Journal of NeuroInterventional Surgery最新文献

{"title":"Age-related differences in diffusion-weighted imaging lesion volume and reversal in patients with successful recanalization after mechanical thrombectomy.","authors":"Satoshi Takaishi, Toshihiro Ueda, Noriko Usuki, Kentaro Tatsuno, Tomohide Yoshie, Yoshihisa Yamano","doi":"10.1136/jnis-2024-021922","DOIUrl":"10.1136/jnis-2024-021922","url":null,"abstract":"<p><strong>Background: </strong>With the advancement of mechanical thrombectomy (MT), post-treatment diffusion-weighted imaging (DWI) lesion reversal (DWIR) has been reported. This study aimed to compare the volumes of DWI lesions and the frequencies of DWIR between younger and elderly patients who underwent successful recanalization with MT.</p><p><strong>Methods: </strong>The study retrospectively analyzed 177 consecutive patients who underwent successful recanalization with MT for anterior large vessel occlusion (LVO) at our hospital between April 2011 and September 2022. Patients were categorized into two age groups: <70 years and ≥70 years. MRI was performed before treatment and 24 hours after treatment. The DWI lesion volumes and DWIR frequencies were compared between the two groups.</p><p><strong>Results: </strong>The median age of the patients was 78 years and 19.8% were in the <70 years group. No significant differences were found between the groups in terms of occluded vessel sites and recanalization time. The baseline DWI lesion was significantly larger in the <70 years group (16.0 mL vs 4.0 mL, P<0.001). The frequency of DWIR did not significantly differ between the groups (65.7% vs 55.6%). DWI lesion volume significantly decreased after treatment in the <70 years group but showed no significant change in the ≥70 years group.</p><p><strong>Conclusions: </strong>In patients who underwent successful recanalization after MT for anterior LVO, baseline DWI lesions were significantly larger in younger patients compared with elderly patients. Although more than half of the patients in both age groups experienced DWIR, a significant reduction in DWI lesion volume was only observed in younger patients.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"925-931"},"PeriodicalIF":4.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975899","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 treatment of unruptured intracranial aneurysms: Rate of thromboembolic events depicted by diffusion-weighted imaging in relation to different techniques.","authors":"Laurent Pierot, Aymeric Rouchaud, Emmanuel Chabert, Hubert Desal, Frédéric Ricolfi, Coralie Barbe, Sébastien Soize, Adberrahim Zerroug, Francois Eugène, Frédéric Clarençon, Jean-Christophe Ferré","doi":"10.1136/jnis-2024-022051","DOIUrl":"10.1136/jnis-2024-022051","url":null,"abstract":"<p><strong>Background: </strong>The rate of thromboembolic events (TEEs) associated with endovascular treatment (EVT) of intracranial aneurysms is not reported uniformly in the literature due to the various ways that are used to evaluate them. Analysis of Thromboembolic Complications after Endovascular Treatment of Unruptured Intracranial Aneurysms study (ACET) is a prospective, multicenter study, which analyzes the rate of TEEs using diffusion-weighted imaging (DWI) magnetic resonance imaging (MRI) in patients treated for unruptured aneurysms with different endovascular techniques.</p><p><strong>Methods: </strong>Patients were prospectively included in six French centers. Postoperative DWI-MRI was performed within 72 hours post-procedure and independently evaluated. Univariate and multivariate analyses were conducted to determine factors associated with the occurrence of DWI lesions.</p><p><strong>Results: </strong>Of the 233 included patients (54.5±11.2 years, 162 women, (69.5%)), 226 were effectively treated by EVT (coiling: 90 patients, 39.8%; balloon-assisted coiling (BAC): 62, 27.4%; stent-assisted coiling (SAC): 10, 4.4%; flow diversion (FD): 21, 9.3%; intrasaccular flow disruption (ISFD): 43, 19.0%) and had a postoperative MRI showing DWI lesions in 133 patients (58.8%). Univariate and multivariate analyses show the rate of patients with DWI lesions to be significantly higher with BAC (75.8%, P=0.001), SAC (90.0%, P=0.02), and FD (95.2%, P=0.001) compared with coiling alone (41.1%).</p><p><strong>Conclusions: </strong>The rate of DWI lesions after EVT of unruptured aneurysms is primarily influenced by the EVT technique used. Techniques using transient (BAC) or permanent (SAC and FD) device placement in the parent artery are associated with a higher rate of DWI lesions.</p><p><strong>Trial registration number: </strong>ACET: Unique identifier: NCT02862756.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"949-955"},"PeriodicalIF":4.