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The detrimental clinical impact of severe angiographic vasospasm may be diminished by maximal medical therapy and intensive endovascular treatment
Conclusions An intensive endovascular approach of TBA and/or intra-arterial verapamil in combination with induced hypertension for severe aVSP may result in comparable clinical outcomes to those without vasospasm.
Source: Journal of NeuroInterventional Surgery - November 13, 2015 Category: Neurosurgery Authors: Mortimer, A. M., Steinfort, B., Faulder, K., Bradford, C., Finfer, S., Assaad, N., Harrington, T. Tags: Ischemic stroke Source Type: research

Management of aneurysmal subarachnoid hemorrhage: a national survey of current practice
Conclusions At 6 months following publication of the NCEPOD report we found that in the majority of neurosurgical units, most of the key recommendations were being met. However, in the remainder there was variability in clinical practice.
Source: Journal of NeuroInterventional Surgery - November 13, 2015 Category: Neurosurgery Authors: Al-Helli, O., Bush, S., Ingale, H., McConachie, N. Tags: Hemorrhagic stroke Source Type: research

Cerebral vasospasm patterns following aneurysmal subarachnoid hemorrhage: an angiographic study comparing coils with clips
Conclusions Patients with aSAH treated by endovascular coiling and surgical clipping demonstrate distinct vasospasm patterns. While both initially exhibit perianeurysmal spasm, patients treated by coiling go on to develop stepwise progression distally over time. This finding may reflect dispersion of blood breakdown products along preserved CSF egress pathways in patients treated by endovascular coiling.
Source: Journal of NeuroInterventional Surgery - October 14, 2015 Category: Neurosurgery Authors: Jones, J., Sayre, J., Chang, R., Tian, J., Szeder, V., Gonzalez, N., Jahan, R., Vinuela, F., Duckwiler, G., Tateshima, S. Tags: Ischemic stroke Source Type: research

Incidence and morbidity of craniocervical arterial dissections in atraumatic subarachnoid hemorrhage patients who underwent aneurysmal repair
Conclusions Our study indicates an annual increase in the incidence of CCADs in patients admitted with SAH who require aneurysmal repair. More than two-thirds of these patients that developed CCADs had undergone endovascular coiling repair. A diagnosis of CCAD increased the length of hospital stay but had no statistically significant association with mortality in this patient population.
Source: Journal of NeuroInterventional Surgery - September 13, 2015 Category: Neurosurgery Authors: Carr, K., Rincon, F., Maltenfort, M., Birnbaum, L., Dengler, B., Rodriguez, M., Seifi, A. Tags: Editor''s choice, Hemorrhagic stroke Source Type: research

A reappraisal of the Pipeline embolization device for the treatment of posterior circulation aneurysms
Conclusions Patient selection is essential for safe and effective PED treatment of posterior circulation aneurysms. The PED is equally effective in achieving aneurysm obliteration with an acceptable risk profile as it is in the anterior circulation. Dolichoectatic aneurysms were not included in this treatment cohort. PED may be a preferable alternative to open surgical treatment of posterior circulation aneurysms.
Source: Journal of NeuroInterventional Surgery - August 12, 2015 Category: Neurosurgery Authors: Albuquerque, F. C., Park, M. S., Abla, A. A., Crowley, R. W., Ducruet, A. F., McDougall, C. G. Tags: Hemorrhagic stroke, New devices Source Type: research

P-028 coil me now. divert me later
ConclusionsStaged treatment of ruptured complex intracranial aneurysms with coiling in the acute phase and flow diverter treatment following recovery from SAH is both safe and effective. In our series, despite the complexity of the aneurysms treated, limited major morbidity and mortality occurred during the acute phase after rupture. No cases of rebleeding occurred during the interval between coiling and flow diversion. No patients suffered additional morbidity or mortality from flow diverter treatment.DisclosuresW. Brinjikji: None. M. Piano: None. S. Fang: None. G. Pero: None. D. Kallmes: 1; C; Covidien. 2; C; Covidien. L...
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Brinjikji, W., Piano, M., Fang, S., Pero, G., Kallmes, D., Quilici, L., Valvassori, L., Cloft, H., Boccardi, E., Lanzino, G. Tags: SNIS 12th Annual Meeting Oral Poster Abstracts Source Type: research

E-050 last chance carotid stenting: treatment and outcomes of carotid artery stenting in very high risk patients
ConclusionsOur study indicates that CAS can be safely performed in patients considered too high-risk for CEA and who were referred to our center as such by their physicians.DisclosuresJ. Lozano: None. F. Massari: None. C. Brooks: None. M. Perras: None. M. Howk: None. M. Gounis: 1; C; NIH, Philips Healthcare, Covidien/eV3 Neurovascular, Codman Neurovascular, Stryker Neurovascular, Wyss Institute, Tay Sachs Foundation. 2; C; Stryker Neurovascular. N. Henninger: None. A. Wakhloo: 1; C; Phillips Healthcare Medical. 2; C; Stryker. 3; C; Harvard Postgraduate Course, Miami Baptist Vascular Institute. A. Puri: 1; C; Stryker. 2; C; Codman, Covidien.
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Lozano, J., Massari, F., Brooks, C., Perras, M., Howk, M., Gounis, M., Henninger, N., Wakhloo, A., Puri, A. Tags: SNIS 12th Annual Meeting Electronic Poster Abstracts Source Type: research

