{"title":"Predicting futile recanalization before mechanical thrombectomy: the added value of CT imaging markers.","authors":"Yue Wang, Ting Li, Pengfei Wu, Yuezhou Cao, Haibin Shi, Sheng Liu, Feiyun Wu, Jiulou Zhang, Shanshan Lu","doi":"10.1007/s00234-025-03752-5","DOIUrl":"https://doi.org/10.1007/s00234-025-03752-5","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the incremental value of computed tomography (CT) imaging markers beyond clinical factors in predicting futile recanalization (FR) in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy (MT), and to develop an integrated clinical-imaging nomogram for FR risk stratification.</p><p><strong>Methods: </strong>We enrolled 342 AIS patients who achieved successful recanalization-definded as a modified Thrombolysis in Cerebral Infarction grade ≥ 2b after MT-between October 2019 and December 2023. FR was defined as a poor outcome (modified Rankin Scale score 3-6) despite successful recanalization. Independent clinical and imaging predictors of FR were identified by multivariable logistic regression. The added value of CT imaging markers was assessed using integrated discrimination index (IDI) and continuous net reclassification improvement (NRI). Significant predictors were incorporated into a nomogram, and its discrimination and calibration were assessed.</p><p><strong>Results: </strong>FR was observed in 161 patients (47.1%) at 90 days. Independent predictors of FR included older age, female sex, diabetes, higher National Institutes of Health Stroke Scale (NIHSS) scores, higher net water uptake (NWU), lower Alberta Stroke Program Early CT Score (ASPECTS) and unfavorable comprehensive venous outflow (CVO) score (all p < 0.05). Incorporating imaging markers (ASPECTS, NWU, and CVO score) significantly improved the discriminatory performance of the clinical model (IDI: +14.2%; NRI: +82.5%; both p < 0.001 ). Decision curve analysis confirmed the clinical utility of the integrated nomogram.</p><p><strong>Conclusion: </strong>CT imaging markers from Non-contrast CT (NCCT) and CT angiography (CTA) enhance FR risk prediction when added to clinical factors. The integrated nomogram may support individualized treatment decision-making in AIS patients prior to MT.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963307","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 : 2025-09-01Epub Date: 2025-06-11DOI: 10.1007/s00234-025-03658-2
Dan Zhu, Tianle Wang, Yingnan Bai, Xiaoxia Zhang, Zhiyu Li, Ailan Cheng, Yuehua Li, Qing Lu
{"title":"Perivenous-enhanced cortical veins on contrast-enhanced black-blood MRI: a novel marker for blood-brain barrier disruption in ischemic stroke.","authors":"Dan Zhu, Tianle Wang, Yingnan Bai, Xiaoxia Zhang, Zhiyu Li, Ailan Cheng, Yuehua Li, Qing Lu","doi":"10.1007/s00234-025-03658-2","DOIUrl":"10.1007/s00234-025-03658-2","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the feasibility of using perivenous-enhanced cortical veins (PECVs) visualized on contrast-enhanced black-blood MRI (CEBBI) for detecting and classifying blood-brain barrier disruption (BBBD) in patients with ischemic stroke.</p><p><strong>Materials & methods: </strong>This retrospective study included 168 hospitalized patients with acute, subacute, and chronic ischemic stroke who underwent pre- and post-CEBBI imaging. BBBD was classified into three groups based on the enhancement ratio (ER) of normal-appearing white matter (NAWM) before and after contrast administration, as well as leptomeningeal and parenchymal enhancement patterns on CEBBI: no BBBD (NoBBBD), subtle BBBD (SuBBBD), and significant BBBD (SiBBBD). The number of PECVs was recorded bilaterally from the CEBBI source images. Univariate and multivariate linear regression analyses were performed to identify factors associated with BBBD.</p><p><strong>Results: </strong>Increased BBBD was significantly associated with a higher number of PECVs in both the ipsilateral and contralateral hemispheres of the infarct (all p < 0.01). Patients with SuBBBD had significantly more PECVs than those with NoBBBD (median: 14 vs. 3, p < 0.01), and the SiBBBD group had significantly more PECVs than the SuBBBD group (median: 18 vs. 14, p < 0.01). In the ipsilateral hemisphere, a median PECV count of 4.5 distinguished NoBBBD from SuBBBD with 83.3% sensitivity and 83.1% specificity. Similarly, a median count of 8.5 PECVs discriminated SuBBBD from SiBBBD with 78.5% sensitivity and 85.0% specificity.