Neurointervention最新文献

{"title":"Anatomical Variation of Left Internal Mammary Artery and Thyrocervical Trunk: A Case Report.","authors":"Ji-Yeon Han, Jinwook Baek","doi":"10.5469/neuroint.2025.00024","DOIUrl":"10.5469/neuroint.2025.00024","url":null,"abstract":"<p><p>We report a rare case of a left internal mammary artery (LIMA) originating from the left thyrocervical trunk (TCT), which arose directly from the aortic arch. A patient in their 70s presented with bilateral distal internal carotid artery aneurysms, diagnosed through computed tomography angiography performed for headache evaluation. Transfemoral cerebral angiography confirmed the aneurysms and incidentally revealed the anomalous origins of the TCT and LIMA, as well as a left vertebral artery directly arising from the aortic arch. This case emphasizes the importance of recognizing such rare anatomical variations prior to diagnostic or interventional procedures. Thorough preoperative evaluation is critical to avoid complications, particularly in coronary artery bypass grafting and head and neck tumor embolization.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"105-108"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123298","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":"The Woven EndoBridge for Wide-Neck Bifurcation Aneurysms: A Retrospective Study of 120 Cases with Expanded Indications Covering All Subtypes.","authors":"Jun Tanabe, Ichiro Nakahara, Shoji Matsumoto, Jun Morioka, Tetsuya Hashimoto, Akiko Hasebe, Sadayoshi Watanabe, Kenichiro Suyama, Takeya Suzuki, Junpei Koge","doi":"10.5469/neuroint.2025.00297","DOIUrl":"https://doi.org/10.5469/neuroint.2025.00297","url":null,"abstract":"<p><strong>Purpose: </strong>The Woven EndoBridge (WEB) was introduced in Japan in January 2021 and approved for all subtypes of wide-neck bifurcation aneurysms (WNBA). This retrospective study evaluated the safety and efficacy of the WEB device for all subtypes of WNBA.</p><p><strong>Materials and methods: </strong>All patients treated with the WEB at our facility between January 2021 and May 2024 was reviewed. We selected the WEB device according to an oversizing policy, based on cumulative clinical evidence from global experience.</p><p><strong>Results: </strong>We analyzed 120 aneurysms in 117 patients (56 males and 61 females with a mean age of 65.5±12.7 years). There were 45 anterior communicating artery aneurysms, 27 middle cerebral artery aneurysms, 17 internal carotid artery-posterior communicating artery aneurysms, 15 basilar artery top aneurysms, and 16 aneurysms in other locations. Aneurysm characteristics included a maximum diameter of 6.5 [5.3, 7.7] mm, height of 4.9 [3.9, 6.0] mm, width of 4.8 [4.0, 6.2] mm, and dome/neck ratio of 1.2 [1.1, 1.4]. All data are expressed in median [interquartile range]. Angiographic follow-up at 12 months in 96 cases showed complete obliteration in 68.8% and adequate obliteration in 90.6% of cases. Intraoperative ischemic events occurred in 5 cases (4.2%). Hemorrhagic events occurred in 2 cases (1.7%), with symptoms resolving by discharge, except for 1 case of mild paralysis. During follow-up, 1 patient developed a major stroke, resulting in morbidity (0.8%). Retreatment was required in 3 cases (2.5%). On multivariate analysis for complete occlusion at 12 months following WEB treatment, age was statistically associated with the outcome (odds ratio, 0.957 per year; 95% confidence interval, 0.919-0.996; P=0.033).</p><p><strong>Conclusion: </strong>WEB is safe and effective for all subtypes of WNBA, with a low retreatment rate using an oversizing policy. This is the first report in a Japanese population.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507099","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":"Hemodynamic Instability during Squid Embolization of Dural Arteriovenous Fistula: A Case Report.","authors":"Ehab Mahmoud, Osman Koc, Mostafa Mahmoud","doi":"10.5469/neuroint.2024.00521","DOIUrl":"10.5469/neuroint.2024.00521","url":null,"abstract":"<p><p>There are few documented cases of bradycardia or asystole occurring during Onyx embolization of intracranial dural arteriovenous fistulas (DAVFs), although these events are more commonly observed in open neurosurgical procedures, particularly those involving the skull base. We present a case treated for a ruptured paramedian occipital DAVF. During the administration of Squid into the middle meningeal artery, while balloons were inflated in the large occipital arteries bilaterally to control the flow during embolization of the DAVF, the patient experienced an abrupt episode of sinus bradycardia, which recurred after a second injection of Squid. After temporarily halting the injections and deflating the balloons, a third injection was successfully administered without complications, allowing total exclusion of the fistula.