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JOURNAL ARTICLE
Isabel Rodríguez, Laura Ludovica Gramegna, Manuel Requena, Michele Rizzuti, Iker Elosua, Jordi Mayol, Marta Olivé-Gadea, Francesco Diana, Marc Rodrigo-Gisbert, Marián Muchada, Eila Rivera, Álvaro García-Tornel, Federica Rizzo, Marta De Dios, David Rodríguez-Luna, Carlos Piñana, Jorge Pagola, David Hernández, Jesús Juega, Noelia Rodríguez, Manuel Quintana, Carlos Molina, Marc Ribo, Alejandro Tomasello
BACKGROUND: Symptomatic carotid artery stenosis is a significant contributor to ischemic strokes. Carotid artery stenting (CAS) is usually indicated for secondary stroke prevention. This study evaluates the safety and efficacy of CAS performed within a short time frame from symptom onset. METHODS: We conducted a single-center, retrospective study of consecutive patients who underwent CAS for symptomatic carotid stenosis within eight days of symptom onset from July 2019 to January 2022...
March 22, 2024: Interventional Neuroradiology
#22
JOURNAL ARTICLE
Yin Niu, Qiang Zhang, Zhouyang Jiang, Wenyan Li, Zhi Chen
BACKGROUND: The amount of midline shift (MLS) considered safe for middle meningeal artery embolization (MMAE) in patients with chronic subdural hematoma (CSDH) has not been established. Whether MMAE could be used as upfront treatment for unilateral large CSDH patients with significant MLS (>1 cm) has not been reported. OBJECTIVE: To investigate the efficacy and safety of MMAE in unilateral large CSDH patients with MLS > 1 cm. METHODS: Eleven carefully selected CSDH patients with mild or moderate symptoms and significant MLS > 1 cm from 1 May 2021 to 31 August 2022 were included in the study...
March 22, 2024: Interventional Neuroradiology
#23
REVIEW
James Caldwell, Shane S H Lee, Mikal Sarrafzadeh, Dave S Rhodes, Ben J McGuinness
When performing mechanical thrombectomy for stroke patients, some physicians use balloon guide catheters (BGCs) in order to achieve flow reversal and thereby improve reperfusion quality. There is substantial evidence favoring the use of BGCs to improve reperfusion rates and clinical outcomes for thrombectomy patients; however, as we will outline in this review, there is also evidence that BGCs do not achieve reliable flow reversal in many circumstances. Therefore, if we are able to modify our techniques to improve the likelihood of flow reversal during thrombectomy maneuvers, we may be able to further improve reperfusion quality and clinical outcomes...
March 15, 2024: Interventional Neuroradiology
#24
REVIEW
Joo Won Choi, Yang Qiao, Tej I Mehta, Jessica N Wilson, Trevor H Torigoe, Samuel Tsappidi, Y Jonathan Zhang, Stacy C Brown, Ferdinand K Hui, Todd Abruzzo
INTRODUCTION: Dynamic catheter-directed cerebral digital subtraction angiography (dcDSA) is the gold standard for diagnosing dynamic vascular occlusion syndromes such as bowhunter syndrome (BHS). Nonetheless, concerns about its safety exist and no standardized protocols have been published to date. METHODS: We describe our methodology and insights regarding the use of dcDSA in patients with BHS. We also perform a systematic literature review to identify cases of typical and atypical presentations of BHS wherein dcDSA was utilized and report on any procedural complications related to dcDSA...
March 13, 2024: Interventional Neuroradiology
#25
JOURNAL ARTICLE
Laura Stone McGuire, Elsa Nico, Jessica Hossa, Mpuekela Tshibangu, Ankit Mehta, Ali Alaraj
BACKGROUND AND OBJECTIVES: Preoperative embolization of metastatic spinal tumors (MSTs) has proven advantageous in limiting intraoperative blood loss (IBL) during resection. N-butyl cyanoacrylate (nBCA) is a liquid embolic agent known for its rapid hemostatic effects. However, nBCA is associated with a higher risk of distal nontarget embolization. This study highlights the refinement of the embolization technique and assesses its efficacy in performing an initial distal segmental artery plug with concentrated nBCA followed by proximal diluted nBCA for MSTs...