</p><p><strong>Conclusions: </strong>Our findings demonstrated that PECVs are more numerous in the SiBBBD group compared to SuBBBD and NoBBBD groups. The number of PECVs detected on high-resolution post-CEBBI provides a reliable, semi-quantitative method for identifying and classifying BBBD in patients with ischemic stroke. This method offers a direct assessment of BBB integrity and could improve clinical evaluation of stroke-related BBB disruption.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2295-2307"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266924","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 : 2025-09-01Epub Date: 2025-07-26DOI: 10.1007/s00234-025-03724-9
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
{"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":"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":"2519-2526"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","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}
NeuroradiologyPub Date : 2025-09-01Epub Date: 2025-08-07DOI: 10.1007/s00234-025-03718-7
Edwin Gulko, Sheldon Lerman, Eris Spirollari, Sabrina Zeller, Monica Mureb, John Wainwright, Akihiko Oishi, Anoosh Kouyoumdjian, Kevin Clare, Anna Rozenshtein, Fawaz Al-Mufti, Chirag Gandhi, Hasit Mehta
{"title":"The delayed spectral sign in Post-transfer CT imaging: an imaging marker of stroke severity and hemorrhagic risk.","authors":"Edwin Gulko, Sheldon Lerman, Eris Spirollari, Sabrina Zeller, Monica Mureb, John Wainwright, Akihiko Oishi, Anoosh Kouyoumdjian, Kevin Clare, Anna Rozenshtein, Fawaz Al-Mufti, Chirag Gandhi, Hasit Mehta","doi":"10.1007/s00234-025-03718-7","DOIUrl":"10.1007/s00234-025-03718-7","url":null,"abstract":"<p><strong>Purpose: </strong>Acute stroke transfer patients often undergo repeat computed tomography (CT) imaging upon arrival at a thrombectomy-capable center. Often, there is residual intravenous (IV) \"contrast staining\" of acute infarcts on the initial post-transfer CT head exam, which we have detected utilizing dual-layer CT spectral virtual non-contrast images. We term this the delayed spectral sign (DSS). We sought to measure the incidence of the DSS on initial post-transfer CT head exams and evaluate for any associated clinical outcomes.</p><p><strong>Methods: </strong>We performed a retrospective study of acute stroke transfer patients with residual IV contrast on initial post-transfer CT spectral scanner head exams. Two neuroradiologists independently reviewed CT head exams and virtual non-contrast images to measure the incidence of the DSS. Data was analyzed to evaluate significant differences between DSS and non-DSS groups.</p><p><strong>Results: </strong>67 acute stroke transfer patients met inclusion criteria, of whom 8 (11.9%) demonstrated the DSS. Patients with the DSS were more likely to have a large vessel occlusion (100% vs. 64.4%, P = 0.049) and an M1 middle cerebral artery (MCA) occlusion (OR 4.9, P = 0.046). DSS patients had a greater prevalence of intracranial hemorrhage on follow-up CT or magnetic resonance imaging (MRI) exams (OR 9.259, P = 0.008). DSS patients had a higher average National Institute of Health Stroke Scale (NIHSS) upon discharge (22.25 ± 18.3), although this was not statistically significant (P = 0.079). In multivariate regression analyses, DSS was positively associated with intracranial hemorrhage on inpatient follow-up CT or MRI (OR 9.683, P = 0.012).</p><p><strong>Conclusion: </strong>The delayed spectral sign is associated with greater incidences of large vessel occlusions and intracranial hemorrhage on follow-up head imaging.