Journal of NeuroInterventional Surgery最新文献

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Early experience with the Drivewire 24: a newly FDA-approved steerable microwire. Drivewire 24的早期经验:一种新获得fda批准的可操纵微丝。
IF 4.5 1区 医学
Journal of NeuroInterventional Surgery Pub Date : 2025-06-20 DOI: 10.1136/jnis-2025-023730
Eric Alexander Grin, Vera Sharashidze, Charlotte Chung, Jacob F Baranoski, Caleb Rutledge, Howard A Riina, Maksim Shapiro, Eytan Raz, Erez Nossek
{"title":"Early experience with the Drivewire 24: a newly FDA-approved steerable microwire.","authors":"Eric Alexander Grin, Vera Sharashidze, Charlotte Chung, Jacob F Baranoski, Caleb Rutledge, Howard A Riina, Maksim Shapiro, Eytan Raz, Erez Nossek","doi":"10.1136/jnis-2025-023730","DOIUrl":"10.1136/jnis-2025-023730","url":null,"abstract":"<p><strong>Background: </strong>The Drivewire 24 (DW24) is a newly FDA-cleared 0.024 inch steerable guidewire. Its proximally controlled deflectable tip allows for intravascular steering to facilitate selective navigation of diagnostic or therapeutic catheters. We present the first clinical experience with the DW24.</p><p><strong>Methods: </strong>All neurointerventional procedures using the DW24 from October 2024 to April 2025 were retrospectively reviewed. Indications, procedural details, DW24 performance, wire-related complications, and operator feedback were assessed.</p><p><strong>Results: </strong>27 procedures were performed utilizing the DW24. Indications included aneurysm (n=16), stroke (n=5), arteriovenous fistula or malformation (n=4), and diagnostic venography (n=2). Technical success was achieved in 92.6% of cases. Target vessels included the MCA, anterior cerebral artery, posterior cerebral artery, internal carotid artery segments, transverse sinus, and torcula. The device's radiopaque, hydrophilic distal tip aided fluoroscopic visibility, and the variable support enabled articulation across a range of aspiration and delivery catheters without requiring additional support devices. The DW24's steerability enabled access to challenging cerebrovascular anatomy, including one stroke case where conventional guidewires failed to reach a distal M2 occlusion. The DW24's intravascular steering also allowed for the delivery of catheters for Pipeline Embolization Device (PED) deployment and facilitated PED post-processing to improve wall apposition without requiring wire removal, reshaping, or balloon angioplasty. Operators observed a short learning curve. There were no device-related complications, though the wire's response to rotational force was a limitation.</p><p><strong>Conclusion: </strong>The DW24 demonstrated a high technical success rate with no device-related complications. Its versatility across catheter sizes and precise controllability facilitate navigating complex cerebrovasculature. Further studies should assess efficacy in larger cohorts across additional clinical scenarios.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336696","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 treatment of posterior circulation aneurysms with flow diverters with hydrophilic polymer coating in patients receiving prasugrel single antiplatelet therapy: a multicenter case series presenting complication and occlusion rates. 在接受普拉格雷单次抗血小板治疗的患者中,经亲水聚合物涂层的血流分流器对后循环动脉瘤的血管内治疗:一个多中心的病例系列,显示并发症和闭塞率。
IF 4.5 1区 医学
Journal of NeuroInterventional Surgery Pub Date : 2025-06-20 DOI: 10.1136/jnis-2025-023617
Ali Khanafer, Alexander Sirakov, Donald Lobsien, José E Cohen, Mohammad Almohammad, Marie-Sophie Schüngel, Florian Hennersdorf, Thomas Borgmann, Zakarya Ali, Andrei Filioglo, Hansjörg Bäzner, Philipp von Gottberg, Kamran Hajiyev, Pablo Albiña-Palmarola, Stephan Felber, Michael Forsting, Stefan Schob, André Kemmling, Joachim Klisch, Stanimir Sirakov, Hans Henkes
