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Journal of Neurointerventional Surgery

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https://www.readbyqxmd.com/read/29331948/lvis-blue-as-a-low-porosity-stent-and-coil-adjuvant
#1
Matthew J Koch, Christopher J Stapleton, Scott B Raymond, Susan Williams, Thabele M Leslie-Mazwi, James David Rabinov, Aman B Patel
INTRODUCTION: The LVIS Blue is an FDA-approved stent with 28% metallic coverage that is indicated for use in conjunction with coil embolization for the treatment of intracranial aneurysms. Given a porosity similar to approved flow diverters and higher than currently available intracranial stents, we sought to evaluate the effectiveness of this device for the treatment of intracranial aneurysms. METHODS: We performed an observational single-center study to evaluate initial occlusion and occlusion at 6-month follow-up for patients treated with the LVIS Blue in conjunction with coil embolization at our institution using the modified Raymond-Roy classification (mRRC), where mRRC 1 indicates complete embolization, mRRC 2 persistent opacification of the aneurysm neck, mRRC 3a filling of the aneurysm dome within coil interstices, and mRRC 3b filling of the aneurysm dome...
January 13, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29326380/neuroendovascular-management-of-emergent-large-vessel-occlusion-update-on-the-technical-aspects-and-standards-of-practice-by-the-standards-and-guidelines-committee-of-the-society-of-neurointerventional-surgery
#2
Chirag D Gandhi, Fawaz Al Mufti, I Paul Singh, Todd Abruzzo, Barbara Albani, Sameer A Ansari, Adam S Arthur, Mark Bain, Blaise W Baxter, Ketan R Bulsara, Justin M Caplan, Michael Chen, Guilherme Dabus, Don Frei, Steven W Hetts, M Shazam Hussain, Mahesh V Jayaraman, Yasha Kayan, Richard P Klucznik, Seon-Kyu Lee, William J Mack, Thabele Leslie-Mazwi, Ryan A McTaggart, Philip M Meyers, Maxim Mokin, Athos T Patsalides, Charles J Prestigiacomo, G Lee Pride, Robert M Starke, Peter J Sunenshine, Justin F Fraser
No abstract text is available yet for this article.
January 11, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29326379/blood-pressure-levels-post-mechanical-thrombectomy-and-outcomes-in-non-recanalized-large-vessel-occlusion-patients
#3
Nitin Goyal, Georgios Tsivgoulis, Abhi Pandhi, Kira Dillard, Diana Alsbrook, Jason J Chang, Balaji Krishnaiah, Christopher Nickele, Daniel Hoit, Khalid Alsherbini, Andrei V Alexandrov, Adam S Arthur, Lucas Elijovich
OBJECTIVE: Permissive hypertension may benefit patients with non-recanalized large vessel occlusion (nrLVO) post mechanical thrombectomy (MT) by maintaining brain perfusion. Data evaluating the impact of post-MT blood pressure (BP) levels on outcomes in nrLVO patients are scarce. We investigated the association of the post-MT BP course with safety and efficacy outcomes in nrLVO. METHODS: Hourly systolic BP (SBP) and diastolic BP (DBP) values were prospectively recorded for 24 hours following MT in consecutive nrLVO patients...
January 11, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29326378/the-casper-stent-system-for-carotid-artery-stenosis
#4
Sebastian J Mutzenbach, Katharina Millesi, Cornelia Roesler, Erasmia Broussalis, Slaven Pikija, Johann Sellner, Lukas Machegger, Christoph J Griessenauer, Monika Killer-Oberpfalzer
PURPOSE: To report the results of a retrospective analysis of prospectively collected data evaluating the safety and efficacy of a double layer stent engineered for carotid artery occlusive disease. METHODS: Between January 2014 and February 2017, 138 patients (25.4% women; median age 71 years) underwent Casper stent implantation for carotid artery stenosis. Eligibility criteria included stenosis >70% of vessel diameter (or >50% diameter with ulceration) in symptomatic patients or asymptomatic patients with >80% stenosis at the carotid bifurcation or in the proximal internal carotid artery...
