Ceramics ; Esthetics, Dental ; Humans

The annual Live Interventional Neuroradiology & Neurosurgery Course(LINNC) is one of the most important congresses in the neurosurgery and neuroradiology field.LINNC 2009 was held on May 25th this year and lasted for 3 days.In this article, the authors introduced the main points of the congress.The congress mainly discussed some hot topics at present time, including both the clinical and fundamental studies of cerebral arteriovenous malformation, ischemic cerebral disease and intracranial aneurysm, etc.Both neurological and neuroradiological case demonstrations related to the topics, and the main course of the congress were alternately performed.Recent advances in imaging technique and clinical application, such as Dyna-CT and Xper-CT, were also presented on the congress.

Objective Endovascular stenting or combined stenting and Guglielmi detachable coils packing for the treatment of intracranial fusiform and wide necked aneurysms were reported to access the feasibility of the procedures.Methods The coronary stents were implanted across the neck of 3 vertebral fusiform aneurysms and 6 wide necked aneurysms. Microcatheters were introduced into the aneurysm sacs through stent mesh, and finally GDCs were used to embolize the aneurysms. Results The stents were precisely deployed resulting in total occlusion of 7 cases with more than 90% occlusion in 2 cases. All patients recovered well with patency of the parent arteries.Conclusions Endovascular therapy with combined stent implantation and microcoil placement maybe a valid alteration for the treatment of intracranial fusiform or wide necked aneurysms.

Objective To analyze the causes, prevention and treatment of repture druing procedure for intracranial aneurysm embolization with GDC.Methods All the seven patients were embolized. Six patients were ruptured during the procedure and continuously embolized until the bleeding was halted. Another one was identified by post procedure CT. Results Four patients recovered unevent fully with one only suffering from mild deficit. Another 2 patients died of hyper intracranial pressure within one week. Conclusions Rupture during procedure of intracranial aneurysm embolization with GDC may be related to manipulation, properties of the parent artery and arneurysm. Continuous embolization with GDC will provide favorable prognosis for the patients.

Objective To evaluate the endovascular embolization treatment of large and giant ophthalmic aneurysms. Methods Three aneurysms were embolized with coils only and 5 aneurysms were treated with stent placement togather with subsequent coiling. Results In the 3 aneurysms treated only with GDC, total embolization was achieved in 1 and partial embolization in 2. In the stent placement and coiling case, 4 aneurysms were densely packed and another one was partially packed. Conclusions Combined stenting and coiling is effective and safe for the treatment of large and giant ophthalmic artery aneurysm with the preservation of parent artery.

Objective To evaluate our short term results in endovascular treatment of symptomatic vertebral arteral stenosis with stents. Methods Balloon expanded stents were utilized to pass across the vertebral arterial stenosis, and then the balloons were inflated for the deployment of stents, outcoming with restoration of the stenosis to normal size. Results Forty five patients presented with posterior circulation ischemic symptoms and refractory to medical therapy were undertaken with endovascular stenting, showing technically successful in forty three of them. The mean degrees of preoperative and postoperative stenosis were 75.7% and 10.3%, respectively. Follow up data showed disappearence of clinical symptoms in 35 patients, chinical implovement and stabilization in 2. There were no intimal dissection and distal embolization. Short term follow up angiogram revealed no restenosis and intimal hyperplasia. Conclusions Endovascular stenting may be a favorable alternative for the treatment of vertebral arterial stenosis, but long term follow up is necessary.

Objective Investigation of the clearance rate of RBC in cerebral spinal fluid(CSF)after lumber subarachnoid space continuous drainage following subarachnoid hemorrhage(SAH)and the relationship with cerebral vasospasm(CVS) were carried out. Methods An experimental SAH was achieved in dogs by twice injecting fresh autologous arterial blood into cisterna magna of each animal.RBC counts in CSF were measured in the drainage group, puncture group and control group respectively.The degrees of CVS were analyzed through cerebral angiography(%reduction of basilar artery diameter,%RBAD). Results Comparing with puncture group and control group, the drainage group showed a significantly higher clearance rate of RBC with lesser occurrance and degree of CVS. Conclusions RBC and its degeneratives in CSF may be involed in the process of CVS following experimental SAH. Continuous lumber subarachnoid space drainage may prevent CVS.

Objective To explore our clinical experience on treatment of intracranial and extracranial arterial stenosis using multiple stents placement. Methods 17 stents were deployed into 12 arteries in 8 patients with intracranial and extracranial arterial stenosis. We utilized self expanding stents in extracranial carotid arteries and balloon expanding stents for intracranial arteries or vertebral arteries. Results All procedures were performed successfully and all stenoses were dilated and improved. Short term follow up angiogram revealed only one vessel occlusion and no significant restenoses in other stented vessels together with no recurence of clinical symptoms. Conclusions Multiple stents placement is a valid alternative for the treatment of intracranial and extracranial arterial stenoses.

Objective To summarize the early experience and results of endovascular stenting for symptomatic stenosis of middle cerebral artery. Methods We performed percutaneous endovascular stent assisted angioplasty in 20 patients with symptomatic high grade stenosis of MCA, who had either recurrent transient ischemic attacks (TIAs) resistant to medical therapy or perfusion problems. After stenting, the patients was administrated with antiplatelet drug and followed up with DSA、TCD and SPECT. Results Stent placement and angioplasty were successfully performed in all patients except one with MCA rupture during the procedure. The mean degree of stenosis reduced from (78.3?4.7)% to (15.6?4.4)%, and the degree of residual stenosis were less than 30%. None of these patients developed TIAs or stroke during the follow up period. Angiography revealed no evidence of restenosis. TCD and SPECT suggested significant improvement of cerebral perfusion. Conclusions Endovascular stenting for MCA stenosis seems to be a safe and effective therapeutic method. Further study is needed for long term outcome.

Objective To analyse the preliminary outcome and its relevant factors of endovascular stent assisted angioplasty for intracranial stenosis. Methods Sixty one atherosclerotic intracranial stenoses in 57 patients (23 stenoses in posterior and 38 in anterior circulation) were treated with endovascular angioplasty using balloon expandable coronary stents. Results Technical success was achieved in all patients, with no procedural and associated complications except one of intracranial hemorrhage. Angiographic results immediately after stenting suggested that the residual postprocedure stenosis was 0%～32% (mean 8.7%?4.4%), with significant reduction from preprocedure stenosis (74.5%?6.7%). The patients were clinically asymptomatic and had no recurrent TIA and stroke. Follow up angiogram in 43 patients revealed no restenosis (