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Stroke Revisited: Hemorrhagic Stroke pp 179–192Cite as

Angiographic Intervention in Hemorrhagic Stroke

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Part of the book series: Stroke Revisited ((STROREV))

Abstract

Angiographic intervention has an important role in the management of hemorrhagic stroke. Conventional cerebral angiography is the gold standard for the diagnosis of various vascular lesions that cause hemorrhagic stroke. With recent advancements in imaging techniques and endovascular devices, angiographic intervention in the treatment of hemorrhagic stroke has progressed as an alternative to surgery for inaccessible intracranial lesions or inoperable patients. In particular, the International Subarachnoid Aneurysm Trial (ISAT) established endovascular treatment as a feasible modality for the treatment of patients with aneurysmal subarachnoid hemorrhage (SAH). Various endovascular techniques, including conventional simple coil embolization, balloon-assisted coil embolization, stent-assisted coil embolization, and flow diversion, have been performed to prevent fatal rebleeding by blocking the aneurysm from the circulating blood flow. These techniques also provide useful treatment options for vascular lesions, such as dural arteriovenous fistula (dAVF) and arteriovenous malformation (AVM) that are another cause of hemorrhagic stroke. Hemorrhagic stroke requires urgent treatment to prevent fatal complications, and appropriate endovascular treatment options should be selected according to the anatomical configurations of the underlying vascular lesion.

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References

  1. Molyneux A, Kerr R, Stratton I, et al. International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial. Lancet. 2002;360:1267–74.

    Article  PubMed  Google Scholar 

  2. Mcdougall CG, Spetzler RF, Zabramski JM, et al. The barrow ruptured aneurysm trial. J Neurosurg. 2012;116:135–44.

    Article  PubMed  Google Scholar 

  3. Rouchaud A, Brinjikji W, Cloft HJ, et al. Endovascular treatment of ruptured blister-like aneurysms: a systematic review and meta-analysis with focus on deconstructive versus reconstructive and flow-diverter treatments. AJNR Am J Neuroradiol. 2015;36:2331–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Pierot L. Flow diverter stents in the treatment of intracranial aneurysms: where are we? J Neuroradiol. 2011;38:40–6.

    Article  PubMed  Google Scholar 

  5. Kallmes DF, Ding YH, Dai D, et al. A new endoluminal, flow-disrupting device for treatment of saccular aneurysms. Stroke. 2007;38:2346–52.

    Article  PubMed  Google Scholar 

  6. Mendes GA, Silveira EP, Caire F, et al. Endovascular management of deep arteriovenous malformations: single institution experience in 22 consecutive patients. Neurosurgery. 2016;78:34–41.

    Article  PubMed  Google Scholar 

  7. Raymond J, Roy D. Safety and efficacy of endovascular treatment of acutely ruptured aneurysms. Neurosurgery. 1997;41:1235–45. discussion 1245-1236

    Article  CAS  PubMed  Google Scholar 

  8. Sluzewski M, Bosch JA, Van Rooij WJ, et al. Rupture of intracranial aneurysms during treatment with Guglielmi detachable coils: incidence, outcome, and risk factors. J Neurosurg. 2001;94:238–40.

    Article  CAS  PubMed  Google Scholar 

  9. Janssen H, Berlis A, Lutz J, et al. State of practice: endovascular treatment of acute aneurysmal SAH in Germany. AJNR Am J Neuroradiol. 2017;38:1574–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Molyneux AJ, Kerr RS, Yu LM, et al. International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet. 2005;366:809–17.

    Article  PubMed  Google Scholar 

  11. Sadato A, Adachi K, Hayakawa M, et al. Effects of anatomic characteristics of aneurysms on packing density in endovascular coil embolization: analysis of a single center's experience. Neurosurg Rev. 2016;39:109–14. discussion 114

    Article  PubMed  Google Scholar 

  12. Kwon OK, Kim SH, Oh CW, et al. Embolization of wide-necked aneurysms with using three or more microcatheters. Acta Neurochir. 2006;148:1139–45. discussion 1145

    Article  PubMed  Google Scholar 

  13. Baxter BW, Rosso D, Lownie SP. Double microcatheter technique for detachable coil treatment of large, wide-necked intracranial aneurysms. AJNR Am J Neuroradiol. 1998;19:1176–8.

    PubMed  CAS  PubMed Central  Google Scholar 

  14. Moret J, Cognard C, Weill A, et al. Reconstruction technic in the treatment of wide-neck intracranial aneurysms. Long-term angiographic and clinical results. Apropos of 56 cases. J Neuroradiol. 1997;24:30–44.

