Journal of cerebrovascular and endovascular neurosurgery最新文献

Microsurgical management of previously embolized intracranial aneurysms: A single center experience and literature review. 曾被栓塞的颅内动脉瘤的显微手术治疗：单个中心的经验和文献综述。

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2024-12-17 DOI: 10.7461/jcen.2024.E2024.05.004

Vasileios Panagiotopoulos, Ioannis Panagiotis Athinodorou, Kyprianos Kolios, Constantinos Kattou, Andreas Grzeczinski, Andreas Theofanopoulos, Lambros Messinis, Constantine Constantoyannis, Petros Zampakis

{"title":"Microsurgical management of previously embolized intracranial aneurysms: A single center experience and literature review.","authors":"Vasileios Panagiotopoulos, Ioannis Panagiotis Athinodorou, Kyprianos Kolios, Constantinos Kattou, Andreas Grzeczinski, Andreas Theofanopoulos, Lambros Messinis, Constantine Constantoyannis, Petros Zampakis","doi":"10.7461/jcen.2024.E2024.05.004","DOIUrl":"https://doi.org/10.7461/jcen.2024.E2024.05.004","url":null,"abstract":"Background: Endovascular treatment of intracranial aneurysms (IAs) provides less invasiveness and lower morbidity than microsurgical clipping, albeit with a long-term recurrence rate estimated at 20%. We present our single-center experience and a literature review concerning surgical clipping of recurrent previously coiled aneurysms.Methods: Retrospective analysis of nine (9) patients' data and final clinical/angiographic outcomes, who underwent surgical clipping of IAs in our center following initial endovascular treatment, over a 12-year period (2010-2022). Regarding the literature review, data were extracted from 48 studies including 969 patients with 976 aneurysms.Results: 9 patients (5 males - 4 females) were included in the study with a mean age of 49 years. Subarachnoid hemorrhage was the initial presentation in 78% of patients. Aneurysms' most common location was the middle cerebral artery bifurcation (5/9) followed by the anterior communicating artery (3/9) and the internal carotid artery bifurcation (1/9). Indications for surgery were coil loosening, coil compaction, sac regrowth, and residual neck. Procedure-related morbidity and mortality were zero whereas complete aneurysm occlusion was achieved after surgical clipping in all cases (100%). All patients had minimal symptoms or were asymptomatic (mRS 0-1) at the final follow-up.Conclusions: Surgical clipping seems a feasible and safe technique for selected cases of recurrent previously coiled intracranial aneurysms. A universally accepted recurrence classification system and a guideline template for the management of such cases are needed.","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840684","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

National trends in surgical treatment and clinical outcomes among patients with aneurysmal subarachnoid hemorrhage in the Republic of Korea.

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2024-11-29 DOI: 10.7461/jcen.2024.E2024.08.005

Yung Ki Park, Byul-Hee Yoon, Eui-Hyun Hwang, Jae Hoon Kim, Hee In Kang, Yu Deok Won, Jin Whan Cheong

{"title":"National trends in surgical treatment and clinical outcomes among patients with aneurysmal subarachnoid hemorrhage in the Republic of Korea.","authors":"Yung Ki Park, Byul-Hee Yoon, Eui-Hyun Hwang, Jae Hoon Kim, Hee In Kang, Yu Deok Won, Jin Whan Cheong","doi":"10.7461/jcen.2024.E2024.08.005","DOIUrl":"https://doi.org/10.7461/jcen.2024.E2024.08.005","url":null,"abstract":"Objective: In this study, changes in treatment methods and patient prognosis were analyzed using a Korean nationwide medical insurance information database.Methods: Patients with subarachnoid hemorrhage who received surgical treatment for cerebral aneurysm from 2005 to 2020 were included. The specific surgery type was classified using the surgical code and according to whether stents were used. Yearly trends in mortality rates and poor prognosis, using tracheostomy as proxy, were analyzed by a simple regression analysis. A multistep logistic regression analysis was performed to evaluate the risk factors of mortality and poor prognosis.Results: Overall, 83,587 patients were included. Females were predominant (64.5%). Microsurgical clip usage rate decreased by approximately two-thirds from 78.8% in 2005 to 24.4% in 2020. Contrarily, endovascular treatment proportion gradually increased, and stent-assisted coil embolization rate surpassed microsurgical clip usage rate in 2020 (24.6% vs. 24.4%). In the multivariate analysis, endovascular treatment correlated positively with 3-month mortality (hazard ratio [HR]: 1.13, 95% confidence interval [CI]: 1.07-1.19, P<0.0001), although correlated negatively with poor prognosis (tracheostomy) (HR: 0.93, 95% CI: 0.89-0.98, P=0.0050).Conclusions: According to the treatment trend analysis, during the 16 years studied, for patients with subarachnoid hemorrhage due to ruptured cerebral aneurysm, the endovascular treatment rate increased rapidly and stent-assisted coil embolization rate surpassed that of microsurgical clip ligation. Diversification of treatment methods has led to a decrease in mortality and improved prognosis.","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752685","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

