keyword
https://read.qxmd.com/read/37442782/demonstrating-the-value-of-routine-anesthesiologist-involvement-in-acute-stroke-care-a-retrospective-chart-review
#21
JOURNAL ARTICLE
Robert J McCusker, Vernon M Chinchilli, Chanju D Fritch, Puneet S Kochar, Sonal Sharma
INTRODUCTION: The value of routine involvement of anesthesiologists during endovascular thrombectomy (EVT) for acute ischemic stroke has not been clearly demonstrated. At some institutions, anesthesiologists are involved only as needed, while at other institutions, anesthesiologists are involved from the beginning for every EVT. METHODS: We retrospectively analyzed the workflow, intraprocedural variables and complications, and outcomes in acute ischemic stroke patients undergoing EVT at a comprehensive stroke center after implementation of routine involvement of an anesthesia team and compared this cohort with patients who received care from sedation-trained nurses working under the supervision of neurointerventionalists with the involvement of anesthesiologists on an as-needed basis...
October 1, 2023: Journal of Neurosurgical Anesthesiology
https://read.qxmd.com/read/37425071/investigating-angiographic-injection-parameters-for-cerebral-aneurysm-hemodynamic-characterization-using-patient-specific-simulated-angiograms
#22
JOURNAL ARTICLE
R White, A Shields, S V Nagesh, E Smith, J Davies, D R Bednarek, S Rudin, C Ionita, V Chivukula
Cerebral aneurysm (CA) rupture is one of the major causes of hemorrhagic stroke. During endovascular therapy (ET), neurointerventionalists rely on qualitative image sequences and do not have access to crucial quantitative hemodynamic information. Quantifying angiographic image sequences can provide vital information, but it is not possible to perform this in a controlled manner in vivo. Computational fluid dynamics (CFD) is a valuable tool capable of providing high fidelity quantitative data by replicating the blood flow physics within the cerebrovasculature...
February 2023: Proceedings of SPIE
https://read.qxmd.com/read/37355257/high-variability-in-physician-estimations-of-flow-diverting-stent-deployment-versus-presize-neurovascular-software-simulation-a-comparison-study
#23
JOURNAL ARTICLE
Ansaar T Rai, SoHyun Boo, Jonathan Downer, Johannes DuPlessis, Riitta Rautio, Matias Sinisalo, Johanna Pekkola, Vinicius Carraro do Nascimento, Curtis Given, Tufail Patankar
BACKGROUND: Physician variablity in preoperative planning of endovascular implant deployment and associated inaccuracies have not been documented. This study aimed to quantify the variability in accuracy of physician flow diverter (FD) planning and directly compares it with PreSize Neurovascular (Oxford Heartbeat Ltd) software simulations. METHODS: Eight experienced neurointerventionalists (NIs), blinded to procedural details, were provided with preoperative 3D rotational angiography (3D-RA) volumetric data along with images annotated with the distal landing location of a deployed Surpass Evolve (Stryker Neurovascular) FD from 51 patient cases...
June 24, 2023: Journal of Neurointerventional Surgery
https://read.qxmd.com/read/37346826/a-rare-pure-intraventricular-hemorrhage-caused-by-ruptured-internal-carotid-artery-anterior-choroidal-artery-aneurysm-a-case-report-and-literature-review
#24
Yota Suzuki, Yoshiki Hanaoka, Yuki Inomata, Takaaki Kamijo, Yu Fujii, Toshihiro Ogiwara, Tetsuyoshi Horiuchi
Although intraventricular hemorrhage (IVH) frequently develops secondary to intraparenchymal or subarachnoid hemorrhage, pure IVH-non-traumatic spontaneous intracranial hemorrhage confined to the cerebral ventricular system-is rare. Moreover, pure IVH caused by ruptured proximal aneurysm is an extremely rare but life-threatening condition. Herein, we present a case of pure IVH due to a ruptured internal carotid artery -anterior choroidal artery (ICA-AChA) aneurysm and review related literature. A 77-year-old man presenting with altered mental status was hospitalized due to a massive pure IVH with ventriculomegaly...
May 2023: Nagoya Journal of Medical Science
https://read.qxmd.com/read/37321641/percutaneous-transorbital-transvenous-embolization-of-a-cavernous-sinus-dural-arteriovenous-fistula-via-the-superior-orbital-fissure-technical-video
#25
JOURNAL ARTICLE
Ryan M Naylor, Stephen Graepel, Waleed Brinjikji, Harry Cloft, Giuseppe Lanzino
Carotid-cavernous dural arteriovenous fistulas causing debilitating ocular symptoms and/or retrograde cortical venous drainage necessitate curative treatment, which is achieved by disrupting the proximal draining vein. Transvenous embolization of carotid-cavernous dural arteriovenous fistulas can be achieved through the superior or inferior petrosal sinuses, facial veins, or superior ophthalmic veins.1, 2 However, if these approaches are not feasible, various percutaneous approaches have been described that use the skull base foramina to provide direct access to the cavernous sinus...