    PubMed  CAS  Google Scholar 

  15. Kurre W, Berkefeld J. Materials and techniques for coiling of cerebral aneurysms: how much scientific evidence do we have? Neuroradiology. 2008;50:909–27.

    Article  CAS  PubMed  Google Scholar 

  16. Cai K, Zhang Y, Shen L, et al. Comparison of stent-assisted coiling and balloon-assisted coiling in the treatment of ruptured wide-necked intracranial aneurysms in the acute period. World Neurosurg. 2016;96:316–21.

    Article  PubMed  Google Scholar 

  17. Chalouhi N, Jabbour P, Tjoumakaris S, et al. Single-center experience with balloon-assisted coil embolization of intracranial aneurysms: safety, efficacy and indications. Clin Neurol Neurosurg. 2013;115:607–13.

    Article  PubMed  Google Scholar 

  18. Ross IB, Dhillon GS. Balloon assistance as a routine adjunct to the endovascular treatment of cerebral aneurysms. Surg Neurol. 2006;66:593–601. discussion 601-592

    Article  PubMed  Google Scholar 

  19. Sluzewski M, Van Rooij WJ, Beute GN, et al. Balloon-assisted coil embolization of intracranial aneurysms: incidence, complications, and angiography results. J Neurosurg. 2006;105:396–9.

    Article  PubMed  Google Scholar 

  20. Akpek S, Arat A, Morsi H, et al. Self-expandable stent-assisted coiling of wide-necked intracranial aneurysms: a single-center experience. AJNR Am J Neuroradiol. 2005;26:1223–31.

    PubMed  PubMed Central  Google Scholar 

  21. Muto M, Giurazza F, Ambrosanio G, et al. Stent-assisted coiling in ruptured cerebral aneurysms: multi-center experience in acute phase. Radiol Med. 2017;122:43–52.

    Article  PubMed  Google Scholar 

  22. Kim M, Levy EI, Meng H, et al. Quantification of hemodynamic changes induced by virtual placement of multiple stents across a wide-necked basilar trunk aneurysm. Neurosurgery. 2007;61:1305–12. discussion 1312-1303

    Article  PubMed  Google Scholar 

  23. Vanninen R, Manninen H, Ronkainen A. Broad-based intracranial aneurysms: thrombosis induced by stent placement. AJNR Am J Neuroradiol. 2003;24:263–6.

    PubMed  PubMed Central  Google Scholar 

  24. Bendok BR, Parkinson RJ, Hage ZA, et al. The effect of vascular reconstruction device-assisted coiling on packing density, effective neck coverage, and angiographic outcome: an in vitro study. Neurosurgery. 2007;61:835–40. discussion 840-831

    Article  PubMed  Google Scholar 

  25. Kadkhodayan Y, Rhodes N, Blackburn S, et al. Comparison of Enterprise with Neuroform stent-assisted coiling of intracranial aneurysms. AJR Am J Roentgenol. 2013;200:872–8.

    Article  PubMed  Google Scholar 

  26. Higashida RT, Halbach VV, Dowd CF, et al. Initial clinical experience with a new self-expanding nitinol stent for the treatment of intracranial cerebral aneurysms: the Cordis Enterprise stent. AJNR Am J Neuroradiol. 2005;26:1751–6.

    PubMed  PubMed Central  Google Scholar 

  27. Pearl M, Gregg L, Gailloud P. Endovascular treatment of aneurysmal subarachnoid hemorrhage. Neurosurg Clin N Am. 2010;21:271–80.

    Article  PubMed  Google Scholar 

  28. Rong-Bo Q, Hua J, Kai W, et al. Stent-jail technique in endovascular treatment of wide-necked aneurysm. Turk Neurosurg. 2013;23:179–82.

    PubMed  Google Scholar 

  29. Natarajan SK, Shallwani H, Fennell VS, et al. Flow diversion after aneurysmal subarachnoid hemorrhage. Neurosurg Clin N Am. 2017;28:375–88.

    Article  PubMed  Google Scholar 

  30. Makoyeva A, Bing F, Darsaut TE, et al. The varying porosity of braided self-expanding stents and flow diverters: an experimental study. AJNR Am J Neuroradiol. 2013;34:596–602.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Fiorella D, Hsu D, Woo HH, et al. Very late thrombosis of a pipeline embolization device construct: case report. Neurosurgery. 2010;67:onsE313–4. discussion onsE314

    PubMed  Google Scholar 

  32. Sadasivan C, Cesar L, Seong J, et al. An original flow diversion device for the treatment of intracranial aneurysms: evaluation in the rabbit elastase-induced model. Stroke. 2009;40:952–8.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Vinuela F, Fox AJ, Debrun GM, et al. Spontaneous carotid-cavernous fistulas: clinical, radiological, and therapeutic considerations. Experience with 20 cases. J Neurosurg. 1984;60:976–84.

