Interventional Neuroradiology最新文献

{"title":"Chronic subdural hematoma: What precisely are we treating?","authors":"Yang Qiao, Sáfa Alkarawi, Vincent E Provasek, Yi Jonathan Zhang, Samuel Tsappidi, Ferdinand Hui","doi":"10.1177/15910199241263633","DOIUrl":"10.1177/15910199241263633","url":null,"abstract":"<p><p>Subdural hematoma (SDH) refers to the collection of blood between the dura matter and the arachnoid membrane. Advancements in imaging technology have enabled the categorization of SDH based on specific imaging characteristics, causative factors, and the onset of symptoms. Given that the prognosis of SDHs varies significantly and is contingent upon the size and chronicity of the hemorrhage, a comprehensive understanding of its subtypes may carry crucial treatment implications. For example, an acute SDH classically results from severe traumatic brain injury and appears as a homogenous, crescent-shaped hyperdense extra-axial collection. If not treated, over the course of 1-3 weeks, this hematoma will evolve into a sub-acute phenotype as a consequence of subdural effusion and demonstrate mixed-density hemorrhage on imaging. Chronic SDH (cSDH) becomes the end result of an untreated SDH, with neo-membranization and neo-angiogenesis from branches of the middle meningeal artery driving a mass-like growth pattern. This review article aims to elucidate the complex anatomical features of the end-stage cSDH, with a particular focus on reconceptualization of this entity based on its mass-like growth patterns, and how this is driving a shift towards endovascular treatment.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"1948-1953"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734117","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":"Atypical telencephalic reflux pattern in a cavernous sinus dural AV fistula related to an anatomical variation of the basal vein of Rosenthal.","authors":"Shigeta Miyake, Tze P Kee, Andrew Falzon, Hugo Andrade, Timo Krings","doi":"10.1177/15910199241260758","DOIUrl":"10.1177/15910199241260758","url":null,"abstract":"<p><p>Cavernous sinus dural arteriovenous fistula can cause cerebral edema and hemorrhage due to cortical venous reflux and congestion. Understanding complex venous reflux and drainage routes is crucial for treatment planning. Here, we present a case of a cavernous sinus dural arteriovenous fistula with cortical venous reflux via two separate terminations of the telencephalic veins caused by an aplastic basal vein of Rosenthal. The patient presented with diplopia and eye redness and was diagnosed with a Cognard type IIa + b cavernous sinus dural arteriovenous fistula. The shunt was supplied by the dural branches of the internal and external carotid arteries. Multiple shunt points involving the intercavernous sinus and the medial aspect of the left cavernous sinus were identified, with drainage into the supraorbital and intracranial veins, including two separate terminations of the telencephalic veins, one leading to the laterocavernous sinus via the superficial middle cerebral vein and the other to the cavernous sinus via the uncal vein, resulting in basal ganglia venous congestion in the absence of the basal vein of Rosenthal. During transvenous embolization, the intracranial veins, cavernous sinus, and intercavernous sinus were obliterated using a double-catheter technique with a combination of coils and liquid embolics. Telencephalic venous variations can lead to cavernous sinus drainage into the basal ganglia and orbitofrontal brain. This unique drainage pattern underscores the importance of recognizing anatomical variations when managing cavernous sinus dural arteriovenous fistula.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2008-2014"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283638","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":"Pure arterial malformation of the fetal PCA treated with flow diverter stent-case report and literature review.","authors":"Bilandzic Josko, Rotim Kresimir, Rotim Ante, Rotim Nina, Culo Branimir, Kalousek Vladimir","doi":"10.1177/15910199241272602","DOIUrl":"10.1177/15910199241272602","url":null,"abstract":"<p><p>IntroductionThirty-three-year-old female underwent diagnostic work-up for chronic headaches.Case reportCerebral DSA on the right side showed fetal posterior cerebral artery (PCA) with unusually shaped arterial malformation on its proximal part. Malformation was formed by multiple convolutions and loops with no arteriovenous shunting. During endovascular procedure, flow diverter stent was placed in the right C6 segment. Patient was put on double antiaggregation therapy. Four weeks after procedure, patient was admitted to ER with signs of dyphasia. No recent ischemic lesions were detected on emergent magnetic resonance. Dyphasia resolved spontaneously. On