Journal of NeuroInterventional Surgery最新文献

{"title":"The pEGASUS-HPC stent system for intracranial arterial stenosis: a single-center case series.","authors":"Daniel Pielenz, Joachim Klisch, David Fiorella, Matthias Gawlitza, Andreas Steinbrecher, Elke Leinisch, Elmar Lobsien, Karl-Titus Hoffmann, Donald Lobsien","doi":"10.1136/jnis-2024-021737","DOIUrl":"10.1136/jnis-2024-021737","url":null,"abstract":"<p><strong>Background: </strong>Intracranial arterial stenting is a technique for the treatment of symptomatic stenosis. In this single-center retrospective case series we evaluated a novel low profile laser-cut stent with an antithrombogenic hydrophilic polymer coating (pEGASUS-HPC, Phenox GmbH, Bochum, Germany) for the treatment of intracranial stenosis in the setting of acute ischemic stroke and elective cases.</p><p><strong>Methods: </strong>All patients treated with pEGASUS-HPC for one or more intracranial arterial stenoses at our institution were retrospectively included. Clinical, imaging and procedural parameters as well as clinical and imaging follow-up data were collected.</p><p><strong>Results: </strong>We performed 43 interventions in 41 patients with 42 stenoses in our neurovascular center between August 2021 and February 2024. Twenty-one patients (51.2%) were female and the mean±SD age was 71±10.8 years. Thirty-seven (86.1%) procedures were performed in the setting of endovascular acute ischemic stroke treatment. Technical or procedural complications occurred in seven patients (16.3%), six in the thrombectomy group and one in the elective group. One stent-related hemorrhagic complication (subarachnoid hemorrhage) occurred in emergency cases and symptomatic intracerebral hemorrhage occurred in one patient treated in an elective setting. Overall stenosis reduction following pEGASUS-HPC stent implantation was 53.0±18.0%. On follow-up imaging, which was available for 16 patients (37.2%) after an average of 32±58.6 days, 62.5% of the stents were patent.</p><p><strong>Conclusion: </strong>Our single-center case series demonstrates the feasibility of using the pEGASUS-HPC stent system, especially in emergency situations when thrombectomy fails.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"613-619"},"PeriodicalIF":4.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140957547","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 'Braids and beyond: a comprehensive study on pipeline device braid stability from PREMIER data' by Rodriguez-Erazú <i>et al</i>.","authors":"Xuefan Zeng, Yiwei Wang, Tangzhou Liao","doi":"10.1136/jnis-2024-022783","DOIUrl":"10.1136/jnis-2024-022783","url":null,"abstract":"","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"e5"},"PeriodicalIF":4.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693086","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 neurointerventional imaging: use of ultra-high resolution photon counting detector CT in intracranial stent assessment.","authors":"Xuefan Zeng","doi":"10.1136/jnis-2024-022838","DOIUrl":"10.1136/jnis-2024-022838","url":null,"abstract":"","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"e6"},"PeriodicalIF":4.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780393","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 'Transumbilical access for neonatal vein of Galen malformation and pial arteriovenous fistula embolization'.","authors":"Xuefan Zeng","doi":"10.1136/jnis-2024-022752","DOIUrl":"10.1136/jnis-2024-022752","url":null,"abstract":"","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"e11"},"PeriodicalIF":4.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785981","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 biliverdin reductase, a heme degradation pathway enzyme, in the development of vasospasm after subarachnoid hemorrhage.","authors":"Zahra Hasanpour-Segherlou, Hunter Hutchinson, Haiyan Xu, Shawna Amini, Elizabeth Klaas, Melanie E Martinez, Brandon Lucke-Wold, Koji Hosaka, Brian Hoh","doi":"10.1136/jnis-2025-023108","DOIUrl":"https://doi.org/10.1136/jnis-2025-023108","url":null,"abstract":"<p><strong>Background: </strong>Subarachnoid hemorrhage (SAH) is a life-threatening condition with high mortality and significant neurological morbidity, often complicated by delayed cerebral ischemia (DCI) and vasospasm. Heme metabolites such as biliverdin (BV) are implicated in SAH-induced vascular dysfunction, yet the role of biliverdin reductase-A (BVR-A), an enzyme that reduces BV to bilirubin, remains underexplored. This study investigates the contribution of BV and oxidative post-translational modifications of BVR-A to vasospasm development.</p><p><strong>Methods: </strong>We used a murine model of BV injection into the subarachnoid space and analyzed its effects on vasospasm, microthrombosis, neuronal apoptosis, and microglial activation. Additionally, human plasma and cerebrospinal fluid (CSF) samples from patients with SAH with and without vasospasm were evaluated for BVR-A expression and oxidative modifications using immunoprecipitation and western blot techniques.