Clinical NeuroradiologyPub Date : 2025-03-01Epub Date: 2024-11-15DOI: 10.1007/s00062-024-01474-4
Karan Daga, Siddharth Agarwal, Zaeem Moti, Matthew B K Lee, Munaib Din, David Wood, Marc Modat, Thomas C Booth
{"title":"Machine Learning Algorithms to Predict the Risk of Rupture of Intracranial Aneurysms: a Systematic Review.","authors":"Karan Daga, Siddharth Agarwal, Zaeem Moti, Matthew B K Lee, Munaib Din, David Wood, Marc Modat, Thomas C Booth","doi":"10.1007/s00062-024-01474-4","DOIUrl":"10.1007/s00062-024-01474-4","url":null,"abstract":"<p><strong>Purpose: </strong>Subarachnoid haemorrhage is a potentially fatal consequence of intracranial aneurysm rupture, however, it is difficult to predict if aneurysms will rupture. Prophylactic treatment of an intracranial aneurysm also involves risk, hence identifying rupture-prone aneurysms is of substantial clinical importance. This systematic review aims to evaluate the performance of machine learning algorithms for predicting intracranial aneurysm rupture risk.</p><p><strong>Methods: </strong>MEDLINE, Embase, Cochrane Library and Web of Science were searched until December 2023. Studies incorporating any machine learning algorithm to predict the risk of rupture of an intracranial aneurysm were included. Risk of bias was assessed using the Prediction Model Risk of Bias Assessment Tool (PROBAST). PROSPERO registration: CRD42023452509.</p><p><strong>Results: </strong>Out of 10,307 records screened, 20 studies met the eligibility criteria for this review incorporating a total of 20,286 aneurysm cases. The machine learning models gave a 0.66-0.90 range for performance accuracy. The models were compared to current clinical standards in six studies and gave mixed results. Most studies posed high or unclear risks of bias and concerns for applicability, limiting the inferences that can be drawn from them. There was insufficient homogenous data for a meta-analysis.</p><p><strong>Conclusions: </strong>Machine learning can be applied to predict the risk of rupture for intracranial aneurysms. However, the evidence does not comprehensively demonstrate superiority to existing practice, limiting its role as a clinical adjunct. Further prospective multicentre studies of recent machine learning tools are needed to prove clinical validation before they are implemented in the clinic.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"3-16"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical NeuroradiologyPub Date : 2025-03-01Epub Date: 2024-09-02DOI: 10.1007/s00062-024-01451-x
Civan Islak, Ömer Bağcılar, Hakan Hatem Selçuk, Sema Saltık, Bora Korkmazer, Tanyel Zubarioğlu, Serdar Arslan, Ahmet Üstündag, Osman Kızılkılıç
{"title":"A New Perspective On Arterioectatic Spinal Angiopathy with a Reversible Pattern: Cause or Consequence?","authors":"Civan Islak, Ömer Bağcılar, Hakan Hatem Selçuk, Sema Saltık, Bora Korkmazer, Tanyel Zubarioğlu, Serdar Arslan, Ahmet Üstündag, Osman Kızılkılıç","doi":"10.1007/s00062-024-01451-x","DOIUrl":"10.1007/s00062-024-01451-x","url":null,"abstract":"<p><strong>Objective: </strong>In 2022, arterioectatic spinal angiopathy (AESA) of childhood was reported as a fatal, progressive, multi-segment myelopathy associated with a unique form of non-inflammatory spinal angiopathy involving diffuse dilatation of the anterior spinal artery and cord congestion in children. In this study, we present four more cases of AESA, using early and long-term conventional imaging and flat detector computed tomography angiography (FDCTA) imaging to assess the probability of disease regression and prevent unnecessary interventions.</p><p><strong>Methods: </strong>We retrospectively reviewed the clinical and radiological findings of four patients with AESA seen in two neuroradiology departments between 2014 and 2023.</p><p><strong>Results: </strong>The study included three boys and one girl. Two of the boys were siblings. Although the clinical and radiological presentation in the early stages of the clinical course overlapped the definition of AESA, the clinical course was more benign in three of the cases. The clinical courses of the two siblings with monosegmental cord involvement and largely reversible radiological findings suggest that some of the features in the initial definition of the disease cannot be standardized for all patients. The siblings had a mutation of the NDUFS gene, which is involved in mitochondrial function and clinical-radiological reversibility in these patients.