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Interventional Neurology

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
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
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
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
Kaiz S Asif, Ahsan Sattar, Marc A Lazzaro, Brian-Fred Fitzsimmons, John R Lynch, Osama O Zaidat
BACKGROUND: Small aneurysms located at the anterior communicating artery carry significant procedural challenges due to a complex anatomy. Recent advances in endovascular technologies have expanded the use of coil embolization for small aneurysm treatment. However, limited reports describe their safety and efficacy profiles in very small anterior communicating artery aneurysms. OBJECTIVE: We sought to review and report the immediate and long-term clinical as well as radiographic outcomes of consecutive patients with ruptured very small anterior communicating artery aneurysms treated with current endovascular coil embolization techniques...
June 2016: Interventional Neurology
S D Lavine, K Cockroft, B Hoh, N Bambakidis, A A Khalessi, H Woo, H Riina, A Siddiqui, J A Hirsch, W Chong, H Rice, J Wenderoth, P Mitchell, A Coulthard, T J Signh, C Phatorous, M Khangure, P Klurfan, K Ter Brugge, D Iancu, T Gunnarsson, O Jansen, M Muto, I Szikora, L Pierot, P Brouwer, J Gralla, S Renowden, T Andersson, J Fiehler, F Turjman, P White, A C Januel, L Spelle, Z Kulcsar, R Chapot, A Biondi, S Dima, C Taschner, M Szajner, A Krajina, N Sakai, Y Matsumaru, S Yoshimura, O Diaz, P Lylyk, M V Jayaraman, A Patsalides, C D Gandhi, S K Lee, T Abruzzo, B Albani, S A Ansari, A S Arthur, B W Baxter, K R Bulsara, M Chen, J E Delgado Almandoz, J F Fraser, D V Heck, S W Hetts, M S Hussain, R P Klucznik, T M Leslie-Mawzi, W J Mack, R A McTaggart, P M Meyers, J Mocco, C J Prestigiacomo, G L Pride, P A Rasmussen, R M Starke, P J Sunenshine, R W Tarr, D F Frei, M Ribo, R G Nogueira, O O Zaidat, T Jovin, I Linfante, D Yavagal, D Liebeskind, R Novakovic, S Pongpech, G Rodesch, M Soderman, K Ter Brugge, A Taylor, T Krings, D Orbach, A Biondi, L Picard, D C Suh, M Tanaka, H Q Zhang
No abstract text is available yet for this article.
June 2016: Interventional Neurology
Mohammed Hussain, Mohammad Moussavi, Daniel Korya, Siddhart Mehta, Jaskiran Brar, Harina Chahal, Ihtesham Qureshi, Tapan Mehta, Javaad Ahmad, Osama O Zaidat, Jawad F Kirmani
BACKGROUND: Recent advances in the treatment of ischemic stroke have focused on revascularization and led to better clinical and functional outcomes. A systematic review and pooled analyses of 6 recent multicentered prospective randomized controlled trials (MPRCT) were performed to compare intravenous tissue plasminogen activator (IV tPA) and endovascular therapy (intervention) with IV tPA alone (control) for anterior circulation ischemic stroke (AIS) secondary to large vessel occlusion (LVO)...
June 2016: Interventional Neurology
Guangxin Duan, Jiaping Xu, Jijun Shi, Yongjun Cao
Bow hunter's syndrome (BHS), also known as rotational vertebral artery (VA) occlusion syndrome, is a rare yet treatable type of symptomatic vertebrobasilar insufficiency resulting from mechanical occlusion or stenosis of the VA during head and neck rotation or extension. The symptoms of BHS range from transient vertigo to posterior circulation stroke. The underlying pathology is dynamic stenosis or compression of the VA by abnormal bony structures with neck rotation or extension in many cases, such as osteophyte, disc herniation, cervical spondylosis, tendinous bands or tumors...
June 2016: Interventional Neurology
Tanzila Shams, Osama Zaidat, Dileep Yavagal, Andrew Xavier, Tudor Jovin, Vallabh Janardhan
Brain attack care is rapidly evolving with cutting-edge stroke interventions similar to the growth of heart attack care with cardiac interventions in the last two decades. As the field of stroke intervention is growing exponentially globally, there is clearly an unmet need to standardize stroke interventional laboratories for safe, effective, and timely stroke care. Towards this goal, the Society of Vascular and Interventional Neurology (SVIN) Writing Committee has developed the Stroke Interventional Laboratory Consensus (SILC) criteria using a 7M management approach for the development and standardization of each stroke interventional laboratory within stroke centers...
June 2016: Interventional Neurology
(no author information available yet)
[This corrects the article DOI: 10.1159/000441920.].
March 2016: Interventional Neurology
Seby John, Walaa Hazaa, Ken Uchino, Gabor Toth, Mark Bain, Umera Thebo, Muhammad S Hussain
BACKGROUND: It is unknown if intraprocedural blood pressure (BP) influences clinical outcomes and what BP parameter best predicts outcomes in acute ischemic stroke (AIS) patients who undergo intra-arterial therapy (IAT) for emergent large vessel occlusion. METHODS: We retrospectively reviewed 147 patients who underwent IAT for anterior circulation AIS from January 2008 to December 2012 at our institution. Baseline demographics, stroke treatment variables, and detailed intraprocedural hemodynamic variables were collected...
