Journal of NeuroInterventional Surgery最新文献

{"title":"N-hexyl cyanoacrylate (Magic Glue) for middle meningeal artery embolization: a retrospective multicenter analysis.","authors":"Nils Christian Lehnen, Daniel Böhnert, Drini Dracini, Felix J Bode, Mousa Zidan, Tim Lampmann, Alexander Radbruch, Johannes Rosskopf, Jannis Bodden, Bernd Schmitz, Tobias Boeckh-Behrens, Motaz Hamed, Franziska Dorn","doi":"10.1136/jnis-2025-023862","DOIUrl":"https://doi.org/10.1136/jnis-2025-023862","url":null,"abstract":"<p><strong>Background: </strong>Chronic subdural hematoma (cSDH) is common, with an incidence of up to 5/100,000, increasing with age. Surgery carries a recurrence risk of around 20%. Three randomized controlled trials demonstrated the benefit of middle meningeal artery embolization (MMAE) using ethylene vinyl alcohol (EVOH)-based embolics like Onyx (Medtronic) or Squid (Balt Group). Other agents, including particles and N-butyl cyanoacrylate (NBCA), are under investigation. N-hexyl cyanoacrylate (Magic Glue, Balt Group) is a newer NBCA-based embolic with slower precipitation, enabling potentially safer and more effective embolization. Unlike EVOH-based agents, Magic Glue does not require dimethyl sulfoxide (DMSO) flushing, which can cause discomfort and trigeminocardiac reflex and thus often necessitates general anesthesia. We present the first case series of MMAE with Magic Glue.</p><p><strong>Methods: </strong>This retrospective study included patients from three neurointerventional centers treated with MMAE for cSDH using Magic Glue. Patient characteristics (age, sex, antiplatelet or anticoagulant use, symptoms) were assessed. The primary endpoint was the need for repeat surgery or MMAE for recurrence or progression. Secondary endpoints included technical complications, hematoma size reduction, and modified Rankin Scale (mRS) score at last follow-up.</p><p><strong>Results: </strong>58 patients (48 male; mean age 73.9±10.3 years) were included. 31.0% received antiplatelets and 34.5% anticoagulants; 96.6% had symptoms. Repeat treatment was necessary in 15.5%. Technical complications occurred in 5.2%, none requiring intervention. Four procedure-related or presumably procedure-related complications occurred, including one ischemic stroke; all resolved by final follow-up. Initial cSDH size averaged 19.0±6.8 mm, with a mean reduction of 12.5±5.7 mm.</p><p><strong>Conclusions: </strong>This multicenter study suggests MMAE with Magic Glue may be a safe and effective alternative to established liquid embolics.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764986","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":"Catheterization techniques and outcomes of transvenous embolization of cerebrospinal fluid-venous fistulas in the management of spontaneous intracranial hypotension: case series.","authors":"Craig Schreiber, Gary Kocharian, Andrew Garton, Natasha Kharas, Bala McRae-Posani, Gayle Salama, Justin T Schwarz, Srikanth R Boddu, Jared Knopman, Y Pierre Gobin","doi":"10.1136/jnis-2025-023686","DOIUrl":"https://doi.org/10.1136/jnis-2025-023686","url":null,"abstract":"<p><strong>Background: </strong>Endovascular transvenous embolization of spinal cerebrospinal fluid-venous fistulas (CVFs) has been shown in small studies to be a safe and effective treatment for spontaneous intracranial hypotension (SIH).</p><p><strong>Objective: </strong>To validate the safety and effectiveness of this procedure and to describe catheterization techniques available to safely perform these embolization procedures.</p><p><strong>Results: </strong>A total of 21 patients with confirmed CVF underwent 23 endovascular embolization procedures; 18 (86%) patients achieved both clinical and radiographic resolution of their SIH. There were no major neurologic complications from any procedure. One patient had postoperative pulmonary embolism and deep vein thrombosis. The most common side effects were prolonged symptoms of rebound intracranial hypertension (29%) and prolonged back pain with radiculopathy (24%). The azygous vein was used for catheterizing the level of interest in 83% of embolization procedures; the lumbar ascending vein was used for catheterization in 17% of the procedures; and direct catheterization of the segmental/foraminal vein at the level of interest was performed in 61% of the procedures. The epidural venous plexus was accessed and traversed to the level of interest in 39% of the procedures.</p><p><strong>Conclusion: </strong>Endovascular transvenous embolization of CVF is a safe, well-tolerated, and effective treatment for SIH. Given the variability of the venous anatomy, there are multiple routes of catheterization that can be performed to access the level of interest when performing these procedures.