The Expression of Circ-Astn1 Inhibits High Glucose Induced Endothelial Progenitor Cell Dysfunction by Activating Autophagy.

Background: Diabetes mellitus (DM) and complications such as chronic kidney disease and cardiovascular symptoms pose a substantial public health burden. Increasing studies have shown that circular RNAs (circRNAs) regulate many gene expressions that are essential in diverse pathological and biological procedures. However, the roles of particular circRNAs in DM are unclear.Methods: In the current investigation, endothelial progenitor cells (EPCs) were used to search for abnormal expression of circRNAs by using high-throughput sequencing under high glucose (HG) conditions. The regulatory mechanisms and targets were then studied through bioinformatics analysis, luciferase reporter analysis, angiogenic differentiation experiments, flow cytometry detection of apoptosis and RT-qPCR analysis.Results: The circ-Astn1 expression in EPCs decreased after HG treatment. Overexpression or circ-Astn1 suppressed HG induced endothelial cell damage. MicroRNA (miR)-138-5p and SIRT5 were found to be the downstream targets of circ-Astn1 through luciferase reporter analysis. SIRT5 downregulation or miR-138-5p overexpression reversed circ-Astn1's protective effect against HG induced endothelial cell dysfunction, including apoptosis and abnormal vascular differentiation. Furthermore, circ-Astn1 overexpression promoted autophagy activation by increasing SIRT5 expression under HG conditions. Our findings suggest that circ-Astn1 mediated promotion of SIRT5 facilitates autophagy by sponging miR-138-5p.Conlusion: Together, our findings show that the overexpression of circ-Astn1 suppresses HG induced endothelial cell damage by targeting miR-138-5p/SIRT5 axis.

The occurrence and development of abdominal aortic aneurysm may be related to the energy metabolism disorder and local inflammation.

Background: The cellular mechanism of the formation of abdominal aortic aneurysm (AAA) is very complicated. A series of sophisticated events eventually led to significant pathological changes in the anatomical structure and function of the arterial wall and they are still not clear nowadays. Methods: We pooled publicly available GEO datasets (GSE57691 and GSE47472) to get a comprehensive comparisons between normal tissues and AAA tissues to try to reveal molecular mechanism underlying the disease. Total 63 AAA samples and 18 normal tissue samples were compared and we fond that there were 784 significantly different gene (DEGs, threshold set as adjusted P < 0.05 and Log FC < 1) were identified. At the same time, we validate the possible signaling factor expression of AAA by comparing the normal tissue of the human body with the AAA tissue. Results: In the pathway enrichment, we found that FOXP3 related signaling pathways, inflammation-related cytokine signaling pathways, interleukin-8-CXCR1 related signaling pathways and VEGFA and FGFR1 related signal pathway were significantly enrichmented. In Weighted gene co-expression network analysis (WGCNA), we found that the key hub genes were significantly related to lipid catabolic metabolism, which further verified the possibility that AAA might relate to energy metabolism disorders. Conclusion: Based on the comprehensive analysis of previous high-throughput data and the validation of basic experiments, we found that the occurrence of AAA may be related to energy metabolism disorders and local inflammation.

Fractional diffusion model for emission and adsorption prediction of TXIB from wallpaper.

Mercury injection test shows that wallpaper is a porous building material with a complex fractal mass transfer channel. Therefore, fractional Fick's law is employed to investigate sub-diffusion of 2,2,4 trimethy1-1,3-pentanediol diisobutyrate (TXIB) from wallpaper. In view of the fact that a small amount of TXIB has been released from the wallpaper before the environmental chamber experiment, the non-uniform initial concentration is introduced. Based on fractional Fick's law, both fractional convective mass transfer equation and fractional mass balance equation have been firstly proposed. Combining the finite difference method and L1 algorithm, the fractional diffusion model is solved numerically. Numerical simulation results show that the present model matches well with the experimental data. Compared with the previous model based on Fick's law, the present model is in better agreement with experimental data of di-2-ethylhexyl phthalate (DEHP) released from polyvinyl chloride (PVC) flooring. The influence of key parameters on the concentration of TXIB is analyzed graphically. In addition, the absorption amount and absorption rate of TXIB on the environmental bulkhead are numerically simulated for the first time.

