Comparison of Safety and Diagnostic Efficacy of Iohexol 240 mgI/mL, Iopamidol 250 mgI/mL, and Iodixanol 270 mgI/mL in Cerebral Angiography: A Prospective, Multicenter Study.

Purpose: This multicenter prospective study aimed to evaluate the quality and diagnostic effectiveness of cerebral angiography images obtained using low-concentration iodinated contrast agents (iohexol 240 mgI/mL, iopamidol 250 mgI/mL, and iodixanol 270 mgI/mL) and to assess the safety thereof. The study addresses the need for safer contrast agent alternatives without compromising the diagnostic quality of identifying cerebrovascular disease.

Materials And Methods: Conducted in 5 medical centers in South Korea, we enrolled patients aged 19 years or older who were referred for diagnostic cerebral angiography under non-emergency conditions, excluding those with specific health conditions and sensitivities.

Usefulness of sectional images in dural AVF for the interpretation of venous anatomy.

Knowledge of the venous anatomy is essential for appropriately treating dural arteriovenous fistulas (AVFs). It is challenging to determine the overall venous structure despite performing selective angiography for dural AVFs with feeder from multiple selected arteries. This is because only a part of the veins can be observed through the shunt in the selected artery.

Feasibility of Prompt Lumbar Drainage in Patients with Aneurysmal Subarachnoid Hemorrhage.

Background: Numerous studies have shown that continuous lumbar drainage (LD) reduces spontaneous subarachnoid hemorrhage (SAH)-related complications, decreasing the incidence of cerebral vasospasm, delayed cerebral ischemia , and hydrocephalus in patients treated with coiling or clipping, but performing LD before securing the aneurysm is still controversial. Our hospital has been implementing prompt LD for several years, and we present the results in this paper.

Methods: Between January 2014 and December 2020, a total of 438 patients with SAH were included in this retrospective study.

Endovascular Management of Iatrogenic Vertebral Artery Pseudoaneurysm: A Case Report.

Iatrogenic injury of the vertebral artery during cervical spine surgery though uncommon is critical. With advances in interventional endovascular techniques, the therapeutic approach for vertebral artery injuries has changed. Nonetheless, an established strategy for their management is lacking.

Effect of distal access catheter tip position on angiographic and clinical outcomes following thrombectomy using the combined stent-retriever and aspiration approach.

Purpose: Mechanical thrombectomy using the stent-retriever in conjunction with the distal access catheter may improve the rates of successful revascularization and clinical outcomes in patients with acute stroke. We aimed to compare two different thrombectomy techniques, according to the position of the distal access catheter tip in the combined stent-retriever and aspiration approach.

Methods: In this retrospective study, patients with middle cerebral artery occlusion treated with the combined technique were divided into two groups based on the tip position of the distal access catheter: distal group (catheter placed adjacent to the thrombus) and proximal group (catheter placed in the cavernous segment of the internal carotid artery below the ophthalmic artery).

Primary Extracranial Fibrous Meningioma of the Maxillary Sinus: A Case Report and Literature Review.

Meningioma is a common neoplasm of the central nervous system; however, primary extracranial meningioma of the paranasal sinus, especially the maxillary sinus, is rare. We report a case of primary extracranial meningioma (fibrous type) of the maxillary sinus and present a literature review of the imaging features that correlate with fibrous meningioma.

Revision Superficial Temporal Artery-Middle Cerebral Artery Bypass Surgery for Recurrent Acute Ischemic Stroke Due to Delayed Occlusion of the Bypass Graft.

Intravenous thrombolysis (IVT) and endovascular treatment (EVT) are currently the main treatments for reperfusion in acute ischemic stroke. Although the EVT recanalization rate has increased, unsuccessful recanalization is still observed in 10-30% cases. Superficial temporal artery-middle cerebral artery (STA-MCA) bypass is considered a rescue therapy in such cases, but in most centers it is not usually performed for acute ischemic stroke.

Thrombolysis in Large Diffusion-Weighted Imaging Lesions: Lower Chance but Still a Chance.

Background: We sought to investigate whether early thrombolytic treatment can result in favorable functional outcome even in patients with large diffusion-weighted imaging (DWI) lesions.

Materials And Methods: We analyzed 566 patients who received intravenous alteplase within 4.5 hours from onset, initially underwent DWI and magnetic resonance angiography, and had acute infarction confined to anterior circulation.

