Regression of neointimal hyperplasia of an intracranial stent: 6 years follow-up of a wide-necked aneurysm.

We present a case of wide-necked giant aneurysm located at the P1-P2 segment of the posterior cerebral artery. The initial goal for treatment of the aneurysm was hemodynamic flow redirection with subsequent thrombosis so the procedure and involved stent placement to the neck of the aneurysm without any filling material. During follow up, significant in-stent stenosis due to intimal hyperplasia was found at the 6th month on digital subtraction angiography. Regression of in-stent neointimal stenosis at the 18th month and a total disappearance at the 76th month were observed on follow-up angiograms. Illustrating the reversibility of neointimal hyperplasia during a long follow up period was the main goal of this case report.

Posttraumatic nonischemic priapism treated with autologous blood clot embolization.

INTRODUCTION: High-flow arterial priapism is rare and characterized by a prolonged nonpainful erection. Autologous clot embolization allows complete resolution of the problem in most of the cases. AIM: To review our experience with superselective transcatheter embolization in the treatment of nonischemic priapism. MAIN OUTCOME MEASURES: Advances in the understanding of the nonischemic priapism with the aid of newer techniques have altered the current management of nonischemic priapism. MATERIALS AND METHODS: Between 2002 and 2006, 11 patients underwent superselective transcatheter embolization of nonischemic priapism with blunt trauma to the penis or perineum. All patients underwent diagnostic evaluation with color-flow Doppler ultrasound and superselective pudendal arteriography, revealing bilateral arteriocorporal fistula and pseudoaneurysm in two cases, bilateral arteriocorporal fistula in one case, unilateral arteriocorporal fistula in one case, and unilateral arteriocorporal fistula and pseudoaneurysm in seven cases. Autologous blood clot was used as an embolization agent in all cases combined with microcatheter guidance. RESULTS: The procedure was technically successful in all cases. In three (27.2%) cases, a second embolization was required due to recurrence of priapism. In all patients, erectile function was restored within 6 weeks of the procedure. Follow-ups at 6 and 12 months after the last procedure revealed that full erectile capacity was restored in 10 of 11 patients, and these patients did not experience further recurrence of priapism. One patient reported a slight decrease in the quality of his penile erection. CONCLUSIONS: Our experience revealed that superselective transcatheter embolization and transient occlusion of the fistula with autologous blood clot is an effective therapy for the treatment of nonischemic priapism. Furthermore, recovery of erectile function due to recanalization of the occluded vessel occurred weeks after the procedure.