Journal of NeuroInterventional Surgery最新文献

{"title":"Combined collaterals and hemodynamic features to predict the prognosis in acute ischemic stroke patients undergoing mechanical thrombectomy.","authors":"Zhiruo Song, Xiang Fang, Xuerong Jia, Rui Liu, Dong Yang, Anyu Liao, Feiluola Kasaer, Yan Xu, Zhiguo Zhang, Wusheng Zhu, Kangmo Huang, Xinfeng Liu","doi":"10.1136/jnis-2024-022428","DOIUrl":"10.1136/jnis-2024-022428","url":null,"abstract":"<p><strong>Background: </strong>Despite successful recanalization via mechanical thrombectomy (MT), only half of acute ischemic stroke (AIS) patients achieve functional independence. Post-MT hemodynamic features are insufficiently investigated, and the lack of bilateral comparisons limits individual assessment. Therefore, we aimed to explore how individualized hemodynamic features affect functional outcomes using quantitative digital subtraction angiography (Q-DSA).</p><p><strong>Methods: </strong>We screened three prospective databases for anterior circulation AIS participants with successful recanalization via MT. Hemodynamic features, including time to peak (TTP), were measured for four regions of interest (ROIs) on each side with Q-DSA. ROI_C2 served as a reference for correcting TTP values. We defined TTP variation (TTPV), as the degree of difference in TTP between the symptomatic and the healthy sides. A composite indicator, integrating TTPV and collateral status, was developed to reflect comprehensive perfusion capacity. Multivariable logistic regression was employed to investigate the association between TTPV, or the composite indicator, and functional outcomes (90-day modified Rankin Scale <2).</p><p><strong>Result: </strong>Finally, 201 participants (median (interquartile range (IQR) age 68 (57, 75] years, 64.2% males) were enrolled, and 97 (48.3%) patients achieved favourable functional outcomes. TTPV_C2-M1 was significantly related to favorable functional outcome (adjusted OR (aOR) = 0.627; 95% confidence interval (0.407, 0.966); p=0.034). Additionally, the composite indicator of good collaterals and low TTPV_C2-M1 was a powerful predictor for the favorable outcome (aOR=6.693; 95% confidence interval (2.652, 16.896); P<0.001).</p><p><strong>Conclusion: </strong>TTPV_C2-M1 and the composite perfusion indicator showed significant predictive value in prognosis and potentially guided intra-procedure interventions and subsequent management among AIS patients.</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":"142882318","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":"Correspondence on 'Comparing stand-alone endovascular embolization versus stereotactic radiosurgery in the treatment of arteriovenous malformations with Spetzler-Martin grades I-III: a propensity score matched study' by Musmar <i>et al</i>.","authors":"Keyur Shah, Dwarakanath Srinivas","doi":"10.1136/jnis-2024-022670","DOIUrl":"10.1136/jnis-2024-022670","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":"142622201","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":"Comparing validated stroke screening scales for identifying large and medium vessel occlusions: a prospective observational cohort study.","authors":"Sachin A Kothari, Rami Z Morsi, Olivia A Kozel, Archit Baskaran, Neha Sehgal, Okker Verhagen Metman, Harsh Desai, Julian Carrion-Penganos, Sonam Thind, Matthew M Smith, Rohini Rana, Ahmad Chahine, Jehad Zakaria, Lina Karar, Ahmad Sweid, James E Siegler, Elisheva R Coleman, James R Brorson, Scott J Mendelson, Ali Mansour, Shyam Prabhakaran, Tareq Kass-Hout","doi":"10.1136/jnis-2024-022309","DOIUrl":"10.1136/jnis-2024-022309","url":null,"abstract":"<p><strong>Background: </strong>Rapid prehospital identification of acute ischemic stroke secondary to large vessel occlusions (AIS-LVO) has been successful in triaging patients, but the use of stroke screening scales often varies. This study aims to compare different stroke screening scales for the detection of anterior and posterior circulation AIS-LVO and AIS secondary to medium vessel occlusions (AIS-MeVO).