Journal of NeuroInterventional Surgery最新文献

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Novel insights into the pathophysiology of idiopathic intracranial hypertension: a commentary on brain volume and transverse sinus stenosis. 特发性颅内高压病理生理学的新见解:关于脑容量和横窦狭窄的评论。
IF 4.5 1区 医学
Journal of NeuroInterventional Surgery Pub Date : 2025-01-27 DOI: 10.1136/jnis-2024-022817
Xuefan Zeng, Yiwei Wang, Ling Liu
{"title":"Novel insights into the pathophysiology of idiopathic intracranial hypertension: a commentary on brain volume and transverse sinus stenosis.","authors":"Xuefan Zeng, Yiwei Wang, Ling Liu","doi":"10.1136/jnis-2024-022817","DOIUrl":"10.1136/jnis-2024-022817","url":null,"abstract":"","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791825","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}
引用次数: 0
Intraoperative cerebral angiography reveals microsurgically occult sequelae of temporary clip application during elective cerebral aneurysm surgery. 术中脑血管造影显示,在选择性脑动脉瘤手术中使用临时夹子会造成显微外科隐性后遗症。
IF 4.5 1区 医学
Journal of NeuroInterventional Surgery Pub Date : 2025-01-27 DOI: 10.1136/jnis-2024-022349
Philipp Hendrix, Sina Hemmer, Anant Chopra, Oded Goren, Gregory M Weiner, Clemens M Schirmer, Jeffrey D Oliver
{"title":"Intraoperative cerebral angiography reveals microsurgically occult sequelae of temporary clip application during elective cerebral aneurysm surgery.","authors":"Philipp Hendrix, Sina Hemmer, Anant Chopra, Oded Goren, Gregory M Weiner, Clemens M Schirmer, Jeffrey D Oliver","doi":"10.1136/jnis-2024-022349","DOIUrl":"10.1136/jnis-2024-022349","url":null,"abstract":"<p><strong>Background: </strong>Temporary clipping (TC) is an essential adjunct in cerebral aneurysm (CA) surgery. Despite appearing insignificant to the surgeon under the microscope, TC may cause parent vessel injury. Intraoperative diagnostic cerebral angiography (ioDCA) is crucial for assessing aneurysm occlusion and parent vessel integrity. We aimed to assess sequelae of TC evident on immediate ioDCA.</p><p><strong>Methods: </strong>Elective CA clippings with ioDCA in a hybrid operating room from January 2020 to June 2023 were reviewed. Microsurgical and angiographic assessments were performed to identify post-TC parent vessel alterations. Outcomes were compared between TC and non-TC-groups.</p><p><strong>Results: </strong>Collectively, 107 patients underwent 111 craniotomies for clipping of 127 CAs. TC was used in 59/111 cases (53.2%) for treatment of 66/127 CAs (51.9%). CA size and neck were significantly larger in the TC group than in the non-TC group (p<0.001). Parent vessel vasospasm at the site of the previous temporary clip location was evident on 3D rotational angiography in 12/59 (20.3%) TC cases. Clip adjustment rates after ioDCA were similar between groups (TC 13.6% vs non-TC 8.2%, p=0.328). In the TC group compared with the non-TC group, the rates of symptomatic radiographic ischemia and functional decline at discharge were significantly higher (p=0.022 and p=0.045, respectively). However, functional status at follow-up was comparable (p=0.620).</p><p><strong>Conclusions: </strong>TC during CA surgery can cause significant yet microsurgically occult vasospasm in the parent vessel, potentially contributing to symptomatic ischemia and early functional decline. Intraoperative angiography is crucial for detecting this issue, highlighting both its importance and the risks associated with TC.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289417","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}
引用次数: 0
Can the clot meniscus and claw signs predict thrombectomy and clinical outcomes in patients with stroke? A systematic review and meta-analysis. 血栓半月板和爪状征能否预测脑卒中患者的血栓切除术和临床预后?系统回顾和荟萃分析。
IF 4.5 1区 医学
Journal of NeuroInterventional Surgery Pub Date : 2025-01-27 DOI: 10.1136/jnis-2024-022322
Abdullah Reda, Jonathan Cortese, Sherief Ghozy, Aryan Gajjar, Dani Douri, Ramanathan Kadirvel, David F Kallmes
