118:. The main goal is prevention of rupture in unruptured aneurysms, and prevention of rebleeding in ruptured aneurysms by limiting blood circulation to the aneurysm space. Clinically, packing density is recommended to be 20-30% or more of the aneurysm's volume, typically requiring deployment of multiple wires. Higher volumes may be difficult due to the delicate nature of the aneurysm; intraoperative rupture rates are as high as 7.6% for this procedure. In ruptured aneurysms, coiling is performed quickly after rupture because of the high risk of rebleeding within the first few weeks after initial rupture. The patients most suitable for endovascular coiling are those with aneurysms with a small neck size (preferably <4 mm), luminal diameter <25 mm and those that are distinct from the parent vessel. Larger aneurysms are subject to compaction of coils, due to both looser packing densities (more coils are needed) and increased blood flow. Coil compaction renders them unsuitable as they are incapable of stemming blood flow. However, technological advances have made coiling of many other aneurysms possible as well.
270:. Despite the innovative approach, the aneurysms were often found to adapt to the shape of the balloon itself resulting in higher incidents of aneurysm rupture. This procedure was deemed "uncontrollable" due to its high morbidity and mortality rate, but it demonstrated that the endovascular approach was feasible for many aneurysms. Endovascular coils would later be used in 1989 by Hilal et al., but these were short, stiff coils that offered no control, preventing dense packing of the aneurysm. Controllable microguidewire systems were later used.
40:
225:
available in a variety of diameters, lengths, and cross sections. A coil is first inserted along the aneurysm wall to create a frame, with the core then being filled with more coils. A series of progressively smaller coils may also be used. Success is determined by injecting a contrast dye into parent artery and qualitatively determining if dye is flowing into the aneurysm space during fluoroscopy. If no flow is observed, the procedure is considered completed. In the case of wide-necked aneurysms a
127:
clipping, with one study finding a significant decrease in probability of death or dependency compared to a neurosurgical population. Complication rates for coiling as well are generally found to be lower than microsurgery (11.7% and 17.6% for coiling and microsurgery, respectively). Despite this, intraoperative rupture rates for coiling have been documented as being as high as 7.6%. Clinical results are found to be similar at a two-month and one year follow-up between coiling and neurosurgery.
328:, can be used to generate 3D reconstructions of patient specific anatomy. When combined with CFD/FEA, hemodynamics can be estimated in patient specific simulations, giving the clinician greater predictive tools for surgical planning and outcome evaluation to best promote thrombus formation. However, most computer models use many assumptions for simplicity, including rigid walls (non-elastic) for vasculature, substituting a porous medium in place of physical coil representations, and
293:
205:
283:
would be useful as a detachment system. Detachable coils were constructed from a platinum coil soldered to a stainless steel delivery wire, first described in 1991 by
Guglielmi et al. When combined with a controllable microguide wire system, multiple coils could be inserted to fully pack an aneurysm.
224:
The treatment uses detachable coils made of platinum that are inserted into the aneurysm using the microcatheter. A variety of coils are available, including
Guglielmi Detachable Coils (GDC) which are platinum, Matrix coils which are coated with a biopolymer, and hydrogel coated coils. Coils are also
278:
In 1983 the use of electrically induced thrombosis for intracranial aneurysms was described for the first time. A stainless steel electrode supplied a positive current to the aneurysm to stimulate electrothrombosis. Minimal occlusion was achieved, but the researchers discovered that the erosion of
130:
Reported recurrence rates are quite varied, with rates between 20 and 50% of aneurysms recurring within one year of coiling, and with the recurrence rate increasing with time. These results are similar to those previously reported by other endovascular groups. Other studies have questioned whether
126:
A number of studies have questioned the efficacy of endovascular coiling over the more traditional surgical clipping. Most concerns involve the chance of later bleeds or other recanalization. Due to its less invasive nature, endovascular coiling usually presents faster recovery times than surgical
97:
throughout the body. The procedure reduces blood circulation to the aneurysm through the use of microsurgical detachable platinum wires, with the clinician inserting one or more into the aneurysm until it is determined that blood flow is no longer occurring within the space. It is one of two main
249:
The first documented technique of using metal coils to induce thrombosis was accomplished by Mullan in 1974. Copper coils were inserted into a giant aneurysm through externally puncturing the aneurysm wall via craniotomy. Five patients died, with ten having satisfactory process. It did not gain
154:
Similar to patients who experience neurosurgical procedures, coiling results in an increase in resting energy expenditure, albeit at a slightly reduced rate than their neurosurgery counterpart. This can lead to malnutrition if steps are not taken to compensate for the increased metabolic rate.
