Neurointervention最新文献

{"title":"Fully Reversible Contrast-Induced Encephalopathy Mimicking Stroke after Flow Diverter Treatment of Carotid Cave Aneurysm.","authors":"Elie Diamandis,&nbsp;Vanessa M Swiatek,&nbsp;Daniel Behme","doi":"10.5469/neuroint.2022.00353","DOIUrl":"https://doi.org/10.5469/neuroint.2022.00353","url":null,"abstract":"<p><p>Contrast-induced encephalopathy (CIE) is a rare complication of coronary and neurointerventional procedures. The condition is believed to arise from endothelial damage secondary to exposure to iodinated contrast media. A wide spectrum of clinical manifestations has been reported including seizures, cortical blindness, and focal neurological deficits. This report details the case of fully reversible CIE mimicking severe anterior circulation stroke in a 55-year-old female following elective endovascular treatment with a flow diverter of a carotid cave aneurysm. The patient was managed conservatively with intravenous hydration and steroids and showed an excellent prognosis with supportive management.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":"18 1","pages":"58-62"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3c/2d/neuroint-2022-00353.PMC9986354.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9417547","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":"Fracture of a Flow Diverter in the Cervical Internal Carotid Artery Due to Eagle Syndrome.","authors":"Johannes A R Pfaff,&nbsp;Friedrich Weymayr,&nbsp;Monika Killer-Oberpflazer","doi":"10.5469/neuroint.2022.00409","DOIUrl":"https://doi.org/10.5469/neuroint.2022.00409","url":null,"abstract":"<p><p>In Eagle syndrome, elongated styloid processes may provoke internal carotid dissection and pseudoaneurysm causing stroke and data regarding possible complications or long-term results of pseudoaneurysm treatment using a flow diverter are limited. We report a case of a dissection-related pseudoaneurysm in the left cervical carotid artery treated by implantation of a flow diverter. Follow-up imaging of the flow diverter showed fracture of a continuous radiopaque marker at 3 months and fracture of a second continuous radiopaque marker at 7 months, while contrasting of the vessel was preserved. At the time of angiographic control (8 months after implantation), the flow diverter and the extracranial left internal carotid artery were occluded, and the patient did not experience any symptoms throughout the period.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":"18 1","pages":"72-75"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/51/e8/neuroint-2022-00409.PMC9986348.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10856856","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":"PHIL and Squid Embolization of Cerebral Arteriovenous Malformation: A Retrospective Case Series of 23 Patients.","authors":"Eric Yuk Hong Cheung,&nbsp;Rebecca Yuen Ting Ng,&nbsp;Simon Chun Ho Yu,&nbsp;James Tin Fong Zhuang,&nbsp;George Kwok Chu Wong","doi":"10.5469/neuroint.2022.00199","DOIUrl":"https://doi.org/10.5469/neuroint.2022.00199","url":null,"abstract":"<p><p>Precipitating hydrophobic injectable liquid (PHIL; MicroVention, Aliso Viejo, CA, USA) and Squid (Balt, Irvine, CA, USA) are 2 newer liquid embolic agents used in endovascular embolization of cerebral arteriovenous malformation (AVM). This study aims to investigate and compare the effectiveness and safety profile of the 2 newer liquid embolic agents in the embolization of cerebral AVM. This is a retrospective study on all patients diagnosed with cerebral AVM undergoing endovascular embolization with liquid embolic agents PHIL and Squid admitted to the Division of Neurosurgery, Department of Surgery in Prince of Wales Hospital from January 2014 to June 2021. Twenty-three patients with cerebral AVM were treated with 34 sessions of endovascular embolization with either PHIL or Squid (17 sessions each) liquid embolic agents with a male to female ratio of 2.3:1 (male 16; female 7) and mean age of 44.6 (range, 12 to 67). The mean total nidus obliteration rate per session was 57% (range, 5% to 100%). Twenty-one patients (91.3%) received further embolization, stereotactic radiosurgery, or surgical excision after initial endovascular embolization. There were 2 morbidities (1 neurological and 1 non-neurological, 6%) and no mortalities (0%). All patients had static or improvement in modified Rankin Scale at 3 to 6 months at discharge. PHIL and Squid are effective and safe liquid embolic agents for endovascular embolization of cerebral AVM, achieving satisfactory nidal obliteration rates and patient functional outcomes.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":"17 3","pages":"174-182"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/99/ba/neuroint-2022-00199.PMC9626609.