Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences最新文献_第4页

Comparative cost analysis of liquid embolization systems for brain arteriovenous malformation using a real-world US hospital database: TRUFILL® versus OnyxTM. 使用真实世界美国医院数据库:TRUFILL®与OnyxTM对脑动静脉畸形液体栓塞系统的成本比较分析

Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences Pub Date : 2022-05-25 DOI: 10.1177/15910199221103325

S. Satti, Xiaozhou Fan, E. Kottenmeier, R. Khanna, A. Rai

{"title":"Comparative cost analysis of liquid embolization systems for brain arteriovenous malformation using a real-world US hospital database: TRUFILL® versus OnyxTM.","authors":"S. Satti, Xiaozhou Fan, E. Kottenmeier, R. Khanna, A. Rai","doi":"10.1177/15910199221103325","DOIUrl":"https://doi.org/10.1177/15910199221103325","url":null,"abstract":"BACKGROUND\u0000Liquid embolic systems (LES) such as n-butyl cyanoacrylate-based TRUFILL® and ethylene vinyl-alcohol copolymer-based OnyxTM are widely used for the embolization of brain arteriovenous malformations (bAVMs). The purpose of this study was to compare hospital cost and length of stay (LOS) among unruptured bAVM patients undergoing embolization procedures with TRUFILL versus Onyx LES.\u0000\u0000\u0000METHODS\u0000Adult patients with unruptured bAVMs undergoing endovascular embolization with TRUFILL or Onyx LES between January 1, 2010 and June 30, 2020 were identified from the Premier Healthcare Database. Baseline covariates among the two groups were balanced using propensity score matching. Outcomes including total procedure cost, supply cost, and LOS were examined. A Generalized Estimating Equation model was used to assess outcomes in the matched cohorts.\u0000\u0000\u0000RESULTS\u0000A total of 1072 patients were included in the study; 140 embolized with TRUFILL (mean age 47.06 [15.72] years, 45.70% male) and 932 embolized with Onyx (mean age 46.80 [16.65] years, 52.30% male). In the post-match cohort, the total procedure costs were lower for the TRUFILL (n = 130) versus Onyx (n = 333) group, though not significantly ($36,798 vs. $40,988; odds ratio [OR] = 0.90, 95% confidence interval [CI]: 0.73-1.10; p = 0.30). However, supply cost was significantly lower for hospitalizations with TRUFILL compared to Onyx use ($13,281 vs. $16,371, OR = 0.81, 95% CI: 0.68, 0.98; p = 0.026). Hospital LOS was similar in these two groups (TRUFILL: 4.05 vs. Onyx: 4.06 days; OR = 1.00, 95% CI: 0.70, 1.42; p = 0.99).\u0000\u0000\u0000CONCLUSIONS\u0000In a large, multi-center, real-world sample of patients undergoing bAVM embolization, TRUFILL use was associated with significantly lower supply cost compared to Onyx use.","PeriodicalId":126264,"journal":{"name":"Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132337836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mechanical thrombectomy in anterior vs. posterior circulation stroke: A systematic review and meta-analysis. 前循环与后循环卒中的机械取栓:一项系统回顾和荟萃分析。

Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences Pub Date : 2022-05-13 DOI: 10.1177/15910199221100796