Spontaneous Regression of an Intracranial Aneurysm Following Remote Aneurysm Clipping: Evaluation with High-Resolution Vessel Wall MRI.

Spontaneous regression of an unruptured aneurysm is very rare. We present a case of a 64-year-old woman with an unruptured cerebral aneurysm in which spontaneous regression occurred after contralateral clipping. High-resolution magnetic resonance imaging showed that the aneurysm had decreased in size and there was no evidence of thrombus.

Patient Selection and Clinical Efficacy of Urgent Superficial Temporal Artery-Middle Cerebral Artery Bypass in Acute Ischemic Stroke Using Advanced Magnetic Resonance Imaging Techniques.

Background: Selected patients with acute ischemic stroke might benefit from superficial temporal artery-middle cerebral artery (STA-MCA) bypass, but the indications for urgent STA-MCA bypass are unknown.

Objective: To report our experiences of urgent STA-MCA bypass in patients requiring urgent reperfusion who were ineligible for other reperfusion therapies, using advanced magnetic resonance imaging (MRI) techniques.

Methods: The inclusion criteria for urgent STA-MCA bypass were as follows: acute infarct volume <70 mL with a ratio of perfusion/diffusion lesion volume ≥1.

Impact of Prehospital Intervention on Delay Time to Thrombolytic Therapy in a Stroke Center with a Systemized Stroke Code Program.

Background: The use of emergency medical services (EMS) and notification to hospitals by paramedics for patients with suspected stroke are crucial determinants in reducing delay time to acute stroke treatment. The aim of this study is to investigate whether EMS use and prehospital notification (PN) can shorten the time to thrombolytic therapy in a stroke center with a systemized stroke code program.

Methods: Beginning in January 2012, stroke experts in our stroke center received direct calls via mobile phone from paramedics prenotifying the transport of patients with suspected stroke.

Safety of coil occlusion of the parent artery for endovascular treatment of anterior communicating artery aneurysm.

Many studies lay emphasis on the clinical importance of perforating branches of the anterior communicating artery (ACoA) and report that vascular damage of the perforators from ACoA aneurysm during surgery cause subsequent postoperative amnesia. The purpose of our study was to analyze the safety of parent artery occlusion for ACoA aneurysm coiling based on the anatomical features of the ACoA complex in 13 patients with 13 ACoA aneurysms. All patients underwent coiling of the aneurysm sac and ACoA.

High residual platelet reactivity (HRPR) for adenosine diphosphate (ADP) stimuli is a determinant factor for long-term outcomes in acute ischemic stroke with anti-platelet agents: The meaning of HRPR after ADP might be more prominent in large atherosclerotic infarction than other subtypes of AIS.

High residual platelet activation (HRPA) after ADP stimuli has associated with recurrent vascular events in acute atherothrombosis with the use of antiplatelet agents (APAs). However, there has been little evidence supporting this association in acute ischemic stroke (AIS). In this study, we evaluated the influences of HRPR after ADP stimuli on the 1-year incidence of recurrent cardiovascular events and mortality in AIS with APAs.

Thrombectomy using a stent retriever with artificially induced vertebral artery vasospasm in a patient with acute basilar artery occlusion: a case report.

An acute basilar artery occlusion is not an uncommon cause of stroke. It represents 6-10% of large vessel strokes and has been associated with poor clinical outcomes. Multimodal treatments have been introduced to recanalise a basilar artery occlusion successfully.

Liver Function Assessment Using Parenchyma-Specific Contrast-Enhanced Ultrasonography.

The aim of this study was to assess hepatic functional reserve by analyzing the hepatic parenchyma enhancement curve of parenchyma-specific contrast-enhanced ultrasonography (CEUS). Fifty-two patients with cirrhosis who underwent CEUS and indocyanine green tests (ICG) because of a focal liver lesion were enrolled. We evaluated the hemodynamic-related parameters of the time-intensity curve and compared these findings with the ICG retention rate at 15 min (ICG R15).

Mismatch of delayed perfusion volume between TTP and Tmax map of perfusion MRI.

Objective: To look for another set of parameters to predict the change in infarct size in acute stroke patients with a perfusion-weighted imaging (PWI)-diffusion-weighted imaging (DWI) mismatch.

Materials And Methods: We reviewed 54 patients who had PWI-DWI mismatch and vascular occlusion on initial MRI and no recanalization of occluded vessel.

Results: Time-to-peak and time-to-max (TTP-Tmax) perfusion mismatch volume was independently significant as a correlate of infarct volume change (P=.

