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Journal of Neurointerventional Surgery

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https://www.readbyqxmd.com/read/28490608/expanding-the-use-of-flow-diverters-beyond-their-initial-indication-treatment-of-small-unruptured-aneurysms
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/28404769/a-decrease-in-blood-pressure-is-associated-with-unfavorable-outcome-in-patients-undergoing-thrombectomy-under-general-anesthesia
#14
Kilian M Treurniet, Olvert A Berkhemer, Rogier V Immink, Hester F Lingsma, Vivian M C Ward-van der Stam, Markus W Hollmann, Jaap Vuyk, Wim H van Zwam, Aad van der Lugt, Robert J van Oostenbrugge, Diederik W J Dippel, Jonathan M Coutinho, Yvo B W E M Roos, Henk A Marquering, Charles B L M Majoie
BACKGROUND: Up to two-thirds of patients are either dependent or dead 3 months after thrombectomy for acute ischemic stroke (AIS). Loss of cerebral autoregulation may render patients with AIS vulnerable to decreases in mean arterial pressure (MAP). OBJECTIVE: To determine whether a fall in MAP during intervention under general anesthesia (GA) affects functional outcome. METHODS: This subgroup analysis included patients from the MR CLEAN trial treated with thrombectomy under GA...
April 12, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28385727/multicenter-clinical-and-imaging-evaluation-of-targeted-radiofrequency-ablation-t-rfa-and-cement-augmentation-of-neoplastic-vertebral-lesions
#15
Melinda Reyes, Mark Georgy, Lorenzo Brook, Orlando Ortiz, Allan Brook, Vikas Agarwal, Mario Muto, Luigi Manfre, Stefano Marcia, Bassem A Georgy
BACKGROUND: Treatment of spinal metastatic lesions by radiofrequency ablation (RFA) before cementation can potentially help in local tumor control and pain relief. This is often limited by access and tumor location. This study reports multicenter clinical and imaging outcomes following targeted RFA (t-RFA) and cement augmentation in neoplastic lesions of the spine. MATERIAL AND METHODS: A retrospective multicenter study of 49 patients with 72 painful vertebral lesions, evaluated for clinical and imaging outcomes following RFA and cement augmentation of spinal metastatic lesions, was undertaken...
April 6, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28385726/trends-in-vertebral-augmentation-for-spinal-fractures-in-myeloma-patients-a-2002-2012-population-based-study-using-a-large-national-cancer-registry
#16
Falgun H Chokshi, David H Howard, Jeffrey G Jarvik, Richard Duszak
PURPOSE: To evaluate temporal trends and factors associated with vertebral augmentation use in myeloma patients with spinal fractures from 2002 to 2012. METHODS: This retrospective cohort study used the Surveillance, Epidemiology and End Results (SEER)-Medicare claims database for 2002 through 2012. We included patients age ≥66 years with myeloma and spinal fractures. First, we evaluated receipt of vertebral augmentation. Second, multivariate logistic regression was used to assess the impact of sociodemographic factors, treatment facility type, and underlying comorbidities on the odds of undergoing vertebral augmentation...
April 6, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28385725/impact-of-image-reconstruction-parameters-when-using-3d-dsa-reconstructions-to-measure-intracranial-aneurysms
#17
Katrina L Ruedinger, David R Rutkowski, Sebastian Schafer, Alejandro Roldán-Alzate, Erick L Oberstar, Charles Strother
BACKGROUND AND PURPOSE: Safe and effective use of newly developed devices for aneurysm treatment requires the ability to make accurate measurements in the angiographic suite. Our purpose was to determine the parameters that optimize the geometric accuracy of three-dimensional (3D) vascular reconstructions. METHODS: An in vitro flow model consisting of a peristaltic pump, plastic tubing, and 3D printed patient-specific aneurysm models was used to simulate blood flow in an intracranial aneurysm...
April 6, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28377443/predisposing-factors-for-recanalization-of-cerebral-aneurysms-after-endovascular-embolization-a-multivariate-study
#18
Qianqian Zhang, Linkai Jing, Jian Liu, Kun Wang, Ying Zhang, Nikhil Paliwal, Hui Meng, Yang Wang, Shengzhang Wang, Xinjian Yang
BACKGROUND: The recanalization of cerebral aneurysms after endovascular embolization (coiling or stent-assisted coiling) has been a matter of concern. OBJECTIVE: To systematically evaluate the predisposing factors for cerebral aneurysm recanalization using multidimensional analysis in a large patient cohort. METHODS: In 238 patients with 283 aneurysms, patient baseline characteristics, aneurysm morphological characteristics, treatment-related factors, and changes in flow hemodynamics after endovascular treatment (coiling or stent-assisted coiling) were compared between the recanalization and non-recanalization groups...
April 4, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28360354/predictors-of-false-positive-stroke-thrombectomy-transfers
#19
Julia Yi, Danielle Zielinski, Bichun Ouyang, James Conners, Rima Dafer, Michael Chen
BACKGROUND: Most patients with large vessel occlusion (LVO) stroke need to be transferred to receive thrombectomy. To save time, the decision to transfer often relies on clinical scales as a surrogate for LVO rather than imaging. However, clinical scales have been associated with high levels of diagnostic error. The aim of this study is to define the susceptibility to overdiagnosis of our current transfer decision process by measuring the rate of non-treatment transfers, the most common reasons for no treatment and potential predictors...
March 30, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28360353/optical-coherence-tomography-evaluation-of-tissue-prolapse-after-carotid-artery-stenting-using-closed-cell-design-stents-for-unstable-plaque
#20
Kei Harada, Shogo Oshikata, Masahito Kajihara
BACKGROUND AND PURPOSE: During carotid artery stenting (CAS) with the use of closed cell design stents for unstable plaques, tissue prolapse between stent struts was evaluated by optical coherence tomography (OCT). METHODS: 14 carotid stenosis lesions diagnosed as unstable plaques by MRI were evaluated by OCT imaging during CAS using closed cell stents. Cross sectional OCT images within the stented segment were evaluated at 1 mm intervals. The slice rate for the presence of tissue prolapse between the struts was calculated...
March 30, 2017: Journal of Neurointerventional Surgery
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