Interventional Neuroradiology最新文献

{"title":"Impact of bridging intravenous thrombolysis and infarct core growth rate on early neurological improvement in patients with acute anterior circulation ischemic stroke and mechanical thrombectomy.","authors":"Natalie van Landeghem, Christoph Ziegenfuß, Aydin Demircioglu, Benedikt Frank, Martin Köhrmann, Benjamin Stolte, Ramazan Jabbarli, Philipp Dammann, Johannes Haubold, Michael Forsting, Isabel Wanke, Cornelius Deuschl, Yan Li","doi":"10.1177/15910199251336889","DOIUrl":"https://doi.org/10.1177/15910199251336889","url":null,"abstract":"<p><p>PurposeThe aim of this study is to assess the impact of bridging intravenous thrombolysis (IVT), infarct core growth rate (ICGR) and their interaction on neurological outcomes in patients undergoing endovascular thrombectomy (EVT) in acute ischemic stroke (AIS) with anterior large vessel occlusion (LVO).MethodsPatients undergoing EVT due to anterior LVO (ICA to M2 branches) between 2018 and 2022 in a tertiary care center were included. Patient's baseline characteristics, peri-procedural factors of EVT and neurological outcomes were retrospectively analyzed. ICGR was determined by infarct core volume on perfusion CT divided by the time from stroke onset to imaging. Endpoints included early neurological improvement (ENI), defined as NIHSS reduction of ≥8 points after 24 h or NIHSS < 2 at discharge, and intracranial hemorrhage (ICH) on CT at 24 h.ResultsOf 205 patients, 128 (62.4%) received bridging IVT. Neither bridging IVT, ICGR, nor their interaction was significantly associated with ENI or ICH occurrence. Factors significantly associated with ENI included short groin puncture to reperfusion time (OR = 0.98, CI 0.97-0.99, <i>p</i> < 0.001), low pre-stroke mRS (OR = 0.76, CI 0.65-0.89, <i>p</i> = 0.001), and high baseline CT ASPECTS (OR = 1.15, CI 1-1.31, <i>p</i> = 0.049). Factors associated with reduced odds of ICH were short symptom onset to admission time (OR = 1, CI 0.998-1, <i>p</i> = 0.021), short groin puncture to reperfusion time (OR = 1.01, CI 1-1.02, <i>p</i> = 0.039), and complete reperfusion (OR 0.89, CI 0.81-0.97, <i>p</i> = 0.009).ConclusionNeither bridging intravenous thrombolysis, infarct core growth rate, nor their interaction significantly impacted early neurological improvement or intracranial hemorrhage rate.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251336889"},"PeriodicalIF":1.5,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018683","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":"Correlation between lumbar puncture opening pressure and venous sinus pressure gradient in idiopathic intracranial hypertension (IIH).","authors":"Amy T Fulton, Nathan T Tagg, Sidney M Gospe, Beiyu Liu, Shein-Chung Chow, Alexa N Bramall, Erik F Hauck","doi":"10.1177/15910199251328547","DOIUrl":"https://doi.org/10.1177/15910199251328547","url":null,"abstract":"<p><p>BackgroundVenous hypertension has become a recognized condition associated with idiopathic intracranial hypertension (IIH). Thresholds for dural venous sinus stenting (VSS) remain a topic of debate.MethodsIn 50 IIH patients, the lumbar puncture opening pressure (LPOP) and the pressure gradient across the dominant venous sinus were correlated. Clinical variables were compared; linear regression models were created. Venous stenting was performed in select patients with bilateral venous sinus stenosis, papilledema, LPOP >25 cmH2O, and a venous pressure gradient >10 mmHg.ResultsTwenty-nine patients were selected for venous sinus stenting (VSS); 21 patients did not meet the criteria for stenting despite some IIH symptoms. After stent implantation, patients experienced improvement in their symptoms.Across all 50 patients, there was a significant correlation between LPOP and the pressure gradient across the stenosis of the dominant venous sinus (<i>r</i> = 0.76, 95% confidence interval [0.53-1.00], <i>P</i> < .001).ConclusionsAn increased venous pressure gradient across the dominant sigmoid/transverse junction was strongly associated with an increased lumbar puncture opening pressure in IIH patients. A gradient increase of 1 mmHg correlated with an increase of LPOP by 0.85 cmH2O. Patients with higher baseline venous pressure gradients may therefore benefit the most from venous stenting.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251328547"},"PeriodicalIF":1.