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 classification to explore which subgroups of patients are most suitable for this treatment. METHODS:From January 2015 to December 2019, 50 consecutive patients who underwent endovascular recanalization for recurrent symptomatic non-acute MCA occlusion were analyzed retrospectively. All patients were divided into three types according to the angiographic classification. The technical success rate, periprocedural complications, rate of stroke or death within 30 days, and follow-up results were evaluated. RESULTS:The overall technical success rate was 84.0% (42/50). The perioperative complication rate was 14.0% (7/50), and the rate of stroke or death within 30 days was 12.0% (6/50). The revascularization success rate was higher in patients with type I occlusion than in those with type II or type III occlusion (95.5%, 83.3%, and 60%, respectively; p=0.014), and the opposite was true for the perioperative complication rate (4.5%, 11.1%, and 40.0%, respectively; p=0.013). The median clinical follow-up period was 13.4 months (IQR 12.5-15.6), and the rate of stroke or death beyond 30 days was 8.3%. CONCLUSIONS:Endovascular recanalization for non-acute MCA occlusion is technically feasible in reasonably selected patients, especially type I patients, and has potential as an alternative option for patients with recurrent stroke or transient ischemic attack in the short term despite optimal medical therapy.
journal_name
J Neurointerv Surgjournal_title
Journal of neurointerventional surgeryauthors
Gao F,Guo X,Han J,Sun X,Zhou Z,Miao Zdoi
10.1136/neurintsurg-2020-016692subject
Has Abstractpub_date
2020-10-29 00:00:00eissn
1759-8478issn
1759-8486pii
neurintsurg-2020-016692pub_type
杂志文章abstract::Idiopathic intracranial hypertension (IIH) is characterized by headache, papilledema, visual field changes and tinnitus with elevated cerebral spinal fluid opening pressures on lumbar puncture. Left untreated, this condition can lead to permanent visual loss. Previous treatment modalities include medical management, t...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,评审
doi:10.1136/neurintsurg-2012-010468
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The pCONus is a new stent featuring a distal end that opens like a blossoming flower with four petals. The device is implanted in the aneurysm sac at the level of the neck. We report our initial experience in a series of patients treated with this device. METHODS:This retrospective study was app...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-011898
更新日期:2016-09-01 00:00:00
abstract:INTRODUCTION:Various large-bore catheters can be employed for manual aspiration thrombectomy (MAT); clinical differences are rarely explored. METHODS:Prospectively collected demographic, angiographic, and clinical data for patients with acute internal carotid artery, middle cerebral artery M1, or basilar occlusions un...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2018-014633
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Adequate dual antiplatelet (AP) therapy is imperative when performing neurovascular stenting procedures. Currently, no consensus for the ideal AP regimen exists. Thus the present study aimed to gain a better understanding of real world practice AP patterns by surveying neurointerventional surgeons. METHODS:...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2013-010954
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:To elucidate the early detachment of the Solitaire stent during mechanical thrombectomy, we tested the stent in vitro under various conditions and evaluated with microscopy. METHODS:A total of five stents were tested. Using a dynamic mechanical analysis machine, we calculated the tensile force needed for sep...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2013-010942
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Experience with the endovascular treatment of cerebral aneurysms by flow diverter devices (FDDs) is limited to four devices (Pipeline, Covidien; FRED, Microvention; Silk, Balt Extrusion; Surpass, Stryker), as reported in different studies. OBJECTIVE:To describe the initial experience and the technical innov...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-011743
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Malignant gliomas continue to have a poor clinical outcome with available therapies. In the past few years, new targeted biologic therapies have been studied, with promising results. However, owing to problems with ineffective IV delivery of these newer agents, an alternative, more direct delivery mechanism ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,评审
doi:10.1136/neurintsurg-2019-015137
更新日期:2020-02-01 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:Mechanical thrombectomy using a stent retriever has become the standard of care for acute large-vessel occlusions in the anterior circulation. Clots that are refractory to single stent retriever thrombectomy remain a challenge for neurointerventionalists. OBJECTIVE:To assess the efficacy and safety of doubl...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2018-014288
更新日期:2019-03-01 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:The treatment of recurrent aneurysms after previous surgery or embolization is challenging. Little is known regarding the use of the Pipeline Embolization Device (PED) for recurrent aneurysms. OBJECTIVE:To analyze the safety and results of PED therapy for recurrent aneurysms. METHODS:Fifteen patients with ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2012-010612
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Spinal digital subtraction angiography (DSA) is the gold standard for diagnosis of spinal dural arterial venous fistulas (SDAVFs), but can require extensive time, radiation exposure and contrast dose. We hypothesize that contrast-enhanced time-resolved MR angiography (CE-TR MRA) will have utility for the non...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2013-010981
