Abstract:
:The lifetime risk of developing a cerebral aneurysm is about 5%. For some patients, aneurysms can be reasonably managed by conservative measures, including periodic clinical and imaging surveillance. However, the definitive treatment of cerebral aneurysm disease requires securing the aneurysm by surgically excluding it from the cerebrovascular circulation. Most commonly, this can be achieved by either open surgical clipping or embosurgery. Unfortunately, for a minority of patients, these interventions are inadequate because of many aneurysmal factors, such as complex anatomy, giant and wide neck aneurysmal morphology, peripheral small branch origin and skull base location. In situations like these, sacrifice of the parent artery may be preferable, especially when clinical tolerance or image based vascular reserve can be preoperatively demonstrated during temporary occlusion of the vessel. This preoperative procedure, which is known as the Balloon Test Occlusion (BTO), has several variations and technical nuances that can assist the surgeon in predicting which patients may best benefit from parent artery sacrifice (PAS). Together, BTO and PAS are invaluable tools in the management of complicated and atypical cerebral aneurysms. With regard to cerebrovascular aneurysm disease, this review will summarize the development of these procedures, condense the predictability of the numerous BTO variations and provide an overview of the currently available PAS techniques.
journal_name
J Neurointerv Surgjournal_title
Journal of neurointerventional surgeryauthors
Lesley WS,Rangaswamy Rdoi
10.1136/jnis.2009.000539subject
Has Abstractpub_date
2009-12-01 00:00:00pages
112-20issue
2eissn
1759-8478issn
1759-8486pii
jnis.2009.000539journal_volume
1pub_type
杂志文章,评审abstract:BACKGROUND:The Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3 (DEFUSE 3) clinical trial assessed the use of endovascular thrombectomy (EVT) during the period 6-16 hours after last normal in selected patients. This is a secondary cohort analysis of the DEFUSE 3 data assessing potential predictiv...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2020-016548
更新日期:2020-10-19 00:00:00
abstract:BACKGROUND:Stenting of symptomatic intracranial atherosclerosis remains under investigation, yet this option to potentially avert subsequent stroke has been offered at select centers under humanitarian device exemption and off-label use for several years. METHODS:Retrospective case series of consecutive patients under...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/jnis.2010.004523
更新日期:2012-01-01 00:00:00
abstract:INTRODUCTION:Endovascular interventions for intracranial aneurysms have evolved substantially over the past several decades. A citation rank list is used to measure the scientific and/or clinical impact of an article. Our objective was to identify and analyze the characteristics of the 100 most cited articles in the fi...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2017-013688
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Protection of the head and eyes of the neurointerventional radiologist is a growing concern, especially after recent reports on the incidence of brain cancer among these personnel, and the revision of dose limits to the eye lens. The goal of this study was to determine typical occupational dose levels and to...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-011703
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Although it is common practice to wait for an 'embedding time' during mechanical thrombectomy (MT) to allow strut integration of a stentriever device into an occluding thromboembolic clot, there is a scarcity of evidence demonstrating the value or optimal timing for the wide range of thrombus compositions. T...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2018-014601
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Mechanical thrombectomy using stentrievers is the standard of care for emergent large vessel occlusion stroke. Data on the use of stentrievers in smaller caliber vessels are sparse. OBJECTIVE:To present our initial experience with the Mindframe Capture LP device, which was designed for mechanical thrombecto...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-012078
更新日期:2016-11-01 00:00:00
abstract::Acute hemorrhage relating to an expanding pseudoaneurysm of the carotid artery is referred to as carotid blowout syndrome (CBS). CBS is associated with a high morbidity and mortality. We describe the case of a patient who presented with dysphagia and a pulsatile mass in the neck. Imaging revealed a pseudoaneurysm orig...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-012121.rep
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:The low profile visualized intraluminal support (LVIS) device is being increasingly used for the treatment of intracranial aneurysms. Its application in the basilar artery (BA) has not yet been reported. OBJECTIVE:To evaluate the safety and early efficacy of the LVIS device for the treatment of BA aneurysms...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2018-014393
更新日期:2019-04-01 00:00:00
abstract::Several anatomical variations of the radial artery have been described in the literature. Common variations include radial artery loop, recurrent branch, and anastomotic channels connecting the radial and brachial arteries. These variations can pose significant technical challenges to safe radial artery catheterizatio...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2019-015712
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:To understand how three commonly used measures of endovascular therapy correlate with clinical outcome and infarct growth. METHODS:Prospectively enrolled patients underwent baseline MRI and started endovascular therapy within 12 h of stroke onset. The final angiogram was given a primary arterial occlusive le...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2013-010973
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Despite several retrospective studies analyzing the safety and efficacy of transradial access (TRA) versus transfemoral access (TFA) for cerebral angiography, this transition for neurointerventional procedures has been gradual. Nonetheless, based on our positive initial institutional experience with TRA for ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2017-013584
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:Flow induced tangential wall shear stress (WSS) is thought to be involved in aneurysm formation, growth, and rupture. Low WSS was previously associated with rupture, but definitive quantitative analyses remain scant as larger aneurysms are associated with lower WSS regardless of rupture status, and ruptured a...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2013-010871
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Selection bias may have affected enrollment in first generation endovascular stroke trials. We investigate, evaluate, and quantify such bias for these trials at our institution. METHODS:Demographic, clinical, imaging, and angiographic data were prospectively collected on a consecutive cohort of patients wit...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011628
