Interventional Neuroradiology最新文献

{"title":"Comparison of single- versus multi-drug treatment for intra-arterial chemotherapy (IAC) in children with retinoblastoma.","authors":"Amy T Fulton, Arpita Maniar, Alicia Provenzano, Tariq A Firosvi, Julianne Rogers, Bridget Archambault, Beiyu Liu, Shein-Chung Chow, Daniel B Landi, Miguel A Materin, Erik F Hauck","doi":"10.1177/15910199251324028","DOIUrl":"10.1177/15910199251324028","url":null,"abstract":"<p><p>ObjectiveIntra-arterial chemotherapy (IAC) is a well-established treatment for retinoblastoma (RB). However, there are no standardized recommendations regarding the choice of drugs. This study compares the outcomes of single- versus multi-drug therapy.MethodsClinical data was reviewed for RB children treated with IAC at our institution between 2018 and 2023. Patients were divided into single- and multi-drug treatment groups. Clinical parameters included total number of IAC treatments, treatment-related adverse events, duration of additional post-IAC treatments, residual disease, recurrence, and the need for enucleation.ObservationsA total of 101 IAC treatments were included. Multi-drug therapy showed improved outcomes as compared to single-drug therapy, particularly in RB group B and C patients. After multi-drug IAC, less secondary treatment time was required compared to single-drug treatment (2.1 months versus 4.6 months; p = 0.019). Group B and C patients required a median of 8.5 fewer months of secondary treatment after multi- vs. single-drug IAC. Patients treated with multi-drug IAC had an overall lower rate of residual disease or recurrence compared to single-drug IAC patients (26.3% vs. 35.7% recurrence; 52.6% vs. 71.4% residual). In group B and C patients, the difference was more pronounced (12.5% vs. 40% recurrence; 37.5% vs. 60% residual). The overall success rate in preventing enucleation was 90.9%.ConclusionsIAC treatment for RB is safe and effective. IAC prevented enucleation in >90% of our patients. Multi-drug IAC patients required less secondary treatment post-IAC, particularly group B and C patients.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251324028"},"PeriodicalIF":1.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711857","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":"Rescue snaring of Woven EndoBridge (WEB) with direct retrieval from aneurysm sac.","authors":"Gilbert Gravino, Arun Chandran, Richard Pullicino","doi":"10.1177/15910199251328525","DOIUrl":"10.1177/15910199251328525","url":null,"abstract":"<p><p>The Woven EndoBridge (WEB) device is an intrasaccular flow disruption device designed for the treatment of wide-necked aneurysms.^{1, 2} Once deployed into the aneurysm it initiates intra-aneurysmal stasis, thrombosis and occlusion, and flow diversion at the interface of the neck of the aneurysm with the parent vessel.³ The device offers the advantage of reduced operating time and reduced radiation exposure to the patient and the operator. We present a case of a patient in their 70s with a subarachnoid haemorrhage secondary to a ruptured aneurysm at the bifurcation of the right middle cerebral artery. Endovascular treatment was initially attempted with a 7 × 2 mm WEB single layer. Its inadvertent displacement following deployment occluded the superior M2 branch. A snare device was used to capture the proximal marker of the WEB and retrieve the device (Video 1).^{4- 5} The aneurysm was subsequently treated during the same session with a balloon and Comaneci-assisted coiling.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251328525"},"PeriodicalIF":1.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711859","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":"Direct 3D rotational venography: Insights in optimizing visualization.","authors":"Oleg Shekhtman, Georgios S Sioutas, Sneha Sai Mannam, Sandeep Kandregula, Joshua S Catapano, Tina Ehtiati, Jan-Karl Burkhardt, Visish M Srinivasan","doi":"10.1177/15910199251329098","DOIUrl":"10.1177/15910199251329098","url":null,"abstract":"<p><p>IntroductionThree-dimensional rotational venography (3D-RV) expands on three-dimensional rotational angiography to provide high-quality venous anatomy details, complementing traditional two-dimensional digital subtraction angiography and supporting the diagnosis and treatment of venous pathologies. This article presents a series of patients who underwent advanced 3D-RV for the evaluation of idiopathic intracranial hypertension (IIH).MethodsIn this single-center retrospective case series, we analyzed 