{"title":"Combining quantitative susceptibility mapping, arterial spin labeling and diffusion weighted imaging for distinguishing true progression from pseudoprogression in high-grade gliomas.","authors":"Yanzhao Diao, Hexin Liang, Feng Lei, Wenjing Li, Sulian Su, Guihua Jiang","doi":"10.1007/s00234-025-03797-6","DOIUrl":"https://doi.org/10.1007/s00234-025-03797-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate and compare the diagnostic performance of quantitative susceptibility mapping (QSM), 3D pseudo-continuous arterial spin labeling (3D-pCASL), and diffusion-weighted imaging (DWI) in differentiating true progression (TP) from pseudoprogression (PsP) in postoperative high-grade glioma (HGG) patients.</p><p><strong>Methods: </strong>Forty-nine postoperative HGG patients with newly enhanced lesions were enrolled. All participants underwent conventional MRI, QSM, 3D-pCASL, and DWI. Final diagnoses were confirmed by 6-month longitudinal MRI follow-up or histopathology from reoperation. Quantitative parameters-including the hemorrhagic foci area proportion (proQSM), magnetic susceptibility (SUS), relative maximum cerebral blood flow (rCBF<sub>max</sub>), and relative minimum apparent diffusion coefficient (rADC<sub>min</sub>)-were compared between TP and PsP groups using independent samples t-tests. Diagnostic efficacy was assessed via receiver operating characteristic (ROC) curve analysis, and interparametric correlations were evaluated.</p><p><strong>Results: </strong>TP lesions exhibited significantly lower proQSM (p < 0.001) and higher rCBF<sub>max</sub> (p < 0.001) than PsP, with area under the curve (AUC) values of 0.891 and 0.881, respectively. While rADC<sub>min</sub> was marginally reduced in TP (p < 0.05), SUS showed no intergroup difference (p = 0.164). Combining proQSM with rCBF<sub>max</sub> significantly improved diagnostic accuracy (AUC = 0.948). Furthermore, proQSM, rADC<sub>min</sub> showed a negative correlation with rCBF<sub>max</sub>, respectively. (p < 0.0001).</p><p><strong>Conclusion: </strong>proQSM and rCBF<sub>max</sub> serve as complementary biomarkers for TP and PsP differentiation. The integration of QSM and ASL imaging significantly improves diagnostic accuracy compared to conventional parameters, providing a noninvasive strategy for postoperative HGG surveillance.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275438","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}
NeuroradiologyPub Date : 2025-10-09DOI: 10.1007/s00234-025-03801-z
{"title":"European Society of Neuroradiology (ESNR).","authors":"","doi":"10.1007/s00234-025-03801-z","DOIUrl":"https://doi.org/10.1007/s00234-025-03801-z","url":null,"abstract":"","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252084","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":"Meta-analysis of four phase III, Multicenter, randomized trials assessing the efficacy and safety of middle meningeal artery embolization for subdural hematoma.","authors":"Yujun Xi, Chao Liu, Zhiyuan Shen, Wenmiao Luo, Hengzhu Zhang","doi":"10.1007/s00234-025-03792-x","DOIUrl":"https://doi.org/10.1007/s00234-025-03792-x","url":null,"abstract":"<p><strong>Objective: </strong>There is currently no clear consensus on the use of middle meningeal artery embolization (MMAE) for the treatment of chronic subdural hematoma. This study aimed to elucidate the efficacy and safety of the MMAE for chronic subdural hematoma.</p><p><strong>Methods: </strong>We performed a pooled analysis of four recently conducted phase III multicenter randomized controlled trials (EMBOLISE, EMPROTECT, MAGIC-MT, and STEM), encompassing a total of 1,774 patients with subacute or chronic subdural hematoma. MMAE was compared with conventional treatment in terms of treatment failure (primary efficacy outcomes) and serious adverse events (primary safety outcomes). Subgroup analyses were conducted on the basis of surgical combination status, haematoma type, embolic material used, and follow-up duration.</p><p><strong>Results: </strong>Compared with the control, MMAE was associated with a lower risk of treatment failure (risk ratio [RR] = 0.55, 95% confidence interval [CI]: 0.41-0.74, P < 0.001) in chronic subdural hematoma patients, without increasing the incidence of serious adverse events (RR = 0.91, 95% CI: 0.71-1.16, P = 0.45). The benefits were consistent across most subgroups, although they were attenuated in high-risk patients treated with particulate agents. The secondary outcomes, including changes in hematoma volume and thickness, midline shift, and mortality, were not significantly different.</p><p><strong>Conclusion: </strong>MMAE was associated with a lower risk of treatment failure in chronic subdural hematoma patients. Our findings cautiously support its potential role in clinical management. However, further research remains necessary to optimize embolization strategies and refine patient selection criteria.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252047","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}
