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Flow reversal during stroke thrombectomy Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-03-15 James Caldwell, Shane S H Lee, Mikal Sarrafzadeh, Dave S Rhodes, Ben J McGuinness
When performing mechanical thrombectomy for stroke patients, some physicians use balloon guide catheters (BGCs) in order to achieve flow reversal and thereby improve reperfusion quality. There is substantial evidence favoring the use of BGCs to improve reperfusion rates and clinical outcomes for thrombectomy patients; however, as we will outline in this review, there is also evidence that BGCs do not
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Safety and efficacy of dynamic catheter-directed cerebral digital subtraction angiography for diagnosis of bowhunter syndrome spectrum disorders: A systematic review of the literature Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-03-13 Joo Won Choi, Yang Qiao, Tej I Mehta, Jessica N Wilson, Trevor H Torigoe, Samuel Tsappidi, Y Jonathan Zhang, Stacy C Brown, Ferdinand K Hui, Todd Abruzzo
IntroductionDynamic catheter-directed cerebral digital subtraction angiography (dcDSA) is the gold standard for diagnosing dynamic vascular occlusion syndromes such as bowhunter syndrome (BHS). Nonetheless, concerns about its safety exist and no standardized protocols have been published to date.MethodsWe describe our methodology and insights regarding the use of dcDSA in patients with BHS. We also
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Refinement of nBCA embolization technique in treatment of metastatic spinal tumors: Case series and technical report Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-03-12 Laura Stone McGuire, Elsa Nico, Jessica Hossa, Mpuekela Tshibangu, Ankit Mehta, Ali Alaraj
Background and ObjectivesPreoperative embolization of metastatic spinal tumors (MSTs) has proven advantageous in limiting intraoperative blood loss (IBL) during resection. N-butyl cyanoacrylate (nBCA) is a liquid embolic agent known for its rapid hemostatic effects. However, nBCA is associated with a higher risk of distal nontarget embolization. This study highlights the refinement of the embolization
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Neuromodulation: What the neurointerventionalist needs to know Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-03-08 Kobina G. Mensah-Brown, Ryan M. Naylor, Stephen Graepel, Waleed Brinjikji
Neuromodulation is the alteration of neural activity in the central, peripheral, or autonomic nervous systems. Consequently, this term lends itself to a variety of organ systems including but not limited to the cardiac, nervous, and even gastrointestinal systems. In this review, we provide a primer on neuromodulation, examining the various technological systems employed and neurological disorders targeted
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Nationwide trends in intensive care unit utilization in the elective endovascular treatment of unruptured intracranial aneurysms Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-03-08 Varun Padmanaban, William J. Benjamin, Austin Cohrs, Francis J. Jareczek, Sprague W. Hazard, Joseph Christopher Zacko, Ephraim W. Church, Scott D. Simon, Kevin M. Cockroft, Douglas L. Leslie, David Andrew Wilkinson
ObjectiveMultiple studies suggest routine post-operative intensive care unit (ICU) stays after endovascular treatment (EVT) of unruptured intracranial aneurysms (UIAs) is unnecessary, though rates of ICU utilization nationwide are unknown. We aim to evaluate rates and characteristics of ICU utilization in patients undergoing elective endovascular repair of UIAs.MethodsThis is a retrospective cohort
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Eclipse balloon-assisted straight sinus thrombectomy: A novel technique Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-03-08 Kyriakos Papadimitriou, Shyle H Mehta, Danielle Golub, Timothy White, Kevin Shah, Athos Patsalides
Cerebral venous sinus thrombosis comprises 0.5% of all strokes and usually affects young adults. Straight sinus involvement is relatively rare, and it is associated with poor prognosis. Intravenous anticoagulation is considered the first line of treatment. Endovascular approaches such as direct catheter thrombolysis, balloon-assisted thrombolysis, and mechanical thrombectomy may be more efficient and
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Predictors of angiographic resolution in patients with presumed reversible cerebral vasoconstriction syndrome Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-03-06 Adrusht Madapoosi, Laura Stone McGuire, Jessica Hossa, Angelica Fuentes, Mpuekela Tshibangu, Peter Theiss, Sepideh Amin-Hanjani, Ali Alaraj
IntroductionReversible cerebral vasoconstriction syndrome is a complex neurovascular syndrome that presents with varying neurological deficits as well as segmental vasoconstriction of the small and medium cerebral arteries. There is limited literature on pathologies that mimic reversible cerebral vasoconstriction syndrome, so this study aims to understand what factors may impact the angiographic confirmation
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Clopidogrel versus newer P2Y12 inhibitors in the dual antiplatelet therapy for stent-assisted coil embolization of intracranial aneurysms: A meta-analysis Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-03-05 Sávio Batista, Raphael Camerotte, Agostinho C. Pinheiro, Igor Costermani, Anthony Bishay, José Alberto Almeida Filho, Lucca B. Palavani, Edmundo Damiani Bertoli, Raphael Bertani, Jason A. Ellis, Yafell Serulle, Christian Ferreira
