Neuroradiology Journal最新文献

{"title":"Serial VerifyNow P2Y12 platelet reactivity units in cerebral aneurysm patients treated with ticagrelor surrounding stent-coiling or flow diversion.","authors":"Tyler M Bielinski, Prateeka Koul, Malie K Collins, Oded Goren, Gregory M Weiner, Christoph J Griessenauer, Clemens M Schirmer, Philipp Hendrix","doi":"10.1177/19714009241303127","DOIUrl":"10.1177/19714009241303127","url":null,"abstract":"<p><strong>Introduction: </strong>Platelet function testing using serial VerifyNow P2Y12 platelet reactivity units (PRUs) is established for guiding clopidogrel antiplatelet therapy in cerebral aneurysm stenting procedures. However, for ticagrelor, the impact of serial PRU testing and the identification of safe PRU ranges remains unexplored.</p><p><strong>Methods: </strong>Flow diversion stenting (<i>n</i> = 232) and stent-assisted coiling procedures (<i>n</i> = 83) performed 05/2017-12/2021 were reviewed. Out of these, 31 flow diversion and 18 stent-coiling procedures were performed on 44 patients using ticagrelor. Baseline demographics, ticagrelor PRUs, and clinical outcomes were assessed.</p><p><strong>Results: </strong>Collectively, 257 ticagrelor P2Y12 PRUs were obtained. PRUs were <100 in 192/257 (74.7%) tests. Only 11/257 (4.3%) PRUs were >200. The overall median ticagrelor PRU was 38 (IQR 11-101). Among the 49 procedures, median PRUs before the procedure (25, IQR 10-67), on the day of the procedure (68, IQR 44-117), and on the day after the procedure (37, IQR 21-79) did not show the significant differences between the groups. A total of seven thromboembolic complications occurred. Median PRUs surrounding the thromboembolic complications (median 182, IQR 148-235) were significantly higher than preprocedural (<i>p</i> < .001), day of surgery (<i>p</i> < .01), and postprocedural PRUs (<i>p</i> < .01). All seven procedures harbored demographic, anatomic, or procedural features increasing the risk for thromboembolic complications.</p><p><strong>Discussion: </strong>The majority of periprocedural ticagrelor PRUs were <100. PRUs at the time point of thromboembolic complications were >120. Despite procedure-complicating features in each thromboembolic case, it raises the question whether safe ticagrelor PRU levels might be lower than those commonly applied for clopidogrel.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009241303127"},"PeriodicalIF":1.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755645","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":"External validation and performance analysis of a deep learning-based model for the detection of intracranial hemorrhage.","authors":"Ayman Nada, Alaa A Sayed, Mourad Hamouda, Mohamed Tantawi, Amna Khan, Addison Alt, Heidi Hassanein, Burak C Sevim, Talissa Altes, Ayman Gaballah","doi":"10.1177/19714009241303078","DOIUrl":"10.1177/19714009241303078","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to investigate the external validation and performance of an FDA-approved deep learning model in labeling intracranial hemorrhage (ICH) cases on a real-world heterogeneous clinical dataset. Furthermore, we delved deeper into evaluating how patients' risk factors influenced the model's performance and gathered feedback on satisfaction from radiologists of varying ranks.</p><p><strong>Methods: </strong>This prospective IRB approved study included 5600 non-contrast CT scans of the head in various clinical settings, that is, emergency, inpatient, and outpatient units. The patients' risk factors were collected and tested for impacting the performance of DL model utilizing univariate and multivariate regression analyses. The performance of DL model was contrasted to the radiologists' interpretation to determine the presence or absence of ICH with subsequent classification into subcategories of ICH. Key metrics, including accuracy, sensitivity, specificity, positive predictive value, and negative predictive value, were calculated. Receiver operating characteristics curve, along with the area under the curve, were determined. Additionally, a questionnaire was conducted with radiologists of varying ranks to assess their experience with the model.</p><p><strong>Results: </strong>The model exhibited outstanding performance, achieving a high sensitivity of 89% and specificity of 96%. Additional performance metrics, including positive predictive value (82%), negative predictive value (97%), and overall accuracy (94%), underscore its robust capabilities. The area under the ROC curve further demonstrated the model's efficacy, reaching 0.954. Multivariate logistic regression revealed statistical significance for age, sex, history of trauma, operative intervention, HTN, and smoking.</p><p><strong>Conclusion: </strong>Our study highlights the satisfactory performance of the DL model on a diverse real-world dataset, garnering positive feedback from radiology trainees.