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Interventional neuroradiologist

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https://www.readbyqxmd.com/read/29180089/the-pconus2-neck-bridging-device-early-clinical-experience-and-immediate-angiographic-results
#1
P Lylyk, J Chudyk, C Bleise, H Sahl, M Aguilar Pérez, H Henkes, P Bhogal
INTRODUCTION: Wide necked aneurysms are challenging to treat for the interventional neuroradiologist. Recently, numerous devices dedicated to the treatment of these aneurysms have become available. We present our early experience of the pCONus2 and present the technical success rate, clinical outcome and immediate angiographic occlusion rates. METHODS: We performed a retrospective review of prospectively collected data to identify patients treated with the pCONus2 device between February 2015 and February 2017...
November 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29173070/generalist-versus-subspecialist-characteristics-of-the-u-s-radiologist-workforce
#2
Andrew B Rosenkrantz, Wenyi Wang, Danny R Hughes, Richard Duszak
Purpose To assess subspecialty practice characteristics of the U.S. radiologist workforce. Materials and Methods This study used the Medicare Physician and Other Supplier Public Use File and did not constitute human subject research. The authors identified 33 090 radiologists who billed for professional services between 2012 and 2014 and used a validated classification system to map services to seven subspecialties and quantify subspecialty-focused effort on the basis of work relative value units (RVUs). Radiologists with more than half of their billed work RVUs in a single subspecialty were designated subspecialists; the remainder were classified as generalists...
November 27, 2017: Radiology
https://www.readbyqxmd.com/read/29134167/postoperative-imaging-findings-associated-with-transpalpebral-craniotomy-approach-to-anterior-cranial-fossa
#3
Dennis Monks, Allison Weyer, Peter Thurlow, Khaled Aziz, Erik Happ, Michael Goldberg
Background and Purpose  The transpalpebral "eyelid" approach is a novel alternative to the traditional ciliary or supraciliary incision for supraorbital frontal craniotomy and access to the anterior cranial fossa. Though a prior publication from our institution has described the surgical approach in detail along with cosmetic and clinical outcomes, postoperative imaging findings have not yet been described. As this surgical technique becomes more widely practiced, it is essential for neuroradiologists, oculoplastic surgeons, and skull base neurosurgeons to be familiar with the expected postoperative imaging findings, especially those that prompt subsequent intervention...
December 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29072979/cervical-internal-carotid-occlusion-versus-pseudo-occlusion-at-ct-angiography-in-the-context-of-acute-stroke-an-accuracy-interobserver-and-intraobserver-agreement-study
#4
Ange Diouf, Robert Fahed, Mehdi Gaha, Miguel Chagnon, Naïm Khoury, Marc Kotowski, François Guilbert, David Landry, Jean Raymond, Daniel Roy, Alain Weill
Purpose To evaluate the diagnostic accuracy and reliability of computed tomographic (CT) angiography to distinguish true cervical internal carotid artery (ICA) occlusion from pseudo-occlusion (defined as an isolated intracranial thrombus that impedes ascending blood flow) in the context of acute stroke. Materials and Methods This was a retrospective study of patients who underwent thrombectomy with preprocedural CT angiography that helps to demonstrate a lack of attenuation in the cervical ICA on the symptomatic side (24 men and 13 women; mean age, 63 years; age range, 30-86 years)...
October 25, 2017: Radiology
https://www.readbyqxmd.com/read/29064752/improving-clinical-information-on-head-ct-requisitions-from-the-emergency-department-to-aid-interpretation-and-billing-efficiency
#5
Dillon Barron, Thomas Spiegel, Gregory L Katzman, Kateland Haas, Saad Ali
OBJECTIVE: The accuracy of radiologic interpretations is higher when appropriate clinical information is provided, as is the likelihood of reimbursement for the studies. The purpose of this project was to evaluate and improve the quality of clinical information provided on head CT requisitions from an urban emergency department (ED). SUBJECTS AND METHODS: In a prospective study conducted from July 2015 to May 2016, attending neuroradiologists evaluated 1100 randomly selected ED requisitions for unenhanced head CT, grading them for clinical and billing adequacy on a scale of 0-2...
