Journal of NeuroInterventional Surgery最新文献

{"title":"Clinical outcomes and independently adjudicated results of M2 aspiration thrombectomy: a subgroup analysis from the Imperative Trial.","authors":"Justin R Mascitelli, Reade Andrew De Leacy, William Mack, Raul Nogueira, Shahram Majidi, Robert Dana Tomalty, Maxim Mokin, Jan Vargas, Brett L Cucchiara, Kenneth V Snyder, Victoria Parada, Hakeem J Shakir, David Rosenbaum-Halevi, Amin Aghaebrahim, Daniel Hoit, Benjamin Yim, Matthew S Tenser, Alhamza R Al-Bayati, James M Milburn, Shahid M Nimjee, Neil Haranhalli, Michael Nahhas, Darryn Shaff, Kennith F Layton, Narlin Beaty, Robert M Starke, Harris Hawk, Diogo C Haussen, Aqueel Pabaney, Christopher Paul Kellner, Jonathan A Grossberg","doi":"10.1136/jnis-2025-024023","DOIUrl":"https://doi.org/10.1136/jnis-2025-024023","url":null,"abstract":"<p><strong>Background: </strong>The ESCAPE-MeVO (Endovascular Treatment to Improve Outcomes for Medium Vessel Occlusions) and DISTAL (Endovascular Therapy plus Best Medical Treatment vs Best Medical Treatment Alone for Medium Vessel Occlusion Stroke) trials failed to demonstrate the superiority of endovascular thrombectomy over best medical management for medium and small vessel occlusions. Potential limitations of these trials include older patient populations, lower presenting National Institutes of Health Stroke Scale (NIHSS) scores, higher rates of premorbid disability, delayed revascularization times, inclusion of both medium and small vessel occlusions, and widespread use of stent retrievers. Here we present M2 occlusion data from the Imperative Trial, evaluating aspiration thrombectomy with the Zoom System.</p><p><strong>Methods: </strong>The Imperative Trial is a prospective, multicenter, single-arm trial with independent core lab and safety board adjudication, evaluating aspiration thrombectomy with the Zoom System (Imperative Care, Campbell, CA, USA) for large vessel, including M2, occlusions. This subanalysis includes patients with primary M2 occlusions. Angiographic outcomes were defined as modified Treatment in Cerebral Infarction (mTICI) score ≥2b (good) and ≥2c (excellent). Clinical outcomes were defined as modified Rankin Scale score (mRS) 0-2 (good) and 0-1 (excellent) at 90 days. Safety was assessed by all-cause mortality, symptomatic intracranial hemorrhage (sICH), and all hemorrhage.</p><p><strong>Results: </strong>Of 260 enrolled patients, 25% (65/260) had primary M2 occlusions. Median age was 69 years; median NIHSS was 13. Good and excellent reperfusion were achieved in 88% (57/65) and 66% (43/65), respectively. At 90 days, good and excellent clinical outcomes occurred in 62% (39/63) and 56% (35/63), respectively. Mortality, sICH, and any hemorrhage were 4.6% (3/65), 1.5% (1/65), and 18% (12/65), respectively.</p><p><strong>Conclusions: </strong>The Zoom System demonstrated excellent safety and efficacy in M2 occlusions. These findings support aspiration thrombectomy for M2 occlusions as a viable treatment in well-selected patients.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000722","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":"Stentplasty for treating symptomatic intracranial atherosclerotic disease following failure of medical therapy.","authors":"Carlos Dier, Andres Gudino, Domenica Cifuentes, Ruben Calle, Sebastian Sanchez, Navami Shenoy, Elena Sagues, Connor Aamot, Boris Pabón Guerrero, Mario Zanaty, Santiago Ortega-Gutierrez, Satoshi Tateshima, Edgar A Samaniego","doi":"10.1136/jnis-2025-023898","DOIUrl":"https://doi.org/10.1136/jnis-2025-023898","url":null,"abstract":"<p><strong>Purpose: </strong>Endovascular treatment of intracranial atherosclerotic disease (ICAD) remains challenging due to procedural risks and stroke recurrence. Previous trials have favored aggressive medical therapy. In patients refractory to medical therapy, 'stentplasty' using expandable and retrievable devices may provide a safer alternative to balloon angioplasty by allowing controlled submaximal vessel dilation without flow arrest. We present a two-center experience using these devices for treating symptomatic ICAD refractory to maximal medical therapy.