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JOURNAL ARTICLE
Basel Musmar, Nimer Adeeb, Joanna M Roy, Hammam Abdalrazeq, Stavropoula I Tjoumakaris, Elias Atallah, Hamza Adel Salim, Douglas Kondziolka, Jason Sheehan, Christopher S Ogilvy, Howard Riina, Sandeep Kandregula, Adam A Dmytriw, Kareem El Naamani, Ahmed Abdelsalam, Natasha Ironside, Deepak Kumbhare, Cagdas Ataoglu, Muhammed Amir Essibayi, Abdullah Keles, Sandeep Muram, Daniel Sconzo, Arwin Rezai, Ufuk Erginoglu, Johannes Pöppe, Rajeev D Sen, Christoph J Griessenauer, Jan-Karl Burkhardt, Robert M Starke, Mustafa K Baskaya, Laligam N Sekhar, Michael R Levitt, David J Altschul, Malia McAvoy, Assala Aslan, Abdallah Abushehab, Christian Swaid, Adib A Abla, M Reid Gooch, Robert H Rosenwasser, Christopher Stapleton, Matthew Koch, Visish M Srinivasan, Peng R Chen, Spiros Blackburn, Mark J Dannenbaum, Omar Choudhri, Bryan Pukenas, Darren Orbach, Edward Smith, Pascal J Mosimann, Ali Alaraj, Mohammad A Aziz-Sultan, Aman B Patel, Hugo H Cuellar, Michael T Lawton, Jacques Morcos, Bharat Guthikonda, Pascal Jabbour
BACKGROUND: Arteriovenous malformations (AVMs) are uncommon cerebral lesions that can cause significant neurological complications. Surgical resection is the gold standard for treatment, but endovascular embolization and stereotactic radiosurgery (SRS) are viable alternatives. OBJECTIVE: To compare the outcomes of endovascular embolization versus SRS in the treatment of AVMs with Spetzler-Martin grades I-III. METHODS: This study combined retrospective data from 10 academic institutions in North America and Europe...
October 4, 2024: Journal of Neurointerventional Surgery
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JOURNAL ARTICLE
Ankitha M Iyer, Jackson P Midtlien, Carol Kittel, Lucas A Klever, Angelina Wiater, Emily Chang, Connor Margraf, Kyle M Fargen
BACKGROUND: The pathophysiology of idiopathic intracranial hypertension (IIH) and other cerebral venous outflow disorders (CVD) has largely been unexplored. While a correlation between venous sinus pressure and opening pressure (OP) has been previously noted, there are limited data on this relationship in patients with prior venous sinus stenting (VSS). METHODS: A single center retrospective chart review was conducted on CVD patients who underwent diagnostic cerebral venography with manometry followed immediately by lateral decubitus lumbar puncture, from 2016 to 2024...
October 2, 2024: Journal of Neurointerventional Surgery
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LETTER
James M Milburn, Kelsey Rose Casano, Joshua A Hirsch
No abstract text is available yet for this article.
October 2, 2024: Journal of Neurointerventional Surgery
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REVIEW
Malia McAvoy, Buddy Ratner, Manuel J Ferreira, Michael R Levitt
Treatment of intracranial aneurysms is currently limited to invasive surgical and endovascular modalities, and some aneurysms are not treatable with these methods. Identification and targeting of specific molecular pathways involved in the pathogenesis of aneurysms may improve outcomes. Low frequency somatic variants found in cancer related genes have been linked to intracranial aneurysm development. In particular, mutations in the PDGFRB gene lead to constitutively activated ERK and nuclear factor κB signaling pathways, which can be targeted with tyrosine kinase inhibitors...
October 1, 2024: Journal of Neurointerventional Surgery
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JOURNAL ARTICLE
Maximilian Jeremy Bazil, Tomoyoshi Shigematsu, Johanna T Fifi, Alejandro Berenstein
High-flow vascular malformations in neonates may require emergent embolization to prevent or treat congestive heart failure when intervention is indicated.1 While transfemoral access is the traditional approach, this route may be complicated by the sheath size (typically 4F in our experience, as a smaller sheath system may prove suboptimal) needed for embolization. This is especially true when (1) multiple acute interventions are anticipated during the neonatal period and/or (2) when it is preferred to spare femoral access for future treatments in infancy or childhood...