IntroductionStent-assisted coil embolization (SACE) for cerebral aneurysms requires dual antiplatelet therapy (DAPT), commonly clopidogrel plus aspirin is preferable to ticagrelor or prasugrel plus aspirin. However, there are few studies assessing the safety of the association of ticagrelor or prasugrel plus aspirin.ObjectivesCompare the safety of newer P2Y12 inhibitors with clopidogrel in patients
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Does Ischemic Core Volume Modify the Treatment Effect of Endovascular Thrombectomy? Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-03-04 Ahmad A Ballout
Imaging-based selection has become integral in guiding endovascular thrombectomy for large vessel occlusive stroke, driven by positive trial outcomes incorporating parenchymal and perfusion imaging criteria. While small-moderate core trials transformed acute reperfusion therapy, uncertainties persisted for large ischemic strokes. This was recently addressed in several treatment trials which demonstrated
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3D digital subtracted angiography venous roadmapping for endovascular management of dural venous stenosis Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-03-01 François Zhu, Liang Liao, Serge Bracard, Oana Harsan, Luana Lopes De Medeiros, Anne-Laure Derelle, Marc Braun, Benjamin Gory, René Anxionnat
Stenting of the dural venous sinuses has emerged as a therapeutic option for intracranial hypertension and pulsatile tinnitus. However, venous endovascular navigation faces challenges due to lower-quality roadmaps compared to arterial navigation. This study explores the application of three-dimensional (3D) rotational venography in assessing the cerebral venous vasculature and its potential for venous
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Differences in outcome between left-sided and right-sided mechanical thrombectomy for acute ischemic stroke: A systematic review and meta-analysis Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-03-01 Abdullah Ramzan, Sherief Ghozy, Cem Bilgin, Alejandro A. Rabinstein, Ramanathan Kadirvel, David F. Kallmes
BackgroundMechanical thrombectomy (MT) is a safe and effective treatment option for acute ischemic stroke due to large vessel occlusion. To investigate differences in outcomes between patients receiving left-sided and right-sided MT, we performed a systematic review and meta-analysis.MethodsA systematic literature review was performed using Embase, PubMed, Scopus, and Web of Science databases. Additional
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RETRACTED: Rescue intracranial stenting in acute ischemic stroke (study) Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-03-01
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A case of spontaneous brain arteriovenous malformation occlusion: Imaging analysis and clinical debate Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-02-29 Nicola Milazzo, Silvia Pizzuto, Julie Gratieux, Alessandro Sgreccia, Federico Di Maria, Oghuzan Coskun, Stephanie Condette-Auliac, Anne Boulin, Georges Rodesch, Arturo Consoli
The spontaneous occlusion of brain arteriovenous malformations (bAVMs) is a rare event, particularly for unruptured ones. Associated factors include single-venous drainage and small nidus size. Most of the previously reported cases were ruptured bAVMs. We report the case of a middle-aged male patient with an unruptured, rolandic, left-sided bAVM associated with a 30-year history of refractory epilepsy
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Simple coiling of middle meningeal artery embolization for chronic subdural hematoma: An inverse probability of treatment weighting matched cohort study Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-02-29 Pang-Shuo Perng, Ming-Tsung Chuang, Chia-En Wong, Yu Chang, Yuan-Ting Sun, Hao-Kuang Wang, Jung-Shun Lee, Liang-Chao Wang, Chih-Yuan Huang
BackgroundMiddle meningeal artery embolization (MMAE) for chronic subdural hematoma (CSDH) has gained much attention in recent years. However, unintended embolization may occur when employing liquid embolic agents or particles. We present our clinical experience in simple coiling of MMAE to manage CSDH.MethodsPatients underwent either surgical evacuation or MMAE with simple coiling for CSDH were reviewed
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Feasibility of super-bore 0.088″ mechanical thrombectomy in M1 vessels smaller than 8 French: Experience in 20 consecutive cases Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-02-29 Jessica K Campos, Benjamen M Meyer, Muhammad Waqas Khan, Fahad J Laghari, David A Zarrin, Jonathan Collard de Beaufort, Gizal Amin, Kiarash Golshani, Matthew T Bender, Geoffrey P Colby, Li-Mei Lin, Alexander L Coon
IntroductionSuperbore 0.088″ catheters provide a platform for optimizing aspiration efficiency and flow control during stroke mechanical thrombectomy procedures. New superbore catheters have the distal flexibility necessary to navigate complex neurovascular anatomy while providing the proximal support of traditional 8F catheters. The safety and feasibility of Zoom 88™ superbore angled-tip catheters
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Hyperdense sign as a predictor for successful recanalization and clinical outcome in acute ischemic stroke: A systematic review and meta-analysis Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-02-28 Khaled Gharaibeh, Nameer Aladamat, Mohammad Samara, Adam T. Mierzwa, Ahsan Ali, Syed Zaidi, Mouhammad Jumaa