October 24, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28972807/the-future-of-interventional-and-neurointerventional-radiology-learning-lessons-from-the-past
#6
Julian Maingard, Hong Kuan Kok, Dinesh Ranatunga, Duncan Mark Brooks, Ronil V Chandra, Michael J Lee, Hamed Asadi
The rapid progression of medical imaging technology and the ability to leverage knowledge from non-invasive imaging means that Interventional Radiologists (IRs) and Interventional Neuroradiologists are optimally placed to incorporate minimally invasive interventional paradigms into clinical management to advance patient care. There is ample opportunity to radically change the management options for patients with a variety of diseases through the use of minimally invasive interventional procedures. However, this will need to be accompanied by an increased clinical role of IRs to become active partners in the clinical management of patients...
December 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28918386/evaluation-of-previously-embolized-intracranial-aneurysms-inter-and-intra-rater-reliability-among-neurosurgeons-and-interventional-neuroradiologists
#7
Scott L Zuckerman, Nikita Lakomkin, Jordan A Magarik, Jan Vargas, Marcus Stephens, Babatunde Akinpelu, Alejandro M Spiotta, Azam Ahmed, Adam S Arthur, David Fiorella, Ricardo Hanel, Joshua A Hirsch, Ferdinand K Hui, Robert F James, David F Kallmes, Philip M Meyers, David B Niemann, Peter Rasmussen, Raymond D Turner, Babu G Welch, J Mocco
BACKGROUND: The angiographic evaluation of previously coiled aneurysms can be difficult yet remains critical for determining re-treatment. OBJECTIVE: The main objective of this study was to determine the inter-rater reliability for both the Raymond Scale and per cent embolization among a group of neurointerventionalists evaluating previously embolized aneurysms. METHODS: A panel of 15 neurointerventionalists examined 92 distinct cases of immediate post-coil embolization and 1 year post-embolization angiographs...
September 16, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28732458/use-of-a-complete-autologous-blood-recovery-system-the-sorin-xtra%C3%A2-autotransfusion-system-during-mechanical-thrombectomy-of-extensive-cerebral-venous-sinus-thrombosis
#8
C Castaño, C Cubells, S Remollo, M R García-Sort, M Terceño
Background The endovascular therapy for cerebral venous sinus thrombosis (CVST) is currently accepted as a second-line treatment for patients who have failed or those in whom systemic anticoagulation is contraindicated or in a subgroup of patients presenting with rapid neurologic deterioration. A number of different mechanical and pharmacologic endovascular strategies have been reported, either as separate or combined approaches. These new catheters and aspiration systems have a high power and vacuum capacity, which carries a risk of anemization of the patient and hypovolemic shock, being necessitating the transfusion of the patient...
October 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28659428/real-world-experience-of-treatment-decision-making-in-carotid-stenosis-in-a-neurovascular-board
#9
David Leander Rimmele, Axel Larena-Avellaneda, Anna C Alegiani, Michael Rosenkranz, Nils Ole Schmidt, Jan Regelsberger, Friedhelm C Hummel, Tim Magnus, Eike Sebastian Debus, Jens Fiehler, Christian Gerloff, Götz Thomalla
OBJECTIVE: To describe our experience with consensus-based decision-making for treatment of internal carotid artery (ICA) stenosis by neurologists, interventional neuroradiologists, vascular surgeons, and neurosurgeons in a multidisciplinary neurovascular board and to study adherence to treatment recommendations in the context of uncertainty with respect to the best treatment option. METHODS: We established a multidisciplinary neurovascular board meeting twice a week with structured documentation of consensus decisions...
July 25, 2017: Neurology
https://www.readbyqxmd.com/read/28492296/italian-consensus-in-neuroradiological-anesthesia-icona
#10
Carlo A Castioni, Andrea Amadori, Federico Bilotta, Moreno Bolzon, Edoardo Barboni, Anselmo Caricato, Guido Dall'acqua, Francesco DI Paola, Andrea Forastieri Molinari, Paolo Gritti, Italia LA Rosa, Marcello Longo, Carla Maglione, Pietro Martorano, Marina Munari, Valerio Perotti, Frank Rasulo, Maria Ruggiero, Antonio Santoro, Luigia Scudeller, Miriam Tumolo, Anna T Mazzeo
Anesthetic management of patients undergoing endovascular procedures for treating intracranial aneurysms or cerebrovascular malformations must consider a number of specific challenges, in addition to those associated with anesthesia for other specialties. In addition to maintenance of physiological stability, manipulation of systemic and cerebral hemodynamic parameters may be required to treat any sudden unexpected catastrophic neurological events. A multidisciplinary group including neuro- and pediatric anesthesiologists, interventional neuroradiologists, neurosurgeons, and a clinical methodologist contributed to this document...