    Article  CAS  PubMed  Google Scholar 

  34. Newton TH, Cronqvist S. Involvement of dural arteries in intracranial arteriovenous malformations. Radiology. 1969;93:1071–8.

    Article  CAS  PubMed  Google Scholar 

  35. Lasjaunias PBA. Surgical neuroangiography: endovascular treatment of craniofacial lesions. Berlin: Springer; 1987.

    Google Scholar 

  36. Cognard C, Gobin YP, Pierot L, et al. Cerebral dural arteriovenous fistulas: clinical and angiographic correlation with a revised classification of venous drainage. Radiology. 1995;194:671–80.

    Article  CAS  PubMed  Google Scholar 

  37. Borden JA, Wu JK, Shucart WA. A proposed classification for spinal and cranial dural arteriovenous fistulous malformations and implications for treatment. J Neurosurg. 1995;82:166–79.

    Article  CAS  PubMed  Google Scholar 

  38. Friedman JA, Pollock BE, Nichols DA, et al. Results of combined stereotactic radiosurgery and transarterial embolization for dural arteriovenous fistulas of the transverse and sigmoid sinuses. J Neurosurg. 2001;94:886–91.

    Article  CAS  PubMed  Google Scholar 

  39. Bertalanffy A, Dietrich W, Kitz K, et al. Treatment of dural arteriovenous fistulae (dAVF's) at the superior sagittal sinus (SSS) using embolisation combined with micro- or radiosurgery. Minim Invasive Neurosurg. 2001;44:205–10.

    Article  CAS  PubMed  Google Scholar 

  40. Luo CB, Teng MM, Chang FC, et al. Transorbital direct puncture of the posterior cavernous sinus through the internal carotid artery for embolization of isolated cavernous sinus dural arteriovenous fistula. J Neurointerv Surg. 2013;5:e1.

    Article  PubMed  Google Scholar 

  41. Luo CB, Chang FC, Wu HM, et al. Transcranial embolization of a transverse-sigmoid sinus dural arteriovenous fistula carried out through a decompressive craniectomy. Acta Neurochir. 2007;149:197–200. discussion 200

    Article  PubMed  Google Scholar 

  42. Houdart E, Saint-Maurice JP, Chapot R, et al. Transcranial approach for venous embolization of dural arteriovenous fistulas. J Neurosurg. 2002;97:280–6.

    Article  PubMed  Google Scholar 

  43. Rabinov JD, Yoo AJ, Ogilvy CS, et al. ONYX versus n-BCA for embolization of cranial dural arteriovenous fistulas. J Neurointerv Surg. 2013;5:306–10.

    Article  PubMed  Google Scholar 

  44. Kim DJ, Willinsky RA, Krings T, et al. Intracranial dural arteriovenous shunts: transarterial glue embolization--experience in 115 consecutive patients. Radiology. 2011;258:554–61.

    Article  PubMed  Google Scholar 

  45. Nelson PK, Russell SM, Woo HH, et al. Use of a wedged microcatheter for curative transarterial embolization of complex intracranial dural arteriovenous fistulas: indications, endovascular technique, and outcome in 21 patients. J Neurosurg. 2003;98:498–506.

    Article  PubMed  Google Scholar 

  46. Maimon S, Nossek E, Strauss I, et al. Transarterial treatment with Onyx of intracranial dural arteriovenous fistula with cortical drainage in 17 patients. AJNR Am J Neuroradiol. 2011;32:2180–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Cognard C, Januel AC, Silva NA Jr, et al. Endovascular treatment of intracranial dural arteriovenous fistulas with cortical venous drainage: new management using Onyx. AJNR Am J Neuroradiol. 2008;29:235–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Lamin S, Chew HS, Chavda S, et al. Embolization of intracranial Dural arteriovenous fistulas using PHIL liquid embolic agent in 26 patients: a multicenter study. AJNR Am J Neuroradiol. 2017;38:127–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Brown RD Jr, Wiebers DO, Torner JC, et al. Frequency of intracranial hemorrhage as a presenting symptom and subtype analysis: a population-based study of intracranial vascular malformations in Olmsted country, Minnesota. J Neurosurg. 1996;85:29–32.

