Journal of NeuroInterventional Surgery最新文献

{"title":"Minimally invasive intracerebral hematoma evacuation: a difficult road, but a bright future.","authors":"Justin R Mascitelli, Mark D Bain, Christopher Paul Kellner","doi":"10.1136/jnis-2025-023941","DOIUrl":"https://doi.org/10.1136/jnis-2025-023941","url":null,"abstract":"","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of contrast induced encephalopathy: multicenter cohort study and proposed treatment algorithm.","authors":"Frederick P Mariajoseph, Leon T Lai, Adrian Praeger, Justin Moore, Ronil V Chandra, Hamed Asadi, Peter Fawzy, Laetitia de Villiers, Tony Goldschlager, Albert Ho Yuen Chiu, Boaz Kim, Ferdinand Miteff, Ramon Martin Francisco Bañez, Davor Pavlin-Premrl, Winston Chong, Robert Fang, Kate Mahady, Sophie Dunkerton, Brendan Steinfort, Bjoern Picker, Lee-Anne Slater","doi":"10.1136/jnis-2025-023611","DOIUrl":"https://doi.org/10.1136/jnis-2025-023611","url":null,"abstract":"<p><strong>Background: </strong>Contrast induced encephalopathy (CIE) is an increasingly recognized but uncommon complication of endovascular procedures. Despite increased reports, there is limited evidence to guide clinical management. We sought to identify commonly used treatments for CIE and propose management strategies to aid clinical decision making.</p><p><strong>Methods: </strong>A retrospective multicenter study was conducted across 10 neurovascular centers in Australia. Cases were included based on previously proposed diagnostic criteria for CIE. Clinical features, treatments, and outcomes were extracted and analyzed. Descriptive statistics were used to characterize management strategies, and associations with clinical outcomes were assessed using Fisher's exact and χ² tests.</p><p><strong>Results: </strong>56 patients were identified (median age 65 years; 80.4% women). Common interventions included corticosteroids (66.1%), intravenous fluids (66.1%), and antiseizure medications (prophylactic 51.8% and therapeutic 12.5%). Half required intensive care admission for neurological monitoring. Complete recovery was achieved in 87.5% of cases. Corticosteroid administration was significantly associated with symptom resolution within 72 hours (OR 4.51, 95% CI 1.19 to 17.85, P=0.022), while intravenous fluids showed a non-significant trend toward shorter symptom duration (OR 2.25, 95% CI 0.64 to 8.15, P=0.170).</p><p><strong>Conclusions: </strong>CIE generally carries a favorable prognosis. Corticosteroids appeared to shorten symptom duration and may be considered in management. Based on our findings and the existing literature, we propose a treatment algorithm to guide clinicians. Prospective validation is warranted.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Waveform-assisted navigation (WAN) technique to visualize the appropriate position of the aspiration catheter to the thrombus during mechanical thrombectomy.","authors":"Masato Kinoshita, Mikiya Beppu, Shun Ono, Shinichi Yoshimura","doi":"10.1136/jnis-2025-023449","DOIUrl":"https://doi.org/10.1136/jnis-2025-023449","url":null,"abstract":"<p><p>Endovascular thrombectomy has become an established treatment for acute ischemic stroke caused by large vessel occlusion, significantly improving clinical outcomes in eligible patients. Advances in thrombectomy techniques have improved recanalization rates, with newer tools enabling faster and more effective clot retrieval1 The various techniques employed include stent retriever only, aspiration catheter and stent retriever, and direct aspiration2 Whether using direct aspiration or stent retriever with contact aspiration, achieving optimal recanalization requires direct and secure contact between the aspiration catheter and the thrombus3 Proper engagement of the catheter with the clot is critical for efficient aspiration and subsequent vessel recanalization. However, it is impossible to visually confirm whether the aspiration catheter is appropriately in contact with the thrombus. In this report, we introduce a novel approach termed the waveform-assisted navigation (WAN) technique, which uses pressure waveforms to confirm and visualize the secure apposition of the aspiration catheter to the thrombus during thrombectomy(video 1).neurintsurg;jnis-2025-023449v1/V1F1V1Video 1 Waveform-Assisted Navigation (WAN) technique.