Interventional Neuroradiology最新文献

{"title":"Thoracolumbar spinal dural arteriovenous fistulae present with longer arteriovenous transit compared to cranial and cervical dural fistulae.","authors":"Ze'ev Itsekzon-Hayosh, Eef J Hendriks, Sean T O'Reilly, Rabab Al Shahrani, Ronit Agid, Patrick Nicholson, Karel Terbrugge, Ivan Radovanovic, Hugo Andrade, Joanna D Schaafsma, Timo Krings","doi":"10.1177/15910199221149096","DOIUrl":"10.1177/15910199221149096","url":null,"abstract":"<p><strong>Background: </strong>Thoraco-lumbar spinal dural arteriovenous fistulae represent a rare subset of central nervous system vascular malformations. One of the unique features of spinal dural arteriovenous fistulae is their extremely low propensity to cause hemorrhage (either parenchymal or subarachnoid), with a distinct clinical presentation of myelopathy secondary to spinal venous congestion. The exact mechanism for this unique presentation is still unclear.</p><p><strong>Methods: </strong>Following institutional review board approval, we retrospectively analyzed our prospectively maintained database of spinal dural arteriovenous fistulae and cranial (cr) DAVF cases presenting between 2008 and 2021. For all cases, angiograms were reviewed and arteriovenous transit times were calculated. Patient demographics, angiographic features, and clinical and radiological outcomes were assessed.</p><p><strong>Results: </strong>In total, 66 patients presenting with confirmed thoracolumbar spinal dural arteriovenous fistulaes were identified and compared to patients presenting with cervical spinal dural arteriovenous fistulaes (<i>n</i>  =  10), ruptured crDAVFs (<i>n</i>  =  32) and unruptured crDAVFs (<i>n</i>  =  20). Mean age in the target group was 66  ±  13 versus 57-62 in the other groups, <i>p</i> < 0.05 on one-way analysis of variance; with 80% males versus 50%-65% in other groups. Mean arteriovenous transit time in the thoracolumbar group measured 1.98 s ± 0.96 versus 0.25-0.5 s range in other groups (<i>p</i> < 0.0001 on one-way analysis of variance).</p><p><strong>Conclusion: </strong>Prolonged arteriovenous transit times may represent a distinct feature of thoracolumbar spinal dural arteriovenous fistulaes. This may, amongst other factors, play a role in the observed lesser likelihood of hemorrhagic complications compared to other dural arteriovenous shunts.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"57-62"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10494376","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":"Automated CT angiography collateral scoring in anterior large vessel occlusion stroke: A multireader study.","authors":"Mohamed Sobhi Jabal, David F Kallmes, George Harston, Norbert Campeau, Kara Schwartz, Steven Messina, Carrie Carr, John Benson, Jason Little, Alex Nagelschneider, Ajay Madhavan, Deena Nasr, Sherry Braksick, James Klaas, Eugene Scharf, Cem Bilgin, Waleed Brinjikji","doi":"10.1177/15910199221150470","DOIUrl":"10.1177/15910199221150470","url":null,"abstract":"<p><strong>Background: </strong>Computed tomography (CT) angiography collateral score (CTA-CS) is an important clinical outcome predictor following mechanical thrombectomy for ischemic stroke with large vessel occlusion (LVO). The present multireader study aimed to evaluate the performance of e-CTA software for automated assistance in CTA-CS scoring.</p><p><strong>Materials and methods: </strong>Brain CTA images of 56 patients with anterior LVO were retrospectively processed. Twelve readers of various clinical training, including junior neuroradiologists, senior neuroradiologists, and neurologists graded collateral flow using visual CTA-CS scale in two sessions separated by a washout period. Reference standard was the consensus of three expert readers. Duration of reading time, inter-rater reliability, and statistical comparison of readers' performance metrics were analyzed between the e-CTA assisted and unassisted sessions.</p><p><strong>Results: </strong>e-CTA assistance resulted in significant increase in mean accuracy (58.6% to 67.5%, p = 0.003), mean F1 score (0.574 to 0.676, p = 0.002), mean precision (58.8% to 68%, p = 0.007), and mean recall (58.7% to 69.9%, p = 0.002), especially with slight filling deficit (CTA-CS 2 and 3). Mean reading time was reduced across all readers (103.4 to 59.7 s, p = 0.001), and inter-rater agreement in CTA-CS assessment was increased (Krippendorff's alpha 0.366 to 0.676). Optimized occlusion laterality detection was also noted with mean accuracy (92.9% to 96.8%, p = 0.009).