Journal of cerebrovascular and endovascular neurosurgery最新文献

{"title":"Prognostic factors for reocclusion after mechanical thrombectomy plus rescue treatment in acute athereosclerotic steno-occlusion with successful recanalization.","authors":"Kyungryong Baek, Joonwon Lee, Kyung-Wan Kim, Seung Hwan Kim, Hyungon Lee, Sung-Chul Jin","doi":"10.7461/jcen.2025.E2025.02.003","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2025.02.003","url":null,"abstract":"<p><strong>Objective: </strong>Treatment failure usually occurs within 24 hours after mechanical thrombectomy (MT) for acute intracranial atherosclerotic steno-occlusion (ICAS) and is an unexpected event that adversely influences the clinical outcome. We retrospectively evaluated the factors influencing reocclusion after MT plus rescue treatment in acute ICAS patients with successful recanalization.</p><p><strong>Methods: </strong>From January 2013 to December 2020, 60 patients with ICAS who underwent MT plus rescue treatment with successful recanalization were included in our study. We classified the patients into a patency group (n=47, 78.3%) and a reocclusion group (n=13, 21.7%) based on CT angiography data obtained the day after MT plus rescue treatment.</p><p><strong>Results: </strong>Intravenous tissue plasminogen activator (IV t-PA) in the patency group (n=18/47 (38.3%)) significantly differed from that in the reocclusion group (n=1/13 (7.7%)) (p=0.045). The number of thrombectomy attempts in the reocclusion group was significantly greater than that in the patency group (median [interquartile range], 2 [1-3] vs. 1 [0-1.5], p=0.004). According to the univariate logistic regression analysis, the only prognostic factor for reocclusion was the number of thrombectomy attempts (odds ratio (OR), 1.655 [1.046-2.619], p=0.032).</p><p><strong>Conclusions: </strong>In our study of ICAS patients who achieved successful recanalization after MT plus rescue treatment, the number of thrombectomy attempts was an independent prognostic factor for reocclusion after MT. Accordingly, for highly suspicious ICAS lesions, additional attempts at the MT should be carefully performed to prevent reocclusion.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001995","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}

{"title":"Navigating severe vascular tortuosity and cervical carotid loop management in stroke thrombectomy: A case report and review of the literature.","authors":"Milin Patel, Nanthiya Sujijantarat, Aman B Patel, Adam A Dmytriw, Robert W Regenhardt","doi":"10.7461/jcen.2025.E2024.11.004","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2024.11.004","url":null,"abstract":"<p><p>Endovascular therapy is the current gold standard treatment for the management of acute ischemic stroke from large vessel occlusion. Despite this, the presence of severe vascular tortuosity and cervical carotid loops can hinder the success of the procedure. We present a case of an 83-year-old female presenting with acute ischemic stroke and extreme tortuosity including common carotid artery and internal carotid artery consecutive loops, as well as a tandem common carotid artery bifurcation thrombus with an M1 segment occlusion. Subsequently, relevant literature is reviewed regarding the technical management of complex thrombectomy cases. The endovascular procedure involved navigating through extreme vascular tortuosity using multiple endovascular tools for optimal reperfusion using delivery devices to facilitate the procedure. Challenges such as vasospasm and straightening of an internal carotid artery loop occurred during the procedure. However, successful thrombectomy was performed using adequate procedural techniques discussed.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029616","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}

