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Rimal Hanif Dossani, Muhammad Waqas
No abstract text is available yet for this article.
March 5, 2018: Neurosurgery
Tahaamin Shokuhfar, Michael C Hurley, Anas Al-Smadi, Sameer A Ansari, Matthew B Potts, Babak S Jahromi, Tord D Alden, Ali Shaibani
OBJECTIVE The aim of this paper was assess the efficacy and safety of using the MynxGrip arterial closure device in pediatric neuroendovascular procedures where the use of closure devices remains off-label despite their validation and widespread use in adults. METHODS A retrospective review of all pediatric patients who underwent diagnostic or interventional neuroendovascular procedures at the authors' institution was performed. MynxGrip use was predicated by an adequate depth of subcutaneous tissue and common femoral artery (CFA) diameter...
March 2, 2018: Journal of Neurosurgery. Pediatrics
Jae Kim, Shailesh Male, Bharathi D Jagadeesan, Christopher Streib, Ramachandra P Tummala
PURPOSE: Contrast-induced nephropathy is a common clinical concern in patients undergoing neuroendovascular procedures, especially in those with pre-existent kidney disease. We aimed to define the incidence of contrast-induced nephropathy in these high-risk patients in our practice. METHODS: We analyzed data retrospectively from patients undergoing neuroendovascular procedures at two academic medical centers over a 4-year period. Contrast-induced nephropathy was determined by an absolute increase in serum creatinine of 0...
March 1, 2018: Neuroradiology
Michael T Froehler, Rohan Chitale, Jordan A Magarik, Matthew R Fusco
PURPOSE: The efficiency of neuroendovascular procedures may partly depend on the time devoted to placement of a radial arterial line (RAL) for intraoperative blood pressure monitoring. An alternative approach is to use a pressure-sensing sheath (PSS) that serves to provide invasive blood pressure monitoring without requiring a separate procedure for placement. We compared the use of a RAL versus PSS and assessed procedure time, anesthetist and patient satisfaction, and cost. METHODS: We performed a single-center, prospective, blockwise, comparative trial of procedure start time using traditional RAL placement versus the EndoPhys PSS for invasive blood pressure monitoring...
February 27, 2018: Journal of Neurointerventional Surgery
A Sonig, S V Setlur Nagesh, V S Fennell, S Gandhi, L Rangel-Castilla, C N Ionita, K V Snyder, L N Hopkins, D R Bednarek, S Rudin, A H Siddiqui, E I Levy
BACKGROUND AND PURPOSE: The ROI-dose-reduced intervention technique represents an extension of ROI fluoroscopy combining x-ray entrance skin dose reduction with spatially different recursive temporal filtering to reduce excessive image noise in the dose-reduced periphery in real-time. The aim of our study was to compare the image quality of simulated neurointerventions with regular and reduced radiation doses using a standard flat panel detector system. MATERIALS AND METHODS: Ten 3D-printed intracranial aneurysm models were generated on the basis of a single patient vasculature derived from intracranial DSA and CTA...
February 15, 2018: AJNR. American Journal of Neuroradiology
T Kuriyama, N Sakai, M Beppu, C Sakai, H Imamura, K Masago, N Katakami, H Isoda
BACKGROUND AND PURPOSE: Innovative techniques and device-related advances have improved the outcomes of neuroendovascular treatment. 3D imaging has previously used 2 × 2 binning, but 1 × 1 binning has recently been made available. The aim of this study was to evaluate the quantitative ability of conebeam CT for stent delineation and to investigate its effectiveness in the clinical environment. MATERIALS AND METHODS: Four acquisition groups of 3D MIP images acquired using conebeam CT with varying conditions (acquisition time, 10 or 20 seconds and binning, 1 × 1 or 2 × 2) were compared...
February 1, 2018: AJNR. American Journal of Neuroradiology
Hakeem J Shakir, Hussain Shallwani, Leonardo Rangel-Castilla, Amade Bregy, Jason M Davies, Ashish Sonig, Christopher S Ogilvy, Kenneth V Snyder, L Nelson Hopkins, Adnan H Siddiqui, Elad I Levy
The University at Buffalo's neuroendovascular fellowship is one of the longest running fellowship programs in North America. The burgeoning neurointerventional workforce and the rapid growth in the neurointerventional space on the heels of groundbreaking clinical trials prompted us to assess the fellowship's academic impact and its graduates' perceptions and productivity. An anonymized web-based survey was sent to all former neuroendovascular fellows with specific questions pertaining to current practice, research and funding, and perceptions about the fellowship's impact on their skills, competitiveness, and compensation...
