2,140 results match your criteria Journal of neurointerventional surgery[Journal]


The safety and effectiveness of the Woven EndoBridge (WEB) system for the treatment of wide-necked bifurcation aneurysms: final 12-month results of the pivotal WEB Intrasaccular Therapy (WEB-IT) Study.

J Neurointerv Surg 2019 Apr 16. Epub 2019 Apr 16.

Stony Brook University Hospital, Stony Brook, New York, USA.

Introduction: The Woven EndoBridge Intrasaccular Therapy (WEB-IT) Study is a pivotal, prospective, single-arm, investigational device exemption study designed to evaluate the safety and effectiveness of the WEB device for the treatment of wide-neck bifurcation aneurysms.

Methods: One-hundred and fifty patients with wide-neck bifurcation aneurysms were enrolled at 21 US and six international centers. Angiograms from the index procedure, and 6-month and 1-year follow-up visits were all reviewed by a core laboratory. Read More

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http://dx.doi.org/10.1136/neurintsurg-2019-014815DOI Listing

Better is Good.

J Neurointerv Surg 2019 May;11(5):431-432

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http://dx.doi.org/10.1136/neurintsurg-2019-014946DOI Listing

Early post-Humanitarian Device Exemption experience with the Neuroform Atlas stent.

J Neurointerv Surg 2019 Apr 12. Epub 2019 Apr 12.

Cerebrovascular Center, Cleveland Clinic, Cleveland, Ohio, USA.

Introduction: The low-profile Neuroform Atlas stent received FDA Humanitarian Device Exemption status (HDE) in January 2018 for stent-assisted coil embolization of wide-necked saccular aneurysms. We review and report our results with the Atlas stent in our institution within the first year after its HDE approval.

Methods: Our retrospective chart review identified patients treated with the Atlas stent. Read More

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http://dx.doi.org/10.1136/neurintsurg-2019-014874DOI Listing

Admission neutrophil-lymphocyte ratio predicts delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage.

J Neurointerv Surg 2019 Apr 12. Epub 2019 Apr 12.

Department of Neurology, NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, New York, USA.

Background: Delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH) has a multifactorial pathophysiology, with immune dysregulation being an important component. The neutrophil-lymphocyte ratio (NLR) is an established prognostic marker in patients with cancer, cardiac disease, and sepsis.

Objective: To determine whether there is a relationship between NLR and DCI in patients with aSAH. Read More

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http://jnis.bmj.com/lookup/doi/10.1136/neurintsurg-2019-0147
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http://dx.doi.org/10.1136/neurintsurg-2019-014759DOI Listing
April 2019
1 Read

Genetic correlates of wall shear stress in a patient-specific 3D-printed cerebral aneurysm model.

J Neurointerv Surg 2019 Apr 12. Epub 2019 Apr 12.

Neurological Surgery, University of Washington, Seattle, WA, USA.

Objectives: To study the correlation between wall shear stress and endothelial cell expression in a patient-specific, three-dimensional (3D)-printed model of a cerebral aneurysm.

Materials And Methods: A 3D-printed model of a cerebral aneurysm was created from a patient's angiogram. After populating the model with human endothelial cells, it was exposed to media under flow for 24 hours. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014669DOI Listing

Progressive thrombosis of unruptured aneurysms after coil embolization: analysis of 255 consecutive aneurysms.

J Neurointerv Surg 2019 Apr 11. Epub 2019 Apr 11.

Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan.

Introduction: We have observed that aneurysms treated by insufficient coil embolization and filled with contrast agent immediately after the procedure are often completely occluded at follow-up. However, there are limited studies showing progressive thrombosis of aneurysms after coil embolization. Herein, we describe our experience with coil embolization for aneurysms, and discuss the factors involved in progressive thrombosis. Read More

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http://dx.doi.org/10.1136/neurintsurg-2019-014775DOI Listing

'Real-world' comparison of first-line direct aspiration and stent retriever mechanical thrombectomy for the treatment of acute ischemic stroke in the anterior circulation: a multicenter international retrospective study.

J Neurointerv Surg 2019 Apr 11. Epub 2019 Apr 11.

Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, USA.

