Interventional Neuroradiology最新文献

{"title":"Bending stiffness and trackability of carotid stent delivery systems: Bench-top insights for neurointerventional practice.","authors":"Daisuke Yamazaki, Yoshiki Hanaoka, Tetsuyoshi Horiuchi","doi":"10.1177/15910199251368705","DOIUrl":"10.1177/15910199251368705","url":null,"abstract":"<p><p>BackgroundA stable guiding system is essential for successful carotid artery stenting (CAS), particularly when navigating tortuous aortic or supra-aortic anatomy. However, data on the mechanical behavior of stent delivery systems remain scarce.ObjectiveTo assess and compare the bending stiffness and trackability of five commercially available carotid stent delivery systems using bench-top experiments.MethodsFive stent systems-CASPER RX, PRECISE PRO RX, PROTÉGÉ RX, PROTÉGÉ RX Tapered, and Carotid WALLSTENT-were evaluated. Bending stiffness was measured via a three-point bending test along a 20 cm length from the distal tip. Trackability was assessed by measuring resistance force during simulated advancement through a 6F guiding sheath within a 90° angulated vessel model.ResultsCASPER RX demonstrated the lowest bending stiffness in the stent-mounted segment (85-118 cN), whereas the Carotid WALLSTENT had the lowest stiffness in the delivery-shaft segment (120-180 cN). Systems with higher bending stiffness exhibited increased resistance during trackability testing. A correlation between increased bending stiffness and higher advancement resistance was observed across all platforms.ConclusionsCarotid stent delivery systems exhibit diverse mechanical behaviors that impact navigability through tortuous anatomy. Awareness of these mechanical properties can inform device selection and technique optimization during transradial or anatomically challenging CAS procedures.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251368705"},"PeriodicalIF":2.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015337","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":"Photon-counting detector CT angiography to evaluate carotid and subclavian artery stents and compared to ultrasound and angiography - an in-vivo study with spectral reconstructions.","authors":"Frederic De Beukelaer, Laura L Wuyts, Steven van Hedent, Omid Nikoubashman, Iliana Kantzeli, Martin Wiesmann, Arno Reich, João Pinho, Hani Ridwan, Charlotte S Weyland","doi":"10.1177/15910199251374274","DOIUrl":"10.1177/15910199251374274","url":null,"abstract":"<p><p>PurposeTo evaluate the potential of Photon-Counting Detector CT Angiography (PCD-CTA) for the assessment of carotid and subclavian artery stents compared to digital subtraction angiography (DSA) and Duplex ultrasound (DUS).MethodsThis study is a single-center, retrospective analysis of consecutive patients treated with a stent for high grade stenosis of the extra-cranial carotid and the subclavian artery between April 2023 and May 2024. Polyenergetic images (PE), iodine and virtual monoenergetic images were performed at different keV levels (40 and 80) and with two body vascular reconstruction kernels (Bv56 and 72) with and without iterative metal artifact reduction. Three independent readers assessed image quality using a 5-point Likert scale and region of interest analysis. A blinded, independent reading was performed to determine in-stent vessel stenosis.ResultsA total of 19 patients (64.3 ± 10.3 (mean patient age in years ± SD); 9 women) with carotid or subclavian artery stents and available DSA, DUS and PCD-CTA were analyzed. Virtual monoenergetic images (VMI) reconstructed with Bv56 at 40 keV, PE and IOD reconstructed with Bv56 scored higher and achieved higher SNRs and CNRs in the in-stent vessel lumen compared with Bv72 reconstructions (p < 0.001). In 2/19 cases with elevated flow velocities (>250 cm/s) in the in-stent vessel lumen, the subsequently performed PCD-CTA and DSA could rule out a high-grade stenosis.ConclusionPCD-CTA with spectral reconstructions allows a reliable non-invasive assessment of the in-stent vessel lumen in patients after carotid artery or subclavian artery stenting.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251374274"},"PeriodicalIF":2.