Interventional Neuroradiology最新文献

{"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}

{"title":"Embolization of middle meningeal artery (EMMA) for non-acute subdural hematoma: Insight from recent randomized trials and meta-analysis.","authors":"Jai Shankar","doi":"10.1177/15910199251318408","DOIUrl":"10.1177/15910199251318408","url":null,"abstract":"<p><p>Embolization of the middle meningeal artery (EMMA) has emerged as a promising treatment for non-acute subdural hematoma (NASDH), either as an adjunct to surgical drainage or as a primary intervention in patients not undergoing surgery. Recent randomized controlled trials (RCTs) have investigated the efficacy of EMMA using dimethyl sulfoxide (DMSO)-based agents like ONYX and SQUID. The EMBOLISE trial demonstrated a significant reduction in hematoma recurrence with adjunctive EMMA, while the STEM trial showed similar benefits at 180 days. Conversely, the MAGIC MT trial found no significant difference in recurrence rates with EMMA. A meta-analysis of these trials confirmed EMMA's safety, with no significant increase in serious adverse events. The analysis indicated a modest overall benefit in reducing NASDH recurrence (risk difference -0.09, <i>P</i> = 0.02), though results were largely driven by the STEM trial. The benefit of adjunctive EMMA was less clear, with no significant effect found. Primary EMMA showed marginal benefit but with considerable variability. Factors such as primary outcome, trial design, patient demographics, and surgical biases complicate the interpretation of these findings. While the safety of EMMA is supported, its clinical efficacy remains inconclusive. Further trials, including patient-level meta-analyses, are needed to refine the role of EMMA in NASDH management and address existing gaps in the literature.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251318408"},"PeriodicalIF":1.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11791965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122919","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":"Quest for the optimal venous access in a complex skull base dural fistula: Case illustrations and principles.","authors":"Eyad Almallouhi, Mithun G Sattur, Rahim Abo Kasem, Ahmed Muthana, Robert E Wood, Alejandro M Spiotta","doi":"10.1177/15910199251316407","DOIUrl":"10.1177/15910199251316407","url":null,"abstract":"<p><p>Treatment of dural arteriovenous fistulae (DAVFs) is dynamic and evolves between diagnostic and therapeutic angiography.A 79-year-old man with a left jugular foramen DAVF presented with new onset cranial nerve XII palsy. The DAVF progressed from Cognard grade I to IIa + b. A transvenous approach was chosen. Attempts to access the left inferior petrosal sinus (IPS) via the left internal jugular vein failed due to occlusion. An alternative route through the left superior ophthalmic vein and left cavernous sinus to the IPS was devised. Successful coil occlusion of the IPS was achieved. Postoperatively, symptoms resolved, and angiography showed no cortical venous reflux.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251316407"},"PeriodicalIF":1.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11791958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122848","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":"Robotic neurointervention: Beyond the noise.","authors":"Ronil V Chandra, Daniel Cooke, Claus Z Simonsen, Joshua A Hirsch, David Bell","doi":"10.1177/15910199241298323","DOIUrl":"10.1177/15910199241298323","url":null,"abstract":"","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241298323"},"PeriodicalIF":1.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11791952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122862","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":"If time = money, and time = brain, then money = brain.","authors":"Adam A Dmytriw, Hamza A Salim, Vivek S Yedavalli, Adrien Guenego","doi":"10.1177/15910199251318409","DOIUrl":"10.1177/15910199251318409","url":null,"abstract":"","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251318409"},"PeriodicalIF":1.