138:
tested the efficacy of endovascular coiling against the traditional micro-surgical clipping. The study initially found very favorable results for coiling, however its results and methodology were criticized. Since the study's release in 2002, and again in 2005, some studies have found higher
1476:
Cheng, Xiao Qing; Chen, Qian; Zhou, Chang Sheng; Li, Jian Rui; Zhang, Zong Jun; Zhang, Long Jiang; Huang, Wei; Lu, Guang Ming (April 2016). "Whole-brain CT perfusion combined with CT angiography for ischemic complications following microsurgical clipping and endovascular coiling of ruptured
1372:
Ford, Matthew D.; Nikolov, Hristo N.; Milner, Jaques S.; Lownie, Stephen P.; DeMont, Edwin M.; Kalata, Wojciech; Loth, Francis; Holdsworth, David W.; Steinman, David A. (2008-04-03). "PIV-Measured Versus CFD-Predicted Flow
Dynamics in Anatomically Realistic Cerebral Aneurysm Models".
352:
Otani, Tomohiro; Nakamura, Masanori; Fujinaka, Toshiyuki; Hirata, Masayuki; Kuroda, Junko; Shibano, Katsuhiko; Wada, Shigeo (2013-03-26). "Computational fluid dynamics of blood flow in coil-embolized aneurysms: effect of packing density on flow stagnation in an idealized geometry".
151:, aneurysm rupture during the procedure and aneurysm recurrence and rupture after the procedure. Additionally in some patients coiling may not be successful. In general, coiling is only performed when the risk of aneurysm rupture is higher than the risks of the procedure itself.
167:) in the aneurysm, eventually sealing it from the blood flow. This is accomplished by decreasing the amount of blood flow going into the aneurysm, increasing the residence time of the blood (thereby lowering the velocity) in the aneurysm space and reducing the
415:
Babiker, M. H.; Gonzalez, L. F.; Albuquerque, F.; Collins, D.; Elvikis, A.; Zwart, C.; Roszelle, B.; Frakes, D. H. (2013-04-01). "An In Vitro Study of
Pulsatile Fluid Dynamics in Intracranial Aneurysm Models Treated with Embolic Coils and Flow Diverters".
699:
Li, Jian; Su, Long; Ma, Jian; Kang, Ping; Ma, Liujia; Ma, Lianting (2017). "Endovascular coiling versus microsurgical clipping for patients with ruptured very small intracranial aneurysms: Management strategies and clinical outcomes- of 162 cases".
220:
guidance. A guiding catheter is inserted through the femoral artery and advanced to a site close to the aneurysm after which angiography is performed to localize and assess the aneurysm. After this, a microcatheter is navigated into the aneurysm.
195:
While these factors are crucial to the success of the procedure, thrombosis ultimately is dependent on biological processes, with the coiling only providing the appropriate conditions for the process to occur, and hopefully closing the aneurysm.
735:
Piotin, M; Spelle, L; Mounayer, C; Salles-Rezende, MT; Giansante-Abud, D; Vanzin-Santos, R; Moret, J (May 2007). "Intracranial aneurysms: treatment with bare platinum coils—aneurysm packing, complex coils, and angiographic recurrence".