</p><p><strong>Methods: </strong>We prospectively analyzed stroke alert activations at a comprehensive stroke center between August 1, 2022 and December 31, 2023. We applied eight stroke screening scales (BE-FAST, LAMS, PASS, FAST-ED, EMS RACE, 3-ISS, VAN, and NIHSS) to each stroke alert in the emergency department (ED) and inpatient wards. The final diagnosis was classified as AIS-LVO or AIS-MeVO, AIS without LVO or MeVO, intracranial hemorrhage, transient ischemic attack, or stroke mimic.</p><p><strong>Results: </strong>A total of 198 patients were analyzed. The mean age was 63.9±15.3 years, 62.1% were female (n=123), and 84.3% were African American/black subjects (n=167). The LAMS scale had a strong performance (area under the curve (AUC) 0.750 (95% CI 0.668 to 0.831)), closely followed by the FAST-ED (AUC 0.736 (95% CI 0.649 to 0.822)) and the VAN (AUC 0.735 (95% CI 0.651 to 0.818)) scales. Cut-off points selected from coordinates of the receiver operating characteristic curves were 3, 3, and a positive VAN, respectively.</p><p><strong>Conclusion: </strong>This is the first prospective cohort study to compare the performance of eight different screening scales among stroke alerts for detection of AIS-LVO and AIS-MeVO. We found LAMS to be the most discriminative tool, followed by FAST-ED and VAN. However, the findings were non-significant, reinforcing existing retrospective literature that these validated screening scales perform similarly and one is not superior.</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":"142564413","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":"Embolization of indirect carotid cavernous fistulas via the vein of Labbé using contralateral approach.","authors":"Dang-Khoi Tran, Chih Wei Huang, Wen-Hsien Chen, Meng-Ju Lee, Yuang-Seng Tsuei","doi":"10.1136/jnis-2024-022311","DOIUrl":"10.1136/jnis-2024-022311","url":null,"abstract":"<p><p>In our report, we present the case of a 60-year-old adult with symptomatic indirect carotid-cavernous fistulas (CCFs). All venous outflow routes from the cavernous sinus were absent except for an engorged left superficial middle cerebral vein, which extended through the left vein of Labbé to the left transverse sinus and then to right transverse-sigmoid sinus. We approached the diseased cavernous sinus retrogradely, starting from the right femoral vein and passing through the right transverse-sigmoid sinus, left transverse sinus, and left vein of Labbé, ultimately reaching the left CCFs. Embolization was performed using coils, successfully obliterating the fistulas without complications. This case represents the second reported approach through the vein of Labbé for CCFs and the first using a trans-Labbé vein from a contralateral approach (video 1), proving advantageous by avoiding an acute angle between the vein of Labbé and the ipsilateral sigmoid sinus.1-6neurintsurg;jnis-2024-022311v3/V1F1V1Video 1Embolization of CCF using a Trans-Labbé vein from a contralateral approach.‍.</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":"142638840","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 intracranial hypertension secondary to superior sagittal sinus stenosis from invasive meningioma.","authors":"Amanda Baker, Dhrumil Vaishnav, Muhammed Amir Essibayi, Deepak Khatri, David J Altschul","doi":"10.1136/jnis-2024-022602","DOIUrl":"10.1136/jnis-2024-022602","url":null,"abstract":"<p><p>Idiopathic intracranial hypertension (IIH) is characterized by elevated intracranial pressure without a clear cause, often linked to cerebral venous sinus constriction from embryological or acquired factors. Although less common, brain tumors like parasagittal meningiomas can compress the superior sagittal sinus, leading to IIH. Venous stenting has become a minimally invasive and effective intervention for managing IIH caused by superior sagittal sinus stenosis, particularly when residual meningiomas continue to exert pressure on the sinus.1-6Video 1 presents a step-by-step technique for deploying dual Onyx cardiac stents to treat stenosis in the superior sagittal sinus, which is complemented by middle meningeal artery embolization. This helps to reduce the vascular supply to the remaining meningioma tissue. This combined approach not only provides immediate relief from IIH symptoms but also minimizes surgical risks, such as venous infarction and excessive blood loss. It serves as a valuable adjunct in cases where complete surgical tumor removal is challenging.neurintsurg;jnis-2024-022602v2/V1F1V1Video 1- Techinical video of a case of superior sagittal sinus stenosis from an invasive meningioma causing intracranial hypertension successfully treated with a coronary balloon mounted stent.