January 11, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29326377/lymphatic-malformation-with-acquired-horner-syndrome-in-an-infant
#5
Birgit Spors, Joerg Seemann, Natalie Homer, Aaron Fay
An infant presented with right upper eyelid ptosis and was subsequently diagnosed with acquired Horner syndrome. Further evaluation revealed a right-sided cervicothoracic lymphatic malformation. At 13 weeks of age, the child underwent percutaneous intracystic sclerotherapy with a mixture of sodium tetradecyl sulphate and ethanol. Twenty-one weeks after initial treatment, ophthalmic examination showed complete resolution of the blepharoptosis and pupillary miosis. Percutaneous sclerotherapy not only effectively treated the space-occupying lymphatic malformation but also reversed the Horner syndrome that was presumably induced by neural tension (more likely) or compression...
January 11, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29317468/radiation-exposure-and-procedure-and-fluoroscopy-times-in-endovascular-treatment-of-intracranial-aneurysms-a-methodological-comparison
#6
Nicholas K Cheung, Michelle Boutchard, Michael W Carr, Jens J Froelich
BACKGROUND: Limited data are available for radiation exposure, and procedure and fluoroscopy times in neuroendovascular treatment (NET) strategies. OBJECTIVE: This study establishes and compares related parameters between coil embolization (COIL), balloon assisted coil embolization (BAC), stent assisted coil embolization (SAC), and flow diverting technology (FDT) in NET of intracranial aneurysms. MATERIALS AND METHODS: Between 2010 and 2017, 249 consecutive intracranial aneurysms underwent NET at a single center, all performed by the same operator...
January 9, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29311120/transradial-cerebral-angiography-techniques-and-outcomes
#7
Brian M Snelling, Samir Sur, Sumedh S Shah, Priyank Khandelwal, Justin Caplan, Rianna Haniff, Robert M Starke, Dileep R Yavagal, Eric C Peterson
BACKGROUND: Despite several retrospective studies analyzing the safety and efficacy of transradial access (TRA) versus transfemoral access (TFA) for cerebral angiography, this transition for neurointerventional procedures has been gradual. Nonetheless, based on our positive initial institutional experience with TRA for mechanical thrombectomy in acute ischemic stroke patients, we have started transitioning more of our cerebral angiography cases to TRA. Here we present our single institution experience...
January 8, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29298860/pre-hospital-detection-of-acute-ischemic-stroke-secondary-to-emergent-large-vessel-occlusion-lessons-learned-from-electrocardiogram-and-acute-myocardial-infarction
#8
REVIEW
Alexander G Chartrain, Christopher Paul Kellner, J Mocco
Currently, there is no device capable of detecting acute ischemic stroke (AIS) secondary to emergent large vessel occlusion (ELVO) in the pre-hospital setting. The inability to reliably identify patients that would benefit from primary treatment with endovascular thrombectomy remains an important limitation to optimizing emergency medical services (EMS) triage models and time-to-treatment. Several clinical grading scales that rely solely on clinical examination have been proposed and have demonstrated only moderate predictive ability for ELVO...
January 3, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29298859/fast-acquisition-cone-beam-computed-tomography-initial-experience-with-a-10-s-protocol
#9
Visish M Srinivasan, Gouthami Chintalapani, Kevin Matthew Camstra, Sabih T Effendi, Jacob Cherian, Jeremiah N Johnson, Stephen R Chen, Peter Kan
BACKGROUND: Cone-beam computed tomography (CBCT) facilitates the acquisition of cross-sectional imaging in angiography suites using a rotational C-arm and digital flat panel detectors. The applications are numerous, including evaluation of implanted devices and localization of cerebrovascular lesions. We present and validate the clinical utility of an alternative fast CBCT acquisition protocol in the context of neurovascular device imaging. METHODS: Contrast-enhanced (CE)-CBCT images were acquired using a new 10 s protocol in a phantom head model, swine model, and in patients...
January 3, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29298858/in-vitro-measurement-of-the-permeability-of-endovascular-coils-deployed-in-cerebral-aneurysms
#10
Chander Sadasivan, Erica Swartwout, Ari D Kappel, Henry H Woo, David J Fiorella, Barry B Lieber
BACKGROUND AND PURPOSE: Aneurysm recurrence is the primary limitation of endovascular coiling treatment for cerebral aneurysms. Coiling is currently quantified by a volumetric porosity measure called packing density (pd). Blood flow through a coil mass depends on the permeability of the coil mass, and not just its pd. The permeability of coil masses has not yet been quantified. Here we measure coil permeability with a traditional falling-head permeameter modified to incorporate idealized aneurysms...