13 patients with IIH who underwent direct 3D-RV from June 2023 to May 2024. Access was obtained by placing a 6-Fr or larger guide catheter in the rostral internal jugular vein, with a Zoom 35 microcatheter advanced to the middle third of the superior sagittal sinus. A descriptive analysis was performed based on the demographic and radiation metrics.ResultsSixteen direct 3D-RV procedures were performed on 13 patients with IIH (mean age 42.06 ± 13.13 years), including 10 females and three males. General anesthesia was administered for interventions (12 cases) and monitored anesthesia care for manometry (four cases). Venous access was obtained via upper extremity veins in 13 cases (81.25%) and the right common femoral vein in three cases (18.75%). Mean fluoroscopy time was 42.0 ± 29.8 min, contrast dose 92.2 ± 34.2 mL, dose area product (DAP) 18.6 ± 10.5 Gy·cm², and air kerma 1.3 ± 0.56 Gy, with a mean procedure time of 71.3 ± 42.0 min. The 3D-RV procedure contributed an additional 1.86 ± 0.6 Gy to DAP and 0.072 ± 0.021 Gy to air kerma, representing an extra 6.26% and 10.59% of the skin dose, respectively. No procedure-related or in-hospital complications occurred.ConclusionsThe 3D-RV procedure is reliable and safe, offering improved accuracy in assessing venous anatomy and stents without significantly impacting procedure time or radiation dose.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251329098"},"PeriodicalIF":1.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674696","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":"Haptic feedback in robotic endovascular neurosurgical intervention: A necessity or a commodity?","authors":"Gilbert Gravino","doi":"10.1177/15910199241304851","DOIUrl":"10.1177/15910199241304851","url":null,"abstract":"<p><p>Traditionally, both visual and haptic feedback have been regarded as elementary aspects of endovascular neurosurgical intervention. The literature acknowledges that the lack of haptic feedback and the reliance on visual feedback alone in robotic endovascular neurosurgical intervention (RENI) is a limitation. However, several operators who are at the forefront of applying this technology appear to have become quickly accustomed to visual feedback alone. Some have explained their initial scepticism, but upon using the technology they eventually saw the lack of haptic feedback as less of an obstacle and started to regard visual feedback alone as a feasible and safe means to perform procedures. Therefore, this begs the question as to whether haptic feedback is in effect a necessity or a commodity. In this commentary, several considerations are made, presenting arguments supporting the idea that haptic feedback may not be an absolute necessity, and their potential counterarguments. Such reflection and discussion on the topic of haptic feedback in RENI is timely and presently warranted to guide its research and development.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199241304851"},"PeriodicalIF":1.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659042","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":"Virtual simulation for flow-diverter selection and sizing in the endovascular treatment of intracranial aneurysms: A systematic review and meta-analysis.","authors":"Christian Ferreira, Marcio Yuri Ferreira, Raphael Bertani, Lucca Biolcati Palavani, Pedro Glb Borges, Ahmet Günkan, Gean Carlo Müller, Henrique Garcia Maia, Gabriel Semione, Savio Batista, Henrique Laurent Lepine, Daniel Zumofen, Katherine Stark, Ricardo A Hanel, David Gordon, Yafell Serulle, David Langer","doi":"10.1177/15910199251323006","DOIUrl":"10.1177/15910199251323006","url":null,"abstract":"<p><strong>Background: </strong>Endovascular treatment (EVT) of intracranial aneurysms (IAs) has improved significantly with the integration of virtual simulation software (VSS) in surgical planning and device selection. Despite promising outcomes, discrepancies remain between physician and VSS recommendations. This review synthesizes evidence on (1) comparisons between VSS-chosen and physician-chosen dimensions; (2) VSS-chosen and postoperative measured dimensions; and (3) the success rate of VSS-guided device deployment.</p><p><strong>Methods: </strong>A systematic search adhering to PRISMA guidelines was conducted in Medline, Embase, Web of Science, and Cochrane databases up to January 2024. Eligible studies included case series, cohort studies, and randomized trials assessing VSS for stent selection in IAs treatment. Mean difference (MD) and single-arm meta-analysis with 95% confidence intervals (CIs) under a random-effects model were performed for continuous and binary outcomes. Subanalyses were conducted for Sim&Size and PreSize software.