</p><p><strong>Conclusion: </strong>Many mitochondrial diseases, such as this NDUFS mutation, present with myelopathy, and mitochondrial diseases can sometimes show spontaneous recovery. It is crucial to identify other genetic mutations or environmental factors that trigger the accompanying vascular ectatic findings in AESA in larger multicenter studies to prevent its potential lethal course and possible unnecessary surgical-endovascular interventions.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"67-75"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical NeuroradiologyPub Date : 2025-03-01Epub Date: 2024-09-03DOI: 10.1007/s00062-024-01455-7
Mousa Zidan, Yves Leonard Voss, Marcel Wolf, Fee Keil, Carolin Brockmann, Christian Gronemann, Nils Christian Lehnen, Daniel Paech, Hannes Nordmeyer, Franziska Dorn
{"title":"The Dual-layer CGuard Stent Is Safe and Effective in Emergent Carotid Artery Stenting and in Tandem Occlusions: a Multi-centric Study.","authors":"Mousa Zidan, Yves Leonard Voss, Marcel Wolf, Fee Keil, Carolin Brockmann, Christian Gronemann, Nils Christian Lehnen, Daniel Paech, Hannes Nordmeyer, Franziska Dorn","doi":"10.1007/s00062-024-01455-7","DOIUrl":"10.1007/s00062-024-01455-7","url":null,"abstract":"<p><strong>Background: </strong>Dual-layer stents have fallen into disrepute after several studies reported high rates of in-stent occlusions in acute stroke treatments. The CGuard stent is a new-generation hybrid dual-layer stent that has been designed to provide less thrombogenicity and to prevent peri- and postinterventional emboli. The aim of the study is to evaluate the safety and efficacy of the CGuard stent for the acute treatment of occlusion or high-grade stenosis of the extracranial internal carotid artery (ICA) in patients with acute ischemic stroke (AIS) with and without concomitant intracranial large vessel occlusion (LVO).</p><p><strong>Methods: </strong>All patients who underwent emergent carotid artery stenting (CAS) with the CGuard stent were identified and analyzed from the stroke registries from four tertiary German stroke centers. Clinical, procedural, and imaging data were evaluated. Stent patency within 72 h, intracranial hemorrhage, and modified Rankin score (mRS) at discharge were the safety and efficacy end points.</p><p><strong>Results: </strong>Overall, ninety-six patients were included (mean age 70.2 ± 11.8, 66 males (68.8%), median NIHSS score at admission 11 (7-17), IV lysis: n = 44 (45.8%)). Stent placement was successful in all patients. Eighty-three (86.4%) patients had tandem occlusions. In-stent occlusion occurred in 5 patients (5.2%) and 3 patients developed early in-stent stenosis (3.1%). Median mRS at discharge was 2 (1-4).</p><p><strong>Conclusion: </strong>In this multicenter study, the use of the dual-layer CGuard stent for emergent CAS, particularly in tandem occlusions, was safe and resulted in low rates of in-stent occlusions.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"77-85"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical NeuroradiologyPub Date : 2025-03-01Epub Date: 2024-08-23DOI: 10.1007/s00062-024-01450-y
Nikolaos Ntoulias, Alex Brehm, Salvador Miralbés, Bharath Naravetla, Alejandro Spiotta, Christian Loehr, Mario Martínez-Galdámez, Ryan McTaggart, Luc Defreyne, Pedro Vega, Osama O Zaidat, Lori Lyn Price, David S Liebeskind, Markus Möhlenbruch, Rishi Gupta, Marios-Nikos Psychogios
{"title":"Trevo 3 Mm and/or AXS Catalyst 5 for the Treatment of Medium Distal Vessel Occlusion Stroke-results from the ASSIST Registry.","authors":"Nikolaos Ntoulias, Alex Brehm, Salvador Miralbés, Bharath Naravetla, Alejandro Spiotta, Christian Loehr, Mario Martínez-Galdámez, Ryan McTaggart, Luc Defreyne, Pedro Vega, Osama O Zaidat, Lori Lyn Price, David S Liebeskind, Markus Möhlenbruch, Rishi Gupta, Marios-Nikos Psychogios","doi":"10.1007/s00062-024-01450-y","DOIUrl":"10.1007/s00062-024-01450-y","url":null,"abstract":"<p><strong>Background: </strong>The effect of endovascular therapy (EVT) on the outcome of stroke patients with a medium distal vessel occlusion (MDVO) is unclear. We report the results of MDVO patients treated with the 3 mm Trevo stent retriever (SR) and/or the AXS Catalyst 5 distal access catheter.