</p><p><strong>Results: </strong>BV injection in the murine model induced significant vasospasm, increased microthrombosis, neuronal apoptosis, and a reactive morphological shift in microglia. In human samples, oxidative modifications of BVR-A were significantly raised in plasma from patients with SAH with vasospasm compared with those without, despite similar BVR-A expression levels. No significant differences in oxidative modifications were observed in CSF samples.</p><p><strong>Conclusion: </strong>This study shows a novel role of BV in vasospasm development and identifies oxidative modifications of BVR-A as potential modulators of SAH pathology. These findings suggest that BV and altered BVR-A activity may serve as biomarkers or therapeutic targets for improving outcomes in patients with SAH.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127835","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":"Number of passes and outcome of endovascular treatment of anterior circulation large core ischemic stroke: insights from the Endovascular Treatment in Ischemic Stroke (ETIS) registry.","authors":"Victoria Lambrou, Benjamin Gory, Bertrand Lapergue, Gaultier Marnat, Raoul Pop, Lionel Calviere, Mohammad Anadani, Raphael Blanc, Stephanos Nikolaos Finitsis","doi":"10.1136/jnis-2024-021857","DOIUrl":"10.1136/jnis-2024-021857","url":null,"abstract":"<p><strong>Background: </strong>The effect of multiple attempts on the outcome of endovascular treatment (EVT) of anterior circulation large ischemic core (LIC) stroke has not been fully explored.</p><p><strong>Methods: </strong>We analyzed data from the Endovascular Treatment in Ischemic Stroke (ETIS) registry, a prospective, observational, multicenter study of acute ischemic stroke patients treated with EVT at 21 centers in France between January 1, 2015 and June 31, 2023. We included patients with proximal intracranial occlusion and LIC defined as Alberta Stroke Program Early CT Score (ASPECTS) of 0-5 up to 24 hours after last being seen well. We divided patients according to the number of passes with successful reperfusion (modified Thrombolysis In Cerebral Infarction (mTICI) ≥2b) into seven groups, according to the corresponding number of passes. We compared them to the group of patients with unsuccessful reperfusion.</p><p><strong>Results: </strong>A total of 1235 patients with LIC constituted the study cohort. The rate of a modified Rankin Scale (mRS) score of 0 to 3 at 90 days was significantly higher for the one-pass successful recanalization category compared to no recanalization (48.1% vs 17.2%; adjusted OR (aOR) 7.99, 95% CI 4.30 to 14.8, P<0.001) and remained so even after six or more attempts (27.7% vs 17.2%; aOR 3.59, 95% CI 1.37 to 9.39, P=0.009). The rate of symptomatic intracranial hemorrhage was lower for successful recanalization up to two passes (11.1% vs 18.8%; aOR 0.36, 95% CI 0.18 to 0.69, P=0.002) without any significant differences for a higher number of passes.</p><p><strong>Conclusion: </strong>In anterior circulation LIC patients, successful reperfusion, even after six passes, is associated with favorable clinical outcomes with no increased hemorrhagic risk when compared to unsuccessful reperfusion.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"574-579"},"PeriodicalIF":4.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179890","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":"Coil embolization of distal vascular lesion using a 1.5 Fr Marathon microcatheter and 'free-running' technique.","authors":"Chang-Hsien Ou, Chiu-Shih Cheng, William Winardi, Pei-Ling Lin, Cheng-Lung Lee, Wan-Ching Lin","doi":"10.1136/jnis-2023-020893","DOIUrl":"10.1136/jnis-2023-020893","url":null,"abstract":"<p><p>In distal vascular lesions, such as the distal anterior inferior cerebellar artery or posterior inferior cerebellar artery (PICA) dissecting aneurysm, and dural arteriovenous fistula (dAVF) and arteriovenous malformation (AVM), super-selective catheterization and embolization using liquid agents, such as NBCA or Onyx liquid embolic system, is the preferred treatment.1 2 We used a flow-directed 1.5 Fr Marathon microcatheter (Medtronic, Minneapolis, MN, USA) for embolization because commonly used detachable coil-compatible microcatheters can be too short or rigid for superselection.3-6 We designed an in vitro coil compatibility test for the Marathon microcatheter and developed a 'free-running' technique (video 1). Using this technique, we trapped the distal PICA dissecting aneurysm and embolized the fistula points of dAVF precisely and safely without affecting adjacent normal structures, which can occur when applying liquid embolizing agents.1-3 After reviewing the case, we determined that this technique can also potentially be applied for implementing the pressure cooker technique7 and combining the management of AVM.4 neurintsurg;17/6/668/V1F1V1Video 1Free-running technique via 1.5 Fr Marathon microcatheter.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"668"},"PeriodicalIF":4.