Search Our Scientific Publications & Authors

J Vis Exp 2020 May 14(159). Epub 2020 May 14.

Department of Neurosurgery, Kantonsspital Aarau; Cerebrovascular Research Group, Department for BioMedical Research, University of Bern.

Endovascular treatment for intracranial aneurysms gained importance over the past decades, consequently there is an increased need of testing endovascular devices. Animal models respecting rheological, hemodynamic and aneurysm wall conditions are highly warranted. Therefore, the aim of the present study was to design a novel standardized and reproducible surgical technique to create autologous arterial pouch bifurcation aneurysms with non-modified and modified wall conditions in rabbits. Read More

Front Physiol 2020 12;11:454. Epub 2020 May 12.

Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States.

Arterial aneurysms are pathological dilations of blood vessels, which can be of clinical concern due to thrombosis, dissection, or rupture. Aneurysms can form throughout the arterial system, including intracranial, thoracic, abdominal, visceral, peripheral, or coronary arteries. Currently, aneurysm diameter and expansion rates are the most commonly used metrics to assess rupture risk. Read More

Int J Artif Organs 2020 May 30:391398820925493. Epub 2020 May 30.

Division of Cardiac Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

A 50-year-old male with a history of nonischemic dilated cardiomyopathy presented in cardiogenic shock and ultimately underwent durable left ventricular assist device implantation. He recovered well initially but developed persistent bacteremia. His indwelling pacemaker leads were extracted due to evidence of vegetation. Read More

Eur Radiol 2020 May 30. Epub 2020 May 30.

Department of Radiology, Research Institute of Radiological Science and Center for Clinical Image Data Science, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea.

Objectives: To develop a deep learning algorithm for automated detection and localization of intracranial aneurysms on time-of-flight MR angiography and evaluate its diagnostic performance.

Methods: In a retrospective and multicenter study, MR images with aneurysms based on radiological reports were extracted. The examinations were randomly divided into two data sets: training set of 468 examinations and internal test set of 120 examinations. Read More

Eur J Radiol 2020 May 19;129:109064. Epub 2020 May 19.

Department of Radiology and Biomedical Imaging, University of California San Francisco, 4150 Clement St., San Francisco, CA 94121, USA.

Purpose: This study aims to explore wall enhancement characteristics of vertebrobasilar nonsaccular aneurysms (VBNAs) and their relationship to clinical symptoms.

Methods: We retrospectively analyzed VBNAs in the high resolution MR vessel wall imaging (HR-VWI) databases at two institutions. The aneurysmal basic characteristics and wall enhancement characteristics, were evaluated by two radiologists. Read More

Surg Radiol Anat 2020 May 29. Epub 2020 May 29.

Department of Radiology, Niğde Ömer Halisdemir University Faculty of Medicine, Niğde, Turkey.

Purpose: There is not a classification of azygos anterior cerebral artery (ACA) based on anatomical branching levels in the literature. In the present study, a classification of azygos ACA was made based on radiological imaging for a common terminology, and frequency, accompanying vascular anomalies and malformations were investigated.

Methods: A total of 4913 cases who had brain CTA, MRA, contrast-enhanced MRI and DSA in January 2010-January 2020 period were screened for the study. Read More

J Neurointerv Surg 2020 May 29. Epub 2020 May 29.

China International Neuroscience Institute (China-INI), Beijing, China

Background: Intracranial aneurysms (IAs) are common in the population and may cause death.

Objective: To develop a new fully automated detection and segmentation deep neural network based framework to assist neurologists in evaluating and contouring intracranial aneurysms from 2D+time digital subtraction angiography (DSA) sequences during diagnosis.

Methods: The network structure is based on a general U-shaped design for medical image segmentation and detection. Read More

J Neurointerv Surg 2020 May 29. Epub 2020 May 29.

Department of Neurology, Ain Shams University Faculty of Medicine, Cairo, Egypt

Background: Flow diversion (FD) is a common treatment modality for complex intracranial aneurysms. A major concern regarding the use of FD is thromboembolic events (TEE). There is debate surrounding the optimal antiplatelet regimen to prevent TEE. Read More

Biomed Eng Online 2020 May 29;19(1):38. Epub 2020 May 29.

Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China.

Background: As the rupture of cerebral aneurysm may lead to fatal results, early detection of unruptured aneurysms may save lives. At present, the contrast-unenhanced time-of-flight magnetic resonance angiography is one of the most commonly used methods for screening aneurysms. The computer-assisted detection system for cerebral aneurysms can help clinicians improve the accuracy of aneurysm diagnosis. Read More

Pol J Radiol 2020 10;85:e82-e89. Epub 2020 Feb 10.

Department of Radiology, Ege University, Faculty of Medicine, Bornova/Izmir, Turkey.

Purpose: Aim of the study was to find answers to the following questions: What haemodynamic changes may occur in patients with stenotic, aneurysmal, dissection of the carotid artery and its branches? How do these changes differ in patients with normal and carotid disease?

Material And Methods: In order to achieve this aim, the cranio-cervical CT angiography images of patients who were referred to our clinic for any reason and received the diagnosis of carotid stenosis, carotid dissection, and extra or intracranial aneurysm were reviewed retrospectively.

Results: Significant differences were detected in the carotid arteries of normal patients and those with aneurysm and dissection. When normal and aneurismal patients were compared, right and left ICA diameters ( = 0. Read More

AJNR Am J Neuroradiol 2020 May 28. Epub 2020 May 28.

From the Department of Neurosurgery (J.-K.B., V.S., A.S., O.T., J.J., S.C., P.K.), Baylor College of Medicine, Houston, Texas.

Background And Purpose: The Neuroform Atlas is a new microstent to assist coil embolization of intracranial aneurysms that recently gained FDA approval. We present a postmarket multicenter analysis of the Neuroform Atlas stent.

Materials And Methods: On the basis of retrospective chart review from 11 academic centers, we analyzed patients treated with the Neuroform Atlas after FDA exemption from January 2018 to June 2019. Read More

AJNR Am J Neuroradiol 2020 May 28. Epub 2020 May 28.

From the Department of Radiology (A.R., S.M.S., M.A., R.K., W.B., D.F.K.).

Background: Surveillance imaging of previously unruptured, coiled aneurysms remains routine even though reports of rupture of these aneurysms are extremely rare.

Purpose: We performed meta-analysis to examine long-term rupture risk over ≥1-year follow-up duration in patients with unruptured intracranial aneurysm who underwent endovascular therapy.

Data Sources: Multiple databases were searched for relevant publications between 1995 and 2018. Read More

Brain Sci 2020 May 25;10(5). Epub 2020 May 25.

SCDU Department of Interventional and Neurointerventional Radiology, "Maggiore della Carità" University Hospital, 28100 Novara, Italy.

Brain health may be threatened by aneurysm ruptures, and early recognition of these vascular malformations allows for neuroradiological intervention. Neurointerventional procedures are usually performed with femoral artery access. In patients with severe anatomical complexity of the supra-aortic vessels, however, treatment by this approach could be hindered or impossible. Read More

Neurosurgery 2020 May 28. Epub 2020 May 28.

Department of Radiology, New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts.

Background: Tissue growth over covered branches is a leading cause of delayed thrombotic complications after flow-diverter stenting (FDS). Due to insufficient resolution, no imaging modality is clinically available to monitor this phenomenon.

Objective: To evaluate high-frequency optical coherence tomography (HF-OCT), a novel intravascular imaging modality designed for the cerebrovascular anatomy with a resolution approaching 10 microns, to monitor tissue growth over FDS in an arterial bifurcation model. Read More

Cureus 2020 Apr 23;12(4):e7797. Epub 2020 Apr 23.

Neurosurgery, National Hospital for Neurology and Neurosurgery, London, GBR.

Endovascular coil embolization of cerebral aneurysm is a common procedure for managing cerebral aneurysms. We present a rare case of immediate silent coil migration into the pericallosal artery, without distal occlusion, following successful embolization. Despite the entire coil sitting within the lumen of the artery, good distal flow was observed. Read More

World Neurosurg 2020 May 24. Epub 2020 May 24.