Background: Thrombectomy for anterior large vessel occlusion less than 24 hours since last known well is now standard of care. Certain aspects of clinical trials may limit generalizability to 'real-world' practice.

Objective: To compare revascularization rates and outcomes for direct aspiration (ADAPT) and stent retriever thrombectomy following anterior acute ischemic stroke (AIS) in a real-life setting. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014624DOI Listing
April 2019
1 Read

Flow diversion treatment of aneurysms of the complex region of the anterior communicating artery: which stent placement strategy should 'I' use? A single center experience.

J Neurointerv Surg 2019 Apr 11. Epub 2019 Apr 11.

NEURI, Hopital Bicetre, Le Kremlin-Bicetre, France.

Background: Aneurysms of the anterior communicating artery (ACoA) are difficult to treat with coiling or clipping because of the anatomical variation in this region. Flow diversion represents a feasible treatment, but no consensus exists as to which stent deployment technique is more suitable.

Methods: All patients with ACoA aneurysms treated with flow diverters between April 2014 and November 2018 were retrospectively analyzed. Read More

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http://dx.doi.org/10.1136/neurintsurg-2019-014858DOI Listing
April 2019
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Efficacy of endovascular thrombectomy in patients with M2 segment middle cerebral artery occlusions: meta-analysis of data from the HERMES Collaboration.

J Neurointerv Surg 2019 Apr 11. Epub 2019 Apr 11.

Department of Diagnostic Imaging, University of Calgary, Calgary, Alberta, Canada.

Background: The Society of Neurointerventional Surgery revised its operational definition of emergent large vessel occlusion (ELVO) recently to include proximal M2 segment middle cerebral artery (MCA) occlusions. We sought to assess the benefit of endovascular thrombectomy (EVT) over best medical care for M2 segment MCA occlusion.

Methods: Patient level data from trials in the HERMES Collaboration were included. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014678DOI Listing
April 2019
1 Read

A survey of burnout and professional satisfaction among United States neurointerventionalists.

J Neurointerv Surg 2019 Apr 11. Epub 2019 Apr 11.

Interventional Neuroradiology, Massachusetts General Hospital, Boston, Massachusetts, USA.

Background: The toll of burnout on healthcare is significant and associated with physician depression and medical errors.

Objective: To assess the prevalence and risk factors for burnout among neurointerventionalists.

Methods: A 39-question online survey containing questions about neurointerventional practice and the Maslach Burnout Inventory-Human Services Survey for medical personnel was distributed to members of major US neurointerventional physician societies. Read More

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http://jnis.bmj.com/lookup/doi/10.1136/neurintsurg-2019-0148
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http://dx.doi.org/10.1136/neurintsurg-2019-014833DOI Listing
April 2019
2 Reads

Stentriever salvage after failed manual aspiration thrombectomy.

J Neurointerv Surg 2019 Apr 10. Epub 2019 Apr 10.

Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Introduction: Manual aspiration thrombectomy (MAT) and stent retriever mediated aspiration thrombectomy (SMAT) are well described reperfusion strategies for large vessel occlusions. This study aims to identify predictors of successful crossover to SMAT after failed first pass MAT.

Methods: Prospectively collected data for patients with acute large vessel occlusions undergoing thrombectomy over a 23 month period at a comprehensive stroke center were reviewed. Read More

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http://dx.doi.org/10.1136/neurintsurg-2019-014828DOI Listing

Direct carotid puncture for endovascular thrombectomy in acute ischemic stroke.

J Neurointerv Surg 2019 Apr 6. Epub 2019 Apr 6.

Interventional Neuroradiology Service, Department of Radiology, Beaumont Hospital, Dublin, Ireland.

Background: Mechanical thrombectomy is the standard of care for acute ischemic strokes with proximal intracranial occlusion. Arterial access is commonly achieved with femoral artery puncture, although this is not always possible. In this case series, we describe 11 cases of anterior circulation stroke where direct carotid puncture was used to obtain vascular access. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014586DOI Listing
April 2019
2 Reads

Platelet-rich clots as identified by Martius Scarlet Blue staining are isodense on NCCT.

J Neurointerv Surg 2019 Apr 5. Epub 2019 Apr 5.

Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.

