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Interventional Neuroradiology

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https://www.readbyqxmd.com/read/28604190/the-use-of-a-stent-retriever-to-cause-mechanical-dilatation-of-a-vasospasm-secondary-to-iatrogenic-subarachnoid-haemorrhage
#1
Pervinder Bhogal, Dimitris Paraskevopoulos, Hegoda Ld Makalanda
Objective To report the use of a stent-retriever in the management of vasospasm secondary to craniopharyngioma resection. Postoperative improvement was seen both clinically and on perfusion imaging. Methods A patient was admitted for resection of a large craniopharygioma. On day 6 postoperatively the patient had an acute hemiparesis. A computed tomography angiogram and perfusion scan demonstrated acute right-sided cerebral vasospasm and a perfusion defect in the territory of the middle cerebral artery (MCA)...
June 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28604189/utility-of-single-energy-and-dual-energy-computed-tomography-in-clot-characterization-an-in-vitro-study
#2
Waleed Brinjikji, Gregory Michalak, Ramanathan Kadirvel, Daying Dai, Michael Gilvarry, Sharon Duffy, David F Kallmes, Cynthia McCollough, Shuai Leng
Background and purpose Because computed tomography (CT) is the most commonly used imaging modality for the evaluation of acute ischemic stroke patients, developing CT-based techniques for improving clot characterization could prove useful. The purpose of this in-vitro study was to determine which single-energy or dual-energy CT techniques provided optimum discrimination between red blood cell (RBC) and fibrin-rich clots. Materials and methods Seven clot types with varying fibrin and RBC densities were made (90% RBC, 99% RBC, 63% RBC, 36% RBC, 18% RBC and 0% RBC with high and low fibrin density) and their composition was verified histologically...
June 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28604188/correlation-between-clot-density-and-recanalization-success-or-stroke-etiology-in-acute-ischemic-stroke-patients
#3
Manoj Jagani, David F Kallmes, Waleed Brinjikji
Background Predicting recanalization success for patients undergoing endovascular treatment for acute ischemic stroke is of significant interest. Studies have previously correlated the success of recanalization with the density of the clot. We evaluated clot density and its relationship to revascularization success and stroke etiology. Methods We conducted a retrospective review of 118 patients undergoing intra-arterial therapy for acute ischemic stroke. Mean and maximum thrombus density was measured by drawing a circular region of interest on an axial slice of a non-contrast computed tomography scan...
June 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28604187/in%C3%A2-vitro-digital-subtraction-angiographic-evaluation-of-flow-diverters-in-a-patient-specific-aneurysm
#4
Liang-Der Jou
Background The importance of both porosity and pore density of a flow diverter is well recognized in treatment of intracranial aneurysms; however, understanding of the effect of individual wire (wire number and size) is critical in improving device design and use. Methods A total of 10 multi-layered flow diverters with different wire numbers (32, 48, 56, and 72) and sizes (30, 35, and 40 µm) were implanted into identical patient-specific middle cerebral artery aneurysm models. Digital subtraction angiography was acquired at 30 f/s and X-ray signals at three selected regions of interest were compared to determine the amount of intra-aneurysmal flow...
June 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28604186/mechanical-removal-of-a-refluxed-onyx-piece-from-the-middle-cerebral-artery-using-the-solitaire-stent-technical-report
#5
Dilara Gungor, Şükrü Oğuz, Hasan Dinc
Onyx reflux into the parent artery is a rare and sometimes significant complication in the treatment of cerebral arteriovenous malformations (AVMs). We report a patient who presented with Onyx reflux into the M1 segment of the middle cerebral artery (MCA) during embolization of a right temporal AVM. The refluxed Onyx cast was successfully removed by a mechanical thrombectomy device using a self-expandable and fully retrievable Solitaire AB stent.
June 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28604185/cavernous-sinus-dural-arteriovenous-fistula-treated-by-facial-vein-direct-puncture-case-report-and-review-of-the-literature
#6
Atsushi Matsumoto, Masanobu Okauchi, Atsushi Shindo, Masahiko Kawanishi, Takashi Tamiya
Introduction In case of cavernous sinus dural arteriovenous fistula (CSDAVF), transvenous embolization (TVE) of the cavernous sinus (CS) via the inferior petrosal sinus (IPS) is generally performed. However, various approach routes have been reported when the accessibility of the IPS is challenging. We herein report a case of CSDAVF treated by TVE with direct puncture of the facial vein. Case report A 70-year-old woman who suffered from tinnitus, chemosis, diplopia and bruit was referred to our hospital. Digital subtraction angiography (DSA) demonstrated CSDAVF...
