Interventional Neuroradiology最新文献

{"title":"Improvement of cerebral blood flow after balloon angioplasty and stenting for symptomatic middle cerebral artery stenosis.","authors":"Takashi Araga, Toshihiro Ueda, Tomohide Yoshie, Naoki Takao, Haruki Ohtsubo, Kentaro Tatsuno, Noriko Usuki, Satoshi Takaishi, Yoshihisa Yamano","doi":"10.1177/15910199241231148","DOIUrl":"10.1177/15910199241231148","url":null,"abstract":"<p><p>ObjectiveAlthough reports of endovascular treatment for intracranial arterial stenosis have been increasing recently, their efficacy remains to be elucidated. This study aimed to investigate the changes in cerebral hemodynamics of severe middle cerebral artery (MCA) stenosis patients by performing CT perfusion (CTP) after endovascular treatment.MethodsSubjects were those who underwent balloon angioplasty and stenting for symptomatic MCA M1 stenosis refractory to medical therapy at our hospital between 2008 and 2022. We included 36 patients (mean age 63.69 ± 15.24 years, 20 males) who underwent CTP before and within three weeks after treatment. The CTP parameters such as relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), and relative mean transit time (rMTT) were calculated as ipsilateral values divided by contralateral value.ResultsEndovascular treatment consisted of 26 balloon angioplasty and 10 stenting procedures performed at an average of 1 month from onset. CTP was performed at an average of 5.5 days postoperatively. The mean overall stenosis rate decreased from 79.0% to 30.3%. In the balloon angioplasty group, it decreased from 77.6% to 35.3%, and in the stent group, it decreased from 82.7% to 17.5%. After treatment, rCBF and rMTT measured by CTP improved significantly (both <i>p </i>< 0.001), whereas there was no significant change in rCBV. The improvement rates of rCBF and rMTT were mild higher in the stent group, but not significantly so.ConclusionBalloon angioplasty and stenting for symptomatic MCA improved cerebral hemodynamics, resulting in significantly increased rCBF and decreased rMTT.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"1240-1245"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708270","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":"Carotid stenting for symptomatic carotid artery web: Multicenter experience.","authors":"Christopher R Pasarikovski, Jeremy Lynch, Michael Corrin, Jerry C Ku, Ashish Kumar, Vitor M Pereira, Timo Krings, Leodante da Costa, Sandra E Black, Ronit Agid, Victor Xd Yang","doi":"10.1177/15910199231226293","DOIUrl":"10.1177/15910199231226293","url":null,"abstract":"<p><p>ObjectiveCarotid artery webs are an underappreciated cause of recurrent ischemic stroke, and may represent a significant portion of cryptogenic stroke. Evidence-based guidelines for the management of symptomatic carotid webs do not exist. The goal of this study is to audit our local experience for patients with symptomatic carotid artery webs undergoing carotid stenting as a treatment option, along with describing the hypothesized dynamic physiology of carotid webs.MethodsAll patients undergoing stenting for symptomatic carotid artery web at two comprehensive regional stroke centers with high endovascular thrombectomy volume from January 1, 2012 to March 1, 2021 were included. The modified Rankin Scale (mRS) score was used to define functional outcome at 3 months after stenting.ResultsFourteen consecutive patients with symptomatic carotid artery webs underwent stenting. Twelve patients were female (86%), with a median age of 54 (IQR, 48-64) years across all patients. Stroke was the qualifying event in 12 (86%) patients and TIA in 2. Eleven patients (11/14, 79%) achieved a mRS score of 0-2 at 90 days, 2 (14%) were mRS 3-5, and one patient was lost to follow-up. The median follow-up was 12 months (IQR, 10-12). There was no recurrent stroke or TIA like symptoms in any patients.ConclusionsCarotid stenting appears to be safe at preventing recurrent stroke/TIA with a median follow-up of 12 months in this retrospective multicenter observational study.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"1204-1209"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139486632","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":"Transradial stenting of left subclavian artery origin using shockwave intravascular lithotripsy balloon plasty: Technical report and literature review.","authors":"David Barkyoumb, Abdurrahman F Kharbat, José M Orenday-Barraza, Mohit Pahuja, Hakeem J Shakir","doi":"10.1177/15910199241260076","DOIUrl":"10.1177/15910199241260076","url":null,"abstract":"<p><p>Lesions of the subclavian artery often involve pathologic stenosis due to high degrees of calcification within the vessel wall. While endovascular angioplasty and stenting is generally the preferred method for obtaining flow reconstitution, calcification of the vessel wall has proven to significantly impair the efficacy of successful stent deployment. Shockwave intravascular lithotripsy (IVL) is a technology that has been very successful in addressing this challenge in other vascular territories, however its use has yet to be approved for supra-aortic vessels such as the subclavian artery. In this report, the use of IVL for a case of subclavian steal syndrome due to a highly stenosed left subclavian artery is described along with a review of the literature. Although several cases utilizing this technology in subclavian arteries have been reported, none have described the use of a left transradial approach. Therefore the purpose of this report is to demonstrate the efficacy of IVL for supra-aortic vessels so that its benefits can be expanded to a broader patient population.