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance of CT perfusion in detecting contralateral aplasia of the A1 segment in acute internal carotid artery occlusion.","authors":"Tingyu Yi, Zhi-Nan Pan, Ding-Lai Lin, Shujuan Gan, Jintao Chen, Yuehong He, Yan-Min Wu, Xiao-Hui Lin, Lisan Zeng, Mei-Hua Wu, Weifeng Huang, Shuyi Liu, Yi-Ning Yang, Jinhua Ye, Wen-Huo Chen","doi":"10.1136/jnis-2025-023461","DOIUrl":"https://doi.org/10.1136/jnis-2025-023461","url":null,"abstract":"<p><strong>Background and objectives: </strong>Acute occlusion of the internal carotid artery (ICA) accompanied by contralateral A1 segment agenesis (CA-A1) presents distinct clinical and radiological features. Differentiating CA-A1 from non-CA-A1 cases in acute ICA occlusion based on preoperative angiography images is challenging. We hypothesized that CT perfusion (CTP) could help to quickly and accurately recognize acute ICA occlusions with CA-A1 and that the double stent retriever (DSR) technique might improve radiological outcomes in ICA occlusion with CA-A1.</p><p><strong>Methods: </strong>ICA occlusion cases were categorized into CA-A1 and non-CA-A1 groups. The diagnostic performance of CTP for CA-A1 was assessed, and radiological outcomes were compared between DSR and non-DSR groups in the CA-A1 group.</p><p><strong>Results: </strong>A total of 281 cases of acute ICA occlusion were included: 34 with CA-A1 and 247 without CA-A1. Bilateral anterior cerebral artery (ACA) perfusion abnormalities on CTP were more frequent in the CA-A1 group (97.1% vs 5.3%, P<0.001). CTP showed 97% sensitivity, 95% specificity, and 95% accuracy for diagnosing CA-A1. Distal embolism into the ipsilateral ACA was more frequent in the CA-A1 group (29.4% vs 6.5%, P<0.001). Seven ICA occlusions with CA-A1 underwent the DSR technique as the first-line strategy. The risk of distal embolism into the ipsilateral ACA was significantly reduced compared with that in non-DSR cases (0% vs 40.7%, P=0.046).</p><p><strong>Conclusion: </strong>CTP can accurately and quickly detect CA-A1 in acute ICA occlusion. Distal embolism into the ipsilateral ACA is common in the CA-A1 group, and the DSR technique significantly reduces its incidence, showing promise as a first-line strategy.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transverse venous sinus stenting versus cerebrospinal fluid shunting in idiopathic intracranial hypertension: a multi-institutional and multinational database study.","authors":"Jarunee Intrapiromkul, Ansaar T Rai, Dhairya A Lakhani","doi":"10.1136/jnis-2025-023699","DOIUrl":"https://doi.org/10.1136/jnis-2025-023699","url":null,"abstract":"<p><strong>Background: </strong>Cerebrospinal fluid (CSF) shunting and transverse venous sinus (TVS) stenting are promising treatment choices for idiopathic intracranial hypertension (IIH), addressing different aspects of IIH pathophysiology. However, large-scale comparative data remain limited.</p><p><strong>Methods: </strong>We performed a multinational, multi-institutional, retrospective propensity score-matched analysis using the TriNetX platform. Adult patients diagnosed with IIH who underwent either TVS stenting or CSF shunting were included. The primary outcome was treatment failure, defined as the need for subsequent procedures (repeat TVS stenting, CSF shunt, or optic nerve fenestration). Secondary outcomes included residual symptoms (headache, visual disturbances, dizziness, and pulsatile tinnitus), ongoing use of IIH-related medications (furosemide, acetazolamide, and topiramate), and healthcare utilization, assessed through unplanned hospital readmissions and emergency department (ED) visits at 1 year follow-up.