Journal of cerebrovascular and endovascular neurosurgery最新文献

{"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}

{"title":"Navigating the unseen: An aneurysm striking neurosurgeon.","authors":"Inibehe Ime Okon, Imshaal Musharaf, Bipin Chaurasia, Nourou Dine Adeniran Bankole, Stephen Chukwuemeka Igwe, Usoro Udousoro Akpan, Olutayo Toriola, Don Eliseo Lucero-Prisno Iii","doi":"10.7461/jcen.2025.E2024.05.005","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2024.05.005","url":null,"abstract":"<p><p>The irony of life is that in the complex world of neurosurgery, where the skilled mind of the neurosurgeon navigates the delicate terrain of cerebral aneurysm, the same mind can be affected by the very thing it treats. Sometimes the healer becomes the one in need of healing. This predicament highlights the reality of existence that vulnerability transcends professional boundaries, and any individual can become a target.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560491","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":"Cervical vertebral-venous fistula with neurofibromatosis presenting as myelopathy: A case report and literature review.","authors":"Ina Bahl, Rashim Kataria, Trilochan Srivastava, Devendra Purohit, Manmohan Singh","doi":"10.7461/jcen.2025.E2024.08.002","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2024.08.002","url":null,"abstract":"<p><p>Vertebral-venous fistula (VVF) is a rare vascular disorder characterized by an atypical, direct, high-flow shunt between an extracranial vertebral artery and its adjoining vein. While it can originate spontaneously in association with conditions affecting the vascular wall, trauma is also a recognized etiological factor. We report a case of a 64-year-old gentleman with multiple neurofibromas who presented with a cervical VVF leading to cervical myelopathy, successfully managed with endovascular coiling. The condition's rarity and the complex vascular anatomy involved have hindered the development of standardized management guidelines. Our experience aligns with literature indicating that endovascular treatment can be a safe and effective approach for VVF.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560488","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":"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":"10.7461/jcen.2024.E2024.05.003","url":null,"abstract":"<p><strong>Intro: </strong>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.</p><p><strong>Objective: </strong>Describe the technique for safely accessing the radial artery using the sheathless Walrus balloon guide catheter.</p><p><strong>Methods: </strong>A retrospective chart review of thirteen consecutive patients who underwent intervention with radial artery access with a sheathless Walrus BGC was performed.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"71-79"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","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}

{"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":"10.7461/jcen.2024.E2024.05.004","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"1-18"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","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}

{"title":"Multi-modal management of aggressive vertebral hemangioma: A single center experience.","authors":"Mohamed Farouk, Mohamed Ali Kassem, Ashraf Ezzeldein, Mohamed Mohsen Ameen, Ali Hassan Elmokadem, Mohamed M Elsherbini","doi":"10.7461/jcen.2025.E2024.12.003","DOIUrl":"10.7461/jcen.2025.E2024.12.003","url":null,"abstract":"<p><strong>Objective: </strong>This study aims at spotlighting different lines of management of aggressive vertebral hemangioma (VH) through a retrospective analysis of single center experience.</p><p><strong>Methods: </strong>Patients diagnosed with aggressive VHs in a tertiary referral center were reviewed from 2014 through 2024. Data of patients who met the inclusion criteria were analyzed. Patients of all ages, both sexes, and all varieties of clinical presentation were included, only patients who underwent at least one intervention were included.</p><p><strong>Results: </strong>The study included nine patients, comprising six females and three males, with a mean age of 29.3 years (ranging from 14 to 46). Six patients underwent Trans-arterial embolization (TAE), of whom five underwent further surgical procedures, while one patient found TAE to be sufficient as a stand-alone management technique. Eight patients underwent surgical management, five of whom were pre-operatively embolized.</p><p><strong>Conclusions: </strong>Aggressive VHs are rare, and their management is challenging. Most cases require a multi-modal management, especially when presented with neurological deficit. Pre-operative embolization and/or vertebroplasty are safe and useful tools to decrease intra-operative bleeding of such a vascular pathology in cases undergoing open surgical procedures.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"40-49"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617611","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}