June 15, 2023: Interventional Neuroradiology
https://read.qxmd.com/read/37295944/intracranial-atherosclerosis-update-for-neurointerventionalists
#26
REVIEW
Michael J Alexander, Wengui Yu
The management of intracranial atherosclerotic disease (ICAD) has been evolving with advanced imaging, refinements of best medical treatment, and the development of endovascular options. There has been a significant increase in the use of endovascular therapy for symptomatic ICAD in the USA over the past 6 years. The rationale for this review is to update neurointerventionalists in these areas so that evidence-based decisions can be considered when counseling potential patients regarding their risks, benefits, and potential complications...
June 9, 2023: Journal of Neurointerventional Surgery
https://read.qxmd.com/read/37262981/assessment-of-thrombectomy-procedure-difficulty-by-neurointerventionalists-based-on-vessel-geometry-parameters-from-carotid-artery-3d-reconstructions
#27
JOURNAL ARTICLE
Mohammed Salman Shazeeb, Viraj Moholkar, Robert M King, Srinivasan Vedantham, Zeynep Vardar, Afif Kraitem, Clifford Lindsay, Vania Anagnostakou, Jasmeet Singh, Francesco Massari, Katyucia de Macedo Rodrigues, Varun Naragum, Ajit S Puri, Sarena Carniato, Matthew J Gounis, Anna Luisa Kühn
BACKGROUND: Diagnosing and treating acute ischemic stroke patients within a narrow timeframe is challenging. Time needed to access the occluded vessel and initiate thrombectomy is dictated by the availability of information regarding vascular anatomy and trajectory. Absence of such information potentially impacts device selection, procedure success, and stroke outcomes. While the cervical vessels allow neurointerventionalists to navigate devices to the occlusion site, procedures are often encumbered due to tortuous pathways...
May 29, 2023: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://read.qxmd.com/read/37258227/now-that-the-door-is-open-an-update-on-ischemic-stroke-pharmacotherapeutics-for-the-neurointerventionalist
#28
REVIEW
Justin F Fraser, Shivani Pahwa, Michael Maniskas, Christopher Michas, Mesha Martinez, Keith R Pennypacker, David Dornbos
The last 10 years have seen a major shift in management of large vessel ischemic stroke with changes towards ever-expanding use of reperfusion therapies (intravenous thrombolysis and mechanical thrombectomy). These strategies 'open the door' to acute therapeutics for ischemic tissue, and we should investigate novel therapeutic approaches to enhance survival of recently reperfused brain. Key insights into new approaches have been provided through translational research models and preclinical paradigms, and through detailed research on ischemic mechanisms...
May 31, 2023: Journal of Neurointerventional Surgery
https://read.qxmd.com/read/37201247/occupational-radiation-exposure-of-neurointerventionalists-during-endovascular-stroke-treatment
#29
JOURNAL ARTICLE
Charlotte S Weyland, Jessica Jesser, Isabella Bourgart, Tim Hilgenfeld, Michael O Breckwoldt, Dominik Vollherbst, Niclas Schmitt, Fatih Seker, Martin Bendszus, Markus A Möhlenbruch
BACKGROUND: Radiological neuro-interventions, especially endovascular stroke treatment (EST), are increasing in case numbers worldwide with increasing occupational radiation exposure. Aim of this study was to define the radiation exposure of neurointerventionalists (NI) during EST and to compare the accumulated dose reaching the left arm with the left temple. METHODS: This is a prospective observational study in a tertiary stroke center conducted between 11/2021 and 07/2022...
May 13, 2023: European Journal of Radiology
https://read.qxmd.com/read/37133290/balloon-assisted-catheterization-of-occluded-carotid-artery-boca-technique-in-acute-stroke
#30
JOURNAL ARTICLE
Farhan Siddiq, Sachin Bhagavan, M Fawad Ishfaq, Attiya Jaura, Ibrahim Ahmad Bhatti, Camilo R Gomez, Adnan I Qureshi
BACKGROUND: Acute ischemic stroke from tandem occlusion of internal carotid artery (ICA) poses a technical challenge to neurointerventionalists. OBJECTIVE: To present a novel balloon-assisted catheterization of occluded carotid artery (BOCA) technique used for rapid and effective catheterization of occluded/critically stenosed ICA in tandem occlusion. METHODS: A retrospective review of 10 patients with tandem carotid occlusion, treated with BOCA technique for revascularization between July 2020 and June 2021, was performed...
