Interventional Neuroradiology最新文献

{"title":"Multicenter analysis of the incidence of in-stent stenosis following the deployment of flow-redirection endoluminal device in the treatment of intracranial aneurysms.","authors":"Avi A Gajjar, Georgios S Sioutas, Amanda Custozzo, Mohamed M Salem, Nicholas C Field, Oleg Shekhtman, Pierce Davis, Tarun Prabhala, Brian T Jankowitz, John C Dalfino, Alan S Boulos, Jan-Karl Burkhardt, Alexandra R Paul, Visish M Srinivasan","doi":"10.1177/15910199241304855","DOIUrl":"10.1177/15910199241304855","url":null,"abstract":"<p><strong>Introduction: </strong>The Flow Re-direction Endoluminal Device (FRED) is a novel flow diverter with a unique double stent design, with an inner stent composed of 48 nitinol wires, and an outer stent with 16 nitinol wires. It is designed for endovascular cerebral aneurysm treatment, although, limited data exist regarding in-stent stenosis (ISS) rates associated with FRED devices.</p><p><strong>Methods: </strong>A registry encompassing two North American comprehensive stroke centers was the base of this study. We longitudinally assessed patients implanted with FRED devices, emphasizing baseline demographics, aneurysmal characteristics, procedural data, aneurysmal occlusion, and the incidence of ISS.</p><p><strong>Results: </strong>In our cohort of 87 patients receiving 88 FRED devices, ISS occurred in 10.4% (9) of cases. Mild ISS (<50%) was noted in 8.0% (7) of patients, moderate ISS (50-75%) in 1.1% (1), and severe ISS (>75%) in 1.1% (1). Analysis indicated ISS in 17.0% (8) of patients with the FRED device and 5.7% (2) with the FRED-X device; all ISS cases in the FRED-X group were mild. Differences in ISS rates between device types were not significant (<i>p</i> = 0.122). Delayed thrombotic events were documented in 6.9% (6) of patients. Aneurysm occlusion rates, measured via the Raymond-Roy Scale (RRS), showed adequate occlusion (RRS 1 or 2) in 68.8% at 3 months, 74.6% at 6 months, and 89.3% at 12 months.</p><p><strong>Conclusions: </strong>The study elucidates the efficacy and safety profile of FRED devices, presenting favorable aneurysm occlusion rates and low retreatment needs while underscoring the manageability of ISS.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241304855"},"PeriodicalIF":1.5,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The middle meningeal artery Patency After Coil Embolization (PACE) score: A novel descriptor of angiographic occlusion.","authors":"Nicholas S Hernandez, Ryan W Sindewald, Michael G Brandel, Arvin R Wali, Nikhil K Murthy, Jeffrey A Steinberg, Jeffrey S Pannell, Alexander A Khalessi, David R Santiago-Dieppa","doi":"10.1177/15910199241308324","DOIUrl":"10.1177/15910199241308324","url":null,"abstract":"<p><strong>Introduction: </strong>A scoring system to characterize the efficacy of middle meningeal artery (MMA) embolization is lacking and would help predict the likelihood of subdural hematoma resolution.</p><p><strong>Methods: </strong>We developed a simple angiographic classification system ranging from 0 to 3 for quantifying MMA Patency After Coil Embolization (PACE) based residual flow distal to the embolization. MMA embolizations using coils at our institution were used to validate the PACE score system using procedural angiograms. Follow-up CT scans following embolization were reviewed for acute blood products, and to characterize long-term resolution.</p><p><strong>Results: </strong>60 patients were included in the study, with a total of 80 subdural hematomas with follow-up imaging that were available for analysis. 37 patients had a PACE score of 0, 18 had a PACE score of 1, 4 had a PACE score of 2, and 1 had a PACE score of 3. The presence of acute blood products was significantly lower in PACE 0 compared to PACE 1, 2, or 3. The cross-sectional area of the chronic subdural collections was statistically lower on follow-up CT scans after coil embolization.</p><p><strong>Conclusions: </strong>Coil embolization of the MMA may reduce the incidence of acute blood products after embolization and decrease the cross-sectional area of chronic subdural hematoma on long-term follow-up. Lower PACE scores may correlate with lower rates of acute blood products after the procedure and increased resolution of chronic subdural hematoma on follow-up. A larger cohort is required to characterize the superiority between the PACE scores.