The Experts below are selected from a list of 18 Experts worldwide ranked by ideXlab platform
Brigitte D Ala - One of the best experts on this subject based on the ideXlab platform.
-
the next generation hydroCoil initial clinical experience with the hydrofill Embolic Coil
Journal of NeuroInterventional Surgery, 2013Co-Authors: John W D Speirs, Thomas H Burke, Stefanie Y Lee, Brigitte D AlaAbstract:Background Complete packing of intracranial aneurysms has demonstrated a significant decrease in aneurysm recurrence rates with increased volumetric filling. The HydroCoil Embolization System (HES) was developed to increase volumetric filling within the aneurysm sac to maintain long term occlusion. To further enhance ease of HES deployment, a new next generation Embolic Coil, the HydroFill Coil, was developed. Objective To report the first clinical experience with the HydroFill Coil, focusing on safety and effectiveness, with immediate and long term follow-up on cases performed at a single institution by a single operator. Methods Retrospective angiographic and clinical analysis was performed on a non-randomized single arm registry of the first consecutive 11 patients with 14 intracranial saccular aneurysms treated during a 9 month period. Results The immediate angiographic occlusion rate according to the Raymond scale was 100%. Overall packing density of all Coils used was 13–135% (mean 64%). The immediate complication rate was 9% (1/11 patients), secondary to a parent vessel occlusion which resolved after intravenous administration of eptifibatide (Integrilin) without neurological sequelae. The angiographic/MR angiography follow-up period for this series was 13–30 months, with an overall complete occlusion rate of 86% (12/14 aneurysms). 2/14 aneurysms (14%) converted from complete occlusion to filling of small neck remnants. Of the two, one (7%) was a cavernous aneurysm that was retreated. Conclusions Although this initial case series is small, this study demonstrates safe deployment of the HydroFill Coil in ruptured and unruptured aneurysms without major complications, and with a high rate of occlusion on long term follow-up.
David Frakes - One of the best experts on this subject based on the ideXlab platform.
-
finite element modeling of Embolic Coil deployment multifactor characterization of treatment effects on cerebral aneurysm hemodynamics
Journal of Biomechanics, 2013Co-Authors: Haithem Babiker, Brian W Chong, Fernando L Gonzalez, Sachmanik Cheema, David FrakesAbstract:Endovascular Coiling is the most common treatment for cerebral aneurysms. During the treatment, a sequence of Embolic Coils with different stiffness, shapes, sizes, and lengths is deployed to fill the aneurysmal sac. Although Coil packing density has been clinically correlated with treatment success, many studies have also reported success at low packing densities, as well as recurrence at high packing densities. Such reports indicate that other factors may influence treatment success. In this study, we used a novel finite element approach and computational fluid dynamics (CFD) to investigate the effects of packing density, Coil shape, aneurysmal neck size, and parent vessel flow rate on aneurysmal hemodynamics. The study examines a testbed of 80 unique CFD simulations of post-treatment flows in idealized basilar tip aneurysm models. Simulated Coil deployments were validated against in vitro and in vivo deployments. Among the investigated factors, packing density had the largest effect on intra-aneurysmal velocities. However, multifactor analysis of variance showed that Coil shape can also have considerable effects, depending on packing density and neck size. Further, linear regression analysis showed an inverse relationship between mean void diameter in the aneurysm and mean intra-aneurysmal velocities, which underscores the importance of Coil distribution and thus Coil shape. Our study suggests that while packing density plays a key role in determining post-treatment hemodynamics, other factors such as Coil shape, aneurysmal geometry, and parent vessel flow may also be very important.
John W D Speirs - One of the best experts on this subject based on the ideXlab platform.