NeuroradiologyPub Date : 2025-10-09DOI: 10.1007/s00234-025-03775-y
Miguel Ossuna, Pedro Tadao Hamamoto Filho, Marco Antônio Zanini
{"title":"Spontaneous thrombosis of drainage vein in cavernoma-associated developmental venous anomaly.","authors":"Miguel Ossuna, Pedro Tadao Hamamoto Filho, Marco Antônio Zanini","doi":"10.1007/s00234-025-03775-y","DOIUrl":"https://doi.org/10.1007/s00234-025-03775-y","url":null,"abstract":"<p><p>A 57-year-old male with multiple supratentorial and infratentorial cavernomas presented with subacute-onset headache, tinnitus, and worsening neurological deficits. Imaging revealed spontaneous thrombosis of a previously documented developmental venous anomaly (DVA) in the posterior fossa, resulting in cerebellar parenchymal hemorrhage and posterior fossa hypertension consistent with venous infarction. This case highlights the rare occurrence of spontaneous DVA thrombosis, emphasizing its potential for severe complications, such as venous ischemic infarction, parenchymal hemorrhage, venous congestion, or subarachnoid hemorrhage, as well as the importance of sequential imaging in documenting pathological progression.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252078","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}
NeuroradiologyPub Date : 2025-10-07DOI: 10.1007/s00234-025-03794-9
Yeva Prysiazhniuk, Rui Duarte Armindo, Sasha Alexander, Michael Moseley, Kristen W Yeom, Jakub Otáhal, Martin Kynčl, Elizabeth Tong, Jan Petr, Moss Y Zhao, Gary K Steinberg
{"title":"Age-related changes in cerebral blood flow and arterial transit time in children: insights from single- and multi-delay ASL.","authors":"Yeva Prysiazhniuk, Rui Duarte Armindo, Sasha Alexander, Michael Moseley, Kristen W Yeom, Jakub Otáhal, Martin Kynčl, Elizabeth Tong, Jan Petr, Moss Y Zhao, Gary K Steinberg","doi":"10.1007/s00234-025-03794-9","DOIUrl":"https://doi.org/10.1007/s00234-025-03794-9","url":null,"abstract":"<p><strong>Background: </strong>Arterial spin labeling (ASL) MRI is a non-invasive perfusion imaging technique with potential for assessing hemodynamics in children. However, understanding hemodynamic changes in developing brains remains challenging. This study investigates the impact of normal brain development on ASL-derived cerebral blood flow (CBF) and arterial transit time (ATT) in MR-negative children.</p><p><strong>Methods: </strong>Thirty-two pediatric subjects (ages 0.7-17.9 years, mean 9.3 ± 5.3y, 19 male) with MR-negative findings were retrospectively included. Four pseudo-continuous ASL (PCASL) scans were acquired: single-delay (PLD 1525 or 2025 ms) and multi-delay (3 or 7 delays). CBF and ATT in supratentorial gray matter (GM), white matter (WM), and total-brain (TB) regions were analyzed using paired t-tests, Cohen's d, Spearman correlation, and mixed linear regression models.</p><p><strong>Results: </strong>Single-delay CBF was significantly higher than 3-delay CBF in GM and WM (p < 0.001 PLD 2025 ms; p = 0.02 PLD 1525 ms). WM and TB CBF correlated negatively with age (rho=-0.56, p < 0.001), whereas GM CBF showed no significant correlation (rho=-0.03, p = 0.87); the trends differed significantly (p = 0.01). GM and TB ATT increased with age (r<sup>2</sup> > 0.11, p < 0.021). WM and TB CBF correlated with WM and combined WM/GM volumes (rho=-0.42, p = 0.02; rho=-0.46, p = 0.008).</p><p><strong>Conclusion: </strong>GM and WM exhibit distinct age-related hemodynamic patterns. WM perfusion declines with age and correlates with WM volume, while GM perfusion remains stable. The progressive increase in GM ATT highlights the need for cautious interpretation of single-delay ASL data in pediatric studies.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239135","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}