Division of Neurosurgery, Centre Hospitalier de l'université de Montréal (CHUM), Montréal, Québec, Canada. Electronic address:

Background: Scleroderma, or systemic sclerosis, is an autoimmune disorder affecting connective tissues, including blood vessels. Although the exact mechanism is not understood, it results in the production of an abnormal amount of collagen. Cases have been reported in which patients with scleroderma also had intracranial aneurysms. Read More

Neurosurg Rev 2020 May 26. Epub 2020 May 26.

Department of Neurological Surgery, The Ohio State University, Wexner Medical Center, Columbus, OH, USA.

Once considered far-fetched, endoscopic endonasal clipping (EEC) has been reported as a feasible alternative route for treating intracranial aneurysms located in the midline. Appropriately, debates regarding EEC applicability have arisen amongst the neurosurgical community. We aim to define the safety, effectiveness, and current state-of-art in the use of EEC for intracranial aneurysms. Read More

Emerg Radiol 2020 May 26. Epub 2020 May 26.

Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.

Purpose: Multiple intracranial aneurysms (MIA) occur in one-third of patients with intracranial aneurysms (IA), and have been previously associated with an overall worse prognosis. Risk factors for IA formation and rupture in patients with a single IA are well-known. However, risk factors associated with rupture in patients with MIA have been less studied. Read More

J Neurointerv Surg 2020 May 26. Epub 2020 May 26.

Neuroradiology, Centre Hospitalier Regional Universitaire de Montpellier, Montpellier, Languedoc-Roussillon, France.

Background: Evidence about the safety and the efficacy of flow diversion for distal anterior cerebral artery (DACA) aneurysms is scant. To provide further insight into flow diversion for aneurysms located at, or distal to, the A2 segment.

Methods: Consecutive patients receiving flow diversion for DACA aneurysms were retrieved from our prospective database (2014-2020). Read More

Neurocirugia (Astur) 2020 May 23. Epub 2020 May 23.

Unidad de Cuidados Intensivos. Complejo Hospitalario Universitario de A Coruña (CHUAC), Servicio Galego de Saúde (SERGAS), Universidad de A Coruña, A Coruña, España.

Introduction: Spontaneous subarachnoid haemorrhage is a rare cause of stroke, but it causes great socioeconomic impact and high morbidity and mortality. The aim of this study is to describe the clinical profile and evolution of a series of patients with SAH admitted to a tertiary hospital, as well as the diagnostic and therapeutic management.

Material And Methods: Retrospective study of 536 patients diagnosed with SAH admitted to the ICU of the Hospital Universitario de A Coruña between 2003 and 2013 (Age: 56. Read More

World Neurosurg 2020 May 23. Epub 2020 May 23.

Department of Neurosurgery, Chonnam National University Hospital and Medical School, Gwangju, Republic of Korea. Electronic address:

Background: The unilateral anterior interhemispheric approach has been widely used for distal anterior cerebral artery (DACA) aneurysms. However, there are some drawbacks of this approach because of the narrow operative field, including possible brain traction injury, bridging vein injury, and inadequate exposure of the aneurysm. Here, we report a case of a DACA aneurysm covered by the falx that could not be totally exposed with the unilateral interhemispheric approach. Read More

Neurosurgery 2020 May 26. Epub 2020 May 26.

Radiology Department, UH St Ivan Rilski, Sofia, Bulgaria.

Background: Wide-necked cerebral aneurysms in the setting of acute subarachnoid hemorrhage (SAH) remain difficult to treat with endovascular methods despite recent progress in the neuroendovascular field.

Objective: To evaluate the effectiveness and safety of the Comaneci device (Rapid Medical, Israel) in endovascular coil embolization of acutely ruptured, wide-necked sidewall, or bifurcation cerebral aneurysms.

