Clinical Neuroradiology最新文献

{"title":"Real-World Generalizability of Alzheimer's Volumetric MRI Machine-Learning Models: External Validation with British Data.","authors":"Helena Rico Pereira, Vasco Sá Diogo, José Manuel Fonseca, Hugo Alexandre Ferreira, Diana Pinto Prata","doi":"10.1007/s00062-026-01688-8","DOIUrl":"https://doi.org/10.1007/s00062-026-01688-8","url":null,"abstract":"<p><strong>Purpose: </strong>Assessing generalizability and performance of machine learning models in clinical settings is crucial. In this study, we aimed to test our models' performance on an external validation real-world clinical dataset and to evaluate the impact of magnetic field strength and brain volume normalization on the classification.</p><p><strong>Methods: </strong>We validated two previously published models trained on public datasets (Alzheimer's disease [AD], mild cognitive impairment [MCI] and cognitively normal [CN] subjects) on a real-world clinical dataset from UK memory clinics (SLaM-BRC: 255 non-AD [subjects without cognitive complaints], 281 MCI and 711 AD).</p><p><strong>Results: </strong>Our 'CN vs. AD' model showed similar performance when tested at different magnetic fields (1.5T vs. 3.0T: 87.1% of 93 subjects had the same class assignment). The volume-normalized 'CN vs. AD' model (87.7% balanced accuracy [BAC]) led to decreased performance in the SLaM-BRC (81.5% BAC) due to misclassifications of non-AD subjects with evidence of hippocampal atrophy. The non-normalized 'CN vs. MCI vs. AD' model's performance (initially 55.3% BAC) remained similar in the SLaM-BRC cohort (BAC: SLaM-BRC = 54.6%).</p><p><strong>Conclusion: </strong>Volumes normalized to the estimated total intracranial volume led to a smaller difference in performance between internal and external datasets than non-normalized volumes. Our 'CN vs. MCI vs. AD' model performance remained the same, denoting robustness. These findings suggest that dataset and disease/diagnostic heterogeneities, magnetic field, and brain volume normalization may affect models' performance.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microcatheter Aspiration Thrombectomy with a 0.025″ Microcatheter for Distal Vessel Occlusions in Acute Ischemic Stroke with Disabling Deficits.","authors":"Mohammad Almohammad, Lisa Hekers, Mete Dadak, Ali Khanafer, Mariana Gurschi, Bayan Alhaj Moustafa, Zakarya Ali, Lars Timmermann, Ole J Simon, Abdallah Aburub, André Kemmling","doi":"10.1007/s00062-026-01692-y","DOIUrl":"https://doi.org/10.1007/s00062-026-01692-y","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the feasibility and safety of microcatheter aspiration thrombectomy (MAT) using a 0.025″ microcatheter (PX-SLIM™) for distal vessel occlusions (DVOs) in acute ischemic stroke (AIS) with disabling deficits, and to explore outcome differences between patients with and without intravenous thrombolysis (IVT).</p><p><strong>Methods: </strong>This retrospective multicenter study included 21 highly selected AIS patients (July 2022-June 2024) with angiographically confirmed DVOs in the M3-M4, A3-A4, or P3-P4 segments. All had an Alberta Stroke Program Early CT Score (ASPECTS) of 10 and disabling deficits and underwent MAT using the PX-SLIM™ microcatheter. Outcomes included clinical scores-National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS)-angiographic reperfusion using the modified Thrombolysis in Cerebral Infarction (mTICI; success ≥ 2b), and procedural safety.</p><p><strong>Results: </strong>14 patients (66.7%) received IVT + MAT and 7 (33.3%) MAT alone. Successful reperfusion (mTICI ≥ 2b) was achieved in all 21 patients (100%). Median NIHSS improved from 3 at admission to 1 at discharge and 0 at 3 months. At discharge, 90.5% had an mRS of 1 and 9.5% an mRS of 2; at 3 months, 85.7% achieved mRS 0 and 14.3% mRS 1. No hemorrhage, dissection, distal embolization, or AIS recurrence occurred; transient vasospasm was observed in 38% without clinical impact.