</p><p><strong>Methods: </strong>Patients with symptomatic high-grade stenosis (>70-99%) who failed medical therapy and underwent 'stentplasty' with the Tigertriever and Comaneci devices were included. Demographic data, periprocedural complications, and radiological and functional outcomes were evaluated and reported.</p><p><strong>Results: </strong>Eighteen patients were treated, of whom 16 (89%) presented with acute ischemic stroke and two (11%) with transient ischemic attacks. The median admission National Institutes of Health Stroke Scale (NIHSS) score was 9 (IQR 6-21). Stentplasty alone resulted in successful reperfusion (modified Thrombolysis in Cerebral Infarction ≥2b-3) in 11 patients (61%); the remaining seven patients (39%) required rescue therapy with permanent stenting. Median stenosis was reduced from 95% (IQR 92-99%) before treatment to 50% (IQR 48-66%) after stentplasty, and further to 10% (IQR 10-19%) in those receiving permanent stents. One periprocedural complication occurred (6%) involving distal embolization. The median (IQR) improvement in NIHSS score from admission to discharge was 5 (0-8) points. No patients experienced recurrent ischemic strokes or reocclusions during follow-up. All achieved a modified Rankin Scale score of 0-2 at 90-day follow-up (range 30-180 days).</p><p><strong>Conclusion: </strong>Stentplasty using expandable and retrievable devices appears to be a safe and effective treatment option for patients with symptomatic ICAD refractory to medical therapy. While many cases can be successfully treated with stentplasty alone, a subset may require adjunctive permanent stenting to achieve optimal recanalization.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000753","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":"Crowdfunding for stroke: a national analysis.","authors":"Advait Patil, Paul Serrato, Artem Arzyn, Samuel B Snider, Kevin T Huang","doi":"10.1136/jnis-2025-023788","DOIUrl":"https://doi.org/10.1136/jnis-2025-023788","url":null,"abstract":"<p><strong>Background: </strong>Stroke imposes an enormous economic burden on patients and caregivers. Online crowdfunding is widely used to address healthcare costs, reflecting social safety net gaps, yet it has not been studied for stroke. We performed the first national analysis of stroke-related crowdfunding, evaluating fund totals, success rates, geography, and stroke etiology.</p><p><strong>Methods: </strong>We analyzed GoFundMe campaigns (2011-2020) along with socioeconomic data on metropolitan residency, median incomes, cost of living, and Flesch-Kincaid readability. Primary outcomes included total funds raised and funding success rate, assessed with univariable and multivariable regression.</p><p><strong>Results: </strong>10 672 stroke-related campaigns sought $245 843 953 and raised $81 053 044 (median (IQR) $3870 ($887-$6853)); 15.3% met their goal. California ($9 596 254; 1164 campaigns), Texas ($5 275 765; 890 campaigns), and Florida ($5 307 649; 755 campaigns) raised the most funds and had the most campaigns. Hemorrhagic strokes predominated (69.2%, 7307 campaigns). The cohort had a higher percentage of metropolitan residents (17.9%, 95% CI 17.73% to 18.07%, P<0.001) and greater mean household income ($89 481.90, 95% CI $88 900.26 to $90 063.54, P<0.001) than national estimates (17.1% and $75 141.20). Multivariable regression found description length (β 0.34, 95% CI 0.23 to 0.42, P<0.001) and social media likes (β 85.23, 95% CI 82.35 to 88.12, P<0.001), but not shares (β -0.66, 95% CI -1.16 to -0.16, P<0.01), correlated with raising more funds.</p><p><strong>Conclusions: </strong>This study is the first national analysis of crowdfunding for stroke expenses. We found significant funding requests and identified factors influencing success. Compared with national estimates, we find that crowdfunding campaigns in this cohort originate from counties with a greater proportion of metropolitan residents and a greater household income with greater cost of living.