ObjectiveTo assess the prognostic values of hyperdense sign on pretreatment non-contrast head CT scan for successful recanalization (mTICI ≥2b) and 90-day good functional outcome (mRs 0-2) in patients with acute ischemic stroke undergoing mechanical thrombectomy (MT).MethodsLiterature search on PubMed, EMBASE, and Cochrane databases from inception up to 1 November 2023 was conducted. Twelve studies
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Transvenous embolization of noncavernous dural arteriovenous fistulas (dAVFs): A systematic review and meta-analysis Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-02-28 Jaims Lim, Brianna M. Donnelly, Vinay Jaikumar, Marissa D. Kruk, Cathleen C. Kuo, Andre Monteiro, Manhal Siddiqi, Ammad A. Baig, Devan Patel, Kunal P. Raygor, Kenneth V. Snyder, Jason M. Davies, Elad I. Levy, Adnan H. Siddiqui
BackgroundIntracranial dural arteriovenous fistulas (dAVFs) are abnormal connections between arteries and veins within the dura mater. Various treatment modalities, such as surgical ligation, endovascular intervention, and radiosurgery, aim to close the fistulous connection. Although transvenous embolization (TVE) is the preferred method for carotid-cavernous fistulas, its description and outcomes
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Utilization and reimbursement of diagnostic cerebral angiograms: A Medicare trends analysis from 2013 to 2020 Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-02-23 Avi A Gajjar, Michael M Covell, Najib Muhammad, Cathleen Kuo, Georgios S Sioutas, Mohamed M Salem, Sebastian Ivan Fras, Brian T Jankowitz, Jan-Karl Burkhardt, Visish M Srinivasan
IntroductionIncreasing life expectancy has caused growing concern about maintaining viable neurointerventional practices due to altered Medicare payment structures. This study analyzes the financial trends of three common diagnostic tests for cerebrovascular disease: cerebral digital subtraction angiography (DSA), computed tomography angiography (CTA), and magnetic resonance angiography (MRA).MethodsMedicare
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Factors Affecting Selection of TraineE for Neurointervention (FASTEN) Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-02-23 Mohamed Elfil, Rami Z. Morsi, Sherief Ghozy, Ahmed Elmashad, Adnan Siddiqui, Alhamza R. Al-Bayati, Ali Alaraj, Allan Brook, Anthony W. Kam, Arindam Rano Chatterjee, Athos Patsalides, Ben Waldau, Charles J. Prestigiacomo, Charles Matouk, Clemens M. Schirmer, David Altschul, David T. Parrella, Gabor Toth, Gaurav Jindal, Hamza A. Shaikh, Jaydevsinh N. Dolia, Johanna T. Fifi, Justin F. Fraser, Justin Thomas
Background and importanceNeurointervention is a very competitive specialty in the United States due to the limited number of training spots and the larger pool of applicants. The training standards are continuously updated to ensure solid training experiences. Factors affecting candidate(s) selection have not been fully established yet. Our study aims to investigate the factors influencing the selection
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Endovascular neurointervention in Iraq: Realistic obstacles, a hopeful start with “Al-Hayat center” Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-02-13 Ghazwan A Lafta
Endovascular neurointervention nowadays plays an important role in the effective treatment of different head and neck vascular pathologies using minimally invasive means. In Iraq, until recently, endovascular neurointervention field is nearly absent. A new hope was started when an advanced neurointerventional center was created to improve and develop this field in Iraq.
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Optical coherence tomography findings of balloon angioplasty/stenting for in-stent restenosis after carotid artery stenting Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-02-13 Shingo Yamada, Kei Harada, Daichi Baba, Takatusugu Oshima, Koki Tanaka
ObjectivesThe optimal therapeutic methods for in-stent restenosis (ISR) after carotid artery stenting (CAS) remains controversial. This study aimed to use optical coherence tomography (OCT) to evaluate the in-stent architectures during endovascular angioplasty/stenting for ISR.Materials and MethodsSix lesions of ISR after CAS were evaluated by OCT during endovascular angioplasty/stenting.ResultsIn
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Mechanical thrombectomy for the treatment of large vessel occlusion due to cancer-related cerebral embolism: A systematic review Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-02-09 Michelle Toruno, Omar Al-Janabi, Irem Karaman, Sherief Ghozy, Yigit Can Senol, Hassan Kobeissi, Ramanathan Kadirvel, Boyd Ashdown, David F Kallmes
BackgroundCancer-related cerebral embolism due to direct tumor embolization results in a rare acute ischemic stroke with large vessel occlusion (LVO). Despite the established status of mechanical thrombectomy (MT) in LVO management, its effectiveness and safety remains inadequately explored in this specific patient group.MethodsWe conducted a systematic review following Preferred Reporting Items for
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Standardized approach to direct first pass aspiration technique for endovascular thrombectomy: Description and initial experience with CANADAPT Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-02-09 I.R. Macdonald, V. Linehan, B. Sneek, David Volders
BackgroundEndovascular thrombectomy (EVT) is standard of care for acute ischemic stroke. Stent assisted EVT with aspiration (SOLUMBRA) technique has remained a mainstay approach. There is growing evidence that A Direct Aspiration First Pass Technique (ADAPT) is a safe, efficient and effective approach for EVT, offering several advantages. This study describes and reports initial institutional experience
