Interventional Neuroradiology最新文献

{"title":"Effectiveness of subdural evacuating port system (SEPS) and middle meningeal artery embolization (MMAE) for chronic subdural hematomas.","authors":"Vinay Jaikumar, Jaims Lim, Patrick Wahlig, Matthew K Moser, Julia Rupp, Marissa D Kruk, Muhammad Waqas, Devan Patel, Alexander G Fritz, Andre Monteiro, Hamid Sharif Khan, Tyler A Scullen, Mehdi Bouslama, Kunal P Raygor, Pui Man Rosalind Lai, Kenneth V Snyder, Elad I Levy, Jason M Davies, Adnan H Siddiqui","doi":"10.1177/15910199251342309","DOIUrl":"10.1177/15910199251342309","url":null,"abstract":"<p><p>BackgroundPerforming a craniotomy for chronic subdural hematoma (cSDH) in elderly patients with comorbidities can be challenging. The Subdural Evacuating Port System (SEPS; Medtronic, Dublin, Ireland) offers a less-invasive alternative, while middle meningeal artery embolization (MMAE) has shown effectiveness in preventing cSDH recurrence. However, the combined effectiveness of SEPS and MMAE (SEPS + MMAE) remains unclear. This study reports the outcomes of patients undergoing a combination of these procedures for the treatment of cSDH.MethodsA retrospective review of our medical records database was conducted to identify patients with cSDH who were treated with SEPS + MMAE between January 1, 2021, and April 1, 2024. Demographics, comorbidities, procedure, and outcomes data were analyzed. cSDH resolution was tracked by measuring hematoma volumes on noncontrast computed tomography scans pre-SEPS + MMAE, 24-48 h postprocedure, and 6-8 weeks postprocedure.ResultsA total of 35 patients (median age: 77 years [interquartile range (IQR):69-85.5]; men:woman = 22:13) with 49 cSDH, of which 41 cSDHs receiving combined SEPS + MMAE were included. Notably, 38 (92.7%) of the 41 cSDHs were holohemispheric, and 15 (36.6%) had an acute or subacute component. The median pre-SEPS + MMAE cSDH volume was 121.9 mL [IQR:87.9-153.4 mL] with a median midline shift of 6.6 mm [IQR:3.5-10 mm]. All MMAE procedures were performed under conscious sedation. The femoral approach was utilized in 19 patients (54.3%). Three patients required rescue craniotomy. Median post-SPES + MMAE volume was 71.1 mL [IQR:54.5-93.2], resulting in a 38% [IQR:21.9-53] reduction in cSDH volume; and median follow-up SEPS + MMAE volume was 22 mL [IQR:2-59.2] resulting in an 81% [IQR:50.9-98.1] reduction in cSDH volume, compared to pre-SEPS + MMAE levels. Seven (17.1%) patients required readmission for residual or recurrent cSDH within 90 days. Five of these patients were retreated (12.2%), two of whom required craniotomy (4.9%).ConclusionOur experience suggests that SEPS + MMAE was an effective method of cSDH treatment and was associated with low complication rates.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251342309"},"PeriodicalIF":1.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316908","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":"Simulation of cerebrospinal fluid (CSF)-venous fistula embolization in a swine model: A technical video.","authors":"Esref Alperen Bayraktar, Jonathan Cortese, Julien Ognard, Gerard El Hajj, Cem Bilgin, Ramanathan Kadirvel, David F Kallmes, Waleed Brinjikji","doi":"10.1177/15910199251349656","DOIUrl":"10.1177/15910199251349656","url":null,"abstract":"<p><p>Cerebrospinal fluid venous fistulas (CSFVF) can lead to spontaneous intracranial hypotension, causing debilitating symptoms in patients. The transvenous embolization technique has been developed to occlude leakage sites via an endovascular approach. However, the spinal venous anatomy remains relatively unfamiliar to many neurointerventionalists. This technical video presents a swine model designed to train physicians in navigating the spinal venous system, performing embolization injections, observing their spread, and testing new embolization systems for treating CSFVF. Although there are slight anatomical differences, the spinal venous system in swine closely resembles that of humans, including its navigability and employing liquid embolic agents. We successfully embolized multilevel spinal vasculature that can potentially drain into a fistula formation, without any complications.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251349656"},"PeriodicalIF":1.