Neurointervention最新文献

{"title":"Clinical Manifestation and Radiologic Patterns of Spontaneous Cervicocephalic Dissection According to the Anatomic Location: A Single-Center Analysis in Korean Patients","authors":"Yunsun Song, Sang Ik Park, P. Budianto, B. Kwon, D. Suh","doi":"10.5469/neuroint.2022.00143","DOIUrl":"https://doi.org/10.5469/neuroint.2022.00143","url":null,"abstract":"Purpose Spontaneous cervicocephalic dissection (SCAD) is an important cause of stroke and shows various lesion locations and clinical features. The purpose of this study was to analyze the location of SCAD and its clinical and radiologic patterns in Korean patients. Materials and Methods Patients with SCAD who were evaluated between 2013 and 2018 at a tertiary center in Korea were reviewed. We classified and compared the morphological (aneurysm or steno-occlusion) and presenting (hemorrhage or infarction) patterns according to the lesion locations (anterior circulation [AC] vs. posterior circulation [PC]; intradural [ID] vs. extradural [ED]). Results A total of 166 patients were included in this study. The SCAD most commonly occurred in the PC-ID location (65.1%), followed by AC-ID (13.3%), AC-ED (13.3%), and PC-ED (8.4%). Aneurysm and steno-occlusion patterns were observed in 66.9% and 57.8% of the cases, respectively. The aneurysm pattern was significantly more common in the PC-ID location (78.7%) than in other locations. As for the presenting pattern, cerebral infarction was the most common pattern (39.8%), and intracranial hemorrhage was observed only in the ID location (7.2%). Conclusion In Korean patients, PC-ID, especially ID vertebral artery, was the most common location of SCAD, and most cases were accompanied by an aneurysm. It also suggested that these location trends differ by population or ethnicity.","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77554271","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":"Delayed Rupture of an Anterior Communicating Artery Pseudoaneurysm Caused by Distal Occlusion Thrombectomy Using a Stent Retriever: A Case Report and Mechanism of Injury","authors":"D. Shim, Youngrok Do, J. Do, S. Youn","doi":"10.5469/neuroint.2022.00101","DOIUrl":"https://doi.org/10.5469/neuroint.2022.00101","url":null,"abstract":"We report a case of delayed rupture of an anterior communicating artery (Acom) pseudoaneurysm following mechanical thrombectomy (MT) of a distal artery occlusion using a stent retriever. An elderly patient with right hemiparesis showed left proximal internal cerebral artery and middle cerebral artery occlusions. During MT, a fragmented thrombus moved to the anterior cerebral artery (ACA). A stent retriever was deployed to the occluded ACA, and the Acom and proximal ACA segment were significantly straightened. Additionally, we attempted a blind exchange mini-pinning (BEMP) technique, but a subarachnoid hemorrhage (SAH) occurred. Bleeding was almost entirely absorbed 9 days after the procedure, but the SAH recurred at 20 days, and computed tomography angiography revealed a new pseudoaneurysm formation in the Acom. We suggest that the proposed mechanism of pseudoaneurysm formation was likely due to the dislocation and avulsion of the Acom perforators when the ipsilateral ACA was pushed and pulled during MT.","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87295195","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":"The Use of a Pipeline Embolization Device for Treatment of a Ruptured Dissecting Middle Cerebral Artery M3/M4 Aneurysm: Challenges and Technical Considerations","authors":"Robert P. Berwanger, Madeline Hoover, J. Scott, A. Denardo, K. Amuluru, T. Payner, C. Kulwin, D. Sahlein","doi":"10.5469/neuroint.2022.00045","DOIUrl":"https://doi.org/10.5469/neuroint.2022.00045","url":null,"abstract":"Prompt, effective treatment is necessary following aneurysmal subarachnoid hemorrhage to prevent recurrent rupture, which is thought to double mortality. Atypical ruptured aneurysms, such as blister or dissecting pseudoaneurysms, or those that are unusually distal in the middle cerebral artery (MCA) are challenging to treat with either open or endovascular options, though the pipeline embolization device (PED) has shown promise in multiple case series. We present a case of a ruptured dissecting pseudoaneurysm in the distal MCA (distal M3/proximal M4) prefrontal division in an healthy young patient (<60 years) successfully treated with a PED. The PED was chosen both as the only