Journal of NeuroInterventional Surgery最新文献

{"title":"Occlusion site and outcomes in intra-arterial tenecteplase after successful endovascular therapy: a secondary analysis of the ANGEL-TNK trial.","authors":"Shuo Li, Xin Tong, Huachen Zhang, Gang Luo, Ligang Song, Dapeng Sun, Wenhuo Chen, Xiaoxi Yao, Qi Zhou, Xuelei Zhang, Yiwen Xu, Thanh N Nguyen, Zhongrong Miao, Xiaochuan Huo","doi":"10.1136/jnis-2025-024129","DOIUrl":"10.1136/jnis-2025-024129","url":null,"abstract":"<p><strong>Background: </strong>Endovascular thrombectomy achieves macroreperfusion in large vessel occlusion (LVO) stroke, but only one-quarter of patients had excellent functional outcome. Adjunct intra-arterial (IA) tenecteplase could further improve the treatment effect, yet its efficacy across internal carotid artery (ICA) versus middle cerebral artery (MCA) M1/M2 occlusion remains unclear.</p><p><strong>Objective: </strong>To evaluate whether IA tenecteplase improves 90-day functional outcomes in LVO patients stratified by occlusion site (ICA, MCA M1, MCA M2).</p><p><strong>Methods: </strong>Prespecified secondary analysis of the ANGEL-TNK trial (multicenter, randomized, open-label, blinded endpoint) in 19 Chinese stroke centers. Participants were enrolled who had anterior circulation LVO, 4.5-24 hours from symptom onset, and CT angiography (CTA)/magnetic resonance angiography (MRA)-proven ICA, M1, or M2 occlusion.</p><p><strong>Intervention: </strong>Randomization (1:1) to IA tenecteplase (0.125 mg/kg) or standard medical management after expanded Thrombolysis in Cerebral Infarction (eTICI) 2b50-3 reperfusion.</p><p><strong>Main outcome measure: </strong>The primary outcome was the rate of 90-day modified Rankin Scale (mRS) 0-1.</p><p><strong>Results: </strong>There were 256 patients in the trial, including 71 (27.7%) ICA, 122 (47.6%) MCA M1, and 62 (24.2%) MCA M2. ICA occlusion patients treated with IA tenecteplase had higher rates of 90-day mRS 0-1 (39.4% vs 13.2%; relative risk (RR) 2.99; 95% CI 1.51 to 5.96; p=0.002) and mRS 0-3 (54.5% vs 42.1%; RR 1.30; p=0.048) versus controls, with a significant shift toward better mRS scores (median 3 (IQR 1-4) vs 4 (2-6); odds ratio (OR) 2.26; p<0.001). Post hoc analysis showed higher eTICI progression in ICA patients (51.5%) versus MCA M1 (37.9%) and M2 (25.7%). IA tenecteplase had a lower any intracranial hemorrhage within 48 hours in ICA patients (15.2% vs 39.5%; RR 0.38; p<0.001) compared with standard medical management. No significant benefits were observed in the MCA M1/M2 subgroups, and interaction effects were significant between ICA and MCA segments for functional outcomes and safety.</p><p><strong>Conclusions and relevance: </strong>IA tenecteplase had a better functional outcome and lower hemorrhage risk in ICA occlusion compared with standard medical management but not in MCA M1/M2. Occlusion site is a critical determinant of response to IA tenecteplase. A pooled analysis of IA tenecteplase stratified by occlusion site strata is warranted.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"2004-2010"},"PeriodicalIF":4.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145368139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the need for late angiography for complete obliteration of AVMs after endovascular treatment: collaborative AVM center experience and a systematic review.","authors":"Elle Vermeulen, Michael Bruneau, Fons Potters, Martin Podlogar, Wilmar M T Jolink, Roel Haeren, Bart A J M Wagemans, Julie Staals, F J A Meijer, Catharina J M Klijn, Saman Vinke, Joost De Vries, Wim H van Zwam, Hieronymus D Boogaarts","doi":"10.1136/jnis-2025-024046","DOIUrl":"10.1136/jnis-2025-024046","url":null,"abstract":"<p><p>Brain arteriovenous malformations (bAVMs) can be treated curatively by endovascular embolization. However, limited data exist on late recanalization rates. We investigated the rate of late bAVM recanalization following complete endovascular obliteration, confirmed by primary control angiography.We performed a single-center retrospective cohort study on late recurrences in adult patients with bAVMs after complete endovascular obliteration at a Radboud - Isala - MUMC+ (RIM) collaborative AVM center in the Netherlands between 2014 