A sensitive electrochemical immunosensing interface for label-free detection of aflatoxin B1 by attachment of nanobody to MWCNTs-COOH@black phosphorene.

A label-free electrochemical immunosensor has advantages of real-time and rapid detection, but it is weak in detection of small molecular toxins such as aflatoxin B1 (AFB1). The greatest obstacle to achieving this is that small molecules bound to a common immunosensing interface cannot interfere with electron transfer effectively and the detection signal is so weak. Therefore, a sensitive electrochemical immunosensing interface for small molecules is urgently needed. Here, we employed functionalized black phosphorene (BP) as electrode modification materials and anti-AFB1 nanobody (Nb) as a biorecognition element to construct a very sensitive immunosensing interface towards small molecular AFB1. The BP functionalized by carboxylic multi-walled carbon nanotubes (MWCNTs-COOH) via P-C bonding behaved with a satisfactory stability and good catalytic performance for the ferricyanide/ferrocyanide probe, while the small-sized Nb showed good compatibility with the functionalized BP and also had less influence on electron transfer than monoclonal antibody (mAb). Expectedly, the as-prepared immunosensing interface was very sensitive to AFB1 detection by differential pulse voltammetry (DPV) in a redox probe system. Under optimized conditions, a linear range from 1.0 pM to 5.0 nM and an ultralow detection limit of 0.27 pM were obtained. Additionally, the fabricated immunosensor exhibited satisfactory stability, specificity, and reproducibility. The strategy proposed here provides a more reliable reference for label-free sensing of small molecules in food samples.

Waterscapes for Promoting Mental Health in the General Population.

The WHO estimates that, with the development of urbanization, 25% of the population is suffering from psychological and mental distress. Preliminary evidence has suggested that aquatic environments and riparian areas, i.e., waterscapes, can benefit psychological and mental wellbeing. The aim of this study was to identify the processes of waterscape psychological and mental health promotion through aliterature review. We propose a design framework of waterscapes for achieving psychological and mental health in the general population that often visits waterscapes, which has the function of therapeutic landscapes through values of accessibility, versatility, habitats, and biodiversity. According to theories, waterscapes can improve psychological and mental health to divert negative emotions through mitigation (e.g., reduced urban heat island), instoration (e.g., physical activity and state of nature connectedness), and restoration (e.g., reduced anxiety/attentional fatigue). By accessing water (e.g., streams, rivers, lakes, wetlands, and the coast) and riparian areas, people can get in close contact with nature and spend more time in activities (e.g., walking, exploring, talking, and relaxing). Waterscapes with healing effects can enhance psychological resilience to promote people's psychological and mental health. Future research should focus on ensuring an adequate supply of waterscapes and promoting the efficiency of waterscape ecosystem services on mental health. Moreover, fora deep understanding of the complexity of nature-human health associations, it is necessary to explore more consistent evidence for therapeutic waterscapes considering the characteristics and functional mechanisms of waterscape quality, in terms of freshness, luminescence, rippling or fluidity, and cultural value, to benefit public health and biodiversity conservation.

hsa_circ_0058092 protects against hyperglycemia­induced endothelial progenitor cell damage via miR­217/FOXO3.

