2,099 results match your criteria Journal of neurointerventional surgery[Journal]


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 Feb 13. 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
February 2019

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
1 Read

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

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
2 Reads

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
1 Read

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

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

Cumulative incidence of restenosis in the endovascular treatment of extracranial carotid artery stenosis: a meta-analysis.

J Neurointerv Surg 2019 Jan 31. Epub 2019 Jan 31.

CHU Limoges, Centre d'Epidémiologie de Biostatistique et de Méthodologie de la Recherche, Limoges, France.

Objective: To assess the cumulative incidence of restenosis and stroke after stenting for cervical carotid artery stenosis.

Methods: We reviewed PubMed, ScienceDirect, and Scopus and included all studies reporting restenosis after stenting. The cumulative incidence of restenosis at 6 and 12 months was calculated. Read More

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http://jnis.bmj.com/lookup/doi/10.1136/neurintsurg-2018-0145
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http://dx.doi.org/10.1136/neurintsurg-2018-014534DOI Listing
January 2019
7 Reads

Firstline a direct aspiration first pass technique versus firstline stent retriever for acute basilar artery occlusion: a systematic review and meta-analysis.

J Neurointerv Surg 2019 Jan 28. Epub 2019 Jan 28.

Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Beijing, China.

Introduction: Acute basilar artery occlusion (BAO) can result in extremely high disability and mortality. Stent retrievers (SRs) can achieve a high recanalization rate for BAO, therefore improving favorable outcomes. However, the efficacy of a direct aspiration first pass technique (ADAPT) to treat BAO is unclear. Read More

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http://jnis.bmj.com/lookup/doi/10.1136/neurintsurg-2018-0145
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http://dx.doi.org/10.1136/neurintsurg-2018-014573DOI Listing
January 2019
4 Reads

MRI SPACE sequence confirmation of occluded MCA M2 dissection stump masquerading as a ruptured MCA aneurysm.

J Neurointerv Surg 2019 Jan 24. Epub 2019 Jan 24.

Department of Neurosurgery, University of Louisville School of Medicine, Louisville, Kentucky, USA.

Intracranial vascular pathologies often have overlapping clinical presentations. Dissected vessel occlusions and bifurcation aneurysms can appear similar on pretherapeutic imaging. The medical management of these two entities is drastically different. Read More

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http://jnis.bmj.com/lookup/doi/10.1136/neurintsurg-2018-0139
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http://dx.doi.org/10.1136/neurintsurg-2018-013996.repDOI Listing
January 2019
2 Reads

Rotational carotid insufficiency: an unusual cause of bow hunter's syndrome.

J Neurointerv Surg 2019 Jan 23. Epub 2019 Jan 23.

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

We report an unusual case in which physiologic neck rotation impeded perfusion through the internal carotid artery. The patient had a history of prior radical neck surgery and radiation for malignancy. He presented withbow hunter's-like symptoms with transient loss of consciousness and right-sided weakness with left lateral neck rotation. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014210.repDOI Listing
January 2019

A2, M2, P2 aneurysms and beyond: results of treatment with pipeline embolization device in 65 patients.

J Neurointerv Surg 2019 Jan 23. Epub 2019 Jan 23.

Department of Neurosurgery, University of South Florida, Tampa, Florida, USA.

Background: Intracranial aneurysms located in the distal vessels are rare and remain a challenge to treat through surgical or endovascular interventions.

Objective: To describe a multicenter approach with flow diversion using the pipeline embolization device (PED) for treatment of distal intracranial aneurysms.

Methods: Cases of distal intracranial aneurysms defined as starting on or beyond the A2 anterior cerebral artery, M2 middle cerebral artery, and P2 posterior cerebral artery segments were included in the final analysis. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014631DOI Listing
January 2019

WEB embolization versus stent-assisted coiling: comparison of complication rates and angiographic outcomes.

J Neurointerv Surg 2019 Jan 23. Epub 2019 Jan 23.

Department of Neuroradiology, University Hospital Munich (LMU), Munich, Germany.

Background: Intrasaccular flow disruption represents a new paradigm in endovascular treatment of wide-necked bifurcation aneurysms.