and 2022.Additionally, we conducted a systematic review to evaluate the rate of late recanalization following complete endovascular obliteration, confirmed on primary control angiography, in adults with bAVMs. The protocol for this review was registered in PROSPERO (CRD42024546875).Our retrospective study revealed 42 adult patients treated by endovascular means only; 90.5% (38 patients with mean age of 48.1 years) had confirmed complete obliteration. Both primary (6 months post-treatment) and secondary (more than 1 year post-treatment) angiographic control confirmed complete obliteration in 21 of 23 patients with complete follow-up. Mean follow-up was 47.8 months. Two late recurrences (9.5%) were detected at 5- and 6-years' follow-up imaging.Our systematic review included two studies encompassing a total of 19 patients with mean angiographical follow-up of 20.8 months. There were no late recurrences.Late bAVM recurrence after endovascular treatment with proven complete obliteration may be underestimated owing to limited long-term follow-up. Our findings suggest that after a 6-month angiographic confirmed obliteration, a 5-year angiographic imaging control is justified.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"2051-2056"},"PeriodicalIF":4.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312946","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":"Upstream stasis sign as a predictor of stenting outcomes in idiopathic intracranial hypertension.","authors":"Yang Bian, Rongju Zhang, Zhongyu Zhao, Mingxuan Gong, Rui Zhang, Bin Lv, Xiaohui Wang, Xinfeng Liu, Zhihua Du, Xiangyu Cao, Siyu He, Jing Mang, Jun Wang","doi":"10.1136/jnis-2025-024177","DOIUrl":"10.1136/jnis-2025-024177","url":null,"abstract":"<p><strong>Background and objective: </strong>Idiopathic intracranial hypertension (IIH) is associated with venous sinus stenosis (VSS). While stenting has shown potential as a treatment for VSS in patients diagnosed with IIH, clinical outcomes remain variable. Current predictive markers for treatment success are limited. This study aimed to investigate the predictive value of the Upstream Stasis (US) sign, recently proposed based on our imaging observations, in forecasting treatment success in venous sinus stenting for patients diagnosed with IIH.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 102 patients with IIH who underwent venous sinus stenting between May 2016 and August 2024. Patients were categorized based on the presence or absence of the US sign, identified through color-coded cerebral blood flow (CBF) maps. Clinical outcomes were assessed at the 12 month follow-up. Multivariate logistic regression was used to identify independent predictors of favorable outcomes, adjusting for demographic and anatomical factors.</p><p><strong>Results: </strong>The US sign was present in 64.7% of patients and was significantly associated with favorable clinical outcomes (sensitivity 74%, specificity 88%, C-statistic 0.81). Multivariate analysis confirmed that both the US sign (OR 31.6, 95% CI 7.15 to 232.2) and intrinsic stenosis (OR 7.68, 95% CI 2.00 to 36.3) were independent predictors of favorable outcome. Subgroup analysis suggested that the US sign provided additional prognostic value beyond morphological classification into intrinsic and extrinsic stenosis.</p><p><strong>Conclusion: </strong>Our study suggests that the US sign may serve as a valuable imaging biomarker for predicting the outcomes of stenting in patients with IIH and VSS. Large-scale prospective studies are warranted to validate its clinical utility and broader applicability.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"2073-2079"},"PeriodicalIF":4.