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Neurointerventional radiology

Jorge Pena Mogollon, Nicolas Roydon Smoll, Rakshit Panwar
OBJECTIVE: An onsite access to neurointerventional radiology (NIR) may be useful for managing patients with aneurysmal subarachnoid haemorrhage (aSAH) after the aneurysm-securing procedure. We aimed to assess the association between neurological outcomes related to aSAH and onsite access to NIR service. METHODS: This was a sequential period study of 47 patients with aSAH admitted consecutively during the pre-NIR period (Jan 2010 to Jun 2012) compared with 81 patients with aSAH admitted consecutively during the post-NIR period (Jan 2013 to Jun 2015) at an academic tertiary referral ICU...
February 1, 2018: World Neurosurgery
Akash P Kansagra, Adam N Wallace, David R Curfman, James D McEachern, Christopher J Moran, DeWitte T Cross, Jin-Moo Lee, Andria L Ford, S Goyal Manu, Peter D Panagos, Colin P Derdeyn
OBJECTIVE: Shorter time from symptom onset to treatment is associated with improved outcomes in patients who undergo mechanical thrombectomy for treatment of acute ischemic stroke due to emergent large vessel occlusion. In this work, we detail pre-thrombectomy process improvements in a multi-hospital network and report the effect on door-to-puncture time in patients undergoing mechanical thrombectomy. PATIENTS AND METHODS: A streamlined workflow was adopted to minimize door-to-puncture time...
January 30, 2018: Clinical Neurology and Neurosurgery
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
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...
August 2017: Stroke; a Journal of Cerebral Circulation
S Rudin
1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures. Along with development of catheters, embolic materials, pushable coils and the GDC coils there was simultaneous development and improvement of 2D DSA image quality and the introduction of 3D DSA...
June 2016: Medical Physics
Ondrej Volny, Petra Cimflova, Viktor Szeder
BACKGROUND AND PURPOSE: Thrombolysis in cerebral infarction (TICI) with 2b/3 (>50% of occluded territory/complete reperfusion) has been regarded as a successful angiographic outcome. To account for near-perfect angiographic results, the category TICI 2c (near-complete reperfusion) has been introduced. As the degree of inter-rater reliability for TICI with 2c category remains poorly studied, we strived to evaluate the agreement among stroke-treating specialists. METHODS: All consecutive patients, who underwent stent-retriever thrombectomy for acute ischemic stroke in the period between January 2014 and April 2016 at the Department of Neurointerventional Radiology, were analyzed...
May 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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...
April 2017: Emergency Radiology
S K Rammos, B Gardenghi, C Bortolotti, H J Cloft, G Lanzino
Brain arteriovenous malformations are frequently associated with the presence of intracranial aneurysms at a higher-than-expected incidence based on the frequency of each lesion individually. The identification of intracranial aneurysms in association with AVMs has increased due to improvement in diagnostic techniques, particularly 3D and superselective conventional angiography. Intracranial aneurysms may confer a higher risk of hemorrhage at presentation and of rehemorrhage in patients with AVMs and therefore may be associated with a more unfavorable natural history...
June 23, 2016: AJNR. American Journal of Neuroradiology
F Fortea, J Masjuan, F Arikán-Abello, A Rovira, A González, J Arenillas, J Fernández Alen, J Gállego
BACKGROUND: The development of endovascular techniques has put Interventional Neuroradiology (INR) as the first-option treatment in the majority of vascular diseases of the central nervous system. Scientific societies in developed countries have created standard procedures for training and accreditation for a safe practice in these procedures. DISCUSSION: In Spain, we are waiting for the development of the legislation on the accreditation for specialists which will establish the official formative model to achieve an accreditation in INR...
March 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
Eun Soo Kim, Dae Young Yoon, Hye Jeong Kim, Hong Jun Jeon, Jong Young Lee, Byung-Moon Cho, Kwanseop Lee
BACKGROUND AND PURPOSE: The number of citations that an article has received can be used to evaluate its impact on the scientific community. This study aimed to identify the 100 most cited articles in the field of neurointervention and to analyze their characteristics. MATERIALS AND METHODS: We selected the 669 journals that were considered potentially to publish neurointervention articles based on the database of Journal Citation Reports. Using the Web of Science citation search tool, we identified the 100 most cited articles relevant to neurointervention within the selected journals...
May 2017: Journal of Neurointerventional Surgery
Maher A Al-Khawaldeh, Osama K Haddad, Ashraf O Alshabatat, Salil V Deo, Abeer Rababa'h, Salah E Altarabsheh
Ischemic stroke following cardiac surgery is one of the devastating complications that surgeons may encounter, and may lead to serious disabilities for the patient. The clinical course of such a complication may be prolonged if it is not treated properly. Making a quick decision when choosing a revascularization method is very helpful in this matter. Effective treatment options are usually limited. Neurointerventional maneuvers have recently emerged as a possible therapeutic modality in this field. We present the case of a 52-year-old woman who had open heart surgery in Queen Alia Heart Institute, Jordan, to replace a severely stenotic rheumatic mitral valve and repair a leaking tricuspid valve...