</p><p><strong>Results: </strong>Ten studies comprising 658 IAs were included. Pipeline Embolization Device was most commonly used. Findings demonstrated (1) high accuracy of VSS when comparing simulated and postoperative lengths (MD -1.7 mm; 95% CI -4.37 to 0.98 mm); (2) physician-chosen lengths overestimated compared to VSS (MD -2.11 mm; -3.43 to -0.79 mm); (3) no significant difference in physician- versus VSS-chosen diameters (MD -0.04 mm; -0.13 to 0.06 mm); and (4) high VSS-guided deployment success (96%; 93-99%) with low complications (4%). Subanalyses showed 95% and 92% deployment success rates for Sim&Size and PreSize, respectively.</p><p><strong>Conclusion: </strong>VSS effectively estimates device length and achieves high deployment success, with low complication rates, supporting its utility in EVT planning.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251323006"},"PeriodicalIF":1.5,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538021","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":"Analysis of endovascular treatment for cerebral vasospasms after subarachnoid hemorrhage in the Japanese Registry of Neuroendovascular Therapy 4.","authors":"Hisayuki Hosoo, Hirotoshi Imamura, Nobuyuki Sakai, Koji Iihara, Akira Ishii, Chiaki Sakai, Tetsu Satow, Shinichi Yoshimura, Yoshiro Ito, Mikito Hayakawa, Aiki Marushima, Hiroshi Yamagami, Yuji Matsumaru","doi":"10.1177/15910199251323003","DOIUrl":"10.1177/15910199251323003","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the periprocedural and postprocedural outcomes of endovascular treatments for cerebral vasospasm after subarachnoid hemorrhage using data from the Japan Registry of Neuroendovascular Therapy 4 (JR-NET4) (2015-2019).</p><p><strong>Methods: </strong>In this retrospective multicenter study, procedures of endovascular treatment for cerebral vasospasms registered in JR-NET4 were analyzed. The procedure outcomes and complications for percutaneous transluminal angioplasty (PTA) and intra-arterial administration of vasodilators (IA-vasodilator) were compared. The factors associated with imaging and symptom improvement were assessed.</p><p><strong>Results: </strong>Analysis of 1549 procedures revealed that 83.5% of procedures were IA-vasodilator and 16.5% of procedures were PTA. Postprocedural imaging improvement was achieved in 97.0% of patients, and 50.1% of patients experienced symptomatic improvement. The overall complication rate was 1.6%. No significant differences were detected in overall complication rates between patients who underwent PTA and intra-arterial administration of vasodilators; however, hemorrhagic complications were significantly more frequent in patients who underwent PTA. Shorter intervals from symptom onset and the absence of periprocedural complications were associated with improved imaging and neurological outcomes. Local anesthesia and prior treatment with endovascular embolization for ruptured aneurysms were associated with enhanced neurological improvements.</p><p><strong>Conclusion: </strong>Endovascular treatment for cerebral vasospasm is safe and effective. Factors such as early intervention and treatment under local anesthesia may contribute to neurological improvements. However, caution is warranted for PTA due to the slightly higher incidence of hemorrhagic complications.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251323003"},"PeriodicalIF":1.5,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538017","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":"Mechanical thrombectomy for acute ischemic stroke performed without continuous saline flushes and using moderate sedation: The TOOFAST technique.","authors":"Carl M Porto, Abigail A Teshome, Joshua R Feler, Krisztina Moldovan, Santos Santos Fontanez, Radmehr Torabi, Mahesh V Jayaraman, Dylan N Wolman","doi":"10.1177/15910199251323010","DOIUrl":"10.1177/15910199251323010","url":null,"abstract":"<p><strong>Background: </strong>Rapid reperfusion is an important predictor of neurologic recovery in acute ischemic stroke due to large vessel occlusion (AIS-LVO) treated with mechanical thrombectomy (MT). We present a single-institution retrospective observational study of the ThrOmbectomy withOut Flushes or AnestheSia Teams (TOOFAST) technique, which eliminates continuous heparinized saline flushes and employs conscious sedation (CS) to streamline MT preparation.