Arteriovenous Malformations in the Pediatric Population: Review of the Existing Literature
Arteriovenous malformations (AVMs) in the pediatric population are relatively rare but reportedly carry a higher rate of rupture than in adults. This could be due to the fact that most pediatric AVMs are only detected after rupture. We aimed to review the current literature regarding the natural history and the clinical outcome after multimodality AVM treatment in the pediatric population, as optimal management for pediatric AVMs remains controversial. A multidisciplinary approach using multimodality therapy if needed has been proved to be beneficial in approaching these lesions in all age groups. Microsurgical resection r...
Source: Interventional Neurology - August 31, 2016 Category: Neurology Source Type: research
Improving the Evaluation of Collateral Circulation by Multiphase Computed Tomography Angiography in Acute Stroke Patients Treated with Endovascular Reperfusion Therapies
Good collateral circulation (CC) is associated with favorable outcomes in acute stroke, but the best technique to evaluate collaterals is controversial. Single-phase computed tomography angiography (sCTA) is widely used but lacks temporal resolution. We aim to compare CC evaluation by sCTA and multiphase CTA (mCTA) as predictors of outcome in endovascular treated patients.Methods: Consecutive endovascular treated patients with M1 middle cerebral artery (MCA) or terminal intracranial carotid artery (TICA) occlusion confirmed by sCTA were included. Two more CTA acquisitions with 8- and 16-second delays were performed for mCT...
Source: Interventional Neurology - August 31, 2016 Category: Neurology Source Type: research
Erratum
Intervent Neurol 2016;5:193 (Source: Interventional Neurology)
Source: Interventional Neurology - August 23, 2016 Category: Neurology Source Type: research
The Role of Catheter Angiography in the Diagnosis of Central Nervous System Vasculitis
Background: Central nervous system vasculitis (CNSV) is a rare disorder, the pathophysiology of which is not fully understood. It involves a combination of inflammation and thrombosis. CNSV is most commonly associated with headache, gradual changes in mental status, and focal neurological symptoms. Diagnosis requires the effective use of history, laboratory testing, imaging, and biopsy. Catheter angiography can be a powerful tool in the diagnosis when common and low-frequency angiographic manifestations of CNSV are considered. We review these manifestations and their place in the diagnostic algorithm of CNSV.Summary: We re...
Source: Interventional Neurology - August 11, 2016 Category: Neurology Source Type: research
Internal Carotid Artery S-Shaped Curve as a Marker of Fibromuscular Dysplasia in Dissection-Related Acute Ischemic Stroke
Conclusion: S-shaped ICA curves are predictably bilateral, highly associated with carotid dissections in patients with moderate to severe strokes, and may suggest an underlying presence of FMD.Intervent Neurol 2016;5:185-192 (Source: Interventional Neurology)
Source: Interventional Neurology - July 15, 2016 Category: Neurology Source Type: research
Functional Independence following Endovascular Treatment for Basilar Artery Occlusion despite Extensive Bilateral Pontine Infarcts on Diffusion-Weighted Imaging: Refuting a Self-Fulfilling Prophecy
Conclusion: Extensive bilateral pontine DWI lesions among patients with BAO are not an unequivocal indicator of poor prognosis. We advise strong caution when considering these findings in the treatment decision algorithm.Intervent Neurol 2016;5:179-184 (Source: Interventional Neurology)
Source: Interventional Neurology - July 14, 2016 Category: Neurology Source Type: research
Is Intra-Arterial Treatment for Acute Ischemic Stroke Less Effective in Women than in Men
Conclusion: Contrary to other studies, we found a significant interaction between sex and treatment effect in the MR CLEAN trial. Pooled analyses of all published thrombectomy trials did not confirm this finding. In MR CLEAN, women seem to have a slightly more unfavorable profile, causing higher mortality and more serious adverse events, but insufficient to explain the absence of an overall effect. This suggests a play of chance and makes it clear that IAT should not be withheld in women.Intervent Neurol 2016;5:174-178 (Source: Interventional Neurology)
Source: Interventional Neurology - July 5, 2016 Category: Neurology Source Type: research
Is Intra-Arterial Treatment for Acute Ischemic Stroke Less Effective in Women than in Men?