follow-up magnetic resonance angiography 5 years after the procedure, main portion of malformation has diminished with slightly filling of posterior part supplied by right P1.DiscussionHere, reported finding is consistent with previously described pure arterial malformation (PAM). Main intention of our treatment was to induce malformation remodeling with flow diverter placement. Two main risks arise when using flow diverters on fetal PCA region. Firstly, there is possibility of occluding fetal PCA alongside malformation. On the contrary, high flow through fetal PCA could hinder malformation thrombosis. Some case series reported high rate of fetal PCA occlusion without ischemic sequelae in the PCA teritory. Others consider flow diverters highly ineffective treatment for the fetal PCA aneurysms due to low rate of complete aneurysm occlusion.ConclusionWe presented first reported case in which flow diverter was used to treat PAM. Slow malformation thrombosis leaves enough time for collateral circulation to recruit and supply territory of the vessel affected by the malformation.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2021-2024"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901753","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":"Middle meningeal artery embolization with standalone or adjunctive coiling for treatment of chronic subdural hematoma: Systematic review and meta-analysis.","authors":"Haydn Hoffman, Jason J Sims, Christopher Nickele, Violiza Inoa, Lucas Elijovich, Nitin Goyal","doi":"10.1177/15910199241304852","DOIUrl":"10.1177/15910199241304852","url":null,"abstract":"<p><p>IntroductionMiddle meningeal artery embolization (MMAe) is increasingly utilized as a primary or secondary treatment for chronic subdural hematoma (cSDH) and is usually performed with liquid embolics or particles. Outcomes after MMAe with coiling as a standalone treatment, or an adjunct to other agents, have not been reviewed.MethodsA systematic review of the literature was performed to identify all original research that included patients who underwent standalone or adjunctive coiling for MMAe. The primary outcome was the need for rescue treatment defined as any unplanned reintervention for recurrent or residual cSDH.ResultsA total of 10 studies comprising 346 patients (mean age 73 years, 39% female) who underwent MMAe with coils were included. The majority of embolizations were with coils and particles (<i>n</i> = 176), followed by standalone coiling (137) and coiling with liquid embolics (120). The pooled rate of rescue treatment after embolization was 9.4% (95% CI 6.4-13.6, <i>I</i>²= 0). The pooled complication rate was 2.6% (95% CI 1.3-5.1, <i>I</i>²= 0). In the subgroup analysis of four studies reporting results after standalone coiling, the pooled rescue treatment rate was 8.2% (95% CI 4.0-15.9, <i>I</i>²= 0) and there were no complications.ConclusionMMAe with coils is safe and potentially effective, but additional studies evaluating long-term clinical and radiographic results after standalone coiling are needed.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"1806-1814"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813047","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":"Experimental evaluation of the plunger technique: A method of cyclic manual aspiration thrombectomy for treatment of acute ischemic stroke.","authors":"Demitria A Poulos, James S Keith, Michael T Froehler, Bryan C Good","doi":"10.1177/15910199241230364","DOIUrl":"10.1177/15910199241230364","url":null,"abstract":"<p><p>BackgroundMechanical thrombectomy via direct aspiration is a rapid treatment for acute ischemic stroke. This method often results in the partial ingestion of the clot or \"corking\" of the catheter tip. Cyclic aspiration may take advantage of the mechanical properties of the clot, resulting in greater clot ingestion and overall procedure success.MethodsAn <i>in vitro</i> analysis was performed comparing static and cyclic (plunger technique) aspiration. Embolus analogs were used to create occlusions in a mock circulatory flow loop, and one aspiration attempt (first pass effect) using either a static or plunger technique was performed. The percent ingestion of each embolus analog was recorded for each trial.ResultsStatic aspiration for 0% and 50% hematocrit embolus analogs resulted in ingestions of 12.8 ± 4.6% and 15.1 ± 10.0%, respectively, while plunger technique (cyclic) aspiration resulted in 15.8 ± 7.3% and 34.4 ± 19.5% ingestion. Complete ingestion was observed only with 50% hematocrit analogs, occurring in 30% of plunger and 10% of static cases. Statistical differences were determined between the two aspiration techniques for the 50% hematocrit samples, with the plunger technique yielding significantly more ingestion. In addition, the plunger technique was shown to maintain a negative vacuum pressure throughout the duration of cyclic plunging.ConclusionsThe plunger technique for manual cyclic aspiration resulted in higher rates of complete ingestion and greater average % ingestions when compared to static aspiration. Increased clot ingestion can result in a higher rate of complete reperfusion during the first aspiration attempt, maximizing the number of patients with good clinical outcomes.