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301529","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":"A novel neurointerventional subarachnoid aqueductoplasty technique for the treatment of aqueductal stenosis: a cadaveric feasibility study.","authors":"Serdar Rahmanov, Mohammadmahdi Sabahi, Yatin Srinivash Ramesh Babu, Natalia Jedlinska-Obrzut, Hamid Borghei-Razavi, Badih Adada, Michal Obrzut","doi":"10.1136/jnis-2025-024209","DOIUrl":"10.1136/jnis-2025-024209","url":null,"abstract":"<p><strong>Objective: </strong>Aqueductal stenosis is a common cause of obstructive hydrocephalus, resulting in ventricular dilation and neurological deterioration. Standard treatments such as shunting, endoscopic third ventriculostomy, and traditional aqueductoplasty are effective but are associated with risks including parenchymal injury, infection, and long-term failure. As neurosurgery shifts toward minimally invasive techniques, there is a growing interest in approaches that avoid brain parenchyma transgression. This study introduces a novel neurointerventional method for treating aqueductal stenosis via the subarachnoid route through the foramen magnum and the fourth ventricle using standard endovascular tools.</p><p><strong>Methods: </strong>Five formalin-fixed, silicone-injected, alcohol-preserved cadaveric heads were studied. Contrast was injected into the ventricular system. Catheters were introduced via simulated lumbar puncture or cisterna magna access and then advanced via the foramen of Magendie into the fourth ventricle and then through the aqueduct, utilizing Cone-beam CT, needle guidance software, and biplane fluoroscopy-guided navigation. A self-expanding stent was deployed in the aqueduct, and balloon aqueductoplasty was performed. Anatomical accuracy and technical success were confirmed via endoscopy through a transcallosal approach.</p><p><strong>Results: </strong>Aqueductal access was successfully achieved in all specimens without brain parenchymal violation. Stent placement and balloon dilation were performed without complications and confirmed endoscopically.</p><p><strong>Conclusion: </strong>This novel, image-guided, minimally invasive approach enables aqueductal catheterization via the subarachnoid route. It offers a brain-sparing alternative for treating aqueductal stenosis and may extend to future subarachnoid procedures such as third ventriculostomy or cyst fenestration. In vivo studies are warranted.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"2011-2016"},"PeriodicalIF":4.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355120","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":"Single antiplatelet therapy and tirofiban bridged with surface modified flow diverters for ruptured blood blister-like aneurysms: single center experience and systematic review.","authors":"Ching-Chang Chen, Chun-Ting Chen, Mun-Chun Yeap, Shuo-Chi Chien, Po-Chuan Hsieh, Yi-Ming Wu, Kun-Ting Hong","doi":"10.1136/jnis-2025-023832","DOIUrl":"10.1136/jnis-2025-023832","url":null,"abstract":"<p><strong>Background: </strong>Blood blister-like aneurysms (BBAs) of the internal carotid artery are rare but high risk lesions that frequently re-rupture due to their fragile structure and dissecting pathology. Treatment is particularly challenging in ruptured cases, given the risks associated with dual antiplatelet therapy. Recent advancements in flow diverter stents (FDSs) with surface modifications, and the use of single antiplatelet therapy (SAPT), offer a potential alternative strategy.</p><p><strong>Methods: </strong>We conducted a retrospective review of 17 patients with ruptured internal carotid artery BBAs treated with surface modified FDS under SAPT (ticagrelor or prasugrel) bridged periprocedurally with intravenous tirofiban. All procedures were performed within the acute phase of subarachnoid hemorrhage. Clinical, radiographic outcomes, and procedure related complications were evaluated.</p><p><strong>Results: </strong>Among 17 patients, 94.1% achieved complete angiographic occlusion, and 76.5% attained favorable clinical outcomes (modified Rankin Scale score ≤2). No aneurysm rebleeding or device related ischemic events occurred. A total of 11 patients underwent external ventricular drainage or ventriculoperitoneal shunting without discontinuing SAPT, and no hemorrhagic complications were observed. A literature review incorporating seven additional series identified a total of 42 FDS plus SAPT treated BBA cases, with similar safety and efficacy profiles.</p><p><strong>Conclusions: </strong>Surface modified FDS with SAPT and tirofiban bridging appears to be a promising treatment option for ruptured BBAs, offering high occlusion rates with minimal thromboembolic and hemorrhagic complications. Larger prospective studies are needed to validate these findings.