Journal of NeuroInterventional Surgery最新文献

{"title":"Insights into the prognostic significance of thrombus composition in cancer related stroke after thrombectomy.","authors":"Yi Huang, Yingquan Ye, Lingling Bao, Xuefan Zeng, Zhixiang Chen","doi":"10.1136/jnis-2024-022882","DOIUrl":"10.1136/jnis-2024-022882","url":null,"abstract":"","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006994","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":"Pre-operative internal maxillary artery embolization for temporomandibular joint replacement: safety and outcomes from a 10-year institutional experience.","authors":"Nanthiya Sujijantarat, Varun Padmanaban, William J Smith, Joseph P McCain, Leonard B Kaban, Briana J Burris, Daniel D Choi, Anna M Larson, Aladine A Elsamadicy, Paul Serrato, Guilherme Dabus, Robert W Regenhardt, Christopher J Stapleton, Aman B Patel, James D Rabinov","doi":"10.1136/jnis-2024-022975","DOIUrl":"https://doi.org/10.1136/jnis-2024-022975","url":null,"abstract":"<p><strong>Background: </strong>Temporomandibular joint replacement (TMJR) can result in large volume blood loss (BL) from the underlying internal maxillary artery (IMA). Pre-operative IMA embolization has been utilized to reduce intra-operative BL, but prior studies are limited to small case series.</p><p><strong>Methods: </strong>Adult patients undergoing pre-operative IMA embolization for TMJR between June 2014 and September 2024 at a single institution were included. Electronic medical records were reviewed for demographic information, treatment details, and outcomes. Historical controls were identified via citations and PubMed searches.</p><p><strong>Results: </strong>Pre-operative IMA embolization was performed in 73 patients (108 sides) undergoing TMJR. Coils were used in 96% of the patients, with a median of three coils used per side (interquartile range (IQR) 3-4). Middle meningeal artery (MMA) was occluded in 26% of the sides completed. There was one intra-procedural complication of a self-limited retrograde femoral artery dissection. Median operative BL/side during TMJR was 100 mL (IQR 50-181). There were no embolization-related complications in hospital or at follow-up (median follow-up of 12 months (IQR 4-24)). Using the BL per side beyond the third quartile of the historical controls as the definition of excessive BL, the embolized cohort contained half the number of patients with excessive BL (12.5%) compared with the historical cohort (25.0%).</p><p><strong>Conclusion: </strong>Pre-operative IMA embolization is safe and may be effective at reducing BL and excessive hemorrhage during TMJR. A randomized controlled trial is needed to ascertain its benefits compared with the conventional approach.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189591","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":"Factors affecting visual outcomes after dural venous sinus stenting in idiopathic intracranial hypertension.","authors":"Shuran Wang, Raynald, Runhua Zhang, Hongchao Yang, Xu Tong, Shuang Song, Xiaofang Liang, Yilong Wang, Zhongrong Miao, Dapeng Mo","doi":"10.1136/jnis-2024-022727","DOIUrl":"https://doi.org/10.1136/jnis-2024-022727","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to identify factors at baseline associated with visual outcomes of patients with idiopathic intracranial hypertension (IIH) with venous sinus stenosis who underwent venous sinus stenting.</p><p><strong>Methods: </strong>The study eyes were divided into two groups according to mean deviation (MD) at 6-month post-stenting follow-up: MD better than -2.0 dB (the favorable visual outcome group) and equal to -2.0 or worse (the poorer visual outcome group). Variables at baseline between the two groups were compared. A multivariable logistic regression model was performed to identify the factors at baseline associated with poorer MD outcomes at 6 months.</p><p><strong>Results: </strong>The poorer recovery group had a lower incidence of tinnitus (5.9% vs 27.5%, P=0.015), worse initial best corrected visual acuity (0.22 vs 0, in logMAR, P=0.000), worse preoperative MD (-8.64 vs -3.05, P=0.000) and higher trans-stenotic gradient pressure (19.5 vs 16, P=0.002) and total cranial gradient pressure (TCGP) (25.75 vs 18, P=0.000), lower ganglion cell complex (GCC) thickness (90.5 vs 99, P=0.005), higher focal loss volume percentage (2.35 vs 0.84, P=0.002) and global loss volume percentage (4.87 vs 1.8, P=0.012) of GCC. Multivariate analysis showed that worse preoperative MD and higher TCGP (OR 45.61, 95% CI 5.21 to 399.48; P=0.001 and OR 8.45, 95% CI 1.60 to 44.67; P=0.012, respectively) were associated with an increased risk of poorer MD outcomes at the 6-month follow-up.