Outcomes of bypass surgery in asymptomatic moyamoya angiopathy: A multicenter study with propensity-score weighting.

Introduction: Asymptomatic moyamoya angiopathy (MMA) is increasingly detected through noninvasive imaging; however, its optimal management remains controversial. This multicenter retrospective cohort study compared outcomes in asymptomatic versus symptomatic MMA patients undergoing surgical revascularization.

Patients And Methods: A total of 475 patients treated with bypass surgery across multiple academic centers were included, with 56 (11.

ProSPective evaluation of the dIagnostic accuracy of siNe spiN non-contrast flatdEtectoR CT (FDCT) for the detection of intracranial hemorrhage in stroke patients - Protocol of a non-inferiority comparison to multi detector CT.

Rationale: Whether syngo DynaCT Sine Spin non-contrast flat detector CT (FDCT) imaging is sufficient to rule out intracranial hemorrhage in suspected acute stroke patients is unknown.

Aim: To determine if syngo DynaCT Sine Spin non-contrast FDCT imaging is non-inferior to conventional multidetector CT (MDCT) imaging for the detection and exclusion of intracranial hemorrhages in suspected acute stroke patients.

Sample Size: To enroll 252 participants in three buckets (126 ischemic stroke patients, 126 hemorrhagic stroke patients (including 14 patients with an isolated infratentorial hemorrhage).

Safety and efficacy of preoperative embolization in the treatment of brain arteriovenous malformations with perinidal aneurysms and single draining vein: a multicenter study with propensity score-weighting.

Background And Objectives: Arteriovenous malformations (AVMs) with perinidal aneurysms and single draining vein are associated with an elevated risk of rupture and increased procedural complexity. The role of preoperative embolization in this high-risk anatomical subset remains unclear. This study aimed to evaluate the safety and efficacy of microsurgery with preoperative embolization, compared with microsurgery alone in patients with such AVMs.

Comprehensive Assessment of the Vecta46 Intermediate Catheter for Neurovascular Interventions.

Background Advancements in neuroendovascular surgery with sophisticated catheters have enhanced outcomes in complex procedures. The FDA-approved Vecta46 intermediate catheter (IMC) by Stryker Corporation (Kalamazoo, MI) is used in various neurovascular interventions. Since its approval, the Vecta46 IMC has not been comprehensively studied.

Single-Session Middle Meningeal Artery Embolization With Concomitant Evacuation Surgery for Chronic Subdural Hematoma: Impact of Surgical Approach.

Background And Objectives: Single-session middle meningeal artery embolization (MMAE) combined with surgical evacuation is a rapidly emerging strategy in the treatment of chronic subdural hematoma (cSDH). However, the effect of different evacuation techniques within this approach remains unclear.

Methods: We conducted a retrospective multicenter cohort study across 8 US institutions of patients with cSDH who underwent single-session MMAE with concomitant surgical evacuation between 2018 and 2024.

Predictors of Futile Recanalization After Endovascular Therapy for Acute Large Vessel Occlusive Intracranial Atherosclerosis: A Secondary Analysis of RESCUE-ICAS.

Background And Objectives: Futile recanalization in endovascular thrombectomy (EVT) occurs when recanalization is achieved but patients nevertheless experience a poor functional outcome. Variables associated with futile recanalization after endovascular therapy in intracranial atherosclerosis-related large vessel occlusion have not been previously described.

Methods: This was a secondary analysis of Registry of Emergent Large Vessel Occlusion due to Intracranial Stenosis (RESCUE-ICAS), a multicenter prospective observational cohort study conducted at 25 EVT-capable centers in North America, Europe, and Asia.

The role of Area Deprivation Index in treatment selection for anterior communicating artery aneurysms.

Objective: Patient outcomes in medicine vary significantly when stratified by socioeconomic status (SES). In the cerebrovascular area specifically, rates of treatment of intracranial aneurysms (IAs) and overall outcomes after subarachnoid hemorrhage vary significantly by SES. Less is known about the effect of SES on the selection of seemingly equivocal treatment modalities (microsurgery vs endovascular embolization) for IAs.

Social Media Mentions are a Stronger Predictor of Citations than 5-Year Impact Factor in Neurosurgical Research.

Background And Objectives: X (formerly known as Twitter) is a social media platform gaining popularity in neurosurgery. Other disciplines have demonstrated a positive correlation between Twitter activity and traditional citation metrics. This study aims to determine if X activity is a greater predictor of citation rates than a journal's 5-year impact factor (IF) among major neurosurgical journals.

