Biomedical subjects

Rosana Ceratto

Publications and source records attributed to Rosana Ceratto.

6 recordsLinked to original sources

PubMed2004

Percutaneous vertebroplasty: technique and results in 192 procedures.

Percutaneous vertebroplasty with acrylic cement (usually polymethylmethacrylate) consists of injecting cement into vertebral bodies weakened by osseous lesions. The objective of this procedure is to obtain an analgesic effect by mechanical stabilization in destructive lesions of the spine. The three major indications are aggressive vertebral hemangiomas, severe or refractory pain related to osteoporotic vertebral fractures, and malignant vertebral tumors. Complications are infrequent, but occur essentially in patients with vertebral malignant tumors. We present our experience with 148 patients that underwent 192 percutaneous PMMA vertebroplasties for the treatment of painful osteoporotic compression fractures (76 patients, 105 vertebral levels), hemangiomas (31 patients, 43 vertebral levels) and neoplasms (31 patients, 43 vertebral levels). In a vast majority of appropriately selected cases and especially in osteoporotic cases, vertebroplasty constitutes a relatively simple procedure with a very high rate of success.

Adult↗

PubMed2003

Covered stent as an innovative tool for tumor devascularization and endovascular arterial reconstruction.

A temporal paraganglioma was pre-operatively embolised with particles and due to the fact that the internal carotid artery was encased by the tumor and that multiple petrous feeders precluded safe embolization, we decided to implant a balloon-expandable covered stent. On immediate post-procedural angiography, the arterial diameter was restored and a complete devascularization of the tumor was achieved. The tumor was operated with minimal blood loss and the carotid artery was released from surrounding tumor using the frame of the stent as a surgical limit. Covered stents may become a valuable tool for pre-operative tumor devascularization and arterial reconstruction especially when dealing with hypervascular tumors of the cranial base that encase the carotid artery.

Adult↗

PubMed2003

Reconstructive endovascular approach for a cavernous aneurysm in infancy.

We report a unique case of endovascular arterial reconstruction using stent and coils in a symptomatic cavernous aneurysm presented in infancy. A 3-year-old infant presented with a partial cavernous sinus syndrome secondary to a bilobulate cavernous aneurysm with subarachnoid extension. Direct clipping represented a considerable challenge and trapping after bypass grafting was considered to risky. A combined endovascular approach using stent and coils was performed. A 4 x 18 mm balloon-expandable stent was then placed across the aneurysm orifice allowing the complete obliteration of the remnant with coils implanted through the stent mesh. Digital substraction angiography documented patency of the ICA lumen and complete obliteration of the aneurysm. A 24-months angiographic follow-up was performed confirming persistent aneurysm exclusion and patency of the parent vessel with no signs of in-stent de novo stenosis. Reconstructive endovascular technique using stent and coils allowed the treatment of a complex vascular condition. The cavernous lesion was excluded from the circulation while preserving normal flow through the parent vessel and its branches. Long-tern follow up is a major concern, specially in pediatric patients but the 24 months angiographic follow-up is encouraging.

Carotid Artery Diseases↗

PubMed2002

Partially clipped intracranial aneurysm obliterated with combined stent and coil implantation.

PURPOSE: To report a case of endovascular stent placement to assist stable coil deployment in a symptomatic, wide-necked, partially clipped aneurysm. CASE REPORT: A 48-year-old woman presented for endovascular treatment of a symptomatic posterior communicating artery aneurysm remnant that was surgically clipped 10 years ago. A 3.5-mm x 12-mm balloon-expandable stent was placed across the aneurysm orifice followed by complete obliteration of the remnant with coils implanted through the stent mesh. Digital subtraction angiography documented continued patency of the arterial lumen and complete obliteration of the aneurysm at 11 months. CONCLUSIONS: Partial aneurysm clipping may assist or complicate secondary interventional procedures and interfere with correct visualization of the neck. Stent placement obviates the need for the balloon-assist method of coil embolization for wide-necked aneurysm remnants, acting as a mechanical barrier to hold the coils in a very unfavorable anatomy.

Angiography, Digital Subtraction↗

PubMed2002

Endovascular reconstruction of intracranial arteries by stent placement and combined techniques.

OBJECT: The authors investigated the feasibility, safety, and short-term outcome of stent treatment for intracranial aneurysms, stenoses, and dissections. METHODS: One hundred twenty-three consecutive patients with intracranial saccular, dissecting, and fusiform aneurysms, atherosclerotic lesions, and dissections were selected for intracranial stent implantation with or without adjunctive coil placement. One hundred eleven patients (mean age 47 years, range 3-73 years) underwent stent treatment; 12 patients (9.8%) were not treated. These 111 patients were divided into four groups: in Group 1 there were 62 patients with saccular aneurysms; Group 2 included nine patients (10 lesions) with dissecting or fusiform aneurysms; in Group 3 there were 36 patients with symptomatic intracranial atheromatous stenoses of more than 50%; and Group 4 included four patients with symptomatic intracranial dissections. All patients underwent computerized tomography scanning and/or magnetic resonance imaging and cerebral digital subtraction angiography preoperatively. Of the 72 aneurysms in Groups 1 and 2, 59 (82%) were treated with combined endovascular stent implantation and endosaccular coil placement. In 67 aneurysms (93%) we achieved complete or nearly complete obliteration. All patients with arterial narrowing achieved residual stenoses of less than 30% postangioplasty. One patient required repeated angioplasty. The morbidity rate in the series was 10.9% and the mortality rate was 6.3%. CONCLUSIONS: These findings indicate that stent treatment is feasible and seems to be an effective modality for arterial reconstruction. This versatile tool allows the treatment of a wide variety of challenging intracranial lesions.

Adolescent↗

PubMed2002

Angioplasty and stent placement in intracranial atherosclerotic stenoses and dissections.

BACKGROUND AND PURPOSE: Stent placement has been shown to increase the safety and effectiveness of balloon angioplasty in cervical carotid disease. Here, the authors investigated the feasibility, safety, and short-term outcome of stent-assisted angioplasty for the treatment of intracranial stenoses. METHODS: Thirty-four patients (age range, 12-77 years; mean age, 54 years) with symptomatic intracranial atherosclerotic lesions and dissections that produced stenosis of more than 50% were selected and treated with stents. Eighteen lesions (53%) were located in the anterior circulation, and 16 (47%) were in the vertebrobasilar complex. The mean stenosis was 75%. RESULTS: At follow up, 21 patients (62%) improved clinically, 11 (32%) remained stable, and the condition of two patients (6%) deteriorated. In all patients, the angiographic degree of stenosis was reduced to less than 30%. In 10 patients (29%), two or more stents were implanted: Two stents were implanted in six patients, and three, in four patients. The transient procedural morbidity rate was 12%, and the transient neurologic morbidity rate was 6%. One patient had hemorrhagic transformation due to reperfusion and died, and another patient had a massive myocardial infarction after 5 months. Twenty patients were followed up with angiography for at least 6 months, and none required repeat angioplasty. CONCLUSION: Endovascular revascularization of intracranial arteries by means of stent-assisted angioplasty is technically feasible, effective, and safe in selected patients.

Adolescent↗