Journal of NeuroInterventional Surgery最新文献

{"title":"Tenzing Assisted Delivery of Aspiration (TADA) technique for thrombectomy of medium vessel occlusions using the Freeclimb 54 catheter: multicenter experience.","authors":"Fabio Settecase, Ajit S Puri, Shane Sh Lee, Rajkamal S Khangura, Ronald F Budzik, Peter J Pema, Thymur Chaudury, Matthew J Page, Ben J McGuinness, Marco Colasurdo, Daniel A Tonetti, Jonathan A Grossberg, Jasmeet Singh, Anna Luisa Kuhn, Matthew D Alexander, Bahram Varjavand, Ryan A Priest, JaeHyun Kim, Blaise W Baxter, Warren T Kim, Joey D English, James Caldwell","doi":"10.1136/jnis-2024-022693","DOIUrl":"10.1136/jnis-2024-022693","url":null,"abstract":"<p><strong>Background: </strong>Medium vessel occlusions (MeVOs) account for 25-40% of acute ischemic stroke. The Tenzing 5 (Route 92 Medical, San Mateo, California, USA) and FreeClimb 54 (Route 92 Medical, San Mateo, California, USA) catheter is a novel delivery-aspiration catheter combination designed to facilitate aspiration thrombectomy (AT) of MeVOs. We report our clinical experience using the Tenzing assisted delivery of aspiration (TADA) technique with FreeClimb 54 for first-line AT of MeVO.</p><p><strong>Methods: </strong>We retrospectively reviewed consecutive patients who underwent MeVO first-line AT using TADA with FreeClimb 54 at nine institutions in the USA and one in New Zealand.</p><p><strong>Results: </strong>94 MeVOs (65 primary, 29 secondary) were treated in 92 patients: median age 71 (IQR 58-81) years; 49/92 (53%) women. FreeClimb 54 was successfully delivered by Tenzing 5 to all 94/94 MeVOs: 26 proximal M2; 44 distal M2; 5 M3; 6 A2; 4 A3; and 8 P2. Median target vessel diameter on DSA was 1.7 (IQR 1.4-1.8) mm. A leading microwire was used to advance Tenzing in 84% of cases. A stent retriever was used for additional thrombectomy passes in 6/94 (6%) patients. For a primary MeVO, final modified expanded Thrombolysis in Cerebral Infarction (meTICI) 2B-3 reperfusion was achieved in 63/65 (97%) patients, after a median of 1 (IQR 1-2) pass, with a first pass effect (FPE, meTICI 2C-3) in 43/65 (66%). Secondary MeVO FPE (eTICI 2C-3) was achieved in 20/29 (69%) patients. Tenzing 5-FreeClimb 54 related complications occurred in 2/94 (2%) patients: one perforation with asymptomatic subarachnoid hemorrhage and one embolus to new territory.</p><p><strong>Conclusions: </strong>MeVO first-line AT using the TADA technique with Tenzing 5 and FreeClimb 54 had a high FPE with a low complication rate.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"e197-e205"},"PeriodicalIF":4.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143039319","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":"Aspiration catheter tip flutter is a reliable indicator of successful clot aspiration in ADAPT.","authors":"Dan-Dong Li, Jing Zheng, Ke-Da Pan, Pi-Guang Yao, Meng-Yao Wang, Ren-Hua Duan, Wei Li, Shao-Huai Chen, Bo Yin","doi":"10.1136/jnis-2024-021800","DOIUrl":"10.1136/jnis-2024-021800","url":null,"abstract":"<p><strong>Background: </strong>A direct aspiration first pass technique (ADAPT) has emerged as a fast, safe, and efficacious method for treating acute large vessel occlusion. However, successful clot aspiration is not guaranteed in every ADAPT procedure. We have observed that when the catheter effectively ingested the clot, the catheter tip displayed a distinct fluttering motion, referred to herein as tip flutter. Thus this study aimed to assess whether this catheter tip flutter can be used as a sign of successful clot aspiration.</p><p><strong>Methods: </strong>This retrospective study included 231 consecutive patients admitted to our institution due to acute ischemic stroke and treated with ADAPT between October 2018 and November 2023. We obtained baseline and procedural data from all patients. Additionally, we assessed the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of the tip flutter in predicting clot aspiration.</p><p><strong>Results: </strong>The incidence of embolus translocation was significantly higher in the tip flutter positive group than in the tip flutter negative group (P<i><</i>0.001). Also, hyperdense artery presentation was more prevalent in the positive group (P<0.001), whereas the clot burden score was higher in the negative group (P=0.002). Clot aspiration in the first pass occurred in 83 (96.5%) and 37 (25.5%) patients in the positive and negative groups, respectively (P<0.001). Multivariable logistic regression analysis showed the tip flutter sign (OR 1.09, 95% CI 0.16 to 1.29; P<0.001) was an independent predictor of successful clot aspiration. Sensitivity, specificity, PPV, NPV, and accuracy of the tip flutter for predicting clot aspiration were 69.2%, 97.3%, 96.5 %, 74.5%, and 82.7%, respectively.