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316911","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":"Perfusion imaging parameters predict long-term clinical outcome in isolated posterior cerebral artery occlusion stroke patients.","authors":"Hamza Adel Salim, Dhairya A Lakhani, Janet Me, Aneri Balar, Shenwen Huang, Meisam Hoseinyazdi, Licia Luna, Francis Deng, Nathan Z Hyson, Mona Bahouth, Adam A Dmytriw, Adrien Guenego, Gregory W Albers, Hanzhang Lu, Victor C Urrutia, Kambiz Nael, Elisabeth B Marsh, Argye E Hillis, Rafael Llinas, Max Wintermark, Jeremy J Heit, Tobias D Faizy, Vivek Yedavalli","doi":"10.1177/15910199251342839","DOIUrl":"10.1177/15910199251342839","url":null,"abstract":"<p><p>BackgroundIsolated posterior cerebral artery (PCA) occlusions, which account for 5% of ischemic strokes, significantly impact patient quality of life due to effects on the thalamus and visual cortex. Current guidelines for acute treatment and the prognostic utility of perfusion imaging in PCA strokes remain limited and underexplored.MethodsWe conducted a retrospective analysis of 21 patients with isolated PCA occlusions from January 2017 to March 2023 at two comprehensive medical institutions. Perfusion imaging parameters, including time-to-maximum (Tmax) > 4 s, Tmax > 6 s, Tmax > 8 s, Tmax > 10 s, and mismatch volume, were extracted. The primary outcome was the modified Rankin Scale (mRS) score at 90 days.ResultsThe median age of patients was 70 years, with 62% being male. Time-to-maximum > 4 s volume (rho = 0.46, 95% CI, 0.1-0.71, <i>p</i> = 0.036) and Tmax > 6 s volume (rho = 0.45, 95% CI, 0.09-0.71, <i>p</i> = 0.04) showed significant positive correlations with 90-day mRS scores. Other perfusion parameters, such as Tmax > 8 s volume and mismatch volume, approached statistical significance, while rCBF and hypoperfusion intensity ratio did not show significant correlations.ConclusionsPerfusion imaging parameters, particularly Tmax tissue volumes, are correlated with long-term clinical outcomes in patients with isolated PCA occlusions. These findings support the potential role of perfusion imaging in the prognostic assessment and management of PCA stroke patients. Future studies with larger cohorts are warranted to confirm these results and to establish standardized perfusion imaging protocols for PCA occlusions.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251342839"},"PeriodicalIF":1.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316910","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":"Does endovascular thrombectomy using super-bore 0.088\" large distal platform offer advantages over balloon guide catheters in acute ischemic stroke secondary to large vessel occlusion?","authors":"Annie Trang, Clint Badger, Jose Marino, Souvik Singha, Shyam Majmundar, Timothy Miller, Dheeraj Gandhi, Jacob Cherian","doi":"10.1177/15910199251347789","DOIUrl":"10.1177/15910199251347789","url":null,"abstract":"<p><p>BackgroundBalloon guide catheters (BGCs) can optimize recanalization in endovascular thrombectomies, but recent studies suggest that aspiration catheters sized closely to the target vessel can be effective for recanalization.ObjectiveTo compare the outcomes, efficacy, and safety of a single-surgeon experience replacing BGCs with large distal platform (LDP) catheters.MethodsThis is a retrospective study of patients with anterior circulation large vessel occlusion undergoing endovascular thrombectomies. Our study population was divided based on use of either the Zoom™ 0.088\" LDP (Imperative Care, Inc., Campbell, CA, USA) or Walrus™ BGC (Q'Apel Medical, Fremont, CA, USA). Primary outcomes were the thrombectomy technique used, time from groin puncture to recanalization, first pass effect (FPE), degree of final reperfusion (modified treatment in cerebral infarction [mTICI]), postoperative complications, and all-cause mortality at 90 days.ResultsWe analyzed 48 cases: 27 with Walrus™ BGC and 21 with LDP. Contact aspiration was primarily used with LDP (<i>p</i> < 0.001), while a stent-retriever-based technique was preferred with BGC (<i>p</i> < 0.001). The median groin-to-recanalization time was shorter for the LDP cohort (<i>p</i> = 0.001). Both cohorts achieved mTICI ≥ 2b in all cases, with more mTICI of 3 in the LDP cohort (<i>p</i> = 0.38). The LDP cohort also had a greater FPE (<i>p</i> = 0.034). Four cases with iatrogenic dissections were observed with Walrus™ BGC (<i>p</i> = 0.12) and 2 cases with downstream emboli with using the LDP (<i>p</i> = 0.19). All-cause mortality was similar between cohorts (<i>p</i> > 0.99).ConclusionThe super-bore LDP offers a significant advantage over BGCs, achieving faster reperfusion times without compromising safety or recanalization effectiveness. Switching to super-bore 0.088\" Zoom may enhance thrombectomy procedures.