The Impact of Postprocedural Anticoagulant Use in Patients Undergoing Woven EndoBridge: A Multicenter Propensity Score-Matched Study.

The Woven EndoBridge (WEB) device has become a prominent treatment for wide-neck bifurcation intracranial aneurysms since its FDA approval in 2018. However, the impact of anticoagulant therapy on its efficacy and patient outcomes remains underexplored. This study aims to evaluate the effects of postoperative anticoagulant use on aneurysm occlusion, retreatment rates, and functional outcomes following WEB device implantation.

Comparative analysis of safety and efficacy of flow diversion with and without surface modification technology, FRED-X, FRED, PED shield and PED in 386 patients: A single center experience with systematic review and network meta analysis.

Introduction: The FRED-X is a newer generation flow diverting stent (FDS) with surface modification that has demonstrated favorable efficacy in treating intracranial aneurysms. Our study provides an analysis of patients treated using FRED-X compared to FRED, PED Shield and PED.

Materials And Methods: This was a retrospective single center study and a systematic review with network meta analysis of patients who underwent flow diversion using FRED-X, FRED, PED Shield or PED.

The impact of frailty on patient selection and outcomes for open versus endovascular treatment of unruptured intracranial aneurysms: A propensity-score matched analysis.

Background And Objectives: Endovascular treatment (EVT) has been demonstrated to have improved post-operative outcomes and fewer complications compared to open microsurgical clipping of unruptured intracranial aneurysms (UIAs). Our study analyzes patient selection and outcomes for open versus EVT stratified by frailty measured using the Risk Analysis Index (RAI).

Methods: This was a retrospective study of patients who underwent open or EVT for an UIA at our institution between March 2017 and June 2022.

Robotic versus manual diagnostic and stenting procedures: a systematic review and meta-analysis.

Objective: Endovascular procedures are associated with improved outcomes and patient satisfaction compared to open surgery in selected cases. However, this is at the cost of increased radiation exposure. Robotic procedures are thought to minimize radiation exposure and may confer procedural efficacy due to the lack of operator fatigue.

Use of mean apparent propagator (MAP) MRI in patients with acute ischemic stroke: A comparative study with DTI and NODDI.

Purpose: To evaluate the Mean Apparent Propagator (MAP) MRI for processing multi-shell diffusion imaging in patients with acute ischemic stroke (AIS) and correlate to diffusion tensor imaging (DTI) and neurite orientation and dispersion density imaging (NODDI).

Methods: We enrolled patients with AIS from 1/2022 to 4/2024 who underwent multi-shell diffusion imaging on a 3.0-Tesla scanner to generate DTI, NODDI and MAP measures.

The impact of access site on procedure time and post-anesthesia care unit (PACU) time in patients undergoing outpatient diagnostic angiograms: A propensity-score matched analysis stratified by body mass index.

Background And Objectives: Body mass index (BMI) is a modifiable risk factor that has been shown to affect outcomes in neurointervention. The impact of BMI on choice of access site (transradial access (TRA) or transfemoral access (TFA), remains undescribed to our knowledge. Our study analyzes outcomes of TRA and TFA stratified by BMI in patients undergoing diagnostic cerebral angiograms in an outpatient setting.

Pretreatment factors associated with symptomatic stroke in Moyamoya disease patients: A multicenter study.

Objectives: Moyamoya disease (MMD) is a cerebrovascular disorder marked by the progressive steno-occlusion of the bilateral internal carotid arteries and the formation of abnormal collateral vessel networks at the base of the brain. Previous studies have attempted to identify risk factors predictive of postoperative complications to improve patient management. This study aims to identify pretreatment factors associated with post-bypass symptomatic strokes in MMD patients.

Comparative efficacy and safety of N-butyl cyanoacrylate vs. Onyx in the treatment of arteriovenous malformations: a systematic review and meta-analysis.

Since the first use of embolization for cerebral arteriovenous malformations (AVMs) by Luessenhop and Spence in 1960, this procedure has become a cornerstone in the multimodal treatment approach for brain AVMs. Currently, in the United States, the main embolic agents employed are n-butyl cyanoacrylate (NBCA) and Onyx (Medtronic, Minneapolis, MN). This systematic review and meta-analysis aim to compare these two agents in terms of efficacy and safety.

Socioeconomic influences on stroke outcomes: A comprehensive zip code-based hospital analysis.

Background And Objectives: Stroke remains a leading cause of morbidity and mortality worldwide. Socioeconomic disparities significantly affect the treatment and outcomes of cardiovascular and cerebrovascular diseases, including acute ischemic stroke. This study examines patients treated at Thomas Jefferson University Hospital, with ZIP code-based socioeconomic data predominantly representing areas in Pennsylvania and New Jersey, as the majority of patients originate from these regions.

Procedural outcomes of the transradial versus transfemoral approach for diagnostic cerebral angiograms according to BMI: a propensity score-matched analysis.

Objective: BMI has been shown to affect choice of access site in coronary intervention procedures, with lower complications reported during transradial (TR) access. To the authors' knowledge, the effect of BMI on outcomes in patients undergoing diagnostic cerebral angiography remains undescribed. This study compares outcomes for BMI subgroups based on access site (TR vs transfemoral [TF] access).

Comparative Outcomes of Unilateral vs Bilateral Revascularization in Moyamoya Disease: A Multicenter Retrospective Study.

Background And Objectives: Moyamoya disease (MMD) is characterized by progressive steno-occlusion of the internal carotid arteries, leading to compensatory collateral vessel formation. The optimal surgical approach for MMD remains debated, with bilateral revascularization potentially offering more comprehensive protection but involving more extensive surgery compared to unilateral revascularization. This study aims to compare bilateral revascularization and unilateral revascularization short-term safety profile in the treatment of MMD.