October 1, 2024: Journal of Neurointerventional Surgery
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JOURNAL ARTICLE
Fernanda Rodriguez-Erazú, Gustavo M Cortez, Demetrius K Lopes, Salvador F Gutierrez-Aguirre, Otavio Frederico De Toledo, Amin Aghaebrahim, Eric Sauvageau, David F Kallmes, Jens Fiehler, Ricardo A Hanel
BACKGROUND: The pipeline embolization device (PED) has been increasingly used to treat brain aneurysms; however, concerns have been raised about braid stability with newer drawn filled tubing technology devices. OBJECTIVE: To evaluate braid stability of PED early generations using data from the PREMIER trial. METHODS: All consecutive intracranial aneurysms treated with PED (Classic and Flex) within the PREMIER trial were reviewed for braid stability (fish mouthing, foreshortening, braid bump, braid collapsing)...
October 1, 2024: Journal of Neurointerventional Surgery
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JOURNAL ARTICLE
Jonathan A Grossberg, Eric W Christensen, James M Milburn, Guilherme Dabus, Richard E Heller, Joshua A Hirsch
BACKGROUND: Congress enacted the No Surprises Act (NSA) in 2021. The NSA relies on the ability for providers to appeal their out-of-network (OON) payment through an arbitration process known as Independent Dispute Resolution (IDR). This study was designed to evaluate the effective access to IDR for mechanical thrombectomy (MT). METHODS: This study uses a simulation to model the likelihood that neurointerventionalists have financially viable access to the NSA IDR process to seek adequate payment for MT OON claims...
October 1, 2024: Journal of Neurointerventional Surgery
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JOURNAL ARTICLE
Longhui Zhang, Fangguang Chen, Thanh N Nguyen, Yuesong Pan, Yufan Liu, Mengxing Wang, Shuo Li, Dapeng Sun, Xiaochuan Huo, BaiXue Jia, Zhongrong Miao
BACKGROUND: Previous studies have indicated that a subset of patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO) experience spontaneous recanalization (SR), but the prognosis and factors associated with SR in these individuals are not well characterized. METHODS: We conducted a post hoc secondary analysis of the Study of Endovascular Therapy in Acute Anterior Circulation Large Vessel Occlusive Patients with a Large Infarct Core (ANGEL-ASPECT) trial...
September 27, 2024: Journal of Neurointerventional Surgery
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JOURNAL ARTICLE
Helge C Kniep, Lukas Meyer, Gabriel Broocks, Matthias Bechstein, Christian Heitkamp, Laurens Winkelmeier, Vincent Geest, Tobias D Faizy, Ludger Feyen, Caspar Brekenfeld, Fabian Flottmann, Rosalie V McDonough, Mate Maros, Maximilian Schell, Uta Hanning, Goetz Thomalla, Jens Fiehler, Susanne Gellissen
BACKGROUND: Successful recanalization defined as modified Thrombolysis in Cerebral Infarction Score (mTICI) ≥2b is not achieved in 15%-20% of patients with acute ischemic stroke. This study aims to identify patient-specific factors associated with early stopping without successful recanalization. We hypothesized that the probability of the decision for early stopping during mechanical thrombectomy (MT) is higher in patients with an unfavorable prognosis. METHODS: All patients enrolled in the German Stroke Registry (GSR) between June 2015 and December 2021 were screened...
September 27, 2024: Journal of Neurointerventional Surgery
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JOURNAL ARTICLE
Hanna Styczen, Volker Maus, Daniel Weiss, Lukas Goertz, René Hosch, Christian Rubbert, Nikolas Beck, Mathias Holtkamp, Luca Salhöfer, Rosa Schubert, Cornelius Deuschl, Felix Nensa, Johannes Haubold
BACKGROUND: We investigate the association of imaging biomarkers extracted from fully automated body composition analysis (BCA) of computed tomography (CT) angiography images of endovascularly treated acute ischemic stroke (AIS) patients regarding angiographic and clinical outcome. METHODS: Retrospective analysis of AIS patients treated with mechanical thrombectomy (MT) at three tertiary care-centers between March 2019-January 2022. Baseline demographics, angiographic outcome and clinical outcome evaluated by the modified Rankin Scale (mRS) at discharge were noted...
September 26, 2024: Journal of Neurointerventional Surgery
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JOURNAL ARTICLE
Huanwen Chen, Marco Colasurdo, Mihir Khunte, Ajay Malhotra, Dheeraj Gandhi
BACKGROUND: The safety and efficacy of endovascular thrombectomy (EVT) for large vessel occlusion (LVO) strokes associated with infective endocarditis (IE) compared with medical management (MM) is unclear. METHODS: In this nationwide analysis of hospitalizations in the United States, we assessed the outcomes of EVT versus medical management (MM) for patients with LVO and IE. Primary outcome was routine home discharge with self-care. Secondary outcomes include home discharge, in-hospital mortality, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH)...
