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Interventional neuroradiologist

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https://www.readbyqxmd.com/read/29909185/accuracy-of-smartphone-based-evaluation-of-emergent-large-vessel-occlusion-on-cta
#1
Douglas T Hidlay, Ryan A McTaggart, Grayson Baird, Shadi Yaghi, Morgan Hemendinger, Eric L Tung, Eleanor L Dibiasio, Richard A Haas, Mahesh V Jayaraman
OBJECTIVES: Mechanical thrombectomy is the standard of care for stroke caused by an emergent large vessel occlusion in the anterior circulation, and the ability to rapidly review CTA is one hurdle in minimizing the time from diagnosis to intervention. We evaluated the diagnostic accuracy and confidence in review of stroke CTA for ELVO via a smartphone-based application as compared to PACS workstation. PATIENTS AND METHODS: Seventy-six head and neck CTA studies performed for stroke from one comprehensive and seven primary stroke centers were independently reviewed remotely on smartphone by two blinded interventional neuroradiologists in actual-use circumstances...
June 11, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29749883/rapid-sequence-brain-magnetic-resonance-imaging-for-chiari-i-abnormality
#2
James Pan, Jennifer L Quon, Eli Johnson, Bryan Lanzman, Anjeza Chukus, Allen L Ho, Michael S B Edwards, Gerald A Grant, Kristen W Yeom
OBJECTIVE Fast magnetic resonance imaging (fsMRI) sequences are single-shot spin echo images with fast acquisition times that have replaced CT scans for many conditions. Introduced as a means of evaluating children with hydrocephalus and macrocephaly, these sequences reduce the need for anesthesia and can be more cost-effective, especially for children who require multiple surveillance scans. However, the role of fsMRI has yet to be investigated in evaluating the posterior fossa in patients with Chiari I abnormality (CM-I)...
May 11, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29691597/preoperative-digital-subtraction-angiography-in-incidental-unruptured-intracranial-aneurysms-how-much-is-too-much
#3
Moriz Herzberg, Robert Forbrig, Christian Schichor, Hartmut Brückmann, Franziska Dorn
PURPOSE: Digital subtraction angiography (DSA) is deemed necessary to precisely visualize intracranial aneurysms and define individual treatment strategies. In patients with unruptured intracranial aneurysms (UIA) who were diagnosed by MRI, a four-vessel DSA is usually performed to detect additional aneurysms. This study aimed to evaluate whether the evaluation of all vessels beyond the aneurysm-harboring artery is really necessary. MATERIAL AND METHODS: Patients with an UIA that was detected on MRA (TOF/ceMRA) were prospectively included...
April 24, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29614675/the-vascular-hypothesis-of-alzheimer-s-disease-a-key-to-preclinical-prediction-of-dementia-using-neuroimaging
#4
Jack de la Torre
The vascular hypothesis of Alzheimer's disease (VHAD) was proposed 24 years ago from observations made in our laboratory using aging rats subjected to chronic brain hypoperfusion. In recent years, VHAD has become a mother-lode to numerous neuroimaging studies targeting cerebral hemodynamic changes, particularly brain hypoperfusion in elderly patients at risk of developing Alzheimer's disease (AD). There is a growing consensus among neuroradiologists that brain hypoperfusion is likely involved in the pathogenesis of AD and that disturbed cerebral blood flow (CBF) can serve as a key biomarker for predicting conversion of mild cognitive impairment to AD...
2018: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29572267/long-term-visual-outcome-in-patients-treated-by-flow-diversion-for-carotid-ophthalmic-aneurysms
#5
Romain Touzé, Valérie Touitou, Eimad Shotar, Joseph Gabrieli, Mehdi Drir, Bertrand Mathon, Nader-Antoine Sourour, Frédéric Clarençon
BACKGROUND: Flow-diverter stents (FDSs) are an upgrade in the treatment of intracranial aneurysms. However, complications concerning covered branches have been reported, especially the ophthalmic artery (OA). The purpose of our study was to evaluate the long-term ophthalmic complication rate of carotid-ophthalmic aneurysms (COA) without visual pathways compression, treated by a FDS covering the OA by performing an exhaustive ophthalmic examination. MATERIAL AND METHODS: Retrospective analysis of a single-center database screening the patients treated from October 2009 to April 2015 for an intracranial aneurysm with a FDS...