May 3, 2023: Operative Neurosurgery (Hagerstown, Md.)
https://read.qxmd.com/read/37013378/an-unusual-arrangement-between-the-highest-denticulate-ligament-and-posterior-inferior-cerebellar-artery
#31
Aditi Patel, Johnathan Baudoin, Arada Chaiyamoon, Juan J Cardona, Ana Carrera, Francisco Reina, Joe Iwanaga, Aaron S Dumont, R Shane Tubbs
The posterior inferior cerebellar artery (PICA) is often involved in pathologies of the posterior cranial fossa. Therefore, a good understanding of the vessel's normal and variant courses is important to the neurosurgeon or neurointerventionalist. During the routine microdissection of the craniocervical junction, an unusual arrangement between the highest denticulate ligament and PICA was observed. On the right side, the PICA was given rise to by the V4 segment of the vertebral artery 9 mm after the artery entered the dura mater of the posterior cranial fossa...
April 4, 2023: Anatomy & Cell Biology
https://read.qxmd.com/read/36972494/diversity-among-endovascular-neurointerventionalists-in-canada-results-of-a-national-survey-2022
#32
JOURNAL ARTICLE
Ze'ev Itsekzon-Hayosh, Ronit Agid
AIM: Neurointervention (NIR) is a relatively new developing filed of medicine. Diversity and inclusion in various medical fields has made a significant progress. However, many surgical and interventional fields are still lagging in this respect. The aim of this study was to evaluate the degree of diversity and inclusion amongst neurointerventionalists in Canada. MATERIALS AND METHODS: A survey was completed in June 2022 by each neurointerventional division in Canada...
March 27, 2023: Interventional Neuroradiology
https://read.qxmd.com/read/36947484/heart-rate-and-heart-rate-variability-during-diagnostic-and-interventional-neuroendovascular-procedures
#33
JOURNAL ARTICLE
Muhammed Amir Essibayi, Aureliana Toma, Wenzhu Mowrey, Jiyue Qin, Mousa Hamad, Jessica Ryvlin, Ryan Holland, Rose Fluss, Dorothea Altschul, Li-Mei Lin, David J Altschul
INTRODUCTION: Heart rate variability (HRV) reflects the activity of the autonomic nervous system (ANS) and can be used as a potential predictor of stress-related cardiovascular diseases. This study aimed to assess whether physical and mental strain during the performance of cerebral endovascular procedure influence time-domain HRV parameters in operating surgeon. MATERIALS AND METHODS: Heart rate (HR) and HRV metrics were measured using a HR sensor chest strap before, during, and after neuroendovascular interventions performed by a single neurosurgeon...
March 22, 2023: Interventional Neuroradiology
https://read.qxmd.com/read/36872879/development-of-an-in-vitro-model-based-on-patient-vessel-geometry-for-simulated-use-testing-in-neurointerventional-surgery
#34
JOURNAL ARTICLE
Mark Epshtein, Mohammed Salman Shazeeb, Anna Luisa Kühn, Vania Anagnostakou, Christopher M Raskett, Robert M King, Mayank Goyal, Vitor Mendes Pereira, Adam S Arthur, Ajit S Puri, David Fiorella, Matthew J Gounis
BACKGROUND: Neurointerventionalists use in-vitro vascular models to train for worst-case scenarios and test new devices in a simulated use environment to predict clinical performance. According to the Food and Drug Administration (FDA), any neurovascular navigation device should be able to successfully navigate two 360-degree turns and two 180-degree turns at the distal portion of the anatomical model. Here, we present a device benchmarking vascular model that complies with FDA recommendations...
March 6, 2023: Interventional Neuroradiology
https://read.qxmd.com/read/36861988/a-comparison-of-outcomes-between-transfemoral-versus-transradial-access-for-carotid-stenting
#35
JOURNAL ARTICLE
Kareem El Naamani, Omaditya Khanna, Amit Syal, Arbaz A Momin, Rawad Abbas, Abdelaziz Amllay, Abhijeet Sambangi, Adam Hunt, Jaime Dougherty, Charles L Lawall, Stavropoula I Tjoumakaris, M Reid Gooch, Nabeel A Herial, Robert H Rosenwasser, Hekmat Zarzour, Richard F Schmidt, Pascal M Jabbour
BACKGROUND: The transradial (TR) approach has emerged as an alternative to the transfemoral (TF) approach in carotid artery stenting (CAS) because of its perceived benefits in access site complications and overall patient experience. OBJECTIVE: To assess outcomes of TF vs TR approach for CAS. METHODS: This is a retrospective single-center review of patients receiving CAS through the TR or TF route between 2017 and 2022. All patients with symptomatic and asymptomatic carotid disease who underwent attempted CAS were included in our study...