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764985","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":"Non-stenotic dominant oblique occipital sinus causing dehiscent duplication of the jugular bulb: imaging diagnosis and novel endovascular management with stenting.","authors":"Alexis Guédon, Nawel Mohammed-Brahim, Francesco Arpaia, Matteo Fantoni, Vittorio Civelli, Emmanuel Houdart","doi":"10.1136/jnis-2025-023971","DOIUrl":"https://doi.org/10.1136/jnis-2025-023971","url":null,"abstract":"<p><strong>Background: </strong>This study investigates a rare cause of pulsatile tinnitus related to a dehiscent duplication of the jugular bulb associated with a non-stenotic dominant oblique occipital sinus. We report a series of treated patients and describe a novel radiological feature-the 'playing card heart sign'.</p><p><strong>Methods: </strong>In this retrospective single-center study, four patients presenting with venous pulsatile tinnitus due to five dehiscent jugular bulb duplications associated with a non-stenotic dominant oblique occipital sinus were included between January 2023 and September 2024. Clinical assessment included symptom onset, body mass index, and Tinnitus Handicap Inventory score. High-resolution temporal bone CT scans and cerebral venous imaging were used to identify anatomical anomalies. Patients with a significant clinical impact underwent endovascular stenting. Outcomes were assessed at follow-up.</p><p><strong>Results: </strong>The mean patient age was 41.9 years, with a median body mass index of 27.4 kg/m². Tinnitus was unilateral in three patients and alternating in one. Imaging revealed a bony dehiscence overlying a duplicated jugular bulb, ipsilateral to a non-stenotic dominant oblique occipital sinus, with no venous pressure gradient. Stenting (n=5) led to complete resolution of tinnitus in all patients, with a median follow-up of 15 months and no reported complications.</p><p><strong>Conclusions: </strong>Jugular bulb duplication with dehiscence, associated with a non-stenotic dominant oblique occipital sinus, represents an under-recognized cause of pulsatile tinnitus. This condition can be effectively treated with stenting. Identification of the 'playing card heart sign' on imaging is key for accurate diagnosis and management.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753615","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":"Inpatient spinal intervention is associated with improved outcomes following thoracolumbar pathologic compression fractures: a national retrospective study.","authors":"Matthew K McIntyre, Huanwen Chen, Dheeraj Gandhi, Ajay Malhotra, Dhairya A Lakhani, Jesse J Liu, Marco Colasurdo","doi":"10.1136/jnis-2025-023835","DOIUrl":"https://doi.org/10.1136/jnis-2025-023835","url":null,"abstract":"<p><strong>Background: </strong>Pathologic vertebral compression fractures (pVCFs) are associated with significant pain and worsened quality of life. Spinal interventions such as kyphoplasty, vertebroplasty, and radiofrequency ablation can improve patient outcomes; however, there is a paucity of data on the optimal timing of these procedures. This study aims to evaluate the real-world effectiveness of inpatient spinal interventions versus conservative management (CM) for pVCF patients.</p><p><strong>Methods: </strong>This is a retrospective cohort analysis of the Nationwide Readmissions Database from 2016 to 2022. Adult patients admitted non-electively for pathologic thoracolumbar wedge compression fractures were included. The primary outcome was hospital discharge to home. Outcomes for patients who underwent spinal intervention (kyphoplasty, vertebroplasty, and/or radiofrequency ablation) versus CM were compared using Poisson or logistic regression analyses.</p><p><strong>Results: </strong>2933 patients were included (median age 77 years, 54.1% female) of whom 921 (31.4%) underwent spinal intervention. Compared with CM, those who underwent intervention were significantly more likely to be discharged home (61.1% vs 52.5%; adjusted OR 1.50, 95% CI 1.11 to 2.03, P=0.009), had significantly longer lengths of hospital stay (median 6 vs 4 days; Poisson rate ratio 1.61, 95% CI 1.12 to 2.10, P<0.001), and higher hospitalization cost (adjusted B 10.7, 95% CI 9.5 to 12.0, P<0.001). Among those discharged home during the index admission, there was no difference in 180-day major morbidity or mortality between groups.</p><p><strong>Conclusion: </strong>For pVCF patients, early inpatient spinal intervention was significantly associated with higher odds of discharge to home without increased adverse events.