Abstract:
BACKGROUND:In acute stroke management, time efficiency in the continuum of patient management is critical. We aimed to determine if implementation of system improvements at our institution translated to reduced picture-to-puncture (P2P) times over a 6-year period. METHODS:We conducted a single-center retrospective analysis using a prospective acute stroke database of patients treated with intra-arterial therapy from October 2007 to October 2013. Patient demographics, stroke severity, neuroimaging and treatment time points were collected. Annual P2P times, defined as the interval between pretreatment neuroimaging (picture) and commencement of intra-arterial therapy (puncture), were assessed and compared. RESULTS:From 2007 to 2013 a total of 189 patients were identified, of which 181 met the study criteria. At initial presentation, median baseline NIH Stroke Severity score was 17.00 (IQR 11.00-22.00). Annual median P2P times decreased from 171 to 123.5 min, showing a median decrease of 11.5 min per annum (95% CI -23.9 to 0.9) and trending towards statistical significance (p=0.069). Plotted data revealed longer P2P times in instances where stroke onset or CT acquisition times were out-of-hours. Using median regression modeling, the annual decrease in P2P median time reached statistical significance when independently adjusting for CT acquisition time (13.5 min P2P median time reduction, 95% CI -27.0 to -0.1, p=0.048) and for stroke onset time (14.5 min annual P2P median time reduction, 95% CI -26.1 to -2.8, p=0.015). CONCLUSIONS:As a consequence of systems improvement at our institution, we were able to demonstrate improved annual median P2P times from 2007 to 2013.
journal_name
J Neurointerv Surgjournal_title
Journal of neurointerventional surgeryauthors
van Heerden J,Yan B,Churilov L,Dowling RJ,Mitchell PJdoi
10.1136/neurintsurg-2014-011177subject
Has Abstractpub_date
2015-08-01 00:00:00pages
564-8issue
8eissn
1759-8478issn
1759-8486pii
neurintsurg-2014-011177journal_volume
7pub_type
杂志文章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:Human placenta is a convenient resource for biomedical research, and has not yet been used for neurointerventional surgery research. OBJECTIVE:Our objective was to explore the feasibility of using human placenta to test various endovascular interventions and for training. DESIGN:18 placentas soon after del...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2013-010813
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Collateral status modified the effect of endovascular treatment (EVT) for stroke in several randomized trials. We assessed the association between collaterals and functional outcome in EVT treated patients and investigated if this association is time dependent. METHODS:We included consecutive patients from ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/neurintsurg-2018-014619
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVE:To determine the relative effectiveness of proximal and distal protection in prevention of cerebral ischemic events during carotid artery stent (CAS) placement using diffusion-weighted MRI (DW-MRI). METHODS:We analyzed data from patients who had undergone DW-MRI before and within 24 hours of CAS for symptoma...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2016-012661
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Cerebrovascular infundibular dilations (IDs) are triangular-shaped widenings less than 3 mm in diameter, which are most commonly found at the posterior communicating artery (PCoA). The aims of this systematic review are to elucidate the natural histories of IDs, determine their risk of progression to signifi...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,评审
doi:10.1136/neurintsurg-2015-011827
更新日期:2016-08-01 00:00:00
abstract:INTRODUCTION:To explore the patency and growth of surgical sidewall aneurysms in rabbits. MATERIALS AND METHODS:Forty sidewall aneurysms were created in the right common carotid artery (RCCA). Intravenous digital subtraction angiography (DSA) through the ear vein was performed immediately after creation. Three weeks l...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2012-010575
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Trials of endovascular thrombectomy (EVT) mostly excluded patients with large core strokes so the safety and efficacy of EVT is not well established in such patients. Moreover, the definition of large core and its measurement differ between semi-quantitative (ASPECTS) and quantitative (core volume) imaging m...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,评审
doi:10.1136/neurintsurg-2019-015509
更新日期:2020-12-01 00:00:00
abstract::Large and giant aneurysms pose significant challenges to the endovascular techniques of coil embolization or parent vessel reconstruction. Many large aneurysms are wide-necked with bulbous domes and frequently require stent-assisted coiling or flow diversion to reconstruct and preserve flow through the parent artery. ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2012-010276
更新日期:2013-07-01 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 transradial approach (TRA) reduces mortality, morbidity, access site complications, hospital cost, and length of stay while maximizing patient satisfaction. We aimed to assess the technical success and safety of TRA for elderly patients (aged ≥75 years). METHODS:A retrospective chart review and comparat...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2020-016140
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The impact of the Warfarin and Aspirin for Symptomatic Intracranial Disease (WASID) data is described in combination with the commercial release of the Wingspan stenting system on the frequency of neurointervention for the treatment of symptomatic intracranial atherosclerotic disease (ICAD) in a ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/jnis.2009.000497
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:There is a discrepancy in clinical outcomes and the achieved recanalization rates with stent retrievers in the endovascular treatment of ischemic stroke. It is our hypothesis that procedural release of embolic particulate may be one contributor to poor outcomes and is a modifiable risk. The goal of this stud...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011491
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVE:Despite promising initial results, current knowledge regarding the use of the Low-profile Visualized Intraluminal Support (LVIS) device to treat wide-necked intracranial aneurysms is still limited. Our aim is to evaluate the feasibility, efficacy, and safety of the LVIS device in stent-assisted coiling of int...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,评审