vessel sparing option in the young patient as well as for its potential as a vessel sacrifice tool if the pseudoaneurysm was felt to be incompletely treated, which in this case was not necessary—though would have leveraged the thrombogenicity of the device as a therapeutic advantage.","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87333931","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":"Retrieval of Displaced Woven EndoBridge Intrasaccular Flow Disruptor Using Solitaire Platinum Revascularization Device","authors":"Ramon Martin Francisco Bañez, W. Chong","doi":"10.5469/neuroint.2022.00059","DOIUrl":"https://doi.org/10.5469/neuroint.2022.00059","url":null,"abstract":"The Woven EndoBridge (WEB; MicroVention, Aliso Viejo, CA, USA) intrasaccular flow disruptor is a therapeutic option for wide neck bifurcation intracranial aneurysms that does not require the use of adjunctive techniques such as stents or balloon remodeling. As with other endovascular devices, displacement of the WEB is a recognized complication. Few reports have been published regarding the management of this type of complication. We describe a case of retrieval of a displaced WEB using a Solitaire Platinum revascularization device (Medtronic, Minneapolis, MN, USA). Interventionists should be aware of this option in the management of such a complication.","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74900526","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":"Transradial Approach for Thoracolumbar Spinal Angiography and Tumor Embolization: Feasibility and Technical Considerations","authors":"M. Caton, E. Smith, A. Baker, C. Dowd, R. Higashida","doi":"10.5469/neuroint.2022.00010","DOIUrl":"https://doi.org/10.5469/neuroint.2022.00010","url":null,"abstract":"The transradial approach (TRA) is an effective and safe alternative to transfemoral access for diagnostic neuroangiography and craniocervical interventions. While the technical aspects of supraclavicular intervention are well-described, there are little data on the TRA for thoracolumbar angiography and intervention. The authors describe the feasibility of the TRA for preoperative thoracic tumor embolization, emphasizing technique, device selection, navigation, and catheterization of thoracolumbar segmental arteries. This approach extends the benefits of TRA to spinal interventional neuroradiology.","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86207821","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":"Subsequent Subarachnoid Hemorrhage from Clinically Unrelated Vertebral Artery Dissection after Thrombolytic Therapy.","authors":"Min-Jeong Bae,&nbsp;Sam Yeol Ha","doi":"10.5469/neuroint.2021.00458","DOIUrl":"https://doi.org/10.5469/neuroint.2021.00458","url":null,"abstract":"<p><p>Thrombolysis administration poses certain safety issues in ischemic stroke patients with cerebrovascular changes that are vulnerable to hemorrhage. Furthermore, the lack of related studies has resulted in an unclear understanding of thrombolysis safety in ischemic stroke patients with intracranial dissection, including those involving the vertebral artery. This study describes a case of a 59-year-old female who developed subarachnoid hemorrhage from clinically unrelated vertebral artery dissection after thrombolysis. Histories of severe headache with posterior fossa involvement in patients receiving thrombolytic therapy may indicate careful assessment for intracranial vertebral artery dissection, even if the clinical picture of the patient suggests another arterial syndrome.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ab/4d/neuroint-2021-00458.PMC8891590.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39689543","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":"Idiopathic Intracranial Hypertension in Asians: A New Perspective and the Need for Scrutiny.","authors":"Ki Baek Lee,&nbsp;Soo Jeong,&nbsp;Deok Hee Lee","doi":"10.5469/neuroint.2021.00507","DOIUrl":"https://doi.org/10.5469/neuroint.2021.00507","url":null,"abstract":"While reviewing the clinical settings of typical idiopathic intracranial hypertension (IIH), we found that there was a gap between the reports from Western countries and our domestic clinical experience. The typical description of IIH is as follows: a rare condition of unknown cause, which causes increased intracranial pressure (ICP), and is characterized by symptoms related to increased ICP, especially in young obese females aged 25–45 