Neurointervention最新文献

{"title":"Assessing Radiation Exposure and Contrast Agent Utilization: A Comparative Analysis of the Woven EndoBridge Device and Stent-Assisted Coil Embolization for Managing Unruptured Wide-Neck Bifurcation Aneurysms.","authors":"J. Baek, H. Jeong, Ji-Yeon Han, Y. Heo, S. Yun, W. Lee, S. Kim","doi":"10.5469/neuroint.2024.00143","DOIUrl":"https://doi.org/10.5469/neuroint.2024.00143","url":null,"abstract":"PURPOSE\u0000In this study, we determined whether there were significant differences in procedure time, radiation dose, fluoroscopy time, and total contrast media dose when unruptured wideneck bifurcation aneurysms (WNBAs) were treated with the Woven EndoBridge (WEB) device and stent-assisted coil (SAC) embolization.\u0000\u0000\u0000MATERIALS AND METHODS\u0000The WEB device and SAC embolization (14:17) were used to treat 31 cases of internal carotid artery bifurcation, anterior communicating artery, middle cerebral artery bifurcation, and basilar bifurcation aneurysms between August 2021 and December 2022. The procedure time, radiation dose, fluoroscopy time, and total contrast medium dose between the 2 treatment groups were compared and analyzed. In the WEB device group, the results between operators were compared, and the follow-up radiologic outcomes were investigated.\u0000\u0000\u0000RESULTS\u0000The procedure and fluoroscopy times were significantly shorter in the WEB device group. Radiation and total contrast media dose were also significantly smaller in the WEB device, but there was no significant difference in results between operators. The follow-up radiological outcome showed adequate occlusion in 83.3% (10/12) of cases.\u0000\u0000\u0000CONCLUSION\u0000The WEB device can be used as an alternative treatment method among the available endovascular treatment methods for WNBAs to reduce radiation exposure and the dose of contrast media when used adequately with appropriate indications.","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140703941","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":"Traditional Thrombus Composition and Related Endovascular Outcomes: Catching up with the Recent Evidence.","authors":"Jang-Hyun Baek","doi":"10.5469/neuroint.2024.00087","DOIUrl":"https://doi.org/10.5469/neuroint.2024.00087","url":null,"abstract":"Endovascular thrombectomy is the primary treatment for acute intracranial vessel occlusion and significantly improves recanalization success rate. However, achieving optimal recanalization remains a challenge. The histopathological components of thrombus composition play a crucial role in determining endovascular outcomes. This review aimed to consolidate the recent evidence on the impact of thrombus composition on mechanical properties and endovascular outcomes. The relationship between thrombus composition and mechanical properties was significant, with fibrin and/or platelet-rich thrombi being stiff, tough, elastic, and less deformable; fibrin-rich thrombi were sticky and had higher friction with the vessel wall. Erythrocyte composition was positively associated with successful recanalization, whereas lower platelet composition was associated with specific outcomes, such as the first-pass effect and complete recanalization. The number of thrombectomy device passes was possibly related to erythrocyte, platelet, and fibrin composition, with a smaller number of passes associated with erythrocyte-rich thrombi. Procedural time was consistently related to thrombus composition, with shorter times observed for erythrocyte-rich thrombi. The relationship between thrombus composition and secondary embolism remains inconclusive. Understanding the role of thrombus composition in endovascular outcomes is crucial to optimize stroke treatment. Although evidence suggests a link between thrombus composition and mechanical properties, further research is needed to establish stronger correlations and to reduce study variations. Exploring non-traditional thrombus components such as leukocytes and neutrophil extracellular traps is vital. Thrombus imaging could provide a practical solution for predicting thrombus composition before endovascular procedures. This review highlights the importance of thrombus composition for enhancing endovascular stroke treatment strategies.","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140742724","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":"Asian-Australasian Federation of Interventional and Therapeutic Neuroradiology (AAFITN) Biennial Congress 2023 Hong Kong: A Celebration of 30 Years of AAFITN's Advancements and Remarkable Journey.","authors":"George Kwok Chu Wong","doi":"10.5469/neuroint.2023.00479","DOIUrl":"10.5469/neuroint.2023.00479","url":null,"abstract":"","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10910185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138808420","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":"A \"Radial Ready\" Tricoaxial Setup for Anterior Circulation Mechanical Thrombectomy: Technical Aspects and Preliminary Results.","authors":"Stefano Molinaro, Riccardo Russo, Francesco Mistretta, Gaetano Risi, Umberto Amedeo Gava, Mauro Bergui","doi":"10.5469/neuroint.2023.00500","DOIUrl":"10.5469/neuroint.2023.00500","url":null,"abstract":"<p><strong>Purpose: </strong>Mechanical thrombectomy (MT) is the standard of care for acute ischemic stroke (AIS) due to large vessel occlusion (LVO). The choice of a transradial approach (TRA) for anterior circulation LVOs is still debatable; the use of a specific tricoaxial system could help mitigate numerous issues related to transradial MT.