Cover stents vs Coilling or in Combination for bail out of Visceral aneurysms
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1 Cover stents vs Coilling or in Combination for bail out of Visceral aneurysms Prof. Furuzan Numan M.D Chief of Interventional Radiology Department Cerrahpasa School of Medicine & Memorial Hospital, ISTANBUL, TURKIYE
2 Faculty disclosure Numan Furuzan I have no financial relationships to disclose.
3 Coilling; Techniques and devices to treat Visceral Aneurysms and Pseudoaneurysms (platinium,hydrogel,dacron fiber),(pushable,detachable) Coverstenting (Advanta,Jostent,Viabahn,Fluency..) (baloon expandable, selfexpandable) Coilling and coverstenting Liquid Agents; (Glue,Onyx,Squid) Flow diverter devices;!!! (Silk,Multilayerstent,..)
4 Coverstent Techniques Saccular or Fusiform Aneurysms: Coverstent needs healty landing zone proximally and distally,should feet the artery diameter at both side Teaching Points May-June Issue 2013 RadioGraphics 2013;
5 Coilling Techniques: Direct Coilling:Detacable,3D,Cage Forming, filling inside with soft coils Sandwich Technique:Occlusion of the feeding artery proximally and distally,with or without coilling The aneurysm sac. Stent Modelling Coilling: Aneurysms with wide neck and at the bifurcation are not suitable for coverstentting Teaching Points May-June Issue 2013 RadioGraphics 2013;
6 Platinum Coils From framing to filling to finishing, the MicroPlex Coil System (MCS) consists of a complete line of 10 and 18 sized platinum coils for the endovascular treatment of cerebral aneurysms and other vascular lesions. HYDROCOILS Dacron fiber coils
7 ote: This copy is for your personal non-commercial use only. To order presentation-ready opies for distr ibution to your colleagues or clients, contact us at ights. TESTINAL IMAGING Abdominal and Pelvic Aneurysms and Pseudoaneurysms: Imaging Review with Clinical, Radiologic, and Treatment Teaching Points May-June Issue 2013 Abdominal and Pelvic Aneurysms and Pseudoaneurysms: Imaging Review with Clinical, Radiologic, and Treatment Correlation 1 Correlation RadioGraphics 2013; E71 LY M BBS, M D
8 Splenic Artery Aneurysms/Pseudoaneurysms Pregnancy,multiparity, Splenomegaly,Portal Hypertension,Liver transplantasion Hypertension, FMD, Alfa-antitrypsin deficiency Aneurysms calcified and larger than 2 cm may rupture Pseudoaneurysms:Trauma,pancreatitis,mycotic infection Complications of intervention:thomboembolism,ischemic pancreatitis,pneumococcal sepsis send.
9 FMD,multiple Splenic Aneurysms discovered during pregnancy,under f-up
10 Thrombocytopenia,Splenomegaly:Coilling thrombo
11 Hepatic Artery Aneurysms/Pseudoaneurysms Atherosclerosis,multiple,50%male gender PAN,FMD (65 % of aneurysms larger than 2 cm rupture and 21% causes death) Quincke Send.(pain, hemobilia,obstructive jaundice) Pseudoaneuryms:Trauma, liver transplantation, biyopsy,percutaneus and laparoscopic procedures of biliary system. Dual vascularization of liver makes it easy to intervent for both techniques
12 R hepatic Artery Aneurysm:Coilling Teaching Points May-June Issue 2013 RadioGraphics 2013;
13 R Hepatic artery pseudoaneurysm after biyopsy: Coverstent and Coilling Teaching Points May-June Issue 2013 RadioGraphics 2013;
14 CHA aneurysm :Sandwich Technique, coilling Teaching Points May-June Issue 2013 RadioGraphics 2013;
15 SMA,GDA,PDA,CT Aneurysms/Pseudoaneurysms Infection,dissection,atherosclerosis,pancreatitis,multiple,male =women gender,abdominal pain and ischemic complications % of aneurysms larger than 3cm rupture Pseudoaneuryms:Trauma, pancreatitis,post-op, Surgery or endointervention.
16 SMA branch aneurysms :2 saccular aneuryms treated using coils, 1 fusiform untreated
17 SMA branch aneurysms :2 saccular aneuryms treated using coils, 1 fusiform untreated
18 Celiac Truncus Aneurysm:Coverstent Teaching Points May-June Issue 2013 RadioGraphics 2013;
19 Renal Artery Aneurysms/Pseudoaneurysms R sided,no gender difference,80% saccular 20% FMD Pseudoaneurysms:Biyopsy (Lkidney lower pole, Tx kidney upper pole),trauma
20 FMD,bilateral renal artery aneurysms:coilling
21 FMD,bilateral renal artery aneurysms:coilling
22 FMD,bilateral renal artery aneurysms:coilling
23 Tx kidney, pseudoaneurysm and AVF after biyopsy:glue Transcatheter liquid emb.
24 Post-nefrectomy AVF:Coilling during balloon occlusion Pushable coil non-target emb.to R Pulmonary artery
25 Post-nefrectomy AVF:Coilling during balloon occlusion
26 R Renal artery injury during plasty:coverstent
27 Post traumatic LCCA and LSCA aneurysms:coverstent
28 Bronchial artery aneurysm: Coilling
29 Bronchial artery aneurysm: Coilling
30 Pediatr Radiol Oct;35(10): Epub 2005 May 13. Lumbar and iliac artery aneurysms in Menkes' disease: endovascular cover stent treatment of the lumbar artery aneurysm. Adaletli I, Omeroglu A, Kurugoglu S, Elicevik M, Cantasdemir M, Numan F. Department of Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
31 R IIA pseudoaneurysm at anastomosis site after AAA open repair : Coverstent during aortic cuff extension procedure
32 Post traumatic LCIA-LCIV high flow AVF : Coverstent
33 Bilateral IIA Aneurysms:Coilling and Coverstent
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