Background: Current studies on clot characterization in acute ischemic stroke focus on fibrin and red blood cell composition. Few studies have examined platelet composition in acute ischemic stroke clots. We characterize clot composition using the Martius Scarlet Blue stain and assess associations between platelet density and CT density. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014637DOI Listing
April 2019
1 Read

Pipeline embolization device diameter is an important factor determining the efficacy of flow diversion treatment of small intracranial saccular aneurysms.

J Neurointerv Surg 2019 Mar 29. Epub 2019 Mar 29.

Department of Radiology, University of Maryland, Baltimore, Maryland, USA.

Objective: Flow diversion using the Pipeline embolization device (PED) has become a widely used treatment method for intracranial aneurysms. However, a subset of aneurysms will fail to occlude following treatment and the factors that influence the efficacy of flow diversion remain uncertain. As smaller diameter PEDs inherently have greater metal density than larger devices, we elected to investigate whether PED diameter influences treatment efficacy when using a single device. Read More

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http://dx.doi.org/10.1136/neurintsurg-2019-014792DOI Listing
March 2019
2 Reads

Safety and quality of endovascular therapy under general anesthesia and conscious sedation are comparable: results from the GOLIATH trial.

J Neurointerv Surg 2019 Mar 29. Epub 2019 Mar 29.

Neurology, Aarhus University Hospital, Aarhus, Denmark.

Background: The "General or Local Anesthesia in Intra-Arterial Therapy" (GOLIATH) trial compared infarct growth and outcome in patients undergoing endovascular therapy (EVT) under either general anesthesia (GA) or conscious sedation (CS). The results were the same for the primary outcome (infarct growth) but successful reperfusion was higher in the GA arm.

Objective: To further examine differences in the quality and safety of EVT with the two anesthetic regimens in a post hoc analysis of GOLIATH. Read More

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http://dx.doi.org/10.1136/neurintsurg-2019-014712DOI Listing

MISTIE III: a big step in the right direction.

J Neurointerv Surg 2019 Apr;11(4):326-327

Department of Neurosurgery, The Mount Sinai Health System, New York, NY, USA.

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http://dx.doi.org/10.1136/neurintsurg-2019-014870DOI Listing

A new set of eyes: development of a novel microangioscope for neurointerventional surgery.

J Neurointerv Surg 2019 Mar 16. Epub 2019 Mar 16.

Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.

Background: Endovascular technological advances have revolutionized the field of neurovascular surgery and have become the mainstay of treatment for many cerebrovascular pathologies. Digital subtraction angiography (DSA) is the 'gold standard' for visualization of the vasculature and deployment of endovascular devices. Nonetheless, with recent technological advances in optics, angioscopy has emerged as a potentially important adjunct to DSA. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014610DOI Listing
March 2019
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Endovascular treatment of debilitating tinnitus secondary to cerebral venous sinus abnormalities: a literature review and technical illustration.

J Neurointerv Surg 2019 Mar 14. Epub 2019 Mar 14.

Department of Surgery, The University of Hong Kong, Hong Kong.

Background And Objective: Pulsatile tinnitus (PT) can be debilitating and lead to significant morbidity. Cerebral venous sinus lesions, such as venous sinus stenosis, diverticula, and high-riding jugular bulb, are uncommon causes of PT, for which there is no standard treatment. Endovascular interventions have shown promising results for PT secondary to idiopathic intracranial hypertension, and may be a valid therapeutic option for isolated venous PT. Read More

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http://dx.doi.org/10.1136/neurintsurg-2019-014725DOI Listing

Testing bioresorbable stent feasibility in a rat aneurysm model.

J Neurointerv Surg 2019 Mar 9. Epub 2019 Mar 9.

Department of Neurosurgery, Kantonsspital Aarau, Switzerland.

Background: Advances in stent-assisted coiling have incrementally expanded endovascular treatment options for complex cerebral aneurysms. After successful coil consolidation and aneurysm occlusion, endovascular scaffolds are no longer needed. Thus, bioresorbable stents that disappear after aneurysm healing could avoid future risks of in-stent thrombosis and the need for lifelong antiplatelet therapy. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014697DOI Listing

Periprocedural safety and technical outcomes of the new Silk Vista Baby flow diverter for the treatment of intracranial aneurysms: results from a multicenter experience.

