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Distal cerebral vasospasm treatment following aneurysmal subarachnoid hemorrhage using the Comaneci device: technical feasibility and single-center preliminary results
Conclusion This initial experience suggests that distal mechanical angioplasty performed with the Comaneci-17 device for refractory vasospasm following aSAH seems to be safe, with good feasibility and efficacy.
Source: Journal of NeuroInterventional Surgery - March 14, 2023 Category: Neurosurgery Authors: Thiery, L., Carle, X., Testud, B., Boulouis, G., Habert, P., Tradi, F., Reyre, A., Lehmann, P., Dory-Lautrec, P., Stellmann, J.-P., Girard, N., Brunel, H., Hak, J.-F. Tags: Hemorrhagic stroke Source Type: research

Endovascular thrombectomy for anterior circulation stroke beyond 6 hours of onset in Sweden 2015 to 2020: rates and outcomes in a nationwide register-based study
Conclusion Late window EVTs have increased substantially over time, and currently account for one third of anterior circulation treatments. Early and late window patients had similar outcomes.
Source: Journal of NeuroInterventional Surgery - March 14, 2023 Category: Neurosurgery Authors: Ullberg, T., von Euler, M., Wester, P., Arnberg, F., Norrving, B., Andersson, T., Wasselius, J. Tags: Open access, Ischemic stroke Source Type: research

Association between time to treatment and clinical outcomes in endovascular thrombectomy beyond 6 hours without advanced imaging selection
Conclusion In this real-world study, there was minimal change in functional disability, sICH and in-hospital mortality within and across the late window. While confirmatory randomized trials are needed, these findings suggest that EVT remains feasible and safe when performed in AIS patients selected without advanced neuroimaging between 6–24 hours from stroke onset.
Source: Journal of NeuroInterventional Surgery - March 14, 2023 Category: Neurosurgery Authors: Dhillon, P. S., Butt, W., Podlasek, A., McConachie, N., Lenthall, R., Nair, S., Malik, L., Bhogal, P., Makalanda, H. L. D., Spooner, O., Krishnan, K., Sprigg, N., Mortimer, A., Booth, T. C., Lobotesis, K., White, P., James, M. A., Bath, P., Dineen, R. A., Tags: Ischemic stroke Source Type: research

Endovascular treatment of acute ischemic stroke in patients with pre-morbid disability: a meta-analysis
Conclusion In eligible patients with pre-morbid disability, observational studies suggest that EVT carries a higher chance of return to baseline mRS compared with patients treated with MM or without pre-morbid disability, although with higher mortality than patients without pre-morbid disability. These findings argue against the routine exclusion of such patients from EVT and merit validation with randomized trials.
Source: Journal of NeuroInterventional Surgery - March 14, 2023 Category: Neurosurgery Authors: Bala, F., Beland, B., Mistry, E., Almekhlafi, M. A., Goyal, M., Ganesh, A. Tags: Ischemic stroke Source Type: research

Republished:Delayed aneurysm rupture following treatment with the WEB embolization device
We present a case of a multiply ruptured anterior communicating artery aneurysm treated via WEB embolization. A post-treatment CT scan confirmed no evidence of rebleeding during treatment. Four hours after treatment, the patient developed an acute, significant increase in intracranial pressure with bloody ventriculostomy output, with CT scan demonstrating new parenchymal and intraventricular hemorrhage. The aneurysm was subsequently treated via microsurgical clipping that did not identify an "uncovered" bleb or rupture source.
Source: Journal of NeuroInterventional Surgery - February 14, 2023 Category: Neurosurgery Authors: Gross, B. A., Lang, M. J. Tags: Hemorrhagic stroke Source Type: research

Risk factors of unexplained early neurological deterioration after treatment for ischemic stroke due to large vessel occlusion: a post hoc analysis of the HERMES study
Conclusions UnEND is not an uncommon event, with a similar rate which ever treatment arm is considered. In the clinical scenario of AIS due to large vessel occlusion, no patient-related factor seems to increase the risk for UnEND when treated by EVT compared with MM.
Source: Journal of NeuroInterventional Surgery - February 14, 2023 Category: Neurosurgery Authors: Bourcier, R., Goyal, M., Muir, K. W., Desal, H., Dippel, D. W. J., Majoie, C. B. L. M., van Zwam, W. H., Jovin, T. G., Mitchell, P. J., Demchuk, A. M., van Oostenbrugge, R. J., Brown, S. B., Campbell, B., White, P., Hill, M. D., Saver, J. L., Weimar, C., Tags: Ischemic stroke Source Type: research

Endovascular thrombectomy beyond 24 hours from ischemic stroke onset: a propensity score matched cohort study
Conclusion In this real world study, EVT beyond 24 hours from stroke onset or last known well appeared to be feasible, with comparable safety and functional outcomes to EVT initiation between 6 and 24 hours. Randomized trials assessing the efficacy of EVT in the VL window are warranted, but may only be feasible with a large international collaborative approach.
Source: Journal of NeuroInterventional Surgery - February 14, 2023 Category: Neurosurgery Authors: Dhillon, P. S., Butt, W., Podlasek, A., Barrett, E., McConachie, N., Lenthall, R., Nair, S., Malik, L., James, M. A., Dineen, R. A., England, T. J. Tags: Ischemic stroke Source Type: research

