Wide-necked bifurcation aneurysms, which are balloon-like bulges in an artery wall in the brain, present a unique challenge for surgeons because of their location.
Resting near the base of the skull, these aneurysms can be difficult to dissect or treat with endovascular technology, said neurosurgeon Peter Kan, M.D., of Baylor St. Luke’s Medical Center.
Brain aneurysms are fairly common and can be repaired. But in 1 to 2 percent of patients, the aneurysm ruptures, causing headaches, dizziness and irreversible brain damage, he said. A traditional treatment involves surgical clipping, in which doctors place a tiny clamp at the base of the aneurysm to stop or prevent bleeding. Another corrective measure emerged in the early 1990s: accessing the aneurysm through a leg artery—known as endovascular surgery—rather than performing an open procedure on the brain. That method was the standard for years, Kan said.
Since then, a popular treatment emerged involving installing coronary stents or detachable coils as a way to seal off the aneurysm. But for wide-necked aneurysms, this procedure is not foolproof; the coils can fall out, Kan said, so doctors have adapted by using a combination of clipping and coils.
Most recently, surgical clipping with endovascular therapy has become the preferred treatment for wide-necked aneurysms. Kan was among the first to treat patients with PulseRider, a neurovascular implant developed by the California-based medical device company Pulsar Vascular, which enables minimally invasive endovascular treatment for the complex brain aneurysm.
“I have a long-standing interest in devices used to treat brain aneurysms, so I’m involved in a lot of trials,” Kan said. “I’ve done about six cases, and I’m trying to be one of the early adopters.”
PulseRider’s technology uses a collapsible, bony frame made of nitinol (nickel titanium) that is installed in a closed position through a leg artery. Upon reaching the aneurysm at the base of the skull, the frame opens like the scaffolding of an umbrella to reinforce the vessel walls and mitigate the problems of earlier endovascular devices while preserving blood flow. Essentially, the retrievable implant acts as a bridge for aneurysms located near a vessel branch point and is used in conjunction with coil embolization, where platinum springs are employed to seal an aneurysm to avoid rupture or hemorrhage, Kan said.
“We can use this as a bridge device,” he said. “We put stents in to hold the coils, but putting in that much metal is a risk.”
PulseRider leaves 90 percent less metal inside the patient than traditional stenting, Kan said, and also conforms to the anatomy of each patient’s aneurysm.
Shorter recovery time
A group of European and American researchers tested PulseRider in 15 patients with unruptured wide-necked bifurcation aneurysms and published the results in the January 2016 edition of the American Journal of Neuroradiology.
Among the 14 patients where PulseRider was effective, 12 showed complete occlusions, or closed blood vessels, and two showed neck remnants, which is the presence of a portion of the original arterial wall. The researchers concluded that “PulseRider stent-assisted coiling of wide-neck bifurcation aneurysms was feasible with low procedural complication rates,” and that
“preliminary results are encouraging,” despite the study’s small number of participants.
“It’s a great device and there is an advantage to using it,” Kan said. In addition, the recovery period for patients treated with PulseRider is generally shorter than for those who undergo traditional open aneurysm procedures. In fact, Kan said, the first patient to receive this treatment at Baylor St. Luke’s was discharged from the hospital the day after PulseRider was implanted.Peter Kan, M.D., holds PulseRider, a neurovascular device that enables minimally invasive endovascular treatment of patients diagnosed with wide-necked bifurcation aneurysms.
RT @WebsEdge_Health: ASHG TV sat down with Brendan Lee, Professor & Chairman, Dept. of Molecular & Human #Genetics @bcmhouston to learn mor…
“One of the important questions we want to answer is ‘Why don’t these work better?’”@AnnKloppMD explains how our HPV-Related Cancers Moon Shot is working to overcome barriers using #immunotherapy: https://t.co/kL6uLPuGFj @CancerFrontline #CancerMoonshot #endcancer
Join us for the "Grill Your Ace Off" event this Saturday, October 19 with Cypress @AceHardware! Proceeds benefit @CMNHospitals: https://t.co/UeNuaDzp9h
A new technique developed by Rice bioscientists has allowed them to make the most comprehensive analysis yet of signaling pathways that drive patterning of human ectoderm.Read more: https://t.co/fmCDuInplI https://t.co/6iBO8MfaCI
University of Houston@UHouston
RT @GetInvolvedUH: Join us for InfraRED: Spooktacular TONIGHT from 7:00-10:00PM in the Student Centers Houston Room. This year’s activities…
University of Houston@UHouston
RT @UHoustonLib: .@UH_Arch_Art_Lib is pleased to host an opening reception for student artist Morgan Stahl on November 8https://t.co/Eq2V…
Veterans getting better care through partnerships, says VA secretary https://t.co/j29GiiYZSQ via #VAntagePoint
Mark your calendars for @BCMCancerCenter’s Lights Out, Cancer event happening Feb. 8. To learn more about this event or how you could participate even if you can't attend, please visit: https://t.co/DcJyiczUvu #BCMLightsOutCancer #BCMLOC https://t.co/uwVfAQxgcO
Finding your way around one of the largest cancer centers in the world can be daunting. Here’s how our patient escorts can help: https://t.co/e1w2DxY0VX #endcancer
How has rapidly changing technology affected medical education? Resonance, our student-run podcast, takes a look in their latest episode. https://t.co/Wrg2qSosMm #BCMResonance #podcasts #education
"The circulatory system’s response to panic...a pounding feeling in the head or chest and/or prompt feelings of lightheadedness or dizziness, according to the Texas Heart Institute. https://t.co/yfBHBgwHuC @Texas_Heart
RT @RiceArch: This week's episode of the Rice Architecture podcast Tête-à-Tête features a conversation with student Ethan Chan about the Ri…
RT @RiceVolleyball: PREVIEW: No. 1️⃣ 9️⃣ Owls head to Marshall, LA Tech this weekend.📰 » https://t.co/4mJMTaXB3i#GoOwls👐 x #RFND
Harris Health System@harrishealth
Happy #HealthcareSecurityWeek to our amazing Department of Public Safety team! Thanks for keeping staff and patients safe. https://t.co/Nu9OELntVs
CAR T-cell therapy side effects in #lymphoma patients can include: -flu-like symptoms -confusion -irritability Here’s what to know from our Dr. Felipe Samaniego: https://t.co/8JyOI2mv5f #CART #endcancer https://t.co/d09u8YdaLN