Neuroradiology JournalPub Date : 2025-02-01Epub Date: 2024-03-24DOI: 10.1177/19714009241242651
Buse Cagla Ari, Baran Baydar, Mehmet Elgezen
{"title":"Carotidynia: Overview of an uncommon identification for unilateral neck pain.","authors":"Buse Cagla Ari, Baran Baydar, Mehmet Elgezen","doi":"10.1177/19714009241242651","DOIUrl":"10.1177/19714009241242651","url":null,"abstract":"<p><strong>Background: </strong>Carotidynia, also known as Fay Syndrome, manifests as an atypical facial neuralgia characterized by an unusual neck pain extending towards the head and associated with carotid artery tenderness. Diagnostic criteria include neck tenderness, elevated carotid pulse without anatomical abnormalities, and neck distension. It was initially classified as a vascular headache but later re-evaluated and reclassified as a nonentity-a general condition caused by nonvascular factors. The etiology has not been extensively elucidated.</p><p><strong>Case presentation: </strong>We present two cases characterized by dysphagia, intermittent discomfort, and numbness in the throat and cervical region. Although the neurological examinations yielded no abnormalities, the diagnosis of carotidynia was ultimately established among the differential diagnoses upon the identification of wall thickening and inflammatory alterations through neuroimaging.</p><p><strong>Conclusions: </strong>Carotidynia is consistent with idiopathic vasculitis near the distal common carotid artery. Inflammatory processes trigger sympathetic plexus stimulation, causing discomfort in the head and neck. Neuroimaging resolves ambiguities in idiopathic unilateral neck pain, detecting soft tissue growth near the carotid artery. \"Carotidynia\" now refers to a diagnostic symptom and clinical entity encompassing a variety of disorders; therefore, approach to definition remains controversial. This report aims to raise healthcare awareness by highlighting two different cases of carotidynia.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"124-127"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140207927","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}
Neuroradiology JournalPub Date : 2025-02-01Epub Date: 2024-08-08DOI: 10.1177/19714009241269540
Shruti Mishra, Ashok Srinivasan, Lauren Kelsey, Katherine Bojicic, Maria Masotti, Qiaochu Chen, Ellen Hoeffner, Steven Kronick, Diana Gomez-Hassan
{"title":"Implementing a rapid cord compression Magnetic Resonance Imaging protocol in the emergency department: Lessons learned.","authors":"Shruti Mishra, Ashok Srinivasan, Lauren Kelsey, Katherine Bojicic, Maria Masotti, Qiaochu Chen, Ellen Hoeffner, Steven Kronick, Diana Gomez-Hassan","doi":"10.1177/19714009241269540","DOIUrl":"10.1177/19714009241269540","url":null,"abstract":"<p><strong>Background & purpose: </strong>(1) Evaluate efficacy of an abbreviated total spine protocol in triaging emergency department (ED) patients through retrospective evaluation. (2) Describe patient outcomes following implementation of a rapid cord compression protocol.</p><p><strong>Methods: </strong>(1) All contrast-enhanced total spine magnetic resonance imaging studies (MRIs) performed on ED patients (<i>n</i> = 75) between 10/1-12/31/2022 for evaluation of cord compression were included. Two readers with 6 and 5 years of experience blindly reviewed the abbreviated protocol (comprised of sagittal T2w and axial T2w sequences) assessing presence of cord compression or severe spinal canal stenosis. Ground truth was consensus by a neuroradiology fellow and 2 attendings. (2) The implemented rapid protocol included sagittal T1w, sagittal T2w Dixon and axial T2w images. All ED patients (<i>n</i> = 85) who were imaged using the rapid protocol from 5/1-8/31/2023 were included. Patient outcomes and call-back rates were determined through chart review.</p><p><strong>Results: </strong>(1) Sensitivity and specificity for severe spinal canal stenosis and/or cord compression was 1.0 and 0.92, respectively, for reader 1 and 0.78 and 0.85, respectively, for reader 2. Negative predictive value was 1.0 and 0.97 for readers 1 and 2, respectively. (2) The implemented rapid cord compression protocol resulted in 60% reduction in imaging time at 1.5T. The call-back rate for additional sequences was 7%. In patients who underwent surgery, no additional MRI images were acquired in 82% of cases (9/11).</p><p><strong>Conclusions: </strong>Implementing an abbreviated non-contrast total spine protocol in the ED results in a low call-back rate with acquired MRI images proving sufficient for both triage and treatment planning in most patients.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"79-86"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908007","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}