June 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28604184/obituary
#7
(no author information available yet)
No abstract text is available yet for this article.
June 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28604183/treatment-of-an-internal-carotid-artery-aneurysm-with-a-flow-diverter-through-a-double-lumen-balloon-catheter
#8
José M Amorim, Santiago Rosati, Ronit Agid, Vítor Mendes Pereira, Timo Krings
Background Double lumen balloon catheters (DLBCs) are currently used in the treatment of intracranial aneurysms, especially when involving balloon or stent-assisted coiling. The existing DLBCs allow the delivery of self-expandable stents but do not offer the possibility to deploy flow-diverters. Despite the increasing use and success of flow-diverters, there have been numerous reports of procedural complications such as early in-stent thrombosis or delayed distal embolization. It seems that these complications can be avoided by correct stent positioning and adequate wall apposition, achieved either by manoeuvres with the microguidewire and/or microcatheter or by performing balloon angioplasty following an exchange guidewire manoeuvre...
June 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304208/issues-with-vertebral-artery-dissections
#9
Marc A Bronson, Stephen M Perle, Peter Tuchin
No abstract text is available yet for this article.
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304207/dural-venous-sinus-stenting-for-medically-and-surgically-refractory-idiopathic-intracranial-hypertension
#10
Sudhakar R Satti, Lakshmi Leishangthem, Alejandro Spiotta, M Imran Chaudry
Background Idiopathic intracranial hypertension (IIH) is a syndrome defined by elevated intracranial hypertension without radiographic evidence of a mass lesion in the brain. Dural venous sinus stenosis has been increasingly recognized as a treatable cause, and dural venous sinus stenting (DVSS) is increasingly performed. Methods A 5 year single-center retrospective analysis of consecutive patients undergoing DVSS for medically refractory IIH. Results There were 43 patients with a mean imaging follow-up of 6...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304206/restenosis-after-stenting-in-symptomatic-vertebral-arterial-orifice-disease-and-considerations-for-better-outcome
#11
Jun Young Chang, Hyun Park, Oki Kwon, Moon-Ku Han
We have performed stenting in 11 patients with symptomatic vertebral arterial orifice stenosis refractory to medical treatment or impairment in anterior circulation. Three of the 11 patients experienced asymptomatic severe in-stent restenosis or occlusion. Bare metal stents were used in those three patients, two of whom received revascularization therapy. Development of sufficient cervical collateral channels reconstituting the distal vertebral artery was the common feature in patients with asymptomatic in-stent restenosis...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304205/stenting-of-the-cervical-internal-carotid-artery-in-acute-stroke-management-the-karolinska-experience
#12
Anastasios Mpotsaris, Christoph Kabbasch, Jan Borggrefe, Vamsi Gontu, Michael Soderman
Background Emergency stent placement in the extracranial internal carotid artery in combination with anterior circulation thrombectomy is a routine procedure. Yet, precise indications and clinical safety in this setting remains controversial. Present data for mechanical thrombectomy include few studies with acute stenting of tandem occlusions. We evaluated the feasibility, safety and clinical outcome of this endovascular treatment in a retrospective analysis of all consecutive cases at a comprehensive stroke centre...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304204/changes-in-contrast-transit-times-on-digital-subtraction-angiography-post-pipeline-embolization-device-deployment
#13
Ahmed E Hussein, Andreas Linninger, Sophia F Shakur, Fady T Charbel, Chih-Yang Hsu, Fady T Charbel, Ali Alaraj
It is postulated that hemodynamic changes occur in the distal vascular bed post-deployment of Pipeline Embolization Devices (PEDs). In this paper, we evaluate changes in the contrast transit times (TTs) on digital subtraction angiography (DSA) post-PED interventions. DSA films were analyzed using custom-made software for the time-density relationship at baseline and compared to post-PED deployment. All analyses were performed within the middle cerebral artery (MCA) M1 segment. Analyses included TT10%-100% (time needed for the contrast to change from 10% image intensity to 100%), TT100%-10%, and TT25%-25%...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304203/manual-aspiration-thrombectomy-using-a-penumbra-catheter-in-patients-with-acute-migrated-mca-occlusion
#14
Sung Hyun Baik, Hyo Sung Kwak, Seung Bae Hwang, Gyung Ho Chung