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33448237","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":"Intracranial Artery Stenosis in Young Men Related to Habitual Periodic Cigarette Smoking in a Closed Space: Could It Be a New Syndrome?","authors":"Dae Chul Suh","doi":"10.5469/neuroint.2022.00290","DOIUrl":"https://doi.org/10.5469/neuroint.2022.00290","url":null,"abstract":"Cerebrovascular disease (stroke) is decreasing in tendency and is the 4th leading cause of death in 2020 in Korea, after cancer, cardiac disease, and pneumonia, which are all increasing in tendency. Racial differences between Asians and Caucasians have been suggested to explain the distribution of cerebral atherosclerosis. Angiographic and autopsy studies in stroke patients have shown that Asians tend to have more intracranial vascular occlusions, whereas whites tend to have more extracranial lesions. This difference tends to be more definite and statistically significant when a single severe stenosis is present. Cigarette smoking (CS) is a major risk factor for cerebral atherosclerotic disease. Intracranial atherosclerotic stenosis is thought to be more prevalent among young smokers with angiographically-confirmed symptomatic severe atherosclerotic stenosis. The overall smoking rate in Korea was 20.6% in 2020 and has continuously decreased in tendency year by year. Males showed a much higher rate of 34.0% than females (6.6%) in 2020. Younger males with 19–49 years of age showed a higher smoking rate, revealing that the forties showed the highest smoking rate, and then a decreasing tendency in even older males. A study in healthy young men showed a significant decrease in cerebral flow rate after CS, especially in the anterior circulation. Considering the changes in flow velocity and cross-sectional area in cerebral arteries, it could be suggested that cerebrovascular impedance increased after CS, especially at the main trunk level of the distal intracranial vessels. A single intracranial artery stenosis, especially in M1 segment, has been found in the relatively young males who have been exposed to a habitual and periodic heavy smoking atmosphere in a closed space. Those patients could not reveal any other specific risk factors for atherosclerosis except smoking. Habitual and periodic smoking in a closed room is often related to gambling once or twice a month, night duty at work, or overnight condolences for the deceased as with a traditional Korean funeral process (Fig. 1). Such intracranial stenotic lesions may improve after proper medication, including antiplatelet agents or even angioplasty, without requiring intracranial stenting, which was a relatively common procedure in Korea.","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"131-132"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6b/2b/neuroint-2022-00290.PMC9626614.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40539227","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":"Double-Balloon-Assisted Coiling for Wide-Necked Posterior Communicating Artery Aneurysms with a Fetal-Type Variant of the Posterior Cerebral Artery: A Case Series.","authors":"Yasuhiko Nariai,&nbsp;Tomoji Takigawa,&nbsp;Akio Hyodo,&nbsp;Kensuke Suzuki","doi":"10.5469/neuroint.2022.00276","DOIUrl":"https://doi.org/10.5469/neuroint.2022.00276","url":null,"abstract":"<p><p>Endovascular treatment for wide-necked posterior communicating artery (PcomA) aneurysms with a fetal-type variant of the posterior cerebral artery (PCA) is often challenging. Since the complete occlusion rates achieved with the currently available treatment methods are unsatisfactory, we aimed to study the effectiveness of a double-balloon-assisted technique for these aneurysms. From September 2014 to August 2020, 6 consecutive patients with PcomA aneurysms with fetal-type PCAs and no previous treatment were treated with this technique at our institution (3 ruptured cases and 3 unruptured cases). The indication for this technique is that the neck of the aneurysm should significantly and broadly incorporate both the internal carotid artery and fetal-type PCA, such that a single-balloon remodeling and single stent would be inadequate to protect both the arteries. In all patients, the fetal-type PCAs were preserved without a stent and with adequate occlusion status. This double-balloon technique can be effective in the treatment of these aneurysms.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"183-189"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/16/a1/neuroint-2022-00276.PMC9626608.