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Journal of Neurointerventional Surgery

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https://www.readbyqxmd.com/read/28918386/evaluation-of-previously-embolized-intracranial-aneurysms-inter-and-intra-rater-reliability-among-neurosurgeons-and-interventional-neuroradiologists
#1
Scott L Zuckerman, Nikita Lakomkin, Jordan A Magarik, Jan Vargas, Marcus Stephens, Babatunde Akinpelu, Alejandro M Spiotta, Azam Ahmed, Adam S Arthur, David Fiorella, Ricardo Hanel, Joshua A Hirsch, Ferdinand K Hui, Robert F James, David F Kallmes, Philip M Meyers, David B Niemann, Peter Rasmussen, Raymond D Turner, Babu G Welch, J Mocco
BACKGROUND: The angiographic evaluation of previously coiled aneurysms can be difficult yet remains critical for determining re-treatment. OBJECTIVE: The main objective of this study was to determine the inter-rater reliability for both the Raymond Scale and per cent embolization among a group of neurointerventionalists evaluating previously embolized aneurysms. METHODS: A panel of 15 neurointerventionalists examined 92 distinct cases of immediate post-coil embolization and 1 year post-embolization angiographs...
September 16, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28918385/wall-enhancement-ratio-and-partial-wall-enhancement-on-mri-associated-with-the-rupture-of-intracranial-aneurysms
#2
Guang-Xian Wang, Li Wen, Sheng Lei, Qian Ran, Jin-Bo Yin, Zi-Li Gong, Dong Zhang
OBJECTIVES: To evaluate the risk factors for rupture of intracranial aneurysms (IAs) using high resolution MRI (HRMRI). METHODS: 91 consecutive patients with 106 IAs were reviewed from February 2016 to April 2017. Patients and IAs were divided into ruptured and unruptured groups. In addition to the clinical characteristics of the patients, the features of IAs (eg, shape) were evaluated by CT angiography, whereas wall thickness, enhanced patterns, and enhancement ratio (ER) were evaluated by MRI...
September 16, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28918384/systematic-review-and-meta-analysis-of-effectiveness-of-preoperative-embolization-in-surgery-for-metastatic-spine-disease
#3
Panya Luksanapruksa, Jacob M Buchowski, Sasima Tongsai, Weerasak Singhatanadgige, Jack W Jennings
BACKGROUND: Preoperative embolization (PE) may decrease intraoperative blood loss (IBL) in decompressive surgery of hypervascular spinal metastases. However, no consensus has been found in other metastases and no meta-analysis which reviewed the benefit of PE in spinal metastases has been conducted. OBJECTIVE: To assess IBL in spinal metastases surgery in a randomized controlled trial (RCT) and cohort studies comparing PE and a control group of non-embolized patients...
September 16, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28916562/impact-of-coil-price-knowledge-by-the-operator-on-the-cost-of-aneurysm-coiling-a-single-center-study
#4
Stephanos Finitsis, Robert Fahed, Ian Gaulin, Daniel Roy, Alain Weill
BACKGROUND: Endovascular treatment of aneurysms with coils is among the most frequent treatments in interventional neuroradiology, and represents an important expense. Each manufacturer has created several types of coils, with prices varying among brands and coil types. The objective of this study was to assess the impact of cost awareness of the exact price of each coil by the operating physician on the total cost of aneurysm coiling. MATERIALS AND METHODS: This was a comparative study conducted over 1 year in a single tertiary care center...
September 15, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28899867/epidural-interlaminar-injections-in-severe-degenerative-lumbar-spine-fluoroscopy-should-not-be-a-luxury
#5
Dimitrios K Filippiadis, Thomas Rodt, Maria-Chrysanthi Kitsou, Chrysanthi Batistaki, Nikolaos Kelekis, Georgia Kostopanagiotou, Alexis Kelekis
OBJECTIVE: To assess technical efficacy, accuracy, and safety of epidural (interlaminar) injections performed blindly in patients with a severely degenerated lumbar spine. METHODS: Over 12 consecutive months, 138 patients with a severe degenerative lumbar spine underwent epidural (interlaminar) injection as therapy for low back pain and neuralgia. Patients had already undergone a blind epidural infiltration with minimum or no pain reduction. The session was repeated in the angiography suite...
