Clinical Neuroradiology最新文献

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Quantitative Magnetic Resonance Imaging for Neurodevelopmental Outcome Prediction in Neonates Born Extremely Premature-An Exploratory Study. 用于预测极早产新生儿神经发育结果的定量磁共振成像--一项探索性研究。
IF 2.8 3区 医学
Clinical Neuroradiology Pub Date : 2024-06-01 Epub Date: 2024-01-30 DOI: 10.1007/s00062-023-01378-9
Victor U Schmidbauer, Mehmet S Yildirim, Gregor O Dovjak, Katharina Goeral, Julia Buchmayer, Michael Weber, Patric Kienast, Mariana C Diogo, Florian Prayer, Marlene Stuempflen, Jakob Kittinger, Jakob Malik, Nikolaus M Nowak, Katrin Klebermass-Schrehof, Renate Fuiko, Angelika Berger, Daniela Prayer, Gregor Kasprian, Vito Giordano
{"title":"Quantitative Magnetic Resonance Imaging for Neurodevelopmental Outcome Prediction in Neonates Born Extremely Premature-An Exploratory Study.","authors":"Victor U Schmidbauer, Mehmet S Yildirim, Gregor O Dovjak, Katharina Goeral, Julia Buchmayer, Michael Weber, Patric Kienast, Mariana C Diogo, Florian Prayer, Marlene Stuempflen, Jakob Kittinger, Jakob Malik, Nikolaus M Nowak, Katrin Klebermass-Schrehof, Renate Fuiko, Angelika Berger, Daniela Prayer, Gregor Kasprian, Vito Giordano","doi":"10.1007/s00062-023-01378-9","DOIUrl":"10.1007/s00062-023-01378-9","url":null,"abstract":"<p><strong>Purpose: </strong>Neonates born at < 28 weeks of gestation are at risk for neurodevelopmental delay. The aim of this study was to identify quantitative MR-based metrics for the prediction of neurodevelopmental outcomes in extremely preterm neonates.</p><p><strong>Methods: </strong>T1-/T2-relaxation times (T1R/T2R), ADC, and fractional anisotropy (FA) of the left/right posterior limb of the internal capsule (PLIC) and the brainstem were determined at term-equivalent ages in a sample of extremely preterm infants (n = 33). Scores for cognitive, language, and motor outcomes were collected at one year corrected-age. Pearson's correlation analyses detected relationships between quantitative measures and outcome data. Stepwise regression procedures identified imaging metrics to estimate neurodevelopmental outcomes.</p><p><strong>Results: </strong>Cognitive outcomes correlated significantly with T2R (r = 0.412; p = 0.017) and ADC (r = -0.401; p = 0.021) (medulla oblongata). Furthermore, there were significant correlations between motor outcomes and T1R (pontine tegmentum (r = 0.346; p = 0.049), midbrain (r = 0.415; p = 0.016), right PLIC (r = 0.513; p = 0.002), and left PLIC (r = 0.504; p = 0.003)); T2R (right PLIC (r = 0.405; p = 0.019)); ADC (medulla oblongata (r = -0.408; p = 0.018) and pontine tegmentum (r = -0.414; p = 0.017)); and FA (pontine tegmentum (r = -0.352; p = 0.045)). T2R/ADC (medulla oblongata) (cognitive outcomes (R<sup>2</sup> = 0.296; p = 0.037)) and T1R (right PLIC)/ADC (medulla oblongata) (motor outcomes (R<sup>2</sup> = 0.405; p = 0.009)) revealed predictive potential for neurodevelopmental outcomes.</p><p><strong>Conclusion: </strong>There are relationships between relaxometry‑/DTI-based metrics determined by neuroimaging near term and neurodevelopmental outcomes collected at one year of age. Both modalities bear prognostic potential for the prediction of cognitive and motor outcomes. Thus, quantitative MRI at term-equivalent ages represents a promising approach with which to estimate neurologic development in extremely preterm infants.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"421-429"},"PeriodicalIF":2.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11129968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139576224","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}
引用次数: 0