Neuroradiology JournalPub Date : 2025-02-01Epub Date: 2024-03-23DOI: 10.1177/19714009241242587
Ian Mark, Ajay Madhavan, Carrie Carr, Jeremy Cutsforth-Gregory
{"title":"Intrathecal hematoma following epidural blood patch: An alternative mechanism to intrathecal puncture.","authors":"Ian Mark, Ajay Madhavan, Carrie Carr, Jeremy Cutsforth-Gregory","doi":"10.1177/19714009241242587","DOIUrl":"10.1177/19714009241242587","url":null,"abstract":"<p><p>Intrathecal blood after a percutaneous epidural blood patch is a known complication, one that has been previously attributed to inadvertent needle tip position in the subarachnoid space. We present two cases with imaging confirmation of an alternative mechanism, one that includes blood transferring from the epidural space to the subarachnoid space through a pre-existing dural defect.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"121-123"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140194828","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 outcome of bridge mechanical thrombectomy with different IV-tPA dosages in the standard and extended time window in real-world practice.","authors":"Hao-Te Liu, Wen-Chun Deng, Ching-Wen Chang, Yi Ming Wu, Ho-Fai Wong, Chien-Hung Chang, Mun-Chun Yeap, Ching-Chang Chen, Chung-Ting Chen, Yu-Ting Huang, Yao-Liang Chen","doi":"10.1177/19714009241269447","DOIUrl":"10.1177/19714009241269447","url":null,"abstract":"<p><strong>Background: </strong>Differences of treatment outcome between full or reduced dose of tissue plasminogen activator (tPA) for bridge mechanical thrombectomy (MT) in the extended time window have not been clearly established. We aimed to present real-world results of bridge MT with different tPA dosages in the standard and extended windows.</p><p><strong>Materials and methods: </strong>Patients with anterior circulation stroke treated with MT between 2017 and 2021 at two stroke referral centers were retrospectively reviewed. Bridge MT with tPA were categorized as full (0.9 mg/kg) or reduced (<0.9 mg/kg) dose. Standard window (SW) cohort was defined as MT performed within 6 h of acute ischemic stroke onset, while those beyond 6 h as the extended window (EW) cohort. 90 days Modified Rankin Scale (mRS) score, technical treatment success, in-hospital mortality, and post-treatment hemorrhage were analyzed.</p><p><strong>Results: </strong>A total of 423 patients met the inclusion criteria, 218 of which treated in the SW, while 205 treated in the EW. Within the SW cohort, the full-dose tPA group demonstrated a higher proportion of good functional outcome (GFO) at 90 days (mRS0-3) versus reduced (49% vs 21%, <i>p</i> = 0.0358). The overall GFO of SW was higher than that of the EW cohort (33% vs 20%, <i>p</i> = 0.0480). Within the EW cohort, GFO was similar between full and reduced dose groups. Successful reperfusion rate was lower in SW versus EW cohorts (39% vs 58%, <i>p</i> = 0.0199).</p><p><strong>Conclusion: </strong>In real-world practice, the GFO of bridge MT is better than MT alone. The tPA dosage is not a determining factor of GFO in EW MT.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"87-92"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056895","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}
Neuroradiology JournalPub Date : 2025-02-01Epub Date: 2024-06-12DOI: 10.1177/19714009241260801
Adam A Dmytriw, Aristides Hadjinicolaou, Georgios Ntolkeras, Eleonora Tamilia, Matthew Pesce, Laura F Berto, P Ellen Grant, Elizabeth Pang, Banu Ahtam