January 3, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29288193/assessment-of-endothelialization-of-aneurysm-wall-over-time-in-a-rabbit-model-through-cd31-scoring
#11
Praveen Kolumam Parameswaran, Daying Dai, Yong-Hong Ding, Tina Gunderson, David F Kallmes, Kadirvel Ramanathan
BACKGROUND: Intracranial aneurysms represent a significant health concern and are poorly understood despite decades of research. Our study focused on understanding temporal patterns of endothelial cell distribution in different spatial locations within the aneurysm early after creation in a rabbit model. METHODS: Elastase induced saccular aneurysms were created in rabbits and harvested on day 1 (n=3) and after 2 (n=5), 4 (n=4), 8 (n=5), and 12 (n=6) weeks. Sham operated controls (n=3) were harvested on the same day...
December 29, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29288194/increased-middle-cerebral-artery-mean-blood-flow-velocity-index-after-stroke-thrombectomy-indicates-increased-risk-for-intracranial-hemorrhage
#12
Markus Kneihsl, Kurt Niederkorn, Hannes Deutschmann, Christian Enzinger, Birgit Poltrum, Renate Fischer, Daniela Thaler, Christina Hermetter, Gerit Wünsch, Franz Fazekas, Thomas Gattringer
BACKGROUND AND PURPOSE: Cerebral hyperperfusion has been related to the risk of intracranial hemorrhage (ICH) in stroke patients after vessel recanalization therapy. We hypothesized that after successful mechanical thrombectomy for acute anterior circulation stroke, hemodynamics detectable by transcranial Duplex (TCD) sonography would vary, and that increased blood flow velocities would be associated with ICH. METHODS: We retrospectively identified all ischemic stroke patients with successful endovascular recanalization for anterior circulation vessel occlusion (Thrombolysis in Cerebral Infarction 2b-3) between 2010 and 2017...
December 28, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29275325/mechanical-thrombectomy-in-orally-anticoagulated-patients-with-acute-ischemic-stroke
#13
Gustavo Zapata-Wainberg, Álvaro Ximénez-Carrillo, Santiago Trillo, Blanca Fuentes, Antonio Cruz-Culebras, Clara Aguirre, María Alonso de Leciñana, Rocío Vera, Eduardo Bárcena, Andrés Fernández-Prieto, José Carlos Méndez-Cendón, Jose Luis Caniego, Exuperio Díez-Tejedor, Jaime Masjuan, José Vivancos
BACKGROUND AND PURPOSE: To investigate the efficacy and safety of mechanical thrombectomy in patients with acute ischemic stroke according to the oral anticoagulation medication taken at the time of stroke onset. MATERIALS AND METHODS: A retrospective multicenter study of prospectively collected data based on data from the registry the Madrid Stroke Network was performed. We included consecutive patients with acute ischemic stroke treated with mechanical thrombectomy and compared the frequency of intracranial hemorrhage and the modified Rankin Scale (mRS) score at 3 months according to anticoagulation status...
December 23, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29273647/assessment-of-human-placenta-as-an-ex-vivo-vascular-model-for-testing-of-liquid-embolic-agent-injections-with-adjunctive-techniques
#14
Hideo Okada, Joonho Chung, Daniel M Heiferman, Demetrius K Lopes
PURPOSE: This project sought to test the utility of post-delivery human placenta (HP) as a vascular model for liquid embolic agent (LEA) simulation, along with adjunctive techniques. MATERIALS AND METHODS: Twelve LEA injections were performed under fluoroscopy in HP with two reflux control methods: dual lumen 'mini' balloon-catheter (n=9); and injection after proximal nBCA plug formation through a second microcatheter ('pressure cooker') (n=3). Measured outcomes included liquid embolic agent (LEA) advancement and reflux...
December 22, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29259124/referral-facility-ct-perfusion-prior-to-inter-facility-transfer-in-patients-undergoing-mechanical-thrombectomy
#15
Amin Aghaebrahim, Eric Sauvageau, Pedro Aguilar-Salinas, Gustavo Cortez, Roberta Santos, Ricardo A Hanel
BACKGROUND AND PURPOSE: The use of CT perfusion (CTP) imaging at a referring hospital is feasible and may shorten the door to puncture time for patients with acute ischemic stroke. METHODS: We conducted a single center retrospective review of a prospectively maintained database of consecutive ischemic stroke patients transferred to our center for consideration of endovascular therapy. Patients were divided into two groups. Group 1 consisted of patients transferred from facilities where CTP (using automated RAPID software) was routinely performed and group 2 consisted of patients transferred from facilities that did not perform perfusion imaging...