</p><p><strong>Conclusion: </strong>Automated assistance for CTA-CS using e-CTA software provided helpful decision support for readers in terms of improving scoring accuracy and reading efficiency for physicians with a range of experience and training backgrounds and leading to significant improvements in inter-rater agreement.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"95-100"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10539381","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":"Three-dimensional rotational angiography improves mechanical thrombectomy recanalization rate for acute ischaemic stroke due to middle cerebral artery M2 segment occlusions.","authors":"Andrea Rosi, Gianmarco Bernava, Jeremy Hofmeister, Madruzzato Nicolò, José Boto, Hasan Yilmaz, Philippe Reymond, Olivier Brina, Michel Muster, Emmanuel Carrera, Karl-Olof Lövblad, Paolo Machi","doi":"10.1177/15910199221145745","DOIUrl":"10.1177/15910199221145745","url":null,"abstract":"<p><strong>Background: </strong>Occlusions of the middle cerebral artery (MCA) M2 segments can be difficult to address with mechanical thrombectomy (MTB) using standard projections and this can affect the final recanalization. Three-dimensional rotational angiography (3D-RA) allows to obtain a 3D model of cerebral vessels in a few seconds and to determine the best two-dimensional (2D) projections to be selected to evaluate and treat cerebrovascular diseases, such as aneurysms or vascular malformations. We aimed to determine if 3D-RA could be applied also in MTB.</p><p><strong>Methods: </strong>A retrospective review of two patient cohorts treated during two time periods of 12 months before and after the introduction of 3D-RA use at our institution for MTB in M2 occlusions. Analyses were conducted to compare the two groups for procedural characteristics, such as timing, recanalization rate and complications and clinical outcome.</p><p><strong>Results: </strong>One hundred acute ischaemic stroke (AIS) patients (3D-RA group = 57; controls = 43) underwent MTB for an M2 occlusion during the two study periods. Recanalization rates were significantly higher in cases treated with 3D-RA. The mean 3D technique thrombectomy time was compared to that of non-3D cases (47 vs. 49 min, respectively).</p><p><strong>Conclusions: </strong>Our findings showed that 3D-RA is a useful tool to select specific working projections to AIS patients presenting an M2 occlusion by improving final recanalization compared to standard projections, without increasing the overall procedural time.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"8-16"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10372045","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":"FLAIR hyperintense vessels on MRI post brain arteriovenous malformation embolization: A novel finding associated with post-procedure intraparenchymal hemorrhage.","authors":"Timothy G White, Kevin A Shah, Madison Fraser, Justin Turpin, Ina Teron, Thomas W Link, Amir R Dehdashti, Henry H Woo","doi":"10.1177/15910199221146585","DOIUrl":"10.1177/15910199221146585","url":null,"abstract":"<p><strong>Introduction: </strong>Brain arteriovenous malformations (BAVMs) are frequently managed by endovascular embolization with a growing number of centers embolizing with intent to cure. Hemorrhage post-embolization is a severe and poorly understood complication. We present a novel imaging finding associated with post-embolization hemorrhage that has significantly impacted the management of patients at our institution.</p><p><strong>Methods: </strong>A retrospective review of all patients undergoing embolization of BAVM at a single center was performed. Post-embolization magnetic resonance imaging (MRI) was reviewed for the presence of T2 fluid-attenuated inversion recovery (FLAIR) hyperintense vessels (FHVs). Bivariate analysis was performed to determine associations between patient characteristics and risk of hemorrhage.