-
the next generation hydroCoil initial clinical experience with the hydrofill Embolic Coil
Journal of NeuroInterventional Surgery, 2013Co-Authors: John W D Speirs, Thomas H Burke, Stefanie Y Lee, Brigitte D AlaAbstract:Background Complete packing of intracranial aneurysms has demonstrated a significant decrease in aneurysm recurrence rates with increased volumetric filling. The HydroCoil Embolization System (HES) was developed to increase volumetric filling within the aneurysm sac to maintain long term occlusion. To further enhance ease of HES deployment, a new next generation Embolic Coil, the HydroFill Coil, was developed. Objective To report the first clinical experience with the HydroFill Coil, focusing on safety and effectiveness, with immediate and long term follow-up on cases performed at a single institution by a single operator. Methods Retrospective angiographic and clinical analysis was performed on a non-randomized single arm registry of the first consecutive 11 patients with 14 intracranial saccular aneurysms treated during a 9 month period. Results The immediate angiographic occlusion rate according to the Raymond scale was 100%. Overall packing density of all Coils used was 13–135% (mean 64%). The immediate complication rate was 9% (1/11 patients), secondary to a parent vessel occlusion which resolved after intravenous administration of eptifibatide (Integrilin) without neurological sequelae. The angiographic/MR angiography follow-up period for this series was 13–30 months, with an overall complete occlusion rate of 86% (12/14 aneurysms). 2/14 aneurysms (14%) converted from complete occlusion to filling of small neck remnants. Of the two, one (7%) was a cavernous aneurysm that was retreated. Conclusions Although this initial case series is small, this study demonstrates safe deployment of the HydroFill Coil in ruptured and unruptured aneurysms without major complications, and with a high rate of occlusion on long term follow-up.
Haithem Babiker - One of the best experts on this subject based on the ideXlab platform.
-
finite element modeling of Embolic Coil deployment multifactor characterization of treatment effects on cerebral aneurysm hemodynamics
Journal of Biomechanics, 2013Co-Authors: Haithem Babiker, Brian W Chong, Fernando L Gonzalez, Sachmanik Cheema, David FrakesAbstract:Endovascular Coiling is the most common treatment for cerebral aneurysms. During the treatment, a sequence of Embolic Coils with different stiffness, shapes, sizes, and lengths is deployed to fill the aneurysmal sac. Although Coil packing density has been clinically correlated with treatment success, many studies have also reported success at low packing densities, as well as recurrence at high packing densities. Such reports indicate that other factors may influence treatment success. In this study, we used a novel finite element approach and computational fluid dynamics (CFD) to investigate the effects of packing density, Coil shape, aneurysmal neck size, and parent vessel flow rate on aneurysmal hemodynamics. The study examines a testbed of 80 unique CFD simulations of post-treatment flows in idealized basilar tip aneurysm models. Simulated Coil deployments were validated against in vitro and in vivo deployments. Among the investigated factors, packing density had the largest effect on intra-aneurysmal velocities. However, multifactor analysis of variance showed that Coil shape can also have considerable effects, depending on packing density and neck size. Further, linear regression analysis showed an inverse relationship between mean void diameter in the aneurysm and mean intra-aneurysmal velocities, which underscores the importance of Coil distribution and thus Coil shape. Our study suggests that while packing density plays a key role in determining post-treatment hemodynamics, other factors such as Coil shape, aneurysmal geometry, and parent vessel flow may also be very important.
Thomas H Burke - One of the best experts on this subject based on the ideXlab platform.
-
the next generation hydroCoil initial clinical experience with the hydrofill Embolic Coil
Journal of NeuroInterventional Surgery, 2013Co-Authors: John W D Speirs, Thomas H Burke, Stefanie Y Lee, Brigitte D AlaAbstract:Background Complete packing of intracranial aneurysms has demonstrated a significant decrease in aneurysm recurrence rates with increased volumetric filling. The HydroCoil Embolization System (HES) was developed to increase volumetric filling within the aneurysm sac to maintain long term occlusion. To further enhance ease of HES deployment, a new next generation Embolic Coil, the HydroFill Coil, was developed. Objective To report the first clinical experience with the HydroFill Coil, focusing on safety and effectiveness, with immediate and long term follow-up on cases performed at a single institution by a single operator. Methods Retrospective angiographic and clinical analysis was performed on a non-randomized single arm registry of the first consecutive 11 patients with 14 intracranial saccular aneurysms treated during a 9 month period. Results The immediate angiographic occlusion rate according to the Raymond scale was 100%. Overall packing density of all Coils used was 13–135% (mean 64%). The immediate complication rate was 9% (1/11 patients), secondary to a parent vessel occlusion which resolved after intravenous administration of eptifibatide (Integrilin) without neurological sequelae. The angiographic/MR angiography follow-up period for this series was 13–30 months, with an overall complete occlusion rate of 86% (12/14 aneurysms). 2/14 aneurysms (14%) converted from complete occlusion to filling of small neck remnants. Of the two, one (7%) was a cavernous aneurysm that was retreated. Conclusions Although this initial case series is small, this study demonstrates safe deployment of the HydroFill Coil in ruptured and unruptured aneurysms without major complications, and with a high rate of occlusion on long term follow-up.