Hybrid dynamic bright and black blood angiography by non-contrast-enhanced vessel selective saturation angiography.

The integrity of vessel walls and changes in blood flow are involved in many diseases, and information about these anatomical and physiological conditions is important for a diagnosis. There are several different angiography methods that can be used to generate images for diagnostic purposes, but often using different imaging techniques and MR sequences. The purpose of this study was to develop a method that allows time-resolved, vessel-selective simultaneous bright and black blood imaging by vesselselective blood saturation.

Child-centredness in paediatric magnetic resonance imaging: Information needs and experiences of children requiring magnetic resonance imaging and their parents.

Background: Assessing patient experiences is essential to provide high quality health-care. The objectives of this study were to examine (1) child- and parent-reported information status before magnetic resonance imaging (MRI), (2) experiences during an MRI and (3) needs and suggestions for improvement.

Methods: Children (≥8 years) and parents answered questionnaires (before and after planned MRI examination) covering mental condition, information status/needs, preparation for MRI, and potential stressors.

Impact of Woven EndoBridge Shape Modification on Aneurysm Recanalization at Short-Term Follow-up Digital Subtraction Angiography.

Background: Woven EndoBridge (WEB) shape modification (WSM) is a frequently observed phenomenon after aneurysm embolization.

Objective: To test our hypothesis that WSM is associated with worse aneurysm occlusion on short-term angiographic follow-up images.

Methods: Patients with short-term follow-up digital subtraction angiography (DSA) available were included.

Benefit and risk of intravenous alteplase in patients with acute large vessel occlusion stroke and low ASPECTS.

Background: The benefit of best medical treatment including intravenous alteplase (IVT) before mechanical thrombectomy (MT) in patients with acute ischemic stroke and extensive early ischemic changes on baseline CT remains uncertain. The purpose of this study was to evaluate the benefit of IVT for patients with low ASPECTS (Alberta Stroke Programme Early CT Score) compared with patients with or without MT.

Methods: This multicenter study pooled consecutive patients with anterior circulation acute stroke and ASPECTS≤5 to analyze the impact of IVT on functional outcome, and to compare bridging IVT with direct MT.

Persistent challenges in endovascular treatment decision-making for acute ischaemic stroke.

Purpose Of Review: Although endovascular treatment (EVT) is the gold standard for treating acute stroke patients with large vessel occlusion (LVO), multiple challenges in decision-making for specific conditions persist. Recent evidence on a selection of patient subgroups will be discussed in this narrative review.

Recent Findings: Two randomized controlled trials (RCTs) have been published in EVT of basilar artery occlusion (BAO).

Quantitative Lesion Water Uptake as Stroke Imaging Biomarker: A Tool for Treatment Selection in the Extended Time Window?

Background And Purpose: Patients presenting in the extended time window may benefit from mechanical thrombectomy. However, selection for mechanical thrombectomy in this patient group has only been performed using specialized image processing platforms, which are not widely available. We hypothesized that quantitative lesion water uptake calculated in acute stroke computed tomography (CT) may serve as imaging biomarker to estimate ischemic lesion progression and predict clinical outcome in patients undergoing mechanical thrombectomy in the extended time window.

Reversible Ischemic Lesion Hypodensity in Acute Stroke CT Following Endovascular Reperfusion.

Background And Objectives: In acute stroke, early ischemic lesion hypodensity on CT is considered the imaging hallmark of brain infarction, representing a state of irreversible tissue damage with a continual increase of net water uptake. This dogma, however, is challenged by rare cases of apparently reversed early lesion hypodensity after complete reperfusion. The purpose of this study was to investigate the occurrence of reversible ischemic edema after endovascular treatment.

Woven EndoBridge (WEB) Width at the Aneurysm Neck Level Affects Early Angiographic Aneurysm Occlusion.

Purpose: Endovascular therapy with the Woven EndoBridge (WEB) device is a safe treatment approach, whereby neoendothelialization at the neck area is a crucial element for aneurysm occlusion. We hypothesized that WEB sizing at the aneurysmal neck level has an impact on early aneurysm occlusion.

Methods: Patients with short-term follow-up digital subtraction angiography following WEB treatment of unruptured aneurysms were included.

Relationship between the degree of recanalization and functional outcome in acute ischemic stroke is mediated by penumbra salvage volume.

Background: The presence of metabolically viable brain tissue that may be salvageable with rapid cerebral blood flow restoration is the fundament rationale for reperfusion therapy in patients with large vessel occlusion stroke. The effect of endovascular treatment (EVT) on functional outcome largely depends on the degree of recanalization. However, the relationship of recanalization degree and penumbra salvage has not yet been investigated.

