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https://www.readbyqxmd.com/read/28611839/utilization-of-a-novel-multi-durometer-intracranial-distal-access-catheter-nuances-and-experience-in-110-consecutive-cases-of-aneurysm-flow-diversion
#1
Geoffrey P Colby, Li-Mei Lin, Risheng Xu, Narlin Beaty, Matthew T Bender, Bowen Jiang, Judy Huang, Rafael J Tamargo, Alexander L Coon
BACKGROUND: Coaxial catheter support systems provide a safe and stable foundation in endovascular treatment of intracranial aneurysms. Increasingly, robust distal intracranial support is sought during complex neurointerventions. The AXS Catalyst 5 distal access catheter (Cat5) is a new intracranial catheter designed for improved trackability and stability. We report the first experience using Cat5 for aneurysm treatment by flow diversion. METHODS: A single-center aneurysm database was reviewed for cases of aneurysm treatment with the Pipeline embolization device (PED) that utilized Cat5...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28580051/cerebral-misery-perfusion-on-susceptibility-weighted-imaging-in-acute-carotid-dissection
#2
Arian Mashhood, Paggie Kim, Frankis Almaguel, Geoffery McWilliams, J Paul Jacobson
The cerebral vasculature incorporates several fail-safes that must be breached before an irreversible ischemic event takes place. In particular, when autoregulatory vasodilatation fails secondary to falling cerebral perfusion pressure (CPP; stage I hemodynamic failure), increases in the oxygen extraction fraction work to maintain the cerebral metabolic rate of oxygen. Previously, failure of this mechanism, stage II hemodynamic failure, or misery perfusion, has been imaged via positron emission tomography/computed tomography (PET/CT)...
October 2016: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/28579511/streamlining-workflow-for-endovascular-mechanical-thrombectomy-lessons-learned-from-a-comprehensive-stroke-center
#3
REVIEW
Hongjin Wang, Arthur Thevathasan, Richard Dowling, Steven Bush, Peter Mitchell, Bernard Yan
BACKGROUND: Recently, 5 randomized controlled trials confirmed the superiority of endovascular mechanical thrombectomy (EMT) to intravenous thrombolysis in acute ischemic stroke with large-vessel occlusion. The implication is that our health systems would witness an increasing number of patients treated with EMT. However, in-hospital delays, leading to increased time to reperfusion, are associated with poor clinical outcomes. This review outlines the in-hospital workflow of the treatment of acute ischemic stroke at a comprehensive stroke center and the lessons learned in reduction of in-hospital delays...
June 1, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28569123/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-trial-methods
#4
Tudor G Jovin, Jeffrey L Saver, Marc Ribo, Vitor Pereira, Anthony Furlan, Alain Bonafe, Blaise Baxter, Rishi Gupta, Demetrius Lopes, Olav Jansen, Wade Smith, Daryl Gress, Steven Hetts, Roger J Lewis, Ryan Shields, Scott M Berry, Todd L Graves, Tim Malisch, Ansaar Rai, Kevin N Sheth, David S Liebeskind, Raul G Nogueira
Rationale Efficacy of mechanical thrombectomy for acute stroke due to large vessel occlusion initiated beyond 6 h of time last seen well has not been demonstrated in randomized trials. Aim To establish whether subjects considered to have substantial areas of salvageable brain based on age-adjusted clinical core mismatch who can undergo endovascular treatment within 6-24 h from time last seen (TLSW) well have better outcomes at three months compared to subjects treated with standard medical therapy alone...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28565991/platelet-testing-in-flow-diversion-a-review-of-the-evidence
#5
L Ian Taylor, James C Dickerson, Robert J Dambrino, M Yashar S Kalani, Philipp Taussky, Chad W Washington, Min S Park
OBJECTIVE Although the use of dual antiplatelet therapy with flow diversion is recommended and commonplace, the testing of platelet inhibition is more controversial. METHODS The authors reviewed the medical literature to establish and describe the physiology of platelet adhesion, the pharmacology of antiplatelet medications, and the mechanisms of the available platelet function tests. Additionally, they present a review of the pertinent neurointerventional and interventional cardiology literature. RESULTS Competing reports in the neurointerventional literature argue for and against the use of routine platelet function testing, with adjustments to the dosage or medications based on the results...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28559507/in-defense-of-our-patients
#6
EDITORIAL
Shazam Hussain, David Fiorella, J Mocco, Adam Arthur, Italo Linfante, Gregory Zipfel, Henry Woo, Donald Frei, Raul Nogueira, Felipe C Albuquerque
No abstract text is available yet for this article.
June 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28526977/standards-of-practice-in-interventional-neuroradiology
#7
Olav Jansen, Istvan Szikora, Francesco Causin, Hartmut Brückmann, Kyriakos Lobotesis
The growing importance of INR has resulted in the need to define and promote professional standards of clinical practice. Several professional organizations have published guidelines recently for the neurointerventional treatment of cerebrovascular diseases, including technical and personal recommendations, but detailed definitions of technical and organizational conditions needed for the safe and effective performance of such treatments are lacking. To fill this gap ESNR, ESMINT and the UEMS Division for Neuroradiology established a working group, to develop a consensus paper on "Standards of Practice in Interventional Neuroradiology"...