</p><p><strong>Conclusion: </strong>MAT using the PX-SLIM™ microcatheter appears to be a technically feasible approach with an acceptable safety profile in this small, highly selected cohort. The encouraging results are exploratory, and larger prospective studies are needed to confirm these findings.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Anesthesia on Thrombectomy Outcomes in Large Stroke: a TENSION Subanalysis.","authors":"Sophia Hohenstatt, Martin Bendszus, Jens Fiehler, Susanne Bonekamp, Anne Hege Aamodt, Blanca Fuentes, Elke R Gizewski, Michael D Hill, Antonin Krajina, Laurent Pierot, Claus Z Simonsen, Kamil Zeleňák, Rolf A Blauenfeldt, Mayank Goyal, Christian Herweh, Peter A Ringleb, Silvia Schönenberger, Wolfgang Wick, Götz Thomalla, Markus A Möhlenbruch, Dominik F Vollherbst","doi":"10.1007/s00062-026-01689-7","DOIUrl":"https://doi.org/10.1007/s00062-026-01689-7","url":null,"abstract":"<p><strong>Introduction: </strong>This post-hoc subanalysis of the TENSION trial evaluated the association between anesthesia strategy and neurological outcomes in patients with large-core infarcts undergoing mechanical thrombectomy (MT).</p><p><strong>Methods: </strong>We analyzed patients from the interventional arm of the TENSION trial who underwent MT under general anesthesia (GA) or conscious sedation (CS). Anesthesia strategy was not prespecified and was selected by the local stroke team. Key outcomes included early neurological improvement (ENI) or deterioration (END), modified Rankin Scale (mRS) at 90 days, procedural metrics, and safety outcomes. Multivariable logistic regression was performed to assess the independent association between anesthesia strategy and ENI, END, and favorable functional outcome, defined as mRS 0-3 at 90 days. Sensitivity analyses were conducted in patients with successful reperfusion.</p><p><strong>Results: </strong>A total of 117 patients were included, of whom 50 were treated under GA and 67 under CS. No significant differences were observed between GA and CS for ENI (46.0% vs. 62.7%, p = 0.09) or END (56.0% vs. 46.3%, p = 0.30) at 24 h. Likewise, 90-day functional outcome did not differ significantly between groups, with mRS 0-3 achieved in 24.0% of GA patients and 36.0% of CS patients (p = 0.057). In adjusted analyses, anesthesia strategy was not independently associated with ENI, END, or mRS 0-3 at 90 days. Reperfusion success, first-pass recanalization, and safety outcomes were similar between groups. In the sensitivity analysis restricted to successfully reperfused patients, total procedure time was shorter in the CS group, but neurological and functional outcomes remained similar.</p><p><strong>Conclusion: </strong>In this post-hoc subanalysis of patients with large-core infarcts undergoing MT, anesthesia strategy was not independently associated with early neurological or 90-day functional outcomes. GA and CS were associated with comparable procedural success and safety. Given the non-randomized design, limited sample size, and potential for residual confounding, further studies are needed to clarify optimal anesthesia selection in large-core stroke patients undergoing MT.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiating Hemorrhage and Contrast Extravasation After Mechanical Thrombectomy Using Virtual Non-Contrast Photon-Counting CT.","authors":"Eya Khadhraoui, Roland Schwab, Mathias Becker, Elie Diamandis, Maciej Pech, Daniel Behme, Sebastian Johannes Müller","doi":"10.1007/s00062-026-01684-y","DOIUrl":"https://doi.org/10.1007/s00062-026-01684-y","url":null,"abstract":"<p><strong>Background: </strong>In the early phase after mechanical thrombectomy, differentiating between intracranial hemorrhage and contrast medium extravasation on CT imaging remains a major diagnostic challenge. Both can appear hyperdense on standard CT scans, however, they have significantly different clinical implications, particularly regarding anticoagulation decisions. The Virtual Non-Contrast (VNC) technique using photon-counting computed tomography (PCCT), offers the potential to reliably distinguish between blood and iodine-based contrast material in a single scan by virtually removing the iodine component.