Journal of NeuroInterventional Surgery最新文献

{"title":"Comparison of drug-coated balloon with bare-metal stent in patients with symptomatic intracranial atherosclerotic stenosis: the AcoArt sICAS randomized clinical trial.","authors":"Gaoting Ma, Dapeng Sun, BaiXue Jia, Li Ling, Thanh N Nguyen, Xuan Sun, Bo Yu, Changming Wen, Tao Cheng, Wenhuo Chen, Ju Han, Hongxing Han, Geng Guo, Jianghua Yu, Liping Wei, Rui Huang, Gengsheng Mao, Qingyu Shen, Xinguang Yang, Bo Wang, Gang Luo, Xiaochuan Huo, Feng Gao, Dapeng Mo, Ning Ma, Zhongrong Miao","doi":"10.1136/jnis-2024-022768","DOIUrl":"https://doi.org/10.1136/jnis-2024-022768","url":null,"abstract":"<p><strong>Background: </strong>Restenosis after stenting with a standard bare-metal stent (BMS) is the main cause of stroke recurrence for symptomatic intracranial atherosclerotic stenosis (sICAS). Whether a drug-coated balloon (DCB) could reduce the risk of restenosis for such patients is unknown. We aimed to investigate the efficacy and safety of DCB in reducing 6 month restenosis in patients with sICAS.</p><p><strong>Methods: </strong>A prospective, multicenter, randomized, open-label, blinded endpoint clinical trial was conducted at 13 stroke centers across China. Eligible patients aged 18-80 years with sICAS defined as a recent transient ischemic attack (<180 days) or ischemic stroke (14-180 days) before enrollment attributed to a 70-99% atherosclerotic stenosis of a major intracranial artery were recruited between June 4, 2021 and September 15, 2022 (final follow-up: April 13, 2023). Patients were randomly assigned to receive a DCB (n=90) or BMS at a 1:1 ratio. The primary outcome was the post-procedure incidence of restenosis in the target lesion at 6 months (165-225 days). The safety outcome was post-procedure target vessel-related stroke (hemorrhage or ischemia) or death at 30 days.</p><p><strong>Results: </strong>Among 201 randomized patients, 180 were confirmed eligible (mean age 58 years) and completed the trial. Compared with BMS, DCB was associated with a lower rate of post-procedure incidence of restenosis in the target lesion at 6 months (6.9% vs 32.9%, OR 0.15, 95% CI 0.05 to 0.42, P=0.0003). Regarding the safety outcome, post-procedure target vessel-related stroke (hemorrhage or ischemia) or death at 30 days did not differ between the two groups (4.4% vs 5.6%, OR 0.79, 95%CI 0.21 to 3.05, P=0.73).</p><p><strong>Conclusion: </strong>DCB was superior to BMS in reducing the incidence of restenosis without increasing the risk of target vessel-related stroke or death within 6 months. Further trials comparing the outcomes of DCB with medical management for sICAS are warranted.</p><p><strong>Trial registration number: </strong>ClinicalTrials.gov Identifier: NCT04631055.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516054","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":"Do scoring systems help us to estimate prognosis after mechanical thrombectomy? Data from the German Stroke Registry.","authors":"Marianne Hahn, Sonja Gröschel, Roman Paul, Luis Weitbrecht, Maria Protopapa, Sebastian Reder, Ahmed E Othman, Klaus Gröschel, Timo Uphaus","doi":"10.1136/jnis-2024-022772","DOIUrl":"https://doi.org/10.1136/jnis-2024-022772","url":null,"abstract":"<p><strong>Background: </strong>Numerous scoring systems have been developed to individualize estimation of functional outcome after endovascular thrombectomy (EVT) of acute ischemic stroke. The aim of our study was to assess their utility for clinical practice based on a large cohort from real-world care of EVT.</p><p><strong>Methods: </strong>For 13 082 patients included in the German Stroke Registry Endovascular Treatment (GSR-ET) (July 2015 to December 2021), we calculated the following prognostic tools: pre-interventional PRE-, Totaled Health Risks in Vascular Events - Endovascular therapy (THRIVE-EVT)- and Computed Tomography for Late Endovascular Reperfusion (CLEAR) scores and post-interventional MR PREDICTS@24 hours and BET-score. Area under the receiver operating characteristic curve (AUC) analyses in the total cohort and pre-defined subgroups were performed to determine each tool's prognostic value for good functional outcome (modified Rankin Scale (mRS) 0-2) and mortality at 90-day follow-up.