Circular RNAs (circRNAs) regulate the expression of genes that are critical for various biological and pathological processes. Previous studies have reported that the expression of hsa_circ_0058092 is decreased in patients with diabetes mellitus (DM); however, the specific role of this circRNA in DM is unknown. In the present study, endothelial progenitor cells (EPCs) were isolated and a decreased hsa_circ_0058092 expression was found under conditions of hyperglycemia (HG). The overexpression of hsa_circ_0058092 protected the EPCs against HG­induced damage by preserving cell survival, proliferation, migration and angiogenic differentiation. The overexpression of hsa_circ_0058092 also decreased the HG­induced increase in NADPH­oxidase proteins and inflammatory cytokines. Further investigation revealed that the overexpression of hsa_circ_0058092 enhanced FOXO3 expression, which was mediated through the interaction with miR­217. Furthermore, the upregulation of miR­217 or the downregulation of FOXO3 abolished the protective effects of hsa_circ_0058092 against HG­induced EPC damage. On the whole, these data suggest that hsa_circ_0058092 acts via the miR­217/FOXO3 pathway to protect against EPCs HG­induced damage, and to preserve the migration and angiogenesis of EPCs.

Downregulated Circular RNA hsa_circ_0000291 Suppresses Migration And Proliferation Of Gastric Cancer Via Targeting The miR-183/ITGB1 Axis.

BACKGROUND: Circular RNAs are implicated in a variety of cancers. This investigation found that hsa_circ_0000291 expression was upregulated in gastric cancer (GC) cell lines, yet its role in GC has not yet been reported. OBJECTIVE: To explore the effects of hsa_circ_0000291 on GC cell proliferation and invasion. MATERIALS AND METHODS: In the current research, we used the gastric cancer cell lines MGC803 and MKN-28 to study hsa_circ_0000291 function. The relationship between hsa_circ_0000291, miR-183 and ITGB1 was analyzed by firefly luciferase analysis and Western blots, and qRT-PCR approaches were used for protein and gene expression analysis, respectively. Tumor growth and metastasis were determined in nude mice xenografts using MKN-28 cells, with or without hsa_circ_000r0291 downregulation. RESULTS: Our data showed that hsa_circ_0000291 was upregulated in GC cell lines, whereas hsa_circ_0000291 silencing suppressed cell metastasis and proliferation in in vivo and in vitro studies. Our results showed that the downregulation of hsa_circ_0000291 suppressed integrin beta 1 (ITGB1) expression via miR-183 "sponging," which was validated by rescue experiments using the luciferase reporter assay. Our observations suggested that hsa_circ_0000291 silencing suppressed the aggressive, metastatic GC phenotype. CONCLUSION: Taken together, hsa_circ_0000291 knockdown inhibited GC cell metastasis and growth by regulating the miR-183/ITGB1 axis. Importantly, this approach could provide a therapy target and potential biomarker for the diagnosis and treatment of GC.

A Novel Reverse Branch Technique for Reconstruction of a Renal Artery Perfused by the False Lumen After Thoracic Endovascular Aortic Repair.

PURPOSE: To describe an innovative endovascular technique that successfully reconstructs a renal artery completely perfused by the false lumen after thoracic endovascular aortic repair (TEVAR). CASE REPORT: A 65-year-old patient diagnosed with acute Stanford type B aortic dissection underwent successful TEVAR 4 years ago. Regular follow-up found that the thoracic aorta was well repaired, but the false lumen in the abdominal aorta had enlarged year by year. The left renal artery was supplied entirely by the false lumen, which caused kidney hypoperfusion. The abdominal aorta was successfully remodeled using endovascular aneurysm repair with reconstruction of the left renal artery using Viabahn stent-grafts inserted through the patent false lumen. At 6 months, computed tomography showed false lumen thrombosis and patent Viabahn stent-grafts in the false lumen. CONCLUSION: The false lumen reverse branch technique was feasible in our case, which provides a new idea for dealing with distal dissection involving the renovisceral arteries after TEVAR.

Quercitrin treatment protects endothelial progenitor cells from oxidative damage via inducing autophagy through extracellular signal-regulated kinase.