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753604","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":"Dynamic transcranial Doppler monitoring predicts intracranial hemorrhage in patients with anterior circulation large vessel occlusion after endovascular treatment.","authors":"Yan Wang, Yi-Han Wang, Hui-Sheng Chen","doi":"10.1136/jnis-2025-023629","DOIUrl":"https://doi.org/10.1136/jnis-2025-023629","url":null,"abstract":"<p><strong>Background: </strong>Endovascular treatment (EVT) is the most effective treatment for large vessel occlusion (LVO) stroke. Intracranial hemorrhage (ICH) is one of the most common complications after EVT, which is closely associated with poor clinical outcome.</p><p><strong>Objective: </strong>In this study, we investigated the value of dynamic transcranial Doppler (TCD) monitoring in predicting ICH in patients with anterior circulation LVO.</p><p><strong>Methods: </strong>Based on a prospective cohort, we consecutively collected details of patients with anterior LVO who received successful recanalization after EVT (modified Thrombolysis in Cerebral Infarction score 2b-3) and underwent dynamic TCD monitoring within 24 hours after EVT. TCD was monitored at 30 min, 6 hours, 12 hours and 24 hours after EVT, and the related parameters were measured and calculated, including bilateral peak systolic velocity (PSV), bilateral pulse index (PI), and their different values and ratios at different time points. Logistic regression models were used to detect which TCD parameters were independent predictors of ICH.</p><p><strong>Results: </strong>A total of 98 eligible patients were included in this study, including 40 (41%) with ICH. Compared with non-ICH group, multiple logistic regression analysis showed that the difference in value of bilateral PSV at 30 min after EVT (median: -4.5 cm/s vs 0.5 cm/s, P=0.005) was an independent predictor of ICH. A model including this parameter had significantly higher area under the curve values (AUC=0.752) for predicting ICH compared with the baseline model (AUC=0.686) in patients.</p><p><strong>Conclusion: </strong>TCD may identify patients at risk of ICH after successful EVT in patients with anterior LVO, and the difference in value of bilateral PSV at 30 min after EVT was an independent predictor of ICH.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753603","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":"Hemodynamic analysis of optimal branch selection for flow-diverting stents in middle cerebral artery bifurcation aneurysms: a pilot study.","authors":"Xin Feng, Jiwan Huang, Shiyan Weng, Chi Huang, Mengshi Huang, Zhuohua Wen, Runze Ge, Can Li, Jiancheng Lin, Hao Yuan, Lele Dai, Wenxin Chen, Ruizhe Yi, Anqi Xu, HongYu Shi, Yuheng Jin, Xueyan Deng, Zehui Xie, Shuyin Liang, Yiming Bi, Shixing Su, Xin Zhang, Xifeng Li, Chubin Ou, Jianping Xiang, Chuan-Zhi Duan","doi":"10.1136/jnis-2025-023406","DOIUrl":"https://doi.org/10.1136/jnis-2025-023406","url":null,"abstract":"<p><strong>Background: </strong>Despite the expanding use of flow-diverting stents (flow diverters-FDs) for middle cerebral artery (MCA) bifurcation aneurysms, their efficacy remains contentious in this complex anatomy. Current studies report conflicting complete occlusion rates (55-92%) and significant branch stenosis/occlusion risks (8-43%), highlighting unmet needs in stent placement strategy.</p><p><strong>Methods: </strong>In this retrospective cohort study combining clinical data with computational fluid dynamics (CFD), 20 MCA bifurcation aneurysms (19 patients) treated with FDs were analyzed. Patient-specific models derived from three-dimensional digital subtraction angiography underwent CFD simulations to quantify pre/post-stent hemodynamic changes. Key parameters (inflow rate, wall shear stress, residual flow volume) were compared between aneurysms with complete versus incomplete healing, and the impact of stent placement in branches of varying diameters was analyzed.</p><p><strong>Results: </strong>At a median follow-up of 9 months, complete occlusion was achieved in 55% (11/20) and partial occlusion in 25% (5/20). Though not statistically significant, hemodynamic analysis revealed the daughter artery diameter ratio (DR)-stratified efficacy. Stents with a DR between 0.65 and 0.80 placed in smaller-diameter branches more effectively reduced inflow rate, relative inflow rate, and aneurysm wall shear stress. Conversely, stents with a DR between 0.80 and 0.95 were more effective in larger-diameter branches.</p><p><strong>Conclusion: </strong>This study indicates that vessel DR could guide intraoperative decisions for FD placement in MCA bifurcations. Prioritizing smaller branches in certain anatomical profiles may enhance flow remodeling without increasing procedural risks. These findings suggest a hemodynamic basis for moving beyond traditional size-based approaches and could inform more precise stent selection in complex bifurcation interventions. Further validation through controlled trials is needed.