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015394","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":"Indirect flow diversion for the treatment of saccular posterior inferior cerebellar artery aneurysms: An 11-year single-center retrospective study.","authors":"Baptiste Donnard, Gregoire Boulouis, Cyrille Kuntz, Fouzi Bala, Richard Bibi, Heloise Ifergan, Valere Barrot, Clemence Hoche, Thibault Agripnidis, Johannes Kaesmacher, Denis Herbreteau, Kevin Janot","doi":"10.1177/15910199251368702","DOIUrl":"10.1177/15910199251368702","url":null,"abstract":"<p><p>IntroductionPosterior inferior cerebellar artery (PICA) aneurysms are rare but associated with high rupture rates and significant morbidity and mortality. Both surgical and endovascular treatments can be technically challenging. This study evaluates the efficacy and safety of indirect flow diversion using flow-diverting stents (FDS) deployed in the vertebral artery, covering the PICA origin.Patients and methodsWe retrospectively reviewed all patients treated at our center between March 2013 and March 2024 for proximal saccular PICA aneurysms using FDS deployed in the V4 segment of the vertebral artery. Clinical and aneurysm characteristics, procedural details, imaging follow-up, and clinical outcomes were collected and analyzed.ResultsFourteen patients were treated, including eight (57%) as first-line procedures. Adequate aneurysm occlusion (O'Kelly-Marotta grade C or D) was achieved in 50% of cases at last follow-up (median: 38.5 months (interquartile range: 29.5-48.0; total: 47.6 person-years)). No hemorrhagic or clinically significant ischemic events occurred. One asymptomatic ischemic lesion (7%) was detected on magnetic resonance imaging. No aneurysm growth or rupture was observed during follow-up. PICA patency was preserved in all cases, with non-significant narrowing in two patients. Neointimal hyperplasia was observed in six patients (43%).ConclusionIndirect flow diversion with vertebral artery FDS coverage of the PICA origin appears to be a technically feasible and safe strategy. Although complete occlusion rates may be lower than in other anatomical locations, the long-term stability and low complication rates support its use as a therapeutic option in selected cases.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251368702"},"PeriodicalIF":2.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12364839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873147","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":"Long-term ophthalmologic symptoms after treatment of intracranial aneurysms by ophthalmic artery-covering flow diverter.","authors":"Francois-Louis Collemiche, Thomas Checkouri, Cyril Dargazanli, Quentin Varnier, Liesjet Eh van Dokkum, Pierre-Henri Lefevre, Gregory Gascou, Arnaud Muyl-Cipollina, Vincent Daien, Vincent Costalat, Federico Cagnazzo","doi":"10.1177/15910199251324030","DOIUrl":"10.1177/15910199251324030","url":null,"abstract":"<p><p>BackgroundOphthalmic complications after ophthalmic-covering flow diversion (OCFD) for intracranial aneurysms have been rarely reported with a large variability. A large systematic investigation of visual symptoms after OCFD has yet to be performed. This study aimed to explore ophthalmological symptoms and associated predicting factors in patients treated with OCFD.MethodsConsecutive patients receiving flow diversion (FD) treatment with or without ophthalmic artery (OA) coverage (n = 257) (January 2015-January 2021) were contacted for a telephone interview with a standardized 5-item questionnaire. Answers from patients with OCFD (n = 127) and a control group (n = 60) of FD-treated aneurysms without OCFD were collected and compared.ResultsThe rate of new ipsilateral visual symptoms was 37% in the OCFD and 3.2% in the control group (p < 0.0001). After adjusting for age and gender, OCFD was significantly associated with a higher risk of visual symptoms (aOR 7.2; 95%CI [2.43-21.3], p = 0.0004), compared to controls. The most common symptoms were blurry vision (15.7%), phosphenes (14.9%) and vision loss (11.8%). After a mean follow-up of 5.4 years 7.1% had persistent symptoms. Logistic regression identified OA slow flow/occlusion on angiograms as a reliable predictor of the risk of phosphenes and vision loss, respectively.ConclusionOCFD is associated with new visual symptoms in up to 37% of patients, that are persistent in 7.1%. Phosphenes and vision loss may be predicted based on the patency of the OA on angiographic runs. These data should be considered when covering OA with flow diverter, and the patients appropriately informed.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251324030"},"PeriodicalIF":2.1,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873148","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 surface coating on postinterventional DWI lesions: A comparative analysis of coated and uncoated FRED and DERIVO flow-diverters in the treatment of intracranial aneurysms.","authors":"Christoph Ziegenfuß, Natalie van Landeghem, Adrian Engel, Ramazan Jabbarli, Philipp Dammann, Ulrich Sure, Michael Forsting, Isabel Wanke, Lukas Goertz, Christoph Kabbasch, Cornelius Deuschl, Yan Li","doi":"10.1177/15910199251367504","DOIUrl":"10.1177/15910199251367504","url":null,"abstract":"<p><p>PurposeRecent advancements in flow-diverter (FD) technology have introduced various coating strategies to reduce platelet aggregation and thromboembolic complications in