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Flow diverters (FD) can cause rare but devastating delayed aneurysm ruptures in which matrix metalloproteinases (MMPs) have been potentially implicated. Concomitant coiling or anti-inflammatory medications have been proposed to prevent the risk of delayed ruptures. The aim of this study was to ev...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-012207
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We compared outcomes between endovascular (EV) therapy and intravenous (IV) thrombolysis in large vessel strokes. METHODS:223 patients who had received either IV (n=100) or EV (n=123) therapy were analyzed. Only patients with strokes involving the internal carotid artery terminus (ICA-T, n=45), ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2012-010429
更新日期:2013-09-01 00:00:00
abstract::The treatment of palpebral and periorbital fistulas may be challenging due to the presence of multiple anastomosis with eloquent ophthalmic and intracranial vascular territories. Moreover, cosmetic and functional characteristics of this area pose unique challenges to open surgical approaches and endovascular therapy. ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2017-013239
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:There is no consensus regarding the best treatment option for unruptured aneurysms of the posterior communicating artery (PCom) presenting with oculomotor nerve palsy (ONP). We aimed to assess predictors of ONP recovery in a multicenter series of consecutive patients. MATERIALS AND METHODS:A retrospective r...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2020-015802
更新日期:2020-10-01 00:00:00
abstract::Patients with cavernous carotid fistulas (CCFs) can present with pituitary hypoperfusion and hypopituitarism; however, there are no previous reports of pituitary or hormonal abnormalities developing after CCF embolisation in an asymptomatic patient. We describe a patient with no hormonal abnormalities who developed sy...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-012104.rep
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Chronic subdural hematoma (CSDH) is a common condition requiring surgical treatment; however, recurrence occurs in 15% of cases at 1 year. Middle meningeal artery (MMA) embolization has recently emerged as a promising treatment to prevent CSDH recurrence. OBJECTIVE:To investigate the effect of MMA embolizat...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,随机对照试验
doi:10.1136/neurintsurg-2019-015421
更新日期:2020-07-01 00:00:00
abstract:PURPOSE:Although the anatomic course of the posterior interior cerebellar artery (PICA) is variable, it is thought to be very rare for the artery to cross midline, with an estimated incidence of 0.1%. Bihemispheric PICA crosses midline and typically serves both PICA territories. METHODS:We present 11 cases of bihemisp...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2012-010527
更新日期:2013-11-01 00:00:00
abstract::Currently, there is no device capable of detecting acute ischemic stroke (AIS) secondary to emergent large vessel occlusion (ELVO) in the pre-hospital setting. The inability to reliably identify patients that would benefit from primary treatment with endovascular thrombectomy remains an important limitation to optimiz...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,评审
doi:10.1136/neurintsurg-2017-013428
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:The DEFUSE 3 and DAWN trials have shown the benefit of thrombectomy beyond 6 hours of stroke symptom onset in carefully selected patients. OBJECTIVE:To evaluate the real-world outcomes of stent retriever thrombectomy beyond 6 hours of stroke onset using combined individual patient data from the North Americ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2018-014272
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Expansion of the endovascular and surgical workforce in the USA might lead to carotid revascularization procedures being carried out at low volume centers. OBJECTIVE:To evaluate trends in the treatment of carotid stenosis at high volume centers in the USA and compare outcomes by hospital volume. METHODS:Us...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011180
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Open surgery and the retrograde endovascular approach via the distal left common carotid artery (LCCA) have some limitations in LCCA ostial stenosis treatment. The 'no touch' technique used in the renal artery was modified for this situation. METHODS:Fifteen selective LCCA stenosis patients were treated by ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2016-012544
更新日期:2017-02-01 00:00:00
abstract::We describe a case where a complex unruptured basilar tip aneurysm was treated with a unique method of stent-assisted coil embolization. The aneurysm was considered to have a complex anatomy since both the left posterior cerebral artery and left superior cerebellar artery originated from the dome of the aneurysm. Also...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011288.rep
更新日期:2015-10-01 00:00:00
abstract::Endovascular treatment of carotid cavernous fistulas (CCFs) via a transvenous approach is standard, but in rare cases this approach is challenging due to absence or thrombosis of the commonly used venous routes. A 61-year-old woman presented with a symptomatic CCF with all but one of the venous access routes to the CC...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2017-013229.rep
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:No studies have assessed the incidence of craniocervical arterial dissections (CCADs) and its association to mortality in hospitalized patients with a primary diagnosis of atraumatic subarachnoid hemorrhage (SAH) requiring aneurysmal repair. We hypothesize that the incidence of CCADs in these patients has in...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011324
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:With increasing use of flow-diverting stents for the treatment of intracranial aneurysms, standardized methods and a common language to evaluate angiographic outcomes are needed. Multiple grading scales have been developed for this purpose but none has been widely adopted. OBJECTIVE:To analyze these scales ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-012193
更新日期:2016-12-01 00:00:00
abstract::We report two cases of delayed post-embolectomy stenosis--that is, a new stenosis in the vascular bed of a previous endovascular embolectomy. The first case was discovered incidentally in a patient returning after embolectomy for evaluation of cerebral aneurysms. The second case was discovered on an MR angiogram obtai...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011136.rep
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Over half of patients who receive intravenous tissue plasminogen activator for middle cerebral artery division (MCA-M2) occlusion do not recanalize, leaving a large percentage of patients who may need mechanical thrombectomy (MT). However, the outcomes of MT for M2 occlusion have not been well characterized....
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,多中心研究
doi:10.1136/neurintsurg-2017-013159
更新日期:2018-04-01 00:00:00