G. Adusumilli, J. Pederson, N. Hardy, K. Kallmes, K. Hutchison, H. Kobeissi, D. Heiferman, J. Heit

{"title":"Mechanical thrombectomy in anterior vs. posterior circulation stroke: A systematic review and meta-analysis.","authors":"G. Adusumilli, J. Pederson, N. Hardy, K. Kallmes, K. Hutchison, H. Kobeissi, D. Heiferman, J. Heit","doi":"10.1177/15910199221100796","DOIUrl":"https://doi.org/10.1177/15910199221100796","url":null,"abstract":"BACKGROUND\u0000High-quality evidence exists for mechanical thrombectomy (MT) treatment of acute ischemic stroke (AIS) due to large vessel occlusion of the anterior circulation (AC-LVO). The evidence for MT treatment of posterior circulation large vessel occlusion (PC-LVO) is weaker, largely drawn from lower quality studies specific to PC-LVO and extrapolated from findings in AC-LVO, and ambiguous with regards to technical success. We performed a systematic review and meta-analysis to compare the technical success and functional outcomes of MT in PC-LVO versus AC-LVO patients.\u0000\u0000\u0000METHODS\u0000We identified comparative studies reporting on patients treated with MT in AC-LVO versus PC-LVO. The primary outcome of interest was thrombolysis in cerebral infarction (TICI) ≥ 2b. Secondary outcomes included rates of TICI 3, 90-day functional independence, first-pass-effect, average number of passes, and 90-day mortality. A separate random effects model was fit for each outcome measure.\u0000\u0000\u0000RESULTS\u0000Twenty studies with 12,911 patients, 11,299 (87.5%) in the AC-LVO arm and 1612 (12.5%) in the PC-LVO arm, were included. AC-LVO and PC-LVO patients had comparable rates of successful recanalization [OR = 1.02 [95% CI: 0.79-1.33], p = 0.848). However, the AC-LVO group had greater odds of 90-day functional independence (OR = 1.26 [95% CI: 1.00; 1.59], p = 0.050) and lower odds of 90-day mortality (OR = 0.58 [95% CI: 0.43; 0.79], p = 0.002).\u0000\u0000\u0000CONCLUSIONS\u0000MT achieves similar rates of recanalization with a similar safety profile in PC-LVO and AC-LVO patients. Patients with PC-LVO are less likely to achieve functional independence after MT. Future studies should identify PC-LVO patients who are likely to achieve favourable functional outcomes.","PeriodicalId":126264,"journal":{"name":"Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125788398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Application of convolutional network models in detection of intracranial aneurysms: A systematic review and meta-analysis. 卷积网络模型在颅内动脉瘤检测中的应用:系统综述和荟萃分析。

Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences Pub Date : 2022-05-13 DOI: 10.1177/15910199221097475

S. Abdollahifard, A. Farrokhi, Fateme Kheshti, Mahtab Jalali, A. Mowla

{"title":"Application of convolutional network models in detection of intracranial aneurysms: A systematic review and meta-analysis.","authors":"S. Abdollahifard, A. Farrokhi, Fateme Kheshti, Mahtab Jalali, A. Mowla","doi":"10.1177/15910199221097475","DOIUrl":"https://doi.org/10.1177/15910199221097475","url":null,"abstract":"Introduction Intracranial aneurysms have a high prevalence in human population. It also has a heavy burden of disease and high mortality rate in the case of rupture. Convolutional neural network(CNN) is a type of deep learning architecture which has been proven powerful to detect intracranial aneurysms. Methods Four databases were searched using artificial intelligence, intracranial aneurysms, and synonyms to find eligible studies. Articles which had applied CNN for detection of intracranial aneurisms were included in this review. Sensitivity and specificity of the models and human readers regarding modality, size, and location of aneurysms were sought to be extracted. Random model was the preferred model for analyses using CMA 2 to determine pooled sensitivity and specificity. Results Overall, 20 studies were used in this review. Deep learning models could detect intracranial aneurysms with a sensitivity of 90/6% (CI: 87/2–93/2%) and specificity of 94/6% (CI: 0/914–0/966). CTA was the most sensitive modality (92.0%(CI:85/2–95/8%)). Overall sensitivity of the models for aneurysms more than 3 mm was above 98% (98%-100%) and 74.6 for aneurysms less than 3 mm. With the aid of AI, the clinicians’ sensitivity increased to 12/8% and interrater agreement to 0/193. Conclusion CNN models had an acceptable sensitivity for detection of intracranial aneurysms, surpassing human readers in some fields. The logical approach for application of deep learning models would be its use as a highly capable assistant. In essence, deep learning models are a groundbreaking technology that can assist clinicians and allow them to diagnose intracranial aneurysms more accurately.","PeriodicalId":126264,"journal":{"name":"Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130228406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Stent-assisted coiling of unruptured paraclinoid aneurysms with wide neck or unfavorable dome-to-neck ratio: Results of ventral wall vs dorsal wall with propensity score matching analysis. 支架辅助盘绕未破裂的宽颈或不利圆颈比的类旁动脉瘤:腹侧壁与背侧壁的倾向评分匹配分析结果。

Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences Pub Date : 2022-05-11 DOI: 10.1177/15910199221100966

