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Journal of Neurointerventional Surgery

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https://www.readbyqxmd.com/read/28710086/onyx-embolization-prior-to-stereotactic-radiosurgery-for-brain-arteriovenous-malformations-a-single-center-treatment-algorithm
#1
John D Nerva, Jason Barber, Michael R Levitt, Jason K Rockhill, Danial K Hallam, Basavaraj V Ghodke, Laligam N Sekhar, Louis J Kim
BACKGROUND: Embolization before stereotactic radiosurgery (SRS) for brain arteriovenous malformations (BAVMs) is controversial. OBJECTIVE: To compare clinical and radiographic outcomes in patients undergoing pre-SRS embolization with ethylene copolymer (Onyx) with outcomes in patients undergoing SRS alone. METHODS: Seventy consecutive patients with BAVMs who underwent SRS were retrospectively reviewed. Univariate and multivariate analyses were performed to assess the factors associated with radiographic obliteration and complication...
July 14, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28710085/risk-factors-for-and-outcomes-of-intraprocedural-rupture-during-endovascular-treatment-of-unruptured-intracranial-aneurysms
#2
Shuhei Kawabata, Hirotoshi Imamura, Hidemitsu Adachi, Shoichi Tani, So Tokunaga, Takayuki Funatsu, Keita Suzuki, Nobuyuki Sakai
BACKGROUND AND PURPOSE: The risk factors for intraprocedural rupture (IPR) of unruptured intracranial aneurysms (UIAs) and the outcomes of IPR itself are unclear. This study was performed to identify the independent risk factors for and outcomes of IPR. MATERIALS AND METHODS: We retrospectively evaluated the medical records and radiologic data of 1375 patients (1406 UIAs) who underwent coil embolization from January 2001 to October 2016. RESULTS: IPR occurred in 20 aneurysms of 20 patients (1...
July 14, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28710084/neuroprotective-strategies-following-intraparenchymal-hemorrhage
#3
REVIEW
Robin Moshe Babadjouni, Ryan E Radwanski, Brian P Walcott, Arati Patel, Ramon Durazo, Drew M Hodis, Benjamin A Emanuel, William J Mack
Intracerebral hemorrhage and, more specifically, intraparenchymal hemorrhage, are devastating disease processes with poor clinical outcomes. Primary injury to the brain results from initial hematoma expansion while secondary hemorrhagic injury occurs from blood-derived products such as hemoglobin, heme, iron, and coagulation factors that overwhelm the brains natural defenses. Novel neuroprotective treatments have emerged that target primary and secondary mechanisms of injury. Nonetheless, translational application of neuroprotectants from preclinical to clinical studies has yet to show beneficial clinical outcomes...
July 14, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28710083/a-review-and-comparison-of-three-neuronavigation-systems-for-minimally-invasive-intracerebral-hemorrhage-evacuation
#4
REVIEW
Alexander G Chartrain, Christopher P Kellner, Kyle M Fargen, Alejandro M Spiotta, David A Chesler, David Fiorella, J Mocco
Advances in stereotactic navigation technology have helped to improve the ease, reliability, and workflow of neurosurgical intraoperative navigation. These advances have also allowed novel, minimally invasive neurosurgical techniques to emerge. Minimally invasive techniques for intracerebral hemorrhage (ICH) evacuation, including endoscopic evacuation and passive catheter drainage, are notable examples, and as these gain support in the literature and their use expands, stereotactic navigation will take on an increasingly important and central role...
July 14, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28710082/accuracy-and-precision-of-venous-pressure-measurements-of-endovascular-microcatheters-in-the-setting-of-dural-venous-sinus-stenosis
#5
Michael B Avery, Sheryl Sambrano, Javed Khader Eliyas, Muneer Eesa, Alim P Mitha
INTRODUCTION: Dural venous sinus stenosis (DVSS) may lead to increased intracranial pressure, sometimes requiring a stent if a high pressure gradient exists. Many neuroendovascular physicians use microcatheters to measure gradients, yet there are no studies comparing the accuracies and precisions of modern day microcatheters. We examined pressure recordings from five commonly used microcatheters in an experimental DVSS model. METHODS: Using a programmable pump, dynamic flow was established in a closed circuit mimicking the venous sinus waveform...