March 12, 2024: Interventional Neuroradiology
#26
JOURNAL ARTICLE
Kobina G Mensah-Brown, Ryan M Naylor, Stephen Graepel, Waleed Brinjikji
Neuromodulation is the alteration of neural activity in the central, peripheral, or autonomic nervous systems. Consequently, this term lends itself to a variety of organ systems including but not limited to the cardiac, nervous, and even gastrointestinal systems. In this review, we provide a primer on neuromodulation, examining the various technological systems employed and neurological disorders targeted with this technology. Ultimately, we undergo a historical analysis of the field's development, pivotal discoveries and inventions gearing this review to neuro-adjacent subspecialties with a specific focus on neurointerventionalists...
March 8, 2024: Interventional Neuroradiology
#27
JOURNAL ARTICLE
Varun Padmanaban, William J Benjamin, Austin Cohrs, Francis J Jareczek, Sprague W Hazard, Joseph Christopher Zacko, Ephraim W Church, Scott D Simon, Kevin M Cockroft, Douglas L Leslie, David Andrew Wilkinson
OBJECTIVE: Multiple studies suggest routine post-operative intensive care unit (ICU) stays after endovascular treatment (EVT) of unruptured intracranial aneurysms (UIAs) is unnecessary, though rates of ICU utilization nationwide are unknown. We aim to evaluate rates and characteristics of ICU utilization in patients undergoing elective endovascular repair of UIAs. METHODS: This is a retrospective cohort study utilizing a nationwide private-payer database in the United States to evaluate the ICU utilization in patients undergoing elective endovascular repair of UIAs between 2005 and 2019...
March 7, 2024: Interventional Neuroradiology
#28
JOURNAL ARTICLE
Kyriakos Papadimitriou, Shyle H Mehta, Danielle Golub, Timothy White, Kevin Shah, Athos Patsalides
Cerebral venous sinus thrombosis comprises 0.5% of all strokes and usually affects young adults. Straight sinus involvement is relatively rare, and it is associated with poor prognosis. Intravenous anticoagulation is considered the first line of treatment. Endovascular approaches such as direct catheter thrombolysis, balloon-assisted thrombolysis, and mechanical thrombectomy may be more efficient and should be considered in cases in which there is involvement of the deep venous system, declining neurological status, or less invasive treatment options have failed...
March 7, 2024: Interventional Neuroradiology
#29
JOURNAL ARTICLE
Adrusht Madapoosi, Laura Stone McGuire, Jessica Hossa, Angelica Fuentes, Mpuekela Tshibangu, Peter Theiss, Sepideh Amin-Hanjani, Ali Alaraj
INTRODUCTION: Reversible cerebral vasoconstriction syndrome is a complex neurovascular syndrome that presents with varying neurological deficits as well as segmental vasoconstriction of the small and medium cerebral arteries. There is limited literature on pathologies that mimic reversible cerebral vasoconstriction syndrome, so this study aims to understand what factors may impact the angiographic confirmation of reversible cerebral vasoconstriction syndrome on follow-up and play a role in establishing the diagnosis...
March 5, 2024: Interventional Neuroradiology
#30
REVIEW
Sávio Batista, Raphael Camerotte, Agostinho C Pinheiro, Igor Costermani, Anthony Bishay, José Alberto Almeida Filho, Lucca B Palavani, Edmundo Damiani Bertoli, Raphael Bertani, Jason A Ellis, Yafell Serulle, Christian Ferreira
INTRODUCTION: Stent-assisted coil embolization (SACE) for cerebral aneurysms requires dual antiplatelet therapy (DAPT), commonly clopidogrel plus aspirin is preferable to ticagrelor or prasugrel plus aspirin. However, there are few studies assessing the safety of the association of ticagrelor or prasugrel plus aspirin. OBJECTIVES: Compare the safety of newer P2Y12 inhibitors with clopidogrel in patients that underwent a SACE for cerebral aneurysms. METHODS: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, we searched PubMed and Embase for studies comparing newer P2Y12 inhibitors with clopidogrel in patients undergoing DAPT for SACE...
March 5, 2024: Interventional Neuroradiology
#31
(no author information available yet)
No abstract text is available yet for this article.
