Neuroradiology Journal最新文献

{"title":"Drug response testing for elective carotid artery stenting: Prevalence of non-response to aspirin and clopidogrel and influence on post-interventional occurrence of cerebral ischemia.","authors":"Farzaneh Yousefi, Dimah Hasan, Frederic De Beukelaer, Hani Ridwan, Omid Nikoubashman, Martin Wiesmann, Charlotte S Weyland","doi":"10.1177/19714009251372360","DOIUrl":"https://doi.org/10.1177/19714009251372360","url":null,"abstract":"<p><p>BackgroundThe patient-associated prevalence of Clopidogrel (CPG)-and Aspirin (ASS)-nonresponse is not well understood and varies depending on the patient population. The influence of responder status for platelet inhibition in patients eligible for carotid artery stenting (CAS) on post-interventional cerebral ischemia is unknown.MethodsWe conducted a retrospective, mono-center analysis of all patients with response-test undergoing elective CAS between 2010 and 2024 and available MRI before and after CAS. Study groups were formed according to ASS- and CPG-response. Cerebral ischemia patterns were compared between study groups in univariate analysis and patient-associated co-morbidities were tested for association with drug resistance or infarction frequency.ResultsIn total, 50/68 (73.5%) of patients showed adequate response to ASS and CPG. Non-response to CPG was higher than to ASS (clopidogrel resistance rate: 14.8%, aspirin resistance rate: 9.2%). All patients with non-response were bridged with GP IIb/IIIa antagonist tirofiban during CAS. Under these conditions, the responder status did not influence post-interventional cerebral infarction patterns.ConclusionAntiplatelet non-response, especially for CPG, is very frequent in patients undergoing CAS. When bridging patients with tirofiban during intervention, responder status had no influence on post-interventional cerebral infarction patterns.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009251372360"},"PeriodicalIF":0.8,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of the pipeline vantage flow diverter for the treatment of saccular aneurysms in the posterior cerebral circulation.","authors":"Omar Abu-Fares, Antonis Adamou, Peter Raab, Heinrich Lanfermann, Alexander Sirakov, Marie Middendorff, Harold F Hounchonou, Joachim K Krauss, Shadi Al-Afif","doi":"10.1177/19714009251373070","DOIUrl":"https://doi.org/10.1177/19714009251373070","url":null,"abstract":"<p><p>IntroductionPosterior circulation aneurysms are particularly challenging to treat due to their anatomical complexity and the high perforator density within this region. The pipeline vantage flow diverter (PVFD) has shown promising results in treating anterior circulation aneurysms. However, its efficacy and safety in treating posterior circulation saccular aneurysms are not well investigated.MethodsSingle-center study reviewed patients with posterior circulation aneurysms treated with the PVFD between September 2021 and March 2024. Patients and aneurysm characteristics, clinical results, and radiological results were documented.Results22 patients harboring 24 aneurysms were identified. All aneurysms had a saccular morphology. Complications included ischemic events in two patients (8.3%), one leading to mRS deterioration from 0 to 3. One cerebral hemorrhage leading to mRS shift from 0 to 1 was also documented. At the latest imaging follow-up available (median 14.3 months), complete aneurysm occlusion (Class I, Raymond-Roy occlusion classification (RROC) was achieved in 50% of the cases, residual neck (Class II) in 41.7%, and residual aneurysm (Class III) in 8.3%. Basilar bifurcation aneurysms had lower complete occlusion rates (RROC I: 33.3%) and higher complication rates (16.7% with mRS shift) compared to other locations. In-stent stenosis was rare (4.5%). A limitation of the study is the retrospective, single-center study design.ConclusionThe PVFD demonstrates high occlusion rates and a favorable safety profile in the treatment of saccular aneurysms in the posterior circulation. However, treatment of basilar bifurcation aneurysms with the PVFD remains challenging due to the complex anatomy and high-flow dynamics in this location.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009251373070"},"PeriodicalIF":0.