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Neurointervention

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https://www.readbyqxmd.com/read/27894558/helicopter-scene-response-for-stroke-patients-a-5-year-experience
#1
Andrew Hawk, Catherine Marco, Matt Huang, Bonnie Chow
OBJECTIVE: The purpose of this study was to examine the usefulness of an emergency medical service (EMS)-requested air medical helicopter response directly to the scene for a patient with clinical evidence of an ischemic cerebrovascular accident (CVA) and transport to a regional comprehensive CVA center. METHODS: CareFlight, an air medical critical care transportation service, is based in Dayton, OH. The 3 CareFlight helicopters are geographically located and provided transport to all CVA scene patients in this study...
November 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27857870/persistent-trigeminal-artery-in-endonasal-resection-of-skull-base-tumors-a-systematic-review
#2
Jasper Shen, James Tourje, Elena E Chang, Adam N Mamelak, Arthur W Wu
Background Primitive persistent trigeminal artery (PTA) is an uncommon embryologic vascular communication between the carotid and basilar arteries, which can be intimately involved by skull base tumors (SBT). Owing to its rarity, skull base surgeons should familiarize themselves with the anatomical variations of PTA to avoid catastrophic complications. Objective To appraise and summarize the available evidence of PTA involved by SBTs while advocating a standardized algorithm for the surgical planning of these patients...
December 2016: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/27853491/dissection-of-extracranial-internal-carotid-artery-due-to-balloon-guiding-catheter-resulting-in-asymptomatic-internal-carotid-artery-occlusion
#3
Suha Akpinar, Guliz Yilmaz
Dissection of the internal carotid artery (ICA) is a rare condition that accounts for a significant proportion of ischemic strokes in young adults. Iatrogenic dissection as a complication of neurointerventional procedures is a traumatic dissection which has been reported relatively rare in the literature. In this report, a case of dissection of the ICA is reported that was caused by repetitive movement of the balloon guiding catheter during stent-assisted thrombectomy (SAT), resulting in occlusion of the ICA...
July 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
https://www.readbyqxmd.com/read/27843786/diffuse-alveolar-hemorrhage-in-patients-undergoing-neurointervention-a-case-report
#4
Yun Suk Choe, Na Young Kim, Ae Ryoung Lee
INTRODUCTION: Diffuse alveolar hemorrhage (DAH) is a very rare complication but acute and life-threatening event. Clopidogrel has generally administered for neurointerventional surgery, but there were no reports of DAH related to clopidogrel in patients undergoing neurointervention. CASE PRESENTATION: A 70-year-old male presented with DAH associated with clopidogrel after transfemoral cerebral angiography and coil embolization for cerebral aneurysm. The chest radiography showed bilateral symmetric peribronchial consolidation and bronchoscopy revealed diffuse hemorrhage on the bronchial wall at the bilateral lung...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27811176/a-standardized-neurointerventional-thrombectomy-protocol-leads-to-faster-recanalization-times
#5
Donald Frei, Constance McGraw, Kathryn McCarthy, Michelle Whaley, Richard J Bellon, David Loy, Jeff Wagner, Alessandro Orlando, David Bar-Or
BACKGROUND AND PURPOSE: Intra-arterial therapy (IAT) is most effective when performed rapidly after ischemic stroke onset. However, there are limited performance benchmarks in IAT and there is a scarcity of information on how to structure an effective IAT protocol and its impact on time to treatment. The objective of our study was to detail a standardized IAT protocol, and to assess its influence on time to treatment in ischemic stroke. METHODS: This was a retrospective observational study over 4 years at a comprehensive stroke center...
November 3, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27799374/where-did-the-clot-go-an-unusual-complication-of-mechanical-thrombectomy-caused-by-malignancy-related-subclavian-steal-phenomenon-in-a-patient-with-acute-basilar-artery-occlusion
#6
Nikkie Randhawa, Jonathan P Squires, Manraj Kanwal Singh Heran, Sharanpal K Mann
Subclavian steal is a relatively common vascular phenomenon usually caused by atherosclerotic disease. While symptoms are rare, arm claudication of the ipsilateral limb is most common, with paroxysmal symptoms of vertebrobasilar insufficiency (often exercise induced) being relatively uncommon. Here we present a case of brachial artery embolism during mechanical thrombectomy for basilar artery thrombosis, secondary to subclavian steal phenomenon. This atypical and potentially irreversible complication should be considered in patients with acute ischemic stroke undergoing neurointerventional management when subclavian steal is discovered angiographically...
October 31, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27797875/where-did-the-clot-go-an-unusual-complication-of-mechanical-thrombectomy-caused-by-malignancy-related-subclavian-steal-phenomenon-in-a-patient-with-acute-basilar-artery-occlusion
#7
Nikkie Randhawa, Jonathan P Squires, Manraj Kanwal Singh Heran, Sharanpal K Mann
Subclavian steal is a relatively common vascular phenomenon usually caused by atherosclerotic disease. While symptoms are rare, arm claudication of the ipsilateral limb is most common, with paroxysmal symptoms of vertebrobasilar insufficiency (often exercise induced) being relatively uncommon. Here we present a case of brachial artery embolism during mechanical thrombectomy for basilar artery thrombosis, secondary to subclavian steal phenomenon. This atypical and potentially irreversible complication should be considered in patients with acute ischemic stroke undergoing neurointerventional management when subclavian steal is discovered angiographically...