</p><p><strong>Results: </strong>A total of 50 patients underwent 75 embolization procedures. Forty-six post-embolization MRIs were available for review. There were four hemorrhages and 100% of those presented with FHV. In contrast, only 11.9% of embolization procedures without post-procedural hemorrhage had FHVs on MRI. In total, 18.7% of embolizations led to some morbidity or mortality, with only 6.7% leading to permanent morbidity or mortality. In bivariate analysis, only the presence of FHVs was correlated with the risk of hemorrhage (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>This is the first series to describe the finding of hyperintense blood vessels on FLAIR imaging after embolization of BAVMs and correlate it with hemorrhage post embolization. This finding can help guide practitioners and potentially identify patients at risk of delayed hemorrhage post embolization.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"17-23"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10445307","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":"Automated estimation of ischemic core volume on noncontrast-enhanced CT via machine learning.","authors":"Iris E Chen, Brian Tsui, Haoyue Zhang, Joe X Qiao, William Hsu, May Nour, Noriko Salamon, Luke Ledbetter, Jennifer Polson, Corey Arnold, Mersedeh BahrHossieni, Reza Jahan, Gary Duckwiler, Jeffrey Saver, David Liebeskind, Kambiz Nael","doi":"10.1177/15910199221145487","DOIUrl":"10.1177/15910199221145487","url":null,"abstract":"<p><strong>Background: </strong>Accurate estimation of ischemic core on baseline imaging has treatment implications in patients with acute ischemic stroke (AIS). Machine learning (ML) algorithms have shown promising results in estimating ischemic core using routine noncontrast computed tomography (NCCT).</p><p><strong>Objective: </strong>We used an ML-trained algorithm to quantify ischemic core volume on NCCT in a comparative analysis to pretreatment magnetic resonance imaging (MRI) diffusion-weighted imaging (DWI) in patients with AIS.</p><p><strong>Methods: </strong>Patients with AIS who had both pretreatment NCCT and MRI were enrolled. An automatic segmentation ML approach was applied using Brainomix software (Oxford, UK) to segment the ischemic voxels and calculate ischemic core volume on NCCT. Ischemic core volume was also calculated on baseline MRI DWI. Comparative analysis was performed using Bland-Altman plots and Pearson correlation.</p><p><strong>Results: </strong>A total of 72 patients were included. The time-to-stroke onset time was 134.2/89.5 minutes (mean/median). The time difference between NCCT and MRI was 64.8/44.5 minutes (mean/median). In patients who presented within 1 hour from stroke onset, the ischemic core volumes were significantly (p  =  0.005) underestimated by ML-NCCT. In patients presented beyond 1 hour, the ML-NCCT estimated ischemic core volumes approximated those obtained by MRI-DWI and with significant correlation (<i>r</i>  =  0.56, p < 0.001).</p><p><strong>Conclusion: </strong>The ischemic core volumes calculated by the described ML approach on NCCT approximate those obtained by MRI in patients with AIS who present beyond 1 hour from stroke onset.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"32-41"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10440669","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":"Prehospital technologies for early stroke detection - A review.","authors":"Deepsha Agrawal, Permesh Dhillon, Isabel Siow, Keng Siang Lee, Oliver Spooner, Leonard Yeo, Pervinder Bhogal","doi":"10.1177/15910199231152372","DOIUrl":"10.1177/15910199231152372","url":null,"abstract":"<p><p>The rate of neural circuitry loss in a typical large vessel occlusion well emphasizes that 'Time is Brain'. Every untreated minute in a large vessel ischaemic stroke results in loss of 1.9 million neurons and 13.8 billion synapses. As such, it is essential to optimize the flow-limiting steps in delivering the current standard of care. The current diagnostic model involves recognition of symptoms by patients, followed by access to Emergency Medical Services and subsequent physical examination and neuroimaging in the Emergency Department. With more than 50% of stroke patients using Emergency Medical Services as the first point of care contact, it can be deduced that the outcome of the 'stroke chain of survival' can be improved by addressing the bottleneck of prehospital stroke diagnosis. Here we present a review of the existing technologies.