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Neurointervention

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https://www.readbyqxmd.com/read/28712895/parent-and-child-balloon-technique-for-navigating-guide-catheters-during-neurointerventions
#1
Tomotaka Ohshima, Kojiro Ishikawa, Shunsaku Goto, Taiki Yamamoto
BACKGROUND: and Purpose: The stabilization of a guide catheter is an important factor for performing successful neurointerventional procedures. We present our technique for navigating guide catheters using parent and child balloons. MATERIALS AND METHODS: In nine patients with severe atherosclerosis or anatomical variations such as a bovine arch, 8-9-F balloon-mounted guide catheters were navigated using balloon-attached guidewires. Both balloons were complementarily used for flow navigation and vessel fixation at the appropriate portions and times...
July 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28710081/use-of-a-next-generation-multi-durometer-long-guide-sheath-for-triaxial-access-in-flow-diversion-experience-in-95-consecutive-cases
#2
Li-Mei Lin, Matthew T Bender, Geoffrey P Colby, Narlin B Beaty, Bowen Jiang, Jessica K Campos, Judy Huang, Rafael J Tamargo, Alexander L Coon
BACKGROUND: Intracranial access techniques in modern neurointerventions have shifted towards more robust access platforms. The long guide sheath is one of the building blocks of triaxial systems used in intracranial embolizations. Here we present our experience with the AXS Infinity LS long sheath in the triaxial platform for the implantation of the Pipeline embolization device (PED). METHODS: We retrospectively identified patients who underwent PED Flex treatment with the AXS Infinity LS at a single institution...
July 14, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28706116/training-standards-in-neuroendovascular-surgery-program-accreditation-and-practitioner-certification
#3
REVIEW
Arthur L Day, Adnan H Siddiqui, Philip M Meyers, Tudor G Jovin, Colin P Derdeyn, Brian L Hoh, Howard Riina, Italo Linfante, Osama Zaidat, Aquilla Turk, Jay U Howington, J Mocco, Andrew J Ringer, Erol Veznedaroglu, Alexander A Khalessi, Elad I Levy, Henry Woo, Robert Harbaugh, Steven Giannotta
BACKGROUND AND PURPOSE: Neuroendovascular surgery is a medical subspecialty that uses minimally invasive catheter-based technology and radiological imaging to diagnose and treat diseases of the central nervous system, head, neck, spine, and their vasculature. To perform these procedures, the practitioner needs an extensive knowledge of the anatomy of the nervous system, vasculature, and pathological conditions that affect their physiology. A working knowledge of radiation biology and safety is essential...
July 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28702112/patient-preference-for-transradial-access-over-transfemoral-access-for-cerebrovascular-procedures
#4
Sudhakar R Satti, Ansar Z Vance, Sohil N Golwala, Tim Eden
PURPOSE: Shared decision-making, when physicians and patients collaborate and agree on health care decisions, is a key tenant of patient-centered care. Choice of access site for neurovascular procedures is rarely a shared decision point between physicians and patients. We present our initial evaluation of patient preference for radial over femoral access for cerebrovascular procedures. MATERIALS AND METHODS: IRB approved single-center, prospective, and consecutive survey of all patients undergoing transradial access for cerebrovascular imaging and intervention...
June 2017: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/28675348/navien-catheter-experience-in-neuroendovascular-interventions
#5
Gaurav Jindal, Luciano Giacon, Moronke Iyoha, Timothy Miller, Francois Aldrich, Marc Simard, Ravishankar Shivashankar, Dheeraj Gandhi
Purpose Advancements in catheter technology have allowed for greater flexibility and trackability. We report 265 consecutive, single-center neurointerventional cases using the Navien guide catheter. Materials and methods Retrospective analysis was performed of consecutive intracranial endovascular procedures utilizing the Navien catheter. Data collected included procedure type, catheters, guide catheter position, cervical access artery tortuosity grade and complications. Results The 5 French catheter was used in 130 cases...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28662097/reconstructive-endovascular-treatment-of-vertebral-artery-dissecting-aneurysms-with-the-low-profile-visualized-intraluminal-support-lvis-device
#6
Chuan-Chuan Wang, Yi-Bin Fang, Ping Zhang, Xuan Zhu, Bo Hong, Yi Xu, Jian-Min Liu, Qing-Hai Huang
INTRODUCTION: The Low-profile Visualized Intraluminal Support (LVIS) device is a new generation of self-expanding braided stent recently introduced in China for stent assisted coiling of intracranial aneurysms. The aim of our study is to evaluate the feasibility, safety, and efficacy of the LVIS device in reconstructive treatment of vertebral artery dissecting aneurysms (VADAs). METHODS: We retrospectively reviewed the neurointerventional database of our institution from June 2014 to May 2016...
2017: PloS One
https://www.readbyqxmd.com/read/28652299/timing-of-complications-during-and-after-elective-endovascular-intracranial-aneurysm-coiling
#7
Michelle Masayo Kameda-Smith, Paula Klurfan, Brian Anthony van Adel, Ramiro Larrazabal, Forough Farrokhyar, Michael Bennardo, Thorsteinn Gunnarsson
OBJECTIVE: To determine the time to complications during and after elective endovascular intracranial aneurysm coiling. METHODS: A retrospective chart review of patients undergoing elective endovascular aneurysm coiling between March 2006 and October 2013 in one large Eastern Canadian Neurointerventional Service was performed. Data regarding the incidence, time and type of complication related to the endovascular coiling procedure and clinical outcome at last follow-up were collected...
June 26, 2017: Journal of Neurointerventional Surgery
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
#8
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
#9
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
#10
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
#11
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 well (TLSW) 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
#12
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
#13
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
#14
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"...
June 2017: Neuroradiology
https://www.readbyqxmd.com/read/28503833/moral-enhancement-meets-normative-and-empirical-reality-assessing-the-practical-feasibility-of-moral-enhancement-neurotechnologies
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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