Methods: We retrospectively reviewed 45 anterior communicating artery, 24 internal carotid artery, 21 middle cerebral artery bifurcation, 15 anterior cerebral artery, and 13 posterior circulation aneurysms, which were treated using Comaneci-assisted coil embolization from August 2017 to January 2019. Read More

Neurosurgery 2020 May 26. Epub 2020 May 26.

Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania.

Background: The Neuroform Atlas stent™ (by Stryker, Fremont, California) represents the most recent widely available upgrade to intracranial stenting, providing a laser cut open cell stent with a diameter of 3.0 to 4.5 mm that is delivered through an 0. Read More

Dtsch Arztebl Int 2020 Apr;117(14):235-242

Department of Neurosurgery, UMC Mannheim, Medical Faculty, Ruprecht-Karls-Universität Heidelberg; Department of Neuroradiology, University Hospital Erlangen, University of Erlangen-Nuremberg; Department of Neurology, Center of Neurology and Neurosurgery, Universitätsklinikum Goethe- Universität Frankfurt.

Background: About 2 million adults in Germany harbor an unruptured intracranial aneurysm (IA). Rupture can lead to a life-threatening subarachnoid hemorrhage. If an IA is detected incidentally in cranial imaging, it must be decided how to proceed. Read More

Int J Neurosci 2020 May 25:1-8. Epub 2020 May 25.

Vascular Interventional Department, The Affiliated Hospital Of Hangzhou Normal University, Hangzhou, Zhejiang Province, China.

With the rapid development of noninvasive angiography techniques such as Magnetic Resonance Angiography (MRA) and Computer Tomography Angiography (CTA), more and more patients with intracranial arterial dolichoectasia (IADE) have been found, and clinical studies on this kind of vascular abnormity have become hot subjects in neurology. We presented two young patients with IADE extensively involving the branches of intracranial arteries, which were different from patients described in other articles. A young male patient was diagnosed with IADE after examination on admission, and further detailed examination revealed that the patient had osteropathia striata. Read More

J Neurosurg 2020 May 22:1-7. Epub 2020 May 22.

Objective: Cerebral bypasses are performed for the purpose of either flow augmentation for ischemic cerebrovascular disease or flow replacement for vessel sacrifice during complex aneurysm or tumor surgery. Saphenous vein grafts (SVGs) are commonly used interposition grafts. The authors of this study sought to compare the efficacy of autologous versus cadaveric SVGs in a large series of cerebral bypasses using interposition vein grafts with long-term angiographic follow-up. Read More

Clin Neurol Neurosurg 2020 May 4;195:105884. Epub 2020 May 4.

Department of Neurosurgery, Severance Stroke Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address:

Objective: Temporary clipping of the internal carotid artery can be required during microsurgery of a ruptured anterior choroidal artery (AchoA) aneurysm. Although it is suspected that such temporary clipping might be related to ischemic complications following surgery, no detailed analysis has been reported yet.

Patients And Methods: Eighty-nine patients with ruptured AchoA aneurysms treated by microsurgical clipping were recruited between January 1996 and December 2017. Read More

Acta Biomater 2020 May 19. Epub 2020 May 19.

State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai 201620, PR China. Electronic address:

Aneurysmal subarachnoid hemorrhage is a common complication caused by an intracranial aneurysm that can lead to hemorrhagic stroke, brain damage, and death. Knowing this clinical situation, the purpose of this study was to develop a controlled-release stent covered with a core-shell nanofiber mesh, fabricated by emulsion electrospinning, for the treatment of aneurysms. By encapsulating atorvastatin calcium (AtvCa) in the inner of poly (L-lactide-co-caprolactone) (PLCL) nanofibers, the release period of AtvCa was effectively extended. Read More

World Neurosurg 2020 May 19. Epub 2020 May 19.

Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, USA. Electronic address:

Objective: Treatment of unruptured intracranial arteriovenous malformations (AVMs) has become controversial since the ARUBA study was published in 2014. We sought to analyze changes in the demographics, clinical presentation and treatment strategies in two patient cohorts from the same institution separated by 40 years.

