Journal of neuroendovascular therapy最新文献

{"title":"Technique for Recanalization of Sheath Introducer Occlusion due to Captured Thrombus during Mechanical Thrombectomy for Acute Ischemic Stroke: A Technical Note.","authors":"Yukitaka Ishida, Toru Umehara, Yoshihiro Yano, Shogo Taniwaki, Hidekazu Nakata, Takashi Koyama, Manabu Sasaki, Koichi Taniwaki, Toshiaki Fujita, Mamoru Taneda, Haruhiko Kishima","doi":"10.5797/jnet.tn.2023-0099","DOIUrl":"10.5797/jnet.tn.2023-0099","url":null,"abstract":"<p><strong>Objective: </strong>Mechanical thrombectomy (MT) is the gold standard treatment for acute ischemic stroke. During these interventions, a thrombus frequently obstructs a guiding catheter. The obstructed guiding catheter should be withdrawn before distal embolism occurs; however, albeit infrequently, the thrombus occludes even a sheath introducer (SI). While conventionally new SI placement is required for continuation of treatment, we propose a viable alternative for recanalization of the occluded SI, termed vacuum-assisted delivery of thrombus (VADT), with a clinical report of our cases. The usefulness of this technique was also evaluated in simulation experiments.</p><p><strong>Case presentations: </strong>The VADT procedure is as follows: 1) insert a peel-away sheath, originally attached to a balloon-guiding catheter (BGC), into the SI to continuously open the hemostatic valve; 2) advance the BGC into the peel-away sheath while applying mechanical aspiration; and 3) remove the peel-away sheath/BGC assembly slowly. In a simulation environment using an artificial thrombus, we repeated the VADT procedure five times and reproducibly achieved SI reopening within only 10-20 seconds. From March 2013 to September 2022, 204 patients were treated with MT at our stroke center and SI occlusion occurred in three patients (1.5%). These events occurred exclusively in patients with extracranial internal carotid artery occlusion. All three patients with SI occlusion underwent successfully thrombus extraction in the SI using the VADT on the first try.</p><p><strong>Conclusion: </strong>The results of clinical experience and simulation experiments strongly support VADT as a reliable option for recanalization of an occluded SI.</p>","PeriodicalId":73856,"journal":{"name":"Journal of neuroendovascular therapy","volume":"18 5","pages":"149-154"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11129056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141163087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventive Strategies for Perioperative Ischemic Heart Disease during Carotid Artery Stenting.","authors":"Shinya Fukuta, Mitsuhiro Iwasaki, Hidekazu Yamazaki, Masahiro Maeda, Masaki Koh, Yasufumi Inaka, Hiroaki Sato, Taichiro Hayase, Masafumi Morimoto","doi":"10.5797/jnet.oa.2023-0062","DOIUrl":"10.5797/jnet.oa.2023-0062","url":null,"abstract":"<p><strong>Objectives: </strong>We have been performing preoperative coronary artery assessments and implementing coronary revascularization or intraoperative adjunctive therapies as needed in patients scheduled for carotid artery stenting (CAS) to prevent ischemic heart disease. In this study, we report the results of a retrospective observation of patients who underwent CAS under our treatment strategy to prevent perioperative coronary ischemic complications.</p><p><strong>Methods: </strong>A total of 224 cases from January 2014 to December 2021 were included. Following preoperative coronary artery CTA, preoperative coronary artery treatment or intraoperative adjunctive therapy (temporary transcutaneous cardiac pacemaker [TTCP] or intra-aortic balloon pumping [IABP]) was performed based on the degree of stenosis. We analyzed the outcomes of patients treated with CAS under this strategy at our institution.</p><p><strong>Results: </strong>Coronary artery disease was detected preoperatively in 143 cases (64%), with 91 cases (41%) indicated for coronary revascularization. Preoperative coronary artery treatment was performed in 76 cases (34%) prior to CAS, and adjunctive therapy with TTCP or IABP was provided in 28 cases (13%) during the procedure. No case developed perioperative coronary ischemic complication.</p><p><strong>Conclusion: </strong>In patients who have undergone CAS, perioperative coronary ischemic complications might be reduced by evaluating the risk of ischemic heart disease preoperatively, performing pre-CAS coronary artery intervention based on the severity of the lesions, and administering intraoperative adjunctive therapy.