{"title":"Endovascular treatment of posterior circulation aneurysms with flow diverters with hydrophilic polymer coating in patients receiving prasugrel single antiplatelet therapy: a multicenter case series presenting complication and occlusion rates.","authors":"Ali Khanafer, Alexander Sirakov, Donald Lobsien, José E Cohen, Mohammad Almohammad, Marie-Sophie Schüngel, Florian Hennersdorf, Thomas Borgmann, Zakarya Ali, Andrei Filioglo, Hansjörg Bäzner, Philipp von Gottberg, Kamran Hajiyev, Pablo Albiña-Palmarola, Stephan Felber, Michael Forsting, Stefan Schob, André Kemmling, Joachim Klisch, Stanimir Sirakov, Hans Henkes","doi":"10.1136/jnis-2025-023617","DOIUrl":"10.1136/jnis-2025-023617","url":null,"abstract":"<p><strong>Background: </strong>The present study reports a multicenter experience of using hydrophilic polymer-coated (HPC) flow diverters (FDs) with prasugrel single antiplatelet therapy (SAPT) to treat posterior circulation aneurysms (PCAs).</p><p><strong>Methods: </strong>A prospectively maintained database was retrospectively reviewed to identify all cases of intracranial PCA treated with HPC-coated FDs under SAPT (prasugrel). The clinical presentation and outcomes, periprocedural and postprocedural complications, and degree of occlusion at follow-up (FU) were evaluated.</p><p><strong>Results: </strong>A total of 74 patients were treated (45.9% female). Ischemic complications were experienced by two patients (2.7%) and were dependent on the use of FDs. No cases of aneurysm rupture or hemorrhagic complications related to antiplatelet therapy or the FD treatment were recorded. The rate of complete occlusion was 77.9% in the early FU period (3-6 months) and 90.3% in the initial 12-month period.</p><p><strong>Conclusion: </strong>In this single-arm retrospective study, HPC-coated FDs with prasugrel SAPT were associated with high safety in the treatment of ruptured and unruptured PCA and high occlusion rates at early- and mid-term FU.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336697","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
High-resolution CT angiography for follow-up evaluation of intracranial aneurysms treated with the Woven EndoBridge device: comparison with digital subtraction angiography. 高分辨率CT血管造影对颅内动脉瘤的随访评价:与数字减影血管造影的比较。
IF 4.5 1区 医学
Journal of NeuroInterventional Surgery Pub Date : 2025-06-20 DOI: 10.1136/jnis-2025-023628
Kenichiro Suyama, Ichiro Nakahara, Shoji Matsumoto, Junpei Koge, Jun Tanabe, Akiko Hasebe, Eiji Fujiwara, Shiho Tanaka, Tatsunori Mase, Yuichi Hirose
{"title":"High-resolution CT angiography for follow-up evaluation of intracranial aneurysms treated with the Woven EndoBridge device: comparison with digital subtraction angiography.","authors":"Kenichiro Suyama, Ichiro Nakahara, Shoji Matsumoto, Junpei Koge, Jun Tanabe, Akiko Hasebe, Eiji Fujiwara, Shiho Tanaka, Tatsunori Mase, Yuichi Hirose","doi":"10.1136/jnis-2025-023628","DOIUrl":"10.1136/jnis-2025-023628","url":null,"abstract":"<p><strong>Purpose: </strong>Digital subtraction angiography (DSA) is the gold standard for follow-up evaluation of intracranial aneurysms treated with the Woven EndoBridge (WEB) device. This study aimed to assess the efficacy of high-resolution CT angiography (HR-CTA) as a less invasive alternative by comparing its diagnostic performance with that of DSA.</p><p><strong>Methods: </strong>This single-center retrospective study analyzed the angiographic and clinical data of patients treated with the WEB device for cerebral aneurysms between January 2021 and December 2024. Patients who underwent HR-CTA within 2 weeks before or after follow-up DSA were included. Occlusion status was assessed using the Bicêtre Occlusion Scale Score (BOSS) and binary classification. The concordance rate between HR-CTA and DSA was evaluated.