Neurointervention最新文献

{"title":"Updating Korean Reimbursement Criteria for Endovascular Thrombectomy in Contemporary Stroke Care.","authors":"Woo Sang Jung","doi":"10.5469/neuroint.2026.01221","DOIUrl":"https://doi.org/10.5469/neuroint.2026.01221","url":null,"abstract":"","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149195868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atropine-Associated Central Anticholinergic Syndrome during Carotid Artery Stenting: A Case Report.","authors":"Jang-Hyun Baek","doi":"10.5469/neuroint.2026.01158","DOIUrl":"https://doi.org/10.5469/neuroint.2026.01158","url":null,"abstract":"<p><p>Acute neurobehavioral deterioration during carotid artery stenting (CAS) requires prompt evaluation for serious neurological complications. We report a patient in their 70s who developed profound hyperactive delirium approximately 15 minutes after receiving prophylactic intravenous atropine (0.25 mg) during CAS. The episode was characterized by severe agitation, bilateral mydriasis, and facial flushing without focal neurological deficits. Repeated angiography and subsequent neuroimaging showed no evidence of thromboembolism, intracranial hemorrhage, cerebral edema, or cerebral hyperperfusion. Contrast-induced encephalopathy and cerebral hyperperfusion syndrome were considered but were less consistent with the overall clinical, temporal, and radiographic findings. The patient returned to neurological and cognitive baseline approximately 16 hours after symptom onset without specific antidotal treatment. The close temporal relationship to atropine exposure and characteristic neurobehavioral and autonomic features favored atropine-associated central anticholinergic syndrome, which should be considered in the differential diagnosis of acute neurobehavioral deterioration during CAS.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Hybrid Endovascular Technique for Tympanojugular Paraganglioma: Flow Diversion Followed by Direct Transauricular Squid Embolization.","authors":"Rory Fairhead, Rupert Obholzer, Tufail Patankar, Naga Kandasamy, Jeremy Lynch","doi":"10.5469/neuroint.2026.00857","DOIUrl":"https://doi.org/10.5469/neuroint.2026.00857","url":null,"abstract":"<p><p>Skull-base paragangliomas with persistent internal carotid artery (ICA) supply can be challenging to devascularize safely. We report a 17-yearold male with an Succinate Dehydrogenase Complex Iron Sulfur Subunit B (SDHB)-associated tympanojugular paraganglioma treated using a staged hybrid endovascular strategy after subtotal resection. Persistent supply from a short ICA feeder and circumferential involvement of the petrous ICA precluded safe conventional transarterial embolization. A Surpass Elite flow-diverting stent was deployed across the feeder after dual antiplatelet therapy to preserve parent-vessel patency, reduce tumour inflow, and reinforce the arterial wall. Four months later, protected direct transauricular and transcervical puncture embolization with Squid 12 was performed under intermittent ICA balloon occlusion. Marked tumor devascularization was achieved without embolic or thromboembolic complication, and definitive resection was completed without new neurological or cranial nerve deficit. This staged approach may provide a useful adjunct for selected skull-base paragangliomas with persistent ICA supply when conventional embolization carries unacceptable risk.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Estimated Arterial Stiffness with Collateral Status and Functional Outcome after Endovascular Thrombectomy: A Secondary Analysis of the OPTIMAL-BP Trial.","authors":"Minho Han, Eunjeong Park, Jae Wook Jung, Hyungwoo Lee, JoonNyung Heo, Young Dae Kim, Haram Joo, Kwang Hyun Kim, Jaeseob Yun, Jin Kyo Choi, Il Hyung Lee, Byung Moon Kim, Dong Joon Kim, Na Young Shin, Bang-Hoon Cho, Seong Hwan Ahn, Hyungjong Park, Sung-Il Sohn, Jeong-Ho Hong, Tae-Jin Song, Yoonkyung Chang, Gyu Sik Kim, Kwon-Duk Seo, Kijeong Lee, Jun Young Chang, Jung Hwa Seo, Sukyoon Lee, Jang-Hyun Baek, Han-Jin Cho, Dong Hoon Shin, Jinkwon Kim, Joonsang Yoo, Minyoul Baik, Yo Han Jung, Yang-Ha Hwang, Chi Kyung Kim, Jae Guk Kim, Chan Joo Lee, Sungha Park, Soyoung Jeon, Hye Sun Lee, Sun U Kwon, Oh Young Bang, Ji Hoe Heo, Hyo Suk Nam","doi":"10.5469/neuroint.2026.00822","DOIUrl":"https://doi.org/10.5469/neuroint.2026.00822","url":null,"abstract":"<p><strong>Purpose: </strong>Estimated pulse wave velocity (ePWV) is a surrogate of arterial stiffness that may influence stroke outcomes and potentially affect collateral circulation. We examined the association of ePWV with collateral status and 3-month functional outcome after successful endovascular thrombectomy and explored the contribution of collateral status to this relationship across blood pressure (BP) management strategies.