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"28-31"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818680","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":"Steerable Microcatheter Facilitates Navigation through Tortuous Internal Carotid Artery Lesions in Carotid Artery Stenting.","authors":"Shuto Fushimi, Nagatsuki Tomura, Takashi Shuto, Fukutaro Ohgaki, Yoshitaka Nakayama","doi":"10.5469/neuroint.2025.00045","DOIUrl":"10.5469/neuroint.2025.00045","url":null,"abstract":"<p><p>The treatment of carotid stenosis complicated by severe vessel tortuosity can present challenges in distal vessel selection and device delivery. This article reports the use of a steerable microcatheter (SM) for carotid artery stenting (CAS) in such cases. A 67-year-old male with transient lower extremity weakness and bilateral cerebral infarctions was found to have bilateral carotid stenosis. CAS was planned for both carotid arteries due to coronary artery disease. The left carotid artery exhibited severe stenosis with a 90-degree angle between the common and internal carotid artery (ICA). Anticipating difficulty in navigating the device, we used a 2.4 Fr SM. By adjusting the catheter tip to align with the ICA, we successfully guided the wire distally. Following the catheter exchange, a distal protection device was deployed, and CAS was completed successfully. SMs provide exceptional vascular selectivity and support, improving success in complex cases.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":"20 1","pages":"42-46"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502214","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":"Safety and Efficacy of Thrombectomy for Distal Medium Vessel Occlusions of the Middle Cerebral Artery.","authors":"Marcel Cedric Berger, Andreas Simgen, Philipp Dietrich, Weis Naziri","doi":"10.5469/neuroint.2024.00500","DOIUrl":"10.5469/neuroint.2024.00500","url":null,"abstract":"<p><strong>Purpose: </strong>Mechanical thrombectomy (MT) for distal medium vessel occlusions (DMVOs) in the middle cerebral artery (MCA) is less established than for large vessel occlusions. This study evaluates the safety and efficacy of MT in DMVOs, comparing it with M1-segment occlusions.</p><p><strong>Materials and methods: </strong>This retrospective study analyzed 218 patients who underwent MT for isolated M1 (n=123) or distal M2+M3 (n=35) occlusions between January 2020 and August 2023. Outcomes included procedural complications, hemorrhagic events, reperfusion rates, and clinical severity and disability at admission and discharge. Multivariate logistic regression identified predictors of favorable outcomes (modified Rankin Scale≤2) at discharge.</p><p><strong>Results: </strong>Median admission National Institutes of Health Stroke Scale (NIHSS) scores were higher in the M1 group (13, interquartile range [IQR]: 8) compared to the distal M2+M3 group (8, IQR: 7; P<0.001), with significant improvements at discharge in both groups (6 [IQR: 8] for M1 and 2.5 [IQR: 5] for M2+M3; P=0.025). Favorable outcomes were more frequent in the M2+M3 group (50.0%) compared to M1 (28.1%; P=0.023). Recanalization rates (modified Thrombolysis in Cerebral Infarction≥2b) were excellent (>90% in both groups; P=0.300). Procedural complications were rare, with vessel perforations occurring infrequently (M1: 1.6%; M2+M3: 2.9%; P=0.531). Symptomatic intracranial hemorrhage rates were similarly low (2.4% vs. 2.9%; P=0.889). Multivariate analysis identified younger age (P=0.045) and lower NIHSS (P=0.061) as predictors of favorable outcomes in distal occlusions.</p><p><strong>Conclusion: </strong>MT is safe and effective for DMVOs of the MCA, demonstrating significant improvements in clinical outcomes and comparable complication rates to MT for M1-segment occlusions. Given the typically less severe presentations in DMVO and similar risk profiles, careful patient selection and individualized treatment remain critical.