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Journal of Neurointerventional Surgery

Alexander G Chartrain, Hazem Shoirah, Edward C Jauch, J Mocco
Endovascular thrombectomy (EVT) is now the standard of care for eligible patients with acute ischemic stroke (AIS) secondary to emergent large vessel occlusion (ELVO). However, there remains uncertainty in how hospital systems can most efficiently route patients with suspected ELVO for EVT treatment. Given the relative geographic distribution of centers with and without endovascular capabilities, the value of prehospital triage directly to centers with the ability to provide EVT remains debated. While there are no randomized trial data available to date, there is substantial evidence in the literature that may offer guidance on the subject...
July 12, 2018: Journal of Neurointerventional Surgery
Brian M Howard, Jason M Frerich, Thomas P Madaelil, Jacques E Dion, Frank C Tong, C Michael Cawley, Jonathan A Grossberg
BACKGROUND: Aneurysmal subarachnoid hemorrhage is a potentially devastating condition, and among the first priorities of treatment is aneurysm occlusion to prevent re-hemorrhage. An emerging strategy to treat patients whose aneurysms are not ideal for surgical or endovascular treatment is subtotal coiling followed by flow diversion in the recovery phase or 'plug and pipe'. However, data regarding the safety and efficacy of this strategy are lacking. METHODS: A retrospective cohort study was performed to evaluate the efficacy and safety of 'plug and pipe'...
July 7, 2018: Journal of Neurointerventional Surgery
Lauren Parks Golding, Gregory N Nicola, Sameer A Ansari, Andrew B Rosenkrantz, Ezequiel Silva Iii, Laxmaiah Manchikanti, Joshua A Hirsch
The Medicare and CHIP Reauthorization Act of 2015 remains the payment policy law of the land. 2017 was the first year in which performance reporting will tangibly impact future physician payments. The Centers for Medicare & Medicaid Services (CMS) considers 2017 and 2018 transitional years before full implementation in 2019. As such, 2018 increases the reporting requirements over 2017 in the form of a gradual phase-in while introducing several key changes and new elements. Indeed, it is the nature of the transition itself that led to the somewhat unique title of this manuscript, i...
July 4, 2018: Journal of Neurointerventional Surgery
Ashutosh P Jadhav, Shashvat M Desai, Joshua A Hirsch
No abstract text is available yet for this article.
July 4, 2018: Journal of Neurointerventional Surgery
Yonggang Hao, Wenhua Liu, Huaiming Wang, Wenjie Zi, Dong Yang, Wei Wang, Xiguang Tian, Fuqiang Guo, Ping Jin, Yunyun Xiong, Xinfeng Liu, Gelin Xu
OBJECTIVE: Asymptomatic intracranial hemorrhage (aSICH) is a common phenomenon after endovascular treatment of acute ischemic stroke, but its prognostic impacts remain unclear. This study evaluated functional outcomes of thrombectomy in patients with and without aSICH. METHODS: Patients with acute ischemic stroke due to large artery occlusion in the anterior circulation who were treated with thrombectomy were enrolled in 21 centers. According to CT scans performed within 72 hours of endovascular procedures, patients with aSICH or without intracranial hemorrhage were included while patients with symptomatic intracranial hemorrhage (SICH) were excluded...
July 3, 2018: Journal of Neurointerventional Surgery
Ruben Mühl-Benninghaus, Alena Haußmann, Andreas Simgen, Toshiki Tomori, Wolfgang Reith, Umut Yilmaz
BACKGROUND AND PURPOSE: In recent years, implantation of flow diverters has emerged as an option for the endovascular treatment of intracranial aneurysms. One complication of treatment with flow diverters is the occurrence of in-stent stenosis, which has been reported to be partially reversible. The purpose of our study was to assess the incidence and dynamics of in-stent stenosis on angiographic short term and long term follow-up after treatment with flow diverters. METHODS: A retrospective review of our prospectively maintained database identified all patients with intracranial internal carotid artery (ICA) aneurysms treated by flow diverters at our institution between 2014 and 2017...