{"title":"Noninferiority of coiling versus coiling with particles in middle meningeal artery embolization: A technical note and case series.","authors":"Ryan W Sindewald, Arvin R Wali, Nikhil K Murthy, Michael G Brandel, Jeffrey A Steinberg, Jeffrey S Pannell, Alexander A Khalessi, David R Santiago-Dieppa","doi":"10.7461/jcen.2025.E2024.07.001","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2024.07.001","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the possibility of using coils as a standalone treatment for middle meningeal artery embolization.</p><p><strong>Methods: </strong>Four patients (3 females, 1 male, median age 77.5) with bilateral subdural hematomas were treated with bilateral MMA embolization. One hematoma of each patient was treated with coils and PVA, and the other was treated exclusively with coils. New or resolved symptoms, radiographic imaging demonstrating hematoma change, and complications were recorded and compared between the two treatment modalities. Minimum follow-up time was three months.</p><p><strong>Results: </strong>All patients demonstrated symptomatic and radiographic improvement at three month follow-up. None of the patients in this cohort received surgical evacuation of the hematoma prior to or after embolization. One patient had previously been treated for hydrocephalus with a VP shunt. There were no postoperative complications. In the hematomas treated with a combination of coils and particles, three showed complete resolution with one showing interval improvement on imaging. All hematomas treated with coils alone demonstrated complete resolution after three months.</p><p><strong>Conclusions: </strong>Middle meningeal artery embolization with coils alone has demonstrated noninferior results to embolization with a combination of particle embolisate and coils in this small cohort.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045173","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}

{"title":"Superficial temporal artery-middle cerebral artery bypass for progressive cerebral infarction in invasive aspergillosis-induced total occlusion of internal carotid artery: A rare case and literature review.","authors":"Minje Jeon, Sung-Tae Kim, Suckyoon Lee, Jin Lee, Jung Hae Ko, Se-Young Pyo, Won-Hee Lee, Hangwoo Lee, Yeong Gyun Jeong","doi":"10.7461/jcen.2025.E2024.06.003","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2024.06.003","url":null,"abstract":"<p><p>Central nervous system (CNS) aspergillosis is a life-threatening infection primarily affecting immunocompromised patients and may lead to severe cerebral infarction through vascular invasion. However, there is limited data on the treatment options for aspergillosis-induced cerebral infarction especially surgical treatments such as superficial temporal artery (STA)-middle cerebral artery (MCA) bypass surgery. Herein, we present a case of cerebral infarction in a 59-year-old male with progressive right eye ptosis. Specifically, he had ipsilateral MCA stenosis originating from paranasal sinusitis due to invasive aspergillosis. After 3 months, the patient was readmitted due to worsening cerebral infarction and complete internal carotid artery (ICA) occlusion. Conservative treatment failed to improve cerebral perfusion, leading to gradual neurological decline. Consequently, STA-MCA bypass was performed to stabilise the patient. Postoperative imaging revealed a patent bypass graft and an enhanced cerebral perfusion. Although the patient experienced persistent left-sided hemiparesis, his overall neurological condition remained stable for 1 year, with a Glasgow Coma Scale score of 15. STA-MCA bypass should be considered a potential treatment option for patients with aspergillosis-induced vasculitis resulting in cerebral infarction secondary to total ICA occlusion.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805143","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}

{"title":"The relationship between inflammatory markers and prognosis in patients with ruptured aneurysms treated by endovascular intervention.","authors":"Necati Ucler, Sedat Yasin","doi":"10.7461/jcen.2025.E2024.12.002","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2024.12.002","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the prognosis of patients with subarachnoid hemorrhage after anterior communicating artery (Acom) artery aneurysm rupture who underwent endovascular treatment according to inflammatory markers.</p><p><strong>Methods: </strong>A retrospective assessment of medical data revealed 223 consecutive patients who received endovascular Acom artery aneurysmal subarachnoid hemorrhage (SAH) therapy. The study comprised 80 patients, excluding those who had microsurgery following endovascular treatment, those who had diagnostic angiography, patients with ruptured aneurysms at other locations, and those who needed extra surgery. The patients' preoperative electronic medical records were used to collect values of white blood cell (WBC), neutrophil, lymphocyte, C-reactive protein (CRP), neutrophil/lymphocyte ratio (NLR), and CRP/lymphocyte ratio (CLR).</p><p><strong>Results: </strong>The study divided patients into two groups based on their modified Rankin Scale (mRS) scores: Group 1 (71.2%) had 57 patients on a scale of 0-2 and Group 2 (28.8%) had 23 patients on a scale of 3-6. Inflammatory markers such as WBC, neutrophils, lymphocytes, CRP, NLR, and CLR levels were higher in Group 2 than in Group 1.</p><p><strong>Conclusions: </strong>Our study evaluated the impact of inflammatory markers (WBC, neutrophils, lymphocytes, CRP, NLR, and CLR) on the prognosis of patients with intracerebral aneurysmal hemorrhage treated endovascularly. Our results indicated that these parameters aligned in their ability to predict the severity of the neurological condition.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805146","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}

