Journal of NeuroInterventional Surgery最新文献

{"title":"Assessment of post-EVT surveillance angiography: a critical appraisal.","authors":"Xuefan Zeng","doi":"10.1136/jnis-2024-022877","DOIUrl":"10.1136/jnis-2024-022877","url":null,"abstract":"","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950229","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 'Onyx dilution reduces time to resolution of chronic subdural hematomas after middle meningeal artery embolization' by Hung <i>et al</i>.","authors":"Xuefan Zeng, Yiwei Wang","doi":"10.1136/jnis-2024-022875","DOIUrl":"https://doi.org/10.1136/jnis-2024-022875","url":null,"abstract":"","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137895","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":"Higher risk of recurrence in partially thrombosed cerebral aneurysms post-WEB (Woven EndoBridge) device treatment: insights from the WorldWideWEB Consortium registry.","authors":"Guillaume Saliou, Hamza Adel Salim, Basel Musmar, Nimer Adeeb, Assala Aslan, Christian Swaid, Miguel Cuellar, Mahmoud Dibas, Nicole M Cancelliere, Jose Danilo Bengzon Diestro, Oktay Algin, Sherief Ghozy, Sovann V Lay, Adrien Guenego, Leonardo Renieri, Joseph Anthony Carnevale, Panagiotis Mastorakos, Kareem ElNaamani, Eimad Shotar, Markus A Möhlenbruch, Michael Kral, Charlotte Chung, Mohamed M Salem, Ivan Lylyk, Paul M Foreman, Hamza Shaikh, Vedran Župančić, Muhammad Ubaid Hafeez, Joshua S Catapano, Muhammad Waqas, Muhammet Arslan, Onur Ergun, James D Rabinov, Yifan Ren, Clemens M Schirmer, Mariangela Piano, Anna Luisa Kuhn, Caterina Michelozzi, Robert M Starke, Ameer E Hassan, Mark Ogilvie, Anh Nguyen, Jesse Jones, Waleed Brinjikji, Marie Teresa Nawka, Marios-Nikos Psychogios, Christian Ulfert, Bryan Pukenas, Jan Karl Burkhardt, Thien J Huynh, Juan Carlos Martinez-Gutierrez, Muhammed Amir Essibayi, Sunil A Sheth, Diana Slawski, Rabih Tawk, Benjamin Pulli, Boris Lubicz, Pietro Panni, Ajit S Puri, Guglielmo Pero, Eytan Raz, Christoph J Griessenauer, Hamed Asadi, Adnan H Siddiqui, Elad I Levy, Neil Haranhalli, David Altschul, Andrew F Ducruet, Felipe C Albuquerque, Robert W Regenhardt, Christopher J Stapleton, Peter Kan, Vladimir Kalousek, Pedro Lylyk, Srikanth Reddy Boddu, Jared Knopman, Stavropoula I Tjoumakaris, Hugo Cuellar, Pascal Jabbour, Frédéric Clarençon, Nicola Limbucci, Vitor M Pereira, Aman B Patel, Adam A Dmytriw, Steven D Hajdu","doi":"10.1136/jnis-2024-022628","DOIUrl":"10.1136/jnis-2024-022628","url":null,"abstract":"<p><strong>Background: </strong>The Woven EndoBridge (WEB) device is a prevalent treatment for intracranial aneurysms. While many studies have assessed the obliteration rate post-WEB embolization, few have focused on long-term outcomes in partially thrombosed aneurysms.</p><p><strong>Objective: </strong>To assess whether partially thrombosed aneurysms are at higher risk of recurrence or retreatment following WEB embolization compared with non-thrombosed aneurysms.</p><p><strong>Methods: </strong>We evaluated data from 22 academic institutions, focusing on previously untreated cerebral aneurysms treated with the WEB device. Logistic regression was utilized to analyze factors predicting long-term aneurysm obliteration and retreatment necessity.</p><p><strong>Results: </strong>Among 1303 patients, 26 presented with a partially thrombosed aneurysm. In the partially thrombosed group, the mean aneurysm maximal diameter was 10.7±4 mm with a neck ratio of 1.99±1.19 mm, larger than in the control group where the mean aneurysm maximal diameter was 6.81±2.37 mm with a neck ratio of 1.64±0.51 mm (P<0.001 for both maximal diameter and neck ratio). At the final follow-up, partially thrombosed aneurysms treated by the WEB device had a 38.5% retreatment rate, compared with 7.0% for non-thrombosed aneurysms (P<0.001). Among partially thrombosed aneurysms, the Raymond-Roy type IIIa/b occlusion rate was higher (38.5% vs 9.9%, P<0.001). On multivariate analysis, partially thrombosed aneurysms compared with non-thrombosed aneurysms had an increased rate of retreatment (OR 3.64, 95% CI 1.28 to 10.1).