Atherosclerosis is a disease resulting from impaired endothelial function, often caused by oxidant injury or inflammation. Endothelial progenitor cells (EPCs) play a critical role in repairing damaged endothelium and protecting against atherosclerosis. Quercitrin, a plant-derived flavonoid compound, displays antioxidant and anti-inflammatory activities. In this study, we showed that quercitrin treatment reduced the apoptosis of EPCs caused by oxidized low-density lipoprotein (ox-LDL) in a dose-dependent manner. Quercitrin improved tube formation, migration and adhesion of ox-LDL-treated EPCs. To determine the effect of quercitrin in vivo, EPCs treated with or without ox-LDL and quercitrin were locally injected into the ischemic hind limb muscle of nude mice. Those injected with EPCs treated with ox-LDL and quercitrin showed significantly increased local accumulation of EPCs, blood flow recovery and capillary density compared with the control and ox-LDL only groups. Furthermore, we showed that quercitrin enhanced autophagy and upregulated mitogen-activated protein kinase and ERK phosphorylation in a dose-dependent manner in vitro. Autophagy inhibitors, chloroquine and 3-methyladenine, abrogated quercitrin-enhanced autophagy caused by ox-LDL as evidenced by decreased numbers of branch points, migratory cells and adherent cells, and increased numbers of apoptotic cells. The ERK inhibitor PD98059 abrogated quercitrin-enhanced autophagy, as identified by decreased autophagosome formation and downregulated ERK phosphorylation. The inhibition of ERK did not affect the expression of Rac1, but enhanced phosphorylation of Akt. Quercitrin treatment also increased the expression of E-cadherin, and PD98059 abrogated the upregulation of E-cadherin induced by quercitrin. Our findings suggested that autophagy is a protective mechanism in EPCs exposed to oxidative damage. Quercitrin can promote autophagy through the activation of ERK and the ERK signaling pathway is therefore thought to play a pivotal role in mediating the protective effects on EPCs.

[Surgical management of post carotid artery stenting restenosis].

OBJECTIVE: To discuss the feasibility, safety and effectiveness of surgical management of post carotid artery stenting (CAS) restenosis, mainly focusing on the surgical options and indications. METHODS: This study represented retrospective analysis of 3 kinds of surgical managements of 21 patients with symptomatic post CAS restenosis from April 2012 to April 2014. Patch carotid endarterectomy (pCEA), Eversion carotid endarterectomy (eCEA) or carotid excision and graft interposition (CEGI) was selected to remove the stent and reconstruct the blood flow, based on the preoperative imaging results and intraoperative adhesion degree. Use of carotid shunt, blood loss, operative time, carotid artery cross-clamp time and other data were recorded. Patients were followed for improvement of symptoms, complications and restenosis. RESULTS: Eleven, 4 and 6 patients received pCEA, eCEA or CEGI respectively. All the stents were successfully removed. Shunts were deployed in 14 cases. The mean bleeding was (152.6 ± 38.0) ml, the mean operation time was (100.7 ± 34.8) min and the mean carotid artery clamping time was (29.1 ± 4.6) min. In the early postoperative period, there were no infection, strokes, cranial nerve injury, myocardial infarction or mortalities. One patient developed neck hematoma, while 2 patients had the symptoms of hyperperfusion such as headache, irritability and multi-lingual but no intracranial hemorrhage happened according to the brain CT scan, who all fully recovered within 3 days. Within a median follow-up of (13.2 ± 4.3) months, no strokes, myocardial infarctions or recurrent restenosis (> 50%) on duplex ultrasound imaging or CTA was discovered except for 1 patient who died of lung cancer. CONCLUSION: Surgical management to remove the stent and reconstruct the blood flow, which offered new options in the treatment of post CAS restenosis, with its initially confirmed simplicity, feasibility, safety and validity.

[Single-center experience on clinical application of "anatomic fixation" unibody bifurcated stent-graft in endovascular repair].

