Journal of Neuroradiology最新文献

{"title":"Thrombectomy alone vs thrombectomy with over 2/3-dose intravenous thrombolysis pretreatment in the DIRECT-MT trial","authors":"Wenjin Yang ,&nbsp;Hongjian Zhang ,&nbsp;Lei Zhang ,&nbsp;Zifu Li ,&nbsp;Pengfei Xing ,&nbsp;Hongjian Shen ,&nbsp;Yongxin Zhang ,&nbsp;Xiaoxi Zhang ,&nbsp;Xiaofei Ye ,&nbsp;Qinghai Huang ,&nbsp;Yi Xu ,&nbsp;Yongwei Zhang ,&nbsp;Jianmin Liu ,&nbsp;Conghui Li ,&nbsp;Pengfei Yang ,&nbsp;DIRECT-MT Investigators","doi":"10.1016/j.neurad.2023.04.004","DOIUrl":"10.1016/j.neurad.2023.04.004","url":null,"abstract":"<div><h3>Background</h3><p>The DIRECT-MT trial showed that endovascular thrombectomy<span> (EVT) alone was noninferior to EVT preceded by intravenous alteplase. However, the infusion of intravenous alteplase was uncompleted before the initiation of EVT in most cases of this trial. Therefore, the additional benefit and risk of over 2/3-dose intravenous alteplase pretreatment remain to be assessed.</span></p></div><div><h3>Methods</h3><p>We assessed patients with acute anterior circulation ischemic stroke<span> who received EVT alone or with over 2/3-dose intravenous alteplase pretreatment from the DIRECT-MT trial. Patients were assigned to the thrombectomy-alone group and the alteplase pretreatment group. The primary outcome was the distribution of modified Rankin Scale<span> (mRS) at 90 days. The interaction of treatment allocation and collateral capacity was assessed.</span></span></p></div><div><h3>Results</h3><p><span>A total of 393 patients (thrombectomy alone: 315; alteplase pretreatment: 78) were identified. The thrombectomy alone was comparable with alteplase pretreatment prior to the thrombectomy on the distribution of mRS at 90 days without significant effect modification by collateral capacity (adjusted common odds ratio (acOR), 1.12; 95% CI, 0.72–1.74; adjusted P for interaction = 0.83). Successful reperfusion before thrombectomy and the number of passes in the thrombectomy alone group differed significantly from the alteplase pretreatment group (2.6% vs. 11.5%; corrected </span><em>P</em> = 0.02 and 2 vs. 1; corrected <em>P</em> = 0.003). There was no interaction between treatment allocation and collateral capacity on all outcomes.</p></div><div><h3>Conclusions</h3><p>EVT alone and EVT preceded by over 2/3-dose intravenous alteplase might have equal efficacy and safety for patients with acute anterior circulation large vessel occlusion, except for successful perfusion before thrombectomy and the number of passes.</p></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9484099","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}

{"title":"MRI features and disability in multiple sclerosis: A systematic review and meta-analysis","authors":"Fardin Nabizadeh ,&nbsp;Rasa Zafari ,&nbsp;Mobin Mohamadi ,&nbsp;Tahereh Maleki ,&nbsp;Mohammad Sadegh Fallahi ,&nbsp;Nazanin Rafiei","doi":"10.1016/j.neurad.2023.11.007","DOIUrl":"10.1016/j.neurad.2023.11.007","url":null,"abstract":"<div><h3>Background</h3><p>In this systematic review<span> and meta-analysis, we aimed to investigate the correlation between disability in patients<span><span> with Multiple sclerosis (MS) measured by the </span>Expanded Disability Status Scale (EDSS) and brain Magnetic Resonance Imaging (MRI) features to provide reliable results on which characteristics in the MRI can predict disability and prognosis of the disease.</span></span></p></div><div><h3>Methods</h3><p>A systematic literature search was performed using three databases including PubMed, Scopus, and Web of Science. The selected peer-reviewed studies must report a correlation between EDSS scores and MRI features. The correlation coefficients of included studies were converted to the Fisher's z scale, and the results were pooled.</p></div><div><h3>Results</h3><p>Overall, 105 studies A total of 16,613 patients with MS entered our study. We found no significant correlation between total brain volume and EDSS assessment (95 % CI: -0.37 to 0.08; z-score: -0.15). We examined the potential correlation between the volume of T1 and T2 lesions and the level of disability. A positive significant correlation was found (95 % CI: 0.19 to 0.43; z-score: 0.31), (95 % CI: 0.17 to 0.33; z-score: 0.25). We observed a significant correlation between white matter volume and EDSS score in patients with MS (95 % CI: -0.37 to -0.03; z-score: -0.21). Moreover, there was a significant negative correlation between gray matter volume and disability (95 % CI: -0.025 to -0.07; z-score: -0.16).</p></div><div><h3>Conclusion</h3><p>In conclusion, this systematic review and meta-analysis revealed that disability in patients with MS is linked to extensive changes in different brain regions, encompassing gray and white matter, as well as T1 and T2 weighted MRI lesions.</p></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139089256","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}