</p>","PeriodicalId":73856,"journal":{"name":"Journal of neuroendovascular therapy","volume":"18 5","pages":"131-136"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11129055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141163211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Lumbar Drainage before Endovascular Treatment for Ruptured Intracranial Aneurysms.","authors":"Toshitsugu Terakado, Yoshiro Ito, Koji Hirata, Masayuki Sato, Tomoji Takigawa, Aiki Marushima, Mikito Hayakawa, Wataro Tsuruta, Noriyuki Kato, Yasunobu Nakai, Kensuke Suzuki, Yuji Matsumaru, Eiichi Ishikawa","doi":"10.5797/jnet.oa.2023-0069","DOIUrl":"10.5797/jnet.oa.2023-0069","url":null,"abstract":"<p><strong>Objective: </strong>Intraoperative rebleeding during endovascular treatment for ruptured intracranial aneurysms is associated with poor prognosis. Lumbar drainage is performed preoperatively to control intracranial pressure; however, it is associated with a risk of brain herniation or rebleeding because intracranial pressure may change rapidly. Therefore, this study aimed to examine the efficacy and safety of preoperative lumbar drainage.</p><p><strong>Methods: </strong>This retrospective study enrolled 375 patients who underwent endovascular treatment of ruptured intracranial aneurysms at our institution between April 2013 and March 2018. The incidence of rebleeding and clinical outcomes were compared between patients who did and did not undergo preoperative lumbar drainage.</p><p><strong>Results: </strong>Among the 375 patients with ruptured intracranial aneurysms, 324 (86.0%) and 51 (14.0%) patients did and did not undergo lumbar drainage, respectively. The incidence of rebleeding was 11/324 (3.4%) and 2/51 (3.9%) in lumbar drainage and nonlumbar drainage groups, respectively, with no statistical differences (p = 0.98). Of the rebleeding cases, 9/11 (81%) and 2/2 (100%) in lumbar drainage and nonlumbar drainage groups, respectively, were due to intraoperative bleeding, and 2/11 (19%) in the lumbar drainage group, the causes of the rebleeding were undetermined. The incidence of symptomatic vasospasm did not differ significantly between the groups (13.2% vs. 11.8%, P = 0.776), while the incidence of hydrocephalus (24.6% vs. 11.8%, P = 0.043) and meningitis (15.2% vs. 5.9%, P = 0.075) were slightly higher in the lumbar drainage group. Favorable clinical outcomes (modified Rankin Scale score <2) at discharge were less frequent in the lumbar drainage group (55.3% vs. 70.0%, P = 0.051). No significant differences were observed in the propensity score-matched analysis.</p><p><strong>Conclusion: </strong>Lumbar drainage before endovascular treatment for ruptured intracranial aneurysms is a safe procedure that does not increase the incidence of rebleeding.</p>","PeriodicalId":73856,"journal":{"name":"Journal of neuroendovascular therapy","volume":"18 2","pages":"29-36"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10878735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Treatment of Bifurcation Aneurysms with the Woven EndoBridge: Product Features and Selected Results of Off-Label Use.","authors":"Kohsuke Teranishi, Ryogo Ikemura, Sho Arai, Yumiko Mitome-Mishima, Takayuki Kitamura, Akihide Kondo, Hidenori Oishi","doi":"10.5797/jnet.ra.2023-0086","DOIUrl":"10.5797/jnet.ra.2023-0086","url":null,"abstract":"<p><p>Treatment for wide-neck bifurcation cerebral aneurysms (WNBAs) is widely performed by endovascular treatment as well as open surgical clipping. However, due to factors such as the shape and size of the aneurysms, as well as the anatomical features of surrounding branch vessels, there are some cases in which simple coiling or conventional adjunctive techniques, such as balloon-assisted or neck bridge stent-assisted coiling, are not sufficient to achieve a satisfactory cure. Against this backdrop, the device known as the Woven EndoBridge (WEB) (MicroVention, Aliso Viejo, CA, USA) was developed and can be deployed directly into the aneurysm for treatment. Over a decade has passed since its development, and it is now used in many countries worldwide. This review provides insights into the evolution of the WEB device from its development to the date of this writing, highlighting the unique features of the device and its treatment indications. Additionally, it discusses the posttreatment course, perspectives on recurrence and retreatment, imaging assessments, and potential off-label use based on numerous studies primarily conducted in Europe and the USA.