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https://www.readbyqxmd.com/read/29783870/safety-and-efficacy-of-a-new-outreach-distal-access-catheter-tactics-for-coil-embolization-of-unruptured-intracranial-aneurysms
#1
Toshinori Matsushige, Shigeyuki Sakamoto, Daizo Ishii, Katsuhiro Shinagawa, Koji Shimonaga, Masahiro Hosogai, Tomohiro Kawasumi, Junpei Oshita, Takahito Okazaki, Kaoru Kurisu
Background and purpose Current large-bore catheters can be easily and safely placed in the intracranial vessels for the stabilization of microcatheters in several neurointervention scenarios. We considered that a novel 3.4 French catheter (TACTICS, Technorat Corporation, Aichi, Japan) might be useful for intermediate/distal access in a triaxial system. Here, we present our initial experience using the TACTICS catheter for treatment of intracranial aneurysms. Materials and methods A total of 35 endovascular coils were placed to embolize unruptured intracranial aneurysms of the anterior circulation using the TACTICS catheter between December 2016 and November 2017...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29773566/multisociety-consensus-quality-improvement-revised-consensus-statement-for-endovascular-therapy-of-acute-ischemic-stroke-from-the-american-association-of-neurological-surgeons-aans-american-society-of-neuroradiology-asnr-cardiovascular-and-interventional-radiology
#2
https://www.readbyqxmd.com/read/29736159/consensus-statements-by-korean-society-of-interventional-neuroradiology-and-korean-stroke-society-hyperacute-endovascular-treatment-workflow-to-reduce-door-to-reperfusion-time
#3
Dae-Hyun Kim, Byungjun Kim, Cheolkyu Jung, Hyo Suk Nam, Jin Soo Lee, Jin Woo Kim, Woong Jae Lee, Woo-Keun Seo, Ji-Hoe Heo, Seung Kug Baik, Byung Moon Kim, Joung-Ho Rha
Recent clinical trials demonstrated the clinical benefit of endovascular treatment (EVT) in patients with acute ischemic stroke due to large vessel occlusion. These trials confirmed that good outcome after EVT depends on the time interval from symptom onset to reperfusion and that in-hospital delay leads to poor clinical outcome. However, there has been no universally accepted in-hospital workflow and performance benchmark for rapid reperfusion. Additionally, wide variety in workflow for EVT is present between each stroke centers...
May 7, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29719553/47-consecutive-cases-of-pipeline-flex-flow-diversion-utilizing-a-novel-large-bore-intracranial-intermediate-catheter-nuances-and-institutional-experience-with-the-syphontrak
#4
Li-Mei Lin, Bowen Jiang, Matthew T Bender, Erick M Westbroek, Jessica K Campos, Rafael J Tamargo, Judy Huang, Alexander L Coon, Geoffrey P Colby
Background: The increasing complexity of modern neurointerventions has necessitated a shift in intracranial access techniques towards more robust distal support platforms. Here we present our experience with the Syphontrak Support Catheter (Codman Neuro, Raynham, MA, USA) in the triaxial platform for the implantation of the second-generation Pipeline Flex embolization device (PED Flex; Medtronic Neurovascular, Irvine, CA, USA). Methods: We retrospectively identified patients who underwent PED Flex treatment utilizing the Syphontrak at a single institution...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29678885/the-burden-of-neurothrombectomy-call-a-multicenter-prospective-study
#5
Michelle M Williams, Taylor A Wilson, Thabele Leslie-Mazwi, Joshua A Hirsch, Ryan T Kellogg, Alejandro M Spiotta, Reade De Leacy, J Mocco, Felipe Albuquerque, Andrew F Ducruet, Adam Arthur, Visish M Srinivasan, Peter Kan, Maxim Mokin, Travis M Dumont, Alan Reeves, Jasmeet Singh, Stacey Q Wolfe, Kyle M Fargen
INTRODUCTION: Neurothrombectomy frequency is increasing, and a better understanding of the neurothrombectomy call burden is needed. METHODS: Neurointerventional physicians at nine participating stroke centers prospectively recorded time requirements for all neurothrombectomy (NT) consultations over 30 consecutive 24 hour call periods. RESULTS: Data were collected from a total of 270 days of call. 214 NT consultations were reported (mean 0...
