Publications by authors named "Killer-Oberpfalzer M"
Background And Purpose: This animal study was designed to evaluate in vivo the acute and short-term safety and efficacy of the new Artisse intrasaccular device (ISD) for aneurysm occlusion and to gain knowledge about the behavior in the aneurysms.
Materials And Methods: The device was implanted in 7 white New Zealand rabbits with bifurcation aneurysms. Immediate and 90-day angiographic follow-up as well as histologic and scanning electron microscope imaging were evaluated.
Background And Purpose: This study evaluates the early clinical performance of the new Artisse Intrasaccular Device (Artisse ISD), a self-expandable intrasaccular flow diverter, for treating wide-necked aneurysms (WNAs). We report initial safety and efficacy outcomes in the first cohort of patients treated with this novel device.
Methods: Prospective clinical and radiological data were collected for all patients treated with the Artisse ISD at three Austrian neurovascular centers from July 2023 to August 2024.
The Artisse intrasaccular device (Medtronic) offers a novel treatment option for unruptured and ruptured wide-neck bifurcating intracranial aneurysms.1 2The Artisse device features enhancements including a distal tip for dome protection, platinum band markers for improved visibility, and a bilayer high-density platinum core nitinol mesh basket for enhanced flexibility and visibility when compared with previous devices.2-7 Data from case series demonstrate the procedural safety and efficacy of the Artisse device.
View Article and Find Full Text PDFObjective: Dolichoectatic vertebrobasilar aneurysms (DVBAs) are expansions of arterial tissue leading to aneurysmal formations without an obvious neck. Their natural history is poorly understood; usually patients are admitted with thromboembolic complications and/or neurological symptoms from the mass effect. There have not been international collective data, and correct timing for highly risky treatments has been under discussion.
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- 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.
Article Synopsis
- * Data from 670 patients revealed that while IVT may improve some outcomes, such as higher chances of achieving a modified Rankin Scale score of 0-2 in univariable analysis, this benefit was not consistently observed in more rigorous multivariable analyses.
- * Overall, the findings suggest that adjunctive IVT may not significantly enhance clinical outcomes or safety compared to MT alone for this patient population.
Background: Despite the increased use of mechanical thrombectomy (MT) in recent years, there remains a lack of research on in-hospital mortality rates following the procedure, the primary factors influencing these rates, and the potential for predicting them. This study aimed to utilize interpretable machine learning (ML) to help clarify these uncertainties.
Methods: This retrospective study involved patients with anterior circulation large vessel occlusion (LVO)-related ischemic stroke who underwent MT.
Article Synopsis
- Researchers aimed to identify factors predicting aneurysm occlusion and retreatment following WEB embolization due to limited existing studies.
- The study reviewed data from 763 patients across 30 institutions, finding a 65.1% complete occlusion rate at follow-up and a 7.3% retreatment rate.
- Key negative predictors for complete occlusion included smoking history, larger aneurysm size, and wall branch presence, while intraprocedural occlusion significantly improved long-term outcomes.
Article Synopsis
- Mechanical thrombectomy is the standard treatment for large vessel occlusions, but there's limited evidence for its effectiveness in treating distal and medium vessel occlusions, particularly for patients with low stroke scale scores (≤6).
- A study analyzed data from 41 academic centers, comparing outcomes of low versus higher stroke scale score patients who underwent thrombectomy, revealing high successful reperfusion rates in both groups.
- Results showed that patients with lower stroke scale scores experienced better functional outcomes and lower mortality rates, but the treatment's effectiveness compared to intravenous thrombolysis (IVT) is still uncertain.
Objective: The placement of flow-diverting devices has become a common method of treating unruptured intracranial aneurysms of the internal carotid artery. The progressive improvement of aneurysm occlusion after treatment-with low complication and rupture rates-has led to a dilemma regarding the management of aneurysms in which occlusion has not occurred within 6-24 months. The authors aimed to identify clinical consensus regarding management of intracranial aneurysms displaying persistent filling 6-24 months after flow diversion and to ascertain questions that may drive future investigation.
View Article and Find Full Text PDFBackground: Intrasaccular devices have become increasingly popular in the treatment of cerebral aneurysms, particularly at the bifurcation. Here we evaluate the Contour Neurovascular System, an intrasaccular device for the endovascular treatment of cerebral aneurysms, in a multicenter cohort study, the largest to the best of our knowledge.
Methods: Consecutive patients with intracranial aneurysms treated with the Contour Neurovascular System between February 2017 and October 2022 at 10 European neurovascular centers were prospectively collected and retrospectively reviewed.
Background: Stroke resulting from occlusion of the middle cerebral artery (MCA) can have devastating consequences, potentially leading to a loss of independence. This study aimed to investigate the relationship between the distance to the thrombus (DT) and both ischemic lesion volume (ILV) and clinical outcomes.
Methods: We retrospectively evaluated patients with thromboembolic MCA M1 segment occlusion who underwent neurovascular imaging followed by endovascular thrombectomy (EVT) at two comprehensive stroke centers over a 3-year period (2018-2020).