September 24, 2024: Journal of Neurointerventional Surgery
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JOURNAL ARTICLE
Dan-Dong Li, Jing Zheng, Ke-Da Pan, Pi-Guang Yao, Meng-Yao Wang, Ren-Hua Duan, Wei Li, Shao-Huai Chen, Bo Yin
BACKGROUND: A direct aspiration first pass technique (ADAPT) has emerged as a fast, safe, and efficacious method for treating acute large vessel occlusion. However, successful clot aspiration is not guaranteed in every ADAPT procedure. We have observed that when the catheter effectively ingested the clot, the catheter tip displayed a distinct fluttering motion, referred to herein as tip flutter. Thus this study aimed to assess whether this catheter tip flutter can be used as a sign of successful clot aspiration...
September 20, 2024: Journal of Neurointerventional Surgery
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JOURNAL ARTICLE
Hidetoshi Matsukawa, Charles Matouk, Kazutaka Uchida, Sami Al Kasab, Mohammad-Mahdi Sowlat, Sameh Samir Elawady, Ilko Maier, Pascal Jabbour, Joon-Tae Kim, Stacey Q Wolfe, Ansaar T Rai, Robert M Starke, Marios-Nikos Psychogios, Edgar A Samaniego, Adam S Arthur, Hugo Cuellar, Brain M Howard, Daniele G Romano, Omar Tanweer, Justin R Mascitelli, Isabel Fragata, Adam Polifka, Joshua W Osbun, Roberto Javier Crosa, Min S Park, Michael R Levitt, Waleed Brinjikji, Mark Moss, Richard Williamson, Pedro Navia, Peter Kan, Reade Andrew De Leacy, Shakeel A Chowdhry, Mohamad Ezzeldin, Alejandro M Spiotta, Shinichi Yoshimura, Ali M Alawieh
BACKGROUND: A higher number of recanalization attempts reduces the efficacy of endovascular thrombectomy (EVT) for acute ischemic stroke secondary to large vessel occlusion (LVO). We assessed the impact of switching EVT techniques after a failed first pass on procedural and clinical outcomes. METHODS: This multicenter international study, conducted between January 2013 and December 2022, included patients undergoing EVT for anterior circulation LVO (internal carotid artery or M1 segments) with failed first pass recanalization...
September 20, 2024: Journal of Neurointerventional Surgery
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JOURNAL ARTICLE
Jae Guk Kim, Sue Young Ha, You-Ri Kang, Hotak Hong, Dongmin Kim, Myungjae Lee, Leonard Sunwoo, Wi-Sun Ryu, Joon-Tae Kim
BACKGROUND: To evaluate the stand-alone efficacy and improvements in diagnostic accuracy of early-career physicians of the artificial intelligence (AI) software to detect large vessel occlusion (LVO) in CT angiography (CTA). METHODS: This multicenter study included 595 ischemic stroke patients from January 2021 to September 2023. Standard references and LVO locations were determined by consensus among three experts. The efficacy of the AI software was benchmarked against standard references, and its impact on the diagnostic accuracy of four residents involved in stroke care was assessed...
September 20, 2024: Journal of Neurointerventional Surgery
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JOURNAL ARTICLE
Philipp Hendrix, Sina Hemmer, Anant Chopra, Oded Goren, Gregory M Weiner, Clemens M Schirmer, Jeffrey D Oliver
BACKGROUND: Temporary clipping (TC) is an essential adjunct in cerebral aneurysm (CA) surgery. Despite appearing insignificant to the surgeon under the microscope, TC may cause parent vessel injury. Intraoperative diagnostic cerebral angiography (ioDCA) is crucial for assessing aneurysm occlusion and parent vessel integrity. We aimed to assess sequelae of TC evident on immediate ioDCA. METHODS: Elective CA clippings with ioDCA in a hybrid operating room from January 2020 to June 2023 were reviewed...