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251347789"},"PeriodicalIF":1.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316907","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 multidisciplinary simulation training on endovascular thrombectomy: Workflow, patient outcomes and anaesthetic management.","authors":"Caroline G Fugelli, Martin W Kurz, Britt S Hansen, Soffien Ajmi, Jan T Kvaløy, Lars Fjetland, Cecilie Grøtteland, Snorre Eikeland, Hege Ersdal","doi":"10.1177/15910199251336952","DOIUrl":"10.1177/15910199251336952","url":null,"abstract":"<p><p>BackgroundEndovascular thrombectomy (EVT) is a time-sensitive treatment for acute stroke patients. This study was conducted to evaluate the impact of multidisciplinary simulation training on workflow, patient outcomes, and anaesthetic management during EVT.MethodsThis pre-post interventional study treated 244 stroke patients with EVT (55 pre- and 189 postintervention) between May 2016 and November 2021. A multidisciplinary in situ EVT simulation training programme, including a new EVT protocol with a higher blood pressure target range, was implemented in 2017. We assessed the following variables: (1) Workflow metrics: Process times, revascularisation success, and complications; (2) patient outcomes: Symptomatic intracerebral haemorrhage, functional outcomes at 90 days, and the National Institute of Health Stroke Scale postprocedure; and (3) anaesthetic management: Systolic blood pressure (SBP) thresholds, adherence to protocol, and the conversion rate from conscious sedation to general anaesthesia.ResultsThe postintervention workflow improved significantly, with a reduction in the median groin puncture-to-reperfusion time from 76 to 53 min (<i>p</i> = 0.003) and in the door-to-angio suite arrival time from 54 to 35 min (<i>p</i> < 0.001). Other EVT workflow metrics and patient outcomes remained unchanged. Postintervention haemodynamic management significantly changed with increasing median SBP outside protocol thresholds (14 vs. 28.5 min, <i>p</i> = 0.003). A variety of different combinations of anaesthetics were used for conscious sedation.ConclusionsMultidisciplinary simulation training improved EVT workflow times, highlighting its potential to optimise processes. However, the lack of significant improvement in patient outcomes and anaesthetic management suggests the need for a stronger focus on anaesthesia in future training to optimise EVT outcomes.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251336952"},"PeriodicalIF":1.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316909","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":"Use of a novel, non-continuous aspiration pump during mechanical thrombectomy: An in vitro study.","authors":"K Rose Duncan, Dana Defta, Brian Jankowitz, Yin C Hu","doi":"10.1177/15910199251348742","DOIUrl":"10.1177/15910199251348742","url":null,"abstract":"<p><p>BackgroundAspiration thrombectomy has become a standard tool for clot extraction in ischemic stroke. The ALGO Smart Pump (Von Vascular, Sunrise, FL) utilizes novel non-continuous aspiration and real-time objective data with the intent of increasing clot ingestion and first-pass effect while reducing distal emboli and time to reperfusion.MethodsFive different catheters were used to test clot extraction with the ALGO pump in a Mentice flow model. Clot extraction time, clot length, clot lodging or \"corking\" within the catheter, first-pass effect, distal embolization, and catheter distortion were assessed for each thrombectomy procedure. Thirty thrombectomies were performed with each catheter for a total of 150 thrombectomies.ResultsAll trials achieved reperfusion on the first pass. Complete clot ingestion with resumption