Interventional Neuroradiology最新文献

{"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}

{"title":"Mechanical Comaneci 17-stent angioplasty for a sub-optimally deployed flow-diverter stent.","authors":"Georgi Vladev, Alexander Sirakov, Kristina Sirakova, Sanimir S Sirakov","doi":"10.1177/15910199221149633","DOIUrl":"10.1177/15910199221149633","url":null,"abstract":"<p><p>Flow diverter stents are increasingly used as the sole endovascular treatment method for complex or wide-necked intracranial aneurysms.¹ Technical complications related to stent deployment are infrequently reported in the literature. During treatment, implant misbehaviors may occur, including incomplete tubular expansion with insufficient aneurysmal coverage and wall apposition, proximal or distal narrowing, and twisting along the axis.^{2- 4} Little is known about this phenomenon, especially if it relates to the operator experience, deployment techniques, different devices, and implant properties. The management of these complications requires technical precision and is often remediated by \"massaging\" the stent with the delivery system, balloon angioplasty, or placement of additional self-expandable stents. Lastly, if critically damaged, the stent could be taken out of the vessel with a combination of maneuvers called \"stentectomy.\"⁵ These techniques often necessitate multiple navigations and the utilization of a larger microcatheter. We aim to highlight the feasibility of Comaneci 17 stent-angioplasty as an effective bailout strategy for inadequately deployed flow diverter stents. The suggested approach's technical aspects, including pros and cons, have been discussed.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"143"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10454134","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":"Validation of the Charlotte large artery occlusion endovascular therapy outcome score using Viz.ai-derived cerebral blood volume index.","authors":"Rahul R Karamchandani, Hongmei Yang, Jeremy B Rhoten, Dale Strong, Sagar Satyanarayana, Andrew W Asimos","doi":"10.1177/15910199221149563","DOIUrl":"10.1177/15910199221149563","url":null,"abstract":"<p><strong>Background: </strong>The Charlotte large artery occlusion endovascular therapy outcome score (CLEOS) predicts poor 90-day outcomes for patients presenting with internal carotid artery (ICA) or middle cerebral artery (MCA) occlusions. It incorporates RAPID-derived cerebral blood volume (CBV) index, a marker of collateral circulation. We validated the predictive ability of CLEOS with Viz.ai-processed computed tomography perfusion (CTP) imaging.</p><p><strong>Methods: </strong>The original CLEOS derivation cohort was compared to a validation cohort consisting of all ICA and MCA thrombectomy patients treated at a large health system with Viz.ai-processed CTP. Rates of poor 90-day outcome (mRS 4-6) were compared in the derivation and validation cohorts, stratified by CLEOS. CLEOS was compared to previously described prediction models using area under the curve (AUC) analyses. Calibration of CLEOS was performed to compare predicted risk of poor outcomes with observed outcomes.</p><p><strong>Results: </strong>One-hundred eighty-one patients (mean age 66.4 years, median NIHSS 16) in the validation cohort were included. The validation cohort had higher median CTP core volumes (24 vs 8 ml) and smaller median mismatch volumes (81 vs 101 ml) than the derivation cohort. CLEOS-predicted poor outcomes strongly correlated with observed outcomes (<i>R</i>² = 0.82). AUC for CLEOS in the validation cohort (0.72, 95% CI 0.64-0.80) was similar to the derivation cohort (AUC 0.75, 95% CI 0.70-0.80) and was comparable or superior to previously described prognostic models.</p><p><strong>Conclusions: </strong>CLEOS can predict risk of poor 90-day outcomes in ICA and MCA thrombectomy patients evaluated with pre-intervention, Viz.ai-processed CTP.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"80-87"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10496574","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":"pCONUS 2 and pCONUS 2-HPC in the treatment of wide-necked intracranial aneurysms: Multicentre UK experience.","authors":"James Yeomans, Simon Gatt, Ezaz Habeeb Mohamed, Robert Crossley, Peter Keston, David Minks, Nicholas Dobbs, Alexander Mortimer, Jonathan Downer, Anand Sastry","doi":"10.1177/15910199221150467","DOIUrl":"10.1177/15910199221150467","url":null,"abstract":"<p><strong>Background/purpose: </strong>pCONUS 2 and pCONUS 2-HPC are neck-bridging devices that provide coiling support in the endovascular treatment of wide-necked intracranial aneurysms. To date, limited multicentre data has been published. This study provides the first pooled data from multiple UK centres regarding outcomes for these devices covering the periprocedural period to 6-month follow-up.