811:
Piotin M, Spelle L, Mounayer C, Loureiros C, Ghorbani A, Moret J. Intracranial aneurysms coiling with matrix. Immediate results in 152 patients and midterm anatomic follow-up from 115 patients. Stroke
November 2008 (e-pub ahead of
1424:
Kakalis, N. M. P.; Mitsos, A. P.; Byrne, J. V.; Ventikos, Y. (2008-06-01). "The
Haemodynamics of Endovascular Aneurysm Treatment: A Computational Modelling Approach for Estimating the Influence of Multiple Coil Deployment".
250:
popularity due to the specialized equipment required, in addition to the technique being unsuitable for many types of aneurysms. Later, in 1980, similar techniques were developed by Alksne and Smith using iron suspended in
904:; Woodward, Scott H.; Bendok, Bernard R.; Hanel, Ricardo A.; Guterman, Lee R.; Hopkins, L. Nelson (2004-10-01). "Effects of arterial geometry on aneurysm growth: three-dimensional computational fluid dynamics study".
320:
research method include flexibility of selecting variables, but one comparative study has found that simulations tend to over-emphasis results compared to PIV, and are more beneficial for trends than exact values.
241:. While the procedure itself has been and continues to be compared to surgical clipping, the development of the concept and procedure has resulted in it becoming the gold standard at many centers.
652:"The durability of endovascular coiling versus neurosurgical clipping of ruptured cerebral aneurysms: 18 year follow-up of the UK cohort of the International Subarachnoid Aneurysm Trial (ISAT)"
865:
Nagano, Ayano; Yamada, Yoshitaka; Miyake, Hiroji; Domen, Kazuhisa; Koyama, Tetsuo (April 2016). "Increased
Resting Energy Expenditure after Endovascular Coiling for Subarachnoid Hemorrhage".
822:
Raja PV, Huang J, Germanwala AV, Gailloud P, Murphy KP, Tamargo RJ (2008). "Microsurgical clipping and endovascular coiling of intracranial aneurysms: A critical review of the literature".
304:
Given the complexity of modeling the vasculature, much research has been devoted towards modeling the hemodynamics of an aneurysm before and after an intervention. Techniques such as
237:
Endovascular coiling was a developed through the synthesis of a number of innovations that took place between 1970 and 1990 in the field of electronics, neurosurgery, and
332:
for fluid behavior. However, new predictive models are being developed as computational power increases, including algorithms for simulations of coil behavior in-vivo.
316:(CFD/FEA) have yielded results that have influenced the direction of research, but no model to date has been able to account for all factors present. Advantages of the
254:
in a limited set of patients. There were no deaths in 22 consecutive cases with low morbidity. This technique also did not gain traction due to advances in clipping.
1056:
Oushy, Soliman; Rinaldo, Lorenzo; Brinjikji, Waleed; Cloft, Harry; Lanzino, Giuseppe (June 2020). "Recent advances in stent-assisted coiling of cerebral aneurysms".
628:
Mitchell P, Kerr R, Mendelow AD, Molyneux A. Could late rebleeding overturn the superiority of cranial aneurysm coil embolization over clip ligation seen in ISAT?"
1042:
135:
1318:
Wong, George K. C.; Poon, W. S. (2011-10-01). "Current status of computational fluid dynamics for cerebral aneurysms: the clinician's perspective".
590:"Retreatment of ruptured cerebral aneurysms in patients randomized by coiling or clipping in the International Subarachnoid Aneurysm Trial (ISAT)"
44:
Post-embolization arteriogram showing coiled aneurysm (indicated by yellow arrows) of the posteriorcerebral artery with a residual aneurysmal sac.
1026:
1303:
Guglielmi, G; Guerrisi, G; Guidetti, B (1983). "L'elettrotrombosi intravasale nelle malformazioni vascolari sperimentalmente provocate".
1526:
139:
recurrence rates with coiling, while others have concluded that there is no clear consensus between which procedure is preferred.
1107:
Mullan, S. (1974-12-01). "Experiences with surgical thrombosis of intracranial berry aneurysms and carotid cavernous fistulas".