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241308324"},"PeriodicalIF":1.5,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of staged primary coiling followed by delayed flow diversion of ruptured intracranial aneurysms: A systematic review and meta-analysis.","authors":"A Alayli, M Monsour, S Schimmel, E Pressman, F Klocksieben, M Mokin, W R Guerrero, K Vakharia","doi":"10.1177/15910199241305426","DOIUrl":"10.1177/15910199241305426","url":null,"abstract":"<p><strong>Background: </strong>Ruptured intracranial aneurysms lead to significant mortality and morbidity. Recent advancements have suggested staged coiling with subsequent flow diverter stent placement may reduce the risk of hemorrhage with dual antiplatelet therapy (DAPT) or stent thrombosis in the acute inflammatory phase after aneurysm rupture while still appropriately mitigating risk of aneurysmal rehemorrhage.</p><p><strong>Materials and methods: </strong>A systematic review and single-arm meta-analysis was conducted. Studies reporting patients receiving coiling followed by delayed flow diverter placement on a separate day were included.</p><p><strong>Results: </strong>Five studies, comprising 94 patients, were included for meta-analysis. Average time between procedures ranged from 9.8 to 169 days; 24% (95% CI: 10-41%) of patients had a poor functional neurologic outcome (modified Rankin Scale > 2) at discharge compared to 4% (0-11%) at last follow-up. There was one incidence of rehemorrhage between treatments, 0% (0-4%). Vasospasm after coiling was the most common adverse event, 16% (1-41%). There was low risk of ischemic complications [1% (0-8%) with coil placement and 5% (1-11%) with stent placement]. Intraprocedural intracranial hemorrhage was also rare (two patients during coil placement; no cases during stent placement). There were no significant differences if flow diversion was performed less than or greater than 100 days from coiling.</p><p><strong>Conclusions: </strong>Our study highlights the benefit of primary coiling with staged flow diversion for the management of ruptured intracranial aneurysms with a low risk for complications. Namely, the rate of rebleeding between treatments was exceptionally low. We advocate for the greater consideration of this treatment combination in the treatment of ruptured intracranial aneurysms.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241305426"},"PeriodicalIF":1.5,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring robotic advances, applications, and challenges in neuroendovascular surgery: A scoping review of the CorPath GRX system.","authors":"Santiago Gomez-Paz, Patrick King, Alwyn Gomez, Ramesh Grandhi","doi":"10.1177/15910199241305691","DOIUrl":"10.1177/15910199241305691","url":null,"abstract":"<p><strong>Background: </strong>The integration of robotics into neuroendovascular surgery has the potential to revolutionize the field by enhancing precision, reducing procedure-related risks, and improving patient outcomes. The CorPath GRX system represents a significant advancement in this domain. In this systematically conducted scoping review, we explore the current applications, advances, and challenges associated with robot-assisted neuroendovascular surgery.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across PubMed, Scopus, Embase, and Web of Science, covering publications from January 2015 to December 2024. Relevant data were extracted from studies involving human subjects and reporting the use of robotic guidance with the CorPath GRX system for neuroendovascular procedures for review and discussion.</p><p><strong>Results: </strong>We identified 14 studies with a total of 336 patients who underwent robot-assisted neuroendovascular procedures, including both diagnostic (48.2%) and therapeutic (51.8%) applications. Among the therapeutic interventions, 140 patients were treated for hemorrhagic pathology, including 128 procedures for unruptured intracranial aneurysms and 12 for ruptured aneurysms. These procedures primarily involved stent-assisted coiling or flow diversion therapy. Additionally, 34 patients were treated for ischemic pathology, primarily carotid artery stenosis, involving balloon angioplasty and stent placement. A tumor was addressed in 1 intervention via coil embolization of tumor feeders, showcasing the versatility of robot-assisted interventions. Technical success rates were high across the studies, with most procedures achieving 100% success. Manual conversions were for device malfunctions or anatomical challenges. Complications reports varied, with some studies detailing specific device malfunctions and others providing less specific accounts.