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878870","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":"Transcirculation retrograde placement of a Pipeline embolization device for treatment of a vertebrobasilar junction aneurysm.","authors":"Visish M Srinivasan, Christopher S Graffeo, Lea Scherschinski, Neil Majmundar, Joshua S Catapano, Ethan A Winkler, Ashutosh P Jadhav, Andrew F Ducruet, Michael T Lawton, Felipe C Albuquerque","doi":"10.1136/jnis-2023-021363","DOIUrl":"10.1136/jnis-2023-021363","url":null,"abstract":"<p><p>Transcirculation catheterization, also known as the retrograde approach, involves the navigation of a catheter or other endovascular device from one arterial circulation to the other (right to left, or anterior to posterior).1-4 We present a case of a complex vertebrobasilar junction aneurysm previously treated by bilateral vertebral artery deconstruction, precluding antegrade access (video 1). Following the creation of a protective occipital artery to posterior inferior cerebellar artery (PICA) bypass, the patient was treated with transcirculation placement of a Pipeline embolization device (PED).5-9 The right internal carotid artery was accessed with a guide catheter using a transradial approach. The microwire-microcatheter combination was then tracked through the right posterior communicating artery, down the basilar trunk, and to the left PICA. The PED was successfully deployed from the left vertebral artery to the mid-basilar artery. At 3-month follow-up, the aneurysm was completely obliterated. The nuances of transcirculation technique, especially for flow diversion, are discussed. (Used with permission from Barrow Neurological Institute, Phoenix, Arizona, USA.) neurintsurg;17/9/1024/V1F1V1Video 1Transcirculation retrograde placement of a Pipeline embolization device for treatment of a vertebrobasilar junction aneurysm previously treated by bilateral vertebral artery deconstruction, precluding antegrade access.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"1024"},"PeriodicalIF":4.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306072","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":"Venous sinus stenting under conscious sedation.","authors":"Erwah Kalsoum, Luca Scarcia, Mohamad Abdalkader, Adam A Dmytriw, Firas Farhat, Titien Tuilier, Maxime Geismar, Christophe Quesnel, Ayman Tourbah, Mohamed Abdellaoui, Thanh N Nguyen, Raghid Kikano, Rami El Ojaimi","doi":"10.1136/jnis-2024-022109","DOIUrl":"10.1136/jnis-2024-022109","url":null,"abstract":"<p><strong>Background: </strong>Venous sinus stenting (VSS) is an increasingly performed procedure for the treatment of idiopathic intracranial hypertension (IIH) refractory to medical treatment. VSS is typically performed under general anesthesia.</p><p><strong>Objective: </strong>To present our experience of VSS in patients with IIH performed under conscious sedation.</p><p><strong>Methods: </strong>Retrospective review of a prospectively maintained database of all patients with IIH who underwent VSS in a single center between September 2019 and January 2024. The sedation protocol consisted of a remifentanil-based target-controlled infusion. Patients' clinical and radiological data, dosage of anesthesia, procedural characteristics, and outcomes were collected.</p><p><strong>Results: </strong>Twenty-six patients with IIH underwent venous manometry (VM) and VSS under awake sedation and were included in our study. Patients were predominantly women (24/26) with a median age (IQR) of 33 (13) years. The median (IQR) body mass index was 34 (10) kg/m². There was no need for general anesthesia conversion. Technical success was achieved in all patients. Median (IQR) follow-up after stenting was 7 (2) months. All patients reported resolution of the pulsatile tinnitus; headaches regressed in 20/24 (83.3%) patients and papilledema improved in 16/20 (80%). Only one non-neurological complication (retroperitoneal hematoma) occurred, without any permanent morbidity or mortality.</p><p><strong>Conclusion: </strong>Our study confirms that performing VM and VSS under conscious sedation is safe and feasible. Conscious sedation is a viable alternative to general anesthesia for managing IIH in these patients.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"939-942"},"PeriodicalIF":4.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The benefit of favorable venous outflow profiles is mediated through the reduced risk of intracranial hemorrhage in acute ischemic stroke patients undergoing endovascular treatment.","authors":"Shuyu Jiang, Chen Gong, Liping Huang, You Wang, Zhiyuan Wang, Yankun Chen, Jinxian Yuan, Li Wang, Siyin Gong, Dandan Tan, Peng Zhang, Yunyi Huang, Yuetao Wen, Yang Hu, Zhipeng Li, Wenze Li, Jin Liu, Jing Guo, Shengli Chen, Yangmei Chen, Tao Xu","doi":"10.1136/jnis-2024-021826","DOIUrl":"10.1136/jnis-2024-021826","url":null,"abstract":"<p><strong>Background: </strong>Favorable venous outflow (VO) has been recognized as an independent predictor of excellent clinical outcomes in acute ischemic stroke caused by anterior circulation large vessel occlusion (AIS-LVO) patients who received endovascular treatment (EVT). However, the reasons why VO affects clinical outcomes have not been fully explained. In this study, we aimed to identify the potential mediators of VO affecting prognosis.