958:
Morales, H. G.; Kim, M.; Vivas, E. E.; Villa-Uriol, M.-C.; Larrabide, I.; Sola, T.; Guimaraens, L.; Frangi, A. F. (2011-11-01).
325:
1150:
Alksne, J. F.; Smith, R. W. (1980-06-01). "Stereotaxic occlusion of 22 consecutive anterior communicating artery aneurysms".
262:
As a means of avoiding invasive methods, early endovascular interventions involved the usage of detachable and nondetachable
213:
86:
771:
Raymond, J; Guilbert, F; Weill, A; Georganos, SA; Juravsky, L; Lambert, A; Lamoureux, J; Chagnon, M; Roy, D (June 2003).
309:
329:
1305:
Proceedings of III Congress of the
Italian Society of Neuroradiology. Bari: Associazione Italiana di Neuroradiologia
305:
238:
39:
773:"Long-term angiographic recurrences after selective endovascular treatment of aneurysms with detachable coils"
588:
Campi A, Ramzi N, Molyneux AJ, Summers PE, Kerr RS, Sneade M, Yarnold JA, Rischmiller J, Byrne JV (May 2007).
1531:
1277:
313:
115:
90:
650:
Molyneux, Andrew J; Birks, Jacqueline; Clarke, Alison; Sneade, Mary; Kerr, Richard S C (2015-02-21).
217:
1193:
Serbinenko, F. A. (1974-08-01). "Balloon catheterization and occlusion of major cerebral vessels".
251:
216:
or neurosurgeon with the patient under general anaesthesia. The whole procedure is performed under
292:
1502:
1458:
1406:
1351:
1265:
1089:
1036:
937:
847:
501:
449:
386:
1019:
Endovascular coiling and its influence on intra-aneurysmal hemodynamics by image-based modeling
878:
1494:
1450:
1442:
1398:
1390:
1343:
1335:
1257:
1218:
1210:
1175:
1167:
1132:
1124:
1081:
1073:
1022:
999:
981:
929:
921:
882:
839:
794:
753:
717:
681:
611:
561:
553:
493:
441:
433:
378:
370:
168:
99:
60:
1486:
1434:
1382:
1327:
1249:
1202:
1159:
1116:
1065:
989:
971:
913:
874:
831:
784:
745:
709:
671:
663:
601:
545:
485:
425:
362:
297:
263:
1289:
17:
960:"How Do Coil Configuration and Packing Density Influence Intra-Aneurysmal Hemodynamics?"
994:
959:
835:
789:
772:
676:
651:
667:
1520:
1093:
453:
267:
1506:
1462:
1410:
1355:
1269:
851:
636:, J Mocco, L. Nelson Hopkins, "International Subarachnoid Aneurysm Trial analysis",
505:
941:
390:
280:
172:
1069:
606:
589:
917:
1490:
1331:
1206:
1163:
1120:
713:
749:
474:"Endovascular treatment of intracranial aneurysms: review of current practice"
429:
366:
179:
aneurysm type (directly on the parent artery or on a bifurcation of an artery)
164:
1446:
1394:
1339:
1261:
1253:
1214:
1171:
1128:
1077:
985:
925:
557:
549:
536:
Guglielmi, Guido (2009-03-13). "History of the genesis of detachable coils".
489:
473:
437:
374:
1438:
317:
204:
1498:
1454:
1402:
1347:
1085:
1003:
933:
886:
843:
798:
757:
721:
685:
615:
565:
497:
445:
382:
1237:
1222:
1179:
1136:
901:
94:
182:
aneurysm position (relative angle of aneurysm to approaching blood flow)
72:
976:
1386:
148:
208:
Resected middle cerebral artery aneurysm filled with multiple coils.
291:
226:
203:
103:
175:, is ultimately dependent on several factors, including:
1236:
Group, British
Medical Journal Publishing (1963-03-16).
171:
of the aneurysm wall. This change in the blood flow, or
1238:"Obliteration of Intracranial Aneurysms by Pilojection"
131:
new matrix coils work better than bare platinum coils.