doi:10.1136/neurintsurg-2016-012403
更新日期:2017-06-01 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::We report a case of a direct carotid-cavernous fistula (CCF) in a patient with Ehlers-Danlos syndrome type IV who presented with progressive chemosis and diplopia. To prevent potential lethal arterial wall injury due to the fragility of the arterial vessel wall, the ipsilateral carotid artery and internal jugular vein...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2014-011414.rep
更新日期:2016-01-01 00:00:00
abstract::More than half a decade of experience and follow-up has now been accumulated with regard to flow diversion as a treatment for intracranial aneurysms; however, many uncertainties, such as the nature of aneurysmal remnants and the meaning of non-regressed, non-perfused aneurysmal masses, are still unknown. Here we discu...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-012093.rep
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Initial studies investigating correlations between stroke etiology and clot composition are conflicting and do not account for clot size as determined by area. Radiological studies have shown that cardioembolic strokes are associated with shorter clot lengths and lower clot burden than non-cardioembolic clot...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2020-016966
更新日期:2020-12-09 00:00:00
abstract:BACKGROUND:Towards the translation of computational fluid dynamics (CFD) techniques into the clinical workflow, performance increases achieved with parallel multi-central processing unit (CPU) pulsatile CFD simulations in a patient-derived model of a bilobed posterior communicating artery aneurysm were evaluated while ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2012-010586
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Reversible cerebral vasoconstriction syndromes (RCVS) represent a heterogeneous group of cerebrovascular disease characterized by acute presentations and transient segmental narrowing of the distal intracranial arteries. A series of patients with RCVS were studied to better understand the clinica...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/jnis.2010.004242
更新日期:2011-09-01 00:00:00
abstract:INTRODUCTION:Transarterial embolization with Onyx is a relatively safe and increasingly common method of treating cranial dural arteriovenous fistulas (DAVF) and arteriovenous malformations (AVM). Cranial neuropathy resulting from this procedure has been reported. CASE REPORTS:Three case histories are presented in two...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2012-010328
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:To describe the use of DynaCT angiographic imaging for the evaluation of Wingspan in-stent restenosis (ISR). METHODS:Two patients were treated with Wingspan stenting and percutaneous transluminal angioplasty (Patient 1 had treatment of a severe stenosis of the right middle cerebral artery and ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/jnis.2009.000505
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Little is known about the safety of long-term anticoagulation in patients with unruptured saccular intracranial aneurysms, although case reports of anticoagulation in patients with fusiform and saccular aneurysms have been published. The goal of this study was to estimate the rate of subarachnoid...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2012-010359
更新日期:2013-09-01 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:OBJECTIVE:To determine whether drug-eluting (DE) stents offer any advantage over bare-metal (BM) stents in terms of restenosis rates and to identify indications for vertebral artery stenting (VAS) based on the current literature. METHODOLOGY:A retrospective analysis was performed for patients who underwent extracrania...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2011-010051
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Volume coils were developed to improve occlusion rates of intracranial aneurysms. Previous studies have shown increased packing density and comparable occlusion rates, but subgroup analyses of aneurysm size have not been carried out. OBJECTIVE:To evaluate the safety and efficacy of the Penumbra Coil 400 (PC...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-012014
更新日期:2016-10-01 00:00:00
abstract:INTRODUCTION:Venous outflow obstruction is recognized as a contributing factor in a subset of patients with idiopathic intracranial hypertension (IIH). Little is known about venous sinus waveform morphology or how it changes after stenting. METHODS:Fifteen patients with IIH underwent waveform recording during catheter...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2018-013858
更新日期:2018-11-01 00:00:00
abstract::The purpose of this publication is to provide a comprehensive review on the techniques and tools used for vascular access in neurointerventional procedures. Using published literature, we reviewed data on access methods, sites, tools, and techniques for neurointerventions. Recommendations are provided based on quality...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2019-015573
更新日期:2020-08-01 00:00:00
abstract::Ischemic strokes in childhood are rare. Thrombolytic therapy with intravenous (IV) tissue plasminogen activator (tPA) has been the main intervention for the management of pediatric stroke patients, but safety data are lacking and efficacy has been questioned. Recently, successful endovascular treatments for acute isch...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-011821.rep
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Larger bore aspiration catheters are expected to significantly improve the speed and completeness of acute stroke revascularization. OBJECTIVE:To evaluate the navigability and clot retrieval performance of a novel 8Fr aspiration catheter, Millipede 088 (Perfuze Ltd), using fresh-frozen cadavers and an in vi...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2020-016218
更新日期:2020-06-30 00:00:00
abstract:BACKGROUND:Endovascular recanalization for medically refractory non-acute middle cerebral artery (MCA) occlusion remains a clinical dilemma, and limited data are available. We report the multicenter clinical results of endovascular recanalization for symptomatic non-acute MCA occlusion and propose a new angiographic cl...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2020-016692
更新日期:2020-10-29 00:00:00