Comparative study of the refined mini-pterional approach with reduced skin incision versus the conventional mini-pterional approach for clipping unruptured middle cerebral artery aneurysms: a propensity score-matched analysis.

This study aimed to compare the safety and efficacy of the refined mini-pterional approach (rMP), utilizing a smaller skin incision, with the conventional mini-pterional approach (cMP) for microsurgical clipping of unruptured intracranial aneurysms (UIAs) in the middle cerebral artery (MCA). A retrospective cohort analysis was conducted, including 186 patients: 92 patients who underwent rMP between 2021 and 2022, and 94 patients treated with cMP between 2019 and 2020. Clinical outcomes included length of stay (LOS, days), operative time (minutes), intraoperative blood loss (ml), aneurysm obliteration rate, postoperative complication rates, and the severity of temporalis muscle atrophy (TMA).

Trajectory clustering of immune cells and its association with clinical outcomes after aneurysmal subarachnoid hemorrhage.

Background And Purpose: The immune response following aneurysmal subarachnoid hemorrhage (aSAH) can exacerbate secondary brain injury and impact clinical outcomes. As the immune response after aSAH is a dynamic process, we aim to track and characterize immune cell trajectories over time to identify patterns associated with various clinical outcomes.

Methods: In this retrospective single-center study of patients with aSAH, we analyzed immune cell count trajectories, including neutrophil, monocyte, and lymphocyte counts, collected from day 1 to day 14.

Nationwide Cohort observational study on the safety and efficacy of COVID-19 vaccination in patients with Moyamoya disease.

The safety and efficacy of coronavirus disease 2019 (COVID-19) vaccination in patients diagnosed with Moyamoya disease (MMD) have not been established. Using National Health Insurance Service data, this study analyzed the occurrence of stroke-related events and mortality following COVID-19 vaccination among patients diagnosed with MMD from 2008 to 2020. Among 10,297 MMD patients, 296 (2.

Incidence and Risk Factors of Contrast-Induced Sialadenitis after Therapeutic Neuroendovascular Procedures.

Background And Purpose: Swelling of the salivary glands, known as contrast-induced sialadenitis (CIS), is an adverse reaction to iodide contrast agents. However, the incidence and risk factors of CIS after therapeutic neuroendovascular procedures have not yet been established.

Materials And Methods: Demographic and procedural factors that may influence the development of CIS were retrospectively analyzed to identify the incidence and risk factors of this condition.

Prediction of contralateral progression in patients with bilateral nonhemorrhagic moyamoya disease following unilateral revascularization surgery.

Objective: This study was designed to identify predictive factors associated with substantial contralateral progression in adult patients with bilateral nonhemorrhagic moyamoya disease (MMD) who undergo revascularization surgery (RS) on one hemisphere.

Methods: The authors retrospectively analyzed 174 contralateral hemispheres of patients with bilateral nonhemorrhagic MMD (non-hMMD) who underwent RS on one side. The primary endpoint was defined as substantial contralateral progression requiring additional RS 6 months after the initial RS.

Clinical Outcomes of Clipping and Coil Embolization for Ruptured Intracranial Aneurysms Categorized by Region and Hospital Size: A Nationwide Cohort Study in Korea.

Background: To analyze the outcomes of clipping and coiling for ruptured intracranial aneurysms (RIAs) based on data from the National Health Insurance Service in South Korea, with a focus on variations according to region and hospital size.

Methods: This study analyzed the one-year mortality rates for patients with RIAs who underwent clipping or coiling in 2018. Coiling was further categorized into non-stent assisted coiling (NSAC) and stent assisted coiling (SAC).

Factors predicting recanalization following stent-assisted coil embolization of unruptured intracranial aneurysms with long-term follow-up.

Objective: Stents have been widely used for coil embolization for intracranial aneurysms. Few studies have analyzed the risk factors of recanalization through long-term follow-up observation of only stent-assisted coiling. We analyzed the risk factors for recanalization through long-term observations.

Prediction of postoperative cerebral infarction after combined bypass surgery in adult moyamoya disease: combining quantitative parameters on RAPID perfusion CT with clinically related factors.