355:
98:
treatments for cerebral aneurysms, the other being
59:
49:
32:
163:The treatment works by promoting blood clotting (
640:, March 2008 / Vol. 108 / No. 3 / Pages 436-436.
212:Endovascular coiling is usually performed by an
867:Journal of Stroke and Cerebrovascular Diseases
472:Currie, S; Mankad, K; Goddard, A (Jan 2011).
266:to occlude the aneurysm while preserving the
8:
418:IEEE Transactions on Biomedical Engineering
1041:: CS1 maint: location missing publisher (
879:10.1016/j.jstrokecerebrovasdis.2015.12.008
38:
993:
975:
788:
675:
605:
136:International Subarachnoid Aneurysm Trial
467:
465:
463:
341:
1285:
1275:
1034:
147:Risks of endovascular coiling include
114:Endovascular coiling is used to treat
29:
1367:
1365:
953:
951:
245:Filling the intravascular compartment
7:
1427:IEEE Transactions on Medical Imaging
1375:Journal of Biomechanical Engineering
531:
529:
527:
525:
523:
521:
519:
517:
515:
410:
408:
406:
404:
402:
400:
347:
345:
68:
964:American Journal of Neuroradiology
836:10.1227/01.neu.0000333291.67362.0b
790:10.1161/01.STR.0000073841.88563.E9
25:
578:J Neurointerv Surg. 2011 Apr 27.
1479:Journal of Clinical Neuroscience
1320:Journal of Clinical Neuroscience
1058:Expert Review of Medical Devices
1021:. Barcelona, Spain. p. 19.
188:angle of parent vessel curvature
102:. Clipping is an alternative to
214:interventional neuroradiologist
27:Medical treatment for aneurysm
1:
1070:10.1080/17434440.2020.1778463
668:10.1016/s0140-6736(14)60975-2
324:Medical images, particularly
65:Interventional neuroradiology
607:10.1161/STROKEAHA.106.466987
478:Postgraduate Medical Journal
310:computational fluid dynamics
300:derived from a CT angiogram.
918:10.3171/jns.2004.101.4.0676
296:A 3D reconstruction of the
1548:
1491:10.1016/j.jocn.2015.05.067
1332:10.1016/j.jocn.2011.02.014
1207:10.3171/jns.1974.41.2.0125
1164:10.3171/jns.1980.52.6.0790
1121:10.3171/jns.1974.41.6.0657
714:10.1016/j.wneu.2015.11.079
632:108: 437-442, March 2008.
306:particle image velocimetry
1477:intracranial aneurysms".
750:10.1148/radiol.2431060006
430:10.1109/TBME.2012.2228002
367:10.1007/s11517-013-1062-5
69:
54:Endovascular embolization
37:
18:Guglielmi detachable coil
1527:Interventional radiology
1254:10.1136/bmj.1.5332.700-a
1017:Morales, Hernan (2012).
550:10.3171/2009.2.JNS081039
490:10.1136/pgmj.2010.105387
239:interventional radiology
1439:10.1109/TMI.2008.915549
1195:Journal of Neurosurgery
1152:Journal of Neurosurgery
1109:Journal of Neurosurgery
906:Journal of Neurosurgery
638:Journal of Neurosurgery
630:Journal of Neurosurgery
538:Journal of Neurosurgery
314:finite element analysis
258:Endovascular approaches
1381:(2): 021015–021015–9.
301:
274:Detachable coil system
209:
91:intracranial aneurysms
295:
279:the electrode due to
207:
191:size of aneurysm neck
218:fluoroscopic imaging
185:coil packing density
83:Endovascular coiling
33:Endovascular coiling
252:methyl methacrylate
1288:has generic name (
977:10.3174/ajnr.A2635
702:World Neurosurgery
302:
210:
116:cerebral aneurysms
1387:10.1115/1.2900724
1326:(10): 1285–1288.
1028:978-84-615-9824-3
970:(10): 1935–1941.
662:(9969): 691–697.