September 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28488754/virtual-endovascular-treatment-of-intracranial-aneurysms-models-and-uncertainty
#11
REVIEW
Ali Sarrami-Foroushani, Toni Lassila, Alejandro F Frangi
Virtual endovascular treatment models (VETMs) have been developed with the view to aid interventional neuroradiologists and neurosurgeons to pre-operatively analyze the comparative efficacy and safety of endovascular treatments for intracranial aneurysms. Based on the current state of VETMs in aneurysm rupture risk stratification and in patient-specific prediction of treatment outcomes, we argue there is a need to go beyond personalized biomechanical flow modeling assuming deterministic parameters and error-free measurements...
May 10, 2017: Wiley Interdisciplinary Reviews. Systems Biology and Medicine
https://www.readbyqxmd.com/read/28413700/endovascular-stroke-treatment-in-a-small-volume-stroke-center
#12
Gry N Behzadi, Lars Fjetland, Rajiv Advani, Martin W Kurz, Kathinka D Kurz
INTRODUCTION: Our purpose was to evaluate the safety and efficacy of endovascular treatment (EVT) of stroke caused by large vessel occlusions (LVO) performed by general interventional radiologists in cooperation with stroke neurologists and neuroradiologists at a center with a limited annual number of procedures. We aimed to compare our results with those previously reported from larger stroke centers. PATIENTS AND METHODS: A total of 108 patients with acute stroke due to LVO treated with EVT were included...
April 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28366071/vessel-wall-signal-enhancement-on-3-t-mri-in-acute-stroke-patients-after-stent-retriever-thrombectomy
#13
Peter Abraham, J Scott Pannell, David R Santiago-Dieppa, Vincent Cheung, Jeffrey Steinberg, Arvin Wali, Mihir Gupta, Robert C Rennert, Roland R Lee, Alexander A Khalessi
OBJECTIVE In vivo and in vitro studies have demonstrated histological evidence of iatrogenic endothelial injury after stent retriever thrombectomy. However, noncontrast vessel wall (VW)-MRI is insufficient to demonstrate vessel injury. Authors of this study prospectively evaluated iatrogenic endothelial damage after stent retriever thrombectomy in humans by utilizing high-resolution contrast-enhanced VW-MRI. Characterization of VW-MRI changes in vessels subject to mechanical injury from thrombectomy may allow better understanding of the biological effects of this intervention...
April 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28259513/harnessing-neuroimaging-capability-in-pediatric-stroke-proceedings-of-the-stroke-imaging-laboratory-for-children%C3%A2-workshop
#14
EDITORIAL
Nomazulu Dlamini, Max Wintermark, Heather Fullerton, Stephen Strother, Wayne Lee, Bruce Bjornson, Kristin P Guilliams, Steven Miller, Adam Kirton, Christopher G Filippi, Alexandra Linds, Rand Askalan, Gabrielle deVeber
On June 5, 2015 the International Pediatric Stroke Study and the Stroke Imaging Laboratory for Children cohosted a unique workshop focused on developing neuroimaging research in pediatric stroke. Pediatric neurologists, neuroradiologists, interventional neuroradiologists, physicists, nurse practitioners, neuropsychologists, and imaging research scientists from around the world attended this one-day meeting. Our objectives were to (1) establish a group of experts to collaborate in advancing pediatric neuroimaging for stroke, (2) develop consensus clinical and research magnetic resonance imaging protocols for pediatric stroke patients, and (3) develop imaging-based research strategies in pediatric ischemic stroke...
April 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28183836/low-dose-ct-for-craniosynostosis-preserving-diagnostic-benefit-with-substantial-radiation-dose-reduction
#15
J C Montoya, L J Eckel, D R DeLone, A L Kotsenas, F E Diehn, L Yu, A C Bartley, R E Carter, C H McCollough, J G Fletcher
BACKGROUND AND PURPOSE: Given the positive impact of early intervention for craniosynostosis, CT is often performed for evaluation but radiation dosage remains a concern. We evaluated the potential for substantial radiation dose reduction in pediatric patients with suspected craniosynostosis. MATERIALS AND METHODS: CT projection data from pediatric patients undergoing head CT for suspected craniosynostosis were archived. Simulated lower-dose CT images corresponding to 25%, 10%, and 2% of the applied dose were created using a validated method...