Objective: To perform a matched case-control study comparing complications and angiographic outcome using the Woven Endobridge (WEB) device and stent-assisted coiling (SAC).

Methods: Sixty-six patients treated with the WEB at three German tertiary care centers were included and matched with 66 patients treated with SAC based on aneurysm location and unruptured/ruptured aneurysm status. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014555DOI Listing
January 2019
3 Reads

Validation of an extrinsic compression and early ambulation protocol after diagnostic transfemoral cerebral angiography: a 5-year prospective series.

J Neurointerv Surg 2019 Jan 23. Epub 2019 Jan 23.

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

Background And Purpose: Access-site complications constitute a substantial portion of the morbidity associated with transfemoral cerebral angiography, yet no standardized protocol exists for femoral closure and practice patterns vary widely. The objective of this single-arm prospective cohort study was to validate the efficacy and safety of a standardized femoral closure strategy for all diagnostic angiography, regardless of antiplatelet regimen.

Methods: A single-arm, prospective study was designed enrolling consecutive patients undergoing diagnostic transfemoral cerebral angiography by a single neurointerventional surgeon from March 2013 - March 2018. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014572DOI Listing
January 2019
3 Reads

SEIMLESS: Simultaneous Extracranial, Intracranial Management of (tandem) LESsions in Stroke.

J Neurointerv Surg 2019 Jan 23. Epub 2019 Jan 23.

St Vincent Mercy Medical Center, Toledo, Ohio, USA.

Background: Pooled individual data from the landmark stroke trials of 2015 conclude that the benefit of endovascular thrombectomy for patients with intracranial arterial occlusion also extends to patients with concomitant (so-called 'tandem') occlusions of proximal vessels. However, there is heterogeneity and debate in the management of these patients, without a clear standard of care. In particular, there is contention regarding whether the proximal or distal lesion should be treated first. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014403DOI Listing
January 2019
1 Read

Racial and economic disparities in the access to treatment of unruptured intracranial aneurysms are persistent problems.

J Neurointerv Surg 2019 Jan 23. Epub 2019 Jan 23.

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

Background And Purpose: Previous studies have documented disparate access to cerebrovascular neurosurgery for patients of different racial and socioeconomic backgrounds. We further investigated the effect of race and insurance status on access to treatment of unruptured intracranial aneurysms (UIAs) and compared it with data on patients with aneurysmal subarachnoid hemorrhage (aSAH).

Methods: Through the use of a national database, admissions for clipping or coiling of an UIA and for aSAH were identified. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014626DOI Listing
January 2019

Treatment of broad-based intracranial aneurysms with low profile braided stents: a single center analysis of 101 patients.

J Neurointerv Surg 2019 Jan 23. Epub 2019 Jan 23.

Department of Neuroradiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

Background And Purpose: Low profile braided stents have facilitated the endovascular treatment of broad-based intracranial aneurysms.

Methods: Between 2013 and June 2018, we attempted 104 Leo baby stent placements in 101 patients. Locations were the anterior communicating artery (AcomA) (37 aneurysms, 35. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014488DOI Listing
January 2019
2 Reads

Significance of simulated conventional images on dual energy CT after endovascular treatment for ischemic stroke.

J Neurointerv Surg 2019 Jan 22. Epub 2019 Jan 22.

Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, Japan.

Background And Purpose: CT scans often reveal post-interventional cerebral hyperdensities (PCHDs) immediately after intra-arterial thrombectomy (IAT) for ischemic stroke. Dual energy CT (DE-CT) can indicate whether PCHDs are caused by hemorrhage or iodinated contrast. Hyperdense lesions, detected on DE-CT with the use of iodinated contrast, could be associated with delayed hemorrhagic transformation and poor outcome. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014486DOI Listing
January 2019

Neuroform Atlas Stent System for the treatment of intracranial aneurysm: primary results of the Atlas Humanitarian Device Exemption cohort.

J Neurointerv Surg 2019 Jan 22. Epub 2019 Jan 22.