264:balloon catheters
169:wall shear stress
100:surgical clipping
80:
79:
16:(Redirected from
1539:
1511:
1510:
1473:
1467:
1466:
1421:
1415:
1414:
1369:
1360:
1359:
1315:
1309:
1308:
1300:
1294:
1293:
1287:
1283:
1281:
1273:
1233:
1227:
1226:
1190:
1184:
1183:
1147:
1141:
1140:
1104:
1098:
1097:
1053:
1047:
1046:
1040:
1032:
1014:
1008:
1007:
997:
979:
955:
946:
945:
897:
891:
890:
862:
856:
855:
830:(6): 1187–1202.
819:
813:
809:
803:
802:
792:
783:(6): 1398–1403.
768:
762:
761:
732:
726:
725:
696:
690:
689:
679:
647:
641:
626:
620:
619:
609:
585:
579:
576:
570:
569:
533:
510:
509:
469:
458:
457:
424:(4): 1150–1159.
412:
395:
394:
349:
298:Circle of Willis
73:edit on Wikidata
42:
30:
21:
1547:
1546:
1542:
1541:
1540:
1538:
1537:
1536:
1517:
1516:
1515:
1514:
1475:
1474:
1470:
1423:
1422:
1418:
1371:
1370:
1363:
1317:
1316:
1312:
1302:
1301:
1297:
1284:
1274:
1235:
1234:
1230:
1192:
1191:
1187:
1149:
1148:
1144:
1106:
1105:
1101:
1055:
1054:
1050:
1033:
1029:
1016:
1015:
1011:
957:
956:
949:
899:
898:
894:
864:
863:
859:
821:
820:
816:
810:
806:
770:
769:
765:
734:
733:
729:
698:
697:
693:
649:
648:
644:
627:
623:
587:
586:
582:
577:
573:
535:
534:
513:
484:(1023): 41–50.
471:
470:
461:
414:
413:
398:
351:
350:
343:
338:
290:
276:
260:
247:
235:
202:
161:
145:
124:
112:
76:
45:
28:
23:
22:
15:
12:
11:
5:
1545:
1543:
1535:
1534:
1529:
1519:
1518:
1513:
1512:
1468:
1433:(6): 814–824.
1416:
1361:
1310:
1295:
1228:
1201:(2): 125–145.
1185:
1158:(6): 790–793.
1142:
1115:(6): 657–670.
1099:
1064:(6): 519–532.
1048:
1027:
1009:
947:
912:(4): 676–681.
900:Hoi, Yiemeng;
892:
873:(4): 813–818.
857:
814:
804:
763:
727:
691:
642:
621:
600:(5): 1538–44.
580:
571:
511:
459:
396:
361:(8): 901–910.
340:
339:
337:
334:
326:CT angiography
289:
286:
275:
272:
259:
256:
246:
243:
234:
231:
201:
198:
193:
192:
189:
186:
183:
180:
160:
157:
144:
141:
123:
120:
111:
108:
106:for bleeding.
89:treatment for
78:
77:
70:
67:
66:
63:
57:
56:
51:
47:
46:
43:
35:
34:
26:
24:
14:
13:
10:
9:
6:
4:
3:
2:
1544:
1533:
1530:
1528:
1525:
1524:
1522:
1508:
1504:
1500:
1496:
1492:
1488:
1484:
1480:
1472:
1469:
1464:
1460:
1456:
1452:
1448:
1444:
1440:
1436:
1432:
1428:
1420:
1417:
1412:
1408:
1404:
1400:
1396:
1392:
1388:
1384:
1380:
1376:
1368:
1366:
1362:
1357:
1353:
1349:
1345:
1341:
1337:
1333:
1329:
1325:
1321:
1314:
1311:
1306:
1299:
1296:
1291:
1279:
1271:
1267:
1263:
1259:
1255:
1251:
1248:(5332): 700.