</p><p><strong>Purpose: </strong>To evaluate the clinical feasibility and diagnostic performance of the VNC technique in patients after thrombectomy, with focus on the differentiation between hemorrhage and contrast extravasation.</p><p><strong>Methods: </strong>In this retrospective study, we analyzed hyperdense areas of 36 patients who underwent PCCT imaging shortly after mechanical thrombectomy. Two experienced neuroradiologists independently assessed the presence of intracranial hemorrhage and residual contrast extravasation using the VNC datasets. Findings, including measured volumes, were compared to follow-up scans.</p><p><strong>Results: </strong>VNC imaging enabled reliable differentiation between hemorrhage and contrast staining. The sensitivity for detecting hemorrhage was 0.93 (25 of 27 patients, confidence interval 0.77-0.98), with a specificity of 100%. Contrast extravasation was correctly diagnosed in the 9 remaining cases using both VNC and native CT.</p><p><strong>Conclusion: </strong>The VNC technique using PCCT demonstrates high clinical utility in the early post-thrombectomy setting, offering reliable differentiation between intracranial hemorrhage and contrast extravasation in the majority of cases. However, isolated cases with extensive contrast extravasation or overlapping imaging features may still pose diagnostic limitations.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atlas-based Multi-Parametric Quantitative Brain MRI Analysis of Children with Neurofibromatosis Type 1.","authors":"Allison K Duh, Lydia T Tam, Linda Liverani, Nathan N Ng, Emily S McKenna, Nathan C Rowe, Cynthia J Campen, Sarah J MacEachern, Kristen W Yeom, Laura M Prolo, Nils D Forkert","doi":"10.1007/s00062-026-01690-0","DOIUrl":"10.1007/s00062-026-01690-0","url":null,"abstract":"<p><strong>Purpose: </strong>Neurofibromatosis type 1 (NF1) is a multisystem disorder with wide-ranging clinical presentations. Patients with NF1 may manifest with macrocephaly, strokes, and cognitive deficits, abnormal neural development, and other neurologic symptoms. This study used an atlas-based approach to quantitatively examine structural and physiologic changes of the brain in children with NF1.</p><p><strong>Methods: </strong>Children evaluated for NF1 over a 9-year period at a children's hospital were retrospectively reviewed (n = 34). Children with intracranial tumors or prior strokes were excluded. Patients received diffusion-weighted imaging (DWI) and arterial spin labeling (ASL) perfusion imaging on a 3T MRI scanner. Using an atlas-based approach, quantitative assessment of regional brain volumes, median apparent diffusion coefficient (ADC), and cerebral blood flow (CBF) was performed for the cerebral cortex, thalamus, caudate, putamen, globus pallidus, hippocampus, amygdala, nucleus accumbens, brainstem, and cerebral white matter. Differences were tested between NF1 patients and 100 typically developing controls.</p><p><strong>Results: </strong>Compared to controls, children with NF1 demonstrated significantly increased volume measurements in all brain regions (p < 0.001), significantly higher median ADC values in all structures except for the putamen and nucleus accumbens (p < 0.001), and significantly lower median CBF most notable in the cerebral white matter (p < 0.001), globus pallidus (p < 0.001), hippocampus (p < 0.001), amygdala (p < 0.001), and brainstem (p = 0.001).</p><p><strong>Conclusion: </strong>This study measured microstructural and physiologic brain changes in children with NF1 compared to typically developing children. Further studies are needed to elucidate the cellular and molecular basis for these differences. With further refinement, atlas-based quantitative MRI brain signatures may serve as useful biomarkers of neural development, cognitive dysfunction, and risks for vasculopathy-related strokes in children with NF1.