Aneurysm Embolization Paper

The blood vessel that Dr. Eltahawy was concerned about was thin and looked as though it would collapse in on itself. First, Dr. Eltahawy tried a balloon catheter. At the top of the catheter was a small balloon that could inflate to maintain a shape or structure of a blood vessel. However, because the blood vessel was so thin, the balloon catheter was not very effective. Instead, Dr. Eltahawy installed a stent. A stent is a wire mesh tube. It is placed in a blood vessel permanently to maintain the shape of the vessel and to allow for the free flow of blood. Throughout this entire independent study, I realize that shadowing in the medical field is less about learning about medicine and more about discovering about whether becoming a doctor is the right step. This independent study has been a step in the right

Usually, accessing vascular structures is done through a needle to puncture the vessel percutaneously, followed by a wire introduced through the needle to secure the vascular access. The needle is then removed and a sheath is advanced over the wire. Vascular sheaths are hollow structures with a built in diaphragm to prevent bleeding. Catheters are then placed into and out of the sheath with a minimal loss of blood.11

Placement of a chest tube indicated for pleural effusion and pneumothorax. There have been two kinds of chest tubes being used, including a Pigtail catheter and chest tube thoracotomy.

angioplasty. It is a procedure where a stent is placed in the artery through the groin and restores

Stent devices were invented in the 1980s and refined in the 1990s. Stenting techniques have transformed and expanded the therapeutic capabilities of angioplasty. There are two classification for stents based on their mode of deployment balloon-expandable and self-expandable. Stents are small mesh tubes which inserted to keep arteries open after angioplasty procedure. Drug -eluting stents have a polymer coating over mesh. This Polymer coatings have been proven to be durable and deliver drug in a uniform and controlled way ( White, Hollier 2007).

Groin access, guiding catheter navigated to the internal carotid artery, then intermediate catheter and microcatheter are pushed through and slightly passed the clot.

A large part of the decision between these two procedures depends on the aneurysms. Factors such as size, location, anatomy and morphology contribute to the treatment team decision as to which procedure would be most beneficial to the patient. During surgical clipping a clip is placed across the neck of the aneurysm cutting off the blood flow to the aneurysm. Singer et al. describes the risks of this procedure being temporary arterial occlusion, intraoperative hemorrhage or new or exacerbated neurologic deficits. The other commonly used surgery, endovascular coiling consist of inserting coils in the lumen of the aneurysm. Thrombus then forms in reaction to the coils and clots off blood flow to the aneurysm, preventing it from rupture or leaking. Complications of this procedure are different from surgical clipping. Aneurysmal rupture and thromboembolism are the main complications of endovascular coiling. Some patients may be placed on a combination of a heparin and or antiplatelet therapy to help prevent a thromboembolic event (Singer et al.). New procedures are being developed for aneurysms such as bypass surgery. This technique redirects blood flow within the brain and uses a built vessel connection to permanently occlude the artery on which the aneurysm sits (Zhang et al. pg. 99). Bypass surgery is more challenging and requires specially trained neurosurgeons for a successful procedure. Decisions and information about regarding the ideal time to treat the aneurysm needs to be addressed as well. There is some controversy about the timing of treatment for both ruptured and unruptured aneurysms. As it in other procedures the risk versus benefits of treating need to be taken into consideration. Risk factors for treating a unuptured aneurysm and having poor outcomes include advanced age and having larger aneurysms. Characteristics of the aneurysm, size,

The stent is inserted into the artery by balloon angioplasty, to expand the vessel walls in order to return blood flow back to normal. There are two types of stents, bare-metal stents and drug-eluting stents. Once a BMS is inserted into the vessel, it become fully endothelialized.. However, The animation explains that in about 1/3 of BMS implants, restenosis occurs. On the other hand DES were developed to combat this issue. The polymer coating on the DES contains a drug which aids in the inhibition of restenosis. However, the endothelialization process for drug-eluting stents has shown to be problematic, which can in time cause stent thrombosis, which can possibly lead to myocardial infarction. It is important to note that these stents should be used in patients how do not have complex coronary stenosis because the off-label use is not completely understood and has a higher risk of

All of the factors contribute to the patient’s risk, but only hypertension can potentially be modified to decrease the patient’s risk for further expansion of the aneurysm.

If the ultrasound has findings, or if there are clinical symptoms that suggest proximal disease (iliocaval), then an x-ray venogram of the pelvis may be performed. However, it is not the method of choice. This is beneficial though because compared to CT, it uses a significant less amount of radiation. It still uses radiation, but not as much. The lowest rating in the rankings is x-ray venography of the lower extremity. This exam is generally used in conjunction with thrombolysis. Thrombolysis is a treatment to dissolve dangerous clots in the blood vessels to improve blood flow and prevent damage to the tissues and organs. It may involve the injection of clot-busting drugs through an intravenous line or through a long catheter that delivers drugs directly to the site of the blockage. These types of exams are not as common as the use of an MRI or CT machine may be because of the severity of a

A stent is a small mesh tube that's used to treat narrow or weak arteries, for example, the coronary arteries which supply oxygen-rich blood to your heart. Doctors place stents in arteries as part of a procedure called percutaneous coronary intervention, or PCI, sometimes called angioplasty. In coronary arteries narrowed by the buildup of plaque the procedure opens the blockage and restores blood flow to the heart muscle. Doctors also may place a stent in weak arteries to improve blood flow and help prevent the arteries from bursting. To place a stent in one of your coronary arteries your doctor will make a small opening in a blood vessel in your upper thigh, arm or neck. Through this opening your doctor will thread a thin flexible tube call a catheter.

This is the most common treatment. In this procedure, a catheter is placed in the heart. The catheter is placed through the valve. Then a tiny balloon on the end of the catheter is blown up to open the valve.

I rejected my null hypothesis that the aneurysm recurrence rate from stent assisted coiling is equal to that of unassisted coiling in favor of the alternative hypothesis that the aneurysm recurrence rate from stent assisted coiling is not equal to that of unassisted coiling. A two proportion Z-test with a Z value of -4.858766 is less than the table Z value of 1.96 at an alpha level of 0.05 allowed me to make that claim. The results from this study would be able to help patients and doctors alike to determine which treatment would be the best to reduce the chance of aneurysms recurring.

Therefore, carotid artery stenting is considered effective and a viable alternative for the patients who are unsuitable for carotid endarterectomy.

An angiogram ( which is also refers to as an arteriogram) is a special test in which a neuroradiologist injects dye into the blood vessels in the brain and obtains images of the blood vessels. At this point, the angiogram is the test that most accurately shows the Arteriovenous malfunction resection and its relationship to the surrounding arteries and veins. Arteriovenous Malformation Resection are found in most adults the ages between 20 to 40 year olds what happens during surgery this type of Things you can expect are Arteriovenous Malformation Resection involves delicately separating the Arteriovenous Malformation Resection from the surrounding tissue by using a microscope than a neurosurgeon will cut off the blood supply to the Arteriovenous Malformation Resection this type of procedure is called microsurgical resection. The other type of surgical procedure is called Stereotactic radiotherapy what happends during this surgery is that they deliver deliver a concentrated dose of radiotherapy to the core of the Arteriovenous Malformation Resection in one session. Over the course of 2 to 5 years, the vessels of