</p><p><strong>Conclusions: </strong>Overall, the CorPath GRX system demonstrated high feasibility and safety for neuroendovascular procedures, indicating significant potential benefits, particularly if integrated into telemedicine practices. The CorPath GRX system shows promise in facilitating precise and safe neuroendovascular procedures. Current evidence highlights a wide range of benefits; however, further research is needed to investigate long-term outcomes and other potential areas of impact.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241305691"},"PeriodicalIF":1.5,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"REtrieving thrombi and Separated Coils/catheters Unexpectedly detached during Endovascular therapy: RESCUE - the use of thrombectomy devices for rescue therapy in interventional neuroradiology.","authors":"Darragh Herlihy, Sneha Singh, Patrick Nicholson, Emma Griffin, Alan O'Hare, Paul Brennan, John Thornton, Sarah Power","doi":"10.1177/15910199241299139","DOIUrl":"10.1177/15910199241299139","url":null,"abstract":"<p><strong>Purpose: </strong>Intraprocedural complications during intracranial embolisation include thromboembolic vessel occlusion, catheter tip detachment and coil migration. Stentrievers and aspiration catheters are valuable devices for the management of these complications. We present our experience with the use of these devices. We describe the devices and techniques used, case details and clinical outcomes. Currently there is no standardised approach for the management of the above intraprocedural complications.</p><p><strong>Methods: </strong>We performed a retrospective review of our interventional neuroradiology database of patients who underwent endovascular treatment in our institution from January 2012 to January 2019 and identified embolisation procedures during which either stentrievers or aspiration catheters were utilised.</p><p><strong>Results: </strong>We present a case series of 24 cases in which these devices were utilised as rescue devices over a period of 7 years. We provide three illustrative cases.</p><p><strong>Conclusion: </strong>Stentrievers and aspiration catheters can be used safely and effectively as adjunctive or rescue devices during embolisation procedures.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241299139"},"PeriodicalIF":1.5,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of recurrent subdural hematoma after unilateral MMA embolization that resolved after contralateral MMA embolization.","authors":"Yigit Can Senol, Mona Asghariahmadabad, Daniel L Cooke, Luis E Savastano","doi":"10.1177/15910199241267342","DOIUrl":"10.1177/15910199241267342","url":null,"abstract":"<p><p>Middle meningeal artery embolization (MMAe) is rapidly emerging as a valuable intervention to decrease the risk of recurrent subdural hematoma (SDH) after surgical evacuation. The role of upfront bilateral MMAe for unilateral SDH and the value of contralateral MMAe after SDH recurrence post evacuation and ipsilateral MMAe are still unknown. Here, we report the case of an elderly patient that presented with a large acute on chronic SDH and underwent surgical drainage and ipsilateral MMAe (with Contour PVA particles, 150-250 µm). At one month follow-up, he was found to have a significant radiographic recurrence of the SDH with interval acute hemorrhage. Angiography revealed complete occlusion of the trunk of the previously embolized ipsilateral MMA, and the presence of robust anastomotic branches from the contralateral MMA crossing the midline to collateralize patent distal branches of the previously embolized MMA. Decision was made to proceed with contralateral MMAe, which resulted in near complete SDH resolution at 6 months follow-up.