Neuroscience Department, Bon Secours Mercy Health St Vincent Medical Center, Toledo, USA.

Background And Objective: Stent-assisted coil embolization is a well-established treatment of intracranial wide-necked aneurysms. The Neuroform Atlas Stent System is a new generation microstent designed to enhance coil support, conformability, deliverability, and improve deployment accuracy. We present the 1-year efficacy and angiographic results of the Humanitarian Device Exemption (HDE) cohort from the Atlas Investigational Device Exemption (IDE) clinical trial. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014455DOI Listing
January 2019

Quantification of hemodynamic irregularity using oscillatory velocity index in the associations with the rupture status of cerebral aneurysms.

J Neurointerv Surg 2019 Jan 22. Epub 2019 Jan 22.

Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Japan.

Background: Complex and unstable flow patterns are reported to be associated with the rupture status of cerebral aneurysms, while their evaluation depends on qualitative analysis of streamlines of bloodflow. Oscillatory velocity index (OVI) is a hemodynamic parameter to quantify flow patterns. The aim of this study is to elucidate the associations between OVI and the rupture status of cerebral aneurysms. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014489DOI Listing
January 2019
1 Read

Transradial versus transfemoral access for anterior circulation mechanical thrombectomy: comparison of technical and clinical outcomes.

J Neurointerv Surg 2019 Jan 22. Epub 2019 Jan 22.

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

Background: A transradial approach (TRA) is associated with fewer access site complications than a transfemoral technique (TFA).However, there is concern that performing mechanical thrombectomy (MT) via TRA may lead to longer revascularization times and thus worse outcomes. Nonetheless, TRA may confer added benefits in MT since navigation of challenging aortic arch and carotid anatomy is often facilitated by a right radial artery trajectory. Read More

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http://jnis.bmj.com/lookup/doi/10.1136/neurintsurg-2018-0144
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http://dx.doi.org/10.1136/neurintsurg-2018-014485DOI Listing
January 2019
4 Reads

Transradial approach for flow diversion treatment of cerebral aneurysms: a multicenter study.

J Neurointerv Surg 2019 Jan 22. Epub 2019 Jan 22.

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

Background: The transradial approach (TRA) to endovascular procedures decreases access site morbidity and mortality in comparison with the traditional transfemoral technique (TFA). Despite its improved safety profile, there is a concern that TRA is less favorable for neurointerventional procedures that require large coaxial systems to manage the small tortuous cerebral vessels.

Objective: To report our experience with TRA for flow diverter placement for treatment of unruptured cerebral aneurysms. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014620DOI Listing
January 2019

Social media and predictors of traditional citations: insights from the Journal of Neurointerventional Surgery.

J Neurointerv Surg 2019 Feb;11(2):99-100

Department of Neurological Surgery, Wake Forest University, Winston-Salem, North Carolina, USA.

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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-2018-014689DOI Listing
February 2019
2 Reads

Characterization of strut indentation during mechanical thrombectomy in acute ischemic stroke clot analogs.

J Neurointerv Surg 2019 Jan 19. Epub 2019 Jan 19.

Cerenovus, Galway Neuro Technology Centre, Galway, Ireland.

Background: Although it is common practice to wait for an 'embedding time' during mechanical thrombectomy (MT) to allow strut integration of a stentriever device into an occluding thromboembolic clot, there is a scarcity of evidence demonstrating the value or optimal timing for the wide range of thrombus compositions. This work characterizes the behavior of clot analogs of varying fibrin and cellular compositions subject to indentation forces and embedding times representative of those imparted by a stentriever during MT. The purpose of this study is to quantify the effect of thrombus composition on device strut embedding, and to examine the precise nature of clot integration into a stentriever device at a microstructural level. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014601DOI Listing
January 2019

The 100 most cited articles in the endovascular management of acute ischemic stroke.

J Neurointerv Surg 2019 Jan 17. Epub 2019 Jan 17.

Department of Radiology, Austin Health, Interventional Radiology Service, Heidelberg, Victoria, Australia.

