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J Scott Pannell, David R Santiago-Dieppa, Arvin R Wali, Brian R Hirshman, Jeffrey A Steinberg, Vincent J Cheung, David Oveisi, Jon Hallstrom, Alexander A Khalessi
This study establishes performance metrics for angiography and neuroendovascular surgery procedures based on longitudinal improvement in individual trainees with differing levels of training and experience. Over the course of 30 days, five trainees performed 10 diagnostic angiograms, coiled 10 carotid terminus aneurysms in the setting of subarachnoid hemorrhage, and performed 10 left middle cerebral artery embolectomies on a Simbionix Angio Mentor™ simulator. All procedures were nonconsecutive. Total procedure time, fluoroscopy time, contrast dose, heart rate, blood pressures, medications administered, packing densities, the number of coils used, and the number of stent-retriever passes were recorded...
August 29, 2016: Curēus
Naoyuki Uchiyama, Kouichi Misaki, Masanao Mohri, Tomoya Kamide, Yuichi Hirota, Ryo Higashi, Hisato Minamide, Yukihiko Kohda, Takashi Asahi, Katsuo Shoin, Masayuki Iwato, Daisuke Kita, Yoshitaka Hamada, Yuya Yoshida, Mitsutoshi Nakada
Five recent multicenter randomized controlled trials (RCTs) have clearly shown the superiority of mechanical thrombectomy in large vessel occlusion acute ischemic stroke compared to systemic thrombolysis. Although 14 hospitals in Ishikawa prefecture have uninterrupted availability of systemic thrombolysis, mechanical thrombectomy is not available at all of these hospitals. Therefore, we established a Kanazawa mobile embolectomy team (KMET), which could travel to these hospitals and perform the acute reperfusion therapy...
October 11, 2016: Neurologia Medico-chirurgica
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
Karen Chen, Srinivasan Paramasivam, Alejandro Berenstein
BACKGROUND: Intracranial vascular malformations in children are being addressed through a variety of treatment modalities including open surgery, external beam radiation, and image-guided neuroendovascular procedures. These patients often receive multiple treatments and incur serial exposures to ionizing radiation which has been linked to tumor development in population-based data. OBJECTIVE: This study quantifies the effect of collimation on exposures from single procedures and over patient lifetimes to estimate excess risk of lifetime tumor development...
September 5, 2016: Journal of Neurointerventional Surgery
Akash P Kansagra, James D McEachern, Thomas P Madaelil, Adam N Wallace, DeWitte T Cross, Christopher J Moran, Colin P Derdeyn
BACKGROUND: Abciximab is used to treat thromboembolic complications of neuroendovascular procedures, but outcomes of treatment are not well defined. OBJECTIVE: To examine the angiographic and clinical outcomes based on route of abciximab administration and degree of vessel recanalization. MATERIALS AND METHODS: A prospectively maintained database of neuroendovascular procedures performed between January 2004 and May 2015 was retrospectively reviewed to identify cases with thromboembolic complications treated with abciximab...
August 18, 2016: Journal of Neurointerventional Surgery
Mark R Villwock, David J Padalino, Raghu Ramaswamy, Eric M Deshaies
BACKGROUND: The future of neuroendovascular treatment for intracranial atherosclerotic disease (ICAD) has been debated since the results of SAMMPRIS reflected poor outcomes following endovascular therapy. There is currently a large spectrum of current management strategies. We compared historical outcomes of patients with ICAD and stroke that were treated with angioplasty-alone versus stent placement. METHODS: We extracted a population from the Nationwide Inpatient Sample (NIS) (2005-2011) and the National Inpatient Sample (NIS) (2012) composed of patients with ICAD and infarction that were admitted nonelectively and received endovascular revascularization...
June 2016: Journal of Vascular and Interventional Neurology
Ashish Sonig, Elad I Levy
No abstract text is available yet for this article.