</p><p><strong>Results: </strong>All pre-interventional tools achieved a moderate prognostic value for predicting good functional outcome (PRE: AUC (95% confidence interval): 0.757 (0.747-0.768), THRIVE-EVT: 0.751 (0.740-0.761), CLEAR: 0.731 (0.72-0.742)), had a higher predictive value than the admission National Institute of Health Stroke Scale ((NIHSS); 0.705 (0.694-0.716), all P<0.001), but were inferior to the NIHSS 24 hours after EVT (0.864 (0.855-0.872), all P<0.001). Predictive capacity for mortality was less accurate (AUC range: 0.697-0.729). Subgroup analyses revealed that the PRE-score was most robust at predicting good functional outcome, whereas the THRIVE-EVT score was superior in predicting mortality. Post-interventionally, MR PREDICTS@24 hours yielded high predictive accuracy for good functional outcome and mortality (both AUC >0.85), superior to 24-hour NIHSS for all subgroups, except patients <50 years of age.</p><p><strong>Conclusion: </strong>Pre-interventional scoring tools predict functional outcome after EVT better than stroke severity alone. Post-interventionally, the MR PREDICTS@24 hours tool adds predictive value to the 24-hour NIHSS as a single prognostic feature. Multivariate prognostic tools incorporating (post-)procedural information enable individualization of prognosis assessment after EVT under routine-care conditions.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501989","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":"CTA-based deep-learning integrated model for identifying irregular shape and aneurysm size of unruptured intracranial aneurysms.","authors":"Ke Tian, Zhenyao Chang, Yi Yang, Peng Liu, Mahmud Mossa-Basha, Michael R Levitt, Dihua Zhai, Danyang Liu, Hao Li, Yang Liu, Jinhao Zhang, Cijian Cao, Chengcheng Zhu, Peng Jiang, Qingyuan Liu, Hongwei He, Yuanqing Xia","doi":"10.1136/jnis-2024-022784","DOIUrl":"https://doi.org/10.1136/jnis-2024-022784","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence can help to identify irregular shapes and sizes, crucial for managing unruptured intracranial aneurysms (UIAs). However, existing artificial intelligence tools lack reliable classification of UIA shape irregularity and validation against gold-standard three-dimensional rotational angiography (3DRA). This study aimed to develop and validate a deep-learning model using computed tomography angiography (CTA) for classifying irregular shapes and measuring UIA size.</p><p><strong>Methods: </strong>CTA and 3DRA of UIA patients from a referral hospital were included as a derivation set, with images from multiple medical centers as an external test set. Senior investigators manually measured irregular shape and aneurysm size on 3DRA as the ground truth. Convolutional neural network (CNN) models were employed to develop the CTA-based model for irregular shape classification and size measurement. Model performance for UIA size and irregular shape classification was evaluated by intraclass correlation coefficient (ICC) and area under the curve (AUC), respectively. Junior clinicians' performance in irregular shape classification was compared before and after using the model.</p><p><strong>Results: </strong>The derivation set included CTA images from 307 patients with 365 UIAs. The test set included 305 patients with 350 UIAs. The AUC for irregular shape classification of this model in the test set was 0.87, and the ICC of aneurysm size measurement was 0.92, compared with 3DRA. With the model's help, junior clinicians' performance for irregular shape classification was significantly improved (AUC 0.86 before vs 0.97 after, P<0.001).</p><p><strong>Conclusion: </strong>This study provided a deep-learning model based on CTA for irregular shape classification and size measurement of UIAs with high accuracy and external validity. The model can be used to improve reader performance.