</p><p><strong>Conclusion: </strong>This study found that worse preoperative MD and higher TCGP at baseline may be associated with poorer visual outcomes after stenting treatment.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189588","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":"Predicting symptomatic intracranial hemorrhage after endovascular treatment of vertebrobasilar artery occlusion: PEACE score.","authors":"Yingjie Xu, Andrea Maria Alexandre, Alessandro Pedicelli, Xianjun Huang, Mingtong Wei, Pan Zhang, Miaomiao Hu, Xin Chen, Zhiliang Guo, Juehua Zhu, Hao Chen, Chuyuan Ni, Ligen Fan, Ruyue Wang, Qizhang Wang, Jianshang Wen, Yongliang Yang, Wuwei Chu, Zheng Dai, Shidong Tan, Aldobrando Broccolini, Arianna Camilli, Serena Abruzzese, Carlo Cirelli, Mauro Bergui, Dott Andrea Romi, Luca Scarcia, Erwah Kalsoum, Giulia Frauenfelder, Grzegorz Meder, Simona Scalise, Maria P Ganimede, Luigi Bellini, Bruno Del Sette, Francesco Arba, Susanna Sammali, Andrea Salcuni, Sergio L Vinci, Giacomo Cester, Luisa Roveri, Lei Wang, Zuowei Duan, Shuai Zhang, Guoqiang Xu, Shizhan Li, Yong Liang, Zongyi Wu, Shengfei Qin, Guanglin Luo, Zhixin Huang, Lulu Xiao, Wen Sun","doi":"10.1136/jnis-2024-022802","DOIUrl":"https://doi.org/10.1136/jnis-2024-022802","url":null,"abstract":"<p><strong>Background: </strong>Current clinical decision tools for assessing the risk of symptomatic intracranial hemorrhage (sICH) in patients with vertebrobasilar artery occlusion (VBAO) who received endovascular treatment (EVT) have limited performance. This study develops and validates a clinical risk score to precisely estimate the risk of sICH in VBAO patients.</p><p><strong>Methods: </strong>The derivation cohort recruited patients with VBAO who received EVT from the Posterior Circulation IschemIc Stroke Registry in China. Based on the posterior circulation-Alberta Stroke Program Early CT Score (pc-ASPECTS) evaluation method, the cohort was further divided into non-contrast CT (NCCT) and diffusion weighted imaging (DWI) cohorts to construct predictive models. sICH was diagnosed according to the Heidelberg Bleeding Classification within 48 hours of EVT. Clinical signature was constructed in the derivation cohort using machine learning and was validated in two additional cohorts from Asia and Europe.</p><p><strong>Results: </strong>We enrolled 1843 patients who underwent EVT and had complete data. pc-ASPECTS of 1710 patients was evaluated on NCCT and 699 patients on DWI. In the NCCT cohort, 1364 individuals made up the training set, of whom 101 (7.4%) developed sICH. In the DWI cohort, the training set consisted of 560 individuals, with 44 (7.9%) experiencing sICH. Predictors of sICH were: glucose, pc-ASPECTS, time from estimated occlusion to groin puncture (EOT), poor collateral circulation, and modified Thrombolysis in Cerebral Infarction (mTICI) score. From these predictors, we derived the weighted poor collateral circulation-EOT-pc-ASPECTS-mTICI-glucose (PEACE) score. The PEACE score showed good discrimination in the training set (area under the curve (AUC)_NCCT=0.85; AUC_DWI=0.86), internal validation set (AUC_NCCT=0.81; AUC_DWI=0.82), and two additional external validation set (Asia: AUC_NCCT=0.78, AUC_DWI=0.80; Europe: AUC_NCCT=0.74, AUC_DWI=0.78).</p><p><strong>Conclusion: </strong>The PEACE score reliably predicted the risk of sICH in VBAO patients who underwent EVT.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189590","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":"SCUBA evacuation within 24 hours of basal ganglia hemorrhage results in promising functional outcomes.","authors":"Christopher Paul Kellner, Muhammad Ali, Roshini Kalagara, Akhil Rao, Colton Smith, Joshua Finesilver, Trevor Hardigan, Tomoyoshi Shigematsu, John Liang, Fernanda Carvalho Poyraz, Michael F Waters, Magdy Selim, J Mocco","doi":"10.1136/jnis-2024-022591","DOIUrl":"https://doi.org/10.1136/jnis-2024-022591","url":null,"abstract":"<p><strong>Background: </strong>The recently completed Early Minimally Invasive Removal of Intracerebral Hemorrhage (ENRICH) trial demonstrated a benefit for endoport-mediated evacuation within ≤24 hours for lobar hemorrhages but not for basal ganglia hemorrhages (BGH). We performed an exploratory evaluation of the Stereotactic Cerebral Underwater Blood Aspiration (SCUBA) technique for BGH evacuation.