January 17, 2018: Neurosurgery
Chirag D Gandhi, Fawaz Al Mufti, I Paul Singh, Todd Abruzzo, Barbara Albani, Sameer A Ansari, Adam S Arthur, Mark Bain, Blaise W Baxter, Ketan R Bulsara, Justin M Caplan, Michael Chen, Guilherme Dabus, Don Frei, Steven W Hetts, M Shazam Hussain, Mahesh V Jayaraman, Yasha Kayan, Richard P Klucznik, Seon-Kyu Lee, William J Mack, Thabele Leslie-Mazwi, Ryan A McTaggart, Philip M Meyers, Maxim Mokin, Athos T Patsalides, Charles J Prestigiacomo, G Lee Pride, Robert M Starke, Peter J Sunenshine, Justin F Fraser
No abstract text is available yet for this article.
January 11, 2018: Journal of Neurointerventional Surgery
Nicholas K Cheung, Michelle Boutchard, Michael W Carr, Jens J Froelich
BACKGROUND: Limited data are available for radiation exposure, and procedure and fluoroscopy times in neuroendovascular treatment (NET) strategies. OBJECTIVE: This study establishes and compares related parameters between coil embolization (COIL), balloon assisted coil embolization (BAC), stent assisted coil embolization (SAC), and flow diverting technology (FDT) in NET of intracranial aneurysms. MATERIALS AND METHODS: Between 2010 and 2017, 249 consecutive intracranial aneurysms underwent NET at a single center, all performed by the same operator...
January 9, 2018: Journal of Neurointerventional Surgery
Kyle Davis, Christopher Morrison
BACKGROUND: The development of thromboembolism is one of the most common complications of neuroendovascular procedures. Although several small studies have deemed clopidogrel safe and effective in the prevention of intracranial stent thrombosis, ticagrelor has yet to be assessed in this setting. OBJECTIVE: The objective of this study was to retrospectively evaluate the safety and efficacy of ticagrelor in patients undergoing neuroendovascular procedures. METHODS: A retrospective review of patients receiving ticagrelor following neuroendovascular aneurysm repair...
January 1, 2017: Journal of Pharmacy Practice
Ichiro Deguchi, Norio Tanahashi, Masaki Takao
BACKGROUND: An intravenous recombinant tissue plasminogen activator (rt-PA, alteplase .6 mg/kg) for acute cerebral infarction within 3 hours of onset was approved in Japan in 2005. The treatment window was subsequently extended to within 4.5 hours of onset. However, few Japanese studies have compared the efficacy and safety of rt-PA therapy between patients treated within 3 hours and patients treated within 3-4.5 hours. METHODS: This study included 323 patients who received rt-PA for acute cerebral infarction within 3 hours or 3-4...
April 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Keri S Kim, Justin F Fraser, Stephen Grupke, Aaron M Cook
Neuroendovascular techniques for treating cerebral aneurysms and other cerebrovascular pathology are increasingly becoming the standard of care. Intraluminal stents, aneurysm coils, and other flow diversion devices typically require concomitant antiplatelet therapy to reduce thromboembolic complications. The variability inherent with the pharmacodynamic response to common antiplatelet agents such as aspirin and clopidogrel complicates optimal selection of antiplatelet agents by clinicians. This review serves to discuss the literature related to antiplatelet use in neuroendovascular procedures and provides recommendations for clinicians on how to approach patients with variable response to antiplatelet agents, particularly clopidogrel...
December 1, 2017: Journal of Neurosurgery
Michael A Silva, Alfred P See, Samir K Shah, Priyank Khandelwal, Nirav J Patel, Heather Lyu, Matthew T Menard, Mohammad Ali Aziz-Sultan
PURPOSE: Cardiac myxomas are common tumors of the heart with disproportionate impact on young patients, occasionally with dramatic systemic dissemination of tumor emboli with catastrophic multiorgan system ischemia. The coincident comorbidities can increase the risk of traditional treatments for tumor embolus in each region. CASE REPORT: A young patient with previously unknown cardiac myxoma presented with seizure and was found to have stress cardiomyopathy, multiple cerebral large vessel occlusions with acute ischemic stroke, bilateral lower extremity tumor emboli and rhabdomyolysis, and renal tumor embolus with acute tubular necrosis...