{"title":"Magnetoencephalography for the pediatric population, indications, acquisition and interpretation for the clinician.","authors":"Adam A Dmytriw, Aristides Hadjinicolaou, Georgios Ntolkeras, Eleonora Tamilia, Matthew Pesce, Laura F Berto, P Ellen Grant, Elizabeth Pang, Banu Ahtam","doi":"10.1177/19714009241260801","DOIUrl":"10.1177/19714009241260801","url":null,"abstract":"<p><p>Magnetoencephalography (MEG) is an imaging technique that enables the assessment of cortical activity via direct measures of neurophysiology. It is a non-invasive and passive technique that is completely painless. MEG has gained increasing prominence in the field of pediatric neuroimaging. This dedicated review article for the pediatric population summarizes the fundamental technical and clinical aspects of MEG for the clinician. We discuss methods tailored for children to improve data quality, including child-friendly MEG facility environments and strategies to mitigate motion artifacts. We provide an in-depth overview on accurate localization of neural sources and different analysis methods, as well as data interpretation. The contemporary platforms and approaches of two quaternary pediatric referral centers are illustrated, shedding light on practical implementations in clinical settings. Finally, we describe the expanding clinical applications of MEG, including its pivotal role in presurgical evaluation of epilepsy patients, presurgical mapping of eloquent cortices (somatosensory and motor cortices, visual and auditory cortices, lateralization of language), its emerging relevance in autism spectrum disorder research and potential future clinical applications, and its utility in assessing mild traumatic brain injury. In conclusion, this review serves as a comprehensive resource of clinicians as well as researchers, offering insights into the evolving landscape of pediatric MEG. It discusses the importance of technical advancements, data acquisition strategies, and expanding clinical applications in harnessing the full potential of MEG to study neurological conditions in the pediatric population.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"7-20"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307130","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}
Neuroradiology JournalPub Date : 2025-02-01Epub Date: 2024-07-27DOI: 10.1177/19714009241269475
Vivek S Yedavalli, Dhairya A Lakhani, Manisha Koneru, Aneri B Balar, Cynthia Greene, Meisam Hoseinyazdi, Mehreen Nabi, Hanzhang Lu, Risheng Xu, Licia Luna, Justin Caplan, Adam A Dmytriw, Adrien Guenego, Jeremy J Heit, Gregory W Albers, Max Wintermark, Victor Urrutia, Judy Huang, Kambiz Nael, Richard Leigh, Elisabeth B Marsh, Argye E Hillis, Rafael H Llinas
{"title":"Simplifying venous outflow: Prolonged venous transit as a novel qualitative marker correlating with acute stroke outcomes.","authors":"Vivek S Yedavalli, Dhairya A Lakhani, Manisha Koneru, Aneri B Balar, Cynthia Greene, Meisam Hoseinyazdi, Mehreen Nabi, Hanzhang Lu, Risheng Xu, Licia Luna, Justin Caplan, Adam A Dmytriw, Adrien Guenego, Jeremy J Heit, Gregory W Albers, Max Wintermark, Victor Urrutia, Judy Huang, Kambiz Nael, Richard Leigh, Elisabeth B Marsh, Argye E Hillis, Rafael H Llinas","doi":"10.1177/19714009241269475","DOIUrl":"10.1177/19714009241269475","url":null,"abstract":"<p><strong>Background: </strong>Prolonged venous transit (PVT), defined as presence of time-to-maximum <math><mrow><mo>≥</mo></mrow></math> 10 s within the superior sagittal sinus (SSS) and/or torcula, is a novel, qualitatively assessed computed tomography perfusion surrogate parameter of venous outflow with potential utility in pretreatment acute ischemic stroke imaging for neuroprognostication. We aim to characterize the correlation between PVT and neurological functional outcomes in thrombectomy-treated patients.</p><p><strong>Methods: </strong>A prospectively-collected database of large vessel occlusion acute ischemic stroke patients treated with thrombectomy was retrospectively analyzed. Spearman's rank correlation coefficient and point-biserial correlations were performed between PVT status (i.e., no region, either SSS or torcula, or both), 90-day modified Rankin score (mRS), mortality (mRS 6), and poor functional outcome (mRS 4-6 vs 0-3).</p><p><strong>Results: </strong>Of 128 patients, correlation between PVT and 90-day mRS (<math><mrow><mi>ρ</mi></mrow></math> = 0.35, <i>p</i> < 0.0001), mortality (r = 0.26, <i>p</i> = 0.002), and poor functional outcome (r = 0.27, <i>p</i> = 0.002) were significant.</p><p><strong>Conclusion: </strong>There is a modest, significant correlation between PVT and severity of neurological functional outcome. Consequently, PVT is an easily-ascertained, qualitative metric that may be useful as an adjunct for anticipating a patient's clinical course. Future analyses will determine the significance of incorporating PVT in clinical decision-making.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"59-63"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789394","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}