October 25, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27789790/treatment-of-wide-necked-aneurysms-with-the-low-profile-visualized-intraluminal-support-lvis-jr-device-a-multicenter-experience
#8
J A Grossberg, R A Hanel, G Dabus, K Keigher, D C Haussen, E Sauvageau, I Linfante, D Gonsales, P Aguilar Salinas, M Bouslama, M Mayich, R G Nogueira, D K Lopes
BACKGROUND: The Low-profile Visualized Intraluminal Support (LVIS) Junior stent is newly approved for the treatment of wide-necked intracranial aneurysms. OBJECTIVE: To report our multicenter experience with use of the LVIS Jr device. METHODS: The neurointerventional databases of the participating institutions were retrospectively reviewed for aneurysms treated with LVIS Jr from the time of Food and Drug Administration approval until February 2016...
October 27, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27742747/coiling-of-wide-necked-carotid-artery-aneurysms-assisted-by-a-temporary-bridging-device-comaneci-preliminary-experience
#9
S Fischer, A Weber, A Carolus, F Drescher, F Götz, W Weber
BACKGROUND: Endovascular treatment of wide-necked aneurysms remains challenging without the use of adjunctive devices to preserve the parent artery. OBJECTIVE: To present our initial experience with a temporary bridging device, the Comaneci (Rapid Medical, Israel). The compliant remodeling mesh protects the parent artery during coil occlusion without flow arrest in the distal vasculature. Permanent dual antiplatelet therapy is not required since the device is fully removed at the end of the procedure...
October 14, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27718098/neurovascular-emergencies-imaging-diagnosis-and-neurointerventional-treatment
#10
W Tania Rahman, Julius Griauzde, Neeraj Chaudhary, Aditya S Pandey, Joseph J Gemmete, Suzanne T Chong
Neurovascular emergencies, consisting of acute ischemic stroke, non-traumatic aneurysmal subarachnoid hemorrhage, arteriovenous malformation, dural arteriovenous fistula, and carotid- cavernous fistula, can have an acute presentation to the emergency department. Radiologists should have an understanding of these processes and their imaging findings in order to provide a prompt and accurate diagnosis. Neurointerventional radiology plays a critical role in providing additional diagnostic information and potentially curative treatment...
October 7, 2016: Emergency Radiology
https://www.readbyqxmd.com/read/27707873/prehospital-care-delivery-and-triage-of-stroke-with-emergent-large-vessel-occlusion-elvo-report-of-the-standards-and-guidelines-committee-of-the-society-of-neurointerventional-surgery
#11
G Lee Pride, Justin F Fraser, Rishi Gupta, Mark J Alberts, J Neal Rutledge, Ray Fowler, Sameer A Ansari, Todd Abruzzo, Barb Albani, Adam Arthur, Blaise Baxter, Ketan R Bulsara, Michael Chen, Josser E Delgado Almandoz, Chirag D Gandhi, Don Heck, Steven W Hetts, Joshua A Hirsch, M Shazam Hussain, Richard Klucznik, Seon-Kyu Lee, William J Mack, Thabele Leslie-Mazwi, Ryan A McTaggart, Philip M Meyers, J Mocco, Charles Prestigiacomo, Athos Patsalides, Peter Rasmussen, Robert M Starke, Peter Sunenshine, Donald Frei, Mahesh V Jayaraman
No abstract text is available yet for this article.
October 5, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27679537/off-label-use-of-the-angioseal-vascular-closure-device-for-femoral-arteriotomy-retrospective-analysis-of-safety-and-efficacy
#12
Sumedh S Shah, Giancarlo Perez, Brian M Snelling, Diogo C Haussen, Samir Sur, Ishna Sharma, Dileep R Yavagal, Mohamed Samy Elhammady, Eric C Peterson
BACKGROUND: Angioseal, an arteriotomy closure device (ACD), functions as a collagen plug that physically closes arteriotomy sites and can simultaneously induce platelet activation and aggregation. When used 'on-label', the safety and efficacy profile of Angioseal is superior compared with those of other ACDs. However, Angioseal is sometimes deployed in less than ideal situations. Therefore, we sought to assess the safety and efficacy of 'off-label' Angioseal use in patients undergoing femoral arteriotomies...
September 27, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27641263/assessment-of-dual-antiplatelet-regimen-for-pipeline-embolization-device-placement-a-survey-of-major-academic-neurovascular-centers-in-the-united-states
#13
Raghav Gupta, Justin M Moore, Christoph J Griessenauer, Nimer Adeeb, Apar S Patel, Roy Youn, Karen Poliskey, Ajith J Thomas, Christopher S Ogilvy
INTRODUCTION: Flow diversion with the Pipeline Embolization Device (PED) is currently adopted for treatment of a variety of intracranial aneurysms. The elevated risk of thromboembolic complications associated with the device necessitates the need for administration of antiplatelet agents. We sought to assess current dual antiplatelet therapy practices patterns and their associated costs, following PED placement. MATERIALS AND METHODS: An online questionnaire assessing dual antiplatelet regimens following flow diversion for treatment of intracranial aneurysms was developed and disseminated to 80 neurosurgeons at major academic cerebrovascular centers...