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000724","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 of flow diversion in blister-like intracranial aneurysms during acute subarachnoid hemorrhage: a single-arm meta-analysis.","authors":"João Pedro Veras Torres, Matheus Trovão Ribeiro, Nicolas Silva Tundisi, Henrique Laurent Lepine, Eberval Gadelha Figueiredo","doi":"10.1136/jnis-2025-024020","DOIUrl":"https://doi.org/10.1136/jnis-2025-024020","url":null,"abstract":"<p><strong>Background: </strong>Blister-like intracranial aneurysms are rare fragile lesions with a high risk of rupture leading to acute subarachnoid hemorrhage (aSAH) and significant morbidity. Flow diversion (FD) has emerged as a promising endovascular treatment, particularly for complex cases unsuitable for clipping or coiling, but evidence in ruptured settings remains limited due to challenges such as the risks of dual antiplatelet therapy. This study aimed to evaluate the efficacy and safety of FD in ruptured blister-like aneurysms during aSAH through a systematic review and meta-analysis.</p><p><strong>Methods: </strong>A single-arm meta-analysis was conducted following PRISMA guidelines, searching Medline, Web of Science, Embase, and Cochrane Library from inception to the present. Inclusion criteria were patients of any age with acutely ruptured blister-like aneurysms treated with FD, focusing on occlusion rates, complications, rebleeding, retreatment, modified Rankin Scale (mRS) scores, and mortality. Data were analyzed using a random effects model, with heterogeneity assessed by I² and quality evaluated using the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>Twenty observational studies (n=209 patients) were included. The mean age was 50.7 years and 60.7% were women. Follow-up occlusion reached 83% (95% CI 0.72 to 0.94; I²=86%), while immediate occlusion was 37% (95% CI 0.18 to 0.55; I²=92%). Functional outcomes showed 91% had an mRS score of 0-2 at follow-up (95% CI 0.86 to 0.96; I²=0%) and 64% at discharge (95% CI 0.32 to 0.96; I²=96%). Complications were 9% intraprocedural (95% CI 0.04 to 0.15; I²=36%) and 6% postprocedural (95% CI 0.01 to 0.11; I²=0%), with rebleeding at 2% (95% CI 0.00 to 0.06; I²=0%) and mortality at 2% (95% CI 0.00 to 0.06; I²=0%). Sensitivity and publication bias analyses confirmed the stability of the results.</p><p><strong>Conclusions: </strong>FD achieves high occlusion and favorable functional outcomes in ruptured blister-like aneurysms, although immediate occlusion and complications pose challenges. Future research should optimize antiplatelet strategies and standardize protocols.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000745","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":"In situ ischemic postconditioning for acute ischemic stroke: preliminary exploratory study.","authors":"Xiao Jiang, Longfei Wu, Shuling Liu, Yongbo Xu, Bohao Zhang, Sifei Wang, Leilei Luo, Wenbo Zhao, Yang Yao, Chen Cao, Heng Zhao, Xunming Ji, Ming Wei","doi":"10.1136/jnis-2025-024031","DOIUrl":"https://doi.org/10.1136/jnis-2025-024031","url":null,"abstract":"<p><strong>Background: </strong>Endovascular therapy within 24 hours of stroke onset is effective and safe, but successful recanalization does not always give favorable outcomes. Ischemic postconditioning (IPostC), a reperfusion strategy with potential neuroprotective effects, has been extensively studied in preclinical models, but its impact in humans remains unclear. Building on a previous dose escalation study, we aimed to investigate the effect of in situ IPostC on infarct volume in patients with acute ischemic stroke following mechanical thrombectomy.</p><p><strong>Methods: </strong>This prospective, externally controlled, non-randomized trial compared in situ IPostC (four cycles of 2 min of occlusion/2 min of release) plus thrombectomy with contemporaneous external controls receiving thrombectomy alone. Propensity score matching (PSM) minimized selection bias. The primary outcome was infarct volume at 72 hours post-thrombectomy. Deep infarct volume was also compared in post hoc analyses. Peripheral blood was collected 24 hours post-procedure to assess leukocyte populations, with mononuclear cell subsets characterized by flow cytometry. Serum inflammatory biomarkers were also measured in both groups.