July 3, 2018: Journal of Neurointerventional Surgery
Adrien Collin, Marc-Antoine Labeyrie, Stephanie Lenck, Akli Zetchi, Armand Aymard, Jean-Pierre Saint-Maurice, Vittorio Civelli, Emmanuel Houdart
OBJECTIVE: To determine long term safety and efficacy of endovascular treatment of spinal cord arteriovenous malformations (AVMs), with calibrated particle embolization as a firstline approach. METHODS: We reviewed clinical and imaging data of consecutive patients who underwent endovascular treatment for both nidal and fistulous type spinal cord AVMs in our center, from 1990 to 2015. Outcome at the last follow-up was assessed by an independent observer. RESULTS: Embolization of spinal cord AVMs was performed in 61 patients, including 46 (75%) with particles (exclusively in 29 patients), 30 (49%) with cyanoacrylate, and 6 (10%) with combined surgical treatments...
July 3, 2018: Journal of Neurointerventional Surgery
Minerva H Zhou, Akash P Kansagra
OBJECTIVE: To compare performance of routing paradigms for patients with acute ischemic stroke using clinical outcomes. METHODS: We simulated different routing paradigms in a system comprising one primary stroke center (PSC) and onecomprehensive stroke center (CSC), separated by distances representative of urban, suburban, and rural environments. In the Nearest Center paradigm, patients are initially sent to the nearest center, while in CSC First, patients are sent to the CSC...
July 3, 2018: Journal of Neurointerventional Surgery
Josser E Delgado Almandoz, Yasha Kayan, Adam N Wallace, Ronald M Tarrel, Jennifer L Fease, Jill Marie Scholz, Anna M Milner, Pezhman Roohani, Maximilian Mulder, Mark L Young
PURPOSE: To report the efficacy of A Direct Aspiration first-Pass Thrombectomy (ADAPT) technique with larger-bore ACE aspiration catheters as first-line treatment for anterior circulation emergent large vessel occlusions (ELVOs), and assess for the presence of a first-pass effect with ADAPT. METHODS: We retrospectively reviewed 152 consecutive patients with anterior circulation ELVOs treated with the ADAPT technique as first-line treatment using ACE60, 64, or 68 at our institution...
July 3, 2018: Journal of Neurointerventional Surgery
Won Kyung Lee, Chang Wan Oh, Heeyoung Lee, Kun Sei Lee, Hyeonseon Park
BACKGROUND: Despite increasing usage of endovascular treatments for intracranial aneurysms, few research studies have been conducted on the incidence of unruptured aneurysm (UA) and subarachnoid hemorrhage (SAH), and could not show a decrease in the incidence of SAH. Moreover, research on socioeconomic disparities with respect to the diagnosis and treatment of UA and SAH is lacking. METHOD: Trends in the incidences of newly detected UA and SAH and trends in the treatment modalities used were assessed from 2005 to 2015 using the nationwide database of the Korean National Health Insurance Service in South Korea...
June 22, 2018: Journal of Neurointerventional Surgery
Qiang Zhang, Hao Zhao, Qi Sun, Jingfeng Han, Hao Zhang, Tonghui Shan, Wenlong Pan, Chuanqi Gu, Ruxiang Xu, Gengsheng Mao
PURPOSE: Three-dimensional (3D) scans with flat detector angiographic systems are widely used for neurointerventions by providing detailed vascular information. However, its associated radiation dose and streak metal artifact generated by implanted treatment devices remain issues. This work evaluates the feasibility and clinical value of volume of interest imaging combined with metal artifact reduction (VOI+MAR) to generate high quality 3D images with reduced radiation dose and metal artifacts...
June 22, 2018: Journal of Neurointerventional Surgery
Perry P Ng, Theodore C Larson, Christopher W Nichols, Mark M Murray, Karen L Salzman, Richard H Smith
BACKGROUND: Stent retriever thrombectomy (SRT) in acute thromboembolic stroke can result in post-thrombectomy subarachnoid hemorrhage (PTSAH). Intraprocedural findings associated with PTSAH are not well defined. OBJECTIVE: To identify angiographic findings and procedural factors during SRT that are associated with PTSAH. MATERIALS AND METHODS: This was a retrospective, observational cohort study of consecutive patients with middle cerebral artery (MCA) acute ischemic stroke treated with SRT...
June 21, 2018: Journal of Neurointerventional Surgery
Erasmia Broussalis, Christoph Griessenauer, Sebastian Mutzenbach, Slaven Pikija, Hendrik Jansen, Valdo Stevanovic, Monika Killer-Oberpfalzer
INTRODUCTION: Despite various measures to protect against distal embolization during carotid artery stenting (CAS), periprocedural ischemic lesions are still encountered. OBJECTIVE: To evaluate the periprocedural cerebral diffusion weighted imaging (DWI) lesion burden after CASPER stent placement. METHODS: Patients who underwent CAS using the CASPER stent system were reviewed. Degrees of carotid stenosis and plaque configuration were determined...