{"title":"Can the clot meniscus and claw signs predict thrombectomy and clinical outcomes in patients with stroke? A systematic review and meta-analysis.","authors":"Abdullah Reda, Jonathan Cortese, Sherief Ghozy, Aryan Gajjar, Dani Douri, Ramanathan Kadirvel, David F Kallmes","doi":"10.1136/jnis-2024-022322","DOIUrl":"10.1136/jnis-2024-022322","url":null,"abstract":"<p><strong>Background: </strong>The angiographic shape of an occlusion, like the clot meniscus sign and the claw sign, has been reported to potentially impact the recanalization rate and clinical outcome in patients undergoing mechanical thrombectomy for acute ischemic strokes.</p><p><strong>Method: </strong>Following PRISMA guidelines, a systematic literature search was conducted across PubMed, Scopus, Embase and Web of Science databases. Patients were grouped into clot meniscus/claw sign positive and negative groups based on the definitions obtained from each study. Primary outcomes included technical success, with a meta-analysis performed using a random-effects model to calculate proportions and odds ratios (OR) with 95% confidence intervals (Cl).</p><p><strong>Results: </strong>We included seven studies recruiting 1572 patients. The results indicated that the positive and negative groups had comparable first-pass effect (OR 1.95; 95% CI 0.76 to 5.01; P=0.167) and final recanalization (OR 1.36; 95% CI 0.81 to 2.27; P=0.248) rates. However, the rate of having a favorable functional outcome was significantly higher in the positive group than in the negative sign group (OR 1.91; 95% CI 1.25 to 2.92; P<0.003). Within the sign-positive population, the use of contact aspiration was associated with a significantly higher rate of recanalization compared with using a stent retriever (OR 0.18; 95% CI 0.07 to 0.49; P<0.001). This result did not translate into a clinical impact, as both stent retriever and contact aspiration showed comparable rates of functional independence at 3 months (OR 0.22; 95% CI 0.02 to 2.33; P=0.210).</p><p><strong>Conclusion: </strong>The presence of the clot meniscus/claw sign is not associated with recanalization outcomes after thrombectomy. However, it might be a good sign to predict which thrombectomy technique might be associated with better recanalization, although current evidence may need further confirmation.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406435","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}
引用次数: 0
Safety and efficacy of the Contour Neurovascular System for treating intracranial aneurysms: a systematic review and meta-analysis. Contour 神经血管系统治疗颅内动脉瘤的安全性和有效性:系统回顾和荟萃分析。
IF 4.5 1区 医学
Journal of NeuroInterventional Surgery Pub Date : 2025-01-27 DOI: 10.1136/jnis-2024-022461
Ahmet Günkan, Luca Scarcia, Marcio Yuri Ferreira, Marina Vilardo, Luis Flavio Fabrini Paleare, Jhon E Bocanegra-Becerra, Mohamed E M Fouad, Henrique Garcia Maia, Gabriel Semione, Andrea Maria Alexandre, Leonardo Vilardo, Frédéric Clarençon, Yafell Serulle, Pascal Jabbour
{"title":"Safety and efficacy of the Contour Neurovascular System for treating intracranial aneurysms: a systematic review and meta-analysis.","authors":"Ahmet Günkan, Luca Scarcia, Marcio Yuri Ferreira, Marina Vilardo, Luis Flavio Fabrini Paleare, Jhon E Bocanegra-Becerra, Mohamed E M Fouad, Henrique Garcia Maia, Gabriel Semione, Andrea Maria Alexandre, Leonardo Vilardo, Frédéric Clarençon, Yafell Serulle, Pascal Jabbour","doi":"10.1136/jnis-2024-022461","DOIUrl":"10.1136/jnis-2024-022461","url":null,"abstract":"<p><strong>Background: </strong>The Contour Neurovascular System (CNS, Stryker, Kalamazoo, MI) has a unique design that allows it to address various aneurysm morphologies, including wide-necked, irregular, and shallow-shaped lesions. However, evidence of its safety and efficacy remains limited. This systematic review and meta-analysis synthesizes the current data on CNS performance.</p><p><strong>Methods: </strong>A comprehensive search guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) standards was performed across PubMed, Embase, and Web of Science, including studies with ≥5 patients reporting on CNS use. Efficacy outcomes included immediate and last follow-up adequate aneurysm occlusion and technical success. Safety outcomes included good functional outcome (modified Rankin Scale (mRS) score of 0-2 at last follow-up), procedure-related morbidity (permanent neurological deficits), procedure-related mortality, intraoperative and postoperative complications. Pooled analyses with 95% confidence intervals (CI) were conducted, with heterogeneity assessed using I² statistics, and a random-effects model was applied.