</p><p><strong>Materials/methods: </strong>This retrospective, single-arm study assessed 65 patients treated over 3 years from the time of procedure to 6 months post-procedure across four UK centres. Data collected included patient demographics, aneurysm characteristics and antiplatelet regimens. Outcome measures were angiographic results and procedure-related complications from the immediate periprocedural period to 6-month follow-up.</p><p><strong>Results: </strong>Fifty-four unruptured (83.1%) and 11 ruptured (16.9%) aneurysms were treated. Fifty-five aneurysms were located in the anterior circulation (87.7%). There were four device-related intraprocedural complications: three cases of asymptomatic, temporary thrombus formation and one mortality associated with branch vessel occlusion and aneurysm re-bleeding in a ruptured case. There were no post-procedural device-related complications. Satisfactory occlusion was achieved in 58/65 procedures (89.2%) at time of treatment and in 44/60 (73.3%) at 6 months. Satisfactory occlusion correlated with aneurysm size and coiling packing density. Retreatment was required for five unruptured cases (7.7%) and was straightforward with the device in situ.</p><p><strong>Conclusion: </strong>pCONUS 2 and pCONUS 2-HPC have good short-term safety profiles. The use of pCONUS 2-HPC in the acute treatment of ruptured aneurysms with postprocedural SAPT is feasible. The devices have an intraprocedural complication rate of 4/65 (6.2%) across multiple UK centres, including a single death (1.5%).</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"63-70"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10846784","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 outflow stenting for symptomatic developmental venous anomaly.","authors":"Kislay Kishore, Vivek Bodani, Richard Olatunji, MingYang Meah Gao, Vivek Pai, Thomas Marotta, Julian Spears, Vitor Mendes Pereira","doi":"10.1177/15910199221121370","DOIUrl":"10.1177/15910199221121370","url":null,"abstract":"<p><p>Developmental venous anomaly (DVA) is one of the commonest vascular malformations in the brain but rarely symptomatic. Various pathomechanisms such as mechanical compression, increased in-flow into DVA or outflow obstruction have been described as causative factors in symptomatic DVAs. We report a unique case of a pontomedullary DVA with venous outflow obstruction causing progressive neurological worsening in a young adult despite anticoagulation, who was treated with a novel approach of venous outlet stenting of the collector vein with favorable outcome. In carefully selected cases, this endovascular treatment can be an effective and safe alternative when other measures fail.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"128-131"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40706607","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":"Fractal analysis of healthy and diseased vasculature in pediatric Moyamoya disease.","authors":"Daniel S Weber, Kevin T Huang, Alfred P See","doi":"10.1177/15910199231152513","DOIUrl":"10.1177/15910199231152513","url":null,"abstract":"<p><strong>Background and purpose: </strong>Fractal dimension is an objective metric for the notion of structural complexity. We sought to investigate differences in structural complexity between healthy and affected territories of cerebral vasculature in moyamoya, as well as associated scalp vasculature and native transdural collaterals in patients with moyamoya by comparing their respective fractal dimensions.</p><p><strong>Methods: </strong>Our cohort consisted of 15 transdural collaterals from 12 patients with unilateral anterior circulation moyamoya. Frames of distal arterial vasculature from internal and external carotid angiograms were selected then automatically segmented and also manually annotated by a cerebrovascular surgeon. In the affected hemisphere, the region with transdural collateral supply was compared to the contralateral region. The resulting skeletonized angiograms were analyzed for their fractal dimensions.</p><p><strong>Results: </strong>We found the average fractal dimension (Df) of the moyamoya-side ICA was 1.82 with slightly different means for the anteroposterial (AP) and lateral views (mean  =  1.82; mean  =  1.81). The overall mean for healthy cerebral vasculature was also found to be 1.82 (AP: mean  =  1.83; lateral: mean  =  1.81). Mean Df of native transdural collaterals was found to be 1.82 (AP: mean  =  1.83; lateral: mean  =  1.81). The mean Df difference between autosegmented and manually segmented images was 0.013.