years. Furthermore, they suggested that a reason for the recent increase in disease incidence in Western society was probably due to the rapid increase in the obese population. In our clinical experience, however, we seldom experience morbid obesity in IIH patients, the trend of which seems a little different from typical reports so far. Although we read a case report published in 2018 by Miyachi et al. with interest several years ago, we failed at the time to pay attention to the body habitus of 2 young Japanese female patients described in the report. One patient was a 27-year-old female (165 cm, 48 kg), and the other was a 17-yearold young female (163 cm, 54 kg). Their body-mass indices were 17.6 kg/m and 20.3 kg/m, respectively. The authors had already mentioned in the report that some other etiology of IIH apart from obesity must be present. This observation suggests the need for having an Asian perspective in the management of medically refractory IIH patients. Since the control of other risk factors of increased ICP is a prerequisite for the long-term durability of a stenting procedure, they emphasized the importance of persistent weight control and management of other risk factors, including obstructive sleep apnea. In reports from Western countries, the importance of weight control has been emphasized for the long-term durability of initially responsive dural sinus stenting. Even bariatric surgery is considered in a refractory situation. However, measures to be taken for Asian patients, who are not overweight or may essentially be underweight, are unclear. Although Miyachi et al. reported a good initial clinical response in both Asian patients, we believe they should follow up these 2 patients in the long term since dural sinus stenting is not a curative treatment for IIH. Since stenting of a collapsed sinus lumen only helps cut the vicious cycle of increased ICP, which is aggravated by secondary venous hypertension caused by extrinsic compression of the sinus, the risk of consecutive sinus lumen colCorrespondence to: Deok Hee Lee, MD, PhD Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-5944 Fax: +82-2-476-0090 E-mail: dhlee@amc.seoul.kr","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b4/7b/neuroint-2021-00507.PMC8891586.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39907009","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":"Central Venous Reflux, a Rare Cause of Neurological Manifestations in Hemodialysis Patients: A Case Report and Literature Review.","authors":"Francisco Caiza-Zambrano,&nbsp;Carolina Mora Palacio,&nbsp;Silvia Garbugino,&nbsp;Fabio Maximiliano Gonzalez,&nbsp;Marta Bala Biolcati,&nbsp;Miguel Ángel Saucedo,&nbsp;Carlos Rugilo,&nbsp;Mariano Forrester,&nbsp;Fernando Lombi,&nbsp;Manuel Fernández Pardal,&nbsp;Ricardo Reisin,&nbsp;Pablo Bonardo","doi":"10.5469/neuroint.2021.00444","DOIUrl":"https://doi.org/10.5469/neuroint.2021.00444","url":null,"abstract":"<p><p>Central venous disease (CVD) is a serious complication in hemodialysis patients. Neurological manifestations are rare. We describe a female with end-stage renal disease with throbbing headache accompanied by paresthesia, weakness, and abnormal posture of her right hand during dialysis sessions. Motor symptoms completely resolved after each dialysis session, although the headaches persisted for several hours. No neurological deficit was evidenced on physical examination. Digital subtraction angiography identified an incomplete thrombosis of the left brachiocephalic vein with retrograde flow in the internal jugular vein, sigmoid sinus, and transverse sinus on the left side. This case illustrates that cerebral venous congestion due to CVD can produce neurological symptoms. Furthermore, we systematically review the literature to identify the characteristics of the cases described so far. This allows clinicians to know the entity and have a high index of suspicion in a hemodialysis patient who develops neurological symptoms.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5b/40/neuroint-2021-00444.PMC8891583.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39819659","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":"Comparison of Visual Outcomes of Ophthalmic Artery Aneurysms Treated with Microsurgical Clipping and Endovascular Coiling.","authors":"Guangdong Lu,&nbsp;Jaewoo Chung,&nbsp;Jung Cheol Park,&nbsp;Jae Sung Ahn,&nbsp;Byung Duk Kwun,&nbsp;Deok Hee Lee","doi":"10.5469/neuroint.2020.00185","DOIUrl":"https://doi.org/10.5469/neuroint.2020.00185","url":null,"abstract":"<p><strong>Purpose: </strong>Post-treatment visual deficit is a major concern associated with both microsurgical clipping and endovascular coiling for the treatment of ophthalmic artery (OphA) aneurysms of the internal carotid artery. We aimed to compare the safety and effectiveness of the 2 modalities.