Search

Introduction The Woven EndoBridge device (WEB) was developed as an alternative to treat Wide-Necked bifurcation aneurysms. It has proven to be effective and safe, however, cases of recanalization have been reported. The purpose of this study was to evaluate and quantify hemodynamic parameters and indexes with CFD of the intracranial aneurysms before and after WEB simulation and to establish their relationship to complete occlusion.Materials and methods Using the heterogeneous model based on the marching cubes algorithm, we created 3D representations of 27 bifurcated intracranial aneurysms treated with the single-layer WEB device to evaluate hemodynamics parameters with CFD, calculated with and without the WEB.Results We observed a lower treatment entry concentration indices (ICI) (2.12 ± 1.31 versus 3.14 ± 0.93, p-value: 0.029) previous to placement of WEB and higher pre-treatment FN (7.56 ± 5.92 versus 3.35 ± 1.51, p-value: 0.018) and post-treatment FN (5.34 ± 5.89 versus 1.99 ± 0.83, p-value: 0.021) for cases with successful occlusions. Lower post-treatment SRa (197.81 ± 221.29 versus 80.02 ± 45.25, p-value: 0.044) and higher pre (0.11 ± 0.07 versus 0.25 ± 0.19, p-value: 0.011) and post-treatment MATT (0.69 ± 1.23 versus 1.02 ± 0.46, p-value: 0.006) were observed in non-occluded cases.Conclusions In our CFD analysis of the hemodynamic parameters of IA, we found lower ICI before the placement of the WEB device and higher FN pre- and post-treatment for cases with successful occlusions. Non-occluded cases had lower post-treatment SRa and higher pre-treatment and post-treatment MATT.

Purpose This study is a systematic review about the WEB device and addresses the efficacy and safety of this device for the endovascular treatment of ruptured and unruptured intracranial aneurysms.Material and methods This systematic literature review followed PRISMA-P guidelines and included studies published until 2010. PubMed and ScienceDirect databases were searched, resulting in 22 articles meeting the inclusion criteria.Results The studies involved 1705 patients and 1224 aneurysms, predominantly wide-neck aneurysms in the middle cerebral artery, internal carotid artery, and basilar artery. The treatment success rate was 28.1%, with the WEB-SL and WEB-SLS devices being commonly used. The immediate post-treatment adequate occlusion rate was 33.3%, increasing to 49.7% at follow-up. Thromboembolic complications occurred in 6.5% of cases, while other complications were observed in 3.1% of cases. The mortality rate associated with the WEB device was low, approximately 1%.Conclusion The WEB device demonstrates favorable outcomes in treating patients with intracranial aneurysms, with adequate occlusion rates improving over time. Thromboembolic complications are the primary concern, but overall complication and mortality rates remain low. Further research is needed to optimize device selection, standardize classification systems, and enhance long-term evaluation and training protocols.

Background and aims Endovascular treatment for cerebrovascular disease is accepted as a first-line option with level I evidence in patients with an early and late time of window of onset symptoms, and an additional option in patients who do not respond or with contraindications to systemic thrombolysis; nevertheless the efficacy and outcomes of some groups were not clear, one of them are patients aged 80 years and older, because they were excluded of the trials, so the evidence is controversial with significant heterogeneity, for that reason in our study, we decided to analyze the age in the patients treated in our stroke center, as a predictor of prognosis, and to provide a baseline for the establishment of personalized treatment plans.Methods Observational, retrospective study of patients that received endovascular treatment for cerebrovascular disease in a Colombian stroke center between 2016 and 2020, continuous and categorical variables were compared using the Student's ttest and Chi-Square. To determine cut-off points in the variable against death and Rankin score variable on 90th day.Results In total, 108 patients were recruited, 35 of them were of 80 or more years, and the mean age was 72.7 years, we found age as a significant variable to predict the risk in the population over 80 years of age [RR 3.37 CI (95% 1.14–103) p=  0.029].Conclusions Age younger than 80 is a significant predictor for results and long-term outcomes in patients suffering from stroke, and in patients older than 80 years old a Thrombolysis in Cerebral Infarction score 2b-3 is a predictor of good outcomes. Further studies are needed to evaluate the relationship between intrahospital complications and long-term outcomes.

Introduction The Woven EndoBridge device (WEB) is used to treat wide-neck bifurcation aneurysms. These devices are deployed inside the sac. Therefore, the mesh structure provides apposition with the aneurysm wall and induces aneurysmal thrombosis. The objective of our study was to evaluate the anatomic and device-related parameters and indexes with Computational Fluid Dynamics (CFD) of the intracranial aneurysms before and after WEB simulation and find their relationship to complete occlusion.Materials and methods Using the heterogeneous model based on the marching cubes algorithm, we created 3D representations of 27 bifurcated intracranial aneurysms treated with the single-layer WEB device to evaluate anatomic and device-related parameters with CFD.Results In our CFD analysis, we observed higher large volumes (Va) (0.25 ± 0.18 versus 0.39 ± 0.09, p-value= 0.025) and higher volume to neck surface ratio (Ra) (1.32 ± 0.17 versus 1.54 ± 0.14, p-value= 0.021) in cases with occlusion failure.Conclusions Large aneurysm volumes (Va) and higher volume to neck surface ratio (Ra) could be associated with occlusion failure in aneurysms treated with the WEB device.

