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Interventional Neurology

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https://www.readbyqxmd.com/read/27781052/arteriovenous-malformations-in-the-pediatric-population-review-of-the-existing-literature
#1
REVIEW
Mohammad El-Ghanem, Tareq Kass-Hout, Omar Kass-Hout, Yazan J Alderazi, Krishna Amuluru, Fawaz Al-Mufti, Charles J Prestigiacomo, Chirag D Gandhi
Arteriovenous malformations (AVMs) in the pediatric population are relatively rare but reportedly carry a higher rate of rupture than in adults. This could be due to the fact that most pediatric AVMs are only detected after rupture. We aimed to review the current literature regarding the natural history and the clinical outcome after multimodality AVM treatment in the pediatric population, as optimal management for pediatric AVMs remains controversial. A multidisciplinary approach using multimodality therapy if needed has been proved to be beneficial in approaching these lesions in all age groups...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27781051/improving-the-evaluation-of-collateral-circulation-by-multiphase-computed-tomography-angiography-in-acute-stroke-patients-treated-with-endovascular-reperfusion-therapies
#2
Alvaro García-Tornel, Vanessa Carvalho, Sandra Boned, Alan Flores, David Rodríguez-Luna, Jorge Pagola, Marian Muchada, Estela Sanjuan, Pilar Coscojuela, Jesus Juega, Noelia Rodriguez-Villatoro, Bijoy Menon, Mayank Goyal, Marc Ribó, Alejandro Tomasello, Carlos A Molina, Marta Rubiera
: Good collateral circulation (CC) is associated with favorable outcomes in acute stroke, but the best technique to evaluate collaterals is controversial. Single-phase computed tomography angiography (sCTA) is widely used but lacks temporal resolution. We aim to compare CC evaluation by sCTA and multiphase CTA (mCTA) as predictors of outcome in endovascular treated patients. METHODS: Consecutive endovascular treated patients with M1 middle cerebral artery (MCA) or terminal intracranial carotid artery (TICA) occlusion confirmed by sCTA were included...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27781050/the-role-of-catheter-angiography-in-the-diagnosis-of-central-nervous-system-vasculitis
#3
REVIEW
Randall C Edgell, Ahmed E Sarhan, Jazba Soomro, Collin Einertson, Joanna Kemp, Peyman Shirani, Theodore K Malmstrom, Jeroen Coppens
BACKGROUND: Central nervous system vasculitis (CNSV) is a rare disorder, the pathophysiology of which is not fully understood. It involves a combination of inflammation and thrombosis. CNSV is most commonly associated with headache, gradual changes in mental status, and focal neurological symptoms. Diagnosis requires the effective use of history, laboratory testing, imaging, and biopsy. Catheter angiography can be a powerful tool in the diagnosis when common and low-frequency angiographic manifestations of CNSV are considered...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27781049/erratum
#4
(no author information available yet)
[This corrects the article DOI: 10.1159/000443617.].
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27781048/internal-carotid-artery-s-shaped-curve-as-a-marker-of-fibromuscular-dysplasia-in-dissection-related-acute-ischemic-stroke
#5
Diogo C Haussen, Ashutosh Jadhav, Leticia C Rebello, Samir Belagaje, Aaron Anderson, Tudor Jovin, Amin Aghaebrahim, Deepak Gulati, Bryan Wells, Michael Frankel, Raul G Nogueira
BACKGROUND AND PURPOSE: Craniocervical fibromuscular dysplasia (FMD) is associated with dissections and with S-shaped curves in the internal carotid artery (ICA). We evaluated the occurrence of S-curves in patients presenting with acute strokes due to ICA steno-occlusive dissections. METHODS: This was a retrospective review of the interventional databases of two academic tertiary-care institutions. The presence of ICA S-shaped curves, C-shaped curves, 360-degree loops, as well as classic FMD and atherosclerotic changes at the ICA bulb and curve/loop was determined...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27781047/functional-independence-following-endovascular-treatment-for-basilar-artery-occlusion-despite-extensive-bilateral-pontine-infarcts-on-diffusion-weighted-imaging-refuting-a-self-fulfilling-prophecy
#6
Diogo C Haussen, Renato A C Oliveira, Vikas Patel, Raul G Nogueira