Background We retrospectively assessed the efficacy and safety of manual aspiration thrombectomy (MAT) using a Penumbra catheter in patients with acute migrated middle cerebral artery (MCA) occlusion. Methods We conducted a retrospective review of patients who underwent MAT using Penumbra 4 or 5 MAX reperfusion catheters for the treatment of acute MCA occlusion between January 2012 and December 2015. A migrated thrombus was defined as distal migration greater than ≥1 cm on initial cerebral angiography compared with preprocedural angiographic findings...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304201/evaluation-of-the-characteristics-of-various-types-of-finishing-coils-for-the-embolization-of-intracranial-aneurysms-in-an-experimental-model-with-radiolucent-coils
#15
Keisuke Ota, Noriaki Matsubara, Shigeru Miyachi, Takashi Izumi, Masashi Ito, Takumi Asai, Takashi Yamanouchi, Toshihiko Wakabayashi
In endovascular coil embolization of intracranial aneurysms, very soft coils, often called "finishing coils," are usually selected in the final stage of coil embolization. The authors developed a radiolucent coil made of thin nylon thread to evaluate the performance of coils under a situation simulating the course of embolization. The characteristics of various types of finishing coils were investigated using radiolucent coils. Experimental embolization was performed with a silicone aneurysm filled with radiolucent coils simulating the final stage of embolization...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304200/advance-an-effective-and-feasible-technique-in-acute-stroke-treatment
#16
Erdem Gurkas, Cetin Kursad Akpinar, Emrah Aytac
Background and purpose Different techniques regarding efficient utilization of thrombectomy devices have been reported. Here, we described a novel technique named ADVANCE that is based on advancing a distal access catheter over the stent retriever. In this study, we aimed to report our initial results with this novel thrombectomy technique. Methods and results Sixty-seven consecutive acute anterior circulation ischemic stroke patients (35 male, 32 female) between January 2015 and January 2016 who were treated by mechanical thrombectomy were included in this prospective study...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304199/jailed-double-microcatheter-technique-following-horizontal-stenting-for-coil-embolization-of-intracranial-wide-necked-bifurcation-aneurysms-a-technical-report-of-two-cases
#17
Takahiro Kitahara, Taketo Hatano, Makoto Hayase, Etsuko Hattori, Akinori Miyakoshi, Takehiko Nakamura
The horizontal stenting technique facilitates endovascular treatment of wide-necked bifurcation intracranial aneurysms. Previous literature shows, however, that subsequent coil embolization at initial treatment results in incomplete obliteration in many cases. The authors present two consecutive cases of wide-necked large bifurcation aneurysms to describe an additional coil embolization technique following horizontal stenting. The patients were a 53-year-old female with an unruptured internal carotid artery terminus aneurysm and a 57-year-old female with a recurrent basilar artery tip aneurysm...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304198/extracranial-vertebral-artery-rupture-likely-secondary-to-cupping-therapy-superimposed-on-spontaneous-dissection
#18
Jae Young Choi, Jae Il Lee
No abstract text is available yet for this article.
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28304197/endovascular-treatment-of-a-dural-arteriovenous-fistula-in-a-patient-with-loeys-dietz-syndrome-a-case-report
#19
Rie Aoki, Kittipong Srivatanakul, Takahiro Osada, Kazuko Hotta, Takatoshi Sorimachi, Mitsunori Matsumae, Hiroko Morisaki
Background Loeys-Dietz syndrome (LDS) is a recently recognized autosomal dominant connective tissue disease. The manifestations of LDS include vascular tortuosity, scoliosis, craniosynostosis, aneurysm and aortic dissections. Clinical presentation A 35-year-old woman treated with Stanford type B aortic dissection and breast cancer was referred to us for Borden type II dural arteriovenous fistula (dAVF) draining to the vein of Galen, involving the midline of tentorium cerebelli. The dAVF was treated successfully by combined transarterial and transvenous embolization...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28156167/gamma-knife-radiosurgery-for-the-treatment-of-intracranial-dural-arteriovenous-fistulas
#20
Adam A Dmytriw, Michael L Schwartz, Michael D Cusimano, Vitor Mendes Pereira, Timo Krings, Michael Tymianski, Ivan Radovanovic, Ronit Agid
Background Intracranial dural arteriovenous fistulae (DAVF) may present a treatment challenge. Endovascular embolization is in most cases the first line of treatment but does not always achieve cure. Gamma Knife (GK) radiosurgery represents an alternative treatment option, and the purpose of this study was to further evaluate its utility. Methods We reviewed all cases of DAVF treated between 2009 and 2016 at our institution with GK radiosurgery independently, or following failed/refused endovascular or surgical management...
April 2017: Interventional Neuroradiology
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