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"1225-1231"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697405","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":"Endovascular treatment simulations using a novel <i>in vitro</i> brain arteriovenous malformation model based on three-dimensional printing millifluidic technology.","authors":"Rodrigo Rivera, Alvaro Cespedes, Juan Pablo Cruz, Gladys Carlota Rivera, Alvaro Valencia, Aymeric Rouchaud, Charbel Mounayer","doi":"10.1177/15910199231184605","DOIUrl":"10.1177/15910199231184605","url":null,"abstract":"<p><p>BackgroundBrain arteriovenous malformations (bAVM) are complex vascular diseases. Several models have been used to simulate endovascular treatments; thus <i>in vitro</i> models have not been widely employed because it has been difficult to recreate realistic phantoms of this disease.ObjectiveTo describe the development and evaluate the preliminary experience of a novel bAVM <i>in vitro</i> model for endovascular embolization using millifluidic three-dimensional (3D) printing technology.MethodsWe designed a bAVM phantom starting from simple to more complex designs, composed of a nidus, feeding arteries and draining vein. We recreate the design by using millifluidic technology with stereolithography 3D printing. Structural and functional tests were performed using angiographic images and computer flow dynamics. Treatment simulations with ethylene vinyl alcohol were tested using two different microcatheter position techniques. A Likert-scale questionnaire was applied to perform a qualitative evaluation of the model.ResultsWe developed a realistic model of a bAVM with hollow channels. The structural evaluation showed a high precision of the 3D printing process. Embolization tests with the liquid agent gave similar sensations and material behaviour as <i>in vivo</i> cases. There were no significant differences between microcatheter position techniques, thus we observed a trend for better nidus filling with a deeper in-nidus position technique.ConclusionsWe were able to create and test a novel bAVM <i>in vitro</i> model with stereolithography 3D printing in resin. It showed a high capacity for simulating endovascular embolization characteristics, with an excellent user experience. It could be potentially used for training and testing of bAVM embolizations.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"1342-1349"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9677318","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 D-dimer on the outcomes of endovascular thrombectomy for acute ischemic stroke: A systematic review and meta-analysis.","authors":"Abdullah Reda, Sherief Ghozy, Mohamed Elfil, Eris Spirollari, Aryan Gajjar, Fawaz Al-Mufti","doi":"10.1177/15910199241289628","DOIUrl":"10.1177/15910199241289628","url":null,"abstract":"<p><p>BackgroundThere has been growing data about the association between D-dimer levels and thrombectomy outcomes in acute ischemic stroke patients (AIS) with no cumulative evidence. This systematic review and meta-analysis aim to discuss and analyze the findings of the current studies to provide more robust evidence in this regard.MethodsA systematic search was conducted through PubMed, Web of Science, Embase, and Scopus to retrieve all relevant investigations. A meta-analysis was conducted, and the results were presented in odds ratio (ORs) for binary variables and ratio of means (ROM) for continuous variables, each accompanied by its respective 95% confidence intervals (CIs).ResultsAfter searching and screening, 14 studies were included. The analysis showed that the low D-dimer group had significantly higher rates of favorable functional outcome (OR: 4.40; 95%CI: 2.65-7.30; <i>p</i> < 0.001, n = 3) and recanalization (OR: 4.13; 95%CI: 1.57-10.84; <i>p</i> = 0.004, n = 3) than the high one. The association between D-dimer levels and first-pass effect and re-occlusion risk was also demonstrated. Eventually, two studies also demonstrated a significant association between high D-dimer levels and deep venous thrombosis and symptomatic intracranial hemorrhage as post-thrombectomy complications.ConclusionCurrent evidence indicates a significant association between D-dimer levels and post-thrombectomy outcomes in AIS patients. However, current data are remarkably heterogeneous, and additional comparative investigations are needed.