</p><p><strong>Results: </strong>After 1:1 PSM, 19 patients per group were analyzed. The IPostC group showed significantly less deep infarct volume progression (median 2.3 vs 4.7 mL; P=0.045), lower interleukin 6 levels (median 26.4 vs 32.6 pg/mL; P=0.032), higher Th/CTL ratios (median 2.04 vs 1.65; P<0.01), and reduced natural killer cell proportions (median 1.10% vs 1.68%; P=0.047).</p><p><strong>Conclusions: </strong>In situ IPostC following thrombectomy for large vessel occlusion stroke may be associated with reduced deep infarct volume progression and favorable immunomodulatory effects, warranting further validation in phase II trials.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05909982.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957542","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":"Early angiographic response to Pipeline Vantage flow diverter embolization of intracranial carotid aneurysms.","authors":"M Harrison Snyder, Adel M Malek","doi":"10.1136/jnis-2025-023567","DOIUrl":"https://doi.org/10.1136/jnis-2025-023567","url":null,"abstract":"<p><strong>Background: </strong>The Pipeline Vantage 027 flow diverter became available a year ago in the United States. We report an observational study of its safety and early angiographic response in the treatment of internal carotid artery (ICA) aneurysms.</p><p><strong>Methods: </strong>All patients treated with the Vantage 027 for ICA aneurysms from April to November 2024 at a single center were included. Intraprocedural contrast-enhanced cone-beam CT was used to evaluate vessel wall apposition. A novel proximal ledge deformity is defined as delayed elevation of one stent edge into the lumen while the opposite edge remains wall-apposed.</p><p><strong>Results: </strong>Twenty-four aneurysms (mean size 4.2±2.7 mm) in 20 patients underwent Vantage 027 embolization. Clinical follow-up at 6 months revealed no major/minor stroke and a single reversible ischemic attack following dual anti-platelet therapy (DAPT) non-compliance. Follow-up angiography in all patients revealed complete occlusion in 19/24 aneurysms at a median of 3.5 months (79%). Severe ≥50% stenosis was noted in 7/20 (35%) with distal fishmouth deformity in 12/20 (60%); both fishmouthing (p=0.003) and severe stenosis (p=0.04) were associated with younger age. We also observed a proximal ledge in 5/20 (25%) with luminal caliber compromise.</p><p><strong>Conclusions: </strong>Although Vantage 027 ICA aneurysm embolization resulted in early robust aneurysm involution, it was associated with an age-dependent fishmouthing braid deformity and a proximal ledge deformity possibly requiring extended DAPT. These results encourage further analysis of the vascular response to Vantage 027 and similar stents.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957399","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":"Impact of pre-test probability on AI-LVO detection: a systematic review of LVO prevalence across clinical contexts.","authors":"Marta Olivé-Gadea, Jordi Mayol, Manuel Requena, Marc Rodrigo-Gisbert, Federica Rizzo, Alvaro Garcia-Tornel, Renato Simonetti, Francesco Diana, Marian Muchada, Jorge Pagola, David Rodriguez-Luna, Noelia Rodriguez-Villatoro, Marta Rubiera, Carlos A Molina, Alejandro Tomasello, David Hernandez, Marta de Dios Lascuevas, Marc Ribo","doi":"10.1136/jnis-2025-023775","DOIUrl":"https://doi.org/10.1136/jnis-2025-023775","url":null,"abstract":"<p><strong>Background: </strong>Rapid identification of large vessel occlusion (LVO) in acute ischemic stroke (AIS) is essential for reperfusion therapy. Screening tools, including Artificial Intelligence (AI) based algorithms, have been developed to accelerate detection but rely heavily on pre-test LVO prevalence. This study aimed to review LVO prevalence across clinical contexts and analyze its impact on AI-algorithm performance.