Migration of an Atrial Septal Defect Occluder in a Pregnant Patient.

• Delayed migration of ASDO is a rare complication. • Evidence of ASDO migration in pregnant patients is lacking. • TTE provides safe and rapid imaging to assess hemodynamics and ASDO location in pregnancy.

Bleeding Risk With Antiplatelets and Bruton's Tyrosine Kinase Inhibitors in Patients With Percutaneous Coronary Intervention.

Bruton's tyrosine kinase inhibitors (BTKi), known for their off-target antiplatelet effects and increased bleeding risk, have become more frequently used in patients with cancer with lymphoid malignancies. When encountering patients on BTKi who also require antiplatelet therapies, particularly dual-antiplatelet therapy that is a well-established treatment after percutaneous coronary intervention (PCI), the potential increase in bleeding risk raises concern. The development of new-generation BTKi with a higher selectivity, such as acalabrutinib and zanubrutinib, could be an answer to this conundrum, but bleeding still occurs.

Hyperacute immune responses associate with immediate neuropathology and motor dysfunction in large vessel occlusions.

Objective: Despite successful endovascular therapy, a proportion of stroke patients exhibit long-term functional decline, regardless of the cortical reperfusion. Our objective was to evaluate the early activation of the adaptive immune response and its impact on neurological recovery in patients with large vessel occlusion (LVO).

Methods: Nineteen (13 females, 6 males) patients with acute LVO were enrolled in a single-arm prospective cohort study.

Safety and efficacy of the surpass streamline for intracranial aneurysms (SESSIA): A multi-center US experience pooled analysis.

Background And Purpose: Flow diversion has established as standard treatment for intracranial aneurysms, the Surpass Streamline is the only FDA-approved braided cobalt/chromium alloy implant with 72-96 wires. We aimed to determine the safety and efficacy of the Surpass in a post-marketing large United States cohort.

Materials And Methods: This is a retrospective multicenter study of consecutive patients treated with the Surpass for intracranial aneurysms between 2018 and 2021.

Dataset on flow diversion procedures performed with the Pipeline Embolization Device, Pipeline Flex, and Surpass Streamline for intracranial aneurysms.

Flow diversion is an evolving endovascular modality for treating intracranial aneurysms. Although rare, serious adverse events following flow diversion may include ischemic stroke, intracranial hemorrhage, or delayed rupture of the treated aneurysm. This dataset describes 141 flow diversion procedures performed with the Pipeline Embolization Device, Pipeline Flex, or Surpass Streamline on 126 subjects with intracranial aneurysms [1].

Angiography suite cone-beam CT perfusion for selection of thrombectomy patients: A pilot study.

Background And Purpose: The availability of cone-beam CT perfusion (CBCTP) in angiography suites may improve large-vessel occlusion (LVO) triage and reduce reperfusion times for patients presenting during extended time window. We aim to evaluate the perfusion maps correlation and agreement between multidetector CT perfusion (MDCTP) and CBCTP when obtained sequentially in patients undergoing endovascular therapy.

Methods: This is a prospective, pilot, single-arm interventional cohort study of consecutive patients with anterior circulation LVO.

Primary Cardiac Triple-Hit Lymphoma.

Cardiac double-hit and triple-hit lymphomas (DHLs, THLs) are rare; in fact, studies examining both DHL and THL remain scarce. THL with cardiac involvement constitutes a rare disease with few cases reported so far. Thus, in this study, we report the case of a 67-year-old woman who presented with initial symptoms of pulmonary embolism.

Pipeline Embolization Device and Pipeline Flex Versus Surpass Streamline Flow Diversion in Intracranial Aneurysms: A Retrospective Propensity Score-Matched Study.

Objective: To compare safety and efficacy profiles in aneurysms treated with Pipeline Embolization Device or Pipeline Flex versus Surpass Streamline flow diverters (FDs).

Methods: Patients who underwent flow diversion for aneurysm treatment at 2 centers were included. Covariates comprised patient demographics, comorbidities, and aneurysm characteristics.

Acute Carotid Artery Stenting Versus Balloon Angioplasty for Tandem Occlusions: A Systematic Review and Meta-Analysis.

Background Despite thrombectomy having become the standard of care for large-vessel occlusion strokes, acute endovascular management in tandem occlusions, especially of the cervical internal carotid artery lesion, remains uncertain. We aimed to compare efficacy and safety of acute carotid artery stenting to balloon angioplasty alone on treating the cervical lesion in tandem occlusions. Similarly, we aimed to explore those outcomes' associations with technique approaches and use of thrombolysis.

Endovascular embolization of high-grade cerebral dural arteriovenous fistulas - assessment of long-term recurrences.

Introduction: Endovascular therapy has shown to be safe and effective for the treatment of cerebral dural arteriovenous fistulas; however, recurrence after complete occlusion is not uncommon, and the timing of recurrence remains unknown.

Methods: A retrospective single-center cohort study was conducted from January 2005 to December 2020. Patients with high-grade (≥Borden II-Cognard IIB) dural arteriovenous fistulas treated with endovascular therapy were included in this study.

Carotid artery angioplasty versus stenting for management of acute tandem occlusions.