</p><p><strong>Conclusion: </strong>Partially thrombosed aneurysms are associated with a poorer occlusion rate and a higher rate of retreatment following WEB embolization. For partially thrombosed aneurysms, the WEB device appears suboptimal as a first-line treatment, and therefore alternative techniques should be prioritized.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015928","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":"Novel approach in neurovascular navigation: Artiria Medical SmartGUIDE deflectable tip microwire.","authors":"Mohammad Al-Tibi, Shah Islam, Federico Carpani, James Lord, Ahmed Abdelghafar, Dan DeAngelis, Pascal John Mosimann","doi":"10.1136/jnis-2025-023947","DOIUrl":"https://doi.org/10.1136/jnis-2025-023947","url":null,"abstract":"<p><p>Neurointerventionalists increasingly treat distal vascular targets with complex anatomy. Current guidewires require iterative hand shaping of the tip to navigate microcatheters and devices. Manual shaping often necessitates wire removal and reinsertion, risking wire damage, longer procedural times, increased vessel injury, and higher costs. The Artiria Medical SmartGUIDE 1 enables real time in situ tip deflection, allowing a single wire to reach a wide range of targets without manual reshaping. It can be locked in position to anchor microcatheters at branch points and prevent buckling or herniation, obviating the need for ancillary support devices, such as a balloon or metallic mesh. The wire can also shape and steer microcatheters on demand by torquing from within, potentially reducing risky maneuvers, such as looping within an aneurysm dome. We demonstrate the use of the deflectable Artiria Medical SmartGUIDE microwire in navigating through tortuous ophthalmic artery branches to perform preoperative embolization of highly vascular orbital tumor (video 1). We provide a comprehensive up to date comparison to other real-time steerable devices.2 3 4 5 6 7neurintsurg;jnis-2025-023947v1/V1F1V1Video 1-Artiria Medical SmartGUIDE 0.014'' Deflectable-Tip Microwire.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between GLP-1 receptor agonist use and neurosurgical intervention in patients with idiopathic intracranial hypertension and obesity: a propensity-matched, multi-institutional, cohort study.","authors":"Jaylene Cassandra Debiec, Allison Toth, Romil Singh, Nihas Mateti, Muhammad Saim, Hassan A Shakeel, Evan Luther","doi":"10.1136/jnis-2025-024139","DOIUrl":"https://doi.org/10.1136/jnis-2025-024139","url":null,"abstract":"<p><strong>Introduction: </strong>Idiopathic intracranial hypertension (IIH) is characterized by elevated intracranial pressure and most commonly affects obese women. While its etiology remains unclear, many patients require ventriculoperitoneal shunting (VPS) for symptoms. In those with transverse sinus stenosis, venous sinus stenting (VSS) is an alternative. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been associated with reduced headache burden and visual symptoms in IIH. Since GLP-1 RAs reach steady state around 5 weeks and can produce 10% weight loss by 6 months, we evaluated their impact on neurosurgical/neurovascular procedures at these time points.</p><p><strong>Methods: </strong>Our retrospective cohort study utilized TriNetX Research Network to compare IIH patients treated with GLP-1 RAs to untreated controls. Propensity score matching balanced demographics, comorbidities, and medication use before comparing odds of neurosurgical interventions, including VSS, VPS, and optic nerve sheath fenestration (ONSF) at ≥5 weeks and ≥6 months after GLP-1 RA initiation. Odds ratios (OR) were estimated via a generalized linear model.</p><p><strong>Results: </strong>After propensity matching, 2690 patients were included in each group. GLP-1 RA use was linked to lower odds of undergoing VSS at 5 weeks (OR 2.40; CI: 1.44 to 4.00; P<i>=</i>0.0005) and 6 months (OR 2.31; CI: 1.10 to 4.86; P<i>=</i>0.0233) and lower odds of VPS at 5 weeks (OR 3.34; CI: 2.00 to 5.61; P<i>=</i>0.0001) and 6 months (OR 2.51; CI: 1.35 to 4.68; P<i>=</i>0.0026).</p><p><strong>Conclusion: </strong>GLP-1 RA therapy was associated with lower odds of neurosurgical intervention in IIH patients. These findings support evidence of GLP-1 RAs as a potential noninvasive treatment.