Long-Term Outcome of Rescue Stenting for Acute Intracranial Atherosclerotic Stenosis Related Large Vessel Occlusion in Anterior Circulation.

Background And Purpose: Rescue stent (RS) is an accepted rescue option after failed mechanical thrombectomy (MT) for acute ischemic stroke due to intracranial atherosclerotic stenosis (ICAS)-related large vessel occlusion (LVO). However, the long-term outcomes (≥ 12 months) of RS have not yet been elucidated.

Materials And Methods: We retrospectively analyzed the data of 154 patients with RS for ICAS-related LVO, which were identified from prospectively maintained multicenter database of RS after MT failure, to assess good outcome (mRS 0-2), mortality, stroke recurrence, symptomatic intracranial hemorrhage (SICH) and stent patency.

One-year clinical and radiologic outcomes of Surpass Evolve flow diverter for large unruptured intracranial aneurysms.

Background: Surpass Evolve Flow Diverter (SE-FD; Stryker Neurovascular, Kalamazoo, MI, USA) was launched in 2019 as a new generation FD of Surpass Streamline. The aim of this study was to report the effectiveness and safety of SE-FD insertion for unruptured intracranial aneurysm at one-year follow-up.

Methods: Between November 2019 and October 2021, a total of 106 patients with 108 aneurysms were treated with FD in single institution.

Perioperative Low-Dose Aspirin Management for Planned Clipping Surgery: When, How Long, and With What Precautions?

Background And Objective: Perioperative low-dose aspirin (ASA) management for open craniotomy surgery lacked information. We analyze to establish the perioperative ASA strategy to minimize both hemorrhagic and thromboembolic complications.

Methods: The investigators designed a multicenter retrospective study, which included patients scheduled to have clipping surgery for unruptured intracranial aneurysm.

Pedicled frontal periosteal rescue flap via eyebrow incision for skull base reconstruction (SevEN-002).

Purpose: Cerebrospinal fluid (CSF) leakage is one of the major complications after endoscopic endonasal surgery. The reconstructive nasoseptal flap is widely used to repair CSF leakage. However, it could not be utilized in all cases; thus, there was a need for an alternative.

Intraventricular hemorrhage clot clearance rate as an outcome predictor in patients with aneurysmal subarachnoid hemorrhage: A retrospective study.

Background: The development of intraventricular hemorrhage (IVH) in aneurysmal subarachnoid hemorrhage (aSAH) is linked with higher mortality and poor neurological recovery. Previous studies have investigated the effect of the amount and distribution of the initial IVH on the prognosis of aSAH. However, no studies have assessed the relationship between the changes in IVH over time and the prognosis of aSAH.

Delays in Intracerebral Hemorrhage Management Is Associated with Hematoma Expansion and Worse Outcomes: Changes in COVID-19 Era.

Purpose: The coronavirus disease 2019 (COVID-19) pandemic disrupted the emergency medical care system worldwide. We analyzed the changes in the management of intracerebral hemorrhage (ICH) and compared the pre-COVID-19 and COVID-19 eras.

Materials And Methods: From March to October of the COVID-19 era (2020), 83 consecutive patients with ICH were admitted to four comprehensive stroke centers.

Flow diverter for the treatment of large (> 10 mm) vertebral artery dissecting aneurysms.

Objective: To evaluate the outcomes of flow-diverting device (FDD) treatment for large vertebral artery dissecting aneurysms (VADAs).

Methods: This retrospective study evaluated 12 patients with 12 VADAs who were treated using FDD between 2013 and 2020. Clinical and radiographic data, including procedure-related complications and clinical outcomes assessed using the modified Rankin Scale (mRS) at the time of the last follow-up, were collected and reviewed.

Virtual dissection of the real brain: integration of photographic 3D models into virtual reality and its effect on neurosurgical resident education.

Objective: Virtual reality (VR) is increasingly being used for education and surgical simulation in neurosurgery. So far, the 3D sources for VR simulation have been derived from medical images, which lack real color. The authors made photographic 3D models from dissected cadavers and integrated them into the VR platform.

Recurrence and risk factors of posterior communicating artery aneurysms after endovascular treatment.

Background: Endovascular treatment (EVT) of posterior communicating artery aneurysms (PcomA) is challenging because of posterior communicating artery (Pcom) architecture. Additionally, these aneurysms have a high risk of recanalization compared with those located elsewhere.

Methods: The radiographic findings of 171 patients treated with EVT at two institutions were retrospectively reviewed.

Source Image Based New 3D Rotational Angiography for Differential Diagnosis between the Infundibulum and an Internal Carotid Artery Aneurysm : Pilot Study.

Objective: Distinguishing between an infundibulum and a true aneurysm is clinically important. This study aimed to evaluate whether using source image based new three-dimensional rotational angiography (S-n3DRA) can increase the rate of aneurysm detection and improve distinction between a true aneurysm and an infundibulum.

Methods: Twenty-two consecutive patients with 23 lesions, were evaluated by time-of-flight (TOF) magnetic resonance angiography (MRA), S-n3DRA, and digital subtraction angiography (DSA).

