Interventional Neuroradiology最新文献

{"title":"Endovascular treatment of cerebral venous thrombosis involving the deep venous system.","authors":"Brent Morel, Jessa Hoffman, Christopher Roark, Zach Folzenlogen, Joshua Seinfeld, David Case","doi":"10.1177/15910199251330723","DOIUrl":"https://doi.org/10.1177/15910199251330723","url":null,"abstract":"<p><p>BackgroundCerebral venous thrombosis (CVT) is a rare but important cause of stroke. The superficial venous sinuses, including the superior sagittal sinus, are the most common location of CVT. Thrombosis of the deep venous system occurs less frequently, but can be more clinically severe by causing disturbances of consciousness due to involvement of deep anatomic structures including the thalamus and basal ganglia, leading to a higher incidence of death and disability. While anticoagulation is the standard initial recommended therapy for patients with CVT, endovascular intervention is sometimes proposed to help relieve cerebral venous hypertension.MethodsWe performed a retrospective case series review of a single-center interventional database over a 13-year time period to identify cases of CVT that underwent endovascular therapy and analyzed clinical and radiographic characteristics of these patients.ResultsWe identified 43 patients who underwent endovascular treatment for CVT. Twelve of these cases involved the deep system. Of the 12 patients in our consecutive case series, all 12 experienced recanalization of the deep system following catheter-directed alteplase infusions in the superficial or straight sinuses. On follow-up, these patients clinically did well in spite of initially poor neurologic examinations.ConclusionIn this single-center retrospective case series of 12 patients with deep and superficial venous thrombosis, endovascular treatment with site-directed thrombolytic infusion of the superficial venous sinuses with or without catheterization of the straight sinus resulted in angiographic recanalization of the deep veins and improved radiologic and clinical outcomes in 100% of the patients.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251330723"},"PeriodicalIF":1.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hydrophilic-coated sheaths for reducing radial artery spasm during transradial procedures: A systematic review and meta-analysis.","authors":"Mishaal Hukamdad, Kaho Adachi, Youssef Soliman, Rime Ezzeldin, Suhas V V Tatapudi, Mohamad Ezzeldin","doi":"10.1177/15910199251329150","DOIUrl":"10.1177/15910199251329150","url":null,"abstract":"<p><p>BackgroundTransradial access for interventional procedures has become increasingly favored over the transfemoral approach. However, radial artery spasm (RAS) and radial artery occlusion (RAO) pose challenges to this approach.AimsThis study aims to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing hydrophilic coated (HC) introducer sheaths with non-coated (NC) introducer sheaths during transradial procedures. The impact on RAS, RAO, periprocedural pain, and complications is evaluated.MethodsPubMed, Embase, and the Cochrane Library were searched for RCTs utilizing HC sheaths in their intervention arm and NC sheaths in the control arm for patients undergoing transradial procedures. Outcomes included incidence of RAS, RAO, pain or discomfort during the procedure, procedure duration, pseudoaneurysm, and hematoma. RevMan 5.4 software was used to analyze pooled risk ratios and mean differences with 95% confidence intervals.ResultsEight RCTs were included in this study. HC sheaths significantly reduced the risk of RAS and periprocedural pain or discomfort compared to NC sheaths (RR = 0.38, 95% CI [0.24, 0.60], <i>I</i>²= 19% and RR = 0.47, 95% CI [0.37, 0.59], <i>I</i>²= 1%, respectively). The use of HC sheaths had no significant effect on the risk of RAO, hematoma, or pseudoaneurysm.ConclusionThe use of HC sheaths can enhance the overall patient and operator experience by reducing the risk of RAS and pain during transradial procedures, with no significant effect on RAO, hematoma, or pseudoaneurysm. This study provides evidence supporting the superiority of HC introducer sheaths over NC sheaths during transradial interventions.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251329150"},"PeriodicalIF":1.