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Journal of Neurointerventional Surgery

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https://www.readbyqxmd.com/read/28798268/how-safe-and-effective-are-existing-treatments-for-wide-necked-bifurcation-aneurysms-literature-based-objective-performance-criteria-for-safety-and-effectiveness
#1
REVIEW
David Fiorella, Adam S Arthur, Richard Chiacchierini, Evelyne Emery, Andy Molyneux, Laurent Pierot
INTRODUCTION: Wide-necked bifurcation aneurysms (WNBAs) present unique technical challenges for both endovascular and surgical treatments which aim to achieve complete occlusion of the aneurysm without compromising the patency of the incorporated regional parent vessels. We present a meta-analysis of traditional therapies for WNBAs to provide critical benchmarks for safety and effectiveness. METHODS: Following a systematic search of the literature and the application of pre-specified appropriateness criteria, 43 (including 2794 aneurysms treated) and 65 (including 5366 patients treated) references with sufficient detail were identified to include in a meta-analysis of efficacy and safety, respectively...
August 10, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28798267/pretreatment-predictors-of-malignant-evolution-in-patients-with-ischemic-stroke-undergoing-mechanical-thrombectomy
#2
Alessandro Davoli, Caterina Motta, Giacomo Koch, Marina Diomedi, Simone Napolitano, Angela Giordano, Marta Panella, Daniele Morosetti, Sebastiano Fabiano, Roberto Floris, Roberto Gandini, Fabrizio Sallustio
BACKGROUND: Few data exist on malignant middle cerebral artery infarction (MMI) among patients with acute ischemic stroke (AIS) after endovascular treatment (ET). Numerous predictors of MMI evolution have been proposed, but a comprehensive research of patients undergoing ET has never been performed. Our purpose was to find a practical model to determine robust predictors of MMI in patients undergoing ET. METHODS: Patients from a prospective single-center database with AIS secondary to large intracranial vessel occlusion of the anterior circulation, treated with ET, were retrospectively analyzed...
August 10, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28798266/thrombectomy-of-calcified-emboli-in-stroke-does-histology-of-thrombi-influence-the-effectiveness-of-thrombectomy
#3
Tomas Dobrocky, Eike Piechowiak, Alessandro Cianfoni, Felix Zibold, Luca Roccatagliata, Pascal Mosimann, Simon Jung, Urs Fischer, Pasquale Mordasini, Jan Gralla
BACKGROUND AND PURPOSE: Thrombus composition has been postulated to affect the success of endovascular therapy. Calcified clots are composed of large amounts of calcium phosphate which influences their mechanical properties and may serve as a model for testing this hypothesis. The aim of this study was to evaluate the recanalization and complication rates of calcified thromboemboli in patients with acute ischemic stroke who underwent thrombectomy. MATERIAL AND METHODS: A retrospective analysis was performed of all calcified intracranial thromboemboli in patients suffering an acute ischemic stroke, referred for endovascular therapy at two centers between January 2013 and July 2016...
August 10, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28768820/thrombectomy-versus-medical-management-for-large-vessel-occlusion-strokes-with-minimal-symptoms-an-analysis-from-stopstroke-and-gestor-cohorts
#4
Diogo C Haussen, Fabricio O Lima, Mehdi Bouslama, Jonathan A Grossberg, Gisele S Silva, Michael H Lev, Karen Furie, Walter Koroshetz, Michael R Frankel, Raul G Nogueira
INTRODUCTION: It remains unclear whether patients presenting with large vessel occlusion strokes and mild symptoms benefit from thrombectomy. OBJECTIVE: To compare outcomes of endovascular therapy versus medical management in patients with large vessel occlusion strokes and National Institute of Health Stroke Scale (NIHSS) score ≤5. METHODS: This was a retrospective analysis combining two large prospectively collected datasets including patients with (1) admission NIHSS score ≤5, (2) premorbid modified Rankin Scale (mRS) score 0-2, and (3) middle cerebral-M1/M2, intracranial carotid, anterior cerebral or basilar artery occlusions...
August 2, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28768819/rabbit-aneurysm-models-mimic-histologic-wall-types-identified-in-human-intracranial-aneurysms
#5
Shunli Wang, Daying Dai, Praveen Kolumam Parameswaran, Ramanathan Kadirvel, Yong-Hong Ding, Anne M Robertson, David F Kallmes
BACKGROUND: Semiquantitative scales correlate histopathologic findings in the walls of human aneurysms with rupture status. OBJECTIVE: To apply a semiquantitative scale to the rabbit elastase-induced aneurysm model to determine whether rabbit histologic types mimic the full range of histologic subtypes of humans. MATERIALS AND METHODS: Twenty-seven elastase-induced female rabbit aneurysms were studied, harvested at 2 weeks (n=5) and 12 weeks (n=22)...
August 2, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28768818/sofia-intermediate-catheter-and-the-snake-technique-safety-and-efficacy-of-the-sofia-catheter-without-guidewire-or-microcatheter-construct
#6
Jeremy J Heit, Johnny Hy Wong, Adrienne M Mofaff, Nicholas A Telischak, Robert L Dodd, Michael P Marks, Huy M Do
BACKGROUND: Neurointerventional surgeries (NIS) benefit from supportive endovascular constructs. Sofia is a soft-tipped, flexible, braided single lumen intermediate catheter designed for NIS. Sofia advancement from the cervical to the intracranial circulation without a luminal guidewire or microcatheter construct has not been described. OBJECTIVE: To evaluate the efficacy and safety of the new Sofia Non-wire Advancement techniKE (SNAKE) for advancement of the Sofia into the cerebral circulation...
August 2, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28754807/balloon-assisted-coil-embolization-and-large-stent-delivery-for-cerebral-aneurysms-with-a-new-generation-of-dual-lumen-balloons-copernic-2l
#7
Adrien Guenego, Jean-Baptiste Zerlauth, Francesco Puccinelli, Steven Hajdu, David C Rotzinger, Felix Zibold, Eike I Piechowiak, Pasquale Mordasini, Jan Gralla, Tomas Dobrocky, Roy T Daniel, René Chapot, Pascal J Mosimann
INTRODUCTION: Dual coaxial lumen balloon microcatheters through which small stents can be delivered have recently been described. We report a series of a new type of dual lumen balloon catheter with a parallel lumen design enabling enhanced inflation and deflation properties through which larger stents may be deployed, including flow diverters (FD). METHODS: All aneurysms that were treated with a Copernic 2L (COP2L) dual lumen balloon catheter at our institution between February 2014 and December 2016 were assessed...
July 28, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28754806/impact-of-balloon-guide-catheter-on-technical-and-clinical-outcomes-a-systematic-review-and-meta-analysis
#8
Waleed Brinjikji, Robert M Starke, M Hassan Murad, David Fiorella, Vitor M Pereira, Mayank Goyal, David F Kallmes
BACKGROUND AND PURPOSE: Flow arrest with balloon guide catheters (BGCs) is becoming increasingly recognized as critical to optimizing patient outcomes for mechanical thrombectomy. We performed a systematic review and meta-analysis of the literature for studies that compared angiographic and clinical outcomes for patients who underwent mechanical thrombectomy with and without BGCs. MATERIALS AND METHODS: In April 2017 a literature search on BGC and mechanical thrombectomy for stroke was performed...
July 28, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28710086/onyx-embolization-prior-to-stereotactic-radiosurgery-for-brain-arteriovenous-malformations-a-single-center-treatment-algorithm
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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