Interventional Neuroradiology最新文献

{"title":"Macrowire-only direct aspiration first-pass technique for endovascular mechanical thrombectomy: Multicenter technical series using the 0.035″ aristotle Colossus wire.","authors":"William Ares, Daniel Tonetti, Manisha Koneru, Ahmet Dalkilic, Walid Salah, Waleed Brinjikji, Kenan Rajjoub, Eytan Raz, Ayaz Khawaja, Christopher Southwood, Richard Dalyai, Lee Birnbaum, Shakeel Chowdhry, Huy Do, Evan Joyce, Daniel Calnan, Adel Malek, Ramesh Grandhi","doi":"10.1177/15910199251343117","DOIUrl":"10.1177/15910199251343117","url":null,"abstract":"<p><p>BackgroundLarger \"macrowires\" may facilitate microcatheter-free delivery of large-bore aspiration catheters (ACs) for intracranial endovascular mechanical thrombectomy. We examined the safety and efficacy of the Aristotle Colossus Guidewire for this use.MethodsIn this retrospective analysis of prospective data from 12 institutions, we identified anterior circulation endovascular mechanical thrombectomy cases involving the Aristotle Colossus guidewire over a 12-month period. The primary efficacy endpoint was successful delivery of the AC to the site without the use of adjunct devices. Multivariable logistic regression was performed with clinically relevant covariables.ResultsIn 122 patients (median age 74 years (interquartile range (IQR) 63-82)), most intracranial occlusions were in the M1 segment of the middle cerebral artery (95/122, 78.0%). The primary endpoint of microcatheter-free AC delivery was met in 87.7% (107/122) of patients; 93/122 (76.2%) patients underwent microcatheter-free delivery with successful reperfusion via contact aspiration (modified thrombolysis in cerebral infarction grade ≥ 2B). The median number of passes was 1 (IQR 1-2). Multivariable regression demonstrated that severe internal carotid artery tortuosity or cervical loop presence (odds ratio (OR): 0.09, 95% confidence interval (CI): 0.01-0.54, p = 0.01) and presence of intracranial atherosclerotic disease (OR: 0.15, 95% CI: 0.03-0.83, p = 0.03) were significantly associated with lower odds of successful AC delivery over the guidewire. Intraprocedural vasospasm occurred in 4.9% (6/122) of cases; there were no reports of vessel dissection or perforation.ConclusionsWe demonstrate the favorable performance of the Aristotle Colossus guidewire for anterior circulation ischemic stroke intervention. The macrowire appears to safely facilitate navigation of the neurovasculature by large-bore ACs without the need for microcatheter and/or stentriever.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251343117"},"PeriodicalIF":1.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of angiotensin-converting enzyme inhibition on outcomes after middle meningeal artery embolization in patients with chronic subdural hematoma: A multinational, multi-institutional database study.","authors":"Dhairya A Lakhani, Aneri B Balar, Amelia Adcock, Sanjay Bhatia, Sijin Wen, Ansaar T Rai","doi":"10.1177/15910199251345042","DOIUrl":"10.1177/15910199251345042","url":null,"abstract":"<p><p>BackgroundThe effects of initiating angiotensin-converting enzyme inhibitors (ACEi) in patients with chronic subdural hematoma (cSDH) treated with middle meningeal artery embolization (MMAE) have not been well studied. There is conflicting evidence regarding ACEi use in patients with cSDH who undergo surgery alone, with some studies showing improved outcomes and others showing poorer outcomes. This study presents a real-world, multicenter analysis comparing the outcomes of ACEi reinitiation in this patient cohort.MethodsWe used TriNetX platform to compare outcomes of ACEi initiation in patients with cSDH treated with MMAE. Cohorts were defined using ICD-10 codes. The outcomes included inpatient readmission, need for surgery, and mortality within 6 months following treatment.ResultsA total of 2108 patients with cSDH who underwent MMAE were identified, of whom 251 initiated ACEi within 1 month of treatment. After propensity score matching, patients who received ACEi following MMAE had no significant differences in unplanned readmission (odds ratio (OR): 0.78, 95% confidence interval (CI): 0.54-1.11, <i>p</i> = 0.17;39.2% vs. 45.3%), need for surgery (OR: 0.59, 95% CI:0.29-1.22, <i>p</i> = 0.15;5.3% vs. 8.6%), and mortality rates (OR: 1.26,95% CI: 0.69-2.27, <i>p</i> = 0.45;11.0% vs. 9.0%) at 6 months compared to those who did not receive ACEi.ConclusionACEi initiation does not significantly impact outcomes in patients with cSDH treated with MMAE. If ACEi needs to be reinitiated for other indications, it may be safe in this cohort.