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"2054-2059"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297043","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 the treatment of large vessel occlusion due to cancer-related cerebral embolism: A systematic review.","authors":"Michelle Toruno, Omar Al-Janabi, Irem Karaman, Sherief Ghozy, Yigit Can Senol, Hassan Kobeissi, Ramanathan Kadirvel, Boyd Ashdown, David F Kallmes","doi":"10.1177/15910199241230356","DOIUrl":"10.1177/15910199241230356","url":null,"abstract":"<p><p>BackgroundCancer-related cerebral embolism due to direct tumor embolization results in a rare acute ischemic stroke with large vessel occlusion (LVO). Despite the established status of mechanical thrombectomy (MT) in LVO management, its effectiveness and safety remains inadequately explored in this specific patient group.MethodsWe conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using the Nested Knowledge AutoLit software, encompassing databases like Embase, PubMed, Scopus, and Web of Science, from their inception up to 9 May 2023.ResultsIn the review of 35 studies encompassing 37 cases, mean patient age was 52 years, and 30% were female. Cardiac myxoma (29.7%), cardiac papillary fibroelastoma (16.2%), and squamous cell carcinoma of the lung (8.1%) were the most frequent underlying cancers. The left middle cerebral artery was the most commonly affected occlusion site (24.3%). Of the patients, 67.5% underwent MT alone, while 32.5% received MT combined with intravenous thrombolysis. Successful reperfusion (thrombolysis in cerebral infarction (TICI) 2b-3) was achieved in 89.1% of cases, with 59.4% reaching TICI 3. Functional independence was observed in 29.7% of patients.ConclusionWhile limitations exist, this comprehensive study highlights the potential benefits of MT in a patient group historically excluded from major trials, warranting further investigation.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"1560-1568"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708271","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":"Utilization and reimbursement of diagnostic cerebral angiograms: A Medicare trends analysis from 2013 to 2020.","authors":"Avi A Gajjar, Michael M Covell, Najib Muhammad, Cathleen Kuo, Georgios S Sioutas, Mohamed M Salem, Sebastian Ivan Fras, Brian T Jankowitz, Jan-Karl Burkhardt, Visish M Srinivasan","doi":"10.1177/15910199241233333","DOIUrl":"10.1177/15910199241233333","url":null,"abstract":"<p><p>IntroductionIncreasing life expectancy has caused growing concern about maintaining viable neurointerventional practices due to altered Medicare payment structures. This study analyzes the financial trends of three common diagnostic tests for cerebrovascular disease: cerebral digital subtraction angiography (DSA), computed tomography angiography (CTA), and magnetic resonance angiography (MRA).MethodsMedicare Part B National Summary Data files from 2013 to 2020 were queried by Current Procedural Terminology (CPT) codes for DSA (36221-36228), CTA (70496, 70498), and MRA (70544-70547, 70549). Inflation-adjusted charges and reimbursement were calculated using the U.S. City Average Consumer Price Index for Medical Services. Regression analysis was performed on charges, reimbursement, and volume.ResultsA total of 1,519,245 diagnostic procedures were conducted between 2013 and 2020 (782,370 angiograms, 246,603 CTAs, and 490,272 MRAs). A total of $41.005 million was reimbursed by Medicare in 2020 for these diagnostic procedures. The annual percent change in volume for all procedures was -2.90%. From 2013 to 2020, inflation-adjusted: Medicare total physician reimbursement decreased for cerebral angiograms (-4.12%, p = 0.007), CTAs (-2.77%, p = 0.458), and MRAs (-9.06%, p < 0.001). Procedural volume billed to Medicare decreased for cerebral angiograms (-4.63%, p = 0.007) and MRAs (-2.94%, p = 0.0.81) and increased for CTAs (+3.15%, p = 0.004). The greatest increase in Medicare reimbursement (+66.75%) came from CPT code 36224, \"place catheter carotid artery\", and the greatest decrease in Medicare reimbursement (-8.66%) came from CPT code 36226, \"place catheter vertebral artery.\"ConclusionsThis study provides an analysis of Medicare reimbursement trends for routine cerebrovascular angiogram techniques. The findings highlight a decline in Medicare reimbursements for neurointerventionalists.