</p><p><strong>Results: </strong>A total of 54 eligible examinations were identified. Using the BOSS, 46 examinations were concordant, resulting in an agreement rate of 85.2%. The Cohen's κ coefficient was 0.81 (95% CI 0.69 to 0.93), indicating a very high level of agreement. All discordant cases resulted from HR-CTA overestimating occlusion status; however, HR-CTA accurately identified aneurysm remnants. Univariate analyses identified BOSS 0' as the only significant factor contributing to discrepancies. In the binary evaluation, all 54 examinations were fully concordant (κ=1.00, 95% CI 1.00 to 1.00).</p><p><strong>Conclusions: </strong>HR-CTA demonstrated a high concordance rate with DSA for evaluating occlusion status after WEB placement. Its reliable assessment of aneurysm remnants suggests HR-CTA could serve as a practical and less invasive alternative to DSA in follow-up evaluations.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336698","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
Use of carotid web angioarchitecture in stratification of stroke risk. 颈动脉网血管结构在卒中风险分层中的应用。
IF 4.5 1区 医学
Journal of NeuroInterventional Surgery Pub Date : 2025-06-20 DOI: 10.1136/jnis-2025-023368
Bruck Negash, Daniel D Wiggan, Eric A Grin, Karl L Sangwon, Charlotte Chung, Eleanor Gutstadt, Vera Sharashidze, Eytan Raz, Maksim Shapiro, Koto Ishida, Jose L Torres, Cen Zhang, Michelle A Nakatsuka, Sara K Rostanski, Melissa J Rethana, Alexandra Kvernland, Matthew Sanger, Kaitlyn Lillemoe, Alexander Allen, Sean Kelly, Jacob F Baranoski, Caleb Rutledge, Howard A Riina, Peter Kim Nelson, Erez Nossek
{"title":"Use of carotid web angioarchitecture in stratification of stroke risk.","authors":"Bruck Negash, Daniel D Wiggan, Eric A Grin, Karl L Sangwon, Charlotte Chung, Eleanor Gutstadt, Vera Sharashidze, Eytan Raz, Maksim Shapiro, Koto Ishida, Jose L Torres, Cen Zhang, Michelle A Nakatsuka, Sara K Rostanski, Melissa J Rethana, Alexandra Kvernland, Matthew Sanger, Kaitlyn Lillemoe, Alexander Allen, Sean Kelly, Jacob F Baranoski, Caleb Rutledge, Howard A Riina, Peter Kim Nelson, Erez Nossek","doi":"10.1136/jnis-2025-023368","DOIUrl":"10.1136/jnis-2025-023368","url":null,"abstract":"<p><strong>Objective: </strong>To validate the carotid web (CW) risk stratification assessment described in previous works within a larger cohort of patients with symptomatic and incidentally found asymptomatic CWs.</p><p><strong>Methods: </strong>A retrospective analysis of our institution's electronic medical records identified all patients with a diagnosis of CW from 2017 to 2024. We included symptomatic patients and those with asymptomatic CWs, that is, incidentally found webs without history of stroke or transient ischemic attack. Patient charts were reviewed for demographics, imaging, comorbidities, and a diagnosis of stroke after diagnosis of asymptomatic CW. All angles were measured as described in previous work on a sagittal reconstruction of neck CT angiography in which the common carotid artery (CCA), external carotid artery, and internal carotid artery (ICA) were well visualized, together with the CW itself. Principal component analysis and logistic regression were performed to evaluate the association between high-risk angles and stroke risk.  