Endovascular treatment of blood blister-like aneurysms in the internal carotid artery using a Willis covered stent

Background Despite the current availability of flow diverter devices(FDD), problems remains regarding optimal endovascular treatment(EVT) for blood blister-like aneurysms(BBAs) of the internal carotid artery(ICA). Objective To evaluate the safety and efficacy of EVT of BBAs in the ICA with a Willis covered stent. Methods 20 consecutive patients(5 men and 15 women) with ruptured BBAs underwent EVT using a Willis covered stent in two institutions from March 2013 to March 2018. Clinical observations, angiographic characteristics, and procedural and follow-up outcomes were retrospectively evaluated. Results 20 consecutive patients(5 men and 15 women) with ruptured BBAs underwent EVT using a Willis covered stent in two institutions from March 2013 to March 2018. Clinical observations, angiographic characteristics, and procedural and follow-up outcomes were retrospectively evaluated. Conclusion Our initial results demonstrate that reconstructive EVT using a Willis covered stent provides a viable approach to treat ICA BBAs. However, an expanded clinical evaluation and larger cohort are needed to confirm the results.

Reconstructive treatment of symptomatic vertebral artery dissecting aneurysms with Willis covered stent: Initial experience

Background:Symptomatic vertebral artery dissecting aneurysm(VADA)is a challenging disease with controversy on treatment strategy due to anatomic configuration and their nature.Moreover,the outcomes of reconstructive treatment have not been well established.Objective:To evaluate the safety and efficacy of reconstructive endovascular treatment(EVT)for symptomatic VADAs with Willis covered stent.Methods:We evaluated retrospectively 13 patients with symptomatic VADAs who treated with Willis covered stent,compared with stent-assisted coiling(SAC)on the characteristics,posttreatment course,angiographic and clinical follow-up outcomes at an average of 14.4 months(range,3-48 months).Results:A total of 33 patients with symptomatic VADAs were reviewed,23 of these patients with ruptured VADAs.The technical successful rate is 100%respectively in Willis covered stent(Group A)and SAC(Group B,n=20).The initial complete occlusion rate was significant higher in group A(100%)than group B(30%)(p<0.01).Major procedure-related complications were not significant different in the two groups.Serial follow-up angiograms revealed 5 recurrent VADAs in group B and no recurrence in group A(p>0.05).No obvious in-stent stenosis and no re-hemorrhage and delayed ischemic symptoms during the follow-up period.The final angiograms of all survived patients demonstrated the complete occlusion rate was higher in group A(100%)than group B(80%),but no significant statistical difference(p>0.05).Clinical outcomes were favorable in 31(93.9%),severe disability occurred in one in group B,and only one death in group A.The final clinical outcomes were also not significant difference in the two groups(p>0.05).Conclusions:Our initial result demonstrated reconstructive EVT with Willis covered stent provides a viable approach for selected symptomatic VADAs involving the intracranial and extracranial segments,which is similar to favorable results with SAC.However,an expanded clinical experiences and larger cohort studies are needed.

Effects of mRNA, Protein Expression and Activity for Myocardial SOD2 by a Single Bout of or Long-Term Strenuous Endurance Exercise in Rats

Objective: To explore the effects of myocardial SOD2 by strenuous endurance exercise. Methods: 27 grown male SD rats were randomly divided into control group (C), a single bout of strenuous endurance exercise group (E1) and seventh-week strenuous endurance exercise group (E2). Real-time PCR was used to observe the changes of mRNA expression for myocardial SOD2. Western bolt was used to observe the changes of SOD2 protein expression. In addition, SOD2, T-SOD and SOD1 activity changes were observed. Results: Myocardial SOD2 expression level at mRNA and protein of Group E1, E2 was significantly higher than that in group C, and SOD2 and T-SOD activity in group E2 were significantly higher than those in group C. Those changes were more obvious in group E2. Conclusions: Strenuous endurance exercise can improve level of myocardial SOD2 expression at mRNA and protein, and enhance the activity for SOD2, thus increasing the activity for T-SOD. Effect of long-term strenuous endurance exercise was better than a single bout of one.