更新日期:2015-02-01 00:00:00
abstract::We present two cases of aberrant origins of vertebral arteries. Case 1 is of a patient undergoing evaluation of an infrarenal aortic aneurysm stent graft. Computed tomography (CT) angiogram revealed an aberrant right vertebral artery that subsequently joined a second right vertebral artery that had the typical origin ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/jnis.2009.001271
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The use of stentrievers (ST) is rapidly growing due to several potential benefits over other available treatments. ST potentially restore flow before clot retrieval and reduce procedural time. We aimed to study the impact of these potential benefits. METHODS:Patients with acute stroke treated wi...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,多中心研究
doi:10.1136/neurintsurg-2013-010748
更新日期:2014-05-01 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::Intracranial dural arteriovenous fistulas with retrograde leptomeningeal or cortical drainage are considered aggressive. Conventional treatment in these cases is possible surgically or with endovascular arterial injections of Onyx or cyanoacrylate, but there are still some cases where distal navigation is not possible...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2013-010890
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:The likelihood of retreatment in patients undergoing procedures for cerebral aneurysms (CAs) has an important role in deciding the optimal treatment type. Existing determinations of retreatment rates, particularly for unruptured CAs, may not represent current clinical practice. OBJECTIVE:To use population-l...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2018-014112
更新日期:2019-04-01 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::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:Flow diversion is an established technique for treatment of cerebral aneurysms. The Pipeline embolization device (PED) is the only FDA-approved flow diverting stent in the USA. A second-generation device, PED Flex, has recently been released with modifications to the delivery system. Published reports of exp...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2015-011894
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Stent assistance for treatment of wide-based aneurysms is becoming rapidly accepted. METHODS:Cases of aneurysms arising in the paraclinoid location of the internal carotid artery treated with intracranial stents and/or bare platinum coils were analyzed retrospectively from our prospectively collected databa...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/jnis.2010.002303
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:Recent reports suggest that placement of a venous sinus stent improves symptoms in selected patients with idiopathic intracranial hypertension (IIH). We report our evaluation of the long-term patency of venous stents placed for IIH. METHODS:We retrospectively reviewed our clinical database for 30 patients (...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2013-010691
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:The rates of recanalization and reinterventions after endovascular treatment (EVT) of intracranial aneurysms are unknown. Various risk factors have been suggested including the configuration of the aneurysm and the endovascular technique. Recently, an increasing number of patients have received antiplatelet ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2011-010111
更新日期:2012-09-01 00:00:00
abstract::Infectious intracranial aneurysms (IIAs) are a rare cerebrovascular complication of systemic infections induced by microbial infiltration and degradation of the arterial vessel wall. Studies on the epidemiology and management of IIAs are limited to case reports and retrospective single-center studies, and report a lar...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章,评审
doi:10.1136/neurintsurg-2017-013603
更新日期:2018-07-01 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:BACKGROUND:Treatment of dural arteriovenous fistula involving the transverse-sigmoid region with cortical reflux is complex and treatment options may require sacrifice of the fistulous segment of the sinus. OBJECTIVE:To review our results in this subset of patients and describe current endovascular decision-making and...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2012-010497
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:Evaluation of flow diversion treatment of intracranial aneurysms is difficult owing to lack of knowledge of the target hemodynamic environment. OBJECTIVE:To identify hemodynamic conditions created after flow diversion that induce fast aneurysm occlusion. METHODS:Two groups of aneurysms treated with flow di...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2013-011080
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:The optimal treatment for medically refractory non-acute intracranial artery occlusion is uncertain, and endovascular recanalization remains a technical challenge. Here, a multicenter clinical experience of dual-roadmap guidance for endovascular recanalization of non-acute intracranial artery occlusion is re...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/neurintsurg-2020-016754
更新日期:2020-10-26 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::Gadolinium chelates can be utilized as a fluoroscopic contrast agent when iodinated contrast is contraindicated. However, the nephrotoxicity of gadolinium at radiographic doses limits its role as fluoroscopic contrast. Gadolinium chelate-enhanced digital subtraction angiography (DSA) is particularly limited by the kV ...
journal_title:Journal of neurointerventional surgery
pub_type: 杂志文章
doi:10.1136/jnis.2010.002790
更新日期:2011-03-01 00:00:00