March 23, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29443076/optimized-management-of-endovascular-treatment-for-acute-ischemic-stroke
#6
Katharina Schregel, Daniel Behme, Ioannis Tsogkas, Michael Knauth, Ilko Maier, André Karch, Rafael Mikolajczyk, Mathias Bähr, Jörn Schäper, José Hinz, Jan Liman, Marios-Nikos Psychogios
This manuscript describes a streamlined protocol for the management of patients with acute ischemic stroke, which aims at the minimization of time from hospital admission to reperfusion. Rapid restoration of cerebral blood flow is essential for the outcomes of patients with acute ischemic stroke. Endovascular treatment (EVT) has become the standard of care to accomplish this in patients with acute stroke due to large vessel occlusion (LVO). To achieve reperfusion of ischemic brain regions as fast as possible, all in-hospital time delays have to be carefully avoided...
January 18, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29438036/cervical-ica-pseudo-occlusion-on-single-phase-cta-in-patients-with-acute-terminal-ica-occlusion-what-is-the-mechanism-and-can-delayed-cta-aid-diagnosis
#7
James Wareham, Robert Crossley, Sarah Barr, Alex Mortimer
BACKGROUND: Single-phase CT angiography (CTA) forms the basis of hyperacute stroke imaging but many patients with terminal internal carotid artery (ICA) occlusion exhibit a pseudo-occlusion of the cervical ICA whereby a column of unopacified blood mimics a tandem cervical ICA lesion. We aimed to investigate the utility of a delayed phase acquisition to aid identification of a pseudo-occlusion and investigated the mechanism for this imaging artefact. METHODS: Thirteen patients with a pseudo-occlusion were compared with 13 patients without...
February 6, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29405178/assessment-of-occupational-radiation-dose-in-interventional-settings
#8
Fabiola Cretti
INTRODUCTION: In light of both current Italian radioprotection law and the new European Directive, radiation dose monitoring was carried out on the interventional staff, of the new Papa Giovanni XXIII Hospital in Bergamo, Italy, potentially exposed to high radiation levels. METHODS: Interventional activities were mapped and personal dose data were collected for three years using thermo-luminescent dosimeters. Effective dose (ED) to whole body and equivalent dose (HT) to hands and eye lenses were estimated from Hp(10) and Hp(0...
February 1, 2018: La Medicina del Lavoro
https://www.readbyqxmd.com/read/29375231/recruiting-an-acute-coronary-team-to-perform-emergent-mechanical-thrombectomy-in-acute-ischemic-stroke-patients-a-successful-case-and-team-model-in-a-local-hospital
#9
Shih-Wei Meng, Ruei-Cheng Kuo, Hui-Jen Yang, Chao-Lun Lai, Chih-Cheng Wu, Mu-Yang Hsieh
Stroke treatment has entered a new era after the publication of multiple randomized trials involving the use of a stent retriever since 2015. In Taiwan, the demand for interventional neuroradiologists to perform mechanical thrombectomy is high. For this reason, providing this standard care requires reshaping of the care model. Here, we report our experience in recruiting an acute coronary care team to perform emergent mechanical thrombectomy, which is essential in a patient with acute ischemic stroke.