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468329","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":"Clinical outcomes after stenting treatment in patients with idiopathic intracranial hypertension and intrinsic versus extrinsic venous sinus stenosis.","authors":"Xu Tong, Zhongao Guan, Xiaoqing Li, Shuran Wang, Shuang Song, Yawen Gan, Fangguang Chen, Jie He, Ketao Tu, Zhenfei Yu, Dapeng Mo","doi":"10.1136/jnis-2024-022760","DOIUrl":"https://doi.org/10.1136/jnis-2024-022760","url":null,"abstract":"<p><strong>Background: </strong>Endovascular stenting is a promising treatment for patients with idiopathic intracranial hypertension (IIH) and venous sinus stenosis (VSS). However, data on the impact of stenosis type on clinical outcomes of patients undergoing stenting treatment remain limited. This prospective cohort study aimed to compare post-stenting outcomes in patients with IIH and intrinsic versus extrinsic VSS.</p><p><strong>Methods: </strong>Patients with IIH and VSS undergoing stenting at a tertiary hospital in China were enrolled consecutively from 2017 to 2023. Based on digital subtraction angiography, high-resolution MRI, and intravascular ultrasound findings, patients were categorized into two groups: intrinsic or extrinsic stenosis. At 6 months post-stenting, clinical outcomes including cerebrospinal fluid (CSF) pressure, headache, visual impairment, and papilledema were recorded. Multivariable regression models were used to explore the relationship between stenosis type and clinical outcomes.</p><p><strong>Results: </strong>In total, 92 patients were included, 60 with intrinsic stenosis and 32 with extrinsic stenosis. At 6 months, the intrinsic group had lower CSF pressure (median 180 vs 210 mmH₂O, β coefficient -31.8, 95% CI -54.0 to -9.6) and a higher rate of complete symptom resolution (81.7% vs 40.6%, OR 8.88, 95% CI 2.60 to 30.30) than the extrinsic group. Additionally, 36.8% (95% CI 10.5% to 77.2%) of the effect of stenosis type on complete symptom resolution at 6 months was mediated through reduction in CSF pressure.</p><p><strong>Conclusion: </strong>This single-center study suggested that patients with IIH and intrinsic VSS had lower CSF pressure and better symptom recovery compared with those with extrinsic VSS at 6 months post-stenting. Further validation in other centers and populations is needed.</p><p><strong>Trial registration number: </strong>ChiCTR.org.cn, ChiCTR-ONN-17010421.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468326","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":"The River study: the first prospective multicenter trial of a novel venous sinus stent for the treatment of idiopathic intracranial hypertension.","authors":"Athos Patsalides, Kyle M Fargen, Jason M Davies, Srikanth R Boddu, Marc Dinkin, Ryan Priest, Howard D Pomeranz, Y Pierre Gobin, Adnan H Siddiqui","doi":"10.1136/jnis-2024-022540","DOIUrl":"https://doi.org/10.1136/jnis-2024-022540","url":null,"abstract":"<p><strong>Background: </strong>The River stent is the first stent specifically designed for intracranial venous sinuses. We report the 1-year results of the River trial, performed to obtain Humanitarian Device Exemption approval of the River stent in the United States (US).</p><p><strong>Methods: </strong>The River trial was a prospective, open-label, multicenter, single-arm trial which enrolled 39 subjects at 5 US centers. Eligible patients had clinical diagnosis of idiopathic intracranial hypertension (IIH) with severe headaches or visual field loss and had failed medical therapy. The primary safety endpoint was the 1-year rate of major adverse events compared with cerebrospinal fluid (CSF) shunting using historical controls. The primary benefit endpoint was a composite at 1 year of clinical improvement and absence of venous sinus stenosis. Secondary endpoints included improvement in pulsatile tinnitus, visual symptoms, quality of life (QOL) scores, and medications.</p><p><strong>Results: </strong>All procedures were technically successful. There was one serious adverse event, a gastrointestinal hemorrhage observed 2 months after the procedure while the patient was still on dual antiplatelet therapy. The primary safety endpoint was met with a rate of major adverse event of 5.4% versus 51.7% for CSF shunts. The primary benefit endpoint was achieved in 60% of trial participants. Additional improvements were also observed in opening CSF pressure, headaches, papilledema, pulsatile tinnitus, visual symptoms, and QOL scores. Post hoc analysis demonstrated that subjects with minimal or absent papilledema at baseline showed similar improvement compared with subjects with papilledema at baseline, in terms of headaches, pulsatile tinnitus, and QOL.