Clin Neuroradiol
August 2025
Purpose: To compare the efficacy and safety of the pEGASUS-HPC and CREDO heal coated stent systems used with the NeuroSpeed percutaneous angioplasty (PTA) balloon catheter, for treating acute symptomatic intracranial artery stenosis (ICAS) with or without acute vessel occlusion (VO).
Methods: This retrospective, multicenter study included patients with ICAS between June-2021 and June-2024 treated with the NeuroSpeed PTA balloon catheter and either stent system. Clinical endpoints included National Institutes of Health Stroke Scale (NIHSS) scores and modified ranking scores (mRS), safety and efficacy endpoints included in-stent thrombosis and in-stent stenosis.
ObjectivesY-stent-assisted coiling (Y-SAC) is an established technique for managing wide-necked intracranial bifurcation aneurysms. However, data on the use of the pEGASUS stent, a self-expanding open-cell stent with an antithrombogenic hydrophilic polymer coating, remain limited. This study evaluated the effectiveness and safety of Y-SAC with pEGASUS stents in patients with intracranial bifurcation aneurysms.
View Article and Find Full Text PDFPurpose: To evaluate the safety, efficacy, and clinical outcomes of stent-assisted coiling (SAC) and flow diversion (FD) with hydrophilic polymer-coated (HPC) devices under prasugrel single antiplatelet therapy (SAPT) in the treatment of acutely ruptured wide-neck intracranial aneurysms.
Methods: This multicenter retrospective case series included patients with ruptured saccular intracranial aneurysms treated through SAC or FD with HPC-coated devices under SAPT at four specialized neurovascular centers. Baseline demographics, aneurysm characteristics, procedural details, and clinical outcomes were analyzed.
Objective: Status epilepticus (SE) represents one of the most common neurological emergencies. The International League Against Epilepsy (ILAE) redefined SE duration thresholds from 30 to 5 min for convulsive SE in 2015. We conducted a prospective population-based study to determine SE incidence and outcomes under the revised criteria and compared findings with historical data using the 30-min definition.
View Article and Find Full Text PDFBackgroundStent-assisted coiling (SAC) is increasingly used to treat ruptured wide-necked intracranial aneurysms. The pEGASUS-HPC stent, featuring a hydrophilic polymer coating (HPC) to reduce thrombogenicity, may offer a safe option in subarachnoid hemorrhage (SAH). This study evaluates its safety and efficacy in a multicenter retrospective cohort.
View Article and Find Full Text PDFThe aim of this study is to present the initiation of robotic-guided (RG) spine surgery into routine clinical care at a single center with the use of intraoperative CT (iCT) automatic registration-based navigation. The workflow included iCT with automatic registration, fusion with preoperative imaging, verification of preplanned screw trajectories, RG introduction of K-wires, and the insertion of pedicle screws (PSs), followed by a control iCT scan. All patients who underwent RG implantation of pedicle screws using the Cirq robotic arm (BrainLab, Munich, Germany) in the thoracolumbar spine at our department were included in the study.
View Article and Find Full Text PDFObjective: This study was undertaken to develop and validate an automatic, artificial intelligence-enhanced software tool for hippocampal sclerosis (HS) detection, using a variety of standard magnetic resonance imaging (MRI) protocols from different MRI scanners for routine clinical practice.
Methods: First, MRI scans of 36 epilepsy patients with unilateral HS and 36 control patients with epilepsy of other etiologies were analyzed. MRI features, including hippocampal subfield volumes from three-dimensional (3D) magnetization-prepared rapid acquisition gradient echo (MPRAGE) scans and fluid-attenuated inversion recovery (FLAIR) intensities, were calculated.
To investigate the safety and efficacy of using the pEGASUS HPC stent pusher instead of a microwire for catheterization of nonruptured cerebral aneurysms during stent-assisted coiling. In this multicenter retrospective study (July 2021-June 2024), 107 patients with 118 incidental nonruptured cerebral aneurysms underwent stent-assisted coiling using pEGASUS HPC stents. Based on the catheterization technique, cases were assigned to either the microwire-assisted catheterization (MAC, n = 58) or the stent pusher-assisted catheterization (PAC, n = 60) group.
View Article and Find Full Text PDFDeep brain stimulation of the subthalamic nucleus (STN-DBS) is an established intervention for alleviating both motor and non-motor symptoms in advanced Parkinson's disease (PD). However, patient outcomes may vary widely, underscoring the need for predictive biomarkers. Neuroimaging techniques, such as neurite orientation dispersion and density imaging (NODDI), a biophysical model-based MRI technique, offer promise in forecasting clinical outcomes and supporting preoperative counseling.
View Article and Find Full Text PDFPharmacoresistant epilepsy affects approximately one-third of all epilepsy patients, and resective surgery may offer favorable outcomes for carefully selected patients with focal epilepsy. The accurate identification of the epileptogenic zone (EZ) is essential for successful surgery, particularly in cases where non-invasive diagnostics are inconclusive. Invasive diagnostics with stereoelectroencephalography (SEEG) offer a reliable approach to localizing the EZ, especially in MRI-negative cases.
View Article and Find Full Text PDFBackground: We investigated the relationship of piriform cortex (PC) structural network centrality with drug resistance and epilepsy duration as markers of sustained epileptic activity.
Methods: PCs were manually delineated on retrospectively collected 3D-T1-MRI images of patients with temporal lobe epilepsy (TLE). Connectomes were computed from diffusion MRI scans, including the PC as network nodes.
Background: The aim of this study was to assess the surgical outcomes and survival of patients surgically treated for metastatic epidural spinal cord compression (MESCC), with a specific focus on identifying factors that influence overall survival and readmission-free survival.
Methods: All patients who underwent surgery for spine metastases at our department in the period 2018-2022 were included in the study.