H. Ni, Yunfei Hang, Sheng Liu, Z. Jia, Hai-bin Shi, Lin-Bo Zhao

{"title":"Stent-assisted coiling of unruptured paraclinoid aneurysms with wide neck or unfavorable dome-to-neck ratio: Results of ventral wall vs dorsal wall with propensity score matching analysis.","authors":"H. Ni, Yunfei Hang, Sheng Liu, Z. Jia, Hai-bin Shi, Lin-Bo Zhao","doi":"10.1177/15910199221100966","DOIUrl":"https://doi.org/10.1177/15910199221100966","url":null,"abstract":"OBJECTIVE\u0000This study aimed to evaluate the clinical safety and efficacy of stent-assisted coil embolization of unruptured wide-necked paraclinoid aneurysms based on the projection distribution.\u0000\u0000\u0000METHODS\u0000Between November 2015 and September 2020, 267 unruptured paraclinod aneurysms in 236 patients were identified with a wide neck or unfavorable dome-to-neck ratio and treated with stent-assisted coiling technique. The classification of this segment aneurysms was simplified to the dorsal group (located on the anterior wall) and ventral group (Non-dorsal). Following propensity score matching analysis, the clinical and radiographic data were compared between the two groups.\u0000\u0000\u0000RESULTS\u0000Among 267 aneurysms, 186 were located on the ventral wall and 81 were on the dorsal wall. Dorsal wall aneurysms had a larger size (p < .001), wider neck (p = .001), and higher dome-to-neck ratio (p = .023) compared with ventral wall aneurysms. Propensity score-matched analysis found that dorsal group had a significantly higher likelihood of unfavorable results in immediate (residual sac, 39.4% vs. 18.2%, p = .007) and follow-up angiography (residual sac, 14.8% vs. 1.9%, p = .037) compared with ventral group, with significant difference in recurrence rates (9.3% vs. 0%, p = .028). The rates of procedure-related complications were not significantly different, but one thromboembolic event occurred in the dorsal group with clinical deterioration.\u0000\u0000\u0000CONCLUSIONS\u0000Traditional stent-assisted coiling can be given preference in paraclinoid aneurysms located on the ventral wall. The relatively high rate of recurrence in dorsal wall aneurysms with stent assistance may require other treatment options.","PeriodicalId":126264,"journal":{"name":"Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132067171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Severe papilledema and multiple hypercoagulability abnormalities in patient with dural arterio-venous fistulas. 硬脑膜动静脉瘘患者严重乳头水肿及多重高凝异常。

Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences Pub Date : 2022-05-04 DOI: 10.1177/15910199221098215

Chi-Wei Tien, Patrick K. Nicholson, E. Margolin

{"title":"Severe papilledema and multiple hypercoagulability abnormalities in patient with dural arterio-venous fistulas.","authors":"Chi-Wei Tien, Patrick K. Nicholson, E. Margolin","doi":"10.1177/15910199221098215","DOIUrl":"https://doi.org/10.1177/15910199221098215","url":null,"abstract":"A 54-year-old man noticed right-sided pulsatile tinnitus for the past six months and recently started experiencing transient visual obscurations when standing up. MRI demonstrated two separate brain dural arteriovenous fistulas (bdAVF) in sagittal and right sigmoid dural sinuses. Neuro-ophthalmological exam demonstrated severe bilateral optic disc edema with preserved visual acuity but early nerve fiber bundle defects on visual field testing. Hypercoagulable profile testing revealed very elevated D-dimer, significantly decreased protein S level and elevated homocysteine levels. This case highlights importance of referring all patients with bdAVFs for neuro-ophthalmological consultation as venous hypertension can cause increased intracranial pressure and resultant papilledema. Papilledema does not affect central vision until late stages when visual loss is irreversible thus screening for its presence and pre-treatment extent of peripheral visual loss is paramount. It also demonstrates that hypercoagulable workup should be initiated in all patients with bdAVF in order to prevent future thromboembolic events.","PeriodicalId":126264,"journal":{"name":"Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences","volume":"58 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116432279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Percutaneous transosseous embolization of a diploic vein arteriovenous fistula with intracranial and extracranial shunting. 经皮经骨栓塞治疗伴颅内外分流的双静脉动静脉瘘。

Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences Pub Date : 2022-05-03 DOI: 10.1177/15910199221096009

M. Noufal, C. Liang, V. Chhabra

引用次数: 0

Intravascular lithotripsy for severely calcified carotid artery stenosis - A new frontier in carotid artery stenting? 血管内碎石治疗严重钙化颈动脉狭窄——颈动脉支架置入术的新前沿?

Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences Pub Date : 2022-05-03 DOI: 10.1177/15910199221097887

Jasmeet Singh, A. Kuhn, F. Massari, Marwa Elnazeir, Roberto Kutcher, A. Puri

引用次数: 2

Flow diverter retreatment for intracranial aneurysms: A meta-analysis of efficacy and feasibility. 颅内动脉瘤分流术再治疗:疗效和可行性的荟萃分析。

Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences Pub Date : 2022-05-03 DOI: 10.1177/15910199221095972

I-Lin. Lee, Yung-Shuo Kao, Yen-Jun Lai, Ho-Hsian Yen

{"title":"Flow diverter retreatment for intracranial aneurysms: A meta-analysis of efficacy and feasibility.","authors":"I-Lin. Lee, Yung-Shuo Kao, Yen-Jun Lai, Ho-Hsian Yen","doi":"10.1177/15910199221095972","DOIUrl":"https://doi.org/10.1177/15910199221095972","url":null,"abstract":"BACKGROUND\u0000Recurrent intracranial aneurysm carries a risk of rupture and retreatment is often necessary. However, there is no consensus on the best retreatment modality of choice. Flow diverter has emerged as a promising option for this population in recent years. Given its high cost, patient selection to optimize outcomes is very important.\u0000\u0000\u0000PURPOSE\u0000To identify patient factors predisposing to failure of flow diverter retreatment.\u0000\u0000\u0000METHOD\u0000We conducted a systematic search on PubMed, Cochrane Library, Embase, Ovid/Medline, and ClinicalTrial.gov from 2000 to 2021. Studies regarding flow diverter retreatment of recurrent aneurysms were analyzed if they meet the inclusion criteria.\u0000\u0000\u0000RESULTS\u0000A total of twenty-six studies were identified. Among 374 patients retreated with flow diverters, about 0.86 [0.81; 0.92] were successfully occluded and only 0.06 [0.02; 0.10] had unfavorable neurological outcomes. Major complications included intracranial hemorrhage (n = 7), ischemic stroke or thromboembolic event (n = 12), and death (n = 2). In-stent stenosis was reported in 10 of the cases. Saccular aneurysms are associated with a higher occlusion rate while aneurysm location, size, status, and prior treatment modality have no significant impact on retreatment efficacy.\u0000\u0000\u0000CONCLUSIONS\u0000We demonstrated that flow diverter is an effective retreatment strategy except in patients with non-saccular aneurysms. It should be considered as a first-line option for patients with recurrent intracranial aneurysm.","PeriodicalId":126264,"journal":{"name":"Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115441611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Super-selective cavernous sinus and inferior petrosal sinus sampling for Cushing syndrome: Technique and interpretation. 库欣综合征的超选择性海绵窦和岩下窦取样:技术和解释。

Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences Pub Date : 2022-05-02 DOI: 10.1177/15910199221099409

M. Caton, E. Smith, A. Baker, C. Dowd

引用次数: 0

A new era in the treatment of wide necked bifurcation aneurysms: Intrasaccular flow disruption. 宽颈分岔动脉瘤治疗的新时代:囊内血流阻断。

Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences Pub Date : 2022-04-26 DOI: 10.1177/15910199221094390

D. Heiferman, N. Goyal, V. Inoa, C. Nickele, A. Arthur

{"title":"A new era in the treatment of wide necked bifurcation aneurysms: Intrasaccular flow disruption.","authors":"D. Heiferman, N. Goyal, V. Inoa, C. Nickele, A. Arthur","doi":"10.1177/15910199221094390","DOIUrl":"https://doi.org/10.1177/15910199221094390","url":null,"abstract":"Wide-necked bifurcation aneurysms (WNBAs) are challenging lesions to treat via both open surgical and endovascular techniques. Presently, there are 3 intrasaccular devices available to address many of the limitations of prior techniques, all of which are at different phases of approval for human use around the world. These devices include the Woven EndoBridge (WEB®) made by MicroVention, the Artisse™ Embolization Device made by Medtronic, and the Contour Neurovascular System™ made by Cerus Endovascular. Although heterogenous in design, these devices rely on the principle of using fine mesh overlying the aneurysm neck to slow blood inflow, promoting stagnation and thrombosis that ultimately leads to healing across the neck and exclusion from the circulation. While our understanding improves as long-term occlusion rates from these devices continue to be studied, the safety profiles and short-term success rates demonstrated in recent studies provide optimism for these innovative intrasaccular devices for the treatment of WNBAs. In this paper, we review these 3 intra-saccular flow disruption devices for use in WNBAs and summarize recent literature and studies of their effectiveness and safety.","PeriodicalId":126264,"journal":{"name":"Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133928781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4