July 14, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28710081/use-of-a-next-generation-multi-durometer-long-guide-sheath-for-triaxial-access-in-flow-diversion-experience-in-95-consecutive-cases
#6
Li-Mei Lin, Matthew T Bender, Geoffrey P Colby, Narlin B Beaty, Bowen Jiang, Jessica K Campos, Judy Huang, Rafael J Tamargo, Alexander L Coon
BACKGROUND: Intracranial access techniques in modern neurointerventions have shifted towards more robust access platforms. The long guide sheath is one of the building blocks of triaxial systems used in intracranial embolizations. Here we present our experience with the AXS Infinity LS long sheath in the triaxial platform for the implantation of the Pipeline embolization device (PED). METHODS: We retrospectively identified patients who underwent PED Flex treatment with the AXS Infinity LS at a single institution...
July 14, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28705890/mechanical-thrombectomy-of-m1-and-m2-middle-cerebral-artery-occlusions
#7
Hisham Salahuddin, Guru Ramaiah, Diana E Slawski, Julie Shawver, Mark Buehler, Syed F Zaidi, Mouhammad Jumaa
BACKGROUND: Over half of patients who receive intravenous tissue plasminogen activator for middle cerebral artery division (MCA-M2) occlusion do not recanalize, leaving a large percentage of patients who may need mechanical thrombectomy (MT). However, the outcomes of MT for M2 occlusion have not been well characterized. OBJECTIVE: To determine if MT of M2 occlusion is as safe and efficacious as current standard-of-care MT for M1 occlusions. METHODS: With institutional review board approval, we retrospectively reviewed records of 212 patients undergoing MT for isolated MCA M1 or M2 occlusions during a 36-month period (Sept 2013 to Sept 2016) at two centres...
July 13, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28701298/carotid-stenting-for-unilateral-stenosis-can-increase-contralateral-hemispheric-cerebral-blood-flow
#8
Akiyo Sadato, Shingo Maeda, Motoharu Hayakawa, Kazuhide Adachi, Hiroshi Toyama, Ichiro Nakahara, Yuichi Hirose
BACKGROUND: The revascularization of carotid stenosis can increase ipsilateral cerebral blood flow (CBF). Occasionally, elevated CBF is also evident on the contralateral side, but this phenomenon is poorly understood. OBJECTIVE: To analyze retrospectively the relationship between a contralateral CBF increase and several clinical and radiologic features. MATERIALS AND METHODS: We retrospectively analyzed 40 patients with unilateral cervical carotid stenosis treated by carotid artery stenting (CAS)...
July 12, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28689184/evaluation-of-a-novel-liquid-embolic-agent-precipitating-hydrophobic-injectable-liquid-phil-in-an-animal-endovascular-embolization-model
#9
Dominik F Vollherbst, Ruth Otto, Andreas von Deimling, Johannes Pfaff, Christian Ulfert, Hans U Kauczor, Martin Bendszus, Christof M Sommer, Markus A Möhlenbruch
BACKGROUND: The choice of the embolic agent and the embolization technique can have a significant impact on the success of endovascular embolization. OBJECTIVE: To evaluate a novel iodinated copolymer-based liquid embolic agent (precipitating hydrophobic injectable liquid (PHIL)) in the porcine rete mirabile (RM), serving as an endovascular embolization model. Onyx, as an established liquid embolic agent, served as comparator. MATERIALS AND METHODS: Sixteen embolization procedures were performed using PHIL (n=8) or Onyx (n=8) as liquid embolic agent...
July 8, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28689183/acute-thrombus-formation-on-phosphorilcholine-surface-modified-flow-diverters
#10
Miklos Marosfoi, Frederic Clarencon, Erin T Langan, Robert M King, Olivia W Brooks, Takamisu Tamura, John M Wainwright, Matthew J Gounis, Srinivasan Vedantham, Ajit S Puri
PURPOSE: Thromboembolic complications remain a limitation of flow diverting stents. We hypothesize that phosphorilcholine surface modified flow diverters (Pipeline Flex with Shield Technology, sPED) would have less acute thrombus formation on the device surface compared with the classic Pipeline Embolization device (cPED). METHODS: Elastase-induced aneurysms were created in 40 rabbits and randomly assigned to receive cPED or sPED devices with and without dual antiplatelet therapy (DAPT) (four groups, n=10/group)...
