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Walter Casagrande MD. Sections of Cerebrovascular Surgery And Endovascular Neurosurgery

Travel Stories : An Argentinian Story. Walter Casagrande MD. Sections of Cerebrovascular Surgery And Endovascular Neurosurgery Hospital Juan A. Fernandez Buenos Aires, Argentina. Acknowledgement. Rosario Dr. Sergio Petrocelli Dr. Juan Godes

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Walter Casagrande MD. Sections of Cerebrovascular Surgery And Endovascular Neurosurgery

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  1. TravelStories: AnArgentinianStory Walter Casagrande MD. Sections of CerebrovascularSurgery And EndovascularNeurosurgery Hospital Juan A. Fernandez Buenos Aires, Argentina

  2. Acknowledgement Rosario Dr. Sergio Petrocelli Dr. Juan Godes Córdoba Dr. Gustavo Foa Torres Dr. Federico Roca Tucumán Dr. Roberto Gonzalez Buenos Aires Dr. Gustavo Mazenga Dra. Silvia Garbugino Dr. Luis Lemme-Plaghos

  3. ClinicalCharacteristics 24 monthsstudyperiod (June/08 - June/10) 36 Total aneurysmstreated Incidental 7 (19,4%) TreatedPreviously 7 (19,4%) MassEffect 18 (50%) PreviousSubaracnoidHemorrhage 4 (11,2%)

  4. MorphologicalCharacteristics WideNeck 9 (25%) Large 6 (16,7%) Giant 8 (22,2%) Non Saccular 8 (22,2%) Recurrent 5 (13,9%)

  5. WideNeck- Incidental Immediate FU

  6. WideNeck- Incidental 6 mounths FU

  7. Giant-MassEffect Pre-treatment

  8. Giant-MassEffect Post-treatment

  9. Giant-MassEffect 6 mounths FU

  10. Giant-MassEffect MRI August 08 MRI September 09

  11. RecurrentAneurysm

  12. RecurrentAneurysms 6 mounths FU

  13. RecurrentAneurysm

  14. Non SaccularAneurysm

  15. Non Saccular

  16. Leo + 3,5 x 50

  17. Silk 5 x 50

  18. Limitations Vascular Morphology Progressioninsidethevessels

  19. Limitations Silk 4,5 x 25

  20. Limitations Morphology of Aneurysm

  21. Limitations = Challenges Dr. Juan Godes Dr. Sergio Petrocelli

  22. Limitations = Challenges 4 months FU withClopidogrel Pre-treatment

  23. Complications 3 CarotidOclutions (2 reopendafter 24Hs.) 1 StentMigration (NeurologicalDeficit) (2,7%)

  24. Limitations = Challenges

  25. Results CLINICAL FOLLOW UP MassEffectdiminished 16 (n18) (89%) NeurologicalDeficit 1 (2,7%) Hemorrhage(0%) Death 1 (Pneumonia) (2,7%)

  26. AngiographicResults 4M.(n31) 12M.(n10) 24M.(n8) Ocl. 10% 1 (3,2%) 1 (10%) Ocl.85-90% 17 (54,9%) 2 (20%) 1 (12,5%) Ocl.100% 13 (41,9%) 7 (70%) 7 (87,5%)

  27. Conclusions SilkStent induces “endovascularreconstruction” • Rebuilds arterial wall in wideneck and fusiformaneurysms • Effectively reduces masseffect • Preventsrebleeding • Long-Termdurability of occlusions

  28. TANTIE GRAZIE !!!

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