Neurointervention最新文献

{"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}

{"title":"Snowballing Technique for High Flow Arteriovenous Fistula: A Technical Note.","authors":"Riyadh Nasser Alokaili,&nbsp;Hesham Riyadh Alokaili,&nbsp;Mohammad F Badran,&nbsp;Homoud Abdulaziz Aldahash,&nbsp;Shagran M Binkhamis","doi":"10.5469/neuroint.2021.00276","DOIUrl":"https://doi.org/10.5469/neuroint.2021.00276","url":null,"abstract":"<p><p>A novel endovascular technique to occlude high flow direct arteriovenous fistulae is presented, where the distal tip of the microcatheter acts as a nucleus that the operator can grow a plug from a liquid embolic agent. Its advantages (such as cost-saving and distal reachability), disadvantages (such as embolic material instability), and technique are discussed.</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/ee/9f/neuroint-2021-00276.PMC8891581.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39769733","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":"Usefulness of Self-Expandable Stent for Recanalization of Intracranial Atherosclerotic Disease: Preliminary Experience with Enterprise Stent.","authors":"Woo Sang Jung,&nbsp;Sam-Soo Kim,&nbsp;Kyung-Yul Lee,&nbsp;Sang Hyun Suh","doi":"10.5469/neuroint.2022.00017","DOIUrl":"https://doi.org/10.5469/neuroint.2022.00017","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this preliminary study is to evaluate the efficacy and safety of the Enterprise stent for intracranial atherosclerotic disease (ICAD) in patients who presented with acute stroke due to vessel steno-occlusion and in patients with symptomatic disease despite optimum medical management.</p><p><strong>Materials and methods: </strong>A retrospective data analysis was performed on 15 consecutive patients who were treated with Enterprise stenting for recanalization of symptomatic intracranial steno-occlusive arteries due to underlying ICAD. Their clinical and radiological data were reviewed to evaluate procedural results, periprocedural and postprocedural complications, and clinical outcome.</p><p><strong>Results: </strong>Enterprise stents were deployed as a rescue method in 15 patients for recanalization of steno-occlusion. All patients achieved final modified thrombolysis in cerebral infarction (mTICI) score improvement (53.3% with a mTICI score from 0 to 2b or 3, 46.7% with a mTICI score from 1 to 3). Two postprocedural complications (1 symptomatic intracranial hemorrhage and 1 severe brain edema, 13.3%) occurred among 15 patients. Among 12 patients with acute ischemic stroke (AIS), 6 patients (50%) had improvement in their National Institute of Health Stroke Scale of more than 4 at discharge. Seven patients (58.3%) had a good functional outcome with 3-month modified Rankin Score (mRS)≤2, and mortality occurred (mRS=6) in 2 patients (16.7%). None of the 10 AIS and 3 transient ischemic attack patients experienced further ischemic events attributable to the treated steno-occlusion during the follow-up period (ranged from 4 to 36 months, median 12 months).</p><p><strong>Conclusion: </strong>This retrospective study suggests that Enterprise stenting can effectively and safely achieve recanalization in symptomatic steno-occlusive intracranial arteries.</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/b8/6f/neuroint-2022-00017.PMC8891589.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39937319","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":"Imaging in Acute Anterior Circulation Ischemic Stroke: Current and Future.","authors":"Hyun Jeong Kim, Hong Gee Roh","doi":"10.5469/neuroint.2021.00465","DOIUrl":"10.5469/neuroint.2021.00465","url":null,"abstract":"<p><p>Clinical trials on acute ischemic stroke have demonstrated the clinical effectiveness of revascularization treatments within an appropriate time window after stroke onset: intravenous thrombolysis (NINDS and ECASS-III) through the administration of tissue plasminogen activator within a 4.5-hour time window, endovascular thrombectomy (ESCAPE, REVASCAT, SWIFT-PRIME, MR CLEAN, EXTEND-IA) within a 6-hour time window, and extending the treatment time window up to 24 hours for endovascular thrombectomy (DAWN and DEFUSE 3). However, a substantial number of patients in these trials were ineligible for revascularization treatment, and treatments of some patients were considerably futile or sometimes dangerous in the clinical trials. Guidelines for the early management of patients with acute ischemic stroke have evolved to accept revascularization treatment as standard and include eligibility criteria for the treatment. Imaging has been crucial in selecting eligible patients for revascularization treatment in guidelines and clinical trials. Stroke specialists should know imaging criteria for revascularization treatment. Stroke imaging studies have demonstrated imaging roles in acute ischemic stroke management as follows: 1) exclusion of hemorrhage and stroke mimic disease, 2) assessment of salvageable brain, 3) localization of the site of vascular occlusion and thrombus, 4) estimation of collateral circulation, and 5) prediction of acute ischemic stroke expecting hemorrhagic transformation. Here, we review imaging methods and criteria to select eligible patients for revascularization treatment in acute anterior circulation stroke, focus on 2019 guidelines from the American Heart Association/American Stroke Association, and discuss the future direction of imaging-based patient selection to improve treatment effects.