April 20, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29674324/indications-for-the-performance-of-intracranial-endovascular-neurointerventional-procedures-a-scientific-statement-from-the-american-heart-association
#6
REVIEW
Clifford J Eskey, Philip M Meyers, Thanh N Nguyen, Sameer A Ansari, Mahesh Jayaraman, Cameron G McDougall, J Kevin DeMarco, William A Gray, David C Hess, Randall T Higashida, Dilip K Pandey, Constantino Peña, Hermann C Schumacher
Intracranial endovascular interventions provide effective and minimally invasive treatment of a broad spectrum of diseases. This area of expertise has continued to gain both wider application and greater depth as new and better techniques are developed and as landmark clinical studies are performed to guide their use. Some of the greatest advances since the last American Heart Association scientific statement on this topic have been made in the treatment of ischemic stroke from large intracranial vessel occlusion, with more effective devices and large randomized clinical trials showing striking therapeutic benefit...
May 22, 2018: Circulation
https://www.readbyqxmd.com/read/29667266/application-of-the-dawn-clinical-imaging-mismatch-and-defuse-3-selection-criteria-benefit-seems-similar-but-restrictive-volume-cut-offs-might-omit-potential-responders
#7
Célina Ducroux, Naim Khoury, Augustin Lecler, Raphaël Blanc, Annaëlle Chetrit, Hocine Redjem, Gabriele Ciccio, Stanislas Smajda, Simon Escalard, Jean-Philippe Desilles, Mikaël Mazighi, Malek Ben Maacha, Michel Piotin, Robert Fahed
BACKGROUND: We aimed to conduct an external validation of the selection criteria of the diffusion-weighted-imaging or computerized-tomography-perfusion assessment with clinical mismatch in the triage of wake-up and late-presenting strokes undergoing Neurointervention with Trevo (DAWN) and the Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke (DEFUSE3) trials in a cohort of unknown onset stroke (UOS) patients treated with thrombectomy. METHODS: A validation cohort of UOS patients was selected from a prospectively collected thrombectomy database to match the inclusion criteria of DAWN and DEFUSE3...
April 18, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29651772/monitoring-neurointerventional-radiation-doses-using-dose-tracking-software-implications-for-the-establishment-of-local-diagnostic-reference-levels
#8
Holly Acton, Karl James, Richard G Kavanagh, Colm O'Tuathaigh, Deirdre Moloney, Gerald Wyse, Noel Fanning, Michael Maher, Owen J O'Connor
OBJECTIVES: There is potential for high radiation exposure during neurointerventional procedures. Increasing regulatory requirements mandate dose monitoring of patients and staff, and justification of high levels of radiation exposure. This paper demonstrates the potential to use radiation dose-tracking software to establish local diagnostic reference levels. METHODS: Consecutive neurointerventional procedures, performed in a single institution within a one-year period, were retrospectively studied...
April 12, 2018: European Radiology
https://www.readbyqxmd.com/read/29650787/management-of-small-unruptured-intracranial-aneurysms-a-survey-of-neuroradiologists
#9
A Malhotra, X Wu, B Geng, D Hersey, D Gandhi, P Sanelli
BACKGROUND AND PURPOSE: The long-term history and management of unruptured intracranial aneurysms is not well understood. Our aim was to determine current practice patterns in the management of unruptured intracranial aneurysms, especially regarding imaging surveillance for conservatively managed aneurysms of this type. MATERIALS AND METHODS: An on-line survey was designed to examine physician practice and preference regarding the management of small unruptured intracranial aneurysms (≤7 mm in diameter)...
April 12, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29628947/recommendations-for-endovascular-care-of-stroke-patients
#10
Michelle Hill, Brenda A Glenn, Brenda J Reese, Benjamin Morrow
The field of neurointerventional radiology (NIR) therapy, including acute ischemic stroke intervention, endovascular intracranial aneurysm management, and treatment of intra- and extracranial large-vessel disease, has evolved over the past 18 years. To support this specialized advanced care requires nursing standards of care for staff to provide direct patient care in NIR suites and intensive management of this high-risk patient population. The intent of this paper is to provide a complementary document for the Stroke Interventional Laboratory Consensus (SILC) statement that will specifically address the nursing standards of care for patients in an NIR suite...
