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.
Objectives: The benefit of carotid endarterectomy (CEA) may be diminished by cranial nerve injury (CNI). Using a quality improvement registry, we aimed to identify the nerves affected, duration of symptoms (transient vs. persistent), and clinical predictors of CNI.
Introduction: This article in the EuroIntervention Tools & Techniques series provides the "How-to-do" for carotid artery stenting (CAS) plus tips & tricks, and brings to you the knowledge to obtain good results thus providing a safe therapy. The dynamic images can be viewed at www.eurointervention.org Endovascular carotid intervention was developed due to a need to provide a less-invasive and less-traumatic revascularisation strategy for patients considered high-risk for open surgery. The rapid advancement in endovascular technologies and techniques over the last 10 years has resulted in the evolution of CAS to a refined procedure with great potential to be applied to routine carotid revascularisation practice. The benchmark for perioperative stroke or death for carotid revascularisation is the limit of 6% for symptomatic and 3% for asymptomatic patients.
Introduction: Endovascular treatment with coils is an established treatment for intracranial aneurysms, despite the risk of reopening the aneurysm after the treatment (1). Approximately 10% of the patients need additional treatment with coils at some time during follow-up due to the reopening (2). Magnetic resonance (MR) angiography is increasingly used as a noninvasive alternative to the standard follow-up with intraarterial digital subtraction angiography (DSA) in patients with coiled aneurysms (3). Besides its safety, MR angiography is performed in an outpatient setting and creates less discomfort for patients than does intraarterial DSA. The test characteristics and cost-effectiveness of MR angiography compared with those of intraarterial DSA are good (4,5), but more insight in the subsequent image-based additional treatment decisions is desirable before MR angiography is implemented as a standard follow-up imaging technique. We investigated whether therapeutic decision making can be solely based on MR angiographic findings by comparing treatment decisions based on findings of MR angiography and intraarterial DSA in the follow-up of patients with coil-treated aneurysms who were examined by using both imaging techniques.
OBJECTIVE. The purpose of this study was to determine the utilization by specialty and guidance method for vertebral augmentation (including vertebroplasty and kyphoplasty) in the United States from 2001 to 2010.
Introduction: Although coil placement has been accepted as a treatment for intracranial aneurysms, unfavorable aneurysm features, such as wide neck, large size, fusiform morphology, and posttreatment recanalization, remain important challenges (1–6). Stent-assisted coil placement has been developed to address these challenges but has been associated with relatively high rates of aneurysm recurrence and procedure-induced mortality (4). Such limitations of coil placement have fueled the continual search for better endovascular options for treatment of intracranial aneurysms. Endovascular placement of flow diversion devices such as the pipeline embolization device (PED) (ev3 Neurovascular, Irvine, Calif) for endoluminal circumferential reconstruction of segmental vascular defects as a treatment for intracranial aneurysms is gaining widespread acceptance (7–10). The purpose of this study was to evaluate the midterm clinical and angiographic outcomes after PED placement for intracranial aneurysms.
In order to further improve the impact of the continuously evolving neurointerventional techniques, the interventional neuroradiologist needs to have at his disposal more powerful techniques to image the central nervous system. With the recent development of diagnostics techniques that are computed tomography and magnetic resonance based we are now able to assess not just morphology, but also physiology, physiopathology and function. This review discusses the place of diagnostic techniques in the evaluation that the interventional neuroradiologist hast to make when confronted with patients. We provide an overview of current techniques for the brain and spine.
Background and Purpose—The frequent use of a longer time window for recanalization therapy in patients with basilar artery occlusion (BAO) in daily practice is not supported by any scientific evidence. We investigated the relationship between time to recanalization therapy and functional outcome in BAO with data from the Basilar Artery International Cooperation Study (BASICS).
Background and Purpose—Impairments in cerebrovascular reserve (CVR) have been variably associated with increased risk of ischemic events and may stratify stroke risk in patients with high-grade internal carotid artery stenosis or occlusion. The purpose of this study is to perform a systematic review and meta-analysis to summarize the association of CVR impairment and stroke risk.
Background—Carotid intima-media thickening is associated with increased cardiovascular risk in humans. We discovered that intima formation and cell proliferation in response to carotid injury is greater in SJL/J (SJL) in comparison with C3HeB/FeJ (C3H/F) mice. The purpose of this study was to identify candidate genes contributing to intima formation.
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