May 19, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28503833/moral-enhancement-meets-normative-and-empirical-reality-assessing-the-practical-feasibility-of-moral-enhancement-neurotechnologies
#8
Veljko Dubljević, Eric Racine
Moral enhancement refers to the possibility of making individuals and societies better from a moral standpoint. A fierce debate has emerged about the ethical aspects of moral enhancement, notably because steering moral enhancement in a particular direction involves choosing amongst a wide array of competing options, and these options entail deciding which moral theory or attributes of the moral agent would benefit from enhancement. Furthermore, the ability and effectiveness of different neurotechnologies to enhance morality have not been carefully examined...
June 2017: Bioethics
https://www.readbyqxmd.com/read/28456915/reversible-cerebral-vasoconstriction-syndrome-recognition-and-treatment
#9
REVIEW
Cecilia Cappelen-Smith, Zeljka Calic, Dennis Cordato
Reversible cerebral vasoconstriction syndrome (RCVS) is a rare but increasingly recognized disorder with over 500 cases published in the literature. The condition is characterized by recurrent severe thunderclap headaches with or without other neurological symptoms and diffuse segmental narrowing of the cerebral arteries which is reversible within 3 months. RCVS may occur spontaneously but in over 50% of cases, it is associated with various other conditions, including vasoactive medications or illicit drugs and the post-partum state...
June 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28450432/safety-and-efficacy-of-aneurysm-treatment-with-the-web-results-of-the-webcast-2-study
#10
L Pierot, I Gubucz, J H Buhk, M Holtmannspötter, D Herbreteau, L Stockx, L Spelle, J Berkefeld, A-C Januel, A Molyneux, J V Byrne, J Fiehler, I Szikora, X Barreau
BACKGROUND AND PURPOSE: Flow disruption with the Woven EndoBridge (WEB) device is an innovative technique for the endovascular treatment of wide-neck bifurcation aneurysms. The initial version of the device (WEB Double-Layer) was evaluated in the WEB Clinical Assessment of IntraSaccular Aneurysm Therapy (WEBCAST) study, whereas the French Observatory study evaluated both WEB Double-Layer and Single-Layer versions of the device. WEBCAST 2 was designed to evaluate the WEB Single-Layer with Enhanced Visualization...
April 27, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28434772/neurointerventional-staffing-the-next-frontier
#11
EDITORIAL
Karl-Olof Lövblad, Laurie Bouchez, Amine M Korchi, Zsolt Kulcsar
No abstract text is available yet for this article.
April 20, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28424017/computed-tomography-perfusion-based-selection-of-endovascularly-treated-acute-ischaemic-stroke-patients-are-there-lessons-to-be-learned-from-the-pre-evidence-era
#12
Marios-Nikos Psychogios, Michael Knauth, Raya Bshara, Katharina Schregel, Ioannis Tsogkas, Ismini Papageorgiou, Ilko Maier, Jan Liman, Daniel Behme
Introduction Some of the latest groundbreaking trials suggest that noncontrast cranial computed tomography and computed tomography-angiography are sufficient tools for patient selection within six hours of symptom onset. Before endovascular stroke therapy became the standard of care, patient selection was one of the most useful tools to avoid futile reperfusions. We report the outcomes of endovascularly treated stroke patients selected with a perfusion-based paradigm and discuss the implications in the current era of endovascular treatment...
April 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28411263/use-of-platelet-function-testing-before-pipeline-embolization-device-placement-a-multicenter-cohort-study
#13
Nimer Adeeb, Christoph J Griessenauer, Paul M Foreman, Justin M Moore, Hussain Shallwani, Rouzbeh Motiei-Langroudi, Abdulrahman Alturki, Adnan H Siddiqui, Elad I Levy, Mark R Harrigan, Christopher S Ogilvy, Ajith J Thomas
BACKGROUND AND PURPOSE: Thromboembolic complications constitute a significant source of morbidity after neurointerventional procedures. Flow diversion using the pipeline embolization device for the treatment of intracranial aneurysms necessitates the use of dual antiplatelet therapy to reduce this risk. The use of platelet function testing before pipeline embolization device placement remains controversial. METHODS: A retrospective review of prospectively maintained databases at 3 academic institutions was performed from the years 2009 to 2016 to identify patients with intracranial aneurysms treated with pipeline embolization device placement...
May 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28400985/spanning-from-the-west-to-east-an-updated-review-on-endovascular-treatment-of-intracranial-atherosclerotic-disease
#14
REVIEW
Mohammed Hussain, Neil Datta, Zhe Cheng, David Dornbos, Asif Bashir, Ibrahim Sultan, Tapan Mehta, Faris Shweikeh, Paul Mazaris, Nora Lee, Amre Nouh, Xiaokun Geng, Yuchuan Ding
Ischemic stroke is a major cause of morbidity and mortality, incurring significant cost. Intracranial atherosclerotic disease (ICAD) accounts for 10-15% of ischemic stroke in Western societies, but is an underlying pathology in up to 54% of ischemic strokes in Asian populations. ICAD has largely been treated with medical management, although a few studies have examined outcomes following endovascular treatment. Our objective was to summarize the major trials that have been performed thus far in regard to the endovascular treatment of ICAD and to provide direction for future management of this disease process...