Conclusion: Contrary to other studies, we found a significant interaction between sex and treatment effect in the MR CLEAN trial. Pooled analyses of all published thrombectomy trials did not confirm this finding. In MR CLEAN, women seem to have a slightly more unfavorable profile, causing higher mortality and more serious adverse events, but insufficient to explain the absence of an overall effect. This suggests a play of chance and makes it clear that IAT should not be withheld in women.Intervent Neurol 2016;5:174-178 (Source: Interventional Neurology)
Source: Interventional Neurology - July 4, 2016 Category: Neurology Source Type: research
Local Fibrinolysis in Spontaneous Supratentorial Hematomas: Comparison with Surgical and Medical Treatment
Conclusions: The study demonstrated the applicability of minimally invasive craniopuncture with local fibrinolysis for the management of supratentorial SICHs and the advantages it may have in certain categories of patients. The method proved particularly useful in lobar SICHs, being associated with the lowest mortality. Mixed SICHs do not represent a predilection for surgical interventions; however, the results related to mixed supratentorial locations need confirmation in larger cohorts.Intervent Neurol 2016;5:165-173 (Source: Interventional Neurology)
Source: Interventional Neurology - June 30, 2016 Category: Neurology Source Type: research
Clopidogrel plus Aspirin for Symptomatic Intracranial Atherosclerotic Stenosis: A Pilot Study
Conclusion: A prolonged course of dual antiplatelet therapy for symptomatic intracranial atherosclerotic disease may be associated with less vascular events with no increase in hemorrhagic complications.Intervent Neurol 2016;5:157-164 (Source: Interventional Neurology)
Source: Interventional Neurology - June 27, 2016 Category: Neurology Source Type: research
Treatment Strategies for Acute Ischemic Stroke Caused by Carotid Artery Occlusion
Background: Acute ischemic stroke caused by internal carotid artery (ICA) occlusion usually has a poor prognosis, especially the T occlusion cases without functional collaterals. The efficacy of intravenous (IV) or intra-arterial (IA) thrombolysis with recombinant tissue plasminogen activator (rt-PA) remains ambiguous in these patients. Eendovascular recanalization of the occluded carotid has been attempted in recent years as a potential strategy. However, the different etiologies of ICA occlusion pose a significant challenge to neurointerventionists. Recently, several endovascular evolvements have been reported in treatin...
Source: Interventional Neurology - June 27, 2016 Category: Neurology Source Type: research
CBV_ASPECTS Improvement over CT_ASPECTS on Determining Irreversible Ischemic Lesion Decreases over Time
Conclusions: In acute stroke, CBV_ASPECTS correlates with the final infarct volume. However, when CT is performed after 120 min from symptom onset, CBV_ASPECTS does not add relevant information to CT_ASPECTS.Intervent Neurol 2016;5:140-147 (Source: Interventional Neurology)
Source: Interventional Neurology - June 27, 2016 Category: Neurology Source Type: research
Visual Improvement after Intra-Arterial Thrombolysis for Central Retinal Artery Occlusion Does Not Correlate with Time to Treatment
Conclusion: The visual improvement observed in this series had no relationship to the time from symptom onset to treatment with IAT. This suggests that patients may have the possibility for improvement even with delayed presentation to the neurointerventionalist. Other factors, such as completeness of retinal occlusion, may be more important than time to treatment. Additional studies to determine optimal patient selection criteria for the endovascular treatment of acute CRAO are needed.Intervent Neurol 2016;5:131-139 (Source: Interventional Neurology)
Source: Interventional Neurology - June 16, 2016 Category: Neurology Source Type: research
Recanalization and Angiographic Reperfusion Are Both Associated with a Favorable Clinical Outcome in the IMS III Trial
Conclusion: Reperfusion (mTICI) and recanalization (AOL) predicted a favorable clinical outcome with comparable accuracy in ischemic stroke participants treated with EVT. Optimal revascularization goals to maximize clinical outcome (modified Rankin Scale score of 0-2) consisted of complete recanalization (AOL 3) and reperfusion of at least 50% of the arterial tree of the symptomatic artery (mTICI 2b/3) in the IMS III trial setting.Intervent Neurol 2016;5:118-122 (Source: Interventional Neurology)
Source: Interventional Neurology - June 15, 2016 Category: Neurology Source Type: research
Safety Outcomes Using a Proximal Protection Device in Carotid Stenting of Long Carotid Stenoses
Conclusion: In our patient cohort, it was found that a proximal embolic protection device is safe for patients with carotid stenosis, including those with a carotid lesion length >10 mm and/or angiographic string sign.Intervent Neurol 2016;5:123-130 (Source: Interventional Neurology)
Source: Interventional Neurology - June 15, 2016 Category: Neurology Source Type: research