</p><p><strong>Methods: </strong>We reviewed data from patients presenting to an urban health system with BGH who underwent SCUBA evacuation according to institutional guidelines. Three cohorts were then created: (1) all patients with BGH evacuation using the SCUBA approach; (2) patients with BGH evacuation using SCUBA within ≤24 hours and with ENRICH-defined intraventricular hemorrhage (IVH) selection criteria; and (3) SCUBA evacuation within ≤24 hours, ENRICH-defined IVH, and intracerebral hemorrhage (ICH) volumes of ≥30 mL. Key outcomes included evacuation percentage, residual hematoma volume ≤15 mL, and 6-month modified Rankin Scale (mRS) score of 0-3.</p><p><strong>Results: </strong>Sixty-eight patients with BGH underwent SCUBA. Median preoperative ICH volume was 35 mL and median postoperative volume was 1.3 mL for a median evacuation percentage of 97%, with 90% achieving ≤15 mL residual volume. For 19 patients in cohort 2 and 12 patients in cohort 3, median evacuation percentages were 98% and 100% of patients had ≤15 mL residual volume in both groups. A good outcome was achieved in 53% and 50% of patients, respectively.</p><p><strong>Conclusions: </strong>SCUBA evacuation for BGH in patients who otherwise meet ENRICH criteria suggests superior 6-month outcomes compared with ENRICH BGH patients (utility-weighted mRS 0.51 vs 0.34). A randomized clinical trial is warranted to prospectively evaluate SCUBA evacuation within 24 hours in patients with spontaneous BGH.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189593","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":"Partial transvenous embolization as an intermediate strategy for large brain arteriovenous malformations: A technical note.","authors":"Ryuichi Noda, Vinicius Moreira Lima, Christina Iosif, José Eduardo Vitorino Galon, Faisal Alabbas, Suzana Saleme, Aymeric Rouchaud, Charbel Mounayer","doi":"10.1136/jnis-2024-022692","DOIUrl":"https://doi.org/10.1136/jnis-2024-022692","url":null,"abstract":"<p><strong>Background: </strong>Endovascular transvenous embolization (TVE) was developed as a curative technique for brain arteriovenous malformations (bAVMs) with small nidi and a single draining vein. We describe a partial transvenous embolization technique (pTVE) as an intermediate embolization session to decrease hemorrhagic complications of larger nidi with multiple venous outlets.</p><p><strong>Method: </strong>We reviewed our single-center database of bAVMs treated endovascularly between January 2023 and March 2024. Six consecutive patients underwent 10 sessions of pTVE for ruptured AVMs.</p><p><strong>Results: </strong>The median age of patients was 24.5 years. The median nidus size was 5 cm (range 4-6 cm). Three patients had grade III lesions according to the Spetzler-Martin classification, two were grade IV, and one was grade V. Four patients had draining veins with multiple efferent veins with each collecting vein, one patient had multiple efferent veins with one collecting vein, and one patient had one efferent vein with a long bifurcation. pTVE achieved partial occlusion in all cases without any hemorrhagic complications. One patient had the AVM totally occluded with two sessions of pTVE. Decision-making was facilitated by creating subcategories of venous angioarchitecture and detailing the technical particularities in the corresponding category.</p><p><strong>Conclusion: </strong>We described a novel treatment technique of transvenous embolization as an adjunct strategy for large bAVMs.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189589","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":"Machine learning for clinical outcome prediction in cerebrovascular and endovascular neurosurgery: systematic review and meta-analysis.","authors":"Haydn Hoffman, Jason J Sims, Violiza Inoa-Acosta, Daniel Hoit, Adam S Arthur, Dan Y Draytsel, YeonSoo Kim, Nitin Goyal","doi":"10.1136/jnis-2024-021759","DOIUrl":"10.1136/jnis-2024-021759","url":null,"abstract":"<p><strong>Background: </strong>Machine learning (ML) may be superior to traditional methods for clinical outcome prediction. We sought to systematically review the literature on ML for clinical outcome prediction in cerebrovascular and endovascular neurosurgery.</p><p><strong>Methods: </strong>A comprehensive literature search was performed, and original studies of patients undergoing cerebrovascular surgeries or endovascular procedures that developed a supervised ML model to predict a postoperative outcome or complication were included.