Scepter dual-lumen balloon catheter for Onyx embolization for dural arteriovenous fistula.

Background: This study aimed to evaluate the efficacy and safety of Scepter dual-lumen balloon catheter for transarterial Onyx embolization of dural arteriovenous fistula (DAVF).

Methods: Transarterial Onyx embolization using a Scepter dual-lumen balloon catheter (Scepter-assisted Onyx embolization) for DAVF was attempted in a total of 35 patients (mean age, 52.5 years; M:F = 24:11) between October 2012 and December 2018.

Clinical Features and Outcomes of Intracranial Aneurysm Associated with Moyamoya Disease.

Background And Purpose: Moyamoya disease (MMD) is a rare form of intracranial stenoocclusive disease that can be associated with intracranial aneurysms. We evaluated the clinical features and outcomes of MMD-associated aneurysms while focusing on their locations.

Methods: Between January 1998 and December 2018 there were 1,302 adult and pediatric patients diagnosed as MMD at a single institution.

Recurrence and retreatment of anterior communicating artery aneurysms after endovascular treatment: a retrospective study.

Background: Surgical treatment of anterior communicating artery (Acom) aneurysm is challenging due to anatomic complexity. We aimed to describe our experiences with endovascular treatment (EVT) of Acom aneurysms, and to evaluate the incidence and risk factors of recurrence and retreatment.

Methods: The study comprised 260 patients who were treated at a single center between January 2010 and December 2018.

Evaluation of the angiographic outcomes after clipping of intracranial aneurysms: determination of predisposing factors for occurrence of aneurysm remnants.

: Aneurysm remnants after microsurgical clipping have a risk of regrowth and rupture and have not been validated in the era of three-dimensional angiography. Therefore, this study aimed to evaluate the angiographic outcome using three-dimensional rotational images and determine the predictors for remnants after microsurgical clipping.: Between January 2014 and May 2017, 139 aneurysms in 106 patients who were treated with microsurgical clipping, were eligible for this study.

Preliminary experience of stent-assisted coiling of wide-necked intracranial aneurysms with a single microcatheter.

Background: The purpose of this study was to report our preliminary experience of stent-assisted coiling (SAC) of wide-necked intracranial aneurysms with a single microcatheter in patients with parent arteries that were small-caliber, with stenosis, or a very tortuous course.

Methods: Between March 2018 and December 2018, we treated 394 aneurysms in 359 patients with endovascular treatment. Among 197 aneurysms treated by SAC, there were 16 cases (all wide-necked unruptured aneurysms) treated by SAC with a single microcatheter and a Neuroform Atlas stent.

Coil-Protected Technique for Liquid Embolization in Neurovascular Malformations.

Objective: To evaluate the safety and efficacy of the coil-protected technique for liquid embolization in neurovascular malformations.

Materials And Methods: Twenty-two patients who underwent coil-protected liquid embolization for symptomatic cranial (n = 13) and spinal (n = 9) arteriovenous fistula (AVF) or arteriovenous malformations (AVMs) were identified. A total of 36 target feeder vessels were embolized with N-butyl cyanoacrylate and/or Onyx (Medtronic).

Mechanical Thrombectomy in Subtypes of Basilar Artery Occlusion: Relationship to Recanalization Rate and Clinical Outcome.

Background Acute stroke because of basilar artery occlusion (BAO) represents 1% of all ischemic strokes. However, recanalization rates and treatment outcome for the different pathologic subtypes of BAO stroke are not fully understood. Purpose To compare the recanalization rate and clinical outcomes of mechanical thrombectomy in different subtypes of BAO.

Microsurgical Treatment of Unruptured Anterior Choroidal Artery Aneurysms: Incidence of and Risk Factors for Procedure-Related Complications.

Objective: To describe our experiences with microsurgical treatment of unruptured anterior choroidal artery (AchA) aneurysms, and to evaluate the incidence of and risk factors for procedure-related complications.

Methods: The study included 110 patients treated between January 2012 and December 2016. All patients met the following criteria: 1) microsurgical treatment of an unruptured AchA aneurysm was performed; and 2) clinical and radiographic follow-up data were available, including findings from preoperative digital subtraction angiography.

Radiographic and microsurgical characteristics of proximal (A1) segment aneurysms of the anterior cerebral artery.

Background: Proximal A1 segment aneurysms of the anterior cerebral artery (ACA) radiologically resemble internal carotid artery bifurcation (ICBIF) aneurysms because of their anatomical proximity. However, proximal A1 aneurysms exhibit distinguishing features, relative to ICBIF aneurysms. We report our experience of managing proximal A1 aneurysms, then compare them to ICBIF aneurysms.

Long-Term Results of Gamma Knife Radiosurgery for Intracranial Meningioma.

Background: The predominant treatment modality for meningioma is surgical resection. However, gamma knife radiosurgery is also an important treatment modality for meningioma that is small or cannot be completely removed because of its location. In this study, we evaluated the effectiveness and long-term results of radiosurgical treatment for meningioma in our institution.