</p><p><strong>Results: </strong>Of 134 530 IIH patients identified, 1362 underwent TVS stenting and 5278 underwent CSF shunting. After propensity score matching, patients who received TVS stenting had significantly lower odds of repeat interventions (9.6% vs 38.6%; OR 0.169, 95% CI 0.136 to 0.212, P<0.001). They also had significantly lower odds of residual headache, visual disturbances, and papilledema. However, stenting was associated with higher odds of persistent pulsatile tinnitus (6.7% vs 2.2%; OR 3.183, P<0.001). TVS stenting was associated with lower odds of unplanned inpatient readmissions (24.1% vs 40.5%; OR 0.466, P<0.001) and ED visits (22.0% vs 34.0%; OR 0.548, P<0.001).</p><p><strong>Conclusion: </strong>Both TVS stenting and CSF shunting resulted in symptomatic improvement and reduced medication use in patients with IIH. However, stenting was associated with significantly lower treatment failure rates, fewer residual papilledema, headaches and visual symptoms, and reduced healthcare utilization. Persistent pulsatile tinnitus was more common following stenting.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the occlusive sign play a role in endovascular thrombectomy: a radiomics-based approach.","authors":"Bingyang Zhao, Weidong Yu, Dongsheng Ju, Xinzhao Jiang, Zhongyu Zhao, Shenwen Zhu, Jie Li, Siyu He, Jing Mang","doi":"10.1136/jnis-2025-023559","DOIUrl":"https://doi.org/10.1136/jnis-2025-023559","url":null,"abstract":"<p><strong>Background and purpose: </strong>Large vessel occlusion (LVO) is a major cause of acute ischemic stroke (AIS). Identifying its underlying etiology, particularly intracranial atherosclerotic stenosis (ICAS), is crucial for optimizing endovascular thrombectomy (EVT). Intra-procedural occlusive signs can offer clues, but their interpretation is often subjective. This study proposes a radiomics-based approach to objectively characterize angiographic signs and predict occlusion etiology in real time.</p><p><strong>Methods: </strong>We retrospectively included 465 EVT-treated patients with acute M1-segment MCA occlusion from two centers (January 2018-December 2023). Radiomics features were extracted from angiographic parametric imaging (API) and used to develop a radiomics score via least absolute shrinkage and selection operator (LASSO) logistic regression. The score's predictive value for ICAS-LVO was assessed using logistic regression, and the optimal cut-off was determined via the Youden index. Subgroup analyses were performed to compare procedural outcomes between radiomics-inferred ICAS and embolic occlusions.</p><p><strong>Results: </strong>The radiomics score was significantly higher in ICAS-related occlusions than in embolic occlusions (median 0.39 vs 0.89, P<0.001) and was the strongest independent predictor of ICAS etiology (adjusted odds ratio (OR) 25.40, 95% CI 12.13 to 56.94, P<0.001). Key discriminative features included texture-based parameters from perfusion maps. Based on the Youden index, a cut-off of 0.569 was defined to stratify cases into radiomics-inferred ICAS and embolic groups. Among patients treated with contact aspiration, those with radiomics-inferred ICAS occlusion had lower first-pass reperfusion rates compared with those with radiomics-inferred embolic occlusion (35.6% vs 60.7%, P-value Bonferroni correction =0.004).</p><p><strong>Conclusion: </strong>Radiomics features extracted from API offer an objective method for intra-procedural inference of occlusion etiology, particularly ICAS-LVO. This approach may support technical efficacy and procedural planning during EVT, especially in populations or regions with higher ICAS prevalence.