</p><p><strong>Results: </strong>A total of 60 studies predicting 71 outcomes were included. Most cohorts were derived from single institutions (66.7%). The studies included stroke (32), subarachnoid hemorrhage ((SAH) 16), unruptured aneurysm (7), arteriovenous malformation (4), and cavernous malformation (1). Random forest was the best performing model in 12 studies (20%) followed by XGBoost (13.3%). Among 42 studies in which the ML model was compared with a standard statistical model, ML was superior in 33 (78.6%). Of 10 studies in which the ML model was compared with a non-ML clinical prediction model, ML was superior in nine (90%). External validation was performed in 10 studies (16.7%). In studies predicting functional outcome after mechanical thrombectomy the pooled area under the receiver operator characteristics curve (AUROC) of the test set performances was 0.84 (95% CI 0.79 to 0.88). For studies predicting outcomes after SAH, the pooled AUROCs for functional outcomes and delayed cerebral ischemia were 0.89 (95% CI 0.76 to 0.95) and 0.90 (95% CI 0.66 to 0.98), respectively.</p><p><strong>Conclusion: </strong>ML performs favorably for clinical outcome prediction in cerebrovascular and endovascular neurosurgery. However, multicenter studies with external validation are needed to ensure the generalizability of these findings.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076068","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":"Illustrative case of prosopagnosia after diagnostic cerebral angiography and systematic review of transient cortical blindness after cerebral angiography.","authors":"Pui Man Rosalind Lai, Elad I Levy","doi":"10.1136/jnis-2024-022624","DOIUrl":"https://doi.org/10.1136/jnis-2024-022624","url":null,"abstract":"<p><strong>Background: </strong>Transient cortical blindness is a rare complication after cerebral angiography. We report an unusual case of face blindness (prosopagnosia) in a patient who underwent diagnostic cerebral angiography for an incidentally discovered left middle cerebral artery aneurysm. The patient experienced difficulty recognizing faces 3 hours postprocedure, with resolution of symptoms within 24 hours.</p><p><strong>Objective: </strong>To carry out a systematic review of transient cortical blindness after cerebral angiography to investigate factors associated with, and management of, this rare phenomenon.</p><p><strong>Methods: </strong>The review was conducted using PubMed and Embase, with search terms related to cerebral angiography and transient blindness. Included studies reported transient cortical blindness after diagnostic or interventional cerebral angiography and detailed patient demographics, procedural specifics, onset and resolution of blindness, and postprocedural imaging findings.</p><p><strong>Results: </strong>Twenty-two articles involving 63 patients were identified. Most cases (n=54, 85.7%) were associated with diagnostic procedures. All nine interventional cases involved cerebral aneurysm treatments. Forty-two (66.7%) patients experienced complete blindness, with an average onset of 2 hours postprocedure and resolution within 82 hours (range 6 hours-21 days). Postprocedural neuroimaging abnormalities were observed in 24 (53.3%) cases, mainly showing contrast enhancement in the occipital lobe. All patients recovered vision.</p><p><strong>Conclusions: </strong>Our review highlights the rarity of prosopagnosia after cerebral angiography, a rare variant of cortical blindness. The findings suggest that cortical blindness resolves spontaneously within a short period. Although complete visual loss is more commonly reported in the literature, facial recognition deficits are rare. Awareness of transient cortical blindness after cerebral angiography is essential for accurate diagnosis and management.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074732","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":"Comparison of flow diverter alone versus flow diverter with coiling for large and giant intracranial aneurysms: systematic review and meta-analysis of observational studies.","authors":"Rahim Abo Kasem, Zachary Hubbard, Conor Cunningham, Hani Almorawed, Julio Isidor, Imad Samman Tahhan, Mohammad-Mahdi Sowlat, Sofia Babool, Layal Abodest, Alejandro M Spiotta","doi":"10.1136/jnis-2024-022845","DOIUrl":"https://doi.org/10.1136/jnis-2024-022845","url":null,"abstract":"<p><strong>Background: </strong>Large and giant intracranial aneurysms pose treatment challenges. The benefit-risk balance of flow diverters (FDs) alone versus FDs with coiling remains unclear. This study aimed to compare these two strategies.