March 1, 2024: Interventional Neuroradiology
#32
REVIEW
Abdullah Ramzan, Sherief Ghozy, Cem Bilgin, Alejandro A Rabinstein, Ramanathan Kadirvel, David F Kallmes
BACKGROUND: Mechanical thrombectomy (MT) is a safe and effective treatment option for acute ischemic stroke due to large vessel occlusion. To investigate differences in outcomes between patients receiving left-sided and right-sided MT, we performed a systematic review and meta-analysis. METHODS: A systematic literature review was performed using Embase, PubMed, Scopus, and Web of Science databases. Additional literature was searched for manually. Studies reporting safety and efficacy metrics for MT were included...
March 1, 2024: Interventional Neuroradiology
#33
JOURNAL ARTICLE
François Zhu, Liang Liao, Serge Bracard, Oana Harsan, Luana Lopes De Medeiros, Anne-Laure Derelle, Marc Braun, Benjamin Gory, René Anxionnat
Stenting of the dural venous sinuses has emerged as a therapeutic option for intracranial hypertension and pulsatile tinnitus. However, venous endovascular navigation faces challenges due to lower-quality roadmaps compared to arterial navigation. This study explores the application of three-dimensional (3D) rotational venography in assessing the cerebral venous vasculature and its potential for venous navigation. The methods involve venous 3D digital subtracted angiography (DSA) in patients with dural venous stenosis, with image acquisition using a biplane angiographic system...
February 29, 2024: Interventional Neuroradiology
#34
JOURNAL ARTICLE
Jessica K Campos, Benjamen M Meyer, Muhammad Waqas Khan, Fahad J Laghari, David A Zarrin, Jonathan Collard de Beaufort, Gizal Amin, Kiarash Golshani, Matthew T Bender, Geoffrey P Colby, Li-Mei Lin, Alexander L Coon
INTRODUCTION: Superbore 0.088″ catheters provide a platform for optimizing aspiration efficiency and flow control during stroke mechanical thrombectomy procedures. New superbore catheters have the distal flexibility necessary to navigate complex neurovascular anatomy while providing the proximal support of traditional 8F catheters. The safety and feasibility of Zoom 88™ superbore angled-tip catheters in the middle cerebral artery (MCA) segments smaller than the catheter diameter have not been previously described...
February 28, 2024: Interventional Neuroradiology
#35
JOURNAL ARTICLE
Pang-Shuo Perng, Ming-Tsung Chuang, Chia-En Wong, Yu Chang, Yuan-Ting Sun, Hao-Kuang Wang, Jung-Shun Lee, Liang-Chao Wang, Chih-Yuan Huang
BACKGROUND: Middle meningeal artery embolization (MMAE) for chronic subdural hematoma (CSDH) has gained much attention in recent years. However, unintended embolization may occur when employing liquid embolic agents or particles. We present our clinical experience in simple coiling of MMAE to manage CSDH. METHODS: Patients underwent either surgical evacuation or MMAE with simple coiling for CSDH were reviewed. Clinical and radiographic outcomes were assessed at admission, 1-month, and 6-month intervals...
February 28, 2024: Interventional Neuroradiology
#36
JOURNAL ARTICLE
Nicola Milazzo, Silvia Pizzuto, Julie Gratieux, Alessandro Sgreccia, Federico Di Maria, Oghuzan Coskun, Stephanie Condette-Auliac, Anne Boulin, Georges Rodesch, Arturo Consoli
The spontaneous occlusion of brain arteriovenous malformations (bAVMs) is a rare event, particularly for unruptured ones. Associated factors include single-venous drainage and small nidus size. Most of the previously reported cases were ruptured bAVMs. We report the case of a middle-aged male patient with an unruptured, rolandic, left-sided bAVM associated with a 30-year history of refractory epilepsy. We documented the spontaneous thrombosis of the venous drainage of the AVM without any sign of bleeding. Finally, we underline the difference between ruptured-induced occlusion and truly spontaneous thrombosis of the bAVMs...
