NeuroradiologyPub Date : 2024-10-23DOI: 10.1007/s00234-024-03488-8
Luigi Vincenzo Pastore, Sniya Valsa Sudhakar, Kshitij Mankad, Enrico De Vita, Asthik Biswas, Martin M Tisdall, Aswin Chari, Matteo Figini, M Zubair Tahir, Sophie Adler, Friederike Moeller, J Helen Cross, Suresh Pujar, Konrad Wagstyl, Mathilde Ripart, Ulrike Löbel, Luigi Cirillo, Felice D'Arco
{"title":"Integrating standard epilepsy protocol, ASL-perfusion, MP2RAGE/EDGE and the MELD-FCD classifier in the detection of subtle epileptogenic lesions: a 3 Tesla MRI pilot study.","authors":"Luigi Vincenzo Pastore, Sniya Valsa Sudhakar, Kshitij Mankad, Enrico De Vita, Asthik Biswas, Martin M Tisdall, Aswin Chari, Matteo Figini, M Zubair Tahir, Sophie Adler, Friederike Moeller, J Helen Cross, Suresh Pujar, Konrad Wagstyl, Mathilde Ripart, Ulrike Löbel, Luigi Cirillo, Felice D'Arco","doi":"10.1007/s00234-024-03488-8","DOIUrl":"https://doi.org/10.1007/s00234-024-03488-8","url":null,"abstract":"<p><strong>Background: </strong>Malformations of cortical development (MCDs) in children with focal epilepsy pose significant diagnostic challenges, and a precise radiological diagnosis is crucial for surgical planning. New MRI sequences and the use of artificial intelligence (AI) algorithms are considered very promising in this regard, yet studies evaluating the relative contribution of each diagnostic technique are lacking.</p><p><strong>Methods: </strong>The study was conducted using a dedicated \"EPI-MCD MR protocol\" with a 3 Tesla MRI scanner in patients with focal epilepsy and previously negative MRI. MRI sequences evaluated included 3D FLAIR, 3D T1 MPRAGE, T2 Turbo Spin Echo (TSE), 3D T1 MP2RAGE, and Arterial Spin Labelling (ASL). Two paediatric neuroradiologists scored each sequence for localisation and extension of the lesion. The MELD-FCD AI classifier's performance in identifying pathological findings was also assessed. We only included patients where a diagnosis of MCD was subsequently confirmed on histology and/or sEEG.</p><p><strong>Results: </strong>The 3D FLAIR sequence showed the highest yield in detecting epileptogenic lesions, with 3D T1 MPRAGE, T2 TSE, and 3D T1 MP2RAGE sequences showing moderate to low yield. ASL was the least useful. The MELD-FCD classifier achieved a 69.2% true positive rate. In one case, MELD identified a subtle area of cortical dysplasia overlooked by the neuroradiologists, changing the management of the patient.</p><p><strong>Conclusions: </strong>The 3D FLAIR sequence is the most effective in the MRI-based diagnosis of subtle epileptogenic lesions, outperforming other sequences in localisation and extension. This pilot study emphasizes the importance of careful assessment of the value of additional sequences.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505047","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":"Comparison of Syn T2-FLAIR and Syn DIR with conventional T2-FLAIR in displaying white matter hyperintensities in migraine patients.","authors":"Zhen-Zhen Liu, Hai-Yang Yu, Yuan-Hui Li, Zhi-Cheng Zhang, Bin-Liang Zhao, Jie Zhang, Ruo-Mi Guo","doi":"10.1007/s00234-024-03477-x","DOIUrl":"https://doi.org/10.1007/s00234-024-03477-x","url":null,"abstract":"<p><strong>Objective: </strong>Young migraine patients often present with white matter hyperintensities (WMHs) on magnetic resonance imaging (MRI). This study aimed to analyze whether synthetic (Syn) T2-FLAIR and Syn double inversion recovery (DIR) can reveal WMHs more clearly and sensitively than conventional T2-FLAIR.</p><p><strong>Materials and methods: </strong>Conventional MRI and Syn MRI data from 50 young migraine patients were analyzed prospectively. WMHs in each anatomical region (periventricular, deep white matter, and juxtacortical) were recorded separately. The differences in the clarity of lesion boundaries and the number of lesions displayed in the three sequences in the same anatomical region were analyzed.</p><p><strong>Results: </strong>A total of 80 (periventricular area, 15; deep white matter, 31; juxtacortical area, 34), 163 (17, 50, 96), and 134 (18, 42, 74) lesions were observed with conventional T2-FLAIR, Syn T2-FLAIR, and Syn DIR, respectively. Syn T2-FLAIR and Syn DIR can show lesions more clearly than conventional T2-FLAIR (all P < 0.001). There was no significant difference in the number of lesions observed in the periventricular white matter among the three sequences (P = 0.159, 0.083, 0.322). Syn T2-FLAIR and Syn DIR can detect more lesions in the deep white matter than conventional T2-FLAIR (P < 0.001, P = 0.006). Syn T2-FLAIR revealed more lesions in the juxtacortical white matter than Syn DIR and conventional T2-FLAIR imaging (all P < 0.001), and conventional T2-FLAIR revealed the fewest lesions (P < 0.001).