Article Synopsis
- This study examined how taking antiplatelet medications before and after procedures affects the risk of thromboembolic complications (TECs) in patients treated with the Woven EndoBridge (WEB) device for specific brain aneurysms.
- It analyzed data from multiple centers, involving a total of 1412 patients, to determine if antiplatelet drugs reduce the likelihood of TECs, finding that those who took them before the procedure had a significantly lower risk.
- The study concluded that while preprocedural antiplatelet use significantly lowers the chances of TECs, the effect does not carry over when the medication is taken post-procedure.
Background: Optimal anesthetic strategy for the endovascular treatment of stroke is still under debate. Despite scarce data concerning anesthetic management for medium and distal vessel occlusions (MeVOs) some centers empirically support a general anesthesia (GA) strategy in these patients.
Methods: We conducted an international retrospective study of MeVO cases.
Effect of concomitant usage of alteplase and mechanical thrombectomy for M1 middle cerebral artery occlusion on clinical outcome: a retrospective analysis of 457 patients from two centers.
Front Neurol
February 2024
Introduction: Endovascular thrombectomy (EVT) and concomitant usage of intravenous alteplase (alteplase) in large vessel occlusion stroke may produce unwanted excess intracerebral hemorrhage (ICH). Whether this applies specifically to isolated occlusion of the M1 segment of the middle cerebral artery (MCA) is unknown.
Methods: A retrospective study from two tertiary thrombectomy centers.
Background: Mechanical thrombectomy (MT) has revolutionized the treatment of acute ischemic stroke (AIS) due to large vessel occlusion (LVO), but its efficacy and safety in medium vessel occlusion (MeVO) remain less explored. This multicenter, retrospective study aims to investigate the incidence and clinical outcomes of vessel perforations (confirmed by extravasation during an angiographic series) during MT for AIS caused by MeVO.
Methods: Data were collected from 37 academic centers across North America, Asia, and Europe between September 2017 and July 2021.
Article Synopsis
- The study aimed to evaluate the effectiveness and safety of the pRESET LITE stent retriever for treating medium vessel occlusions in acute ischemic stroke patients.
- A retrospective analysis included 227 patients from 37 institutions, distinguishing between proximal and distal occlusions, revealing successful reperfusion rates of 85% and 97%, respectively.
- Despite a 7% complication rate and a significant percentage of patients experiencing hemorrhagic transformations, the procedure showed a favorable outcome in 58% of cases after three months.
Article Synopsis
- Thrombus migration (TM) in patients with M1 middle cerebral artery occlusion is common, occurring in about 22.8% of those analyzed in the study, particularly among those receiving alteplase treatment.
- The research involved a retrospective study of 463 patients who underwent endovascular thrombectomy (EVT), examining the relationship between TM, reperfusion successes, and patient outcomes through angiographic imaging.
- Findings suggest that while alteplase use and the time interval to angiography are linked to TM, the occurrence of TM itself does not correlate with better clinical outcomes measured by the modified Rankin scale.
Article Synopsis
- The Woven EndoBridge (WEB) device is effective for treating intracranial aneurysms, yet the postoperative use of aspirin shows varied practices among clinicians.
- A multicenter study involving 1492 patients compared outcomes between those who took aspirin post-surgery and those who didn't, revealing that aspirin users had better functional outcomes and lower mortality rates but higher rates of retreatment.
- The findings suggest that while aspirin may improve recovery and reduce death rates after WEB treatment, it also increases the likelihood of needing additional procedures, indicating a need for further research on optimal postoperative care.
Article Synopsis
- The study investigates the first pass effect (FPE) in endovascular treatment (EVT) for medium vessel occlusion strokes, focusing on its predictors and impact on patient outcomes.
- The analysis included 836 patients, revealing that FPE occurred in 36.1% and was linked to better functional outcomes as well as lower rates of mortality and intracranial hemorrhage.
- FPE was significantly associated with favorable outcomes at 90 days, suggesting its importance in improving recovery and reducing complications in stroke patients.
Background: Robotic-assisted neurointervention was recently introduced, with implications that it could be used to treat neurovascular diseases.
Objective: To evaluate the effectiveness and safety of the robotic-assisted platform CorPath GRX for treating cerebral aneurysms.
Methods: This prospective, international, multicenter study enrolled patients with brain aneurysms that required endovascular coiling and/or stent-assisted coiling.
Unlabelled: BackgroundThe Neqstent coil-assisted flow diverter (NQS) is a neck bridging device to facilitate coil occlusion of intracranial aneurysms. CAFI is a prospective, single-arm, multicenter study on the safety and performance of the NQS adjunctive therapy device together with platinum coils for treatment of unruptured intracranial aneurysms.
Methods: Thirty-eight patients were enrolled.
Background: Endovascular therapy has revolutionized the treatment of cerebral aneurysms in recent years and decades. So-called intrasaccular devices (i.e.
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.