Carotid Revascularization in the Modern Era: A Comparative Review of Carotid Endarterectomy, Carotid Angioplasty and Stenting, and Transcarotid Artery Revascularization.

Carotid artery stenosis is a major cause of acute ischemic stroke, accounting for approximately 15% of cases. Although optimal medical therapy remains the cornerstone of management, current guidelines recommend consideration of surgical intervention for symptomatic patients with ≥50% stenosis and asymptomatic patients with ≥70% stenosis. Extensive evidence supports carotid endarterectomy (CEA) as the gold standard procedure, whereas transfemoral carotid angioplasty and stenting (TF-CAS) and transcarotid artery revascularization (TCAR) offer safe alternatives for patients with high surgical risk.

Safety and efficacy of the Celt arterial closure device in a femoral first neuroendovascular practice: prospective cohort study.

Objectives: To evaluate the safety and efficacy of the Celt arterial closure device (ACD), allowing immediate upright position and ambulation within 30 minutes, for femoral access closure in neuroendovascular procedures.

Methods: Single center prospective study of consecutive neuroendovascular procedures performed via transfemoral access over 6 months. The Celt ACD was preferentially used for arterial closure in eligible cases.

Demonstration of physiologic, clinical and angiographic improvement of dural arteriovenous fistula via primary transverse sinus stenting.

A healthy, middle-aged man presented with acute on chronic progressive photophobia, headache and visual impairment. Clinical workup demonstrated advanced papilledema, tortuous optic nerves, flattened globes and intracranial pressure of >55 cm HO. Diagnostic cerebral angiogram demonstrated a Cognard IIA tentorial dural arteriovenous fistula (dAVF) associated with transverse sinus stenosis.

Pure arterial malformations of the brain: A systematic review of clinical presentation, diagnosis, and management.

Background: Pure arterial malformations (PAMs) of the brain are rare vascular anomalies, typically identified incidentally and characterized by tortuous arterial loops. Their unclear etiology and management pose diagnostic and therapeutic challenges.

Methods: A systematic review of Medline, EMBASE, and Web of Science databases (1900-present) identified 15 studies involving 54 patients with PAM.

Interventional treatment strategies for arteriovenous malformations of the mandible and maxilla: 30-year institutional case series.

BackgroundFacial arteriovenous malformations (AVMs) can pose a risk of hemorrhage, bone erosion, and cosmetic deformity. Our objective is to evaluate treatment strategies and outcomes of patients with AVMs of the mandible and maxilla at our institution.MethodsA retrospective, consecutive series of patients with AVMs involving the mandible, maxilla and adjacent tissues was identified.

Traumatic Vertebral Artery Injury: Diagnosis, Natural History, and Key Considerations for Management.

Vertebral artery injury (VAI) is a known complication of blunt cervical spine trauma with a potential risk of stroke. Factors including cervical bony injury, spinal cord injury, and overall trauma severity have been linked to an increased risk of VAI. Despite its prevalence, there is little consensus on various aspects of this pathology, including its initial screening, diagnostic approaches, and therapeutic strategies.

Higher risk of recurrence in partially thrombosed cerebral aneurysms post-WEB (Woven EndoBridge) device treatment: insights from the WorldWideWEB Consortium registry.

Background: The Woven EndoBridge (WEB) device is a prevalent treatment for intracranial aneurysms. While many studies have assessed the obliteration rate post-WEB embolization, few have focused on long-term outcomes in partially thrombosed aneurysms.

Objective: To assess whether partially thrombosed aneurysms are at higher risk of recurrence or retreatment following WEB embolization compared with non-thrombosed aneurysms.

Parenchymal Hematoma After Endovascular Thrombectomy Is Associated With Pretreatment Basal Ganglia Infarct Volume.

Background And Purpose: Parenchymal hematomas (PHs) represent an important complication in ischemic stroke after endovascular thrombectomy (EVT), but the risk factors are incompletely understood. Neuroimaging data preintervention, such as infarct topography, may help elucidate predisposing factors and inform more nuanced patient care intra- and postprocedurally.

Methods: Large vessel occlusion patients with pre-EVT MRI were included from a single quaternary center.