Cem Bilgin, Rishabh Gupta, Atakan Orscelik, Amir Hassankhani, Yigit Can Senol, Hassan Kobeissi, Sherief Ghozy, Ramanathan Kadirvel, Waleed Brinjikji, David F Kallmes
{"title":"Impact of carotid artery tortuosity on mechanical thrombectomy outcomes: A systematic review.","authors":"Cem Bilgin, Rishabh Gupta, Atakan Orscelik, Amir Hassankhani, Yigit Can Senol, Hassan Kobeissi, Sherief Ghozy, Ramanathan Kadirvel, Waleed Brinjikji, David F Kallmes","doi":"10.1177/19714009251317499","DOIUrl":"10.1177/19714009251317499","url":null,"abstract":"<p><strong>Background: </strong>Carotid artery tortuosity (CAT) may complicate mechanical thrombectomy (MT), potentially causing delays or preventing recanalization. However, the relationship between CAT and MT outcomes remains largely unexplored. This systematic review aims to evaluate the existing evidence regarding the impact of CAT on MT outcomes.</p><p><strong>Methods: </strong>Following PRISMA guidelines, a systematic literature search was conducted using MEDLINE, EMBASE, Web of Science, Cochrane, and Scopus databases. Studies providing data for MT outcomes based on CAT status were included. Outcomes of interest included successful recanalization, first-pass efficacy (FPE), procedure time, functional independence, and procedure-related complications.</p><p><strong>Results: </strong>Our search identified nine studies with 2737 patients. Three studies employed DSA to assess tortuosity, whereas the remaining six studies preferred CTA. In seven studies, CAT was associated with prolonged procedure times. In five studies, successful recanalization rates were significantly lower in CAT patients as compared to patients with non-tortuous arteries. Two studies showed that CAT could alter FPE or successful recanalization rates of first-line MT techniques. No study found statistically significant relationships between CAT and functional independence. Three studies examined the association between CAT and safety outcomes, and only one study found increased intracranial hemorrhage rates in patients with CAT. All nine studies employed different CAT criteria.</p><p><strong>Conclusions: </strong>Despite the vast MT literature, the number of studies reporting CAT status remains low. CAT may affect procedure time and technical outcomes of MT. Therefore, employing a uniform CAT definition and reporting CAT more frequently can provide insights into management of patients with acute large vessel occlusions.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009251317499"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075871","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}
Neuroradiology JournalPub Date : 2025-02-01Epub Date: 2024-03-15DOI: 10.1177/19714009241240057
Abdul-Rahman Alkiswani, Cody Heskett, Lane Fry, Adeesya Gausper, Kevin Le, Aaron Brake, Catherine Lei, Frank A De Stefano, Ernest J Madarang, Jeremy Peterson, Koji Ebersole
{"title":"Aneurysm of the Artery of Wollschlaeger and Wollschlaeger.","authors":"Abdul-Rahman Alkiswani, Cody Heskett, Lane Fry, Adeesya Gausper, Kevin Le, Aaron Brake, Catherine Lei, Frank A De Stefano, Ernest J Madarang, Jeremy Peterson, Koji Ebersole","doi":"10.1177/19714009241240057","DOIUrl":"10.1177/19714009241240057","url":null,"abstract":"<p><p>The Artery of Wollschlaeger and Wollschlaeger (AWW) is a non-eloquent, tentorial branch of the superior cerebellar artery (SCA). Coursing posteriorly from an intradural origin, the AWW passes through the ambient cistern and supplies the medial tentorium. Due to its small diameter, the AWW is often only identified in the context of secondary dilation from pathologies such as dural arteriovenous fistulas (DAVF). Herein, we report the first case, to our knowledge, of an aneurysm of the AWW associated with a posterior fossa DAVF Swift identification and diagnosis followed by cautious treatment of both the aneurysm and fistula were critical to avert rupture and optimize outcomes, avoiding potential hemorrhagic complications.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"110-114"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140947","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}
Adrienn Tóth, Jennifer Y Cho, Evan Wilson, Jim O'Doherty, Maria Vittoria Spampinato