E-075 neurosarcoidosis presenting as aneurysmal subarachnoid hemorrhage: an interesting case and novel treatment
Neurosarcoidosis, the term used for sarcoidosis involving the central nervous system, represents an uncommon form of sarcoidosis, found in a 5% of patients with systemic sarcoidosis. Clinically evident cerebrovascular involvement in neurosarcoidosis has been reported but appears to be an extremely rare manifestation of neurosarcoidosis. The literature describes these cerebral vasculopathic changes as areas of stenosis and/or vascular irregularity, with clinical manifestations including headache, ischemic stroke, and parenchymal hemorrhage. Neurosarcoidosis has even been described as the etiology for a case of moyamoya synd...
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Gaughen, J. Tags: SNIS 12th Annual Meeting Electronic Poster Abstracts Source Type: research

Outcomes of manual aspiration thrombectomy for acute ischemic stroke refractory to stent-based thrombectomy
Conclusions This study suggests that MAT with the Penumbra reperfusion catheter can further increase the revascularization rate without serious complications in patients with acute stroke with refractory occlusions after SBT with a Solitaire stent.
Source: Journal of NeuroInterventional Surgery - June 11, 2015 Category: Neurosurgery Authors: Kim, S. K., Yoon, W., Moon, S. M., Park, M. S., Jeong, G. W., Kang, H. K. Tags: Ischemic stroke Source Type: research

Results of a national cerebrovascular neurosurgery survey on the management of cerebral vasospasm/delayed cerebral ischemia
Conclusions In this preliminary glimpse of actual cerebral vasospasm management practice in the USA, two salient points emerge: (1) there is considerable variability in intra-arterial therapies for vasospasm; and (2) there are major differences in the perceived effectiveness of these therapies. Standardization of intra-arterial therapies may contribute to improved outcomes. A prospective randomized trial evaluating endovascular treatment for cerebral vasospasm is needed.
Source: Journal of NeuroInterventional Surgery - May 14, 2015 Category: Neurosurgery Authors: Bulsara, K. R., Gunel, M., Amin-Hanjani, S., Chen, P. R., Connolly, E. S., Friedlander, R. M. Tags: Ischemic stroke Source Type: research

Methamphetamine use is an independent predictor of poor outcome after aneurysmal subarachnoid hemorrhage
Conclusions Methamphetamine users have significantly worse outcomes at 1 and 3 years following aSAH. Further analysis is necessary to understand the pathological response associated with methamphetamine use in this setting.
Source: Journal of NeuroInterventional Surgery - April 13, 2015 Category: Neurosurgery Authors: Moon, K., Albuquerque, F. C., Mitkov, M., Ducruet, A. F., Wilson, D. A., Crowley, R. W., Nakaji, P., McDougall, C. G. Tags: Hemorrhagic stroke Source Type: research

Pipeline Embolization Device as primary treatment for blister aneurysms and iatrogenic pseudoaneurysms of the internal carotid artery
Conclusions The PED should be used selectively in the setting of acute SAH. Dual antiplatelet therapy can complicate hydrocephalus management, and the lack of immediate aneurysm occlusion creates the risk of short-term re-rupture. PED treatment for iatrogenic ICA pseudoaneurysms can provide a good angiographic and neurological outcome.
Source: Journal of NeuroInterventional Surgery - February 12, 2015 Category: Neurosurgery Authors: Nerva, J. D., Morton, R. P., Levitt, M. R., Osbun, J. W., Ferreira, M. J., Ghodke, B. V., Kim, L. J. Tags: Hemorrhagic stroke Source Type: research

Is aneurysm repair justified for the patients aged 80 or older after aneurysmal subarachnoid hemorrhage?
Conclusions Better prognosis was obtained when ruptured aneurysm was repaired in the elderly than it was treated conservatively. From the results of this study, we should not hesitate to offer the definitive surgery for the elderly with aSAH.
Source: Journal of NeuroInterventional Surgery - October 7, 2014 Category: Neurosurgery Authors: Sadamasa, N., Koyanagi, M., Fukuda, H., Chin, M., Handa, A., Yamagata, S. Tags: Hemorrhagic stroke Source Type: research

Endovascular treatment of fusiform intracranial vertebral artery aneurysms using reconstructive techniques
Conclusions The use of reconstructive techniques in the endovascular treatment of unruptured fusiform intracranial vertebral artery aneurysms is feasible, safe, and effective in the mid term. In patients presenting with SAH, however, the safety and effectiveness of these techniques remain unclear.
Source: Journal of NeuroInterventional Surgery - September 5, 2014 Category: Neurosurgery Authors: Dabus, G., Lin, E., Linfante, I. Tags: Hemorrhagic stroke Source Type: research

Safety and predictors of aneurysm retreatment for remnant intracranial aneurysm after initial endovascular embolization
Conclusions Aneurysm retreatment is a safe option without a significant increase in morbidity or mortality. SAH, posterior circulation aneurysms and larger aneurysm dome size are predictors of aneurysms requiring retreatment.
Source: Journal of NeuroInterventional Surgery - August 6, 2014 Category: Neurosurgery Authors: Teleb, M. S., Pandya, D. J., Castonguay, A. C., Eckardt, G., Sweis, R., Lazzaro, M. A., Issa, M. A., Fitzsimmons, B.-F., Lynch, J. R., Zaidat, O. O. Tags: Editor''s choice, Hemorrhagic stroke Source Type: research

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