Journal of cerebrovascular and endovascular neurosurgery最新文献

{"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}

{"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":"10.7461/jcen.2024.E2024.08.005","url":null,"abstract":"<p><strong>Objective: </strong>In this study, changes in treatment methods and patient prognosis were analyzed using a Korean nationwide medical insurance information database.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"19-32"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","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}

{"title":"ERRATUM: Imaging follow-up strategy after endovascular treatment of intracranial aneurysms: A literature review and guideline recommendations.","authors":"Yong-Hwan Cho, Jaehyung Choi, Chae-Wook Huh, Chang Hyeun Kim, Chul Hoon Chang, Soon Chan Kwon, Young Woo Kim, Seung Hun Sheen, Sukh Que Park, Jun Kyeung Ko, Sung-Kon Ha, Hae Woong Jeong, Hyen Seung Kang","doi":"10.7461/jcen.2024.E2023.08.008.E","DOIUrl":"https://doi.org/10.7461/jcen.2024.E2023.08.008.E","url":null,"abstract":"","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":"27 1","pages":"80"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766208","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":"Ruptured aneurysm of the medial posterior choroidal artery in the pineal region: A rare location easily missed.","authors":"Samuel Hall, Difei Wang, Vishnu Suresh, Nicholas Borg, Diederik Bulters","doi":"10.7461/jcen.2025.E2024.09.007","DOIUrl":"10.7461/jcen.2025.E2024.09.007","url":null,"abstract":"<p><p>Aneurysms of the pineal region are rare and theoretically could arise from the medial posterior choroidal artery (MPChoA) or lateral posterior choroidal arteries (LPChoA). A 64-year-old lady with subarachnoid haemorrhage (SAH) and intraventricular haemorrhage (IVH) due to a ruptured MPChoA aneurysm was treated with microsurgical aneurysm excision via an occipital interhemispheric approach. This case demonstrates the importance of being mindful of rare aneurysm locations when initial vascular imaging in SAH appears normal.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"66-70"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545439","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":"\"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":"<p><p>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.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"50-59"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","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}

