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Journal of Neurointerventional Surgery

Chuanchuan Wang, Yina Wu, Zhengzhe Feng, Jing Wang, Qiang Li, Rui Zhao, Bo Hong, Yi Xu, Qinghai Huang, Yibin Fang, Jianmin Liu
BACKGROUND: The low profile visualized intraluminal support (LVIS) device is being increasingly used for the treatment of intracranial aneurysms. Its application in the basilar artery (BA) has not yet been reported. OBJECTIVE: To evaluate the safety and early efficacy of the LVIS device for the treatment of BA aneurysms. METHODS: A prospectively maintained database was retrospectively reviewed for all patients with BA aneurysms treated by LVIS stents at our institution...
November 10, 2018: Journal of Neurointerventional Surgery
Philipp Gruber, Christina Braun, Timo Kahles, Martin Hlavica, Javier Anon, Michael Diepers, Krassen Nedeltchev, Jatta Berberat, Luca Remonda
OBJECTIVES: Intracranial arteriosclerotic disease is a relevant cause of ischemic stroke worldwide with a high recurrence rate despite best medical treatment. Following the SAMMPRIS trial, endovascular treatment has remained a second-line therapy. Meanwhile, there has been significant advances in device technology. SeQuent Please NEO is a novel polymer-free, drug-coated (paclitaxel/iopromide) balloon (DCB) primarily designed for cardiology. Because of its high flexibility and pushability, it may also be suitable for intracranial use...
November 10, 2018: Journal of Neurointerventional Surgery
Praveen Kolumam Parameswaran, Daying Dai, Yong-Hong Ding, Matthew W Urban, Logan Manlove, Venkatachalem Sathish, Juan R Cebral, David F Kallmes, Ramanathan Kadirvel
BACKGROUND: Flow diverters (FDs) are increasingly used in the treatment of intracranial aneurysms, and carry the risk of thromboembolic complications, even in patients treated with dual antiplatelet therapy. The effect of FDs on the downstream vascular is unknown. The aim of the study was to investigate vascular wall pulse wave velocity (PWV) and contractility changes following FD treatment in a rabbit model. METHODS: FDs (Pipeline Embolic Device, Medtronic Inc...
November 10, 2018: Journal of Neurointerventional Surgery
Lucas Alexandre Ramos, Wessel E van der Steen, Renan Sales Barros, Charles B L M Majoie, Rene van den Berg, Dagmar Verbaan, W Peter Vandertop, I Jsbrand Andreas Jan Zijlstra, A H Zwinderman, Gustav J Strijkers, Silvia Delgado Olabarriaga, Henk A Marquering
BACKGROUND AND PURPOSE: Delayed cerebral ischemia (DCI) is a severe complication in patients with aneurysmal subarachnoid hemorrhage. Several associated predictors have been previously identified. However, their predictive value is generally low. We hypothesize that Machine Learning (ML) algorithms for the prediction of DCI using a combination of clinical and image data lead to higher predictive accuracy than previously applied logistic regressions. MATERIALS AND METHODS: Clinical and baseline CT image data from 317 patients with aneurysmal subarachnoid hemorrhage were included...
November 10, 2018: Journal of Neurointerventional Surgery
Nikita Lakomkin, Mandip Dhamoon, Kirsten Carroll, Inder Paul Singh, Stanley Tuhrim, Joyce Lee, Johanna T Fifi, J Mocco
BACKGROUND: Accurate assessment of the prevalence of large vessel occlusion (LVO) in patients presenting with acute ischemic stroke (AIS) is critical for optimal resource allocation in neurovascular intervention. OBJECTIVE: To perform a systematic review of the literature in order to identify the proportion of patients with AIS presenting with LVO on image analysis. METHODS: A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in order to identify studies reporting LVO rates for patients presenting with AIS...
November 10, 2018: Journal of Neurointerventional Surgery
James Wareham, Richard Flood, Kevin Phan, Robert Crossley, Alex Mortimer
BACKGROUND: The crucial role of thrombectomy in the management of emergent large vessel occlusive stroke is not disputed but there is a technical failure rate in a significant minority of patients whose outcomes are often poor. Our objective was to perform a systematic review and meta-analysis to assess the safety and efficacy of permanent self-expandable stent deployment as a bailout procedure in cases of failed anterior circulation thrombectomy. METHODS: Two independent reviewers searched the Pubmed (Medline) database for studies reporting outcomes following failed endovascular thrombectomy with subsequent rescue therapy employing self-expandable stents...
November 10, 2018: Journal of Neurointerventional Surgery
Adam C Lieber, Javin Bose, Xiangnan Zhang, Hayley Seltzberg, Joanne Loewy, Andrew Rossetti, J Mocco, Christopher P Kellner
BACKGROUND: Given the anxiety patients experience during angiography, evidence supporting the efficacy of music therapy during these angiographic procedures is potentially of clinical value. OBJECTIVE: To analyze the existing literature forthe use of music therapy during cerebral, coronary, and peripheral angiography to determine whether it improves patient anxiety levels, heart rate, and blood pressure during the procedure. METHODS: PubMed, Embase, and Scopus were searched to identify studies of interest...