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"1261-1266"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933704","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":"Distal mechanical thrombectomy using beveled tip aspiration zoom catheters: A preliminary study.","authors":"Jonathan Dallas, Vincent N Nguyen, Joel M Sequeiros, Shelby Graham, Jared Burns-Martin, Nitin Goyal, Kasra Khatibi","doi":"10.1177/15910199241258289","DOIUrl":"10.1177/15910199241258289","url":null,"abstract":"<p><p>IntroductionDistal medium vessel occlusion (DVO) thrombectomy has been shown to be efficacious with safety profiles comparable to large vessel occlusion (LVO) thrombectomy. A novel, highly-trackable, bevel-tipped Zoom 35 catheter can be used as an aspiration catheter for DVO thrombectomy.MethodsThis is a retrospective, single-arm, multi-institutional observational study evaluating the efficacy and safety of aspiration thrombectomy for DVO using the Zoom 35 catheter. Patient demographics, presenting and discharge NIHSS, primary and rescue thrombectomy, site of occlusion, TICI score, and intracranial hemorrhage were chart abstracted. Descriptive statistics were used to evaluate the efficacy and safety of thrombectomy.ResultsFourteen patients (mean age 66.64 ± 13.75 years) were included. The mean NIHSS at presentation was 10.79 ± 5.48, and the mean ASPECTS was 9.00 ± 0.89. Nine patients (64.3%) received tPA. Primary occlusion location was M3 in nine cases (64.3%), M2/M3 junction in two cases (14.3%), A2 in one case (7.1%), A3 in one case (7.1%), and P1 in one case (7.1%). TICI scores were 3 in seven cases (50.0%), 2C in three cases (21.4%), and 2B in four cases (28.6%). There was one postoperative SAH (7.1%) and one asymptomatic ICH (7.1%). Mean discharge NIHSS was 3.38 ± 4.44, with a mean decrease of 7.31 from presentation (p < 0.0001, t-test).ConclusionZoom 35 beveled-tip aspiration microcatheters are highly trackable and associated with improved radiographic and clinical outcomes for the treatment of DVO with a good safety profile.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"1899-1903"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238603","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":"Quantitative evaluation of the effects of flow diverter treatment on aneurysm hemodynamics using time-resolved rotational angiography.","authors":"Jeremy C Peterson, Julie M DiNitto, Annette Birkhold, Nickalus Kahn, Christopher Nickele, Dan Hoit, Violiza Inoa, Lucas Elijovich, David Dornbos, Adam S Arthur","doi":"10.1177/15910199241252519","DOIUrl":"10.1177/15910199241252519","url":null,"abstract":"<p><p>BackgroundThere have been immense advancements in the hardware and software of digital subtraction angiography systems over the last several years. These advancements continue to make progress toward the goals of offering better visualization and reducing radiation exposure. A newer advancement in this arena is presenting three-dimension data over time resulting in four-dimensional-digital subtracted angiography visualization. We have evaluated these protocols related to the evaluation of the treatment of intracranial aneurysms with pipeline flow diversion.MethodsFour-dimensional-digital subtracted angiography imaging was acquired on an Artis Q Biplane angiographic system (Siemens Healthcare AG, Forchheim, Germany). A six second four-dimensional-digital subtracted angiography protocol was performed pre and post flow diverter placement. Pre and post reconstructed images were sent through a dedicated prototype research workstation (Syngo X-Workplace; Siemens Healthineers AG) for further flow evaluation.ResultsThe treatment of an aneurysm with flow diversion led to a filling delay of 0.278 ± 0.422 s inside the aneurysms, whereas distal to the aneurysms the filling of the vessel segment occurred earlier post procedural (negative filling delay of -0.15 ± 0.31 s. The flow ratio inside the aneurysm decreased to 63.6 ± 23% of its pre-treatment value and distal to the aneurysm the flow remained substantially the same (flow ratio: 95.6 ± 0.29%). Data showed a relative filling delay of the aneurysm normalized to the distal vessel of 0.43 ± 0.36 s. The relative flow ratio of the aneurysm in comparison to the distal parent vessel was 72.2 ± 31%.ConclusionsAnalysis of a four-dimensional-digital subtracted angiography acquisition allows assessment of the effects of flow diversion treatment on aneurysm hemodynamic parameters and shows a significant decrease in flow inside the aneurysm compared to the parent vessel distal to the aneurysm.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"1470-1477"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877786","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":"Standardized approach to direct first pass aspiration technique for endovascular thrombectomy: Description and initial experience with CANADAPT.","authors":"I R Macdonald, V Linehan, B Sneek, David Volders","doi":"10.1177/15910199241230360","DOIUrl":"10.1177/15910199241230360","url":null,"abstract":"<p><p>BackgroundEndovascular thrombectomy (EVT) is standard of care for acute ischemic stroke. Stent assisted EVT with aspiration (SOLUMBRA) technique has remained a mainstay approach. There is growing evidence that A Direct Aspiration First Pass Technique (ADAPT) is a safe, efficient and effective approach for EVT, offering several advantages. This study describes and reports initial institutional experience in the use of a standardized scientific based aspiration only technique: CANADAPT.MethodsSingle center prospective cohort study was performed on consecutive patients treated for large/medium vessel ischemic stroke with CANADAPT. Intravenous thrombolytics