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracranial Dotter angioplasty using Tenzing (Tenzingplasty) for acute ischemic stroke with underlying intracranial atherosclerotic disease.","authors":"Fabio Settecase, James Caldwell, Mubashir Pervez, Omar Kass-Hout, Warren T Kim, Rajkamal S Khangura, Matthew D Alexander, Amanda Baker, Nathan Farkas, Peter J Pema, Tom Pearson, Shane S Lee, Matthew J Page, Ben McGuinness, Ashish A Gajjar, JaeHyun Kim, Matheus Antoniazzi Dabus, Joey D English, Guilherme Dabus","doi":"10.1136/jnis-2025-023663","DOIUrl":"https://doi.org/10.1136/jnis-2025-023663","url":null,"abstract":"<p><strong>Introduction: </strong>Catheter-mediated (Dotter) angioplasty has been previously described for extracranial/peripheral arteries. Tenzing (Route 92 Medical, San Mateo, California, USA), a shelf-reducing delivery catheter, has an atraumatic tapered distal tip that progressively enlarges to maximal outer diameter of 1.2 mm (Tenzing 5), 1.6 mm (Tenzing 7), and 2.1 mm (Tenzing 8).</p><p><strong>Objective: </strong>To report our initial experience treating acutely symptomatic intracranial atherosclerotic disease (ICAD) using Dotter angioplasty with Tenzing (Tenzingplasty).</p><p><strong>Methods: </strong>After institutional review board approvals, we retrospectively reviewed clinical and procedural data of patients with underlying ICAD treated with off-label Tenzingplasty between 2022 and 2025, either as part of endovascular treatment for large vessel occlusion, or after medical therapy failure <96 hours from presentation.</p><p><strong>Results: </strong>We identified 53 consecutive patients with symptomatic ICAD who underwent Tenzingplasty, median (IQR) age 63 (57-70) years, 29 (55%) male. ICAD locations were: M1 (24), M2 (9), internal carotid artery (3), vertebral V4 segment (7), basilar (8), vertebrobasilar junction (1), and A2 anterior cerebral artery (1). First pass aspiration thrombectomy for patients with an initial modified Thrombolysis in Cerebral Infarction score 0 (without crossing the ICAD lesion) was performed in 34/53 (64%). After median 1 (IQR 1-2) Tenzingplasty pass, median (IQR) stenosis improved from 100% (95-100) to 60% (42-76) post-Tenzingplasty (P<0.0001). Subsequent balloon angioplasty or stenting was performed in 4% and 21%, respectively. Successful final reperfusion (expanded Thrombolysis in Cerebral Infarction 2b-3) was achieved in 81%, with one Tenzingplasty-related complication (a non-flow limiting dissection), and no perforations. In follow up, 25/44 (57%) had a 90-day modified Rankin Scale score of 0-2.</p><p><strong>Conclusion: </strong>Tenzingplasty may be a feasible and safe rescue therapy for improving luminal caliber, flow restoration, and/or lesion preparation for stenting in acutely symptomatic ICAD.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicenter evaluation of the safety and efficacy of varying doses of cangrelor used in acute cerebrovascular stenting in patients with acute ischemic stroke.","authors":"Devin N Holden, James Spencer Dingman, Lauren H Sutton, Ciro Ramos-Estebanez, Faten El Ammar, Jirapuck Warinpramote, Raffe Siddiqui, Richard Choi, Laura Schneider, Richard Baker, Veronica Bonderski, Rami Z Morsi, Harsh Desai, Tareq Kass-Hout, Jasmeet Singh, Anna Luisa Kuhn, Ajit S Puri, Salvador F Gutierrez-Aguirre, Ricardo A Hanel, Osama O Zaidat, Yazan Ashouri, Mohammad AlMajali, Eve Anderson, Lori Wetmore, Michael Barats, Lauren Kimmons, Whitney Scott, Andrew Webb, Riley Johnson, J Nicholas O'Donnell, Pouya Entezami","doi":"10.1136/jnis-2025-023526","DOIUrl":"10.1136/jnis-2025-023526","url":null,"abstract":"<p><strong>Background: </strong>Acute ischemic stroke often necessitates neuroendovascular interventions such as thrombectomy and, occasionally, stenting for large vessel occlusions or intracranial atherosclerotic disease. Effective antiplatelet therapy is essential during stenting to mitigate thrombosis risks, but consensus on optimal cangrelor dosing remains elusive. This study evaluates the safety and efficacy of various cangrelor doses used in acute cerebrovascular stenting.