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251345042"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of anesthesia choice during thrombectomy for distal and medium vessel occlusions: A systematic review and meta-analysis.","authors":"Ahmed Alkhiri, Fahad N Alrajban, Asayel A Alghamdi, Mohammed A Alqahtani, Ibrahim M Al Dahnin, Joud A Osailan, Lamya M Almobty, Jasmine S Alrashidy, Yasir M Aljadani, Ali H Alnajim, Raef A Alharbi, Mishari S Alqahtani, Yasser Aladdin, Seraj Makkawi","doi":"10.1177/15910199251342667","DOIUrl":"10.1177/15910199251342667","url":null,"abstract":"<p><p>BackgroundPhysicians may opt for general anesthesia (GA) during endovascular thrombectomy (EVT) when treating distal and medium vessel occlusion (DMVO), particularly in agitated patients where accessing small vessels presents challenges. However, little is known about how GA and non-GA approaches compare in terms of safety, efficacy, and procedural outcomes for DMVO patients undergoing EVT.MethodsThis systematic review and meta-analysis conform to the established guidelines and protocols for this type of data synthesis. We searched Medline, Embase, Web of Science, and the Cochrane Library up to August 2024. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models.ResultsSix studies with 3019 patients fit the selection criteria. Of the included patients, 883 (29.2%) were treated under GA. The median age of participants ranged from 68 to 76 years, with median initial National Institute for Health Stroke Scale scores varying from 4 to 15.5. There was no statistically significant difference in terms of good functional outcomes (modified Rankin scale 0-2 at 90 days) between the two groups (OR, 0.97 [95% CI, 0.72-1.30]; <i>p</i> = 0.83). Recanalization metrics and procedural complications were similar between groups. Patients treated under GA had higher 90-day mortality (OR, 1.98, [95% CI 1.43-2.72]; <i>p</i> < 0.01).ConclusionIn this study, both anesthesia methods demonstrated comparable effectiveness; however, GA was associated with higher 90-day mortality. Additional robust evidence is needed to validate these findings and establish their clinical significance across different subgroups of DMVO.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251342667"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The NeVa stent-retriever - a single-centre real-world experience.","authors":"Pervinder Bhogal, Marco Mancuso-Marcello, Rory Fairhead, Katherine Parkin, Giovanna Klefti, Levansri Makalanda, Ken Wong, Joseph Lansley, Karthikeyan Vanchilingham, Michael Przyszlak, Rukhtam Saqib, Oliver Spooner","doi":"10.1177/15910199251337176","DOIUrl":"10.1177/15910199251337176","url":null,"abstract":"<p><p>Stent-retriever-based mechanical thrombectomy (MT) is an effective treatment for acute ischemic stroke (AIS) caused by large vessel occlusion (LVO). First-pass effect (FPE) is one most powerful predictors of positive outcomes in LVO AIS patients treated with MT. We performed an independent central reader review of our prospectively maintained database to identify all patients treated first with the NeVa stent retriever at our single high-volume Comprehensive Stroke Centre.Overall, 89 patients met our inclusion criteria. The median age was 73 yrs (range 28-88; 52% male). The median presentation NIHSS was 16 (range 5-30) and 49% received IV tPA prior to MT. 93% of target occlusions were in the anterior circulation (<i>n</i> = 83) with a median ASPECT score on plain CT of 8 (range 5-10). A Balloon Guide Catheter (BGC) was used in 80% of cases and a distal aspiration catheter was used in all cases. Longer NeVa models (≥29 mm) were used in 89% of cases. FPE was demonstrated in 57% of cases (eTICI score of ≥2c) with modified FPE demonstrated in 65.1% of cases (eTICI score of ≥2b (67%)). A final eTICI score of ≥2c was achieved in 87% of cases. Good functional outcome (mRS ≤2) was achieved in 40% of patients (<i>n</i> = 81).The NeVa stent-retriever has a very high rate of FPE and final recanalization in this real-world cohort of patients from the NeVa One registry. These results are higher than those previously published and may support longer NeVa device use with a BGC and proximal aspiration to optimize FPE.