</p><p><strong>Results: </strong>Nine studies, including 483 patients (58.8% female; mean age: 59.3±15.6 years) with 484 aneurysms, were analyzed. Of the 467 patients in whom rupture status was reported, 81.8% presented with unruptured aneurysms and 18.2% with ruptured aneurysms. Immediate adequate aneurysm occlusion rate was 53% (95% CI: 1% to 100%), with follow-up adequate occlusion at 93% (95% CI: 88% to 97%) and technical success at 98% (95% CI: 95% to 100%). Intraoperative and postoperative complication rates were 3% (95% CI: 0% to 7%) and 7% (95% CI: 3% to 12%), respectively. Procedure-related morbidity was 2% (95% CI: 0% to 3%), with no procedure-related mortality.</p><p><strong>Conclusion: </strong>The CNS is a safe and effective novel intrasaccular device for treating intracranial aneurysms.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693104","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}
引用次数: 0
Endovascular therapy versus medical management in isolated anterior cerebral artery acute ischemic stroke: a multinational multicenter propensity score-weighted study. 孤立性大脑前动脉急性缺血性卒中的血管内治疗与药物治疗:一项多国多中心倾向评分加权研究
IF 4.5 1区 医学
Journal of NeuroInterventional Surgery Pub Date : 2025-01-27 DOI: 10.1136/jnis-2024-022467
Hamza Adel Salim, Benjamin Pulli, Vivek Yedavalli, Fathi Milhem, Basel Musmar, Nimer Adeeb, Dhairya A Lakhani, Muhammed Amir Essibayi, Jeremy Josef Heit, Tobias D Faizy, Kareem El Naamani, Nils Henninger, Sri Hari Sundararajan, Anna Luisa Kuhn, Jane Khalife, Sherief Ghozy, Luca Scarcia, Leonard Ll Yeo, Benjamin Yq Tan, Robert W Regenhardt, Nicole M Cancelliere, Aymeric Rouchaud, Jens Fiehler, Sunil A Sheth, Ajit S Puri, Christian Dyzmann, Marco Colasurdo, Leonardo Renieri, João Pedro Filipe, Pablo Harker, Răzvan Alexandru Radu, Mohamad Abdalkader, Piers Klein, Thomas R Marotta, Julian Spears, Takahiro Ota, Ashkan Mowla, Pascal Jabbour, Arundhati Biswas, Frédéric Clarençon, James E Siegler, Thanh N Nguyen, Ricardo Varela, Amanda Baker, David Altschul, Nestor Gonzalez, Markus A Möhlenbruch, Vincent Costalat, Benjamin Gory, Paul Stracke, Constantin Hecker, Gaultier Marnat, Hamza Shaikh, Christoph J Griessenauer, David S Liebeskind, Alessandro Pedicelli, Andrea Maria Alexandre, Illario Tancredi, Erwah Kalsoum, Boris Lubicz, Aman B Patel, Vitor Mendes Pereira, Max Wintermark, Adrien Guenego, Adam A Dmytriw
{"title":"Endovascular therapy versus medical management in isolated anterior cerebral artery acute ischemic stroke: a multinational multicenter propensity score-weighted study.","authors":"Hamza Adel Salim, Benjamin Pulli, Vivek Yedavalli, Fathi Milhem, Basel Musmar, Nimer Adeeb, Dhairya A Lakhani, Muhammed Amir Essibayi, Jeremy Josef Heit, Tobias D Faizy, Kareem El Naamani, Nils Henninger, Sri Hari Sundararajan, Anna Luisa Kuhn, Jane Khalife, Sherief Ghozy, Luca Scarcia, Leonard Ll Yeo, Benjamin Yq Tan, Robert W Regenhardt, Nicole M Cancelliere, Aymeric Rouchaud, Jens Fiehler, Sunil A Sheth, Ajit S Puri, Christian Dyzmann, Marco Colasurdo, Leonardo Renieri, João Pedro Filipe, Pablo Harker, Răzvan Alexandru Radu, Mohamad Abdalkader, Piers Klein, Thomas R Marotta, Julian Spears, Takahiro Ota, Ashkan Mowla, Pascal Jabbour, Arundhati Biswas, Frédéric Clarençon, James E Siegler, Thanh N Nguyen, Ricardo Varela, Amanda Baker, David Altschul, Nestor Gonzalez, Markus A Möhlenbruch, Vincent Costalat, Benjamin Gory, Paul Stracke, Constantin Hecker, Gaultier Marnat, Hamza Shaikh, Christoph J Griessenauer, David S Liebeskind, Alessandro Pedicelli, Andrea Maria Alexandre, Illario Tancredi, Erwah Kalsoum, Boris Lubicz, Aman B Patel, Vitor Mendes Pereira, Max Wintermark, Adrien Guenego, Adam A Dmytriw","doi":"10.1136/jnis-2024-022467","DOIUrl":"10.1136/jnis-2024-022467","url":null,"abstract":"<p><strong>Background: </strong>Isolated anterior cerebral artery occlusions (ACAo) in patients with acute ischemic stroke present significant challenges due to their rarity. The efficacy and safety of endovascular therapy (EVT) in comparison with best medical therapy (BMT) for ACAo remains unclear. This study aimed to assess the outcomes of these treatments.