RESULTS: Twenty-six symptomatic and 26 asymptomatic patients were identified. Of note, the number of patients with hypertension, hyperlipidemia, and smoking history was 17 (65.0%), 16 (62.0%), and 8 (31.0%) for symptomatic patients and 18 (69.0%), 17 (65.0%), and 15 (58.0%) for asymptomatic patients. All angular measurements showed statistically significant associations with stroke status. The CCA-web-pouch angle showed the strongest association (p=2.07×10⁻⁴), followed by the CCA-pouch-tip angle (p=3.23×10⁻⁴), ICA-web-pouch angle (p=0.004), and ICA-pouch-tip angle (p=0.005). Each additional high-risk angle increased the odds of stroke by 9.47-fold (p<0.0001). The associated probability of stroke increased from 6.3% with no high-risk angles to 39.1% with one high-risk angle and further to 85.9% with two high-risk angles. The model demonstrated high sensitivity, correctly identifying 84.6% of positive cases, and high specificity, correctly identifying 88.5% of negative cases. The F1 score was 0.863, indicating good overall model performance.  CONCLUSION: Given this successful stratification of CWs into high- and low-risk groups, the utilization of geometric CW parameters may play a role in improving patient selection for intervention in the setting of incidentally diagnosed CW. .</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336699","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
Effectiveness of subdural evacuating port system (SEPS) and middle meningeal artery embolization (MMAE) for chronic subdural hematomas - a multicenter experience. 硬膜下疏散口系统(SEPS)和脑膜中动脉栓塞(MMAE)治疗慢性硬膜下血肿的有效性-一个多中心的经验。
IF 4.5 1区 医学
Journal of NeuroInterventional Surgery Pub Date : 2025-06-19 DOI: 10.1136/jnis-2025-023489
Jaims Lim, Vinay Jaikumar, Alexandra R Paul, Matthew Cullen, Christopher P Kellner, J Mocco, Brandon D Philbrick, Kunal Vakharia, Patrick Wahlig, Marissa D Kruk, Kenneth V Snyder, Elad I Levy, Jason M Davies, Adnan H Siddiqui
{"title":"Effectiveness of subdural evacuating port system (SEPS) and middle meningeal artery embolization (MMAE) for chronic subdural hematomas - a multicenter experience.","authors":"Jaims Lim, Vinay Jaikumar, Alexandra R Paul, Matthew Cullen, Christopher P Kellner, J Mocco, Brandon D Philbrick, Kunal Vakharia, Patrick Wahlig, Marissa D Kruk, Kenneth V Snyder, Elad I Levy, Jason M Davies, Adnan H Siddiqui","doi":"10.1136/jnis-2025-023489","DOIUrl":"10.1136/jnis-2025-023489","url":null,"abstract":"<p><strong>Background: </strong>Craniotomy for subdural hematoma (SDH) in elderly patients with comorbidities can be challenging. The Subdural Evacuating Port System (SEPS; Medtronic, Minneapolis, MN) offers a less invasive alternative, while middle meningeal artery embolization (MMAE) has shown effectiveness in preventing SDH recurrence. We evaluated the combined effectiveness of SEPS+MMAE for chronic SDH (cSDH) treatment.</p><p><strong>Methods: </strong>Retrospective database reviews were conducted. Demographic, comorbidity, procedural, and outcomes data were analyzed. cSDH resolution was tracked by measuring hematoma volumes on noncontrast computed tomograms pre-SEPS+MMAE, 24-48 hours post-SEPS+MMAE, and 6-8 weeks afterward (follow-up-SEPS+MMAE).</p><p><strong>Results: </strong>Our study included 114 patients (median age: 77 years (interquartile range (IQR): 69-83 years); men: women=74:40) with 134 cSDHs treated with SEPS+MMAE were included. Median pre-SEPS+MMAE cSDH volume was 122.9 mL (88-152.4 mL) with midline shift of 6 mm (3.4-9.5 mm). Most MMAE procedures were performed under general anesthesia (68.7%), utilizing the femoral approach (61.9%) and particle embolic agents (55.2%). In-hospital rescue craniotomy was required after 10 (7.5%) procedures. Median post-SEPS+MMAE and follow-up-SEPS+MMAE cSDH volume reductions were 71.1 mL (54.1-94.8 mL) and 23.4 mL (2-56.3 mL), respectively, resulting in 38.1% (22.1-52.9%) and 79.9% (51-97.8%) reductions, respectively. Of 109 patients with follow-up, 10 (9.2%) were