December 19, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29259123/antiplatelet-pretreatment-and-outcomes-following-mechanical-thrombectomy-for-emergent-large-vessel-occlusion-strokes
#16
Abhi Pandhi, Georgios Tsivgoulis, Rashi Krishnan, Muhammad F Ishfaq, Savdeep Singh, Daniel Hoit, Adam S Arthur, Christopher Nickele, Andrei Alexandrov, Lucas Elijovich, Nitin Goyal
BACKGROUND: Few data are available regarding the safety and efficacy of antiplatelet (APT) pretreatment in acute ischemic stroke (AIS) patients with emergent large vessel occlusions (ELVO) treated with mechanical thrombectomy (MT). We sought to evaluate the association of APT pretreatment with safety and efficacy outcomes following MT for ELVO. METHODS: Consecutive ELVO patients treated with MT during a 4-year period in a tertiary stroke center were evaluated. The following outcomes were documented using standard definitions: symptomatic intracranial hemorrhage (sICH), successful recanalization (SR; modified TICI score 2b/3), mortality, and functional independence (modified Rankin Scale scores of 0-2)...
December 19, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29259122/hemodynamics-and-coil-distribution-with-changing-coil-stiffness-and-length-in-intracranial-aneurysms
#17
Soichiro Fujimura, Hiroyuki Takao, Takashi Suzuki, Chihebeddine Dahmani, Toshihiro Ishibashi, Hiroya Mamori, Makoto Yamamoto, Yuichi Murayama
PURPOSE: The purpose of this study was to investigate hemodynamics and coil distribution with changing coil stiffness and length using the finite element method (FEM) and computational fluid dynamics (CFD) analysis. METHODS: Basic side-wall and bifurcation type aneurysm models were used. Six types of coil models were generated by changing the coil stiffness and length, based on commercially available embolic coils. Coil embolization was simulated using FEM. CFD was performed to characterize the hemodynamics in the aneurysms after embolization...
December 19, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29246908/long-term-follow-up-of-aneurysms-treated-electively-with-woven-stent-assisted-coiling
#18
Nicholas Kiu Cheung, Albert Hy Chiu, Andrew K Cheung, Jason David Wenderoth
BACKGROUND: Preliminary short-term results for stent-assisted coil embolization (SACE) using woven/braided stents have been promising. However, evidence supporting mid- to long-term efficacy and durability is lacking. OBJECTIVE: To report the long-term results for the durability of elective intracranial aneurysms treated with woven stents. MATERIALS AND METHODS: Between May 2012 and May 2015, 98 consecutive patients with 103 aneurysms underwent elective woven SACE across three Australian neurovascular centres...
December 15, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29246907/a-new-combined-parameter-predicts-re-treatment-for-coil-embolized-aneurysms-a-computational-fluid-dynamics-multivariable-analysis-study
#19
Soichiro Fujimura, Hiroyuki Takao, Takashi Suzuki, Chihebeddine Dahmani, Toshihiro Ishibashi, Hiroya Mamori, Makoto Yamamoto, Yuichi Murayama
PURPOSE: Coil embolization is a minimally invasive method used to treat cerebral aneurysms. Although this endovascular treatment has a high success rate, aneurysmal re-treatment due to recanalization remains a major problem of this method. The purpose of this study was to determine a combined parameter that can be useful for predicting aneurysmal re-treatment due to recanalization. METHODS: Patient-specific geometries were used to retrospectively analyze the blood flow for 26 re-treated and 74 non-retreated aneurysms...
December 15, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29246906/comparison-of-the-efficacy-and-safety-of-thrombectomy-devices-in-acute-stroke-a-network-meta-analysis-of-randomized-trials
#20
Hamidreza Saber, Gary B Rajah, Riyad Y Kherallah, Ashutosh P Jadhav, Sandra Narayanan
INTRODUCTION: Mechanical thrombectomy (MT) is increasingly used for large-vessel occlusions (LVO), but randomized clinical trial (RCT) level data with regard to differences in clinical outcomes of MT devices are limited. We conducted a network meta-analysis (NMA) that enables comparison of modern MT devices (Trevo, Solitaire, Aspiration) and strategies (stent retriever vs aspiration) across trials. METHODS: Relevant RCTs were identified by a systematic review. The efficacy outcome was 90-day functional independence (modified Rankin Scale (mRS) score 0-2)...
December 15, 2017: Journal of Neurointerventional Surgery
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