</p><p><strong>Methods: </strong>This multinational, multicenter study analyzed data from the MAD-MT registry. Data were collected retrospectively from 37 sites across North America, Asia, and Europe. Inverse probability of treatment weighting (IPTW) was applied to balance confounding variables. The primary outcome was functional independence (modified Rankin Scale (mRS) scores of 0-2) at 90 days. Secondary outcomes included excellent outcomes (mRS 0-1), mortality at 90 days, and NIH Stroke Scale (NIHSS) score on day 1 post treatment.</p><p><strong>Results: </strong>Of the 108 patients, 36 received BMT and 72 underwent EVT. The median age was 75 years, and 56% were male. At 90 days, 40% of patients achieved mRS 0-2, with no significant difference between EVT and BMT (38% vs 45%, p=0.46). Procedural success (mTICI 2b-3) was 91% in the EVT group, with a sICH rate of 2.9%. IPTW-adjusted analysis showed no significant difference between EVT and BMT for functional independence (OR 1.17, 95% CI 0.23 to 6.02, p=0.85), mortality (25% vs 21%, p=0.71) or day 1 NIHSS scores (Beta 2.2, 95% CI -0.51 to 4.8, p=0.11).</p><p><strong>Conclusions: </strong>EVT showed high procedural success but did not significantly improve functional outcomes or mortality compared with BMT in patients with ACAo. Further randomized trials are needed to clarify EVT's role in ACAo.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755177","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}
引用次数: 0
Enhancing clinical practice: a critical appraisal of thoracic MRI prior to vertebral augmentation surgery in patients with lumbar vertebral fractures. 加强临床实践:腰椎骨折患者椎体隆胸手术前胸部MRI的关键评估。
IF 4.5 1区 医学
Journal of NeuroInterventional Surgery Pub Date : 2025-01-27 DOI: 10.1136/jnis-2024-022806
Xuefan Zeng, Xiya Wang, Yifei Gong
{"title":"Enhancing clinical practice: a critical appraisal of thoracic MRI prior to vertebral augmentation surgery in patients with lumbar vertebral fractures.","authors":"Xuefan Zeng, Xiya Wang, Yifei Gong","doi":"10.1136/jnis-2024-022806","DOIUrl":"10.1136/jnis-2024-022806","url":null,"abstract":"","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755179","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}
引用次数: 0
Computational modeling of basal ganglia hemorrhage morphology improves functional outcome prognostication after minimally invasive surgical evacuation. 基底神经节出血形态学的计算模型提高了微创手术后功能预后的预测。
IF 4.5 1区 医学
Journal of NeuroInterventional Surgery Pub Date : 2025-01-27 DOI: 10.1136/jnis-2024-022631
Ahmed Kashkoush, Rebecca L Achey, Mark Davison, Peter A Rasmussen, Varun R Kshettry, Nina Moore, Joao Gomes, Mark Bain
{"title":"Computational modeling of basal ganglia hemorrhage morphology improves functional outcome prognostication after minimally invasive surgical evacuation.","authors":"Ahmed Kashkoush, Rebecca L Achey, Mark Davison, Peter A Rasmussen, Varun R Kshettry, Nina Moore, Joao Gomes, Mark Bain","doi":"10.1136/jnis-2024-022631","DOIUrl":"10.1136/jnis-2024-022631","url":null,"abstract":"<p><strong>Introduction: </strong>Anatomic factors that predict outcomes following basal ganglia intracranial hemorrhage (bgICH) evacuation are poorly understood. Given the compact neuroanatomic organization of the basal ganglia, we hypothesized that bgICH spatial representation could predict postoperative functional outcomes.</p><p><strong>Methods: </strong>Patients undergoing minimally invasive surgical bgICH evacuation between 2013 and 2024 at one center were retrospectively reviewed. bgICH volumes were segmented and stereotactically localized using anatomic landmarks. Heat maps that identified bgICH spatial representation across functional outcome states were generated. Differential bgICH volume overlap with each heat map was calculated after subtracting out that patient's contribution to the map. Area under the receiver operating characteristic curve (AUC) was used to evaluate the diagnostic accuracy of differential volume overlap for poor functional outcome (modified Rankin Scale score of 4-6 within 1 year of surgery) and compared with that of the intracranial hemorrhage (ICH) score with a z test.