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of PubMed, Embase, Scopus, Cochrane, and Web of Science was performed up to October 2024. Studies comparing FDs with or without adjunctive coiling in large/giant intracranial aneurysms were included. The primary outcome was complete aneurysm occlusion, defined by the Raymond-Roy Occlusion Classification. Additional outcomes included procedural and postprocedural complications. Data were analyzed using a random effects model.</p><p><strong>Results: </strong>15 studies with 1130 patients were analyzed, with 557 in the FD alone group and 573 in the FD+coiling group. The meta-analysis revealed that FD+coiling significantly improved complete aneurysm occlusion rates (OR 1.59, 95% CI 1.06 to 2.40, P=0.03). While overall ischemic complications were significantly lower in the FD alone group, a sensitivity analysis showed no significant difference (OR 0.49, 95% CI 0.20 to 1.23, P=0.13). Subgroup analysis of fusiform aneurysms showed no significant difference in complete aneurysm occlusion rates (OR 1.10, 95% CI 0.50 to 2.40, P=0.82). Procedural and hemorrhagic complications did not differ significantly, and no publication bias was detected in the results.</p><p><strong>Conclusions: </strong>Combining FDs with coiling improved complete aneurysm occlusion rates in large and giant saccular intracranial aneurysms, although the impact on complications remains controversial. Further investigation into the benefit-risk ratio of this combined approach is warranted.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074731","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":"Balloon-mounted versus self-expandable stent in failed neurothrombectomy: a post hoc analysis of the SAINT study.","authors":"Mahmoud H Mohammaden, Pedro N Martins, Hassan Aboul-Nour, Alhamza R Al-Bayati, Ameer E Hassan, Wondwossen Tekle, Johanna T Fifi, Shahram Majidi, Okkes Kuybu, Bradley A Gross, Michael Lang, Gustavo M Cortez, Ricardo A Hanel, Amin Aghaebrahim, Eric Sauvageau, Mohamed A Tarek, Mudassir Farooqui, Santiago Ortega-Gutierrez, Cynthia B Zevallos, Milagros Galecio-Castillo, Sunil A Sheth, Michael Nahhas, Sergio Salazar-Marioni, Thanh N Nguyen, Mohamad Abdalkader, Piers Klein, Muhammad Hafeez, Peter Kan, Omar Tanweer, Ahmad Khaldi, Hanzhou Li, Mouhammad Jumaa, Syed F Zaidi, Marion Oliver, Mohamed M Salem, Jan-Karl Burkhardt, Bryan Pukenas, Nicholas Vigilante, Mary Penckofer, James E Siegler, Sophia Peng, Ali Alaraj, Jonathan A Grossberg, Raul Nogueira, Diogo C Haussen","doi":"10.1136/jnis-2024-022795","DOIUrl":"https://doi.org/10.1136/jnis-2024-022795","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have shown that when thrombectomy has failed, rescue intracranial stenting is associated with better clinical outcomes compared with failed reperfusion. However, comparative data regarding stent type are lacking.</p><p><strong>Objective: </strong>To compare the procedural and clinical outcomes of balloon-mounted stents (BMS) with those of self-expandable stents (SES).</p><p><strong>Methods: </strong>Retrospective analysis of a prospectively collected database from the Stenting and Angioplasty in NeuroThrombectomy (SAINT) consortium. Patients were included if thrombectomy had failed and they then underwent rescue emergency stenting. Patients treated with SES or BMS were compared using inverse probability of treatment weighting. The primary outcome was the final reperfusion as measured by the modified Thrombolysis in Cerebral Infarction (mTICI) Scale. Safety measures included rates of symptomatic intracranial hemorrhage, procedural complications, and 90-day mortality.</p><p><strong>Results: </strong>A total of 328 patients were included. Baseline clinical and procedural characteristics were well balanced among both groups. The BMS group (n=127) had higher rates of successful reperfusion (94.5% vs 86.6%, aOR=4.23, 95% CI 1.57 to 11.37, P=0.004) and increased likelihood of higher degree of final reperfusion on the mTICI Scale (acOR=2.06, 95% CI 1.19 to 3.57, P=0.01) than the SES group (n=201). No difference in modified Rankin Scale shift (acOR=0.98, 95% CI 0.54 to 1.79, P=0.95), rates of mRS0-2 (26% vs 36%, aOR=0.93, 95% CI 0.46 to 1.88, P=0.83) and mRS0-3 (43% vs 50%, aOR=0.92, 95% CI 0.51 to 1.66, P=0.77) at 90 days were noted. Safety measures were comparable in both groups.</p><p><strong>Conclusion: </strong>The present study demonstrates higher reperfusion rates with BMS than with SES in failed thrombectomy procedures that involved rescue stenting. No differences in hemorrhagic complications or clinical outcomes were noted. Further larger controlled studies are warranted.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066167","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}