March 2016: Interventional Neurology
Joey D English, Dileep R Yavagal, Rishi Gupta, Vallabh Janardhan, Osama O Zaidat, Andrew R Xavier, Raul G Nogueira, Jawad F Kirmani, Tudor G Jovin
Five landmark multicenter, prospective, randomized, open-label, blinded end point clinical trials have recently demonstrated significant clinical benefit of endovascular therapy with mechanical thrombectomy in acute ischemic stroke (AIS) patients presenting with proximal intracranial large vessel occlusions. The Society of Vascular and Interventional Neurology (SVIN) appointed an expert writing committee to summarize this new evidence and make recommendations on how these data should guide emergency endovascular therapy for AIS patients...
March 2016: Interventional Neurology
Krishna Amuluru, Fawaz Al-Mufti, Stephen Hannaford, Inder Paul Singh, Charles J Prestigiacomo, Chirag D Gandhi
BACKGROUND: Developmental venous anomalies (DVAs) are variations of normal transmedullary veins draining white and gray matter. In the vast majority of cases, DVAs are diagnosed incidentally and should be considered as benign entities. In extremely rare circumstances, DVAs may become symptomatic due to mechanical or flow-related etiologies. Thrombosis of the collector vein of a DVA is a rare type of a flow-related complication with only 29 cases reported in the literature, the majority of which are supratentorial...
March 2016: Interventional Neurology
Srikant Rangaraju, Michael Frankel, Tudor G Jovin
BACKGROUND: Early prognostication of long-term outcomes following ischemic stroke can facilitate medical decision-making. We hypothesized that the 24-hour National Institute of Health Stroke Scale (NIHSS) predicts 3-month clinical outcomes in anterior circulation stroke. METHODS: Secondary analyses of the Interventional Management of Stroke 3 (IMS3) and intravenous tissue plasminogen activator (IV tPA) for acute ischemic stroke [National Institute of Neurological Diseases and Stroke (NINDS) IV tPA] trials were performed...
March 2016: Interventional Neurology
Silvia I Gesheva, Laurel H Hastings, Jason D Wilson
BACKGROUND: Posterior circulation strokes comprise approximately 20-25% of all strokes of ischemic origin. Strokes affecting this area carry a significantly higher risk for subsequent stroke or death as compared to anterior circulation strokes. Embolic protection device (EPD) use for carotid artery stenosis has translated into percutaneous interventions of proximal vertebral artery (VA) stenosis. However, the use of EPDs when treating intracranial lesions has yet to be studied and may not be feasible as the vessel caliber is frequently smaller than in existing devices...
March 2016: Interventional Neurology
Maxim Mokin, Chelsey C Ciambella, Muhammad W Masud, Elad I Levy, Kenneth V Snyder, Adnan H Siddiqui
BACKGROUND: Acute cerebral venous sinus thrombosis (VST) can be difficult to diagnose because of its diverse clinical presentation. The utility of perfusion imaging for diagnosing VST is not well understood. SUMMARY: We retrospectively reviewed cases of acute VST in patients who underwent whole-brain (320-detector-row) computed tomographic (CT) perfusion imaging in combination with craniocervical CT venography. Perfusion maps that were analyzed included cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time, and time to peak...
March 2016: Interventional Neurology
Ashutosh P Jadhav, Andrew F Ducruet, Brian T Jankowitz, Tudor G Jovin
BACKGROUND: Symptomatic bilateral internal carotid occlusive disease is a rare but potentially devastating entity. Medical therapy alone is associated with high rates of mortality and recurrent stroke. The optimal management of this disease remains poorly understood. METHODS: A retrospective review of a prospectively maintained database was conducted for patients who presented with an acute stroke in the setting of bilateral carotid occlusive disease between May and October 2013...
March 2016: Interventional Neurology
Sadaharu Torikoshi, Yoshinori Akiyama
BACKGROUND: Based on the results of several randomized controlled trials, acute endovascular thrombectomy is strongly recommended for patients with acute ischemic stroke due to large artery occlusion (LAO). The incidence of an intracranial aneurysm has been reported to be approximately 5% in the general population. Therefore, the possibility of the coincidence of LAO and an intracranial aneurysm at the distal part of an occluded vessel should be considered. SUMMARY: A 74-year-old female patient presented with the sudden onset of consciousness disturbance and left-sided weakness...
March 2016: Interventional Neurology
Ihtesham A Qureshi, Alberto Maud, Salvador Cruz-Flores, Gustavo J Rodriguez
BACKGROUND AND PURPOSE: In this article, we present our experience with the recanalization of the middle cerebral artery (MCA), we hypothesize that there are higher rates of recanalization with fewer stent retriever passes and better clinical outcomes in patients with division MCA occlusions. A more complex anatomy at the bifurcation may prevent a faster recanalization in main trunk MCA occlusions. METHODS: We retrospectively identified consecutive patients admitted with MCA occlusions who underwent mechanical thrombectomy using stent retrievers...
March 2016: Interventional Neurology
Hesham Masoud, Thanh N Nguyen, Coleman O Martin, William E Holloway, Sudheer Ambekar, Dileep R Yavagal, Diogo C Haussen, Raul Nogueira, Diego J Lozano, Ajit Puri, Ayman Quateen, Daniela Iancu, Michael G Abraham, Michael Chen, Sonal Mehta, Tim Malisch, Franklin Marden, Robin Novakovic, Daniel Roy, Alain Weill, Alexander M Norbash
Mechanical thrombectomy using retrievable stents or stent retriever devices has become the mainstay of intra-arterial therapy for acute ischemic stroke. The recent publication of a series of positive trials supporting intra-arterial therapy as standard of care for the treatment of large vessel occlusion will likely further increase stent retriever use. Rarely, premature stent detachment during thrombectomy may be encountered. In our multicenter case series, we found a rate of detachment of less than 1% (n = 7/1,067), and all were first-generation Solitaire FR devices...
March 2016: Interventional Neurology
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