Interventional Neuroradiology最新文献

{"title":"The significance of stent sizing for parent vessel stenosis after flow diversion of MCA bifurcation aneurysms.","authors":"Svetozar Matanov, Georgi Vladev, Alexander Sirakov, Kristian Ninov, Marin Penkov, Hristo Tsonev, Kristina Sirakova, Vasil Karakostov, Stanimir Sirakov","doi":"10.1177/15910199241285503","DOIUrl":"10.1177/15910199241285503","url":null,"abstract":"<p><strong>Background: </strong>Wide-necked bifurcation aneurysms (WNBA) of the middle cerebral artery (MCA) present significant therapeutic challenges. Flow-diverter stents have been increasingly adopted for their management, though they may give rise to adverse outcomes such as in-stent stenosis (ISS). This study explores the association between stent oversizing and the incidence of ISS following flow-diverter stent placement in MCA bifurcation aneurysms.</p><p><strong>Methods: </strong>A retrospective study included 34 patients who underwent flow-diverter stent placement for MCA bifurcation aneurysms between 2020 and 2023. Data on patient demographics, aneurysm morphology, and stent sizing were collected. ISS was evaluated through follow-up imaging at 6-month post-procedure. Stent oversizing was determined by calculating the difference between the stent diameter and the proximal and distal parent vessel diameters. Statistical analyses included Pearson correlation and chi-square tests, with significance established at <i>p</i> < 0.05.</p><p><strong>Results: </strong>The studied group had a mean age of 57.8 years, with 81.6% female patients. The average aneurysm neck size was 3.6 mm, with a mean dome-to-neck ratio of 1.6. ISS was detected in 64.7% of cases proximally and 88.2% distally. A statistically significant negative correlation (<i>r</i> = -0.496, <i>p</i> = 0.003) was observed between stent oversizing and ISS, indicating that increased stent oversizing was associated with a higher incidence of ISS, particularly in the distal vessel segments.</p><p><strong>Conclusion: </strong>The findings indicate that stent oversizing is significantly associated with the development of ISS in MCA bifurcation aneurysms treated with flow-diverter stents. Careful consideration of stent sizing, particularly minimizing oversizing in distal segments, may mitigate the risk of ISS and improve clinical outcomes. These results underscore the importance of meticulous stent selection and procedural planning in neurointerventional practice.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241285503"},"PeriodicalIF":1.7,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346736","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":"Trans-Clot MAP gradient: A novel innovative technique during thrombectomy for acute ischemic stroke with potential applications for assessing collateral circulation, determining clot etiology, informing device selection, and predicting first-pass success.","authors":"Amit Chaudhari, Mohammad Al Majali, Eugene I Lin, Osama O Zaidat","doi":"10.1177/15910199241286547","DOIUrl":"10.1177/15910199241286547","url":null,"abstract":"<p><p>Endovascular mechanical thrombectomy has significantly improved recovery in acute ischemic stroke (AIS). While traditional patient selection has relied on factors such as last known well and penumbra volume, emerging research highlights the importance of collateral circulation in influencing thrombectomy success. However, current methods to assess collateral circulation are often unreliable and lack standardization, limiting their integration into clinical decision-making and prompting the need for innovative approaches. This study introduces trans-clot manometry as a promising approach for quantitatively assessing collateral blood flow before thrombectomy. Two patients were included in this study: a 64-year-old female with a left M1 near-complete occlusion and an 81-year-old male with a left P1 occlusion. After receiving intravenous tenecteplase, each patient underwent emergent thrombectomy where intraoperative trans-clot manometry revealed significant trans-clot mean arterial pressure (MAP) gradients (66.7% for Patient 1 and 96.9% for Patient 2). Both patients had successful first-pass thrombectomy (Patient 1: TICI 3; Patient 2: TICI 3), with substantial clinical improvement (Patient 1: NIHSS 11 to 1; Patient 2: NIHSS 19 to 8). Intraoperative trans-clot manometry offers a simple yet powerful, objective, and generalizable measure of collateral circulation, applicable to a wide range of AIS cases regardless of clot location or vessel size. In addition, real-time correlations with heart-rate variability and radial artery pressures provide an intrinsic quality control, ensuring proper execution of the technique and accuracy of the resulting MAP gradient. Future research will focus on validating this approach, determining its generalizability, and establishing MAP gradient thresholds to enhance device selection and predict first-pass success.