Ahmed Abdelsalam, Hayes B Fountain, Ian A Ramsay, Evan M Luther, Mohammad Mahdi Sowlat, Michael A Silva, Ameer E Hassan, Aman B Patel, Tiffany Eatz, Pradeep Joseph, Robert W Regenhardt, Sudhakar R Satti, Adnan H Siddiqui, Sai Sanikommu, Ammad A Baig, Priyank Khandelwal, Alejandro M Spiotta, Robert M Starke
INTRODUCTION: This study is the first multicentric report on the safety, efficacy, and technical performance of utilizing a large bore (0.081″ inner diameter) access catheter in neurovascular interventions. METHODS: Data were retrospectively collected from seven sites in the United States for neurovascular procedures via large bore 0.081″ inner diameter access catheter (Benchmark BMX81, Penumbra, Inc.). The primary outcome was technical success, defined as the access catheter reaching its target vessel...
June 20, 2024: Interventional Neuroradiology
Rosalie Ea Morrish, Alec T Chunta, Brooke L Belanger, Paige M Croney, M Suheel Abdul Salam, Crista Thompson, Muneer Eesa, John H Wong, Alim P Mitha
BACKGROUND: Bioresorbable polymer-based flow-diverting stents have potential benefits over existing metal devices. This study aimed to evaluate the safety and efficacy of the novel ReSolv device, which is a primarily polymer-based flow-diverting stent, using the in vivo rabbit sidewall saccular aneurysm model. METHODS: ReSolv stents were deployed in 14 New Zealand White rabbits that had undergone aneurysm creation procedures. Animals were allocated to follow-up time points of 1, 3, 6, 9, 12, 16, or 18 months...
June 20, 2024: Interventional Neuroradiology
Justin E Vranic, Robert W Regenhardt, Amine Awad, Omer Doron, James Rabinov
BACKGROUND: Carotid-cavernous fistulas (CCFs) are complex arteriovenous shunting lesions of the cavernous sinus with diverse clinical presentations. This study aimed to analyze clinical outcomes and differentiate patients treated with conservative observation versus those needing endovascular intervention. METHODS: A retrospective analysis of 84 patients with angiographically confirmed CCF was conducted from 2000 to 2022. Endovascular treatment decisions were made at the discretion of neurointerventionalists...
June 17, 2024: Interventional Neuroradiology
Shigeta Miyake, Andrew Falzon, Tze Phei Kee, Hugo Andrade, Timo Krings
Although rare, cerebral arterial fenestration may present challenges in diagnosis and treatment. Here we present a case of a supraclinoid internal carotid artery (ICA) fenestration adjacent to an ICA aneurysm, successfully treated with balloon-assisted coil embolization. A female in her 50's presented with an acute subarachnoid hemorrhage from a ruptured left ICA-ophthalmic artery (OA) aneurysm. Digital subtraction angiography revealed a focal ICA fenestration distal to the posterior communicating artery (Pcom)...
June 17, 2024: Interventional Neuroradiology
Shuhai Long, Sun Yu, Chengcheng Shi, Ji Ma, Zhen Li, Jingliang Cheng, Yuncai Ran, Xinwei Han, Tengfei Li
BACKGROUND: In intracranial stenting, good stent apposition is crucial, and high-resolution C-arm computer tomography (CT) is utilized to assess whether stent apposition is complete. This study was aimed at finding optimal hypertonic or isotonic contrast media injection concentration for high-resolution C-arm CT to assess apposition of flow diversion (FD) after carotid artery stenting in swine. METHODS: Twelve FD stents were implanted into the left carotid artery of Bama swine through the endovascular method...
June 17, 2024: Interventional Neuroradiology
Marco Marangoni, Ian R Macdonald, Gwynedd E Pickett, Adrienne Weeks, Cha-Ney Kim, Axel Rohr, William Guest, Manraj K S Heran, David Volders
BACKGROUND: Radial arterial access has gained interest for neurovascular procedures in recent years. Although there are no randomized control trials for neurointervention procedures using radial access, there is growing literature demonstrating its feasibility and favorable outcomes. Equipment technical improvements, like the recently introduced BENCHMARK™ BMX®81 System, have made radial navigation safer, with improved maneuverability and support for a variety of procedures...
