Flow diverter stents with hydrophilic polymer coating for the treatment of acutely ruptured aneurysms using single antiplatelet therapy: Preliminary experience.

BACKGROUND: The use of flow diverter stent (FDS) has limitations in cases of subarachnoid haemorrhage caused by ruptured aneurysm, due to the need for double antiplatelet therapy and the delay in the aneurysm occluding. The p48 MW and the p64 MW (Phenox) are available with Hydrophilic Polymer Coating (HPC), that reduces the risk of thrombus formation. Purpose of this study is to evaluate the safety and efficacy of p48 and p64 MW HPC with single antiplatelet therapy for the acute treatment of ruptured aneurysm. METHODS: We retrospectively evaluated all patients treated for acutely ruptured aneurysms with a p48 MW HPC or p64 MW HPC from October 2019 to April 2020 using single antiplatelet therapy. For each patient, we considered demographic and aneurysm-related data, clinical presentation, size and location of the implanted flow diverter stent, intra- and post-procedural complications, aneurysm occlusion. RESULTS: Seven patients were included. The ruptured aneurysms were four saccular, two blister-like and one dissecting, six in the anterior and one in posterior circulation. No intraprocedural stent thrombosis and rebleeding was observed. In two cases the aneurysm is completely excluded, in one patient it was found only neck perfusion, in three cases there were mild reduction of the sac and in one case there was a persistent perfusion. No patients needed retreatment in this series. CONCLUSION: In our experience, FDS HPC appears a potential treatment option in selected cases. Our study is limited by small population and short-term follow-up. We report our preliminary data, but further investigations are necessary.

Magnetic resonance imaging in the postsurgical evaluation of patients with mandibular condyle fractures treated using the transparotid approach: our experience.

PURPOSE: To evaluate the morphostructural and functional modifications of the temporomandibular joint and the onset of parotid complications in patients with extracapsular monocondylar fractures treated by reduction with the application of a titanium microplate via a transparotid approach. MATERIALS AND METHODS: The study was comprised of 20 patients (16 male patients and 4 female patients) with a mean age of 25 years (range, 15-44 years) who had undergone reduction of condyle fractures. Twelve months after surgery, all patients were examined by means of magnetic resonance imaging (MRI) of the temporomandibular joint and parotid gland on the treated side. MRI examination was performed by use of coronal T2-weighted turbo spin echo sequences, as well as parasagittal T1-weighted turbo spin echo and T2-weighted fast field echo sequences. Images were acquired from the resting position to the position of maximum oral opening. RESULTS: The 1-year clinical outcome in our patients was good. MRI showed, on the treated side, 5 cases of anterior dislocation of the disc (25%), 1 case of disc degeneration (5%), and 1 case of parotid fistula (5%). CONCLUSION: Both trauma and surgical intervention can damage the meniscal capsuloligamentous complex. MRI allowed the complications due to the trauma and/or treatment to be identified and made it possible to compare the condyles and joint function.