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"1983-1989"},"PeriodicalIF":4.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supply cost and outcome comparison of nBCA, Onyx, and coils for middle meningeal artery embolizations: a single-center retrospective analysis.","authors":"Kiernan Joseph Gunn, Eric Sleasman, Sajal Medha K Akkipeddi, Prasanth Romiyo, Eric Davis, Pablo Valdes Barrera, Santiago Mendoza-Ayus, Vidhya Dhar, Derrek Schartz, Vincent N Nguyen, Tarun Bhalla, Thomas Mattingly, Matthew T Bender","doi":"10.1136/jnis-2025-024003","DOIUrl":"10.1136/jnis-2025-024003","url":null,"abstract":"<p><strong>Background: </strong>Middle meningeal artery (MMA) embolization is increasingly utilized in the treatment of chronic subdural hematoma (cSDH); however, supply cost variation between embolization agents remains unclear. We hypothesized that nBCA might be associated with lower costs, given the ability to use a single vial and treat multiple pedicles.</p><p><strong>Objective: </strong>To compare the supply costs of MMA embolizations using ethylene vinyl-alcohol copolymer-based Onyx (Onyx), n-butyl cyanoacrylate-based TRUFILL (nBCA), and/or coils.</p><p><strong>Methods: </strong>This retrospective study analyzed 100 consecutive MMA embolizations performed at a single institution before March 2025. The supplies (including catheters and embolic agents) used in each embolization, along with procedure time, laterality, and number of pedicles embolized, were documented. Radiographic and clinical patient outcomes were evaluated.</p><p><strong>Results: </strong>Of the 100 procedures: 63 used nBCA, 26 Onyx, 2 coils, 2 nBCA and coils, and 7 Onyx and coils. Supply costs ranged from approximately $5000 to $18 000. Onyx was significantly less expensive than nBCA in supply cost per patient ($7910 vs $10 241; P<0.0001), cost per side ($6467 vs $7857; P=0.010), and cost per pedicle ($4375 vs $5369; P=0.012). Mean cost per patient was highest for nBCA and coils ($13 541 ± $1331), Onyx and coils ($12 364 ± $3259), and coils alone ($11 058 ± $1144). There were no significant differences in short-term complications (stroke, seizure, cranial nerve palsy, retreatment, hospital readmissions; P>0.05), functional outcomes (modified Rankin Scale; P=0.813), or complete cSDH resolution (P=0.149) between embolic techniques.</p><p><strong>Conclusions: </strong>There is significant variation in supply cost associated with different MMA embolization techniques. In our institutional experience, Onyx was associated with the lowest supply cost per patient, hemisphere, and pedicle. Complication rates and functional status did not significantly differ across techniques.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"1997-2003"},"PeriodicalIF":4.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232772","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":"Navigating the epidural plexus: a venographic classification system to predict technical feasibility in cerebrospinal fluid-venous fistula embolization.","authors":"Federico Cagnazzo, Anne Ducros, Nicolas Lonjon, Francois-Louis Collemiche, Emmanuelle Le Bars, Liesjet E H van Dokkum, Vincent Costalat, Antonio Marrazzo","doi":"10.1136/jnis-2025-023993","DOIUrl":"10.1136/jnis-2025-023993","url":null,"abstract":"<p><strong>Background: </strong>Navigating the epidural plexus (EP) is a key step in transvenous embolization of cerebrospinal fluid-venous fistulas (CSFVFs) in spontaneous intracranial hypotension (SIH). However, no standard venographic classification currently exists to predict procedural complexity. This study proposes a venographic classification of the EP and evaluates its correlation with technical outcomes.</p><p><strong>Methods: </strong>From November 2022 to May 2025, 85 patients underwent transvenous embolization for CSFVF. In 75 cases, detailed EP venography was available and categorized as: Type I (55%), homogeneous EP, Type II (34.5%), septated channels, and Type III (10.5%), complex, narrow pathways. Of the 75 cases with available EP venography, EP microcatheter navigation was performed in 65 cases: technical endpoints were extracted from these cases.