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/27/3b/neuroint-2021-00465.PMC8891584.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39885699","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":"Y Stent Rendezvous to Treat Symptomatic Innominate Artery Stenosis.","authors":"Goran Mitreski,&nbsp;Hamed Asadi,&nbsp;Mark Duncan Brooks","doi":"10.5469/neuroint.2021.00472","DOIUrl":"https://doi.org/10.5469/neuroint.2021.00472","url":null,"abstract":"<p><p>A male in his 60s presented with transient ischemic attacks 5 years after aortic arch branch graft repair for type A aortic dissection. Computed tomographic angiography demonstrated 80% stenosis of the brachiocephalic artery close to the origins of the right common carotid and subclavian arteries. The case was reviewed at our multidisciplinary aortic meeting and a plan for endovascular management was made. Percutaneous endovascular Y stenting from the innominate artery into the left common carotid and subclavian arteries was achieved using self-expanding nitinol stents with a rendezvous technique that included retrograde right radial artery, retrograde right external carotid artery, and retrograde right femoral arterial approaches. At 6 months review, the stents remained widely patent and the patient was symptom-free.</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/c1/20/neuroint-2021-00472.PMC8891582.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39619336","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":"Thanks to the Reviewers of the Neurointervention","authors":"S. Suh","doi":"10.5469/neuroint.2021.00493","DOIUrl":"https://doi.org/10.5469/neuroint.2021.00493","url":null,"abstract":"","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72799412","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":"Use of Distal Intracranial Catheters for Better Working View of Cerebral Aneurysms Hidden by Parent Artery or Its Branches: A Technical Note.","authors":"Ehab Mahmoud,&nbsp;Samuel Lenell,&nbsp;Christoffer Nyberg,&nbsp;Ljubisa Borota","doi":"10.5469/neuroint.2021.00269","DOIUrl":"https://doi.org/10.5469/neuroint.2021.00269","url":null,"abstract":"<p><p>A good working view is critical for safe and successful endovascular treatment of cerebral aneurysms. In a few cases, endovascular treatment of cerebral aneurysms may be challenging due to difficulty in obtaining a proper working view. In this report of 6 cases, we described the advantage of using a distal intracranial catheter (DIC) to achieve better visualization of cerebral aneurysms hidden by a parent artery or its branches. Between September 2017 and January 2021, we treated 390 aneurysms with endovascular techniques. In 6 cases in which it was difficult to obtain a proper working view, the DIC was placed distally close to the aneurysm in order to remove the parent artery projection from the working view and obtain better visualization of the aneurysm. Clinical and procedural outcomes and complications were evaluated. The position of the DIC was above the internal carotid artery siphon in the 6 cases. All aneurysms were successfully embolized. Raymond-Roy class 1 occlusion was achieved in all 4 unruptured aneurysms, while the result was class 2 in the 2 ruptured aneurysms. Placement of the DIC was atraumatic without dissections or significant catheter-induced vasospasm in all patients. Transient dysphasia was seen in 2 cases and transient aphasia in 1. Using this technique, we have found it possible to better visualize the aneurysm sac or neck and thereby treat cases we otherwise would have considered untreatable.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e0/2b/neuroint-2021-00269.PMC8561035.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39490086","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":"Cascade of Complications Following Carotid Body Tumor Excision.","authors":"Pawan K Garg,&nbsp;Sarbesh Tiwari,&nbsp;Tushar S Ghosh,&nbsp;Surendra Patel,&nbsp;Ankur Sharma,&nbsp;Pushpinder S Khera","doi":"10.5469/neuroint.2021.00248","DOIUrl":"https://doi.org/10.5469/neuroint.2021.00248","url":null,"abstract":"<p><p>Carotid body tumor excision can lead to various complications including vascular injury and pseudoaneurysm formation. Here we describe a case of carotid body tumor excision followed by series of complications including pseudoaneurysm formation, failure of primary surgical repair, carotid stump syndrome following parent artery occlusion, and persistent hypotension.</p>","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e2/26/neuroint-2021-00248.PMC8561026.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39466116","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":"Fund Correction: Unrecognized Ruptured Intracranial Aneurysm Presenting as Cerebral Vasospasm-Induced Ischemic Stroke: A Case Report.","authors":"Joong-Goo Kim,&nbsp;Chul-Hoo Kang,&nbsp;Jay Chol Choi,&nbsp;Jong-Kook Rhim","doi":"10.5469/neuroint.2021.00017.e1","DOIUrl":"https://doi.org/10.5469/neuroint.2021.00017.e1","url":null,"abstract":"","PeriodicalId":19140,"journal":{"name":"Neurointervention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c1/24/neuroint-2021-00017-e1.PMC8561029.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39540725","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}