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241286547"},"PeriodicalIF":1.7,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346737","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":"Arterial spin labeling detects trapped labeled spins in flow-diverted aneurysms and it reflects intra-aneurysmal flow stasis.","authors":"Tatsuya Oki, Atsushi Tsuji, Shota Ishida, Jun Matsubayashi, Kazumichi Yoshida, Yoshiyuki Watanabe","doi":"10.1177/15910199241286130","DOIUrl":"10.1177/15910199241286130","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated arterial spin labeling (ASL) imaging findings in flow-diverted aneurysms (FD-ANs).</p><p><strong>Methods: </strong>Twenty-one patients with internal carotid artery aneurysms treated with flow-diverter stent (FDS) were included. Time-of-flight magnetic resonance angiography (TOF-MRA) and ASL were performed before and after follow-up digital subtraction angiography (DSA) on the day, 6 months, and/or 1 year after treatment. Two radiologists rated the clarity of the depiction of FD-ANs for MRA on a 3-point scale and the ASL signal intensity of the aneurysm as negative or positive. A neurosurgeon assessed DSA findings using the O'Kelly-Marotta (OKM) grading scale, categorizing them into filling and stasis grades. The 23 examinations were classified according to the OKM grading scale, and the proportion of ASL-positive cases and the proportion of cases with MRA scores of 1-2 (detectable) were calculated for each grade. The relationship between the OKM grading scale and ASL positivity or MRA detectable was examined using Fisher's exact test.</p><p><strong>Results: </strong>Of seven examinations where the statis grade was 1 or 2, no examinations showed ASL positivity. However, among the 16 examinations in which the stasis grade was 3, 9 examinations showed ASL positivity. A significant association was observed between stasis grade and ASL positivity (<i>p </i>= 0.035). In contrast, no significant relationship was observed between the OKM grading scale and the MRA 3-point scale.</p><p><strong>Conclusion: </strong>High-signal ASL in FD-ANs could reflect stasis within the aneurysm; therefore, noninvasive ASL can indicate reduction in intra-aneurysmal blood flow after treatment and reperfusion during posttreatment observation.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241286130"},"PeriodicalIF":1.7,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346730","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":"Shining light on neurovascular disease.","authors":"Adnan H Siddiqui, Tommy Andersson","doi":"10.1177/15910199241285962","DOIUrl":"10.1177/15910199241285962","url":null,"abstract":"<p><p>Tortuosity and fragility of the intracranial vasculature have precluded the application of novel intravascular imaging modalities during the treatment of cerebrovascular pathologies. In other circulatory beds, these technologies have transformed clinical and therapeutic decision-making. A new report demonstrates the clinical use of high-resolution intravascular imaging in the human cerebrovasculature using neuro optical coherence tomography. This technology provides an unprecedented opportunity to examine the luminal dimensions of cerebrovascular disease. We expect that the neurointerventional community will rapidly adopt this technology-similar to wider adoptions by other vascular specialties-for both a better understanding of underlying disease and clarity of endovascular therapeutic safety and effectiveness.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241285962"},"PeriodicalIF":1.7,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346734","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":"Radiographic predictors of neurologic outcomes in patients with basilar artery occlusion: A single-center experience.","authors":"Daryl Goldman, Mais Al-Kawaz, Preethi Reddi, Amol Mehta, Puneet Belani, Milad Shafizadeh, Stavrous Matsoukas, Christopher P Kellner, J Mocco, Johanna T Fifi, Shahram Majidi","doi":"10.1177/15910199241285581","DOIUrl":"10.1177/15910199241285581","url":null,"abstract":"<p><strong>Background: </strong>Randomized controlled trials indicate functional and mortality benefits in endovascular therapy for basilar artery occlusion (BAO). However, these studies only include patients who meet specific prognostic scores. This study investigates radiographic predictors of posterior circulation territory infarcts that may predict neurologic outcome at 90-day post-intervention.