</p><p><strong>Results: </strong>Overall, embolization was technically successful in all cases. EP navigation was performed in 65/75 cases (87%), with a 91% success rate overall: highest in Type I (97.5%)-Type II (90%), and lowest in Type III (50%). Type III EPs were associated with longer fluoroscopy times per level (510 vs 60-70 s, p=0.0008) and a higher rate of EP perforation (66% vs 10% Type I and 0% Type II; p<0.001). EP navigation time per segment decreased over time, from 130 s (first year) to 60 s (after 24 months), reflecting a learning curve.</p><p><strong>Conclusions: </strong>The proposed EP classification correlates with procedural complexity and outcomes. It may aid in preprocedural planning and improve the safety and efficiency of transvenous CSFVF embolization.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"1964-1970"},"PeriodicalIF":4.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301558","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":"Middle meningeal artery embolization as a surgical adjunct for non-acute subdural hematoma: real world outcomes and treatment effect heterogeneity.","authors":"Huanwen Chen, Matthew K McIntyre, Dhairya A Lakhani, Ajay Malhotra, Peter Kan, Dheeraj Gandhi, Marco Colasurdo","doi":"10.1136/jnis-2025-024312","DOIUrl":"10.1136/jnis-2025-024312","url":null,"abstract":"<p><strong>Background: </strong>Middle meningeal artery embolization (MMAE) is a promising treatment for non-acute subdural hematoma (NASDH), but trial evidence is limited by heterogeneity and open label design bias. This study aims to assess the real world effectiveness of MMAE as an adjunct to surgery and to explore sources of treatment effect heterogeneity.</p><p><strong>Methods: </strong>This was a retrospective cohort study of the Nationwide Readmissions Database (2016-22). Adults who underwent NASDH surgery were included and divided into two groups: surgery with MMAE and surgery only groups. Propensity score matching (PSM) balanced patient characteristics. The primary outcome was treatment failure (subdural hematoma readmission, repeat surgery, or death). The secondary outcome was surgical rescue. Cox proportional hazards models compared outcomes within 180 days. Interaction testing identified sources of treatment effect heterogeneity.</p><p><strong>Results: </strong>Of 31 444 included NASDH patients, 1544 underwent surgery with MMAE. After PSM, 1511 patients had surgery with MMAE and 4394 had surgery only. Surgery with MMAE was not associated with different rates of treatment failure (HR 0.80; 95% CI 0.56 to 1.13; P=0.20) or surgical rescue (HR 0.67; 95% CI 0.41 to 1.07; P=0.09). Interaction analyses revealed that surgical modality significantly modulated MMAE's association risk of treatment failure (P interaction <0.001). Among patients treated with percutaneous drainage (Burr hole or twist drill trephination), surgery with MMAE was associated with a significantly lower risk of treatment failure (HR 0.42; 95% CI 0.25 to 0.71; P=0.001) and surgical rescue (HR 0.50; 95% CI 0.27 to 0.91; P=0.023). Surgery with MMAE was not associated with treatment benefit among patients who underwent open evacuation.</p><p><strong>Discussion: </strong>For NASDH patients requiring surgery, MMAE was significantly associated with superior outcomes as an adjunct to percutaneous drainage, but not as an adjunct to open evacuation.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"2057-2063"},"PeriodicalIF":4.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative assessment of early neointimal formation: P8RI-coated Silk Vista versus Pipeline Vantage (Shield) in a rabbit model using optical coherence tomography.","authors":"Jonathan Cortese, Géraud Forestier, Sylvia M Bardet, Maxime Baudouin, Romain Chauvet, Marie Laure Perrin, Alexis Belgacem, Francesco Diana, Voahirana Ratsimbazafy, Marine Coulomb, Margot D'Arrigo, Edouard Lefebvre, Sylvain Dulaurent, Gregory Sasselina, Daphnee Chandellier, Jérémy Mounier, Claude Couquet, Caroline Croguennec, Ludovic Micallef, Aurélien Le Flahec, Nicolas Dubois, Laurent Spelle, Charbel Mounayer, Faraj Terro, Aymeric Rouchaud","doi":"10.1136/jnis-2025-024213","DOIUrl":"10.1136/jnis-2025-024213","url":null,"abstract":"<p><strong>Background: </strong>Several coating strategies have been recently introduced to reduce thrombogenicity of flow diverters (FDs), while the P8RI coating focuses on stimulating endothelial cells for faster arterial healing. This study aims to evaluate early neointimal growth over the FD struts by comparing these two strategies in an animal model.