</p><p><strong>Methods: </strong>Data was derived from a prospective, multicenter global registry (ASSIST registry) which enrolled patients treated with operator preferred EVT technique at 71 sites from January 2019 to January 2022. Three techniques were assessed: SR classic, direct aspiration, and a combined approach. Additional inclusion criteria were (a) EVT performed with the 3 mm Trevo SR and/or AXS Catalyst 5 distal access catheter on the first pass and (b) an occlusion of the M2 segment or M3 segment of the middle cerebral artery or the A1, A2 or A3 segment of the anterior cerebral artery. The primary outcome was achieving an expanded Thrombolysis in Cerebral Infarction (eTICI) score of 2c or 3 on the first pass, with the primary technique as adjudicated by core lab. The primary clinical outcome measure was a 90-day modified Rankin Scale (mRS) score of 0-2.</p><p><strong>Results: </strong>A total of 155 patients (10.4% of the ASSIST population) were included. Most patients had an M2 occlusion (93.5%). First pass eTICI reperfusion was achieved in 43.1% of the patients. No modifying effect of the frontline technique was found. The rate of mRS 0-2 (overall 65.0%) did not significantly differ between groups.</p><p><strong>Conclusion: </strong>The data suggests that the Trevo 3 mm SR and/or the AXS Catalyst 5 may be an option to treat medium distal vessel occlusion, but more data is needed to demonstrate safety and efficacy in this patient cohort. Further improvements are needed regarding materials and techniques to improve reperfusion results in this patient cohort in the future.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"51-57"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical NeuroradiologyPub Date : 2025-03-01Epub Date: 2024-08-23DOI: 10.1007/s00062-024-01440-0
Maria Lourdes Diaz, Tomás Carmona, Manuel Requena, Carlos Piñana, David Hernández, Francesco Diana, Marta De Dios, Jordi Farrero, Marc Ribo, Arturo Fredes Araya, Laura Ludovica Gramegna, Francisco Purroy, Leandro Fernandez, Jordi Villalba, Manuel Quintana, Alejandro Tomasello
{"title":"Remote Teleproctoring with the TEGUS System for Mechanical Thrombectomy in a Non-Comprehensive Stroke Center: Initial Preliminary Data On Clinical Experience.","authors":"Maria Lourdes Diaz, Tomás Carmona, Manuel Requena, Carlos Piñana, David Hernández, Francesco Diana, Marta De Dios, Jordi Farrero, Marc Ribo, Arturo Fredes Araya, Laura Ludovica Gramegna, Francisco Purroy, Leandro Fernandez, Jordi Villalba, Manuel Quintana, Alejandro Tomasello","doi":"10.1007/s00062-024-01440-0","DOIUrl":"10.1007/s00062-024-01440-0","url":null,"abstract":"<p><strong>Purpose: </strong>Mechanical thrombectomy (MT) is typically performed by experienced neurointerventional radiologists. However, logistical and geographic limitations often hinder access to rapid MT. This study reports the first clinical experience using TEGUS teleproctoring to support MT conducted by general interventional radiologists (IR) at non-comprehensive stroke centers, compared to on-site proctoring outcomes.</p><p><strong>Methods: </strong>The Arnau de Vilanova Hospital in Spain used to transfer stroke patients requiring MT to a comprehensive Stroke Center 160 km away. To overcome COVID-19 mobility restrictions, the Tegus Teleproctoring System was installed. Before teleproctoring, the general interventional radiologist underwent six months of neurointerventional training at a primary stroke center. From April 2021 to May 2023, general IR conducted MT either with on-site proctor supervision or teleproctoring support. We aim to compare clinical outcome of patients receiving MT according to proctoring method.</p><p><strong>Results: </strong>During the study, 49 MTs were performed: 15 with TEGUS teleproctoring and 34 with on-site proctoring. Both groups had similar baseline characteristics, except for NIHSS scores (Tegus 9 [IQR 6-20] vs 18 [IQR 12-22], p = 0.034). No significant differences were found in door-to-revascularization time (82 ± 28.2 vs 84 ± 26.4) min, p = (0.895). The final mTICI distribution and 90-day mRS scores were comparable after adjusting by stroke severity. There were no reports of symptomatic intracranial hemorrhage in either group.</p><p><strong>Conclusion: </strong>This study shows the feasibility of Tegus remote teleproctoring during emergent cases of MT in a remote hospital. It could improve the learning curve of interventional radiologists with limited experience in MT, and lower the territorial inequity associated to MT.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"35-41"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical NeuroradiologyPub Date : 2025-03-01Epub Date: 2024-10-07DOI: 10.1007/s00062-024-01463-7