readmitted for cSDH residual/recurrence within 90 days, eight (7.3%) required retreatment: five (4.6%) with craniotomy, three (2.8%) with SEPS. Hyperlipidemia (P=0.002), anticoagulant use (P=0.036), and larger pre-SEPS+MMAE cSDH volume (P<0.001) predicted greater SEPS-mediated clearance. Older age (P=0.03), coronary artery disease (P=0.004), membranes within cSDH (P=0.039), acute/subacute components in cSDH (P=0.047), and unilateral cSDH (P=0.017) predicted less SEPS-mediated clearance. Older age (P=0.006), acute/subacute components in cSDH (P=0.016), and longer follow-up (P=0.013) predicted higher MMAE effectiveness. Higher pre-SEPS+MMAE cSDH volume (P=0.047) and unilateral MMAE for bilateral cSDH (P=0.036) predicted lower MMAE effectiveness.</p><p><strong>Conclusion: </strong>SEPS+MMAE was an effective, safe treatment for cSDH.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333292","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
Vein of Galen aneurysmal malformation treatment with direct open surgical access of the transverse sinus and transvenous selective endovascular embolization: a hybrid approach. 直接开放横窦和经静脉选择性血管内栓塞治疗盖伦静脉动脉瘤畸形:一种混合方法。
IF 4.5 1区 医学
Journal of NeuroInterventional Surgery Pub Date : 2025-06-19 DOI: 10.1136/jnis-2025-023490
Gilbert Gravino, Saad Aamir, Sofie Dietvorst, Kush Bhatt, Fergus Robertson, Chris Parks, Richard Craig, Conor Mallucci, Arun Chandran, Mani Puthuran
{"title":"Vein of Galen aneurysmal malformation treatment with direct open surgical access of the transverse sinus and transvenous selective endovascular embolization: a hybrid approach.","authors":"Gilbert Gravino, Saad Aamir, Sofie Dietvorst, Kush Bhatt, Fergus Robertson, Chris Parks, Richard Craig, Conor Mallucci, Arun Chandran, Mani Puthuran","doi":"10.1136/jnis-2025-023490","DOIUrl":"10.1136/jnis-2025-023490","url":null,"abstract":"<p><p>Vein of Galen aneurysmal malformations (VOGMs) are rare congenital cerebrovascular malformations associated with an almost 100% morbidity and mortality rate if untreated. Open surgical case reports had reported intraoperative neonatal mortality rates close to 100%, rendering the disease untreatable. The development of endovascular techniques subsequently provided a viable treatment option for these complex cases, with a staged transarterial approach currently being the preferred mainstay treatment.We report on a technique that involves direct exposure of the transverse sinus under image-guided mini-craniotomy in a vascular hybrid intraoperative theater, followed by direct puncture of the transverse sinus with venous access to embolize the VOGM via a transvenous route. This was performed in a 3-year-old patient in whom further transarterial embolization was not feasible and who had bilateral occlusion of the internal jugular veins. The procedure was successful, with elimination of the high-flow arteriovenous shunt and no procedure-related complications.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333293","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
Outcomes of flow diversion in intracranial aneurysms accompanied by parent artery stenosis. 颅内动脉瘤伴载动脉狭窄的血流转移的结果。
IF 4.5 1区 医学
Journal of NeuroInterventional Surgery Pub Date : 2025-06-17 DOI: 10.1136/jnis-2025-023485
Tao Quan, Yanting Gai, Xin Feng, Suzana Saleme, Binghui Liu, Xin Zhang, Donglei Song, Chuan-Zhi Duan, Charbel Mounayer, Sheng Guan
