Neuroradiology最新文献

{"title":"Early venous filling following reperfusion therapy in acute ischemic stroke: a systematic review and meta-analysis.","authors":"Natan Lucca Lima, Marcos Henrique da Silva Mezzari, Luís Cláudio Izidio Costa Júnior, Davi Orli Machado Grüdtner, Bárbara Ghizoni Maggi, Darlos Kelvin de Azevedo, João Cândido Spezia de Souza, Wilson Jordão Mota Bezerra Júnior, Yasmin Guimarães Rodrigues, Gustavo Rassier Isolan","doi":"10.1007/s00234-025-03722-x","DOIUrl":"https://doi.org/10.1007/s00234-025-03722-x","url":null,"abstract":"<p><strong>Background: </strong>Early venous filling (EVF), detected by digital subtraction angiography after endovascular therapy, may indicate hyperperfusion and vascular injury. Emerging evidence suggests that EVF is associated with adverse outcomes and complications, highlighting its potential role as a prognostic imaging marker in acute ischemic stroke (AIS).</p><p><strong>Methods: </strong>A systematic search was conducted in the MEDLINE, Embase, Cochrane Library, and Web of Science databases to identify studies evaluating the outcomes of EVF following reperfusion therapy in cases of AIS. The outcomes included hemorrhagic transformation (HT), parenchymal hematoma (PH), hemorrhagic infarction (HI), symptomatic intracranial hemorrhage (sICH), cerebral infarction as hypodensity on imaging, malignant brain edema (MBE), and unfavorable outcome measured by modified Rankin scale (mRS ≥ 3) after 90 days. A meta-analysis using a random-effects model was conducted to pool the data.</p><p><strong>Results: </strong>In the data analyses of 12 studies and 2,446 patients, the presence of EVF post-reperfusion was associated with increased risks of HT (odds ratio [OR] = 4.31; 95% confidence interval [CI] [3.00, 6.21]; p < 0.001), PH (OR = 5.73; 95% CI [2.82, 11.65]; p < 0.001), sICH (OR = 6.43; 95% CI [3.49, 8.47]; p < 0.001), cerebral infarction (OR = 15.95; 95% CI [6.37, 39.92]; p < 0.001), MBE (OR = 3.69; 95% CI [2.26, 6.04]; p < 0.001), and unfavorable functional outcomes (OR = 2.58; 95% CI [1.27, 5.23]; p = 0.009).</p><p><strong>Conclusions: </strong>EVF may serve as a predictor of increased risk of hemorrhagic events, cerebral infarction on imaging, MBE, and unfavorable functional outcomes after brain reperfusion therapy.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal duration of dual antiplatelet therapy after endovascular treatment of intracranial aneurysms with stenting: a systematic review and meta-analysis.","authors":"Anderson Matheus Pereira da Silva, Ocílio de Deus, Luciano Falcão, Mariana Lee Han, Filipe Virgilio Ribeiro, Pedro Lucas Machado Magalhães, Altair Melo Neto, Othon Trevisan Meira, Mariana Leticia Bastos Maximiano, Gustavo Sousa Noleto, Ahmet Günkan, Pascal M Jabbour","doi":"10.1007/s00234-025-03710-1","DOIUrl":"https://doi.org/10.1007/s00234-025-03710-1","url":null,"abstract":"<p><strong>Background: </strong>The optimal duration of dual antiplatelet therapy (DAPT) following endovascular treatment of intracranial aneurysms remains uncertain. While DAPT effectively prevents thromboembolic complications, prolonged therapy may increase bleeding risk. This systematic review and meta-analysis compared the efficacy and safety of short-term versus long-term DAPT in patients undergoing endovascular treatment with stent-assisted coiling or flow diversion.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis according to PRISMA guidelines. Studies were identified through PubMed, Embase and Cochrane from inception to January 2025. Eligible studies included randomized controlled trials (RCTs) and observational cohorts comparing short-term DAPT (≤ 6 months) with long-term DAPT (> 6 months) in adults treated for intracranial aneurysms. Pooled risk ratio (RR) with 95% confidence intervals (CI) were calculated using a random-effects model. Risk of bias was assessed using RoB 2 for RCTs and ROBINS-I for observational studies.</p><p><strong>Results: </strong>Seven studies, comprising a total of 17,380 patients, were included, one RCT and six retrospective cohorts. The pooled analysis showed no significant difference in thromboembolic events between short- and long-term DAPT (RR: 1.18; 95% CI: 0.42-3.30; I² = 60.5%). Short-term DAPT was associated with a lower risk of major bleeding (RR: 0.54; 95% CI: 0.32-0.91; I² = 0%). No significant differences were observed between groups in retreatment (RR: 0.94; 95% CI: 0.24-3.62) or mortality (RR: 3.11; 95% CI: 0.96-10.09).