September 12, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28899866/subacute-endovascular-recanalization-of-symptomatic-cerebral-artery-occlusion-a-propensity-score-matched-analysis
#6
Sang Hun Lee, Dae Chul Suh, Su Hee Cho, Jae Jon Sheen, Deok Hee Lee, Jong S Kim
BACKGROUND: The interval between the onset of cerebral vessel occlusion and recanalization has been shown to be an independent predictor of poor outcomes. However, endovascular recanalization of symptomatic cerebral vessel occlusion in the subacute period has not been well documented. We investigated the safety and efficacy of subacute recanalization of occluded cerebral vessels in patients with ischemic stroke or transient ischemic attacks (TIAs). METHODS: Between 2014 and 2015, 98 patients were admitted to the emergency room for ischemic stroke or TIA with a small infarct core, which was defined as modest early ischemic change on non-contrast CT or overt diffusion-perfusion mismatch...
September 12, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28866638/prediction-of-hyperperfusion-phenomenon-after-carotid-artery-stenting-and-carotid-angioplasty-using-quantitative-dsa-with-cerebral-circulation-time-imaging
#7
Keita Yamauchi, Yukiko Enomoto, Katharina Otani, Yusuke Egashira, Toru Iwama
BACKGROUND: Hyperperfusion syndrome after carotid interventions has a low incidence but it can lead to morbidity and mortality. OBJECTIVE: To evaluate the usefulness of quantitative DSA for predicting hyperperfusion phenomenon (HPP) after carotid artery stenting and angioplasty. METHODS: Thirty-three consecutive patients with carotid stenosis treated with carotid artery stenting or angioplasty between February 2014 and August 2016 were included...
September 2, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28855347/prolonged-cerebral-circulation-time-is-more-associated-with-symptomatic-carotid-stenosis-than-stenosis-degree-or-collateral-circulation
#8
Yong-Sin Hu, Wan-Yuo Guo, I-Hui Lee, Feng-Chi Chang, Chung-Jung Lin, Chun-Jen Lin, Chao-Bao Luo, Chih-Chun Wu, Han-Jui Lee
BACKGROUND AND PURPOSE: Current practice of revascularization for carotid stenosis (CS) primarily relies on symptoms and degree of stenosis. Other parameters, such as collateral circulation and cerebral circulation time (CCT), might influence the stroke risk in CS. This study was conducted to (1) investigate whether CCT is more associated with symptomatic CS than degree of stenosis and (2) elucidate the associations among the degree of stenosis, collateral status, and CCT. METHODS: From 2010 to 2016, 82 patients with unilateral CS were enrolled for DSA and divided into symptomatic and asymptomatic groups based on clinical presentation...
August 30, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28855346/impact-of-time-to-endovascular-reperfusion-on-outcome-differs-according-to-the-involvement-of-the-proximal-mca-territory
#9
Dennis M Hedderich, Tobias Boeckh-Behrens, Benjamin Friedrich, Benedikt Wiestler, Silke Wunderlich, Claus Zimmer, Urs Fischer, Justus F Kleine, Johannes Kaesmacher
BACKGROUND: The time interval between symptom onset and reperfusion is a major determinant of the benefit of endovascular therapy (ET) and patients' outcome. The impact of time may be attenuated in patients with robust collaterals. However, not all regions in the middle cerebral artery (MCA) territory have access to collaterals. PURPOSE: To evaluate if the involvement of the poorly collateralized proximal MCA territory has an impact on the degree of time dependency of patients' outcome...
August 30, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28855345/workflow-and-factors-associated-with-delay-in-the-delivery-of-intra-arterial-treatment-for-acute-ischemic-stroke-in-the-mr-clean-trial
#10
Esmee Venema, Nikki Boodt, Olvert A Berkhemer, Pleunie P M Rood, Wim H van Zwam, Robert J van Oostenbrugge, Aad van der Lugt, Yvo B W E M Roos, Charles B L M Majoie, Hester F Lingsma, Diederik W J Dippel
OBJECTIVE: The effect of intra-arterial treatment (IAT) for acute ischemic stroke is highly time-dependent. We investigated the delay of IAT and factors associated with such delay. METHODS: MR CLEAN was a randomized trial of IAT plus usual care versus usual care alone (n=500). With multivariable linear regression, we analyzed the effect of intravenous treatment, general anesthesia, off-hours and inter-hospital transfer on time to admission to the emergency department (ED) of the intervention center and time to treatment...
August 30, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28824008/bibliometric-indices-defining-academic-productivity-and-citation-rates-of-researchers-departments-and-journals
#11
REVIEW
Rebecca M Garner, Joshua A Hirsch, Felipe C Albuquerque, Kyle M Fargen
There has been an increasing focus on academic productivity for the purposes of promotion and funding within departments and institutions but also for comparison of individuals, institutions, specialties, and journals. A number of quantitative indices are used to investigate and compare academic productivity. These include various calculations attempting to analyze the number and citations of publications in order to capture both the quality and quantity of publications, such as the h index, the e index, impact factor, and Eigenfactor score...
