Background: Rapid identification of large vessel occlusion (LVO) in acute ischemic stroke (AIS) is essential for reperfusion therapy. Screening tools, including Artificial Intelligence (AI) based algorithms, have been developed to accelerate detection but rely heavily on pre-test LVO prevalence. This study aimed to review LVO prevalence across clinical contexts and analyze its impact on AI-algorithm performance.
View Article and Find Full Text PDFBackground: Rescue stenting (RS) is a bailout strategy for failed thrombectomy. Optimal platelet inhibition strategy after RS remains unclear.
Objectives: We aimed to describe and compare different platelet inhibition strategies during/after RS.
Eur Radiol
August 2025
Objectives: Arterial spin labeling (ASL) MRI is a non-invasive imaging modality that measures cerebral blood flow (CBF) without the need for contrast agents or radiation, offering insights into hemodynamic changes. Carotid revascularization procedures, carotid endarterectomy and carotid artery stenting, aim to improve cerebral perfusion and reduce the risk of ischemic events. This study explores ASL's clinical potential in assessing CBF changes in carotid stenosis patients prior to revascularization procedures.
View Article and Find Full Text PDFTo evaluate the available evidence on the efficacy and safety of flow diverters (FD) with or without adjunctive coils (C) for the treatment of large and giant aneurysms. A systematic review and meta-analysis of relevant studies in PubMed and selected articles up to December 2022 were conducted. The primary objective was to evaluate the rate of favorable occlusion O'Kelly Marotta (OKM) C-D at the last follow-up, while the secondary objective was to assess complication rates.
View Article and Find Full Text PDFBackground: There are limited therapeutic options in cases of failed reperfusion (modified thrombolysis in cerebral infarction [mTICI] score < 2b) after stent-retriever and/or aspiration based endovascular treatment (EVT) for acute ischemic stroke. Despite the absence of data supporting its use, rescue therapy (balloon angioplasty and/or stent implantation) is often utilized in such cases. Studies are limited to large vessel occlusions, while the outcomes and complications after rescue therapy in medium/distal vessel occlusions (MDVOs) have not been reported.
View Article and Find Full Text PDFInterv Neuroradiol
August 2024
Spinal arteriovenous fistulas (SAVFs) are the most common type of vascular malformation of the spine in adult patients. They can lead to acute or progressive myelopathy due to venous congestion of the medullary veins. While most SAVFs are acquired, their pathophysiology remains unclear.
View Article and Find Full Text PDFBackground And Purpose: Angioplasty and stent placement have been described as a bailout technique in individuals with failed thrombectomy. We aimed to investigate Stent retriever AssIsted Lysis (SAIL) with tirofiban before angioplasty and stent placement.
Materials And Methods: Patients from 2 comprehensive stroke centers were reviewed (2020-2023).
Background: The impact of thrombolytics directed towards different thrombus components regarding site of occlusion in combination with mechanical thrombectomy (MT) to achieve endovascular complete recanalization is unclear.
Methods: Retrospective analysis of a prospective database in two stroke centers. Intracranial thrombi retrieved by MT were analyzed using hematoxylin-eosin staining for fibrin and red blood cell proportions, and CD61 immunostaining for platelets proportion in thrombus (PLTPT) assessment.
The identification of large vessel occlusion with underlying intracranial atherosclerotic disease (ICAS-LVO) before endovascular treatment (EVT) continues to be a challenge. We aimed to analyze baseline clinical-radiological features associated with ICAS-LVO that could lead to a prompt identification. We performed a retrospective cross-sectional study of consecutive patients with stroke treated with EVT from January 2020 to April 2022.
View Article and Find Full Text PDFIntroduction: Grading of carotid stenosis is routinely performed with non-invasive techniques, such as carotid ultrasound (CUS) and computerized tomography angiography (CTA), which have limitations in grading definition. Moreover, the actual hemodynamic impact of a stenosis remains poorly defined. Preliminary studies explored the application of the resting full-cycle ratio (RFR), measured with pressure wire (PW), but the correlation between RFR and morphological/hemodynamic parameters is still undefined.
View Article and Find Full Text PDFJ Neurointerv Surg
December 2023
Background: Cognitive improvement after endovascular embolization of an intracranial dural arteriovenous fistula (dAVF) remains unexplored. We aim to investigate cognitive changes following endovascular embolization of dAVFs.