</p><p><strong>Conclusions: </strong>The River study 1- year results establish safety and suggest efficacy for venous sinus stenting in IIH subjects who have failed medical therapy.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468332","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":"Longitudinal evaluation of neointimal formation using optical coherence tomography for an intracranial aneurysm with flow diverter placement in vivo: preliminary experience.","authors":"Yoshikazu Matsuda, Ryo Aiura, Eisuke Hirose, Tohru Mizutani","doi":"10.1136/jnis-2024-022947","DOIUrl":"https://doi.org/10.1136/jnis-2024-022947","url":null,"abstract":"<p><p>Placement of a flow diverter (FD) has been a mainstream treatment for intracranial aneurysms. Neointimal formation in the aneurysmal neck and stent struts is important for promoting aneurysm healing and reducing ischemic complications. Although several animal studies have reported the longitudinal evaluation of neointimal formation post-FD placement using optical coherence tomography (OCT), no human studies have been published. We describe the first case of a patient with follow-up longitudinal angiography and OCT examination at 1 and 3 months post-FD placement for an internal carotid artery aneurysm. At 1 month, the OCT images showed complete neointimal formation on stent struts of the parent artery and partial neointimal formation on the neck. The aneurysm was occluded on angiography at 3 months and all stent struts were covered with neointima on OCT images. An OCT examination may provide insights regarding the mechanism underlying the healing process of aneurysms treated by an FD.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432840","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":"Inter-proceduralist variability in angiographic outcomes after stroke thrombectomy and the importance of quality over quantity of passes.","authors":"Huanwen Chen, Rosy L Njonkou-Tchoquessi, Ananya Iyyangar, Paige Skorseth, Shyam Majmundar, Jacob Cherian, Timothy R Miller, Sunil A Sheth, Dheeraj Gandhi, Marco Colasurdo","doi":"10.1136/jnis-2024-022870","DOIUrl":"https://doi.org/10.1136/jnis-2024-022870","url":null,"abstract":"<p><strong>Background: </strong>Complete recanalization (CR, modified Treatment in Cerebral Ischemia (mTICI) score of 2c or better) is associated with favorable outcomes after endovascular thrombectomy (EVT) for stroke patients. However, the degree of inter-proceduralist differences in CR rates is unknown, and whether higher CR rates are being achieved by performing more passes or by focusing on first-pass effectiveness is also unclear.</p><p><strong>Methods: </strong>This was a multicenter retrospective study of anterior circulation large vessel occlusion stroke patients in the United States from 2016 to 2022. Patients treated by proceduralists with at least 50 cases were included. CR rates for each proceduralist were assessed and proceduralists were divided into tertiles. First-pass effect (FPE, defined as CR after one pass) and the number of passes for patients treated by the top tertile of proceduralists were compared with the bottom tertile. Mediation analyses were conducted to assess causal links between CR rates and number of passes or FPE.</p><p><strong>Results: </strong>A total of 1096 EVTs performed by 11 proceduralists were identified. CR rates were highly variable across providers (43.1% to 75.3%, p<0.001). Patients treated by the top tertile were more likely to experience FPE (OR 1.99, 95% CI 1.49 to 2.67, p<0.001) and did not undergo more passes (p=0.69) compared with the bottom tertile. Higher rates of FPE among patients was a significant mediator of higher odds of CR among patients treated by the top tertile (p<0.001).</p><p><strong>Conclusions: </strong>Angiographic outcomes among EVT proceduralists are highly variable. Proceduralists who achieve higher rates of CR are doing so with higher rates of FPE, not more passes.