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E-043 Reversible Cerebral Vasoconstriction Syndrome: Non-invasive Imaging Findings and Angiographic Evaluation
We present indirect findings on non-invasive imaging, such as transient cerebral edema, convexal subarachnoid hemorrhage, intraparenchymal hemorrhage and cerebral. Direct signs of single or multivessel arterial vasoconstriction are seen on CTA, MRA and confirmed on DSA. Reversibility of the vasoconstriction is demonstrated after intra-arterial administration of calcium channel blocker. Conditions such as diffuse atherosclerotic arterial narrowing, vasculitis, posterior reversible encephalopathy, cerebral edema secondary to venous congestion and vasospasm secondary to aneurysmal subarachnoid hemorrhage were among the pathol...
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: de Macedo Rodrigues, K., Hito, R., Takhtani, D., Lozano, J., Wakhloo, A., Puri, A. Tags: Electronic poster abstracts Source Type: research

E-099 Does Anterior Cerebral Artery Vasospasm after Spontaneous Subarachnoid Hemorrhage Predict Short Term Cognitive Outcome
ConclusionsOur study reaffirms that occurrence of DCI after SAH predicts poor cognitive outcome at 3 months. The fact that cognitive outcomes were not superior in patients treated for CVS suggests that a complex pathophysiology determines outcomes after SAH. Relatively poor cognitive outcome among patients with SAH in locations other than ACA/ACom alludes to involvement of functional neural network apart from frontal lobe based networks that needs further investigation.DisclosuresV. Pandav: None. B. Bohnstedt: None. L. Yearout: None. D. Thompson: None. B. Ray: None.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Pandav, V., Bohnstedt, B., Yearout, L., Thompson, D., Ray, B. Tags: Electronic poster abstracts Source Type: research

O-026 The US WEB Intrasaccular Therapy Study (WEB-IT): 30 Day Results
ConclusionsThe WEB-IT pivotal study provides the largest prospective study of safety and effectiveness data for the WEB aneurysm occlusion system. Demographics and safety follow-up to 30 days provide initial safety information: the primary safety and effectiveness endpoints at 1 year will be reported in a subsequent abstract.DisclosuresD. Fiorella: 1; C; Sequent Medical, Penumbra, Microvention, Seimens. 2; C; Sequent, Microvention, Medtronic, Penumbra, Codman. A. Arthur: 1; C; Sequent Medical. 2; C; Sequent Medical. A. Molyneux: 1; C; Sequent Medical. J. Byrne: 1; C; Sequent.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Fiorella, D., Arthur, A., Molyneux, A., Byrne, J. Tags: Oral abstracts Source Type: research

Infundibular dilations of the posterior communicating arteries: pathogenesis, anatomical variants, aneurysm formation, and subarachnoid hemorrhage
Conclusions IDs can rarely progress to aneurysms or rupture. Young patients with type II or III IDs with coexisting aneurysms or hypertension may benefit from long-term imaging surveillance.
Source: Journal of NeuroInterventional Surgery - July 13, 2016 Category: Neurosurgery Authors: Chen, C.-J., Moosa, S., Ding, D., Raper, D. M., Burke, R. M., Lee, C.-C., Chivukula, S., Wang, T. R., Starke, R. M., Crowley, R. W., Liu, K. C. Tags: Hemorrhagic stroke Source Type: research

Endovascular parent vessel sacrifice in ruptured dissecting vertebral and posterior inferior cerebellar artery aneurysms: clinical outcomes and review of the literature
Conclusions In patients with good collateral circulation, endovascular sacrifice may be the preferred treatment for acutely ruptured dissecting aneurysms involving the distal vertebral artery.
Source: Journal of NeuroInterventional Surgery - July 13, 2016 Category: Neurosurgery Authors: Madaelil, T. P., Wallace, A. N., Chatterjee, A. N., Zipfel, G. J., Dacey, R. G., Cross, D. T., Moran, C. J., Derdeyn, C. P. Tags: Hemorrhagic stroke Source Type: research

Delayed infarction following aneurysmal subarachnoid hemorrhage: Can the role of severe angiographic vasospasm really be dismissed?
Conclusions Severe angiographic vasospasm may be linked to infarction in patients who present late. These infarcts are mostly large despite maximal treatment. We question the notion that proximal vasospasm has a minor role in delayed ischemia.
Source: Journal of NeuroInterventional Surgery - July 13, 2016 Category: Neurosurgery Authors: Mortimer, A. M., Steinfort, B., Faulder, K., Harrington, T. Tags: Hemorrhagic stroke Source Type: research

The negative predictive value of CT angiography in the setting of perimesencephalic subarachnoid hemorrhage
Conclusions The NPV of normal CTA for an arterial abnormality in patients with PMSAH is high and our results therefore question the role of invasive imaging. The findings also suggest that a prospective study designed to clarify the necessity of performing DSA in this population would be feasible.
Source: Journal of NeuroInterventional Surgery - June 13, 2016 Category: Neurosurgery Authors: Mortimer, A. M., Appelman, A. P., Renowden, S. A. Tags: Hemorrhagic stroke, Neuroimaging Source Type: research

