Septoplasty: Scepter Balloon Angioplasty for Vasospasm after Aneurysmal Subarachnoid Hemorrhage
Conclusion: The Scepter XC is a safe and effective balloon microcatheter for angioplasty of cerebral vasospasm after subarachnoid hemorrhage, allowing for superselective delivery of a vasodilator. Its ease of deliverability and visibility often allows for the performance of the procedure under i.v. conscious sedation.Intervent Neurol 2017;6:229-235 (Source: Interventional Neurology)
Source: Interventional Neurology - June 20, 2017 Category: Neurology Source Type: research
Optional Endovascular Therapy of Dissecting Posterior Cerebral Artery Aneurysm
We present here three cases collected from Maison Blanche Hospital (Intervention Neuroradiology Department, CHU Reims, France) during 2011-2012; they were females, at a young age and the affected side was on the right. The first case was affected at the P2-P3 segment, the aneurysm was fusiform in shape and she presented with ischemic stroke, while the second and third cases were affected at the P2 segment, the aneurysms being saccular in shape; one of them presented with subarachnoid hemorrhage with a history of migraine and the other patient presented with ischemic stroke. All of them had no history of trauma, hypertensio...
Source: Interventional Neurology - June 16, 2017 Category: Neurology Source Type: research
Internal Carotid Artery and the Proximal M1 Segment Are Optimal Targets for Mechanical Thrombectomy
Background and Purpose: Mechanical thrombectomy (MT) is an established treatment of acute anterior circulation stroke caused by large vessel occlusion (LVO). We compared the clinical outcome (3-month modified Rankin Scale, mRS) in hyperacute ( (Source: Interventional Neurology)
Source: Interventional Neurology - May 18, 2017 Category: Neurology Source Type: research
Comparison of Vacuum Pressures and Forces Generated by Different Catheters and Pumps for Aspiration Thrombectomy in Acute Ischemic Stroke
This report assesses the pressures and forces generated by different catheters and pumps.Methods: Vacuum pressures were measured using a vacuum gauge for several catheters (Stryker Catalyst6, Penumbra Ace 064, Medtronic Arc 061, and Penumbra 041) and pumps (Penumbra pump, 60-mL syringe, and the ASPIRE device). Suction forces were calculated based on pressure and catheter tip size (force = area × pressure). Vacuum pressures and forces were also assessed with a coaxial microcatheter (Rebar 18; inner diameter = 0.021 inches), mimicking a combined aspiration and stent retriever approach.Results: All catheters transmitted simi...
Source: Interventional Neurology - May 17, 2017 Category: Neurology Source Type: research
A Comparison of Mechanical Thrombectomy in the M1 and M2 Segments of the Middle Cerebral Artery: A Review of 585 Consecutive Patients
Background: Mechanical thrombectomy for anterior-circulation large-vessel occlusion has shown benefit; however, the question of whether this technique is safe and effective in the distal vasculature remains unanswered. We sought to compare the outcome data from mechanical thrombectomy of the M2 branches of the middle cerebral artery (MCA) with those of the M1 segment.Methods: We performed a retrospective analysis of prospectively collected data of patients with acute ischaemic stroke undergoing mechanical thrombectomy of isolated M1 or M2 branches of the MCA between August 2008 and August 2016.Results: We identified 585 pa...
Source: Interventional Neurology - May 12, 2017 Category: Neurology Source Type: research
Cost Analysis of the Addition of Hyperacute Magnetic Resonance Imaging for Selection of Patients for Endovascular Stroke Therapy
Background and Purpose: Patient selection is important to determine the best candidates for endovascular stroke therapy. In application of a hyperacute magnetic resonance imaging (MRI) protocol for patient selection, we have shown decreased utilization with improved outcomes. A cost analysis comparing the pre- and post-MRI protocol time periods was performed to determine if the previous findings translated into cost opportunities.Materials and Methods: We retrospectively identified individuals considered for endovascular stroke therapy from January 2008 to August 2012 who were ≤8 h from stroke symptoms onset. Patients pr...
Source: Interventional Neurology - May 4, 2017 Category: Neurology Source Type: research
Safety and Efficacy of Low-Profile, Self-Expandable Stents for Treatment of Intracranial Aneurysms: Initial and Midterm Results - A Systematic Review and Meta-Analysis
Low-profile stents seem to be associated with a higher incidence of thromboembolic events compared with preexisting stents. We conducted a systematic review of 11 eligible reports and a meta-analysis of 7 reports with respect to the clinical efficacy and safety of low-profile stents. There were 217 intracranial aneurysms reported; 22% were ruptured aneurysms. In all, 72% were treated using single stenting, 19% were treated using overlapping stenting, and 6% were treated using balloon angioplasty followed by stenting; 3% were used to assess the flow diverter effect in a dissecting aneurysm or were treated using unexpected s...