NeuroradiologyPub Date : 2025-10-02DOI: 10.1007/s00234-025-03748-1
Lucca Tamara Alves Carretta, Ocilio Ribeiro Gonçalves, Mariana Lee Han, Kenzo Ogasawara Donato, Yasmin Picanço Silva, Luciano Falcão, Rian Barreto Arrais Rodrigues de Morais, Nicole Baptista de Oliveira, Mariana Letícia de Bastos Maximiano, Ahmet Günkan
{"title":"LVIS versus enterprise stents for stent-assisted coiling of intracranial aneurysms: a systematic review and meta-analysis.","authors":"Lucca Tamara Alves Carretta, Ocilio Ribeiro Gonçalves, Mariana Lee Han, Kenzo Ogasawara Donato, Yasmin Picanço Silva, Luciano Falcão, Rian Barreto Arrais Rodrigues de Morais, Nicole Baptista de Oliveira, Mariana Letícia de Bastos Maximiano, Ahmet Günkan","doi":"10.1007/s00234-025-03748-1","DOIUrl":"https://doi.org/10.1007/s00234-025-03748-1","url":null,"abstract":"<p><strong>Purpose: </strong>This systematic review and meta-analysis aimed to compare the clinical and angiographic outcomes of the LVIS versus the Enterprise stent for the treatment of intracranial aneurysms (IAs).</p><p><strong>Methods: </strong>Eligible studies were extracted from PubMed, Scopus, and Embase comparing LVIS/Enterprise. Data on angiographic occlusion rates, neurological deficits, in-stent stenosis, hemorrhagic complications, thromboembolic complications and aneurysm recanalization were analyzed with statistical methods.</p><p><strong>Results: </strong>5 observational studies (912 patients: 457 treated with LVIS and 455 with Enterprise) were analyzed. LVIS was linked to a significantly lower likelihood of Raymond-Roy Occlusion Classification (RROC) Class 3 (RR 0.30; 95% CI 0.13-0.71; I²=0%) and aneurysm recanalization (RR 0.38; 95% CI 0.18-0.82; I²=0%). No statistically significant differences were found between the two groups regarding mRS 0-2, RROC Class 1 or 2, or the incidence of neurological deficits, in-stent stenosis, hemorrhagic or thromboembolic events.</p><p><strong>Conclusion: </strong>LVIS and Enterprise demonstrate safety and efficacy in the endovascular management of IAs. LVIS may provide improved angiographic outcomes by lowering the risk of recurrence and incomplete occlusion. These findings support its potential advantage in treating complex aneurysms. Further confirmation through randomized controlled trials (RCT) is needed.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206930","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}
NeuroradiologyPub Date : 2025-10-01DOI: 10.1007/s00234-025-03761-4
Lefan Yu, Mengmeng Feng, Yi Shang, Zhaohai Ren, Hanqi Xing, Yue Chang, Ke Dong, Yao Xiao, Yiren Qin, Hui Dai
{"title":"The relationship between choroid plexus volume, DTI-ALPS index, kidney function, and amyloid pathology in alzheimer's disease.","authors":"Lefan Yu, Mengmeng Feng, Yi Shang, Zhaohai Ren, Hanqi Xing, Yue Chang, Ke Dong, Yao Xiao, Yiren Qin, Hui Dai","doi":"10.1007/s00234-025-03761-4","DOIUrl":"https://doi.org/10.1007/s00234-025-03761-4","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the effect of the choroid plexus volume (CPV) changes on paravascular drainage function, Alzheimer's disease (AD) pathology, and the kidney-brain axis in AD.</p><p><strong>Methods: </strong>A total of 74 AD patients and 32 healthy controls (HC) were included for this study, and cerebrospinal fluid (CSF) AD biomarker data and serum creatinine levels were collected from 28 AD patients. CP volume (CPV) calculation was performed using 3D-T1 images and the diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) index was calculated using DTI images to assess paravascular drainage function. Mediation analyses were used to assess the mediating role of CPV and ALPS index between kidney function and AD pathology.</p><p><strong>Results: </strong>AD patients had larger CPV and smaller ALPS index than HCs (p < 0.001), and both were associated with cognitive performance in the overall cohort(B = -4.7, SEM, 1.478, p = 0.002; B = 3.8, SEM, 1.789, p = 0.037) and could serve as independent predictors for AD (p < 0.01). In AD patients with CSF data, CPV was negatively associated with estimated glomerular filtration rate (eGFR) (r = -0.402; p = 0.046), CSF amyloid-β (Aβ) 40 (r = -0.415; p = 0.039) and positively associated with Aβ42/Aβ40 ratio (r = 0.505; p = 0.01). CPV partially mediated the effect of kidney function on AD pathology while ALPS index did not.</p><p><strong>Conclusion: </strong>CPV and ALPS index may serve as potential imaging markers for AD, and the CP was involved in the crosstalk of the kidney-brain axis.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200375","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}