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048466","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":"Outcomes of patients with heart failure after thrombectomy for ischemic stroke: A systematic review and meta-analysis.","authors":"Gabriel Marinheiro, Gabriel de Almeida Monteiro, Ivo Queiroz, Lucas M Barbosa, Antonio Mutarelli, Luíza Maria Amaral Tanus, Pedro Henrique Reginato, Ocílio Ribeiro Gonçalves, Marcondes Pimentel Cruz, Agostinho C Pinheiro, Keven Ferreira da Ponte, Gisele Sampaio Silva, João Paulo Mota Telles","doi":"10.1177/15910199251328548","DOIUrl":"https://doi.org/10.1177/15910199251328548","url":null,"abstract":"<p><p>BackgroundMechanical thrombectomy (MT) is an effective treatment for acute ischemic stroke, but its outcomes in patients with heart failure (HF) are uncertain. Some studies suggest worse outcomes in these patients, while others show no significant differences in mortality or functional recovery.MethodsWe systematically searched the MEDLINE, Embase, and Cochrane databases until August 2024. Studies were included if they compared patients with HF to those without. All statistical analyses were carried out using R, version 4.1.1. A subanalysis examined outcomes in HF patients with reduced left ventricular ejection fraction (LVEF).ResultsWe included 3587 patients, of which 1187 (33.1%) were in the HF group. We found a significantly higher mortality (RR 2.01; 95% CI: 1.33-3.03; <i>p</i> < 0.01) and lower risk of favorable neurologic outcome (RR 0.76; 95% CI: 0.67-0.86; <i>p</i> < 0.01) at 90 days on HF group, without a notable difference in the occurrence of symptomatic intracranial hemorrhage (sICH) (RR 1.57; 95% CI: 0.98-2.51; <i>p</i> = 0.06) or recanalization success (RR 1.02; 95% CI: 0.98-1.07; <i>p</i> = 0.28). HF patients with reduced LVEF also showed higher mortality (RR 1.91; 95% CI: 1.05-3.49; <i>p</i> = 0.03) and worse functional outcomes (RR 0.83; 95% CI: 0.72-0.95; <i>p</i> < 0.01) compared to those without HF.ConclusionsHF patients undergoing MT for ischemic stroke may have worse functional outcomes and higher mortality at 90 days compared to non-HF patients despite similar rates of sICH and recanalization success. Our findings suggest that patients with HF may have a worse prognosis compared to those without HF following MT for ischemic stroke.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251328548"},"PeriodicalIF":1.5,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021923","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":"Long-term functional outcomes for elderly patients treated with endovascular thrombectomy.","authors":"Rahul R Karamchandani, Hongmei Yang, Katelynn J Teli, Dale Strong, Jeremy B Rhoten, Jonathan D Clemente, Gary Defilipp, Nikhil M Patel, Joe D Bernard, William R Stetler, Jonathan M Parish, Andrew U Hines, Shraddha T Patel, Harsh N Patel, Amy K Guzik, Stacey Q Wolfe, Anna Maria Helms, Lauren Macko, Laura Williams, Julia Retelski, Andrew W Asimos","doi":"10.1177/15910199251332407","DOIUrl":"https://doi.org/10.1177/15910199251332407","url":null,"abstract":"<p><p>BackgroundFunctional outcomes in elderly thrombectomy patients have been commonly reported up to 90 days, though long-term neurological status is not as well characterized. We studied 1-year outcomes in patients ≥ 80 years old and identified predictors of functional independence in elderly patients.MethodsRetrospective analysis of anterior circulation thrombectomy patients presenting from November 2016-August 2023 to a large health system. The primary outcome was 1-year modified Rankin Scale score (mRS) 0-2. Outcomes were compared between patients ≥ 80 and < 80 years old. Logistic regression was performed to identify predictors of 1-year functional independence in the elderly.Results957 patients were included, 220 (23%) of whom were ≥ 80 years old. A significantly lower proportion of patients ≥ 80 years old, compared to < 80 years, were functionally independent at 1-year (18.6% versus 45.9%, p < 0.001). In the elderly, predictors of functional independence included age (odds ratio (OR) 0.83, 95% confidence interval (CI) 0.74-0.93, p = 0.002), premorbid mRS score (OR 0.51, 95% CI 0.29-0.88, p = 0.016), presenting National Institutes of Health Stroke Scale score (OR 0.93, 95% CI 0.87-0.995, p = 0.035), cerebral blood volume index (OR 50.7, 95% CI 2.8-935, p = 0.008), and first-pass recanalization (OR 2.77, 95% CI 1.20-6.38, p = 0.017).ConclusionElderly thrombectomy patients had lower rates of functional independence at 1-year, though these are similar to previously reported rates at 90-days in octogenarians and nonagenarians. Factors associated with good outcomes in the elderly, including collateral status and single-pass revascularization, may be prognostically informative beyond the 90-day time window.