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11791953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122923","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 effect of the size of the new contour neurovascular device for altering intraaneurysmal flow.","authors":"Mariya S Pravdivtseva, Andrey N Pravdivtsev, Sönke Peters, Johannes Hensler, Naomi Larsen, Jan-Bernd Hövener, Olav Jansen, Fritz Wodarg","doi":"10.1177/15910199221145985","DOIUrl":"10.1177/15910199221145985","url":null,"abstract":"<p><strong>Background: </strong>Recently, a novel intrasaccular device (contour neurovascular system, contour) was introduced to treat intracranial aneurysms. Contour is placed at thе aneurysm neck and reduces the intraaneurysmal blood inflow. Contour comes in a range of sizes to target different aneurysms. The efficiency of altering flow with contour and the effect of device size have not yet been investigated. Therefore, we studied the effect of the device size with patient-based aneurysm models using 2D digital subtraction angiography (DSA).</p><p><strong>Methods: </strong>Three patient-based aneurysm models with necks ranging from 2.7 to 9.7 mm were produced, providing standardized testing conditions. Contours with diameters of 5, 11, and 14 mm were implanted into the models, four of each size. 2D DSA images were acquired before and after implanting contour (15 frames/s, manual contrast injection). After injecting angiographic contrast agent, the DSA signal was recorded over time to calculate the contrast washout time (WOT), which is a measure of flow diversion efficiency.</p><p><strong>Results: </strong>All contour devices caused contrast agent stasis and increased WOT in aneurysm sac (<i>p</i>-value = 0.0005). The median relative WOT was largest for 5-mm contour (6.6 ± 3.2) and similar for 11-mm contour (3.4 ± 2.6) and 14-mm contour (3.2 ± 3.8). The implantation procedure might affect WOT values even for contours of the same size; the overall relative WOT ranged between 1.5 and 10.89.</p><p><strong>Conclusion: </strong>The 5-mm contour showed the longest WOT value in our study, while no apparent difference between 11-mm contour and 14-mm contour was found.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"49-56"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10525460","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":"High resolution 7T MR imaging in characterizing culprit intracranial atherosclerotic plaques.","authors":"Rami Fakih, Alberto Varon Miller, Ashrita Raghuram, Sebastian Sanchez, Jacob M Miller, Sedat Kandemirli, Chengcheng Zhu, Amir Shaban, Enrique C Leira, Edgar A Samaniego","doi":"10.1177/15910199221145760","DOIUrl":"10.1177/15910199221145760","url":null,"abstract":"<p><strong>Background: </strong>Current imaging modalities underestimate the severity of intracranial atherosclerotic disease (ICAD). High resolution vessel wall imaging (HR-VWI) MRI is a powerful tool in characterizing plaques. We aim to show that HR-VWI MRI is more accurate at detecting and characterizing intracranial plaques compared to digital subtraction angiography (DSA), time-of-flight (TOF) MRA, and computed tomography angiogram (CTA).</p><p><strong>Methods: </strong>Patients with symptomatic ICAD prospectively underwent 7T HR-VWI. We calculated: degree of stenosis, plaque burden (PB), and remodeling index (RI). The sensitivity of detecting a culprit plaque for each modality as well as the correlations between different variables were analyzed. Interobserver agreement on the determination of a culprit plaque on every imaging modality was evaluated.</p><p><strong>Results: </strong>A total of 44 patients underwent HR-VWI. Thirty-four patients had CTA, 18 TOF-MRA, and 18 DSA. The sensitivity of plaque detection was 88% for DSA, 78% for TOF-MRA, and 76% for CTA. There's significant positive correlation between PB and degree of stenosis on HR-VWI MRI (p < 0.001), but not between PB and degree of stenosis in DSA (p = 0.168), TOF-MRA (p = 0.144), and CTA (p = 0.253). RI had a significant negative correlation with degree of stenosis on HR-VWI MRI (p = 0.003), but not on DSA (p = 0.783), TOF-MRA (p = 0.405), or CTA (p = 0.751). The best inter-rater agreement for culprit plaque detection was with HR-VWI (p = 0.001).</p><p><strong>Conclusions: </strong>The degree of stenosis measured by intra-luminal techniques does not fully reflect the true extent of ICAD. HR-VWI is a more accurate tool in characterizing atherosclerotic plaques and may be the default imaging modality in clinical practice.