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"1775-1785"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465508","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":"Delayed appearance of basilar trunk small atypical aneurysms in nontraumatic, initially angiogram-negative subarachnoid hemorrhage: A report of three patients.","authors":"William C Johnson, Matthew R Webb, Jonathan W Espinosa, Lee A Birnbaum, Pavel Rodriguez, Justin R Mascitelli","doi":"10.1177/15910199231151274","DOIUrl":"10.1177/15910199231151274","url":null,"abstract":"<p><p>BackgroundRepeat angiography will identify vascular pathology in approximately 10% of cases following angiogram-negative subarachnoid hemorrhage (anSAH), but small atypical aneurysms of the basilar artery are very uncommon.ObjectiveTo report a case series of delayed appearance of nontraumatic basilar artery small atypical aneurysms.MethodsIRB approval was obtained for this retrospective case series and patient consent was waived.ResultsHerein we report three cases of spontaneous anSAH, all of whom had a negative digital subtraction angiogram (DSA) on admission and all of whom had appearance of a small atypical aneurysms of the upper basilar trunk/apex on follow-up imaging (two during the initial admission and one in a delayed fashion). All three patients were ultimately treated with flow diversion (although one patient underwent attempted coiling that was abandoned due to inability to catheterize the aneurysm).ConclusionThis report highlights the importance of a repeat DSA in cases of anSAH as well as the importance of scrutinizing the basilar trunk for these very small atypical aneurysms that may go unnoticed.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"1990-1997"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10548866","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 sinus stenting for management of spontaneous skull-base CSF leaks: A systematic review and meta-analysis.","authors":"Jordan M Rasmussen, Kautilya R Patel, Daniel L Surdell, William E Thorell, Nicholas Borg, Patrick J Opperman, Geoffrey Casazza, Anne K Maxwell, Christie Barnes, Samuel Pate, Cindy M Schmidt, Mithun G Sattur","doi":"10.1177/15910199241311626","DOIUrl":"10.1177/15910199241311626","url":null,"abstract":"<p><p>BackgroundIdiopathic intracranial hypertension (IIH) is strongly associated with spontaneous skull-base cerebrospinal fluid (CSF) leaks. Venous sinus stenting (VSS) has proven effective for the treatment of IIH. Hence, its role in spontaneous skull-base CSF leaks is being explored actively.MethodsWe performed a systematic literature search across EMBASE, MEDLINE, Scopus, The Cochrane Library, and Google Scholar to identify studies reporting the use of VSS for spontaneous skull-base CSF leaks. Studies with pediatric patients, non-English articles, and nonspontaneous leaks were excluded. Failure of treatment (persistence / recurrence of CSF leak) was regarded as the primary outcome.ResultsEight studies with 62 patients undergoing VSS for spontaneous skull-base CSF leaks were included. Mean age of the patients was 51.9 years; 87.5% were females. Obesity was highly prevalent, with a mean body mass index of 33.9 kg/m² (4 studies). IIH was noted in 74.6% patients (7 studies). Twenty-six patients (41.9%) underwent VSS alone whereas 36 patients (58.1%) underwent surgical repair + VSS. Seven patients (11.3%) had a failure of treatment. Three failures from one study could not be definitively ascribed to either of the groups. Hence, the estimated failure rate for VSS alone ranged from 18.6% (95% CI [0.02 - 0.46]) to 26.4% (95% CI [0.11 - 0.46]), whereas that for surgical repair + VSS ranged from 5.5% (95% CI [0.00 - 0.16]) to 12.2% (95% CI [0.01 - 0.32]). Furthermore, the estimated rate for resolution of concomitant IIH-related symptoms was 88.7% (95% CI [0.75 - 0.98%]). Majority of the studies did not report any serious complications or mortality related to VSS.ConclusionVSS has a potential role in the management of spontaneous skull-base CSF leaks. Its exact indications as a standalone treatment versus as an adjuvant to surgical repair, and the predictors for successful treatment remain to be defined.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"1843-1851"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364345","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":"Synthetic hair extensions and radiation dose during cranial angiographic procedures.","authors":"Osama Intikhab, Erin Elliott, Jessica Scudder, Abhay Moghekar, Philippe Gailloud","doi":"10.1177/15910199241276682","DOIUrl":"10.1177/15910199241276682","url":null,"abstract":"","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2036-2037"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008781","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}