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Journal of Neurointerventional Surgery

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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
#1
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
#2
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/28601815/practice-makes-perfect-establishing-reasonable-minimum-thrombectomy-volume-requirements-for-stroke-centers
#3
EDITORIAL
Kyle M Fargen, David J Fiorella, J Mocco
No abstract text is available yet for this article.
June 10, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28600483/extending-the-indications-for-transvenous-approach-embolization-for-superficial-brain-arteriovenous-malformations
#4
Dinark Conceição Viana, Luis Henrique de Castro-Afonso, Guilherme Seizem Nakiri, Lucas Moretti Monsignore, Felipe Padovani Trivelato, Oscar Benedicto 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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/28487360/ultrasound-for-the-evaluation-of-stenosis-after-flow-diversion
#9
Cameron M McDougall, Khurshid Khan, Maher Saqqur, Andrew Jack, Jeremy Rempel, Carol Derksen, Yin Xi, Michael Chow
BACKGROUND AND PURPOSE: Flow diversion is a relatively new strategy used to treat complex cerebral aneurysms. The optimal method for radiographic follow-up of patients treated with flow diverters has not been established. The rate and clinical implications of in-stent stenosis for these devices is unclear. We evaluate the use of transcranial Doppler ultrasound (TCD) for follow-up of in-stent stenosis. MATERIALS AND METHODS: We analyzed 28 patients treated with the Pipeline embolization device (PED) over the course of 42 months from January 2009 to June 2012...
May 9, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28487359/venous-sinus-stenting-shortens-the-duration-of-medical-therapy-for-increased-intracranial-pressure-secondary-to-venous-sinus-stenosis
#10
Tarek A Shazly, Ashutosh P Jadhav, Amin Aghaebrahim, Andrew F Ducruet, Brian T Jankowitz, Tudor G Jovin, Gabrielle R Bonhomme
INTRODUCTION: Medical treatment, cerebrospinal fluid (CSF) shunting, and optic nerve sheath fenestration are standard treatments for increased intracranial pressure (ICP) in patients with idiopathic intracranial hypertension (IIH). Venous sinus stenting provides a novel alternative surgical treatment in cases of venous sinus stenosis with elevated ICP. METHODS: 12 consecutive subjects with papilledema, increased ICP, and radiological signs of dural sinus stenosis underwent cerebral venography and manometry...
May 9, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28465406/helistroke-neurointerventionalist-helicopter-transport-for-interventional-stroke-treatment-proof-of-concept-and-rationale
#11
Ferdinand K Hui, Amgad El Mekabaty, Jacky Schultz, Kelvin Hong, Karen Horton, Victor Urrutia, Imama Naqvi, Shawn Brast, John K Lynch, Zurab Nadareishvili
BACKGROUND AND PURPOSE: It is increasingly recognized that time is one of the key determinants in acute stroke outcome when interventional stroke therapy is applied. With increasing device efficacy and understanding of imaging triage options, reducing pre-treatment time loss may be a critical component of improving interventional stroke outcomes for the population at large. Time sensitive procedures such as organ harvest have transported physicians to the patient site to improve time to procedure...
May 2, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28465405/the-golden-35%C3%A2-min-of-stroke-intervention-with-adapt-effect-of-thrombectomy-procedural-time-in-acute-ischemic-stroke-on-outcome
#12
Ali Alawieh, Alyssa K Pierce, Jan Vargas, Aquilla S Turk, Raymond D Turner, M Imran Chaudry, Alejandro M Spiotta
INTRODUCTION: In acute ischemic stroke (AIS), extending mechanical thrombectomy procedural times beyond 60 min has previously been associated with an increased complication rate and poorer outcomes. OBJECTIVE: After improvements in thrombectomy methods, to reassess whether this relationship holds true with a more contemporary thrombectomy approach: a direct aspiration first pass technique (ADAPT). METHODS: We retrospectively studied a database of patients with AIS who underwent ADAPT thrombectomy for large vessel occlusions...
May 2, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28465404/does-the-dsa-reconstruction-kernel-affect-hemodynamic-predictions-in-intracranial-aneurysms-an-analysis-of-geometry-and-blood-flow-variations
#13
P Berg, S Saalfeld, S Voß, T Redel, B Preim, G Janiga, O Beuing
BACKGROUND: Computational fluid dynamics (CFD) blood flow predictions in intracranial aneurysms promise great potential to reveal patient-specific flow structures. Since the workflow from image acquisition to the final result includes various processing steps, quantifications of the individual introduced potential error sources are required. METHODS: Three-dimensional (3D) reconstruction of the acquired imaging data as input to 3D model generation was evaluated...
May 2, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28465403/middle-cerebral-artery-flow-velocity-increases-more-in-patients-with-delayed-intraparenchymal-hemorrhage-after-pipeline
#14
Denise Brunozzi, Sophia F Shakur, Ahmed E Hussein, Fady T Charbel, Ali Alaraj
OBJECTIVE: Pipeline Embolization Devices (PED) are commonly used for endovascular treatment of cerebral aneurysms but can be associated with delayed ipsilateral intraparenchymal hemorrhage (DIPH). The role that altered intracranial hemodynamics may play in the pathophysiology of DIPH is poorly understood. We assess middle cerebral artery (MCA) flow velocity changes after PED deployment. MATERIALS AND METHODS: Patients with aneurysms located proximal to the internal carotid artery terminus treated with PED at our institution between 2015 and 2016 were retrospectively reviewed...