Pilomyxoid Astrocytoma Occurring in the Third Ventricle.

Pilomyxoid astrocytoma (PMA) is a rare central nervous system tumor that has been included in the 2007 World Health Organization Classification of Tumors of the Central Nervous System. Due to its more aggressive behavior, PMA is classified as Grade II neoplasm by the World Health Organization. PMA predominantly affects the hypothalamic/chiasmatic region and occurs in children (mean age of occurrence = 10 months).

A case report of sporadic hemiplegic migraine associated cerebral hypoperfusion: comparison of arterial spin labeling and dynamic susceptibility contrast perfusion MR imaging.

Unlabelled: The pathogenesis of sporadic hemiplegic migraine remains unclear, and perfusion-weighted magnetic resonance imaging (PWI) has been used for characterization of hemodynamic changes in migraine aura. We report a case of sporadic hemiplegic migraine in which magnetic resonance perfusion imaging showed left cerebral hypoperfusion. Dynamic susceptibility contrast (DSC) perfusion maps showed hypoperfusion with posterior predominance in the left cerebral hemisphere.

Comparative Analysis of Endovascular Stroke Therapy Using Urokinase, Penumbra System and Retrievable (Solitare) Stent.

Background: Higher reperfusion rates have been established with endovascular treatment for acute ischemic stroke patients. There are limited data on the comparative performance of mechanical thrombectomy devices. This study aimed to analyse the efficacy and safety of the stent retriever device (Solitaire stent) by comparing procedure time, angiographic outcome, complication rate and long term clinical outcome with previous chemical thrombolysis and mechanical thrombectomy using penumbra system.

The rCBV ratio on perfusion-weighted imaging reveals the extent of blood flow on conventional angiography after acute ischemic stroke.

Objective: In this study, we evaluated the relationship between the rCBV (regional cerebral blood flow volume) ratio on perfusion-weighted imaging (PWI) and the extent of collateral flow on conventional angiography.

Methods: We recruited 98 patients with AIS (within 24h after ischemic events). All the patients were evaluated by MRI, including PWI and diffusion-weighted imaging (DWI), and underwent digital subtraction angiography (DSA) of the brain.

Direct Relationship between Angiographic Characteristics of Carotid Atherosclerotic Plaque and Filling Defect in the Cerebral Protection Filters : Based on the Conventional Angiography.

Objective: Neurologic complications during carotid artery stenting (CAS) are usually associated with distal embolic event. These embolic incident during CAS are highly associated with the carotid plaque instability. The current study was undertaken to identify the angiographic characteristics of carotid plaque vulnerability, which was represented as filling defect in the cerebral protection filters during CAS.

Management of aneurysms of the proximal (A1) segment of the anterior cerebral artery.

Objective: Aneurysms originating from the proximal segment (A1) of the anterior cerebral artery are rare; however, because of their small size, the risk of injury of perforating arteries, and the location of the aneurysm in the surgical field, they are challenging to treat. We report on 15 patients with A1 aneurysms and review surgical views according to the direction of aneurysms.

Methods: Fifteen patients were diagnosed with A1 aneurysms and underwent surgical clipping or endovascular coiling at our institution between January 2006 and March 2012.

Comparative study of shear wave velocities using acoustic radiation force impulse technology in hepatocellular carcinoma: the extent of radiofrequency ablation.

Background/aims: The purpose of this study was to assess the value of acoustic radiation force impulse (ARFI) for predicting the extent of radiofrequency ablation (RFA) in hepatocellular carcinoma (HCC) by correlating the elasticity of HCC and peritumoral parenchyma (as measured by ARFI) with the extent of ablation determined by computed tomography (CT).

Methods: From September 2009 to June 2011, 158 patients underwent RFA ablation for HCC (single, ≤3 cm). We evaluated the data of a total of 38 prospectively enrolled patients who underwent both ARFI imaging and contrast-enhanced CT after one session of 12 minutes of RFA without a change in needle position.

Acoustic radiation force impulse elastography for hepatocellular carcinoma-associated radiofrequency ablation.

Aim: To evaluate the potential usefulness of acoustic radiation force impulse (ARFI) images for evaluation of hepatocellular carcinomas (HCC)-associated radiofrequency ablation.

Methods: From January 2010 to June 2010, a total of 38 patients with HCC including recurred HCCs after RFA underwent ARFI elastography. The brightness of tumor was checked and the shear wave velocity was measured for the quantification of stiffness.