reinterventions compared to the Onyx group (55% vs 19%, p Conclusions Type II endoleaks associated with sac growth treated with Onyx are less likely to require further reinterventions than with Coil Embolization, and there is a trend towards greater need for EVAR explant following Coil Embolization. With a high rate of further reintervention and potential for sac rupture, diligent follow-up is required after attempted type II Embolization regardless of technique.

Osamu Ikeda - One of the best experts on this subject based on the ideXlab platform.

  • Endovascular Management of Visceral Artery Pseudoaneurysms: Transcatheter Coil Embolization Using the Isolation Technique
    CardioVascular and Interventional Radiology, 2010
    Co-Authors: Osamu Ikeda, Yoshitaka Tamura, Yutaka Nakasone, Yasuyuki Yamashita
    Abstract:

    Purpose To describe our experiences with treatment of visceral artery pseudoaneurysms (VAPA) by transcatheter Coil Embolization using an isolation technique and to propose indications for treating VAPA with this method. Materials and Methods We treated 37 patients with VAPA endovascularly: There were 15 pancreaticoduodenal arcade, 10 hepatic, 5 renal, 3 splenic, and 1 each left gastric, gastroepiploic, adrenal, and superior mesenteric artery pseudoaneurysms. Preprocedure computed tomography (CT) and/or angiographic studies confirmed the presence of VAPA in all 37 patients. Using the isolation technique, we embolized vessels at sites distal and proximal to the pseudoaneurysm. Results Transcatheter Coil Embolization with the isolation technique was technically successful in 33 (89%) of 37 patients, and angiogram confirmed the complete disappearance of the VAPA in 32 patients. No major complications occurred during the procedures. In a patient with a pancreaticoduodenal arcade artery pseudoaneurysm, we were unable to control hemorrhage. In 30 of 32 patients who recovered after transcatheter Coil Embolization using the isolation technique, follow-up CT scan showed no flow in VAPA; they survived without rebleeding. Two of the 32 patients (6%) with confirmed complete disappearance of VAPA on angiogram and CT scan obtained the day after the procedure manifested rebleeding during follow-up. Conclusion Transcatheter Coil Embolization using the isolation technique is an effective alternative treatment in patients with VAPA. In combination with Coil Embolization, the isolation technique is particularly useful in patients whose pseudoaneurysms present surgical difficulties.

  • endovascular management of visceral artery pseudoaneurysms transcatheter Coil Embolization using the isolation technique
    CardioVascular and Interventional Radiology, 2010
    Co-Authors: Osamu Ikeda, Yoshitaka Tamura, Yutaka Nakasone, Yasuyuki Yamashita
    Abstract:

    To describe our experiences with treatment of visceral artery pseudoaneurysms (VAPA) by transcatheter Coil Embolization using an isolation technique and to propose indications for treating VAPA with this method. We treated 37 patients with VAPA endovascularly: There were 15 pancreaticoduodenal arcade, 10 hepatic, 5 renal, 3 splenic, and 1 each left gastric, gastroepiploic, adrenal, and superior mesenteric artery pseudoaneurysms. Preprocedure computed tomography (CT) and/or angiographic studies confirmed the presence of VAPA in all 37 patients. Using the isolation technique, we embolized vessels at sites distal and proximal to the pseudoaneurysm. Transcatheter Coil Embolization with the isolation technique was technically successful in 33 (89%) of 37 patients, and angiogram confirmed the complete disappearance of the VAPA in 32 patients. No major complications occurred during the procedures. In a patient with a pancreaticoduodenal arcade artery pseudoaneurysm, we were unable to control hemorrhage. In 30 of 32 patients who recovered after transcatheter Coil Embolization using the isolation technique, follow-up CT scan showed no flow in VAPA; they survived without rebleeding. Two of the 32 patients (6%) with confirmed complete disappearance of VAPA on angiogram and CT scan obtained the day after the procedure manifested rebleeding during follow-up. Transcatheter Coil Embolization using the isolation technique is an effective alternative treatment in patients with VAPA. In combination with Coil Embolization, the isolation technique is particularly useful in patients whose pseudoaneurysms present surgical difficulties.