November 10, 2018: Journal of Neurointerventional Surgery
Kevin Phan, Serag Saleh, Adam A Dmytriw, Julian Maingard, Christen Barras, Joshua A Hirsch, Hong Kuan Kok, Mark Brooks, Ronil V Chandra, Hamed Asadi
BACKGROUND: Prompt revascularization of the ischemic penumbra following an acute ischemic event (AIS) has established benefit within the literature. However, use of the semi-quantitative Alberta Stroke Program Early CT Score (ASPECTS) to evaluate patient suitability for revascularization has been inconsistent in patient risk stratification and selection. OBJECTIVE: To conduct a meta-analysis to evaluate the available evidence for a clinically valid ASPECTS threshold in assessment of suitability for revascularization following AIS...
November 10, 2018: Journal of Neurointerventional Surgery
Jildaz Caroff, Marta Iacobucci, Aymeric Rouchaud, Cristian Mihalea, Fernando Mota de Carvalho, Victor Erwin D Jocson, Vanessa Chalumeau, Valerio Da Ros, Robert M King, Rose Arslanian, Léon Ikka, Nidhal Ben Achour, Jacques Moret, Laurent Spelle
BACKGROUND: Neo-intimal hyperplasia (NIH) is frequently observed after flow-diverter stent (FDS) implantation. Although mostly asymptomatic, this vascular response can sometimes lead to delayed ischemic strokes. This study intended to evaluate the factors potentially influencing the rates of NIH following FDS treatment. MATERIAL AND METHODS: All aneurysm treatments performed with a Pipeline embolization device (PED) or a SILK stent from May 2011 to May 2015 were collected in a prospectively maintained database...
November 10, 2018: Journal of Neurointerventional Surgery
Ali Alawieh, Robert M Starke, Arindam Rano Chatterjee, Aquilla Turk, Reade De Leacy, Ansaar T Rai, Kyle Fargen, Peter Kan, Jasmeet Singh, Lukas Vilella, Fábio Nascimento, Travis M Dumont, David McCarthy, Alejandro M Spiotta
BACKGROUND: The efficacy of endovascular thrombectomy (ET) for acute ischemic stroke (AIS) in octogenarians is still controversial. OBJECTIVE: To evaluate, using a large multicenter cohort of patients, outcomes after ET in octogenarians compared with younger patients. METHODS: Data from prospectively maintained databases of patients undergoing ET for AIS at seven US-based comprehensive stroke centers between January 2013 and January 2018 were reviewed...
November 2, 2018: Journal of Neurointerventional Surgery
Ke Li, Ming Ren, Ran Meng, Yuchuan Ding, Gary B Rajah, Feng Wang, Xunming Ji
BACKGROUND: Venous stenting has been proven to be a safe and effective therapeutic option for patients with idiopathic intracranial hypertension (IIH) and cerebral venous sinus stenosis (CVSS). However, its use in patients with cerebral venous sinus thrombosis-related CVSS has been less reported. PURPOSE: To explore the safety and efficacy of stenting for patients with cerebral venous sinus thrombosis (CVST)-related CVSS. METHODS: The clinical presentation, treatment, and outcome of patients with CVST-related CVSS received venous stenting in the chronic stage after failed medical treatment were retrospectively evaluated...
November 2, 2018: Journal of Neurointerventional Surgery
Romain Bourcier, Suzana Saleme, Julien Labreuche, Mikael Mazighi, Robert Fahed, Raphael Blanc, Benjamin Gory, Maeva Kyheng, Gaultier Marnat, Serge Bracard, Hubert Desal, Arturo Consoli, Michel Piotin, Bertrand Lapergue
INTRODUCTION: Despite successful recanalization with mechanical thrombectomy (MT) for acute anterior ischemic stroke (AAIS), the number of passes may impact clinical outcome.We analyzed the impact of more than three MT passes (>3) in a trial that evaluated contact aspiration (CA) versus stent retriever (SR) as the first-line technique in AAIS. METHODS: We included patients with mTICI 2b/3 recanalization after MT for isolated intracranial occlusions. The primary outcome was the percentage of patients with a 90-day modified Rankin Scale (mRS)≤2...
November 2, 2018: Journal of Neurointerventional Surgery
Joshua A Hirsch, Thabele Leslie-Mazwi, Gregory N Nicola, James Milburn, Claudia Kirsch, David A Rosman, Chris Gilligan, Laxmaiah Manchikanti
No abstract text is available yet for this article.