1247:
1243:
1239:
1232:
1229:
1224:
1220:
1216:
1212:
1208:
1204:
1200:
1196:
1189:
1186:
1181:
1177:
1173:
1169:
1165:
1161:
1157:
1153:
1146:
1143:
1138:
1134:
1130:
1126:
1122:
1118:
1114:
1110:
1103:
1100:
1095:
1091:
1087:
1083:
1079:
1075:
1071:
1067:
1063:
1059:
1052:
1049:
1044:
1038:
1030:
1024:
1020:
1013:
1010:
1005:
1001:
996:
991:
987:
983:
978:
973:
969:
965:
961:
954:
952:
948:
943:
939:
935:
931:
927:
923:
919:
915:
911:
907:
903:
896:
893:
888:
884:
880:
876:
872:
868:
861:
858:
853:
849:
845:
841:
837:
833:
829:
825:
818:
815:
808:
805:
800:
796:
791:
786:
782:
778:
774:
767:
764:
759:
755:
751:
747:
743:
739:
731:
728:
723:
719:
715:
711:
707:
703:
695:
692:
687:
683:
678:
673:
669:
665:
661:
657:
653:
646:
643:
639:
635:
631:
625:
622:
617:
613:
608:
603:
599:
595:
591:
584:
581:
575:
572:
567:
563:
559:
555:
551:
547:
543:
539:
532:
530:
528:
526:
524:
522:
520:
518:
516:
512:
507:
503:
499:
495:
491:
487:
483:
479:
475:
468:
466:
464:
460:
455:
451:
447:
443:
439:
435:
431:
427:
423:
419:
411:
409:
407:
405:
403:
401:
397:
392:
388:
384:
380:
376:
372:
368:
364:
360:
356:
348:
346:
342:
335:
333:
331:
330:navier-stokes
327:
322:
319:
315:
311:
307:
299:
294:
287:
285:
282:
273:
271:
269:
268:parent artery
265:
257:
255:
253:
244:
242:
240:
232:
230:
229:may be used.
228:
222:
219:
215:
206:
199:
197:
190:
187:
184:
181:
178:
177:
176:
174:
170:
166:
158:
156:
152:
150:
142:
140:
137:
132:
128:
121:
119:
117:
109:
107:
105:
101:
96:
92:
88:
84:
74:
64:
62:
58:
55:
52:
48:
41:
36:
31:
19:
1532:Neurosurgery
1482:
1478:
1471:
1430:
1426:
1419:
1378:
1374:
1323:
1319:
1313:
1304:
1298:
1278:cite journal
1245:
1241:
1231:
1198:
1194:
1188:
1155:
1151:
1145:
1112:
1108:
1102:
1061:
1057:
1051:
1018:
1012:
967:
963:
909:
905:
895:
870:
866:
860:
827:
824:Neurosurgery
823:
817:
807:
780:
776:
766:
744:(2): 500–8.
741:
737:
730:
705:
701:
694:
659:
655:
645:
637:
633:
629:
624:
597:
593:
583:
574:
541:
537:
481:
477:
421:
417:
358:
354:
323:
303:
281:electrolysis
277:
261:
248:
236:
223:
211:
194:
173:hemodynamics
162:
153:
146:
133:
129:
125:
113:
110:Medical uses
87:endovascular
82:
81:
53:
1286:|last=
708:: 763–769.
50:Other names
1521:Categories
1307:: 139–146.
656:The Lancet
544:(1): 1–8.
336:References
308:(PIV) and
165:thrombosis
1485:: 50–56.