August 2016: Neurosurgery
Dong Seong Shin, Ali Yilmaz, Ayca Ozkul, Dong Kyu Yeo, Sun-Chul Hwang, Bum-Tae Kim
Objective The transfemoral approach is a common route for catheterization of the supra-aortic vessels in neuroendovascular therapy. However, in some cases, the patient's anatomy prevents transfemoral catheterization or distal access to the carotid s. In such cases, direct carotid exposure (DCE) for neuroendovascular approaches may be used to treat cerebrovascular diseases. Methods We present 11 cases in which we were unable to perform the distal approach and DCE was the preferred neuroendovascular treatment procedure...
July 1, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Koichi Arimura, Koji Iihara
Recently, several new randomized controlled trials have been reported which showed the efficacy of neuroendovascular therapy for acute ischemic stroke. Confirming the major vessel occlusion in the proximal anterior circulation, limited ischemic core and preserved ischemic penumbra, using stent retrievers to achieve successful reperfusion, and shortening the onset-to-reperfusion time were the essential factors to achieve good clinical outcome. With these new evidences, it has been proved that neuroendovascular therapy became one of the standard treatments for acute ischemic stroke...
April 2016: Nihon Rinsho. Japanese Journal of Clinical Medicine
Satoshi Inoue, Atsushi Fujita, Takashi Mizowaki, Yoshito Uchihashi, Ryuichi Kuroda, Seishirou Urui, Eiji Kurihara, Eiji Kohmura
We report a patient with Trousseau syndrome who presented with repeated acute middle cerebral artery (MCA) occlusion, which was successfully treated by performing mechanical thrombectomy. A 66-year-old man with a lung lesion and abdominal lymph node swelling experienced a sudden onset of left hemiparesis. Magnetic resonance angiography (MRA) revealed a right MCA occlusion. Perfusion-weighted imaging revealed reduced cerebral blood flow in the right MCA territory. Complete recanalization of the occluded vessel was achieved by performing mechanical thrombectomy, and his symptoms remarkably disappeared...
June 2016: No Shinkei Geka. Neurological Surgery
Fawaz Al-Mufti, Krishna Amuluru, Chirag D Gandhi, Charles J Prestigiacomo
Endovascular treatment of intracranial aneurysms with complex morphologies such as giant, wide-necked, or fusiform aneurysms is challenging. Stent-assisted coiling and balloon-assisted coiling are alternative techniques to treat such complex aneurysms, but studies have shown less-than-expected efficacy, as suggested by their high rate of recanalization. The management of complex aneurysms via microsurgery or conventional neuroendovascular strategies has traditionally been poor. However, over the last few years, flow-diverting stents (FDS) have revolutionized the treatment of such aneurysms...
July 2016: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
R Yasuda, M Maeda, M Umino, Y Nakatsuka, Y Umeda, N Toma, H Sakaida, H Suzuki
We describe a case series of suspected metallic embolism after coil embolization for intracranial aneurysms. Between January 2012 and December 2014, 110 intracranial aneurysms had been treated by coil embolization in our institution. In 6 cases, the postprocedural MR imaging revealed abnormal spotty lesions not detected on the preprocedural MR imaging. The lesions were also undetectable on the postprocedural CT scan. They were demonstrated as low-intensity spots on T1WI, T2WI, DWI, and T2*-weighted imaging...
September 2016: AJNR. American Journal of Neuroradiology
Italo Linfante
No abstract text is available yet for this article.
May 2016: Journal of Neurointerventional Surgery
Ramsey Ashour, Alfred P See, Hormuzdiyar H Dasenbrock, Priyank Khandelwal, Nirav J Patel, Bianca Belcher, Mohammad Ali Aziz-Sultan
OBJECTIVE: In early-generation hybrid biplane endovascular operating rooms, switching from surgical to angiographic position is cumbersome. In this report, we highlight the unique design of a new hybrid neuroendovascular operating suite that allows surgical access to the head while keeping the biplane system over the lower body of the patient. Current and future hybrid neuroendovascular operating suite applications are discussed. METHODS: We collaborated with engineers to implement the following modifications to the design of the angiographic system: translation of the bed toward the feet to allow biplane cerebral imaging in the head-side position and the biplane left-side position; translation of the base of the A-plane C-arm away from the feet to allow increased operator space at the head of the bed and to allow cerebral imaging in both the head-side and left-side positions; use of a specialized boom mount for the display panel to increase mobility; and use of a radiolucent tabletop with attachments for the headrest or radiolucent head clamp system...