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2349-2356"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794988","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":"A systematic review on volumetric analysis in orbital MRI.","authors":"Michiel Degraeve, Virginie Ninclaus, Julie Deferm, Nele Brusselaers, Reinhilde Jacobs, Robin Willaert","doi":"10.1007/s00234-025-03734-7","DOIUrl":"10.1007/s00234-025-03734-7","url":null,"abstract":"<p><strong>Aim: </strong>Volumetric analysis of orbital soft tissues using magnetic resonance imaging (MRI) offers valuable diagnostic and pathophysiological insights into orbital inflammation, trauma, and tumors. However, the optimal MRI protocols and post-processing methods for specific conditions remain unclear.</p><p><strong>Methods: </strong>A systematic search was performed in PubMed/MEDLINE, Web of Science, and Cochrane Library for all studies published before November 2024. This review adhered to PRISMA guidelines and was prospectively registered. Primary outcomes included (i) MRI acquisition parameters, (ii) post-processing volumetry techniques, and (iii) regions of interest (ROI). Secondary outcomes assessed clinical relevance and validation methods.</p><p><strong>Results: </strong>From 4323 records, 35 articles were included. Significant heterogeneity was observed regarding MRI acquisition and post-processing techniques. Volumetry most commonly targeted extraocular muscles and orbital fat, although definitions of ROI borders varied widely. Analysis of the globe, orbital cavity, optic nerve, and lacrimal gland was less frequent. Validation of volumetric methods was reported in only a minority of studies.</p><p><strong>Conclusions: </strong>Accurate interpretation of volumetric data requires careful consideration of technical variables. Standardization of acquisition protocols, validated segmentation methods, and automated volumetry approaches are essential for enhancing reproducibility and clinical applicability. This systematic review provides a comprehensive framework for future research in orbital MRI volumetry.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2533-2549"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006386","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 : 2025-09-01Epub Date: 2025-07-15DOI: 10.1007/s00234-025-03702-1
Sricharan S Veeturi, Kerry E Poppenberg, Nandor K Pinter, Vinay Jaikumar, Elad I Levy, Adnan H Siddiqui, Vincent M Tutino
{"title":"Evaluation of radiogenomics for risk stratification of intracranial aneurysms: a pilot study.","authors":"Sricharan S Veeturi, Kerry E Poppenberg, Nandor K Pinter, Vinay Jaikumar, Elad I Levy, Adnan H Siddiqui, Vincent M Tutino","doi":"10.1007/s00234-025-03702-1","DOIUrl":"10.1007/s00234-025-03702-1","url":null,"abstract":"<p><strong>Purpose: </strong>Aneurysm wall enhancement (AWE) is an imaging biomarker that could aid in risk stratification of intracranial aneurysms (IAs) In this pilot study, we explored the potential of a radiogenomics approach by combining blood-based biomarkers and AWE for better risk stratification of IAs.</p><p><strong>Methods: </strong>Patient specific vessel wall imaging scans and whole blood samples were obtained, and IAs were classified as high-risk or low-risk using two different metrics: symptomatic status (3 symptomatic vs. 13 asymptomatic) and PHASES score (4 with a high score vs. 12 with a low score). Radiomics features (RFs) were extracted from the pre- and post-contrast MRI for all IA sac walls, and significantly different RFs were identified through univariate analysis. RNA sequencing from whole blood samples for these patients was also performed to identify differentially expressed genes (DEGs) between high and low-risk IA groups. Principal component analysis (PCA) and clustering analysis were applied, using both risk metrics, to evaluate discriminatory power. Lastly, ontological and correlation analyses were carried out to investigate biological mechanisms associated with the DEGs.</p><p><strong>Results: </strong>Our analysis of 16 IAs identified 12 RFs and 97 genes that were significantly different between symptomatic and asymptomatic IAs (RF: p-value < 0.05; DEG: fold-change > 2, p-value < 0.01). Examining risk with respect to PHASES score, we identified 6 significant radiomics features and 38 differentially expressed genes. Through principal component analysis and clustering analysis, we found that DEGs only and radiogenomics features produced a better separation between high- and low-risk than RFs alone for both risk metrics. Furthermore, we found a significant correlation between 7 unique RFs and 38 DEGs.</p><p><strong>Conclusion: </strong>We demonstrated that a radiogenomics approach can help in better risk stratification of IAs.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"2425-2435"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12546524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637595","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 : 2025-08-30DOI: 10.1007/s00234-025-03749-0