Pretreatment CTP Collateral Parameters Predict Good Outcomes in Successfully Recanalized Middle Cerebral Artery Distal Medium Vessel Occlusions. 治疗前 CTP 侧支参数可预测成功再通大脑中动脉远端中血管闭塞的良好疗效。
IF 2.8 3区 医学
Clinical Neuroradiology Pub Date : 2024-06-01 Epub Date: 2023-12-28 DOI: 10.1007/s00062-023-01371-2
Vivek Yedavalli, Manisha Koneru, Omar Hamam, Meisam Hoseinyazdi, Elisabeth Breese Marsh, Raf Llinas, Victor Urrutia, Richard Leigh, Fernando Gonzalez, Risheng Xu, Justin Caplan, Judy Huang, Hanzhang Lu, Max Wintermark, Jeremy Heit, Adrien Guenego, Greg Albers, Kambiz Nael, Argye Hillis
{"title":"Pretreatment CTP Collateral Parameters Predict Good Outcomes in Successfully Recanalized Middle Cerebral Artery Distal Medium Vessel Occlusions.","authors":"Vivek Yedavalli, Manisha Koneru, Omar Hamam, Meisam Hoseinyazdi, Elisabeth Breese Marsh, Raf Llinas, Victor Urrutia, Richard Leigh, Fernando Gonzalez, Risheng Xu, Justin Caplan, Judy Huang, Hanzhang Lu, Max Wintermark, Jeremy Heit, Adrien Guenego, Greg Albers, Kambiz Nael, Argye Hillis","doi":"10.1007/s00062-023-01371-2","DOIUrl":"10.1007/s00062-023-01371-2","url":null,"abstract":"<p><strong>Background/purpose: </strong>Distal medium vessel occlusions (DMVOs) account for a large percentage of vessel occlusions resulting in acute ischemic stroke (AIS) with disabling symptoms. We aim to assess whether pretreatment quantitative CTP collateral status (CS) parameters can serve as imaging biomarkers for good clinical outcomes prediction in successfully recanalized middle cerebral artery (MCA) DMVOs.</p><p><strong>Methods: </strong>We performed a retrospective analysis of consecutive patients with AIS secondary to primary MCA-DMVOs who were successfully recanalized by mechanical thrombectomy (MT) defined as modified thrombolysis in cerebral infarction (mTICI) 2b, 2c, or 3. We evaluated the association between the CBV index and HIR independently with good clinical outcomes (modified Rankin score 0-2) using Spearman rank correlation, logistic regression, and ROC analyses.</p><p><strong>Results: </strong>From 22 August 2018 to 18 October 2022 8/22/2018 to 10/18/2022, 60 consecutive patients met our inclusion criteria (mean age 71.2 ± 13.9 years old [mean ± SD], 35 female). The CBV index (r = -0.693, p < 0.001) and HIR (0.687, p < 0.001) strongly correlated with 90-day mRS. A CBV index ≥ 0.7 (odds ratio, OR, 2.27, range 6.94-21.23 [OR] 2.27 [6.94-21.23], p = 0.001)) and lower likelihood of prior stroke (0.13 [0.33-0.86]), p = 0.024)) were independently associated with good outcomes. The ROC analysis demonstrated good performance of the CBV index in predicting good 90-day mRS (AUC 0.73, p = 0.003) with a threshold of 0.7 for optimal sensitivity (71% [52.0-85.8%]) and specificity (76% [54.9-90.6%]). The HIR also demonstrated adequate performance in predicting good 90-day mRS (AUC 0.77, p = 0.001) with a threshold of 0.3 for optimal sensitivity (64.5% [45.4-80.8%]) and specificity (76.0% [54.9-90.6%]).</p><p><strong>Conclusion: </strong>A CBV index ≥ 0.7 may be independently associated with good clinical outcomes in our cohort of AIS caused by MCA-DMVOs that were successfully treated with MT. Furthermore, a HIR < 0.3 is also associated with good clinical outcomes. This is the first study of which we are aware to identify a CBV index threshold for MCA-DMVOs.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"341-349"},"PeriodicalIF":2.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058908","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}
引用次数: 0
Efficacy and Safety Outcomes for Acute Ischemic Stroke Patients Treated with Intravenous Infusion of Tirofiban After Emergent Carotid Artery Stenting. 急诊颈动脉支架置入后静脉输注替罗非班治疗急性缺血性脑卒中患者的疗效和安全性结果。