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A visual journey through medium vessel occlusion strokes: From diagnosis to treatment.","authors":"Alexander Stebner, Salome L Bosshart, Satoru Fujiwara, Roberto Souza, Mariana Bento, Johanna Ospel","doi":"10.1177/15910199251323117","DOIUrl":"10.1177/15910199251323117","url":null,"abstract":"<p><p>Acute ischemic stroke occurs when a blood clot obstructs cerebral blood flow, leading to ischemia and potentially irreversible brain damage. While large vessel occlusions are known for their catastrophic effects, medium vessel occlusions (MeVOs) also contribute significantly to stroke-related disability. These occlusions, which occur in smaller, mid-sized vessels, can result in substantial neurological deficits depending on their location and the availability of collateral circulation. The detection of MeVOs poses unique diagnostic challenges, as their subtle presentations are often overlooked in standard imaging. Timely and accurate identification is critical for initiating appropriate therapies, including intravenous thrombolysis, endovascular thrombectomy, and secondary prevention measures. This editorial takes you on a visual journey through the world of MeVOs, exploring their locations, challenging cases, and the diverse techniques used to identify them. With detailed illustrations, it demonstrates how to recognize these occlusions on both advanced and conventional imaging, including guidance on spotting them on digital subtraction angiography. Finally, it delves into how these strokes are treated, offering a comprehensive and engaging look at the unique challenges and solutions in MeVO management.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251323117"},"PeriodicalIF":1.7,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515742","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 isolated left gastric artery: A shape-shifting pitfall for neuroangiographers.","authors":"Philippe Gailloud","doi":"10.1177/15910199251324042","DOIUrl":"10.1177/15910199251324042","url":null,"abstract":"","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251324042"},"PeriodicalIF":1.7,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515752","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":"Blazing the trail! Commentary on \"Intra-arterial lidocaine administration in middle meningeal artery for short-term treatment of subarachoid hemorrhage-related headaches\" by Qureshi et al.","authors":"Alexander Sirakov, Kristian Ninov, Kristina Sirakova, Stanimir Stefanov Sirakov","doi":"10.1177/15910199251324039","DOIUrl":"10.1177/15910199251324039","url":null,"abstract":"<p><p>In their recently published INR study, Qureshi et al. present their results on intra-arterial lidocaine administration in the middle meningeal artery for the short-term treatment of subarachnoid hemorrhage (SAH)-related headaches. The authors demonstrate that their proposed intra-arterial treatment consistently alleviates headaches in patients with SAH. The purpose of this commentary is to commend the authors on their paper and the notable results they have achieved. It is always pleasant to encounter studies that not only make it to the \"Latest Online\" section of neurointerventional journals but also push the boundaries, advancing our understanding and care for patients in the most meaningful ways. There is no doubt that our field has witnessed remarkable progress and an expanding spectrum of interventions that endovascular neuroservices can offer. Several therapeutic approaches have emerged from similarly constructive articles, including intra-arterial chemotherapy for malignant cerebral tumors, innovative treatments for cerebrospinal fluid-venous fistulas, hydrocephalus, and chronic subdural hematomas, as well as the implantation of brain-computer interface devices.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251324039"},"PeriodicalIF":1.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501312","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":"Endovascular flow diversion reconstruction of petrocervical dissections with the proximal anchoring technique: Experience in 31 consecutive cases.","authors":"Jessica K Campos, Benjamen M Meyer, Fahad J Laghari, David A Zarrin, Muhammad W Khan, Jonathan Collard de Beaufort, Gizal Amin, Ashish Ramesh, Narlin B Beaty, Matthew T Bender, Shuichi Suzuki, Geoffrey P Colby, Alexander L Coon","doi":"10.1177/15910199251317552","DOIUrl":"10.1177/15910199251317552","url":null,"abstract":"<p><strong>Introduction: </strong>Flow diverting stents (FDS) are routinely used to reconstruct the arteries of the head and neck. When placed into the mobile cervical internal carotid artery (cICA) segment, the FDS runs the risk of post-procedure stent migration and proximal intimal hyperplasia reaction from physiologic movement of the neck. We report our experience using a novel proximal anchoring technique during endovascular flow reconstruction of complex petrocervical dissections to prevent this potentially deleterious result.</p><p><strong>Methods: </strong>We reviewed a prospectively maintained IRB-approved institutional database of the senior authors to identify cases of FDS treatment in the mobile petrocervical segments which had the proximal FDS \"anchored\" with a nitinol stent.