</p><p><strong>Methods: </strong>Retrospective review of prospectively collected data for AIS-LVO patients at our comprehensive stroke center from January 1, 2020, to December 31, 2023. Patients were >18 years with premorbid modified Rankin Scale (mRS) <3. Cases were performed under CS without continuous pressurized heparinized saline flushes or anesthesiologist involvement. Cases were categorized as presenting to the emergency department or from inpatient units (in-house), outside hospital transfers, or those undergoing hyperacute MRI.</p><p><strong>Results: </strong>Among 947 total cases, 638 were analyzed. 374 (58.6%) were in-house activations, 205 (32.1%) were transfers, and 59 (9.2%) underwent hyperacute MRI. Median presenting National Institutes of Health Stroke Scale (NIHSS) was 15 (interquartile range (IQR) 9-20) and 34.7% of patients received intravenous thrombolysis. Median arrival-to-access and NIR-to-access times for in-house activations were 67 (IQR 56-80) and 39 (IQR 29-48) minutes, respectively. Embolization to new territory occurred in 11 (1.7%) patients while vascular perforation occurred in 9 (1.4%). Median NIHSS shift from admission to discharge was -9 (IQR -15 to -5). At 90 days, 46.5% (106/228) remained mRS <3.</p><p><strong>Conclusions: </strong>The TOOFAST technique may result in rapid access times with a profile of safety, procedural parameters, and neurologic outcomes comparable to published trial standards.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251323010"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524964","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":"Multicenter study of HPC coated p48 and p64 flow diverters for treatment of intracranial aneurysms under dual antiplatelet therapy.","authors":"Lukas Goertz, Charlotte S Weyland, Omid Nikoubashman, Franziska Bürkle, Frederic de Beukelaer, Eberhard Siebert, Christian Gronemann, Sophia Hohenstatt, Franziska Dorn, Georg Bohner, Martin Wiesmann, Hani Ridwan, Christoph Kabbasch","doi":"10.1177/15910199251318066","DOIUrl":"10.1177/15910199251318066","url":null,"abstract":"<p><strong>Objective: </strong>Phenox flow diverters (p64 and its smaller vessel variant p48) represent an established treatment option for intracranial aneurysms. This study evaluates the safety and efficacy of the new generation of these devices with an additional antithrombotic surface coating (HPC).</p><p><strong>Methods: </strong>Consecutive patients treated between 2020 and 2023 at three institutions were retrospectively reviewed for aneurysm characteristics, procedural details, complications, and angiographic outcomes.</p><p><strong>Results: </strong>Sixty-one patients (mean age 56 years) were treated for 61 aneurysms. The mean aneurysm size was 8.3 ± 4.9 mm, 12 (19.7%) were ruptured, 16 (26.2%) were recurrent after previous treatment, 10 (16.4%) were located in the posterior circulation, and 7 (11.5%) had nonsaccular morphology. All procedures were technically successful, with a single device sufficient in 60/61 (98%) cases. Delivery problems included device twisting in one case and incomplete proximal opening in another. Additional angioplasty was performed in 3/61 (4.9%) procedures and additional coiling in 4 (6.6%). There were 3 (4.9%) major events (1 thromboembolic ischemic stroke, 1 fatal intracranial hemorrhage, and 1 delayed aneurysm rupture) and 6 (9.8%) minor strokes. Follow up at a mean of 6 months showed complete occlusion in 33/42 (79%) aneurysms, neck remnants in 5 (12%), and aneurysm remnants in 4 (10%).</p><p><strong>Conclusions: </strong>The results demonstrate comparable acceptable complication rates and angiographic results of the Phenox HPC, which are similar to other flow diverters. Long-term and comparative studies are needed to evaluate the full potential of these devices.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251318066"},"PeriodicalIF":1.5,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494376","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":"Is there a simple and accessible solution to improve acute infarct core imaging? The utility of steady-state CT angiographic source images obtained from a delayed phase acquisition.","authors":"Alex Mortimer, Richard Flood, Sophie Dunkerton, Sarah Beth McClelland, David Minks, Robert Crossley, James Wareham, Aubrey Smith, Anthony Cox, Rose Bosnell","doi":"10.1177/15910199251315790","DOIUrl":"10.1177/15910199251315790","url":null,"abstract":"<p><strong>Background: </strong>Early identification and quantification of core infarct is of importance in stroke management for treatment selection, prognostication, and complication prediction. Non-contrast computed tomography (CT) (NCCT) remains the primary tool, but it suffers from limited sensitivity and inter-rater variability; CT perfusion is inconsistently available and commonly blighted by movement artefact. We assessed the performance of a standardised form of CT angiographic source imaging (CTASI) obtained through addition of a delayed phase at 40 seconds post-contrast injection (DP40) following fast-acquisition CT angiography.