Pioneering artificial intelligence-based real time assistance for intracranial liquid embolization in humans: an initial experience.

Background: Liquid embolization in neuroendovascular procedures carries the risk of embolizing an inappropriate vessel. Operators must pay close attention to multiple vessels during the procedure to avoid ischemic complications. We report our experience with real time artificial intelligence (AI) assisted liquid embolization and evaluate its performance.

Stent-Assisted Coil Embolization of Ruptured Aneurysms in the Acute Stage: Advantages and Disadvantages.

Objective: In the acute stage of ruptured cerebral aneurysms, limited devices are available, making the treatment difficult. We aimed to evaluate the outcomes of the coil embolization with stenting for the ruptured cerebral aneurysms in the acute stage.

Methods: We assessed 22 cases treated with stenting among 134 of 169 consecutive patients with subarachnoid hemorrhages undergoing an endovascular treatment between April 2014 and December 2021, of which 134 underwent an embolization during the acute stage.

Intracranial Non-Sinus-Type Dural Arteriovenous Fistulas Could Be Curable by Transarterial Embolization or Transvenous Embolization with Liquid Embolic Material.

Objective: Recently, the occlusion rate of transarterial embolization (TAE) for intracranial non-sinus-type dural arteriovenous fistulas (NSDAVFs) has improved after ONYX was introduced. Additionally, when TAE for NSDAVF is unsuccessful, transvenous embolization (TVE) has become available as an alternative treatment. We investigated the factor for the favorable occlusion rate of endovascular treatment for NSDAVF at our institutions.

Carotid artery stenting for stenosis after carotid artery replacement: An illustrative case report.

Background: There are few reports on the treatment of carotid artery stenosis after arterial vessel replacement. We report and discuss an illustrative case of carotid artery stenting (CAS) performed for stenosis after carotid artery replacement.

Case Description: A woman in her 20s experienced injury to the right carotid artery during an operation for removal of a carotid body tumor 6 years before presentation.

Two patients of visual disturbance and optic perineuritis after placement of a flow diverter.

The pathogenesis of new visual symptoms after flow diverter stent placement in the ophthalmic artery for internal carotid artery aneurysms remains unclear. We report two cases of patients who developed visual field disturbance and decreased visual acuity following flow diverter placement. The "doughnut sign" was found around the optic nerve on magnetic resonance imaging.

Comprehensive Risk Analysis of the Wingspan Stent in Relation to Target Vessels.

Objective: To facilitate understanding for the safe use of the Wingspan stent, a comprehensive literature analysis was conducted, and incidence rates of 30-day stroke or death before and after the Stenting versus Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial were compared. We also investigated the associations between 30-day stroke or death rate and four lesion vessels, the internal carotid artery (ICA), middle cerebral artery (MCA), basilar artery (BA), and vertebral artery (VA).

Methods: We searched MEDLINE, Embase, Web of Science, and Cochrane Library databases.

A Case of Pterygopalatine Fossa Arteriovenous Malformation Treated by Transarterial Embolization Using a Dual-Lumen Balloon Catheter.

Objective: We report a rare case of pterygopalatine fossa arterial venous shunt disease with venous congestion of the superior ophthalmic vein (SOV) that was treated by transarterial balloon-assisted embolization.

Case Presentation: A 57-year-old man presented with congestion of the right bulbar conjunctiva, protrusion, and swelling of the right eyelid was admitted to our hospital. Angiography demonstrated an arteriovenous fistula (AVF) forming small congregated vessels in the pterygopalatine fossa fed by the branch of the ophthalmic artery (OA) and artery of the superior orbital fissure, draining into the SOV via the inferior ophthalmic vein (IOV).

A Case of Scalp Arteriovenous Malformation Treated by Transvenous Embolization Using Onyx.

Objective: We treated a case of scalp arteriovenous malformation (sAVM) by transvenous embolization using Onyx.

Case Presentation: We describe the case of a 17-year-old woman with a pulsatile mass at the right temporal area. DSA identified sAVM with the venous pouch between the right occipital artery (OA) and the right two occipital veins (OVs), which was also fed by multiple branches of the right posterior auricular artery (PAA) and superficial temporal artery (STA).