were administered according to routine practice, independent of the decision to proceed with EVT. A sequential stepwise aspiration only technique was then applied, CANADAPT, consisting of three maneuvers, A, B and C. The reperfusion success rate, number of passes, use of rescue technique, complication rate and procedural cost were determined.ResultsTwenty-two patients were included in this case series representing M1 (17, 77%), M1/2 (2, 9%), carotid-T (2, 9%) and basilar (1, 5%) occlusions. First pass recanalization was achieved in 11 (50%) of patients. A further four patients had successful reperfusion with a second pass of CANADAPT (total 68% success rate). Only one patient had successful reperfusion with the aspiration catheter at the clot interface (CANADAPT A). All others required some withdrawal of the aspiration catheter for reperfusion (CANADAPT B and C). Seven patients had SOLUMBRA rescue. Of these, five patients (22% of total patients) had further successful reperfusion. Overall median procedural time was 23 min for first recanalization and 30 min for final recanalization. The cost per procedure was $6630 ± 1069 for CANADAPT, and $13,530 ± 2706 for SOLUMBRA techniques.ConclusionsCANADAPT represents a standardized scientific-based approach to aspiration only thrombectomy intervention. This initial study demonstrates the safety, efficiency and efficacy of this technique for use in EVT.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"1232-1239"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708272","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":"Optical coherence tomography findings of balloon angioplasty/stenting for in-stent restenosis after carotid artery stenting.","authors":"Shingo Yamada, Kei Harada, Daichi Baba, Takatusugu Oshima, Koki Tanaka","doi":"10.1177/15910199241232465","DOIUrl":"10.1177/15910199241232465","url":null,"abstract":"<p><p>ObjectivesThe optimal therapeutic methods for in-stent restenosis (ISR) after carotid artery stenting (CAS) remains controversial. This study aimed to use optical coherence tomography (OCT) to evaluate the in-stent architectures during endovascular angioplasty/stenting for ISR.Materials and MethodsSix lesions of ISR after CAS were evaluated by OCT during endovascular angioplasty/stenting.ResultsIn one lesion, the OCT system could not be crossed because of elongation distal to the ISR lesion. In five lesions, pre-procedural OCT clearly revealed neointimal hyperplasia or neoatherosclerosis. The mean in-stent area stenosis was 84%. After regular balloon angioplasty, tissue compression and dissection of various sizes and layers were detected. After balloon angioplasty (with a mean balloon size of 5.4 mm), the minimum lumen area (from 1.7 ± 0.6 to 11.4 ± 5.3 mm², <i>p</i> < 0.01) and the minimum in-stent area (12.7 ± 2.6 to 21.8 ± 5.0 mm², <i>p</i> < 0.01) showed a significant increase. Additional stent was placed in one lesion that developed into a flap by dissection after balloon angioplasty. In another lesion in which sufficient dilatation was not achieved by balloon angioplasty, a major stroke occurred by acute occlusion of the ISR lesion 10 months later.ConclusionsOCT can detect the in-stent architecture of ISR lesions after balloon angioplasty and additional stent placement. However, which dissection should be treated by additional stent remain problematic.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"1246-1252"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724706","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":"Spontaneous thrombosis with a conservative approach to posterior spinal artery pseudoaneurysm management: A case series.","authors":"Yasaman Pirahanchi, Benjamin Atchie, Michael Flynn, Ian Kaminsky","doi":"10.1177/15910199241249779","DOIUrl":"10.1177/15910199241249779","url":null,"abstract":"<p><p>In this study, we address the rarity and management challenges associated with ruptured spinal artery pseudoaneurysms, which comprise < 1% of subarachnoid hemorrhage cases. With our limited understanding of their natural history, the prevailing consensus leans towards surgical clipping, contrasting with the typically benign symptoms of sudden back pain and lower extremity weakness. Despite reported low morbidity and mortality, fatal re-ruptures underscore the need for effective management strategies. In this context, we present the largest case series to date, featuring five patients with spinal subarachnoid hemorrhage from isolated posterior spinal artery pseudoaneurysms. All cases achieved spontaneous thrombosis and resolution through conservative management, challenging the prevailing surgical emphasis. The patients, aged 58-81, exhibited varied symptoms, including back pain, paresthesia, confusion, and seizures, with hypertension as a common comorbidity. The results of these cases lead us to tender a \"hybrid\" management strategy, combining conservative measures with short-term follow-up angiograms, fostering a paradigm shift and warranting further investigation into individualized patient care within larger clinical cohorts.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"1998-2001"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877787","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}