Prediction of persistent incomplete occlusion of intracranial aneurysms treated with woven EndoBridge device.

While the Woven EndoBridge (WEB) device has transformed the treatment of wide-neck intracranial aneurysms, incomplete occlusion remains a significant challenge requiring better understanding of contributing factors. A retrospective analysis was conducted on multicenter data from patients who underwent WEB device treatment for intracranial aneurysms between January 2011 and December 2022. Using machine learning models, Cox regression, and time-stratified analyses, we evaluated factors associated with persistent incomplete occlusion, defined as non-improving Raymond-Roy Occlusion Classification grade 2 or 3 at final follow-up.

Traumatic vertebral artery occlusion is associated with high rates of recanalization: insights from a systematic review and meta-analysis.

Background: Vertebral artery occlusion (VAO) is a known complication of blunt cervical injuries and can be associated with a risk of devastating strokes. VAO can spontaneously recanalize, particularly following cervical spine intervention. The aim of this study is to examine overall recanalization rates, recanalization in the context of cervical spine intervention, and the associations between VAO and stroke, spinal cord injury, and acute cervical deformity.

Incidence and predictors of Woven EndoBridge (WEB) shape modification following treatment of intracranial aneurysms in a large multicenter study.

The Woven EndoBridge (WEB) device is FDA-approved for the treatment of bifurcation aneurysms. Despite its wide popularity, it has been under scrutiny for its association with potential aneurysm recanalization and retreatment due to device shape modification. This study aims to analyze the shape modification rate of WEB devices and identify factors associated with this phenomenon, as well as its correlation with aneurysm retreatment.

Endovascular thrombectomy for large vessel occlusion stroke patients with baseline disability: Long-term outcomes and end-of-life care.

Background: One third of all patients with acute ischemic strokes have a pre-existing disability. Patients with pre-existing disabilities have historically been excluded from landmark clinical trials of acute stroke interventions, leading to ongoing controversy about the risks and benefits of acute stroke interventions such as endovascular thrombectomy (EVT). To address this controversy, we compared long-term outcomes and end-of-life care in large vessel occlusion (LVO) patients with moderate-to-severe baseline disability treated with EVT versus medical management alone.

Pre-operative internal maxillary artery embolization for temporomandibular joint replacement: safety and outcomes from a 10-year institutional experience.

Background: Temporomandibular joint replacement (TMJR) can result in large volume blood loss (BL) from the underlying internal maxillary artery (IMA). Pre-operative IMA embolization has been utilized to reduce intra-operative BL, but prior studies are limited to small case series.

Methods: Adult patients undergoing pre-operative IMA embolization for TMJR between June 2014 and September 2024 at a single institution were included.

Impact of smoking on recurrence rates among wide-neck intracranial aneurysms treated with Woven EndoBridge: a multicenter retrospective study.

Objective: Tobacco smoking is among the factors known to significantly augment the risk of untreated intracranial aneurysm (IA) growth and rupture. Smoking appears to have a variable effect on different endovascular treatment modalities. The impact of smoking on the safety, efficacy, and outcomes of Woven EndoBridge (WEB) device use for wide-neck IAs has not been evaluated.

Surgical Outcomes After Preoperative Embolization in Hypervascular Spinal Metastases: A Propensity Scored Study of 191 Patients.

Study Design: Retrospective propensity-score matched, case-control study at 2 academic tertiary care centers.

Objective: To assess the effect of preoperative embolization (PE) on (1) intraoperative blood loss, defined as conventional estimates of blood loss (EBL) and hemoglobin mass loss; and (2) secondary outcomes in patients with spinal metastases from hypervascular histologies.

Background Context: PE intends to reduce blood loss during surgery for spinal metastases of hypervascular tumors such as renal cell carcinoma.

Impact and determinants of door in-door out time for stroke thrombectomy transfers in a large hub-and-spoke network.

Introduction: The mantra "time is brain" cannot be overstated for patients suffering from acute ischemic stroke. This is especially true for those with large vessel occlusions (LVOs) requiring transfer to an endovascular thrombectomy (EVT) capable center. We sought to evaluate the spoke hospital door in-door out (DIDO) times for patients transferred to our hub center for EVT.