  • Nonoperative management of unruptured visceral artery aneurysms: Treatment by transcatheter Coil Embolization
    Journal of vascular surgery, 2008
    Co-Authors: Osamu Ikeda, Yoshitaka Tamura, Yutaka Nakasone, Yasuhiko Iryou, Yasuyuki Yamashita
    Abstract:

    Purpose To describe our experiences with the treatment of visceral artery aneurysms (VAA) by transcatheter Coil Embolization and to propose indications for treating VAA by this method. Methods We treated 22 patients with VAA by Coil Embolization; 9 had splenic-, 7 renal-, 4 pancreaticoduodenal arcade-, and 2 proper hepatic artery aneurysms. All nine splenic artery aneurysms patients presented with chronic hepatitis-C; four had hepatocellular carcinoma. Of the seven renal artery aneurysms patients, four were hypertensive and three had rheumatoid arthritis. Both pancreaticoduodenal arcade artery aneurysms patients manifested severe stenosis of the celiac axis. Our transcatheter Coil Embolization procedure includes Coil Embolization and Coil-packing of the aneurysmal sac, preserving the native arterial circulation. Results Transcatheter Coil Embolization with aneurysm packing was technically successful in 16 (72.7%) of the 22 patients and the native arterial circulation was preserved. Postprocedure angiograms confirmed complete disappearance of the VAA. In four of the nine splenic artery aneurysm patients, the native arterial circulation was not preserved. In one renal artery aneurysm patient, stenosis at the aneurysmal neck necessitated placement of a stent before transcatheter Coil Embolization. Magnetic resonance angiographs obtained during the follow-up period (mean 27 months) demonstrated complete thrombosis of the VAA in all 22 patients. Infarction occurred in one splenic- and two renal artery aneurysms patients; the latter developed flank pain and fever after the procedure. Conclusions Transcatheter Coil Embolization is an effective alternative treatment for patients with saccular and proximal VAA. In particular, the isolation technique using Coil Embolization is advantageous in splenic artery aneurysm patients.

Koji Mizokami - One of the best experts on this subject based on the ideXlab platform.

  • Initial experience of a novel sheath guide for transbrachial Coil Embolization of cerebral aneurysms in the anterior cerebral circulation.
    Neurosurgery, 2013
    Co-Authors: Tomonori Iwata, Takahisa Mori, Hiroyuki Tajiri, Yuichi Miyazaki, Masahito Nakazaki, Koji Mizokami
    Abstract:

    The transfemoral approach is a common technique for Coil Embolization of cerebral aneurysms in the anterior cerebral circulation. However, it is difficult to advance a guiding catheter into the carotid artery via the femoral route in patients with a tortuous aortic arch, an unfavorable supra-aortic takeoff, aortic diseases, or occlusion of the femoral artery. To report our initial experiences of Coil Embolization of cerebral aneurysms in the anterior cerebral circulation with a novel sheath guide for transbrachial carotid cannulation. A sheath guide designed specifically for transbrachial carotid cannulation was developed; transbrachial Coil Embolization for cerebral aneurysms began in May 2011. Included for analysis were patients who underwent transbrachial Coil Embolization for cerebral aneurysms in the anterior cerebral circulation from May 2011 to January 2012. Adjuvant techniques, angiographic results, procedural success, and periprocedural complications were investigated. Ten patients underwent transbrachial Coil Embolization of cerebral aneurysms in the anterior cerebral circulation. All procedures were successful using the brachial route. No periprocedural complications occurred. Patients were permitted to get seated immediately after Coil Embolization even during hemostasis. The sheath guide specifically designed for transbrachial carotid cannulation was useful for Coil Embolization of cerebral aneurysms in the anterior cerebral circulation.

  • Initial experience of a novel sheath guide for transbrachial Coil Embolization of cerebral aneurysms in the anterior cerebral circulation.
    Neurosurgery, 2012
    Co-Authors: Tomonori Iwata, Takahisa Mori, Hiroyuki Tajiri, Yuichi Miyazaki, Masahito Nakazaki, Koji Mizokami
    Abstract:

    Background The transfemoral approach is a common technique for Coil Embolization of cerebral aneurysms in the anterior cerebral circulation. However, it is difficult to advance a guiding catheter into the carotid artery via the femoral route in patients with a tortuous aortic arch, an unfavorable supra-aortic takeoff, aortic diseases, or occlusion of the femoral artery. Objective To report our initial experiences of Coil Embolization of cerebral aneurysms in the anterior cerebral circulation with a novel sheath guide for transbrachial carotid cannulation. Methods A sheath guide designed specifically for transbrachial carotid cannulation was developed; transbrachial Coil Embolization for cerebral aneurysms began in May 2011. Included for analysis were patients who underwent transbrachial Coil Embolization for cerebral aneurysms in the anterior cerebral circulation from May 2011 to January 2012. Adjuvant techniques, angiographic results, procedural success, and periprocedural complications were investigated. Results Ten patients underwent transbrachial Coil Embolization of cerebral aneurysms in the anterior cerebral circulation. All procedures were successful using the brachial route. No periprocedural complications occurred. Patients were permitted to get seated immediately after Coil Embolization even during hemostasis. Conclusion The sheath guide specifically designed for transbrachial carotid cannulation was useful for Coil Embolization of cerebral aneurysms in the anterior cerebral circulation.