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50158139","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 management of saccular aneurysms of the proximal A1 segment: technical particularities and long term outcomes.","authors":"Liang Liao, Patricio Muszynski, François Zhu, Oana Harsan, Luana Lopes De Medeiros, Serge Bracard, René Anxionnat","doi":"10.1136/jnis-2024-021799","DOIUrl":"10.1136/jnis-2024-021799","url":null,"abstract":"<p><strong>Background: </strong>Saccular aneurysms of the proximal A1 segment (SAPA₁) are rare, but their treatment is challenging and scarcely described in the literature. We report the immediate and long term outcomes of their endovascular management.</p><p><strong>Methods: </strong>We retrospectively analyzed all consecutive SAPA₁ cases treated endovascularly at our center between 2003 and 2023. Per procedural complications and radioclinical outcomes were prospectively recorded.</p><p><strong>Results: </strong>Among 2468 patients followed up for aneurysms, 12 (0.49%) had an SAPA₁ (average age 53.8±9.6 years, 9 women). The SAPA₁ averaged 3.3 mm, all posteriorly oriented. Ten were ruptured (83.3%). Initial treatments included conventional coiling or balloon assisted coiling (CC/BAC) for nine aneurysms, and proximal A1 segment focal occlusion (PA₁FO) for three. Initial occlusion was deemed satisfactory in all instances: total occlusion in eight cases (67%) and subtotal occlusion in four cases (33%). Four aneurysmal perforations occurred (33%), all during CC/BAC on ruptured aneurysms. Over a 10.2 year average follow-up, six recanalizations (50%) were noted, all after initial CC/BAC: three were early (≤14 days), with one causing fatal rebleeding. No recanalizations after PA₁FO was observed (five in total, two as a complement after CC/BAC). Favorable clinical outcomes (modified Rankin Scale score of 0-2) were seen in 91% of cases (11/12) at the last follow-up.</p><p><strong>Conclusions: </strong>Selective coiling of the aneurysmal sac is technically difficult due to their small size and the complex microcatheterization pathway. This method presents a significant risk of aneurysmal perforation, especially in ruptured cases, and a high rate of recanalization. PA₁FO, when collateralization permits, appears to be a reliable therapeutic alternative offering favorable long term outcomes.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"607-612"},"PeriodicalIF":4.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141321034","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":"Telescopic carotid stenting method suppresses plaque protrusion in carotid stenting for high-lipid core plaque lesions.","authors":"Masashi Kotsugi, Ichiro Nakagawa, Shohei Yokoyama, Yudai Morisaki, Ryosuke Maeoka, Hiromichi Hayami, Tomoya Okamoto, Kengo Yamada, Ryosuke Matsuda, Shuichi Yamada","doi":"10.1136/jnis-2025-023439","DOIUrl":"https://doi.org/10.1136/jnis-2025-023439","url":null,"abstract":"<p><strong>Background: </strong>Carotid lipid core plaques (LCPs) have been detected during assessment of carotid artery stenosis using catheter-based near-infrared spectroscopy (NIRS). Treatment with carotid artery stenting (CAS) using dual-layered stents might cause plaque protrusion, and subsequent thromboembolic complications.</p><p><strong>Objective: </strong>We aimed to evaluate whether the telescopic carotid stenting (TCS) method suppresses plaque protrusion in patients with high LCPs as assessed by NIRS during CAS.</p><p><strong>Methods: </strong>Participants comprised 63 consecutive patients with high LCP, defined as maximal lipid core burden index >400, undergoing CAS using dual-layered stents. For comparison, the study was divided into two distinct periods, with stenting by the standard method in the earlier period, and TCS in the later period. NIRS and intravenous ultrasonography (IVUS) were performed at baseline and after balloon dilatation to analyze the maximal lipid core burden index at the minimal luminal area (MLA) (max-LCBI_MLA), and the frequency of plaque protrusion.</p><p><strong>Results: </strong>Baseline clinical and lesion characteristics, including symptoms, degree of stenosis, and plaque assessment by NIRS-IVUS, were not significantly different. MLA post-balloon percutaneous transmural angioplasty (PTA) was significantly smaller with the TCS method (9.2±1.5 mm²) than with the standard method (11.7±3.5 mm², P=0.002), and MLA change ratio before and after post-balloon PTA was significantly smaller with the TCS (2.2±0.6) than with the standard method (2.8±1.1, P=0.038). Plaque protrusion post-CAS was significantly less with the TCS (0 case, 0%) than with the standard method (4 cases, 20%, P=0.008).</p><p><strong>Conclusion: </strong>The TCS method suppresses plaque protrusion in patients with high LCPs undergoing CAS, as assessed by NIRS.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127838","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":"Engaging medical students in neurointerventional surgery: opportunities in the age of the National Residence Matching Program (NRMP) fellowship match.","authors":"Reade Andrew De Leacy, Matthew Robert Amans","doi":"10.1136/jnis-2025-023625","DOIUrl":"https://doi.org/10.1136/jnis-2025-023625","url":null,"abstract":"","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":"17 6","pages":"563-564"},"PeriodicalIF":4.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127865","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}