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009241303078"},"PeriodicalIF":1.3,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733361","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":"The safety and efficacy of pRESET stent retriever for treatment of thrombo-embolic stroke; a systematic review and meta-analysis.","authors":"Mohammad Amin Habibi, Muhammad Hussain Ahmadvand, Pouria Delbari, Saba Sabet, Amir Hessam Zare, Mohammad Sina Mirjani, Amir Reza Boskabadi, Zahra Aslani Kolur, Maryam Bozorgi","doi":"10.1177/19714009241303083","DOIUrl":"10.1177/19714009241303083","url":null,"abstract":"<p><strong>Background: </strong>The pRESET stent retriever is a self-expanding nitinol stent designed for mechanical thrombectomy in cases of large vessel occlusion during acute ischemic stroke. This systematic review and meta-analysis synthesize the available evidence on the safety and efficacy of the pRESET device.</p><p><strong>Methods: </strong>This is a systematic review and meta-analysis study conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The electronic databases of PubMed, Embase, WoS, and Scopus were systematically reviewed from inception to 8 July 2024.</p><p><strong>Results: </strong>A total of eight studies involving 1163 patients were included. The pooled mortality rate was 18% with a 95% CI of [12%, 25%]. The rates of any hemorrhagic complication, parenchymal hemorrhage, and subarachnoid hemorrhage were 22% with a 95% CI of [12%, 36%], 7% with a 95% CI of [4%, 13%], and 10% with a 95% CI of [5%, 17%], respectively. The rate of favorable functional outcome (modified Rankin Scale 0-2) at 90 days was 43% with a 95% CI of [34%, 52%]. Successful recanalization rates were 60% with a 95% CI of [52%, 67%] after the first pass and 90% with a 95% CI of [83%, 95%] after the final pass. Rescue devices were used in 13% with a 95% CI of [7%, 24%] of cases.</p><p><strong>Conclusions: </strong>The pRESET stent retriever demonstrates high recanalization rates and reasonable safety outcomes in patients undergoing mechanical thrombectomy for acute ischemic stroke due to large vessel occlusion. Further randomized trials directly comparing pRESET to other stent retrievers are warranted.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009241303083"},"PeriodicalIF":1.3,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741027","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":"Transulnar approach as an alternative access site for neuroendovascular procedures.","authors":"Sara Gómez-Pena, Carmen Trejo, Carlos Pérez-García, Alfonso López-Frías, Santiago Rosati, Ángela H Schmolling, Manuel Moreu","doi":"10.1177/19714009241303120","DOIUrl":"10.1177/19714009241303120","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to describe our experience and safety considerations associated with the use of the transulnar approach in neurointerventional procedures when radial access is not feasible.</p><p><strong>Methods: </strong>A prospective exploratory analysis was conducted on 35 patients who underwent diagnostic or therapeutic neuroangiography via transulnar approach due to radial access limitations. Technical aspects of the transulnar approach, patient demographics, procedural details, and complications were documented. Statistical analysis was performed using SPSS Statistics software.</p><p><strong>Results: </strong>Among the 35 procedures, the transulnar approach demonstrated a high success rate (97.14%), with only one procedural failure. Indications for transulnar access included larger ulnar artery caliber (46%), radial artery spasm (37%), severe tortuosity of the radial artery (17%), and other anatomical considerations. Complications were rare, with only two access-related complications observed: a type I hematoma and ulnar artery vasospasm. No major bleeding episodes occurred, highlighting the safety profile of transulnar access.</p><p><strong>Conclusion: </strong>The transulnar approach represents a feasible alternative for neurointerventional procedures when radial access is not achievable. It offers high success rates and minimal complications, comparable to the radial approach. Anatomical considerations, safety profile, and patient preference support its consideration as a secondary option in neurointerventional practice. Further research and larger studies are warranted to validate its efficacy and safety in a broader patient population.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009241303120"},"PeriodicalIF":1.3,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733362","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":"Association of imaging biomarkers with molecular subtypes of medulloblastoma.","authors":"Maryam Aljaafary, Akeel A Alali","doi":"10.1177/19714009241303065","DOIUrl":"10.1177/19714009241303065","url":null,"abstract":"<p><p><b>Background and purpose:</b> The World Health Organization (WHO) subdivided medulloblastoma into genetic and histopathological groups, each with a specific therapeutic intervention and different clinical outcomes. These subtypes may present with distinct imaging features. Therefore, the current study aimed to identify magnetic resonance imaging (MRI) biomarkers to predict the precise pathological characteristics of medulloblastoma. <b>Methods:</b> This study included 28 patients with a first diagnosis of medulloblastoma who underwent preoperative brain MRI with subsequent surgical resection and histopathological confirmation at our hospital between 2010 and 2022. Conventional MRI parameters, including apparent diffusion coefficient (ADC) mean values, were correlated with molecular subtypes to identify distinct MRI biomarkers. <b>Results:</b> Out of 28 tumors, two (7.1%) tumors exhibited wingless (WNT) activation, thirteen (46.4%) exhibited sonic hedgehog (SHH) activation, and thirteen (46.4%) exhibited non-WNT/non-SHH activation (Group 3 or 4). Statistical analysis revealed a significant association of SHH-activated tumors with paramidline/cerebellar location and the presence of peritumoral edema (<i>p</i> value = <0.0001). No significant correlations were found between the genetic subtypes and the other MRI parameters. A distinctive distribution of the ADC-mean values among the various genetic subtypes with recognizable tendencies was identified. However, it was statistically insignificant. <b>Conclusion:</b> Conventional MRI features of the paramidline/hemispheric location and the presence of peritumoral edema were significantly correlated with the SHH activated pathway and hence can be used to facilitate the preoperative implementation of SHH-targeted therapeutic intervention. Although the ADC-mean measurements were not statistically significant, a recognizable distribution of values among the various genetic subtypes was identified.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009241303065"},"PeriodicalIF":1.3,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717347","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":"Hemodynamic changes of arteriovenous malformation and endovascular embolization.","authors":"Weiming Kong, Shikai Liang, Kevin Abel Sene, Xianli Lv","doi":"10.1177/19714009241303056","DOIUrl":"10.1177/19714009241303056","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the hemodynamic changes caused by arteriovenous malformation (AVM) and AVM embolization through a meta-analysis of the existing literature. <b>Method:</b> Search for relevant studies on PubMed/Medline until November 7, 2023, and further screen the bibliographies of relevant studies to ensure comprehensive search. According to the PRISMA guidelines, manuscripts were selected to provide local hemodynamic information on AVM arterial feeders and drainage veins. <b>Result:</b> A total of 13 studies were included in the final analysis. The diameter of the supplying artery (y = 0.002x + 2.24, R² = 0.99) and flow velocity (y = 0.09x + 54.55, R² = 0.92) had a positive linear relationship with cerebral blood flow. The pressure difference through the small AVM nidus was higher than that in the large AVM, with values of (y = -12.23x + 101.39, R² = 0.96). There was a negative linear correlation between the sessions of AVM embolization and blood flow (1 session: y = -150.7x + 564.97, R² = 0.98 and 4 sessions: y = -118.81x + 750.07, R² = 0.99). There was a positive linear relationship between the increase in arterial pressure, peri-AVM parenchymal perfusion, and the percentage of occlusion in the medium-sized AVMs. However, this correlation was a nonlinear relationship between elevated arterial pressure, peri-AVM parenchymal perfusion, and the percentage of large AVM occlusion. <b>Conclusion:</b> The hemodynamic changes of AVM (in the feeding arteries, compartments of AVM, and draining veins) follow a linear relationship. The impact of embolization on hemodynamics in medium and small AVMs follows a linear relationship. The impact of embolization of large AVMs on hemodynamics follows a nonlinear relationship.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009241303056"},"PeriodicalIF":1.3,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717455","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":"Abnormal cochlear enhancement in Norrie disease.","authors":"Emil Jernstedt Barkovich, Suely Fazio Ferraciolli, Camilo Jaimes","doi":"10.1177/19714009241303096","DOIUrl":"10.1177/19714009241303096","url":null,"abstract":"<p><p>Norrie disease (ND) is a rare x-linked disease with retinal and cochlear vascular abnormalities. Clinically, it is characterized by congenital blindness and progressive sensorineural hearing loss during adolescence. We present images of a 3 year old child with ND and normal hearing demonstrating bilateral cochlear enhancement on brain MRI, a finding which has not been previously reported. ND mouse models show progressive degeneration of the endolymph-producing stria vascularis (SV); we hypothesize that these changes allow gadolinium leakage into the endolymph. Our images indicate that cochlear enhancement precedes changes in hearing and suggest that temporal bone/internal auditory canal MR imaging should be considered in the evaluation of ND. Future studies are needed to characterize the temporal evolution of this cochlear enhancement and how it corresponds with hearing loss. Mouse models suggest that it may be a transient phenomenon and diminish as the SV degenerates further. As ND gene therapy trials approach clinical use, cochlear enhancement could aid candidate selection and provide insight into treatment effect.