J Neurointerv Surg 2019 Mar 9. Epub 2019 Mar 9.

Neuroradiology, Alfried Krupp Krankenhaus Ruttenscheid, Essen, Germany.

Purpose: The aim of our study was to assess the technical success and the safety of this new low-profile flow diverter Silk Vista Baby (SVB) by evaluating the intraprocedural and periprocedural complication rate.

Material/methods: Clinical, procedural, and angiographic data were analyzed.

Results: 41 consecutive patients (28 women; age average 50. Read More

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http://dx.doi.org/10.1136/neurintsurg-2019-014770DOI Listing
March 2019
2 Reads

Endovascular therapy for middle cerebral artery M2 segment occlusion: subanalyses of RESCUE-Japan Registry 2.

J Neurointerv Surg 2019 Mar 9. Epub 2019 Mar 9.

Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.

Objective: To compare the efficacy of endovascular therapy (EVT) with that of medical treatment in 'real-world 'patients with M2 occlusion.

Methods: This was a post hoc analysis of the Recovery by Endovascular Salvage for Cerebral Ultra-acute Embolism Japan Registry 2. Among 2420 patients in the registry, we evaluated patients with isolated M2 occlusion and those with functional independence before the stroke. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014627DOI Listing
March 2019
2 Reads

Volumetric T2-weighted MRI improves the diagnostic accuracy of spinal vascular malformations: comparative analysis with a conventional MR study.

J Neurointerv Surg 2019 Mar 6. Epub 2019 Mar 6.

Neurointervention Centre, Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.

Background: To date, very little study of the importance of a volumetric T2-weighted MR sequence in the evaluation of spinal vascular malformations (SVMs) has been carried out.

Objective: To determine the utility and accuracy of a volumetric T2 MR sequence compared with conventional T2 in the diagnosis of SVMs.

Methods: Retrospective analysis of all patients who underwent spinal DSA for suspected SVMs was conducted. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014522DOI Listing
March 2019
2 Reads

In vitro accuracy and inter-observer reliability of CT angiography in detecting intracranial aneurysm enlargement.

J Neurointerv Surg 2019 Mar 6. Epub 2019 Mar 6.

Neurological surgery, University of Iowa, Iowa City, Iowa, USA.

Background And Purpose: To evaluate the accuracy and inter-observer variability when CT angiography is used to identify unruptured intracranial aneurysm growth.

Methods: Two silicone phantom models were used in this study. Each phantom had eight aneurysms of variable size. Read More

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http://dx.doi.org/10.1136/neurintsurg-2019-014737DOI Listing
March 2019
1 Read

Stent assisted coiling versus non-stent assisted coiling for the management of ruptured intracranial aneurysms: a meta-analysis and systematic review.

J Neurointerv Surg 2019 May 6;11(5):489-496. Epub 2019 Mar 6.

Department of Neurosurgery, Changhai Hospital, Naval Medical University, Shanghai, China.

Purpose: To compare the safety and efficiency of stent assisted coiling (SAC) with non-SAC for the management of ruptured intracranial aneurysms.

Methods: A meta-analysis that compared SAC with coiling alone and balloon assisted coiling was conducted by database searching. The primary outcomes of this study were immediate occlusion and progressive thrombosis rate, overall perioperative complication rate, and angiographic recurrence. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014388DOI Listing
May 2019
2 Reads

Need for rescue treatment and its implication: stent retriever versus contact aspiration thrombectomy.

J Neurointerv Surg 2019 Mar 6. Epub 2019 Mar 6.

Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea.

Backgroud: The need for rescue treatment (RT) may differ depending on first-line modality (stent retriever (SR) or contact aspiration (CA)) in endovascular thrombectomy (EVT). We aimed to investigate whether the type of first-line modality in EVT was associated with the need for RT.

Methods: We identified all patients who underwent EVT for anterior circulation large-vessel occlusion from prospectively maintained registries of 17 stroke centers. Read More

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http://jnis.bmj.com/lookup/doi/10.1136/neurintsurg-2018-0146
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http://dx.doi.org/10.1136/neurintsurg-2018-014696DOI Listing
March 2019
8 Reads

Endovascular mechanical thrombectomy for acute stroke in young children.