October 29, 2018: Journal of Neurointerventional Surgery
Lei Zhang, Dongwei Dai, Zifu Li, Guoli Duan, Yong-Wei Zhang, Pengfei Yang, Qinghai Huang, Yi Xu, Bo Hong, Jianmin Liu
BACKGROUND: Analyzing risk factors for hyperperfusion-induced intracranial hemorrhage (HICH) after carotid artery stenting (CAS) in patients with symptomatic severe carotid stenosis. METHODS: This study retrospectively analyzed clinical data of 210 patients, who had symptomatic severe carotid stenosis (70-99%) and received CAS treatment between June 2009 and June 2015, and evaluated the relationship of HICH with patients' clinical baseline data, imaging features, and treatment strategies...
October 27, 2018: Journal of Neurointerventional Surgery
Simon Nagel, Christian Herweh, Johannes Alex Rolf Pfaff, Simon Schieber, Silvia Schönenberger, Markus A Möhlenbruch, Martin Bendszus, Peter Arthur Ringleb
OBJECTIVE: To identify simplified selection criteria for mechanical thrombectomy (MT) in longer and unknown time windows. METHODS: Patients with large vessel occlusion (LVO) in the anterior circulation who underwent MT between January 2014 and November 2017 were identified from the local registry. Patients were selected for analysis if they met the current guideline recommendation for MT treatment except for time window (HERMES-like) and were divided according to time they were last seen well (LSW): LSW <6 hours or LSW >6 hours before MT...
October 27, 2018: Journal of Neurointerventional Surgery
Christoph Kabbasch, Lukas Goertz, Eberhard Siebert, Moriz Herzberg, Jan Borggrefe, Franziska Dorn, Thomas Liebig
BACKGROUND: The Woven EndoBridge (WEB) device is a novel endovascular tool for the treatment of wide-necked intracranial aneurysms. OBJECTIVE: To evaluate factors influencing aneurysm occlusion and aneurysm recurrence after WEB embolization. METHODS: A total of 113 patients (mean age 58.9±11.9 years) with 114 aneurysms (mean size 8.6±4.6 mm) were successfully treated with the WEB device at three German tertiary care centers between May 2011 and February 2018...
October 24, 2018: Journal of Neurointerventional Surgery
Li Liang, David A Steinman, Olivier Brina, Christophe Chnafa, Nicole M Cancelliere, Vitor M Pereira
BACKGROUND: Intracranial aneurysms (IAs) are vascular dilations on cerebral vessels that affect between 1%-5% of the general population, and can cause life-threatening intracranial hemorrhage when ruptured. Computational fluid dynamics (CFD) has emerged as a promising tool to study IAs in recent years, particularly for rupture risk assessment. However, despite dozens of studies, CFD is still far from clinical use due to large variations and frequent contradictions in hemodynamic results between studies...
October 19, 2018: Journal of Neurointerventional Surgery
Alexander Marco Kollikowski, Franco Amaya, Guido Stoll, Wolfgang Müllges, Michael Klaus Schuhmann, Mirko Pham
BACKGROUND AND PURPOSE: Endovascular treatment of large-vessel occlusion stroke often necessitates patient transfer by a twin-track approach: endovascular thrombectomy (ET) in endovascular-capable facilities preceded by intravenous thrombolysis in primary stroke centers. We tested the open hypothesis that recent landmark trials on ET had any significant effect on logistical performance measures among different modes of admission. METHODS: We retrospectively categorized 250 patients who presented at our institution as: (A) primarily admitted or transferred from (B) inner-city and (C) regional hospitals...
October 19, 2018: Journal of Neurointerventional Surgery
Jingzhi Li, Yang Hua, Laurence Needleman, Flemming Forsberg, John R Eisenbray, Zhaojun Li, Ran Liu, Xiaojie Tian, Liqun Jiao, Ji-Bin Liu
OBJECTIVE: The study was designed to investigate if vascular occlusion in the internal carotid artery (ICA) or the contralateral vertebral artery (VA) contribute to developing in-stent restenosis (ISR) in patients with vertebral artery ostium stenosis (VAOS). METHODS: 420 consecutive patients treated with VAOS stents (from a population of 8145 patients with VAOS) from January 2013 to December 2014 were analyzed in this retrospective study; 216 with drug eluted stents and 204 with bare metal stents...
October 18, 2018: Journal of Neurointerventional Surgery
Ju Han, Jun Zhang, Xiao Zhang, Jinping Zhang, Yun Song, Wei Zhao, Meimei Zheng, Lili Sun, Wei Wang
BACKGROUND: The optimal treatment for patients with symptomatic severe intracranial atherosclerotic disease is not well established. Angioplasty and stenting have been attempted, with controversial results, mainly attributed to perioperative complications and a high incidence of restenosis or in-stent restenosis. Drug-coated balloons (DCBs) have shown encouraging results for coronary and peripheral artery disease, without convincing data for intracranial vasculature. OBJECTIVES: To assess the feasibility, clinical and angiographic outcomes of DCBs for patients with intracranial de novo atherosclerotic disease...
October 18, 2018: Journal of Neurointerventional Surgery
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