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Interventional neuroradiologist

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https://www.readbyqxmd.com/read/29443076/optimized-management-of-endovascular-treatment-for-acute-ischemic-stroke
#1
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
#2
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
#3
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
#4
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
#5
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...
January 22, 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
#6
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 Safety and Efficacy Analysis of FRED Embolic 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
#7
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...
January 6, 2018: La Radiologia Medica
https://www.readbyqxmd.com/read/29180089/the-pconus2-neck-bridging-device-early-clinical-experience-and-immediate-angiographic-results
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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