Carotid endarterectomy in the asymptomatic elderly: a systematic review of literature.

Asymptomatic carotid stenosis (ACS) carries a 4.7% risk of ipsilateral stroke if left untreated. Carotid endarterectomy (CEA) is a surgical intervention that has demonstrated efficacy in reducing stroke risk among symptomatic elderly.

Comparing stand-alone endovascular embolization versus stereotactic radiosurgery in the treatment of arteriovenous malformations with Spetzler-Martin grades I-III: a propensity score matched study.

Background: Arteriovenous malformations (AVMs) are uncommon cerebral lesions that can cause significant neurological complications. Surgical resection is the gold standard for treatment, but endovascular embolization and stereotactic radiosurgery (SRS) are viable alternatives.

Objective: To compare the outcomes of endovascular embolization versus SRS in the treatment of AVMs with Spetzler-Martin grades I-III.

Telescoping Flow Diverters for the Treatment of Brain Aneurysms: Indications and Outcome.

Objective: Few studies have reported the impact of telescoping flow diverters (FDs) in intracranial aneurysm treatment. Our study compared aneurysms treated using telescoping FDs to those treated with a single FD and identified predictors of telescoping.

Methods: This was a single-center retrospective review of a prospectively maintained database of aneurysms treated with FDs between 2011 and 2023.

Extended Length of Stay After Mechanical Thrombectomy for Stroke: A Single-Center Analysis of 703 Patients.

Background And Objectives: Mechanical thrombectomy (MT) is crucial for improving functional outcomes for acute ischemic stroke. Length of stay (LOS) is a reimbursement metric implemented to incentivize value-based care. Our study aims to identify predictors of LOS in patients undergoing MT at a high-volume center in the United States.

Initial Experience with the Eclipse Double-Lumen Balloon Catheter for Embolization of Cranial Vascular Malformations.

Background: Double lumen balloon catheters (DLBCs) have emerged as a potential alternative to single lumen balloon catheters for endovascular embolization of arteriovenous malformations (AVMs) and dural arteriovenous fistulas (dAVFs). This study describes our preliminary experience with the Eclipse 2L DLBC in treating AVMs and dAVFs.

Methods: Patients who underwent embolization of cranial dAVFs or AVMs at our institution from August 2021 to March 2024 were included.

Predictors of Extended Length of Stay After Treatment of Unruptured Intracranial Aneurysms.

Background: Despite their asymptomatic occurrence, unruptured intracranial aneurysms (UIAs) account for a significant proportion of hospital charges and healthcare resource utilization in the United States. Hospital length of stay (LOS) is a reimbursement metric utilized to incentivize value-based care. Our study identifies predictors of extended LOS (eLOS) after elective treatment of UIAs.

The impact of the Woven EndoBridge device on the treatment of anterior circulation wide-neck bifurcation aneurysms: a single-center experience.

Objective: The paucity of literature comparing Woven EndoBridge (WEB) embolization to microsurgical clipping for anterior circulation wide-neck bifurcation aneurysms (WNBAs) underscores the need for further investigation into the optimal management of this patient subpopulation. The objective of this study was to compare the rate of endovascular and microsurgical treatment of WNBAs before and after the introduction of the WEB device. In addition, the authors performed a comparison of demographics, aneurysm characteristics, and treatment outcomes in patients before and after the introduction of the WEB device.

The effect of institutional case volume on post-operative outcomes after endarterectomy and stenting for symptomatic carotid stenosis.

Objective: To investigate the effects of yearly institutional case volume for carotid endarterectomy (CEA) and stenting (CAS) among symptomatic carotid stenosis patients on the rates of postoperative stroke and inpatient mortality.

Materials And Methods: Patients with prior stroke ("symptomatic") undergoing CEA or CAS during an inpatient stay were identified from the National Inpatient Sample for years 2012-2015. The primary variable was volume of CEA or CAS performed annually by each institution.

Correlation of Computed Tomography Angiography to Digital Subtraction Angiography in Carotid Stenosis with Real-World Assessment of Overestimation of Carotid Stenosis on Computed Tomography Angiography.

Objective: Computed tomography angiography (CTA) is a well-established diagnostic modality for carotid stenosis. However, false-positive CTA results may expose patients to unnecessary procedural complications in cases where surgical intervention is not warranted. We aim to assess the correlation of CTA to digital subtraction angiography (DSA) in carotid stenosis and characterize patients who were referred for intervention based on CTA and did not require it based on DSA.

The impact of mechanical thrombectomy on the blood-brain barrier in patients with acute ischemic stroke: A non-contrast MR imaging study using DP-pCASL and NODDI.

Background And Purpose: While mechanical thrombectomy (MT) achieves restoration of cerebral blood flow to the area at risk in patients with acute ischemic stroke (AIS), the influx of blood flow may exacerbate the blood-brain barrier (BBB) disruption and extravasation across the BBB, and it therefore remains unclear how reperfusion impacts the blood-brain barrier integrity. In this study, we use diffusion-prepared pseudocontinuous ASL (DP-pCASL) and Neurite Orientation Dispersion and Density Imaging (NODDI) sequence to measure the water exchange rate (k) in patients who underwent either MT or medical management and determine its impact on the brain tissue microstructure in order to elucidate the impact of MT on BBB complex integrity.

Materials And Methods: We prospectively enrolled 21 patients with AIS treated at our institution from 10/2021 to 6/2023 who underwent MR imaging at a 3.