</p><p><strong>Methods: </strong>This is a retrospective cohort study of a prospectively maintained thrombectomy database of all patients who underwent mechanical thrombectomy for BAO. Baseline demographics, comorbidities, baseline functional status (mRS), and severity of presenting neurologic deficits (NIHSS) were collected. Pc-ASPECTS, posterior circulation collateral score (PCCS), and basilar artery on computed tomography angiography (BATMAN) measured radiographic characteristics. Core infarct territory was identified. Primary outcomes were good neurologic outcome (mRS 0-3) and poor neurologic outcome (mRS 4-6) at 90-day post-thrombectomy. 90-day mortality was a secondary outcome.</p><p><strong>Results: </strong>About 21.5% of patients achieved a good neurologic outcome. About 32.3% of patients were deceased at 90 days. Receiver operating characteristic analysis shows PCCS collateral scores (AUC = 0.74, SE = 0.03, CI = 0.62-0.74) and BATMAN (AUC = 0.72, SE = 0.04, CI = 0.35-0.49) have potential to differentiate between those with good neurologic outcome from those with poor neurologic outcome. Although there was no statistically significant difference in AUC between the three curves, pc-ASPECTS score trended toward being weaker predictor of neurologic outcome (AUC = 0.49, SE = 0.04, CI = 0.35-0.49). There were significant associations between 90-day poor neurologic outcome and established infarcts within the pons (<i>p</i> = 0.01), left cerebellum (<i>p</i> = 0.01), and left occipital lobe (<i>p</i> = 0.03) on pre-thrombectomy CT.</p><p><strong>Conclusion: </strong>Low BATMAN and PCCS collateral scores can be predictors of poor neurologic outcomes at 90-day post-thrombectomy for BAO while pc-ASPECTS score may be a weaker predictor of outcome.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241285581"},"PeriodicalIF":1.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287270","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":"Hemorrhagic versus non-hemorrhagic presentation of presumed reversible cerebral vasoconstriction syndrome (RCVS): Presentations and outcomes.","authors":"Adrusht Madapoosi, Laura Stone McGuire, Angelica Fuentes, Mpuekela Tshibangu, Peter Theiss, Tatiana Abou Mrad, Sepideh Amin-Hanjani, Ali Alaraj","doi":"10.1177/15910199241285501","DOIUrl":"https://doi.org/10.1177/15910199241285501","url":null,"abstract":"<p><strong>Introduction: </strong>Reversible cerebral vasoconstriction syndrome (RCVS) can present with hemorrhage, ischemia, or both. We aim to compare the differences in presentation and outcomes between patients with RCVS.</p><p><strong>Methods: </strong>The hemorrhagic presentation group had 58 patients, and the non-hemorrhagic presentations had 30 patients. Subgroup analysis compared patients with evidence of one or more types of hemorrhage (<i>n</i> = 53), no evidence of hemorrhage or infarction (<i>n</i> = 23), evidence of infarction only (<i>n</i> = 7), and combination of hemorrhage and infarction (<i>n</i> = 5). Clinical and radiographic data were analyzed.</p><p><strong>Results: </strong>Migraine (<i>p</i> = 0.030) and intracranial tumors (<i>p</i> = 0.004) were more frequent in non-hemorrhagic presentation. Seizures on admission (<i>p</i> = 0.047) and higher than average C-reactive protein (CRP) (<i>p</i> = 0.037) were seen at a higher rate in patients with hemorrhagic presentation. RCVS2 scores were not unexpectedly higher in patients with hemorrhage than non-hemorrhagic presentations (<i>p</i> = 0.010). Outcomes between the hemorrhagic and non-hemorrhagic groups were comparable. Subgroup analysis found a higher subset of patients with opiate use (<i>p</i> = 0.046) in the hemorrhage-only group. Patients with hemorrhage presented with a thunderclap headache (<i>p</i> < 0.001) more often when compared to the other three groups. RCVS2 score was not unexpectedly higher in the hemorrhage-only group compared with the other groups (<i>p</i> = 0.004).</p><p><strong>Conclusion: </strong>A history of migraines was associated with ischemia, while intracranial tumor was significantly associated with evidence of either an infarct, or no changes on imaging. Exposure to opiates, and seizures or thunderclap headache on presentation were associated with hemorrhage. If our data are reproducible, the RCVS2 score may benefit from inclusion of other, small hemorrhages as criterion for diagnosis for RCVS.