June 21, 2018: Journal of Neurointerventional Surgery
Neasa Fitzpatrick, Ronan Motyer, Brian Gibney, Sharon Duffy, Sean Murphy, Paul O'Brien, Daniel Ryan, John Thornton
Carotid artery free-floating thrombus (FFT) is a rare but clinically significant cause of embolic stroke. Treatment has historically been confined to carotid surgery or best medical therapy, with neither option proved to be superior. However, recent advancements in endovascular interventions have heralded a new age of innovative management strategies for vascular disease. We present three distinct cases of stroke secondary to carotid artery FFT, successfully treated with stent retriever endovascular thrombectomy...
June 20, 2018: Journal of Neurointerventional Surgery
Orlando M Diaz, Maria M Toledo, John O F Roehm, Richard P Klucznik, Ponraj Chinnadurai, Gloria Viviana Lopez, Gavin W Britz
PURPOSE: To report percutaneous transcranial puncture, embolisation and occlusion of a very symptomatic hypoglossal canal/anterior condylar vein dural arteriovenous fistula (DAVF) using syngo iGuide navigational software in a patient in whom transarterial and transvenous embolisation and surgery had failed. METHODS: After unsuccessful arterial and venous embolisation and surgical treatment of a symptomatic hypoglossal canal DAVF, a 47-year-old man was transferred for further management...
June 16, 2018: Journal of Neurointerventional Surgery
Shuhei Kawabata, Hirotoshi Imamura, Keita Suzuki, Shoichi Tani, Hidemitsu Adachi, Nobuyuki Sakai
A middle-aged patient with an internal carotid-posterior communicating artery aneurysm and basilar artery tip aneurysm was treated by stent-assisted coiling. One ischemic infarction and two transient ischemic attacks occurred with the same symptoms (inability to walk unassisted and tendency to fall to the left) during the first 2 years post-treatment. The ischemic infarction was found in the right side of the pons, consistent with the vascular territory of the stent-containing vessel. The cause of the delayed ischemic stroke was investigated on DSA and cone beam CT, which revealed that the proximal end of the stent, one marker band, was just covering a small perforating artery of the basilar artery trunk...
June 16, 2018: Journal of Neurointerventional Surgery
Nitin Goyal, Konark Malhotra, Muhammad F Ishfaq, Georgios Tsivgoulis, Christopher Nickele, Daniel Hoit, Adam S Arthur, Andrei V Alexandrov, Lucas Elijovich
INTRODUCTION: Debate continues about the optimal anesthetic management for patients undergoing endovascular treatment (ET) of acute ischemic stroke due to emergent large vessel occlusion. OBJECTIVE: To compare, using current evidence, the clinical outcomes and procedural characteristics among patients undergoing general anesthesia (GA) and local or monitored anesthesia (non-GA). METHODS: We performed a systematic review and meta-analysis of all available studies that involved the use of stent retrievers for ET (stentriever group)...
June 15, 2018: Journal of Neurointerventional Surgery
David F Kallmes, Joshua A Hirsch, Adnan H Siddiqui
No abstract text is available yet for this article.
June 15, 2018: Journal of Neurointerventional Surgery
Young Deok Kim, Jae Seung Bang, Si Un Lee, Won Joo Jeong, O-Ki Kwon, Seung Pil Ban, Tac Keun Kim, Seung Bin Kim, Chang Wan Oh
BACKGROUND: The long-term outcomes of endovascular coiling and surgical clipping for the treatment of unruptured intracranial aneurysms are unclear. METHODS: We performed a nationwide retrospective cohort study using claims data from the Korean Health Insurance Review and Assessment Service on patients undergoing surgical clipping or endovascular coiling from 2008 to 2014. Inverse probability treatment weighting for average treatment effect on the treated and the multiple imputation method were used to balance covariates and handle missing values...
June 6, 2018: Journal of Neurointerventional Surgery
David F Kallmes, Adnan H Siddiqui, Sameer A Ansari, David S Liebeskind, Osama O Zaidat
No abstract text is available yet for this article.
June 6, 2018: Journal of Neurointerventional Surgery
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