Introduction Three-dimensional (3D) printing has evolved for medical applications as it can produce customized 3D models of devices and implants that can improve patient care. In this study, we aimed to validate the geometrical accuracy of the 3D models of intracranial aneurysms printed using Stereolithography 3D printing technology.Materials and methods To compare the unruptured intracranial aneurysm mesh between the five patients and 3D printed models, we opened the DICOM files in the Sim&Size® simulation software, selected the region of interest, and performed the threshold check. We juxtaposed the 3D reconstructions and manually rotated the images to get the same orientation when needed and measured deviations at different nodes of the patient and 3D printed model meshes.Results In the first patient, 80% of the nodes were separated by <0.56 mm and 0.17 mm. In the second patient, the deviations were below 0.17 mm for 80% of the meshes’ nodes. In the next three patients, the deviations were below 0.21, 0.23, and 0.11 mm for 80% of the meshes’ nodes. Finally, the overall deviation was below 0.21 mm for 80% of the mesh nodes of the five aneurysmsConclusions 3D printed models of intracranial aneurysms are accurate, having surfaces that resemble that of patients’ angiographies with an 80% cumulative deviation below 0.21 mm.

The UV photofragmentation spectra of cold cytosine–M+complexes (M+: Na+, K+, Ag+) were recorded and analyzed through comparison with geometry optimizations and frequency calculations of the ground and excited states at the SCS-CC2/Def2-SVPD level of theory. While in all complexes, the ground state minimum geometry is planar (Cssymmetry), the ππ* state minimum geometry has the NH2group slightly twisted and an out-of-plane metal cation. This was confirmed by comparing the simulated ππ* Franck–Condon spectra with the vibrationally resolved photofragmentation spectra of CytNa+and CytK+. Vertical excitation transitions were also calculated to evaluate the energies of the CT states involving the transfer of an electron from the Cyt moiety to M+. For both CytK+and CytNa+complexes, the first CT state corresponds to an electron transfer from the cytosine aromatic π ring to the antibonding σ* orbital centered on the alkali cation. This πσ* state is predicted to lie much higher in energy (>6 eV) than the band origin of the π–π* electronic transition (around 4.3 eV) unlike what is observed for the CytAg+complex for which the first excited state has a nOσ* electronic configuration. This is the reason for the absence of the Cyt++ M charge transfer fragmentation channel for CytK+and CytNa+complexes.

The collision-induced dissociation of the protonated cytosine–guanine pair was studied using tandem mass spectrometry (MS3) coupled to infrared multiple photon dissociation spectroscopy with the free electron laser at Orsay (CLIO) to determine the structure of the CH+and GH+ionic fragments. The results were rationalized with the help of electronic structure calculations at the density functional theory level with the B3LYP/6-311++G(3df,2p) method. Several tautomers of each fragment were identified for the first time, some of which were previously predicted by other authors. In addition, two unexpected and minor tautomers were also found: cytosine keto-imino [CKI(1,2,3,4)H+] and guanine keto-amino [GKA(1,3,7)H+]. These results highlight the importance of the DNA base tautomerization assisted by inter- and intramolecular proton or hydrogen transfer within the protonated pairs.

In this paper, we present the IRMPD spectra of three ionic complexes between guanine (G) and silver (Ag+): [GAg-H2O]+, [GAgG]+produced in the electrospray ionization source of the mass spectrometer, and [GAg]+produced by collision induced dissociation of the [GAgG]+complex. On the basis of the comparison of theoretically calculated IR spectra, we show that there are two isomers of each complex containing two different keto-amino (KA) tautomers of G (GKA(1,9) and GKA(1,7)). The observed isomers are the most stable structures in aqueous solution, and their experimentally estimated relative populations are in better agreement with the calculated relative populations in solution than in the gas phase, both at 298 K. We concluded that these observations suggest that GKA(1,9) and GKA(1,7) coexist in solution according to previous theoretical reports (Colominas, C.; et al. J. Am. Chem. Soc.1996, 118, 6811). We were unable to find any evidence of the presence of the GEA(9), GKA(3,7), GKA(3,9), or GKA(7,9), whose relative stabilities in solution are strongly dependent on the theoretical method used to account for the solvent effect (Hanus, M.; et al. J. Am. Chem. Soc.2003, 125, 7678).

The present study reports the first structural characterization of protonated cyameluric acid ([CA + H]+) in the gas phase, which paves the way for prospective bottom-up research on the condensed-phase chemistry of CA in the protonated form. A number of [CA + H]+keto-enol isomers can a priori be produced as a result of protonation at available N and O positions of precursor neutral CA tautomers, yet ab initio computations predict different reduced [CA + H]+isomer populations dominating the solution and gas phases that are involved in the ion generation process (i.e., electrospray ionization). Infrared multiple photon dissociation spectra were recorded in the 990–1900 and 3300–3650 cm–1regions and compared with theoretical [B3LYP/6-311++G(d,p)] IR absorption spectra of several [CA + H]+isomers, providing a satisfactory agreement for the most stable monohydroxy form in the gas phase, [1358a]+, yet the contribution of its nearly isoenergetic OH rotamer, [1358b]+, cannot be neglected. This is indicative of the occurrence of [CA + H]+isomer interconversion reactions, assisted by protic solvent molecules, during their transfer into the gas phase. The results suggest that available O positions on neutral CA are energetically favored protonation sites in the gas phase.