</p><p><strong>Conclusions: </strong>In this study, we found that tip flutter was a reliable indicator of successful clot aspiration during ADAPT.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"e400-e404"},"PeriodicalIF":4.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289412","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":"Enhancing thrombectomy outcomes with Adaptive Pulsatile Aspiration (APA): the role of complete clot ingestion in reducing thrombectomy time and distal embolization.","authors":"Victor M Lu, John Thompson, Turki Elarjani, Emade Jaman, Josiah Sherman, Manning Hanser, Mazen Abuawad, Kaustubh Limaye, Waldo R Guerrero, Kunal Vakharia, Daniel Walzman, Isaac Josh Abecassis, Reade Andrew De Leacy, R Webster Crowley, Robert M Starke","doi":"10.1136/jnis-2024-022683","DOIUrl":"10.1136/jnis-2024-022683","url":null,"abstract":"<p><strong>Background: </strong>Complete clot ingestion (CCI) is defined as full ingestion of the clot into the catheter or pump canister without any external clot remnants at the catheter tip. The aim of this study was to demonstrate that using the CCI metric in vitro, partially ingested ('corked') clots pose a higher risk of distal emboli given distal emboli may exist in the setting of Thrombolysis In Cerebral Infarction 3 (TICI 3) revascularization.</p><p><strong>Methods: </strong>Thrombectomies using an in vitro synthetic clot analog were conducted across six catheters using the novel ALGO Smart Pump with Adaptive Pulsatile Aspiration (APA) (Von Vascular Inc, Sunrise, FL) and compared against the Penumbra static Engine Pump (Alameda, CA).</p><p><strong>Results: </strong>A total of 360 aspiration thrombectomies were completed with an overall CCI rate of 56.9%. Cases achieving CCI were significantly faster (P<0.001) and those with successful CCI had no instances of distal embolization, whereas cases with incomplete clot ingestion ('corking') showed a 5.2% rate of distal embolization (P<0.001). The overall rate of first pass effect was comparable between two systems. ALGO's APA mode achieved a significantly higher rate of CCI compared with the Penumbra Engine Pump's continuous aspiration (77.2% vs 36.7%, P<0.001), as well as shorter mean aspiration (43.7 s vs 73.2 s, P<0.001). Additionally, these trends were also reflected across all individually tested catheter types between the pump systems.</p><p><strong>Conclusions: </strong>Our findings demonstrate that CCI is a feasible and valuable metric for assessing thrombectomy efficacy in vitro, resulting in more favorable CCI outcomes with the ALGO system compared with the Penumbra system.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"e374-e380"},"PeriodicalIF":4.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854404","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":"Can intracranial vessel wall MR imaging help make high risk procedures safer?","authors":"Arindam R Chatterjee","doi":"10.1136/jnis-2024-022749","DOIUrl":"10.1136/jnis-2024-022749","url":null,"abstract":"","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"e191-e192"},"PeriodicalIF":4.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854266","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 of physiologically relevant synthetic thrombus for use in visual analysis of in vitro mechanical thrombectomy device testing.","authors":"Holly Berns, Sophia Robertson, Kailey Lewis, Jesse Wells, Wyatt Clark, Timothy A Becker","doi":"10.1136/jnis-2024-021743","DOIUrl":"10.1136/jnis-2024-021743","url":null,"abstract":"<p><strong>Background: </strong>Ischemic stroke is a leading cause of death and significant long-term disability worldwide. Mechanical thrombectomy is emerging as a standard treatment for eligible patients. As clinical implementation of stent retrieval and aspiration thrombectomy increases, there is a need for physiologically relevant in vitro device efficacy testing. Critical to this testing is the development of standardized 'soft' and 'hard' synthetic blood clots that mimic the properties of human thrombi and are compatible with imaging technologies. Synthetic clots allow researchers to extract information regarding clot integration, model hemodynamics, and quantify the physics of thrombectomy.