</p><p><strong>Conclusion: </strong>Syn T2-FLAIR and Syn DIR sequences can clearly and sensitively detect WMHs, especially in deep and juxtacortical white matter areas.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471185","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 : 2024-10-21DOI: 10.1007/s00234-024-03494-w
{"title":"European Society of Neuroradiology (ESNR).","authors":"","doi":"10.1007/s00234-024-03494-w","DOIUrl":"https://doi.org/10.1007/s00234-024-03494-w","url":null,"abstract":"","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471187","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 : 2024-10-21DOI: 10.1007/s00234-024-03489-7
Hanani Abdul Manan, Nur Shaheera Aidilla Sahrizan, Kamalanathan Palaniandy, Hamzaini Abdul Hamid, Noorazrul Yahya
{"title":"The utilisation of fMRI for pre-operative mapping in the paediatric population with central nervous system tumours: a systematic review.","authors":"Hanani Abdul Manan, Nur Shaheera Aidilla Sahrizan, Kamalanathan Palaniandy, Hamzaini Abdul Hamid, Noorazrul Yahya","doi":"10.1007/s00234-024-03489-7","DOIUrl":"https://doi.org/10.1007/s00234-024-03489-7","url":null,"abstract":"<p><strong>Background: </strong>Functional MRI (fMRI) is a well-established tool for pre-operative planning, providing neurosurgeons with a roadmap of critical functional areas to preserve during surgery. Despite its increasing use, there is a need to compare task-based (tb-fMRI) and resting-state fMRI (rs-fMRI) in the peadiatric population to comprehensively evaluate the existing literature on the use of fMRI for pre-operative mapping in pediatric patients, comparing tb-fMRI and rs-fMRI.</p><p><strong>Methods: </strong>Two databases were searched for relevant studies published before July 2024 following the PRISMA guidelines. Eleven studies were selected and comprised 431 participants: 377 patients with different types and locations of brain tumours, and 54 healthy controls (HC).</p><p><strong>Results: </strong>Results indicate that tb-fMRI could reliably locate the eloquent cortex with more than an 80% success rate. Furthermore, results were comparable with intraoperative mapping. Two studies reported that 68-81% of patients did not develop deficits in the postoperative period. Results also found that rs-fMRI can fill the gap in the situation of paediatric patients when other techniques do not apply to younger patients.</p><p><strong>Conclusion: </strong>This study suggests that tb-fMRI is more effective for pre-operative mapping in pediatric patients, offering precise localisation of critical brain functions and enhancing surgical planning. Although rs-fMRI is less demanding and compatible with light sedation, it lacks the specificity needed for accurate identification of language, sensory, and motor areas, which limits its clinical relevance. rs-fMRI can aid in function-preserving treatments for brain tumour patients and reduce the need for invasive procedures. Combining tb-fMRI with intraoperative mapping optimizes precision and safety in pediatric-neurosurgery.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471190","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 : 2024-10-18DOI: 10.1007/s00234-024-03482-0
Elisabeth S Lindland, Martin S Røvang, Anne Marit Solheim, Silje Andreassen, Ingerid Skarstein, Nazeer Dareez, Bradley J MacIntosh, Randi Eikeland, Unn Ljøstad, Åse Mygland, Steffan D Bos, Elling Ulvestad, Harald Reiso, Åslaug R Lorentzen, Hanne F Harbo, Atle Bjørnerud, Mona K Beyer