</p><p><strong>Results: </strong>The proximal anchoring technique was successfully performed in the mobile cervical segment in a total of 31 cases over the study period. Each case involved a complex ICA dissection with 68% (n = 21) having an accompanying pseudoaneurysm. Fifty-two percent (n = 16) were female. Surpass Streamline and Evolve FDS were utilized in all cases. An average of 2.2 ± 0.1 FDS devices were utilized (range 2-4 FDS), with each case utilizing a laser-cut nitinol carotid stent as the proximal anchor. The average stent diameter was 5.64 ± 0.2 mm (range 4-8 mm) and length of 30.1 ± 1.5 mm (range 20-60 mm). On last follow-up angiography, there were no instances of stent migration or proximal neointimal hyperplasia.</p><p><strong>Conclusion: </strong>Utilization of the proximal anchoring technique on FDS constructs in the mobile cICA may provide additional protection from post-procedure stent migration and intimal reaction attributed to patient neck movement resulting in augmentation of successful healing.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251317552"},"PeriodicalIF":1.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458060","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":"Flow diversion in the treatment of intracranial aneurysms using the novel FRED X device: An early experience from a single high-volume center.","authors":"Thomas Mandel Clausen, Ryan Nakamura, Andie Conching, Joo Won Choi, Yi Jonathan Zhang, Ferdinand Hui, Samuel Tsappidi","doi":"10.1177/15910199251319059","DOIUrl":"10.1177/15910199251319059","url":null,"abstract":"<p><strong>Background: </strong>The Flow Re-Direction Endoluminal Device X (FRED X) offers several benefits over other flow-diverter devices including an antithrombotic coating, optimized in-vessel stability, and increased flexibility for easier device placement. We present a to-date experience of the safety and utility of the FRED X device in the repair of posterior and anterior circulation aneurysms.</p><p><strong>Methods: </strong>A retrospective review was conducted on all endovascular procedures that utilized the FRED X device at our center from May 2022 to November 2023.</p><p><strong>Results: </strong>77 patients (72.7% women, mean age 58.9), underwent a total of 85 procedures using the FRED X device. Indications included treatment of incidentally discovered aneurysms, acute dissections, aneurysm rupture, repair of residual filling following prior intervention, and use of FRED X for recanalization of non-aneurysmal extracranial stroke. 31.3% of the aneurysms were in the posterior circulation, 68.7% were in the anterior circulation. 9.4% of patients presented with SAH due to acute aneurysm rupture. Patients treated with FRED X were separated into OFF-Label (40.0%) or ON-label (60.0%) indications. Occlusion rate at 6-month follow-up were 72.2% in the OFF-label group, 66.7% in the ON-label group, and 68.4% overall. Rate of major periprocedural complications was 1.2% and the cumulative rate of postprocedural complication at follow-up was 5.3%.</p><p><strong>Conclusion: </strong>This study shows that FRED X treatment of intracranial aneurysms is safe in both OFF-label and ON-label indications. Continued follow-up of our patient population will further establish the safety, efficacy, and long-term stability of this device.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251319059"},"PeriodicalIF":1.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440932","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":"Venous sinus stenting for management of spontaneous skull-base CSF leaks: A systematic review and meta-analysis.","authors":"Jordan M Rasmussen, Kautilya R Patel, Daniel L Surdell, William E Thorell, Nicholas Borg, Patrick J Opperman, Geoffrey Casazza, Anne K Maxwell, Christie Barnes, Samuel Pate, Cindy M Schmidt, Mithun G Sattur","doi":"10.1177/15910199241311626","DOIUrl":"10.1177/15910199241311626","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic intracranial hypertension (IIH) is strongly associated with spontaneous skull-base cerebrospinal fluid (CSF) leaks. Venous sinus stenting (VSS) has proven effective for the treatment of IIH. Hence, its role in spontaneous skull-base CSF leaks is being explored actively.</p><p><strong>Methods: </strong>We performed a systematic literature search across EMBASE, MEDLINE, Scopus, The Cochrane Library, and Google Scholar to identify studies reporting the use of VSS for spontaneous skull-base CSF leaks. Studies with pediatric patients, non-English articles, and nonspontaneous leaks were excluded. Failure of treatment (persistence / recurrence of CSF leak) was regarded as the primary outcome.