Vivek Yedavalli, Hamza Adel Salim, Dhairya A Lakhani, Aneri Balar, Janet Mei, Licia Luna, Francis Deng, Nathan Z Hyson, Jens Fiehler, Paul Stracke, Gabriel Broocks, Christian Heitkamp, Gregory W Albers, Max Wintermark, Tobias D Faizy, Jeremy J Heit
{"title":"High Hypoperfusion Intensity Ratio Is Independently Associated with Very Poor Outcomes in Large Ischemic Core Stroke.","authors":"Vivek Yedavalli, Hamza Adel Salim, Dhairya A Lakhani, Aneri Balar, Janet Mei, Licia Luna, Francis Deng, Nathan Z Hyson, Jens Fiehler, Paul Stracke, Gabriel Broocks, Christian Heitkamp, Gregory W Albers, Max Wintermark, Tobias D Faizy, Jeremy J Heit","doi":"10.1007/s00062-024-01463-7","DOIUrl":"10.1007/s00062-024-01463-7","url":null,"abstract":"<p><strong>Background: </strong>Recent advances have highlighted the efficacy of endovascular thrombectomy (EVT) in patients with large ischemic core stroke, yet a significant portion still experience very poor outcomes, defined as a 90-day modified Rankin Score (mRS) of 5-6. This study aims to investigate the hypoperfusion intensity ratio (HIR) as a prognostic imaging parameter for these outcomes.</p><p><strong>Methods: </strong>In a multicenter retrospective cohort study, data from consecutive patients undergoing EVT for acute ischemic stroke with large vessel occlusion (AIS-LVO) at two comprehensive stroke centers were analyzed. The study included patients with an Alberta Stroke Program Early CT Score (ASPECTS) of 5 or less and utilized pretreatment perfusion imaging to calculate HIR. The primary outcome was very poor outcomes (90 days mRS 5-6).</p><p><strong>Results: </strong>Among 102 patients included, 59 (57.8%) had very poor outcome (90 days mRS 5-6). Multivariable logistic regression analysis adjusting for multiple covariates including admission National Institutes of Health Stroke Scale (NIHSS) and EVT revealed that higher admission NIHSS (adjusted odds ratio [aOR] 1.224, 95% CI 1.089-1.374, p = 0.001) and HIR (aOR per 0.1 incremental change, 1.34, 95% CI 1.02-1.82, P = 0.042) were independently associated with very poor outcomes.</p><p><strong>Conclusion: </strong>This study demonstrates that admission NIHSS and HIR are independently associated with very poor outcome (90 days mRS 5-6) in patients with large ischemic core strokes. These findings highlight the importance of collateral status and perfusion imaging in predicting outcomes in this patient population, suggesting a potential role for HIR in the triage and management of large core stroke patients.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"131-139"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical NeuroradiologyPub Date : 2025-03-01Epub Date: 2024-08-12DOI: 10.1007/s00062-024-01449-5
Marian Maximilian Hasl, João Pinho, Sophie Gina Baldus, Anna Gerhards, Martin Wiesmann, Jörg B Schulz, Arno Reich, Omid Nikoubashman
{"title":"Pre-stroke Functional Status in Patients Undergoing Mechanical Thrombectomy: How Relevant Are False Estimations in the Emergency Setting?","authors":"Marian Maximilian Hasl, João Pinho, Sophie Gina Baldus, Anna Gerhards, Martin Wiesmann, Jörg B Schulz, Arno Reich, Omid Nikoubashman","doi":"10.1007/s00062-024-01449-5","DOIUrl":"10.1007/s00062-024-01449-5","url":null,"abstract":"<p><strong>Purpose: </strong>The modified Rankin scale (mRS) is frequently used in the emergency setting to estimate pre-stroke functional status in stroke patients who are candidates to acute revascularization therapies (ps-mRS). We aimed to describe the agreement between pre-stroke mRS evaluated in the emergency department (ED-ps-mRS) and pre-stroke mRS evaluated comprehensively post-admission (PA-ps-mRS).</p><p><strong>Methods: </strong>Retrospective study of consecutive ischemic stroke patients undergoing mechanical thrombectomy, with available ED-ps-mRS and PA-ps-mRS. ED-ps-mRS was evaluated by the treating neurologist and documented in the emergency stroke treatment protocol. PA-ps-mRS was retrospectively evaluated with information registered in the clinical record. Collection of baseline characteristics and 3‑month outcomes. Patients with ED-overestimated pre-stroke functional status (ED ps-mRS ≤ 2 and PA-ps-mRS ≥ 3) were compared to correct low and high ED-ps-mRS groups.