Methods: Neuropsychology in dural ArterIal Fistula (NAIF) was a prospective multicentric study including patients with an angiographic diagnosis of dAVF who underwent endovascular embolization over the course of 4 years.
J Neurointerv Surg
September 2024
Background: Collateral blood supply of distal vessels has been linked to clinical outcome, infarct volume and recanalization rates in patients with large vessel occlusion. Our study aimed to explore the effects of catheterization during mechanical thrombectomy in collaterals.
Methods: We quantified the flow diversion effect secondary to arterial occlusions in an in vitro model which was connected in a flow-loop setup with a saline reservoir and a pump supplying pulsatile flow.
Background: Treatment of brain arteriovenous malformations (b-AVM) carries a risk of iatrogenic injury to eloquent brain regions. Intraoperative neuro-monitoring (IONM) has increasingly been used to monitor spontaneous or evoked neural activity during neurosurgery, but its use is not as well characterized in the endovascular treatment (EVT) of b-AVMs. We aimed to provide a systematic review and meta-analysis of studies reporting any neurological deficit after b-AVM embolization with IONM, with or without provocative test (PT), and no-IONM.
View Article and Find Full Text PDFBackground: Acute ischemic stroke with large or medium-vessel occlusion associated with intracranial artery calcification (IAC) is an infrequent phenomenon presumably associated with intracranial atherosclerotic disease. We aimed to characterize IAC and its impact on endovascular treatment outcomes.
Methods: We performed a retrospective cross-sectional study of consecutive patients with stroke treated with thrombectomy from January 2020 to July 2021 in our institution.
Introduction: Endovascular treatment (EVT) for acute ischemic stroke (AIS) between 6 and 24 h is established as a standard of care among patients selected by multiparametric neuroimaging. We aimed to explore neuroimaging parameters in late-window large vessel occlusion (LVO) patients and its association with non-contrast computed tomography (NCCT) findings.
Methods: We included consecutive AIS patients within 6-24 h from the symptoms onset with LVO.
Background: Flow diverters have emerged in recent years as a safe and effective treatment for intracranial aneurysms, with expanding indications. The Derivo embolization device (DED) is a second-generation flow diverter with a surface finish that may reduce thrombogenicity. We report our multicenter experience evaluating its safety and efficacy.
View Article and Find Full Text PDFIntrasaccular flow disruptors (IFD) have been introduced in the treatment of intracranial aneurysms (IAs) to overcome the low aneurysm occlusion rate and the high recanalization rate of the coiling technique. Among them, the Contour Neurovascular System (CNS) and the Neqstent (NQS) were designed to reconstruct the aneurysmal neck and both can be used as assisting coiling devices. We aimed to report our preliminary experience with the flow disruptor-assisted coiling (IFD-AC) technique.
View Article and Find Full Text PDFBackground: Remote access of trainees to training centers via video streaming (tele-observership, e‑fellowship) emerges as an alternative to acquire knowledge in endovascular interventions. Situational awareness is a summary term that is also used in surgical procedures for perceiving and understanding the situation and projecting what will happen next. A high situational awareness would serve as prerequisite for meaningful learning success during tele-observerships.
View Article and Find Full Text PDFJ Neurointerv Surg
January 2022
Background: A direct aspiration first pass thrombectomy (ADAPT) is a fast-growing technique for which a broad catalog of catheters that provide a wide range of aspiration forces can be used. We aimed to characterize different catheters' aspiration performance on stiff clots in an in vitro vascular model. We hypothesized that labeled catheter inner diameter (labeled-ID) is not the only parameter that affects the aspiration force (asp-F) and that thrombus-catheter tip interaction and distensibility also play a major role.
View Article and Find Full Text PDFTherap Adv Gastroenterol
July 2019
Background: The objective of this study was to analyse the prevalence of metabolic bone disease (MBD) in a cohort of Southern European patients with inflammatory bowel disease (IBD) and to identify associated risk factors in this population.
Methods: We conducted a retrospective, both cross-sectional and longitudinal study of MBD, assessed by dual energy X-ray absorptiometry (DXA), among patients diagnosed with IBD and previously recognized risk factors for this complication from two referral Spanish institutions.
Results: A total of 612 patients (58.