</p>","PeriodicalId":73856,"journal":{"name":"Journal of neuroendovascular therapy","volume":"18 3","pages":"65-74"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10973567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences and Advantages of Particles versus Liquid Material for Preoperative Intracranial Tumor Embolization: A Retrospective Multicenter Study.","authors":"Yu Iida, Taisuke Akimoto, Shigeta Miyake, Ryosuke Suzuki, Wataru Shimohigoshi, Satoshi Hori, Jun Suenaga, Yasunobu Nakai, Katsumi Sakata, Tetsuya Yamamoto","doi":"10.5797/jnet.oa.2023-0083","DOIUrl":"10.5797/jnet.oa.2023-0083","url":null,"abstract":"<p><strong>Objectives: </strong>The superiority and usefulness of liquid material over particles for embolization have been a topic of debate due to differences in materials and techniques. This study aimed to identify the complications and outcomes associated with both embolization materials.</p><p><strong>Methods: </strong>This retrospective multicenter cohort study included 93 patients from an endovascular treatment registry, treated from January 1, 2018 to May 31, 2022. It included patients who underwent preoperative embolization for meningioma, solitary fibrous tumor/hemangiopericytoma, and hemangioblastoma. Data for patient characteristics, procedural factors, complications, and outcomes were collected from medical records.</p><p><strong>Results: </strong>A tortuous access route was the only factor independently associated with complications (<i>p</i> = 0.020). Although liquid material was more frequently used for embolization in relatively high-risk conditions, complication rates did not differ significantly between the groups (<i>p</i> = 0.999). In the liquid material group, the tip of the microcatheter could be guided closer to the tumor (<i>p</i> <0.001) using a distal access catheter and flow-guide microcatheters. The subgroup middle meningeal artery embolization had less operative bleeding in the liquid material group (<i>p</i> <0.001), whereas the particles group exhibited less intraoperative blood loss than the liquid material group (<i>p</i> = 0.006).</p><p><strong>Conclusion: </strong>The vascular tortuosity of the access route was only associated with complications in preoperative tumor embolization. Liquid material and particles showed no difference in complication rates. The use of particles in embolization may reduce intraoperative bleeding, but not in all cases can it be used safely. Therefore, a thorough understanding of the characteristics of both approaches and their relative advantages in clinical practice is essential to opt for the appropriate material according to the case.</p>","PeriodicalId":73856,"journal":{"name":"Journal of neuroendovascular therapy","volume":"18 4","pages":"110-118"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11076144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations and Literature Review for Treating Subarachnoid Hemorrhage due to Blood Blister-Like Aneurysms.","authors":"Ryousuke Orimoto, Kouichi Ebiharara, Michihiro Hayasaka","doi":"10.5797/jnet.oa.2024-0009","DOIUrl":"10.5797/jnet.oa.2024-0009","url":null,"abstract":"<p><strong>Objective: </strong>Subarachnoid hemorrhage (SAH) due to blood blister-like aneurysm (BBA) is rare but very risky during treatment. Moreover, there is no established treatment method. In this study, we performed endovascular treatment (EVT) as the first-line treatment on patients with SAH during the subacute phase, and cases were analyzed in this series.</p><p><strong>Methods: </strong>Patients with SAH due to BBA who visited our hospital between April 2021 and March 2023 were enrolled in this study. We waited as long as possible during the acute phase and performed EVT during the subacute phase. We performed stent-assisted coiling (SAC) as the first-line treatment and performed DSA approximately 6 months after treatment.</p><p><strong>Results: </strong>Ninety-six patients with SAH visited our hospital during the study period and six had SAH due to BBAs. There were two males and four females aged 56.2 ± 14.6 years. We performed SAC in five patients, and one died owing to rebleeding before treatment. Two patients received treatments because of rebleeding. One patient died on the day after rebleeding, whereas the other experienced rebleeding and treatments twice and achieved a good outcome. Four patients had good outcomes (modified Rankin scale [mRS]: 0). The surviving patients achieved complete occlusion at follow-up DSA. However, two patients had poor outcomes (mRS: 6).</p><p><strong>Conclusion: </strong>Patients with SAH due to BBA treated in the subacute phase may achieve good outcomes; however, there is a risk of rebleeding during the waiting period, which often causes poor outcomes.