Partially thrombosed giant basilar tip aneurysm that remarkably decreased in size after stent-assisted coiling associated with the disappearance of neovascularization.

Endovascular treatment for partially thrombosed giant basilar tip aneurysms has not been established because of its low cure rate and numerous associated comorbidities. Although some authors reported the growth mechanism of partially thrombosed aneurysm, there is no report for the process of its shrinkage after treatment. We describe a case of a partially thrombosed giant basilar tip aneurysm presenting with disturbance of consciousness because of a mass effect and brain edema.

Rapid ventricular pacing for flow control during transarterial Onyx embolization of tentorial dural arteriovenous fistulas.

We report transarterial Onyx embolization with flow control using rapid ventricular pacing (RVP) in a middle-aged male patient with tentorial dural arteriovenous fistulas (TDAVFs). The patient completed angiographic obliteration in one session without any complications, and the 6-month postangiographic obliteration follow-up showed no evidence of residual or recurrent dural arteriovenous fistulas. RVP may be a novel treatment option of flow control to facilitate the embolic agent penetrating into the venous side and to achieve complete cure in transarterial embolization of TDAVFs.

T-Stent or Half T-Stent-Assisted Embolization of Wide-Necked Aneurysms at the Internal Carotid-Posterior Communicating Artery Bifurcation.

Objective: We report the usefulness and pitfalls of coil embolization using the T or half T-stent technique for aneurysms located at internal carotid artery-posterior communicating artery (ICA-P-com) bifurcation in which the neck is wide and the P-com must be kept patent due to it being the fetal-type with a hypoplastic P1 segment.

Case Presentations: Two cases were treated using the T-stent technique and two were treated using the half T-stent technique. The average age of the patients was 70.

[A Case of Erdheim-Chester Disease that was Difficult to Differentiate from Meningioma].

Objective: Erdheim-Chester disease(ECD)is a rare type of non-Langerhans histiocytosis. We report a surgical case of ECD with multiple lesions at the falx cerebri, tentorium cerebelli, and in the suprasellar region, with a literature review.

Case Report: A 70-year-old woman presented with frequent falling and difficulty in standing.

Clinical trial of carotid artery stenting using dual-layer CASPER stent for carotid endarterectomy in patients at high and normal risk in the Japanese population.

Background: The dual-layer nitinol CASPER stent was designed to prevent plaque prolapse into its strut and periprocedural stroke.

Objective: To conduct a clinical trial for government approval of the device in patients at either high or normal risk for carotid endarterectomy (CEA).

Methods: Eligible patients had ≥50% symptomatic stenosis or ≥80% asymptomatic stenosis according to the North American Symptomatic Carotid Endarterectomy Trial methods (peak systolic velocity 130 and 230 cm/s on ultrasonography, respectively).

Intraosseous Arteriovenous Fistula Around the Anterior Condylar Confluence as an Occipital Bone Fracture Sequela.

Background: Although traumatic dural arteriovenous fistula (AVF) is a rare condition, dural injury associated with skull fracture is one of the major factors for the formation of dural AVF at the skull fracture area. We report a case of de novo intraosseous AVF around the anterior condylar confluence after head injury associated with skull base fracture.

Case Description: A woman in her 70s presented with pulsatile tinnitus 3 months after cerebellar infarction and occipital bone fracture.

Cavernous Sinus Dural Arteriovenous Fistulas: General Aspects.

Cavernous sinus (CS) dural arteriovenous fistulas (AVF), which are most common in middle-aged females, present with benign symptoms such as exophthalmos, chemosis, and orbital bruit. Benign CS dural AVF without cortical venous drainage (CVD) have the rare potential for development of CVD with neurological symptoms, even without treatment. On the other hand, aggressive type AVF with CVD can cause more aggressive symptoms such as cerebral hemorrhage.

A Case of Anterior Cranial Fossa Dural Arteriovenous Fistula with Transient Ocular Movement Disorder after Embolization.

Objective: We report a case of anterior cranial fossa dural arteriovenous fistula (dAVF) in which ocular movement was impaired after Onyx embolization from the ophthalmic artery (OphA).

Case Presentation: A 76-year-old male was admitted to our hospital for treatment of an incidentally found anterior cranial fossa dAVF. Onyx was injected from the right anterior ethmoidal artery (AEA) to close the shunt.