</p><p><strong>Methods: </strong>This work develops polyacrylamide and alginate-based synthetic clots that are compatible with particle image velocimetry (PIV) and radiographic imaging techniques while maintaining mechanical properties of 'soft' and 'hard' human clots. Dynamic mechanical analysis testing using an HR2-Rheometer demonstrates comparable mechanical properties to human clots previously tested by this research group and provided in existing literature.</p><p><strong>Results: </strong>The synthetic clots are formulated with either 0.5% w/v polyethylene microspheres for PIV visualization or 20% w/v barium sulfate for angiographic visualization, enabling real-time imaging of clot behavior during thrombectomy simulations. The soft formulation shows compressive and shear properties of ~12 kPa and 2-3 kPa, respectively. The hard clots are 3-4 times stiffer, with compressive and shear properties of 41-42 kPa and 8-9 kPa, respectively.</p><p><strong>Conclusion: </strong>Standardized synthetic clots offer a platform for reproducible device testing. This provides a greater understanding of mechanical thrombectomy device efficacy, which may lead to quantifiable advances in device development and eventual improved clinical outcomes.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"e388-e392"},"PeriodicalIF":4.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860003","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":"Safety and efficacy of cangrelor in endovascular thrombectomy compared with glycoprotein IIb/IIIa Inhibitors.","authors":"Alex Devarajan, Shouri Gottiparthi, Michael T Caton, Aya Ouf, Katty Wu, Daryl Goldman, Nicole Davis, Nadine Musallam, Jack Zhang, Naina Rao, Neha Dangayach, Connor Davy, Michael G Fara, Shahram Majidi, Thomas Oxley, Christopher Paul Kellner, Tomoyoshi Shigematsu, Reade Andrew De Leacy, J Mocco, Johanna T Fifi, Hazem Shoirah","doi":"10.1136/jnis-2024-022228","DOIUrl":"10.1136/jnis-2024-022228","url":null,"abstract":"<p><strong>Background: </strong>Cangrelor, an intravenous P2Y12-receptor inhibitor, is a reversible and short-acting antithrombotic medication non-inferior to irreversible glycoprotein IIb/IIIa inhibitors (GPIs) like eptifibatide. There are insufficient data to compare the medications in endovascular thrombectomies (EVTs) requiring emergent platelet inhibition.</p><p><strong>Objective: </strong>To review our institution's experience with cangrelor in EVT and compares its safety and efficacy against GPIs.</p><p><strong>Methods: </strong>A large healthcare system retrospective review identified all patients who had received cangrelor or eptifibatide intraoperatively during EVT between December 2018 and March 2023 for this cohort study. Clinical data were reviewed. Functional status was defined by the modified Rankin Scale (mRS) and National Institutes of Health Stroke Scale (NIHSS) at multiple time points. Multivariate regression was performed.</p><p><strong>Results: </strong>Of 1010 EVT patients, 36 cangrelor and 104 eptifibatide patients were selected. There were no differences in baseline function or presentations. Cangrelor was frequently administered for stenting tandem occlusions (n=16, 44.4%), and successful reperfusion occurred in 30 (83.3%) patients. On multivariate analysis, cangrelor was associated with decreased odds of hemorrhagic conversion (adjusted OR (aOR)=0.76, P=0.004) and symptomatic hemorrhage (aOR=0.86, P=0.021). There were no differences in thrombotic re-occlusion. Cangrelor was associated with a lower 24-hour NIHSS score (7.0 vs 12.0, P=0.013) and discharge NIHSS score (3.0 vs 9.0, P=0.004). There were no differences in in-hospital mortality or length of stay. Cangrelor was associated with improved odds of favorable outcome, defined as mRS score 0-2, at discharge (aOR=2.69, P=0.001) and on 90-day follow-up (aOR=2.23, P=0.031).</p><p><strong>Conclusion: </strong>Cangrelor was associated with a decreased risk of hemorrhagic conversion and might lead to favorable functional outcomes for patients during hospitalization in comparison with GPIs. Prospective studies are warranted to investigate its use in EVT.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"e320-e325"},"PeriodicalIF":4.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558076","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":"Cumulative in-hospital radiation dose in patients with acute ruptured intracranial aneurysm: a comparative analysis evaluating the effect of radiation dose reducing efforts.","authors":"Ilah Shin, Minkook Seo, Ji Young Lee, Jinhee Jang, Kook-Jin Ahn, Woo Cheul Cho, David J Park, Yong Sam Shin, Jai Ho Choi, Bum-Soo Kim","doi":"10.1136/jnis-2025-023242","DOIUrl":"https://doi.org/10.1136/jnis-2025-023242","url":null,"abstract":"<p><strong>Background: </strong>The cumulative impact of radiation dose reduction strategies in acute hospital settings remains underreported. This study quantifies and compares cumulative radiation exposure in patients with ruptured intracranial aneurysms before and after implementing dose reduction strategies.