Flow diverter assisted coil embolization of a very small ruptured ophthalmic artery aneurysm
We report a case in which a patient presented with subarachnoid hemorrhage and a very small ruptured ophthalmic artery aneurysm, for which endovascular therapy was preferred secondary to severe cardiac comorbidities. Due to the aneurysm size, a small 1.5 mm coil was needed, but presented a significant risk of migration. Conventional stent assisted coiling was considered suboptimal as the small coil could have easily migrated through the strut. We present a novel technique of flow diverter assisted coil embolization in which a coil was placed within the aneurysm and a pipeline embolization device was then partially dep...
Source: Journal of NeuroInterventional Surgery - June 11, 2016 Category: Neurosurgery Authors: Dornbos, D., Pillai, P., Sauvageau, E. Tags: Hemorrhagic stroke Source Type: research

Onyx embolization in distal dissecting posterior inferior cerebellar artery aneurysms
Conclusions Angiographic, diagnostic imaging, and clinical results of our small series indicate that Onyx embolization of dissecting distal PICA aneurysms with parent artery preservation is an effective option with acceptable morbidity and mortality rate, in those cases in which surgical clipping or endovascular coiling of the aneurysmal sac is not suitable.
Source: Journal of NeuroInterventional Surgery - April 13, 2016 Category: Neurosurgery Authors: Puri, A. S., Massari, F., Hou, S. Y., Lozano, J. D., Howk, M., Perras, M., Brooks, C., Gounis, M. J., Kan, P., Wakhloo, A. K. Tags: Hemorrhagic stroke Source Type: research

Monotherapy with stenting in subarachnoid hemorrhage (SAH) after middle cerebral artery dissection
We describe a young patient who presented with acute headache from a subarachnoid hemorrhage that was ultimately determined to be due to a vascular dissection in the middle cerebral artery. The initial angiogram showed vascular irregularities in this area with stenosis. Repeat imaging 4 days after presentation identified a pseudoaneurysm proximal to the stenosis. The patient was successfully treated with a self-expanding nitinol stent and followed up with serial angiography during postoperative recovery in the hospital; additional angiograms were performed approximately 1 and 6 months after treatment. Serial angi...
Source: Journal of NeuroInterventional Surgery - March 15, 2016 Category: Neurosurgery Authors: Puri, A. S., Gounis, M. J., Massari, F., Howk, M., Weaver, J., Wakhloo, A. K. Tags: Electronic pages Source Type: research

Evaluation of time to aneurysm treatment following subarachnoid hemorrhage: comparison of patients treated with clipping versus coiling
Conclusions Older patients with SAH and those treated at non-teaching hospitals were more likely to have delays to aneurysm clipping procedures. These associations were unique to open surgery as age and hospital teaching status did not affect time to coiling procedures.
Source: Journal of NeuroInterventional Surgery - March 15, 2016 Category: Neurosurgery Authors: Attenello, F. J., Reid, P., Wen, T., Cen, S., Kim-Tenser, M., Sanossian, N., Russin, J., Amar, A., Giannotta, S., Mack, W. J., Tenser, M. Tags: Hemorrhagic stroke Source Type: research

Evaluation of an anatomic definition of non-aneurysmal perimesencephalic subarachnhoid hemorrhage
Conclusions Our anatomic definition of PSAH correlated with a low risk of brain aneurysm and was applied with excellent inter-observer agreement.
Source: Journal of NeuroInterventional Surgery - March 15, 2016 Category: Neurosurgery Authors: Wallace, A. N., Vyhmeister, R., Dines, J. N., Chatterjee, A. R., Kansagra, A. P., Viets, R., Whisenant, J. T., Moran, C. J., Cross, D. T., Derdeyn, C. P. Tags: Hemorrhagic stroke Source Type: research

Rates of local procedural-related structural injury following clipping or coiling of anterior communicating artery aneurysms
Conclusions Clipping of ACOM aneurysms is associated with significantly higher rates of structural injury than coiling, and this may be a reason for superior cognitive outcomes in patients treated with coiling in previously published studies.
Source: Journal of NeuroInterventional Surgery - February 14, 2016 Category: Neurosurgery Authors: Mortimer, A. M., Steinfort, B., Faulder, K., Erho, T., Scherman, D. B., Rao, P. J., Harrington, T. Tags: Hemorrhagic stroke Source Type: research

The Trevo XP 3x20 mm retriever ('Baby Trevo) for the treatment of distal intracranial occlusions
Conclusions Our initial data suggest that treatment of distal cerebrovascular occlusions with the Trevo XP 3x20 mm Retriever is feasible. Although this device emerges as a promising technology for small and tortuous distal intracranial vessels, larger studies are still necessary to establish its safety and clinical benefit.
Source: Journal of NeuroInterventional Surgery - February 14, 2016 Category: Neurosurgery Authors: Haussen, D. C., Lima, A., Nogueira, R. G. Tags: New devices Source Type: research

Critical assessment of the morbidity associated with ruptured cerebral arteriovenous malformations
Conclusions Our assessment of morbidity associated with brain AVM rupture is higher than previously assumed and reported. These results should be further validated in a larger, more representative sample. An accurate understanding of the morbidity associated with AVM rupture is important as more patients with unruptured brain AVMs seek consultation.
Source: Journal of NeuroInterventional Surgery - January 13, 2016 Category: Neurosurgery Authors: Majumdar, M., Tan, L. A., Chen, M. Tags: Editor''s choice, Hemorrhagic stroke Source Type: research

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