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009241303096"},"PeriodicalIF":1.3,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711512","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":"The safety and efficiency of SMART coil for brain aneurysm: A systematic review and meta-analysis.","authors":"Mohammad Amin Habibi, Mohammad Sina Mirjnani, Rasa Zafari, Zahra Saadat, Bahareh Zahedinasab, Pouria Delbari, Amir Hessam Zare, Amirmahdi Sheipouri, Sheida Mobader Sani","doi":"10.1177/19714009241303095","DOIUrl":"10.1177/19714009241303095","url":null,"abstract":"<p><strong>Background: </strong>The SMART coil system is a relatively new generation of embolic coils consisting of a bare platinum coil, a detachment pusher, and a detachment handle. This study investigated the safety and efficiency of the SMART coil system in treating cerebral aneurysms.</p><p><strong>Method: </strong>PubMed/Medline, Embase, Web of Science, and Scopus were searched until October, 1st 2023. Non-English language, non-human studies, and non-original studies were excluded.</p><p><strong>Results: </strong>A total of 7 studies were included. The results of our study reflected complete aneurysm occlusion (mRRC1) rate of 45% (95% CI, 0.35-0.56), neck remnant aneurysm (mRRC2) rate of 36% (95% CI, 0.30-0.42), and residual aneurysm (mRRC3) rate of 22% (95% CI, 0.12-0.38) during post-procedural assessment. Moreover, considering longest follow-up, our study showed complete aneurysm occlusion (mRRC1) rate of 66% (95% CI, 0.43-0.84), neck remnant aneurysm (mRRC2) rate of 27% (95% CI, 0.13-0.49), and residual aneurysm (mRRC3) rate of 9% (95% CI, 0.04-0.20). In addition, recanalization and retreatment rates were reported 10% (95% CI, 0.06-0.17) and 9% (95% CI, 0.06-0.12), respectively. The rates of adverse and serious adverse events were 9% (95% CI, 0.07-0.10) and 6% (95% CI, 0.01-0.22), respectively. Three studies reported a stroke rate which was 2% (95% CI, 0.00-0.13), and five studies reported a mortality rate which was 6% (95% CI, 0.03-0.11).</p><p><strong>Conclusion: </strong>The findings suggested that the SMART coil can be a safe and efficient treatment in patients with intracranial aneurysms compared to other available treatment methods.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009241303095"},"PeriodicalIF":1.3,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11585007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696004","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":"Balloon protection of the Labbe vein during venous sinus stenting.","authors":"Ian Leonard-Lorant, Guillaume Koch, Mathilde Goudot, Anca Hasiu, Ciprian Juravle, Mihai Harangus, Rémy Beaujeux, Raoul Pop","doi":"10.1177/19714009241303148","DOIUrl":"10.1177/19714009241303148","url":null,"abstract":"<p><p><b>Background:</b> Endovascular treatment of dural venous sinus stenosis using auto-expandable stents is progressively becoming a central part in the management of patients with idiopathic intracranial hypertension (IIH) and pulsatile tinnitus. One potential concern during stenting is impairment of venous outflow in the Labbé vein, which usually drains in close proximity to the culprit transverse sinus stenosis. <b>Methods:</b> We propose a technique which can counteract venous outflow impairment, consisting of temporary balloon protection of the Labbé vein during stent deployment. <b>Results:</b> We illustrate the use of this technique in a case of IIH with intrinsic dural sinus stenosis induced by a large arachnoid granulation situated close to the insertion of the Labbé vein. The stent was deployed under temporary balloon inflation in order to deflect the arachnoid granulation away from the vein ostium. <b>Conclusions:</b> In selected cases of intrinsic stenosis, temporary balloon protection can be used to avoid Labbé vein flow impairment during venous sinus stenting.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009241303148"},"PeriodicalIF":1.3,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11584999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692940","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":"Cangrelor use in a pediatric patient with aneurysmal subarachnoid hemorrhage.","authors":"Riccardo Russo, Stefano Molinaro, Francesco Mistretta, Umberto Gava, Giovanni Morana, Paola Peretta, Giovanni Del Borrello, Pietro Zeppa, Mauro Bergui","doi":"10.1177/19714009241303122","DOIUrl":"10.1177/19714009241303122","url":null,"abstract":"<p><p>We herein report the case of a pediatric patient suffering from subarachnoid hemorrhage (SAH) due to a ruptured internal carotid artery (ICA) saccular aneurysm. Considering the unfavorable anatomy and irregular shape of the aneurysm, a flow diverter (FD) stent was positioned in addition to coils in an acute setting. Cangrelor (Kengreal, Chiesi, USA) IV bolus followed by maintenance IV infusion was administered in addition to ASA at the time of intervention. Transitioning from cangrelor to thienopyridine (clopidogrel) was done the day after the procedure without any ischemic or hemorrhagic complications. The patient was discharged symptom-free 24 days later. We discuss technical considerations focusing specifically on antiplatelet therapy management.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009241303122"},"PeriodicalIF":1.3,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11585005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693151","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}