</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":"142638851","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":"DOT sign indicates persistent hypoperfusion and poor outcome in patients with incomplete reperfusion following thrombectomy.","authors":"Adnan Mujanovic, Daniel Windecker, Bettina Serrallach, Christoph C Kurmann, Roman Rohner, Elias Auer, Petra Cimflova, Thomas R Meinel, Franziska Dorn, René Chapot, David Seiffge, Eike Immo I Piechowiak, Tomas Dobrocky, Jan Gralla, Urs Fischer, Sara Pilgram-Pastor, Johannes Kaesmacher","doi":"10.1136/jnis-2024-022253","DOIUrl":"10.1136/jnis-2024-022253","url":null,"abstract":"<p><strong>Background: </strong>Distal occlusions associated with incomplete reperfusion (expanded Thrombolysis in Cerebral Infarction, <eTICI 3) may not reperfuse spontaneously and thus prompt ischemia (ie, persistent hypoperfusion). We aimed to assess whether the recently reported Distal Occlusion Tracker (DOT) sign on immediate non-contrast post-interventional flat-panel detector computed tomography (FPDCT) is associated with persistent hypoperfusion.</p><p><strong>Methods: </strong>Retrospective registry analysis of patients undergoing endovascular therapy between July 2020 and December 2022, with available immediate post-interventional FPDCT and 24 hours follow-up perfusion imaging. Persistent hypoperfusion was defined as a perfusion deficit at 24 hours directly corresponding to the area of incomplete reperfusion on final angiography run. The DOT sign was defined as a punctiform or tubular hyperdense signal increase on FPDCT indicative of a residual occlusion. Association between the DOT sign (present/absent) with the occurrence of persistent hypoperfusion and poor outcome (modified Rankin scale (mRS) score 3-6) was evaluated using logistic regression analysis.</p><p><strong>Results: </strong>Of 292 patients included (median age 73 years; 47% female), 209 had incomplete reperfusion. Among patients with incomplete reperfusion, 61% had a present DOT sign and 46% had persistent hypoperfusion. In the overall cohort, but also within each eTICI stratum, a present DOT sign was associated with persistent hypoperfusion on 24±12 hours follow-up perfusion imaging (adjusted odds ratio (aOR) 4.8, 95% confidence interval (CI) 2.0 to 12.3 for patients with eTICI 2 a-2c). A present DOT sign was also associated with poor outcome (aOR 2.6, 95% CI 1.1 to 6.2).</p><p><strong>Conclusion: </strong>Patients with <eTICI 3 and a present DOT sign have a higher likelihood of persistent hypoperfusion and might constitute a subgroup that could particularly benefit from additional reperfusion attempts.</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":"142289415","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":"Endovascular arterial embolization versus conservative management with nasal packing alone for severe epistaxis: a nationwide cohort study.","authors":"Huanwen Chen, Mihir Khunte, Marco Colasurdo, Sonali Gunawardane, Ajay Malhotra, Dheeraj Gandhi","doi":"10.1136/jnis-2024-022790","DOIUrl":"10.1136/jnis-2024-022790","url":null,"abstract":"<p><strong>Background: </strong>Endovascular arterial embolization (EAE) is an effective treatment for severe epistaxis refractory to conservative management with nasal packing. However, contemporary real-world data are lacking, as are data on head-to-head comparisons of EAE versus nasal packing alone.