Publications by authors named "Pero G"
Among the causes of spontaneous intracranial hypotension (SIH), cerebrospinal fluid (CSF)-venous fistulas (CVFs) represent a recently discovered and poorly understood aetiology, for which invasive treatment (surgery vs endovascular treatment) may be required. However, CVFs are not always immediately identified during surgery. We describe a case of a woman with a 2-year history of SIH who was found to harbour a T8 CVF.
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- The study aimed to identify the optimal sizes for middle cerebral artery (MCA) bifurcation aneurysms that are most suitable for treatment with the Woven EndoBridge (WEB) device, focusing on aneurysm width and neck dimensions.
- Using a large retrospective database, the researchers analyzed unruptured MCA bifurcation aneurysms and established ideal cutoff values of 6.1 mm for width and 4.6 mm for neck size regarding treatment effectiveness.
- Findings indicated that aneurysms smaller than these cutoff values had significantly higher rates of occlusion (93% for width and 90% for neck) and lower retreatment rates compared to larger aneurysms, highlighting the importance of
Article Synopsis
- Air embolism is an uncommon cause of stroke, often linked to medical procedures, with this case specifically highlighting its occurrence after a gastroscopy.
- The patient exhibited symptoms like aphasia and weakness on one side of the body due to blockage in a brain artery but managed to recover completely.
- A CT scan showed a specific "hypodense dot sign" indicating the presence of air in the brain, which can help in diagnosing air embolism quickly for effective treatment.
Article Synopsis
- The Tigertriever is an innovative stentriever designed to improve mechanical thrombectomy by allowing better user control for tackling different clot types and vessel sizes.
- This paper combines insights from experienced professionals to evaluate the Tigertriever's capabilities and shares updated techniques for its use in clinical settings.
- It highlights the "FLEX" approach, which promotes efficient clot integration while minimizing disruption, especially important for working in challenging distal locations.
Article Synopsis
- - The study aimed to create a predictive calculator to determine the chances of achieving adequate occlusion (Raymond-Roy classification 1 or 2) when using the woven endobridge (WEB) device for intracranial aneurysms, drawing from a large dataset.
- - Analyzed data from 356 patients across 30 centers worldwide revealed that larger aneurysm neck size and partial thrombosis were linked to lower chances of successful occlusion, while the calculator showed good predictive accuracy.
- - The newly developed tool offers a valuable resource for clinicians to better estimate the success of using the WEB device in treating intracranial aneurysms, helping to enhance patient care.
Article Synopsis
- - The Woven EndoBridge (WEB) device is used for treating wide-neck intracranial bifurcation aneurysms smaller than 10 mm, but there's limited data on its effectiveness for larger aneurysms.
- - A study reviewed data from the WorldWide WEB Consortium involving 898 patients to compare outcomes between small and large aneurysms, using propensity score matching (PSM) for accuracy.
- - Results showed that large aneurysms had significantly lower rates of adequate occlusion and higher rates of retreatment compared to small aneurysms, suggesting that these findings could influence treatment choices and patient discussions in the future.
Article Synopsis
- The Woven EndoBridge (WEB) device is being studied as a new treatment for intracranial aneurysms, particularly its effectiveness for off-label uses which require further investigation.
- A study of 162 patients utilizing machine learning developed predictive models for successful occlusion after off-label WEB treatment, analyzing various factors linked to outcomes.
- Findings indicated that larger neck diameter and the presence of daughter sacs significantly predicted poorer occlusion results, emphasizing the need for further validation to refine patient selection and treatment strategies.
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
- This multicentric study investigated neuroradiological findings in COVID-19 patients during the early pandemic in Italy, focusing on data collected from May to June 2020 at two hospitals.
- A total of 415 patients were enrolled, with notable findings including ischemic stroke (29.4% of patients) and a variety of non-stroke neuroimaging lesions like PRES-like syndrome and encephalitis.
- The study concluded that COVID-19 patients are at increased risk of strokes due to a pro-thrombotic environment, reinforcing findings observed globally regarding brain imaging in infected patients.
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: The Woven EndoBridge (WEB) devices have been used for treating wide neck bifurcation aneurysms (WNBAs) with several generational enhancements to improve clinical outcomes. The original device dual-layer (WEB DL) was replaced by a single-layer (WEB SL) device in 2013. This study aimed to compare the effectiveness and safety of these devices in managing intracranial aneurysms.
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- 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.
Background: Endovascular thrombectomy (EVT) is a treatment option in patients with a cerebral venous thrombosis (CVT) who deteriorate despite anticoagulant treatment. Assessment of thrombus composition in CVT may provide insights into the pathophysiology of the disease and suggest new therapeutic strategies.
Case Report: A 47-year-old woman (smoking habit and estradiol/progesterone-releasing intra-uterine device) diagnosed with massive CVT underwent EVT (complete recanalization via aspiration catheter and stentriever) due to acute-onset left-sided weakness and dysarthria despite 72 h of full-dose subcutaneous low-molecular heparin.
Safety and efficacy of endovascular thrombectomy for primary and secondary MeVO.