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131070","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":"Acute ischemic stroke and reperfusion drive molecular immune-vascular activations detectable in peripheral blood.","authors":"Francesca Rapido, Nicola Marchi, Julien Labreuche, Adrien Ter Schiphorst, Marine Blaquière, Frédéric de Bock, Victoria Calcado, Julien Fendeleur, Philippe Marin, Pierre-François Perrigault, Marinette Moynier, Gerald Chanques, Vincent Costalat, Cyril Dargazanli","doi":"10.1136/jnis-2025-023885","DOIUrl":"https://doi.org/10.1136/jnis-2025-023885","url":null,"abstract":"<p><strong>Background: </strong>Inflammation drives damage in acute ischemic stroke (AIS). Here, we map temporal and molecular mechanisms of immune-vascular response in patients with AIS treated with endovascular thrombectomy (EVT) for anterior circulation large-vessel occlusion.</p><p><strong>Methods: </strong>In this prospective cohort, 52 patients underwent serial peripheral blood sampling at groin puncture (Pre), catheter withdrawal (T0), and 6, 24, and 48 hours post-reperfusion. Thirteen immune and vascular players were quantified by mesoscale multiplex assays. Clinical outcomes were the modified Rankin Scale (mRS) score at 3 months and the National Institutes of Health Stroke Scale (NIHSS) at 24 hours.</p><p><strong>Results: </strong>Adjusted by age, baseline Alberta Stroke Program Early CT Score (ASPECTS) and NIHSS scores, higher pre-EVT peripheral blood levels of interleukin (IL)-1β, IL-4, IL-10, and IL-13 were associated with poorer 24-hours NIHSS. Post-EVT reperfusion, IL-6 and its downstream effectors vascular cell adhesion molecule- (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) levels rose in peripheral blood over time, suggesting cerebrovascular inflammation, accompanied by the increased levels of acute-phase reactants C-reactive protein (CRP) and serum amyloid A (SAA), indicative of a systemic inflammatory engagement. In the same timeframe, interferon-gamma (IFN-γ) blood levels decreased. Adjusted by age, baseline ASPECT and NIHSS scores, and pre-thrombectomy biomarker levels, higher post-EVT levels of IL-6, VCAM-1, ICAM-1, and SAA were associated with poorer 24-hours NIHSS and unfavorable mRS 3 month outcomes, supporting an evolving immune dysregulation following AIS.</p><p><strong>Conclusion: </strong>This exploratory study points to immune and vascular activation mechanisms from pre- to post-EVT, representing possible disease indicators and targets.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131067","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":"Procedure duration predicts outcomes more than prehospital delay in endovascular stroke treatment.","authors":"Hassan Saad, Andrew B Koo, Jonathan A Grossberg, Ma Tianwen, Brian M Howard, Mohammad-Mahdi Sowlat, Bachar El Baba, Ariana Chacon, Pascal Jabbour, Ansaar Rai, Justin Dye, Ali Alaraj, C Michael Cawley, Frank C Tong, Feras Akbik, Aqueel Pabaney, Mohamad Ezzeldin, David Fiorella, Shinichi Yoshimura, Joon-Tae Kim, Nitin Goyal, Adam S Arthur, Isabel Fragata, Fazeel M Siddiqui, Justin Mascitelli, Charles Matouk, Ilko Maier, Min S Park, Michael Levitt, Ramesh Grandhi, Marios-Nikos Psychogios, Stacey Q Wolfe, Robert M Starke, Amir Shaban, Edgar A Samaniego, Omar Tanweer, Daniele G Romano, Pedro Navia, Hugo H Cuellar, Adam J Polifka, Josh Osbun, Mark E Moss, Kaustubh Limaye, Maxim Mokin, Waleed Brinjikji, Ergun Daglioglu, Richard Williamson, David Altschul, Christopher S Ogilvy, Roberto Javier Crosa, Benjamin Gory, Alexandra R Paul, Peter Kan, Walter Casagrande, Shakeel A Chowdhry, Michael F Stiefel, Alejandro M Spiotta, Ali M Alawieh","doi":"10.1136/jnis-2025-023906","DOIUrl":"https://doi.org/10.1136/jnis-2025-023906","url":null,"abstract":"<p><strong>Background: </strong>Endovascular thrombectomy (EVT) has transformed acute ischemic stroke (AIS) care, with onset-to-puncture (OTP) time widely recognized as a critical determinant of outcome. However, emerging evidence suggests that in-hospital procedure time (PT)-from arterial puncture to final recanalization-may have an equally or more significant impact. This study examines the relative contribution of PT versus OTP to functional outcomes in patients with AIS undergoing EVT.