</p><p><strong>Methods: </strong>This was a retrospective cohort study of the Nationwide Readmissions Database (NRD) from 2016 to 2021 in the United States. Patients with severe epistaxis treated with nasal packing alone or EAE with or without nasal packing were included and followed for 180 days. Propensity score matching (PSM) for demographics, comorbidities, and hemorrhage risk factors was performed to balance patient characteristics. Primary outcome was recurrent epistaxis. Secondary outcomes include rates of non-routine hospital discharge (indicating short-term morbidity or mortality) and ischemic stroke.</p><p><strong>Results: </strong>25 160 patients admitted to hospital for severe epistaxis were included; 754 (3.3%) underwent EAE. After PSM, 1542 patients remained in the conservative management group, and 743 remained in the EAE group. Overall, the risk of epistaxis readmission was lower after EAE compared with conservative management (HR 0.47, 95% CI 0.26 to 0.87, P=0.016); the 180-day epistaxis readmission rate was 4.6% and 10.6%, respectively (P=0.024). EAE was significantly associated with lower rates of non-routine discharge (22.1% vs 28.9%, P=0.026), despite a higher rate of ischemic stroke (1.6% vs 0.4%, P=0.017).</p><p><strong>Conclusions: </strong>For patients with severe epistaxis, EAE is associated with a significant reduction of epistaxis recurrence rates as well as lower rates of patient morbidity compared with nasal packing alone, despite a small but significant increase in risk of ischemic stroke.</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":"142882321","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":"Effect of abnormal distribution of abdominal adiposity and skeletal muscle on the outcomes of endovascular treatment for emergent large vessel occlusion.","authors":"Chengcheng Cui, Zhiwen Geng, Hao Chen, Mengxia Lu, Yuqiao Wang, Dayong Shen, Rui Li, Lulu Xiao, Xinfeng Liu","doi":"10.1136/jnis-2024-022386","DOIUrl":"10.1136/jnis-2024-022386","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to investigate the relationships between imaging indicators of obesity, as measured by computed tomography (CT), and clinical outcomes at 90 days and 1 year after emergent endovascular therapy (EVT).</p><p><strong>Methods: </strong>Participants with emergent large vessel occlusion (ELVO) who underwent EVT were prospectively enrolled. During hospitalization, CT scans were performed to evaluate the visceral adipose tissue area (VATA) and skeletal muscle area (SMA) at the level of the third lumbar spine. Multivariate regression analysis was used to assess the correlation of obesity-related imaging measures with various outcomes: mortality, favorable functional outcomes (modified Rankin scale (mRS) score 0-2), and functional improvement (shift in mRS score) at 90 days and 1 year.</p><p><strong>Results: </strong>A total of 306 ELVO patients were included in the study, with a median age of 64 years and a median baseline National Institutes of Health Stroke Scale (NIHSS) score of 18. After adjusting for potential confounders, the VATA-to-SMA ratio (VSR) was significantly associated with a favorable functional outcome (OR 0.30, 95% CI 0.13 to 0.70) at 90 days and a favorable functional outcome (OR 0.27, 95% CI 0.12 to 0.61) and functional improvement (OR 0.33, 95% CI 0.12 to 0.92) at the 1 year follow-up.</p><p><strong>Conclusion: </strong>Our study indicated that lower VSR levels are associated with favorable functional outcomes, along with functional improvement at 90 days and 1 year of follow-up.</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":"142576011","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":"The correlation between intracranial pressure and venous sinus pressures changes after venous sinus stenting.","authors":"Ankitha M Iyer, Jackson P Midtlien, Carol Kittel, Lucas A Klever, Angelina Wiater, Emily Chang, Connor Margraf, Kyle M Fargen","doi":"10.1136/jnis-2024-022250","DOIUrl":"10.1136/jnis-2024-022250","url":null,"abstract":"<p><strong>Background: </strong>The pathophysiology of idiopathic intracranial hypertension (IIH) and other cerebral venous outflow disorders (CVD) has largely been unexplored. While a correlation between venous sinus pressure and opening pressure (OP) has been previously noted, there are limited data on this relationship in patients with prior venous sinus stenting (VSS).