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Safety Profile of Middle Meningeal Artery Embolization for Chronic Subdural Hematoma: a Multinational Multicenter Study.","authors":"Bluyé DeMessie, Alireza Karandish, Muhammed Amir Essibayi, Hamza Adel Salim, Deepak Khatri, Neil Haranhalli, Amanda Baker, Richard Zampolin, Allan L Brook, Seon-Kyu Lee, Nimer Adeeb, Dhairya A Lakhani, Yan-Lin Li, Diego Alejandro Ortega, Nicole Cancelliere, Jose Danilo Diestro, Joseph Carnevale, Craig Schreiber, Atakan Orscelik, Zachary Abecassis, Spencer Raub, Georgios S Sioutas, Abdulrhman Alsalama, Clairice Pearce, Giancarlo Salsano, Rahim Abo Kasem, Svetlana Kvint, Andrew Falzon, Vance Cantrell, Brian Holliday, Jefferson O Abaricia, Pedram Maleknia, Leonardo Cruz-Criollo, Samantha Schimmel, Basel Musmar, Matthew Alexander, Jorge Rios Zermeno, Koul Prateeka, Ahmed Aljuboori, Dominik F Vollherbst, Domagoj Gajski, Jared Cooper, Omar Alwakaa, Mohamad Ezzeldin, James Grist, Fulvio Zaccagna, Christopher S Ogilvy, Fawaz Al-Mufti, Vladimir Kalousek, Markus A Möhlenbruch, Luca Scarcia, William W Wroe, Hussein A Zeineddine, Tang Si Zhao, Peter B Sporns, Anil Gopinathan, Robert W Regenhardt, Spiros L Blackburn, Clemens M Schirmer, Thien Huynh, Rabih Tawk, Fabio Settecase, Stavropoula Tjoumakaris, Pascal Jabbour, Kunal Vakharia, Mario Zanaty, Santiago Ortega-Gutierrez, Jesse G Jones, Marco Colasurdo, Hussein H Nasser, Sri Hari Sundararajan, Pascal J Mosimann, Erez Nossek, Eytan Raz, Sami Al Kasab, Alejandro M Spiotta, Lucio Castellan, Bruno Del Sette, Ali Alaraj, Caterina Michelozzi, Davide Saraceno, Pietro Panni, Visish M Srinivasan, Jan-Karl Burkhardt, Gaultier Marnat, Pietro Mario Santini, Michael R Levitt, Giuseppe Lanzino, Jared Knopman, Tareq Kass-Hout, Julian Spears, Thomas Marotta, Vitor Mendes Pereira, Tufail Patankar, Adam A Dmytriw, David J Altschul","doi":"10.1007/s00062-026-01686-w","DOIUrl":"https://doi.org/10.1007/s00062-026-01686-w","url":null,"abstract":"<p><strong>Background: </strong>Middle meningeal artery embolization (MMAE) has emerged as a treatment for chronic subdural hematoma (cSDH), but comprehensive real-world safety data remain limited.</p><p><strong>Methods: </strong>We performed a multicenter retrospective analysis of 1781 consecutive patients undergoing MMAE for cSDH (2019-2025). The primary outcome was any procedure-related complication within 30 days. Inverse probability of treatment weighting (IPTW) assessed the association between technical success and complications, adjusting for demographic, clinical, and procedural confounders.</p><p><strong>Results: </strong>Mean age was 72.8 ± 12.4 years; 68.1% were male. The 30-day complication rate was 5.1% (91/1781; 95% CI, 4.1-6.2). In-hospital mortality was 2.9% (47/1625). Technical success was achieved in 97.5% (1505/1543). Among documented complications, thromboembolic events were most common (37.2%; 32/86), followed by hemorrhagic complications (23.8%; 20/84) and access-site hematoma (10.4%; 8/77). Among patients with classifiable symptom status, 80.6% of complications were symptomatic, yielding an overall symptomatic complication rate of 3.0%. Neurological deterioration occurred in 27.1% (248/915). Among 1552 patients with documented surgical approach, complication rates were similar between surgery plus embolization (4.9%; 34/690) and embolization alone (5.2%; 45/860; OR, 0.94; 95% CI, 0.59-1.48; p = 0.79). After IPTW adjustment, technical success was associated with an 86% reduction in complication odds (OR, 0.14; 95% CI, 0.05-0.40; p < 0.001).</p><p><strong>Conclusions: </strong>In this large multicenter cohort, MMAE was associated with a 5.1% complication rate. Technical success was the strongest protective factor. Embolization with or without surgery showed equivalent safety profiles.