</p>","PeriodicalId":73856,"journal":{"name":"Journal of neuroendovascular therapy","volume":"18 7","pages":"183-190"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11260517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asymptomatic Complete Spiral Stent Fracture in Subclavian Artery with Progressive Restenosis in the Early Postoperative Period: A Case Report.","authors":"Daisuke Izawa, Hiroyuki Matsumoto, Yuta Nakanishi, Toshiki Shimizu, Hirokazu Nishiyama","doi":"10.5797/jnet.cr.2024-0019","DOIUrl":"10.5797/jnet.cr.2024-0019","url":null,"abstract":"<p><strong>Objective: </strong>Stent fractures may be a risk factor for delayed restenosis, but it is difficult to diagnose asymptomatic stent fractures in the subclavian artery (SCA). We report a rare case of percutaneous transluminal angioplasty and stenting (PTAS) for SCA stenosis with asymptomatic severe stent fracture that showed progressive in-stent stenosis in the early postoperative period.</p><p><strong>Case presentation: </strong>A 70-year-old woman presented with left arm claudication. Magnetic resonance imaging at the time of admission showed SCA stenosis with severe calcification. Because of the left subclavian steal phenomenon on ultrasonography of the left vertebral artery, she underwent PTAS using a balloon-expandable stainless stent. Ultrasonography the day after treatment showed appropriate stent placement. Computed tomography angiography (CTA) 30 days after PTAS showed an asymptomatic complete spiral stent fracture at the mid-portion of the stent. The in-stent stenosis then gradually progressed on follow-up ultrasonography at the site of the stent fracture. Nine months after the first PTAS, a second PTAS using a self-expandable nitinol stent was performed because the peak systolic velocity exceeded 300 cm/s on Doppler ultrasound. Two years after the second PTAS, no neurological symptoms and no stent deformation were observed.</p><p><strong>Conclusion: </strong>PTAS with a balloon-expandable stainless stent for SCA stenosis with severe calcification may lead to stent fracture. In the case of severe stent fracture, careful follow-up may be needed for the detection of asymptomatic in-stent stenosis in the early postoperative period.</p>","PeriodicalId":73856,"journal":{"name":"Journal of neuroendovascular therapy","volume":"18 7","pages":"191-196"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11260515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Outcomes in Patients with Unruptured Anterior Choroidal Artery Aneurysms: A Single-Center Experience.","authors":"Mikako Nomoto, Tomoki Kidani, Masayoshi Kida, Koji Kobayashi, Yosuke Fujimi, Saki Kawamoto, Nobuyuki Izutsu, Katsunori Asai, Yonehiro Kanemura, Shin Nakajima, Toshiyuki Fujinaka","doi":"10.5797/jnet.oa.2024-0038","DOIUrl":"10.5797/jnet.oa.2024-0038","url":null,"abstract":"<p><strong>Objective: </strong>Treatment of anterior choroidal artery (AChA) aneurysms is frequently associated with ischemic complications. This study aimed to report the outcomes of treatment of unruptured AChA aneurysms in our hospital.</p><p><strong>Methods: </strong>Between January 2015 and March 2022, 40 patients were treated for an unruptured AChA aneurysm in our hospital. Age, sex, aneurysm size, AChA branching type, treatment, occlusion rate, complications, modified Rankin Scale (mRS) score before surgery and after 90 days, and recurrence were investigated. The branching type was classified as internal carotid artery (ICA), neck, or dome type based on the location of the AChA origin.</p><p><strong>Results: </strong>The mean age was 61.1 ± 1.9 years; 15 patients were men and 25 were women. The mean aneurysm diameter was 4.4 ± 0.3 mm. The branching type was ICA in four patients, neck in 35, and dome in one. Treatment was surgical clipping in 22 patients and endovascular coil embolization in 18 (14 with stent assistance). Motor-evoked potential (MEP) monitoring was used in all patients of the clipping group and 9 cases of the coiling group. Treatment complications occurred in eight patients (20%). mRS score worsened by more than one point 90 days after treatment in four patients (10%); however, the proportion of patients who experienced this did not significantly differ between the clipping and coiling groups. Although the odds of a thrombotic complication were higher with coiling than clipping, the difference was not significant (odds ratio: 10.2; P = 0.08). The rate of complete occlusion was lower in the coiling group (72.2% vs. 95.3%), but the difference was not significant. The median follow-up was 696 days (range: 99-2053). No aneurysm recurrence or rupture occurred.</p><p><strong>Conclusion: </strong>AChA branching type is important for treatment decision-making in patients with AChA aneurysms. Rates of complications and occlusion do not significantly differ between clipping and coiling of AChA aneurysms. MEP monitoring may be useful in preventing thrombotic complications during coil embolization.