of free flow through the catheter was seen in 65.3% of trials, with the remainder involving corking of the clot in the catheter or at the catheter tip. When the clot became corked, 63.3% of the time it was corked completely within the catheter; in the other 36.7%, the clot was corked at the catheter tip. Distal emboli were seen in 3.3% of trials. No evidence of catheter distortion was observed.Discussion/ConclusionThe ALGO non-continuous aspiration pump is effective at clot extraction with a wide range of catheters in the in vitro model. The low incidence of catheter tip-corking and distal emboli as well as the high first-pass reperfusion rate suggests the possibility of improved reperfusion with non-continuous aspiration.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251348742"},"PeriodicalIF":1.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302047","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":"Early results with EmboTrap III stent retriever: A multicenter US experience.","authors":"Georgios S Sioutas, Alex N Hoang, Fadi Al Saiegh, Oz Haim, Sanjana Salwi, Avi A Gajjar, Mohamed M Salem, Peter Kan, Omar Tanweer, Justin R Mascitelli, Brian T Jankowitz, Jan-Karl Burkhardt, Visish M Srinivasan","doi":"10.1177/15910199251348512","DOIUrl":"10.1177/15910199251348512","url":null,"abstract":"<p><p>BackgroundMechanical thrombectomy with stent retrievers has become a standard treatment for acute ischemic stroke due to large vessel occlusion. Here we present a multicenter US experience using the EmboTrap III stent retriever, the latest iteration within its class.MethodsWe retrospectively reviewed patients with acute ischemic stroke treated with the EmboTrap III device at 4 US centers. We recorded baseline demographics, clinical characteristics, and procedural details. Outcomes included first-pass effect (FPE), modified FPE (mFPE), final mTICI scores, 90-day functional outcomes, and complications.ResultsA total of 92 patients were included, median age of 72 years, and 56.5% were women. The mean NIHSS on admission was 16.6 ± 8.1 and the median ASPECTS score was 9. IV thrombolysis was administered in 34.1%. Median last known normal to reperfusion time was 304 min. Final successful reperfusion (mTICI ≥ 2b) was achieved in 91.3% of patients. FPE (mTICI ≥ 2c after a first pass with the device) was achieved in 53.3% of patients, and mFPE (mTICI ≥ 2b after a first pass with the device) was achieved in 79.3% of patients. At 90 days, 22.9% of patients had modified Rankin Scale (mRS) ≤ 2. There were no device-related complications.ConclusionIn this multicenter study, the EmboTrap III achieved high final recanalization success and FPE/mFPE rates with low complication rates.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251348512"},"PeriodicalIF":1.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302046","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 aspiration catheter inner diameter on first-pass effect: A systematic review and meta-analysis.","authors":"Seyed Behnam Jazayeri, Abdullah Reda, Jonathan Cortese, Abdelrahman Reda, Seyed Farzad Maroufi, Sherief Ghozy, Ramanathan Kadirvel, David F Kallmes","doi":"10.1177/15910199251345637","DOIUrl":"10.1177/15910199251345637","url":null,"abstract":"<p><p>BackgroundThe first-pass effect (FPE) refers to the complete or near-complete revascularization with a single pass of mechanical thrombectomy devices. While previous claims suggest a link between larger catheters and the effectiveness of contact aspiration (CA) thrombectomy, no extensive research has confirmed if larger distal inner diameter (ID) catheters achieve higher FPE rates.MethodsWe searched PubMed, Scopus, and Web of Science to assess the impact of aspiration catheter distal ID size on FPE. The primary outcome was FPE rate, defined as thrombolysis in cerebral ischemia (TICI) grades 2c-3 at first pass, and the secondary outcome was modified FPE (TICI 2b-3 in a single pass). Aspiration catheters were categorized based on distal ID: 0.060-0.069 (medium bore), 0.070-0.074 (large bore), and greater than 0.074 inches (super-large bore). Rates of FPE were pooled using random effect models and compared using a Chi-square test.ResultsOur study included 34 articles with 4831 patients. FPE rates were 27.7% (95% CI, 15.1-45.3) for medium bore, 46.6% (95% CI, 33.7-59.9) for large, and 58.3% (95% CI, 44.8-70.7) for super-large catheters. The FPE rate was significantly higher for super-large bore catheters compared with other groups (χ² = 7.26, p = 0.03). A similar trend was observed for modified FPE rates, which were 51.1% (95% CI, 45.3-56.8) for medium bore, 60.0% (95% CI, 52.8-66.8) for large bore, and 80% (95% CI, 56.3-94.2) for super-large bore catheters (χ² = 8.14, p = 0.03).ConclusionOur analysis indicates that larger CA catheters are correlated with higher FPE rates.