{"title":"Outcomes of flow diversion in intracranial aneurysms accompanied by parent artery stenosis.","authors":"Tao Quan, Yanting Gai, Xin Feng, Suzana Saleme, Binghui Liu, Xin Zhang, Donglei Song, Chuan-Zhi Duan, Charbel Mounayer, Sheng Guan","doi":"10.1136/jnis-2025-023485","DOIUrl":"https://doi.org/10.1136/jnis-2025-023485","url":null,"abstract":"<p><strong>Background: </strong>The impact of parent artery stenosis on the treatment of intracranial aneurysms by using flow diversion (FD) remains unknown. This multicenter retrospective study aimed to evaluate the clinical and radiological outcomes of patients with intracranial aneurysms accompanied by parent artery stenosis of different etiologies after FD implantation.</p><p><strong>Methods: </strong>The study cohort included patients who received FD treatment at four comprehensive centers from March 2013 to June 2024. The etiological factors underlying intracranial arterial stenosis were categorized as intracranial atherosclerosis (ICAS), intracranial arterial dissection (ICAD), and matricidal aneurysms (MA).</p><p><strong>Results: </strong>A total of 161 patients with intracranial aneurysms accompanied by parent artery stenosis were ultimately included for in-depth analysis. The procedures were successfully performed in all patients, with a low incidence of periprocedural complications. In the clinical and angiographic follow-up, all patients had a favorable outcome (modified Rankin Scale score 0-2), and the complete occlusion rate of aneurysms was 64.0% at median 8.0 months (IQR 6-13.5 months). A comparative analysis revealed that, in contrast to the ICAD and MA groups, the ICAS group exhibited a significantly higher rate of in-stent restenosis (28% vs 16.7% vs 5.5%, <i>p</i> = 0.020).</p><p><strong>Conclusions: </strong>FDs demonstrated satisfactory performance in terms of periprocedural complications, favorable clinical outcomes, and complete occlusion on follow-up imaging in the management of intracranial aneurysms accompanied by parent artery stenosis. Notably, ICAS exerted a substantially greater influence on in-stent restenosis and entailed a higher requirement for repeat angioplasty compared with ICAD and MA.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317152","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
Early clinical experience with the Emboguard Balloon Guide Catheter: impact on technical success and patient outcomes in large vessel occlusion thrombectomy. 早期应用Emboguard球囊导尿管的临床经验:对大血管闭塞血栓切除术技术成功和患者预后的影响。
IF 4.5 1区 医学
Journal of NeuroInterventional Surgery Pub Date : 2025-06-17 DOI: 10.1136/jnis-2025-023519
Bishow C Mahat, Mohamed F Doheim, Anmol Almast, Matthew T Starr, Nirav R Bhatt, Jussie Correia Lima, Marcelo Rocha, Raul G Nogueira, Alhamza R Al-Bayati
{"title":"Early clinical experience with the Emboguard Balloon Guide Catheter: impact on technical success and patient outcomes in large vessel occlusion thrombectomy.","authors":"Bishow C Mahat, Mohamed F Doheim, Anmol Almast, Matthew T Starr, Nirav R Bhatt, Jussie Correia Lima, Marcelo Rocha, Raul G Nogueira, Alhamza R Al-Bayati","doi":"10.1136/jnis-2025-023519","DOIUrl":"https://doi.org/10.1136/jnis-2025-023519","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the performance of the newer-generation Emboguard Balloon Guide Catheter (EBGC) in treating anterior circulation large vessel occlusions (LVOs).</p><p><strong>Methods: </strong>A prospectively maintained endovascular thrombectomy database was reviewed to identify consecutive non-tandem LVO patients treated with the EBGC. Procedural outcomes included rates of complete recanalization (modified Thrombolysis in Cerebral Infarction (mTICI) 2c/3), successful recanalization (mTICI 2b/3), first-pass effect (FPE) (mTICI 2c/3 after the first pass), modified FPE (mTICI 2b/3 after the first pass), and the number of passes. Clinical outcomes assessed included National Institutes of Health Stroke Scale (NIHSS) scores at discharge, functional independence (modified Rankin Scale (mRS) 0-2), and fair outcomes (mRS 0-3). Safety outcomes evaluated included symptomatic intracranial hemorrhage (sICH) and 90-day mortality.