J Neurointerv Surg 2019 Mar 6. Epub 2019 Mar 6.

Radiology, Johns Hopkins Hospital, Baltimore, Maryland, USA.

Background: Mechanical thrombectomy has emerged as a standard of care for acute stroke from large vessel occlusion in adults but remains controversial in children. Cerebral vessels are nearly adult size by 5 years of age but the technical feasibility of achieving recanalization in younger and smaller children with current endovascular tools remains unclear.

Objective: To systematically review the literature on mechanical thrombectomy for stroke in children less than 5 years of age. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014540DOI Listing
March 2019
1 Read

Effect of extracranial lesion severity on outcome of endovascular thrombectomy in patients with anterior circulation tandem occlusion: analysis of the TITAN registry.

J Neurointerv Surg 2019 Mar 6. Epub 2019 Mar 6.

Department of Diagnostic and Interventional Neuroradiology, CHRU Nancy, Nancy, France.

Introduction: Endovascular treatment (EVT) for tandem occlusion (TO) of the anterior circulation is complex but effective. The effect of extracranial internal carotid artery (EICA) lesion severity on the outcomes of EVT is unknown. In this study we investigated the effect of EICA lesion severity on the outcomes of tandem occlusion EVT. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014629DOI Listing
March 2019
1 Read

A prospective study of the transradial approach for diagnostic cerebral arteriography.

J Neurointerv Surg 2019 Mar 6. Epub 2019 Mar 6.

Neurosurgery, UPMC, Pittsburgh, Pennsylvania, USA.

Background: The transradial approach for cardiac catheterization is associated with improved patient safety and satisfaction in comparison with the transfemoral approach. Prospective data for the transradial approach for cerebral arteriography are lacking.

Objective: To carry out a prospective study of consecutive patients undergoing transradial cerebral arteriography at our institution to evaluate the safety, feasibility, and limitations of this approach. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014686DOI Listing
March 2019
6 Reads

Impact of procedural time on clinical and angiographic outcomes in patients with acute ischemic stroke receiving endovascular treatment.

J Neurointerv Surg 2019 Mar 6. Epub 2019 Mar 6.

Zeenat Qureshi Stroke Institute, St. Cloud, Minnesota, USA.

Background: Procedural time in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy may affect clinical outcomes. We performed a pooled analysis of the effect of procedural time on clinical outcomes using data from three prospective endovascular treatment trials.

Objective: To examine the relationship between endovascular procedural time and clinical outcomes of patients with AIS following endovascular treatment. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014576DOI Listing
March 2019
1 Read

Endovascular thrombectomy in pediatric patients with large vessel occlusion.

J Neurointerv Surg 2019 Mar 6. Epub 2019 Mar 6.

The Mount Sinai Health System, New York, New York, USA.

Background: Pediatric acute ischemic stroke with underlying large vessel occlusion is a rare disease with significant morbidity and mortality. There is a paucity of data about the safety and outcomes of endovascular thrombectomy in these cases, especially with modern devices.

Methods: We conducted a retrospective review of all pediatric stroke patients who underwent endovascular thrombectomy in nine US tertiary centers between 2008 and 2017. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014320DOI Listing
March 2019
2 Reads

Matricidal cavernous aneurysms: a multicenter case series.

J Neurointerv Surg 2019 Feb 27. Epub 2019 Feb 27.

University of Tennessee Health Science Center Department of Neurosurgery, Memphis, Tennessee, USA.

Background: Cavernous carotid artery aneurysms (CCAs) represent a unique subset of intracranial aneurysms due to their distinct natural history and the anatomy of the cavernous sinus. Enlarging CCAs can cause elastic compression of the parent internal carotid artery (ICA). We suggest defining aneurysms that cause luminal stenosis of their parent vessels as 'matricidal aneurysms. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014562DOI Listing
February 2019
1 Read

Distal transradial access in the anatomical snuffbox for diagnostic cerebral angiography.

J Neurointerv Surg 2019 Feb 27. Epub 2019 Feb 27.

Neurological Surgery, University of Miami MILLER School of Medicine, Miami, Florida, USA.