intracranial aneurysm treatment. This study compared postinterventional diffusion-weighted imaging (DWI) lesions, as markers of thromboembolic events, between coated and uncoated FDs.MethodsA retrospective analysis was conducted on patients treated for intracranial aneurysms between June 2018 and December 2024. The primary outcome was the occurrence of postinterventional DWI + lesions, with periprocedural factors analyzed for their association.ResultsA total of 91 patients with 104 aneurysms were treated with 43 uncoated (<i>n</i> = 30 FRED, <i>n</i> = 13 DERIVO) and 51 coated FDs (<i>n</i> = 36 FREDX, <i>n</i> = 15 DERIVO2Heal). DWI + lesions were observed in 39.5% of uncoated and 54.9% of coated FD cases (<i>p</i> = 0.1). After 1:1 propensity score matching, no significant difference was found (<i>p</i> = 0.131). Contrast stasis (<i>p</i> = 0.025) within aneurysm sac after FD deployment, FD proximal/distal ratio (<i>p</i> = 0.007), FD size (<i>p</i> = 0.047), and intervention duration (<i>p</i> = 0.036) were significantly associated with DWI + lesions. In multivariable analysis, contrast stasis (ORa = 3.7, 95% CI 1.1-11.9, <i>p</i> = 0.029), FD proximal/distal ratio (ORa = 27.8, 95% CI 1.8-426.8, <i>p</i> = 0.017), and older age (ORa = 1.06, 95% CI 1.00-1.11, <i>p</i> = 0.050) increased incidence of DWI + lesions.ConclusionIn this single-center observational study, coated FRED and DERIVO FDs did not reduce postinterventional DWI + lesions compared to their uncoated counterparts.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251367504"},"PeriodicalIF":2.1,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12350298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835084","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":"Intra-arterial thrombolysis after successful endovascular reperfusion for large vessel occlusion stroke: A meta-analysis of randomized seven controlled trials.","authors":"Ali Mortezaei, Nadir Al-Saidi, Yan Lin Li, Vivek S Yedavalli, Robert W Regenhardt, Adam A Dmytriw","doi":"10.1177/15910199251367556","DOIUrl":"10.1177/15910199251367556","url":null,"abstract":"<p><p>BackgroundAlthough thrombectomy is the standard of care for acute ischemic stroke (AIS) due to large-vessel occlusion (LVO), many patients fail to achieve disability-free recovery, highlighting the need for adjunctive therapy to improve outcomes.PurposeThis systematic review and meta-analysis aimed to compare intra-arterial thrombolysis (IAT) and placebo following the successful recanalization of AIS-LVO.Materials and MethodsA systematic literature review of four databases was performed. Categorical and continuous outcomes were calculated using Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs), respectively. Any potential heterogeneity was resolved through leave-one-out influence analysis. Risk of bias was assessed using the RoB2 tool. Our study was not registered in PROSPERO. The primary analysis included three published RCTs; four additional trials, including posterior circulation or preliminary data, were incorporated in sensitivity analyses to validate robustness.ResultsA total of three trials with enrolled patients 1187 were included in the study. Four additional trials were also included only for sensitivity analysis. The findings showed that patients who received IAT had a significantly higher rate of 90-day functional excellence (RR = 1.15, 95%CI = 1.01-1.3, <i>P</i> = .032, <i>I</i>² = 0.0%) than the control group. There was no significant difference between the two groups regarding functional independence, mortality, symptomatic or any intracranial hemorrhage, and total adverse events. There was a significantly higher functional excellence rate in IAT group compared with control group in studies that included patients with expanded thrombolysis in cerebral infarction score (eTICI) score of 2b-3 versus 2c-3 (RR = 1.5, 95%CI = 1.23-1.82 <i>P</i> = .016, <i>I</i>² = 0.0%) and female patients derived more benefit from IAT than placebo (RR = 1.42, 95%CI = 1.15-1.75, <i>P</i> = .001, <i>I</i>² = 0.0%). Notably, there was no significant heterogeneity across any primary and secondary outcomes.ConclusionIn patients with AIS-LVO presenting within 24 h of time last seen well who achieved successful endovascular recanalization, IAT significantly improved the likelihood of functional excellence at three months without hemorrhagic risk. Further research is warranted to validate these findings.