Journal of cerebrovascular and endovascular neurosurgery最新文献

Prognosis of subarachnoid hemorrhage determined by intracranial pressure thresholds. 颅内压阈值对蛛网膜下腔出血预后的影响。

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2025-07-23 DOI: 10.7461/jcen.2025.E2025.04.003

Thara Tunthanathip, Rakkrit Duangsoithong, Sakchai Sae-Heng

{"title":"Prognosis of subarachnoid hemorrhage determined by intracranial pressure thresholds.","authors":"Thara Tunthanathip, Rakkrit Duangsoithong, Sakchai Sae-Heng","doi":"10.7461/jcen.2025.E2025.04.003","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2025.04.003","url":null,"abstract":"Objective: Subarachnoid hemorrhage (SAH) is a severe neurological condition often associated with elevated intracranial pressure (ICP), which can impact patient outcomes. The present study aimed to evaluate the prognostic significance of ICP thresholds in predicting prognosis in SAH patients.Methods: A retrospective cohort study was conducted, including patients diagnosed with SAH who underwent ventriculostomy between January 2019 and December 2024. Prognostic factors were estimated from various clinical-radiographic characteristics and ICP using the Cox regression model. Additional analyses were performed to evaluate the relationship between ICP thresholds and hazard ratio by dose-response analysis.Results: A total of 110 SAH patients were included in the study. The analysis demonstrated a significant association between elevated ICP and poor outcomes (Hazard ratio (HR) 1.06, 95% CI 1.03-1.09). In multivariable analysis, ICP value was significantly associated with prognosis when the model was adjusted with pupillary light reflex (HR 1.04, 95% CI 1.01-1.08). In addition, SAH patients were divided into two groups based on the ICP cutoff value of 24 mmHg. Consequently, the group with ICP values of 24 mmHg or higher was strongly associated with poor prognosis (p-value of log-rank test=0.01).Conclusions: Our study demonstrates that elevated ICP, particularly beyond the threshold of 24 mmHg, is strongly associated with poor outcomes in SAH patients. These findings support the inclusion of ICP thresholds in prognostic assessment and underscore the need for vigilant ICP monitoring and early intervention in the neurocritical care setting.","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Double stent-assisted coiling with Neuroform Atlas stents for treating ruptured blood blister-like aneurysms. 神经形态Atlas支架辅助双支架盘绕治疗破裂的血泡样动脉瘤。

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2025-07-23 DOI: 10.7461/jcen.2025.E2025.05.003

Hyoung Bin Kim, Lee Hwangbo, Young Ha Kim, Pil Soo Kim, Jun Kyeung Ko

{"title":"Double stent-assisted coiling with Neuroform Atlas stents for treating ruptured blood blister-like aneurysms.","authors":"Hyoung Bin Kim, Lee Hwangbo, Young Ha Kim, Pil Soo Kim, Jun Kyeung Ko","doi":"10.7461/jcen.2025.E2025.05.003","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2025.05.003","url":null,"abstract":"Objective: A ruptured blood blister-like aneurysm (BBA) of the supraclinoid internal carotid artery is a rare but surgically challenging vascular disease. Numerous endovascular approaches have been reported, but optimal management remains controversial. This study aimed to report on our experience and assess the safety and efficacy of our treatment strategy.Methods: The treatment strategy basically involves stent-assisted coiling using semi-jailing technique followed by stent overlap with Neuroform Atlas stents. Angiographic results (modified Raymond scale), clinical outcomes (modified Rankin Scale), and technical feasibility were evaluated.Results: A total of ten patients with ruptured BBAs were treated via this technique (8 women; mean age, 45.4 years). Procedures were successfully applied without any procedure-related symptomatic complications except one thromboembolism. The immediate angiographic results were complete occlusion in 6 aneurysms, residual neck in 1 aneurysm, and residual sac in 3 aneurysms. Early complementary treatment was required in one. Follow-up angiograms (mean, 9.6 months), which were available in 8 patients, showed complete resolution of BBAs in all, except one who was retreated with a flow diverter. At the end of the observation period (mean, 41.0 months), all patients had excellent clinical outcomes (modified Rankin Scale 0-1), except two with initial poor grade subarachnoid hemorrhage.Conclusions: Double stent-assisted coiling using Neuroform Atlas stents offers a feasible and practical reconstructive option for ruptured BBAs, particularly in healthcare systems where flow diverters are not approved for acute-phase use.","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Overcoming refractory subgaleal hematoma with endovascular treatment: A novel therapeutic approach. 用血管内治疗克服难治性galal下血肿：一种新的治疗方法。

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2025-07-16 DOI: 10.7461/jcen.2025.E2024.11.001

Bong-Gyu Ryu, Yongjae Lee, Dae Han Choi

引用次数: 0

Rescue waffle cone technique for managing stent dislodgement into a target aneurysm. 救援华夫锥技术处理支架移位到目标动脉瘤。

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2025-07-16 DOI: 10.7461/jcen.2025.E2025.03.001