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective cohort study of consecutive patients with AIS-LVO who underwent EVT. Baseline computed tomographic angiography (CTA) was applied to assess VO by the Cortical Vein Opacification Score (COVES). The primary outcome was functional independence at 90 days (modified Rankin Scale (mRS) score of 0-2). Classifying subtypes of intracranial hemorrhage (ICH) to explore the relationship between ICH subtypes and VO. Multivariate logistic regression and causal mediation analyses were used to evaluate the relationship among VO, functional independence, and potential mediators.</p><p><strong>Results: </strong>Among 860 AIS-LVO patients undergoing EVT, a total of 515 patients were included in the present study after strict screening. In multivariate logistic regression analysis, favorable VO profiles (defined as COVES 3-6) were significantly associated with a lower incidence of ICH (24.2% vs 46.9%, adjusted odds ratio (aOR) 0.48, 95% confidence interval (CI) 0.30 to 0.77, P=0.002) and a higher proportion of functional independence (58.9% vs 15.0%, aOR 4.07, 95% CI 2.41 to 6.88, P<0.001). Mediation analysis showed that favorable VO profiles significantly reduced the incidence of parencuymal hematoma (PH) 2 accounting for 8.0% (95% CI 0.9% to 19.0%) of its beneficial effect on functional independence.</p><p><strong>Conclusion: </strong>This study demonstrated the potential mediating effects of severe ICH for the beneficial effect of favorable VO on clinical prognosis among patients with AIS-LVO who underwent EVT.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"967-973"},"PeriodicalIF":4.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751937","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":"Development and validation of a nomogram for cerebral hemorrhage in patients with carotid stenosis undergoing stenting: a multicenter retrospective study.","authors":"Xianjun Zhang, Xiaoliang Wang, Teng Ma, Wentao Gong, Yong Zhang, Naidong Wang","doi":"10.1136/jnis-2024-022022","DOIUrl":"10.1136/jnis-2024-022022","url":null,"abstract":"<p><strong>Background: </strong>Hyperperfusion-induced cerebral hemorrhage (HICH) is a rare but severe complication in patients with carotid stenosis undergoing stent placement for which predictive models are lacking. Our objective was to develop a nomogram to predict such risk.</p><p><strong>Methods: </strong>We included a total of 1226 patients with carotid stenosis who underwent stenting between June 2015 and December 2022 from three medical centers, divided into a development cohort of 883 patients and a validation cohort of 343 patients. The model used LASSO regression for feature optimization and multivariable logistic regression to develop the predictive model. Model accuracy was assessed via the receiver operating characteristic curve, with further evaluation of calibration and clinical utility through calibration curves and decision curve analysis (DCA). The model underwent internal validation using bootstrapping and external validation with the validation cohort.</p><p><strong>Results: </strong>Older age (OR 1.07, p=0.005), higher degrees of carotid stenosis (OR 1.07, p=0.006), poor collateral circulation (OR 6.26, p<0.001), elevated preoperative triglyceride levels (OR 1.27, p=0.041) and neutrophil counts (OR 1.36, p<0.001) were identified as independent risk factors for HICH during hospitalization. The nomogram constructed based on these predictive factors demonstrated an area under the curve (AUC) of 0.817. The AUCs for internal and external validation were 0.809 and 0.783, respectively. Calibration curves indicated good model fit, and DCA confirmed substantial clinical net benefit in both cohorts.</p><p><strong>Conclusion: </strong>We developed and validated a nomogram to predict HICH in patients with carotid stenosis post-stenting, facilitating early identification and preventive intervention in high-risk individuals.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"974-979"},"PeriodicalIF":4.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860002","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":"Evaluating the effects of recreational drug use on ruptured cerebral arteriovenous malformation presentation and in-hospital outcomes: a national inpatient sample analysis.","authors":"Avi A Gajjar, Aditya Goyal, Karmen Gill, Aditya Behal, Amanda Custozzo, Alan S Boulos, John C Dalfino, Nicholas C Field, Alexandra R Paul","doi":"10.1136/jnis-2024-022398","DOIUrl":"10.1136/jnis-2024-022398","url":null,"abstract":"<p><strong>Background: </strong>Recent literature highlights the adverse effects of recreational marijuana on cerebrovascular pathologies and outcomes. However, its impact on arteriovenous malformation (AVM) outcomes is unknown.