This study describes the peri-procedural and late complications and angiographic follow-up results of 32 patients with 34 complex aneurysms treated with flow diverter Silk stents in a single centre. In this retrospective study, 40 Silk stents (SS) were implanted in 34 complex intracranial aneurysms in 32 patients. In our series, 20 (58.8%) carotid-ophthalmic internal carotid artery (ICA), six (17.6%) cavernous ICA, two (5.9%) supraclinoid ICA, two (5.9%) petrosal ICA (the same patient- bilateral) and four (11.8%) posterior circulation aneurysms were treated. One of the posterior circulation lesions was a fenestrated-type aneurysm. Twenty wide-necked, saccular; eight neck remnant; four fusiform and two blister-like aneurysms were included in our series. SS were successfully implanted in all patients (100%). Misdeployment occurred in 17.6% of patients. In two of these patients adequate stent openness was achieved via Hyperglide balloon dilatation. Coil embolization in addition to SS placement was utilized in four aneurysms. One patient (3%) experienced transient morbidity due to a thromboembolic event and there was one mortality (3%) due to remote intraparenchymal haemorrhage. Complete occlusion of 27/33 (81.8%) and 29/33 (87.9%) aneurysms was achieved six and 12 months after the procedure, respectively. In-stent intimal hyperplasia was detected in 6.1% patients. Flow-diverter Silk stent implantation is an effective method of treating complex aneurysms with acceptable mortality and morbidity rates. Complete occlusion is achieved in most of the complex aneurysms.
1 March 2014 in The American Journal of Emergency Medicine
Intracranial lipoma is an uncommon entity. A rare type of tumor in the internal auditory canal (IAC) and the cerebellopontine angle (CPA) is lipoma. There are a few case reports in the literature related to intravestibular lipoma. Herein, we report a case of lipomas within the cerebellopontine angle and vestibule of the inner ear in a patient with tinnitus and dizziness. The patient was evaluated with a 1.5 T magnetic resonance imaging (MRI) system. MRI and CT showed the masses in the left CPA and the left IAC. These lesions were hyperintense on both T1- and T2 weighted images and showed no enhancement after gadolinium administration. Conservative management was suggested. Histopathological diagnosis is rarely necessary with the widespread use of magnetic resonance imaging. Considering significant morbidity during resection, conservative follow-up is the best approach for CPA and IAC lipoma. Keywords: Cerebellopontine Angle; Lipoma; Magnetic Resonance Imaging
1 November 2015 in Diagnostic and Interventional Imaging
Doi:10.5152/akd.2014.4705 Objective: In this study, we aimed to research the relation between breast arterial calcifications (BACs) detected on mammography and two well-known markers of cardiovascular diseases-carotid artery intima-media thickness (C-IMT) and haemodynamics parameters like carotid peak-systolic velocity (PSV), end-diastolic velocity (EDV) and resistive index (RI). Methods: The study group consisted of 50 consecutive BAC (+) women and the control group consisted of 55 BAC (-) women. In all participants, BAC was diagnosed using mammography and C-IMT was measured using B-mode and Doppler ultrasonography. BAC was defined as two linear calcification depositions in a conical periphery or as calcific rings at the mammographic evaluation. Doppler spectrum samples were obtained from 2 cm proximal to the main carotid artery bifurcation. Results: Postmenopausal female patients ranging in age from 40 to 86 included in this study. When the groups were adjusted for age, a statisti-cally significant difference was found between mean C-IMT of BAC (+) and BAC (-) groups (0.81±0.2 vs. 0.69±0.2 mm; p<0.001). No significant differences were observed between BAC (+) and BAC (-) groups in terms of PSV, EDV, RI. Conclusion: The findings of the present study suggest that BAC, diagnosed by mammography, is independently associated with C-IMT. C-IMT measurement is suggested as a useful tool to detect early atherosclerotic changes. However, haemodynamic variables (PSV, EDV, RI) were not statistically different between the BAC (+) and BAC (-) groups. Prospective larger cohort studies are needed to further elucidate whether BA