Objective: The aim of this study was to identify predictive factors of postoperative cerebral infarction (PostCI) following combined bypass (CB) surgery in adult patients with moyamoya disease (MMD) using quantitative parameters from the rapid processing of perfusion and diffusion (RAPID) perfusion CT (PCT) software.

Methods: The authors retrospectively reviewed 276 total hemispheres in patients with MMD who underwent CB. Preoperative volumes of time-to-maximum (Tmax) > 4 sec and > 6 sec were obtained from the RAPID analysis of PCT.

Relationship between in-stent restenosis following carotid artery stenting and platelet reactivity to clopidogrel.

Objective: To analyze the relationship between in-stent restenosis (ISR) following carotid artery stenting (CAS) and platelet clopidogrel reactivity confirmed by the P2Y12 reaction unit (PRU) and inhibition rate (IR).

Methods: We retrospectively analyzed 171 patients who underwent CAS with extracranial carotid stenosis from January 2016 to December 2019. Dual antiplatelet therapy with 100 mg aspirin and 75 mg clopidogrel was started ≥5 days before CAS.

Optimal blood pressure for stroke prevention in healthy adults below 65 years: A nationwide 10-year observational study.

Background: There have been few reports on the preventative value of intensive blood pressure (BP) management for stroke since the American College of Cardiology/American Heart Association (ACC/AHA) announced the new criteria for hypertension (HTN) in 2017. This study aimed to identify optimal BP for prevention of stroke in healthy adults under 65 years.

Methods: We conducted a 10-year observational study on the risk of stroke, subclassified as hemorrhagic stroke (HS) or ischemic stroke (IS), according to BP categories (low-normal BP, high-normal BP, elevated BP, stage 1 HTN, and stage 2 HTN) using the National Health Insurance Service Database.

Clinical Outcomes of Coil Embolization for Unruptured Intracranial Aneurysms Categorized by Region and Hospital Size : A Nationwide Cohort Study in Korea.

Objective: To analyze the outcomes of coil embolization (CE) for unruptured intracranial aneurysm (UIA) according to region and hospital size based on National Health Insurance Service data in South Korea.

Methods: The incidence of complications, including intracranial hemorrhage (ICRH) and cerebral infarction (CI), occurring within 3 months and the 1-year mortality rates in UIA patients who underwent CE in 2018 were analyzed. Hospitals were classified as tertiary referral general hospitals (TRGHs), general hospitals (GHs) or semigeneral hospitals (sGHs) according to their size, and the administrative districts of South Korea were divided into 15 regions.

Results of Double Low-Profile Visualized Intraluminal Support Blue Stenting for the Treatment of Fusiform Cerebral Aneurysms.

Background: The flow diversion technique is increasingly used for reconstructive endovascular treatment of fusiform cerebral aneurysms. Double stenting with the Low-profile Visualized Intraluminal Support (LVIS) Blue stent is one of the flow diversion techniques. The aim of this study was to analyze the clinical and angiographic outcomes of LVIS Blue double stenting for fusiform cerebral aneurysms.

Initial severity of aneurysmal subarachnoid hemorrhage (SAH): Trend over time.

Objective: The trend in the initial severity of aneurysmal subarachnoid hemorrhage (SAH) is unclear. This study aimed to evaluate whether there was an improvement in the initial severity of SAH over time.

Methods: From January 1, 2005, to December 31, 2020, we identified patients who visited the emergency department of our institution with SAH due to intracranial aneurysm rupture.

Optimal Duration of Dual Antiplatelet Therapy after Stent- Assisted Coil Embolization of Unruptured Intracranial Aneurysms : A Prospective Randomized Multicenter Trial.

Objective: Stent-assisted coil embolization (SAC) has been increasingly used to treat various types of intracranial aneurysms. Delayed thromboembolic complications are major concerns regarding this procedure, so dual antiplatelet therapy with aspirin and clopidogrel is needed. However, clinicians vary the duration of dual antiplatelet therapy after SAC, and no randomized study has been performed.

Quantitative radiological analysis and clinical outcomes of urgent EC-IC bypass for hemodynamic compromised patients with acute ischemic stroke.