</p><p><strong>Conclusion: </strong>In accordance with the clinical understanding of moyamoya disease, the distal arterial structural complexity is not affected in moyamoya, and is maintained by transdural collaterals formed by vasculogenesis. Autosegmentation of cerebral vasculature is also shown to be accurate when compared to manual segmentation.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"101-106"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10628824","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":"Effectiveness and safety of the Trevo® Retriever for mechanical thrombectomy in Chinese patients with acute ischemic stroke: Trevo Retriever China Registry.","authors":"Xuelei Zhang, Jinchao Liu, Hongxing Han, Pinyuan Zhang, Xianglin Chen, Haicheng Yuan, Maohua Chen, Qiyi Zhu, David S Liebeskind, Zhongrong Miao","doi":"10.1177/15910199231151275","DOIUrl":"10.1177/15910199231151275","url":null,"abstract":"<p><strong>Background: </strong>To quantify the effectiveness and safety of the Trevo® Retriever for endovascular treatment of acute ischemic stroke (AIS) patients in China.</p><p><strong>Methods: </strong>Trevo Retriever Registry (China) was a prospective, multicenter, non-comparative, open-label study of patients with AIS treated with the Trevo Retriever. The primary outcome was the proportion of patients achieving an expanded Thrombolysis in Cerebral Infarction (eTICI) score ≥2b at the end of endovascular treatment. Secondary outcomes included first-pass eTICI score ≥2b and 90-day modified Rankin Scale (mRS) score ≤2.</p><p><strong>Results: </strong>The Trevo Retriever Registry (China) enrolled and followed 201 patients (62.1 ± 12.5 years-old; 70.6% male) at 11 centers. The pre-procedure NIHSS score and ASPECTS were 16 (interquartile range (IQR), 13-21) and 7 (IQR, 6-9), respectively, and 188 (93.5%) patients had an mRS score of 0 prior to the stroke. The main stroke etiology was large artery atherosclerosis, accounting for 71.6% (144/201) of patients. Post-procedure eTICI ≥2b was 98.4% (187/190). First-pass eTICI ≥2b was 74.7% (136/182). The 90-day good outcome (mRS ≤2) rate was 73.6% (148/201). The 90-day all-cause mortality was 5.5% (11/201). Neurological deterioration at 24 h post-procedure was observed in 7.7% (15/195) patients. Embolism in a new territory was seen in one patient (0.5%). Two (1.0%) procedure-related adverse events (AEs) occurred, which were intra-procedure cerebral artery embolism. No Trevo related AEs occurred.</p><p><strong>Conclusions: </strong>This real-world study of the Trevo Retriever in China demonstrated a high rate of revascularization and first-pass success that resulted in an overall high good function outcome rate and low mortality.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"107-113"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10621764","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 optical coherence tomography in selected patients with recurrent cryptogenic stroke: A case series and technical discussion.","authors":"Răzvan Alexandru Radu, Federico Cagnazzo, Imad Derraz, Cyril Dargazanli, Grégory Gascou, Pierre-Henri Lefevre, Caroline Arquizan, Vincent Costalat","doi":"10.1177/15910199221150472","DOIUrl":"10.1177/15910199221150472","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in secondary stroke prevention during the last several years, cryptogenic stroke remains associated with a high risk of recurrence. Studies have shown that the recurrence risk is higher in patients with large artery disease in which complex carotid plaques and carotid WEBs are identified.</p><p><strong>Methods: </strong>This is a case series of six patients with cryptogenic recurrent stroke in which conventional imaging and extensive workup did not identify an etiology. Intravascular optic coherence tomography (OCT) was performed using a ballon-guided flow-arrest technique to identify possible covert carotid lesions.</p><p><strong>Results: </strong>We present six cases in which, with the help of OCT, we identified three carotid WEBs with associated thrombosis and two ulcerated carotid artery plaques. Four patients were subsequently treated with endovascular stent placement without complications. OCT permitted the distinction between complicated carotid artery plaque and carotid WEB.</p><p><strong>Conclusion: </strong>Intravascular OCT is a feasible and safe approach to identifying patients with covert carotid wall abnormalities, like carotid WEBs and ulcerated plaques, that are amenable to carotid stenting to reduce recurrent stroke risk.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"88-94"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10506251","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}