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ESTUDIOS


05 septiembre 2013

AMERICAN JOURNAL OF NEURORADIOLOGY. MRA Versus DSA for Follow-Up of Coiled Intracranial Aneurysms: A Meta-Analysis

M.J. van Amerongen, H.D. Boogaarts, J. de Vries, A.L.M. Verbeek, F.J.A. Meijer, M. Prokop and R.H.M.A. Bartels

Summary: MR angiography is proposed as a safer and less expensive alternative to the reference standard, DSA, in the follow-up of intracranial aneurysms treated with endovascular coil occlusion. We performed a systematic review and meta-analysis to evaluate the accuracy of TOF-MRA and contrast-enhanced MRA in detecting residual flow in the follow-up of coiled intracranial aneurysms. Literature was reviewed through the PubMed, Cochrane, and EMBASE data bases. In comparison with DSA, the sensitivity of TOF-MRA was 86% (95% CI: 82–89%), with a specificity of 84% (95% CI: 81–88%), for the detection of any recurrent flow. For contrast-enhanced MRA, the sensitivity and specificity were 86% (95% CI: 82–89%) and 89% (95% CI: 85–92%), respectively. Both TOF-MRA and contrast-enhanced MRA are shown to be highly accurate for detection of any recanalization in intracranial aneurysms treated with endovascular coil occlusion.

19 junio 2014

AMERICAN JOURNAL OF NEURORADIOLOGY. Patients Prone to Recurrence after Endovascular Treatment: Periprocedural Results of the PRET Randomized Trial on Large and Recurrent Aneurysms

J. Raymond,b, R. Klink, M. Chagnon, S.L. Barnwell, A.J. Evans, J. Mocco, B.L. Hoh, A.S. Turk, R.D. Turner, H. Desal, D. Fiorella, S. Bracard, A. Weill, F. Guilbert and D. Roy on behalf of the PRET Collaborative Group

Background and Purpose: Some patients with large or recurrent aneurysms may be at increased risk of recurrence postcoiling. The Patients Prone to Recurrence after Endovascular Treatment (PRET) trial was designed to assess whether hydrogel coils were superior to platinum coils in these high-risk patients. This article reports periprocedural safety and operator-assessed angiographic results from the PRET trial.

24 abril 2014

AMERICAN JOURNAL OF NEURORADIOLOGY. An In Vivo, MRI-Integrated Real-Time Model of Active Contrast Extravasation in Acute Intracerebral Hemorrhage

R.I. Aviv, T. Huynh, Y. Huang, D. Ramsay, P. Van Slyke, D. Dumont, P. Asmah, R. Alkins, R. Liu and K. Hynynen

Background and Purpose: The “spot sign” or contrast extravasation is strongly associated with hematoma formation and growth. An animal model of contrast extravasation is important to test existing and novel therapeutic interventions to inform present and future clinical studies. The purpose of this study was to create an animal model of contrast extravasation in acute intracerebral hemorrhage.

01 septiembre 2014

NEUROSURGERY. Solitaire AB Stent-Assisted Coiling of Wide-Necked Intracranial Aneurysms: Mid-term Results From the SOLARE Study

Gory, Benjamin MD, MSc*; Klisch, Joachim MD, PhD‡; Bonafé, Alain MD, PhD§; Mounayer, Charbel MD, PhD¶; Beaujeux, Remy MD‖; Moret, Jacques MD#; Lubicz, Boris MD, PhD**; Riva, Roberto MD*; Turjman, Francis MD, PhD*

Background: Endovascular treatment of intracranial aneurysms can be technically difficult when the neck is wide. The Solitaire AB stent (Covidien, Irvine, California), the only fully retrieved stent, assists in the coiling of wide-neck intracranial aneurysms.

01 agosto 2014

NEUROSURGERY. Characteristics of Posterior Cerebral Artery Aneurysms: An Angiographic Analysis of 93 Aneurysms in 81 Patients

Goehre, Felix MD*,‡; Jahromi, Behnam Rezai MB‡; Hernesniemi, Juha MD, PhD‡; Elsharkawy, Ahmed MD§; Kivisaari, Riku MD, PhD‡; von und zu Fraunberg, Mikael MD, PhD¶; Jääskeläinen, Juha MD, PhD¶; Lehto, Hanna MD‡; Lehecka, Martin MD, PhD‡

Background: Posterior cerebral artery (PCA) aneurysms are rare lesions. Because of their low incidence, the individual or institutional experience is usually limited.