</p><p><strong>Methods: </strong>This retrospective study included 166 patients with subarachnoid hemorrhage (SAH) due to ruptured intracranial aneurysms, comparing two time periods: pre-adjustment (July 2012-March 2013) and post-adjustment (January 2017-March 2022) of dose reduction strategies. Radiation doses from imaging modalities, including X-ray, computed tomography (CT), and angiography, were collected. Cumulative radiation dose (CRD) and cumulative effective dose (CED) were calculated and compared between the two periods.</p><p><strong>Results: </strong>Angiography accounted for the largest share of the CRD in clipping and coiling procedures (about 75% and 95%, respectively), whereas its contribution to the CED was lower in clipping and coiling procedures (about 20 and 60%, respectively), reflecting differences in radiation weighting for biological effects. Significant reductions in both mean CRD and CED were observed in the post-period for both clipping and coiling procedures, with reductions of approximately 40% and 30% in CRD (P<.001 and P=0.013) and 45% and 35% in CED (P< .001 and P=0.002), respectively.</p><p><strong>Conclusion: </strong>The implementation of radiation dose reduction strategies significantly decreased both cumulative radiation and effective doses, highlighting the importance of continuous optimization to enhance patient safety without compromising diagnostic and therapeutic efficacy.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187174","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 embolization for medically refractory pediatric epilepsy: a case series.","authors":"Risheng Xu, Ethan Srinivasan, Alice Hung, Ryan Patrick Lee, Liam Hughes, Emily Johnson, Connor Liu, Lisa R Sun, Ryan J Felling, Anne Comi, Siddarth Gupta, Sarah Kelley, Babitha Harida, Carl Stafstrom, Eric Kossoff, Christa Habela, Kristen Baranano, Joseph Scafidi, Sue Hong, Stacey Suskauer, George Jallo, Matthew Smyth, Aylin Tekes, Melike Guryildirim, Doris Lin, Alan Cohen, Monica S Pearl, Ahmad Marashly, Shenandoah Robinson","doi":"10.1136/jnis-2025-023265","DOIUrl":"https://doi.org/10.1136/jnis-2025-023265","url":null,"abstract":"<p><strong>Background: </strong>Endovascular embolization has been reported in limited case series and case reports as a minimally invasive option for managing refractory epilepsy, particularly in cases where traditional surgical interventions are high risk.</p><p><strong>Objective: </strong>To explores the feasibility, safety, and outcomes of endovascular embolization in pediatric patients with intractable epilepsy due to varied etiologies.</p><p><strong>Methods: </strong>This retrospective case series includes four pediatric patients with medically refractory epilepsy, who underwent staged endovascular embolization at a tertiary care center between 2022 and 2024. Patients were selected based on contraindications to conventional surgical approaches and failure of at least two anti-seizure medications. Outcome measures included seizure frequency reduction, functional improvements, and procedure-related complications. Follow-up duration ranged from 10 to 15 months after the last embolization.</p><p><strong>Results: </strong>The cohort included four patients aged 2 to 9 years, and a total of 12 embolization procedures were performed. Three patients achieved freedom from seizures, while one undergoing a palliative procedure showed meaningful improvement in seizure frequency. No patients required rescue surgery, and none experienced hydrocephalus or neurologically unexpected complications during the follow-up period. Postprocedural deficits were similar to functional hemispherectomy outcomes. Parents and clinicians reported substantial developmental and functional improvements across multiple domains.</p><p><strong>Conclusions: </strong>Endovascular embolization is a promising minimally invasive strategy for pediatric patients with refractory epilepsy, particularly when anatomical or medical considerations preclude traditional surgery. Further research is warranted to refine patient selection criteria and assess long-term efficacy compared with established surgical approaches. This series expands the potential applications of endovascular techniques in epilepsy management.