Background And Purpose: Endovascular thrombectomy (EVT) has revolutionized the management of acute ischemic stroke. Landmark clinical trials have shown EVT to be one of the most efficacious interventions in clinical medicine over the past 5 years. A method of recognition for an article in the scientific community is to use a citation rank list, in order to identify the seminal works in the academic medical literature. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014600DOI Listing
January 2019
1 Read

Validation studies of virtual reality simulation performance metrics for mechanical thrombectomy in ischemic stroke.

J Neurointerv Surg 2019 Jan 17. Epub 2019 Jan 17.

Faculty of Life and Health Sciences, Ulster University, Londonderry, UK.

Introduction: Mechanical thrombectomy (MT) has transformed the treatment of ischemic stroke. However, patient access to MT may be limited due to a shortage of doctors specifically trained to perform MT. The studies reported here were done to (1) develop, operationally define, and seek consensus from procedure experts on the metrics which best characterize a reference procedure for the performance of an MT for ischemic stroke and (2) evaluate their construct validity when implemented in a virtual reality (VR) simulation. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014510DOI Listing
January 2019
1 Read

Comparative analysis of coil embolization in posterior and anterior communicating artery aneurysms.

J Neurointerv Surg 2019 Jan 17. Epub 2019 Jan 17.

Department of Radiology, Korea Veterans Hospital Medical Center, Seoul, The Republic of Korea.

Background: Recanalization rates after coil embolization are known to be higher in cerebral aneurysms of the posterior (vs anterior) circulation. Although often grouped with anterior lesions, aneurysms of the posterior communicating artery (PcoA) may nevertheless behave differently.

Objective: We performed a comparative analysis to explore differences in recanalization rates of PcoA and anterior communicating artery (AcoA) aneurysms, both integral to the circle of Willis. Read More

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http://jnis.bmj.com/lookup/doi/10.1136/neurintsurg-2018-0144
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http://dx.doi.org/10.1136/neurintsurg-2018-014490DOI Listing
January 2019
5 Reads

Safety and efficiency of the fifth generation Woven EndoBridge device: technical note.

J Neurointerv Surg 2019 Jan 17. Epub 2019 Jan 17.

Department of Interventional Neuroradiology Neuro Brain Vascular Center, Hopital Bicetre, APHP, Paris Sud Université, Le Kremlin-Bicetre, Île-de-France, France.

Backround: The treatment of wide neck bifurcation aneurysms remains challenging despite the introduction of new techniques (Y stenting, waffle cone technique, or flow diverter stents). The Woven EndoBridge (WEB) device is an innovative solution for this type of cerebral aneurysm. A new WEB 17 is now available and has been designed to offer smaller sized devices to optimize navigability and delivery. Read More

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http://jnis.bmj.com/lookup/doi/10.1136/neurintsurg-2018-0143
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http://dx.doi.org/10.1136/neurintsurg-2018-014343DOI Listing
January 2019
5 Reads

Anatomical characterization of the inferior petrosal sinus and adjacent cerebellopontine angle cistern for development of an endovascular transdural cerebrospinal fluid shunt.

J Neurointerv Surg 2019 Jan 9. Epub 2019 Jan 9.

Department of Neurosurgery, Tufts Medical Center, Boston, Massachusetts, USA.

Background And Purpose: We evaluated the inferior petrosal sinus (IPS) and adjacent cerebellopontine angle (CPA) cistern as a potential implantation site for a novel venous endovascular transdural CSF shunt concept to treat communicating hydrocephalus. We analyzed the dimensions of the IPS, CPA cistern, and distances to adjacent neurovascular structures.

Materials And Methods: Gadolinium enhanced T1 weighted brain MRI datasets of 36 randomly selected patients, aged 20-80 years, were analyzed with three-dimensional multiplanar reconstruction to measure IPS diameter and length, CPA cistern depth, and IPS proximity to the vertebrobasilar arteries and brainstem. Read More

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http://jnis.bmj.com/lookup/doi/10.1136/neurintsurg-2018-0144
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http://dx.doi.org/10.1136/neurintsurg-2018-014445DOI Listing
January 2019
1 Read

Minimally invasive endoscopic hematoma evacuation vs best medical management for spontaneous basal-ganglia intracerebral hemorrhage.