Oonagh Scallan - One of the best experts on this subject based on the ideXlab platform.

  • Onyx versus Coil Embolization for the treatment of type II endoleaks.
    Journal of vascular surgery, 2020
    Co-Authors: Oonagh Scallan, Stewart Kribs, Adam H. Power, Guy Derose, Audra Duncan, Luc Dubois
    Abstract:

    Little evidence is available supporting the optimal treatment of type II endoleaks associated with aortic sac growth. Previous studies have lacked comparisons between treatment methods and long-term follow-up. The purpose of the present study was to review our center's experience with the treatment of type II endoleaks comparing Onyx (a liquid Embolization agent consisting of ethylene vinyl alcohol; Medtronic, Minneapolis, Minn) Embolization and Coil Embolization. A retrospective review of prospectively collected data from a vascular surgery database was performed to identify all patients who had undergone Embolization of a type II endoleak for aortic sac growth after endovascular aneurysm repair from 2005 to 2018. The Onyx and Coil Embolization groups were compared using univariate statistics. A total of 58 patients had undergone 77 Embolization procedures for type II endoleaks with either Onyx (27 patients; 37 procedures) or Coils (31 patients; 40 procedures). The average aneurysm size at Embolization was larger in the Onyx group (77.9 ± 15.1 mm) compared with Coil Embolization (73.4 ± 11.9 mm). The mean follow-up was 57 months for the Onyx group and 74 months for the Coil Embolization group. Of the 27 patients who had undergone Onyx Embolization, 2 (7.4%) had required graft explantation compared with 5 of the 31 patients (16.1%) who had undergone Coil Embolization (P = .33). The results of the per-patient analysis showed that the Coil Embolization group had a significantly greater rate of the need for further reintervention compared with the Onyx group (55% vs 19%; P < .01). Clinical success was observed in 13 patients (48%) in the Onyx Embolization group compared with 10 patients (32%) in the Coil Embolization group (P = .04). Two patients in each group had presented with secondary rupture of the aneurysm sac after attempted Embolization. Type II endoleaks associated with sac growth treated with Onyx were less likely to require further reinterventions than were those treated with Coil Embolization. A trend was found toward a greater need for endovascular aneurysm repair explant after Coil Embolization. With a high rate of further reintervention and potential for sac rupture, diligent follow-up is required after attempted type II Embolization, regardless of the technique used. Copyright © 2020 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  • Onyx versus Coil Embolization for the treatment of type II endoleaks.
    Journal of vascular surgery, 2020
    Co-Authors: Oonagh Scallan, Stewart Kribs, Adam H. Power, Guy Derose, Audra Duncan, Luc Dubois
    Abstract:

    Objective There is little evidence supporting the optimal treatment of type II endoleaks associated with aortic sac growth. Previous studies have lacked comparisons between treatment methods and long-term follow-up. The purpose of this study was to review our center's experience with the treatment of type II endoleaks comparing Onyx (a liquid Embolization agent consisting of ethylene vinyl alcohol) Embolization with Coil Embolization. Methods A retrospective review of a prospectively collected vascular surgery database was performed to identify all patients who underwent Embolization of a type II endoleak for aortic sac growth after EVAR between 2005 and 2018. Onyx and Coil Embolization groups were compared using univariate statistics. Results In total, 58 patients underwent 77 Embolizations for type II endoleaks with either Onyx (27 patients, 37 procedures) or Coils (31 patients, 40 procedures). The average aneurysm size at the time of Embolization was larger in the Onyx group (77.9mm±15.1) compared to Coil Embolization (73.4mm±11.9). Mean follow-up was 57 months in the Onyx group and 74 months in the Coil Embolization group. Among the 27 patients undergoing Onyx Embolization, two patients (7.4%) required graft explantation compared to five patients (16.1%) among the 31 patients undergoing Coil Embolization (p=.33). Based on per-patient analysis, the Coil Embolization group had a significantly higher rate of need for further reinterventions compared to the Onyx group (55% vs 19%, p Conclusions Type II endoleaks associated with sac growth treated with Onyx are less likely to require further reinterventions than with Coil Embolization, and there is a trend towards greater need for EVAR explant following Coil Embolization. With a high rate of further reintervention and potential for sac rupture, diligent follow-up is required after attempted type II Embolization regardless of technique.