February 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29582979/contemporary-endovascular-techniques-for-the-curative-treatment-of-cerebral-arteriovenous-malformations-and-review-of-neurointerventional-outcomes
#11
Pascal J Mosimann, René Chapot
INTRODUCTION: Since the first landmark randomized trials on unruptured bAVMs were published, there has been emerging concerns about the role of endovascular therapy. For bAVMs considered inoperable, embolization remains an option worth considering, especially in young patients presenting with a rupture. We aimed to review the curative potential of contemporary stand-alone embolization techniques enabling high occlusion rates and their respective short and long term safety profile. PATIENTS AND METHODS: We performed a PubMed search with the terms "curative embolization of brain arteriovenous malformations" and "endovascular cure of brain arteriovenous malformations" focusing on the last ten years (2008-2018) and compliant to the PRISMA reporting guidelines...
March 26, 2018: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29582974/contemporary-tools-in-avm-surgery
#12
Marco Cenzato, Flavia Dones, Davide Boeris, Eleonora Marcati, Alessia Fratianni, Francesco M Crisà, Alberto Debernardi
Arteriovenous malformations (AVMs) are rare entities and therefore considered the main challenge for a neurosurgeon. Since the publication of the ARUBA study, one of the most popular debate regards the actual surgical indication for unruptured AVMs. Our group recently published a multicenter review of more than 500 cases underlying the important role of surgery. In the last decades, the expanding technologies used in the treatment of AVMs have shown an ongoing improvement overcoming some of the existing difficulties and shortcomings...
March 26, 2018: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29581344/eligibility-for-endovascular-trial-enrollment-in-the-6-to-24-hour-time-window-analysis-of-a-single-comprehensive-stroke-center
#13
Ashutosh P Jadhav, Shashvat M Desai, Cynthia L Kenmuir, Marcelo Rocha, Matthew T Starr, Bradley J Molyneaux, Bradley A Gross, Brian T Jankowitz, Tudor G Jovin
BACKGROUND AND PURPOSE: The results of the DAWN trial (Diffusion-Weighted Imaging or Computerized Tomography Perfusion Assessment With Clinical Mismatch in the Triage of Wake Up and Late Presenting Strokes Undergoing Neurointervention With Trevo) support the benefit of endovascular therapy in patients presenting beyond the 6-hour time window with anterior circulation large vessel occlusions. The impact of these results with respect to additional number of eligible patients in clinical practice remains unknown...
April 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29570006/use-of-the-apollo-detachable-tip-microcatheter-for-endovascular-embolization-of-arteriovenous-malformations-and-arteriovenous-fistulas
#14
Bruno C Flores, Alfred P See, Gregory M Weiner, Brian T Jankowitz, Andrew F Ducruet, Felipe C Albuquerque
OBJECTIVE Liquid embolic agents have revolutionized endovascular management of arteriovenous malformations (AVMs) and arteriovenous fistulas (AVFs). Nonetheless, since 2005, the US FDA has received more than 100 reports of microcatheter breakage or entrapment related to Onyx embolization, including 9 deaths. In 2014, the Apollo detachable-tip microcatheter became the first of its kind available in the US. Since then, few reports on its safety have been published. METHODS The authors conducted a retrospective review of endovascular cases by searching the patient databases at 2 tertiary cerebrovascular centers (Barrow Neurological Institute and University of Pittsburgh Medical Center)...
March 23, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29536505/influence-of-cyp2c19-phenotype-on-the-effect-of-clopidogrel-in-patients-undergoing-a-percutaneous-neurointervention-procedure
#15
Miriam Saiz-Rodríguez, Daniel Romero-Palacián, Carlos Villalobos-Vilda, José Luis Caniego, Carmen Belmonte, Dora Koller, Eduardo Bárcena, María Talegón, Francisco Abad-Santos
This observational retrospective study assessed the antiplatelet response and clinical events after clopidogrel treatment in patients who underwent percutaneous neurointervention, related to CYP2C19 metabolizer status (normal (NM), intermediate/poor (IM-PM), and ultrarapid (UM); inferred from *2, *3, and *17 allele determination). From 123 patients, IM-PM had a higher aggregation value (201.1 vs. 137.6 NM, 149.4 UM, P < 0.05) and lower response rate (37.5% vs. 69.8% NM, 61.1% UM), along with higher treatment change rate (25% vs...
