Neurointervention最新文献

{"title":"Striving to Improve Image Quality and Minimize Radiation Dose in Neurointerventional Procedures.","authors":"Sang Hyun Suh","doi":"10.5469/neuroint.2025.00311","DOIUrl":"10.5469/neuroint.2025.00311","url":null,"abstract":"","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"49-51"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemifacial Spasm Caused by Posterior Inferior Cerebellar Artery Compression due to Vertebral Artery Aneurysm: Management with Stent-Assisted Coil Embolization.","authors":"Nagatsuki Tomura, Masaki Sonoda, Takashi Shuto","doi":"10.5469/neuroint.2025.00073","DOIUrl":"10.5469/neuroint.2025.00073","url":null,"abstract":"<p><p>A 45-year-old female presented with progressive right hemifacial spasm (HFS) over 6 months. Magnetic resonance imaging revealed the right posterior inferior cerebellar artery (PICA) as the culprit vessel for HFS and a fusiform aneurysm in the vertebral artery (VA) just proximal to it. Following the patient's request for endovascular treatment of the VA, stent-assisted coil embolization was performed to achieve PICA deviation through VA straightening after stent placement and thereby reduce HFS symptoms. At 21 months post-procedure, her HFS had resolved, with imaging confirming PICA deviation due to VA straightening, suggesting that this anatomical change contributed to symptom resolution.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"109-113"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venous Sinus Stenting Alone as an Effective Treatment for Complex Dural Arteriovenous Fistulas with Sinus Thrombosis.","authors":"Maximilian Thormann, Roland Schwab, Anastasios Mpotsaris, Maciej Powerski, Daniel Behme","doi":"10.5469/neuroint.2025.00262","DOIUrl":"10.5469/neuroint.2025.00262","url":null,"abstract":"<p><p>Dural arteriovenous fistulas (dAVFs) are rare vascular malformations, often complicated by sinus thrombosis and cortical reflux. We report a patient with a Cognard Type IIb dAVF at the right transverse sinus and ipsilateral sigmoid sinus thrombosis, unsuitable for conventional embolization due to contralateral sinus hypoplasia. A novel therapeutic approach involving direct jugular vein puncture, venous recanalization, and stenting using a stiff 0.035-inch guidewire effectively downgraded the dAVF to Cognard Type I. At 3-month follow-up, stable angiographic outcomes, marked clinical improvement, and absence of seizures confirmed the efficacy of sinus stenting as a standalone treatment in an anatomically challenging case.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"89-93"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trans-Galen Approach for Embolization of Sphenoparietal Sinus Dural Arteriovenous Fistulas.","authors":"Dang-Khoi Tran, Minh-Anh Nguyen, Thanh-Tinh Truong, Yuang-Seng Tsuei, Quoc-Tuan Tran","doi":"10.5469/neuroint.2025.00094","DOIUrl":"10.5469/neuroint.2025.00094","url":null,"abstract":"<p><p>A patient in their early 60s presented with a headache and right-sided numbness. Imaging revealed a hemorrhagic lesion in the left thalamus and venous engorgement involving the left sphenoparietal sinus, with drainage through the basal vein of Rosenthal and the superficial middle cerebral vein. The trans-Galen approach was utilized for embolization, successfully obliterating the fistulas using coils without retrograde opacification. Post-procedure angiography demonstrated complete occlusion. This case underscores the trans-Galen approach as a safe and effective strategy for managing complex sphenoparietal sinus dural arteriovenous fistulas, providing direct access while minimizing complications and ensuring procedural success.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"114-118"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technical Aspects and Tips and Tricks for Double Stent Retriever Thrombectomy.","authors":"Grzegorz Marek Karwacki, Guillaume Marie, Alexander von Hessling","doi":"10.5469/neuroint.2025.00199","DOIUrl":"10.5469/neuroint.2025.00199","url":null,"abstract":"<p><p>Randomized clinical trials have established the clinical efficacy of mechanical revascularization compared to drug therapy. Successful reperfusion in mechanical thrombectomy is achieved in 53% to 83% of cases, often requiring multiple thrombectomies, which can prolong procedure times and potentially lead to worse outcomes and higher complication risks. The current body of literature suggests that the first pass effect (FPE) is of paramount importance. To achieve a higher FPE, a double stent retriever (DSR) technique is becoming more popular. This publication shares our experience, challenges, and learning journey in implementing DSR in our department.