NeuroradiologyPub Date : 2025-09-30DOI: 10.1007/s00234-025-03781-0
Shiori Amemiya, Hidemasa Takao, Osamu Abe
{"title":"Spatiotemporal patterns of amyloid deposition as prognostic markers of Alzheimer's disease.","authors":"Shiori Amemiya, Hidemasa Takao, Osamu Abe","doi":"10.1007/s00234-025-03781-0","DOIUrl":"https://doi.org/10.1007/s00234-025-03781-0","url":null,"abstract":"<p><strong>Purpose: </strong>The study aims to characterize the spatiotemporal distribution of amyloid deposition, differentiate between its subtypes, and explore their predictive value for patient cognitive outcomes.</p><p><strong>Methods: </strong>Amyloid PET data from a prospective consortium study, the Alzheimer's Disease Neuroimaging Initiative, were used. A spatial independent component analysis revealed regions of amyloid deposition covariation, which served as regions of interest. A subtype and stage inference analysis was then performed to infer spatiotemporal patterns from cross-sectional data. Multinomial logistic regression models evaluated the impacts of demographics and risk factors on subtype assignment and determined the prognostic value of the subtypes for cognitive decline. Longitudinal data were used for validation.</p><p><strong>Results: </strong>The study included 1,049 participants (466 cognitively normal, 447 mild cognitive impairment, and 136 Alzheimer's disease; 72 ± 8 years; 543 women), with follow-up data available for 643 (915 ± 431 days from baseline). Three distinct spatiotemporal patterns were identified, primarily affecting the parietal, frontotemporal, and occipital lobes, respectively, in the early stages. The amyloid deposition rates differed between the subtypes, even after age, diagnosis, apolipoprotein E ε4 carriership (APOE), baseline amyloid burden, and tracer types were controlled for (occipital vs. parietal: β = 32.6, P < .001; occipital vs. frontotemporal: β = 17.0, P = .017; parietal vs. frontotemporal: β = 15.6, P = .026). The rates of change in cognitive scores, adjusted for age, diagnosis, APOE, baseline amyloid burden, baseline cognitive score, and tracer types also differed between the subtypes (occipital vs. Stage 0: β = 0.162, P = .021; occipital vs. parietal: β = 0.134, P = .013).</p><p><strong>Conclusion: </strong>Amyloid PET subtyping may serve as a valuable independent prognostic biomarker.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200404","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}
NeuroradiologyPub Date : 2025-09-30DOI: 10.1007/s00234-025-03782-z
Ho-Joon Lee, Dong Ah Lee, Kang Min Park
{"title":"White matter and glymphatic system alterations in patients with focal epilepsy: insights from PSMD and DTI-ALPS index.","authors":"Ho-Joon Lee, Dong Ah Lee, Kang Min Park","doi":"10.1007/s00234-025-03782-z","DOIUrl":"https://doi.org/10.1007/s00234-025-03782-z","url":null,"abstract":"<p><strong>Objectives: </strong>Peak width of skeletonized mean diffusivity (PSMD) is a neuroimaging biomarker of white matter integrity in cerebral small-vessel disease. However, the significance of PSMD in focal epilepsy remains unclear. This study aimed to investigate alterations in white matter microstructure and glymphatic system function in patients with focal epilepsy by comparing PSMD and the diffusion tensor imaging (DTI) along perivascular spaces (DTI-ALPS) index with healthy controls and by exploring their associations with seizure lateralization and treatment response.</p><p><strong>Methods: </strong>We retrospectively analyzed DTI data from 102 patients with focal epilepsy and 88 healthy controls. PSMD values and the DTI-ALPS index were obtained using a standard processing pipeline, and between-group comparisons were performed. Associations between PSMD and clinical characteristics were also evaluated.