1447:0278-0062
1395:0148-0731
1340:1532-2653
1262:0007-1447
1215:0022-3085
1172:0022-3085
1129:0022-3085
1094:219328499
1078:1745-2422
1037:cite book
986:0195-6108
926:0022-3085
902:Meng, Hui
738:Radiology
558:0022-3085
454:206612828
438:0018-9294
375:0140-0118
318:in-silico
200:Procedure
159:Mechanism
61:Specialty
1507:24464063
1499:26775148
1463:27015964
1455:18541488
1411:31375424
1403:18412502
1356:22669620
1348:21795051
1270:30623125
1242:Br Med J
1086:32500761
1004:21885712
934:15481725
887:26796057
852:21058347
844:18824986
799:12775880
758:17293572
722:26732968
686:25465111
616:17395870
566:19284239
506:30220296
498:20937736
446:23192467
383:23529587
288:Research
104:stenting
95:bleeding
1223:4841872
1180:6991648
1137:4609023
995:7965998
942:6565151
677:4356153
634:But see
391:7811834
233:History
122:Results
1505:
1497:
1461:
1453:
1445:
1409:
1401:
1393:
1354:
1346:
1338:
1268:
1260:
1221:
1213:
1178:
1170:
1135:
1127:
1092:
1084:
1076:
1025:
1002:
992:
984:
940:
932:
924:
885:
850:
842:
812:print)
797:
777:Stroke
756:
720:
684:
674:
614:
594:Stroke
564:
556:
504:
496:
452:
444:
436:
389:
381:
373:
149:stroke
85:is an
1503:S2CID
1459:S2CID
1407:S2CID
1352:S2CID
1266:S2CID
1090:S2CID
938:S2CID
848:S2CID
502:S2CID
450:S2CID
387:S2CID
227:stent
143:Risks
71:[
1495:PMID
1451:PMID
1443:ISSN
1399:PMID
1391:ISSN
1344:PMID
1336:ISSN
1290:help
1258:ISSN
1219:PMID
1211:ISSN
1176:PMID
1168:ISSN
1133:PMID
1125:ISSN
1082:PMID
1074:ISSN
1043:link
1023:ISBN
1000:PMID
982:ISSN
930:PMID
922:ISSN
883:PMID
840:PMID
795:PMID
754:PMID
718:PMID
682:PMID
612:PMID
562:PMID
554:ISSN
494:PMID
442:PMID
434:ISSN
379:PMID
371:ISSN
134:The
93:and
1487:doi
1435:doi
1383:doi
1379:130
1328:doi
1250:doi
1203:doi
1160:doi
1117:doi
1066:doi
990:PMC
972:doi
914:doi
910:101
875:doi
832:doi
785:doi
746:doi
742:243
710:doi
672:PMC
664:doi
660:385
602:doi
546:doi
542:111
486:doi
426:doi
363:doi
1523::
1501:.
1493:.
1483:26
1481:.
1457:.
1449:.
1441:.
1431:27
1429:.
1405:.
1397:.
1389:.
1377:.
1364:^
1350:.
1342:.
1334:.
1324:18
1322:.
1282::
1280:}}
1276:{{
1264:.
1256:.
1244:.
1240:.
1217:.
1209:.
1199:41
1197:.
1174:.
1166:.
1156:52
1154:.
1131:.
1123:.
1113:41
1111:.
1088:.
1080:.
1072:.
1062:17
1060:.
1039:}}
1035:{{
998:.
988:.
980:.
968:32
966:.
962:.
950:^
936:.
928:.
920:.
908:.
881:.
871:25
869:.
846:.
838:.
828:62
826:.
793:.
781:34
779:.
775:.
752:.
740:.
716:.
706:99
704:.
680:.
670:.
658:.
654:.
610:.
598:38
596:.
592:.
560:.
552:.
540:.
514:^
500:.
492:.
482:87
480:.
476:.
462:^
448:.
440:.
432:.
422:60
420:.
399:^
385:.
377:.
369:.
359:51
357:.
344:^
1509:.
1489::
1465:.
1437::
1413:.
1385::
1358:.
1330::
1292:)
1272:.
1252::
1246:1
1225:.
1205::
1182:.
1162::
1139:.
1119::
1096:.
1068::
1045:)
1031:.
1006:.
974::
944:.
916::
889:.
877::
854:.
834::
801:.
787::
760:.
748::
724:.
712::
688:.
666::
618:.
604::
568:.
548::
508:.
488::
456:.
428::
393:.
365::
312:/
75:]
20:)
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