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187175","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":"REcanalization of Distal Cerebral Vessels In Acute Stroke Using ApeRio (REVISAR).","authors":"Franziska Dorn, Jan Borggrefe, Kai Kallenberg, Marielle Ernst, Daniel Behme, Annette Foerschler, Christoph Kabbasch, Thomas Liebig, Bernd Turowski, Hannes Nordmeyer","doi":"10.1136/jnis-2024-022810","DOIUrl":"https://doi.org/10.1136/jnis-2024-022810","url":null,"abstract":"<p><strong>Background: </strong>Although recently presented randomized trials have failed to prove an overall benefit of mechanical thrombectomy (MT) for patients with medium vessel occlusions (MeVOs), questions remain unanswered, particularly regarding the technology and the role of dedicated small devices. This prospective multicenter, core lab reviewed registry study investigates the efficacy and safety of the APERIO Hybrid used as a first-line device for the treatment of MeVO patients.</p><p><strong>Methods: </strong>Data from all MeVO patients who underwent MT with the APERIO or APERIO Hybrid¹⁷ as a first-line technique were prospectively included. The primary endpoint was the successful recanalization (Thrombolysis In Cerebral Infarction (TICI) 2b/3) after up to three passes with the APERIO without the use of a rescue technique and without any symptomatic intracranial hemorrhage (ICH).</p><p><strong>Results: </strong>134 patients were enrolled from 10 stroke centers. The primary endpoint was reached in 97 patients (81.5%, 95% CI 74.5% to 88.5%). In patients who failed the primary endpoint, TICI 2b/3 was reached with 4 to 6 APERIO passes in 4 patients (3.3%) and with other techniques in 18 patients (15%). Overall recanalization success was 95.8%. TICI 2b/3 with APERIO Hybrid was achieved after the first pass in 76 patients (63.9%), in 23 (19.3%) after 2 passes, and in 1 patient (0.8%) after 3 passes. Modified Rankin Scale (mRS) 0-2 at 90 days was reached by 79.0% of the patients. Symptomatic ICH occurred in no patients, asymptomatic ICH in 16 (13.5%), and subarachnoid hemorrhage in 15 patients (12.6%).</p><p><strong>Conclusion: </strong>APERIO and APERIO Hybrid¹⁷ have been proven to be both safe and effective first-line devices for MT in MeVO stroke at different centers and with high rates of successful recanalization.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187185","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":"Efficacy and safety of a new mechanical balloon-based flow diverter in the treatment of intracranial aneurysms.","authors":"Jingwei Li, Wei Ni, Yiran Lu, Li Li, Chuan He, Chao Gao, Tianxiao Li, Xinjian Yang, Hongqi Zhang","doi":"10.1136/jnis-2025-023225","DOIUrl":"https://doi.org/10.1136/jnis-2025-023225","url":null,"abstract":"<p><strong>Background: </strong>Flow diverters (FDs) are the first-line treatment of intracranial aneurysms (IAs). A groundbreaking mechanical balloon-based FD device was developed to enhance the precise landing and deployment efficiency for FDs.</p><p><strong>Objective: </strong>To investigates the efficacy and safety of this innovative device in a prospective cohort.</p><p><strong>Methods: </strong>This study was a prospective multicenter observational study conducted between September 2019 and November 2021. Patients diagnosed with unruptured IAs and treated with this innovative FD device alone were included. The immediate implantation success rate, the successful aneurysm occlusion rate (Raymond I-II or OKM C-D), the complete occlusion rate (Raymond I or OKM D), and the parent artery stenosis rate (>50%) at follow-up were evaluated as the evaluation index of efficacy. The mortality rate, adverse events (AEs), neurological AEs, and serious adverse events (SAEs) were evaluated as the evaluation index of safety.</p><p><strong>Results: </strong>A total of 128 patients were included, and all of the FD deployments were successful (success rate reached 100%). At the 12-month mark, 91.4% (117/128) of patients achieved successful occlusion, 85.9% (110/128) achieved complete occlusion, and only 0.8% (1/128) exhibited parent artery stenosis >50% (without need for additional treatment). During the follow-up, there were no reported mortalities or cerebral hemorrhage, while 6 neurological adverse events (4.69%) and 4 SAEs (3.1%) were observed.</p><p><strong>Conclusions: </strong>The mechanical balloon-based FD showed a remarkable occlusion rate alongside minimal ischemic and hemorrhagic adverse events compared with existing FDs. This innovative mechanical balloon-based design may be an important direction for future FD design.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159684","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}