{"title":"Are white matter hyperintensities associated with neuroborreliosis? The answer is twofold.","authors":"Elisabeth S Lindland, Martin S Røvang, Anne Marit Solheim, Silje Andreassen, Ingerid Skarstein, Nazeer Dareez, Bradley J MacIntosh, Randi Eikeland, Unn Ljøstad, Åse Mygland, Steffan D Bos, Elling Ulvestad, Harald Reiso, Åslaug R Lorentzen, Hanne F Harbo, Atle Bjørnerud, Mona K Beyer","doi":"10.1007/s00234-024-03482-0","DOIUrl":"https://doi.org/10.1007/s00234-024-03482-0","url":null,"abstract":"<p><strong>Purpose: </strong>Many consider white matter hyperintensities (WMHs) to be important imaging findings in neuroborreliosis. However, evidence regarding association with WMHs is of low quality. The objective was to investigate WMHs in neuroborreliosis visually and quantitatively.</p><p><strong>Materials and methods: </strong>Patients underwent brain MRI within one month of diagnosis and six months after treatment. Healthy controls were recruited. WMHs were counted by visual rating and the volume was calculated from automatic segmentation. Biochemical markers and scores for clinical symptoms and findings were used to explore association with longitudinal volume change of WMHs.</p><p><strong>Results: </strong>The study included 74 patients (37 males) with early neuroborreliosis and 65 controls (30 males). Mean age (standard deviation) was 57.4 (13.5) and 57.7 (12.9) years, respectively. Baseline WMH lesion count was zero in 14 patients/16 controls, < 10 in 36/31, 10-20 in 9/7 and > 20 in 13/11, with no difference between groups (p = 0.90). However, from baseline to follow-up the patients had a small reduction in WMH volume and the controls a small increase, median difference 0.136 (95% confidence interval 0.051-0.251) ml. In patients, volume change was not associated with biochemical or clinical markers, but with degree of WMHs (p values 0.002-0.01).</p><p><strong>Conclusion: </strong>WMH lesions were not more numerous in patients with neuroborreliosis compared to healthy controls. However, there was a small reduction of WMH volume from baseline to follow-up among patients, which was associated with higher baseline WMH severity, but not with disease burden or outcome. Overall, non-specific WMHs should not be considered suggestive of neuroborreliosis.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471183","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":"Classification, angioarchitecture and treatment outcomes of medullary bridging vein-draining dural arteriovenous fistulas in the foramen magnum region: a multicenter study.","authors":"Tomohiko Ozaki, Masafumi Hiramatsu, Hajime Nakamura, Yasunari Niimi, Shuichi Tanoue, Katsuhiro Mizutani, Ichiro Nakahara, Yuji Matsumaru, Yasushi Matsumoto, Timo Krings, Toshiyuki Fujinaka","doi":"10.1007/s00234-024-03478-w","DOIUrl":"https://doi.org/10.1007/s00234-024-03478-w","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to classify medullary bridging vein-draining dural arteriovenous fistulas (MBV-DAVFs) located around the foramen magnum (FM) according to their location and characterize their angioarchitecture and treatment outcomes.</p><p><strong>Methods: </strong>Patients with MBV-DAVFs diagnosed between January 2013 and October 2022 were included. MBV-DAVFs were classified into four groups. Jugular vein-bridging vein (JV-BV) DAVF: located in proximity to jugular fossa, Anterior condylar vein (ACV)-BV DAVF: proximity to anterior condylar canal, Marginal sinus (MS)-BV DAVF: lateral surface of FM and Suboccipital cavernous sinus (SCS)-BV DAVF: proximity to dural penetration of vertebral artery.</p><p><strong>Results: </strong>Twenty patients were included, three JV-BV, four ACV-BV, three MS-BV and ten SCS-BV DAVFs, respectively. All groups showed male predominance. There were significant differences in main feeders between JV (jugular branch of ascending pharyngeal artery) and SCS group (C1 dural branch). Pial feeders from anterior spinal artery (ASA) or lateral spinal artery (LSA) were visualized in four SCS and one MS group. Drainage pattern did not differ between groups. Transarterial embolization (TAE) was performed in three, two, one and two cases and complete obliteration was obtained in 100%, 50%, 100% and 0% in JV, ACS, MS and SCS group, respectively. Successful interventions without major complications were finally obtained in 100%, 75%, 100%, and 40% in JV, ACS, MS and SCS group, respectively.</p><p><strong>Conclusion: </strong>JV-BV DAVFs were successfully treated using TAE alone. SCS-BV DAVFs were mainly fed by small C1 dural branches of vertebral artery often with pial feeders from ASA or LSA, and difficultly treated by TAE alone.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471184","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 : 2024-10-08DOI: 10.1007/s00234-024-03472-2
Mena Samaan, Arevik Abramyan, Srihari Sundararajan, Emad Nourollah-Zadeh, Hai Sun, Anil Nanda, Sudipta Roychowdhury, Gaurav Gupta