Results: A total of 175 patients (n = 71 females, median age 67.
The effect of subthalamic stimulation (STN-DBS) on patients' personal satisfaction with life and their Parkinson's disease (PD) treatment is understudied, as is its correlation with quality of life (QoL). Therefore, we tested the hypothesis that STN-DBS for PD enhances satisfaction with life and treatment. In a prospective, multicenter study with a 6-month follow-up involving 121 patients, we measured the main outcomes using the Satisfaction with Life and Treatment Scale (SLTS-7).
View Article and Find Full Text PDFPurpose: Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers and several studies demonstrate that STAT3 has critical roles throughout the course of PDAC pathogenesis.
Methods: TCGA, microarray, and immunohistochemistry data from a PDAC cohort were used for clinical analyses. Panc89 cells with ADAM8 knockout, re-expression of ADAM8 mutants, and Panc1 cells overexpressing ADAM8 were generated.
: Epilepsy surgery for extratemporal lobe epilepsy (ETLE) is challenging, particularly when MRI findings are non-lesional and seizure patterns are complex. Invasive diagnostic techniques are crucial for accurately identifying the epileptogenic zone and its relationship with surrounding functional tissue. Microscope-based augmented reality (AR) support, combined with navigation, may enhance intraoperative orientation, particularly in cases involving subtle or indistinct lesions, thereby improving patient outcomes and safety (e.
View Article and Find Full Text PDFBioengineering (Basel)
July 2024
Surgical education demands extensive knowledge and skill acquisition within limited time frames, often limited by reduced training opportunities and high-pressure environments. This review evaluates the effectiveness of extended reality-based head-mounted display (ExR-HMD) technology in surgical education, examining its impact on educational outcomes and exploring its strengths and limitations. Data from PubMed, Cochrane Library, Web of Science, ScienceDirect, Scopus, ACM Digital Library, IEEE Xplore, WorldCat, and Google Scholar (Year: 2014-2024) were synthesized.
View Article and Find Full Text PDFBackground: Hereditary hemorrhagic telangiectasia (HHT, Rendu- Osler-Weber disease, or Osler's disease for short) is a systemic disease that can severely impair the quality of life and that requires interdisciplinary treatment. Among rare diseases, it is relatively common, with a prevalence of approximately 1/5000.
Methods: This review is based on publications retrieved by a selective literature search, including the two international guidelines on clinically relevant aspects of HHT.
: Microsurgical resection with intraoperative neuromonitoring is the gold standard for acoustic neurinomas (ANs) which are classified as T3 or T4 tumors according to the Hannover Classification. Microscope-based augmented reality (AR) can be beneficial in cerebellopontine angle and lateral skull base surgery, since these are small areas packed with anatomical structures and the use of this technology enables automatic 3D building of a model without the need for a surgeon to mentally perform this task of transferring 2D images seen on the microscope into imaginary 3D images, which then reduces the possibility of error and provides better orientation in the operative field. : All patients who underwent surgery for resection of ANs in our department were included in this study.
View Article and Find Full Text PDF: The aim of this study is to present our experience in the surgical treatment of calcified thoracic herniated disc disease via a transthoracic approach in the lateral position with the use of intraoperative computed tomography (iCT) and augmented reality (AR). All patients who underwent surgery for calcified thoracic herniated disc via a transthoracic transpleural approach at our Department using iCT and microscope-based AR were included in the study. : Six consecutive patients (five female, median age 53.
View Article and Find Full Text PDFDespite its broad use in cranial and spinal surgery, navigation support and microscope-based augmented reality (AR) have not yet found their way into posterior fossa surgery in the sitting position. While this position offers surgical benefits, navigation accuracy and thereof the use of navigation itself seems limited. Intraoperative ultrasound (iUS) can be applied at any time during surgery, delivering real-time images that can be used for accuracy verification and navigation updates.
View Article and Find Full Text PDFThe effects of subthalamic nucleus deep brain stimulation (STN-DBS) on anxiety in Parkinson's disease (PD) are understudied. We identified clinical predictors of STN-DBS effects on anxiety in this study. In this prospective, open-label, multicentre study, we assessed patients with anxiety undergoing STN-DBS for PD preoperatively and at 6-month follow-up postoperatively.
View Article and Find Full Text PDFDeep brain stimulation of the subthalamic nucleus (STN-DBS) effectively treats motor and non-motor symptoms in advanced Parkinson's disease (PD). As considerable interindividual variability of outcomes exists, neuroimaging-based biomarkers, including microstructural metrics, have been proposed to anticipate treatment response. In this prospective open-label study, we sought to detect microstructural properties of brain areas associated with short-term non-motor outcomes following STN-DBS.
View Article and Find Full Text PDFWorld Neurosurg
July 2024
Background: Our study presents a single-center experience of resection of intradural spinal tumors either with or without using intraoperative computed tomography-based registration and microscope-based augmented reality (AR). Microscope-based AR was recently described for improved orientation in the operative field in spine surgery, using superimposed images of segmented structures of interest in a two-dimensional or three-dimensional mode.
Methods: All patients who underwent surgery for resection of intradural spinal tumors at our department were retrospectively included in the study.
Adjuvant treatment for Glioblastoma Grade 4 with Temozolomide (TMZ) inevitably fails due to therapeutic resistance, necessitating new approaches. Apoptosis induction in GB cells is inefficient, due to an excess of anti-apoptotic XPO1/Bcl-2-family proteins. We assessed TMZ, Methotrexate (MTX), and Cytarabine (Ara-C) (apoptosis inducers) combined with XPO1/Bcl-2/Mcl-1-inhibitors (apoptosis rescue) in GB cell lines and primary GB stem-like cells (GSCs).
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