Methods: We retrospectively reviewed the electronic medical records for a consecutive series of patients with unruptured intracranial AVMs seen at the Mayo Clinic between 2003-2017 and compared them to a previously published historical cohort from the same institution, seen between 1974-1985. Read More

Oper Neurosurg (Hagerstown) 2020 May 22. Epub 2020 May 22.

Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.

Distal anterior cerebral artery (ACA) aneurysms remain a relatively rare and challenging entity for both open microsurgical and endovascular treatments. These lesions provide a significant surgical challenge because of the narrow interhemispheric surgical field, limited proximal control, common fixation of the aneurysm to the adjacent cingulate gyrus, and possible involvement of an unpaired azygos A2. These challenges result in a known association between distal ACA aneurysms and higher operative morbidity. Read More

World Neurosurg 2020 May 10. Epub 2020 May 10.

Acıbadem University Atakent Hospital, Department of Neurosurgery.

Background: Cerebral aneurysm and aneurysm rupture have rarely been reported in the literature during pregnancy. Aneurysm might rupture and may cause intracranial hemorrhage during or after pregnancy. Aneurysmal subarachnoid hemorrhage (aSAH) during pregnancy presents a challenge regarding treatment and management. Read More

World Neurosurg 2020 May 11. Epub 2020 May 11.

Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan.

Objective: Surgical skills are generally acquired by watching the "hand movements" of experts. "Eye movements" are now attracting attention in skill-learning fields. Eye-tracking technology was introduced preliminarily to develop a better skill-learning system for neuroendovascular treatments. Read More

Interv Neuroradiol 2020 May 21:1591019920926334. Epub 2020 May 21.

Department of Interventional Neuroradiology, Jean-Minjoz University Hospital, Besançon, France.

The Woven EndoBridge Device (WEB) is efficient and safe in the treatment of wide-neck bifurcation intracranial aneurysms. A crucial step in operative planning is establishing the appropriate dimension of the device, and there are limitations to the therapeutic solutions provided by WEBs. We describe a case of a right middle cerebral artery bifurcation wide-neck aneurysm treated with WEB. Read More

No Shinkei Geka 2020 May;48(5):451-457

Department of Neurosurgery, Japanese Red Cross Fukui Hospital.

BMC Neurol 2020 May 20;20(1):199. Epub 2020 May 20.

New Era Stroke Care and Research Institute, The PLA Rocket Force Characteristic Medical Center, No. 16 Xinjiekouwai Street, Xicheng District, Beijing, 100088, China.

Background: Direct evidence of intimal flaps, double lumen and intramural haematomas (IMH) is difficult to detect on conventional angiography in most intracranial vertebrobasilar dissecting aneurysms (VBDAs). Our purpose was to assess the value of three-dimensional high-resolution magnetic resonance vessel wall imaging (3D HRMR VWI) for identifying VBDAs.

Methods: Between August 2013 and January 2016, consecutive patients with suspicious VBDAs were prospectively enrolled to undergo catheter angiography and VWI (pre- and post-contrast). Read More

World Neurosurg 2020 May 17. Epub 2020 May 17.

Department of Neurosurgery, Vienna General Hospital, Medical University of Vienna, Vienna, Austria. Electronic address:

Introduction: The Neutrophil-to-Lymphocyte Ratio (NLR) has been investigated as an independent predictive marker for clinical outcomes in vascular diseases. This study aimed to investigate the peri-interventional behavior of NLR in patients with ruptured and unruptured intracranial aneurysms (IAs).

Methods: 117 patients with IAs, who were treated at our department and had available complete data, were retrospectively identified during a ten-year period. Read More

World Neurosurg 2020 May 17. Epub 2020 May 17.

Department of Cerebrovascular Surgery, International Medical, Center, Saitama Medical University, Hidaka, Japan.

Background: Although the tentorial branch of superior cerebellar artery (SCA) was reported to be a frequent finding in living subjects in one study, its clinical relevance, especially in surgery for aneurysms, has not been elucidated. We herein present our experience with the tentorial branch of SCA identified during surgical intervention of a distal SCA aneurysm and discuss its clinical relevance.

