Neurointervention最新文献

{"title":"Transulnar Arterial Access for Intra-Operative Cerebral Angiography during Prone Cerebrovascular Surgery.","authors":"Hasan Ahmad, Om Gandhi, Jaskeerat Gujral, Rashad Jabarkheel, Sartaaj Walia, Sandeep Kandregula, Omar Choudhri","doi":"10.5469/neuroint.2025.00934","DOIUrl":"10.5469/neuroint.2025.00934","url":null,"abstract":"<p><p>We reviewed our experience using transulnar access (TUA) to obtain intraoperative cerebral angiography during prone surgery for vascular pathology, where conventional transfemoral and transradial access can be difficult. Ten consecutive patients treated between April 2020 and August 2025 were included. Ulnar artery access was obtained in the supine position before the patient was turned prone for surgery, and angiography was performed after the procedure without repositioning. Eight patients had arteriovenous malformations and 2 had dural arteriovenous fistulas. In all cases, intraoperative angiography was successfully completed through the ulnar artery. The mean ulnar artery diameter was 2.4 mm, indicating adequate vessel size for catheterization, and mean fluoroscopy time was 7.5 minutes. No immediate access-site complications occurred, and no case required conversion to another access route. These findings suggest that TUA is technically feasible and may provide a practical option for intraoperative cerebral angiography when prone positioning limits access to traditional arterial sites. Although the study is limited by its small sample size and retrospective design, the consistent procedural success supports further investigation.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"35-43"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12960038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145775139","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":"Ultrasound-Guided Retrograde Internal Jugular Venous Puncture in Neurointerventional Procedures.","authors":"Jan Mohd Suhail, Santhosh Babu Kannan Bharathy, Shikhar Garg, Shoban Haridass, Shyamkumar Nidugala Keshava","doi":"10.5469/neuroint.2025.00745","DOIUrl":"10.5469/neuroint.2025.00745","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the safety and efficacy of ultrasound-guided retrograde internal jugular venous (IJV) puncture in neurointerventional procedures.</p><p><strong>Materials and methods: </strong>This single-centre retrospective study evaluates data collected over 20 years. All punctures were performed under general anaesthesia using ultrasound guidance. The data were analyzed to assess patient demographics, indications and potential advantages, the technique of puncture, safety, outcomes, and complications associated with such punctures.</p><p><strong>Results: </strong>The study included 60 patients (males: n=38, 63%; females: n=22, 37%). The median age was 33 years (range 13-73 years). A total of 74 retrograde jugular punctures were performed. Isolated right-sided punctures were done in 31 patients (52%), isolated left-sided punctures in 18 (30%), and 11 patients (18%) underwent bilateral punctures. The preferred access needle was an 18G needle; however, micropuncture access was used in some patients. No inadvertent arterial punctures were encountered. The most common indication was mechanical thrombectomy for cerebral venous thrombosis (62%). Other indications included transvenous embolization of carotid-cavernous fistulae (16%), embolization of cerebral dural arteriovenous fistulae (8%), inferior petrosal sinus sampling (8%), and cerebral venous sinus angioplasty or stenting (6%). In all procedures, the expected technical outcome was achieved.</p><p><strong>Conclusion: </strong>Ultrasound-guided retrograde IJV puncture is a safe and effective method for accessing neurovascular pathologies requiring a transvenous approach. Based on our experience, this access has been routinely used without any major complications. We foresee the technique being accepted on a larger scale in the future.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"29-34"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12960039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648981","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":"Traxcess-14 Microguidewire-Assisted Electrocoagulation as a Therapeutic Option for Basilar Artery Pseudoaneurysm: A Case Report.","authors":"Zifeng Dai, Junjun Zhang, Jianfei Zhang, Fanyong Gong, Shengjun Zhou","doi":"10.5469/neuroint.2025.01109","DOIUrl":"10.5469/neuroint.2025.01109","url":null,"abstract":"<p><p>Basilar artery pseudoaneurysm (BAPA) is an extremely rare yet life-threatening intracranial vascular lesion, characterized by insidious clinical onset and a remarkably high mortality risk upon rupture. In this case report, we describe a patient who was admitted to our department with spontaneous subarachnoid hemorrhage (SAH). Emergency digital subtraction angiography performed on admission revealed no vascular anomalies. One month after SAH onset, a comprehensive multimodal imaging evaluation ultimately confirmed the diagnosis of BAPA. Given the technical challenges in conventional management for this specific case, Traxcess-14 microguidewire-assisted endovascular electrocoagulation was performed as a last-resort therapy. Finally, follow-up imaging at 6 months demonstrated complete resolution of BAPA. Thus, we propose that Traxcess-14 microguidewire-assisted endovascular electrocoagulation may serve as a potential salvage treatment for highly selective BAPA cases in which conventional therapeutic approaches are unfeasible or have failed.