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topological Alterations of Functional Brain Networks in Post-Stroke Cognitive Impairment: a Graph-Theoretical Study.","authors":"Pahati Tuxunjiang, Ainikaerjiang Aihemaiti, Yimuran Subi, Hanjiaerbieke Kukun, Rui Xu, Yuchen Liu, Yuhui Xiong, Yunling Wang","doi":"10.1007/s00062-026-01674-0","DOIUrl":"https://doi.org/10.1007/s00062-026-01674-0","url":null,"abstract":"<p><strong>Objective: </strong>To investigate topological alterations of functional brain networks in patients with post-stroke cognitive impairment (PSCI) using resting-state functional magnetic resonance imaging (rs-fMRI), and to explore the relationship between network organization and post-stroke cognitive performance.</p><p><strong>Materials and methods: </strong>This study was conducted with a prospective enrollment of 45 patients with ischemic stroke, including 21 patients with PSCI and 24 patients with post-stroke non-cognitive impairment (PSNCI), coupled with the recruitment of 30 age-, sex-, and education-matched healthy controls (HC). All participants underwent brain rs-fMRI and cognitive function assessment. This study further employed comparative analyses to clarify the inter-group differences of global and nodal topological metrics, and the correlation between different brain regions and cognitive scores.</p><p><strong>Results: </strong>Compared with the HC group, both PSCI and PSNCI groups exhibited significant topological alterations of functional brain networks, including increased characteristic path length (Lp), reduced global efficiency (Eg) and local efficiency (Eloc), and disrupted small-worldness (σ). However, PSCI and PSNCI groups exhibited no significant differences in global network metrics. At the nodal level, PSCI and PSNCI patients showed increased nodal clustering coefficient (NCp) and local efficiency (NLe) in the left medial and paracingulate cortices, left caudate nucleus, and right paracentral lobule. Pearson correlation analysis revealed that Eloc (r = 0.580, P = 0.006), σ (r = 0.513, P = 0.017) and normalized clustering coefficient (γ) (r = 0.581, P = 0.006) were positively correlated with MoCA scores in PSCI group. Clustering coefficient (Cp) (r = -0.492, P = 0.015) was negatively correlated with the MMSE score in PSNCI group.</p><p><strong>Conclusions: </strong>The global and node topological properties of the brain networks in patients with PSCI have changed. This is manifested as impaired information transmission efficiency and decreased integration ability in the entire brain. The abnormal global properties are related to cognitive dysfunction, providing valuable insights from the imaging perspective for understanding the neural cognitive mechanism of PSCI.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Need for Training and Reporting Standards in Middle Meningeal Artery Embolization.","authors":"Rosalie Morrish, Johanna M Ospel","doi":"10.1007/s00062-026-01680-2","DOIUrl":"https://doi.org/10.1007/s00062-026-01680-2","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stent Retriever Assisted Endoluminal Reconstruction (STARecon) in Interventional Stroke Management.","authors":"Valdas Stonys, Francesco Morra, Patrick Thurner, Jawid Madjidyar, Miklos Krepuska, Anna Kyselyova, Mate Czencz, Susanne Wegener, Andreas R Luft, Christoph Globas, Zsolt Kulcsar, Tilman Schubert","doi":"10.1007/s00062-026-01679-9","DOIUrl":"10.1007/s00062-026-01679-9","url":null,"abstract":"<p><strong>Purpose: </strong>Endovascular stroke treatment has become the standard of care for acute large vessel occlusion and has significantly improved clinical outcomes. However, the procedure is still associated with possible complications, including vessel injury and reocclusion. This monocentric retrospective observational cohort study aims to evaluate the outcomes of the STent retriever Assisted endoluminal Reconstruction (STARecon) technique. In this case series we propose temporary deployment of a stent retriever as a potential bailout strategy in situations of spontaneous vessel reocclusion or uncertain vessel narrowing not associated with intracranial atherosclerotic disease (ICAD), including suspected iatrogenic dissection.