February 28, 2024: Interventional Neuroradiology
#37
REVIEW
Khaled Gharaibeh, Nameer Aladamat, Mohammad Samara, Adam T Mierzwa, Ahsan Ali, Syed Zaidi, Mouhammad Jumaa
OBJECTIVE: To assess the prognostic values of hyperdense sign on pretreatment non-contrast head CT scan for successful recanalization (mTICI ≥2b) and 90-day good functional outcome (mRs 0-2) in patients with acute ischemic stroke undergoing mechanical thrombectomy (MT). METHODS: Literature search on PubMed, EMBASE, and Cochrane databases from inception up to 1 November 2023 was conducted. Twelve studies which reported hyperdense sign, recanalization and clinical outcomes were included in qualitative synthesis and meta-analysis...
February 28, 2024: Interventional Neuroradiology
#38
REVIEW
Jaims Lim, Brianna M Donnelly, Vinay Jaikumar, Marissa D Kruk, Cathleen C Kuo, Andre Monteiro, Manhal Siddiqi, Ammad A Baig, Devan Patel, Kunal P Raygor, Kenneth V Snyder, Jason M Davies, Elad I Levy, Adnan H Siddiqui
BACKGROUND: Intracranial dural arteriovenous fistulas (dAVFs) are abnormal connections between arteries and veins within the dura mater. Various treatment modalities, such as surgical ligation, endovascular intervention, and radiosurgery, aim to close the fistulous connection. Although transvenous embolization (TVE) is the preferred method for carotid-cavernous fistulas, its description and outcomes for noncavernous dAVFs vary. This has prompted a systematic review and meta-analysis to comprehensively assess the effectiveness of TVE in treating noncavernous dAVFs, addressing variations in outcomes and techniques...
February 28, 2024: Interventional Neuroradiology
#39
JOURNAL ARTICLE
Avi A Gajjar, Michael M Covell, Najib Muhammad, Cathleen Kuo, Georgios S Sioutas, Mohamed M Salem, Sebastian Ivan Fras, Brian T Jankowitz, Jan-Karl Burkhardt, Visish M Srinivasan
INTRODUCTION: Increasing life expectancy has caused growing concern about maintaining viable neurointerventional practices due to altered Medicare payment structures. This study analyzes the financial trends of three common diagnostic tests for cerebrovascular disease: cerebral digital subtraction angiography (DSA), computed tomography angiography (CTA), and magnetic resonance angiography (MRA). METHODS: Medicare Part B National Summary Data files from 2013 to 2020 were queried by Current Procedural Terminology (CPT) codes for DSA (36221-36228), CTA (70496, 70498), and MRA (70544-70547, 70549)...
February 22, 2024: Interventional Neuroradiology
#40
JOURNAL ARTICLE
Mohamed Elfil, Rami Z Morsi, Sherief Ghozy, Ahmed Elmashad, Adnan Siddiqui, Alhamza R Al-Bayati, Ali Alaraj, Allan Brook, Anthony W Kam, Arindam Rano Chatterjee, Athos Patsalides, Ben Waldau, Charles J Prestigiacomo, Charles Matouk, Clemens M Schirmer, David Altschul, David T Parrella, Gabor Toth, Gaurav Jindal, Hamza A Shaikh, Jaydevsinh N Dolia, Johanna T Fifi, Justin F Fraser, Justin Thomas DO, Krishna Amuluru, Louis J Kim, Mark Harrigan, Matthew R Amans, Max Kole, Max Mokin, Michael Abraham, Mouhammad Jumaa, Nazli Janjua, Osama Zaidat, Patrick P Youssef, Priyank Khandelwal, Qingliang Tony Wang, Ramesh Grandhi, Ricardo Hanel, Ryan T Kellogg, Santiago Ortega-Gutierrez, Sunil Sheth, Thanh N Nguyen, Viktor Szeder, Yin C Hu, Albert J Yoo, Omar Tanweer, Brian Jankowitz, Jeremy J Heit, Richard Williamson, Tareq Kass-Hout, Richard W Crowley, Mohammad El-Ghanem, Fawaz Al-Mufti
BACKGROUND AND IMPORTANCE: Neurointervention is a very competitive specialty in the United States due to the limited number of training spots and the larger pool of applicants. The training standards are continuously updated to ensure solid training experiences. Factors affecting candidate(s) selection have not been fully established yet. Our study aims to investigate the factors influencing the selection process. METHODS: A 52-question survey was distributed to 93 program directors (PDs)...
February 22, 2024: Interventional Neuroradiology
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