March 2, 2023: Neurosurgery
https://read.qxmd.com/read/36763101/anatomical-characteristics-and-morphometric-analyses-of-the-internal-carotid-artery-using-retrospective-angiographic-images
#36
JOURNAL ARTICLE
Woranan Kirisattayakul, Nukanda Kiatkitkul, Montita Trakulsantirat, Waranon Munkong, Panuwat Pattum, Joe Iwanaga, R Shane Tubbs, Arada Chaiyamoon, Sitthichai Iamsaard
PURPOSE: Anatomical variations of the internal carotid artery (ICA) can cause complications during endovascular treatments. Therefore, the aim of this study was to investigate the features of the ICAs obtained from 2D digital subtraction angiography (2D DSA). METHODS: The morphometrics and angles of the ICA segments from 2D DSA images from a total of 100 patients (45 males and 55 females) were investigated. The lengths (L1-3), angles (A1-3), and diameters (D1-6) through the ICA measurement points (five segments: C2 [petrous], C3 [lacerum], C4 [cavernous], C5 [clinoid], C6 [ophthalmic]) were systemically recorded by two observers...
February 10, 2023: Surgical and Radiologic Anatomy: SRA
https://read.qxmd.com/read/36732006/newer-updates-in-pediatric-vascular-diseases
#37
REVIEW
Zachary M Wilseck, Leanne Y Lin, Neeraj Chaudhary, Francisco Rivas-Rodriguez
Pediatric neurovascular pathology directly involves or is in close proximity to the central nervous system (CNS). These vascular pathologies can occur in isolation or in association with broader syndromes. While some vascular pathologies are unique to the pediatric population, the full spectrum of adult neurovascular lesions can also affect children however, may present differently both clinically and on diagnostic imaging. Non-invasive (Ultrasound, CT, MRI) imaging plays a critical role in the diagnosis, treatment planning, and follow-up of vascular lesions involving the CNS...
January 2023: Seminars in Roentgenology
https://read.qxmd.com/read/36701756/the-rationale-behind-transcirculation-neuroendovascular-interventions-literature-review-through-a-case-series-approach
#38
REVIEW
Marco Colasurdo, Gautam Edhayan, Alaha Al Taweel, Maggie Barghash, Peter Kan, Karthikram Raghuram
BACKGROUND: With the development of advanced endovascular techniques and materials, neurointerventionalists can perform challenging and complex cases that were previously difficult to perform. Transcirculation approaches could be a useful tool used in complicated cases, providing access to the target vessel, through the contralateral or opposite circulation, when anterograde access is difficult or nonachievable. OBJECTIVE: To retrospectively review cerebrovascular interventions performed through a transcirculation approach performed by staff at our Institution...
April 1, 2023: Operative Neurosurgery (Hagerstown, Md.)
https://read.qxmd.com/read/36609542/mechanical-thrombectomy-decision-making-and-prognostication-stroke-treatment-assessments-prior-to-thrombectomy-in-neurointervention-satin-study
#39
JOURNAL ARTICLE
Kyle M Fargen, Carol Kittel, Brian P Curry, Connor W Hile, Stacey Q Wolfe, Patrick Brown, Maxim Mokin, Ansaar T Rai, Michael Chen, Robert M Starke, Felipe C Albuquerque, Sameer A Ansari, Peter Kan, Alejandro M Spiotta, Guilherme Dabus, Thabele M Leslie-Mazwi, Joshua A Hirsch
BACKGROUND: Mechanical thrombectomy (MT) is the standard-of-care treatment for stroke patients with emergent large vessel occlusions. Despite this, little is known about physician decision making regarding MT and prognostic accuracy. METHODS: A prospective multicenter cohort study of patients undergoing MT was performed at 11 comprehensive stroke centers. The attending neurointerventionalist completed a preprocedure survey prior to arterial access and identified key decision factors and the most likely radiographic and clinical outcome at 90 days...
January 6, 2023: Journal of Neurointerventional Surgery
https://read.qxmd.com/read/36597952/catheter-design-primer-for-neurointerventionalists
#40
REVIEW
Cem Bilgin, Jared Hutar, Jiahui Li, Oscar Castaño, Marc Ribo, David F Kallmes
Neurovascular catheter technology has rapidly evolved over the past decade. While performance characteristics are well known to the practitioner, the design features of these new-generation catheters and their implications on performance metrics remain a mystery to most clinicians due to the limited number of available resources. This knowledge gap hampers informed device choices and also limits collaboration between clinicians and engineers. To aid fellow neurointerventionalists, in this primer we have summarized the basic concepts of catheter design and construction...
December 7, 2022: Journal of Neurointerventional Surgery
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