Biomedical subjects

S Goericke

Publications and source records attributed to S Goericke.

3 recordsLinked to original sources

PubMed2005

Treatment of wide-necked intracranial aneurysms with a self-expanding stent: mid-term results.

PURPOSE: To evaluate mid-term clinical and angiographic results after using a self-expanding neurovascular stent and coils for the management of broad-based intracranial aneurysms. METHODS: During the period from August 2001 to October 2004 we treated a total of 42 patients with 44 aneurysms using a self-expandable stent. To date we have data on more than 6 months of follow-up in 25 patients with 26 aneurysms. Aneurysm occlusion was divided into the following categories: 100 % (complete), 95-99 % (subtotal), and < 95 % (incomplete). RESULTS: In 15 aneurysms complete occlusion, in 11 aneurysms subtotal occlusion was initially achieved. Control DSA showed progressive thrombosis in seven aneurysms leading to total occlusion in another 4 aneurysms. Three recanalizations were observed in one large and two giant ICA aneurysms. No vessel occlusion occurred. One vessel stenosis of the stented segment was noted, but it was not clinically relevant. One patient experienced a small embolic infarction after stopping antiplatelet medication. No persistent deterioration of the clinical status occurred. CONCLUSION: Combining a stent with coils seems to be an acceptable treatment option for broad-based intracranial aneurysms. As this special subgroup of treated aneurysms includes only those with an unfavourable geometry, the results are extremely promising.

Aneurysm, Ruptured↗

PubMed2004

Multimodal imaging in the elastase-induced aneurysm model in rabbits: a comparative study using serial DSA, MRA and CTA.

BACKGROUND AND PURPOSE: The elastase-induced aneurysm model in rabbits has proved to be suitable for testing new endovascular occlusion devices. The purpose of this study was to evaluate different imaging modalities for the depiction of anatomy and size of elastase-induced aneurysms and for serial follow-up imaging. MATERIALS AND METHODS: Elastase-induced aneurysms were created in eight Chinchilla bastard rabbits by endoluminal incubation of porcine elastase. Serial imaging was performed using intravenous DSA (IVDSA), contrast-enhanced MRA (CEMRA), and time-of-flight MRA (TOF) 14 days, 4 weeks and 3 months after aneurysm creation. Intraarterial DSA (IADSA) and CT angiography (CTA) were performed after 3 months. Aneurysm size and geometry (height H, width W, neck width N) were compared. RESULTS: On IVDSA after two weeks mean aneurysm height was 6.2 mm (range 2.8 - 11.0 mm), mean aneurysm width was 2.8 mm (range 2.0 - 4.2 mm) and mean aneurysm neck width was 2.7 mm (range 2.0 - 4.2 mm). We did not observed any statistically significant change in aneurysm dimensions during follow-up at 4 weeks (CEMRA: H: 5.4, W: 2.4, N: 2.4; TOF: H: 5.7, W: 2.4, N: 2.7) and 3 months (CEMRA: H: 5.8, W: 2.6, N: 2.6; TOF: H: 6.9, W: 2.8, N: 3.0). Aneurysm dimensions could be best seen on IADSA (H: 6.2, W: 3.0, N: 2.7) with good correlation to CTA (r = 0.94; H: 6.1, W: 2.8, N: 2.6), CE-MRA (r = 0.92), and TOF (r = 0.97). TOF was superior to CEMRA in delineating the aneurysm wall. CONCLUSIONS: Serial imaging using MRA, CTA or intravenous and intraarterial angiography is feasible in the elastase-induced aneurysm model. Contrast-enhanced MRA, TOF-MRA and CTA showed good correlation to IADSA and are all suitable for non-invasive pretherapeutic measurement of aneurysm size.

Angiography↗

PubMed2001

Flow-directed microcatheters for cerebral embolizations using Ethibloc--an in vitro study.

We conducted an in vitro performance study to test the flow-directed Spinnaker microcatheter for potential endovascular embolizations with Ethibloc as embolic agent. We performed in vitro testing using 50 Spinnaker 1.8F hydrophilic infusion microcatheters of three different types. As embolic agent, different mixtures of Ethibloc and Lipiodol (E/L 1:1, 1:2, 1:3) were used. In an in vitro setting, each catheter was injected to a maximum of ten times (E/L 1:1, n = 20 catheters; E/L 1:2, n = 20; E/L 1:3, n = 10). In addition, we evaluated the thinner Spinnaker 1.5F microcatheter (165/20, n = 10). Five Spinnaker 1.5F catheters were each injected with a mixture of Ethibloc and Lipiodol (E/L 1:2 and 1:3). When a mixture of E/L 1:1 was used, 9 of 20 (45%) Spinnaker 1.8F microcatheters ruptured distally near the tip of the microcatheter, each during injection nos. 5-9. One Spinnaker 1.8F was distally occluded after the fifth injection. With a mixture of E/L 1:2, 4 of 20 (20%) Spinnaker 1.8F microcatheters ruptured distally, during injection no. 6 (n = 2), 7 (n = 1), and 8 (n = 1). With a mixture of E/L 1:3, all ten Spinnaker 1.8F microcatheters could be injected without any problems. All ten microcatheters of the thinner Spinnaker 1.5F ruptured (10-18 cm proximally to the catheter tip). This in vitro study using the flow-directed Spinnaker microcatheter revealed that microcatheters can rupture. The Spinnaker 1.8F can rupture when a mixture of Ethibloc and Lipiodol 1:1 or 1:2 and more than four injections are used. The Spinnaker 1.8F does not rupture when a mixture of E/L 1:3 is used, or with a mixture of E/L 1:1 or 1:2 and injecting to a maximum of four times. The Spinnaker 1.5F microcatheter is not suitable for embolizations using Ethibloc. For embolizations with Ethibloc we therefore recommend the use of a guidewire-directed microcatheter.

Catheterization↗