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Title: | Endovascular Treatment of Wide-Necked Visceral Artery Aneurysms Using the Neurovascular Comaneci Neck-Bridging Device: A Technical Report. | Authors: | Brooks D.M.;Chandra R.V.;Lee M.J.;Asadi H.;Maingard J.;Kok H.K.;Phelan E.;Logan C.;Ranatunga D. | Institution: | (Maingard, Ranatunga, Brooks, Asadi) Interventional Radiology Service, Department of Radiology, Austin Hospital, Heidelberg, Melbourne, Australia (Kok, Phelan, Logan, Lee, Asadi) Interventional Radiology Service, Department of Radiology, Beaumont Hospital, and Royal College of Surgeons in Ireland, Dublin, Ireland (Chandra, Asadi) Interventional Neuroradiology Unit, Monash Imaging, Monash Health, Melbourne, Australia (Chandra, Asadi) Department of Imaging, Monash University, Melbourne, Australia (Brooks, Asadi) Interventional Neuroradiology Service, Radiology Department, Austin Hospital, Melbourne, Australia (Asadi) School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, Australia (Kok) Department of Interventional Radiology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom | Issue Date: | 2-Nov-2017 | Copyright year: | 2017 | Publisher: | Springer New York LLC (E-mail: barbara.b.bertram@gsk.com) | Place of publication: | United States | Publication information: | CardioVascular and Interventional Radiology. 40 (11) (pp 1784-1791), 2017. Date of Publication: 01 Nov 2017. | Journal: | CardioVascular and Interventional Radiology | Abstract: | Introduction: Visceral and renal artery aneurysms (VRAAs) are an uncommon clinical entity but carry a risk of rupture with associated morbidity and mortality. The rupture risk is particularly high when the aneurysms are large, of unfavourable morphology or in the setting of pregnancy and perioperative period. Endovascular approaches are now first line in the treatment of VRAA, but conventional techniques may be ineffective in excluding aneurysms with unfavourable anatomy such as those with wide necks or at arterial bifurcation points. The neurovascular Comaneci neck-bridging device is used to temporarily cover the neck of intracranial aneurysms without occluding forward arterial flow during endovascular coiling. We report the novel use of the Comaneci neck-bridging device for the treatment of complex peripheral VRAAs. Material(s) and Method(s): We describe the treatment of two patients with renal and splenic artery aneurysms demonstrating unfavourable anatomic morphology for conventional endovascular approaches. Result(s): In the first patient, the renal artery aneurysm was situated at the intrarenal bifurcation of the main renal artery in the setting of a solitary kidney. In the second patient, the splenic artery aneurysm was situated close to the splenic hilum at the distal splenic arterial bifurcation. The Comaneci neck-bridging device was successfully used in both cases to assist coil embolisation with visceral preservation. Conclusion(s): The Comaneci neck-bridging device is potentially safe and effective for the treatment of peripheral VRAA with unfavourable anatomic characteristics that would have been deemed unsuitable for treatment using conventional techniques. Level of Evidence: Level 4, Technical Report.Copyright © 2017, Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE). | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1007/s00270-017-1733-y | ORCID: | Maingard, Julian; ORCID: http://orcid.org/0000-0001-8958-2411 | Link to associated publication: | Click here for full text options | PubMed URL: | 28664233 [http://www.ncbi.nlm.nih.gov/pubmed/?term=28664233] | ISSN: | 0174-1551 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/38306 | Type: | Article | Subjects: | solitary kidney/di [Diagnosis] *spleen artery aneurysm/su [Surgery] treatment outcome treatment response heparin artery catheter *vascular equipment vascular guide wire Cobra 2 Comaneci neck bridging device Imager MACH 2 guiding catheter Neuron MAX 088 adult aneurysm rupture anticoagulant therapy article clinical article clinical effectiveness device safety *endovascular surgery female follow up human hypertension kidney angiography kidney function perioperative period priority journal *renal artery aneurysm/di [Diagnosis] *renal artery aneurysm/su [Surgery] *spleen artery aneurysm/di [Diagnosis] Target Helical *endovascular surgery female follow up human hypertension kidney function perioperative period priority journal *renal artery aneurysm / *diagnosis / *surgery solitary kidney / diagnosis *spleen artery aneurysm / *diagnosis / *surgery treatment outcome treatment response kidney angiography adult aneurysm rupture anticoagulant therapy Article clinical article clinical effectiveness device safety |
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