</p><p><strong>Materials and methods: </strong>In this secondary analysis of the Outcome in Patients Treated With Intra-Arterial Thrombectomy-Optimal Blood Pressure Control trial, 285 patients were analyzed. Collateral status was assessed using the Tan scale (poor, 0-1; good, 2-3). Poor functional outcome was defined as 3-month modified Rankin Scale score of 3-6. Multivariable logistic and mediation analyses were performed to evaluate the association between ePWV and functional outcomes and to explore direct and indirect pathways.</p><p><strong>Results: </strong>A total of 285 patients were included (mean age, 73.3±11.3 years; 40.4% women). Each 1 m/s increase in ePWV was associated with poor collaterals (adjusted odds ratio [OR] 1.276, 95% confidence interval [CI] 1.083-1.503) and poor functional outcome (adjusted OR 1.338, 95% CI 1.121-1.597). In mediation analyses, collateral status accounted for only a small proportion of the association between ePWV and poor functional outcome (indirect effect: adjusted β 0.022, 95% CI 0.001-0.053), whereas the direct effect remained significant (adjusted β 0.237, 95% CI 0.115-0.359). Neither the direct effect of ePWV on functional outcome nor the indirect effect through collateral status differed according to BP management strategy.</p><p><strong>Conclusion: </strong>Higher ePWV was associated with poor collateral status and unfavorable functional outcome after successful reperfusion. Collateral status accounted for only a small proportion of the observed association between ePWV and functional outcome.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Subdural Hematoma in the Super-Aged Society: From a Traumatic Curiosity to a Self-Perpetuating Vascular-Inflammatory Disease.","authors":"Dae Chul Suh","doi":"10.5469/neuroint.2026.00955","DOIUrl":"https://doi.org/10.5469/neuroint.2026.00955","url":null,"abstract":"<p><p>Chronic subdural hematoma (cSDH) was traditionally regarded as a simple mechanical consequence of head trauma, treated by burr-hole drainage alone. Recent ultrastructural, histopathological, and clinical evidence has reframed cSDH as a chronic, self-perpetuating disease driven by inflammation, pathological angiogenesis, and hyperfibrinolysis within an outer neomembrane, rather than a static pool of blood. As Korea and other nations enter super-aged societies, the incidence of cSDH is rising steeply with age, and its associated disability and mortality are increasingly recognized as important public health concerns. This review summarizes the evolving disease concept of cSDH and its patient- and hematoma-related risk factors, then outlines conventional conservative and surgical treatment before focusing on contemporary evidence for middle meningeal artery embolization (MMAE) as a mechanism-targeted adjunct or alternative to surgery. Pooled and individual randomized trial data, together with recently completed and ongoing studies, are reviewed alongside the burden of recurrence, cost-effectiveness, and country-specific reimbursement issues exemplified by Korean practice. Emerging biomarker-based and artificial-intelligence-guided approaches to patient stratification, together with early transvascular access to the subdural space through the MMA, are also discussed. Taken together, current evidence supports MMAE as a promising, mechanism-targeted adjunctive strategy in selected highrisk patients rather than a universal replacement for surgery, and highlights the need for standardized technique, longer-term outcome data, and precision-medicine approaches as cSDH becomes an increasingly important neurointerventional and public health concern.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: After Carotid Artery Stenting, Diffusion Lesions Need a Lesion-Burden Estimand.","authors":"Kwon-Duk Seo, Taemin Kim, Minsoo Sung, Sang Hyun Suh","doi":"10.5469/neuroint.2026.00864","DOIUrl":"https://doi.org/10.5469/neuroint.2026.00864","url":null,"abstract":"","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"After Carotid Artery Stenting, Diffusion Lesions Need a Lesion-Burden Estimand.","authors":"Zisheng Liu, Jun Sun","doi":"10.5469/neuroint.2026.00787","DOIUrl":"https://doi.org/10.5469/neuroint.2026.00787","url":null,"abstract":"","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary to: Carotid Stenting for Asymptomatic Carotid Stenosis: Call for Judicious Approach.","authors":"Seon-Kyu Lee, Evan Lipsitz, Daniel Labovitz","doi":"10.5469/neuroint.2026.00598","DOIUrl":"https://doi.org/10.5469/neuroint.2026.00598","url":null,"abstract":"","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Stepwise Procedural Guide Based on Angiographic Signs during Temporary Stent Retriever Deployment for Intracranial Atherosclerotic Disease-Related Large Vessel Occlusion.","authors":"Yukishige Hashimoto, Fusao Ikawa, Toshikazu Hidaka, Masaru Abiko, Nobutaka Horie","doi":"10.5469/neuroint.2026.00430","DOIUrl":"https://doi.org/10.5469/neuroint.2026.00430","url":null,"abstract":"<p><p>While temporary stent retriever deployment (TSRD) is an