J Neurointerv Surg
September 2025
Purpose: Endovascular treatment of intracranial atherosclerotic disease (ICAD) remains challenging due to procedural risks and stroke recurrence. Previous trials have favored aggressive medical therapy. In patients refractory to medical therapy, 'stentplasty' using expandable and retrievable devices may provide a safer alternative to balloon angioplasty by allowing controlled submaximal vessel dilation without flow arrest.
View Article and Find Full Text PDFObjectiveIntracranial plaque enhancement (IPE) is a potential biomarker of plaque vulnerability but lacks a standardized definition. While subjective assessment may be prone to observer variability, a voxel-based quantification method can detect subtle signal intensity (SI) changes. This study aimed to compare the inter-rater reliability of subjective IPE evaluation with that of a voxel-based quantification method.
View Article and Find Full Text PDFNeuroradiology
August 2025
Purpose: Evaluating intracranial aneurysm (IA) rupture risk is essential for guiding management. Although intrasaccular thrombosis (IST) is less common, it can contribute to aneurysm growth, mass effect, and rupture. Aneurysm wall enhancement (AWE) on high-resolution MRI (HR-MRI) offers valuable insight into IST and IA progression.
View Article and Find Full Text PDFBackground: The modified Fisher score is commonly used after aneurysmal subarachnoid hemorrhage (aSAH) to estimate hemorrhage burden and support early prognostication, although its accuracy in predicting cognitive outcomes remains limited. This study compares the predictive value of the subjective asessment of aSAH volume through the modified Fisher score with an objetive volumetric quantification in prognosticating cognitive outcomes.
Methods: This retrospective observational study included patients with aSAH between 2009 and 2024 and good functional recovery (modified Rankin score ≤ 2) at least 6 months after aSAH.
Background And Objectives: It is unknown what determines the volume of aneurysmal subarachnoid hemorrhage (aSAH). We aimed to investigate the features associated to the burden of subarachnoid hemorrhage after aneurysm rupture and its impact on clinical outcomes.
Methods: Patients admitted with aSAH between 2009 and 2022 were included.
A small fraction of intracranial aneurysms (IA) contains intrasaccular thrombosis (IST). This study explores the hemodynamic causes of IST formation in IAs. We performed computational hemodynamic analysis in 26 IAs: 13 thrombosed and 13 non-thrombosed.
View Article and Find Full Text PDFInterv Neuroradiol
May 2025
ObjectiveAneurysm wall enhancement (AWE) is a potential biomarker of inflammation within the aneurysm wall that has been correlated with a higher risk of rupture. Aspirin (ASA) may decrease AWE due to its anti-inflammatory properties. We aimed to assess the effect of ASA on AWE in an animal model and a cohort of patients with unruptured intracranial aneurysms (UIAs).
View Article and Find Full Text PDFObjective: Increased contrast enhancement of the aneurysm wall may indicate aneurysm instability. The authors tested different predictive models of aneurysm instability on a cohort of patients imaged with high-resolution magnetic resonance imaging (HR-MRI).
Methods: Patients with intracranial aneurysms were prospectively scanned with HR-MRI.
Background: The volume of hemorrhage is a crucial factor in predicting outcomes following aneurysmal subarachnoid hemorrhage (aSAH). Although grading scales such as the Fisher score are widely used, they can lead to inaccuracies in quantifying the total blood volume because of their reliance on visual assessment. We analyzed a large cohort of patients with aSAH with a semiautomated software for the precise quantification of hemorrhage volume.
View Article and Find Full Text PDFAJNR Am J Neuroradiol
April 2025
Background And Purpose: The determination of aneurysm wall enhancement (AWE) by human readers on visual inspection alone is subjective and prone to error. A 3D method for quantifying the signal intensity (SI) of the aneurysm enables objective determination of AWE. Interreader agreement and agreement between subjective and objective determination of AWE were assessed in this study.
View Article and Find Full Text PDF