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742317","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":"A hybrid model based on vessel wall magnetic resonance imaging predicts recurrence in posterior circulation ischemic stroke: a multi-institutional study.","authors":"Yejun Wu, Ran Zhang, Xiaoyun Liang, Guangliang Ju, Fangbing Li, Tianxiang Hu, Borui Zheng, Lina Zhang","doi":"10.1136/jnis-2025-023572","DOIUrl":"https://doi.org/10.1136/jnis-2025-023572","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to develop and validate a hybrid model integrating clinical features, vessel wall magnetic resonance imaging (VWMRI) characteristics, and radiomic features to predict the recurrence risk of posterior circulation ischemic stroke (PCIS).</p><p><strong>Methods: </strong>This multicenter, retrospective study included 266 PCIS patients with basilar artery atherosclerosis (Institution I: 227; Institution II: 39). Data included clinical information, VWMRI imaging features, and radiomic features. Six predictive models were constructed using the logistic regression algorithm: (1) clinical-imaging model, (2-4) single-sequence radiomics models (2D PDWI, 3D T1WI, 2D T2WI), (5) multi-sequence radiomics model, and (6) hybrid model. Model performance was evaluated using receiver operating characteristic curves, calibration metrics, decision curve analysis across training/internal validation (8:2 split), and external validation cohorts.</p><p><strong>Results: </strong>The hybrid model exhibited superior predictive performance across all cohorts, with an area under the curve of 0.872 in the training cohort, 0.883 in the internal validation cohort, and 0.869 in the external validation cohort, outperforming all other models. Calibration curves demonstrated excellent fit, with mean absolute errors of 0.03/0.06. Decision curve analysis indicated significant net benefit within clinically relevant threshold ranges. Key risk factors for PCIS recurrence included involvement of perforating arteries, non-dorsal plaque location, elevated low-density lipoprotein cholesterol, high total cholesterol, a history of alcoholism, and 16 radiomic signatures.</p><p><strong>Conclusions: </strong>The hybrid model enhances the accuracy of predicting PCIS recurrence risk. With robust performance in both internal and external validation cohorts, this model demonstrates strong clinical utility and potential to facilitate early intervention and personalized treatment strategies.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742316","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":"Cognitive impairment in cerebral venous congestion: The need for improved assessment tools - a literature review.","authors":"Ferdinand K Hui, Sherief Ghozy, Matthew Robert Amans, Waleed Brinjikji, Mohamad Abdalkader, Vivek Yedavalli, Abraham Sc Chyung, Vitor M Pereira, Stephanie Lenck, Adnan H Siddiqui, Argye E Hillis, Kyle M Fargen","doi":"10.1136/jnis-2025-023392","DOIUrl":"https://doi.org/10.1136/jnis-2025-023392","url":null,"abstract":"<p><p>ObjectiveCognitive impairment is increasingly recognized in patients with cerebral venous congestion (CVC), yet the cognitive tools used are largely adapted from stroke and dementia research. This review examines current literature on cognitive function in CVC, including conditions such as cerebral venous sinus thrombosis (CVST), idiopathic intracranial hypertension (IIH), and dural arteriovenous fistulas (dAVFs). Special emphasis is placed on the limitations of common screening tools like the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE). Cognitive dysfunction-primarily affecting executive function, processing speed, and attention-is reported in up to 86% of CVC cases, yet only about 20% of studies use validated cognitive testing tools, most of which may lack sensitivity for CVC-specific deficits. Emerging techniques such as ocular motor testing and physiological markers show promise but require further validation. There is an urgent need for standardized, CVC-specific cognitive assessment protocols that reflect the unique pathophysiology of venous disorders. Future research should prioritize the development of targeted cognitive batteries and integrate objective physiological measures to enhance diagnostic accuracy.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707800","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":"Association of initial core volume on non-contrast CT using a deep learning algorithm with clinical outcomes in acute ischemic stroke: a potential tool for selection and prognosis?","authors":"Alan Flores, Xavier Ustrell, Laia Seró, Antoni Suarez, Ylenia Avivar, Leonardo Cruz-Criollo, Milagros Galecio-Castillo, Jorge Cespedes, Judith Cendrero, Victor Salvia, Alvaro Garcia-Tornel, Marta Olive Gadea, Pere Canals, Santiago Ortega-Gutierrez, Marc Ribó","doi":"10.1136/jnis-2025-023897","DOIUrl":"https://doi.org/10.1136/jnis-2025-023897","url":null,"abstract":"<p><strong>Background: </strong>In an extended time window, contrast-based neuroimaging is valuable for treatment selection or prognosis in patients with stroke undergoing reperfusion treatment. However, its immediate availability remains limited, especially in resource-constrained regions. We sought to evaluate the association of initial core volume (ICV) measured on non-contrast computed tomography (NCCT) by a deep learning-based algorithm with outcomes in patients undergoing reperfusion treatment.