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40333790","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 of Arterial Steno-Occlusive Lesions in Symptomatic Moyamoya Disease.","authors":"Jae-Chan Ryu,&nbsp;Yun Hyeok Choi,&nbsp;Mi Hyeon Kim,&nbsp;Eun Ji Moon,&nbsp;Youngjin Kim,&nbsp;Boseong Kwon,&nbsp;Yunsun Song,&nbsp;Deok Hee Lee","doi":"10.5469/neuroint.2022.00332","DOIUrl":"https://doi.org/10.5469/neuroint.2022.00332","url":null,"abstract":"<p><p>The efficacy and safety of endovascular treatment (EVT) for moyamoya disease (MMD) have rarely been investigated. The objective of this study was to summarize the clinical outcomes of EVT for MMD and determine the potential role of EVT in treating symptomatic steno-occlusive lesions in MMD. Reports from January 2000 to December 2021 describing EVT in MMD were collected through a literature search. The search terms included \"moyamoya\", \"stent\", \"angioplasty\", and \"endovascular\". Data regarding baseline demographics, previous medical history, treated vessel, periprocedural complications, and angiographical recurrence were retrieved. This review included 10 studies with details of 19 patients undergoing a total of 31 EVT procedures. Twenty-one EVTs were performed as initial treatments for MMD, and 10 were performed as additional treatments for angiographical recurrence. The mean follow-up period of the initial EVTs was 9.0±11.9 months, with angiographical recurrence in 11 (68.8%) cases. The mean follow-up period of additional EVTs was 4.3±3.9 months, and seven (70.0%) EVTs showed restenosis of the re-treated vessel. Across all initial and additional EVTs, there were no differences in characteristics between the recurrence and non-recurrence groups. Overall, two periprocedural complications (9.5%) occurred, one vessel rupture and one massive intracerebral hemorrhage with subarachnoid hemorrhage. EVT plays a limited role in the management of symptomatic intracranial arterial steno-occlusive lesions of MMD. Recent advances in understanding the pathomechanism of MMD may urge neuro-interventionists to find a new endovascular approach with better balloon angioplasty or stenting mechanisms.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":"17 3","pages":"161-167"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e1/d5/neuroint-2022-00332.PMC9626607.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33500995","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":"National Trends in Medical Costs and Prognosis of Acute Ischemic Stroke Patients in Endovascular Thrombectomy Era: Analysis Using Medical Claim Data in Korea.","authors":"Woo Sang Jung,&nbsp;Kwon-Duk Seo,&nbsp;Sang Hyun Suh","doi":"10.5469/neuroint.2022.00234","DOIUrl":"https://doi.org/10.5469/neuroint.2022.00234","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate trends in medical costs and prognosis in acute ischemic stroke (AIS) patients in Korea from 2008 to 2017 using medical claims data.</p><p><strong>Materials and methods: </strong>All data for the past decade was collected from a big data hub provided by the Health Insurance Review & Assessment Service. Using several Korean Standard Classification of Disease codes, we estimated the number of patients, the costs of medical insurance, and prognosis according to the treatment with or without endovascular thrombectomy (EVT) among in-patients with AIS.</p><p><strong>Results: </strong>Since 2014, when EVT was covered by insurance, the number of patients who underwent EVT for AIS has increased significantly. Also, in the past decade, the medical costs following inpatient care for AIS with EVT have increased gradually, and the overall medical costs for the first year post-stroke have also increased. The prognosis of AIS patients with EVT was different according to the time of treatment. Annual trends for both mortality and cerebral hemorrhage after treatment of AIS with EVT have gradually decreased.</p><p><strong>Conclusion: </strong>In this study, we found that both inpatient medical costs and 1-year cumulative medical costs have gradually increased, and the prognosis has gradually improved in patients receiving EVT treatment among AIS patients.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"152-160"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1b/3f/neuroint-2022-00234.PMC9626611.