</p><p><strong>Conclusions: </strong>Short-term DAPT demonstrates similar efficacy to long-term DAPT in preventing thromboembolic events and retreatment, with a lower incidence of major bleeding. These findings suggest that shorter DAPT regimens may offer a favorable safety profile. However, further large-scale RCTs are needed to establish definitive guidelines.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of large vessel occlusion using artificial intelligence tools: A systematic review and meta-analysis.","authors":"Julyana Dantas, Giovana Barros, Antonio Mutarelli, Caroline Dagostin, Pedro Romeiro, Giulia Almirón, Nicole Felix, Agostinho Pinheiro, Matheus A Bannach","doi":"10.1007/s00234-025-03716-9","DOIUrl":"https://doi.org/10.1007/s00234-025-03716-9","url":null,"abstract":"<p><strong>Background and purpose: </strong>Large vessel occlusion (LVO) accounts for a third of all ischemic strokes. Artificial intelligence (AI) has shown good accuracy in identifying LVOs on computed tomography angiograms (CTA). We sought to analyze whether AI-adjudicated CTA improves workflow times and clinical outcomes in patients with confirmed LVOs.</p><p><strong>Materials and methods: </strong>We systematically searched PubMed, Embase, and Web of Science for studies comparing initial radiological assessment assisted by AI softwares versus standard assessment of patients with acute LVO strokes. Results were pooled using a random-effects model as mean differences for continuous outcomes or odds ratio (OR) for dichotomous outcomes, along with 95% confidence intervals (CI).</p><p><strong>Results: </strong>We included 9 studies comprising 1,270 patients, of whom 671 (52.8%) had AI-assisted radiological assessment. AI consistently improved treatment times when compared to standard assessment, as evidenced by a mean reduction of 20.55 minutes in door-to-groin time (95% CI -36.69 to -4.42 minutes; p<0.01) and a reduction of 14.99 minutes in CTA to reperfusion (95% CI -28.45 to -1.53 minutes; p=0.03). Functional independence, defined as a modified Rankin scale 0-2, occurred at similar rates in the AI-supported group and with the standard workflow (OR 1.27; 95% CI 0.92 to 1.76; p=0.14), as did mortality (OR 0.71; 95% CI 0.27 to 1.88; p=0.49).</p><p><strong>Conclusions: </strong>The incorporation of AI softwares for LVO detection in acute ischemic stroke enhanced workflow efficiency and was associated with decreased time to treatment. However, AI did not improve clinical outcomes as compared with standard assessment.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144743365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cortical venous opacification score predicts outcomes after thrombectomy in large vessel occlusion stroke: a systematic review and meta-analysis.","authors":"Rafaela Correia Maciel, Wei Jun Lee, Beatriz Aguiar de Macedo, Davi Barbosa Pereira da Silva, Amanda Boutrik, Maria Clara Merighi, Henrique Alexsander Ferreira Neves, Luisa Braga Salles Machado, Bernard Giancristoforo Campos","doi":"10.1007/s00234-025-03701-2","DOIUrl":"https://doi.org/10.1007/s00234-025-03701-2","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess whether the Cortical Vein Opacification Score (COVES), a visual scoring system based on single-phase Computed Tomography Angiography (CTA), is associated with clinical and radiological outcomes in patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO) after endovascular treatment (EVT).</p><p><strong>Methods and materials: </strong>A systematic review and meta-analysis were conducted according to PRISMA guidelines. PubMed, EMBASE, and Cochrane Library were searched from inception to early June 2025, identifying 572 articles, of which 6 were included. Post-hoc analyses of randomized controlled trials (RCTs) and observational studies, with patients stratified by venous outflow (VO) status, were included. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was assessed using I² statistic. Sensitivity analyses were performed in outcomes that presented high heterogeneity.</p><p><strong>Results: </strong>The six studies included 2,709 patients. VO + was associated with higher excellent (RR 1.34; p < 0.001) and successful reperfusion (RR 1.05; p = 0.001). Functional independence at 90 days (modified Rankin Scale [mRS] 0-2) was higher in the VO + group (RR 2.67; p = 0.002). VO + was associated with lower rates of symptomatic intracranial hemorrhage (sICH), parenchymal hematoma (PH), and mortality at 90 days.