Case Description: A 71 year-old female presented with cerebral infarction in the SCA area, and a partially thrombosed, large, fusiform aneurysm was located inthe lateral pontomesencephalic segment of the SCA. Read More

Sci Rep 2020 May 20;10(1):8330. Epub 2020 May 20.

Department of Molecular Pharmacology, Research Institute, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita City, Osaka, 564-8565, Japan.

Smooth muscle cells (SMCs) are the major type of cells constituting arterial walls and play a role to maintain stiffness via producing extracellular matrix. Here, the loss and degenerative changes of SMCs become the major histopathological features of an intracranial aneurysm (IA), a major cause of subarachnoid hemorrhage. Considering the important role of SMCs and the loss of this type of cells in IA lesions, we in the present study subjected rats to IA models and examined how SMCs behave during disease progression. Read More

Am J Med Case Rep 2020 19;8(5):128-133. Epub 2020 Mar 19.

Internal Medicine, State University of New York- Downstate Health Science University, Brooklyn, NY, USA- 11203.

Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has been found to be associated with an increased risk of cardiovascular disease, and the development of arterial aneurysms in particular, intracranial aneurysms. In this review, we will review the reported HIV-associated extracranial aneurysms (HECAA) and their possible association with HIV/AIDS. We will discuss the proposed pathogenetic pathways leading to arterial aneurysms. Read More

Transl Stroke Res 2020 May 19. Epub 2020 May 19.

Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100050, China.

Machine learning (ML) as a novel approach could help clinicians address the challenge of accurate stability assessment of unruptured intracranial aneurysms (IAs). We developed multiple ML models for IA stability assessment and compare their performances. We enrolled 1897 consecutive patients with unstable (n = 528) and stable (n = 1539) IAs. Read More

Clin Neuroradiol 2020 May 18. Epub 2020 May 18.

Interventional Neuroradiology Unit, Monash Imaging, Monash Health, Melbourne, Victoria, Australia.

The development of endovascular treatment for intracranial aneurysms has established new techniques such as balloon and stent-assistance, flow diversion and endosaccular occlusion devices. Antiplatelet treatment is an important aspect to reduce risk of thrombus formation on microcatheters and implanted devices when utilizing these methods. It is particularly relevant for flow diverting stents to prevent early and late stent thrombosis. Read More

J Mol Med (Berl) 2020 May 18. Epub 2020 May 18.

Department of Neurology, Faculty of Medicine, Jagiellonian University Medical College, ul. Botaniczna 3, 31-503, Krakow, Poland.

Multiple classes of small RNAs (sRNAs) are expressed in the blood and are involved in the regulation of pivotal cellular processes. We aimed to elucidate the expression patterns and functional roles of sRNAs in the systemic response to intracranial aneurysm (IA) rupture. We used next-generation sequencing to analyze the expression of sRNAs in patients in the acute phase of IA rupture (first 72 h), in the chronic phase (3-15 months), and controls. Read More

J Neurointerv Surg 2020 May 18. Epub 2020 May 18.

Neurological Surgery, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.

Background: Inflammation of the arterial wall may lead to aneurysm formation. The presence of aneurysm enhancement on high-resolution vessel wall imaging (HR-VWI) is a marker of wall inflammation and instability. We aim to determine if there is any association between increased contrast enhancement in the aneurysmal wall and its parent artery. Read More

Interv Neuroradiol 2020 May 18:1591019920925706. Epub 2020 May 18.

Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei.

Background: To investigate the discrepancy between two-dimensional digital subtraction angiography and three-dimensional rotational angiography for small (<5 mm) cerebral aneurysms and the impact on decision making among neuro-interventional experts as evaluated by online questionnaire.

Materials And Methods: Eight small (<5 mm) ruptured aneurysms were visually identified in 16 image sets in either two-dimensional or three-dimensional format for placement in a questionnaire for 11 invited neuro-interventionalists. For each set, two questions were posed: Question 1: "Which of the following is the preferred treatment choice: simple coiling, balloon remodeling or stent assisted coiling?"; Question 2: "Is it achievable to secure the aneurysm with pure simple coiling?" The discrepancies of angio-architecture parameters and treatment choices between two-dimensional-digital subtraction angiography and three-dimensional rotational angiography were evaluated. Read More

Proc Inst Mech Eng H 2020 May 19:954411920917531. Epub 2020 May 19.