</p><p><strong>Materials and methods: </strong>From November 2022 to November 2023, 22 patients underwent TRA-MT for anterior circulation LVOs, both as first-line and rescue from transfemoral approach (TFA) failure, with the same triaxial setup consisting of a 7F introducer sheath, 7F guide catheter, and aspiration catheters ranging from 5.5F to 5F in relation to the occlusion site. Choice of thrombectomy technique was at operator discretion. Patients' demographic data, clinical presentation, treatment details, complications, rate of crossover to TFA, successful revascularization (modified thrombolysis in cerebral infarction [mTICI] score ≥2b), and good clinical outcome at 3 months (modified Rankin scale [mRS] 0-2) were reported.</p><p><strong>Results: </strong>Of 20 patients selected, 10 (50%) had occlusion of M1 segment of middle cerebral artery (MCA), 6 (30%) of internal carotid artery (ICA) terminus, and 4 (20%) with M2 MCA occlusions; 12/20 (60%) were right-sided occlusions and 8/20 (40%) were left-sided. The mean National Institutes of Health Stroke Scale score was 9.25 at admission. Successful revascularization to mTICI 2b-3 was achieved in 18/20 patients (90%). Intracranial complications were reported in 2 (10%) patients. Rate of radial artery occlusion at 24 hours was 10,6%; no access-site haemorrhagic complications were reported. Symptomatic intracranial hemorrhage occurred in 2 (10%) patients. mRS score 0-2 at 3 months was 50%.</p><p><strong>Conclusion: </strong>The high technical effectiveness and good safety profile of this specific tricoaxial setup for TRA-MT in AIS, even for large proximal LVOs, could constitute a viable alternative to TFA-MT in selected cases.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10910181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139472761","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":"Facilitated Retrograde Access via the Facial Vein for Transvenous Embolization of the Cavernous Sinus Dural Arteriovenous Fistula with Isolated Ophthalmic Venous Drainage.","authors":"Meshari AlAli, Boseong Kwon, Yunsun Song, Deok Hee Lee","doi":"10.5469/neuroint.2023.00493","DOIUrl":"10.5469/neuroint.2023.00493","url":null,"abstract":"<p><p>Management of cavernous sinus dural arteriovenous fistula (CSDAVF) continues to present significant challenges, particularly when the inferior petrosal sinus is thrombosed, collapsed, or angiographically invisible. In this study, we introduce facilitated retrograde access via the facial vein, which is employed in the transvenous embolization of CSDAVF with isolated superior ophthalmic venous drainage. We also present illustrative cases and technical points.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10910183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425187","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":"Findings of Angiography and Carotid Vessel Wall Imaging Associated with Post-Procedural Clinical Events after Carotid Artery Stenting.","authors":"Sujin Jeon, Heejae Park, Hyo Sung Kwak, Seung Bae Hwang","doi":"10.5469/neuroint.2023.00486","DOIUrl":"10.5469/neuroint.2023.00486","url":null,"abstract":"<p><strong>Purpose: </strong>Vessel wall imaging (VWI) for carotid plaque is better for detecting unstable carotid plaque such as intraplaque hemorrhage (IPH), lipid-rich necrotic core (LRNC), and thin/ruptured fibrous cap. However, the role of VWI before carotid artery stenting (CAS) is unclear. Thus, this study aimed to determine the findings of symptomatic carotid stenosis before CAS on angiography and carotid VWI and to evaluate the imaging findings associated with post-procedural clinical events after CAS.</p><p><strong>Materials and methods: </strong>This retrospective study included 173 consecutive patients who underwent carotid VWI, CAS, and post-procedural diffusion-weighted imaging (DWI) after CAS. Findings of unstable plaque on carotid VWI and unstable findings on angiography were analyzed. We also analyzed the incidence of post-procedural clinical events, any stroke, myocardial infarction (MI), and death within 30 days of CAS.</p><p><strong>Results: </strong>Of 173 patients, 101 (58.4%) had initial ischemic symptoms and positive findings on DWI. Symptomatic patients were significantly higher in patients with IPH than in patients without IPH (62.4% vs. 45.8%, P=0.031). Degree of stenosis, thrombus of the stenotic lesion, flow delay of internal carotid artery, and flow arrest by filter thrombus had significantly higher prevalence in the symptomatic group. Twenty patients (11.6%) had post-procedural clinical events such as any stroke, clinical symptoms, and/or MI. Hyperlipidemia and intraluminal thrombus on angiography were identified as significant factors influencing post-procedural events after CAS.</p><p><strong>Conclusion: </strong>An intraluminal thrombus on angiography was identified as a significant factor influencing post-procedural clinical events after CAS.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10910175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139472764","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":"Intrasaccular Flow Disruptor (Woven EndoBridge) Assisted Embolization of Vertebral Arteriovenous Fistulas.","authors":"Oktay Algin","doi":"10.5469/neuroint.2023.00514","DOIUrl":"10.5469/neuroint.2023.00514","url":null,"abstract":"","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10910184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139735737","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":"In Vitro Head-to-Head Comparison of Flow Reduction between Fibered and Non-Fibered Pushable Coils.","authors":"Jong-Tae Yoon, Boseong Kwon, Joon Ho Choi, Sun Moon Hwang, Mihyeon Kim, Sungbin Hwang, Yunsun Song, Deok Hee Lee","doi":"10.5469/neuroint.2024.00031","DOIUrl":"10.5469/neuroint.2024.00031","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the embolization effects of a non-fibered pushable coil with a conventional fibered pushable coil in an in vitro bench-top experiment.