{"title":"Discrepancy in vessel tortuosity measurements of anterior circulation cerebral artery between digital subtraction angiography and magnetic resonance angiography.","authors":"Jae Ho Kim, Hyeondong Yang, Nak-Hoon Son, Chang Ki Jang, Jae Whan Lee, Kwang-Chun Cho","doi":"10.7461/jcen.2025.E2024.11.005","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2024.11.005","url":null,"abstract":"<p><strong>Objective: </strong>Tortuosity in blood vessels is a common angiographic feature that plays a crucial role in hemodynamics and is implicated in systemic diseases such as arterial hypertension and diabetes mellitus. Although studies exist on the relationship between vessel tortuosity and intracranial aneurysms, standard imaging modalities and parameters representing vessel tortuosity are controversial. This study compared vessel tortuosity based on angle measurements using magnetic resonance angiography (MRA) and digital subtraction angiography (DSA).</p><p><strong>Methods: </strong>A retrospective analysis of 85 patients with 63 males (75.3%) with unruptured anterior circulation aneurysms between December 2021 and December 2022 was conducted using MRA and DSA. The vessel angles of several segments in the carotid siphon, internal carotid artery bifurcation, and the inflow angles to intracranial aneurysms were measured to evaluate the discrepancy between MRA and DSA.</p><p><strong>Results: </strong>No significant difference was observed in vessel and inflow angles between MRA and DSA, except the internal carotid artery-middle cerebral artery (ICA-MCA) angle, which shows a significant difference (MRA; 50.26˚ (interquartile range (IQR), 33.49-70.57), DSA; 50.75˚ (IQR, 34.91-62.24), p-value=0.035).</p><p><strong>Conclusions: </strong>We found a discrepancy between MRA and DSA in measuring the ICA-MCA angle. Further studies are required to address observed discrepancies between imaging modalities and improve the accuracy of hemodynamic analysis in clinical settings.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733760","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}

{"title":"Rescue angioplasty and stenting in refractory acute vertebrobasilar occlusion after mechanical thrombectomy: A single center experience.","authors":"Sejin Choi, Chul-Hoo Kang, Joong Goo Kim, Jeong Jin Park, Jin Pyeong Jeon, Banzrai Chimeglkham, Jin-Deok Joo, Jong-Kook Rhim","doi":"10.7461/jcen.2025.E2024.11.003","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2024.11.003","url":null,"abstract":"<p><strong>Objective: </strong>Acute vertebrobasilar occlusion can led to a fatal outcome, but lack of established procedures poses many difficulties in its management. Although mechanical thrombectomy (MT) has shown positive outcomes recently, high reocclusion rate remains a hurdle. This study is to share experience and to review technical challenges of rescue angioplasty and/or stenting (RAS) for refractory occlusions after MT in posterior circulation ischemic stroke (PCIS).</p><p><strong>Methods: </strong>Out of 494 patients with acute ischemic stroke from January 2014 to December 2022 in a Hospital, PCIS was identified in 50 patients. 2 extracranial vertebral artery occlusion patients were excluded. For 48 patients, MT was applied as the primary treatment. RAS was done for reocclusion after MT in 15 patients. We evaluated patient characteristics and clinical course, emphasizing the technical aspects of treatment.</p><p><strong>Results: </strong>Compared to those without rescue procedures, RAS group had a higher percentage of large artery atherosclerosis as an etiology (p<0.001), long segment occlusions (p=0.03), and was more likely to involve posterior inferior cerebellar artery (p=0.007). There was no difference in functional outcome at 6 months between these two groups. Reopening could not achieve (N=2, 13.3%) and procedural complication rate (iatrogenic rupture) is 6.7% in RAS group. Rescue procedures were complicated with dissection, plaque rupture and migration, device damage, and misplacement of the balloon/stent. Avoiding these traps, finding true lumen, and reconstructing the flow by connecting the proximal and distal normal were the keys to the successful RAS.</p><p><strong>Conclusions: </strong>RAS could be inevitable during endovascular treatment for PCIS and being aware of possible events and technical strategies would navigate interventionists to successful recanalization and the better outcomes.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733763","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}