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"82-88"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjunctive Coiling in Flow Diverter Treatment Does Not Prevent Delayed Rupture: A Nationwide Survey.","authors":"Shigeru Miyachi, Reo Kawaguchi","doi":"10.5469/neuroint.2025.00129","DOIUrl":"10.5469/neuroint.2025.00129","url":null,"abstract":"<p><strong>Purpose: </strong>Delayed rupture (DR) can occur even after successful deployment of flow diverters (FDs). Although coiling is often added to reduce the risk of rupture in high-risk intracranial aneurysms, its effectiveness remains unproven. To assess current practice in Japan, a questionnaire was distributed to evaluate the effect of coiling on rupture prevention.</p><p><strong>Materials and methods: </strong>A retrospective survey was sent to 124 institutions with qualified FD practitioners, receiving 76 responses (61%). A total of 5,527 patients treated with FDs were included in the study, and clinical records of 5,211 aneurysms were analyzed.</p><p><strong>Results: </strong>DRs (excluding intraprocedural accidents) occurred in 36 cases (0.7%). Of 1,286 aneurysms treated with FD and coiling, 9 (0.7%) ruptured. Ruptured aneurysms in the FD with coiling group were located in the supraclinoid segment (4 cases), paraclinoid internal carotid artery (ICA) (3 cases), and basilar artery (2 cases), of which 7 were classified as giant (diameter >20 mm). In the FD-alone group, 55% (15/27) of ruptured aneurysms were located in the cavernous ICA. Time to rupture ranged from 1 to 2,220 days with no significant difference between groups, except for 1 exceptionally delayed case. Outcomes were worse in the FD with coiling group, where 67% (6/9) had a modified Rankin Scale score of 6. The DR rate was identical between the FD-alone and FD with coiling groups.</p><p><strong>Conclusion: </strong>Coiling does not appear to prevent rupture after FD treatment. Aneurysms treated with coiling tended to be larger, to rupture earlier, and to have worse outcomes, probably due to selection bias. Routine loose coiling may provide psychological reassurance but lacks proven efficacy as a preventive measure.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"66-70"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Alternative Approach to Treating Spinal Epidural Arteriovenous Fistula: A Case Report of Direct Puncture.","authors":"Bora Chung, Jieun Roh, Su Hun Lee, Seung Kug Baik","doi":"10.5469/neuroint.2025.00346","DOIUrl":"10.5469/neuroint.2025.00346","url":null,"abstract":"<p><p>We present a case of a patient in their 50s with a spinal epidural arteriovenous fistula (SEDAVF) at L2 level with intradural venous reflux. Initial transarterial embolization was attempted but failed due to vessel tortuosity and vasospasm. The second embolization was carried out with percutaneous puncture of the epidural venous sac under cone-beam computed tomography angiography (CBCTA) guidance. Following the complete obliteration of the fistula, resolution of the venous congestion and significant improvement of the patient's symptoms were achieved. This case highlights the utility of the percutaneous approach as an alternative treatment strategy for SEDAVFs when traditional endovascular routes are not feasible. Advanced imaging techniques, such as CBCTA, facilitate precise navigation and successful embolization.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"99-104"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Procedure Time of Endovascular Thrombectomy as Performance Measure of Acute Stroke Treatment.","authors":"Eung-Joon Lee, Han-Yeong Jeong, Jayoun Kim, Nan Hee Park, Min Kyoung Kang, Dongwhane Lee, Jinkwon Kim, Yo Han Jung, Sungwook Yu, Wook-Joo Kim, Han-Jin Cho, Kyungbok Lee, Tai Hwan Park, Mi Sun Oh, Ji Sung Lee, Joon-Tae Kim, Byung-Woo Yoon, Jong-Moo Park, Hee-Joon Bae, Keun-Hwa Jung","doi":"10.5469/neuroint.2025.00178","DOIUrl":"10.5469/neuroint.2025.00178","url":null,"abstract":"<p><strong>Purpose: </strong>Procedure time (PT), defined as the time between groin access and vessel recanalization, is a recently recognized predictor of outcomes after endovascular thrombectomy (EVT) for acute ischemic stroke (AIS). However, the factors affecting PT and its potential value as a performance measure of AIS treatment remain unexplored.