22. European Stroke Conference 922 Interventional neurology Endovascular Treatment of Ugly Aneurysms using Sandwitch Technique B.H. Lee1, Y.J. Choi2, H.G. Lee3, J.S. Kang4 Dept. of Radiology, Cheonan ChungMu Hospital, Cheonan, SOUTH KOREA1, Dept. of Neu-rology, Cheonan ChungMu Hospital, Cheonan, SOUTH KOREA2, Dept. of Neurology, Cheonan ChungMu Hospital, Cheonan, SOUTH KOREA3, Dept. of Neurology, Cheonan ChungMu Hospital, Cheonan, SOUTH KOREA4 Background: To report mid-term results of endovascular treatment for ugly aneurysms with sand-witch 834 © 2013 S. Karger AG, Basel Scientific Programme technique Methods: Between Dec 2009 and Nov 2011, endovascular treatment with sandwitch technique(stent/ coils/stent/coils/stent…) was performed in 6 patients (M:F=2:4,mean age: 59.7years) with aneurysm surgically difficult or difficult with conventional endovascular treatment. Lesion characteristics were as follows: unruptured aneurysm in five and ruptured in one 4 saccular dissecting aneurysms: 3 in supraclinoid ICA and one in P1 segment 1 fusiform dissecting aneurysm in intracranial vertebral ar-tery 1 P-com aneurysm (rupture during stent-assisted coiling) Results: Technical success was achieved in all patients ( total occlusion in five and subtotal occlu-sion in one ). There was no procedure-related morbidity or motality. Serial angiographic follow-up was available in four patients ( mean: 9.3months, range: 2-15 month). One patient with sub-total occlusion showed near-total occlusion on 2 month follow-up angiogram and there was no recanali-zation or regrowth of aneurysm in remaining three patients. Conclusion: Endovascular treatment with Sandwitch technique was technically feasible and safe for treatment of ugly aneurysm which was surgically difficult or difficult with conventional endovascu-lar treatment. It could be another treatment option if pipeline stent system cannot be used. 923 Interventional neurology Where should we direct our efforts among a few in-hospital steps from ER arrival to achieve faster recanalization in acute ischemic stroke? R. Ito1, T. Mori2, M. Nakazaki3, T. Iwata4, Y. Miyazaki5, Y. Takahashi6 Department of storoke treament Shonan Kamakura General Hospital Stroke Center, Ka-makura, JAPAN1, Department of storoke treament Shonan Kamakura General Hospital Stroke Center, Kamakura, JAPAN2, Department of storoke treament Shonan Kamakura General Hospital Stroke Center, Kamakura, JAPAN3, Department of storoke treament Shonan Kamakura General Hospital Stroke Center, Kamakura, JAPAN4, Department of storoke treament Shonan Kamakura General Hospital Stroke Center, Kamakura, JAPAN5, Department of storoke treament Shonan Ka-makura General Hospital Stroke Center, Kamakura, JAPAN6 Back ground and purpose Faster recanalization is related to better clinical outcome in acute ischemic stroke. The purpose of our retrospective study is to analyze the time taken in various aspects of in-hospital care from ER arrival to arterial puncture in patients undergoing endovascular therapy and to find which step the longest is. Method Stroke Center Database was investigated retrospectively and included in our analysis were patients (1) who were admitted to our institution from January 2004 to June 2012, (2) who presented some neurological symptoms, (3) who underwent MRI following CT, which showed acute ischemic stroke caused by major vessel occlusion and no intracerebral hemorrhage, (4) who underwent endovascular therapy including local intra-arterial fibrinolysis, mechanical thrombectomy using balloon, Merci re-trieval system and Penumbra system and stenting. We examined the times from ER arrival to arterial puncture (ER-AP), from ER arrival to CT ( ER-CT ), from CT to MRI ( CT-MR ), and from MRI to arterial puncture ( MR-AP). Result During the study period, 212 patients were included for retrospective analysis. The average ER-AP time was 2.73 ± 1.39 hours, the average ER-CT, CT-MR and MR-AP times were 0.47 ± 0.38 hours, 0.81 ± 0.37 hours and 1.45 ± 0.68 hours, respectively. The MR to AP step spent the longest time and the CT to MR step was the second. Conclusion CT to MR and MR to arterial puncture times show wide variability and the times must be reduced to achieve faster recanalization by endovascular therapy.
Karger_ESC London_2013
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