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Improvement of cerebral blood flow after balloon angioplasty and stenting for symptomatic middle cerebral artery stenosis Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-02-09 Takashi Araga, Toshihiro Ueda, Tomohide Yoshie, Naoki Takao, Haruki Ohtsubo, Kentaro Tatsuno, Noriko Usuki, Satoshi Takaishi, Yoshihisa Yamano
ObjectiveAlthough reports of endovascular treatment for intracranial arterial stenosis have been increasing recently, their efficacy remains to be elucidated. This study aimed to investigate the changes in cerebral hemodynamics of severe middle cerebral artery (MCA) stenosis patients by performing CT perfusion (CTP) after endovascular treatment.MethodsSubjects were those who underwent balloon angioplasty
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Experimental evaluation of the plunger technique: A method of cyclic manual aspiration thrombectomy for treatment of acute ischemic stroke Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-02-07 Demitria A Poulos, James S Keith, Michael T Froehler, Bryan C Good
BackgroundMechanical thrombectomy via direct aspiration is a rapid treatment for acute ischemic stroke. This method often results in the partial ingestion of the clot or “corking” of the catheter tip. Cyclic aspiration may take advantage of the mechanical properties of the clot, resulting in greater clot ingestion and overall procedure success.MethodsAn in vitro analysis was performed comparing static
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A rare dissecting anterior inferior cerebellar artery aneurysm treated with flow diversion using a silk vista baby device Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-01-24 Omar Kass-Hout, Ziad Darkhabani, Tibor Becske
BackgroundDissecting intracranial pseudoaneurysms represent a challenge for treatment both endovascularly and surgically.MethodsWe review the treatment course of a ruptured anterior inferior cerebellar artery (AICA) dissecting pseudoaneurysm in a 50-year-old patient and review the history of dissecting aneurysms and AICA aneurysms treatment.ResultsAn aneurysm cure was achieved using flow diversion
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Patients’ perceptions on outcomes after mechanical thrombectomy in acute ischemic stroke Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-01-23 Shail Thanki, Elliot Pressman, Kassandra M Jones, Ruby Skanes, Ahmad Armouti, Waldo R Guerrero, Kunal Vakharia, Ashwin B Parthasarathy, Kyle Fargen, Eva A Mistry, Shahid M Nimjee, Ameer E Hassan, Maxim Mokin
BackgroundThe modified Rankin Scale (mRS) is a clinician-reported scale that measures the degree of disability in patients who suffered a stroke. Patients’ perception of a meaningful recovery from severe stroke, expected value of a stroke intervention, and the effect of disparities are largely unknown.MethodsWe conducted a survey of patients, their family members, and accompanying visitors to understand
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Overestimation of ischemic core on baseline MRI in acute stroke Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-01-23 MA McArthur, E Tavakkol, M Bahr-Hosseini, R Jahan, GR Duckwiler, JL Saver, DS Liebeskind, K Nael
Background and PurposeIn patients with acute ischemic stroke (AIS), overestimation of ischemic core on MRI-DWI has been described primarily in regions with milder reduced diffusion. We aimed to assess the possibility of ischemic core overestimation on pretreatment MRI despite using more restricted reduced diffusion (apparent diffusion coefficient (ADC) ≤620 × 10−6 mm2/s) in AIS patients with successful
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Endovascular thrombectomy for posterior cerebral artery strokes in the national inpatient sample (EaT PeCANpIeS) study Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-01-23 Aaron Brake, Lane Fry, Cody Heskett, Abdul-Rahman Alkiswani, Gabriel LeBeau, Frank De Stefano, Catherine Lei, Kevin Le, Adam G Rouse, Jeremy Peterson, Koji Ebersole
BackgroundPosterior cerebral arteries with acute ischemic strokes (PCA-AISs) comprise around 2% of all acute ischemic strokes and may result in significant long-term deficits. Current guidance regarding endovascular thrombectomy (EVT) for PCA-AIS is insufficient as no published randomized trials exist.MethodsAn analysis of the National Inpatient Sample database compared medical management versus EVT
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A technical guide to robotic-assisted carotid angioplasty and stenting with the Corindus CorPath GRX system Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-01-18 Anzhela D Moskalik, Buqing Liang, Branden J Cord, Ben Waldau
Robotic-assisted carotid artery angioplasty and stenting is becoming more popular due to its precision and radiation safety. In this video, we present a case using the CorPath GRX Robotic System (Corindus, a Seimens Healthineers Company, Waltham, Massachusetts, USA) with step-by-step procedure process and technical nuances (video 1). We demonstrate that cervical carotid angioplasty and stenting can
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Safety and efficacy of the Woven Endo-Bridge-17 device for intracranial aneurysm treatment: A systematic review and meta-analysis Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-01-18 Sherief Ghozy, Ahmed Sallam Motawei, Charbel Moussalem, Amro Elrefaei, Hassan Kobeissi, Alzhraa S Abbas, Adam A Dmytriw, David F Kallmes, Ramanathan Kadirvel