{"title":"Traumatic middle meningeal artery pseudoaneurysm: Case report and review of literature.","authors":"Nadeem Mohammed, Harsh Deora, Abhinith Shashidhar, Malla Bhaskara Rao","doi":"10.7461/jcen.2024.E2024.04.004","DOIUrl":"10.7461/jcen.2024.E2024.04.004","url":null,"abstract":"<p><p>Traumatic aneurysms represent less than 1 percent of intracranial aneurysms and middle meningeal artery pseudoaneurysms are even rare. Traumatic aneurysms are usually pseudoaneurysms formed by the rupture of all the layers of the vessel wall. They are associated with high mortality as they can present as epidural, subdural, and rarely intraparenchymal hematoma. However, only nine cases of traumatic pseudoaneurysms of middle meningeal artery are reported that have presented as an acute intracerebral hematoma. We report a case of ruptured pseudo aneurysm of middle meningeal artery presenting with intraparenchymal hematoma in which hematoma evacuation and aneurysm excision was done immediately. The patient recovered well in the post-operative period. In addition, we reviewed all cases of middle meningeal artery pseudoaneurysms reported in the literature either as extradural hematomas, subdural/intraparenchymal hematomas, or subarachnoid hemorrhages. However, identifying the location of the aneurysm intraoperatively may be challenging as the hematoma may obscure the same. Distance from the sphenoid ridge may serve as a good intraoperative guide. Intraoperative localization along with surgical evacuation if done immediately can lead to gratifying results.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"60-65"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985680","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":"Comparison of Woven EndoBridge and stent-assisted coiling for treatment of acutely ruptured wide-neck bifurcation aneurysms: Single-center experience.","authors":"Hossein Ghanaati, Aryoobarzan Rahmatian, Amir Torkaman, Mohammad Dashtkoohi, Mohammad Amin Dabbagh Ohadi","doi":"10.7461/jcen.2024.E2024.11.002","DOIUrl":"10.7461/jcen.2024.E2024.11.002","url":null,"abstract":"<p><strong>Objective: </strong>Treating wide-necked bifurcation aneurysms (WNBA) is challenging. Nevertheless, recent progress in endovascular techniques is promising. Woven EndoBridge devices (WEB) have exhibited outcomes comparable to conventional treatments like stent-assisted coiling (SAC) in treating aneurysms. However, their safety and efficacy in managing acutely ruptured aneurysms remain a topic of interest. This study focuses on this issue.</p><p><strong>Methods: </strong>We searched our database from 2020 to 2023 and found 38 patients with acutely (< a week) ruptured WNBA. We extracted radiologic and clinical data from the available medical reports. Favorable functional and radiologic outcomes were assessed using the modified Rankin scale (mRS) and modified Raymond-Roy occlusion classification (MRRC).</p><p><strong>Results: </strong>Our study population comprised 15 aneurysms treated with WEB and 25 treated with SAC. Operational time was significantly lower in the WEB compared to the SAC group (39.3 vs 66.2 minutes, p value: < 0.001). Immediate (p value=0.64) and the 18th-month (p value=0.42) occlusion rates were comparable between the two groups. Favorable mRS scores in the 3rd month were seen in 100% of SAC patients and 93.3% of WEB patients (p value=0.79). Retreatment (p value=1.0) and complication (p value=0.39) rates were comparable. Vasospasms after the procedure were the most common complication.</p><p><strong>Conclusions: </strong>WEB demonstrated comparable safety and efficacy to SAC in patients with acutely ruptured WNBA. Notably, WEB had a shorter procedure duration. Additional studies with extended follow-up periods are necessary for comprehensive evaluation.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"33-39"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026226","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":"Clinical safety and efficacy of stent-assisted coil embolization with ACCERO stent in cerebral aneurysm: Short-term follow-up and precaution for use.","authors":"Young Ha Kim, Chang Hyeun Kim, Sang Weon Lee, Chi Hyung Lee, Su Hun Lee, Jun Seok Lee, Soon Ki Sung, Dong Wuk Son","doi":"10.7461/jcen.2025.E2025.02.002","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2025.02.002","url":null,"abstract":"<p><strong>Objective: </strong>Stent-assisted coil embolization (SAC) is an effective method of treating intracranial aneurysms. The aim of the study was to assess the safety and efficacy of the new ACCERO stent for the treatment of cerebral aneurysms.</p><p><strong>Methods: </strong>It was a retrospective, single-center study. Nine ruptured and 41 unruptured cerebral aneurysms were treated using the ACCERO stent between February 2021 and December 2023. Patient demographics, aneurysm characteristics, procedural parameters, grade of occlusion, complications, and clinical outcomes were analyzed. Follow-up was conducted with magnetic resonance angiography (MRA) or Digital subtraction angiography (DSA) was performed 6 to 12 months after the procedure.</p><p><strong>Results: </strong>The ACCERO stent deployment was attempted in 51 cases, with replacement by the Neuroform Atlas stent in 1 case. Successful stent deployment was achieved in 50 cases, and appropriate wall apposition to the parent artery. The average clinical follow-up period was 17.1 months. Intimal hyperplasia was observed in 1 case, but no other clinical complications related to the stent occurred. Favorable clinical outcomes were observed in 92% of patients (46/50), including those with subarachnoid hemorrhage. Immediate favorable angiographic outcomes and complete occlusion were achieved in 90% (45/50) and 74% (37/50) of cases, respectively. Among the 45 patients who had imaging follow-up, favorable angiographic outcomes and complete occlusion were observed in 93.3% (43/45) and 82.2% (37/45) of cases, respectively.</p><p><strong>Conclusions: </strong>The ACCERO stent is a braided-type stent that requires more attention than stents, such as the Neuroform Atlas or Enterprise stents. However, since the struts of the stent are fully visible, it can be more useful in treating challenging aneurysms once the user becomes familiar with its use.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143485037","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":"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":"https://doi.org/10.7461/jcen.2024.E2024.04.007","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367111","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}