</p><p><strong>Conclusion: </strong>VO + is associated with better reperfusion and functional independence, as well as reduced hemorrhagic complications and mortality. These findings support the potential prognostic value of VO in AIS-LVO patients undergoing EVT. Heterogeneity and limited number of studies warrant cautious interpretation. Standardized imaging protocols and prospective validation are needed.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144743364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic resonance imaging morphological features of the cisternal segment of the trigeminal nerve in Fabry disease.","authors":"Taku Gomi, Satoshi Matsushima, Akira Baba, Toshiki Tsunogai, Tetsuya Shimizu, Hideto Kuribayashi, Hikaru Nishida, Ken Sakurai, Masahisa Kobayashi, Hiroshi Kobayashi, Hiroya Ojiri","doi":"10.1007/s00234-025-03720-z","DOIUrl":"https://doi.org/10.1007/s00234-025-03720-z","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the magnetic resonance imaging (MRI) characteristics of the trigeminal nerve in Fabry disease (FD) by comparing the morphology of the trigeminal nerve in patients with and without FD.</p><p><strong>Methods: </strong>This retrospective study included 40 patients with FD and 40 age- and sex-matched controls who underwent 3T MRI with constructive interference in steady-state sequence. Two neuroradiologists measured the short-axis length on axial and oblique coronal images and the long-axis length and cross-sectional area on oblique coronal images of the cisternal segment of the trigeminal nerve bilaterally. Morphological differences were assessed between groups and between sides within each group using appropriate t-tests.</p><p><strong>Results: </strong>All measurements were significantly smaller in the FD group than in the control group: axial images: short-axis length (3.20 ± 0.52 mm vs. 3.51 ± 0.51 mm, p = 0.0101); oblique coronal images: short-axis length (2.41 ± 0.28 mm vs. 2.61 ± 0.35 mm, p = 0.007); long-axis length (3.75 ± 0.53 mm vs. 4.14 ± 0.44 mm, p < 0.001); and cross-sectional area (7.71 ± 1.68 mm² vs. 8.93 ± 1.30 mm², p < 0.001). Left-right differences were observed in both groups; the left side was generally larger. Receiver operating characteristic curve analysis showed moderate diagnostic performance (area under the curve, 0.66-0.72).</p><p><strong>Conclusion: </strong>The trigeminal nerves in the cisternal region were significantly smaller in patients with FD than in those without FD. These findings may support its potential utility as an imaging biomarker.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144743341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-specific trajectories of hippocampal aging: structural changes and asymmetry across the lifespan.","authors":"Sebastiano Vacca, Antonella Balestrieri, Carola Politi, Alessandra Serra, Luca Saba","doi":"10.1007/s00234-025-03717-8","DOIUrl":"https://doi.org/10.1007/s00234-025-03717-8","url":null,"abstract":"","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144743342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral vasospasm following aneurysmal subarachnoid hemorrhage: the impact of cocaine use, Hunt-Hess grade, and other risk factors.","authors":"Aliana Rao, Samuel Ricci, Theodore Hannah, Erin Graves, Eric Quach, Kadir Erkmen, Rami Almefty","doi":"10.1007/s00234-025-03713-y","DOIUrl":"https://doi.org/10.1007/s00234-025-03713-y","url":null,"abstract":"<p><strong>Introduction: </strong>Cerebral vasospasm (CV) is a common complication following aneurysmal subarachnoid hemorrhage (aSAH) that contributes to significant morbidity and mortality. While numerous identified CV risk factors exist, illicit substance use's influence, particularly cocaine, remains controversial. This study aims to elucidate relationships between known risk factors and CV's incidence, severity, and refractoriness.</p><p><strong>Methods: </strong>A retrospective chart review was conducted on all aSAH patients between 2014 and 2023 with inclusion criteria of confirmed aneurysms on digital subtraction angiography (DSA) and available urine drug screens (UDS). Demographic data, Hunt-Hess (HH), modified Fisher Scale (mFS), comorbidities, and vasospasm grades were collected. Outcomes, including vasospasm treatment counts, length of stay (LOS), and 3-month modified Rankin Scale (mRS) scores, were recorded.