BackgroundThe Woven Endo-Bridge (WEB) device revolutionized the treatment of wide-necked bifurcation aneurysms by intrasaccular flow diversion. The latest advancement is the WEB-17 system, offering greater flexibility with fewer wires, enabling treatment of smaller distal aneurysms using smaller microcatheters than the WEB-21 system.MethodsWe conducted a systematic review following preferred reporting
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Metal allergy and neurovascular stenting: A systematic review Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-01-16 Dhrumil Vaishnav, Muhammed Amir Essibayi, Aureliana Toma, Genesis Liriano, Raja Sandeep Perkash, Ariel Stock, Ryan Holland, Adam A Dmytriw, Stacey Q Wolfe, Sami Al Kasab, Alejandro Spiotta, Neil Haranhalli, David J Altschul
BackgroundIntracranial stents and flow diverters contain significant amounts of metals, notably nickel, which can cause allergic reactions in a considerable portion of the population. These allergic responses may lead to complications like in-stent stenosis (ISS) and TIA/Stroke in patients receiving stents or flow diverters for intracranial aneurysms.MethodsWe conducted a systematic review of studies
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Balloon-assisted U-turn Technique to Access Cortical Vein for Transvenous Embolization of Mixed Dural-pial Arteriovenous Malformation Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-01-16 Muhammed Amir Essibayi, Dhrumil Vaishnav, Ryan Holland, David J Altschul
Cerebral arteriovenous malformations can be classified into pure pial, mixed dural-pial, and pure dural types. Mixed pial-dural AVMs (DPAVM) are rare and often receive blood supply from dural meningeal arteries, including branches of the internal carotid, external carotid, and vertebral arteries. 1 – 6 DPAVMs, which are usually large and complex, require delicate endovascular and surgical treatment
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Glycoprotein inhibitors as a first line rescue treatment after unsuccessful recanalization of endovascular thrombectomy: A systematic review and meta-analysis Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-01-11 Aaron Brake, Cody Heskett, Naima Alam, Lane Fry, Kevin Le, Jonathan D Mahnken, Michael Abraham
BackgroundIntracranial atherosclerotic disease (ICAD) is a major cause of stroke with a high rate of re-occlusion following mechanical thrombectomy (MT). Among the available rescue options, glycoprotein IIb/IIIa inhibitors (GPI) have shown promise as a potential therapeutic strategy. This systematic review and meta-analysis examine studies exploring the use of glycoprotein inhibitors as a first-line
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Direct superficial temporal artery access for middle meningeal artery embolization Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-01-10 Yang Qiao, Yi Jonathan Zhang, Samuel Tsappidi, Tej I Mehta, Ferdinand K Hui
Middle meningeal artery embolization has become an important option in the management of subdural hemorrhages with multiple prospective studies demonstrating efficacy and randomized controlled trial data on the way. Access to the middle meningeal artery is usually achieved via the external carotid artery to the internal maxillary artery, then the middle meningeal artery. We report a case where a patient
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Radially adjustable stent retriever for mechanical thrombectomy in acute ischemic stroke: Improved first-pass effect with rapid-inflation deflation technique Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-01-09 Sanjeev Sreenivasan, Gaurav Gupta, Robert Wu, Emad Nourollah-Zadeh, Hai Sun, Anil Nanda, Srihari Sundararajan, Sudipta Roychowdhury
IntroductionEvidence for improved first-pass effect with the novel radially adjustable radio-opaque stent retriever Tigertriever is lacking.ObjectiveTo compare improvement in first pass success with Tigertriever using two different techniques—rapid inflation deflation (RID) and suction thrombectomy (ST).MethodsRetrospective analysis of patients with acute ischemic stroke who underwent mechanical thrombectomy
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Safety and efficacy of dual antiplatelet drugs for stent-assisted embolization on risk of stroke and prognosis in patients with ruptured intracranial aneurysms: One center results of CIAP-5 clinical trial Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-01-09 Simin Wang, Tongyu Zhang, Lei Du, Peng Hu, Ming Ye, Liyong Sun, Tao Hong, Guilin Li, Peng Zhang, Hongqi Zhang, Chuan He
BackgroundAlthough stent-assisted coiling embolization (SAC) has been associated with a higher risk of ischemic and hemorrhagic complications, the use of SAC continues to rise for treating ruptured intracranial aneurysms (RIAs). This study aims to assess the safety and effectiveness of dual antiplatelet therapy (DAPT) in the context of RIAs.MethodsWe conducted a retrospective analysis at a single center
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Assessing the efficacy of VerifyNow platelet-function testing in predicting postoperative hemorrhagic complications of neuroendovascular surgery: A systematic review and meta-analysis (part 2) Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-01-09 Devon L Mitchell, Laura Stone McGuire, Syed I Khalid, Ali Alaraj