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251345637"},"PeriodicalIF":1.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258089","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":"Too late to save: The national surge in ruptured arteriovenous malformations and the decline in endovascular utilization from 2016 to 2022.","authors":"Avi A Gajjar, Aditya Dev Goyal, Amanda Custozzo, Alan S Boulos, Ilayda Kayir, John Fantauzzi, Paul J Feustel, Nicholas C Field, John C Dalfino, Alexandra R Paul","doi":"10.1177/15910199251347794","DOIUrl":"10.1177/15910199251347794","url":null,"abstract":"<p><p>IntroductionThe ARUBA trial has influenced a shift towards more conservative management of small, unruptured cerebral arteriovenous malformations (AVMs), leading to less aggressive treatment approaches among neurointerventionalists. However, with evolving endovascular techniques, it is important to assess whether national practice changes have impacted rupture rates and outcomes.MethodsData from the Nationwide Inpatient Sample (NIS) for 2016-2022 regarding clinical characteristics, cost, morbidity, and mortality endovascularly treated AVMs was analyzed. Trends were evaluated using multivariable regression modeling, controlling for patient and hospital characteristics.ResultsA total of 8,935 patients underwent endovascular treatment for cerebral AVMs (6,500 unruptured and 2,435 ruptured). Endovascular treatment for unruptured AVMs declined significantly from 1195 cases in 2016 to 780 in 2022 (-34.7%, <i>p</i> = 0.020). Over the same period, the proportion of AVMs presenting ruptured increased from 15.7% to 25.7%, a 63.7% relative increase (<i>p</i> = 0.015). Multivariable analysis confirmed rising odds of rupture over time among endovascularly treated patients (OR = 1.12, 95% CI 1.00-1.25, <i>p</i> = 0.042). Among 11,205 ruptured AVM patients, the in-hospital mortality rate of thosewho did not undergo surgery rose 67.2% over time (6.7% in 2016 to 11.2% in 2022, <i>p</i> = 0.006).ConclusionThe study reveals an increase in the probability of patients presenting with ruptured AVMs and being observed with a consequent increase in in-hospital mortality. This may be an unintended consequence of less aggressive strategies following the ARUBA trial, prompting a need to reevaluate current management techniques amidst rising costs, morbidity, and mortality.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251347794"},"PeriodicalIF":1.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258094","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":"De Novo brain arteriovenous malformations in alcohol-related cirrhosis.","authors":"Amin Yakubu, Neil V Patel, Emanuele Orru, Jonathan Pace, Timo Krings","doi":"10.1177/15910199251342424","DOIUrl":"10.1177/15910199251342424","url":null,"abstract":"<p><p>We report the case of a 38-year-old female with alcohol-related cirrhosis who developed a de novo left hemispheric sylvian fissure pial arteriovenous malformation (AVM) causing recurrent hemorrhages, ultimately necessitating neurosurgical intervention. The case underscores the interplay between chronic systemic disease and vascular abnormalities. We explore the theory of de novo brain AVM (bAVM) formation in the context of liver cirrhosis, chronic inflammation and pro-angiogenic conditions thus shedding a light on the potential underlying pathological mechanisms of bAVM formation. This case also highlights the challenges of managing concurrent neurovascular and systemic conditions.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251342424"},"PeriodicalIF":1.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258087","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}