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed and compared the baseline characteristics and postoperative visual and angiographic outcomes of OphA aneurysms treated by clipping or coiling between January 2010 and August 2018 at our hospital. In addition, the balloon occlusion test was performed to evaluate the safety of OphA occlusion.</p><p><strong>Results: </strong>This study included 56 aneurysms treated by clipping and 82 aneurysms treated by coiling. Both the immediate and follow-up rates of incomplete aneurysm occlusion were comparable between the 2 groups (21.4% vs. 22.0%; 24.4% vs. 23.6%). The incidence of post-treatment visual deficits was higher in the clipping group than in the coiling group (16.1% vs. 2.4%; P=0.010). We observed total ipsilateral OphA occlusion in 6 patients and near occlusion in 3 patients during endovascular coiling; however, only 1 patient with near OphA occlusion showed a post-treatment visual field defect.</p><p><strong>Conclusion: </strong>OphA aneurysms treated by endovascular coiling exhibited an aneurysm occlusion rate similar to that of microsurgical clipping with fewer post-treatment visual deficits. The total occlusion of OphA with adequate collaterals did not cause post-treatment visual deficits.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/01/f3/neuroint-2020-00185.PMC8891588.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39832476","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 Device for the Treatment of Intracranial Aneurysms: Initial Clinical Experience within an Australian Population.","authors":"Jay Gajera,&nbsp;Julian Maingard,&nbsp;Michelle Foo,&nbsp;Yifan Ren,&nbsp;Anthony Lamanna,&nbsp;Daniel Nour,&nbsp;Jonathan Hall,&nbsp;Dylan Kurda,&nbsp;David Tan,&nbsp;Shivendra Lalloo,&nbsp;Ramon Martin Francisco Bañez,&nbsp;Jeremy Russell,&nbsp;Lee-Anne Slater,&nbsp;Ronil Vikesh Chandra,&nbsp;Winston Chong,&nbsp;Ashu Jhamb,&nbsp;Duncan Mark Brooks,&nbsp;Hamed Asadi","doi":"10.5469/neuroint.2021.00430","DOIUrl":"https://doi.org/10.5469/neuroint.2021.00430","url":null,"abstract":"<p><strong>Purpose: </strong>Advances in endovascular technology have expanded the treatment options for intracranial aneurysms. Intrasaccular flow diversion is a relatively new technique that aims to disrupt blood inflow at the neck of the aneurysm, hence promoting intrasaccular thrombosis. The Woven EndoBridge device (WEB; MicroVention, Aliso Viejo, CA, USA) is an US Food and Drug Administration approved intrasaccular flow diverter for wide-necked aneurysms. We report the early interim clinical and radiological outcomes of patients with both ruptured and unruptured intracranial aneurysms (IAs) treated using the WEB device in an Australian population.</p><p><strong>Materials and methods: </strong>A retrospective analysis was done of patients with ruptured or unruptured IAs who received treatment with WEB across 5 Australian neuroendovascular referral centers between May 2017 and November 2020. Angiographic occlusion was assessed with time-of-flight magnetic resonance angiography. Complications were recorded and clinical outcomes were assessed using the modified Rankin scale at follow-up.</p><p><strong>Results: </strong>In total, 66 aneurysms were treated in 63 patients, with successful deployment of the WEB device in 98.5% (n=65). Eighteen (26.9%) ruptured aneurysms were included. Failure of deployment occurred in a single case. Adjunct coiling and/or stenting was performed in 20.9% (n=14) cases. Sixty-two patients with 65 aneurysms using a WEB device were followed up (mean=9.1 months), and 89.4% of these had complete aneurysm occlusion while 1.5% remained patent. Functional independence was achieved in 93.5% of cases.</p><p><strong>Conclusion: </strong>Early results following the use of WEB devices in Australia demonstrate safety and adequate aneurysm occlusion comparable to international literature.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/73/30/neuroint-2021-00430.PMC8891585.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39759519","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}