    Article  PubMed  Google Scholar 

  50. Hofmeister C, Stapf C, Hartmann A, et al. Demographic, morphological, and clinical characteristics of 1289 patients with brain arteriovenous malformation. Stroke. 2000;31:1307–10.

    Article  CAS  PubMed  Google Scholar 

  51. Ondra SL, Troupp H, George ED, et al. The natural history of symptomatic arteriovenous malformations of the brain: a 24-year follow-up assessment. J Neurosurg. 1990;73:387–91.

    Article  CAS  PubMed  Google Scholar 

  52. Fleetwood IG, Steinberg GK. Arteriovenous malformations. Lancet. 2002;359:863–73.

    Article  PubMed  Google Scholar 

  53. Kim EJ, Halim AX, Dowd CF, et al. The relationship of coexisting extranidal aneurysms to intracranial hemorrhage in patients harboring brain arteriovenous malformations. Neurosurgery. 2004;54:1349–57. discussion 1357-1348

    Article  PubMed  Google Scholar 

  54. Redekop G, Terbrugge K, Montanera W, et al. Arterial aneurysms associated with cerebral arteriovenous malformations: classification, incidence, and risk of hemorrhage. J Neurosurg. 1998;89:539–46.

    Article  CAS  PubMed  Google Scholar 

  55. Graf CJ, Perret GE, Torner JC. Bleeding from cerebral arteriovenous malformations as part of their natural history. J Neurosurg. 1983;58:331–7.

    Article  CAS  PubMed  Google Scholar 

  56. Perret G NH. Arteriovenous malformations: an analysis of 545 cases of cranio-cerebral arteriovenous malformations and fistulae reported to the cooperative study. In: Sahs A, Perret G, Locksley H, Nishioka H, eds. Intracranial Aneurysms and Subarachnoid Hemorrhage: A Cooperative Study. JB Lippincott, Philadelphia; 1969.

    Google Scholar 

  57. Jafar JJ, Davis AJ, Berenstein A, et al. The effect of embolization with N-butyl cyanoacrylate prior to surgical resection of cerebral arteriovenous malformations. J Neurosurg. 1993;78:60–9.

    Article  CAS  PubMed  Google Scholar 

  58. Strozyk D, Nogueira RG, Lavine SD. Endovascular treatment of intracranial arteriovenous malformation. Neurosurg Clin N Am. 2009;20:399–418.

    Article  PubMed  Google Scholar 

  59. Izawa M, Chernov M, Hayashi M, et al. Combined management of intracranial arteriovenous malformations with embolization and gamma knife radiosurgery: comparative evaluation of the long-term results. Surg Neurol. 2009;71:43–52. discussion 52-43

    Article  PubMed  Google Scholar 

  60. Yashar P, Amar AP, Giannotta SL, et al. Cerebral arteriovenous malformations: issues of the interplay between stereotactic radiosurgery and endovascular surgical therapy. World Neurosurg. 2011;75:638–47.

    Article  PubMed  Google Scholar 

  61. Siddiqui AH, Chen PR, Rosenwasser RH. Endovascular therapy: indications, complications, and outcome. Informa Healthcare, New York; 2007.

    Google Scholar 

  62. Crowley RW, Ducruet AF, Mcdougall CG, et al. Endovascular advances for brain arteriovenous malformations. Neurosurgery. 2014;74(Suppl 1):S74–82.

    Article  PubMed  Google Scholar 

  63. Heros RC. Embolization of arteriovenous malformations. J Neurosurg. 2004;100:807–9. discussion 809

    Article  PubMed  Google Scholar 

  64. Han PP, Ponce FA, Spetzler RF. Intention-to-treat analysis of Spetzler-Martin grades IV and V arteriovenous malformations: natural history and treatment paradigm. J Neurosurg. 2003;98:3–7.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, Inje University Haeundae Paik Hospital, Busan, South Korea

    Chae Wook Huh & Sung-Chul Jin

  2. Department of Neurosurgery, Seodaegu Hospital, Busan, South Korea

    Duk Ho Gho

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  1. Department of Neurology, Seoul National University Hospital Department of Neurology, Seoul, Korea (Republic of)

    Seung-Hoon Lee

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Huh, C.W., Gho, D.H., Jin, SC. (2018). Angiographic Intervention in Hemorrhagic Stroke. In: Lee, SH. (eds) Stroke Revisited: Hemorrhagic Stroke. Stroke Revisited. Springer, Singapore. https://doi.org/10.1007/978-981-10-1427-7_13

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  • DOI: https://doi.org/10.1007/978-981-10-1427-7_13

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