August 20, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28823989/transvenous-embolization-of-dural-carotid-cavernous-fistulas-the-role-of-liquid-embolic-agents-in-association-with-coils-on-patient-outcomes
#12
Luís Henrique de Castro-Afonso, Felipe Padovani Trivelato, Marco Túlio Rezende, Alexandre Cordeiro Ulhôa, Guilherme Seizem Nakiri, Lucas Moretti Monsignore, Benedicto Oscar Colli, Antônio Augusto Velasco-E-Cruz, Daniel Giansante Abud
INTRODUCTION: Transvenous embolization is the standard treatment for dural carotid cavernous fistulas (DCCF). Although various embolic materials have been used, the best embolic material for the treatment of DCCF is still unknown. OBJECTIVE: To assess the safety and efficacy of different embolic materials used for the endovascular treatment of DCCF. METHODS: A retrospective data analysis of a consecutive series of 62 patients presenting DCCF was performed...
August 19, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28821628/frontline-adapt-therapy-to-treat-patients-with-symptomatic-m2-and-m3-occlusions-in-acute-ischemic-stroke-initial-experience-with-the-penumbra-ace-and-3max-reperfusion-system
#13
Jens Altenbernd, Oliver Kuhnt, Svenja Hennigs, Ruediger Hilker, Christian Loehr
BACKGROUND: After a series of positive studies for mechanical thrombectomy in large vessel occlusion acute ischemic stroke, the question remains, can symptomatic patients with distal vessel occlusion benefit from mechanical thrombectomy? PURPOSE: To assess the safety and efficacy of the 3MAX reperfusion system as frontline therapy for M2 and M3 occlusions. METHODS: This study retrospectively collected data on 58 patients treated for M2 and M3 occlusions between January and September 2016...
August 18, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28821627/angiographic-and-clinical-outcomes-of-balloon-remodeling-versus-unassisted-coil-embolization-in-the-ruptured-aneurysm-cohort-of-the-gel-the-nec-study
#14
Guilherme Dabus, Waleed Brinjikji, Arun P Amar, Josser E Delgado Almandoz, Orlando M Diaz, Pascal Jabbour, Ricardo Hanel, Ferdinand Hui, Michael Kelly, Kennith F Layton, Jeffrey W Miller, Elad I Levy, Christopher J Moran, Dae Chul Suh, Henry Woo, Robbin Sellar, Brian Hoh, Avery Evans, David F Kallmes
BACKGROUND AND PURPOSE: GEL THE NEC (GTN) was a multicenter prospective registry developed to assess the safety and efficacy of HydroSoft coils in treating intracranial aneurysms. We compared the angiographic and clinical outcomes of aneurysms treated with balloon assisted coil embolization (BACE) versus unassisted coil embolization (CE) in the ruptured aneurysm cohort. MATERIALS AND METHODS: GTN was performed at 27 centers in five countries. Patients aged 21-90 years with a ruptured aneurysm 3-15 mm in size were eligible for enrollment...
August 18, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28821626/current-applications-and-future-perspectives-of-robotics-in-cerebrovascular-and-endovascular-neurosurgery
#15
REVIEW
Simon A Menaker, Sumedh S Shah, Brian M Snelling, Samir Sur, Robert M Starke, Eric C Peterson
Advances in robotic medicine have been adopted by various surgical subspecialties as the benefits of this technology become more readily apparent: precision in narrow operative windows, tremor controlled movements, and modestly improved outcomes, among others. Vascular neurosurgery, in particular, remains open to newer and more cutting edge treatment options for complex pathologies, and robotics may be on the horizon for such advances. We seek to provide a broad overview of these innovations in vascular neurosurgery for both practitioners well acquainted with robotics and those seeking to become more familiar...
August 18, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28814528/physician-training-protocol-within-the-web-intrasaccular-therapy-web-it-study
#16
Adam Arthur, Daniel Hoit, Alexander Coon, Josser E Delgado Almandoz, Lucas Elijovich, Saruhan Cekirge, David Fiorella
INTRODUCTION: The WEB Intra-saccular Therapy (WEB-IT) trial is an investigational device exemption study to demonstrate the safety and effectiveness of the WEB device for the treatment of wide-neck bifurcation aneurysms. The neurovascular replicator (Vascular Simulations, Stony Brook, New York, USA) creates a physical environment that replicates patient-specific neurovascular anatomy and hemodynamic physiology, and allows devices to be implanted under fluoroscopic guidance. OBJECTIVE: To report the results of a unique neurovascular replicator-based training program, which was incorporated into the WEB-IT study to optimize technical performance and patient safety...
August 16, 2017: Journal of Neurointerventional Surgery
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
#17
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
#18
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
#19
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
#20
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
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