</p><p><strong>Results: </strong>Of 88 patients, 43% experienced CV. Cocaine use was significantly more prevalent in the CV group (26% vs. 8%, p = 0.04) and increased CV risk (OR = 4.11, 95% CI: 1.25-16.13, p = 0.03), independent of other factors. Higher HH grades were associated with increased CV incidence (OR = 1.75, p = 0.01), severity (β = 0.271, p = 0.02), and 3-month mRS scores (β = 0.81, p < 0.001). Female sex also predicted vasospasm incidence (OR = 4.78, p = 0.01). Older age was associated with worse long-term outcomes (β = 0.05, p = 0.004). In the multivariable analysis, cocaine revealed a significant increased risk of CV incidence (OR = 5.79, p = 0.02). Higher HH grades significantly impacted CV severity (OR = 0.30, p = 0.01) and worse long-term outcomes (OR = 0.957, p < 0.01) in the multivariable analysis.</p><p><strong>Conclusions: </strong>Females, those with positive cocaine use on UDS, and a history of T2DM were at an increased risk of CV with no impact on severity, recurrence, or 3-month outcomes. Older age was associated with worse long-term outcomes. HH grade was significantly associated with increased vasospasm severity, refractoriness to treatment, and worse long-term outcomes as per mRS scores.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pegasus stent as a rescue therapy in large vessel occlusions with underlying intracranial atherosclerosis: a retrospective Single-Center experience.","authors":"Daniele Giuseppe Romano, Raffaele Tortora, Maria Di Gregorio, Alfredo Siani, Gianpiero Locatelli, Gianmarco Flora, Salvatore Tartaglione, Miriam Caterino, Giulia Pacella, Antonio Romanelli, Aniello Iovino, Paolo Barone, Giulia Frauenfelder","doi":"10.1007/s00234-025-03724-9","DOIUrl":"https://doi.org/10.1007/s00234-025-03724-9","url":null,"abstract":"<p><strong>Purpose: </strong>Large vessel occlusions (LVOs) due to underlying intracranial atherosclerotic disease (ICAD) are associated with higher rates of mechanical thrombectomy (MT) failure and worse clinical outcomes. The pEGASUS-HPC stent is a novel low-profile device with a hydrophilic polymer coating designed to reduce thrombogenicity. Evidence regarding its use in ICAD-related LVOs is currently limited.</p><p><strong>Methods: </strong>We conducted a retrospective single-center study to evaluate the safety and efficacy of the pEGASUS-HPC stent as a rescue treatment following MT failure in ICAD-related LVOs.</p><p><strong>Results: </strong>From December 2022 to December 2024 among 393 thrombectomies performed, 25 patients met the inclusion criteria. The mean age was 66 years (53-90) and 18/25 (72%) were men. The anterior circulation was involved in most cases (17/25, 68%). Median baseline NIHSS was 8 and ASPECTS was 9. Rescue stenting was performed due to persistent occlusion (28%), residual stenosis (56%), or early reocclusion (16%). Final TICI 2b-3 recanalization was achieved in 92% of cases. Pre-stenting angioplasty was performed in 32% and post-stenting in 16% of cases. Periprocedural complications occurred in 16% of patients. Median NIHSS at 24 h was 5 and the median ASPECTS was 8. At 24 h, only 1/25 patients demonstrate in-stent thrombosis. Long-term follow-up (6 months) was available for 76% of patients; stent patency was maintained in all, and 84% achieved a favorable outcome (mRS < 2 at 90 days).</p><p><strong>Conclusion: </strong>Rescue stenting with the pEGASUS-HPC stent in selected cases of ICAD-related LVO appears to be a feasible and effective treatment option after MT failure, with high recanalization rates, favorable clinical outcomes, and acceptable complication rates.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRA evaluation of aneurysms treated with woven endobridge (WEB) devices or coils: an inter- and intra-observer reliability study.","authors":"Pierre-Olivier Comby, Tim E Darsaut, Anass Benomar, Daniela Iancu, Daniel Roy, Roland Jabre, Alain Weill, Nicolas Lecaros, Hanan Alhazmi, Francois Zhu, Thanh N Nguyen, Robert Fahed, William Boisseau, Benjamin Maïer, Johanna Eneling, David Volders, Stephanos Finitsis, Leonardo Olijnyk, Geraud Forestier, Nicolas Raynaud, Adrien Guenego, Jean-François Hak, Vincent L'Allinec, Michael M C Chow, Angélique Bernard, François Lébeaupin, Laura Baptiste, Pierre Thouant, Brivael Lemogne, Marc Lenfant, Jean Raymond","doi":"10.1007/s00234-025-03706-x","DOIUrl":"https://doi.org/10.1007/s00234-025-03706-x","url":null,"abstract":"<p><strong>Background: </strong>Magnetic resonance angiography (MRA) is a commonly used non-invasive imaging modality for the follow-up of treated intracranial aneurysms. The 3-category Montreal classification system is widely used to evaluate treatment outcomes, including aneurysms treated with Woven EndoBridge (WEB) devices or coils. This study aimed to assess the reliability and clinical implications of the Montreal scale for aneurysms imaged with MRA.