{"title":"Endovascular flow diversion treatment of spontaneous craniocervical junction vertebral artery dural fistula and literature review.","authors":"Megan Finneran, Ajeet Gordhan","doi":"10.7461/jcen.2025.E2024.10.001","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2024.10.001","url":null,"abstract":"<p><p>Vertebral artery dural arteriovenous fistulae (VADAVF) are a rare entity. We present a patient who experienced pre-syncopal symptoms and was found to have a VADAVF between the posterior meningeal artery and a cortical vein draining into the sigmoid sinus. The patient initially underwent surgical intervention, which failed to obliterate the shunt. Endovascular treatment with use of a flow diverter provided definitive disconnection of the shunt.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694903","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}

{"title":"An uncommon cause of stroke: Common carotid artery web.","authors":"Igor Pagiola, Henrique Castro Rocha de Aquino Santos, Mario Caitano, Diane Moutinho, Paula Zago, Leonardo Abaurre, Pedro Pianca, Derval Pimentel, Rubia Sfalsini, José Antonio Fiorot, Leandro Barbosa","doi":"10.7461/jcen.2025.E2023.01.001","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2023.01.001","url":null,"abstract":"<p><p>The carotid web (CW), an intimal variant of fibromuscular dysplasia (FMD), is recognized as a cause of stroke and with a high-risk of stroke recurrence. Other names are carotid-bulb atypical FMD, carotid (bulb) diaphragms and it is described like a shelf of tissue from the posterior wall of the carotid bulb. Here we present a case of a young patient with recurrent stroke, with no other risk factors that was diagnosed with a common CW.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694888","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}

{"title":"Reducing complications in duraplasty with autologous dural graft material: A meta-analysis.","authors":"Ahmad Fadhil Maulana, Pandji Winata Nurikhwan, Ardik Lahdimawan, Ilma Fi Ahsani, Muhammad Rasyid Ridho Lahdimawan, Aldiya Jamila","doi":"10.7461/jcen.2025.E2023.12.004","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2023.12.004","url":null,"abstract":"<p><strong>Objective: </strong>This review aims to perform qualitative and quantitative analysis to determine which dural graft materials are preferable for neurosurgical patients.</p><p><strong>Methods: </strong>A literature search using the PubMed database was conducted to collect relevant articles that compared complications associated with autologous and non-autologous dural grafts. The extracted data included graft type and related complications. Screening of all studies was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Statistical tests were conducted using Microsoft Excel to compare categorical variables, and data analysis was performed using Review Manager 5.4.1.</p><p><strong>Results: </strong>A total of twelve studies were deemed eligible from 1,646 articles. These studies included 1,877 patients; 965 (51.4%) received autologous grafts and 912 (48.6%) received non-autologous grafts. Pooled data from autologous grafts showed significant reductions in meningitis (OR=0.31; 95% CI 0.17-0.54), pseudomeningocele (OR=0.50; 95% CI 0.32-0.79), and wound infection rates (OR=0.34; 95% CI 0.14-0.80) compared to the non-autologous group. There were no significant differences in cerebrospinal fluid (CSF) leakage, hydrocephalus, or revision surgery rates.</p><p><strong>Conclusions: </strong>Autologous dural grafts are more effective compared to non-autologous grafts in reducing the incidence of meningitis, pseudomeningocele, and wound infections following duraplasty. However, the risks of CSF leakage, hydrocephalus, and revision surgery are similar for both graft types.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588746","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}