BackgroundDual antiplatelet therapy is used to reduce the risk of thromboembolic complications in neuroendovascular surgery. However, the predictive utility of preoperative platelet-sensitivity testing for decreasing bleed risk in patients undergoing endovascular neurointervention remains unclear.ObjectiveWe conducted a systematic review and meta-analysis to illustrate the association between platelet
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Intra-arterial microguidewire electrocoagulation to treat intracranial vascular diseases Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-01-09 Tao Wu, Yao Wu, Zhao-liang Li, De-hong Yang, Ai-lin Chen, Chun-gang Dai, Qing Zhu
ObjectiveTo investigate the therapeutic effect of intra-arterial microguidewire electrocoagulation on intracranial vascular diseases.MethodsData from 10 patients with cerebral aneurysms between May 2018 and September 2022 were analysed. Patients were treated with endovascular coil embolisation and microguidewire electrocoagulation. XperCT scans were conducted to identify new intracranial haemorrhage
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Assessing the efficacy of VerifyNow platelet-function testing in predicting postoperative thromboembolic complications of neuroendovascular surgery: A systematic review and meta-analysis (part 1) Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-01-08 Devon L Mitchell, Laura Stone McGuire, Syed I Khalid, Ali Alaraj
BackgroundDespite the heavily debated use of routine platelet-function testing, the VerifyNow Platelet Reactivity Unit (PRU) assay has been increasingly adopted as standard of care for assessing risk of postoperative thromboembolic complications of neuroendovascular surgery.ObjectiveWe conducted a systematic review and meta-analysis to examine the relationship between platelet response and risk of
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Disability-free outcomes after mechanical thrombectomy: A systematic review and meta-analysis of the randomized controlled trials Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-01-05 Cem Bilgin, Mohamed Ibrahim, Sherief Ghozy, Mohamed Sobhi Jabal, Mostafa Shehata, Hassan Kobeissi, Ramanathan Kadirvel, Waleed Brinjikji, Alejandro A Rabinstein, David F Kallmes
BackgroundThe modified Rankin Scale (mRS) score of ≤2 (functional independence) has been the most common primary endpoint of modern mechanical thrombectomy (MT) trials. However, unlike mRS 0-1, mRS score of 2 indicates disability. An important proportion of the mRS 2 patients are home dependent and report a significant decrease in their quality of life.PurposeTo investigate excellent outcome (mRS 0-1)
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A review of epidural and non-epidural contrast flow patterns during fluoroscopic and CT-guided epidural steroid injections Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-01-05 Ajay A. Madhavan, Greta B. Liebo, Francis Baffour, Felix E. Diehn, Timothy P. Maus, Naveen S. Murthy, Nicholas G. Rhodes, Christin A. Tiegs-Heiden
Epidural steroid injections are commonly performed using fluoroscopic or CT guidance. With both modalities, the injection of contrast material is necessary before steroid administration to ensure adequate epidural flow and exclude non-epidural flow. While fluoroscopic guidance is conventional, CT is utilized at some centers and can be particularly helpful in the setting of challenging or postoperative
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Indications for alternative endovascular techniques in carotid-cavernous fistulas: A 20-year single-center experience Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-01-04 Richard Voldřich, František Charvát, David Netuka
BackgroundWhile coiling is considered the standard treatment for carotid-cavernous fistulas (CCFs), studies demonstrating excellent results using new materials, especially flow diverter (FD) stents and liquid embolisates, are becoming more frequent. The indications and effectiveness of these alternative endovascular techniques remain unclear.MethodsA total of 22 direct and 20 indirect CCFs were included
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Periprocedural thromboembolic complications of LEO baby stent in endovascular treatment of intracranial aneurysms: Experience in 149 patients Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-01-04 Yunan Shen, Heng Ni, Zhenyu Jia, Yuezhou Cao, Guangdong Lu, Xinglong Liu, Bin Wang, Chun Zhou, Haibin Shi, Sheng Liu, Linbo Zhao
ObjectiveTo report periprocedural thromboembolic complications of LEO Baby stent-assisted coiling of wide-necked intracranial aneurysms and to analyze the possible influencing factors.MethodsWe retrospectively identified 149 patients with aneurysms who underwent LEO Baby stent-assisted embolization between October 2018 and March 2022. Clinical and radiographic data of patients were reviewed to determine
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Immediate procedural safety of adjunctive proximal coil occlusion in middle meningeal artery embolization for chronic subdural hematomas: Experience in 137 cases Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-01-03 Jessica K Campos, Benjamen M Meyer, David A Zarrin, Muhammad Waqas Khan, Jonathan C Collard de Beaufort, Gizal Amin, Michael B Avery, Kiarash Golshani, Narlin B Beaty, Matthew T Bender, Geoffrey P Colby, Li-Mei Lin, Alexander L Coon
BackgroundEndovascular embolization of the middle meningeal artery (MMA) has emerged as an adjunctive and stand-alone modality for the management of chronic subdural hematomas (cSDH). We report our experience utilizing proximal MMA coil embolization to augment cSDH devascularization in MMA embolization.MethodsMMA embolization cases with adjunctive proximal MMA coiling were retrospectively identified