September 15, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27621947/monoplane-3d-overlay-roadmap-versus-conventional-biplane-2d-roadmap-technique-for-neurointervenional-procedures
#14
Dong-Kyu Jang, David A Stidd, Sebastian Schafer, Michael Chen, Roham Moftakhar, Demetrius K Lopes
PURPOSE: We investigated whether a 3D overlay roadmap using monoplane fluoroscopy offers advantages over a conventional 2D roadmap using biplane fluoroscopy during endovascular aneurysm treatment. MATERIALS AND METHODS: A retrospective chart review was conducted for 131 consecutive cerebral aneurysm embolizations by three neurointerventionalists at a single institution. Allowing for a transition period, the periods from January 2012 to August 2012 (Time Period 1) and February 2013 to July 2013 (Time Period 2) were analyzed for radiation exposure, contrast administration, fluoroscopy time, procedure time, angiographic results, and perioperative complications...
September 2016: Neurointervention
https://www.readbyqxmd.com/read/27610120/systematic-review-and-pooled-analyses-of-recent-neurointerventional-randomized-controlled-trials-setting-a-new-standard-of-care-for-acute-ischemic-stroke-treatment-after-20-years
#15
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
https://www.readbyqxmd.com/read/27599906/accuracy-of-stroke-diagnosis-in-telestroke-guided-tissue-plasminogen-activator-patients
#16
Kunal Agrawal, Rema Raman, Karin Ernstrom, Robert Joseph Claycomb, Dawn Matherne Meyer, Thomas Martin Hemmen, Royya Fatima Modir, Pranav Kachhi, Brett Cowan Meyer
OBJECTIVES: The objective of the study is to assess the accuracy of final diagnosis in telestroke-guided tissue plasminogen activator (rt-PA) patients compared with bedside evaluation using computed tomography (CT) or magnetic resonance imaging (MRI) as a surrogate for final stroke diagnosis. The overall goal was to determine if telestroke had similar diagnostic accuracy as bedside evaluations in diagnosing rt-PA-treated patients. MATERIALS AND METHODS: We analyzed all acute stroke code calls who received intravenous rt-PA at our center from October 2013 to June 2015...
September 2, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27596803/pediatric-neurointervention-collimation-on-radiation-exposure-associated-lifetime-excess-tumor-risk
#17
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
https://www.readbyqxmd.com/read/27587043/a-tracking-system-to-calculate-patient-skin-dose-in-real-time-during-neurointerventional-procedures-using-a-biplane-x-ray-imaging-system
#18
V K Rana, S Rudin, D R Bednarek
PURPOSE: Neurovascular interventional procedures using biplane fluoroscopic imaging systems can lead to increased risk of radiation-induced skin injuries. The authors developed a biplane dose tracking system (Biplane-DTS) to calculate the cumulative skin dose distribution from the frontal and lateral x-ray tubes and display it in real-time as a color-coded map on a 3D graphic of the patient for immediate feedback to the physician. The agreement of the calculated values with the dose measured on phantoms was evaluated...
September 2016: Medical Physics
https://www.readbyqxmd.com/read/27540826/pediatric-intracranial-dural-arteriovenous-fistulas-age-related-differences-in-clinical-features-angioarchitecture-and-treatment-outcomes
#19
Steven W Hetts, Parham Moftakhar, Neil Maluste, Heather J Fullerton, Daniel L Cooke, Matthew R Amans, Christopher F Dowd, Randall T Higashida, Van V Halbach
OBJECTIVE Intracranial dural arteriovenous fistulas (DAVFs) are rare in children. This study sought to better characterize DAVF presentation, angioarchitecture, and treatment outcomes. METHODS Children with intracranial DAVFs between 1986 and 2013 were retrospectively identified from the neurointerventional database at the authors' institution. Demographics, clinical presentation, lesion angioarchitecture, treatment approaches, angiographic outcomes, and clinical outcomes were assessed. RESULTS DAVFs constituted 5...
November 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27522095/spot-fluoroscopy-a-novel-innovative-approach-to-reduce-radiation-dose-in-neurointerventional-procedures
#20
Ljubisa Borota, Lars Jangland, Per-Erik Åslund, Elisabeth Ronne-Engström, Christoffer Nyberg, Ehab Mahmoud, Takuya Sakaguchi, Andreas Patz
BACKGROUND: Increased interest in radiation dose reduction in neurointerventional procedures has led to the development of a method called "spot fluoroscopy" (SF), which enables the operator to collimate a rectangular or square region of interest anywhere within the general field of view. This has potential advantages over conventional collimation, which is limited to symmetric collimation centered over the field of view. PURPOSE: To evaluate the effect of SF on the radiation dose...
August 13, 2016: Acta Radiologica
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