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251337176"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of day-1 stent patency following rescue intracranial stenting in failed intracranial thrombectomy.","authors":"Heloise Ifergan, Cyril Dargazanli, Wagih Ben Hassen, Jean-Francois Hak, Benjamin Gory, Julien Ognard, Kevin Premat, Gaultier Marnat, Basile Kerleroux, François Zhu, Guillaume Bellanger, Peter B Sporns, Guillaume Charbonnier, Géraud Forestier, Jildaz Caroff, Cédric Fauché, Frédéric Clarençon, Kevin Janot, Bertrand Lapergue, Gregoire Boulouis","doi":"10.1177/15910199251339900","DOIUrl":"10.1177/15910199251339900","url":null,"abstract":"<p><p>IntroductionThis study aimed to identify factors affecting stent patency in patients treated with rescue intracranial stenting (RIS) for a refractory intracranial occlusion following mechanical thrombectomy (MT), focusing on antithrombotic regimens, and types of devices used.Material and methodsData from 14 university hospitals spanning from 2015 to 2021 were utilized, concentrating on patients who underwent MT in the anterior circulation. The primary outcome was stent patency on follow-up imaging at day 1.ResultsThroughout the study period, a total of 101 patients received RIS at 14 centers for refractory anterior large vessel occlusion (LVO). Amongst the 101 implanted stents, 18 were coronary and 83 were neuro-stents. Seventy-six patients were given a double antiplatelet (AP) regimen following stent implantation. After adjustment on LVO level (M1 vs. carotid), sex, susceptibility vessel sign, number of stent passes, follow-up AP, and coronary versus neuro-stent usage, the presence of follow-up dual antiplatelet regimen was independently linked to stent patency on follow-up imaging (<i>p</i> = .0016). The type of stent and other factors were not.ConclusionOur study shows that in patients treated with RIS in the context of failed MT, starting dual antiplatelet therapy is independently associated with stent patency on follow-up imaging at day 1. In this large series, we have not found evidence supporting the superiority of a specific class of antiplatelet drugs or a stent category, especially coronary versus neuro-stents. These results may inform the design of future clinical trials.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251339900"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and immediate outcomes of the new generation Swift PAC coil in cerebrovascular pathology: A case series.","authors":"Nicolas K Khattar, Jason Jarred Sims, Haydn Hoffman, Christopher Nickele, Violiza Inoa, Daniel A Hoit, Allison E Strickland, Nitin Goyal","doi":"10.1177/15910199251343735","DOIUrl":"10.1177/15910199251343735","url":null,"abstract":"<p><p>BackgroundCoils are widely used in neurovascular interventions due to their effectiveness in achieving precise occlusion of blood vessels. Recently introduced SwiftPAC coil (Penumbra, Alameda, CA) is known for its innovative two-dimensional wave-like design, which makes it adaptable to irregular spaces within vessels with complex anatomical structures often encountered in the head and neck.MethodsWe studied 18 consecutive patients treated using the SwiftPAC coil. The patients underwent pre-procedural imaging and then underwent transfemoral angiography and embolization. The primary outcome measure was technical success, defined as complete occlusion of the target vessel, complication rates, and resolution of clinical symptoms. Secondary outcome measures included the number and size of coils used, procedure duration, and length of hospital stay. These metrics were compared across different indications.ResultsOur analysis included 18 patients (10 females and eight males) aged 16-88 years (mean age: 51 years). Indications for treatment included post-traumatic vessel sacrifices, preoperative embolization for tumors, severe epistaxis, temporo-mandibular joint dysfunction, acute and chronic subdural hematomas, direct carotid-cavernous fistula, aneurysm recurrence, and oropharyngeal hemorrhage. An average of 7 coils was deployed per patient (range: 1-22 coils). All procedures were technically successful except for one case, which was complicated by significant vasospasm preventing coil deployment. Six patients underwent elective embolization, while the remainder underwent urgent and emergent interventions. No major complications were observed.ConclusionsThe SwiftPAC coil is a safe, effective, and efficient two-dimensional wave coil system delivered through a 0.0165″ microcatheter for a variety of indications ranging from middle meningeal artery to vessel sacrifice.