BACKGROUND AND PURPOSE: Extensive brainstem diffusion-weighted imaging (DWI) hyperintensity has been associated with poor outcomes. We aim at documenting a series of patients with extensive DWI pontine lesions who achieved independence following endovascular therapy and aggressive medical therapy in the setting of posterior circulation basilar artery occlusion (BAO). METHODS: This is a retrospective endovascular database review of a single-operator experience over a 9-year period for patients with (1) complete BAO, (2) extensive bilateral pontine DWI changes and (3) 90-day modified Rankin scale 0-2...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27781046/is-intra-arterial-treatment-for-acute-ischemic-stroke-less-effective-in-women-than-in-men
#7
Inger R de Ridder, Puck S S Fransen, Debbie Beumer, Olvert A Berkhemer, Lucie A van den Berg, Marieke J Wermer, Hester Lingsma, Wim H van Zwam, Yvo B Roos, Robert J van Oostenbrugge, Charles B Majoie, Aad van der Lugt, Diederik W J Dippel
INTRODUCTION: Stroke etiology and outcome after ischemic stroke differ between men and women. We examined if sex modifies the effect of intra-arterial treatment (IAT) in a randomized clinical trial of IAT for acute ischemic stroke in the Netherlands (MR CLEAN). PATIENTS AND METHODS: The primary outcome was the score on the modified Rankin scale at 90 days. We tested for interaction between sex and treatment and estimated the treatment effect by sex with multiple ordinal logistic regression with adjustment for prognostic factors...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27781045/local-fibrinolysis-in-spontaneous-supratentorial-hematomas-comparison-with-surgical-and-medical-treatment
#8
Eugeniu Condrea, Valeriu Timirgaz, Stanislav Groppa, Ion Codreanu, Natalia Rotaru
OBJECTIVE: To evaluate the effectiveness of minimally invasive craniopuncture with local fibrinolysis in the management of supratentorial spontaneous intracerebral hemorrhage (SICH). METHODS: The study included 218 consecutive patients with supratentorial SICH who were assigned to one of three groups: treated with minimally invasive craniopuncture with local fibrinolysis, treated with craniotomy or other minimally invasive techniques without local fibrinolysis, or receiving conservative management alone...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27781044/clopidogrel-plus-aspirin-for-symptomatic-intracranial-atherosclerotic-stenosis-a-pilot-study
#9
Tareq Kass-Hout, Melanie Winningham, Omar Kass-Hout, Laura Henriquez, Frank Tong, Jacques Dion, Michael Cawley, Samir Belagaje, Michael Frankel, Aaron Anderson, Fadi Nahab
BACKGROUND AND PURPOSE: There are limited data on the optimal duration of dual antiplatelet therapy for secondary stroke prevention in patients with symptomatic intracranial atherosclerotic disease. METHODS: Consecutive patients presenting with high-grade (70-99%) symptomatic intracranial stenosis from January 1, 2011, to December 31, 2013, and evaluated within 30 days of the index event were eligible for this analysis. All patients underwent treatment with aspirin plus clopidogrel for a target duration of 12 months along with aggressive medical management based on the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) protocol; all patients were given gastrointestinal prophylaxis for the duration of their aspirin and clopidogrel treatment...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27781043/treatment-strategies-for-acute-ischemic-stroke-caused-by-carotid-artery-occlusion
#10
REVIEW
Wei Li, Qin Yin, Gelin Xu, Xinfeng Liu
Background: Acute ischemic stroke caused by internal carotid artery (ICA) occlusion usually has a poor prognosis, especially the T occlusion cases without functional collaterals. The efficacy of intravenous (IV) or intra-arterial (IA) thrombolysis with recombinant tissue plasminogen activator (rt-PA) remains ambiguous in these patients. Eendovascular recanalization of the occluded carotid has been attempted in recent years as a potential strategy. However, the different etiologies of ICA occlusion pose a significant challenge to neurointerventionists...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27781042/cbv_aspects-improvement-over-ct_aspects-on-determining-irreversible-ischemic-lesion-decreases-over-time
#11
Marina Padroni, Sandra Boned, Marc Ribó, Marian Muchada, David Rodriguez-Luna, Pilar Coscojuela, Alejandro Tomasello, Jordi Cabero, Jorge Pagola, Noelia Rodriguez-Villatoro, Jesus M Juega, Estela Sanjuan, Carlos A Molina, Marta Rubiera