</p><p><strong>Objective: </strong>To investigate the differences in AVM outcomes between marijuana users and non-users, focusing primarily on the likelihood of presenting with rupture and secondly, on the effects of other drugs on in-hospital mortality and complications.</p><p><strong>Methods: </strong>Adult patients diagnosed with cerebral AVMs from the National Inpatient Sample were included. Use of recreational drugs, including marijuana, alcohol, opioids, hallucinogens, stimulants, and tobacco, was documented. Univariate and multivariate logistic regression analyses identified associations between drug use and AVM outcomes.</p><p><strong>Results: </strong>A total of 46 480 patients were analyzed, with 11 580 (24.9%) presenting with rupture. Smoking was the most prevalent substance used (18 010, 38.7%), followed by alcohol (3 065, 6.6%), and cannabis (745, 1.6%). Smoking tobacco (OR=0.801; P=0.0002) and cannabis use (OR=0.613; P=0.0523) showed trends towards a protective effect against presentation with AVM rupture. Tobacco use was associated with reduced likelihood of extended length of stay (OR=0.837; P=0.0013), any complications (OR=0.860; P=0.0082), and in-hospital mortality (OR=0.590; P=0.0003). Alcohol use was linked to increased extended length of stay (OR=1.363; P=0.0033) and complications (OR=1.442; P=0.0007).</p><p><strong>Conclusions: </strong>Stimulant use increases the likelihood of presenting with ruptured AVMs and is associated with higher mortality. Tobacco and cannabis use appear to reduce the possibility of extended hospital stays and complications.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"961-966"},"PeriodicalIF":4.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681756","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":"Pre-operative embolization followed by clipping of Cognard type V dural arteriovenous fistula.","authors":"Krishna C Joshi, André Beer-Furlan, R Webster Crowley, Stephan A Munich","doi":"10.1136/neurintsurg-2020-017201","DOIUrl":"10.1136/neurintsurg-2020-017201","url":null,"abstract":"<p><p>This article has been retracted because it describes the use of an investigative agent that has not been approved by the Food and Drug Administration.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"e13"},"PeriodicalIF":4.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25517041","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-invasive imaging modalities for diagnosing pulsatile tinnitus: a comprehensive review and recommended imaging algorithm.","authors":"Madhavi Duvvuri, Haider Ali, Matthew Robert Amans","doi":"10.1136/jnis-2023-020949","DOIUrl":"10.1136/jnis-2023-020949","url":null,"abstract":"<p><p>Pulsatile tinnitus (PT) is a challenging diagnostic condition arising from various vascular, neoplastic, and systemic disorders. Non-invasive imaging is essential for identifying underlying causes while minimizing risks of invasive diagnostic angiography. Although no consensus exists on the primary imaging modality for PT and currently CT, ultrasound, and MRI are used in the diagnostic pathway, MRI is increasingly preferred as the first-line screening test for its diagnostic efficacy and safety. MRI protocols such as time-of-flight, magnetic resonance angiography, diffusion-weighted imaging, and arterial spin labeling can identify serious causes, including vascular shunting lesions, venous sinus stenosis, and tumors. In this narrative review of the current literature we discuss the benefits and limitations of various non-invasive imaging modalities in identifying the characteristic imaging findings of the most common causes of PT and also provide an algorithm that clinicians can use to guide the imaging evaluation.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"916-924"},"PeriodicalIF":4.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12290034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correspondence on \"Nomogram for predicting early neurological deterioration in patients with mild large and medium vessel occlusion stroke intended for medical management: a multicenter retrospective study\" by Qui <i>et al</i>.","authors":"Shaojie Li, Jiayin Wang, Hongzhi Gao","doi":"10.1136/jnis-2024-022794","DOIUrl":"10.1136/jnis-2024-022794","url":null,"abstract":"","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"1025"},"PeriodicalIF":4.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824259","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}