J Neurointerv Surg 2019 Jan 7. Epub 2019 Jan 7.

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

Background: We conducted a case-control study to assess the relative safety and efficacy of minimally invasive endoscopic surgery (MIS) for clot evacuation in patients with basal-ganglia intracerebral hemorrhage (ICH).

Methods: We evaluated consecutive patients with acute basal-ganglia ICH at a single center over a 42-month period. Patients received either best medical management according to established guidelines (controls) or MIS (cases). Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014447DOI Listing
January 2019
1 Read

Effect of routing paradigm on patient centered outcomes in acute ischemic stroke.

J Neurointerv Surg 2019 Jan 4. Epub 2019 Jan 4.

Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri, USA.

Background: To compare performance of routing paradigms for patients with acute ischemic stroke using clinical outcomes.

Methods: We simulated different routing paradigms in a system comprising one primary stroke center (PSC) and one comprehensive stroke center (CSC), separated by distances representative of urban, suburban, and rural environments. In the nearest center paradigm, patients are initially sent to the nearest center, while in CSC first, patients are sent to the CSC. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014537DOI Listing
January 2019

Efficacy of 'drive and retrieve' as a cooperative method for prompt endovascular treatment for acute ischemic stroke.

J Neurointerv Surg 2019 Jan 4. Epub 2019 Jan 4.

Department of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.

Background: Outcomes of endovascular treatment for acute ischemic stroke depend on the time interval from onset to reperfusion. Although the centralized 'mothership' method is considered preferable, the required transportation time increases the risk that a patient with a stroke may not receive intravenous or endovascular therapy. In contrast, 'drive and retrieve' describes a system wherein doctors from comprehensive stroke centers travel to primary stroke centers and provide endovascular treatment for acute ischemic stroke. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014296DOI Listing
January 2019

Outcomes of Multimodality In situ Recanalization in Hybrid Operating Room (MIRHOR) for symptomatic chronic internal carotid artery occlusions.

J Neurointerv Surg 2019 Jan 4. Epub 2019 Jan 4.

Department of Neurosurgery, Beijing Tiantan Hospital Capital Medical University, Beijing, China.

Background: An in situ recanalization procedure of endovascular therapy (ET) or carotid endarterectomy (CEA) has been attempted in patients with symptomatic chronic internal carotid artery occlusions (ICAOs), though the recanalization rates of both are low.

Objective: To investigate the outcomes of Multimodality In situ Recanalization for ICAOs in a Hybrid Operating Room (MIRHOR) at the same session.

Methods: Symptomatic chronic ICAOs were classified into type A or B (short occlusion with or without a tapered residual root [TRR]), and C or D (long occlusion with or without TRR), and managed in a hybrid operating room with ET, CEA, or both, as needed. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014384DOI Listing
January 2019
1 Read

Stent-assisted coiling of cerebral aneurysms using the Y-stenting technique: a systematic review and meta-analysis.

J Neurointerv Surg 2019 Jan 4. Epub 2019 Jan 4.

Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA.

Background: Bifurcation aneurysms can be treated with stent-assisted coiling using two stents in a Y-configuration. We aim to investigate the angiographic and clinical outcomes of Y-stent constructs for the treatment of intracranial aneurysms.

Methods: A systematic review of PubMed, Ovid MEDLINE, and Ovid EMBASE databases was conducted based on PRISMA guidelines. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014517DOI Listing
January 2019

Utilization rates of tissue plasminogen activator and mechanical thrombectomy in patients with acute stroke and underlying malignancy.

J Neurointerv Surg 2019 Jan 2. Epub 2019 Jan 2.

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

Objective: Relatively little is known about the effect of malignancy on patient outcomes after acute ischemic stroke (AIS) or utilization rates of stroke interventions in this population. We aimed to assess the effect of underlying malignancy on outcomes and treatment of AIS at a population level.

Methods: Outcomes after AIS between patients with and without malignancy were compared using a national database of hospital reported outcomes. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014480DOI Listing
January 2019

Curative endovascular treatment for low-grade Spetzler-Martin brain arteriovenous malformations: a single-center prospective study.