Background: The transradial approach for endovascular angiography and interventional procedures is superior to the traditional transfemoral approach in several metrics, including lower access-site complication rates, higher patient satisfaction, and lower hospital costs. Interventional cardiologists have begun to adopt the distal transradial approach (dTRA) for coronary interventions as it has an improved safety profile and improved procedural ergonomics. Adaptation of dTRA for neuroendovascular procedures promises similar benefit, but requires a learning curve. Read More

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http://dx.doi.org/10.1136/neurintsurg-2019-014718DOI Listing
February 2019

Hemodynamic differences between Pipeline and coil-adjunctive intracranial stents.

J Neurointerv Surg 2019 Feb 27. Epub 2019 Feb 27.

Department of Neurovascular, Medtronic plc., Irvine, California, USA.

Introduction: Modern coil-adjunctive intracranial stent designs have increased metal surface coverage to construct putative 'flow diverter lights.' This is rooted in the assumption that flow diversion is linearly correlated with metal surface coverage rather than being a threshold to be reached by device porosity and design.

Objective: To evaluate this assumption, by performing computational flow analysis on three aneurysm models treated with low metal surface coverage stents (ATLAS and Enterprise), a Pipeline flow diverter, and the LVIS Blue stent. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014439DOI Listing
February 2019

Greater infarct growth limiting effect of mechanical thrombectomy in stroke patients with poor collaterals.

J Neurointerv Surg 2019 Feb 27. Epub 2019 Feb 27.

Comprehensive Stroke Unit, Hospital Clinic de Barcelona, Barcelona, Spain.

Objective: Stroke patients with good collateral circulation achieve the best recovery after mechanical thrombectomy (MT) but strict imaging selection may result in untreated patients that could benefit from MT. We assessed whether the extent of collaterals had modifying effects on the amount of ischemic tissue saved from infarction with MT over best medical treatment (BMT).

Methods: This was a single center cohort of consecutive patients (n=339) with proximal occlusions in the carotid territory. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014668DOI Listing
February 2019
2 Reads

European Stroke Organisation (ESO) - European Society for Minimally Invasive Neurological Therapy (ESMINT) Guidelines on Mechanical Thrombectomy in Acute Ischemic Stroke.

J Neurointerv Surg 2019 Feb 26. Epub 2019 Feb 26.

Klinik und Poliklinik für Neuroradiologische Diagnostik und Intervention, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.

Background: Mechanical thrombectomy (MT) has become the cornerstone of acute ischemic stroke management in patients with large vessel occlusion (LVO).

Objective: To assist physicians in their clinical decisions with regard toMT.

Methods: These guidelines were developed based on the standard operating procedure of the European Stroke Organisation and followed the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014569DOI Listing
February 2019

Predictors of malignant brain edema after mechanical thrombectomy for acute ischemic stroke.

J Neurointerv Surg 2019 Feb 23. Epub 2019 Feb 23.

Department of Neurology, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, China.

Background: Malignant brain edema (MBE) is a devastating complication in ischemic stroke. Data on MBE in patients who have had mechanical thrombectomy (MT) are relatively scarce.

Objective: To investigate the incidence, predictors, and clinical outcomes of MBE in patients after MT. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014650DOI Listing
February 2019

Middle meningeal artery embolization for the management of chronic subdural hematoma.

J Neurointerv Surg 2019 Feb 23. Epub 2019 Feb 23.

Univ Tennessee Health Sciences Center Department of Neurosurgery/Semmes-Murphey Clinic, Memphis, Tennessee, USA.

Chronic subdural hematoma (cSDH) is one of the most common neurosurgical diagnoses in adults. The disease is fundamentally a disorder of the meningeal blood vessels, and options exist for the minimally invasive neuroendovascular management. We review the potential role for the endovascular management of cSDH within the context of a discussion of the epidemiology, pathophysiology, and conventional management of this disease. Read More

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http://dx.doi.org/10.1136/neurintsurg-2019-014730DOI Listing
February 2019
1 Read

A Rolling Stone.

J Neurointerv Surg 2019 Mar;11(3):211-212

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http://dx.doi.org/10.1136/neurintsurg-2019-014795DOI Listing
March 2019
1 Read

Relationship of clinical presentation and angiographic findings in patients with indirect cavernous carotid fistulae.