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"24-31"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10430292","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":"Mechanical thrombectomy in stroke patients of advanced age with score-based prediction of outcome.","authors":"Nicolaj Grønbæk Laugesen, Andreas Hjelm Brandt, Trine Stavngaard, Joan Højgaard, Klaus Hansen, Thomas Truelsen","doi":"10.1177/15910199221149073","DOIUrl":"10.1177/15910199221149073","url":null,"abstract":"<p><strong>Background: </strong>Stroke patients ≥80 years constituted only 15% in randomised trials on mechanical thrombectomy (MT), but is a considerable higher proportion in clinical practice. Association of clinical variables collected before MT with functional outcome has not been independently described in these patients, while being important in the decision of patient eligibility for MT.</p><p><strong>Methods: </strong>We included patients consecutively at a single centre (2017-2021) categorised as octogenarians (age: 80-89 years) or nonagenarians (age: 90-99 years). Functional outcome at 90 days was defined as fair (modified Rankin Scale (mRS) 0-3) or poor (mRS 4-6). Clinical variables collected before MT were analysed for association with shift of mRS in a poor direction. Significant predictors were used to produce a risk score of fair outcome. Significance was set at the p < 0.05 level.</p><p><strong>Results: </strong>Nonagenarians (n = 43, 15.5%) compared to octogenarians (n = 235, 84.5%) less likely achieved fair outcome (20.9% vs. 46.0%, p < 0.01) with higher mortality (65.1% vs. 31.9%, p < 0.01). Significant predictors of outcome were: age, adjusted odds ratio (aOR) = 0.91 (95% confidence interval (CI): 0.86-0.97); pre-stroke mRS, aOR = 0.57 (95% CI: 0.44-0.73); National Institute of Health Stroke Scale at admission, aOR = 0.91 (95% CI: 0.87-0.95); Alberta Stroke Program Early Computed Tomography, aOR = 1.23 (95% CI: 1.05-1.45). After bootstrap validation, the area under the curve of the risk score was 0.74 and the optimal cut-off for fair outcome was a score of >7 points.</p><p><strong>Conclusions: </strong>One in two octogenarians achieved fair outcome, however, only one in five nonagenarians had fair outcome. The clinical risk score could be considered as guidance when deciding patient eligibility for MT.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"42-48"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10449689","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":"A single-center comparative study with large sample size on stent-assisted coiling versus coiling alone for the ruptured anterior communicating artery aneurysms: Analysis of safety, efficacy, and prognosis based on propensity score matching.","authors":"Wei Shang, Xiaoting Chang, Yousong Xu, Bin Dong","doi":"10.1177/15910199221150293","DOIUrl":"10.1177/15910199221150293","url":null,"abstract":"<p><strong>Objective: </strong>To compare the safety, efficacy, and prognosis of stent-assisted coiling (SAC) versus coiling alone (CA) in the treatment of ruptured anterior communicating artery aneurysms (ACoAAs).</p><p><strong>Methods: </strong>The clinical and follow-up data of ruptured ACoAAs treated with endovascular treatment in our center from January 2011 to January 2021 were retrospectively collected. Patients were divided into an SAC group and a CA group based on whether stents were used, after which the two groups were matched for propensity scores. The general clinical data, embolization effect, perioperative complications, clinical, and follow-up results after matching were compared.</p><p><strong>Results: </strong>A total of 354 patients were enrolled, of whom 147 patients (41.5%) received SAC and the rest received CA. Comparison baseline of two groups showed that patients with a larger diameter, wide neck, irregular morphology, and anterior direction were more likely to receive SAC. After propensity score matching, 113 patients were included in each group. Immediately postoperative angiography results showed that the complete embolization rate of patients in the SAC group was significantly lower than that in the CA group (62.8% vs. 76.1%, p = 0.03). There were no significant differences between the two groups in the incidence of perioperative complications, mortality, poor prognosis at discharge or follow-up, mid-term complete occlusion rate and recurrence rate.</p><p><strong>Conclusion: </strong>The stent-assisted treatment of ruptured ACoAAs did not increase the risk of perioperative complications or the probability of poor prognosis, indicating that SAC treatment of ruptured ACoAAs is safe and feasible and has a reliable mid-term cure rate.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"71-79"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10846785","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}