</p><p><strong>Methods: </strong>Consecutive patients who received reperfusion treatments were collected from a prospectively maintained registry in three comprehensive stroke centers from January 2021 to May 2024. ICV on admission was estimated on NCCT by a previously validated deep learning algorithm (Methinks). Outcomes of interest included favorable outcome (modified Rankin Scale score 0-2 at 90 days) and symptomatic intracranial hemorrhage (sICH).</p><p><strong>Results: </strong>The study comprised 658 patients of mean (SD) age 72.7 (14.4) years and median (IQR) baseline National Institutes of Health Stroke Scale (NIHSS) score of 12 (6-19). Primary endovascular treatment was performed in 53.7% of patients and 24.9% received IV thrombolysis only. Patients with favorable outcomes had a lower mean (SD) automated ICV (aICV; 12.9 (26.9) mL vs 34.9 (40) mL, P<0.001). Lower aICV was associated with a favorable outcome (adjusted OR 0.983 (95% CI 0.975 to 0.992), P<0.001) after adjusted logistic regression. For every 1 mL increase in aICV, the odds of a favorable outcome decreased by 1.7%. Patients who experienced sICH had a higher mean (SD) aICV (47.8 (61.1) mL vs 20.5 (32) mL, P=0.001). Higher aICV was independently associated with sICH (adjusted OR 1.014 (95% CI 1.004 to 1.025), P=0.009) after adjusted logistic regression. For every 1 mL increase in aICV, the odds of sICH increased by 1.4%.</p><p><strong>Conclusion: </strong>In patients with stroke undergoing reperfusion therapy, aICV assessment on NCCT predicts long-term outcomes and sICH. Further studies determining the potential role of aICV assessment to safely expand and simplify reperfusion therapies based on AI interpretation of NCCT may be justified.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707799","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":"Unpacking the problem-the hidden waste in neurointerventional procedures: quantifying packaging waste in neurointerventional supply chains.","authors":"Johannes Alex Rolf Pfaff, Markus Schober, Christine Seethaler, Andreas Oellerer, Babett Scheiber, Ingrid Lucia Liedtke","doi":"10.1136/jnis-2025-023785","DOIUrl":"https://doi.org/10.1136/jnis-2025-023785","url":null,"abstract":"<p><strong>Background: </strong>Neurointerventional procedures rely on a variety of angiographic devices and disposables. Despite the increasing frequency of these procedures, systematic data on the scale and nature of packaging material attributable to the delivery of these neurointerventional supplies to hospitals are limited. This study aims to quantify the packaging material linked to the delivery of neurointerventional supplies, providing critical insights for future sustainable healthcare logistics.</p><p><strong>Methods: </strong>A prospective observational study was conducted over a 30-day period in April 2025. Every incoming package containing neurointerventional supplies was analyzed for weight, packaging type, and content composition. The supplies were grouped into predefined categories (eg, catheters, coils, stents). The weight of both packaging and supplies was measured, and descriptive statistical analysis was applied to summarize the data.</p><p><strong>Results: </strong>A total of 196 packages were analyzed. The combined gross weight of all packages was 455.07 kg, with 118.31 kg (26.0%) tare weight attributed to packaging materials. Eighty-eight (44.9%) single-item deliveries were received. Catheters were the most common item, appearing in 34.2% of the packages. The median proportion of supply net weight relative to package gross weight was 57.2%. In 38.8% of packages the weight of the packaging exceeded that of the supplies. Only five packages (2.6%) contained more than two items of different types of supply categories.</p><p><strong>Conclusion: </strong>The study shows that packaging materials make a significant contribution to deliveries of neurointerventional supplies, highlighting the substantial burden of packaging waste associated with neurointerventional procedures. The findings emphasize the need for strategies aimed at reducing packaging waste to promote more sustainable practices in healthcare logistics.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707802","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}