J Neurointerv Surg 2019 Feb 18. Epub 2019 Feb 18.

Radiology and Neurological Surgery, Columbia University, New York, USA.

Introduction: Indirect cavernous carotid fistulae (ICCFs) can present with insidious, non-specific symptoms and prove difficult to diagnose. This study evaluates associations among ICCF symptoms and angiographic findings.

Methods: A retrospective analysis was performed of prospectively maintained records at four medical centers to identify patients with ICCFs evaluated with angiography. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014421DOI Listing
February 2019
1 Read

Impact of single phase CT angiography collateral status on functional outcome over time: results from the MR CLEAN Registry.

J Neurointerv Surg 2019 Feb 18. Epub 2019 Feb 18.

Radiology & Nuclear Medicine, Amsterdam University Medical Center (AMC), Amsterdam, The Netherlands.

Background: Collateral status modified the effect of endovascular treatment (EVT) for stroke in several randomized trials. We assessed the association between collaterals and functional outcome in EVT treated patients and investigated if this association is time dependent.

Methods: We included consecutive patients from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in The Netherlands (MR CLEAN) Registry (March 2014-June 2016) with an anterior circulation large vessel occlusion undergoing EVT. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014619DOI Listing
February 2019
4 Reads

Institutional and provider variations for mechanical thrombectomy in the treatment of acute ischemic stroke: a survey analysis.

J Neurointerv Surg 2019 Feb 13. Epub 2019 Feb 13.

Department of Neurology, Neurosurgery and Radiology, University of Minnesota, Minneapolis, MN, USA.

Introduction: Stent retriever combined with aspiration, or the 'Solumbra technique', has recently emerged as one of the popular methods of mechanical thrombectomy (MT). However, the variations in understanding and implementation of the Solumbra technique have not been reported.

Methods: An 18 part anonymous survey questionnaire was designed to extract information regarding technical variations of MT with a focus on the Solumbra technique. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014614DOI Listing
February 2019

An autopsy report of basilar artery aneurysm flow diversion complicated by postoperative day 3 hemorrhage from vessel rupture.

J Neurointerv Surg 2019 May 13;11(5):e2. Epub 2019 Feb 13.

Department of Neurosurgery, West Virginia University Hospital, Morgantown, West Virginia, USA.

A middle-aged patient presented with posterior circulation symptoms attributable to a large eccentric basilar trunk aneurysm. The planned treatment was flow diversion with loose coil packing which was successfully performed using a Pipeline Flex device deployed from the basilar to the left posterior cerebral artery. The complete procedure including live biplane fluoroscopy was digitally recorded. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014511.repDOI Listing
May 2019
1 Read

Large-bore aspiration catheter selection does not influence reperfusion or outcome after manual aspiration thrombectomy.

J Neurointerv Surg 2019 Feb 7. Epub 2019 Feb 7.

Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Introduction: Various large-bore catheters can be employed for manual aspiration thrombectomy (MAT); clinical differences are rarely explored.

Methods: Prospectively collected demographic, angiographic, and clinical data for patients with acute internal carotid artery, middle cerebral artery M1, or basilar occlusions undergoing MAT over 23 months at a comprehensive stroke center were reviewed. We excluded patients in stentriever-based randomized trials/registries. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014633DOI Listing
February 2019
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Impact of blood pressure levels within first 24 hours after mechanical thrombectomy on clinical outcome in acute ischemic stroke patients.

J Neurointerv Surg 2019 Feb 6. Epub 2019 Feb 6.

Department of Neurology, Univ Hosp Olomouc, Olomouc, Czech Republic.

Introduction: Despite early management and technical success of mechanical thrombectomy (MT) for acute ischemic stroke (AIS), not all patients reach a good clinical outcome. Different factors may have an impact and we aimed to evaluate blood pressure (BP) levels in the first 24 hours after MT.

Methods: Consecutive AIS patients treated with MT were enrolled in the retrospective bi-center study. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014548DOI Listing
February 2019
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Complete clot ingestion with cyclical ADAPT increases first-pass recanalization and reduces distal embolization.