{"title":"Photon-counting CT imaging of a patient with coiled and untreated intracranial saccular aneurysms.","authors":"Adrienn Tóth, Jennifer Y Cho, Evan Wilson, Jim O'Doherty, Maria Vittoria Spampinato","doi":"10.1177/19714009251313514","DOIUrl":"10.1177/19714009251313514","url":null,"abstract":"<p><p>We describe a novel application of photon-counting detector CT (PCD-CT) in neurovascular imaging by harnessing the improved spatial resolution, attenuation of electronic noise, and reduction of metal artifacts. The presented case offers the unique challenge of high-quality imaging for the assessment of treated and untreated intracranial saccular aneurysms, in the setting of metal artifacts from embolization coils. Our goal was to explore optimized reconstruction parameters for ultra-high-resolution imaging (UHR) using a dedicated, sharp neurovascular kernel (Hv72) and the highest strength of quantum iterative reconstruction (QIR-4) for detailed characterization of the vasculature. Virtual monoenergetic images (VMIs) and iterative metal artifact reduction (IMAR) were employed to investigate metal artifact reduction techniques. PCD-CT has the promising potential to enhance patient care in the follow-up of patients with treated aneurysms requiring more complex imaging parameters and image post-processing due to intracranial artifacts.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009251313514"},"PeriodicalIF":1.3,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068603","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}
Aaron Rodriguez-Calienes, Nicole M Castillo-Huerta, Juan Vivanco-Suarez, Martha I Vilca-Salas, Diego Bustamante-Paytan, Nagheli Fernanda Borjas-Calderón, Anyela Flor Bruno-Peña, Cristian Morán-Mariños, Oktay Algin, Waldo R Guerrero, Santiago Ortega-Gutierrez
{"title":"Woven EndoBridge 17 device for intracranial aneurysms: A systematic review and meta-analysis.","authors":"Aaron Rodriguez-Calienes, Nicole M Castillo-Huerta, Juan Vivanco-Suarez, Martha I Vilca-Salas, Diego Bustamante-Paytan, Nagheli Fernanda Borjas-Calderón, Anyela Flor Bruno-Peña, Cristian Morán-Mariños, Oktay Algin, Waldo R Guerrero, Santiago Ortega-Gutierrez","doi":"10.1177/19714009251317505","DOIUrl":"10.1177/19714009251317505","url":null,"abstract":"<p><strong>Background: </strong>The Woven EndoBridge 17 (WEB-17) is the latest advancement in the WEB device family. Comprehensive data on its occlusion rates, procedural complications, and mortality is lacking. This meta-analysis aimed to evaluate the efficacy and safety of the WEB-17 device in intracranial aneurysms (IAs).</p><p><strong>Methods: </strong>A systematic literature search was conducted from inception to October 2023 across four databases for studies on IAs treated with WEB 17. Primary outcomes included adequate angiographic occlusion at last follow-up and a composite of intraprocedural and postprocedural complications. Comparative meta-analysis between WEB-17 and its predecessor versions (pvWEB) was performed. Subgroup analyses by IA rupture status were also conducted for the primary outcomes.</p><p><strong>Results: </strong>Eleven studies with 880 patients and 933 IAs were included. Regarding efficacy, the rate of adequate occlusion at last follow-up was 91% (95% CI 86%-94%) and the complete occlusion rate was 69% (95% CI 65%-73%). Safety outcomes demonstrated a composite complication rate of 7% (95% CI 4%-11%), an intraprocedural complication rate of 7% (95% CI 5%-9%; I2 = 0%), and a postprocedural complication rate of 2% (95% CI 1%-5%; I2 = 0%). No differences were found between WEB-17 and pvWEB in terms of adequate occlusion (WEB-17: 87.7% vs pvWEB: 80.4%; OR = 1.35, 95% CI 0.71-2.55) and safety composite outcome (WEB-17: 8.7% vs pvWEB: 10%; OR = 1.05, 95% CI 0.51-2.16). Subgroup analysis did not evidence heterogeneity between subgroups.</p><p><strong>Conclusions: </strong>The WEB-17 device demonstrates promising efficacy and safety profiles for the treatment of IAs. However, these results should be interpreted with caution due to the limited quality of evidence in the included studies. Further prospective, randomized studies are needed to validate these findings.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009251317505"},"PeriodicalIF":1.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053862","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}