</p><p><strong>Methods: </strong>An electronic portfolio of 60 aneurysms (30 treated with WEB devices and 30 with coils) was evaluated by 30 raters from diverse clinical backgrounds. Raters graded aneurysm occlusion using the Montreal classification system and provided management recommendations (delayed follow-up, close follow-up, or re-treatment). Twenty-three raters completed a second evaluation of permuted cases after one month. Reliability was assessed using Gwet's AC2 (κG) coefficients, and the correlation between occlusion grade and management recommendation was analyzed with Cramer's V.</p><p><strong>Results: </strong>Inter-rater agreement for occlusion grades was substantial (κG = 0.70; 95% CI: 0.66-0.75) and similar for WEB-treated (κG = 0.66; 95% CI: 0.59-0.74) and coiled aneurysms (κG = 0.75; 95% CI: 0.68-0.82). Management decisions showed substantial agreement overall (κG = 0.68; 95% CI: 0.60-0.76). Mean intra-rater agreement was almost perfect (κG = 0.84 ± 0.06). Strong correlations were observed between occlusion grades and management recommendations (mean Cramer's V = 0.78 ± 0.13), with consistent management strategies across treatment modalities.</p><p><strong>Conclusion: </strong>The Montreal scale demonstrated substantial reliability and clinical relevance for evaluating aneurysms treated with WEB or coils using MRA, supporting its use in non-invasive follow-up protocols.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stent-assisted coiling and flow diversion with hpc-coated devices under prasugrel monotherapy in ruptured wide-neck aneurysms: a multicenter case series.","authors":"Abdallah Aburub, Stephan Felber, Hans Henkes, André Kemmling, Michael Forsting, Christopher Nimsky, Zakarya Ali, Kamran Hajiyev, Philip von Gottberg, Mohammad Almohammad, Weis Naziri, Andrei Filioglo, Ali Khanafer","doi":"10.1007/s00234-025-03715-w","DOIUrl":"https://doi.org/10.1007/s00234-025-03715-w","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the safety, efficacy, and clinical outcomes of stent-assisted coiling (SAC) and flow diversion (FD) with hydrophilic polymer-coated (HPC) devices under prasugrel single antiplatelet therapy (SAPT) in the treatment of acutely ruptured wide-neck intracranial aneurysms.</p><p><strong>Methods: </strong>This multicenter retrospective case series included patients with ruptured saccular intracranial aneurysms treated through SAC or FD with HPC-coated devices under SAPT at four specialized neurovascular centers. Baseline demographics, aneurysm characteristics, procedural details, and clinical outcomes were analyzed. The primary outcomes included technical success, periprocedural complications, aneurysm occlusion rates at follow-up (FU), and functional outcomes assessed with the modified Rankin Scale (mRS).</p><p><strong>Results: </strong>A total of 46 patients were included (mean age 57.4 years). SAC and FD were performed in equal proportions. Technical success was achieved in 100% of cases. The immediate complete occlusion rate was significantly higher for SAC (95.7%) than FD (21.7%, p < 0.001). However, the occlusion rates at 12-month FU were comparable (SAC 100% vs. FD 95%, p = 0.364). The overall periprocedural complication rate was low (4.3%), and mortality before discharge was 10.9%. Favorable functional outcomes (mRS ≤ 2) at the last FU were achieved in 84% of patients, and no significant differences were observed between the SAC and FD groups.</p><p><strong>Conclusion: </strong>SAC and FD with HPC-coated devices under prasugrel SAPT appeared to be safe and effective in treating ruptured wide-neck aneurysms. Whereas SAC achieved higher immediate occlusion rates, the long-term outcomes were comparable between groups. These findings support the feasibility of SAPT in this high-risk population and warrant further prospective validation.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}