</p><p><strong>Methods: </strong>A retrospective analysis was conducted of 6644 patients with AIS treated at 44 international stroke centers from the Stroke Thrombectomy and Aneurysm Registry (STAR; 2016-2023). Multivariable regression, time-equivalence analysis, and marginal effects modeling were used to assess associations between PT, OTP, and 90-day modified Rankin Scale (mRS) outcomes. Centers were stratified by procedural efficiency and compared using propensity score matching (PSM). Mediation analysis evaluated whether PT accounted for inter-center differences.</p><p><strong>Results: </strong>PT and OTP were independently associated with functional outcomes; however, PT had a significantly stronger effect (adjusted OR for mRS 0-2: PT=0.56 vs OTP=0.96 per hour). Each 5 min increase in PT was equivalent to 78-100 min of additional OTP in outcome impact. Centers with faster average PT had higher rates of functional independence (number needed to treat (NNT)=10), fewer complications, and lower symptomatic intracranial hemorrhage rates. PT significantly mediated the relationship between center tier and outcomes (Sobel's P<0.001).</p><p><strong>Conclusion: </strong>While minimizing OTP remains important, PT exerts a greater influence on outcomes after EVT. Procedural efficiency should be emphasized in stroke systems of care and included in center performance metrics to improve patient outcomes.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091906","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":"Comparative outcomes of self-expanding stenting in symptomatic MCA-M2 versus MCA-M1 segment stenosis.","authors":"Yazhou Jin, Yueqi Zhu, Xinbin Guo, Feng Fan, Tao Quan, Jiangang Zhang, Jinyi Li, Zhen Chen, Sheng Guan, Haowen Xu","doi":"10.1136/jnis-2025-023879","DOIUrl":"10.1136/jnis-2025-023879","url":null,"abstract":"<p><strong>Background: </strong>The outcomes of self-expanding stenting for symptomatic middle cerebral artery (MCA) M2 segment stenosis remain unclear. We aimed to analyze whether the safety and efficacy of M2 and M1 segment stenting procedures differ.</p><p><strong>Methods: </strong>This multicenter retrospective cohort study analyzed data from three stroke centers involving patients who underwent self-expanding stent placement for symptomatic M1 or M2 stenosis between January 2017 and August 2024. Patients were stratified into two groups: M1 stenting (M1S) and M2 stenting (M2S). Safety outcomes included 30-day peri-procedural complications, while efficacy outcomes comprised ipsilateral stroke beyond 30 days through 6 months and in-stent restenosis (ISR) at 6 months. Propensity score matching (PSM) was used to balance baseline characteristics between groups.</p><p><strong>Results: </strong>A total of 318 patients were enrolled. Compared with the M1S group, the M2S group had a similar incidence of 30-day periprocedural complications (5.0% vs 5.4%; odds ratio (OR) 1.08, 95% confidence interval (CI) 0.24 to 4.93; P=0.917), incidence of ipsilateral stroke between 30 days and 6 months postprocedure (3.1% vs 3.9%; OR 1.27, 95% CI 0.16 to 10.40; P=0.821) and ISR rate (25.0% vs 15.8%; OR 0.56, 95% CI 0.23 to 1.35; P=0.193). After a 2:1 PSM (78 vs 39 patients), the two groups remained comparable in terms of 30-day complications, the incidence of ipsilateral stroke beyond 30 days through 6 months, and the ISR rate.</p><p><strong>Conclusion: </strong>Self-expanding stenting for symptomatic M2 stenosis is technically feasible, with a safety and efficacy profile comparable to those of M1 interventions. These preliminary findings warrant validation in randomized trials.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033579","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":"Delayed recanalization of brain arteriovenous malformation after complete obliteration by endovascular embolization.","authors":"Ryuichi Noda, Suzana Saleme, Christophe Rivière Paya, Mohamad Izzat Arslan Che Ros, Aymeric Rouchaud, Charbel Mounayer","doi":"10.1136/jnis-2025-023741","DOIUrl":"https://doi.org/10.1136/jnis-2025-023741","url":null,"abstract":"<p><strong>Background: </strong>Endovascular embolization is an established treatment for brain arteriovenous malformations (bAVMs), supported by advances in embolic agents and catheter technology. However, long-term outcomes after angiographically confirmed complete obliteration, especially delayed recanalization, remain underreported.