increasingly utilized option for intracranial atherosclerotic disease-related large vessel occlusion (ICAD-LVO), standardized criteria to guide the intraprocedural decision between device retrieval, resheathing, and rescue therapies remain undefined. We systematically evaluated real-time angiographic signs to guide this decision-making process. We retrospectively reviewed consecutive patients with ICAD-LVO treated using TSRD at 2 centers. Two angiographic signs were operationalized: the instent thrombotic sign (IST), representing intra-stent filling defects observed during dwell time; and post-resheathing distal flow deterioration (PR-DFD), defined as a temporal reduction in distal opacification after resheathing compared to maximal deployment. The primary outcome was acute procedural success, defined as successfully maintaining target lesion patency. Secondary outcomes included final successful reperfusion (modified Thrombolysis in Cerebral Infarction, mTICI 2b-3), early neurological deterioration (END), and symptomatic intracranial hemorrhage (sICH). Eight patients were included. IST was observed in 3 patients, prompting immediate stent retrieval. In the remaining 5 patients without IST, the device was resheathed; among this subset, PR-DFD occurred in 3. Regarding the primary outcome, acute procedural success was achieved in all 8 patients, although 1 patient with PR-DFD required rescue angioplasty for early reocclusion. Notably, END occurred exclusively in the 2 patients with PR-DFD who did not undergo rescue angioplasty. Secondarily, all patients ultimately achieved final mTICI 2b-3 without sICH. These preliminary observations suggest that IST and PR-DFD may provide practical angiographic cues reflecting thrombotic burden and hemodynamic instability during TSRD.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Closed-Circuit Dual-Port Injector System for Fully Automated Contrast Delivery in Diagnostic Cerebral Angiography.","authors":"Mohammad Rashad, Om Gandhi, Sami Almasri, Suraj Dumasia, Nathan Yu, Warda Ahmed, Jaeha Kim, Giuseppe Lanzino, Linda Bagley, Omar Choudhri","doi":"10.5469/neuroint.2026.00283","DOIUrl":"10.5469/neuroint.2026.00283","url":null,"abstract":"<p><strong>Purpose: </strong>During diagnostic cerebral angiography, catheter navigation requires manual contrast \"puff\" injections, while subsequent 2D/3D runs often use automated power injectors. Using power injectors for navigation puffs has not been described. We present a closed-circuit dual-port injector system (Nemoto Press Duo Elite) that integrates both navigation puff delivery and diagnostic run injection into a single automated platform, eliminating all manual tableside contrast handling. A foot pedal interface enables operator-controlled puff timing, potentially reducing contrast waste and air embolism risk while improving single-operator ergonomics with future remote robotic implications.</p><p><strong>Materials and methods: </strong>This retrospective comparative cohort study compared 19 consecutive patients undergoing diagnostic cerebral angiography with foot pedal-controlled puff injections (June-July 2023) to 19 historical controls using manual hand injections (May 2021). Both groups used 90% contrast concentration. Fluoroscopy time, radiation dose, contrast utilization, and safety outcomes were compared.</p><p><strong>Results: </strong>Groups were demographically matched (mean age 52.1±14.2 vs. 50.2±12.9 years; 73.7% female). All 38 procedures achieved diagnostic adequacy with no complications. The foot pedal group demonstrated significantly shorter procedure time per vessel (11.5±4.4 vs. 18.9±10.5 min/vessel, P=0.010) with no significant differences in fluoroscopy time (P=0.171), radiation dose (P=0.690), or contrast delivered (88.7±30.9 vs. 88.2±42.5 mL, P=0.966). A trend toward improved contrast efficiency was observed (23.4±9.4 vs. 27.4±10.4 mL/vessel, P=0.226). Despite undergoing significantly more 3D rotational runs (1.3±1.0 vs. 0.6±0.7, P=0.030), the foot pedal group maintained comparable safety metrics, strengthening the non-inferiority findings.</p><p><strong>Conclusion: </strong>A closed-circuit dual-port injector system integrating automated navigation puff delivery with diagnostic run injection demonstrates non-inferiority to manual injection for diagnostic cerebral angiography, with shorter procedure time per vessel (39% reduction, P=0.010), though interpretation is limited by differences in indication distribution. By eliminating manual tableside contrast handling, this approach enables precise digital contrast accounting and reduces air embolism risk, establishing a foundation for remote and robotic angiography applications.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"92-102"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13311866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723341","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}