</p><p><strong>Methods: </strong>Eight cases of temporary stenting using STARecon technique with stent retriever to treat spontaneous vessel reocclusion after thrombectomy were analysed. All patients underwent pre- and postinterventional non-invasive angiographic imaging (CTA or MRA) and clinical evaluation. The endovascular technique involved temporary deployment of a stent retriever under glycoprotein IIb/IIIa inhibitor infusion, followed by antithrombotic medication after atraumatic resheathing and removal of the stent retriever.</p><p><strong>Results: </strong>Successful vessel recanalization was achieved in all cases with the duration of temporary stenting using stent retriever between 15 and 50 min (average 30 min 37 s). Postinterventional follow-up imaging demonstrated resolution of the spontaneous reocclusion without significant residual stenosis in all the cases at the treated site with STARecon technique.</p><p><strong>Conclusion: </strong>Our findings suggest that temporary stent retriever deployment using the STARecon technique may represent a valuable alternative to stent reconstruction in endovascular management of spontaneous vessel reocclusion after thrombectomy, including suspected iatrogenic dissection, especially in patients deemed at high risk of intracranial hemorrhage.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seven-Day Modified Rankin Scale Score as an Early Predictor of 90-Day Functional Outcome After Mechanical Thrombectomy.","authors":"Natsuki Akaike, Hiroyuki Ikeda, Hidenobu Hata, Takaaki Kitano, Yasunori Yokochi, Mai Tanimura, Takuya Osuki, Ryosuke Kaneko, Minami Uezato, Masanori Kinosada, Yoshitaka Kurosaki, Masaki Chin","doi":"10.1007/s00062-026-01678-w","DOIUrl":"https://doi.org/10.1007/s00062-026-01678-w","url":null,"abstract":"<p><strong>Purpose: </strong>We hypothesized that the modified Rankin Scale (mRS) score after mechanical thrombectomy (MT) could predict subsequent functional improvement.</p><p><strong>Methods: </strong>We retrospectively analyzed consecutive patients with acute ischemic stroke who underwent MT at our institution between January 2020 and December 2024. The association between the 7‑day and 90-day mRS scores was evaluated in all eligible patients (N = 432). Analyses of functional improvement were performed in patients with a 7-day mRS score of 3-5 (n = 290). Functional improvement was defined as a decrease of ≥ 1 point in the mRS score from day 7 to day 90, and patients were classified into improvement and non-improvement groups.</p><p><strong>Results: </strong>There was a strong correlation between the 7‑day and 90-day mRS scores (r = 0.86), with moderate agreement (weighted κ = 0.48). Functional improvement was observed in 95 (32.8%) of 290 patients with a 7-day mRS score of 3-5. Compared with the non-improvement group, the improvement group was significantly younger (median age, 79 versus 84 years; P < 0.0001), had a higher proportion of prestroke mRS score of 0-2 (82.1% versus 58.0%; P < 0.0001), and a higher prevalence of current smoking (17.9% versus 6.7%; P = 0.003). In multivariable logistic regression analysis, younger age (OR 0.96 per 1‑year increase; 95% CI, 0.93-0.99; P = 0.0030) and a prestroke mRS score of 0-2 (OR 2.7; 95% CI, 1.42-4.98; P = 0.0023) were identified as independent predictors of functional improvement.</p><p><strong>Conclusions: </strong>The 7‑day mRS score after MT was strongly associated with the 90-day mRS score. Among patients with a 7-day mRS score of 3-5, younger age and a prestroke mRS score of 0-2 were independent predictors of functional improvement.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}