"Picket fence" an alternative clipping technique for wide necked and large aneurysms: technical nuances in a case series. 宽颈巨大动脉瘤的另一种剪切技术 "篱笆墙"：系列病例中的技术细节。

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2024-11-08 DOI: 10.7461/jcen.2024.E2023.11.003

Gustavo Parra-Romero, Yair Ugalde-Hernández, Rabindranath García-López

{"title":"\"Picket fence\" an alternative clipping technique for wide necked and large aneurysms: technical nuances in a case series.","authors":"Gustavo Parra-Romero, Yair Ugalde-Hernández, Rabindranath García-López","doi":"10.7461/jcen.2024.E2023.11.003","DOIUrl":"10.7461/jcen.2024.E2023.11.003","url":null,"abstract":"Complex aneurysms are a therapeutic challenge in contemporary neurosurgery. Several microsurgical and endovascular techniques have been proposed for their treatment. The picket fence clipping technique uses fenestrated clips, that are stacked not to reconstruct the neck of the aneurysm, but to create a duct to normalize the cerebral flow by reconstructing the dome. We present four illustrative cases using the picket fence clipping technique. The aneurysms considered were of different locations (ICA, MCA, AComA), of large or giant size with wide necks, in which clipping attempt with a conventional technique was not possible, so that the use of non-conventional clipping techniques had to be applied with favorable results. In our experience we found this technique useful in large and giant, wide-necked aneurysms by reconstructing the parent vessel according to the concept of the ideal closure line in these previously unreported locations, thereby restoring normal cerebral circulation. The use of non-conventional techniques for clipping complex aneurysms can be used alone or in combination for adequate treatment, preserving cerebral circulation without compromising adequate exclusion of the aneurysm. The Picket fence technique is a feasible clipping technique that can be used as a less morbid option in large and giant aneurysms with wide necks.","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592088","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

The natural history of cerebral infundibula: A retrospective cohort study. 脑底畸形的自然史：回顾性队列研究

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2024-10-29 DOI: 10.7461/jcen.2024.E2024.08.003

Saif Yousif, Alexander Vile, Dwarkesh Dharmendra Barot, Charlie Cho, Ananthababu Sadasivan Pattavilakom, Rumal Jayalath

{"title":"The natural history of cerebral infundibula: A retrospective cohort study.","authors":"Saif Yousif, Alexander Vile, Dwarkesh Dharmendra Barot, Charlie Cho, Ananthababu Sadasivan Pattavilakom, Rumal Jayalath","doi":"10.7461/jcen.2024.E2024.08.003","DOIUrl":"https://doi.org/10.7461/jcen.2024.E2024.08.003","url":null,"abstract":"Objective: Debate exists regarding the true pathogenicity of cerebral infundibula (CI). Pre-aneurysmal lesions and benign anatomical variants have both been proposed. In this study, we present the largest single cohort series on the natural history of CI.Methods: Retrospective review of prospective surveillance of 420 CI was undertaken in a single tertiary cerebrovascular centre. All CI diagnosed by a neuroradiologist, diagnosed on either a Magnetic resonance angiography (MRA), Computed tomography angiography (CTA) or Digital subtraction angiography (DSA) were eligible for inclusion. Imaging and demographic characteristics were recorded at baseline. CI growth and aneurysm transformation were the outcomes of interest. Groupwise comparison was conducted via Fischer exact testing. Kaplan Meir curves and Cox proportional hazard ratios were used to assess variables of interest with respect to time on surveillance.Results: 402 patients with 420 CI were surveyed over 2418 infundibula-years. Eleven CI (2.62%) grew on surveillance, and three (0.7%) transformed into aneurysms. Median time to growth was 85 months (36-263) and median time to aneurysm transformation was 112 months (96-142). Of the CI that grew, male sex and CI >2 mm at diagnosis were significant predictors of growth (all p<0.05). Of the CI that grew in surveillance, 2/11 (18.2%) transformed into aneurysms (p=0.001). Aneurysm transformation occurred at a rate of 1.27 per 1000 infundibula years. CI growth on surveillance (p= 0.00016) and size at diagnosis (p=0.038) remained significant predictors of aneurysm transformation on Kaplan Meir curves.Conclusions: The transformation of a CI to an aneurysm occurs at a low rate. A history of growth on surveillance imaging represents significant risk for aneurysm transformation.","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515365","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

