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":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","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}
{"title":"Overcoming refractory subgaleal hematoma with endovascular treatment: A novel therapeutic approach.","authors":"Bong-Gyu Ryu, Yongjae Lee, Dae Han Choi","doi":"10.7461/jcen.2025.E2024.11.001","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2024.11.001","url":null,"abstract":"<p><p>Subgaleal hematoma (SGH) is a rare condition in adults, typically resulting from trauma. It has primarily been treated with traditional methods, such as aspiration and needle puncture. However, Conventional treatments, such as simple compression dressings and needle aspiration, have been found inadequate in addressing refractory SGH. To overcome these challenges, we performed endovascular treatment (EVT), involving selective coil embolization of the vessels feeding the hematoma, followed by percutaneous hematoma aspiration and compression dressing. In this case report, a 37-year-old female patient with head trauma developed a recurrent subgaleal hematoma despite conservative treatments. Endovascular treatment was performed, resulting in significant improvement and no recurrence. This case suggests that EVT provides a viable and effective treatment alternative for adult patients with refractory SGH, offering a less invasive approach compared to surgical incision and drainage, with promising long-term outcomes.</p>","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":"144639102","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 waffle cone technique for managing stent dislodgement into a target aneurysm.","authors":"Jun Kyeung Ko","doi":"10.7461/jcen.2025.E2025.03.001","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2025.03.001","url":null,"abstract":"<p><p>Stent-assisted coiling is an essential technique for managing wide-neck intracranial aneurysms. However, complications such as stent dislodgement can pose significant challenges, potentially compromising procedural success and patient outcomes. We present the case of a 73-year-old woman with an unruptured basilar tip aneurysm who experienced intra-procedural stent dislodgement into the target aneurysm during a Y-stent-assisted coiling attempt. Recognizing the instability of the displaced stent and the risk of further complications, we employed a modified \"waffle cone technique\" using a Solitaire AB stent to successfully secure the aneurysm while preserving parent vessel patency. This case highlights the importance of prompt recognition and innovative problem-solving strategies in managing stent-related complications during neuro-interventions. The rescue waffle cone technique represents a viable alternative for addressing complex stent dislodgement scenarios and improving patient outcomes.</p>","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":"144639103","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}
Javier Degollado-Garcia, Carlos Fernando Nicolas-Cruz, Diana Marmolejo-Moreno, Jose Orenday-Barraza
{"title":"Revascularization surgical options after carotid trauma: Case report from a cerebrovascular blood flow preservation overview.","authors":"Javier Degollado-Garcia, Carlos Fernando Nicolas-Cruz, Diana Marmolejo-Moreno, Jose Orenday-Barraza","doi":"10.7461/jcen.2025.E2025.01.002","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2025.01.002","url":null,"abstract":"<p><p>An 18-year-old male underwent a tracheostomy that was complicated by an iatrogenic left-sided common carotid artery laceration, leading to loss of blood flow and a minor stroke in the anterior and medial territories of the left cerebral circulation. After the lesion was identified, carotid exploration was performed, followed by a vascular reconstruction using a synthetic graft to repair the damaged segment. This manuscript details the microsurgical techniques utilized and discusses the indications for this intervention, with a particular emphasis on stroke prevention.</p>","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":"144328235","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":"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":"<p><p>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.</p>","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}
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":"<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":"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}
{"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":"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":"165-170"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694903","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}
Ina Bahl, Rashim Kataria, Trilochan Srivastava, Devendra Purohit, Manmohan Singh
{"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":"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":"152-158"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560488","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}
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
{"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":"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":"159-164"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694888","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}
Ahmad Fadhil Maulana, Pandji Winata Nurikhwan, Ardik Lahdimawan, Ilma Fi Ahsani, Muhammad Rasyid Ridho Lahdimawan, Aldiya Jamila
{"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":"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":"103-117"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588746","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}