</p><p><strong>Methods: </strong>We systematically reviewed studies reporting consecutive suspected AIS cohorts. Cohorts were grouped into four clinical scenarios based on patient selection criteria: (a) high suspicion of LVO by stroke specialists (direct-to-angiosuite candidates), (b) high suspicion of LVO according to pre-hospital scales, (c) and (d) any suspected AIS without considering severity cut-off in a hospital or pre-hospital setting, respectively. We analyzed LVO prevalence in each scenario and assessed the false discovery rate (FDR) - number of positive studies needed to encounter a false positive, if applying eight commercially available LVO-detecting algorithms.</p><p><strong>Results: </strong>We included 87 cohorts from 80 studies. Median LVO prevalence was: (a) 84% (77-87%), (b) 35% (26-42%), (c) 19% (14-25%), and (d) 14% (8-22%). At high prevalence levels: (a) FDR ranged between 0.007 (1 false positive in 142 positives) and 0.023 (1 in 43), whereas in low prevalence scenarios (Ccand d), FDR ranged between 0.168 (1 in 6) and 0.543 (over 1 in 2).</p><p><strong>Conclusion: </strong>To ensure meaningful clinical impact, AI algorithms must be evaluated within the specific populations and care pathways where they are applied.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957531","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":"Integrated drip-and-ship improves stroke transfer efficiency and outcomes: a comparison with traditional drip-and-ship and mothership models.","authors":"Chun-Min Wang, Che-Wei Lin, Yu-Ming Chang, Ray-Chang Tzeng, Ming-Hsiu Wu, Si-Chon Vong, Tsang-Shan Chen, Shang-Te Wu, Yu-Tai Tsai, Yi-Ting Fang, Chuang-Chou Yang, Yu-Hsiang Su, Meng-Hua Huang, Mu-Han Wu, Feng-Yuan Chu, Yen-Chu Huang, Kuan-Hung Lin, Che-Chao Chang, Sheng-Hsiang Lin, Pi-Shan Sung","doi":"10.1136/jnis-2025-023872","DOIUrl":"https://doi.org/10.1136/jnis-2025-023872","url":null,"abstract":"<p><strong>Background: </strong>While endovascular thrombectomy (EVT) has revolutionized the treatment of acute large vessel occlusions, the appropriate patient transfer paradigm remains controversial. This study compares outcomes of three transfer models in a stroke network: mothership (MS), traditional drip-and-ship (DS), and an integrated DS model using a novel transfer system (TS).</p><p><strong>Methods: </strong>We implemented a novel TS to streamline communication and coordination between primary and comprehensive stroke centers. We analyzed 1063 patients with suspected large vessel occlusion across three groups: MS (n=814), conventional DS without TS (DS TS (-), n=185), and DS with TS (DS TS (+), n=64). Primary outcomes included treatment time metrics, EVT rates, and functional outcomes.</p><p><strong>Results: </strong>DS TS (+) showed improved time metrics, with onset-to-CT angiography (CTA) times comparable to MS (232 vs 255.5 min) and significantly faster than DS TS (-) (305 min). It also achieved the highest rates of both intravenous thrombolysis (51.56%) and EVT (48.44%). Among EVT patients, the DS TS (+) group had the shortest door-to-puncture time (98.0 min vs MS 132.0 min and DS TS (-) 127.0 min, P<0.001) and a shorter onset-to-puncture time compared with the DS TS (-) group. DS TS (+) also showed a promising trend towards superior functional outcomes at 3 months (modified Rankin Scale score 0-2: 54.84% vs MS 39.10% vs DS TS (-) 36.36%).</p><p><strong>Conclusion: </strong>This study shows that an integrated DS model using a structured TS can achieve outcomes comparable to the MS model. Enhancing transfer efficiency through innovative solutions tailored to the regional infrastructure may serve as a viable alternative alongside the MS model.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957483","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":"Role of interleukin-7 in acute large vessel occlusion stroke.","authors":"Jason Zhao, Jacqueline A Frank, Amanda L Trout, Ann M Stowe, Mais Al-Kawaz, Shivani Pahwa, David Dornbos, Keith R Pennypacker, Justin F Fraser","doi":"10.1136/jnis-2025-023637","DOIUrl":"https://doi.org/10.1136/jnis-2025-023637","url":null,"abstract":"<p><strong>Introduction: </strong>Emergent large vessel occlusion (ELVO) stroke is a severe ischemic subtype with high morbidity despite mechanical thrombectomy (MT). Current biomarkers inadequately capture the intracranial immune response driving stroke progression. Interleukin-7 (IL-7) is implicated in neuroinflammation but remains understudied in stroke. This study investigates intracranial and systemic IL-7 expression in patients with ELVO stroke, assessing its association with infarct burden and its potential as a prognostic biomarker.