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241285501"},"PeriodicalIF":1.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287258","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":"FreeClimb 88 catheter with Tenzing 8 delivery for contact aspiration mechanical thrombectomy of anterior circulation large vessel occlusions.","authors":"Matthew D Alexander, James Caldwell, Shane Sh Lee, Warren T Kim, Joey D English, Jaehyun Kim, Ben J McGuinness, Matthew Page, Nebiyat F Belachew, Jonathan A Grossberg, Daniel Tonetti, Jane Khalife, Hamza Shaikh, Omar Kass-Hout, Marco Colasurdo, Ryan Priest, Bahram Varjavand, Rajkamal S Khangura, Thymur A Chaudhry, Fabio Settecase","doi":"10.1177/15910199241284792","DOIUrl":"10.1177/15910199241284792","url":null,"abstract":"<p><strong>Purpose: </strong>Contact aspiration mechanical thrombectomy (CAMT) with 0.088-inch catheters may improve first-pass success rates, but delivery of such catheters can be challenging and limit effectiveness. This study examines the initial multicenter experience using the FreeClimb 88 catheter paired with the Tenzing 8 delivery catheter.</p><p><strong>Materials and methods: </strong>Retrospective analysis was performed of consecutive patients with large vessel occlusion (LVO) of the internal carotid artery (ICA) or M1 segment of the middle cerebral artery treated with off-label CAMT using the FreeClimb 88 and Tenzing 8 at eight sites participating in the early limited release for these devices. Demographic and procedural variables were collected and analyzed with descriptive statistics and multivariable analysis.</p><p><strong>Results: </strong>Fifty-three consecutive patients were treated. Large vessel occlusion was located in the ICA in 19/53 (35.8%) patients; 34/53 (64.2%) were in the M1 segment. FreeClimb 88 was successfully delivered to the site of occlusion in 50/53 (94.3%) of patients. First-pass TICI 2c or 3 was achieved with FreeClimb 88 delivered by Tenzing 8 in 36 (67.9%) cases. Among cases with successful FreeClimb 88 delivery 9/50 (18.0%) required additional smaller devices to perform thrombectomy of distal occlusions after recanalization of the initial LVO. No complications or symptomatic hemorrhages occurred following thrombectomy.</p><p><strong>Conclusion: </strong>Contact aspiration mechanical thrombectomy performed for ICA or M1 LVOs using FreeClimb 88 delivered with Tenzing 8 was safe, effective, and efficient in this early experience, with first-pass TICI 2c or 3 was achieved in 68% of patients without procedural complications occurring in any cases.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241284792"},"PeriodicalIF":1.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287257","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":"Pipeline embolization device as a standalone curative approach for recurrent sigmoid sinus DAVF.","authors":"Vera Sharashidze, Charlotte Chung, Peter Kim Nelson, Maksim Shapiro, Howard Riina, Erez Nossek, Eytan Raz","doi":"10.1177/15910199241282780","DOIUrl":"10.1177/15910199241282780","url":null,"abstract":"<p><p>Dural arteriovenous fistulas (dAVFs) can occur as complications after surgical procedures, especially following the resection of meningiomas near the dural sinus. This case report presents a 74-year-old male who developed a recurrent sigmoid dAVF following meningioma resection. Initially treated with transvenous embolization and middle meningeal artery embolization, the dAVF recurred with worsening clinical symptoms. Conventional treatment options, including sinus sacrifice and transarterial embolization, were unsuitable due to the critical role of the patient's dominant right sigmoid sinus in cerebral venous drainage. Consequently, a reconstructive approach was employed using a pipeline embolization device (PED) construct. The PED successfully occluded the dAVF while preserving the function of the sigmoid sinus. A follow-up angiogram confirmed stable occlusion and normalization of intracranial venous drainage. This case underscores the potential of flow diversion as a viable treatment option for dAVFs, particularly in scenarios where preserving venous sinus function is paramount.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241282780"},"PeriodicalIF":1.