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12391030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Widening the treatment of shallow intracranial aneurysms with intrasaccular flow disruption: The flat WEB experience.","authors":"Federico Sabuzi, Nicola Cavasin, Mariafrancesca Trulli, Simone Di Candia, Michelangelo Digregorio, Francesco Garaci, Valerio Da Ros","doi":"10.1177/19714009251373065","DOIUrl":"https://doi.org/10.1177/19714009251373065","url":null,"abstract":"<p><p>The Woven EndoBridge (WEB) device's effectiveness and safety have been thoroughly assessed in several clinical practice trials. The availability of new WEB sizes expanded the indications for the endovascular treatment of intracranial wide-necked aneurysms. We retrospectively analysed data from all patients with intracranial aneurysms treated with a 6 × 2 or 7 × 2 WEB in two institutions; endovascular embolization was performed both in unruptured and ruptured aneurysms. Seven patients with 7 wide-necked aneurysms were included; one aneurysm was ruptured. All aneurysms involved the anterior circulation. Technical success of embolization performed with flat WEB devices was accomplished and no intraprocedural complications occurred. At 3 months follow-up, adequate occlusion was obtained for six treated aneurysms. With the availability of new WEB sizes, broad-based aneurysms with unfavourable height and aspect ratio are suitable for embolization using intrasaccular flow disruption in our preliminary experience; larger series are needed to confirm their long-term efficacy.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009251373065"},"PeriodicalIF":0.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrograde transvenous coil embolization in spinal epidural arteriovenous fistula with radiculo-perimedullary reflux.","authors":"Torcato Meira, James Lord, David Volders, Karel Terbrugge, Robert Willinsky, Ivan Radovanovic, Eef J Hendriks","doi":"10.1177/19714009251373064","DOIUrl":"https://doi.org/10.1177/19714009251373064","url":null,"abstract":"<p><p>Spinal epidural arteriovenous fistulas (SEAVFs) with intradural reflux are rare but important vascular lesions that may cause progressive myelopathy due to spinal cord venous hypertension. Although traditionally managed by means of arterial embolization or surgical disconnection, these approaches can pose risks, particularly when critical vascular structures, such as the artery of Adamkiewicz, originate in close proximity to the fistulous site. We report the case of a patient in their 60s who presented with progressive paraparesis over approximately 1 year, ultimately attributed to an SEAVF located adjacent to the right L1-L2 neural foramen, with radiculo-perimedullary reflux. The artery of Adamkiewicz was visualized with its origin near the shunt site, rendering arterial embolization unsafe and prompting selection of a purely transvenous endovascular approach. Venous access was obtained via the azygos system, and a microcatheter was navigated through the epidural venous pouch to reach a cranially directed draining vein extending toward the perimedullary venous system, which was then embolized using detachable platinum coils. The procedure achieved complete occlusion of the targeted vein, with early neurological improvement and significant reduction in spinal cord edema on follow-up imaging. This case supports the feasibility, safety, and efficacy of transvenous embolization for SEAVFs and underscores its expanding role in the treatment of complex spinal vascular lesions.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009251373064"},"PeriodicalIF":0.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the diagnostic accuracy of AI in ischemic and hemorrhagic stroke: A comprehensive meta-analysis.","authors":"Neeraj Gul, Yumna Fatima, Hamid Saeed Shaikh, Maham Raheel, Arslan Ali, S Umar Hasan","doi":"10.1177/19714009251373062","DOIUrl":"https://doi.org/10.1177/19714009251373062","url":null,"abstract":"<p><p>Stroke poses a significant health challenge, with ischemic and hemorrhagic subtypes requiring timely and accurate diagnosis for effective management. Traditional imaging techniques like CT have limitations, particularly in early ischemic stroke detection. Recent advancements in artificial intelligence (AI) offer potential improvements in stroke diagnosis by enhancing imaging interpretation. This meta-analysis aims to evaluate the diagnostic accuracy of AI systems compared to human experts in detecting ischemic and hemorrhagic strokes. The review was conducted following PRISMA-DTA guidelines. Studies included stroke patients evaluated in emergency settings using AI-Based models on CT or MRI imaging, with human radiologists as the reference standard. Databases searched were MEDLINE, Scopus, and Cochrane Central, up to January 1, 2024. The primary outcome measured was diagnostic accuracy, including sensitivity, specificity, and AUROC and the methodological