Computed tomography-based triage of extensive baseline infarction: ASPECTS and collaterals versus perfusion imaging for outcome prediction.

Background: Patients presenting with large baseline infarctions are often excluded from mechanical thrombectomy (MT) due to uncertainty surrounding its effect on outcome. We hypothesized that computed tomography perfusion (CTP)-based selection may be predictive of functional outcome in low Alberta Stroke Program Early CT Score (ASPECTS) patients.

Methods: This was a double-center, retrospective analysis of patients presenting with ASPECTS≤5 who received multimodal admission CT imaging between May 2015 and June 2020.

Feasibility of a customizable training environment for neurointerventional skills assessment.

Objective: To meet increasing demands to train neuroendovascular techniques, we developed a dedicated simulator applying individualized three-dimensional intracranial aneurysm models ('HANNES'; Hamburg Anatomic Neurointerventional Endovascular Simulator). We hypothesized that HANNES provides a realistic and reproducible training environment to practice coil embolization and to exemplify disparities between neurointerventionalists, thus objectively benchmarking operators at different levels of experience.

Methods: Six physicians with different degrees of neurointerventional procedural experience were recruited into a standardized training protocol comprising catheterization of two internal carotid artery (ICA) aneurysms and one basilar tip aneurysm, followed by introduction of one framing coil into each aneurysm and finally complete coil embolization of one determined ICA aneurysm.

Evaluation of a modular in vitro neurovascular procedure simulation for intracranial aneurysm embolization.

Background: Rapid development in endovascular aneurysm therapy continuously drives demand for suitable neurointerventional training opportunities.

Objective: To investigate the value of an integrated modular neurovascular training environment for aneurysm embolization using additively manufactured vascular models.

Methods: A large portfolio of 30 patient-specific aneurysm models derived from different treatment settings (eg, coiling, flow diversion, flow disruption) was fabricated using additive manufacturing.

Early clinical course after aneurysmal subarachnoid hemorrhage: comparison of patients treated with Woven EndoBridge, microsurgical clipping, or endovascular coiling.

Background: The Woven EndoBridge (WEB) device has been increasingly used for the treatment of intracranial aneurysms after aneurysmal subarachnoid hemorrhage (SAH). Still, recent major clinical trials on patient management after SAH have defined WEB embolization as an exclusion criterion. In an analysis of an unselected patient cohort, we evaluate the early clinical course of SAH patients after WEB treatment compared to those treated with endovascular coiling or surgical clipping.

A new method to statistically describe microcatheter tip position in patient-specific aneurysm models.

Background And Purpose: Evidence on how to select microcatheters to facilitate aneurysm catheterization during coil embolization is sparse. We developed a new method to define microcatheter tip location inside a patient-specific aneurysm model as a 3-dimensional probability map. We hypothesized that precision and accuracy of microcatheter tip positioning depend on catheter tip shape and aneurysmal geometry.

Current status of training environments in neuro-interventional practice: are animal models still contemporary?

Purpose: Several different training environments for practicing neurointerventional procedures have been realized in silico, in vitro, and in vivo. We seek to replace animal-based training with suitable alternatives. In an effort to determine present training model distribution and preferences, we interviewed interventional neuroradiologists from 25 different countries about their experience in distinct training environments.

Multiparametric MRI of intracranial aneurysms treated with the Woven EndoBridge (WEB): a case of Faraday's cage?

Objective: To evaluate multiparametric MRI including non-contrast and contrast-enhanced morphological and angiographic techniques for intracranial aneurysms treated with the single-layer Woven EndoBridge (WEB) embolization system applying simultaneous digital subtraction angiography (DSA) as the reference of standard.

Materials And Methods: We retrospectively identified all patients with incidental and acute ruptured intracranial aneurysms treated with a WEB device (WEB SL and WEB SLS) between March 2014 and June 2016 in our neurovascular center with early (within 7 days) postinterventional multiparametric MRI as well as mid-term (5-8 months) follow-up MRI and DSA available. Occlusion rates were recorded both in DSA and MR angiography (MRA).

Intra-aneurysmal flow disruption after implantation of the Medina® Embolization Device depends on aneurysm neck coverage.

Background And Purpose: Flow disruption achieved by braided intrasaccular implants is a novel treatment strategy for cerebrovascular aneurysms. We hypothesized that the degree of intra-aneurysmal flow disruption can be quantified in vitro and is influenced by device position across the aneurysm neck. We tested this hypothesis using the Medina® Embolization Device (MED).