OBJECTIVE: To evaluate the clinical outcomes of unibody bifurcated stent-graft in endovascular repair (EVAR). METHODS: Retrospective analyses were conducted for the clinical data and postoperative follow-up results of 125 patients (102 cases from Shanghai Changhai Hospital and another 23 from Shanghai Changzheng Hospital) undergoing EVAR with unibody bifurcated stent-graft from January 2008 to January 2013. RESULTS: The technical success rate was 100%. Perioperative complications including type I endoleak (n = 3, 2.4%) and type II endoleak (n = 4, 3.2%). The incidence of type I endoleak in challenging neck cases was higher than non-challenging ones. And the difference was statistically significant (P = 0.001). Except for 1 dead case, the remainder was followed up for a mean of 26.4 ± 1.5 (1-60) months. Neither aneurysm rupture nor stent-graft migration occurred. Late type I endoleak occurred (n = 2, 1.6%). There were left lower extremity arterial thrombosis (n = 1, 0.8%) and surgical reintervention (n = 1, 0.8%). Among 3 dead cases, 2 died from acute myocardial infarction and another 1 contrast-induced nephropathy. CONCLUSION: Unibody bifurcated stent-graft is both safe and efficacious in the treatment of abdominal aortic aneurysm without the risk of long-term migration. Moreover, it has excellent outcomes for hostile neck or narrow abdominal aortic bifurcation.

α4ß7 Integrin (LPAM-1) is upregulated at atherosclerotic lesions and is involved in atherosclerosis progression.

BACKGROUND/AIMS: Integrin activation and lymphocyte migration to the vascular intima is a key event in early atherosclerosis. α4ß7 integrin (LPAM-1) and its ligand, mucosal addressin cell adhesion molecule (MAdCAM-1) are known to play an important role in homing of activated lymphocytes to gut-associated lymphoid tissues. However, it is unclear whether α4ß7 integrin is involved in the pathogenesis of atherosclerosis. METHODS: The expressions of α4ß7 integrin and its ligands in atherosclerosis plaques from 12 week high fat diet (HFD) fed ApoE(-/-) and C57BL/6 mice were examined using immunofluorescent and immunohistochemical assays, respectively. We also generated ApoE/ß7 double deficient mice and compared atherosclerotic lesion development in ß7(+/+)ApoE(-/-) and ß7(-/-)ApoE(-/-) mice that were fed with HFD for 12 weeks. RESULTS: We found an upregulation of α4ß7 integrin and its ligands VCAM-1 and MAdCAM-1 at atherosclerosis plaques in Apolipoprotein E deficient (ApoE(-/-)) mice fed with HFD for 12 weeks. Over the 12 week HFD period, peripheral blood lymphocyte (PBL) expression of α4ß7 integrin increased in parallel with aortic lesion size. A removal of α4ß7 integrin by genetic deletion of the ß7 chain in the ApoE(-/-) mouse resulted in a markedly decreased 12 week-HFD atherosclerotic plaque area. ß7(-/-) ApoE(-/-) macrophages showed reduced acetylated and native LDL uptake and phagocytic activity, revealing possible roles for α4ß7 at two distinct stages of macrophage dysfunction during atherogenesis. Finally, a reduced activity of integrin downstream signalling components focal adhesion kinase (FAK) and MAPK/ERK1/2 in macrophage indicates their possible engagement during α4ß7 integrin signalling in atherosclerosis. CONCLUSIONS: Together our results reveal a critical role of α4ß7 in diet-induced atherosclerosis in mouse.

[Clinical application of "Anatomical fixation" in the endovascular repair of abdominal aortic aneurysm].