</p><p><strong>Methods: </strong>A multicenter, retrospective cohort study was conducted across 11 comprehensive stroke centers. Patients aged 18-85 with ischemic stroke who underwent emergent cerebrovascular stenting with cangrelor were included. Patients were categorized into low-dose cangrelor (<2 mcg/kg/min; LDC) and high-dose cangrelor (≥2 mcg/kg/min; HDC) cangrelor groups. Outcomes included thrombotic and bleeding complications both intra-procedurally and within 48 hours post-procedure.</p><p><strong>Results: </strong>A total of 230 patients were included in the analysis (LDC: 68; HDC: 162). Baseline characteristics were similar between groups. Thrombotic outcomes, including intraprocedural thrombosis (13% LDC vs 6% HDC; P=0.078) and thrombosis within 48 hours of the procedure (9% LDC vs 4% HDC; P=0.093), showed no statistical differences. Similarly, intraprocedural bleeding (6% LDC vs 5% HDC; P=0.753) and intracranial hemorrhage within 48 hours of the procedure (19% LDC vs 25% HDC; P=0.360) were not statistically different.</p><p><strong>Conclusion: </strong>Different cangrelor dosing regimens demonstrated no significant differences in thrombotic or bleeding complications during acute neuroendovascular stenting for ischemic stroke. Larger, prospective studies are warranted to refine optimal dosing strategies for cangrelor in this population.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral venography and manometry: indications and techniques for success.","authors":"Mohamad Abdalkader, Thanh N Nguyen, Eytan Raz, Sami Al Kasab, Matthew Robert Amans, Maksim Shapiro, Vivek Yedavalli, Athos Patsalides, Kyle M Fargen, Ferdinand K Hui","doi":"10.1136/jnis-2025-023715","DOIUrl":"https://doi.org/10.1136/jnis-2025-023715","url":null,"abstract":"<p><p>Cerebral venography remains an important tool in neurovascular practice despite the increasing reliance on non-invasive imaging modalities such as CT and MR venography. While catheter venography is no longer the primary diagnostic method for cerebrovenous disorders, its role has evolved alongside the expanding indications for intracranial venous interventions. This work explores the indications, technical considerations, and clinical utility of catheter venography and venous manometry in the evaluation and management of cerebrovenous diseases. It highlights the evolving role of venous interventions in neurointerventional practice and provides insights into optimizing procedural outcomes.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microcatheter navigation using a large compliant balloon placed in a cortical vein during transvenous access.","authors":"Ryuichi Noda, Mohamad Izzat Arslan Che Ros, Suzana Saleme, Aymeric Rouchaud, Charbel Mounayer","doi":"10.1136/jnis-2025-023596","DOIUrl":"https://doi.org/10.1136/jnis-2025-023596","url":null,"abstract":"<p><p>Transvenous embolization (TVE) has emerged as the new approach for the curative treatment of brain arteriovenous malformations (bAVMs), though challenges persist in navigating microcatheters through dural venous sinuses. This video article demonstrates a novel balloon-assisted technique to facilitate microcatheter navigation in a complex case of bAVM. A large compliant Copernic RC balloon was temporarily placed in a cortical vein, serving as a buttress to guide the microcatheter into the draining vein. This method enabled the successful cannulation and advancement of a microcatheter in a draining cortical vein using a large compliant balloon without complications. The case highlights the technical feasibility and safety of this approach in TVE for challenging bAVM cases.neurintsurg;jnis-2025-023596v1/V1F1V1Video 1 Microcatheter navigation using a large compliant balloon placed in a cortical vein during a transvenous access.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}