March 14, 2018: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29533711/clinical-results-of-a-new-concept-of-neurothrombectomy-coverage-at-a-remote-hospital-drive-the-doctor
#16
Fatih Seker, Markus A Möhlenbruch, Simon Nagel, Christian Ulfert, Silvia Schönenberger, Johannes Pfaff, Peter A Ringleb, Thorsten Steiner, Martin Bendszus, Christian Herweh
Background Many tertiary care hospitals cannot provide a continuous thrombectomy service due to the lack of a neurointerventionalist. Aims In this study, we present procedural and clinical results of a new concept in which neuroradiologists of a university hospital provide neurointerventional stroke service to a remote hospital ("drive the doctor"). Methods All consecutive patients with acute ischemic stroke due to large vessel occlusion of the anterior circulation treated with mechanical thrombectomy after hours at a remote hospital (distance of about 100 km) between 2012 and 2016 were analyzed retrospectively...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29526058/korean-clinical-practice-guidelines-for-aneurysmal-subarachnoid-hemorrhage
#17
REVIEW
Won-Sang Cho, Jeong Eun Kim, Sukh Que Park, Jun Kyeung Ko, Dae-Won Kim, Jung Cheol Park, Je Young Yeon, Seung Young Chung, Joonho Chung, Sung-Pil Joo, Gyojun Hwang, Deog Young Kim, Won Hyuk Chang, Kyu-Sun Choi, Sung Ho Lee, Seung Hun Sheen, Hyun-Seung Kang, Byung Moon Kim, Hee-Joon Bae, Chang Wan Oh, Hyeon Seon Park
Despite advancements in treating ruptured cerebral aneurysms, an aneurysmal subarachnoid hemorrhage (aSAH) is still a grave cerebrovascular disease associated with a high rate of morbidity and mortality. Based on the literature published to date, worldwide academic and governmental committees have developed clinical practice guidelines (CPGs) to propose standards for disease management in order to achieve the best treatment outcomes for aSAHs. In 2013, the Korean Society of Cerebrovascular Surgeons issued a Korean version of the CPGs for aSAHs...
March 2018: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29498605/mynxgrip-vascular-closure-device-use-in-pediatric-neurointerventional-procedures
#18
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...
May 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29497785/transcervical-access-via-direct-neck-exposure-for-neurointerventional-procedures-in-the-hybrid-angiosuite
#19
Jong Young Lee, Jong-Hwa Park, Hong Jun Jeon, Dae Young Yoon, Seoung Woo Park, Byung Moon Cho
PURPOSE: A complicated course of the femoral route for neurointervention can prevent approaching the target. Thus, we determined whether transcervical access in the hybrid angiosuite is applicable and beneficial in real practice. METHODS: From January 2014 to March 2017, this approach was used in 17 of 453 (3.75%) cases: 11 cerebral aneurysms (4 ruptured, 7 unruptured), 4 acute occlusions of the large cerebral artery, 1 proximal internal carotid artery (ICA) stenosis, and 1 direct carotid cavernous fistula (CCF)...
May 2018: Neuroradiology
https://www.readbyqxmd.com/read/29490066/dual-antiplatelet-therapy-combining-aspirin-and-ticagrelor-for-intracranial-stenting-procedures-a-retrospective-single-center-study-of-154-consecutive-patients-with-unruptured-aneurysms
#20
Ana Paula Narata, Aymeric Amelot, Richard Bibi, Denis Herbreteau, Denis Angoulvant, Yves Gruel, Kevin Janot
BACKGROUND: Dual antiplatelet therapy (DAPT) associating aspirin + clopidogrel is commonly utilized in neurovascular interventions despite unpredictable clopidogrel efficacy with 4% to 50% of patients considered nonresponders. Ticagrelor is an antiplatelet agent with low resistance rates but unknown efficacy and safety in neurovascular patients. OBJECTIVE: To evaluate frequency of ischemic and hemorrhagic events in patients treated with aspirin and ticagrelor when associated with perioperative heparin bolus for unruptured aneurysms treated with intracranial stents...
February 26, 2018: Neurosurgery
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