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251367556"},"PeriodicalIF":2.1,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12350307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835065","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":"Influence of procedural factors associated with injection of liquid embolics on outcomes after middle meningeal artery embolization for chronic subdural hematoma.","authors":"Haydn Hoffman, Jason J Sims, Sai Sriraman, David G Laird, Lucas Elijovich, Nitin Goyal","doi":"10.1177/15910199251367508","DOIUrl":"10.1177/15910199251367508","url":null,"abstract":"<p><p>BackgroundMiddle meningeal artery embolization (MMAe) is an effective treatment for chronic subdural hematoma. There are various procedural aspects related to liquid embolic (LE) injection that could influence radiographic resolution rates but require further study.MethodsA retrospective review of consecutive MMAe procedures using LEs performed at a single institution was performed. Technical factors investigated included type of LE, microcatheter position during embolization, number of branches embolized, and depth of penetration. Outcomes included rescue treatment within 90 days, complete hematoma and midline shift (MLS) resolution, and modified Rankin Scale (mRS) 0-2 at 90 days.ResultsA total of 122 MMA embolizations performed on 95 patients (mean age 70.3 years, 66% male) were included. Hematoma recurrence requiring rescue treatment occurred for 12 hematomas (9.8%) among 10 patients. None of the technical factors were associated with rescue treatment, early MLS resolution, final hematoma resolution, final MLS resolution, or 90-day mRS 0-2. Contralateral penetration of embolisate was associated with increased odds of complete hematoma resolution (OR 8.4, 95% CI 1.79-50.38; <i>p</i> = 0.011) at early follow-up (median 2 months). The mean (± SD) hematoma reduction at early follow-up for contralateral penetration was 76.8% (37.2) compared to 56.5% (36) for only ipsilateral penetration (<i>p</i> = 0.047).ConclusionContralateral penetration of LE may be associated with faster complete hematoma resolution but not the final radiographic result. These results require validation in larger cohorts.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251367508"},"PeriodicalIF":2.1,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12350296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835064","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":"Follow-up imaging characteristics of a Novel Braided Stent (BosSTENT™) in treating transverse sinus stenosis related to venous congestion and/or pulsatile tinnitus.","authors":"Vitor Mendes Pereira, Rodrigo Fellipe Rodrigues, Arturo Consoli, Kevin Janot, Aruma Jimenez, Jose Danilo Bengzon Diestro, Julian Spears, Irene Vanek, Eileen Liu, Nicole Cancelliere","doi":"10.1177/15910199251358917","DOIUrl":"10.1177/15910199251358917","url":null,"abstract":"<p><p>BackgroundTransverse sinus stenosis (TSS) is increasingly recognized as a key contributor to pulsatile tinnitus (PT) and cerebral venous congestion (CVC), including idiopathic intracranial hypertension (IIH). While venous stenting has shown promising clinical outcomes, long-term imaging data on dedicated braided stents remain limited.ObjectiveTo report the clinical and imaging outcomes of the BosSTENT™, a novel self-expanding braided stent, in patients with symptomatic TSS.MethodsThis retrospective study included 27 consecutive patients treated at a single institution between December 2022 and December 2024. All patients presented with PT, with or without chronic headaches or signs of intracranial hypertension. Patients underwent BosSTENT™ deployment and were followed clinically and radiologically for up to 2 years. Outcomes included symptom resolution, procedural safety, and long-term stent integrity based on structured imaging protocols.ResultsOf the 27 patients (96.3% female, mean age 41.4 years), 26 have long-term follow-up, 96.2% achieved overall improvement of PT and 84.6% experienced complete or significant improvement in headaches. One patient experienced a fatal subdural hematoma unrelated to device performance, and two patients had femoral access site complications. Imaging follow up confirmed persistent stent patency and structural integrity in all cases, with no instances of thrombus, in-stent stenosis, migration, fracture, or adjacent stenosis.ConclusionThe BosSTENT™ demonstrates favorable long-term safety and performance in the treatment of symptomatic transverse sinus stenosis. These findings support its role as a dedicated device for venous sinus stenting, particularly in patients with pulsatile tinnitus and intracranial hypertension.