</p><p><strong>Results: </strong>Of the 72 patients included, 56.9% (41/72) were female, with a median age of 73 years (IQR 67-83). Most patients presented with middle cerebral artery (MCA) occlusions (M1 in 59.7% (43/72) and dominant/co-dominant M2 in 25.0% (18/72)). Successful recanalization (mTICI 2b/3) was achieved in 98.6% (71/72) of cases, and complete recanalization (mTICI 2c/3) was achieved in 76.4% (55/72), with a median of 1 pass (IQR 1-2). FPE and modified FPE were achieved in 48.6% (35/72) and 56.9% (41/72) of cases, respectively. The median NIHSS improved significantly from 17 (IQR 11-21) at baseline to 4 (IQR 1-12) at discharge. sICH occurred in only 1.4% (1/72) of cases. At 90 days, 42.6% (23/54) of patients achieved functional independence (mRS 0-2), and mRS 0-3 in 63.2% (36/57).</p><p><strong>Conclusions: </strong>The EBGC demonstrated promising potential with high rates of FPE and successful recanalization together with clinical improvements and a favorable safety profile.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317151","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
Developing a Coordinated Registry Network for devices used for acute ischemic stroke intervention: basilar artery occlusion quality assessment pilot. 为用于急性缺血性脑卒中干预的设备开发协调注册网络:基底动脉闭塞质量评估试点。
IF 4.5 1区 医学
Journal of NeuroInterventional Surgery Pub Date : 2025-06-16 DOI: 10.1136/jnis-2024-021741
Jialin Mao, Sameer A Ansari, Adnan H Siddiqui, Art Sedrakyan, Danica Marinac-Dabic, Murray Sheldon, Mairsíl Claffey, Alicia M Hall, Harsh Sancheti, Thomas Kim, Nam Nguyen, David S Liebeskind
{"title":"Developing a Coordinated Registry Network for devices used for acute ischemic stroke intervention: basilar artery occlusion quality assessment pilot.","authors":"Jialin Mao, Sameer A Ansari, Adnan H Siddiqui, Art Sedrakyan, Danica Marinac-Dabic, Murray Sheldon, Mairsíl Claffey, Alicia M Hall, Harsh Sancheti, Thomas Kim, Nam Nguyen, David S Liebeskind","doi":"10.1136/jnis-2024-021741","DOIUrl":"10.1136/jnis-2024-021741","url":null,"abstract":"<p><strong>Background: </strong>Real-world data can be helpful in evaluating endovascular therapy (EVT) in ischemic stroke care. We conducted a pilot study to aggregate data on basilar artery occlusion (BAO) EVT from existing registries in the USA. We evaluated the availability, completeness, quality, and consistency of common data elements (CDEs) across data sources.</p><p><strong>Methods: </strong>We harmonized patient-level data from five registry data sources and assessed the availability, completeness (defined by the presence in at least four data sources), and consistency of CDEs. We assessed data quality based on seven pre-defined critical domains for BAO EVT investigation: baseline patient and disease characteristics; time metrics; description of intervention; adjunctive devices, revascularization scores, complications; post-intervention National Institutes of Health Stroke Scale scores; discharge disposition; 30-day and 90-day mortality and modified Rankin Scale (mRS) scores.</p><p><strong>Results: </strong>The aggregated dataset of five registries included 493 BAO procedures between January 2013 and January 2020. In total, 88 CDEs were screened and 35 (40%) elements were considered prevalent. Of these 35 CDEs, the majority were collected for >80% of cases when aggregated. All seven pre-defined domains for BAO device investigation could be fulfilled with harmonized data elements. Most data elements were collected with consistent or compatible definitions across registries. The main challenge was the collection of 90-day outcomes.