Tunable and real-time automatic interventional x-ray collimation from semi-supervised deep feature extraction.

Background: The use of endovascular procedures is becoming increasingly popular across multiple clinical domains. These procedures are generally performed under image guidance using an interventional c-arm x-ray system. Radiation exposure to both patients and interventional staff due to use of fluoroscopy is a health and occupational concern, but modifications to the interventional workflow to address radiation may come at the cost of procedure time or quality.

Volumetric microscopy of cerebral arteries with a miniaturized optical coherence tomography imaging probe.

Endovascular interventions are increasingly becoming the preferred approach for treating strokes and cerebral artery diseases. These procedures rely on sophisticated angiographical imaging guidance, which encounters challenges because of limited contrast and spatial resolution. Achieving a more precise visualization of the underlying arterial pathology and neurovascular implants is crucial for accurate procedural decision-making.

Angiographic and clinical outcomes from 396 aneurysms treated with the pipeline flex embolization device with shield technology.

Background: The PEDESTRIAN registry demonstrated high rates of complete long-term occlusion and good clinical outcomes among patients with intracranial aneurysms treated with the pipeline embolization device. The pipeline flex embolization device with shield technology was introduced to minimize thromboembolic complications. In this study, we investigated the safety and effectiveness of pipeline embolization device with shield technology among all patients treated for intracranial aneurysms at our center.

[Impact of artificial intelligence on therapeutic metrics of cerebrovascular attack during the COVID-19 pandemic].

Introduction: The start of the COVID-19 pandemic forced the implementation of changes in the emergency services care system. Concomitantly, at our institution, we implemented the artificial intelligence (AI) software, RAPID.AI, for image analysis in ischemic stroke (IS).

The pCONUS2 and pCONUS2 HPC Neck Bridging Devices : Results from an International Multicenter Retrospective Study.

Introduction: Bifurcation aneurysms represent an ongoing endovascular challenge with a variety of techniques and devices designed to address them. We present our multicenter series of the pCONUS2 and pCONUS2 HPC devices when treating bifurcation aneurysms.

Methods: We performed a retrospective review of our prospectively maintained databases at 3 tertiary neurointerventional centers to identify all patients who underwent coil embolization with the pCONUS2 or pCONUS2 HPC device between February 2015 and August 2021.

Results of the pToWin Study: Using the pCONUS Device for the Treatment of Wide-Neck Intracranial Aneurysms.

Coil embolization has become a well-established option for the treatment of intracranial aneurysms. Yet, wide-neck bifurcation aneurysms (WNBAs) remain a challenge. The pCONUS is the first generation of a stent-like implant for the bridging of WNBAs to enable coiling.

Ophthalmic artery angioplasty for age-related macular degeneration.

Background: There is considerable overlap of contributors to cardiovascular disease and the development of age-related macular degeneration (AMD). Compromised ocular microcirculation due to aging and vascular disease contribute to retinal dysfunction and vision loss. Decreased choroidal perfusion is evident in eyes with dry AMD and is thought to play a role in retinal pigment epithelial dysfunction, the rate of development of geographic atrophy, and the development of neovascularization.

First-in-human endovascular treatment of hydrocephalus with a miniature biomimetic transdural shunt.

Surgical ventriculoperitoneal shunting remains standard treatment for communicating hydrocephalus, despite persistently elevated infection and revision rates. A novel minimally invasive endovascular cerebrospinal fluid (CSF) shunt was developed to mimic the function of the arachnoid granulation which passively filters CSF from the central nervous system back into the intracranial venous sinus network. The endovascular shunt is deployed via a femoral transvenous approach across the dura mater into the cerebellopontine angle cistern.

Diversion-p64: results from an international, prospective, multicenter, single-arm post-market study to assess the safety and effectiveness of the p64 flow modulation device.

Background: The use of flow diversion to treat intracranial aneurysms has increased in recent years.

Objective: To assess the safety and angiographic efficacy of the p64 flow modulation device.

Methods: Diversion-p64 is an international, prospective, multicenter, single-arm, study conducted at 26 centers.

Pipeline Embolization Devices for the Treatment of Intracranial Aneurysms, Single-Center Registry: Long-Term Angiographic and Clinical Outcomes from 1000 Aneurysms.

Background: Prospective studies have established the safety and efficacy of the PipelineTM Embolization Device (PED; Medtronic) for treatment of intracranial aneurysms (IA).

Objective: To investigate long-term outcomes from the Pipeline Embolization Devices for the Treatment of Intracranial Aneurysms (PEDESTRIAN) Registry.

Methods: The PEDESTRIAN Registry data were retrospectively reviewed, which included patients (March 2006 to July 2019) with complex IAs treated with PED.

Early Triage of Cardioembolic Sources Using Chest Spectral Computed Tomography in Acute Ischemic Stroke.

Objectives: The present study investigated the potential usefulness of delayed-phase, low-dose, non-gated, chest spectral CT scans (DSCT) for the early triage of cardioembolic (CE) sources in patients admitted with acute ischemic stroke (AIS), and for the simultaneous detection of myocardial disease and thrombotic complications.