J Neurointerv Surg 2019 Jan 2. Epub 2019 Jan 2.

Department of Interventional Neuroradiology, "Dupuytren" University Hospital, Limoges, France.

Background: The treatment of low grade Spetzler-Martin (SM) brain arteriovenous malformations (AVMs) has been debated in unruptured cases. Nevertheless, in clinical practice there are cases where treatment is preferred; in these cases a very low complication rate is mandatory. In ruptured cases, early and complete obliteration of the nidus is the preferred strategy. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014390DOI Listing
January 2019
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Balloon-assisted tracking technique to overcome intracranial stenosis during thrombectomy for stroke.

J Neurointerv Surg 2018 Dec 22. Epub 2018 Dec 22.

Department of Interventional Neuroradiology, NYU Langone Medical Center, New York City, New York, USA.

Anatomical vessel obstacles such as an intracranial stenosis in stroke are challenging and may lead to delayed clot access for thrombectomy. We describe a simple and effective technique to overcome the step-off between the intermediate catheter and an intracranial vessel stenosis during thrombectomy. The patient presented with acute embolic left middle cerebral artery occlusion and a favorable penumbral pattern. 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-2018-014275.repDOI Listing
December 2018
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Revalidation of the RACE scale after its regional implementation in Catalonia: a triage tool for large vessel occlusion.

J Neurointerv Surg 2018 Dec 22. Epub 2018 Dec 22.

Hospital Germans Trias i Pujol, Badalona, Spain.

Background And Purpose: Our aim was to revalidate the RACE scale, a prehospital tool that aims to identify patients with large vessel occlusion (LVO), after its region-wide implementation in Catalonia, and to analyze geographical differences in access to endovascular treatment (EVT).

Methods: We used data from the prospective CICAT registry (Stroke Code Catalan registry) that includes all stroke code activations. The RACE score evaluated by emergency medical services, time metrics, final diagnosis, presence of LVO, and type of revascularization treatment were registered. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014519DOI Listing
December 2018

Beam hardening artifacts of liquid embolic agents: comparison between Squid and Onyx.

J Neurointerv Surg 2018 Dec 19. Epub 2018 Dec 19.

Interventional Neuroradiology Department, Strasbourg University Hospitals, Strasbourg, France.

Background: Initial clinical experience with Squid shows subjectively reduced artifacts on post-embolization CT scans compared with Onyx. To further investigate these observations, we aimed to perform a comparison of artifacts between Squid and Onyx in a controlled in vitro model.

Materials And Methods: Onyx 18 and all four variants of Squid (Squid 18, Squid 18 low density (LD), Squid 12, Squid 12 LD) were each injected in dimethylsulfoxide (DMSO) compatible test tubes. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014542DOI Listing
December 2018
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Happy New Year.

J Neurointerv Surg 2019 Jan;11(1):1-2

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http://dx.doi.org/10.1136/neurintsurg-2018-014616DOI Listing
January 2019

Stent-screw-assisted internal fixation: the SAIF technique to augment severe osteoporotic and neoplastic vertebral body fractures.

J Neurointerv Surg 2018 Dec 14. Epub 2018 Dec 14.

Department of Neuroradiology, Papa Giovanni XXIII Hospital, Bergamo, Italy.

Objectives: To describe a new technique to obtain minimally invasive but efficient vertebral body (VB) reconstruction, augmentation, and stabilization in severe osteoporotic and neoplastic fractures, combining two pre-existing procedures. The implant of vertebral body stents (VBS) is followed by insertion of percutaneous, fenestrated, cement-augmented pedicular screws that act as anchors to the posterior elements for the cement/stent complex. The screws reduce the risk of stent mobilization in a non-intact VB cortical shell and bridge middle column and pedicular fractures. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014481DOI Listing
December 2018
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Safety and efficacy of cangrelor in acute stenting for the treatment of cerebrovascular pathology: preliminary experience in a single-center pilot study.

J Neurointerv Surg 2018 Dec 14. Epub 2018 Dec 14.