IF 2.8 3区 医学
Clinical Neuroradiology Pub Date : 2024-03-01 Epub Date: 2023-10-05 DOI: 10.1007/s00062-023-01350-7
Rana Garayzade, Ansgar Berlis, Stefan Schiele, Michael Ertl, Hauke Schneider, Gernot Müller, Christoph J Maurer
{"title":"Efficacy and Safety Outcomes for Acute Ischemic Stroke Patients Treated with Intravenous Infusion of Tirofiban After Emergent Carotid Artery Stenting.","authors":"Rana Garayzade, Ansgar Berlis, Stefan Schiele, Michael Ertl, Hauke Schneider, Gernot Müller, Christoph J Maurer","doi":"10.1007/s00062-023-01350-7","DOIUrl":"10.1007/s00062-023-01350-7","url":null,"abstract":"<p><strong>Introduction: </strong>Emergent stenting of the extracranial internal carotid artery (ICA) in stroke patients requires antiplatelet therapy to prevent in-stent thrombosis with a higher risk of intracranial haemorrhage.</p><p><strong>Aim of the study: </strong>Assess the efficacy and safety of emergent carotid stenting with intravenous tirofiban in acute ischemic stroke patients.</p><p><strong>Methods: </strong>Primary endpoint: symptomatic hemorrhage. Secondary endpoints: 90-day functional outcome and mortality.</p><p><strong>Results: </strong>Of the 62 patients, 21 (34%) received tirofiban as a single antiplatelet, and 41 (66%) received combined therapy. Premedication with anticoagulants and antiplatelets was significantly more frequent in the tirofiban-only group. The rate of symptomatic haemorrhage was significantly lower in the tirofiban-only group than in the combined group (4.8% vs. 27%, p = 0.046). The patients with tirofiban alone had a significantly better functional outcome at day 90 than the combined group (52% vs. 24%, p = 0.028). Mortality was equal (24%) in both groups. Pre-interventional NIHSS score (p = 0.003), significant blood pressure fluctuations (p = 0.012), tandem occlusion (p = 0.023), and thrombolysis (p = 0.044) showed relevant influence on the rate of symptomatic hemorrhage in the entire patient cohort.</p><p><strong>Conclusions: </strong>A single antiplatelet therapy with tirofiban regardless of the premedication may improve the functional outcome in patients with stroke due to acute extracranial carotid lesion and emergent carotid stenting with lower rates of serious intracranial haemorrhage. For patients with high pre-interventional NIHSS score, tandem occlusion and after pre-interventional thrombolysis, caution is advised. Additionally, strict blood pressure monitoring should be conducted during the first 72 h after intervention.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"163-172"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41156347","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}
引用次数: 0
Artificial Intelligence Imaging for Predicting High-risk Molecular Markers of Gliomas. 人工智能成像预测胶质瘤的高风险分子标记物
IF 2.8 3区 医学
Clinical Neuroradiology Pub Date : 2024-03-01 Epub Date: 2024-01-26 DOI: 10.1007/s00062-023-01375-y
Qian Liang, Hui Jing, Yingbo Shao, Yinhua Wang, Hui Zhang
{"title":"Artificial Intelligence Imaging for Predicting High-risk Molecular Markers of Gliomas.","authors":"Qian Liang, Hui Jing, Yingbo Shao, Yinhua Wang, Hui Zhang","doi":"10.1007/s00062-023-01375-y","DOIUrl":"10.1007/s00062-023-01375-y","url":null,"abstract":"<p><p>Gliomas, the most prevalent primary malignant tumors of the central nervous system, present significant challenges in diagnosis and prognosis. The fifth edition of the World Health Organization Classification of Tumors of the Central Nervous System (WHO CNS5) published in 2021, has emphasized the role of high-risk molecular markers in