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251332407"},"PeriodicalIF":1.5,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022498","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":"Predictors of angiographic occlusion after embolization of intracranial arteriovenous malformations with curative intent.","authors":"Joanna M Roy, Basel Musmar, Shyam Majmundar, Anand Kaul, Elias Atallah, Mario Zanaty, Saman Sizdahkhani, Nikolaos Mouchtouris, Panagiotis Mastorakos, Stavropoula I Tjoumakaris, Michael R Gooch, Robert H Rosenwasser, Pascal M Jabbour","doi":"10.1177/15910199251332400","DOIUrl":"https://doi.org/10.1177/15910199251332400","url":null,"abstract":"<p><p>BackgroundEndovascular embolization is a potential alternative to open surgery for treating intracranial arteriovenous malformations (AVMs). To our knowledge, predictors of occlusion after curative embolization of AVMs remain limited in literature. Our study aims to identify predictors of radiographic occlusion after embolization of AVMs with curative intent.MethodsThis was a retrospective study of patients who underwent embolization of AVMs with curative intent at a single institution between 2007 and 2022. The primary outcome of cure was defined as radiographic occlusion of the AVM on follow-up. Univariate and multivariate analyses were performed with a <i>P</i> value <0.05 denoting statistical significance.ResultsSixty-six patients underwent embolization of an AVM with curative intent. The median (interquartile range (IQR)) age of the cohort was 53 (36-62), and 48.5% were male. 65.2% (<i>n</i> = 43) patients presented with hemorrhage. 59.1% (<i>n</i> = 39) of the cohort achieved cure on follow-up. Median (IQR) volume of AVM (mm³⁾ and maximum pedicle size (mm) were significantly higher in patients who were not cured on follow-up compared to those who were cured: 14055.12 (2431.71-31235.60) and 1.9 (1.3-2.5) versus 3888 (2063-12518) and 1.3 (1.1-1.6), respectively. On multivariate regression, maximum pedicle size was associated with lower odds of cure (OR: 0.24, 95% CI: 0.07-0.82, <i>P</i> = 0.023).ConclusionsOur study identified maximum pedicle size to be the only significant factor associated with lower odds of radiographic occlusion after curative embolization of AVMs. Further multicenter studies are required to validate these findings.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251332400"},"PeriodicalIF":1.5,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055458","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":"Transient vocal cord paralysis after transverse Sinus stenting.","authors":"Ethan A Miller, Abhay Moghekar, Philippe Gailloud","doi":"10.1177/15910199251332399","DOIUrl":"https://doi.org/10.1177/15910199251332399","url":null,"abstract":"<p><p>We report the case of a young woman diagnosed with idiopathic intracranial hypertension, who did not tolerate long-term pharmacologic treatment and was deemed a candidate for transverse sinus stenting (TSS). Following the procedure, she developed transient palsies of the 10th and 11th cranial nerves. She underwent orotracheal examination and brain magnetic resonance imaging, which ruled out a local structural etiology or brainstem pathology. Her symptoms resolved spontaneously and she returned to baseline neurologic functioning within 12 weeks. Her presentation was likely caused by nerve compression in the jugular foramen by the stent delivery system.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251332399"},"PeriodicalIF":1.5,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022665","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":"Robotic-assisted carotid artery stenting with R-One^TM: Feasibility and safety assessment in patients with carotid web lesions.","authors":"Quentin Alias, Jean-Christophe Ferré, Julien Boucherit, Jean-Yves Gauvrit, François Eugène","doi":"10.1177/15910199251332408","DOIUrl":"https://doi.org/10.1177/15910199251332408","url":null,"abstract":"<p><p>PurposeRobotic-assisted carotid artery stenting (CAS) procedures are on the rise and have demonstrated benefits compared to manual intervention. The R-OneTM robotic platform has demonstrated safety and efficacy for percutaneous coronary interventions, but its utility for procedures in the common carotid artery has not been thoroughly