Background and Purpose: Computational fluid dynamics modeling is useful in the study of the hemodynamic environment of cerebral aneurysms, but patient-specific measurements of boundary conditions, such as blood flow velocity and pressure, have not been previously applied to the study of flow-diverting stents. We integrated patient-specific intravascular blood flow velocity and pressure measurements into computational models of aneurysms before and after treatment with flow-diverting stents to determine stent effects on aneurysm hemodynamics.
Background and Purpose: Recent studies have shown promising results regarding intracranial aneurysms treated with flow diverters. However, these have had adverse effects, including delayed aneurysm occlusion, posttreatment symptoms, and rupture. The hemodynamic profiles of aneurysms treated with flow diverters were analyzed to determine the ones associated with successful and failed treatments.
Background and Purpose: A recent study identified a preprocedural P2Y12 reaction units value of <60 or >240 as a strong independent predictor of perioperative thromboembolic and hemorrhagic complications after treatment of cerebral aneurysms with the Pipeline Embolization Device. This study aimed to determine whether a last-recorded P2Y12 reaction units value of <60 or >240 predicts thromboembolic and hemorrhagic complications up to 6 months after treatment of cerebral aneurysms with the Pipeline Embolization Device in the same patient cohort.
Proximal occlusion of intracranial arteries is a common cause of ischemic stroke, leading to significant morbidity and mortality.1,2 Currently approved managements for patients with ischemic stroke include supportive care in a stroke unit or center, use of aspirin to prevent clot propagation, revascularization with recombinant tissue plasminogen activator (tPA) until 4.5 hours after onset, intraarterial fibrinolysis until 6 hours, and mechanical thrombectomy until 8 hours.
Background: Unruptured aneurysms of the cavernous and paraclinoid internal carotid artery can be approached via microsurgical and endovascular approaches. Trends in treatment reflect a steady shift toward endovascular techniques.
Background: Changes in tumor volume are seen on magnetic resonance imaging within weeks after stereotactic radiosurgery (SRS), but it remains unclear what clinical outcomes early radiological changes portend.
Background and Purpose: Increased oxygen extraction fraction on PET has been considered a risk factor for stroke in patients with carotid stenosis or occlusion, though the strength of this association has recently been questioned. We performed a systematic review and meta-analysis to summarize the association between increased oxygen extraction fraction and ipsilateral stroke risk.
Background and Purpose: Hemodynamics play an important role in the mechanisms that govern the initiation, growth, and possible rupture of intracranial aneurysms. The purpose of this study was to objectively characterize these dynamics, classify them, and connect them to aneurysm rupture.
Summary: Angiographic recurrence following endovascular therapy is an indirect measure of the potential for hemorrhage. Because patients and physicians consider recurrence to be a suboptimal outcome with some chance of future hemorrhage, much effort has been expended to reduce the incidence of recurrence. The literature regarding aneurysm recurrence following endovascular therapy, spanning 2 decades, is extensive. We will review and summarize the effort to reduce recurrence following endovascular treatment of cerebral aneurysms.
Background and Purpose: Endovascular treatment for acute ischemic stroke consists of various mechanical and pharmacologic modalities used for recanalization of arterial occlusions. We performed this study to determine the relationship among procedure time, recanalization, and clinical outcomes in patients with acute ischemic stroke undergoing endovascular treatment.
Background and Purpose: DAVFs rarely involve the sphenoid wings and middle cranial fossa. We characterize the angiographic findings, treatment, and outcome of DAVFs within the sphenoid wings.
Background and Purpose: EL associated with ruptured aneurysms is higher than that for unruptured aneurysms. In this study, the effect of arterial morphologic variation of bifurcation aneurysms on EL was investigated in idealized models of middle cerebral artery aneurysms.
Background and Purpose: Parameters other than luminal narrowing are needed to predict the risk of stroke more reliably, particularly in patients with <70% stenosis. The goal of our study was to identify clinical risk factors and CT features of carotid atherosclerotic plaques, in a retrospective cohort of patients free of stroke at baseline, that are independent predictors of incident stroke on follow-up.
Background and Purpose: Contrast enhancement of intracranial atherosclerotic plaques has recently been investigated using high field and high resolution MR imaging as a risk factor in the development of ischemic stroke. We studied the reliability of conventional MR imaging at 1.5T in evaluating intraplaque enhancement and its relationship with acute cerebrovascular ischemic presentations in patients with severe intracranial atherosclerotic disease.
Background and Purpose: The Safety and Efficacy of NeuroFlo Technology in Ischemic Stroke trial showed a trend for reduced all-cause mortality and positive secondary safety end point outcomes. We present further analyses of the mortality and severe disability data from the Safety and Efficacy of NeuroFlo Technology in Ischemic Stroke trial.
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