September 19, 2024: Journal of Neurointerventional Surgery
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JOURNAL ARTICLE
Adnan Mujanovic, Daniel Windecker, Bettina Serrallach, Christoph C Kurmann, Roman Rohner, Elias Auer, Petra Cimflova, Thomas R Meinel, Franziska Dorn, René Chapot, David Seiffge, Eike Immo I Piechowiak, Tomas Dobrocky, Jan Gralla, Urs Fischer, Sara Pilgram-Pastor, Johannes Kaesmacher
BACKGROUND: Distal occlusions associated with incomplete reperfusion (expanded Thrombolysis in Cerebral Infarction, <eTICI 3) may not reperfuse spontaneously and thus prompt ischemia (ie, persistent hypoperfusion). We aimed to assess whether the recently reported Distal Occlusion Tracker (DOT) sign on immediate non-contrast post-interventional flat-panel detector computed tomography (FPDCT) is associated with persistent hypoperfusion. METHODS: Retrospective registry analysis of patients undergoing endovascular therapy between July 2020 and December 2022, with available immediate post-interventional FPDCT and 24 hours follow-up perfusion imaging...
September 19, 2024: Journal of Neurointerventional Surgery
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JOURNAL ARTICLE
Jianping Xiang, Lei Zhang, Chenbin Rong, Rong Zou, Yumeng Hu, Yongwei Zhang, Ming Wang, Jens Fiehler, Adnan H Siddiqui, Jun Wang, Zhongrong Miao, Pengfei Yang, Shu Wan, Jianmin Liu
BACKGROUND: The aim of this study is to assess the feasibility of identifying the hemodynamic status of intracranial atherosclerotic stenosis (ICAS) using angio-based fractional flow (FF) calculated from a single angiographic view, with wire-based FF as the reference standard. METHOD: The study retrospectively recruited 100 ICAS patients who underwent pressure wire measurement and digital subtraction angiography. The AccuICAD software was used to calculate angio-based FF, with the wire-measured value serving as the reference standard for evaluating the accuracy, consistency, and diagnostic performance of angio-based FF...
September 19, 2024: Journal of Neurointerventional Surgery
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JOURNAL ARTICLE
Daryl Goldman, Mais Al-Kawaz, Preethi Reddi, Kurt A Yaeger, Trevor Hardigan, Amol Mehta, Jacopo Scaggiante, Robert Dana Tomalty, Paul Gulotta, Vernard Fennell, Gabriel A Vidal, Mugilan Poongkunran, James M Milburn, Shahram Majidi
BACKGROUND: Higher positioning of a large bore guide catheter during endovascular thrombectomy (EVT) is hypothesized to potentially improve thrombectomy success. OBJECTIVE: To evaluate the safety and efficacy of intracranial guide catheter placement during EVT using a multicenter database. METHODS: We reviewed data on consecutive patients undergoing EVT for anterior circulation large vessel occlusion (LVO) at three comprehensive stroke centers between October 2019 and December 2022...
September 18, 2024: Journal of Neurointerventional Surgery
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JOURNAL ARTICLE
Xiaolei Shi, Shihai Yang, Changwei Guo, Wenzhe Sun, Jiaxing Song, Shitao Fan, Jie Yang, Chengsong Yue, Jiandi Huang, Linyu Li, Yan Tian, Jinfu Ma, Xu Xu, Zhixi Wang, Weilin Kong, Dongsheng Ye, Zhouzhou Peng, Fengli Li, Wenjie Zi
BACKGROUND: Clinical evidence of the potential influence of stress hyperglycemia ratio (SHR) for patients with large ischemic stroke whether or not receiving endovascular therapy is not clear. METHODS: This study was a subanalysis of a prospective, multicenter registry, and included 745 patients with large ischemic stroke across 38 centers in China. A total of 427 patients were included in this study, with 285 received endovascular therapy (EVT) and 142 received standard medical therapy (SMT)...
September 18, 2024: Journal of Neurointerventional Surgery
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JOURNAL ARTICLE
Nirav R Bhatt, Christian Martin-Gill, Abdullah Al-Qudah, Katharine Dermigny, Mohamed F Doheim, Lucas Rios Rocha, Abdullah Sultany, Guvanch Kakamyradov, Marcelo Rocha, Matthew Starr, Rebecca Patterson, Alhamza R Al-Bayati, Francis X Guyette, Raul G Nogueira
BACKGROUND: We sought to identify systemic factors influencing door-to-puncture times (DTP) among patients with pre-arrival notifications presenting directly to a comprehensive stroke center (CSC) and undergoing emergent mechanical thrombectomy (MT). METHODS: In this retrospective analysis of a prospectively maintained registry of acute ischemic stroke (AIS) patients undergoing MT at two CSCs between January 2021 and October 2023, we included consecutive AIS patients presenting directly to the CSC with pre-arrival notifications via emergency medical services (EMS) and who underwent emergent MT...
September 18, 2024: Journal of Neurointerventional Surgery
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