J Stroke Cerebrovasc Dis
January 2024
Background: Medium-vessel occlusions (MeVO) are emerging as a new target for endovascular treatment (EVT). Primary MeVO occur de novo, while secondary MeVO arise from large vessel occlusion (LVO) through clot migration or fragmentation - spontaneously, following intravenous thrombolysis or EVT. We aimed to evaluate efficacy and safety of EVT in primary and EVT-induced secondary MeVO.
View Article and Find Full Text PDFObjective: The Woven EndoBridge (WEB) device is an intrasaccular flow disruptor designed for wide-necked bifurcation aneurysms. These aneurysms may require the use of a concomitant stent. The objective of this study was to determine the clinical and radiological outcomes of patients undergoing stent-assisted WEB treatment.
View Article and Find Full Text PDFAcute ischemic stroke (AIS) in childhood is a relatively rare but significant condition that can result in long-term disabilities. There is a lack of standardized strategies for diagnosing and treating pediatric AIS due to limited evidence-based data on thrombolytic and endovascular treatments in children. This comprehensive literature review focuses on the experience of a single center in Italy and aims to highlight the main peculiarities of endovascular treatment (EVT) for AIS in childhood.
View Article and Find Full Text PDFCerebral venous thrombosis (CVT) is a rare cause of stroke that tends to affect young people. Endovascular treatment (EVT) has not yet shown to be beneficial in CVT and is therefore actually only indicated as rescue therapy in severe and refractory cases for medical treatment. Clinical, neuroimaging, procedural and follow-up data were evaluated in order to define the safety and efficacy of EVT in the management of CVT between January 2016 and December 2022.
View Article and Find Full Text PDFPurpose: Specific decisions made by neurointerventionists are often lost behind the data of large-scale trials, and many of these studies have taken place before the development of new techniques and devices. This study compares the stent-retriever assisted vacuum-locked extraction (SAVE) technique with a direct aspiration first pass (ADAPT), as well as the use of a balloon guide catheter (BGC), in intracranial internal carotid artery (IC-ICA) occlusions.
Methods: Observational and retrospective study from an Italian hospital, including patients who underwent thrombectomy for IC-ICA occlusion between 1 January 2019 and 31 March 2021.
Background: In this study, the authors evaluated the efficacy and the safety of flow diverter devices (FDD) in anterior communicating artery (ACoA) region aneurysms, focusing on anatomical factors that could affect the outcome, such as the location of the aneurysm along the ACoA (centered on ACoA or decentered on the A1-A2 junction) and the anatomy of the ACoA region.
Methods: Clinical, procedural and follow-up data were analyzed. Aneurysms were classified according to the location along the ACoA (centered or decentered on the A1-A2 junction) and on the basis of the anatomical configuration of the ACoA region.
Objective: In this study, the authors retrospectively evaluated the effectiveness and the safety of non-surgical middle cerebral artery (MCA) aneurysms treated via the implantation of a flow diverter device (FDD).
Methods: Clinical, procedural and follow-up data were analyzed in order to evaluate the safety and effectiveness of the treatment with the FDD in complex MCA aneurysms. Safety was assessed recording (intra-procedural, peri-procedural and delayed) complications in order to determine the morbidity and mortality rates.
Several studies have shown promising outcomes of the Woven EndoBridge (WEB) device for the treatment of wide-necked intracranial bifurcation aneurysms. This is a multicenter study attempts to explore the changes in trends and treatment outcomes over time for WEB embolization of intracranial aneurysms. The WorldWideWEB consortium is a retrospective multicenter collaboration of data from international centers spanning from January 2011 and June 2021, with no limitations on aneurysm location or rupture status.
View Article and Find Full Text PDFObjectives: To investigate the clinical meaning of brain parenchymal computed-tomography hyperdensities (CTHD) in patients treated of anterior circulation acute stroke with reperfusion therapy.
Methods: Patients were retrospectively enrolled from three different hospitals. Brain CT scans were assessed at four time points: We recorded ASPECT scores of pre-treatment CTs, assessed ASPECT scores and the presence of CTHD on post-treatment CTs acquired within 24-30 h and 24-72 h, and examined a one-month CTs follow-up to determine the ischemic evolution of CTHD.
Background: The Woven EndoBridge (WEB) device is a novel intrasaccular flow disruptor tailored for bifurcation aneurysms. We aim to describe the degree of aneurysm occlusion at the latest follow-up, and the rate of complications of aneurysms treated with the WEB device stratified according to rupture status.
Methods: Our data were taken from the WorldWideWeb Consortium, an international multicenter cohort including patients treated with the WEB device.
Article Synopsis
- Previous studies indicate that COVID-19-related strokes have different mechanisms and outcomes compared to non-COVID-19 strokes, prompting a need for more comparative research.
- This study analyzed 697 patients with acute large vessel occlusion (LVO), comparing 302 COVID-19 patients to 395 non-COVID-19 patients, and found significant age and gender differences, with COVID-19 patients generally being younger and more male.
- Results showed that COVID-19 was linked to lower chances of complete revascularization and worse functional outcomes, as well as higher rates of in-hospital complications and mortality.