Prospective study on embolization of intracranial aneurysms with the pipeline device (PREMIER study): 3-year results with the application of a flow diverter specific occlusion classification
Conclusions The PED device presents as a safe and effective modality in treating small- and medium-sized intracranial aneurysms. The application of a flow diverter specific occlusion classification attested the long-term durability with higher rate of successful aneurysm occlusion and no documented aneurysm rupture. Trial registration NCT02186561.
Source: Journal of NeuroInterventional Surgery - February 14, 2023 Category: Neurosurgery Authors: Hanel, R. A., Cortez, G. M., Lopes, D. K., Nelson, P. K., Siddiqui, A. H., Jabbour, P., Mendes Pereira, V., Istvan, I. S., Zaidat, O. O., Bettegowda, C., Colby, G. P., Mokin, M., Schirmer, C. M., Hellinger, F. R., Given, C., Krings, T., Taussky, P., Toth, Tags: Open access, Hemorrhagic stroke Source Type: research

Higher Hospital Frailty Risk Score is associated with increased complications and healthcare resource utilization after endovascular treatment of ruptured intracranial aneurysms
Conclusions Our study found that greater frailty as defined by the HFRS was associated with increased complications, LOS, total costs, and non-routine discharge.
Source: Journal of NeuroInterventional Surgery - February 14, 2023 Category: Neurosurgery Authors: Koo, A. B., Elsamadicy, A. A., Renedo, D., Sarkozy, M., Sherman, J., Reeves, B. C., Havlik, J., Antonios, J., Sujijantarat, N., Hebert, R., Malhotra, A., Matouk, C. Tags: Hemorrhagic stroke, COVID-19 Source Type: research

The butterfly effect: improving brain cone-beam CT image artifacts for stroke assessment using a novel dual-axis trajectory
Conclusions Recent developments in CBCT imaging protocols have significantly improved image artifacts, which has improved diagnostic confidence for stroke and supports a direct-to-angiography suite transfer approach for patients with acute ischemic stroke.
Source: Journal of NeuroInterventional Surgery - February 14, 2023 Category: Neurosurgery Authors: Cancelliere, N. M., Hummel, E., van Nijnatten, F., van de Haar, P., Withagen, P., van Vlimmeren, M., Hallacoglu, B., Agid, R., Nicholson, P., Mendes Pereira, V. Tags: Open access, Neuroimaging Source Type: research

Combined balloon guide catheter, aspiration catheter, and stent retriever technique versus balloon guide catheter and stent retriever alone technique: a systematic review and meta-analysis
Conclusion There was no significant difference in successful reperfusion and FPE between the combined techniques and the stent retriever and BGC alone groups. Neither was there any difference in functional outcomes, complications, or mortality.
Source: Journal of NeuroInterventional Surgery - January 11, 2023 Category: Neurosurgery Authors: Teo, Y. N., Sia, C.-H., Tan, B. Y. Q., Mingxue, J., Chan, B., Sharma, V. K., Makmur, A., Gopinathan, A., Yang, C., Loh, S., Ng, S., Ong, S. J., Teoh, H.-L., Rathakrishnan, R., Andersson, T., Arnberg, F., Gontu, V. K., Lee, T.-h., Maus, V., Meyer, L., Bhog Tags: Ischemic stroke Source Type: research

Impact of leukoaraiosis in patients with acute ischemic stroke treated with thrombectomy: a post hoc analysis of the DIRECT-MT trial
Conclusion Patients with leukoaraiosis with AIS due to large vessel occlusion are at increased risk of a poor functional outcome after IAT but demonstrate similar sICH rates, and IVT preceding IAT does not increase the risk of sICH in Chinese patients with leukoaraiosis.
Source: Journal of NeuroInterventional Surgery - January 11, 2023 Category: Neurosurgery Authors: Yi, T., Zhang, Y., Chen, W.-h., Wu, Y.-m., Lin, D.-l., Lin, X.-h., Zhang, L., Xing, P.-f., Li, T., Zhang, Y., Wang, S., Yang, P., Cai, M.-z., Liu, J., On behalf of for the DIRECT-MT Investigators Tags: Ischemic stroke Source Type: research

How to perform intra-aneurysmal coil embolization after Pipeline deployment: a study from a hemodynamic viewpoint
Conclusion Adjunct coiling could improve the post-PED hemodynamic environment in treated intracranial aneurysms. However, dense packing is not necessary because the intra-aneurysmal hemodynamics tend to stabilize as the packing density reaches an average of 7.06% or after insertion of the second coil.
Source: Journal of NeuroInterventional Surgery - January 11, 2023 Category: Neurosurgery Authors: Zhang, M., Tian, Z., Zhang, Y., Zhang, Y., Wang, K., Leng, X., Yang, X., Xiang, J., Liu, J. Tags: Hemorrhagic stroke Source Type: research

Falsely normal CT perfusion ischemic core readings are common and often associated with deep infarcts
Conclusions CTP may completely fail to detect ischemic core in as many as 25% of cases, especially in isolated deep MCA strokes. Technical refinements of the post-processing algorithms are therefore warranted. TMC infarcts may have a lower risk of reperfusion hemorrhage, potentially due to greater preservation of the neurovascular unit structure in face of delayed recovery of cerebral blood flow.
Source: Journal of NeuroInterventional Surgery - January 11, 2023 Category: Neurosurgery Authors: Bouslama, M., Ravindran, K., Rodrigues, G. M., Pisani, L., Haussen, D. C., Frankel, M. R., Nogueira, R. G. Tags: Neuroimaging Source Type: research

Machine learning and acute stroke imaging
Conclusions ML in acute ischemic stroke imaging has already made tremendous headway. Additional applications and further integration with clinical care is inevitable. Thus, facility with these approaches is critical for the neurointerventional clinician.
Source: Journal of NeuroInterventional Surgery - January 11, 2023 Category: Neurosurgery Authors: Sheth, S. A., Giancardo, L., Colasurdo, M., Srinivasan, V. M., Niktabe, A., Kan, P. Tags: Neuroimaging Source Type: research

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