Publications by authors named "Berlis A"
Background: 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 PDFBackground: Tirofiban is administered for the treatment of aneurysms in cases of thromboembolic complications, as well as in cases of acute stenting or flow-diverter implantation required within the scope of aneurysm treatment. We aimed to investigate the efficacy and safety of tirofiban in this group of patients.
Methods: We conducted a retrospective analysis of all patients undergoing aneurysm treatment and receiving peri-interventional tirofiban administration at our institution between 2009 and 2019.
Prolonged antibiotic therapy is often recommended for the treatment of spinal infections. This study aimed to evaluate the efficacy and safety of outpatient intravenous (IV) antibiotic therapy for spinal neurosurgery patients with spondylodiscitis. We carried out a retrospective study involving 67 patients who were administered peripherally inserted central catheter (PICC) for IV antibiotic treatment from January 2020 to December 2022.
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- Peptide receptor radionuclide therapy (PRRT) is being explored as a treatment for advanced meningioma, utilizing intraarterial delivery of [Lu]Lu-HA-DOTATATE instead of traditional intravenous methods.
- In a study involving 13 patients, the intraarterial PRRT was found to be well tolerated with minimal side effects, and results showed disease control in 10 out of 13 patients, including one complete and one partial remission.
- The findings suggest that intraarterial PRRT may be more effective than intravenous delivery, but further research is needed to confirm these results and understand long-term effects.
Article Synopsis
- Mechanical thrombectomy using the SOFIA/SOFIA PLUS catheters is being evaluated as a primary treatment for acute ischemic stroke with large vessel occlusion, focusing on its safety and efficacy in a multi-center study involving 246 patients.
- Results show that primary aspiration with the catheters achieved 72.8% complete recanalization and 63.8% of patients were functionally independent after 90 days, with acceptable complication rates.
- The study supports using this technique as a first-line approach in stroke treatment, reinforcing the effectiveness of direct aspiration thrombectomy in managing acute ischemic strokes.
Introduction: Rescue intracranial stenting is necessary to provide sufficient recanalization after mechanical thrombectomy (MT) in patients with acute large vessel occlusions (LVO) due to an underlying intracranial atherosclerotic disease (ICAD). The CREDO heal is a novel stent that provides a potentially lower thrombogenicity due to surface modification. We present the first multicentric experience with the CREDO heal for acute rescue stenting.
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- * Data from 459 patients with vessel perforation showed a 90-day mortality rate of 51.9%, with only 16.3% achieving a favorable recovery (mRS 0-2).
- * The findings indicate that large vessel perforation leads to worse outcomes, while thrombolysis doesn’t worsen prognoses; quick management of bleeding is crucial for survival.
Background: The Woven EndoBridge (WEB) device is designed to treat wide-necked bifurcation aneurysms. The WEB 17 is the latest iteration and can be delivered through a 0.017″ microcatheter.
View Article and Find Full Text PDFPurpose: After vertical parasagittal hemispherotomy a restricted diffusion is often seen ipsilaterally and even distant from the adjacent resection margin. This retrospective cohort study analyses the anatomic site and the time course of the diffusion restriction after vertical parasagittal hemispherotomy.
Methods: Fifty-nine patients were included into this study, all of them having had one pre-operative and at least one post-operative MRI, including diffusion imaging at b‑values of 0 and 1000 s/mm with a calculated ADC.
Background And Purpose: Intracranial aneurysm treatment using flow-diverters and flow-disruptors requires a higher level of expertise when compared to more traditional methods. Our hypothesis was that the procedural success and the rate of complications are dependent on the annual case load of a center.
Materials And Methods: Conducting a retrospective analysis on the Database of the German Society for Interventional Radiology for the years 2020 to 2021, we examined flow-diverter and flow-disruptor procedures.
Background: Data on impact of COVID-19 vaccination and outcomes of patients with COVID-19 and acute ischemic stroke undergoing mechanical thrombectomy are scarce. Addressing this subject, we report our multicenter experience.
Methods And Results: This was a retrospective analysis of patients with COVID-19 and known vaccination status treated with mechanical thrombectomy for acute ischemic stroke at 20 tertiary care centers between January 2020 and January 2023.