OBJECTIVE: This paper aims to evaluate the clinical applyment of "Anatomical fixation" and its long-term efficacy . METHODS: Retrospective analysis of clinical data and postoperative follow-up results of 125 patients undogoing EVAR using "anatomical fixation" enrolled in Shanghai Changhai hospital and Shanghai Changzheng hospital from January 2008 to January 2013. RESULTS: The technical success rate was 100%, Perioperative complications including Type I endoleak occurred in 3 patients (2.4%), 4 cases of type II endoleak (3.2%). Incidence of Type I endoleak in challenging neck cases was high than non- challenging neck cases, the difference was statistically significant (P < 0.001). After 30 days and through current follow-up of 124 successful cases(mean:26.4 ± 1.5 months, range 1-60 months). No rupture of the aneurysm and stent graft migrations occurred. Secondary type I endoleak in 2 cases (1.6%), Two cases of secondary type II endoleak (1.6%). Left lower extremity arterial thrombosis in 1 case (0.8%), and secondary surgical intervention in 1 case (0.8%). Three cases of deaths in cumulative, 2 patients died died of acute myocardial infarction. At 3 months, a patient died of the contrast-induced nephropathy, renal failure. CONCLUSIONS: The clinical applyment of "Anatomical fixation" enriched the theory of EVAR, completely solved the complication of incidence of stent-graft migration, greatly improve the repair rate of hostile neck cases, expand the indications for EVAR.

Application of adipose-derived stem cells in critical limb ischemia.

Peripheral artery disease is growing in global prevalence. Its most severe form, critical limb ischemia (CLI), is associated with high rates of limb loss, morbidity, and mortality. Neovascularization is the cornerstone of limb preservation in CLI. In the field of regenerative medicine, basic research and preclinical studies have been conducted using mesenchymal stem cells (MSCs) from adult tissues, including bone marrow and adipose tissue, to overcome clinical shortcomings. Adipose-derived stem cells (ASCs) display stable growth and proliferation kinetics and can differentiate into osteogenic, chondrogenic, adipogenic, myogenic or neurogenic lineages. ASCs are readily available from autologous adipose tissue, and have significant potential for tissue repair under conditions of myocardial infarction, heart failure, hind limb ischemia, and inflammation. This review highlights some of the key reports underlining the potential of ASCs, particularly in diseases involving neovascularization.

Morphological and hemodynamic analysis of mirror posterior communicating artery aneurysms.

BACKGROUND AND PURPOSE: Hemodynamic factors are commonly believed to play an important role in the pathogenesis, progression, and rupture of cerebral aneurysms. In this study, we aimed to identify significant hemodynamic and morphological parameters that discriminate intracranial aneurysm rupture status using 3-dimensional-angiography and computational fluid dynamics technology. MATERIALS AND METHODS: 3D-DSA was performed in 8 patients with mirror posterior communicating artery aneurysms (Pcom-MANs). Each pair was divided into ruptured and unruptured groups. Five morphological and three hemodynamic parameters were evaluated for significance with respect to rupture. RESULTS: The normalized mean wall shear stress (WSS) of the aneurysm sac in the ruptured group was significantly lower than that in the unruptured group (0.52±0.20 versus 0.81±0.21, P = .012). The percentage of the low WSS area in the ruptured group was higher than that in the unruptured group (4.11±4.66% versus 0.02±0.06%, P = .018). The AR was 1.04±0.21 in the ruptured group, which was significantly higher than 0.70±0.17 in the unruptured group (P = .012). By contrast, parameters that had no significant differences between the two groups were OSI (P = .674), aneurysm size (P = .327), size ratio (P = .779), vessel angle (P = 1.000) and aneurysm inclination angle (P = 1.000). CONCLUSIONS: Pcom-MANs may be a useful disease model to investigate possible causes of aneurysm rupture. The ruptured aneurysms manifested lower WSS, higher percentage of low WSS area, and higher AR, compared with the unruptured one. And hemodynamics is as important as morphology in discriminating aneurysm rupture status.

Endovascular treatment of acutely ruptured, wide-necked anterior communicating artery aneurysms using the Enterprise stent.