{"title":"Cerebrovascular implications of takayasu arteritis: a review.","authors":"Mena Samaan, Arevik Abramyan, Srihari Sundararajan, Emad Nourollah-Zadeh, Hai Sun, Anil Nanda, Sudipta Roychowdhury, Gaurav Gupta","doi":"10.1007/s00234-024-03472-2","DOIUrl":"https://doi.org/10.1007/s00234-024-03472-2","url":null,"abstract":"<p><strong>Purpose: </strong>Takayasu arteritis (TA) is a rare, chronic, inflammatory large-vessel vasculitis that affects the aorta and its main branches, including the cerebrovascular system. This review analyzes current knowledge and patient outcomes concerning the cerebrovascular implications of TA.</p><p><strong>Methods: </strong>A literature search, with publications from 1994 to 2024, identified pertinent studies through PubMed. An illustrative case report details a 19-year-old female with Type 1 TA, illustrating the complex decision required in the absence of surgical or endovascular options.</p><p><strong>Results: </strong>Our results offer a demographic analysis of 1,698 TA patients, highlighting a female predominance of 89.99% and a mean symptom onset at 33 years. The clinical spectrum of cerebrovascular involvement presented varied symptoms, most notably dizziness, with significant incidences of ischemic events and bilateral stenosis primarily affecting the carotid and subclavian arteries. The most common type of TA was Type V, affecting 40% of patients studied. Endovascular treatment had a 95% initial success rate, with a 67% restenosis rate. Surgical treatment was successful in 84% of cases, but 21% had notable post-operative complications. Similar to the endovascular population, those treated with stand-alone conservative therapy saw a 93% initial remission rate with 52% having relapsed.</p><p><strong>Conclusion: </strong>Assessing the disease activity of TA is crucial when planning vascular intervention due to its significant impact on treatment outcomes. Despite its greater initial invasiveness, surgical interventions showed lower restenosis rates compared to either endovascular interventions or standalone conservative management. We emphasize advancements in TA management and the pressing need for continued research into diagnostic and treatment protocols for improved patient outcomes.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392196","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":"Machine learning based classification of spontaneous intracranial hemorrhages using radiomics features.","authors":"Phattanun Thabarsa, Papangkorn Inkeaw, Chakri Madla, Withawat Vuthiwong, Kittisak Unsrisong, Natipat Jitmahawong, Thanwa Sudsang, Chaisiri Angkurawaranon, Salita Angkurawaranon","doi":"10.1007/s00234-024-03481-1","DOIUrl":"https://doi.org/10.1007/s00234-024-03481-1","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the efficacy of radiomics features extracted from non-contrast computed tomography (NCCT) scans in differentiating multiple etiologies of spontaneous intracerebral hemorrhage (ICH).</p><p><strong>Methods: </strong>CT images and clinical data from 141 ICH patients from 2010 to 2022 were collected. The cohort comprised primary (n = 57), tumorous (n = 46), and vascular malformation-related ICH (n = 38). Radiomics features were extracted from the initial brain NCCT scans and identified potential features using mutual information. A hierarchical classification with AdaBoost classifiers was employed to classify the multiple etiologies of ICH. Age of the patient and ICH's location were examined alongside radiomics features. The accuracy, area under the curve (AUC), sensitivity, and specificity were used to evaluate classification performance.</p><p><strong>Results: </strong>The proposed method achieved an accuracy of 0.79. For identifying primary ICH, the model achieved a sensitivity of 0.86 and specificity of 0.87. Meanwhile, the sensitivity and specificity for identifying tumoral causes were 0.78 and 0.93, respectively. For vascular malformation, the model reached a sensitivity and specificity of 0.72 and 0.89, respectively. The AUCs for primary, tumorous, and vascular malformation were 0.86, 0.85, and 0.82, respectively. The findings further highlight the importance of texture-based variables in ICH classification. The age and location of the ICH can enhance the classification performance.</p><p><strong>Conclusion: </strong>The use of a machine learning model with radiomics features has the potential in classifying the three types of non-traumatic ICH. It may help the radiologist decide on an appropriate further examination plan to arrive at a correct diagnosis.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378047","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 : 2024-10-01Epub Date: 2024-06-07DOI: 10.1007/s00234-024-03392-1