: The Alberta Stroke Program Early CT Score (ASPECTS) is a useful scoring system for assessing early ischemic signs on noncontrast computed tomography (CT). Cerebral blood volume (CBV) on CT perfusion defines the core lesion assumed to be irreversibly damaged. We aim to explore the advantages of CBV_ASPECTS over CT_ASPECTS in the prediction of final infarct volume according to time. METHODS: Consecutive patients with anterior circulation stroke who underwent endovascular reperfusion according to initial CT_ASPECTS ≥7 were studied...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27781041/visual-improvement-after-intra-arterial-thrombolysis-for-central-retinal-artery-occlusion-does-not-correlate-with-time-to-treatment
#12
Paul S Page, Alexander C Cambon, Robert F James
BACKGROUND: Intra-arterial thrombolysis (IAT) for the treatment of acute central retinal artery occlusion (CRAO) has demonstrated variable results for improving visual acuity and remains controversial. Despite limited evidence, time from symptom onset to thrombolysis is believed to be an important factor in predicting visual improvement after IAT. METHODS: A comprehensive review of the literature was conducted and individual subject level data were extracted from relevant studies...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27781040/safety-outcomes-using-a-proximal-protection-device-in-carotid-stenting-of-long-carotid-stenoses
#13
Kunakorn Atchaneeyasakul, Priyank Khandelwal, Sudheer Ambekar, Kevin Ramdas, Luis Guada, Dileep Yavagal
BACKGROUND: Embolic protection devices can prevent atherosclerotic emboli during carotid stenting. Newer proximal protection devices reverse flow in the internal carotid artery (ICA), leading to reduction in perioperative microemboli. The risk of stroke is high for carotid stenting of ICA lesions with a length >10 mm and/or angiographic string sign. OBJECTIVE: We aimed to evaluate the safety outcomes of proximal embolic protection device usage in this high-risk group...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27781039/recanalization-and-angiographic-reperfusion-are-both-associated-with-a-favorable-clinical-outcome-in-the-ims-iii-trial
#14
Marie L Schmitz, Sharon D Yeatts, Thomas A Tomsick, David S Liebeskind, Achala Vagal, Joseph P Broderick, Pooja Khatri
BACKGROUND: Prompt revascularization is the main goal of acute ischemic stroke treatment. We examined which revascularization scale - reperfusion (modified Treatment in Cerebral Infarctions, mTICI) or recanalization (Arterial Occlusive Lesion, AOL) - better predicted the clinical outcome in ischemic stroke participants treated with endovascular therapy (EVT). Additionally, we determined the optimal thresholds for the predictive accuracy of each scale. METHODS: We included participants from the Interventional Management of Stroke (IMS) III trial with complete occlusion in the internal carotid artery terminus or proximal middle cerebral artery (M1 or M2) who completed EVT within 7 h of symptom onset...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27781038/stent-retriever-based-thrombectomy-in-octogenarians
#15
Jose E Cohen, John M Gomori, Ronen R Leker
BACKGROUND AND AIMS: Stent retriever-based thrombectomy (SRT) may be beneficial in patients with large hemispheric stroke. Previous studies concluded that favorable outcomes are far less frequent after endovascular therapy in older patients but have not explored outcomes in the era of newer-generation stent retrievers. MATERIALS AND METHODS: Consecutive patients with large hemispheric stroke treated with SRT were included. We compared neurological and functional outcomes between patients younger and older than 80...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27781037/rescue-thrombectomy-in-large-vessel-occlusion-strokes-leads-to-better-outcomes-than-intravenous-thrombolysis-alone-a-real-world-applicability-of-the-recent-trials
#16
Raul G Nogueira, Osama O Zaidat, Alicia C Castonguay, Diogo C Haussen, Coleman O Martin, William E Holloway, Nils Mueller-Kronast, Joey English, Italo Linfante, Guilherme Dabus, Tim W Malisch, Franklin A Marden, Hormozd Bozorgchami, Andrew Xavier, Ansaar T Rai, Michael T Froehler, Aamir Badruddin, Thanh N Nguyen, M Asif Taqi, Michael G Abraham, Vallabh Janardhan, Albert J Yoo, Hashem Shaltoni, Alex Abou-Chebl, Peng R Chen, Gavin W Britz, Roberta Novakovic, Ashish Nanda, Ritesh Kaushal, Mohammad A Issa, Michael R Frankel, Rishi Gupta