gliomas. These markers are crucial for enhancing glioma grading and influencing survival and prognosis. Noninvasive prediction of these high-risk molecular markers is vital. Genetic testing after biopsy, the current standard for determining molecular type, is invasive and time-consuming. Magnetic resonance imaging (MRI) offers a non-invasive alternative, providing structural and functional insights into gliomas. Advanced MRI methods can potentially reflect the pathological characteristics associated with glioma molecular markers; however, they struggle to fully represent gliomas' high heterogeneity. Artificial intelligence (AI) imaging, capable of processing vast medical image datasets, can extract critical molecular information. AI imaging thus emerges as a noninvasive and efficient method for identifying high-risk molecular markers in gliomas, a recent focus of research. This review presents a comprehensive analysis of AI imaging's role in predicting glioma high-risk molecular markers, highlighting challenges and future directions.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"33-43"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139565151","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}
引用次数: 0
Diagnostic Value of Perfusion Parameters for Differentiation of Underlying Etiology in Internal Carotid Artery Occlusions. 灌注参数对颈内动脉闭塞潜在病因鉴别的诊断价值。
IF 2.8 3区 医学
Clinical Neuroradiology Pub Date : 2024-03-01 Epub Date: 2023-10-26 DOI: 10.1007/s00062-023-01349-0
Daniel Weiss, Henrik Lang, Christian Rubbert, Kai Jannusch, Marius Kaschner, Vivien Lorena Ivan, Julian Caspers, Bernd Turowski, Robin Jansen, John-Ih Lee, Tobias Ruck, Sven Günther Meuth, Michael Gliem
{"title":"Diagnostic Value of Perfusion Parameters for Differentiation of Underlying Etiology in Internal Carotid Artery Occlusions.","authors":"Daniel Weiss, Henrik Lang, Christian Rubbert, Kai Jannusch, Marius Kaschner, Vivien Lorena Ivan, Julian Caspers, Bernd Turowski, Robin Jansen, John-Ih Lee, Tobias Ruck, Sven Günther Meuth, Michael Gliem","doi":"10.1007/s00062-023-01349-0","DOIUrl":"10.1007/s00062-023-01349-0","url":null,"abstract":"<p><strong>Purpose: </strong>Occlusions of the internal carotid artery (ICA) may be caused by dissection, embolic or macroangiopathic pathogenesis, which partially influences the treatment; however, inferring the underlying etiology in computed tomography angiography can be challenging. In this study, we investigated whether computed tomography perfusion (CT-P) parameters could be used to distinguish between etiologies.</p><p><strong>Methods: </strong>Patients who received CT‑P in acute ischemic stroke due to ICA occlusion between 2012 and 2019 were retrospectively analyzed. Group comparisons between etiologies regarding the ratios of CT‑P parameters between both hemispheres for relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), time to maximum (Tmax), and mean transit time (MTT) were calculated by one-factorial analysis of variance (ANOVA) and compared by pairwise Bonferroni post hoc tests. An receiver operating characteristics (ROC) analysis was performed if differences in group comparisons were found. Multinomial logistic regression (MLR) including pretherapeutic parameters was calculated for etiologies.</p><p><strong>Results: </strong>In this study 69 patients (age = 70 ± 14 years, dissection = 10, 14.5%, embolic = 19, 27.5% and macroangiopathic = 40, 58.0%) were included. Group differences in ANOVA were only found for MTT ratio (p = 0.003, η<sup>2</sup> = 0.164). In the post hoc test, MTT ratio showed a differentiability between embolic and macroangiopathic occlusions (p = 0.002). ROC analysis for differentiating embolic and macroangiopathic ICA occlusions based on MTT ratio showed an AUC of 0.77 (p < 0.001, CI = 0.65-0.89) and a cut-off was yielded at a value of 1.15 for the MTT ratio (sensitivity 73%, specificity 68%). The MLR showed an overall good model performance.