studied. This study aims to assess the feasibility and initial safety of the R-OneTM robotic platform for treating patients with carotid artery disease (CAD) presenting with carotid web-diaphragm lesions.MethodsThe prospective CArotid Robotic procedure Evaluation study included patients with CAD suitable for CAS. The primary endpoint was procedure technical success, defined as the absence of any unplanned manual assistance or conversion to manual CAS for procedural completion. Secondary endpoints included the absence of intra-procedural complications, primary operator radiation exposure, patient radiation exposure, procedure time, and contrast volume.ResultsA total of seven patients were enrolled (mean age: 49.57 ± 13.10 years; 5 females). Procedure technical success rate was 85.7% (6/7). The absence of intra-procedural complications rate was 100%. Mean overall procedure time was 41.71 ± 9.83 min, mean robotic procedure time was 15.86 ± 7.60 min, and mean CAS procedure time was 27.14 ± 8.71 min. The average patient radiation exposure dose was 135.50 ± 78.88 mGy. The mean overall procedure contrast volume was 68.14 ± 20.14 mL, and the mean robotic procedure contrast volume was 1.43 ± 3.78 mL.ConclusionCAS procedures using R-OneTM are feasible and safe with a good technical success rate without complications. To confirm these findings, larger multi-center trials with a diverse range of patients are necessary.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251332408"},"PeriodicalIF":1.5,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055505","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":"Anatomical and geometric considerations for transradial versus transfemoral approach to extracranial carotid artery stenting.","authors":"Navpreet K Bains, Mohamad Ezzeldin, Ibrahim A Bhatti, Adam Delora, Adnan I Qureshi, Rime Ezzeldin, Ameer E Hassan, M Shazam Hussain, Faheem G Sheriff, Gustavo J Rodriguez, Alberto Maud, Ramesh Grandhi, Ali Alaraj, Chizoba Ezepue, Amer Alshekhlee, Omar Tanweer, Ossama Mansour, Saif Bushnaq, Peter Kan, Nazli Janjua, Kaiz S Asif, Muhammad Niazi, Varun Chaubal, Tunmi Anwoju, Zuhair Ali, Leighann Mealer, Maria Martucci, Samantha Miller, Mohammad A Abdulrazzak, Saqib Shaikh, Walid K Salah, Elsa Nico, Oz Haim, Mohammad AlMajali, Gautam Edhayan, Musaab Froukh, Osama O Zaidat, Farhan Siddiq","doi":"10.1177/15910199251330120","DOIUrl":"10.1177/15910199251330120","url":null,"abstract":"<p><p>Background and purposeThe transradial (TR) approach is an alternative to the traditional transfemoral (TF) approach for extracranial carotid artery stenting (eCAS). A successful eCAS may be contingent on the geometry of the great vessels. We aimed to analyze the vessel geometry to identify predictors for successful stent placement, enabling tailored approaches.Materials and methodsMulticenter retrospective data was collected from the electronic health record of patients who underwent eCAS from January 2018 to December 2022. Geometric parameters for great vessels were measured using computed tomography angiography (CTA) or magnetic resonance angiography (MRA). A successful approach was defined as completing eCAS without conversion. We performed a geometric analysis of features correlated with complications and successful completion of eCAS.Results1346 patients underwent TF (1081) and TR (265) eCAS. Conversion from TR to TF occurred in 44 cases (17%). Three TF cases required conversion. Complication rates did not differ between approaches (<i>P</i> = .773), but converting to TF had significantly higher Category 1 complications (<i>P</i> < .001). A smaller angle of origin of the left common carotid artery (A3) correlated with increased complications (<i>P</i> = .039), particularly with angles <90°, peaking at 50°. No other geometric features predicted the success.ConclusionBoth TR and TF stenting can be safely performed for carotid disease, but the angle of the left carotid artery origin predicted an increased risk of complications. No other aortic arch types or great vessel geometry predicted complications. Conversion from TR to TF predicted increased stroke, ICH, and MI.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251330120"},"PeriodicalIF":1.