</p><p><strong>Methods: </strong>Plasma samples were collected from patients with ELVO stroke during MT and from CVD control patients undergoing elective diagnostic cerebral angiography. Systemic and intracranial arterial blood was processed with a proximity extension assay (Olink Proteomics) to quantify IL-7 and other cytokines. Infarct and edema volumes were assessed using MRI or CT at 24 hours post-procedure. Spearman correlation and multivariable linear regression models adjusted for the National Institutes of Health Stroke Scale (NIHSS) score at admission were used to evaluate associations between IL-7 levels (intracranial, systemic, and the difference between compartments) and clinical outcomes.</p><p><strong>Results: </strong>Intracranial IL-7 was independently associated with infarct volume (β=-42 052, P=0.0432; R²=0.232), demonstrating greater overall best fit than systemic IL-7 (P=0.8408) and systemic-intracranial differences (P=0.0857). Intracranial IL-7 was also correlated with infarct volume, edema, and NIHSS score at discharge.</p><p><strong>Conclusion: </strong>Intracranial IL-7 is a significant predictor of infarct burden in ELVO stroke, highlighting its role in localized immune responses. Systemic IL-7 lacked predictive value, suggesting spatially restricted IL-7 signaling within the ischemic environment. IL-7 may serve as a biomarker for stroke severity and a potential therapeutic target.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957504","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":"Liquid embolic penetration of the skull during middle meningeal artery embolization is correlated with chronic subdural hematoma resolution.","authors":"Oishika Das, Alice Hung, Xihang Wang, James Feghali, Wuyang Yang, Vivek Yedavalli, Christopher M Jackson, Judy Huang, Rafael J Tamargo, Justin M Caplan, L Fernando Gonzalez, Risheng Xu","doi":"10.1136/jnis-2025-023763","DOIUrl":"https://doi.org/10.1136/jnis-2025-023763","url":null,"abstract":"<p><strong>Background: </strong>Few studies have explored the role of skull-meninges interaction in outcomes post middle meningeal artery (MMA) embolization. We investigated how the liquid embolic penetration into the skull bone during MMA embolization affects chronic subdural hematoma (cSDH) resolution.</p><p><strong>Methods: </strong>All patients undergoing MMA embolization at our institution from January 2019 to November 2024 were included in this single center retrospective study. Bilateral embolizations were counted as two separate cases. The cohort was divided into two groups: those with embolic agent within skull bone, and those without. Baseline characteristics, procedural details, and SDH resolution status were compared. Univariate analysis was performed.</p><p><strong>Results: </strong>A total of 132 MMA embolization cases were included within this cohort; 49 (37.1%) had liquid embolic agent within the skull bone, and 83 (62.9%) did not. The presence of liquid embolic agent within the skull bone was significantly correlated with higher rates of resolution for cSDH (P=0.005). The cohort with embolic material within bone was also associated with increased diffuse distal penetration (P<0.001) and increased volume of embolic agent (P<0.001). On multivariate analysis limited to patients with >60 days of follow-up, bony embolic penetration remained significantly associated with cSDH resolution (P=0.038).</p><p><strong>Conclusions: </strong>Penetration of liquid embolic agent into the skull during MMA embolization is associated with higher rates of cSDH resolution. Further studies exploring the potential role of skull bone marrow in the inflammatory process involved in cSDH formation are warranted.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957548","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}