June 14, 2024: Interventional Neuroradiology
Melika Amoukhteh, Amir Hassankhani, Payam Jannatdoust, Parya Valizadeh, Sherief Ghozy, Cem Bilgin, David F Kallmes
BACKGROUND: Intracranial dissecting aneurysms present a challenging subset linked to considerable morbidity and mortality, necessitating effective therapeutic strategies to prevent complications. Traditional treatments face technical limitations, while emerging endovascular modalities like stent-assisted coiling, multiple stenting, and flow-diverting devices (FDDs) offer promise in reducing periprocedural risks and enhancing patient outcomes. The aim of this study is to compare the safety and efficacy outcomes of endovascular treatment for intracranial dissecting aneurysms using FDDs versus stents (with or without coiling)...
June 14, 2024: Interventional Neuroradiology
Rashid A Ahmed, James R Withers, Joyce A McIntyre, Thabele M Leslie-Mazwi, Alvin S Das, Adam A Dmytriw, Joshua A Hirsch, James D Rabinov, Omer Doron, Christopher J Stapleton, Aman B Patel, Aneesh B Singhal, Natalia S Rost, Robert W Regenhardt
INTRODUCTION: The mantra "time is brain" cannot be overstated for patients suffering from acute ischemic stroke. This is especially true for those with large vessel occlusions (LVOs) requiring transfer to an endovascular thrombectomy (EVT) capable center. We sought to evaluate the spoke hospital door in-door out (DIDO) times for patients transferred to our hub center for EVT. METHODS: Individuals who first presented with LVO to a spoke hospital and were then transferred to the hub for EVT were retrospectively identified from a prospectively maintained database from January 2019 to November 2022...
June 14, 2024: Interventional Neuroradiology
Rikke Puggaard, Nicolaj Grønbæk Laugesen, Klaus Hansen, Andreas H Brandt, Trine Stavngaard, Thomas C Truelsen
BACKGROUND: Mechanical thrombectomy (MT) in patients with symptoms of acute ischemic stroke (AIS) due to internal carotid artery dissection (ICAD) remains controversial. In this study, we present clinical outcome and safety of MT in acute ICAD compared to other acute carotid artery pathology. METHODS: Patients with symptoms of AIS due to internal carotid artery pathology, treated with MT from 2017-2021, were categorized as ICAD or non-ICAD. Baseline and procedural characteristics, complications, and functional outcome at 90 days were compared between the two groups...
June 13, 2024: Interventional Neuroradiology
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No abstract text is available yet for this article.
June 10, 2024: Interventional Neuroradiology
David Barkyoumb, Abdurrahman F Kharbat, José M Orenday-Barraza, Mohit Pahuja, Hakeem J Shakir
Lesions of the subclavian artery often involve pathologic stenosis due to high degrees of calcification within the vessel wall. While endovascular angioplasty and stenting is generally the preferred method for obtaining flow reconstitution, calcification of the vessel wall has proven to significantly impair the efficacy of successful stent deployment. Shockwave intravascular lithotripsy (IVL) is a technology that has been very successful in addressing this challenge in other vascular territories, however its use has yet to be approved for supra-aortic vessels such as the subclavian artery...
June 10, 2024: Interventional Neuroradiology
Shigeta Miyake, Tze P Kee, Andrew Falzon, Hugo Andrade, Timo Krings
Cavernous sinus dural arteriovenous fistula can cause cerebral edema and hemorrhage due to cortical venous reflux and congestion. Understanding complex venous reflux and drainage routes is crucial for treatment planning. Here, we present a case of a cavernous sinus dural arteriovenous fistula with cortical venous reflux via two separate terminations of the telencephalic veins caused by an aplastic basal vein of Rosenthal. The patient presented with diplopia and eye redness and was diagnosed with a Cognard type IIa + b cavernous sinus dural arteriovenous fistula...
June 7, 2024: Interventional Neuroradiology
Stephen J Sozio, Alexandra Castro, Sri Hari Sundararajan, Steven Schonfeld, Gaurav Gupta, Nancy C Prendergast, Irwin A Keller, Sudipta Roychowdhury
Medium vessel occlusions (MeVOs), defined as occlusion of the M2/M3 and A2/A3 segments of the middle cerebral artery (MCA) and anterior cerebral artery, can be challenging to visualize on CT angiography (CTA) and MR angiography (MRA), given the anatomic complexity of the mid- and distal intracranial vasculature and smaller vessel caliber (Leary MC, Kidwell CS, Villablanca JP, et al. Validation of computed tomographic MCA "dot" sign: an angiographic correlation study. Stroke 2003; 34: 2636-2640; Luijten SPR, Wolff L, Duvekot MHC, et al...