01 agosto 2014

NEUROSURGERY. Are Aneurysms Treated With Balloon-Assisted Coiling and Stent-Assisted Coiling Different? Morphological Analysis of 113 Unruptured Wide-Necked Aneurysms Treated With Adjunctive Devices

Peterson, Eric MD, MS*; Hanak, Brian MD‡; Morton, Ryan MD‡; Osbun, Joshua W. MD‡; Levitt, Michael R. MD‡; Kim, Louis J. MD‡

Background: In the endovascular treatment of wide-necked unruptured aneurysms, there is controversy over which adjunctive device (stent vs balloon) is appropriate. At the payer level it has been posited that stents and balloons treat the same aneurysms, and, as such, the more expensive stents should not be reimbursed.

01 octubre 2014

NEUROSURGERY. Long-term Outcomes of a Randomized Clinical Trial of Stenting vs Aggressive Medical Therapy for Intracranial Arterial Stenosis

Starke, Robert M. MD, MSc; Komotar, Ricardo J. MD; Connolly, E. Sander MD

Stroke is a leading cause of morbidity and mortality and the most significant source of disability in the United States. Patients with recent transient ischemic attacks or stroke and significant intracranial stenosis are at particularly high risk of recurrent stroke. Recent trials have demonstrated that although outcomes for stroke patients are improving with aggressive medical therapy,1-3 the overall long-term prognosis is poor.

01 diciembre 2013

NEUROSURGERY. Magnetic Resonance Imaging-Guided Focused Laser Interstitial Thermal Therapy for Intracranial Lesions: Single-Institution Series

Hawasli, Ammar H. MD, PhD; Bagade, Swapnil MD; Shimony, Joshua S. MD, PhD; Miller-Thomas, Michelle MD; Leuthardt, Eric C. MD

Background: Surgical treatments for deep-seated intracranial lesions have been limited by morbidities associated with resection. Real-time magnetic resonance imaging–guided focused laser interstitial thermal therapy (LITT) offers a minimally invasive surgical treatment option for such lesions.

29 julio 2014

STROKE. Clinical Sciences. Thrombolysis in Ischemic Stroke Without Arterial Occlusion at Presentation

Sourabh Lahoti, MD; Sankalp Gokhale, MD; Louis Caplan, MD; Patrik Michel, MD; Yves Samson, MD; Charlotte Rosso, MD, PhD; Kaustubh Limaye, MD; Archana Hinduja, MD; Aneesh Singhal, MD; Syed Ali, MD; Luther Creed Pettigrew, MD; Richard Kryscio, PhD; Nikita Dedhia, MD; Shirish Hastak, MD, DM; David S. Liebeskind, MD

Background and Purpose: None of the randomized trials of intravenous tissue-type plasminogen activator reported vascular imaging acquired before thrombolysis. Efficacy of tissue-type plasminogen activator in stroke without arterial occlusion on vascular imaging remains unknown and speculative.

18 julio 2013

STROKE. Clinical Sciences. Natural History of Unruptured Intracranial Aneurysms

Seppo Juvela, MD, PhD; Kristiina Poussa, MD; Hanna Lehto, MD; Matti Porras, MD, PhD

Background and Purpose: Unruptured intracranial aneurysms are increasingly being detected and are a notable healthcare burden. We investigated the long-term natural history of unruptured intracranial aneurysms and risk factors predictive of subsequent rupture.

06 agosto 2013

STROKE. Clinical Sciences. Refining Angiographic Biomarkers of Revascularization

Albert J. Yoo, MD; Claus Z. Simonsen, MD, PhD; Shyam Prabhakaran, MD*; Zeshan A. Chaudhry, MD; Mohammad A. Issa, MD; Jennifer E. Fugate, DO; Italo Linfante, MD; David S. Liebeskind, MD; Pooja Khatri, MD, MSc; Tudor G. Jovin, MD; David F. Kallmes, MD; Guilherme Dabus, MD; Osama O. Zaidat, MD, MSc for the Cerebral Angiographic Revascularization Grading Collaborators

Background and Purpose: Angiographic revascularization grading after intra-arterial stroke therapy is limited by poor standardization, making it unclear which scale is optimal for predicting outcome. Using recently standardized criteria, we sought to compare the prognostic performance of 2 commonly used reperfusion scales.

23 julio 2013

STROKE. Clinical Sciences. Importance of Cerebral Artery Recanalization in Patients With Stroke With and Without Neurological Improvement After Intravenous Thrombolysis

Tatiana V. Kharitonova, MD, PhD; Teresa P. Melo, MD; Grethe Andersen, MD, DMSc; Jose A. Egido, MD, FESO; José Castillo, MD, PhD; Nils Wahlgren, MD, FESO on behalf of the SITS investigators

Background and Purpose: Recanalization status after intravenous thrombolysis (IVT) in patients with ischemic stroke is a reference point to proceed with a rescue reperfusion intervention, although early neurological improvement (NI) may preclude endovascular procedures. We aimed to evaluate the importance of restoration of blood flow at the arterial occlusion site in subgroups of patients with stroke stratified by early NI after IVT.

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