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287261","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":"Some minutes matter more: Groin-to-recanalization is the main time-related predictor of outcome in acute ischemic stroke.","authors":"Antonio De Mase, Emanuele Spina, Giovanna Servillo, Stefano Barbato, Giuseppe Leone, Flavio Giordano, Rosaria Renna, Angelo Ranieri, Walter Di Iorio, Massimo Muto, Gianluigi Guarnieri, Mario Muto, Paolo Candelaresi, Vincenzo Andreone","doi":"10.1177/15910199241282714","DOIUrl":"10.1177/15910199241282714","url":null,"abstract":"<p><strong>Introduction: </strong>Endovascular thrombectomy (EVT) is the standard of care for selected patients with acute ischemic stroke (AIS) and large vessel occlusion (LVO), associated with intravenous thrombolysis, when indicated. While many studies focused on pre-hospital and in-hospital pathways, only few analyzed the relationship between groin-to-recanalization (GTR) time and functional outcome.</p><p><strong>Aim: </strong>To explore whether GTR time is an independent predictor of outcome in patients undergoing EVT.</p><p><strong>Methods: </strong>All patients with anterior circulation stroke treated with EVT at a high-volume center from January 2021 to December 2023 were included. The cohort was divided into two groups according to GTR time shorter or longer than 30 min. Regression analysis assessed the association between GTR time and 3-month good outcome, defined as modified Rankin Scale 0-2.</p><p><strong>Results: </strong>The study included 419 patients. The groups had similar baseline characteristics and similar onset to recanalization (OTR) time. Regression analysis showed shorter GTR time is an independent predictor of favorable outcome (OR 2.49 [95% CI 1.26-4.94]). Age, baseline NIHSS, ASPECT score and bridging IVT were also found to be independently associated with outcome.</p><p><strong>Discussion and conclusions: </strong>Our study showed GTR time is an independent predictor of good outcome in patients undergoing EVT with similar OTR time, emphasizing procedural time as a key prognostic factor, even greater than other well-known pre-hospital and in-hospital time-dependent variables. These findings may raise the issue of developing alternative approaches or early \"rescue\" strategies for complicated procedures.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241282714"},"PeriodicalIF":1.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287271","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":"Comparison of the imaging performance of time-of-flight MRA and ultrashort echo time MRA in flow diverters: A phantom study.","authors":"Toshiya Akatsu, Akihiko Wada, Michimasa Suzuki, Haruyuki Fukuchi, Yutaka Ikenouchi, Nao Takano, Fumihiro Yagisawa, Kosuke Teranishi, Akira Ishii, Akihide Kondo, Shigeki Aoki","doi":"10.1177/15910199241285471","DOIUrl":"10.1177/15910199241285471","url":null,"abstract":"<p><strong>Objective: </strong>Flow diverters (FD) are innovative treatments for wide-neck intracranial aneurysms. After-treatment verification of embolization and parent vessel patency is crucial. While evaluation using time-of-flight magnetic resonance angiography (TOF-MRA) is useful, it suffers from signal loss within the FD due to susceptibility effects. This study evaluates the usefulness of ultrashort echo time MRA (UTE-MRA) for after-FD assessment compared to TOF-MRA.</p><p><strong>Methods: </strong>Vascular phantom experiments were conducted using FDs (FRED^®, Pipeline^®, Surpass Streamline^®). TOF-MRA and UTE-MRA were performed under steady (10, 30, 50 cm/s) and pulsatile (17-61 cm/s, mean 34 cm/s) flow conditions using a 3 T MRI system. As evaluation metrics, relative in-FD signal (RIS) was calculated by comparing the signal intensity inside the FD to that without the FD to assess signal retention, and FD luminal to background signal ratio (FD-LBR) was calculated by comparing the signal intensity inside the FD to that of the surrounding background to evaluate vessel visibility.</p><p><strong>Results: </strong>UTE-MRA showed higher FD-LBR values than TOF-MRA for all FDs (<i>p</i> < 0.01). For RIS, UTE-MRA was significantly higher for FRED^® (<i>p</i> < 0.01), but different for other FDs except at 50 cm/s. FRED^® exhibited the highest RIS and FD-LBR values under all conditions, followed by Pipeline^® and Surpass Streamline^®. Flow velocity changes resulted in minimal variations in RIS and FD-LBR values.</p><p><strong>Conclusion: </strong>UTE-MRA provides superior image quality for after-FD assessment, particularly in terms of FD-LBR, compared to TOF-MRA. Differences in FD materials and structures affect image quality. These findings suggest UTE-MRA's clinical utility in follow-up after-FD assessment.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241285471"},"PeriodicalIF":1.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287256","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}