</p><p><strong>Conclusion: </strong>It was possible to differentiate between patients with embolic and macroangiopathic ICA occlusions based on MTT ratios and to define a corresponding cut-off. Differentiation from patients with dissection versus the other etiologies was not possible by CT‑P parameters in our sample.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"219-227"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54231903","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}
引用次数: 0
Elevated Intraocular Pressure Moderated Brain Morphometry in High-tension Glaucoma: a Structural MRI Study. 高眼压青光眼的眼压调节脑形态测量:一项结构MRI研究。
IF 2.8 3区 医学
Clinical Neuroradiology Pub Date : 2024-03-01 Epub Date: 2023-10-05 DOI: 10.1007/s00062-023-01351-6
Liang Jing, Tingqin Yan, Jian Zhou, Yuanzhong Xie, Jianfeng Qiu, Yi Wang, Weizhao Lu
{"title":"Elevated Intraocular Pressure Moderated Brain Morphometry in High-tension Glaucoma: a Structural MRI Study.","authors":"Liang Jing, Tingqin Yan, Jian Zhou, Yuanzhong Xie, Jianfeng Qiu, Yi Wang, Weizhao Lu","doi":"10.1007/s00062-023-01351-6","DOIUrl":"10.1007/s00062-023-01351-6","url":null,"abstract":"<p><p>High-tension glaucoma (HTG) is one of the most common forms of primary open angle glaucoma. The purpose of this study was to assess in HTG brain, whether the elevated intraocular pressure (IOP) had an effect on the brain morphological alterations via structural MRI. We acquired T1WI structural MRI images from 56 subjects including 36 HTG patients and 20 healthy controls. We tested whether the brain morphometry was associated with the mean IOP in HTG patients. Moreover, we conducted moderation analysis to assess the interactions between subject type (HTG - healthy controls) and IOP. In HTG group, cortical thickness was negatively correlated with the mean IOP in the left rostral middle frontal gyrus, left pars triangularis, right precentral gyrus, left postcentral gyrus, left superior temporal gyrus (p < 0.05, FDR corrected). Four of the five regions negatively correlated with mean IOP showed reduced cortical thickness in HTG group compared with healthy controls, which were the left rostral middle frontal gyrus, left pars triangularis, left postcentral gyrus and left superior temporal gyrus (p < 0.05, FDR corrected). IOP moderated the interaction between subject type and cortical thickness of the left rostral middle frontal gyrus (p = 0.0017), left pars triangularis (p = 0.0011), left postcentral gyrus (p = 0.0040) and left superior temporal gyrus (p = 0.0066). Elevated IOP may result brain morphometry alterations such as cortical thinning. The relationship between IOP and brain morphometry underlines the importance of the IOP regulation for HTG patients.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"173-179"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41172469","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}
引用次数: 0
Subcortical Infarction After Transarterial Embolization of a Borden Type III Transverse Sinus Dural Arteriovenous Fistula. Borden III型横窦硬脑膜动静脉瘘经动脉栓塞后的皮质下梗死。
IF 2.8 3区 医学
Clinical Neuroradiology Pub Date : 2024-03-01 Epub Date: 2023-10-05 DOI: 10.1007/s00062-023-01352-5
How-Chung Cheng, Antti Lindgren, Timo Krings