</p>","PeriodicalId":73856,"journal":{"name":"Journal of neuroendovascular therapy","volume":"18 8","pages":"219-223"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11333154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142010056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics of Contrast Leakage and Contrast-Induced Encephalopathy Following Endovascular Treatment for Unruptured Intracranial Aneurysm.","authors":"Nobuyuki Mitsui, Hajime Wada, Masato Saito, Hirotaka Sato, Manabu Kinoshita","doi":"10.5797/jnet.oa.2024-0042","DOIUrl":"10.5797/jnet.oa.2024-0042","url":null,"abstract":"<p><strong>Objective: </strong>Contrast-induced encephalopathy (CIE) is a rare but severe complication that can occur following intravascular treatment of intracranial vascular disease. Although CIE is considered a transient neurological disorder, its natural history, pathophysiology, and risk factors are poorly understood. Contrast leakage (CL) is a more frequently observed adverse event than CIE and can lead to CIE. This retrospective study aimed to elucidate the clinical characteristics of CL and CIE and identify the risk factors for each.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of 61 patients with unruptured intracranial aneurysms who were treated at our institution between January 2019 and May 2023. Risk factors for CIE and CL were identified by Fisher's exact test for univariate analysis of categorical variables and by unpaired <i>t</i>-test for continuous variables. One-way analysis of variance (ANOVA) was conducted, followed by the Tukey-Kramer test for multiple comparisons.</p><p><strong>Results: </strong>Of the 61 patients, 22 (36%) had CL and 4 (6%) had CIE. Among the clinical characteristics analyzed, older age (<i>p</i> = 0.031), larger aneurysm (<i>p</i> = 0.003), lower serum creatinine (<i>p</i> = 0.026), and use of a distal access catheter (<i>p</i> = 0.030) were significant risk factors for CL. CIE occurred only in CL-positive patients (<i>p</i> = 0.014). Of the 4 patients with CIE, neurological symptoms improved within 3 days in 3 patients, and neurological deficit persisted in 1 patient.</p><p><strong>Conclusion: </strong>Older age, larger aneurysm, lower serum creatinine, and use of a distal access catheter are risk factors for developing CL, and female sex and greater volume of contrast medium are potential risk factors. No risk factors for developing CIE from CL were identified.</p>","PeriodicalId":73856,"journal":{"name":"Journal of neuroendovascular therapy","volume":"18 11","pages":"287-292"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11576120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Steerable Microcatheter Effectively Worked in Tumor Embolization.","authors":"Ryuta Yasuda, Naoki Toma, Seiji Hatazaki, Fuki Goto, Shota Ito, Yotaro Kitano, Genshin Mouri, Hidenori Suzuki","doi":"10.5797/jnet.cr.2024-0068","DOIUrl":"10.5797/jnet.cr.2024-0068","url":null,"abstract":"<p><strong>Objective: </strong>A Leonis Mova (LM; SB Kawasumi, Kanagawa, Japan), one of the steerable microcatheters, has a remote-controlled flexible catheter tip manipulated with a dial in the hand grip, which enables operators to overcome complicated branching in endovascular surgeries. We report a case of a pituitary tumor in which the LM worked effectively as a distal access catheter (DAC) in tumor embolization.</p><p><strong>Case presentation: </strong>A female patient in her 70s complained of bitemporal hemianopsia, and an MRI revealed a pituitary tumor that appeared hypervascular. The right internal carotid artery angiography demonstrated a prominent stain from a tumor vessel derived from the meningohypophyseal trunk (MHT). Tumor embolization was scheduled before its removal due to the hypervascularity. In the tumor embolization, the tip of the LM was bent toward the orifice of the right MHT, through which a 1.3F-1.8F 155 cm microcatheter along with a 0.010-inch 200 cm microguidewire was advanced. Locking the LM tip provided good support for the microcatheter and the microguidewire to proceed to the tumor vessel. Successful tumor embolization was achieved with an injection of 0.21 ml of 12.5% n-butyl-cyanoacrylate. Thanks to the tumor embolization, gross total removal of the pituitary tumor was transshenoidally accomplished with the least blood loss. Histopathological diagnosis of pituicytoma was made, and the intraoperative blood loss of 100 ml seemed small for this histology. The patient recovered from the bitemporal hemianopsia and was discharged without a blood transfusion.</p><p><strong>Conclusion: </strong>This is the first report in which the LM was used and well worked in tumor embolization as a DAC.</p>","PeriodicalId":73856,"journal":{"name":"Journal of neuroendovascular therapy","volume":"18 12","pages":"321-325"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}