</p><p><strong>Results: </strong>We included 409 patients (median age 77 years, 50% female, median NIHSS 14). Concordance of dichotomized ED-ps-mRS and PA-ps-mRS (0-2 vs. 3-5) was found in 81.4% (Cohen's kappa = 0.476, p < 0.001). ED-overestimated pre-stroke functional status was found in 69 patients (17%). Patients with ED-overestimated pre-stroke functional status were older (p < 0.001), more frequently presented diabetes (p < 0.001), previous stroke (p = 0.014) and less frequently presented 3‑month functional independence (p < 0.001) compared to patients with correct low ED-ps-mRS. No differences in pre-stroke baseline characteristics between overestimated and correct high ED-ps-mRS was found.</p><p><strong>Conclusion: </strong>Disagreement between dichotomized ED-ps-mRS and PA-ps-mRS (0-2 vs. 3-5) occurred in 1/5 of patients. Overestimation of pre-stroke functional status may falsely reduce the expected proportion of patients achieving favourable 3‑month functional outcomes.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"17-23"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical NeuroradiologyPub Date : 2025-03-01Epub Date: 2024-08-22DOI: 10.1007/s00062-024-01446-8
Roland Schwab, Christoph Kabbasch, Lukas Goertz, Marius Kaschner, Daniel Weiss, Christian Loehr, Hauke Wensing, Maxim Bester, Andreas Simgen, André Kemmling, Christina Wendl, Erelle Fuchs, Maximilian Thormann, Daniel Behme, Hannes Nordmeyer
{"title":"The DERIVO 2 Heal Embolization Device in the Treatment of Ruptured and Unruptured Intracranial Aneurysms: a Retrospective Multicenter Study.","authors":"Roland Schwab, Christoph Kabbasch, Lukas Goertz, Marius Kaschner, Daniel Weiss, Christian Loehr, Hauke Wensing, Maxim Bester, Andreas Simgen, André Kemmling, Christina Wendl, Erelle Fuchs, Maximilian Thormann, Daniel Behme, Hannes Nordmeyer","doi":"10.1007/s00062-024-01446-8","DOIUrl":"10.1007/s00062-024-01446-8","url":null,"abstract":"<p><strong>Backround: </strong>The use of flow diverting stents in the treatment of intracranial aneurysms is associated with a risk of neurological morbidity due to their thrombogenicity. To reduce this risk different surface modifications have been developed. The Derivo 2 Embolization Device (Acandis, Pforzheim, Germany) has proven to be a safe and effective flow diverter. To overcome the risk of thrombo-embolism, the device was modified by adding an anti-thrombogenic fibrin-heparin coating. We aimed to assess the safety and effectiveness of the Derivo 2 heal Embolization Device.</p><p><strong>Methods: </strong>Retrospective multicenter data from nine German neurovascular centers between February 2022 until December 2023 were used. Patients treated with the Derivo 2 heal Embolization Device for unruptured or ruptured intracranial aneurysms were included. Peri- and postprocedural adverse events, clinical outcomes, and angiographic follow-up results were evaluated.</p><p><strong>Results: </strong>84 patients (73.8% female; mean age 58.7 years) with 89 aneurysms (mean size 9.8 mm) were included. 87.6% were located in the anterior circulation. Most of them were sidewall aneurysms (88.8%). 96 flow diverters were used. 99.0% were successfully implanted. An in-stent balloon angioplasty was performed in 6.0% of the cases. An additional coiling was performed in 28.6%. Technical difficulties were present in 12.0% of the cases. Thrombotic events occurred in 4.8% with no neurological sequelae. Mortality and morbidity were 0 and 1.2% respectively. Adequate aneurysm occlusion was achieved in 80.7% with a mean follow-up time of 6.6 months.</p><p><strong>Conclusion: </strong>The Derivo 2 heal Embolization Device showed a satisfying aneurysm occlusion and safety with a low rate of neurological morbidity.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"25-34"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical NeuroradiologyPub Date : 2025-03-01Epub Date: 2024-06-29DOI: 10.1007/s00062-024-01433-z
S Hopf-Jensen, N Bajwa, S Müller-Hülsbeck
{"title":"Endovascular Treatment of Carotid Artery Dissection Caused by Eagle's Syndrome : Case Report.","authors":"S Hopf-Jensen, N Bajwa, S Müller-Hülsbeck","doi":"10.1007/s00062-024-01433-z","DOIUrl":"10.1007/s00062-024-01433-z","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"197-201"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}