Jun Kyeung Ko

引用次数: 0

The efficacy and safety of stent-assisted coil embolization with the semi-jailing technique in patients with unruptured intracranial aneurysm. 支架辅助半监禁线圈栓塞治疗颅内未破裂动脉瘤的疗效和安全性。

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2025-07-16 DOI: 10.7461/jcen.2025.E2025.01.003

Wint Shwe Yee Phyo, Manabu Shirakawa, Hidetoshi Matsukawa, Kazutaka Uchida, Shuntaro Kuwahara, Kensaku Senda, Takanori Miyazaki, Shinichi Yoshimura

{"title":"The efficacy and safety of stent-assisted coil embolization with the semi-jailing technique in patients with unruptured intracranial aneurysm.","authors":"Wint Shwe Yee Phyo, Manabu Shirakawa, Hidetoshi Matsukawa, Kazutaka Uchida, Shuntaro Kuwahara, Kensaku Senda, Takanori Miyazaki, Shinichi Yoshimura","doi":"10.7461/jcen.2025.E2025.01.003","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2025.01.003","url":null,"abstract":"Objective: The stent-assisted coiling (SAC) is a well-known procedure for wide neck intracranial aneurysms. To date, the impact of the semi-jailing technique (SJT) on outcomes in patients with SAC remains unknown. This study aims to evaluate the efficacy and safety of SAC using open- or closed-cell stents in patients with unruptured intracranial aneurysms.Methods: The data of patients treated with SAC between December 2013 and May 2022 was retrospectively investigated. Clinical, aneurysmal, outcomes were compared between patients with and without SJT. The primary outcome was 1-year complete occlusion defined as the Raymond-Roy occlusion classification class I. Safety outcomes included permanent deficits and mortality. Subgroup analysis was also performed regarding open-cell or closed-cell stents.Results: Among 320 patients with SAC, 220 patients undertook SJT (68.8%). The median age of patients was 61.0 years (interquartile range, 50.3-71.0 years) and 73 were male (22.8%). 1-year complete occlusion was obtained in 221 patients (69.1%). Permanent deficits and mortality were observed in 3 (0.9%) and 1 (0.3%) patient, respectively. Compared to non-SJT, SJT was significantly related to 1-year complete occlusion (73.2% vs. 60.0%, adjusted odds ratio 1.85, 95% confidence interval 1.11-3.09, p=0.02). Safety outcomes showed no significant difference between SJT and non-SJT.Conclusions: The results of this study showed the efficacy and safety of SJT in unruptured intracranial aneurysm patients treated with SAC.","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Revascularization surgical options after carotid trauma: Case report from a cerebrovascular blood flow preservation overview. 颈动脉创伤后的血管重建手术选择：来自脑血管血流保存概述的病例报告。

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2025-06-20 DOI: 10.7461/jcen.2025.E2025.01.002

Javier Degollado-Garcia, Carlos Fernando Nicolas-Cruz, Diana Marmolejo-Moreno, Jose Orenday-Barraza

引用次数: 0

Preoperative embolization of brain, head, and neck tumors: Single center experience and literature review. 术前栓塞脑、头颈部肿瘤：单中心经验及文献回顾。

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2025-06-20 DOI: 10.7461/jcen.2025.E2024.12.005

Jimmy Achi-Arteaga, José Guillermo Flores-Vazquez, Irving Fuentes-Calvo, Jimena Gonzalez-Salido, Xavier Wong-Achi

{"title":"Preoperative embolization of brain, head, and neck tumors: Single center experience and literature review.","authors":"Jimmy Achi-Arteaga, José Guillermo Flores-Vazquez, Irving Fuentes-Calvo, Jimena Gonzalez-Salido, Xavier Wong-Achi","doi":"10.7461/jcen.2025.E2024.12.005","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2024.12.005","url":null,"abstract":"Objective: The management of highly vascularized tumors in the brain, head, and neck regions poses significant challenges. This review aims to provide practical insights into using preoperative embolization to improve surgical outcomes and guide healthcare centers with limited expertise in this technique.Methods: A literature review was conducted using PubMed, Scopus, and Web of Science databases with keywords related to preoperative embolization and highly vascularized tumors, detailing its definition, indications, diagnostic considerations, procedural aspects, clinical and surgical implications, and associated complications. The findings are supported by data from 309 patients with brain, head, and neck tumors treated with preoperative embolization at Hospital Clínica Kennedy in Guayaquil, Ecuador, from 2015 to 2023. Cases without embolization or those below the clavicular border were excluded. Illustrations and photographs, based on the authors' surgical experience, are included with informed consent.Results: Preoperative embolization has proven effective in reducing morbidity, enhancing surgical outcomes, and palliating symptoms in inoperable cases by decreasing tumor size. While complications are rare, they can be minimized with careful planning. Despite its efficacy, the lack of randomized controlled trials due to the rarity of hypervascular tumors limits the ability to establish standardized practices.Conclusions: Preoperative embolization is a valuable tool in managing highly vascularized tumors. However, further research and uniform reporting are essential to optimize outcomes and develop clear guidelines for this critical procedure.","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Management of a scalp arteriovenous malformation in a lower-middle income country: A case report. 中低收入国家头皮动静脉畸形的治疗：1例报告。