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A proposed modern standardized technical approach for symptomatic chronic carotid total occlusion management Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-01-03 Răzvan Alexandru Radu, Federico Cagnazzo, Adrien Ter Schiphorst, Paolo Machi, Cyril Dargazanli, Pierre-Henri Lefevre, Gregory Gascou, Vincent Costalat
Chronic carotid total occlusion (CCTO) is a known cause of ischemic stroke and transient ischemic attack. Symptomatic CCTO is associated with up to 30% risk of recurrent ischemic stroke, despite optimal medical treatment. Notably, a randomized controlled trial reported that previous surgical management did not improve the overall prognosis of these patients. Endovascular treatment of CCTO has been
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Woven EndoBridge versus stent-assisted coil embolization for the treatment of ruptured wide-necked aneurysms: A multicentric experience Interv. Neuroradiol. (IF 1.7) Pub Date : 2024-01-03 Aaron Rodriguez-Calienes, Juan Vivanco-Suarez, Yujing Lu, Milagros Galecio-Castillo, Bradley Gross, Mudassir Farooqui, Oktay Algin, Chaim Feigen, David J Altschul, Santiago Ortega-Gutierrez
BackgroundThe potentially higher risk of hemorrhagic complications is of concern in stent-assisted coiling (SAC) of ruptured wide-necked intracranial aneurysms (IAs). The Woven EndoBridge (WEB) is considered an appealing alternative since antiplatelet therapy is not required. Herein, we aimed to compare the safety and effectiveness of WEB vs. SAC for the treatment of ruptured wide-necked IAs.MethodsThis
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Safety of dual antiplatelet therapy using aspirin and low-dose Prasugrel with platelet reactivity testing in flow diverter treatment of intracranial aneurysms. Interv. Neuroradiol. (IF 1.7) Pub Date : 2023-11-29 Liam M Flynn,Ezaz Mohamed,Nicholas Dobbs,Alberto Nania,Johannes Du Plessis,Peter M Keston,Jonny J Downer
BACKGROUND Dual antiplatelet therapy (DAPT) is standard care for intracranial stenting to prevent thrombotic complications. Clopidogrel resistance has resulted in patients receiving newer P2Y12 inhibitors like Prasugrel, which may reduce thrombotic complications but could increase haemorrhagic complications. This study, utilising platelet reactivity testing, compared thrombotic and haemorrhagic complications
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Tenzing 7 delivery catheter with or without a leading microwire for single pass aspiration thrombectomy: A multicenter experience. Interv. Neuroradiol. (IF 1.7) Pub Date : 2023-11-28 Daniel A Tonetti,Manisha Koneru,Meghna Bhattacharyya,Joey D English,Fabio Settecase,Warren T Kim,Jane Khalife,Pratit Patel,Ajith Thomas,Tudor Jovin,Ricardo Hanel,Victor H C Benalia,Gustavo M Cortez,Amin Aghaebrahim,Eric Sauvageau,Mohamad Abdalkader,Thanh N Nguyen,Piers Klein,Adam A Dmytriw,Hamza Shaikh
INTRODUCTION Aspiration mechanical thrombectomy traditionally includes use of an inner microcatheter and leading microwire to navigate an aspiration catheter (AC) to the site of occlusion. Early clinical experience suggests that a leading microwire is often not needed with the Tenzing 7 (T7, Route 92 Medical, San Mateo, CA), a soft tapered tip ledge-reducing delivery catheter. This multicenter experience
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Utilisation of the Scepter Mini dual-lumen balloon - An illustrative series. Interv. Neuroradiol. (IF 1.7) Pub Date : 2023-11-28 Sean Thomas O'Reilly,Eef Jacobus Hendriks,Ze'ev Itsekson,Rabab Alshahrani,Emily Chung,Ivan Radovanovic,Ronit Agid,Patrick Nicholson,Timo Krings
BACKGROUND Dual-lumen balloon microcatheters can aid in the safety and efficacy of endovascular embolisation of cerebrospinal vascular malformations. The Scepter Mini dual-lumen balloon is a novel device with a smaller profile than previous balloon microcatheters, opening up new indications not only in the treatment of cerebrospinal malformations but in various other neurovascular therapeutic and diagnostic
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Diagnosis and surgical therapy of spontaneous intracranial hypotension. Interv. Neuroradiol. (IF 1.7) Pub Date : 2023-11-22 Tomas Klail,Christopher M Jesse,Ralph T Schär,Levin Häni,Andreas Raabe,Christoph J Schankin,Eike I Piechowiak,Tomas Dobrocky
Spontaneous intracranial hypotension (SIH) is a serious medical condition caused by loss of cerebrospinal fluid at the level of the spine, which, when not treated, may cause substantial long-term disability and increase morbidity. The following video summarizes the necessary steps for successful diagnosis and treatment of SIH, starting with a brain and spine magnetic resonance imaging, followed by
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Predictors of devastating functional outcome despite successful basilar thrombectomy. Interv. Neuroradiol. (IF 1.7) Pub Date : 2023-11-21 Rahul R Karamchandani,Sagar Satyanarayana,Hongmei Yang,Jeremy B Rhoten,Dale Strong,Jonathan D Clemente,Gary Defilipp,Nikhil M Patel,Joe D Bernard,William R Stetler,Jonathan M Parish,Andrew U Hines,Harsh N Patel,Anna Maria Helms,Lauren Macko,Laura Williams,Julia Retelski,Amy K Guzik,Stacey Q Wolfe,Andrew W Asimos
BACKGROUND Basilar thrombosis frequently leads to poor functional outcomes, even with good endovascular reperfusion. We studied factors associated with severe disability or death in basilar thrombectomy patients achieving revascularization. METHODS We retrospectively analyzed records from a health system's code stroke registry, including successful basilar thrombectomy patients from January 2017 to