July 2016: World Neurosurgery
(no author information available yet)
ContributorsAmerican Academy of Neurological Surgeons/ Congress of Neurological Surgeons (AANS/CNS): S.D. Lavine, K Cockroft, B Hoh, N Bambakidis, AA Khalessi, H Woo, H Riina. A. SiddiquiAmerican Society of Neuroradiology (ASNR): J. A. HirschAsian Australasian Federation of Interventional and Therapeutic Neuroradiology (AAFITN): W. ChongAustralian and New Zealand Society of Neuroradiology - Conjoint Committee for Recognition of Training in Interventional Neuroradiology (CCINR) representing the RANZCR (ANZSNR), ANZAN and NSA: H...
June 2016: Interventional Neuroradiology
Ali Yilmaz, Ayca Ozkul, Dong Seong Shin, Soo-Bin Im, Seok-Mann Yoon, Bum-Tae Kim
OBJECTIVE: The transradial catheterization (TRC) is becoming widespread, primarily for neurointerventions. Therefore, the evaluation of radial artery puncture in clinical practice and a better understanding of the anatomy are important to improve the safety of neuroendovascular surgery. METHODS: Ten formalin-fixed adult Korean cadavers were dissected to expose radial artery (RA), brachial artery (BrA) and subclvian artery (ScA), bilaterally. Vessel lengths and diameters were meaured using a caliper and distance between the specific point of vessels and the anatomical landmarks including the radial styloid process, the medial epicondyle of the humerus, the sternoclavicular joint, and the vertebral artery orifice were also measured...
December 2015: Journal of Korean Neurosurgical Society
Motoyuki Kumagai, Junichiro Nishizawa, Daisuke Heima, Kazuhiro Takatoku, Yoshihiko Watanabe, Yasuzumi Matsui, Hidenori Miyake
A 67-year-old woman suffered from severe aortic stenosis and atrial fibrillation, and underwent aortic valve replacement with a St. Jude Medical Regent 23-mm valve and pulmonary vein isolation using an AtriCure Isolator Synergy.At 6 days after the operation, she experienced sudden onset of atrial fibrillation, left side paralysis, and dysarthria. Right internal carotid artery embolism was diagnosed via magnetic resonance imaging, and we promptly performed neuroendovascular therapy with a Solitaire FR. Neuroendovascular treatment succeeded, and her neurological function was restored to near-normal...
December 2015: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Tomohiro Matsumoto, Shiro Imagama, Shigeru Miyachi, Takashi Izumi, Hiroki Matsui, Akio Muramoto, Ryoji Tauchi, Kei Ando, Zenya Ito, Naoki Ishiguro
No abstract text is available yet for this article.
January 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Fawaz Al-Mufti, Andrew Bauerschmidt, Jan Claassen, Philip M Meyers, Paolo C Colombo, Joshua Z Willey
BACKGROUND: With the shortage of donor hearts, increasingly more patients with end-stage heart failure are implanted with left ventricular assist devices (LVADs). LVADs are associated with a significant risk of developing acute ischemic strokes (AISs). Very little is known on about the management of AIS in patients with LVAD, especially with regard to the safety and efficacy of neuroendovascular techniques. METHODS: We identified 5 patients with heart failure and LVAD implants who developed AIS and underwent neuroendovascular interventions at Columbia University Medical Center...
April 2016: World Neurosurgery
Blake E S Taylor, Brett E Youngerman, Hannah Goldstein, Daniel H Kabat, Geoffrey Appelboom, William E Gold, Edward Sander Connolly
BACKGROUND: Reducing the rate of 30-day hospital readmission has become a priority in healthcare quality improvement policy, with a focus on better characterizing the reasons for unplanned readmission. In neurosurgery, however, peer-reviewed analyses describing the patterns of readmission have been limited in their number and generalizability. OBJECTIVE: To determine the incidence, timing, and causes of 30-day readmission after neurosurgical procedures. METHODS: We conducted a retrospective longitudinal study from 2009 to 2012 using the Statewide Planning And Research Cooperative System, which collects patient-level details for all admissions and discharges within New York...
September 2016: Neurosurgery
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