</p><p><strong>Objective: </strong>Our study's aim is to describe delayed recanalization of bAVMs following complete obliteration via endovascular embolization and to identify potential radiographic indicators and risk factors.</p><p><strong>Methods: </strong>A retrospective review was conducted on individuals treated at a single center from 2006 to 2024. Inclusion criteria were bAVMs with complete obliteration confirmed on post-procedural and 6-12 month follow-up digital subtraction angiography (DSA), followed by recanalization evidence on long-term imaging. Four individuals met the criteria and were analyzed with a focus on nidus-cast and vessel-cast correspondence.</p><p><strong>Results: </strong>All four individuals developed delayed recanalization 8-11 years post-embolization, despite complete occlusion on initial and short-term imaging. In three individuals, embolic cast mismatch with draining veins or feeding arteries was identified. In one individual, residual hematoma may have masked an occult nidus compartment, creating a pseudo-match on initial DSA. All individuals were successfully retreated by transvenous embolization (TVE).</p><p><strong>Conclusion: </strong>Delayed recanalization of bAVMs after angiographically complete endovascular obliteration is rare but significant. Vein- or artery-cast mismatch and residual hematoma may increase recurrence risk. Long-term imaging surveillance is advised, particularly when vessel-cast correspondence is imperfect. These findings underscore the need for tailored follow-up protocols with patients with embolic cast mismatch to reduce recurrence risk.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086077","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":"Infratentorial brain arteriovenous malformations: natural history and long-term outcome-a propensity score matched analysis using nationwide multicenter prospective registry data.","authors":"Chengzhuo Wang, Bin Wang, Heze Han, Li Ma, Ruinan Li, Zhipeng Li, Haibin Zhang, Kexin Yuan, Anqi Li, Qinghui Zhu, Yongenbo Su, Dezhi Gao, Hengwei Jin, Youxiang Li, Shibin Sun, Yuanli Zhao, Yu Chen, Xiaolin Chen, Jizong Zhao","doi":"10.1136/jnis-2025-023826","DOIUrl":"https://doi.org/10.1136/jnis-2025-023826","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated the natural history of infratentorial brain arteriovenous malformations (AVMs) and compared long-term outcomes of intervention versus conservative management.</p><p><strong>Materials and methods: </strong>Infratentorial AVMs from the nationwide MATCH registry were analyzed. Propensity score matching was used to balance the baseline characteristics. The primary outcome was long-term hemorrhagic stroke or death, while secondary outcomes included obliteration rates and neurological status. Subgroup and sensitivity analyses were used to assess the robustness of the results.</p><p><strong>Result: </strong>Of 4286 AVMs, 523 (12.2%) were infratentorial. The pretreatment annual rupture rate was 7.05% per patient-year. Independent hemorrhage risk factors included flow-related aneurysms, single draining vein, and vein stenosis. After matching, 144 cases (72 per group) were analyzed with a median follow-up of 6.12 years. Post-intervention the annual rupture risk was 2.17% and obliteration rate was 72.22%. Intervention was linked to higher rates of hemorrhagic stroke or death and higher obliteration rates compared with conservative management, with no significant neurological status difference. Only embolization increased the risk of hemorrhage, while microsurgery and radiosurgery did not. Trends were consistent in subgroup analyses.</p><p><strong>Conclusion: </strong>Intervention for infratentorial AVMs may increase the risk of hemorrhagic stroke or death. Embolization therapy may pose long-term risks, and there is no evidence to suggest that surgical resection and stereotactic radiosurgery carry higher risks compared with conservative treatment.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075419","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}