</p><p><strong>Methods: </strong>A single center retrospective chart review was conducted on CVD patients who underwent diagnostic cerebral venography with manometry followed immediately by lateral decubitus lumbar puncture, from 2016 to 2024.</p><p><strong>Results: </strong>206 patients underwent 216 total procedures and were included. Among all patients, there was a moderate nearly one-to-one correlation between OP and torcular or superior sagittal sinus (SSS) pressures. Thirty-two patients underwent testing after having undergone VSS. Patients with previous VSS showed a significantly altered relationship between venous pressures and OP, whereby as venous sinus pressures increased, OP increased more gradually in previously stented patients compared with non-stented patients. For example, when OP was fixed at 21 mm Hg and body mass index at 30 kg/m², predicted mean SSS pressure was 19.47 mm Hg in non-stented patients versus 16.91 mm Hg in stented patients.</p><p><strong>Conclusion: </strong>This study confirmed a strong relationship between OP and venous sinus pressure in CVD patients. However, patients with previous VSS demonstrated an altered relationship with higher CSF pressures relative to venous pressures compared with naïve patients. This finding may have important clinical implications in the management of IIH patients.</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":"142365459","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":"Onyx dilution reduces time to resolution of chronic subdural hematomas after middle meningeal artery embolization.","authors":"Alice Hung, Wuyang Yang, Oishika Das, Xihang Wang, Kathleen Ran, Emeka Ejimogu, Mostafa Abdulrahim, Ryan Nakamura, Ferdinand Hui, Vivek Yedavalli, Christopher M Jackson, Judy Huang, Rafael J Tamargo, Justin M Caplan, L Fernando Gonzalez, Risheng Xu","doi":"10.1136/jnis-2024-022492","DOIUrl":"10.1136/jnis-2024-022492","url":null,"abstract":"<p><strong>Background: </strong>The benefit of distal embolite penetration for middle meningeal artery (MMA) embolization in chronic subdural hematomas (cSDH) remains controversial.</p><p><strong>Objective: </strong>To compare the use of diluted Onyx with undiluted Onyx in the management of cSDH.</p><p><strong>Methods: </strong>This is a retrospective study of patients with cSDH who underwent MMA embolization using Onyx 18 at our institution. The study population was divided into two subgroups based on whether the Onyx used was diluted or not. Baseline characteristics and technical aspects were compared. Primary outcome was cSDH resolution at follow-up. Secondary outcomes included time to resolution and duration of procedure. Univariate statistical analysis was performed.</p><p><strong>Results: </strong>Of the 111 MMA embolizations performed at our institution, 99 were performed using Onyx 18 only. Within this cohort, 53 (53.5%) cases used standard Onyx and 46 (46.5%) cases used diluted Onyx. The diluted Onyx group had significantly greater volume of embolic agent used measured radiographically (P<0.001). There was no significant difference in duration of procedure. The percentage of cSDH resolution at last follow-up was similar between the two groups (P=0.98), but the time to resolution was significantly shorter in the diluted Onyx group (P=0.02).</p><p><strong>Conclusion: </strong>The use of diluted Onyx for MMA embolization is associated with greater embolization volume achieved under similar procedural times. While the percentage of patients who achieved cSDH resolution with diluted Onyx is similar to that for standard Onyx, the time to cSDH resolution is significantly shorter. Adoption of Onyx dilution can be considered in MMA embolization for cSDH.</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":"142622204","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}