J Neurointerv Surg 2019 Feb 4. Epub 2019 Feb 4.

Department of Radiology, New England Center for Stroke Research, Division of Neuroimaging and Intervention, University of Massachusetts Medical School, Worcester, Massachusetts, USA.

Background: Evidence is mounting that first-pass complete recanalization during mechanical thrombectomy is associated with better clinical outcomes in patients presenting with an emergent large vessel occlusion. We hypothesize that aspiration achieving complete clot ingestion results in higher first-pass successful recanalization with quantitative reduction in distal emboli.

Methods: A patient-specific cerebrovascular replica was connected to a flow loop. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014625DOI Listing
February 2019

Differences in hemodynamic characteristics under high packing density between the porous media model and finite element analysis in computational fluid dynamics of intracranial aneurysm virtual treatment.

J Neurointerv Surg 2019 Feb 4. Epub 2019 Feb 4.

Department of Radiology, Huashan Hospital Affiliated to Fudan University, Shanghai, China.

Objective: This study aimed to compare the hemodynamic differences among no sac (NOS), porous media (POM) and finite element analysis (FEA) models to investigate the recurrence-related risks for coiled intracranial aneurysms (IAs).

Methods: The study enrolled 10 patients with 11 IAs who received simple coiling treatment and hemodynamic simulations were performed for all IAs using the above three models. Velocity, wall shear stress (WSS) and residual flow volume (RFV) were calculated and compared in order to assess the model differences for both aneurysm sac and parent vessel regions. Read More

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http://jnis.bmj.com/lookup/doi/10.1136/neurintsurg-2018-0142
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http://dx.doi.org/10.1136/neurintsurg-2018-014218DOI Listing
February 2019
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Using machine learning to optimize selection of elderly patients for endovascular thrombectomy.

J Neurointerv Surg 2019 Feb 2. Epub 2019 Feb 2.

Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA.

Background: Endovascular thrombectomy (ET) is the standard of care for treatment of acute ischemic stroke (AIS) secondary to large vessel occlusion. The elderly population has been under-represented in clinical trials on ET, and recent studies have reported higher morbidity and mortality in elderly patients than in their younger counterparts.

Objective: To use machine learning algorithms to develop a clinical decision support tool that can be used to select elderly patients for ET. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014381DOI Listing
February 2019
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Visual assessment of diffusion weighted imaging infarct volume lacks accuracy and reliability.

J Neurointerv Surg 2019 Feb 2. Epub 2019 Feb 2.

Department of Interventional Neuroradiology, Fondation Rothschild Hospital, Paris, France.

Purpose: The DAWN trial (Diffusion weighted imaging or CT perfusion Assessment with clinical mismatch in the triage of Wake-up and late presenting strokes undergoing Neurointervention with Trevo) has demonstrated the benefits of thrombectomy in patients with unknown or late onset strokes, using automated software (RAPID) for measurement of infarct volume. Because RAPID is not available in all centers, we aimed to assess the accuracy and repeatability of visual infarct volume estimation by clinicians and the consequences for thrombectomy decisions based on the DAWN criteria.

Materials And Methods: 18 physicians, who routinely depend on MRI for acute stroke imaging, assessed 32 MR scans selected from a prospective databaseover two independent sessions. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014613DOI Listing
February 2019
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Effect of balloon guide catheter on clinical outcomes and reperfusion in Trevo thrombectomy.

J Neurointerv Surg 2019 Feb 2. Epub 2019 Feb 2.

Departments of Endovascular Neurosurgery and Stroke, St Vincent Mercy Medical Center, Toledo, Ohio, USA.

Introduction: The Solitaire stent retriever registry showed improved reperfusion, faster procedure times, and better outcome in acute stroke patients with large vessel occlusion treated with a balloon guide catheter (BGC) and Solitaire stent retriever compared with a conventional guide catheter. The goal of this study was to evaluate whether use of a BGC with the Trevo stent retriever improves outcomes compared with a conventional guide catheter.

Methods: The TRACK registry recruited 23 sites to submit demographic, clinical, and site adjudicated angiographic and outcome data on consecutive patients treated with the Trevo stent retriever. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014452DOI Listing
February 2019
3 Reads