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781845","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":"2024 middle meningeal artery embolization trials: A comprehensive review of past, recent, and ongoing trials.","authors":"Avi A Gajjar, Ali Naqvi, John Y Chen, Amanda Custozzo, Alan S Boulos, John C Dalfino, Nicholas C Field, Alexandra R Paul","doi":"10.1177/15910199251329970","DOIUrl":"10.1177/15910199251329970","url":null,"abstract":"<p><p>Background and objectivesMiddle meningeal artery embolization (MMAE) has become a pivotal intervention in managing chronic subdural hematomas (cSDHs). This systematic review synthesizes past, recent, and ongoing clinical trials to assess MMAE's role in cSDH treatment.MethodsA systematic review was conducted using PRISMA guidelines, incorporating PubMed, ClinicalTrials.gov, and reverse bibliography searches to identify clinical trials evaluating MMAE for cSDH. Inclusion criteria included randomized and nonrandomized trials reporting outcomes, such as recurrence rates and procedural safety. Case reports, retrospective reviews, and opinion pieces were excluded.ResultsSeven published and 15 ongoing trials were identified. Landmark randomized controlled trials (RCTs), including EMBOLISE, STEM, and MAGIC-MT, demonstrated reductions in hematoma recurrence and surgical rescues with MMAE, establishing its role as both an adjunctive and standalone therapy. Ongoing trials, such as EMPROTECT and CHESS, investigate diverse embolic agents, procedural strategies, and patient populations to optimize MMAE outcomes. However, challenges remain, including variability in patient selection criteria, embolic materials, and endpoints.ConclusionMMAE is an innovative and minimally invasive approach that has reshaped cSDH management. Evidence supports its efficacy and safety as an adjunct to surgery and a potential standalone therapy for select patients. Future research should focus on long-term outcomes, subgroup analyses, and standardization of protocols to further refine its application and integration into clinical practice.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251329970"},"PeriodicalIF":1.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781843","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":"Modified treatment in cerebral ischemia 1 versus modified treatment in cerebral ischemia 0 before endovascular stroke treatment in middle cerebral artery's M1-occlusion: Predictor for revascularization success and outcome?","authors":"Jessica Jesser, Charlotte S Weyland, Arne Potreck, Ulf Neuberger, Michael O Breckwoldt, Min Chen, Silvia Schönenberger, Martin Bendszus, Markus A Möhlenbruch","doi":"10.1177/15910199231155297","DOIUrl":"10.1177/15910199231155297","url":null,"abstract":"<p><p>BackgroundLittle is known about the implications for revascularization success of target vessel occlusions (TVOs) with persisting antegrade perfusion before initiation of endovascular stroke treatment (EST) (modified treatment in cerebral ischemia (mTICI 1)) compared to a complete occlusion (mTICI 0). Here, we compared these two states of TVO.MethodsRetrospective, single-center analysis of patients treated for M1-segment middle cerebral artery (MCA) occlusion with EST from January 2015 until May 2020 in a tertiary stroke center. Primary study endpoint was successful recanalization (mTICI 2c-3) after one thrombectomy attempt. Secondary endpoints were clinical outcome (modified Rankin Scale (mRS) 90 days after stroke onset), complication rate, and rate of underlying atherosclerotic disease. The two study groups were compared in univariate analysis including patient characteristics and procedural details.ResultsIn this study, 422/581 patients (72.6%) presented with complete M1-occlusion compared to 159/581 (27.4%) with incomplete M1-occlusion. Neither did the recanalization success rate differ between the study groups nor the rate of complications (mTICI 0: 2.4%, mTICI 1: 0.6%, <i>p</i> = 0.304) or underlying atherosclerotic disease. Patients with incomplete initial occlusion showed a lower mRS at discharge (median interquartile range (IQR) mTICI 0: 4 (3-5) vs. mTICI 1: 3 (2-6), <i>p</i> = 0.014), but a comparable mRS 90 days after stroke onset (mTICI 0: 3 (2-6) vs. mTICI 1: 4 (2-6), <i>p</i> = 0.479).ConclusionComplete M1-occlusions (mTICI 0) and incomplete occlusions (mTICI 1) show the same recanalization success, comparable complication rate, and clinical outcome as well as the same rate of underlying atherosclerotic disease. Thus, incomplete M1-occlusions do not allow for an individualized interventional approach.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":"1 1","pages":"195-200"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65433922","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}