quality was assessed using QUADAS-2. Nine studies met the inclusion criteria and were included. The pooled analysis for ischemic stroke revealed a mean sensitivity of 86.9% (95% CI: 69.9%-95%) and specificity of 88.6% (95% CI: 77.8%-94.5%). For hemorrhagic stroke, the pooled sensitivity and specificity were 90.6% (95% CI: 86.2%-93.6%) and 93.9% (95% CI: 87.6%-97.2%), respectively. The diagnostic odds ratios indicated strong diagnostic efficacy, particularly for hemorrhagic stroke (DOR: 148.8, 95% CI: 79.9-277.2). AI-Based systems exhibit high diagnostic accuracy for both ischemic and hemorrhagic strokes, closely approaching that of human radiologists. These findings underscore the potential of AI to improve diagnostic precision and expedite clinical decision-making in acute stroke settings.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009251373062"},"PeriodicalIF":0.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward a high-quality evidence base for pediatric stroke intervention.","authors":"Adam A Dmytriw, Peter B Sporns","doi":"10.1177/19714009251373067","DOIUrl":"https://doi.org/10.1177/19714009251373067","url":null,"abstract":"","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009251373067"},"PeriodicalIF":0.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing efficacy and safety of direct aspiration versus stent retriever thrombectomy in acute basilar artery occlusion: A systematic review and meta-analysis.","authors":"Muhammad Hassan Waseem, Zain Ul Abideen, Kanza Farhan, Haseeb Javed Khan, Dua Ghori, Misha Ahmed, Muhammad Burhan Tariq, Sania Aimen, Muhammad Wajih Ansari, Rowaid Ahmad, Zara Fahim","doi":"10.1177/19714009251371266","DOIUrl":"https://doi.org/10.1177/19714009251371266","url":null,"abstract":"<p><p>Acute basilar artery occlusion (BAO) can lead to severe stroke and is linked to significant disability or death if not treated. This meta-analysis evaluated the effectiveness and safety of first-line thrombectomy options: Direct Aspiration (DA) and Stent Retriever Thrombectomy (SRT) for acute BAO. Electronic databases, including PubMed, Cochrane Central, ScienceDirect, Embase, and Web of Science were searched from inception until July 2025. Studies were included if they were RCTs or observational cohorts involving adults with acute BAO, comparing DA and SRT. The risk ratios (RR) and mean differences (MD) were pooled using Review Manager version. The Newcastle-Ottawa Scale (NOS) was used to assess quality. This meta-analysis included fifteen observational studies pooling 2214 patients. DA significantly increased the postoperative successful (RR = 1.04; 95% CI: 1.01 to 1.07; <i>p</i> = 0.008) and complete (RR = 1.19; 95% CI: 1.03 to 1.38; <i>p</i> = 0.02) recanalization compared to SRT. Similarly, symptomatic intracerebral hemorrhage (sICH) incidence was significantly reduced in the DA arm (RR = 0.65; 95% CI: 0.44 to 0.97; <i>p</i> = 0.04). DA is also associated with decreased procedural duration (MD = -35.17 min; 95% CI: -47.97 to -22.37; <i>p</i> < 0.00001). Meanwhile other outcomes, including postoperative mortality, rescue therapy, and favorable functional outcome were comparable between the 2 groups. DA demonstrated superior recanalization rates, reduced procedural duration, and a lower incidence of sICH compared to SRT. However, both techniques were comparable regarding other outcomes. Nevertheless, the observational study design limits the strength of the conclusion drawn.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009251371266"},"PeriodicalIF":0.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of recurrent cerebral bifurcation aneurysms using flow diverter stent silk vista: A monocentric case series.","authors":"Bartolo Andrea, Di Castelnuovo Augusto, Wlderk Andrea, Bartolo Marcello, Mangiafico Salvatore, Ciavarro Marco, Grillea Giovanni","doi":"10.1177/19714009251362819","DOIUrl":"10.1177/19714009251362819","url":null,"abstract":"<p><p>ObjectiveTo evaluate the efficacy and safety of the Silk Vista flow diverter stent in treating recurrent cerebral bifurcation aneurysms, highlighting angiographic and clinical outcomes in a monocentric case series.MethodsA retrospective analysis of 12 patients (7 male, five female) with recurrent bifurcation aneurysms treated exclusively with the Silk Vista flow diverter was conducted. Aneurysms were located in the anterior communicating artery (75%), middle cerebral artery (17%), and basilar artery (8%). All patients received dual antiplatelet therapy for ten days pre-procedure and 6 months post-procedure, followed by aspirin monotherapy. The O'Kelly-Marotta (OKM) scale was used to assess aneurysm filling, where Grade D indicates complete occlusion. Clinical outcomes were measured using the modified Rankin Scale (mRS), with scores of 0-1 reflecting no or minimal disability.ResultsAt the end of the procedure, 75% (<i>n</i> = 9) of patients exhibited stagnant contrast filling within the aneurysm sac (OKM Grade C) during the venous phase. Periprocedural thromboembolic complications occurred in 17% (<i>n</i> = 2) of cases, without clinical sequelae. No post-hospital complications were observed, and all patients maintained mRS scores of 0-1 at discharge. At 1-year follow-up, complete aneurysm exclusion (OKM Grade D) was achieved in 83% (<i>n</i> = 10), while minimal neck perfusion (OKM Grade C) persisted in 17% (<i>n</i> = 2). No new neurological deficits or deterioration occurred.ConclusionDespite the small sample size and single-center design, the Silk Vista flow diverter demonstrated favorable angiographic and clinical outcomes, supporting its role as a viable and safe option in this complex patient population.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009251362819"},"PeriodicalIF":0.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12343541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High grade torcular DAVF: Technical aspects to safely sacrifice the straight sinus.","authors":"James Lord, Mohammad Al-Tibi, David Volders, Ivan Radovanovic, Karel Terbrugge, Timo Krings, Eef J Hendriks","doi":"10.1177/19714009251362825","DOIUrl":"10.1177/19714009251362825","url":null,"abstract":"<p><p>High grade torcular DAVFs can be challenging to treat, particularly when there is retrograde flow in the straight sinus and deep venous system. We describe the technical steps to safely sacrifice the straight sinus, including preoperative MRI findings, arterial and venous cerebral flow assessment and key points for endovascular treatment.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009251362825"},"PeriodicalIF":0.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12325241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IDH wild-type glioblastoma: Predictive value of standard-of-care (SOC) MRI for establishing MGMT promoter methylation status.","authors":"Kamand Khalaj, Elham Tavakkol, Luis Nunez, Jordan Jafarnia, Antonio Dono, Octavio Arevalo, Andres Rodriguez, Jay-Jiguang Zhu, Yoshua Esquenazi, Roy Riascos, David Timaran-Montenegro","doi":"10.1177/19714009251365745","DOIUrl":"10.1177/19714009251365745","url":null,"abstract":"<p><p>PurposeOxygen 6-methylguanine-DNA methyltransferase (MGMT) promoter methylation is associated with better chemotherapy response and prognosis in glioblastoma patients. This study evaluates the prognostic value of routine MRI findings at initial diagnosis to determine MGMT promoter methylation status.MethodsA retrospective study was performed on 85 patients with histologically confirmed IDH wild-type glioblastoma. Patients were divided into two groups based on MGMT promoter status: methylated (33 [38.8%]) and unmethylated (52 [61.1%]). MRI findings were assessed using the Visually Accessible Rembrandt Imaging lexicon, and variables were analyzed using univariate analysis (X²/Fisher's test) and logistic regression for independent predictors of MGMT promoter methylation.ResultsA thick enhancing tumoral margin (≥3 mm) was present in 67.3% of MGMT unmethylated glioblastomas and 32.7% of MGMT promoter methylated glioblastomas (<i>p</i> = .05). Tumoral cortical extension was observed in 68.7% of unmethylated cases versus 31.3% in methylated cases (<i>p</i> = .01). Non-enhancing tumors were predominantly MGMT methylated (83.3%). In multivariate analysis, tumoral cortical involvement and non-enhancing tumors were independent predictors of MGMT promoter methylation. In survival analysis, higher progression-free survival rates were identified in patients with MGMT promoter methylation (<i>p</i> = .05) and in patients without cortical tumoral extension (<i>p</i> = .05).ConclusionOur study suggests that while the predictive power of the assessed parameters is modest, thick enhancing tumoral margins and cortical tumor extension were more frequently identified in MGMT unmethylated glioblastomas. Conversely, 83.3% of non-enhancing tumors showed MGMT promoter methylation. Furthermore, MGMT promoter methylation and cortical extension were associated with progression-free survival.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009251365745"},"PeriodicalIF":0.8,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12321826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}