Effectiveness of Preradiosurgical Embolization with NBCA for Arteriovenous Malformations - Retrospective Outcome Analysis in a Japanese Registry of 73 Patients (J-REAL study).

Purpose: Recent reports have posed doubts about the effect of preradiosurgical embolization in brain arteriovenous malformation (AVM) because it makes the planning of stereotactic radiosurgery (SRS) difficult and has the risk of recanalization out of the target. We investigated whether the performance and quality of embolization may influence the success of SRS based on a retrospective case cohort study.

Materials And Methods: Seventy-three patients who underwent embolization followed by SRS between 2003 and 2012 in eight institutes with neurointerventionists were considered.

[Transvenous Embolization by Direct Puncture of the Superior Sagittal Sinus Using Indocyanine Green(ICG)Videoangiography for Treatment of Dural Arteriovenous Fistula of the Transverse-Sigmoid Sinus:A Case Report].

We report a case of dural arteriovenous fistula at the left transverse sinus and sigmoid sinus(TS-dAVF), which was treated with transvenous embolization(TVE)by direct puncture of the superior sagittal sinus(SSS)under indocyanine green(ICG)fluoroscopic guidance. A 71-year-old woman presented with pulsatile tinnitus and progressive dementia. A left TS-dAVF with retrograde SSS and cortical venous reflux(Cognard type IIb)was demonstrated on cerebral angiography.

Angiographic Characteristics of Pseudo-occlusion of the Internal Carotid Artery Before and After Stenting.

Background: Various definitions of pseudo-occlusion and clinical outcomes after various treatments have been reported, but reports discussing the stenotic characteristics of pseudo-occlusion are rare.

Objective: To analyze the angiographic characteristics of pseudo-occlusion of the internal carotid artery (ICA) before and after carotid artery stenting (CAS).

Methods: We retrospectively reviewed the angiographic characteristics of 56 patients with pseudo-occlusion of the ICA treated with CAS.

[A Ruptured Vertebral Artery Dissecting Aneurysm Involving the Anterior Spinal Artery:A Case Report].

A 50-year-old woman presented with a subarachnoid hemorrhage caused by a ruptured vertebral artery dissecting aneurysm(VADA)involving the anterior spinal artery(ASA). The ASA branched at the proximal component of the dissecting aneurysm. The rupture point was presumed to be the distal region of the dissecting aneurysm.

In vitro experiments of vessel wall apposition between the Enterprise and Enterprise 2 stents for treatment of cerebral aneurysms.

Background: A closed-cell stent called Enterprise has been used for stent-assisted coil embolization of cerebral aneurysms. The Enterprise stent tends to cause kinks and vessel wall malposition in curved vessels and may cause thromboembolic complications. We evaluated vessel wall apposition of a new closed-cell stent, Enterprise 2, compared with a previous Enterprise stent, using curved vascular silicone models.

Reappraisal of primary balloon angioplasty without stenting for patients with symptomatic middle cerebral artery stenosis.

There is a controversy regarding the safety and efficacy of intracranial stenting. We describe our experience with primary balloon angioplasty without stenting for symptomatic middle cerebral artery (MCA) stenosis. All patients who underwent balloon angioplasty without stenting for MCA stenosis between 1996 and 2010 were retrospectively reviewed.

Flow visualization of recurrent aneurysms after coil embolization by 3D phase-contrast MRI.

Background: Flow patterns in cerebral aneurysms are clinically important. Information on inflow patterns into aneurysms is especially helpful in preventing a recurrence after coil embolization. Computational fluid dynamics (CFD) simulations of patient-specific cerebral aneurysms are feasible and provide information on flow patterns.

Hemodynamic effects of stent struts versus straightening of vessels in stent-assisted coil embolization for sidewall cerebral aneurysms.

Background: Recent clinical studies have shown that recanalization rates are lower in stent-assisted coil embolization than in coiling alone in the treatment of cerebral aneurysms.

Objective: This study aimed to assess and compare the hemodynamic effect of stent struts and straightening of vessels by stent placement on reducing flow velocity in sidewall aneurysms, with the goal of reducing recanalization rates.

Methods: We evaluated 16 sidewall aneurysms treated with Enterprise stents.