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2025-06-11 DOI: 10.7461/jcen.2025.E2025.04.002

Daouda Wague, Ebrima Kalilu Manneh, Mbaye Thioub, Maguette Mbaye, Aissatou Kébé, Hugues Ghislain Atakla

{"title":"Management of a scalp arteriovenous malformation in a lower-middle income country: A case report.","authors":"Daouda Wague, Ebrima Kalilu Manneh, Mbaye Thioub, Maguette Mbaye, Aissatou Kébé, Hugues Ghislain Atakla","doi":"10.7461/jcen.2025.E2025.04.002","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2025.04.002","url":null,"abstract":"Spontaneous scalp arteriovenous malformations (AVMs) are often present at birth but are usually noticed when they cause aesthetic problems in adulthood. Concerning treatment; there has been a shift towards endovascular treatment alone or in combination with surgical resection. In developing countries, endovascular options might not be readily available. We hereby report a case of a large spontaneous scalp AVM managed successfully via surgical excision only. A 35-year-old man presented with a large pulsating mass located in the occipital region of the scalp. This mass had been present from birth and had been growing over the years. Computed tomography (CT) scan and CT-angiography showed an occipital, contrast-enhancing mass, mostly lateralized to the right and fed by the right occipital artery. The patient did not benefit from digital subtraction angiography or pre-operative embolization. An indication for surgical excision was made. The first step was geared at controlling hemorrhage which was only partially effective due to another feeder that was missed on the CT-angiography. The second step involved dissecting and de-vascularizing the lesion. Complete excision of the AVM was achieved along with excision of the adjacent galea. Management of large scalp AVMs is possible even in resource strained environments. Knowledge of the behavior of feeders regarding lateral or midline disease, coupled with meticulous interpretation of available imaging, is essential in planning surgery. Intra- operative bleeding can be controlled by early temporary clipping or ligation of the main feeders and then one can proceed with the surgical resection.","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Successful treatment of rapid onset Foix-Alajouanine syndrome following hyperselective endovascular embolization of thoracic dural arteriovenous fistula: Case report, technical note and literature review. 胸硬膜动静脉瘘高选择性血管内栓塞后快速发作的fox - alajouanine综合征的成功治疗：病例报告，技术说明和文献复习。

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2025-06-01 Epub Date: 2025-02-07 DOI: 10.7461/jcen.2024.E2024.04.007

Pablo Martínez, José Alfredo González Soto, Luis A Rodríguez Hernández, Mallyolo E Pelayo-Salazar, Iván A Rodríguez-Hernández, Michel G Mondragón-Soto, Jorge Balderrama-Bañares, Héctor A Montenegro-Rosales

{"title":"Successful treatment of rapid onset Foix-Alajouanine syndrome following hyperselective endovascular embolization of thoracic dural arteriovenous fistula: Case report, technical note and literature review.","authors":"Pablo Martínez, José Alfredo González Soto, Luis A Rodríguez Hernández, Mallyolo E Pelayo-Salazar, Iván A Rodríguez-Hernández, Michel G Mondragón-Soto, Jorge Balderrama-Bañares, Héctor A Montenegro-Rosales","doi":"10.7461/jcen.2024.E2024.04.007","DOIUrl":"10.7461/jcen.2024.E2024.04.007","url":null,"abstract":"Foix-Alajouanine syndrome is an extremely rare yet important differential diagnosis for subacute lower limb weakness in middle-aged to elderly adults. Current understanding of the pathophysiology of this disease, along with recent publications on successful endovascular interventions, has shifted the perspective and clinical approach for its management. Nonetheless, neurosurgical pathways for clinical treatment are still preferred over endovascular embolization. Here, we present the case of a 63-year-old male who developed a rapidly progressing thoracic medullary syndrome over a 6-month period, compromising motor function, sphincter control, and sensory function in the lower extremities. The patient was diagnosed with venous congestive myelopathy secondary to a dural arteriovenous fistula and underwent endovascular embolization using hyper-selective catheterization. Over an 8-month period, the patient experienced successful recovery of both motor and sensory functions. This case supports the use of minimally invasive techniques for the treatment of dural arteriovenous fistulae with spinal involvement.","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"146-151"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367111","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}

引用次数: 0

Endovascular flow diversion treatment of spontaneous craniocervical junction vertebral artery dural fistula and literature review. 自发性颅颈交界处椎动脉硬膜瘘的血管内分流治疗及文献复习。

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2025-06-01 Epub Date: 2025-03-24 DOI: 10.7461/jcen.2025.E2024.10.001

Megan Finneran, Ajeet Gordhan

引用次数: 0