Lyerly Neurosurgery, Baptist Neurological Institute, Baptist Health, Jacksonville, Florida, USA.

Background: Treatment of acute cerebrovascular pathology, such as acute ischemic stroke or intracranial aneurysms, presents a challenge if an extracranial or intracranial stent is required; immediate platelet inhibition is vital. To date, there is no standardized approach for antiplatelet inhibition in an acute setting.

Objective: To report our preliminary experience and lessons learnt using cangrelor in acute neurointervention. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014396DOI Listing
December 2018
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Pipeline shield with single antiplatelet therapy in aneurysmal subarachnoid haemorrhage: multicentre experience.

J Neurointerv Surg 2018 Dec 14. Epub 2018 Dec 14.

Institute of Neurological Sciences, Prince of Wales Hospital, Randwick, New South Wales, Australia.

Background: The Pipeline Embolisation Device with Shield technology (PED-Shield) is suggested to have reduced thrombogenicity. This reduced thrombogenicity may make it possible to use safely in the acute treatment of aneurysmal subarachnoid haemorrhage (aSAH) on single antiplatelet therapy (SAPT).

Objective: To evaluate the safety and efficacy of the off-label use of PED-Shield with SAPT for the acute treatment of aSAH. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014363DOI Listing
December 2018

The most mentioned neurointervention articles in online media: a bibliometric analysis of the top 101 articles with the highest altmetric attention scores.

J Neurointerv Surg 2018 Dec 11. Epub 2018 Dec 11.

Department of Neurosurgery, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, Korea.

Background And Purpose: Alternative metrics (altmetrics), based on mentions in online media, is a new tool that can help to identify the most influential articles to diverse public audiences. This article aimed to determine the 100 most mentioned articles in the field of neurointervention and to analyze their characteristics.

Materials And Methods: We selected the 808 journals that were considered journals potentially publishing articles on neurointervention. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014368DOI Listing
December 2018

Prognostic importance of CT ASPECTS and CT perfusion measures of infarction in anterior emergent large vessel occlusions.

J Neurointerv Surg 2018 Dec 7. Epub 2018 Dec 7.

Department of Neurology, Emory University, Atlanta, Georgia, USA.

Background: Age, neurologic deficits, core volume (CV), and clinical core or radiographic mismatch are considered in selection for endovascular therapy (ET) in anterior circulation emergent large vessel occlusion (aELVO). Semiquantitative CV estimation by Alberta Stroke Programme Early CT Score (CT ASPECTS) and quantitative CV estimation by CT perfusion (CTP) are both used in selection paradigms.

Objective: To compare the prognostic value of CTP CV with CT ASPECTS in aELVO. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014461DOI Listing
December 2018
4 Reads

First attempt recanalization with ADAPT: rate, predictors, and outcome.

J Neurointerv Surg 2018 Dec 7. Epub 2018 Dec 7.

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

Introduction: The rate of first-attempt recanalization (FAR) with the newer-generation thrombectomy devices, and more specifically with aspiration devices, is not well known. Moreover, the effect of FAR on outcomes after mechanical thrombectomy is not properly understood.

Objective: To report the rate of FAR using a direct aspiration first pass technique (ADAPT), investigate the association between FAR and outcomes, and identify the predictors of FAR. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014294DOI Listing
December 2018
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Preventing vessel perforations in endovascular thrombectomy: feasibility and safety of passing the clot with a microcatheter without microwire: the wireless microcatheter technique.

J Neurointerv Surg 2018 Dec 7. Epub 2018 Dec 7.

Department of Neuroradiology, University Hospital Aachen, Aachen, Germany.

Background: To place a stent retriever for thrombectomy in acute ischemic stroke, the clot has to be passed first. A microwire is usually used for this maneuver. As an alternative, a wireless microcatheter can be used to pass the clot. Read More

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http://jnis.bmj.com/lookup/doi/10.1136/neurintsurg-2018-0142
Publisher Site
http://dx.doi.org/10.1136/neurintsurg-2018-014267DOI Listing
December 2018
2 Reads