</p><p><strong>Materials and methods: </strong>A simplified vascular phantom with 4 channels (1 for the non-fibered coil, 1 for the fibered coil, and 2 for continuous circuit flow) was used. A single coil of the longest length was inserted to evaluate the effect of single-coil embolization, and 3 consecutive coils were inserted to assess the effect of multiple-coil embolization. Post-embolization angiography was performed to obtain flow variables (time to peak [TTP], relative peak intensity [rPI], and angiographic flow reduction score [AFRS]) from time density curves. The packing densities of the two coil types were calculated, and the AFRS of each channel was determined by dividing the TTP by the rPI.</p><p><strong>Results: </strong>When inserting a single coil, the conventional fibered coil demonstrated better flow reduction, as indicated by a higher AFRS (25.6 vs. 17.4, P=0.034). However, the non-fibered coil exhibited a significantly higher packing density (12.9 vs. 2.4, P=0.001). Similar trends were observed with multiple coils.</p><p><strong>Conclusion: </strong>The conventional fibered pushable coil showed better flow reduction efficiency, while the non-fibered pushable coil had a higher packing density, likely due to the flexibility of the coil loops. A better understanding of the distinct characteristics of different pushable coils can enhance the outcomes of various vascular embolization.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10910180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139906209","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":"Endovascular Treatment May Be Effective in Preventing Recurrence of Ischemic Stroke in Vertebral Artery Stump Syndrome: A Case Series.","authors":"Ryo Sakisuka, Takumi Morita, Yuya Tanaka, Shinya Hori, Daisuke Shimo, Naoki Hashimura, Takahiro Kuroyama, Yasushi Ueno","doi":"10.5469/neuroint.2023.00416","DOIUrl":"10.5469/neuroint.2023.00416","url":null,"abstract":"<p><p>Vertebral artery stump syndrome (VASS) is a rare condition that can cause posterior circulation ischemic stroke due to occlusion of the ipsilateral vertebral artery (VA) orifice, resulting in blood flow stagnation and embolus formation. Although there is no established treatment for this condition, we observed 3 cases of VASS out of 326 acute ischemic stroke cases at a single institution from April 2021 to October 2022. Despite the best possible antithrombotic treatment, all 3 patients had recurrent ischemic strokes. One patient underwent drug-eluting stenting of the VA orifice to relieve occlusive flow. The other 2 patients received coil embolization, which resulted in the disappearance of their culprit collateral flow. None of the patients had recurrent ischemic strokes after endovascular intervention. Based on our observations, stenting and coil embolization are effective methods for preventing future recurrences of VASS.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10910182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72014916","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":"Cutting Balloon Angioplasty for Severe In-Stent Restenosis after Carotid Artery Stenting: Long-Term Outcomes and Review of Literature.","authors":"Jeong-Yoon Lee, Min-Surk Kye, Jonguk Kim, Do Yeon Kim, Jun Yup Kim, Sung Hyun Baik, Jihoon Kang, Beom Joon Kim, Hee-Joon Bae, Cheolkyu Jung","doi":"10.5469/neuroint.2024.00010","DOIUrl":"10.5469/neuroint.2024.00010","url":null,"abstract":"<p><strong>Purpose: </strong>Cutting balloon-percutaneous transluminal angioplasty (CB-PTA) is a feasible treatment option for in-stent restenosis (ISR) after carotid artery stenting (CAS). However, the longterm durability and safety of CB-PTA for ISR after CAS have not been well established.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed medical records of patients with ISR after CAS who had been treated with CB-PTA from 2012 to 2021 in our center. Detailed information of baseline characteristics, periprocedural and long-term outcomes, and follow-up imaging was collected.</p><p><strong>Results: </strong>During 2012-2021, a total of 301 patients underwent CAS. Of which, CB-PTA was performed on 20 lesions exhibiting severe ISR in 18 patients following CAS. No patient had any history of receiving carotid endarterectomy or radiation therapy. These lesions were located at the cervical segment of the internal carotid artery (n=16), proximal external carotid artery (n=1), and distal common carotid artery (n=1). The median time interval between initial CAS and detection of ISR was 390 days (interquartile range 324-666 days). The follow-up period ranged from 9 months to 9 years with a median value of 21 months. Four patients (22.2%) were symptomatic. The average of stenotic degree before and after the procedure was 79.2% and 34.7%, respectively. Out of the 18 patients receiving CB-PTA, 16 (88.9%) did not require additional stenting, and 16 (88.9%) did not experience recurrent ISR during the follow-up period. Two patients who experienced recurrent ISR were successfully treated with CB-PTA and additional stenting. No periprocedural complication was observed in any case.</p><p><strong>Conclusion: </strong>Regarding favorable periprocedural and long-term outcomes in our single-center experience, CB-PTA was a feasible and safe option for the treatment of severe ISR after CAS.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10910177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697955","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}