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251358917"},"PeriodicalIF":2.1,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794385","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":"Standardising mechanical thrombectomy complication reporting: A Delphi consensus study to support guidance for national audit.","authors":"Alex Mortimer, David Minks, Pervinder Bhogal, Victoria Young, Jason Macdonald, Anand Sastry, Rose Bosnell, Sarah Beth McClelland, Philip White","doi":"10.1177/15910199251364119","DOIUrl":"10.1177/15910199251364119","url":null,"abstract":"<p><p>BackgroundComplications following mechanical thrombectomy (MT) are common and impact on clinical outcome. However, unless complication reporting is standardised, there is scope for significant variation in results across multiple centres, potentially undermining both inter and intra unit comparisons and multicentre national quality improvement audit programmes. We therefore sought to achieve consensus amongst interventional neuroradiologists (INRs) in England and Wales for reporting of MT complications as part of national audit.MethodsWe conducted a two-round electronic Delphi survey with initial invitation to forty INR panellists representing each neurointerventional centre in England and Wales with questions covering timing, staffing and mode of data entry, specific MT complications (vessel perforation, intracerebral and subarachnoid haemorrhage, vessel dissection, vasospasm and distal or new territory embolisation) and topics for future content inclusion.ResultsThere were 22 and 21 respondents in round one and two, respectively. Consensus was achieved in methods of data entry and in reporting of specific complications (strongly supportive of symptomatic haemorrhagic complication reporting rather than non-clinically relevant changes with clear definitions of when to report distal, new territory embolic or vasospastic complications or arterial dissection). There was also agreement to include tandem lesion, access site and procedural-related physiological complications in future.ConclusionIn this exercise, we have achieved accordance and developed guidance with an emphasis on reporting of clinically relevant/outcome impacting post-MT complications, which will allow for a better standardised and more meaningful national audit process going forward.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251364119"},"PeriodicalIF":2.1,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794386","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":"Quantitative evaluation of the vasodilatory effect of clazosentan in preventing cerebral vasospasm after subarachnoid hemorrhage.","authors":"Shotaro Ogawa, Satoshi Koizumi, Motoyuki Umekawa, Shigeta Fujitani, Hideaki Ono, Satoru Miyawaki, Nobuhito Saito","doi":"10.1177/15910199251362730","DOIUrl":"10.1177/15910199251362730","url":null,"abstract":"<p><p>Background and PurposeAlthough many studies have reported the efficacy of clazosentan in preventing delayed cerebral ischemia associated with cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH), recent studies have shown that its vasodilatory effect does not contribute to improved prognosis, leaving its efficacy controversial. In this study, we quantitatively measured vascular diameter changes during the vasospasm period at various vascular sites to investigate the association between the radiological and clinical effects of clazosentan.Materials and MethodsWe retrospectively analyzed 22 patients with aSAH classified as Fisher group 3, treated at our hospital. Clazosentan (10 mg/h) was administered to 12 patients, while 10 patients received conventional vasospasm management. Arterial diameters at 12 locations were measured at the onset and during the vasospasm period. Quantitative changes in vascular diameter were compared between the clazosentan and nonclazosentan groups.ResultsDuring the vasospasm period, mean arterial diameters increased in all regions, including the posterior circulation, except internal carotid artery (ICA) top in the clazosentan group, while they decreased across all regions in the nonclazosentan group (overall average: + 22.3% vs. -16.9%; <i>p</i> = 0.005). Notably, in the clazosentan group, significant vasodilation was observed in distal arteries (M2: + 46.1%, <i>p</i> = 0.003; M3: + 58.2%, <i>p</i> = 0.001) compared to proximal arteries (ICAtop: -10.7%, <i>p</i> = 0.33; M1p: + 0.38%, <i>p</i> = 0.16; M1d: + 3.6%, <i>p</i> = 0.07). Symptomatic vasospasm occurred exclusively in the nonclazosentan group; however, no significant difference was observed in modified Rankin Scale scores 3 months post-onset (<i>p</i> = 0.38).ConclusionsClazosentan demonstrated a significant vasodilatory effect compared to conventional treatments, particularly in distal arteries. However, its limited effect on proximal arteries suggests a need for supplementary treatments targeting these regions to improve clinical outcomes. Differences in vasodilatory effect at various sites may be associated with the controversy regarding clazosentan's clinical effects.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251362730"},"PeriodicalIF":2.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789116","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}