May 2, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28465402/a-systematic-characterization-of-the-factors-influencing-polymerization-and-dynamic-behavior-of-n-butyl-cyanoacrylate
#15
Bill H Wang, Melfort Boulton, Donald H Lee, David M Pelz, Stephen P Lownie
INTRODUCTION: Brain arteriovenous malformations are abnormal connections between arteries and veins without an intervening capillary bed. Endovascular glue embolization with N-butyl cyanoacrylate (NBCA) is an accepted form of treatment. The reported complication rates vary widely from 2% to 15%, and timing of polymerization appears to play a major role. Additionally, the interaction between NBCA and vessel surface as well as the presence of biological catalysts are poorly understood. METHODS: Polymerization time was measured for mixtures of Lipiodol/NBCA of 50/50, 70/30, and 60/40...
May 2, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28450456/temporal-cascade-of-inflammatory-cytokines-and-cell-type-populations-in-monocyte-chemotactic-protein-1-mcp-1-mediated-aneurysm-healing
#16
Brian L Hoh, Hanain Z Fazal, Siham Hourani, Mengchen Li, Li Lin, Koji Hosaka
BACKGROUND: We have previously shown that monocyte chemotactic protein-1 (MCP-1) promotes aneurysm healing. OBJECTIVE: To determine the temporal cascade and durability of aneurysm healing. METHODS: Murine carotid aneurysms were treated with MCP-1-releasing or poly(lactic-co-glycolic) acid (PLGA)-only coils. Aneurysm healing was assessed by quantitative measurements of intraluminal tissue ingrowth on 5 μm sections by blinded observers. RESULTS: Aneurysm healing occurred in stages characteristic of normal wound healing...
April 27, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28446535/direct-transfer-to-angiosuite-to-reduce-door-to-puncture-time-in-thrombectomy-for-acute-stroke
#17
Marc Ribo, Sandra Boned, Marta Rubiera, Alejandro Tomasello, Pilar Coscojuela, David Hernández, Jorge Pagola, Jesús Juega, Noelia Rodriguez, Marian Muchada, David Rodriguez-Luna, Carlos A Molina
OBJECTIVE: To evaluate direct transfer to the angiosuite protocol of patients with acute stroke, candidates for endovascular treatment (EVT). METHODS: We studied workflow metrics of all patients with stroke who had undergone EVT in the past 12 months. Patients followed three protocols: direct transfer to emergency room (DTER), CT room (DTCT) or angiosuite (DTAS, only last 6 months if admission National Institute of Health Stroke Scale (NIHSS) score >9 and time from onset <4...
April 26, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28438895/the-casper-carotid-artery-stent-a-unique-all-metal-micromesh-stent-designed-to-prevent-embolic-release
#18
Orlando Diaz, Gloria Lopez, John O F Roehm, Ginna De la Rosa, Fernando Orozco, Rafael Almeida
BACKGROUND: Stroke due to the release of embolic debris during the placement of a stent to correct carotid artery stenosis is a constant procedural and peri-procedural threat. The new all metal Casper stent has been created with two layers of nitinol, the inner layer of which has pores diminutive enough to prevent embolic release. OBJECTIVE: To evaluate the safety, effectiveness, and utility of the double layer nitinol Casper carotid artery stent in the treatment of patients with severe carotid artery stenosis...
April 24, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28438894/flow-diverter-treatment-of-intracranial-vertebral-artery-dissecting-pseudoaneurysms
#19
REVIEW
Russell Cerejo, Mark Bain, Nina Moore, Julian Hardman, Andrew Bauer, M Shazam Hussain, Thomas Masaryk, Peter Rasmussen, Gabor Toth
INTRODUCTION: Intracranial vertebral dissecting pseudoaneurysms are a rare, but increasingly recognized, cause of subarachnoid hemorrhage and ischemic stroke. The risks of aneurysm re-rupture and associated morbidity are high. The use of flow diverter stents for the treatment of these aneurysms has not been well studied. OBJECTIVE: To report our data and provide a summarized review of literature using flow diverter stents for the treatment of intracranial vertebral artery dissecting pseudoaneurysms...
April 24, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28404770/endovascular-retrieval-of-dental-needle-retained-in-the-internal-carotid-artery
#20
Kenneth Moore, Nickalus R Khan, L Madison Michael, Adam S Arthur, Daniel Hoit
Intravascular foreign bodies are a known complication of medical and dental procedures. Dental anesthetic needles may be broken off and retained in the oropharynx. These needles have occasionally been reported to migrate through the oral mucosa in to deeper structures. Here we present the case of a 57-year-old man who had a retained dental needle that had migrated into his internal carotid artery. The needle was removed using endovascular techniques. To our knowledge, this is the first report of a retained dental needle being retrieved using this method...
April 12, 2017: Journal of Neurointerventional Surgery
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