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"53-57"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12960035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145998590","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":"Damage to Polymer Coatings on Microguidewire Tips through Shaping and J-wiring for Optimizing Flow Diverter Deployment: A Scanning Electron Microscopy Study.","authors":"Rasmus Holmboe Dahl, Esben Thormann, René Wugt Larsen, Goetz Benndorf","doi":"10.5469/neuroint.2025.01130","DOIUrl":"10.5469/neuroint.2025.01130","url":null,"abstract":"<p><p>Achieving adequate wall apposition is a crucial technical goal when deploying flow diverters to treat wide-neck cerebral aneurysms. The socalled J-wiring technique is a common method used to optimize flow diverter wall apposition. However, the frictional interaction between the shaping device and the microguidewire tip during the formation of the J-loop, as well as the interaction between the J-loop and the flow diverter during J-wiring, may potentially cause damage to the guidewire's coating. Three frequently used guidewires were tested in vitro in a silicone aneurysm model. Manual J-shaping of guidewire tips, along with the J-wiring technique (including J-shaping), caused damage to the surface coating of guidewires, as observed by scanning electron microscopy. Therefore, both mechanisms may contribute to the generation of polymer micro-fragments in patients treated with flow diversion.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"44-52"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12960040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960015","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 Flow-Diverter Implantation in Ruptured Intracranial Aneurysms: Safety and Outcomes in a Resource-Limited Setting.","authors":"Vinayagamani Selvadasan, Satheesh Grahadhurai, Arunkumar Moses Joseph, Arunkumar Natrajan, Rama Shankari Padmanabhan, A K Kabhilan","doi":"10.5469/neuroint.2025.01053","DOIUrl":"10.5469/neuroint.2025.01053","url":null,"abstract":"<p><strong>Purpose: </strong>Flow-diverting stents (FDs) provide a reconstructive option for complex ruptured aneurysms, including blister-like, fusiform, and small saccular lesions. Their use in acute subarachnoid hemorrhage (SAH) is limited by dual antiplatelet therapy (DAPT) and hemorrhagic risk, with scarce data from resource-limited settings.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed 26 patients with ruptured intracranial aneurysms treated with FDs within 7 days of ictus at a single tertiary center (July 2021-June 2025). Exclusion criteria included adjunctive coiling/clipping, FD placement >7 days, and aneurysms >5 mm. Outcomes included 90-day functional status (modified Rankin Scale [mRS]), angiographic occlusion (O'Kelly-Marotta grading), and procedural complications.</p><p><strong>Results: </strong>Mean age was 47.3±12.1 years; 61.5% were male. Aneurysm types were saccular (42.3%), blister-like (34.6%), and fusiform/dissecting (23.1%). FD placement occurred at a mean of 3.9±1.8 days post-ictus, with 100% technical success and no intraprocedural complications. Favorable functional outcome (mRS 0-2) was achieved in 84.6%, and mortality was 15.4%, all secondary to SAH. Complete angiographic occlusion was observed in all 21 patients with imaging follow-up. Procedure-related ischemic complications occurred in 11.5%, mostly transient or minimally disabling, with 1 disabling infarct (mRS 3); no hemorrhagic events related to DAPT or aneurysm rebleeds were observed.</p><p><strong>Conclusion: </strong>Early FD implantation in carefully selected ruptured aneurysms, including small saccular and morphologically complex lesions can achieve high functional recovery and complete angiographic occlusion, even in a resource-limited environment. Ideal case selection and standardized DAPT and hemodynamic protocols are critical. These findings support broader use in challenging aneurysms, but larger prospective studies are warranted to validate outcomes and refine management strategies.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"19-28"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12960037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146156194","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":"Direct Aspiration as First-Line Technique for Acute Intracranial Internal Carotid Artery Occlusion: Preliminary Results.","authors":"Miguel Ramírez-Torres, Blanca Fuentes, Andrés Fernández-Prieto, Alberto Álvarez-Muelas, Andrés Javier Barrios, Remedios Frutos, Cristina Utrilla, Marc Comas-Cufi, Josep Puig, Pedro Navia","doi":"10.5469/neuroint.2025.01200","DOIUrl":"10.5469/neuroint.2025.01200","url":null,"abstract":"<p><strong>Purpose: </strong>Acute intracranial internal carotid artery (ICA) occlusion has high clot burden and poor outcomes. No consensus exists on optimal first-line mechanical thrombectomy (MT) using direct aspiration first pass technique (ADAPT), stent retriever (SR) alone, or combined thrombectomy (non-ADAPT). We compared outcomes between ADAPT and non-ADAPT strategies for ICA occlusion.