Background: Stent-assisted coiling (SAC) is a well-established method for treatment of wide-necked intracranial aneurysms. In this multicenter, retrospective case series we evaluated SAC with a new low-profile, laser-cut stent with an antithrombogenic hydrophilic polymer coating (pEGASUS-HPC) for the treatment of intracranial aneurysms.
Methods: Patients treated with pEGASUS-HPC SAC for one or more intracranial aneurysms were retrospectively included.
In this anthropomorphic head phantom study, samples containing blood and contrast agent with concentrations ranging from 0 to 6 mg iodine per milliliter and another set of samples without blood for reference were scanned with a photon-counting detector CT using a standard cranial protocol. It was demonstrated that photon-counting detector CT can reliably distinguish hemorrhage and contrast media, including density determination of the latter. The technology promises to add value in several neuroimaging applications.
View Article and Find Full Text PDFBackground: Intrasaccular flow disruption is an endovascular approach for the treatment of wide-neck aneurysms and, more specifically, wide-neck bifurcation aneurysms, which are challenging to treat with previously developed technologies. The Woven EndoBridge (WEB) device has demonstrated its efficacy and safety, for both unruptured and ruptured aneurysms.
Methods: The CLEVER study was an observational, multicenter, prospective study conducted in 17 European investigational sites using the WEB 17 device, for the treatment of ruptured and unruptured aneurysms.
Introduction: Emergent stenting of the extracranial internal carotid artery (ICA) in stroke patients requires antiplatelet therapy to prevent in-stent thrombosis with a higher risk of intracranial haemorrhage.
Aim Of The Study: Assess the efficacy and safety of emergent carotid stenting with intravenous tirofiban in acute ischemic stroke patients.
Methods: Primary endpoint: symptomatic hemorrhage.
Purpose: Diagnostic cerebral catheter angiography is used to assess a variety of neurovascular pathologies especially in patients before and after endovascular neurointerventional treatment. In many centers diagnostic cerebral angiographies are performed with the patient staying for one night in the hospital because there are not yet sufficient data on the safety of ambulatory cerebral angiography. At the same time hospitals face a growing demand to perform ambulatory medical procedures.
View Article and Find Full Text PDFPerimesencephalic nonaneurysmal subarachnoid hemorrhage (NASAH) is a rare type of subarachnoid hemorrhage (SAH), usually associated with minor complications compared to aneurysmal SAH. Up to date, data is scarce and consensus on therapeutic management and follow-up diagnostics of NASAH is often missing. This survey aims to evaluate the clinical management among neurosurgical departments in Germany.
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- Vessel perforation during thrombectomy is more common in medium vessel occlusion (MeVO) cases compared to large vessel occlusion (LVO), with a rate of 2.4% in MeVO vs. 1.0% in LVO.
- Among patients who experienced perforation, those in the MeVO group had better functional outcomes at 3 months, achieving independence 25.7% of the time compared to 10.9% in the LVO group.
- Common procedural causes of perforation included navigating beyond the occlusion and retracting the stent retriever or aspiration catheter, highlighting the need for further research to improve safety in thrombectomy procedures.
Background: Evaluation of endovascular therapies for cerebral vasospasm (CVS) documented in the DeGIR registry from 2018-2021 to analyse the current clinical care situation in Germany.
Methods: Retrospective analysis of the clinical and procedural data on endovascular spasm therapies (EST) documented anonymously in the DeGIR registry. We analysed: pre-interventional findings of CTP and consciousness; radiation dose applied, interventional-technical parameters (local medication, devices, angiographic result), post-interventional symptoms, complications and mortality.
The use of stents is well established in the treatment of broad-based intracranial aneurysms. The aim of this study is to report on safety, feasibility and midterm follow-up of the new LVIS EVO braided stent for the treatment of cerebral aneurysms. All consecutive patients with intracranial aneurysms who were treated with the LVIS EVO stent in two high volume neurovascular centers were retrospectively enrolled in this observational study.
View Article and Find Full Text PDFBackground And Purpose: Flow diverters with antithrombotic coatings are increasingly used to improve the safety of flow diverter treatments of intracranial aneurysms. This study aimed to investigate the safety and short-term efficacy of the new FRED X flow diverter.
Materials And Methods: Medical charts and procedural and imaging data of a consecutive series of patients with intracranial aneurysms who were treated with the FRED X at 9 international neurovascular centers were retrospectively analyzed.