Material And Methods: Since July 2020 and promoted by the COVID-19 pandemic, we implemented the use of DSCT after cerebrovascular CT angiography (CTA) among patients with AIS using a dual-layer spectral CT. We explored the presence of CE sources, as well as late myocardium iodine enhancement (LIE) and pulmonary thromboembolism.

Sex-Related Differences after Endovascular Treatment of Acute Ischemic Stroke in the 'Real World'.

Background: Gender differences are often reported in the field of ischemic stroke, although most of such discrepancies were observed in randomized trials involving highly selected populations. We therefore explored gender differences regarding 90-day outcomes in large vessel occlusion (LVO) strokes receiving endovascular treatment in a real world setting.

Methods: This prospective registry included anterior and/or posterior circulation LVO strokes admitted between January 2014 and December 2019 who received mechanical thrombectomy up to 24 hours from symptoms onset or last known to be well.

Long-Term Outcomes of the WEB Device for Treatment of Wide-Neck Bifurcation Aneurysms.

Background And Purpose: Treatment of wide-neck bifurcation aneurysms using endovascular therapy is still challenging even with the development of treatment devices. The purpose of this investigation was to assess the safety and efficacy of treatment with a Woven EndoBridge (WEB) device for wide-neck bifurcation aneurysms.

Materials And Methods: All patients treated with a WEB device at our institution between May 2009 and November 2016 were retrospectively evaluated.

The Contour-Early Human Experience of a Novel Aneurysm Occlusion Device.

Background And Purpose: Endosaccular flow disruption is a recognized treatment options for treating both unruptured and ruptured aneurysms. The Contour device is designed to target the neck of an aneurysm and cause flow disruption within the aneurysm hence promoting thrombosis and neo-endothelialization at the neck. This article presents initial experiences with the Contour.

The p48_HPC antithrombogenic flow diverter: initial human experience using single antiplatelet therapy.

Objective: The p48 is a low-profile, intermediate-porosity flow diverter. phenox GmbH-trademarked hydrophilic polymer coating (pHPC) is a hydrophilic coating that has been shown to reduce the thrombogenicity of nitinol device surfaces. We performed the present study to determine whether the p48_HPC can be implanted using prasugrel alone.

The p48MW Flow Diverter-Initial Human Experience.

Background And Purpose: The use of flow diverters to treat aneurysms arising from small caliber parent vessels has been reported. This article reports the results of the first in experiences with the p48MW (p48 Movable Wire) in humans, a device specifically designed to target vessels 1.75-3 mm in diameter.

Analysis of Flow Dynamics and Outcomes of Cerebral Aneurysms Treated with Intrasaccular Flow-Diverting Devices.

Background And Purpose: Intrasaccular flow diversion offers a promising treatment option for complex bifurcation aneurysms. The purpose of this study was to compare the flow conditions between successfully occluded and incompletely occluded aneurysms treated with intrasaccular devices.

Materials And Methods: The hemodynamics in 18 completely occluded aneurysms after treatment with intrasaccular devices was compared against 18 that were incompletely occluded at follow-up.

The Use of Flow Diversion in Vessels ≤2.5 mm in Diameter-A Single-Center Experience.

Background: Flow diversion has become an accepted treatment strategy for aneurysms; however, there are limited data on the use of these devices in small vessels ≤2.5 mm in diameter.

Methods: We performed a retrospective review of our prospectively maintained database to identify all patients treated with flow diversion between September 2009 and January 2018.

The use of flow diverters to treat aneurysms of the posterior inferior cerebellar artery: Report of three cases.

Objective The objective of this study was to report our experience on the use of flow diverting stents placed within the posterior inferior cerebellar artery (PICA) as a treatment option for aneurysms of the PICA. Methods Three patients with aneurysms of the PICA, both ruptured and unruptured, underwent treatment of their aneurysms with placement of a single flow diverter in the PICA across the neck of the aneurysm. Adjunctive techniques such as coiling were not used.

Treatment of Wide-Necked Bifurcation Aneurysms : Initial Results with the pCANvas Neck Bridging Device.

Background: Recently, numerous devices dedicated to the treatment of wide-necked aneurysms have become available. We present our initial experience with the pCANvas device and present the technical success rate, clinical outcome and immediate angiographic occlusion rates.

Objective: We sought to determine the efficacy of flow with the pCANvas for the treatment of unruptured intracranial aneurysms.

The pCONus2 Neck-Bridging Device: Early Clinical Experience and Immediate Angiographic Results.

Background: Treating wide-necked aneurysms is challenging for the interventional neuroradiologist. Recently, numerous devices dedicated to the treatment of these aneurysms have become available. We report our early experience using the pCONus2 device and present the technical success rate, clinical outcomes, and immediate angiographic occlusion rates.

Endovascular occlusion of pial arteriovenous macrofistulae, using pCANvas1 and adenosine-induced asystole to control nBCA injection.

Background In large-caliber pial macrofistulae (pMF), the combination of high blood flow velocity and large efferent artery diameter makes control over the endovascular vessel occlusion difficult and may result in the inadvertent venous passage of occlusive devices or embolic agents. Case descriptions Patient 1: A 27-year-old man presented with headache and ataxia. An infratentorial pMF supplied by both superior cerebellar arteries with venous ectasia was found.