Background The optimal approach to treat the cervical carotid artery lesion during endovascular thrombectomy (EVT) for acute strokes with tandem occlusions is unclear. While carotid artery stenting (CAS) might be a more definitive recanalization method, the potential risk of intracranial hemorrhage (ICH) limits its routine usage. In this study, we aimed to evaluate the safety outcomes of CAS and carotid artery angioplasty (CAA) in patients with acute tandem occlusions.

Optimal Woven EndoBridge (WEB) Device Size Selection Using Automated Volumetric Software.

Introduction: Selecting the appropriate Woven EndoBridge (WEB) device sizing for the treatment of wide-neck bifurcation aneurysms (WNBAs) remains challenging. The aim of this study was to evaluate different volumetric-based imaging methodologies to predict an accurate WEB device size selection to result in a successful implantation.

Methods: All consecutive patients treated with WEB devices for intracranial aneurysms from January 2019 to June 2020 were included.

Angiography Suite Cone-Beam Computed Tomography Perfusion Imaging in Large-Vessel Occlusion Patients Using RAPID Software: A Pilot Study.

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Safety and Feasibility of Symptomatic Carotid Artery Stent-Assisted Revascularization within 48 Hours after Symptoms Onset.

Objective: We aimed to evaluate the safety and feasibility of carotid artery stenting (CAS) performed in the hyperacute period.

Methods: We analyzed a retrospective database of CAS patients from our center. We included patients with symptomatic isolated ipsilateral extracranial carotid stenosis and acute tandem occlusions who underwent CAS.

Combined Transradial and Transfemoral Approach Using a Compliant Balloon for Emboli Protection at the Vertebral Artery During Subclavian Stenosis Stenting: 2-Dimensional Operative Video.

Endovascular intervention has become the mainstay of treatment for subclavian artery stenosis in many centers, with high technical success and low complication rates.1,2 However, potential embolization during proximal subclavian artery intervention can lead to catastrophic posterior circulation ischemic complications.3-5 Although considered a rare complication, the presence of a contralateral hypoplastic vertebral artery with persisting anterograde vertebral blood flow on the affected side is likely to increase the risk of embolization.

Proximal Internal Carotid artery Acute Stroke Secondary to tandem Occlusions (PICASSO) international survey.

Background: While mechanical thrombectomy (MT) is the standard of care for large vessel occlusion strokes, the optimal management of tandem occlusions (TO) remains uncertain. We aimed to determine the current practice patterns among stroke physicians involved in the treatment of TO during MT.

Methods: We distributed an online survey to neurovascular practitioners (stroke neurologists, neurointerventionalists, neurosurgeons, and radiologists), members of professional societies.

Safety and efficacy of symptomatic carotid artery stenting performed in an emergency setting.

Introduction: Carotid artery stenting (CAS) has increasingly emerged as an alternative strategy to carotid endarterectomy in the treatment of patients with symptomatic carotid stenosis. Optimal timing for CAS after symptoms onset remains unclear. We aimed to evaluate the safety and efficacy of CAS when performed in an emergency setting.

Retrieval of distally migrated coil using stent retriever and proximal aspiration.

Endovascular coiling has become the preferred treatment of many centers for the management of both ruptured and unruptured aneurysms. Coil migration is a rare complication that can lead to vessel occlusion in 90% of the cases. Endovascular techniques for coil retrieval have shown less complication rates than open surgery.

Combined Transradial and Transfemoral Approach With Ostial Vertebral Balloon Protection for the Treatment of Patients With Subclavian Steal Syndrome.

Patients with an obstructive subclavian artery (SA) may exhibit symptoms of vertebrobasilar insufficiency known as subclavian steal syndrome (SSS). Endovascular treatment with stent assisted percutaneous transluminal angioplasty (SAPTA) demonstrates significantly lower percentage of intraoperative and postoperative complications in comparison with open surgery. There is a 1-5% risk of distal intracranial embolization through the ipsilateral vertebral artery (VA) during SAPTA.

Review of current intracranial aneurysm flow diversion technology and clinical use.

Endovascular treatment of intracranial aneurysms (IAs) has evolved considerably over the past decades. The technological advances have been driven by the experience that coils fail to completely exclude all IAs from the blood circulation, the need to treat the diseased parent vessel segment leading to the aneurysm formation, and expansion of endovascular therapy to treat more complex IAs. Stents were initially developed to support the placement of coils inside wide neck aneurysms.

Adenosine Receptor Modulation of Hypoxic-ischemic Injury in Striatum of Newborn Piglets.

Background: Hypoxic-ischemic encephalopathy (HIE) is a major cause of pediatric and adult mortality and morbidity. Unfortunately, to date, no effective treatment has been identified. In the striatum, neuronal injury is analogous to the cellular mechanism of necrosis observed during NMethyl- D-Aspartate (NMDA) excitotoxicity.

Clinical and Imaging Features of Contrast-Induced Neurotoxicity After Neurointerventional Surgery.

Background: Contrast-induced neurotoxicity (CIN) is an infrequent complication of endovascular procedures, and its understanding remains poor. We aimed to study and characterize the clinical and imaging features of a case series of CIN after neurointerventional surgery.

Methods: We reviewed all neuroendovascular consecutive procedures from September 2014 to November 2018.