</p><p><strong>Materials and methods: </strong>Data were collected from a comprehensive stroke center between January 2019 and August 2024. Patients with intracranial ICA occlusions were divided into ADAPT and non-ADAPT groups. Demographic, clinical, angiographic, and clinical outcomes (National Institute of Health Stroke Scale [NIHSS] score at 24 hours and modified Rankin Scale [mRS] score at 3 months) were compared. Good functional outcome was defined as a mRS score of 0-2.</p><p><strong>Results: </strong>Of 85 patients (mean age, 75 years; 47% females), 60 (70.6%) received ADAPT and 25 (29.4%) non-ADAPT (18 with aspiration and SR combined and 7 with SR alone). ADAPT achieved successful recanalization with shorter procedure time (median, 32 minutes vs. 60 minutes, P=0.001), higher modified Treatment In Cerebral Ischemia (mTICI) recanalization rates (final mTICI 2c-3, 75% vs. 52%; P=0.038; mTICI 2b-3, 98.3% vs. 88%; P=0.074), and better outcomes at 3 months (mRS ≤2, 47% vs. 22%; P=0.039). Multivariate analysis showed NIHSS at discharge as the only significant predictor of good functional outcome at 3 months (odds ratio [OR] 0.68, P<0.001), while ADAPT exhibited a trend toward significance (OR 5.10, P=0.075).</p><p><strong>Conclusion: </strong>ADAPT exceeded other strategies for intracranial ICA occlusion as first-line technique, achieving faster recanalization and potentially impacting long-term functional outcome.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":"21 1","pages":"6-18"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12960034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276726","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":"Expanding Precision in Endovascular Stroke Therapy: Thrombectomy Technique Refinement and Preventive Intervention in Contemporary Neurointervention.","authors":"Jang-Hyun Baek","doi":"10.5469/neuroint.2026.00101","DOIUrl":"10.5469/neuroint.2026.00101","url":null,"abstract":"","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"1-3"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12960033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100513","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":"Reflecting on EACoN in Conjunction with KCNI 2025: A Milestone in East Asian Collaboration.","authors":"Lee Hwangbo, Hae Woong Jeong, Sangil Suh","doi":"10.5469/neuroint.2026.00038","DOIUrl":"10.5469/neuroint.2026.00038","url":null,"abstract":"","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"4-5"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12960031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146181422","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":"No Sleep 'Til TICI 3: Propaganda as Graphic Medicine.","authors":"Hesham Elmiselhy Masoud","doi":"10.5469/neuroint.2025.01277","DOIUrl":"10.5469/neuroint.2025.01277","url":null,"abstract":"","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"58-61"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12960032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125269","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":"Retrograde Woven EndoBridge Deployment for a Posterior Communicating Artery Aneurysm after Failed Flow Diverter Treatment: A Case Report.","authors":"Jun Tanabe, Ichiro Nakahara, Kenichi Haraguchi, Akiko Hasebe, Yoko Kato","doi":"10.5469/neuroint.2025.00822","DOIUrl":"10.5469/neuroint.2025.00822","url":null,"abstract":"<p><p>We report a case of a patient in their 60s with a recurrent posterior communicating artery (PCOM) aneurysm after flow diverter (FD) placement, in whom the antegrade approach was not suitable due to coverage of the aneurysmal neck by the prior FD. Given the dominant configuration of the PCOM and the presence of a narrow but patent P1 segment, a retrograde approach via the posterior circulation was considered feasible. After confirming clinically acceptable flow from the vertebrobasilar system, a Woven EndoBridge (WEB) device was successfully deployed into the aneurysmal sac through the P1-PCOM route, intentionally covering the PCOM origin. Postoperative angiography showed stagnation of flow within the aneurysm, and complete occlusion was confirmed on follow-up angiography at 3 months. This case highlights the potential utility of retrograde WEB deployment for recurrent PCOM aneurysms following FD placement, particularly when PCOM occlusion is acceptable and anatomical access permits.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"175-179"},"PeriodicalIF":1.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12585932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308655","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}