Source: Interventional Neurology - April 25, 2017 Category: Neurology Source Type: research
Feasibility of Real-Time Angiographic Perfusion Imaging in the Treatment of Cerebral Vasospasm
Background: Objective assessment and quantification of the severity of cerebral vasospasm following aneurysmal subarachnoid hemorrhage is not routinely utilized. We investigated the feasibility of angiographic perfusion imaging derived from digital subtraction angiography (DSA) following endovascular vasospasm treatment procedures.Methodology: Real-time blood flow analysis was performed using parametric color coding on pre- and postintervention DSA. Semiquantitative parenchymal perfusion parameters (arrival time [AT] of contrast, time to peak [TTP] opacification, and mean transit time [MTT] of contrast) were calculated acr...
Source: Interventional Neurology - April 19, 2017 Category: Neurology Source Type: research
Anchoring Pipeline Flow Diverter Construct in the Treatment of Traumatic Distal Cervical Carotid Artery Injury
We describe different techniques employed to anchor the flow-diverting construct within tortuous, mobile vessels.Intervent Neurol 2017;6:153-162 (Source: Interventional Neurology)
Source: Interventional Neurology - April 18, 2017 Category: Neurology Source Type: research
Utilizing CT with Maximum Intensity Projection Reconstruction Bypassing CTA Improves Time to Groin Puncture in Large Vessel Occlusion Stroke Thrombectomy
Background and Purpose: Prior to thrombectomy for proximal anterior circulation large vessel occlusion (LVO) stroke, recent trials have utilized CT angiography (CTA) for vascular imaging immediately following noncontrast CT (NCCT) for decision-making, but thin-section NCCT with automated maximum intensity projection (MIP) reconstruction also has high accuracy in demonstrating the site of an occluding thrombus. We hypothesized that performing thin-section NCCT with MIP alone prior to thrombectomy improves the time to groin puncture (GP) compared to performing CTA after NCCT.Materials and Methods: We performed a retrospectiv...
Source: Interventional Neurology - March 28, 2017 Category: Neurology Source Type: research
Rescue Treatment with Pipeline Embolization for Postsurgical Clipping Recurrences of Anterior Communicating Artery Region Aneurysms
Conclusion: Flow diversion with PED can be a safe and efficacious treatment approach for recurrent ACom region aneurysms after surgical clipping.Intervent Neurol 2017;6:135-146 (Source: Interventional Neurology)
Source: Interventional Neurology - March 3, 2017 Category: Neurology Source Type: research
Anterior Communicating Artery Aneurysm Treatment with the Pipeline Embolization Device: A Single-Center Experience with Long-Term Follow-Up
Conclusion: The PED can be safely used for the treatment of ACOM artery aneurysms. Complete aneurysm obliteration can be achieved in cases refractory to endovascular coiling. These findings warrant replication in a larger data set.Intervent Neurol 2017;6:126-134 (Source: Interventional Neurology)
Source: Interventional Neurology - February 21, 2017 Category: Neurology Source Type: research
Mechanical Thrombectomy for M2 Occlusions: A Single-Centre Experience
Conclusion: Mechanical thrombectomy in patients with solitary M2 clots is technically possible and carries a high degree of success with a good safety profile. Patients with confirmed M2 occlusion should be considered for mechanical thrombectomy.Intervent Neurol 2017;6:117-125 (Source: Interventional Neurology)
Source: Interventional Neurology - February 15, 2017 Category: Neurology Source Type: research
Radiation Exposure during Neurointerventional Procedures in Modern Biplane Angiographic Systems: A Single-Site Experience
Conclusion: Our diagnostic cerebral angiography group had a lower median and was in the 75th percentile of DAP and FT when compared with the published literature. For interventions, both DAP and number of DSA frames were significantly lower than the values reported in the literature, despite a higher FT. Subgroup analysis by procedure type also revealed a lower or comparable DAP.Intervent Neurol 2017;6:105-116 (Source: Interventional Neurology)
Source: Interventional Neurology - February 10, 2017 Category: Neurology Source Type: research
Utilization of a Novel, Multi-Durometer Intracranial Distal Access Catheter: Nuances and Experience in 110 Consecutive Cases of Aneurysm Flow Diversion
We report the first experience using Cat5 for aneurysm treatment by flow diversion.Methods: A single-center aneurysm database was reviewed for cases of aneurysm treatment with the Pipeline embolization device (PED) that utilized Cat5. Data were collected for patient demographics, aneurysm characteristics, procedural details, catheter positions, vessel tortuosity, and catheter related complications.Results: One hundred and ten cases of aneurysm flow diversion were successfully performed using Cat5. Patient age ranged from 21 to 86 years (mean 57 ± 12.5 years) with 84% women. Aneurysm size ranged from 2 to 28 mm (mean 5.7 Â...
Source: Interventional Neurology - February 2, 2017 Category: Neurology Source Type: research