Wei Jun Lee, Rafaela Correia Maciel, Rahim Abo Kasem, Zaid Najdawi, Mohamed Elfil, Mohammad Khasawneh, Marianna Leite, Davi Barbosa Pereira da Silva, Rodrigo Dos Reis Schevz, Gabriela Quaresma Sardella, Gabor Toth, Fawaz Al-Mufti
{"title":"Direct aspiration versus stent retriever as First-line thrombectomy techniques for acute Basilar artery occlusions: an updated systematic review and Meta-Analysis.","authors":"Wei Jun Lee, Rafaela Correia Maciel, Rahim Abo Kasem, Zaid Najdawi, Mohamed Elfil, Mohammad Khasawneh, Marianna Leite, Davi Barbosa Pereira da Silva, Rodrigo Dos Reis Schevz, Gabriela Quaresma Sardella, Gabor Toth, Fawaz Al-Mufti","doi":"10.1007/s00234-025-03749-0","DOIUrl":"https://doi.org/10.1007/s00234-025-03749-0","url":null,"abstract":"<p><strong>Background: </strong>Endovascular thrombectomy is the primary treatment for acute basilar artery occlusion (BAO), with direct aspiration (DA) and stent retriever (SR) as the main techniques. This updated meta-analysis aims to compare these two techniques in terms of efficacy and safety outcomes.</p><p><strong>Methods: </strong>A search was performed across PubMed, Embase, and Cochrane databases on December 23, 2024. Primary outcomes included good and favorable functional outcomes. Secondary outcomes included procedural outcomes, such as successful and complete recanalization, and safety outcomes, including symptomatic intracranial hemorrhage and mortality at 90 days. Leave-one-out sensitivity analysis was used to assess each study's influence on the pooled effect by systematically excluding one study at each time.</p><p><strong>Results: </strong>Out of 4,424 studies initially screened, a total of 14 studies with 1,851 patients were ultimately included (DA = 830, SR = 1,021). There were no significant differences in favorable and good functional outcomes (OR 1.07; 95% CI 0.82-1.39; P = 0.626; OR 1.19; 95% CI 0.94-1.50; P = 0.152, respectively) nor mortality (OR 0.83; 95% CI 0.63-1.09; P = 0.177). A significant difference was observed in complete recanalization rates in sensitivity analyses, favoring DA, which was not evident in the successful recanalization rates. The DA group also demonstrated a lower risk of sICH (OR 0.56; 95% CI 0.34-0.93; P = 0.025).</p><p><strong>Conclusion: </strong>Our meta-analysis shows that DA and SR techniques for BAO thrombectomy each have distinct procedural trade-offs. Due to data heterogeneity and observational design, neither method can be definitively recommended. Treatment decisions should be individualized until high-quality randomized data are available.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963335","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 : 2025-08-28DOI: 10.1007/s00234-025-03747-2
Ocílio Ribeiro Golçalves, Victor Arthur Ohannesian, Mariana Letícia de Bastos Maximiano, Henrique Maia, Marina Vilardo, Luis Fravio Fabrini Paleare, Christian Ken Fukunaga, João Victor Araujo de Oliveira, Társis Vinícius Cronemberger, Márcio Yuri Ferreira, Kelson James Almeida, João Paulo Mota Telles
{"title":"Feasibility, efficacy, and safety of sheathless transradial mechanical thrombectomy in acute ischemic stroke: A meta-analysis.","authors":"Ocílio Ribeiro Golçalves, Victor Arthur Ohannesian, Mariana Letícia de Bastos Maximiano, Henrique Maia, Marina Vilardo, Luis Fravio Fabrini Paleare, Christian Ken Fukunaga, João Victor Araujo de Oliveira, Társis Vinícius Cronemberger, Márcio Yuri Ferreira, Kelson James Almeida, João Paulo Mota Telles","doi":"10.1007/s00234-025-03747-2","DOIUrl":"https://doi.org/10.1007/s00234-025-03747-2","url":null,"abstract":"<p><strong>Introduction: </strong>Mechanical thrombectomy (MT) is the standard of care for large vessel occlusions (LVO) in acute ischemic stroke (AIS), traditionally performed using transfemoral access (TFA). However, the sheathless transradial approach (sTRA) has emerged as a viable alternative, particularly for patients with complex vascular anatomies.