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Unfavorable clinical outcomes in patients with good collateral scores following endovascular treatment for acute ischemic stroke of the anterior circulation: The UNCLOSE study. Interv. Neuroradiol. (IF 1.7) Pub Date : 2023-11-07 Arturo Consoli,Marco Pileggi,Atm Hasibul Hasan,Mohammad H Rahman,Alice Venier,Alessandro Sgreccia,Silvia Pizzuto,Oguzhan Coskun,Federico Di Maria,Luca Scarcia,Bertrand Lapergue,Georges Rodesch,Serge Bracard,Bailiang Chen
BACKGROUND Patients with acute ischemic stroke secondary to large vessel occlusions and good collaterals are frequently associated with favorable outcomes after mechanical thrombectomy, although poor outcomes are observed also in this subgroup. We aimed to investigate the factors associated with unfavorable outcomes (modified Rankin Scale3-6) in this specific subgroup of patients. METHODS In total
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Distal versus conventional transradial access for diagnostic cerebral angiography and neurointerventional procedures: A systematic review and meta-analysis. Interv. Neuroradiol. (IF 1.7) Pub Date : 2023-11-07 Atakan Orscelik,Yigit Can Senol,Hassan Kobeissi,Sherief Ghozy,Cem Bilgin,Santhosh Arul,Ramanathan Kadirvel,Waleed Brinjikji,David F Kallmes
BACKGROUND Distal transradial artery access (dTRA) has received increasing consideration for performing diagnostic cerebral angiography and neurointerventional procedures. In this meta-analysis, we aim to evaluate the safety and efficacy of dTRA compared to conventional transradial access (cTRA) for cerebral angiography and neurointerventions. METHOD A systematic review and meta-analysis were conducted
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Transradial versus transfemoral approach in cerebral angiography: A meta-analysis. Interv. Neuroradiol. (IF 1.7) Pub Date : 2023-11-07 Sávio Batista,Leonardo de Barros Oliveira,Jordana Borges Camargo Diniz,Agostinho Camara Pinheiro,Henrique Maia,Matheus Duarte,Filipi Fim Andreão,Lucca Biolcati Palavani,Raphael Bertani,José Alberto Almeida Filho,Raphael Muszkat Besborodco,Ricardo Hanel
BACKGROUND Cerebral angiography has two common access sites: Transradial approach and transfemoral approach. However, there's no definitive answer to which one is superior. OBJECTIVE Compare transradial approach and transfemoral approach for a cerebral angiography procedure. METHODS A systematic review of the literature of studies reporting both transradial approach and transfemoral approach results
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Quantitative radial force measurements of Woven EndoBridge devices. Interv. Neuroradiol. (IF 1.7) Pub Date : 2023-10-31 Ugurhan Kutbay,Oktay Algin
BACKGROUND Lateral/radial forces and the mechanical properties of Woven EndoBridge (WEB) devices have significant importance for therapeutic success. In other words, adequate apposition of the lateral wall of a cerebral aneurysm is critical for preventing recurrence or re-rupture risk. OBJECTIVE This study aimed to investigate the pressure values applied by different WEB devices to the lateral walls
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Flow diverter surface modifications for aneurysm treatment: A review of the mechanisms and data behind existing technologies. Interv. Neuroradiol. (IF 1.7) Pub Date : 2023-10-29 Timothy G White,Brandon A Santhumayor,Justin Turpin,Kevin Shah,Daniel Toscano,Ina Teron,Thomas Link,Athos Patsalides,Henry H Woo
Flow diversion (FD) has become a mainstay treatment for large wide-necked aneurysms. Despite excellent safety and efficacy, the risk of thromboembolic complications necessitates the use of dual antiplatelet therapy (DAPT). The use of DAPT makes hemorrhagic complications of stenting carry high morbidity and mortality. Additionally, DAPT usage carries a risk of "nuisance" complications that do not directly
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Nonbifurcating carotid artery-embryological scrutiny, intriguing associations, and review of literature. Interv. Neuroradiol. (IF 1.7) Pub Date : 2023-10-24 Savyasachi Jain,Pooja Jain,Amita Malik,Bheru Dan Charan
Nonbifurcating carotid is quite a rare anatomical variant of carotid anatomy. The embryology of carotid development is more intricate and convoluted than is presently known. This case report finds an unusual case of a nonbifurcating carotid artery whose embryological basis cannot be explained by popular prevalent theories. It also stresses about an abundance of case reports from East Asia on this topic
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Infarct in a new territory: Risk factors and outcomes: A comparative meta-analysis. Interv. Neuroradiol. (IF 1.7) Pub Date : 2023-10-19 Melika Amoukhteh,Amir Hassankhani,Payam Jannatdoust,Parya Valizadeh,Sherief Ghozy,David F Kallmes
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Artificial intelligence improves transfer times and ischemic stroke workflow metrics. Interv. Neuroradiol. (IF 1.7) Pub Date : 2023-10-17 Nicholas C Field,Pouya Entezami,Alan S Boulos,John Dalfino,Alexandra R Paul
INTRODUCTION Rapid initiation of mechanical thrombectomy (MT) for the treatment of large-vessel occlusion (LVO) critically improves patient outcomes. Artificial intelligence algorithms aid in the identification of LVOs and improve door to puncture times as well as patient transfer times. OBJECTIVES We aimed to determine whether the implementation of an LVO detection algorithm that provides immediate