{"title":"Impact of Day 1 carotid patency on outcome in dissection-related tandem occlusions treated with mechanical thrombectomy","authors":"Guillaume Perrin ,&nbsp;Elisabeth Molinier ,&nbsp;Benjamin Gory ,&nbsp;Maeva Kyheng ,&nbsp;Julien Labreuche ,&nbsp;Marco Pasi ,&nbsp;Kevin Janot ,&nbsp;Romain Bourcier ,&nbsp;Igor Sibon ,&nbsp;Arturo Consoli ,&nbsp;Jean-Philippe Desilles ,&nbsp;Jean-Marc Olivot ,&nbsp;Chrysanthi Papagiannaki ,&nbsp;Sebastien Soize ,&nbsp;Jean-Christophe Gentric ,&nbsp;Cyril Dargazanli ,&nbsp;Jildaz Caroff ,&nbsp;Raoul Pop ,&nbsp;Olivier Naggara ,&nbsp;Solene Moulin ,&nbsp;Gaultier Marnat","doi":"10.1016/j.neurad.2024.01.076","DOIUrl":"10.1016/j.neurad.2024.01.076","url":null,"abstract":"<div><h3>Background</h3><p>The clinical benefit of mechanical thrombectomy(MT) for stroke patients with tandem occlusion is similar to that of isolated intracranial occlusions. However, the management of cervical internal carotid artery(ICA) occlusion during the MT, particularly in the setting of carotid dissection, remains controversial. We aimed to investigate the clinical impact of cervical ICA patency at day 1 on 3-month functional outcome.</p></div><div><h3>Methods</h3><p>We collected data from the Endovascular Treatment in Ischemic Stroke, a prospective national registry in 30 French centers performing MT between January 2015 and January 2022. Inclusion criteria were consecutive tandem occlusions related to cervical ICA dissection treated with MT. Tandem occlusions of other etiology, isolated cervical ICA occlusions without intracranial thrombus and patients without day-1 ICA imaging were excluded. Primary endpoint was the 3-month functional outcome. Secondary endpoints included intracranial hemorrhage(ICH), excellent outcome, mortality and early neurological improvement. A sensitivity analysis was performed in patients with intracranial favorable recanalization after MT.</p></div><div><h3>Results</h3><p>During the study period, 137 patients were included of which 89(65%) presented ICA patency at day 1. The odds of favorable outcome did not significantly differ between patients with patent and occluded ICA at day 1(68.7 vs 59.1%;aOR=1.30;95%CI 0.56-3.00,<em>p</em>=0.54). Excellent outcome, early neurological improvement, mortality and ICH were also comparable between groups. Sensitivity analysis showed similar results.</p></div><div><h3>Conclusion</h3><p>ICA patency at day 1 in patients with tandem occlusions related to dissection did not seem to influence functional outcome. Endovascular recanalization of the cervical ICA including stenting might not be systematically required in this setting.</p></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0150986124000865/pdfft?md5=706f348582955ebcd2633c7bc6d7c9b4&pid=1-s2.0-S0150986124000865-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139661536","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}