</p><p><strong>Objectives: </strong>This systematic review and meta-analysis aim to evaluate the feasibility, efficacy, and safety of sTRA in MT for AIS.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis following PRISMA guidelines, including observational studies that reported on MT using sTRA. Primary outcomes included the proportion of successful reperfusion (modified Treatment in Cerebral Infarction [mTICI] grade 2b-3), crossover rates from radial to femoral access, and symptomatic intracerebral hemorrhage (sICH). Secondary outcomes assessed were minor access site-related complications.</p><p><strong>Results: </strong>A total of four studies were included, comprising 138 patients who underwent MT with sTRA. The pooled analysis revealed a high rate of successful reperfusion (97%; 95% CI: 95-100%), with a low crossover rate to TFA (3%; 95% CI: 0-7%). The incidence of sICH was low, at 4% (95% CI: 0-8%), and minor access site-related complications occurred in 5% of patients (95% CI: 2-9%).</p><p><strong>Conclusion: </strong>This meta-analysis demonstrates that sTRA is a feasible and effective approach for MT in AIS, with a favorable safety profile. The technique offers high recanalization rates, low complication rates, and minimal need for crossover to TFA. Future randomized controlled trials comparing MT with sTRA and TFA are needed to confirm these results and refine patient selection criteria for this approach. Despite encouraging results, the small number of included studies and their observational design limit the generalizability of the findings. Therefore, further comparative and randomized trials are needed to validate these outcomes.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963265","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 : 2025-08-25DOI: 10.1007/s00234-025-03744-5
Bardia Hajikarimloo, Salem M Tos, Abhishek Saha, Ibrahim Mohammadzadeh, Ali Mortezaei, Rana Hashemi, Dorsa Najari, Azin Ebrahimi, Adam A Dmytriw, Mohammad Amin Habibi
{"title":"Efficacy and safety of Derivo embolization device in intracranial aneurysms: A systematic review and Meta-Analysis.","authors":"Bardia Hajikarimloo, Salem M Tos, Abhishek Saha, Ibrahim Mohammadzadeh, Ali Mortezaei, Rana Hashemi, Dorsa Najari, Azin Ebrahimi, Adam A Dmytriw, Mohammad Amin Habibi","doi":"10.1007/s00234-025-03744-5","DOIUrl":"https://doi.org/10.1007/s00234-025-03744-5","url":null,"abstract":"<p><strong>Background: </strong>Derivo embolization device (DED) is a second-generation flow diverter (FD) that has been increasingly used in the management of intracranial aneurysms (IAs). DEDs consist of 48 nitinol wires with an inner platinum core and a blue-colored coating of oxides and oxynitrides, which mitigates these FDs' thrombogenicity. This systematic review and meta-analysis evaluate the efficacy and safety of DED in IAs.</p><p><strong>Methods: </strong>On February 25, 2025, a comprehensive search was conducted across PubMed, Embase, Scopus, and Web of Science in accordance with PRISMA guidelines. Studies reporting clinical and radiological outcomes of DED were included.</p><p><strong>Results: </strong>Thirteen studies involving 1125 patients and 1338 aneurysms were included. The meta-analysis revealed a pooled complete occlusion rate of 83% (95% CI: 79%-87%), an adequate occlusion rate of 92% (95% CI: 84%-97%), and a favorable outcomes rate of 97% (95% CI: 92%-100%). Additionally, the meta-analysis demonstrated a pooled adjuvant coiling rate of 15% (95% CI: 7%-26%), a major ischemic complication rate of 1% (95% CI: 0%-2%), and a major hemorrhagic complication rate of 0% (95% CI: 0%-1%).</p><p><strong>Conclusion: </strong>The current study's findings revealed that DEDs are associated with promising complete and adequate occlusion rates concurrent with low rates of major ischemic and hemorrhagic complications.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963309","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}