</p><p><strong>Results: </strong>Forty-five patients were included (62% men, 7% Caucasian, median age 53 years). Thirty-two patients (71%) had poor functional outcome (median follow-up 4.1 months), which was associated with increased age (P=0.032), bgICH volume (P=0.005), intraventricular hemorrhage severity (P=0.032), National Institutes of Health Stroke Scale (P=0.006), and differential volume overlap (P<0.001). Anatomically, poor outcome was associated with bgICH extension into the anterior limb of the internal capsule (P=0.004), caudate (P=0.042), and temporal lobe (P=0.006). The AUC for differential volume overlap was 0.87 (95% CI: 0.76-0.97), which was higher than chance alone (P<0.001), but statistically similar to that (0.82 (0.71-0.97)) of the ICH score (P=0.545).</p><p><strong>Conclusion: </strong>Stereotactic bgICH localization enabled functional outcome prognostication in patients undergoing minimally invasive surgical evacuation.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791818","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}
引用次数: 0
Correspondence on 'Evaluating the effects of recreational drug use on ruptured cerebral arteriovenous malformation presentation and in-hospital outcomes: a national inpatient sample analysis' by Gajjar et al. Gajjar等人关于“评估娱乐性药物使用对脑动静脉畸形破裂表现和住院结果的影响:一项全国住院患者样本分析”的通信。
IF 4.5 1区 医学
Journal of NeuroInterventional Surgery Pub Date : 2025-01-27 DOI: 10.1136/jnis-2024-022873
Siyuan Yang, Jialei Zhou, Xiaoyu Ji
{"title":"Correspondence on 'Evaluating the effects of recreational drug use on ruptured cerebral arteriovenous malformation presentation and in-hospital outcomes: a national inpatient sample analysis' by Gajjar <i>et al</i>.","authors":"Siyuan Yang, Jialei Zhou, Xiaoyu Ji","doi":"10.1136/jnis-2024-022873","DOIUrl":"10.1136/jnis-2024-022873","url":null,"abstract":"","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854210","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}
引用次数: 0
Impact of imaging biomarkers from body composition analysis on outcome of endovascularly treated acute ischemic stroke patients. 通过身体成分分析获得的成像生物标志物对接受血管内治疗的急性缺血性脑卒中患者预后的影响。
IF 4.5 1区 医学
Journal of NeuroInterventional Surgery Pub Date : 2025-01-27 DOI: 10.1136/jnis-2024-022275
Hanna Styczen, Volker Maus, Daniel Weiss, Lukas Goertz, René Hosch, Christian Rubbert, Nikolas Beck, Mathias Holtkamp, Luca Salhöfer, Rosa Schubert, Cornelius Deuschl, Felix Nensa, Johannes Haubold
{"title":"Impact of imaging biomarkers from body composition analysis on outcome of endovascularly treated acute ischemic stroke patients.","authors":"Hanna Styczen, Volker Maus, Daniel Weiss, Lukas Goertz, René Hosch, Christian Rubbert, Nikolas Beck, Mathias Holtkamp, Luca Salhöfer, Rosa Schubert, Cornelius Deuschl, Felix Nensa, Johannes Haubold","doi":"10.1136/jnis-2024-022275","DOIUrl":"10.1136/jnis-2024-022275","url":null,"abstract":"<p><strong>Background: </strong>We investigate the association of imaging biomarkers extracted from fully automated body composition analysis (BCA) of computed tomography (CT) angiography images of endovascularly treated acute ischemic stroke (AIS) patients regarding angiographic and clinical outcome.</p><p><strong>Methods: </strong>Retrospective analysis of AIS patients treated with mechanical thrombectomy (MT) at three tertiary care-centers between March 2019-January 2022. Baseline demographics, angiographic outcome and clinical outcome evaluated by the modified Rankin Scale (mRS) at discharge were noted. Multiple tissues, such as muscle, bone, and adipose tissue were acquired with a deep-learning-based, fully automated BCA from CT images of the supra-aortic angiography.