{"title":"Anatomical differences of intracranial arteries according to sex: a systematic review and meta-analysis","authors":"M.E.H. Ophelders ,&nbsp;M.J.A. van Eldik ,&nbsp;I.N. Vos ,&nbsp;Y.S. Beentjes ,&nbsp;B.K. Velthuis ,&nbsp;Y.M. Ruigrok","doi":"10.1016/j.neurad.2023.05.005","DOIUrl":"10.1016/j.neurad.2023.05.005","url":null,"abstract":"<div><h3>Background and Purpose</h3><p>Intracranial aneurysms are more common in women than in men. Some anatomical variants of the circle of Willis (CoW) are associated with a higher risk of developing intracranial aneurysms. We hypothesized that variations of the CoW are sex dependent which may partly explain why intracranial aneurysms are more common in women. We systematically reviewed and meta-analyzed the literature to compare the presence of anatomical variations of the CoW between women and men in the general population.</p></div><div><h3>Material and Methods</h3><p>A systematic search in Pubmed and EMBASE using predefined criteria, following the PRISMA guidelines was performed. The presence of different CoW anatomical variants and a complete CoW was compared between women and men using an inverse variance weighted random effects meta-analysis to calculate relative risks (RR) with 95% confidence intervals (95% CIs).</p></div><div><h3>Results</h3><p>Fourteen studies were included reporting on 5478 healthy participants (2511 women, 2967 men). Bilateral fetal type posterior cerebral arteries (RR 2.79; 95%CI 1.65–4.72, I²=0%), and a complete CoW (RR 1.24, 95%CI 1.13–1.36; I²=0%) were more prevalent in women than in men. The variants absence or hypoplasia of one of the anterior cerebral arteries (RR 0.58, 95%CI 0.38–0.88, I²=57%) and hypoplasia or absence of both posterior communicating arteries (RR 0.79, 95%CI 0.71–0.87, I²=0%) were more prevalent in men.</p></div><div><h3>Conclusions</h3><p>Several anatomical variations of the CoW are sex dependent, with some variants being more common in women while others in men. Future research should assess how these sex-specific CoW variants relate to the sex-specific occurrence of intracranial aneurysms.</p></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0150986123002043/pdfft?md5=b3a3536322ab253d150012fb257ea1bb&pid=1-s2.0-S0150986123002043-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9531093","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}

{"title":"MRI characterization of in vitro clots at 3T and 7T: A technical note","authors":"Daniela Dumitriu LaGrange ,&nbsp;Lijing Xin ,&nbsp;François Lazeyras ,&nbsp;Karen M. Doyle ,&nbsp;Isabel Wanke ,&nbsp;Karl-Olof Lövblad","doi":"10.1016/j.neurad.2023.06.003","DOIUrl":"10.1016/j.neurad.2023.06.003","url":null,"abstract":"<div><p>In acute ischemic stroke, the composition of the occlusive clot can be associated with the underlying pathophysiology and the response to treatment. For these reasons, it is important to characterize the clot composition from clinical scans. We examine the ability of 3T and 7T MRI to distinguish the composition of <em>in vitro</em> clots, using quantitative T₁ and T₂*, alternatively R₂*, mapping. When comparing the two field strengths, we found a tradeoff between sensitivity for clot composition and confidence in the clot depiction associated with spatial resolution. The loss of sensitivity at 7T can be mitigated by combining the T₁ and T₂* signals.</p></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0150986123002171/pdfft?md5=6cf3944957680f2c44ff6d7865d14db2&pid=1-s2.0-S0150986123002171-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9701635","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}