January 2018: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/29356857/fate-of-the-three-embryonic-dural-sinuses-in-infants-the-primitive-tentorial-sinus-occipital-sinus-and-falcine-sinus
#10
Katsuhiro Mizutani, Tomoru Miwa, Takenori Akiyama, Yoshiaki Sakamoto, Hirokazu Fujiwara, Kazunari Yoshida
PURPOSE: The primitive tentorial, occipital, and falcine sinuses are thought to attain the adult pattern or regress between the fetal stage and adulthood. The anatomy of these three primitive dural sinuses has seldom been studied in the infant population, and it remains unclear when these dural sinuses reach the adult condition. Using computed tomography digital subtraction venography (CT-DSV), we analyzed the anatomy of these embryonic dural sinuses in infants. METHODS: We included 13 infants who underwent CT-DSV prior to neurosurgery and 35 cases with unruptured cerebral aneurysms as normal adult controls...
March 2018: Neuroradiology
https://www.readbyqxmd.com/read/29352057/feasibility-complications-morbidity-and-mortality-results-at-6-months-for-aneurysm-treatment-with-the-flow-re-direction-endoluminal-device-report-of-safe-study
#11
Laurent Pierot, Laurent Spelle, Jérôme Berge, Anne-Christine Januel, Denis Herbreteau, Mohamed Aggour, Michel Piotin, Alessandra Biondi, Xavier Barreau, Charbel Mounayer, Chrisanthi Papagiannaki, Jean-Paul Lejeune, Jean-Yves Gauvrit, Vincent Costalat
BACKGROUND AND PURPOSE: Flow diverters are increasingly used for the treatment of intracranial aneurysms. Evaluation of the first devices available for clinical use showed high efficacy of this treatment although safety results were worse compared with coiling or balloon-assisted coiling. The <u>S</u>afety and Efficacy <u>A</u>nalysis of <u>F</u>RED <u>E</u>mbolic Device in Aneurysm Treatment (SAFE) trial is a single-arm, multicenter, prospective study conducted to precisely analyze the safety and efficacy of the FRED and FRED Jr devices...
January 19, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29307078/summary-of-the-italian-inter-society-recommendations-for-radiation-protection-optimization-in-interventional-radiology
#12
Gaetano Compagnone, Renato Padovani, Maria Antonietta D'Avanzo, Sveva Grande, Francesco Campanella, Antonella Rosi
OBJECTIVES: A Working Group coordinated by the Italian National Institute of Health (Istituto Superiore di Sanità) and the National Workers Compensation Authority (Istituto Nazionale per l'Assicurazione contro gli Infortuni sul Lavoro, INAIL) and consisting of 11 Italian scientific/professional societies involved in the fluoroscopically guided interventional practices has been established to define recommendations for the optimization of patients and staff radiation protection in interventional radiology...
May 2018: La Radiologia Medica
https://www.readbyqxmd.com/read/29180089/the-pconus2-neck-bridging-device-early-clinical-experience-and-immediate-angiographic-results
#13
Pedro Lylyk, Jorge Chudyk, Carlos Bleise, Harald Sahl, Marta Aguilar Pérez, Hans Henkes, Pervinder Bhogal
BACKGROUND: Treating wide-necked aneurysms is challenging for the interventional neuroradiologist. Recently, numerous devices dedicated to the treatment of these aneurysms have become available. We report our early experience using the pCONus2 device and present the technical success rate, clinical outcomes, 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...
February 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29173070/generalist-versus-subspecialist-characteristics-of-the-u-s-radiologist-workforce
#14
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...
March 2018: Radiology
https://www.readbyqxmd.com/read/29134167/postoperative-imaging-findings-associated-with-transpalpebral-craniotomy-approach-to-anterior-cranial-fossa
#15
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
#16
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)...
March 2018: Radiology
https://www.readbyqxmd.com/read/29064752/improving-clinical-information-on-head-ct-requisitions-from-the-emergency-department-to-aid-interpretation-and-billing-efficiency
#17
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...
January 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28972807/the-future-of-interventional-and-neurointerventional-radiology-learning-lessons-from-the-past
#18
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
#19
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...
May 2018: 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
#20
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
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