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"114-120"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10536869","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":"Flex vs. Vantage Pipeline™ Flow Diverters: Technical analysis in treating complex fusiform basilar artery aneurysm.","authors":"Harsh Desai, Sonam Thind, Rami Z Morsi, Sachin A Kothari, Lina Karar, Ahmad Chahine, Jehad Zakaria, Tareq Kass-Hout","doi":"10.1177/15910199241311074","DOIUrl":"10.1177/15910199241311074","url":null,"abstract":"<p><p>We present a case of an adult patient with a large symptomatic fusiform basilar artery aneurysm. This video demonstrates the ease of deploying the new Pipeline™ Vantage Flow Diverter compared to the Flex model in the same vessel. The Flex and Vantage have different deployment techniques-as using the Flex maneuvering technique on the Vantage may damage the braid. The Vantage stent does not require resheathing, dragging, or system loading. The video shows the operator's hands making multiple adjustments to deploy the Flex, while they deploy two Vantage stents and a LOBO^® device occluder before fully deploying the Flex. The Vantage appears to offer a simpler, more streamlined deployment process of mostly unsheathing compared to the Flex flow diverter. Also, the Vantage design might offer a higher aneurysmal occlusion rate with a shorter course of anti-platelet regimen.¹ Of note, the Pipeline™ Shield may be a more appropriate option in some cases.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241311074"},"PeriodicalIF":1.7,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070815","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 relative cerebral blood volume (rCBV) < 42% is independently associated with hemorrhagic transformation in anterior circulation large vessel occlusion.","authors":"Dhairya A Lakhani, Aneri B Balar, Subtain Ali, Musharaf Khan, Hamza A Salim, Manisha Koneru, Sijin Wen, Richard Wang, Janet Mei, Argye E Hillis, Jeremy J Heit, Gregory W Albers, Adam A Dmytriw, Tobias D Faizy, Max Wintermark, Kambiz Nael, Ansaar T Rai, Vivek S Yedavalli","doi":"10.1177/15910199241308322","DOIUrl":"https://doi.org/10.1177/15910199241308322","url":null,"abstract":"<p><strong>Background: </strong>Pretreatment CT perfusion (CTP) marker relative cerebral blood volume (rCBV) < 42% lesion volume has recently shown to predict poor collateral status and poor 90-day functional outcome. However, there is a paucity of studies assessing its association with hemorrhagic transformation (HT). Here, we aim to assess the relationship between rCBV < 42% lesion volume with HT.</p><p><strong>Methods: </strong>In this retrospective study, we included patients with acute ischemic stroke secondary to large vessel occlusion (AIS-LVO) of anterior circulation who had successful recanalization from two comprehensive stroke centers between 9/1/2017 and 10/01/2023. Successful recanalization was defined as modified treatment in cerebral infarction (mTICI) 2b or greater. Logistic regression analysis and ROC analysis were used to assess the relationship between rCBV <42% and HT.</p><p><strong>Results: </strong>In total, 150 patients (median age: 69 years, 58.7% female) met our inclusion criteria. On multivariable logistic regression analysis, taking into account age, sex, hypertension, hyperlipidemia, diabetes, prior stroke or transient ischemic attack, admission National Institute of Health stroke scale (NIHSS), Alberta Stroke Program Early CT Score (ASPECTS), and intravenous thrombolysis, rCBV <34% (aOR:1.01, <i>P</i> < .05), rCBV <38% (aOR:1.01, <i>P</i> < .05) and rCBV <42% (aOR:1.01, <i>P</i> < .05) lesion volumes were independently associated with HT. On ROC analysis rCBV < 42% (AUC = 0.61, <i>P</i> < .05) performed slightly better than rCBV < 38% (AUC = 0.59, <i>P</i> < .05) and rCBV < 34% (AUC = 0.59, <i>P</i> < .05) in predicting HT.</p><p><strong>Conclusion: </strong>The rCBV <42% lesion volume is independently associated with HT in AIS-LVO patients who underwent successful recanalization.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241308322"},"PeriodicalIF":1.