Systematic evaluation of AI-based text-to-image models for generating medical illustrations in neurosurgery: a multi-stage comparative study.

Objective: This study evaluates the effectiveness of artificial intelligence (AI) models in generating accurate, high-quality medical illustrations for vascular neurosurgery. It aims to develop a systematic framework for producing and assessing AI-generated medical images.

Methods: Four AI models-DALL-E, Copilot, Gemini, and Midjourney-were tested to generate illustrations of neurovascular structures and procedures (e.

Single-Session Middle Meningeal Artery Embolization With Concomitant Evacuation Surgery for Chronic Subdural Hematomas: A Multicenter Assessment of Feasibility, Safety, and Efficacy.

Background And Objectives: Middle meningeal artery embolization (MMAE) is a safe and efficacious adjunct to surgical evacuation for symptomatic chronic subdural hematoma (cSDH). We evaluated the concomitant performance of MMAE with surgical evacuation in a single anesthetic session rather than a staged approach.

Methods: In this retrospective, multicenter cohort study, patients with cSDH who underwent MMAE and surgical evacuation during 1 anesthetic session from January 2020 through August 2024 were included.

Impact of smoking on occlusion rates following stereotactic radiosurgery for Spetzler Martin grade I-III brain arteriovenous malformations - A propensity score matched analysis of the MISTA consortium.

Backgroundand Objective: The authors compareocclusion rates in grade I-III AVMs in smokers and non-smokers, using propensity score matching (PSM).

Methods: The authors performed a subgroup analysis of the MISTA consortium, a multicenter registry that includes patients aged 1 to 89 years with AVMs treated between January 2010 and December 2023. Only grade I-III AVMs were included.

Angiographic Occlusion After Flow Diversion of Ruptured and Unruptured Intracranial Aneurysms Using the Flow Redirection Endoluminal Device-X: A Multicenter Analysis.

Background And Objectives: Flow diversion induces progressive aneurysm occlusion by reducing blood flow across the aneurysm neck over time. Various factors, including comorbid conditions, aneurysm characteristics, and stent design, have been shown to affect occlusion rates after flow diversion. Our study analyzed predictors of angiographic occlusion after flow diversion of intracranial aneurysms using the Flow Redirection Endoluminal Device with X-technology (FRED-X).

Comparative Safety and Efficacy of Balloon Mounted Stents and Self Expanding Stents in Rescue Stenting for Large Vessel Occlusion: Secondary analysis of the RESCUE-ICAS Registry.

Background And Purpose: Patients with intracranial stenosis-related large vessel occlusion (ICAS-LVO) may experience better outcomes with stenting compared to standalone mechanical thrombectomy. This study evaluates the safety and clinical outcomes of self-expanding stents (SES) versus balloon-mounted stents (BMS) in ICAS-LVO patients treated with mechanical thrombectomy and stenting.

Materials And Methods: This secondary analysis of the RESCUE-ICAS registry, a multicenter observational study, included ICASLVO patients from 25 stroke centers who underwent stenting.

Early results with EmboTrap III stent retriever: A multicenter US experience.

BackgroundMechanical thrombectomy with stent retrievers has become a standard treatment for acute ischemic stroke due to large vessel occlusion. Here we present a multicenter US experience using the EmboTrap III stent retriever, the latest iteration within its class.MethodsWe retrospectively reviewed patients with acute ischemic stroke treated with the EmboTrap III device at 4 US centers.

Optimal timing for early cranioplasty following craniectomy: A propensity-matched national database study of 3241 patients.

Introduction: Nearly 30 % of patients experience complications following cranioplasty after decompressive craniectomy. However, the optimal timing for this procedure is not well established.

Objective: To compare complication rates for cranioplasty performed at different early monthly intervals after craniectomy.

Outcomes of medical and surgical management in infectious intracranial aneurysms: a multicenter cohort analysis.

Introduction: Infectious intracranial aneurysms (IIAs) are rare but serious complications of systemic infections, particularly infective endocarditis. These aneurysms are prone to rupture, leading to significant morbidity and mortality. Management strategies lack consensus due to the rarity of the condition and reliance on small case series.

A retrospective review of safety and efficacy of the selectFlex neurovascular access catheters.