{"title":"Subcortical Infarction After Transarterial Embolization of a Borden Type III Transverse Sinus Dural Arteriovenous Fistula.","authors":"How-Chung Cheng, Antti Lindgren, Timo Krings","doi":"10.1007/s00062-023-01352-5","DOIUrl":"10.1007/s00062-023-01352-5","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"275-278"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41144683","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}
引用次数: 0
Efficacy and Safety of Dual Antiplatelet Therapy with the Routine Use of Prasugrel for Flow Diversion of Cerebral Unruptured Aneurysms. 普拉格雷常规应用双重抗血小板治疗未破裂脑动脉瘤的疗效和安全性。
IF 2.8 3区 医学
Clinical Neuroradiology Pub Date : 2024-03-01 Epub Date: 2023-10-17 DOI: 10.1007/s00062-023-01355-2
Kenichiro Suyama, Ichiro Nakahara, Shoji Matsumoto, Jun Morioka, Jun Tanabe, Akiko Hasebe, Sadayoshi Watanabe
{"title":"Efficacy and Safety of Dual Antiplatelet Therapy with the Routine Use of Prasugrel for Flow Diversion of Cerebral Unruptured Aneurysms.","authors":"Kenichiro Suyama, Ichiro Nakahara, Shoji Matsumoto, Jun Morioka, Jun Tanabe, Akiko Hasebe, Sadayoshi Watanabe","doi":"10.1007/s00062-023-01355-2","DOIUrl":"10.1007/s00062-023-01355-2","url":null,"abstract":"<p><strong>Purpose: </strong>Prasugrel is not approved for patients treated with flow diverters, which have a high metal coverage ratio. However, robust antiplatelet therapy with prasugrel may prevent thromboembolic complications. We administered prasugrel and aspirin to all patients treated with flow diverters and reported the safety of the antiplatelet therapy regimen.</p><p><strong>Methods: </strong>This retrospective, single-center study evaluated the angiographic and clinical data of consecutive patients treated with flow diverters for cerebral unruptured aneurysms between June 2020 and May 2022. All patients received dual antiplatelet therapy, including prasugrel and aspirin. The administration of prasugrel ended 3 or 6 months after the procedure, whereas aspirin use continued for at least 12 months. Periprocedural complications (< 30 days post-procedure) and delayed complications (> 30 days post-procedure) were recorded.</p><p><strong>Results: </strong>During the study period, 120 unruptured aneurysms were treated with flow diverters in 110 patients. All patients, except one, survived longer than 12 months after the procedure. The rate of thromboembolic complications was 6.4%, and more than half of the patients had transient symptoms; one (0.9%) had a major ischemic stroke. One patient (0.9%) each had an asymptomatic, small subarachnoid hemorrhage and significant hemorrhagic complications with melena. The rate of permanent neurological deficits was 1.8%, and the mortality rate was 0.9%.</p><p><strong>Conclusions: </strong>Dual antiplatelet therapy comprising routine use of prasugrel and aspirin for flow diverter-implanted patients possibly contributed to a low rate of thromboembolic complications and low risk of hemorrhagic complications.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"201-208"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240270","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}
引用次数: 0
Low Dose Pediatric CT Head Protocol using Iterative Reconstruction Techniques: A Comparison with Standard Dose Protocol. 使用迭代重建技术的低剂量儿童CT头部方案:与标准剂量方案的比较。
IF 2.8 3区 医学
Clinical Neuroradiology Pub Date : 2024-03-01 Epub Date: 2023-11-28 DOI: 10.1007/s00062-023-01361-4
Priyanka, Rajagopal Kadavigere, Suresh Sukumar
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引用次数: 0
Societies' Communications. 社团通讯。
IF 2.8 3区 医学
Clinical Neuroradiology Pub Date : 2023-12-01 DOI: 10.1007/s00062-023-01360-5
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引用次数: 0
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