</p><p><strong>Methods: </strong>Bare Silk Vista (bare-SV), P8RI Silk Vista (P8RI-SV), and Pipeline Vantage with Shield technology (Shield-PV) were implanted in rabbits to treat elastase-induced aneurysms (n=6, 10, and 7, respectively) and in the aorta (n=6, 7, and 4, respectively). At 5 and 28 days, the devices were imaged with optical coherence tomography (OCT) to evaluate the stent-coverage ratio. Conventional histology and multiphoton microscopy were also performed.</p><p><strong>Results: </strong>The aneurysm occlusion rate was similar in all three groups (P=0.577). On OCT images, the stent-coverage ratio on day 5 and day 28 (overall and at each location) was significantly higher with P8RI-SV compared with both bare-SV and Shield-PV (Kruskal-Wallis P<0.0001, Dunn post-test P<0.001 for both timepoints). Histological and multiphoton microscopy evaluations confirmed that the struts of P8RI-SV were covered by well-organized neointima expressing a high rate of collagen at the aneurysm neck and in the aorta, compatible with an advanced stage of tissue remodeling and stabilized neointima.</p><p><strong>Conclusion: </strong>P8RI-SV demonstrated higher rates of neointimal formation covering the FD struts compared with bare-SV and Shield-PV at day 5 and day 28 in rabbits. These results confirm faster and improved arterial healing with P8RI coating; however, further studies are needed to evaluate the clinical benefits in patients.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"2027-2033"},"PeriodicalIF":4.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145368146","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":"Incremental value of pericarotid adipose tissue radiomics in predicting in-stent restenosis after carotid artery stenting.","authors":"Dongqing Ren, Yu Lan, Hongyi Li, Dongbo Li, Ronghui Ju, Yang Hou","doi":"10.1136/jnis-2025-023865","DOIUrl":"10.1136/jnis-2025-023865","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the potential of pericarotid adipose tissue radiomics to improve the prediction of in-stent restenosis (ISR) after carotid artery stenting (CAS).</p><p><strong>Methods: </strong>This retrospective study included 191 patients who underwent carotid CT angiography (CTA) and CAS within 1 week at two centers from September 2019 to December 2023. ISR was defined as ≥50% stenosis on follow-up Doppler ultrasound or CTA. Three predictive models were developed and defined as follows: Model A (Clinical), Model B (Clinical + Imaging), and Model C (Clinical + Imaging + Radiomics) using receiver operating characteristic (ROC) analysis, calibration curves, and decision curve analysis.</p><p><strong>Results: </strong>ISR occurred in 44 patients with a mean time interval of 11.3 months. Multivariate Cox regression analyses identified diabetes, fibrinogen, systolic blood pressure, calcified plaque volume, and pericarotid adipose tissue radiomics as independent predictors of ISR. The radiomics score, derived from 15 significant characteristics, outperformed conventional imaging markers. In the training set, Model C (AUC=0.881) significantly outperformed Model A (AUC=0.664) and Model B (AUC=0.840), with statistically significant differences (Model A vs Model C: P=0.001; Model B vs Model C: P=0.0246). This trend was consistent in the validation sets. Calibration curves showed good agreement between predicted and actual ISR probabilities, and decision curve analysis indicated that Model C provided greater net benefits.</p><p><strong>Conclusion: </strong>The radiomic characteristics of pericarotid adipose tissue provide incremental value in predicting ISR after CAS and serve as a valuable biomarker for restenosis risk assessment.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":"2064-2072"},"PeriodicalIF":4.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345682","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}