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40718851","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":"Mechanical Thrombectomy for Acute Ischemic Stroke due to Thrombus in the Pulmonary Vein Stump after Left Pulmonary Lobectomy: A Case Series.","authors":"Yuichiro Tsuji,&nbsp;Ryokichi Yagi,&nbsp;Ryo Hiramatsu,&nbsp;Masahiko Wanibuchi","doi":"10.5469/neuroint.2022.00367","DOIUrl":"https://doi.org/10.5469/neuroint.2022.00367","url":null,"abstract":"<p><p>Cerebral embolic stroke caused by a thrombus in the pulmonary vein stump after left pulmonary lobectomy is a serious complication. We retrospectively analyzed four patients who underwent mechanical thrombectomy for large-vessel occlusion after left pulmonary lobectomy between January 2014 and March 2022. Two cases occurred after left upper lobectomy and the others occurred after left lower lobectomy. All patients presented with cerebral embolic stroke from the day after surgery to the 9th postoperative day, and successful reperfusion was achieved in all cases. Two patients had good outcomes at 90 days. Thrombus in the pulmonary vein stump is the probable cause of cerebral embolism, and mechanical thrombectomy is effective. Further studies are required to establish preventive measures and perioperative management strategies.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"168-173"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2b/f2/neuroint-2022-00367.PMC9626613.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40382910","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":"Mechanical Thrombectomy for Septic Embolism Secondary to Staphylococcus lugdunensis Bacteremia without Infective Endocarditis: A Case Report.","authors":"Anthony Vinh Phuc Nguyen,&nbsp;Samuel Richard Daly,&nbsp;Buqing Liang,&nbsp;Walter Scherbaum Lesley","doi":"10.5469/neuroint.2022.00318","DOIUrl":"https://doi.org/10.5469/neuroint.2022.00318","url":null,"abstract":"<p><p>A cerebral large vessel occlusion due to septic embolism with resultant stroke is a known complication of infective endocarditis and can cause severe neurologic disability. However, septic embolism rarely occurs in the absence of infective endocarditis, and emboli due to different organisms may behave differently. As such, it is important to recognize the different pathogens that can cause septic embolism resulting in cerebral large vessel occlusion and to have data on successful treatments. We describe here a case of mechanical thrombectomy for septic embolism secondary to Staphylococcus lugdunensis bacteremia without infective endocarditis.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"190-194"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3b/d1/neuroint-2022-00318.PMC9626615.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40718794","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 Effectiveness of the Novel Catheter 3.0 System for Diagnostic Cerebral Angiography: A Pilot Study.","authors":"Boseong Kwon,&nbsp;Ki Baek Lee,&nbsp;Jong-Tae Yoon,&nbsp;Joon Ho Choi,&nbsp;Deok Hee Lee,&nbsp;Yunsun Song","doi":"10.5469/neuroint.2022.00248","DOIUrl":"https://doi.org/10.5469/neuroint.2022.00248","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate the safety and effectiveness of a new angiographic system (Catheter 3.0 system) using a 5 French (Fr), large-bore angiography catheter, a 0.032-inch stiff guidewire, and a continuous flushing system in diagnostic cerebral angiography.</p><p><strong>Materials and methods: </strong>This retrospective study included 30 consecutive patients who underwent transfemoral cerebral angiography using the Catheter 3.0 system from October 2019 to March 2020. As the control group, we included 30 consecutive patients examined before the Catheter 3.0 system was introduced. Procedural outcomes, including technical success, procedure time, dose metrics, procedure-related complications, and image quality were reviewed and analyzed.</p><p><strong>Results: </strong>All transfemoral cerebral angiographies were performed for a diagnosis of unruptured intracranial aneurysms. The Catheter 3.0 system showed a significantly shorter fluoroscopy time (6.2 vs. 9.7 minutes, P=0.008) and lower fluoroscopy dose (387.2 vs. 614.4, P=0.002) compared with the conventional 4-Fr catheter system. The Catheter 3.0 system also showed better results in terms of procedural time (21.0 vs. 22.5 minutes, P=0.072) and technical success rate (98.1% vs. 94.0%, P=0.078), although a statistical significance was not reached. The complication rate and qualitative assessment of the digital subtraction angiography (DSA) image quality were similar between the two groups.</p><p><strong>Conclusion: </strong>The Catheter 3.0 system using a 5 Fr catheter with a large inner diameter was convenient, effective, and safe compared with the conventional system in diagnostic cerebrovascular angiography.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":" ","pages":"143-151"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/db/6d/neuroint-2022-00248.PMC9626612.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40638478","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}