</p><p><strong>Results: </strong>A total of 290 stroke patients who underwent MT due to cerebral vessel occlusion in the anterior circulation were included in the study. In the univariate analyses, among all BCA markers, only the lower sarcopenia marker was associated with a poor outcome (P=0.007). It remained an independent predictor for an unfavorable outcome in a logistic regression analysis (OR 0.6, 95% CI 0.3 to 0.9, P=0.044). Fat index (total adipose tissue/bone) and myosteatosis index (inter- and intramuscular adipose tissue/total adipose tissue*100) did not affect clinical outcomes.</p><p><strong>Conclusion: </strong>Acute ischemic stroke patients with a lower sarcopenia marker are at risk for an unfavorable outcome. Imaging biomarkers extracted from BCA can be easily obtained from existing CT images, making it readily available at the beginning of treatment. However, further research is necessary to determine whether sarcopenia provides additional value beyond established outcome predictors. Understanding its role could lead to optimized, individualized treatment plans for post-stroke patients, potentially improving recovery outcomes.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348452","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}
引用次数: 0
Magnesium-based bioresorbable flow diverter for intracranial aneurysms: a pilot study of biocompatibility and bioresorption in a rabbit vascular model. 用于颅内动脉瘤的镁基生物可吸收血流分流器:在兔子血管模型中进行的生物相容性和生物吸收试验研究。
IF 4.5 1区 医学
Journal of NeuroInterventional Surgery Pub Date : 2025-01-27 DOI: 10.1136/jnis-2024-022527
Ryo Akiyama, Akira Ishii, Natsuhi Sasaki, So Matsukawa, Shinichi Yagi, Hideo Chihara, Hidehisa Nishi, Kiyotaka Iwasaki, Shinichi Sakurai, Yoshihito Kawamura, Yoshiki Arakawa
{"title":"Magnesium-based bioresorbable flow diverter for intracranial aneurysms: a pilot study of biocompatibility and bioresorption in a rabbit vascular model.","authors":"Ryo Akiyama, Akira Ishii, Natsuhi Sasaki, So Matsukawa, Shinichi Yagi, Hideo Chihara, Hidehisa Nishi, Kiyotaka Iwasaki, Shinichi Sakurai, Yoshihito Kawamura, Yoshiki Arakawa","doi":"10.1136/jnis-2024-022527","DOIUrl":"10.1136/jnis-2024-022527","url":null,"abstract":"<p><strong>Background: </strong>Bioresorbable flow diverters (BRFDs) have the potential to solve several problems associated with conventional permanent flow diverters. We have constructed bare and poly-L-lactic acid (PLLA)-coated magnesium BRFDs (MgBRFDs) using a high-strength corrosion-resistant magnesium alloy. This study aimed to compare bioresorption and biocompatibility between the two types in a rabbit vascular model to determine which is more clinically feasible in humans.</p><p><strong>Methods: </strong>Bare and PLLA-coated MgBRFDs were fabricated by braiding 48 thin magnesium alloy wires. Mechanical testing was conducted. Bare (n=13) and PLLA-coated (n=13) MgBRFDs were implanted into rabbit aortas and harvested 14, 30, and 90 days after implantation. The physical structure of the resolution process was examined using optical coherence tomography (OCT), micro-computed tomography, and scanning electron microscopy (SEM). The biological response of the vascular tissue was examined using SEM and histopathological analysis.</p><p><strong>Results: </strong>The porosity and pore density of the bare MgBRFD were 64% and 16 pores/mm<sup>2</sup>, respectively; corresponding values for the PLLA-coated MgBRFD were 63% and 12 pores/mm<sup>2</sup>, respectively. The OCT attenuation score was significantly higher for the PLLA-coated MgBRFD at all time points (14 days, P=0.01; 30 days, P=0.02; 90 days, P=0.004). OCT, micro-computed tomography, and SEM demonstrated better stent structure preservation with the PLLA-coated MgBRFD. Neointimal thickness did not significantly change over time in either type of MgBRFD (bare, P=0.93; PLLA-coated, P=0.34); however, the number of inflammatory and proliferative cells peaked at 14 days and then decreased.</p><p><strong>Conclusions: </strong>Both bare and PLLA-coated MgBRFDs had excellent biocompatibility. The PLLA-coated MgBRFD has greater clinical feasibility because of its delayed bioresorption.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681781","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}
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