</p><p><strong>Materials and methods: </strong>Using the Korean Stroke Registry, we compared patients who underwent EVT for AIS from 2018 to 2022 based on 60 minutes PT. We conducted multivariate analysis to investigate whether PT <60 minutes was associated with successful recanalization and good functional stroke outcomes. We also investigated factors that independently predicted PT ≥60 minutes. Furthermore, we determined the cutoff point for PT.</p><p><strong>Results: </strong>We analyzed 4,703 patients (mean age: 69.5±11.9, 60.3% male) who underwent EVT. The mean PT was 54.6±36.7 minutes. Multivariate analysis revealed that PT <60 minutes independently predicted a good functional outcome as represented by modified Rankin Scale scores of 0-2 (adjusted odds ratio [aOR]: 1.40, 95% confidence interval [CI]: 1.22-1.59). PT <60 minutes was significantly associated with successful recanalization after adjusting for confounding variables (aOR: 1.66, 95% CI: 1.33-2.07). Moreover, after adjusting for covariates, age≥65 years (aOR: 1.20, 95% CI: 1.05-1.38), onset-to-door time (aOR: 1.03, 95% CI: 1.01-1.04), door-to-puncture time (aOR: 1.05, 95% CI: 1.03-1.06), posterior circulation stroke (PCS) (aOR: 1.13, 95% CI: 1.02-1.28), and smoking (aOR: 1.24, 95%CI: 1.09-1.45) independently predicted PT ≥60 minutes. Finally, the highest aOR for good stroke outcome was observed in the 60-minute cutoff model (aOR: 1.45, 95%CI: 1.27-1.67).</p><p><strong>Conclusion: </strong>PT <60 minutes was significantly associated with good functional outcomes. Conversely, PT ≥60 minutes was associated with older age, PCS, smoking, prolonged onset-to-door and door-to-puncture time. Further studies are necessary to develop refining strategies for optimizing PT to improve stroke outcomes.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"71-81"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological Challenges in Deep Learning-Based Detection of Intracranial Aneurysms: A Scoping Review.","authors":"Bio Joo","doi":"10.5469/neuroint.2025.00283","DOIUrl":"10.5469/neuroint.2025.00283","url":null,"abstract":"<p><p>Artificial intelligence (AI), particularly deep learning, has demonstrated high diagnostic performance in detecting intracranial aneurysms on computed tomography angiography (CTA) and magnetic resonance angiography (MRA). However, the clinical translation of these technologies remains limited due to methodological limitations and concerns about generalizability. This scoping review comprehensively evaluates 36 studies that applied deep learning to intracranial aneurysm detection on CTA or MRA, focusing on study design, validation strategies, reporting practices, and reference standards. Key findings include inconsistent handling of ruptured and previously treated aneurysms, underreporting of coexisting brain or vascular abnormalities, limited use of external validation, and an almost complete absence of prospective study designs. Only a minority of studies employed diagnostic cohorts that reflect real-world aneurysm prevalence, and few reported all essential performance metrics, such as patient-wise and lesion-wise sensitivity, specificity, and false positives per case. These limitations suggest that current studies remain at the stage of technical validation, with high risks of bias and limited clinical applicability. To facilitate real-world implementation, future research must adopt more rigorous designs, representative and diverse validation cohorts, standardized reporting practices, and greater attention to human-AI interaction.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"52-65"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Complete Obliteration of Recurrent Large Basilar Aneurysm by Combined Use of Additional Woven EndoBridge Device and Flow Diverter: A Case Report.","authors":"Akiko Hasebe, Ichiro Nakahara, Jun Tanabe, Kenichi Haraguchi, Yoko Kato","doi":"10.5469/neuroint.2025.00318","DOIUrl":"10.5469/neuroint.2025.00318","url":null,"abstract":"<p><p>A 44-year-old female experienced a recurrence and enlargement of a basilar top aneurysm 2 years after initial treatment with a Woven EndoBridge (WEB) device. Retreatment using a new WEB device combined with a flow diverter (FD) via a semi-jail technique successfully obliterated the aneurysm without complications. Follow-up imaging at 4 months showed complete occlusion and favorable outcomes. This case suggests that combining WEB and FD may offer effective retreatment for complex, recurrent aneurysms, enhancing coverage and durability. Despite its technical challenges, this approach shows promise, though further long-term studies are needed to confirm its safety and wider applicability.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"94-98"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}