Safety and effectiveness of Neuroform Atlas stent-assisted coil embolization for ruptured intracranial aneurysms. Neuroform Atlas 支架辅助线圈栓塞治疗颅内动脉瘤破裂的安全性和有效性。

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2024-10-11 DOI: 10.7461/jcen.2024.E2024.04.006

Kyu Sik Heo, Jung Ho Ko

{"title":"Safety and effectiveness of Neuroform Atlas stent-assisted coil embolization for ruptured intracranial aneurysms.","authors":"Kyu Sik Heo, Jung Ho Ko","doi":"10.7461/jcen.2024.E2024.04.006","DOIUrl":"https://doi.org/10.7461/jcen.2024.E2024.04.006","url":null,"abstract":"Objective: The treatment outcomes of ruptured intracranial aneurysms using the Neuroform Atlas stent were evaluated.Methods: This study represents a retrospective review that included patients who underwent endovascular treatment for ruptured aneurysms at a single institution. Between January 2018 and September 2022, endovascular treatments including simple coiling or Neuroform Atlas stent-assisted coil embolization were performed in 191 patients with ruptured intracranial aneurysms.Results: Intraprocedural rupture was observed in 11 (8.7%) patients in the Simple Coiling (SC) group, which was slightly higher than that in 4 (6.3%) patients in the Neuroform Atlas stent-assisted coiling (NASAC) group (p=0.241). However, Thromboembolic event (TEE) was slightly more prevalent in the NASAC group, with 4 (6.3%) cases as compared to the 5 (3.9%) cases in the SC group (p=0.235). The retreatment rate was slightly higher in the SC group, with 19 (26.4%) patients as compared to the 10 patients (22.2%) in the NASAC group (p=0.342).Conclusions: The use of the Neuroform Atlas stent (NAS) for ruptured aneurysms might be safe and effective.","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402508","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

Multiple AVM with separate nidi, a case report and review the literatures. 多发性动静脉畸形伴单独的尼迪，病例报告和文献综述。

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2024-10-10 DOI: 10.7461/jcen.2024.E2024.05.002

Morteza Taheri, Aryoobarzan Rahmatian, Parisa Javadnia

引用次数: 0

Radial artery access with a sheathless 0.087" inner diameter balloon guide catheter (Walrus) for neurointerventional procedures: Technique and clinical outcomes. 使用无鞘 0.087" 内径球囊导引导管 (Walrus) 进入桡动脉进行神经介入手术：技术和临床结果。

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2024-09-23 DOI: 10.7461/jcen.2024.E2024.05.003

Simon Levinson, Arjun Pendharkar, Andrew Gauden, Benjamin Pulli

{"title":"Radial artery access with a sheathless 0.087\" inner diameter balloon guide catheter (Walrus) for neurointerventional procedures: Technique and clinical outcomes.","authors":"Simon Levinson, Arjun Pendharkar, Andrew Gauden, Benjamin Pulli","doi":"10.7461/jcen.2024.E2024.05.003","DOIUrl":"https://doi.org/10.7461/jcen.2024.E2024.05.003","url":null,"abstract":"Intro: There is a growing preference among neurointerventionalists for transradial access (TRA) over transfemoral access (TFA) due to improved patient satisfaction, recovery time and reduced access site complication, but using balloon guide catheters (BGCs) in the radial artery remains a challenge. We report our experience in successfully using the 0.087\" inner diameter Walrus BGC without a sheath via the radial artery for non-emergent neurointerventions.Objective: Describe the technique for safely accessing the radial artery using the sheathless Walrus balloon guide catheter.Methods: A retrospective chart review of thirteen consecutive patients who underwent intervention with radial artery access with a sheathless Walrus BGC was performed.Results: All twelve procedures were performed successfully with no instances of conversion from TRA to TFA. There were no significant procedural or access site complications. The mean radial diameter was 2.51 mm.Conclusions: The Walrus 0.087\" ID BGC is an effective tool that can safely be used via the radial artery using a sheathless approach, which helps to maximize the size of the catheter that can be used. This is the first instance of our knowledge of this technique being utilized for neurointerventions and therefore could be used to expand the indications for TRA for a wider range of procedures.","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304926","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

Clipping of a persistent middle cerebral artery aneurysm after previous flow diverter placement: An illustrative case and review of the literature. 夹闭曾放置血流分流器的顽固性大脑中动脉动脉瘤：一个典型病例和文献综述。

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2024-09-01 Epub Date: 2024-01-31 DOI: 10.7461/jcen.2024.E2023.09.002