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251343735"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autologous platelet-rich fibrin as an alternative epidural patch for persistent post-dural puncture headache: A single-center observational study.","authors":"Ioannis Vasilikos, Katerina Argiti, Kevin Joseph, Daniel Strahnen, Angeliki Stathi, Amir El Rahal, Florian Volz, Katharina Wolf, Mukesch Johannes Shah, Jürgen Beck, Horst Urbach, Niklas Lützen","doi":"10.1177/15910199251339537","DOIUrl":"10.1177/15910199251339537","url":null,"abstract":"<p><p>ObjectivesEpidural blood patch (EBP) is the current standard of care for postdural puncture headache (PDPH). However, when EBP fails to provide relief, patients may experience discomfort and functional impairments. This study reports the safety and efficacy of a novel approach that uses autologous platelet-rich fibrin (PRF) as an alternative epidural patch.MethodsSixty-seven patients with persistent PDPH symptoms after conservative medical treatment were screened. Among them, 12 (18%) patients underwent multiple EBP (range: 1-6), which failed to resolve the PDPH symptoms. As an alternative method, an epidural PRF patch (EPP) was used, in which PRF was injected percutaneously epidurally under fluoroscopic guidance. Patient symptoms were collected perioperatively, and a follow-up period of up to 6 months was conducted.ResultsThe 12 patients included showed good tolerance for the EPP procedure, with injection volumes ranging from 15 to 39 ml. Compared to EBP, patients reported a significant reduction in injection-associated pain, as measured by the unidimensional numeric rating scale, with a mean reduction of 52.8% (p ≤ 0.05). The headache impact test scores (HIT-6) obtained before and 6 months after EPP revealed a statistically significant reduction in symptoms by a mean of 33.3% (p ≤ 0.05). Moreover, no adverse effects were observed during follow up. It is noteworthy that all patients experienced significant relief from PDPH-associated symptoms 6 months after the intervention.ConclusionEPP may be a viable solution for patients with persistent PDPH symptoms. Notably, the discomfort experienced due to pain during the EPP procedure was markedly less than that experienced during the EBP procedure. The fact that clinical improvement was observed after 6 months is encouraging and lays the groundwork for additional clinical investigations.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251339537"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-thrombectomy rehabilitation strategies and 90-day outcomes in acute ischemic stroke patients enrolled in randomized controlled trials: A systematic review and meta-analysis.","authors":"Muhammad Shakir, Moeez Ahmed, Zayan Alidina, Yilun Huang, Chun Shing Kwok, Bruce Ovbiagele, Shawn S Wallery, Daniel E Ford, Camilo R Gomez, Daniel F Hanley, Adnan I Qureshi","doi":"10.1177/15910199251341648","DOIUrl":"10.1177/15910199251341648","url":null,"abstract":"<p><p>BackgroundThe post-thrombectomy recovery phase has significant influence on long-term patient outcomes. Our study aims to explore the effect of post-thrombectomy rehabilitation strategies on modified Rankin Scale (mRS) at 90-day.MethodsA search of PubMed, Scopus, Web of Science, ClinicalTrials.gov, and the Cochrane Library from inception to April 2024. Randomized controlled trials (RCTs) were included and assessed for quality using the Cochrane risk of bias tool. The rehabilitation strategies were divided into three groups: as per institutional care, as per national guideline, or not specified. We performed meta-regression to identify the association between rehabilitation strategy used and 90-day outcome defined using mRS.Results23 RCTs were included with 6649 patients (mean age 67 and 26% of patients were men). Rehabilitation \"as per institutional care\" was the most common (52%, 95% confidence interval (CI):31%-72%), followed by \"as per national guidelines\" (17%, 95% CI:5%-39%). We found statistically significant variations in proportions of rehabilitation strategies (<i>F</i>(2,97) = 0.035, <i>p</i> = 0.01). A two-proportion z-test indicated a borderline significant difference between \"as per institutional care\" (52%) and \"as per national guidelines\" (17%) (χ²(1) = 3.52, <i>p</i> = 0.06). In meta-regression, rehabilitation strategies used in the RCT significantly influenced the proportion of patients enrolled in the RCT who achieved mRS 0-2 at 90 days post-thrombectomy (QM (df = 1) = 5.06, <i>p</i> = 0.025). Trials using rehabilitation \"as per institutional care\" (log odds ratio (OR) = 0.64, 95% CI [0.42, 0.87], <i>p</i> < 0.01) and those using rehabilitation \"as per national guidelines\" (log odds ratio = 0.58, 95% CI [0.07-1.08], <i>p</i> = 0.02) were associated with statistical significantly higher odds of having higher proportion of patients with mRS 0-2 at 90 days.ConclusionsThere is variation in rehabilitation strategies utilized post-thrombectomy which influences functional outcomes at 90 days. Rehabilitation protocols should be standardized in RCTs evaluating thrombectomy in acute ischemic stroke patients.