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Mahmoud, Ehab
Publications (3 of 3) Show all publications
Borota, L., Mahmoud, E. & Nyberg, C. (2019). Neuroform Atlas stent in treatment of iatrogenic dissections of extracranial internal carotid and vertebral arteries: a single-centre experience. Interventional Neuroradiology, 25(4), 390-396
Open this publication in new window or tab >>Neuroform Atlas stent in treatment of iatrogenic dissections of extracranial internal carotid and vertebral arteries: a single-centre experience
2019 (English)In: Interventional Neuroradiology, ISSN 1591-0199, E-ISSN 2385-2011, Vol. 25, no 4, p. 390-396Article in journal (Refereed) Published
Abstract [en]

AIM OF THE STUDY: To present our experience in the treatment of iatrogenic dissections of extracranial internal carotid and vertebral arteries with the Neuroform Atlas stent.

MATERIALS AND METHODS: Between January 2017 and February 2018 we treated iatrogenic dissections of three internal carotid arteries and three vertebral arteries. These iatrogenic dissections occurred during the endovascular treatment of ruptured and unruptured intracranial aneurysms. The indication for stenting was haemodynamically significant, flow-limiting dissection with threatening flow arrest. In all six cases, the dissections were treated by placement of Neuroform Atlas stents in the dissected segments of internal carotid or vertebral arteries. Deployment of the stent was followed by the usual dual antiplatelet regimen.

RESULTS: Single or multiple Neuroform Atlas stents were deployed without any technical difficulties, and blood flow was restored immediately after placement of the stents in all six cases. Midterm follow-up (6-8 months) showed complete reconstruction of the shape and lumen of all treated arteries, with negligible intimal hyperplasia.

CONCLUSION: Our results indicate that a favourable outcome can be achieved by treating iatrogenic dissections of extracranial internal carotid and vertebral arteries with the Neuroform Atlas stent.

Keywords
Atlas, iatrogenic dissection, treatment
National Category
Neurosciences Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-382946 (URN)10.1177/1591019919830215 (DOI)000472958900004 ()30803334 (PubMedID)
Available from: 2019-05-07 Created: 2019-05-07 Last updated: 2019-08-16Bibliographically approved
Borota, L., Jangland, L., Åslund, P.-E., Ronne-Engström, E., Nyberg, C., Mahmoud, E., . . . Patz, A. (2017). Spot fluoroscopy: a novel innovative approach to reduce radiation dose in neurointerventional procedures. Acta Radiologica, 58(5), 600-608
Open this publication in new window or tab >>Spot fluoroscopy: a novel innovative approach to reduce radiation dose in neurointerventional procedures
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2017 (English)In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 58, no 5, p. 600-608Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Increased interest in radiation dose reduction in neurointerventional procedures has led to the development of a method called "spot fluoroscopy" (SF), which enables the operator to collimate a rectangular or square region of interest anywhere within the general field of view. This has potential advantages over conventional collimation, which is limited to symmetric collimation centered over the field of view.

PURPOSE: To evaluate the effect of SF on the radiation dose.

MATERIAL AND METHODS: Thirty-five patients with intracranial aneurysms were treated with endovascular coiling. SF was used in 16 patients and conventional fluoroscopy in 19. The following parameters were analyzed: the total fluoroscopic time, the total air kerma, the total fluoroscopic dose-area product, and the fluoroscopic dose-area product rate. Statistical differences were determined using the Welch's t-test.

RESULTS: The use of SF led to a reduction of 50% of the total fluoroscopic dose-area product (CF = 106.21 Gycm(2), SD = 99.06 Gycm(2) versus SF = 51.80 Gycm(2), SD = 21.03 Gycm(2), p = 0.003884) and significant reduction of the total fluoroscopic dose-area product rate (CF = 1.42 Gycm(2)/min, SD = 0.57 Gycm(2)/s versus SF = 0.83 Gycm(2)/min, SD = 0.37 Gycm(2)/min, p = 0.00106). The use of SF did not lead to an increase in fluoroscopy time or an increase in total fluoroscopic cumulative air kerma, regardless of collimation.

CONCLUSION: The SF function is a new and promising tool for reduction of the radiation dose during neurointerventional procedures.

Keywords
X-ray, collimation, digital subtraction angiography (DSA), neurointervention, fluoroscopy, dose saving
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-303911 (URN)10.1177/0284185116658682 (DOI)000397475900013 ()27522095 (PubMedID)
Available from: 2016-09-27 Created: 2016-09-27 Last updated: 2017-08-08Bibliographically approved
Borota, L., Mahmoud, E., Nyberg, C. & Ekberg, T. (2015). Combined percutaneous and transarterial devascularisation of juvenile nasopharyngeal angiofibroma with protection of internal carotid artery: A modification of the technique. Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, 21(3), 390-396
Open this publication in new window or tab >>Combined percutaneous and transarterial devascularisation of juvenile nasopharyngeal angiofibroma with protection of internal carotid artery: A modification of the technique
2015 (English)In: Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, ISSN 1591-0199, Vol. 21, no 3, p. 390-396Article in journal (Refereed) Published
Abstract [en]

Juvenile nasal angiofibroma (JNA) is a hypervascularised, benign, but locally aggressive tumour that grows in the posterior, upper part of the nasal cavity and invades surrounding anatomical structures. The treatment of choice is surgical removal, but complete resection of the tumour can be hampered because of profuse perioperative bleeding. Preoperative embolisation of the tumour has been proposed as an effective method for prevention of perioperative bleeding, thereby shortening of the time of the operation. In this report of five cases, we describe successful preoperative devascularisation of the tumour by applying a modified method of direct intratumoural injection of the liquid embolic agent Onyx combined with protection of the internal carotid artery. The control of bleeding during the embolisation and occlusion of the maxillary or sphenopalatine artery was achieved by using a bi-luminal balloon catheter. Such use of the dual-lumen catheter in treatment of JNA has not been reported so far in the medical literature.

National Category
Neurosciences Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-253999 (URN)10.1177/1591019915581988 (DOI)000356305000018 ()25991005 (PubMedID)
Available from: 2015-06-04 Created: 2015-06-04 Last updated: 2018-01-11Bibliographically approved
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