</p><p><strong>Results: </strong>PSMD was significantly higher in patients with focal epilepsy than in healthy controls (2.218 ± 0.355 × 10<sup>-4</sup> vs. 2.051 ± 0.176 × 10<sup>-4</sup> mm<sup>2</sup>/s, p < 0.001). In addition, PSMD was significantly higher in the ipsilateral hemisphere than in the contralateral hemisphere (2.239 ± 0.356 × 10<sup>-4</sup> vs. 2.109 ± 0.325 × 10<sup>-4</sup> mm<sup>2</sup>/s, p = 0.005). The DTI-ALPS index was significantly lower in patients with focal epilepsy than in healthy controls (1.628 ± 0.256 vs. 1.718 ± 0.305, p = 0.028). PSMD was positively correlated with age in patients (r = 0.417, p < 0.001) and controls (r = 0.343, p = 0.001) and negatively correlated with the DTI-ALPS index in patients (r=-0.376, p < 0.001) and controls (r=-0.409, p < 0.001).</p><p><strong>Conclusion: </strong>Our findings suggest that PSMD is increased in patients with focal epilepsy, potentially reflecting microstructural white matter alterations. Increased PSMD in the ipsilateral hemisphere supports its potential role in lateralizing seizure onset. The significant positive correlation between PSMD and age and the inverse relationship between PSMD and the DTI-ALPS index suggest that PSMD is associated with changes in the glymphatic system and white matter microstructure.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200396","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}
NeuroradiologyPub Date : 2025-09-30DOI: 10.1007/s00234-025-03784-x
Andrés García Pastor, Isabel Lera Ramírez, Alejandro Bonilla Tena, David Seoane, Patricia Calleja, Fernando Ostos, Elena De Celis-Ruiz, Carlos Gómez Escalonilla, Patricia Simal, Alfonso López-Frías López-Jurado, Daniel Perez Gil, Rocío Vera Lechuga, Cristina Moreno-López, Jose Carlos Fernandez-Ferro, María Teresa Montalvo Moraleda, Javier Roa Escobar, Araceli García Torres, Inmaculada Navas Vinagre, Eduardo Escolar Escamilla, Rodrigo Terrero Carpio, Guillermo Martín Ávila, Ana María Iglesias Mohedano, Marta Vales Montero, Antonio Gil Núñez
{"title":"Technical effectiveness and safety of emergent stenting in patients with acute ischemic stroke and carotid near-occlusion.","authors":"Andrés García Pastor, Isabel Lera Ramírez, Alejandro Bonilla Tena, David Seoane, Patricia Calleja, Fernando Ostos, Elena De Celis-Ruiz, Carlos Gómez Escalonilla, Patricia Simal, Alfonso López-Frías López-Jurado, Daniel Perez Gil, Rocío Vera Lechuga, Cristina Moreno-López, Jose Carlos Fernandez-Ferro, María Teresa Montalvo Moraleda, Javier Roa Escobar, Araceli García Torres, Inmaculada Navas Vinagre, Eduardo Escolar Escamilla, Rodrigo Terrero Carpio, Guillermo Martín Ávila, Ana María Iglesias Mohedano, Marta Vales Montero, Antonio Gil Núñez","doi":"10.1007/s00234-025-03784-x","DOIUrl":"https://doi.org/10.1007/s00234-025-03784-x","url":null,"abstract":"<p><strong>Background: </strong>The increased very early risk (within the first 2 days after presenting event) of recurrent stroke among patients with symptomatic carotid near-occlusion (SCNO) and full collapse (FC) might justify ultra-early carotid revascularization of these patients. However, we lack data about technical effectiveness and safety of this approach in SCNO. This study aims to assess the feasibility and safety of emergent carotid stenting (eCAS) in patients with SCNO.</p><p><strong>Methods: </strong>Multicenter study including patients with acute stroke and extracranial carotid stenosis or occlusion undergoing mechanical thrombectomy and eCAS. The main outcomes were revascularization failure (incomplete carotid revascularization/occlusion at 48h), intracerebral hemorrhage (ICH) and symptomatic ICH (sICH). Patients with SCNO with and without FC were compared with the remaining patients.</p><p><strong>Results: </strong>309 patients were included, 215 (69.6%) males, mean age (SD) 67.2 (12.8). 45 patients had SCNO and 16 SCNO + FC. Revascularization failure occurred in 15.6% of SCNO and in 13.4% of the remaining patients (p = 0.826), with no differences between SCNO with or without FC. ICH was more common in patients with SCNO (42% for all SCNO, 47% for SCNO + FC, and 24% for the remaining patients; p = 0.027). This increased risk of ICH associated with SCNO persisted in the multivariate analysis (OR 3.49 [95%CI 1.63 - 7.48], p = 0.001). No significant differences in the rate of sICH were observed between SCNO and the remaining patients.</p><p><strong>Conclusions: </strong>The use of eCAS in acute SCNO seems to be feasible. However, the safety of the procedure is uncertain, as it could be associated with an increased risk of ICH.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200459","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}