Hao Huang, Bing Huang, Xindan Du, Huidan Lin, Xue Li, Xian Zhao, Qinghe Zhou, Ming Yao
{"title":"CT-guided radiofrequency ablation of facial and mandibular nerves in the treatment of compound Meige's syndrome.","authors":"Hao Huang, Bing Huang, Xindan Du, Huidan Lin, Xue Li, Xian Zhao, Qinghe Zhou, Ming Yao","doi":"10.1007/s00234-024-03392-1","DOIUrl":"10.1007/s00234-024-03392-1","url":null,"abstract":"<p><p>This retrospective study examined the clinical outcomes and complications in 6 cases of compound Meige's syndrome, presenting with blepharospasm and masticatory muscle spasm, following treatment with CT-guided radiofrequency ablation targeting bilateral facial nerves and mandibular branches of the trigeminal nerve. After the operation, the symptoms of eyelid spasm and masticatory muscle spasm resolved, but mild facial paralysis and numbness of mandibular nerve innervation persisted. Follow-up for 4-28 months showed that the symptoms of facial paralysis resolved within 2-5 (3.17 ± 0.94) months after the operation, whereas the numbness in the mandibular region persisted, accompanied by a decrease in masticatory function. During the follow-up period, none of the 6 patients experienced a recurrence of Meige's syndrome. These findings suggest that CT-guided radiofrequency ablation of the bilateral facial nerve and mandibular branches of the trigeminal nerve may offer a promising approach to treating compound Meige's syndrome.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"1761-1764"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
NeuroradiologyPub Date : 2024-10-01Epub Date: 2024-07-01DOI: 10.1007/s00234-024-03387-y
J Rueckel, Y Ozpeynirci, C Trumm, C Brem, M Pflaeging, T D Fischer, T Liebig
{"title":"Preliminary results of intracranial aneurysm treatment with derivo2heal embolization device.","authors":"J Rueckel, Y Ozpeynirci, C Trumm, C Brem, M Pflaeging, T D Fischer, T Liebig","doi":"10.1007/s00234-024-03387-y","DOIUrl":"10.1007/s00234-024-03387-y","url":null,"abstract":"<p><strong>Introduction: </strong>The Derivo 2 Heal Embolization Device (D2HED) is a novel flow diverter (FD) providing a fibrin-/heparin-based surface coating aiming at lower thrombogenicity. We evaluate periprocedural aspects and preliminary aneurysm occlusion efficacy for intracranial aneurysm treatment.</p><p><strong>Methods: </strong>Thirty-four D2HEDs deployments (34 aneurysms, 32 patients) between 04/2021 and 10/2023 were analyzed. All patients were under dual antiplatelet therapy (dAPT). Periprocedural details, adverse events, and follow-up (FU) imaging were reviewed by consultant-level neuroradiologists. Complication rates and aneurysm occlusion efficacy are compared with performance data of other FDs based on literature research.</p><p><strong>Results: </strong>Each intervention succeeded in the deployment of one D2HED. Significant and/or increased intraaneurysmal contrast stagnation immediately after D2HED deployment was seen in 73.5% of cases according to O'Kelly-Marotta (OKM) grading scale. Clinically relevant early adverse events occurred in three patients: Among them two cases with fusiform aneurysms in the posterior circulation (ischemic events, early in-stent-thrombosis) and one patient (ischemic event) out of the majority of 31 treated internal carotid artery aneurysms (3,2%). Regarding mid-term FU (> 165 days), one aneurysm did not show progressive occlusion presumably caused by a prominent A1 segment arising from the terminal ICA aneurysm itself. Apart from that, mid-term complete / partial occlusion rates of 80% / 20% could be demonstrated.</p><p><strong>Conclusion: </strong>Our case series - although suffering from restricted sample size - suggests a potential effectiveness of D2HED in managing intracranial aneurysms. Further studies with larger samples are warranted to quantify long-term occlusion efficacy and the impact of antithrombogenic surface coating on the necessary (d)APT.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"1747-1759"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}