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241267342"},"PeriodicalIF":1.5,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early experience with the Aristotle Colossus 0.035' macrowire for mechanical thrombectomy in 30 consecutive cases.","authors":"David A Zarrin, Fahad J Laghari, Jessica K Campos, Benjamen M Meyer, Muhammad W Khan, Jonathan Collard de Beaufort, Gizal Amin, Narlin B Beaty, Matthew T Bender, Shuichi Suzuki, Geoffrey P Colby, Alexander L Coon","doi":"10.1177/15910199241299480","DOIUrl":"10.1177/15910199241299480","url":null,"abstract":"<p><strong>Introduction: </strong>Recent literature continues to demonstrate the successful role of large-bore aspiration catheters in thrombus ingestion during mechanical thrombectomy. However catheter-to-microwire step-off and distal navigation are ongoing challenges in thrombectomy. A new to market 0.035' macrowire (Aristotle 35 Colossus Guidewire, Scientia Vascular, West Vale City, UT) may address such challenges. We report here our early experience in 30 mechanical thrombectomy cases.</p><p><strong>Materials and methods: </strong>We analyzed a prospectively maintained database of the senior authors to identify cases utilizing a 0.035' macrowire with 0.035' aspiration catheters for mechanical thrombectomy.</p><p><strong>Results: </strong>Thirty consecutive cases were identified. Seventeen (57%) patients were female with an average age of 75.3 ± 2.2 years (range 55-97). Average presenting NIHSS was 13.0 ± 1.7. Thrombus locations included 7% (<i>n</i> = 2) in the cervical ICA, 47% (<i>n</i> = 14) in the M1, 43% (<i>n</i> = 13) in the M2, and 3% (<i>n</i> = 1) in the P1. An 088' ID aspiration catheter was navigated to at least the M1 segment in all anterior circulation cases and the basilar in the posterior circulation case. The 0.035' macrowire was placed proximal to the occlusion in all cases allowing coaxial 035' and 071' catheter aspiration passes. TICI 2C/3 was achieved in 87% of cases (<i>n</i> = 26) and TICI 2B in the remaining cases. There were no wire-related perforations or vessel dissections.</p><p><strong>Conclusion: </strong>The Colossus 0.035' macrowire may offer advantages over its smaller counterparts by reducing ledge effect and the need to cross the thrombus. Further comparative studies against currently available microwires in various anatomies are warranted.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241299480"},"PeriodicalIF":1.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of anticoagulant and antiplatelet therapies in the medical management of carotid free-floating thrombus: A systematic review.","authors":"Raphael Camerotte, Marina Vilardo, Filipe Virgilio Ribeiro, Jhon E Bocanegra-Becerra, Ocilio Ribeiro Gonçalves, Luis Paleare, Saul Dominici, Arthur Parke C Corvelo, Christian Ken Fukunaga, Lucas Pari Mitre, Thierry Sobral, Marcio Yuri Ferreira, Christian Ferreira, David Gordon, David Langer, Yafell Serulle","doi":"10.1177/15910199241304164","DOIUrl":"10.1177/15910199241304164","url":null,"abstract":"<p><strong>Background: </strong>The optimal treatment for carotid free-floating thrombus (CFFT) remains uncertain due to limited evidence, with no randomized clinical trials and scarce guidelines, such as ESVS 2023, favoring conservative management. Anticoagulation (ACT) and antiplatelet (APT) therapies are emerging as promising alternatives to high-risk surgical interventions. This systematic review aimed to evaluate the safety and efficacy of ACT and APT therapies for CFFT.</p><p><strong>Methods: </strong>A systematic search was performed across PubMed, Embase, Web of Science, and Cochrane databases. Safety and efficacy endpoints were assessed. A two-sample <i>t</i>-test compared baseline characteristics between groups, and a Chi-square test evaluated differences in categorical variables. Statistical significance was set at <i>p</i> < 0.05. Data were analyzed using R 4.3.0 with the meta package v.7.0-0.</p><p><strong>Results: </strong>Four studies met the inclusion criteria, involving 170 patients diagnosed with CFFT. The APT group included 96 patients (mean age 55.35 ± 13.52 years; 56.25% male), and the ACT group included 74 patients (mean age 58.57 ± 14.28 years; 51.35% male). Thrombus regression was slightly lower in APT (42%) compared to ACT (48%). Both groups showed similar rates of residual stenosis. Antiplatelet had fewer ischemic events within 30 days (none vs. 4% in ACT) and lower intracranial hemorrhage rates (3.3% vs. 5.4% in ACT) but higher mortality (6.3% vs. none in ACT).</p><p><strong>Conclusion: </strong>Both ACT and APT are effective for managing CFFT, each with distinct efficacy and safety profiles. However, randomized trials are necessary to better assess these therapies in CFFT management.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241304164"},"PeriodicalIF":1.