BackgroundSupportive guide catheters are needed to navigate large endovascular devices through complex cerebral vasculature. The Q'Apel SelectFlex family of distal access guide catheters may eliminate the need for triaxial systems through a simplified biaxial approach with reduced costs and similar effectiveness as traditional systems.MethodsA retrospective review of patients who underwent neuroendovascular interventions using SelectFlex catheters at 4 US sites between April 2021 and August 2022 was performed.

The 'Slingshot' technique: balloon-guide assisted tracking of distal systems past tortuosity and ledges in thrombectomy.

Background: We describe and analyze a novel technique by which inflation of a proximal balloon guide catheter (BGC) permits tracking of distal catheter systems past vessel tortuosity and ledges like the ophthalmic segment of the internal carotid artery (ICA). Inflation of the BGC counteracts slippage when deployed, and careful advancement of the system builds up energy that is translated forward, allowing users to cross segments otherwise inaccessible by endovascular techniques.

Methods: A retrospective review of our institutional neurovascular database was conducted, and we identified nine patients for whom the novel 'Slingshot' technique was used for mechanical thrombectomy.

Comparative analysis of Onyx, squid, and n-BCA in middle meningeal artery embolization for chronic subdural hematoma: a meta-analysis of randomized controlled trials.

Background: Selection of an embolic agent for middle meningeal artery embolization (MMAE) in a chronic subdural hematoma (cSDH) is a subject of debate and is limited to observational data. We report the first meta-analysis that exclusively assessed randomized controlled trials (RCTs) to address this gap.

Methods: A systematic review and meta-analysis was conducted, incorporating all available RCTs that compared MMAE plus standard of care (SOC) versus SOC alone for cSDH usingeither Onyx, n-BCA, and Squid as embolic agent for embolization.

International multi-center study of middle meningeal artery embolization for chronic subdural hematoma in cancer patients: Efficacy, safety, and outcomes in a high-risk population.

BackgroundMiddle meningeal artery embolization (MMAE) is a promising treatment for chronic subdural hematoma (cSDH). Cancer patients are at risk for cSDH due to thrombocytopenia. The efficacy of MMAE in this population has not been studied.

Long-term outcomes of resolute Onyx Zotarolimus-eluting stents for symptomatic intracranial stenosis: A multicenter propensity score-matched comparison with stenting versus aggressive medical management for preventing recurrent stroke in intracranial stenosis trial.

BackgroundIntracranial atherosclerotic disease (ICAD) is a leading cause of ischemic stroke. The Medtronic Resolute Onyx Zotarolimus-eluting stents (RO-ZES) are promising in preventing stroke recurrence compared with medical management (MM) and percutaneous angioplasty and stenting (PTAS) at both 30-day and one-year follow-ups. We evaluated long-term outcomes for patients treated with RO-ZES, PTAS, or MM.

Effect of race on procedural and clinical outcomes in middle meningeal artery embolization for primary and adjunctive treatment of chronic subdural hematoma.

BackgroundWe investigated racial disparities in radiologic and clinical outcomes of patients after middle meningeal artery embolization (MMAE) for chronic subdural hematoma (CSDH) with or without evacuation surgery.MethodsThis multicenter retrospective study includes consecutive patients who underwent MMAE across 11 institutions in North America (10 in the United States and 1 in Canada). Patients were stratified using self-reported racial data.

Early Experience With the Dual-Mode Radial-Access Catheter Armadillo in Neuroendovascular Procedures via the Radial Approach: A Multicenter Study of 71 Patients.

Background And Objectives: The transradial approach is increasingly being adopted by neurointerventionalists after several studies showed its safety, efficacy, and patient satisfaction. However, the use of non-radial-specific devices for transradial procedures is a major barrier for transradial adoption. In this study, we aim to demonstrate the efficacy, technical feasibility, and safety of the Armadillo dual-mode guide catheter (Q'Apel Medical Inc.

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.

Order and Timing of Middle Meningeal Artery Embolization as a Perioperative Adjunct to Surgical Evacuation for Chronic Subdural Hematomas: A Multicenter Study.

Background Chronic subdural hematoma (cSDH) is a common neurosurgical condition, and middle meningeal artery embolization (MMAE) has emerged as a minimally invasive adjunct to surgery, but optimal timing remains unclear. Purpose To investigate radiographic and clinical outcomes of patients with cSDH undergoing MMAE as an adjunct to surgical evacuation, focusing on order and timing of MMAE relative to surgery. Materials and Methods This multicenter, retrospective study included consecutive patients undergoing MMAE adjunct to surgery for cSDH at 10 U.