July 8, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28663521/intra-arterial-vasodilators-for-vasospasm-following-aneurysmal-subarachnoid-hemorrhage-a-meta-analysis
#11
Anand Venkatraman, Ayaz M Khawaja, Sahil Gupta, Shalaka Hardas, John P Deveikis, Mark R Harrigan, Gyanendra Kumar
OBJECTIVE: The efficacy of intra-arterial vasodilators (IADs) for the treatment of vasospasm following aneurysmal subarachnoid hemorrhage (aSAH) remains debatable. The objective of this meta-analysis was to pool estimates of angiographic and neurological response, clinical outcome, and mortality following treatment of vasospasm with IADs. METHODS: We searched PubMed, Embase, Scopus, Clinicaltrials.gov, Cochrane database, and CINAHL in December 2015 and August 2016...
June 29, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28652299/timing-of-complications-during-and-after-elective-endovascular-intracranial-aneurysm-coiling
#12
Michelle Masayo Kameda-Smith, Paula Klurfan, Brian Anthony van Adel, Ramiro Larrazabal, Forough Farrokhyar, Michael Bennardo, Thorsteinn Gunnarsson
OBJECTIVE: To determine the time to complications during and after elective endovascular intracranial aneurysm coiling. METHODS: A retrospective chart review of patients undergoing elective endovascular aneurysm coiling between March 2006 and October 2013 in one large Eastern Canadian Neurointerventional Service was performed. Data regarding the incidence, time and type of complication related to the endovascular coiling procedure and clinical outcome at last follow-up were collected...
June 26, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28652298/a-patient-specific-intracranial-aneurysm-model-with-endothelial-lining-a-novel-in-vitro-approach-to-bridge-the-gap-between-biology-and-flow-dynamics
#13
Naoki Kaneko, Toshihiro Mashiko, Katsunari Namba, Satoshi Tateshima, Eiju Watanabe, Kensuke Kawai
OBJECTIVES: To develop an in vitro model for studying the biological effect of complex-flow stress on endothelial cells in three-dimensional (3D) patient-specific vascular geometry. MATERIALS AND METHODS: A vessel replica was fabricated with polydimethylsiloxanes using 3D printing technology from vascular image data acquired by rotational angiography. The vascular model was coated with fibronectin and immersed in a tube filled with a cell suspension of endothelium, and then cultured while being slowly rotated in three dimensions...
June 26, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28637822/pattern-of-pressure-gradient-alterations-after-venous-sinus-stenting-for-idiopathic-intracranial-hypertension-predicts-stent-adjacent-stenosis-a-proposed-classification-system
#14
Daniel Raper, Thomas J Buell, Dale Ding, Ching-Jen Chen, Robert M Starke, Kenneth C Liu
OBJECTIVE: Venous sinus stenting (VSS) is a safe and effective treatment for idiopathic intracranial hypertension (IIH) with angiographic venous sinus stenosis. However, predictors of stent-adjacent stenosis (SAS) remain poorly defined. METHODS: We performed a retrospective review of 47 patients with IIH and intracranial venous stenosis who underwent VSS with pre- and post-stent venography. Patient characteristics, treatments and outcomes were reviewed. Changes in pressure gradient after VSS were classified according to pattern of gradient resolution into types I-III...
June 21, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28637821/endovascular-management-of-aneurysms-associated-with-spinal-arteriovenous-malformations
#15
Sung Chul Jung, Yunsun Song, Su Hee Cho, Joonggoo Kim, Seung Yeon Noh, Sang Hun Lee, Jae Jon Sheen, Seung Chul Rhim, Sang Ryong Jeon, Dae Chul Suh
BACKGROUND: Spinal aneurysms are rare among spinal arteriovenous malformations (SAVMs). There are few reports of endovascular management of spinal aneurysms associated with SAVM. OBJECTIVE: To present endovascular management of aneurysms associated with SAVM. METHODS: Of 91 patients with SAVMs,eight (9%) presented with aneurysms. Of these, three were male and five were female with a median age of 18 years (range 11-38). We evaluated the presenting pattern, lesion level, type of the target aneurysm related to the presenting pattern and AVM nidus, and the result obtained after embolization or open surgery...
