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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleNeurointervention

Endovascular Treatment of Experimental Aneurysms by Use of a Combination of Liquid Embolic Agents and Protective Devices

Yuichi Murayama, Fernando Viñuela, Satoshi Tateshima, Fernando Viñuela Jr and Yoichi Akiba
American Journal of Neuroradiology October 2000, 21 (9) 1726-1735;
Yuichi Murayama
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Fernando Viñuela
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Satoshi Tateshima
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Fernando Viñuela Jr
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Yoichi Akiba
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    fig 1.

    Double-lumen microcatheter placed in the silicone-made aneurysm. A small 1.7F microcatheter system was used for the injection of Onyx (black arrow indicates direction of flow), and a large 2.7F microcatheter system was used for the injection of saline to flush the stagnant DMSO in the aneurysmal sac (white arrows indicate direction of flow)

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    fig 2.

    A, Sagittal view of aneurysm embolized with Onyx. Note incomplete packing of the aneurysm, multiple fragmentation of the embolic mass (open arrow), and recanalization of the aneurysm inflow zone (solid arrow) (hematoxylin-eosin, ×4).

    B, Macroscopic appearance of the neck of the aneurysm with Onyx migration into the parent artery (arrow). No significant thrombus formation was observed.

  • fig 3.
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    fig 3.

    A, Nonsubtraction angiogram shows dense packing of the aneurysmal sac with the combination of a GDC and Onyx. The coil was placed in the aneurysm.

    B, Digital subtraction view shows small neck remnant at the inflow zone (arrow).

    C, Macroscopic appearance of the neck of the aneurysm with complete neoendothelial lining.

    D, Sagittal view of aneurysm embolized with Onyx and a GDC. Note denser packing with Onyx and endothelial lining across the neck of the aneurysm.

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    fig 4.

    A, Plain radiograph shows immediate poststenting and Onyx embolization of the aneurysm.

    B, Follow-up angiogram at 14 days shows moderate degree of stenosis of the parent artery due to intimal hyperplasia (note stent deformity, arrow). The aneurysm was completely occluded with Onyx.

    C, Light microscopic findings of aneurysmal neck 14 days after embolization with Onyx and microstent show thrombus deposition on stent wire (arrow) (hematoxylin-eosin, ×10).

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    fig 5.

    A, Graph shows IAP change during balloon inflation. Note significant increase of IAP with complete balloon inflation with or without saline flush.

    B, Angiogram of experimental aneurysm created on the common carotid artery of a swine.

    C, Approximately 80% occlusion of the aneurysm was achieved with combination of Onyx and a microballoon.

    D, Embolization of the remnant at the inflow zone using nearly complete occlusion technique. Note small space between balloon and distal portion of the aneurysmal neck (arrow).

    E, Example of successful occlusion of the aneurysm with Onyx and balloon technique. Note small concave shape of the Onyx along with balloon shape.

  • fig 6.
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    fig 6.

    A, Light microscopic findings in region of aneurysmal dome 14 day after embolization with Onyx (hematoxylin-eosin, ×25). Dense connective tissue containing moderate number of mixed inflammatory cells is observed along with polymer surfaces. No angionecrosis is present.

    B, Light microscopic findings in region of aneurysmal dome 14 days after embolization with GDCs (hematoxylin-eosin, ×25). Minimum to mild inflammatory reaction is observed along with coils.

    C, Light microscopic findings of aneurysmal neck 14 days after embolization with Onyx. Note tonguelike migration of Onyx into the parent artery and complete coverage with neointima (hematoxylin-eosin, ×10).

    D, Light microscopic findings of aneurysmal neck 14 days after embolization with Onyx and microstent. Note significant intimal hyperplasia (wide arrow) and stent deformity due to tissue reaction (thin arrow) (hematoxylin-eosin, ×5).

Tables

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    Angiographic findings in 20 swine with 40 experimental lateral-wall aneurysms

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American Journal of Neuroradiology
Vol. 21, Issue 9
1 Oct 2000
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Endovascular Treatment of Experimental Aneurysms by Use of a Combination of Liquid Embolic Agents and Protective Devices
Yuichi Murayama, Fernando Viñuela, Satoshi Tateshima, Fernando Viñuela Jr, Yoichi Akiba
American Journal of Neuroradiology Oct 2000, 21 (9) 1726-1735;
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  • Treatment of experimental aneurysms with a new liquid embolic agent and a retrievable stent: proof of concept and feasibility study
  • Preliminary in vivo evaluation of a novel intrasaccular cerebral aneurysm occlusion device
  • Predicting parent vessel patency and treatment durability: a proposed grading scheme for the immediate angiographic results following Onyx HD-500 embolization of intracranial aneurysms
  • 1-Hexyl n-cyanoacrylate compound (Neucrylate™ AN), a new treatment for berry aneurysm. III: Initial clinical results
  • CT and MR Imaging Findings and Their Implications in the Follow-up of Patients with Intracranial Aneurysms Treated with Endosaccular Occlusion with Onyx
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Cite this article
Yuichi Murayama, Fernando Viñuela, Satoshi Tateshima, Fernando Viñuela Jr, Yoichi Akiba
Endovascular Treatment of Experimental Aneurysms by Use of a Combination of Liquid Embolic Agents and Protective Devices
American Journal of Neuroradiology Oct 2000, 21 (9) 1726-1735;

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