</p><p><strong>Conclusions: </strong>This pilot shows the feasibility of aggregating and harmonizing critical CDEs across registries to create a Coordinated Registry Network (CRN). The CRN with partnerships between multiple registries and stakeholders could help improve the breadth and/or depth of real-world data to help answer relevant questions and support clinical and regulatory decisions.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"691-696"},"PeriodicalIF":4.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306071","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}
引用次数: 0
The incidence of infratentorial arteriovenous malformation-associated aneurysms: an institutional case series and systematic literature review. 脑室下动静脉畸形相关动脉瘤的发病率:机构病例系列和系统性文献综述。
IF 4.5 1区 医学
Journal of NeuroInterventional Surgery Pub Date : 2025-06-16 DOI: 10.1136/jnis-2024-022003
Mark Davison, Maximos McCune, Nishanth Thiyagarajah, Ahmed Kashkoush, Rebecca Achey, Michael Shost, Gabor Toth, Mark Bain, Nina Moore
{"title":"The incidence of infratentorial arteriovenous malformation-associated aneurysms: an institutional case series and systematic literature review.","authors":"Mark Davison, Maximos McCune, Nishanth Thiyagarajah, Ahmed Kashkoush, Rebecca Achey, Michael Shost, Gabor Toth, Mark Bain, Nina Moore","doi":"10.1136/jnis-2024-022003","DOIUrl":"10.1136/jnis-2024-022003","url":null,"abstract":"<p><strong>Background: </strong>Arteriovenous malformation (AVM)-associated aneurysms represent a high-risk feature predisposing them to rupture. Infratentorial AVMs have been shown to have a greater incidence of associated aneurysms, however the existing data is outdated and biased. The aim of our research was to compare the incidence of supratentorial vs infratentorial AVM-associated aneurysms.</p><p><strong>Methods: </strong>Patients were identified from our institutional AVM registry, which includes all patients with an intracranial AVM diagnosis since 2000, regardless of treatment. Records were reviewed for clinical details, AVM characteristics, nidus location (supratentorial or infratentorial), and presence of associated aneurysms. Statistical comparisons were made using Fisher's exact or Wilcoxon rank sum tests as appropriate. Multivariable logistic regression analysis determined independent predictors of AVM-associated aneurysms. As a secondary analysis, a systematic literature review was performed, where studies documenting the incidence of AVM-associated aneurysms stratified by location were of interest.</p><p><strong>Results: </strong>From 2000-2024, 706 patients with 720 AVMs were identified, of which 152 (21.1%) were infratentorial. Intracranial hemorrhage was the most common AVM presentation (42.1%). The incidence of associated aneurysms was greater in infratentorial AVMs compared with supratentorial cases (45.4% vs 20.1%; P<0.0001). Multivariable logistic regression demonstrated that infratentorial nidus location was the singular predictor of an associated aneurysm, odds ratio: 2.9 (P<0.0001). Systematic literature review identified eight studies satisfying inclusion criteria. Aggregate analysis indicated infratentorial AVMs were more likely to harbor an associated aneurysm (OR 1.7) and present as ruptured (OR 3.9), P<0.0001.</p><p><strong>Conclusions: </strong>In this modern consecutive patient series, infratentorial nidus location was a significant predictor of an associated aneurysm and hemorrhagic presentation.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"711-716"},"PeriodicalIF":4.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141468699","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
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