April 2017: Aging and Disease
https://www.readbyqxmd.com/read/28391744/malignant-stroke-in-a-ticagrelor-non-responder-as-a-complication-following-aneurysm-treatment-with-the-pipeline-embolization-device%C3%A2
#15
Pegah Ghamasaee, Kevin Carr, Jeremiah Johnson, Ramesh Grandhi
The Pipeline Embolization Device™ (PED; Covidien Neurovascular Inc, Irvine, CA, USA) is a flow-diverting stent often used for the endovascular treatment of large or giant, wide-necked intracranial aneurysms of the internal carotid artery. Because of the inherent thrombogenicity of intracranial stents, dual-antiplatelet therapy is initiated after placement, which has been shown to decrease morbidity and mortality related to perioperative ischemic events in neurointerventional procedures. However, in some series, as much as 50% of patients demonstrate clopidogrel non-responsiveness...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28349170/ct-reconstruction-and-mri-fusion-of-3d-rotational-angiography-in-the-evaluation-of-pediatric-cerebrovascular-lesions
#16
Prakash Muthusami, Nicholas Shkumat, Vanessa Rea, Albert H Chiu, Manohar Shroff
PURPOSE: Complex neurovascular lesions in children require precise anatomic understanding for treatment planning. Although 3DRA is commonly employed for volumetric reformation in neurointerventional procedures, the ability to reconstruct this data into CT-like images (3DRA-CT) is not widely utilized. This study demonstrates the feasibility and usefulness of 3DRA-CT and subsequent MRI fusion for problem solving in pediatric neuroangiography. METHODS: This retrospective study includes 18 3DRA-CT studies in 16 children (age 9...
March 27, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28335660/recommendation-of-the-wfitn-regarding-simulation-in-neurointerventional-training
#17
Luc Picard, George Rodesch, Serge Bracard, Allan Taylor
No abstract text is available yet for this article.
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28262374/should-indications-for-web-aneurysm-treatment-be-enlarged-report-of-a-series-of-20%C3%A2-patients-with-aneurysms-in-atypical-locations-for-web-treatment
#18
L Pierot, A Biondi, A-P Narata, C Mihalea, A-C Januel, G Metaxas, R Bibi, J Caroff, S Soize, C Cognard, L Spelle, D Herbreteau
BACKGROUND AND PURPOSE: Flow disruption with the WEB device is an innovative technique for the endovascular treatment of wide neck bifurcation aneurysms. Good clinical practice trials have shown high safety of this treatment with good efficacy. Technical developments (single layer devices and smaller microcatheters) facilitate the treatment, potentially leading to enlargement of indications. This series is collecting aneurysms in "atypical" locations for WEB treatment and analyzing safety and efficacy of this treatment...
March 2, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28245774/potential-usefulness-of-clopidogrel-pharmacogenetics-in-cerebral-endovascular-procedures-and-carotid-artery-stenting
#19
Jorge Duconge, Dagmar F Hernandez-Suarez
BACKGROUND: Previous reports have shown inadequate response to dual antiplatelet therapy (DAPT) with aspirin and clopidogrel in 5-30% of patients undergoing percutaneous coronary interventions (PCI), due mostly to clopidogrel resistance. This prevalence increases up to 66% in patients undergoing neurointerventional procedures. However, clinical significance of CYP2C19 genotypes in neurointerventional procedures or carotid artery stenting (CAS) is unknown. OBJECTIVE: The purpose of this review is to update our current knowledge and understanding of the pharmacogenetic basis for poor clopidogrel responsiveness in patients undergoing CAS and endovascular interventions as well as to explore usefulness of genotyping to reduce the rate of procedure-related thrombosis that results in ischemic complications...
2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28242653/comparison-of-eye-lens-doses-imparted-during-interventional-and-non-interventional-neuroimaging-techniques-for-assessment-of-intracranial-aneurysms
#20
N Guberina, U Dietrich, M Forsting, A Ringelstein
BACKGROUND: A neurointerventional examination of intracranial aneurysms often involves the eye lens in the primary beam of radiation. OBJECTIVE: To assess and compare eye-lens doses imparted during interventional and non-interventional imaging techniques for the examination of intracranial aneurysms. METHODS: We performed a phantom study on an anthropomorphic phantom (ATOM dosimetry phantom 702-D; CIRS, Norfolk, Virginia, USA) and assessed eye-lens doses with thermoluminescent dosimeters (TLDs) type 100 (LiF:Mg, Ti) during (1) interventional (depiction of all cerebral arteries with triple 3D-rotational angiography and twice 2-plane DSA anteroposterior and lateral projections) and (2) non-interventional (CT angiography (CTA)) diagnosis of intracranial aneurysms...
February 27, 2017: Journal of Neurointerventional Surgery
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