The treatment of anterior communicating artery (AcomA) wide-necked aneurysms with the Enterprise stent (Codman, Miami Lakes, FL, USA) has not been commonly described, due to the complexity of the vascular anatomy and the small vessels of the AcomA complex. To evaluate the feasibility, effectiveness and safety of Enterprise stent placement in AcomA aneurysms, we performed this retrospective study. Between November 2008 and December 2010, 27 wide-necked AcomA ruptured aneurysms were treated within 72 hours of ictus with the Enterprise stent. Data collected and analyzed were: demographic data, morphologic features of the aneurysm, treatment results and follow-up results. Twenty-nine Enterprise stents were successfully deployed in all 27 aneurysms, including Y-configuration stent deployment in two patients. The initial embolization degrees were Raymond class I in 20 patients, class II in five and class III in the other two. The angiographic follow-up of 21 patients (mean, 8.4 months) showed that all aneurysms remained stable or improved; there was no in-stent stenosis, recurrence or retreatment. The clinical follow-up of 26 patients (mean, 12.6 months) showed that 23 patients displayed no symptoms and no or mild disability; three patients remained with severe or moderately severe disability. The Enterprise stent is feasible and safe for endovascular embolization of wide-necked AcomA ruptured aneurysms. Further follow up is needed to assess the long-term efficacy of Enterprise stent placement in AcomA.

Balloon-assisted superselective microcatheterization for transarterial treatment of cranial dural arteriovenous fistulas: technique and results.

BACKGROUND: In transarterial embolization of anterior cranial fossa and tentorial dural arteriovenous fistula (DAVF), acute angulation of the feeding artery off the internal carotid artery (ICA) may render stable distal catheterization and, therefore, successful transarterial treatment difficult. In some anatomic dispositions, following selection of the feeding artery, subsequent forward force may lead to prolapse of the microcatheter into the ICA rather than advancing it into either the ophthalmic artery or the meningohypophyseal trunk. OBJECTIVE: We describe a technique that facilitates stable positioning of the microcatheter by using a nondetachable balloon to temporally block the ICA distal to the feeding artery to redirect the catheter into the feeder and to prevent the microcatheter from protruding into the parent artery. METHODS: In 8 cases where routine superselective microcatheterization failed, a balloon was used to block the ICA distal to the feeding artery in an attempt to facilitate superselective microcatheterization. The balloon was inflated following selection of the feeding vessel with the microcatheter and was kept inflated while advancing the catheter. RESULTS: : Distal stable microcatheter positions could be obtained in all cases, which enabled us to treat the respective DAVFs with a liquid embolic agent. All 8 cases were angiographically cured with penetration of the liquid embolic agent from the distal artery to the proximal vein, and no procedure-related complications occurred. CONCLUSION: The described technique may be a helpful adjunct to gain stable distal microcatheter positions during the transarterial treatment of DAVF.

A comparison of the hemodynamic effects of flow diverters on wide-necked and narrow-necked cerebral aneurysms.

Flow diverters (FD), a new generation of intracranial stents with a low porosity mesh, have been applied as an alternative treatment for intracranial aneurysms. However, their efficacy varies among aneurysms of different morphology. In this study, computational fluid dynamic simulations were performed to examine the influence of an FD on the hemodynamics of wide-necked and narrow-necked cerebral aneurysms. An FD with 70% porosity mesh was deployed across the neck of an ideal narrow-necked and wide-neck aneurysm model. The hemodynamics at the aneurysmal sac were changed markedly in both models. At the inflow portion of the aneurysm neck of the narrow-necked aneurysm, the peak velocity and wall shear stress were reduced by 84% and 91%, respectively. By comparison, in the wide-necked aneurysm model, the results were 47% and 21%, respectively. This study demonstrates that the FD markedly altered the hemodynamic conditions inside intracranial aneurysms, depending on aneurysm morphology. Therefore, hemodynamic modifications should be individually designed for aneurysms with different morphology.