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432459","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":"Subarachnoid iodine leakage on dual-energy computed tomography after mechanical thrombectomy is associated with malignant brain edema.","authors":"Atsushi Ogata, Kuniaki Ogasawara, Masashi Nishihara, Ayako Takamori, Takashi Furukawa, Toshihiro Ide, Hiroshi Ito, Fumitaka Yoshioka, Yukiko Nakahara, Jun Masuoka, Haruki Koike, Hiroyuki Irie, Tatsuya Abe","doi":"10.1136/jnis-2023-021413","DOIUrl":"10.1136/jnis-2023-021413","url":null,"abstract":"<p><strong>Background: </strong>Dual-energy computed tomography (DE-CT) can differentiate between hemorrhage and iodine contrast medium leakage following mechanical thrombectomy (MT) for acute ischemic stroke (AIS). We determined whether subarachnoid hemorrhage (SAH) and subarachnoid iodine leakage (SAIL) on DE-CT following MT were associated with malignant brain edema (MBE).</p><p><strong>Methods: </strong>We analyzed the medical records of 81 consecutive anterior circulation AIS patients who underwent MT. SAH or SAIL was diagnosed via DE-CT performed immediately after MT. We compared the procedural data, infarct volumes, MBE, and modified Rankin scale 0-2 at 90 days between patients with and without SAH and between patients with and without SAIL. Furthermore, we evaluated the association between patient characteristics and MBE.</p><p><strong>Results: </strong>A total of 20 (25%) patients had SAH and 51 (63%) had SAIL. No difference in diffusion-weighted imaging (DWI)-infarct volume before MT was observed between patients with and without SAH or patients with and without SAIL. However, patients with SAIL had larger DWI-infarct volumes 1 day following MT than patients without SAIL (95 mL vs 29 mL; p=0.003). MBE occurred in 12 of 81 patients (15%); more patients with SAIL had MBE than patients without SAIL (22% vs 3%; p=0.027). Severe SAIL was significantly associated with MBE (OR, 12.5; 95% CI, 1.20-131; p=0.006), whereas SAH was not associated with MBE.</p><p><strong>Conclusion: </strong>This study demonstrated that SAIL on DE-CT immediately after MT was associated with infarct volume expansion and MBE.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"248-253"},"PeriodicalIF":4.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140119823","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":"The commercialization of open access publishing: progress or predicament?","authors":"Edgar A Samaniego","doi":"10.1136/jnis-2025-023182","DOIUrl":"https://doi.org/10.1136/jnis-2025-023182","url":null,"abstract":"","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":"17 3","pages":"231-232"},"PeriodicalIF":4.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425457","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":"Feasibility and workflow analysis of IV-DSA-based augmented reality-guided brain arteriovenous malformation resection in a hybrid operating room: i-Flow tailored method.","authors":"Chih-Wei Huang, Chung-Hsin Lee, Kai-Chen Chung, Yuang-Seng Tsuei","doi":"10.1136/jnis-2023-020797","DOIUrl":"10.1136/jnis-2023-020797","url":null,"abstract":"<p><p>Augmented reality (AR) has emerged as a promising technology in various medical fields.1 2 In the context of brain arteriovenous malformation (bAVM) surgery, AR offers the potential to enhance surgical visualization and improve procedural accuracy.3 4 5 6 This report aims to explore the application of digital subtraction angiography (DSA) from an IV contrast injection (IV-DSA) in AR-guided resection of bAVMs in a neurosurgical hybrid operating room.The workflow of IV-DSA-based AR-guided surgery for the resection of bAVMs consists of four main components: (1) acquiring source images through i-Flow tailored or multiphase scans (Siemens, Germany); (2) labelling targets in the workstation using Smartbrush software (Brainlab, Westchester, Illinois, USA); (3) using the Brainlab Curve navigation system; and (4) merging microscopic AR fusion using Zeiss Kinevo (AG, Germany). In video 1 we show the entire workflow and introduce i-Flow tailored IV-DSA data acquisition in the hybrid operating room. In summary, IV-DSA-based augmented reality is an innovative technique for bAVM surgery. neurintsurg;17/3/332/V1F1V1Video 1-i-flow tailored iv-DSA.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"332"},"PeriodicalIF":4.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41133086","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}