January 1, 2017: Vascular and Endovascular Surgery
Ihtesham A Qureshi, Gustavo J Rodriguez, Tatiana Chacon-Quesada, Gavito-Higuera Jose, Salvador Cruz-Flores, Alberto Maud
Background  There have been studies trying to characterize Fibromuscular Dysplasia (FMD); however, most of them are based in mainly non-Hispanic sample. The objective of this study is to better understand the epidemiology and clinical characteristics of craniocervical FMD in the Hispanic population. Methods  We retrospectively reviewed the cerebral angiograms performed in our center in a period of 3.5 years under any indication looking for angiographic patterns of FMD. Exclusion criteria consisted of cases in which the first angiogram was done when the patients were younger than 18 years...
December 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
Visish M Srinivasan, Michael George Zaki Ghali, Oleg E Reznik, Jacob Cherian, Maxim Mokin, Travis M Dumont, John R Gaughen, Ramesh Grandhi, Ajit S Puri, Stephen R Chen, Jeremiah N Johnson, Peter Kan
BACKGROUND: The pipeline embolization device (PED) is frequently used in the treatment of anterior circulation aneurysms, especially around the carotid siphon, with generally excellent results. However, treatment of posterior inferior cerebellar artery (PICA) aneurysms with flow diversion (FD) has not been specifically described or discussed. While there are reports of treating PICA aneurysms using placement of FD stents in the vertebral artery, there are no reports of treating these lesions by placement of flow diverting stents in the PICA vessel itself...
October 20, 2017: Journal of Neurointerventional Surgery
Kazushi Maeda, Shota Yoshida, Ryosuke Otsuji, Nice Ren, Shintaro Nagaoka, Katsuharu Kameda, Yoshiaki Ikai, Junji Uno, Hidefuku Gi, Takumi Uehara, Tatsuya Shingaki
The stabilization of a guiding catheter is a very important factor for successful endovascular treatment. However, it is sometimes difficult to obtain sufficient stabilization because of the tortuosity of the approach route. A Goose Neck Snare is useful for the retrieval of intravascular foreign bodies and can be used to hold the guiding catheter. We describe five cases of endovascular treatment performed while using the Goose Neck Snare via the brachial artery to hold the guiding catheter. We discuss the utility of this strategy...
October 2017: No Shinkei Geka. Neurological Surgery
Yuang-Seng Tsuei, Chih-Hsiang Liao, Chung-Hsin Lee, Yea-Jiuan Liang, Wen-Hsien Chen, Shun-Fa Yang
BACKGROUND: Intraprocedural arterial perforation (IPAP) is a potentially dismal complication of neuroendovascular therapy with high mortality and morbidity rates. The management of IPAP with the techniques described has been well established, but rescue results from the dual-trained endovascular neurosurgeon in the neurosurgical hybrid operating room (OR) are rarely reported. Here, we report five cases of successful rescue of IPAP in the neurosurgical hybrid OR and compare them with other series...
October 12, 2017: Journal of the Chinese Medical Association: JCMA
Raphaël Blanc, Robert Fahed, Pascal Roux, Stanislas Smajda, Gabriele Ciccio, Jean-Philippe Desilles, Hocine Redjem, Mikael Mazighi, Humain Baharvahdat, Michel Piotin
BACKGROUND: Endovascular venous access is increasingly used for the treatment of many cerebrovascular diseases. The quality of venous roadmapping through arterial injection can be problematic because of contrast media dilution, slow flow velocity, and unilateral opacification of the venous system. OBJECTIVE: To describe our experience with the VesselNavigator (Philips Healthcare, Best, The Netherlands) in performing live 3D roadmapping for intracranial venous procedures...
October 11, 2017: Journal of Neurointerventional Surgery
Pearse P Morris, Carol P Geer, Jasmeet Singh, Waleed Brinjikji, Rickey E Carter
AIM: To describe the impact of steps towards reduction of procedural doses of radiation during neuroendovascular procedures. METHODS: Phantom exposures under controlled circumstances were performed using a Rando-Alderson adult-sized head phantom. Customized imaging protocols were devised for pediatric and adult imaging and implemented in clinical use. Outcome data for estimated skin doses (ESD) and dose-area product (DAP) following pediatric and adult diagnostic and interventional procedures over 4...
September 23, 2017: Journal of Neurointerventional Surgery
Ichiro Deguchi, Satoko Mizuno, Shinya Kohyama, Norio Tanahashi, Masaki Takao
BACKGROUND: Neuroendovascular therapy is a common treatment for patients with acute ischemic stroke of the anterior circulation who fail to respond to recombinant tissue plasminogen activator. However, although most hospitals can provide recombinant tissue plasminogen activator therapy, many cannot perform neuroendovascular therapy. Thus, use of a drip-and-ship treatment-liaison system allowing recombinant tissue plasminogen activator-treated patients to be transferred to facilities offering neuroendovascular therapy is important...
January 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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