April 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28120064/giant-basilar-artery-aneurysm-involving-the-origin-of-bilateral-posterior-cerebral-and-superior-cerebellar-arteries-neck-reconstruction-with-pconus-assisted-coiling
#16
Francesco Signorelli, Carmelo Lucio Sturiale, Giuseppe La Rocca, Alessio Albanese, Francesco D'Argento, Pierpaolo Mattogno, Alfredo Puca, Massimiliano Visocchi, Enrico Marchese, Alessandro Pedicelli
Giant aneurysms of the basilar artery are rare and are frequently associated with obstructive hydrocephalus and brainstem compression. Treatment still remains a challenge both for neurosurgeons and for interventional neuroradiologists. Cases reported in the literature are anecdotal and, overall, their outcomes are poor. We present the case of a patient with a giant aneurysm of the basilar artery tip, involving the origin of both the posterior cerebral and superior cerebellar arteries, who underwent coiling and ventriculoperitoneal shunting for associated obstructive hydrocephalus...
2017: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/28118025/interrater-variability-for-ct-angiography-evaluation-between-neurologists-and-neuroradiologist-in-acute-stroke-patients
#17
Michal Bar, Jiri Kral, Tomas Jonszta, Vaclav Marcian, Martin Kuliha, Robert Mikulik
OBJECTIVE: The diagnosis of arterial occlusion has a considerable impact on the indication of mechanical thrombectomy, and CT angiography (CTA) is recommended in the management of acute stroke. The goal of the present study is to assess the interrater agreement in the diagnosis of occlusion of intracranial arteries on CTA between a neuroradiologist and neurologists. METHODS: CTA images of 75 acute stroke patients were evaluated for occlusion of intracranial arteries by an experienced interventional neuroradiologist, and stroke and general neurologists...
March 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28002169/fluoroscopic-guided-lumbar-spinal-drain-insertion-for-thoracic-aortic-aneurysm-surgery
#18
Hamdy Awad, Mohamed Ehab Ramadan, Esmerina Tili, Kathryn Hackett, Eric C Bourekas
We retrospectively reviewed the medical records of 11 patients who were referred by anesthesiologists to an interventional neuroradiologist for fluoroscopy-guided lumbar spinal drain insertion for thoracic aortic aneurysm repair between January 2010 and June 2015. Successful drain insertion was achieved in all patients. Three (27.3%) patients developed drain-related complications. Fluoroscopy-guided spinal drain insertion is an alternative to the conventional, nonimage-guided, blind technique used by anesthesiologists when they expect to encounter difficulty with insertion or in cases of failed insertion...
October 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28000558/coarse-classification-to-region-scalable-refining-for-white-matter-lesions-segmentation-in-multi-channel-mri
#19
Renping Yu, Liang Xiao, Zhihui Wei
Brain lesions, especially White Matter Lesions (WMLs) that mostly found on magnetic resonance images of elderly people, are not only associated with normal aging, but also with various geriatric disorders including cardiovascular diseases, vascular disease, psychiatric disorders and dementia. Quantitative analysis of WMLs in large clinical trials is crucial in scientific investigations of such neurological diseases as well as in studying aging processes. Exploiting the different appearances of WMLs in multiple modalities, we propose a novel coarse classification to region-scalable refining method to segment WMLs in Magnetic Resonance Imaging (MRI) sequences without user intervention...
December 20, 2016: CNS & Neurological Disorders Drug Targets
https://www.readbyqxmd.com/read/27998955/latest-generation-of-flat-detector-ct-as-a-peri-interventional-diagnostic-tool-a-comparative-study-with-multidetector-ct
#20
Johanna Rosemarie Leyhe, Ioannis Tsogkas, Amélie Carolina Hesse, Daniel Behme, Katharina Schregel, Ismini Papageorgiou, Jan Liman, Michael Knauth, Marios-Nikos Psychogios
BACKGROUND AND PURPOSE: Flat detector CT (FDCT) has been used as a peri-interventional diagnostic tool in numerous studies with mixed results regarding image quality and detection of intracranial lesions. We compared the diagnostic aspects of the latest generation FDCT with standard multidetector CT (MDCT). MATERIALS AND METHODS: 102 patients were included in our retrospective study. All patients had undergone interventional procedures. FDCT was acquired peri-interventionally and compared with postinterventional MDCT regarding depiction of ventricular/subarachnoidal spaces, detection of intracranial hemorrhage, and delineation of ischemic lesions using an ordinal scale...
December 20, 2016: Journal of Neurointerventional Surgery
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