This study aimed to demonstrate the effectiveness of urgent extracranial-to-intracranial bypass (EIB) in acute ischemic stroke (AIS) through quantitative analysis of computed tomography perfusion (CTP) results using RAPID software. We retrospectively analyzed 41 patients who underwent urgent EIB for AIS under strict operation criteria. The quantitative data from CTP images were reconstructed to analyze changes in pre- and postoperative perfusion status in terms of objective numerical values using RAPID software.

Navigation of frameless fixation for gamma knife radiosurgery using fixed augmented reality.

Augmented reality (AR) offers a new medical treatment approach. We aimed to evaluate frameless (mask) fixation navigation using a 3D-printed patient model with fixed-AR technology for gamma knife radiosurgery (GKRS). Fixed-AR navigation was developed using the inside-out method with visual inertial odometry algorithms, and the flexible Quick Response marker was created for object-feature recognition.

Long-Term Outcomes of Placement of a Single Transverse Stent through the Anterior Communicating Artery via the Nondominant A1 in Coil Embolization of Wide-Necked Anterior Communicating Artery Aneurysms.

Objective: Placement of a single transverse stent via the nondominant A1 across the anterior communicating artery (AComA) into the contralateral A2 can provide sufficient neck coverage for wide-necked bifurcation AComA aneurysms. The authors described the feasibility, safety and long-term outcomes of this technique.

Methods: Between January 2015 and February 2018, placement of a single transverse stent via the nondominant A1 was attempted in 17 wide-necked bifurcation AComA aneurysms.

Simultaneous Craniotomies for Multiple Intracranial Aneurysm Clippings-One-Stage Surgery with Multiple Craniotomies.

Objective: The treatment of multiple intracranial aneurysms (MIAs) involves various modalities and sometimes requires staged operations. This study aimed to prove the efficacy and safety of one-stage multiple craniotomies (OSMC) for multiple cerebral aneurysms.

Methods: We retrospectively reviewed the medical records of the patients who underwent treatment for intracranial aneurysms between May 2003 and April 2020.

Clinical Outcomes of Clipping and Coiling in Elderly Patients with Unruptured Cerebral Aneurysms: a National Cohort Study in Korea.

Background: We aimed to analyze outcomes of clipping and coiling in treating unruptured intracranial aneurysms (UIAs) in elderly patients and to identify the age at which perioperative risk increases based on national cohort data in South Korea.

Methods: The incidence of perioperative intracranial hemorrhage (ICRH), perioperative cerebral infarction (CI), mortality, and moderate to severe disability data of the patients who underwent coiling or clipping for UIAs were retrieved. Estimated breakpoint (EBP) was calculated to identify the age at which the risk of treatment increases.

Prevention of Microsphere Blockage in Catheter Tubes Using Convex Air Bubbles.

This paper presents a novel method to prevent blockages by embolic microspheres in catheter channels by using convex air bubbles attached to the channels' inner wall surface. The clogging by microspheres can occur by the arching of the microspheres in the catheter. A few studies have been done on reducing the blockage, but their methods are not suitable for use with embolic catheters.

Long-term outcomes of drug-eluting stent implantation in patients with symptomatic extra- and intracranial atherosclerotic stenoses.

Objective: Implantation of drug-eluting stents (DES) for extra- and intracranial atherosclerotic stenoses is an emerging topic. It has the potential benefit of preventing recurrent stroke with a reduced rate of in-stent restenosis (ISR).

Methods: Patients who underwent extra- or intracranial stenting using DES in a single institution were retrospectively reviewed with long-term angiographic and clinical follow-up data.

Higher oscillatory shear index is related to aneurysm recanalization after coil embolization in posterior communicating artery aneurysms.

Background: The recurrence rate of posterior communicating artery (Pcom) aneurysms after endovascular treatment (EVT) is higher than that for aneurysms located in other sites. However, it is still unclear what mechanisms are responsible for the recanalization of cerebral aneurysms. In this investigation, we compared hemodynamic factors related with recanalization of Pcom aneurysms treated by endoluminal coiling using computational fluid dynamics (CFD) with high-resolution three-dimensional digital subtraction angiography images.