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stent retriever expansion as a corrective maneuver to optimize inadequately deployed flow diverter stents.","authors":"A Khanafer, M Almohammad, P von Gottberg, K Hajiyev, A Kemmling, M Forsting, H Henkes","doi":"10.1177/15910199241302436","DOIUrl":"10.1177/15910199241302436","url":null,"abstract":"<p><strong>Background and purpose: </strong>As flow diversion (FD) is becoming increasingly important in the endovascular treatment of intracranial aneurysms, the rate of technical complications is also increasing. Inadequate FD implantation may lead to both ischemic complications and decreased treatment efficacy. The aim of this study was to evaluate the efficacy of off-label stent retriever (SR) use in managing technical complications associated with FD implantation.</p><p><strong>Materials and methods: </strong>A retrospective analysis of data from patients who underwent FD treatment at two neuroradiology centers was performed. The objective was to identify cases in which the FD was inadequately deployed and SR expansion was performed as a corrective maneuver. The analysis included anatomic characteristics, technical information, angiographic and clinical outcomes, and complications.</p><p><strong>Results: </strong>A total of 35 corrective maneuvers with SR were performed in 25 FD treatments. The corrective maneuvers in all treatments were successful, and no additional devices or therapies were required. No procedural complications or technical difficulties were documented.</p><p><strong>Conclusion: </strong>With the growing role of FDs in neurointerventional treatment, familiarity with corrective maneuvers after technical complications or inadequate implantation is important. The findings in our selected cohort demonstrated that SR expansion is an effective and safe corrective maneuver for incompletely opened FDs.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241302436"},"PeriodicalIF":1.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fourth-generation Pipeline^™ Vantage flow diversion: First reported US experience of safety and feasibility.","authors":"Ahmad Sweid, Ahmad Chahine, Stephanie Hage, Rami Z Morsi, Sonam Thind, Lina Karar, Archit Baskaran, Julián Carrión-Penagos, Harsh Desai, Sachin A Kothari, Rohini Rana, Okker Verhagen Metman, Jehad Zakaria, James E Siegler, Issam Awad, Michael C Hurley, Shyam Prabhakaran, Sean Polster, Tareq Kass-Hout","doi":"10.1177/15910199241301119","DOIUrl":"10.1177/15910199241301119","url":null,"abstract":"<p><strong>Background: </strong>The Pipeline^™ Vantage embolization device (Medtronic, Irvine, CA) is the fourth generation of Pipeline flow diverter devices, offering numerous technical improvements. This study aimed to assess the feasibility and safety of The Pipeline^™ Vantage embolization device (Medtronic, Irvine, CA).</p><p><strong>Methods: </strong>This was a single-center retrospective study describing the use of The Pipeline^™ Vantage embolization device for the treatment of intracranial aneurysms. Technical feasibility and safety were assessed in terms of intra and postprocedural complications, as well as neurological morbidity upon follow-up. Both ruptured and unruptured aneurysms were included.</p><p><strong>Results: </strong>We included 12 patients in our study (mean age 62; females: <i>n</i> = 9/12, 75%). Aneurysm morphology varied between saccular (41.6%), fusiform (41.6%), blister (8.3%), and pseudoaneurysm (8.3%). Three cases (25%) involved ruptured aneurysms treated in the acute setting. A transradial access was used in 10 cases (83.3%). There was a 100% success in deployment. Seven cases (58.3%) were treated with adjunct embolization device other than a flow diversion. Eight cases (66.6%) were treated with a single flow diversion, three cases (25%) were treated with two flow diversion, and one case (8.3%) was treated with three flow diversion stents. There were no intraoperative complications. There was one postprocedural complication in a dissecting ruptured PICA aneurysm that was ultimately treated with two flow diversion stents and an intrasaccular device.</p><p><strong>Discussion: </strong>To our knowledge, this is the first US series assessing the periprocedural safety and feasibility of consecutive patients with intracranial aneurysms treated with the Pipeline^™ Vantage device (Medtronic, Irvine, CA).</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241301119"},"PeriodicalIF":1.5,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}