Mechanical Engineering Department, College of Engineering and Technology, Arab Academy for Science, Technology and Maritime Transport (AASTMT), Alexandria, Egypt.

Cerebral aneurysm is a fatal neurovascular disorder. Computational fluid dynamics simulation of aneurysm haemodynamics is one of the most important research tools which provide increasing potential for clinical applications. However, computational fluid dynamics modelling of such delicate neurovascular disorder involves physical complexities that cannot be easily simplified. Read More

Oper Neurosurg (Hagerstown) 2020 May 18. Epub 2020 May 18.

Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.

Internal carotid artery (ICA) bifurcation, or terminus, aneurysms are uncommon, and although they can be accessed with relative ease, clip occlusion of such aneurysms is often challenging due to the close proximity of basal forebrain perforator vessels. This patient had an incidentally discovered ICA terminus aneurysm and elected for microsurgical clipping. A modified orbitozygomatic approach was used to approach the aneurysm. Read More

Oper Neurosurg (Hagerstown) 2020 May 18. Epub 2020 May 18.

Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.

Unclippable giant aneurysms pose a significant microsurgical challenge. Options for management are highly dependent on the aneurysm characteristics and cerebrovascular anatomy. Hunterian (proximal) ligation with either high-flow or low-flow distal revascularization is an option for the treatment of aneurysms of the internal carotid artery (ICA). Read More

Neurosurgery 2020 May 18. Epub 2020 May 18.

Department of Mechanical and Aerospace Engineering, University at Buffalo, Buffalo, New York.

Background: A simple dimensionless aneurysm number ($An$), which depends on geometry and flow pulsatility, was previously shown to distinguish the flow mode in intracranial aneurysms (IA): vortex mode with a dynamic vortex formation/evolution if $An > 1$, and cavity mode with a steady shear layer if $An < 1$.

Objective: To hypothesize that $An\ > \ 1$ can distinguish rupture status because vortex mode is associated with high oscillatory shear index, which, in turn, is statistically associated with rupture.

Methods: The above hypothesis is tested on a retrospective, consecutively collected database of 204 patient-specific IAs. Read More

Comput Biol Med 2020 May 15;120:103759. Epub 2020 Apr 15.

Department of Mechanical and Aerospace Engineering, University at Buffalo, The State University of New York, Buffalo, NY, USA; Canon Stroke and Vascular Research Center, University at Buffalo, The State University of New York, Buffalo, NY, USA. Electronic address:

Background: Computational fluid dynamics(CFD) of intracranial aneurysms requires flow boundary conditions(BCs) as inputs. Patient-specific BCs are usually unavailable and substituted by literature-derived generic BCs. Therefore, we investigated inter-patient BC variations and their influence on middle cerebral artery aneurysmal hemodynamics. Read More

Semin Intervent Radiol 2020 Jun 14;37(2):166-174. Epub 2020 May 14.

Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado.

Neuroangiography (NA) is a minimally invasive procedure used to diagnose patients with neurovascular diseases. Noninvasive imaging has improved dramatically in recent years and is utilized more frequently; however, further evaluation with NA is still required in certain cases. NA indications include intracranial (cerebral aneurysms, arteriovenous malformations, dural arteriovenous fistula, cerebral vasculitis, cerebral vasospasm, ischemic stroke, nontraumatic subarachnoid hemorrhage, intracerebral hemorrhage, Moyamoya, vein of Galen malformation, intracranial tumors, and pseudotumor cerebri) and extracranial (internal and common carotid artery stenosis, vertebral artery stenosis, carotid artery blowout, vertebral artery blowout, epistaxis, oropharyngeal bleeding, and carotid body tumor) pathologies which can help with diagnosis and potential subsequent endovascular treatment. Read More