</p><p><strong>Results: </strong>Eight studies with 62 patients undergoing VSS for spontaneous skull-base CSF leaks were included. Mean age of the patients was 51.9 years; 87.5% were females. Obesity was highly prevalent, with a mean body mass index of 33.9 kg/m² (4 studies). IIH was noted in 74.6% patients (7 studies). Twenty-six patients (41.9%) underwent VSS alone whereas 36 patients (58.1%) underwent surgical repair + VSS. Seven patients (11.3%) had a failure of treatment. Three failures from one study could not be definitively ascribed to either of the groups. Hence, the estimated failure rate for VSS alone ranged from 18.6% (95% CI [0.02 - 0.46]) to 26.4% (95% CI [0.11 - 0.46]), whereas that for surgical repair + VSS ranged from 5.5% (95% CI [0.00 - 0.16]) to 12.2% (95% CI [0.01 - 0.32]). Furthermore, the estimated rate for resolution of concomitant IIH-related symptoms was 88.7% (95% CI [0.75 - 0.98%]). Majority of the studies did not report any serious complications or mortality related to VSS.</p><p><strong>Conclusion: </strong>VSS has a potential role in the management of spontaneous skull-base CSF leaks. Its exact indications as a standalone treatment versus as an adjuvant to surgical repair, and the predictors for successful treatment remain to be defined.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241311626"},"PeriodicalIF":1.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364345","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":"Outcomes of endovascular thrombectomy in patients with cerebral venous thrombosis: A cohort study of 325 patients.","authors":"Aryan Malhotra, Ankita Jain, Eris Spirollari, Rachid Kaddoura, Melinda Christine Arthur, Ariel Sacknovitz, Mohammed B Nawaiseh, Chaitanya Medicherla, Gurmeen Kaur, Chirag D Gandhi, Fawaz Al-Mufti","doi":"10.1177/15910199241310998","DOIUrl":"10.1177/15910199241310998","url":null,"abstract":"<p><strong>Background: </strong>Cerebral venous thrombosis (CVT) is a rare condition that presents with significant treatment challenges and has traditionally been managed with anticoagulation. However, for patients who fail anticoagulation or present with severe symptoms, endovascular thrombectomy (EVT) has emerged as a favorable treatment modality. This study examines the outcomes, complications, and comorbidities associated with EVT in patients with CVT.</p><p><strong>Methods: </strong>A query of the 2015-2019 National (Nationwide) Inpatient Sample was performed for patients admitted to hospitals with ICD-10 diagnosis codes for CVT and ICD-10 procedure codes for usage of EVT. Demographic information, baseline comorbidities, complications, and discharge dispositions were compared between patients who underwent EVT and those who were managed medically.</p><p><strong>Results: </strong>A total of 36,005 patients diagnosed with CVT were identified from 2015(Q4) to 2019. Of these patients, 325 (0.9%) received EVT. Patients who underwent EVT were older (<0.001), more likely to be female (p = 0.016), and had higher rates of diabetes mellitus (p = 0.012), hypertension (p < 0.001), and obesity (p < 0.001). These patients also presented with more severe neurological symptoms, including higher National Institutes of Health Stroke Scale scores (p < 0.001), coma (p < 0.001), and cerebral edema (p < 0.001). Patients undergoing EVT had a higher incidence of in-hospital mortality (p = 0.007) and were less likely to be discharged routinely (p < 0.001).</p><p><strong>Conclusions: </strong>This study found that patients with CVT who underwent EVT were older, more likely to be female, and presented with more severe neurological conditions. After controlling for severity, EVT in patients with CVT was associated with significant risks, including higher rates of complications and inpatient mortality. Although EVT is associated with significant risks, the findings of this study suggest that its outcomes may reflect the severity of the underlying condition rather than the procedure itself. Careful patient selection and individualized management strategies are essential for optimizing outcomes in this high-risk population.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241310998"},"PeriodicalIF":1.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11791959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122932","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 foreseeable potential of robotics in neurointervention: Current robotic systems and applications.","authors":"Ahmet Günkan, Jhon E Bocanegra-Becerra","doi":"10.1177/15910199251318405","DOIUrl":"10.1177/15910199251318405","url":null,"abstract":"","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251318405"},"PeriodicalIF":1.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189204","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}