{"title":"Extended monitoring of re-coiled cerebral aneurysms after initial postcoiling recanalization: Safety and durability of repeat coil embolization","authors":"Jin Woo Bae ,&nbsp;Han San Oh ,&nbsp;Chang-eui Hong ,&nbsp;Kang Min Kim ,&nbsp;Dong Hyun Yoo ,&nbsp;Hyun-Seung Kang ,&nbsp;Young Dae Cho","doi":"10.1016/j.neurad.2023.05.006","DOIUrl":"10.1016/j.neurad.2023.05.006","url":null,"abstract":"<div><h3>Purpose</h3><p>In the endovascular era, postcoiling recanalization of cerebral aneurysms is occurring with greater frequency. Repeat coiling is usually done to prevent rebleeding, although long-term outcomes of re-embolization have yet to be adequately investigated. The present study was undertaken to assess clinical and radiographic outcomes of re-embolization in recanalized aneurysms, focusing on procedural safety, efficacy, and durability.</p></div><div><h3>Method</h3><p>In this retrospective review, we examined 308 patients with 310 recurrent aneurysms. All lesions were re-coiled, once major recanalization (after initial coil embolization) was established. Medical records and radiologic data amassed during extended follow-up were then subject to review. Cox proportional hazards regression analysis was undertaken to identify risk factors for subsequent recurrence.</p></div><div><h3>Result</h3><p>During a lengthy follow-up (mean, 40.2 ± 33.0 months), major recanalization developed again in 87 aneurysms (28.1%). Multivariable Cox regression analysis linked re-recanalization to initial saccular neck width (<em>p</em>=.003) and autosomal dominant polycystic kidney disease (ADPKD; <em>p</em>&lt;.001). Stent implantation (<em>p</em>=.038) and successful occlusion at second coiling (<em>p</em>=.012) were protective against later recanalization in this setting. The more recent the second embolization was performed, the lower the risk of further recurrence (<em>p</em>=.023). Procedure-related complications included asymptomatic thromboembolism (<em>n</em> = 9), transient ischemic neurologic deficits (<em>n</em> = 2), procedural bleeding (<em>n</em> = 1), and coil migration (<em>n</em> = 1), but there were no residual effects or deaths.</p></div><div><h3>Conclusion</h3><p>Repeat coil embolization is a safe therapeutic option for recanalized cerebral aneurysms. Wide-necked status and ADPKD emerged as risks for subsequent recanalization, whereas successful occlusion and stent implantation seemed to reduce the likelihood of recurrence after re-embolization procedures.</p></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9550908","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}

{"title":"Defining the optimal size of an aspiration catheter in relation to the arterial diameter during mechanical thrombectomy for stroke","authors":"Guillaume Charbonnier ,&nbsp;Panagiotis Primikiris ,&nbsp;Maxime Desmarets ,&nbsp;Gregory Tio ,&nbsp;Sergio Vancheri ,&nbsp;Fortunato Di Caterino ,&nbsp;Giovanni Vitale ,&nbsp;Alessandra Biondi","doi":"10.1016/j.neurad.2023.01.158","DOIUrl":"10.1016/j.neurad.2023.01.158","url":null,"abstract":"<div><h3>Background</h3><p>Mechanical thrombectomy for acute ischemic stroke is effective and includes different technical approaches. Operators use direct aspiration, a stent retriever, or a combination of both. Direct aspiration can be performed with various catheters of different sizes depending on the diameter of the occluded vessel.</p></div><div><h3>Purpose</h3><p>We studied the relationship between the catheter diameter in regards to the occluded vessel diameter and the rate of successful recanalization.</p></div><div><h3>Materials and methods</h3><p>We conducted a retrospective, monocentric study on a series of consecutive patients treated with mechanical thrombectomy. For each procedure, we extracted each attempt that used direct aspiration and rated the attempt as successful or unsuccessful. We also measured the occluded artery diameter and calculated the ratio between the occluded artery and the aspiration catheter diameters. We tested the association between the diameter ratio and the recanalization status. We also performed inter-rater agreement for the arterial diameter measurement between three interventional neuroradiologists.</p></div><div><h3>Results</h3><p>We included 119 patients with 201 attempts of direct aspiration. A higher diameter ratio was associated with a higher recanalization rate. The analysis in terciles showed that the odds of success were 4.80 higher when the ratio was &gt;0.71 vs &lt;0.54 (<em>p</em> &lt; 0.01). Inter-rater agreement showed near-perfect intraclass correlation with 0.93 (0.91–0.94) consistency and 0.92 (0.90–0.94) absolute agreement.</p></div><div><h3>Conclusions</h3><p>We demonstrated an association between higher recanalization and a diameter of ratio &gt;0.71 between the aspiration catheter and the occluded artery. These results could guide intraoperative decisions regarding the appropriate selection of aspiration catheters during mechanical thrombectomy increasing the rate of successful recanalisation. A larger study could provide additional data to further specify the optimal ratio.</p></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10660763","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}