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"15-23"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008853","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":"Delayed Aneurysm Rupture Following Endovascular Treatment with Contour Device: A Case Report.","authors":"Osman Koc, Mostafa Mahmoud, Ehab Mahmoud, Ali Ayyad, Ahmad Own","doi":"10.5469/neuroint.2024.00493","DOIUrl":"10.5469/neuroint.2024.00493","url":null,"abstract":"<p><p>Delayed rupture of intracranial aneurysms after endovascular treatment is a rare but serious complication. We report the first documented case of late aneurysmal rupture following treatment with a Contour intrasaccular device. A patient in their 60s with a basilar tip aneurysm underwent endovascular treatment using a 14-mm Contour device. Fifteen months later, the patient presented with a fatal intraventricular hemorrhage, and imaging revealed device displacement and aneurysm growth. This case underscores the importance of meticulous device sizing and follow-up, especially for large aneurysms.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"24-27"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028981","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":"Application of the Woven EndoBridge Device in the Treatment of Multiple Aneurysms of the Distal Posterior Cerebral Artery: A Case Report.","authors":"Abzal Zhumabekov, Jun Tanabe, Ichiro Nakahara, Mynzhylky Berdikhojayev, Yoko Kato","doi":"10.5469/neuroint.2025.00080","DOIUrl":"10.5469/neuroint.2025.00080","url":null,"abstract":"<p><p>The Woven EndoBridge (WEB) device has emerged as a promising alternative to endovascular coiling. This case report demonstrates the use of stent-assisted WEB deployment for the embolization of multiple wide-neck posterior cerebral artery (PCA) aneurysms. A middle-aged patient was diagnosed with 3 unruptured aneurysms in the P3 and P4 segments of the right PCA, with sizes ranging from 2.5 mm to 6.6 mm. Given the small vessel diameter and distal location of the aneurysms, a combined approach was adopted. Coil embolization was performed for the most distal aneurysm, while stent-assisted WEB deployment was used for the proximal and middle aneurysms. The \"flower bud\" technique facilitated the safe positioning of the WEB device in challenging anatomical conditions. The procedure was successfully completed without complications, and the patient was discharged on postoperative day 7 with no neurological deficits. Follow-up at 3 months confirmed adequate embolization of all aneurysms, with in-stent stenosis managed conservatively.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"37-41"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433135","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":"Efficacy of Pressure Cooker Technique in Redo Embolization for High-Flow Torcular Dural Sinus Malformation.","authors":"Frank Gleb Solis Chucos, Rosa Lizbeth Ecos Quispe, Mauro Toledo, Melanie Walker, René Chapot","doi":"10.5469/neuroint.2024.00556","DOIUrl":"10.5469/neuroint.2024.00556","url":null,"abstract":"<p><p>Torcular dural sinus malformations (tDSMs) with high-flow fistulas pose complex management challenges due to their vascularity and the delicate neuroanatomy involved. This report presents the case of a child with tDSM and hydrocephalus, who underwent 3 staged embolization procedures but required a redo intervention due to residual malformation and venous hypertension. Utilizing the pressure cooker technique (PCT) in a redo setting allowed for high-pressure, targeted embolic delivery with minimized reflux, achieving near-complete occlusion and significant symptom relief. This case highlights PCT's potential to improve outcomes in multi-stage treatments of high-flow tDSM, reducing reflux and enhancing safety in technically demanding cases.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"32-36"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067013","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":"Upcoming Korean Congress of NeuroIntervention 2025: Advancing Neurointervention through Global Collaboration.","authors":"Lee Hwangbo, Hae Woong Jeong, Sangil Suh","doi":"10.5469/neuroint.2025.00108","DOIUrl":"10.5469/neuroint.2025.00108","url":null,"abstract":"","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"2-3"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468665","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":"The Use of Macrocyclic Contrast Agents and Woven EndoBridge-Assisted Embolization for Direct Carotid-Cavernous Fistulas due to Aneurysm Rupture.","authors":"Oktay Algin","doi":"10.5469/neuroint.2024.00472","DOIUrl":"10.5469/neuroint.2024.00472","url":null,"abstract":"","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"47-48"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687718","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}