</p><p><strong>Methods: </strong>Contrast resolution between ischaemic and normal grey matter (GM) was compared qualitatively and quantitatively to NCCT. Using Alberta Stroke Program Early CT Score (ASPECTS), DP40 low density was compared to NCCT and venous phase CT perfusion source images (CTPSI) and to 24-hour NCCT ASPECTS in patients with timely endovascular recanalisation (Thrombolysis In Cerebral Infarction 2C/3).</p><p><strong>Results: </strong>Seventy-four patients with a proximal middle cerebral artery or terminal internal carotid artery occlusion were included. The mean attenuation difference between ischaemic and normal GM increased from 4.86+/-3.12 HU (NCCT) to 9.30+/-3.14 HU (DP40) (p < 0.0001). Subjective assessment by two raters revealed that DP40 improved ischaemic tissue conspicuity in 39 to 41 (78-82%) of cases (kappa 0.805, standard error 0.108, 95% confidence interval: 0.593-1.000). The correlation between ASPECTS on baseline imaging and eventual 24-hour ASPECTS improved from R = 0.7197 for NCCT to R = 0.9875 for DP40 (z = 7.89, p < 0.0001). The correlation between DP40 and venous phase CTPSI ASPECTS was 0.9681, p < 0.0001.</p><p><strong>Conclusion: </strong>DP40 CTASI represent a simple technique for improving detection and estimation of extent of ischaemia over NCCT and show close correlation with surrogate measures of infarct core.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251315790"},"PeriodicalIF":1.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054012","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 impact of pre-treatment aneurysm angulation. What happens with WEB devices at follow-up?","authors":"Romina Muñoz, Nicolás Dazeo, Camila García, Kevin Janot, Nourou Dine Adeniran Bankole, Ana Paula Narata, Aymeric Rouchaud, Ignacio Larrabide","doi":"10.1177/15910199251316411","DOIUrl":"10.1177/15910199251316411","url":null,"abstract":"<p><strong>Background: </strong>WEB shape modification has been analyzed in relation to the aneurysm occlusion outcome and techniques have been presented with one-dimensional measurements of the device to quantify the change after implantation. In this work, we present an analysis of pre-treatment vascular morphology and hemodynamics of cases treated with WEB devices, which were three-dimensionally quantified in morphology and position to detect modifications.</p><p><strong>Methods: </strong>Seventeen WEB-treated aneurysms with pre-treatment, post-treatment and follow-up 3D flat-panel CT were included. Three-dimensional measurements of the WEB morphology and position were made at post-treatment and at follow-up. Differences between acquisitions of all measured variables were statistically evaluated (Wilcoxon signed-rank paired test, <i>P</i>-value = 0.05). Pre-treatment aneurysm angles were three-dimensionally measured and CFD simulations were performed to evaluate the influence of flow on WEB changes.</p><p><strong>Results: </strong>WEB height and diameter presented statistically significant changes. Modification of the angle between the WEB axis and parent artery was significantly higher in the group with WEB shape modification (Mann-Whitney U test, <i>P</i> < 0.05). In this group, the median pre-treatment aneurysm angle was smaller than in the group without shape modification (8.16° vs. 13.14°, <i>P</i> = 0.06). Inflow ratio was higher in the WEB shape modification group.</p><p><strong>Conclusions: </strong>An association between the magnitude of morphological changes of the WEB with the direction of its axis within the aneurysm was found. The analysis of pre-treatment morphological and hemodynamic conditions would allow the detection of aneurysm cases in which the WEB will undergo a more pronounced modification.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251316411"},"PeriodicalIF":1.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054013","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}