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251341648"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The initial experience with the Walrus balloon guide catheter - Results from two high-volume thrombectomy centres.","authors":"Pervinder Bhogal, Permesh Singh Dhillon, Richard Flood, Martin Lewis, Anna Podlasek, Ken Wong, Joseph Lansley, Levansri Makalanda, David Minks, Oliver Spooner, Alex Mortimer","doi":"10.1177/15910199251336935","DOIUrl":"10.1177/15910199251336935","url":null,"abstract":"<p><p>BackgroundWe report our initial experience on the use of the Walrus, a new generation balloon guide catheter (BGC) capable of accommodating large bore aspiration catheters for patients undergoing endovascular stroke thrombectomy for large vessel occlusion with a particular focus on procedural aspects related to the vascular anatomy, recanalisation efficacy and complications.MethodsThis is a retrospective, site-adjudicated, two-centre study on consecutive patients with anterior circulation large vessel occlusion treated with the Walrus BGC. Baseline characteristics and procedural and clinical outcomes were analysed.ResultsBetween July 2023 and January 2024, we recruited 300 participants (mean age 69.5 ± 15 years; 132 (44%) females). The mean admission NIHSS was 15.8 ± 6.5, and the mean ASPECTS was 7.6 ± 1.9. Combined stent-retriever and aspiration first-line thrombectomy technique was performed in 235 patients (79%). The Walrus BGC was successfully navigated to the ICA in 99.7% of patients. Near complete-complete recanalisation (eTICI2c-3) was achieved in 75.4% of patients, and the eTICI2b-3 rate was 92.2%. First-pass effect (eTICI2c-3) was achieved in 49% of patients, and the modified first-pass effect (eTICI2b-3) was 65.9%. No significant difference in the arterial puncture-to-guide catheter placement time across the three different arch types (<i>P</i> = .52) or between the favourable and unfavourable ASMETS score (<i>P</i> = .085) was observed. Any intracranial haemorrhage (ICH) occurred in 14.9% of patients, and symptomatic ICH in 3.9%.ConclusionUse of the Walrus large bore BGC during endovascular stroke thrombectomy appears effective in reaching the target vessel without a significant time penalty across various anatomical configurations and tortuosity, whilst maintaining a satisfactory safety profile.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251336935"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial experiences with the target tetra coils: An illustrated case series.","authors":"Jeremy Lynch, Gian Marco Frigerio, Sara Sciacca, Thomas Booth, Martin Lewis, Parthiban Balasundaran, Mohd Shariq, Krishna Bellam-Premnath, Shrikant Londhe, Tufail Patankar, Naga Kandasamy","doi":"10.1177/15910199251343285","DOIUrl":"10.1177/15910199251343285","url":null,"abstract":"<p><p>IntroductionThe management and treatment of intracranial aneurysms have substantially evolved with advancements in neuroendovascular technologies. Among the latest developments are the Target^® Tetra™ coils (Stryker Neurovascular, Kalamazoo, MI, USA). In this non-industry funded illustrated case series we examine the efficacy and safety of Target^® Tetra™ and describe nuances of their usage.MethodsA retrospective two-centre study examined the usage and outcomes of Target^® Tetra™ coil usage in a consecutive series of ruptured and unruptured aneurysms. Data was collected on clinical, technical, and imaging characteristics associated with their usage.ResultsThe dataset consisted of information from a total of 75 patients and 80 aneurysms (mean age 55.7 years). 56/75 (74.7%) aneurysms were treated in the setting of aneurysmal subarachnoid haemorrhage. 80/80 (100%) of the aneurysm treatments were technically successful. 2/80 (2.5%) of the cases encountered technical issues, with 1/80 (1.2%) case of coil migration and 1/80 (1.2%) case where the coil could not be detached. The median clinical follow-up time was 5 months. All-cause mortality was 8%, all occurring in ruptured aneurysms. There was 1/75 (1.3%) rebleed at the time of follow-up. 45% aneurysms patients had imaging follow-up at a median of 5 months. Excluding treatments involving stenting, flow-diversion, and intra-saccular devices the adequate occlusion rate at follow-up was 19/21 (90.5%) for ruptured and 6/6 (100%) for unruptured aneurysms, with an overall rate of 25/27 (92.6%).ConclusionsInitial short-term results suggest the safety and efficacy of the Tetra™ coils. Long-term outcomes in terms of aneurysm occlusion require further study.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251343285"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}