June 21, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28600483/extending-the-indications-for-transvenous-approach-embolization-for-superficial-brain-arteriovenous-malformations
#16
Dinark Conceição Viana, Luis Henrique de Castro-Afonso, Guilherme Seizem Nakiri, Lucas Moretti Monsignore, Felipe Padovani Trivelato, Benedicto Oscar Colli, Daniel Giansante Abud
INTRODUCTION: Transarterial embolization is the standard endovascular treatment strategy for intracranial arteriovenous malformations (AVMs). The transvenous approach has been indicated for the embolization of deep AVMs meeting a set of strict eligibility criteria. The present study aims to assess the safety and efficacy of the transvenous approach for superficial AVMs. METHODS: A retrospective series of 12 patients presenting with cortical AVMs were treated by endovascular embolization using a transvenous approach with a curative intent...
June 9, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28600482/a-multicenter-study-evaluating-the-frequency-and-time-requirement-of-mechanical-thrombectomy
#17
Taylor A Wilson, Thabele Leslie-Mazwi, Joshua A Hirsch, Casey Frey, Teddy E Kim, Alejandro M Spiotta, Reade de Leacy, J Mocco, Felipe C Albuquerque, Andrew F Ducruet, Ahmed Cheema, Adam Arthur, Visish M Srinivasan, Peter Kan, Maxim Mokin, Travis Dumont, Ansaar Rai, Jasmeet Singh, Stacey Q Wolfe, Kyle M Fargen
INTRODUCTION: There are few published data evaluating the incidence of mechanical thrombectomy among stroke centers or the times at which they occur. METHODS: A multicenter retrospective study was performed to identify all patients undergoing emergent thrombectomy for acute ischemic stroke during a 3-month period (June through August 2016). Consultations that did not undergo thrombectomy were not included. RESULTS: Ten institutions participated in the study...
June 9, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28600481/optimal-thresholds-for-ischemic-penumbra-predicted-by-computed-tomography-perfusion-in-patients-with-acute-ischemic-stroke-treated-with-mechanical-thrombectomy
#18
Katsuharu Kameda, Junji Uno, Ryosuke Otsuji, Nice Ren, Shintaro Nagaoka, Kazushi Maeda, Yoshiaki Ikai, Hidefuku Gi
BACKGROUND AND PURPOSE: Optimal thresholds for ischemic penumbra detected by CT perfusion (CTP) in patients with acute ischemic stroke (AIS) have not been elucidated. In this study we investigated optimal thresholds for salvageable ischemic penumbra and the risk of hemorrhagic transformation (HT). METHODS: A total of 156 consecutive patients with AIS treated with mechanical thrombectomy (MT) at our hospital were enrolled. Absolute (a) and relative (r) CTP parameters including cerebral blood flow (aCBF and rCBF), cerebral blood volume (aCBV and rCBV), and mean transit time (aMTT and rMTT) were evaluated for their value in detecting ischemic penumbra in each of seven arbitrary regions of interest defined by the major supplying blood vessel...
June 9, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28592484/analysis-of-neointima-development-in-flow-diverters-using-optical-coherence-tomography-imaging
#19
Yoshikazu Matsuda, Joonho Chung, Demetrius K Lopes
BACKGROUND: Flow diverters are used for the treatment of intracranial aneurysms. Surface modification may decrease the thrombogenicity of flow diverters but the details are unknown. Optical coherence tomography (OCT) is an intravascular imaging test with high resolution which identifies neointimal growth over stents. We compared the development of neointima in a flow diverter and stents with and without surface modification in a swine model. METHODS: In this study we implanted four devices (two in each carotid artery) in four pigs...
June 7, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28490608/expanding-the-use-of-flow-diverters-beyond-their-initial-indication-treatment-of-small-unruptured-aneurysms
#20
J M Pumar, A Mosqueira, H Cuellar, B Dieguez, L Guimaraens, J Masso, S Miralbes, M Blanco-Ulla, M Souto-Bayarri, F Vazquez-Herrero
BACKGROUND: Experience with the endovascular treatment of unruptured small intracranial aneurysms by flow diverter devices is still limited. OBJECTIVE: To assess the safety and efficacy of the SILK flow diverter (SFD) in the treatment of small unruptured cerebral aneurysms (<10 mm). METHODS: We performed a retrospective review of a prospectively maintained database of patients treated with a SFD between July 2008 and December 2013 at 4 institutions in Spain to identify all patients with small unruptured aneurysms (<10 mm)...
May 10, 2017: Journal of Neurointerventional Surgery
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