{"title":"Percutaneous transluminal angioplasty or stenting of petrous and cavernous internal carotid artery stenosis – a systematic review","authors":"Mira Salih ,&nbsp;Akashleena Mallick ,&nbsp;Hamid Hussain Rai ,&nbsp;Felix Nwajei ,&nbsp;Justin M. Cappuzzo ,&nbsp;Kenneth Snyder ,&nbsp;Christopher S. Ogilvy","doi":"10.1016/j.neurad.2023.06.005","DOIUrl":"10.1016/j.neurad.2023.06.005","url":null,"abstract":"<div><p><span>Percutaneous transluminal angioplasty<span> (PTA) and stenting have been used for the treatment of </span></span>internal carotid artery<span> (ICA) stenosis over the past two decades. A systematic review<span> was performed to understand the efficacy of PTA and/or stenting for petrous and cavernous ICA stenosis. In total, 151 patients (mean age 64.9) met criteria for analysis, 117 (77.5%%) were male and 34 (22.5%) were female. Of the 151 patients, 35 of them (23.2%) had PTA, and 116 (76.8%) had endovascular stenting. Twenty-two patients had periprocedural complications. There was no significant difference in the complication rates between the PTA (14.3%) and stent (14.7%) groups. Distal embolism was the most common periprocedural complication. Average clinical follow up for 146 patients was 27.3 months. Eleven patients (7.5%) out of 146 had retreatment.</span></span></p><p>The treatment of petrous and cavernous ICA with PTA and stenting has relatively significant procedure related complication rates and adequate long-term patency.</p></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9695867","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}

{"title":"Breaking the glass ceiling for Mechanical Thrombectomy access in France","authors":"François Zhu ,&nbsp;Basile Kerleroux ,&nbsp;Jean Pierre Pruvo ,&nbsp;Olivier Naggara ,&nbsp;Jildaz Caroff ,&nbsp;Jérôme Berge ,&nbsp;Sonia Alamowitch ,&nbsp;Hubert Desal ,&nbsp;Grégoire Boulouis ,&nbsp;SFNR 2022 - 2025 Board","doi":"10.1016/j.neurad.2023.12.002","DOIUrl":"10.1016/j.neurad.2023.12.002","url":null,"abstract":"","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138886439","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}

{"title":"Hemodynamic alterations of flow diverters on aneurysms at the fetal posterior communicating artery: A simulation study using CFD to compare the surpass streamline, pipeline flex, and tubridge devices","authors":"Yu Fu ,&nbsp;Xin Bian ,&nbsp;Rong Zou ,&nbsp;Rongbo Jin ,&nbsp;Xiaochang Leng ,&nbsp;Feng Fan ,&nbsp;Sen Wei ,&nbsp;Xuan Cui ,&nbsp;Jianping Xiang ,&nbsp;Sheng Guan","doi":"10.1016/j.neurad.2023.07.002","DOIUrl":"10.1016/j.neurad.2023.07.002","url":null,"abstract":"<div><h3>Purpose</h3><p>Traditional flow diverters (FDs) for treating aneurysms at the fetal posterior communicating artery<span> are unsatisfactory. Surpass Streamline is a novel FD with different mesh characteristics; however, the outcomes for such aneurysms remain unclear. This study aimed to compare hemodynamic alterations induced by Surpass Streamline, Pipeline Flex, and Tubridge devices and explore possible strategies for aneurysms at the fetal posterior communicating artery.</span></p></div><div><h3>Methods</h3><p>Two simulated aneurysms (Case 1, Case 2) were constructed from digital subtraction angiography (DSA). The three FDs were virtually deployed, and hemodynamic analysis based on computational fluid dynamics was performed. Hemodynamic parameters, including the sac-averaged velocity magnitude (Velocity), high-flow volume (HFV), and wall shear stress (WSS), were compared between each FD and the untreated model (control). Surpass Streamline was performed in real life for two aneurysms and the clinical outcomes were collected for analysis.</p></div><div><h3>Results</h3><p>Compared to the control, the Surpass resulted in the most significant reduction in flow. In Case 1, the Velocity, HFV, and WSS were reduced by 51.6%, 78.1%, and 64.3%, respectively. In Case 2, the Velocity, HFV, and WSS were reduced by 48.0%, 81.1%, and 65.3%, respectively. Tubridge showed slightly larger changes in hemodynamic parameters than Pipeline. In addition, our analysis suggested that metal coverage was correlated with the WSS, Velocity, and HFV. The postoperative DSA showed that the aneurysm was nearly occluded in Case 1 and decreased in Case 2.</p></div><div><h3>Conclusion</h3><p>Compared to that with the Pipeline and Tubridge, the Surpass resulted in the greatest reduction in hemodynamic parameters and might be effective for aneurysms at the fetal posterior communicating artery. Virtual FD deployment and computational fluid dynamics analysis may be used to predict the treatment outcomes.</p></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9932118","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}