November 2015: Oman Medical Journal
Chang-Hwa Lee, Woo-Kie Min
INTRODUCTION: We present a case of C6 mesenchymal chondrosarcoma and discuss safe posterior to anterior approach subtotal en-bloc spondylectomy. MATERIALS AND METHODS: A 29-year-old male consulted for our department with severe posterior neck pain doing exercise. CT scan demonstrated a primary osteolytic lesion on C6 left transverse foramen and MRI demonstrated the tumor involved C6 vertebra from layers B, C and F sectors 4-6 encasing left vertebral artery. Preoperatively neurointerventional radiology service occluded the left vertebral artery and tumor feeding artery using coil embolization...
July 2016: European Spine Journal
R M Sánchez, E Vañó, J M Fernández, S Rosati, L López-Ibor
BACKGROUND AND PURPOSE: Eye lenses are among the most sensitive organs to x-ray radiation and may be considered at risk during neurointerventional radiology procedures. The threshold dose to produce eye lens opacities has been recently reduced to 500 mGy by the International Commission on Radiologic Protection. In this article, the authors investigated the radiation doses delivered to patients' eyes during interventional neuroradiology procedures at a university hospital. MATERIALS AND METHODS: Small optically stimulated luminescence dosimeters were located over patients' eyes during 5 diagnostic and 31 therapeutic procedures performed in a biplane x-ray system...
March 2016: AJNR. American Journal of Neuroradiology
Marcelo Magaldi Ribeiro de Oliveira, Arthur Nicolato, Marcilea Santos, Joao Victor Godinho, Rafael Brito, Alexandre Alvarenga, Ana Luiza Valle Martins, André Prosdocimi, Felipe Padovani Trivelato, Abdulrahman J Sabbagh, Augusto Barbosa Reis, Rolando Del Maestro
OBJECT The development of neurointerventional treatments of central nervous system disorders has resulted in the need for adequate training environments for novice interventionalists. Virtual simulators offer anatomical definition but lack adequate tactile feedback. Animal models, which provide more lifelike training, require an appropriate infrastructure base. The authors describe a training model for neurointerventional procedures using the human placenta (HP), which affords haptic training with significantly fewer resource requirements, and discuss its validation...
May 2016: Journal of Neurosurgery
Joan C Wojak, Todd A Abruzzo, Jacqueline A Bello, Kristine Ann Blackham, Joshua A Hirsch, Mahesh V Jayaraman, Sean R Dariushnia, Philip M Meyers, Mehran Midia, Eric J Russell, T Gregory Walker, Boris Nikolic
No abstract text is available yet for this article.
November 2015: Journal of Vascular and Interventional Radiology: JVIR
Mougnyan Cox, David C Levin, Laurence Parker, Vijay M Rao
PURPOSE: Cerebral catheter angiography and endovascular neurointerventions (ENIs) were developed and refined by early pioneers in neuroradiology. Recently, with developments in the safety and efficacy of ENIs, other physician specialists have expressed strong interest in performing these procedures. Our purpose was to compare volume and utilization of ENIs, among the various specialties, from 2000 to 2013. METHODS: Data from the Medicare Part B Physician/Supplier Procedure Summary Master Files for 2000 to 2013 were used to study ENI volume and utilization rates, by radiologists, neurosurgeons, neurologists, vascular surgeons, cardiologists, and other physicians...
October 2015: Journal of the American College of Radiology: JACR
(no author information available yet)
No abstract text is available yet for this article.
August 2015: Journal of Vascular and Interventional Radiology: JVIR
Marta Sans Merce, Amine M Korchi, Lisa Kobzeva, Jérôme Damet, Gorislav Erceg, Ana Marcos Gonzalez, Karl-Olof Lovblad, Vitor Mendes Pereira
BACKGROUND: Protection of the head and eyes of the neurointerventional radiologist is a growing concern, especially after recent reports on the incidence of brain cancer among these personnel, and the revision of dose limits to the eye lens. The goal of this study was to determine typical occupational dose levels and to evaluate the efficiency of non-routine radiation protective gear (protective eyewear and cap). Experimental correlations between the dosimetric records of each measurement point and kerma area product (KAP), and between whole body doses and eye lens doses were investigated...
July 2016: Journal of Neurointerventional Surgery
Matthew C Davis, John P Deveikis, Mark R Harrigan
Neurointervention is a rapidly evolving and complex field practiced by clinicians with backgrounds ranging from neurosurgery to radiology, neurology, cardiology, and vascular surgery. New devices, techniques, and clinical applications create exciting opportunities for impacting patient care, but also carry the potential for new iatrogenic injuries. Every step of every neurointerventional procedure carries risk, and a thorough appreciation of potential complications is fundamental to maximizing safety. This article presents the most frequent and dangerous iatrogenic injuries, their presentation, identification, prevention, and management...
June 2015: Seminars in Interventional Radiology
Aleksandra Yakhkind, Hussam A Yacoub, Jacqueline Grove, Jay D Varrato, John E Castaldo
The clinical and neuroimaging characteristics of brain infections related to Propionibacterium acnes are not well-characterized, making early diagnosis and treatment a challenge. More recently, life-threatening central nervous system infections with P. acnes are being reported with increasing frequency as complications of neurointerventional procedures. We present a rare case of P. acnes cerebritis that occurred as a sequela of bare platinum aneurysm coiling and a contaminant of percutaneous angiographic intervention...
2015: Hospital Practice (Minneapolis)
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