Jorn Van Der Veken, Katrien De Keukeleire

引用次数: 0

Giant cerebellar cavernous malformation in children: A case report and literature review. 儿童巨大小脑海绵畸形：病例报告和文献综述。

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2024-09-01 Epub Date: 2024-01-12 DOI: 10.7461/jcen.2024.E2023.04.006

Olim Zaribovich Akramov, Lilia Aleksandrovna Nazarova, Fuat Mukadasavoch Kurbanov, Sukhrob Abdurashibovich Tashmatov, Ikrom Ismatovich Rakhimov, Odilkhon Ayubxanovich Usmankhanov, Bipin Chaurasia

{"title":"Giant cerebellar cavernous malformation in children: A case report and literature review.","authors":"Olim Zaribovich Akramov, Lilia Aleksandrovna Nazarova, Fuat Mukadasavoch Kurbanov, Sukhrob Abdurashibovich Tashmatov, Ikrom Ismatovich Rakhimov, Odilkhon Ayubxanovich Usmankhanov, Bipin Chaurasia","doi":"10.7461/jcen.2024.E2023.04.006","DOIUrl":"10.7461/jcen.2024.E2023.04.006","url":null,"abstract":"Giant cerebellar cavernomas in children are rare and must be differentiated from hemorrhagic cerebellar tumors. The diagnosis and treatment of giant cerebellar cavernomas is challenging, but complete surgical resection can lead to favorable outcomes and complete neurological recovery in most cases. We present a case of eight months old baby who was diagnosed with a giant cavernoma resulting in secondary obstructive hydrocephalus with neuropsychiatric presentations. The patient underwent a paramedian craniotomy surgery with a suboccipital approach and complete surgical resection of the cavernoma was done. Over nine months of observation, the child showed improvement in their ability to walk and fully recovered from a neurological perspective. We also conducted a literature review to identify eleven cases of giant cerebellar cavernomas in children, including our case. The data were analyzed to determine the clinical features, treatment, and outcomes of giant cerebellar cavernomas in children.","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"304-310"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139428105","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

ALARA principles in practice: reduced frame and pulse rates for middle meningeal artery embolization. ALARA 原则在实践中的应用：降低脑膜中动脉栓塞的帧率和脉搏率。

Journal of cerebrovascular and endovascular neurosurgery Pub Date : 2024-09-01 Epub Date: 2024-08-05 DOI: 10.7461/jcen.2024.E2024.02.003

Arvin R Wali, Ryan W Sindewald, Michael G Brandel, Sarath Pathuri, Brian R Hirshman, Javier A Bravo, Jeffrey A Steinberg, Jeffrey S Pannell, Alexander Khalessi, David R Santiago-Dieppa

{"title":"ALARA principles in practice: reduced frame and pulse rates for middle meningeal artery embolization.","authors":"Arvin R Wali, Ryan W Sindewald, Michael G Brandel, Sarath Pathuri, Brian R Hirshman, Javier A Bravo, Jeffrey A Steinberg, Jeffrey S Pannell, Alexander Khalessi, David R Santiago-Dieppa","doi":"10.7461/jcen.2024.E2024.02.003","DOIUrl":"10.7461/jcen.2024.E2024.02.003","url":null,"abstract":"Objective: As the prevalence of neuroendovascular interventions increases, it is critical to mitigate unnecessary radiation for patients, providers, and health care staff. Our group previously demonstrated reduced radiation dose and exposure during diagnostic angiography by reducing the default pulse and frame rates. We applied the same technique for basic neuroendovascular interventions.Methods: We performed a retrospective review of prospectively acquired data after implementing a quality improvement protocol in which pulse rate and frame rate were reduced from 15 p/s to 7.5 p/s and 7.5 f/s to 4.0 f/s respectively. We studied consecutive, unilateral middle meningeal artery embolizations treated with particles. Total radiation dose, radiation per angiographic run, total radiation exposure, and exposure per run were calculated. Multivariable log-linear regression was performed to account for patient body mass index (BMI), number of angiographic runs, and number of vessels catheterized.Results: A total of 20 consecutive, unilateral middle meningeal artery embolizations were retrospectively analyzed. The radiation reduction protocol was associated with a 39.2% decrease in the total radiation dose and a 37.1% decrease in radiation dose per run. The protocol was associated with a 41.6% decrease in the total radiation exposure and a 39.5% decrease in exposure per run.Conclusions: Radiation reduction protocols can be readily applied to neuroendovascular interventions without increasing overall fluoroscopy time and reduce radiation dose and exposure by 39.2% and 41.6% respectively. We strongly encourage all interventionalists to be cognizant of pulse rate and frame rate when performing routine interventions.","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"293-297"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141877019","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