June 4, 2024: Interventional Neuroradiology
Jonathan Dallas, Vincent N Nguyen, Joel M Sequeiros, Shelby Graham, Jared Burns-Martin, Nitin Goyal, Kasra Khatibi
INTRODUCTION: Distal medium vessel occlusion (DVO) thrombectomy has been shown to be efficacious with safety profiles comparable to large vessel occlusion (LVO) thrombectomy. A novel, highly-trackable, bevel-tipped Zoom 35 catheter can be used as an aspiration catheter for DVO thrombectomy. METHODS: This is a retrospective, single-arm, multi-institutional observational study evaluating the efficacy and safety of aspiration thrombectomy for DVO using the Zoom 35 catheter...
June 3, 2024: Interventional Neuroradiology
Linan Qiu, Ye Zhang, Dandan Geng, Yuesong Pan, Xueqian Xu, Jiahao Chen, Minjie Xu, Liuzhu Chen, Yujie Tu, Yezhi Huang, Jingfang Long, Qi Duan, Beilan Wu, Huihua Qiu, Jincai He
BACKGROUND: Acute ischemic stroke poses a significant health threat, and thrombectomy has become a routine treatment. Tirofiban has emerged as a promising adjunct therapy to minimize reocclusion after thrombectomy. We aimed to investigate whether renal function influences the safety and efficacy of tirofiban in patients undergoing endovascular therapy. METHODS: Patients' clinical data collected from the stroke unit were analyzed. The modified Rankin scale score and symptomatic intracranial hemorrhage (sICH) were used as outcome measures...
May 31, 2024: Interventional Neuroradiology
Matea Prenc, Helena Žižek, Petra Radić, Marija Škoro, Ana-Marija Novak, Branimir Čulo, Vladimir Kalousek
The artery of Bernasconi and Cassinari is a small infraclinoid branch of the internal carotid artery that originates from its cavernous segment and then runs along the tentorium. Because of its gracile appearance, it is often visible only when related to neoplasms and vascular lesions in the tentorial regions.1 Dural arteriovenous fistulas (dAVFs) are arteriovenous shunts contained within the dural leaflets, supplied largely by the regional meningeal arteries and classified based on the type of venous drainage...
May 31, 2024: Interventional Neuroradiology
Shi Lin, Wei Chunxiao, Sun Li, Zhang Guimei, Zhang Yaru, Zhai Weijie, Qi Yiming, Zhou Ruolin, Meng Lingjie, Zhang Yan
OBJECTIVE: To investigate the association between von Willebrand factor (vWF) and neutrophil extracellular traps (NETs) in thrombus with clinical severity and peripheral blood immunocytes' indicators in patients with early-stage acute ischemic stroke (AIS). METHODS: A retrospective study was conducted using the clinical data of 66 patients with AIS who underwent endovascular mechanical thrombectomy and had their thrombus samples collected. The concentrations of vWF and NETs in the thrombus samples were quantitatively assessed...
May 29, 2024: Interventional Neuroradiology
Jesse Jones, John Deveikis
Pediatric neurointervention differs from the adult in several important respects. Here we describe a modern approach to readily acquire diagnostic quality images of children. Preparation, access, angiogragraphy and closure have evolved along with new knowledge and technology. This timely "how I do it" series addresses each topic utilizing literature review and our own experience over 35 years.
May 27, 2024: Interventional Neuroradiology
Arsida Bajrami, Songul Senadim, Demet Funda Bas, Eren Erdem, Serdar Geyik
BACKGROUND: Reperfusion of medium vessel occlusions is correlated with good outcomes. However, optimal techniques and medical devices are still unclear. In this study, we sought to evaluate the safety and efficacy of mechanical thrombectomy with Embolus Retriever with Interlinked Cages (ERIC™) retrieval device in patients with acute ischemic stroke due to distal medium vessel occlusions. METHODS: A retrospective review of the prospectively collected mechanical thrombectomy database revealed 50 patients who had fulfilled the inclusion criteria...
May 21, 2024: Interventional Neuroradiology
Shuhai Long, Shuailong Shi, Zhike Zhang, Qi Tian, Zhuangzhuang Wei, Ji Ma, Ye Wang, Jie Yang, Xinwei Han, Tengfei Li
PURPOSE: This study aims to compare the efficacy and safety of using overlapping low-profile visualized intraluminal support (LVIS) devices and flow diversion (FD) for the treatment of unruptured vertebral artery dissection (VAD) in the V3-V4 segments. METHODS: The clinical and imaging data of 71 patients with unruptured VAD in the V3-V4 segments who underwent either dual LVIS stenting (d-LVIS group) or single FD stenting (FD group) at our center from September 2014 to December 2021 were retrospectively analyzed...
May 15, 2024: Interventional Neuroradiology
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