BACKGROUND: The Interventional Management of Stroke III (IMS-III) trial demonstrated no benefit for intravenous recombinant tissue plasminogen activator (IV rt-PA) followed by endovascular therapy versus IV rt-PA alone. However, IMS-III mostly included earlier generation devices. The recent thrombectomy trials have incorporated the stent-retriever technology, but their generalizability remains unknown. METHODS: The North American Solitaire Acute Stroke (NASA) registry recruited patients treated with the Solitaire FR™ device between March 2012 and February 2013...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27610126/aneurysm-study-of-pipeline-in-an-observational-registry-aspire
#17
David F Kallmes, Waleed Brinjikji, Edoardo Boccardi, Elisa Ciceri, Orlando Diaz, Rabih Tawk, Henry Woo, Pascal Jabbour, Felipe Albuquerque, Rene Chapot, Alain Bonafe, Shervin R Dashti, Josser E Delgado Almandoz, Curtis Given, Michael E Kelly, DeWitte T Cross, Gary Duckwiler, Nasser Razack, Ciaran J Powers, Sebastian Fischer, Demetrius Lopes, Mark R Harrigan, Daniel Huddle, Raymond Turner, Osama O Zaidat, Luc Defreyne, Vitor Mendes Pereira, Saruhan Cekirge, David Fiorella, Ricardo A Hanel, Pedro Lylyk, Cameron McDougall, Adnan Siddiqui, Istvan Szikora, Elad Levy
BACKGROUND AND OBJECTIVE: Few prospective studies exist evaluating the safety and efficacy of the Pipeline Embolization Device (PED) in the treatment of intracranial aneurysms. The Aneurysm Study of Pipeline In an observational Registry (ASPIRe) study prospectively analyzed rates of complete aneurysm occlusion and neurologic adverse events following PED treatment of intracranial aneurysms. MATERIALS AND METHODS: We performed a multicenter study prospectively evaluating patients with unruptured intracranial aneurysms treated with PED...
June 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27610125/automated-ct-perfusion-for-ischemic-core-volume-prediction-in-tandem-anterior-circulation-occlusions
#18
Diogo C Haussen, Seena Dehkharghani, Mikayel Grigoryan, Meredith Bowen, Leticia C Rebello, Raul G Nogueira
BACKGROUND/AIM: CT perfusion (CTP) predicts ischemic core volumes in acute ischemic stroke (AIS); however, assumptions made within the pharmacokinetic model may engender errors by the presence of tracer delay or dispersion. We aimed to evaluate the impact of hemodynamic disturbance due to extracranial anterior circulation occlusions upon the accuracy of ischemic core volume estimation with an automated perfusion analysis tool (RAPID) among AIS patients with large-vessel occlusions. METHODS: A prospectively collected, interventional database was retrospectively reviewed for all cases of endovascular treatment of AIS between September 2010 and March 2015 for patients with anterior circulation occlusions with baseline CTP and full reperfusion (mTICI3)...
June 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27610124/endovascular-management-of-sigmoid-sinus-diverticulum
#19
Srinivasan Paramasivam, Sunil Furtado, Tomoyoshi Shigamatsu, Eric Smouha
Sigmoid sinus diverticulum (SSD) is a rare vascular disorder due to dehiscence of the sigmoid plate. It may be associated with prediverticular venous sinus stenosis (SS) and usually presents as pulsatile tinnitus. The mechanism of development of the SSD and tinnitus from a sinus diverticulum and associated SS is unclear. Previous case reports have suggested that remodeling of the venous system targeting the stenosis, elimination of the diverticulum, or both, have resulted in symptom relief. We present a case of SSD with SS, treated by stenting of the stenosis along with coil embolization of the diverticulum, resulting in complete relief of symptoms...
June 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27610123/fractional-flow-assessment-for-the-evaluation-of-intracranial-atherosclerosis-a-feasibility-study
#20
ZhongRong Miao, David S Liebeskind, WaiTing Lo, LiPing Liu, YueHua Pu, XinYi Leng, LiGang Song, XiaoTong Xu, BaiXue Jia, Feng Gao, DaPeng Mo, Xuan Sun, Lian Liu, Ning Ma, Bo Wang, YiLong Wang, YongJun Wang
PURPOSE: Current studies on endovascular intervention for intracranial atherosclerosis select patients based on luminal stenosis. Coronary studies demonstrated that fractional flow measurements assess ischemia better than anatomical stenosis and can guide patient selection for intervention. We similarly postulated that fractional flow can be used to assess ischemic stroke risk. METHODS: This was a feasibility study to assess the technical use and safety of applying a pressure guidewire to measure fractional flow across intracranial stenoses...
June 2016: Interventional Neurology
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