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948459","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":"Macrowire for intracranial thrombectomy: An early experience of a new device and technique for anterior circulation large vessel occlusion stroke.","authors":"Kaustubh Limaye, Sami Al Kasab, Jaidevsinh Dolia, Mohamad Ezzeldin, Daniel Vela Duarte, Vinodh Doss, Sourabh Lahoti, David Hasan, Alejandro Spiotta, Khaled Asi, Vasu Saini, Tapan Mehta, Ameer Hassan, Diogo Haussen, Dileep Yavagal, Jesse Jones, Omar Tanweer, Waleed Brinjikji","doi":"10.1177/15910199241308328","DOIUrl":"10.1177/15910199241308328","url":null,"abstract":"<p><strong>Background and purpose: </strong>Mechanical thrombectomy (MT) has become the standard of care for treatment of acute ischemic stroke secondary to large vessel occlusion up to 24 h from the last known normal time. With ADAPT and SOLUMBRA techniques, classically, a large bore aspiration catheter is delivered over a microcatheter and microwire crossing the clot to perform thrombectomy. Recently, a novel macrowire (Colossus 035 in.) has been introduced as a potential alternative to the use of microwire-microcatheter to allow the delivery of the aspiration catheter (ID = 0.070 in. up to 0.088 in.) over a macrowire alone.</p><p><strong>Objective: </strong>To test the feasibility of delivering an aspiration catheter to clot interface over a macrowire alone.</p><p><strong>Materials and methods: </strong>A retrospective evaluation of prospectively maintained Macrowire for Intracranial Thrombectomy (MINT) Registry where this novel technique was utilized for thrombectomy. Consecutive patients undergoing MT using the MINT technique were included. We collected baseline demographics, imaging and clinical characteristics, rate of procedural success, conversion to traditional MT, and complications.</p><p><strong>Results: </strong>Fifty consecutive patients were recruited during the initial 4 months of the larger study duration. The aspiration catheter was able to be advanced to the clot interface successfully in 46/50 (92%) using the MINT technique. Median time from vascular access to the first pass was 11.30 min (IQR = 7.45-14.30 min) and successful thrombectomy was 14 min (IQR = 10-22.15). The modified first-pass effect with this procedure was 71%. One vasospasm was reported as a procedural complication.</p><p><strong>Conclusions: </strong>MINT is safe and feasible for large vessel occlusion recanalization based on our initial clinical experience in this multicenter study.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241308328"},"PeriodicalIF":1.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846501","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":"Macrowire for Intracranial Thrombectomy: A Video Description.","authors":"Arjun B Kumar, Usama Khan, Kaustubh Limaye","doi":"10.1177/15910199241308318","DOIUrl":"10.1177/15910199241308318","url":null,"abstract":"<p><p>Mechanical thrombectomy has become the cornerstone to achieve reperfusion in large vessel occlusion causing acute ischemic stroke. Since the advent of intracranial thrombectomy, the procedural setup has been to deliver aspiration catheter over microwire and microcatheter to the intracranial occlusion (ADAPT) or to deliver the stent-retriever through the microcatheter (SOLUMBRA) to perform thrombectomy.¹ In both these techniques the quintessential aspect is crossing the clot/thrombus, which increases the chances of clot fragmentation or disruption.² We demonstrate delivering an ultra-large bore (Sofia 0.088, Microvention, Aliso Viejo, CA, USA) to the intracranial occlusion over a macrowire (Aristotle Colossus OD: 0.035' × 200 cm, Scientia Vascular, UT, USA) alone with no use of microcatheter or microwire. The utilization of macrowire to perform thrombectomy provides enough support to guide the large or ultra large bore catheter to the clot interface without the need to cross the clot. As this technique involves no crossing of clot it prevents clot disruption and distal embolization. There are other possible benefits which are under study in MINT Registry³ and include making thrombectomy more time and cost efficient.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241308318"},"PeriodicalIF":1.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846560","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}