Traumatic arteriovenous fistula of the middle meningeal artery treated with selective coil embolization: A case report.

Background: Dural arteriovenous fistulas (AVFs) are reportedly induced by trauma. We report a rare case of traumatic AVF with a direct shunt from the middle meningeal artery (MMA) to the middle meningeal vein (MMV) and multiple drainage routes after head trauma. The patient was effectively treated with selective coil embolization alone without liquid embolic material.

Delayed rupture of a large intracranial internal carotid artery aneurysm after flow diverter placement.

Background: Delayed rupture after flow diverter (FD) placement is a serious complication, and often it leads to death; however, the exact mechanism leading to the rupture remains unclear. Therefore, in this case, study, we report a case of delayed rupture after FD placement and discuss its causes.

Case Description: This study presents the case of a 69-year-old female with multiple aneurysms who underwent FD placement with coil embolization for a large intracranial internal carotid artery aneurysm.

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 Stenosis:Endovascular Techniques and Devices].

The increase in the number of carotid artery stenting cases can be attributed to a decrease in complications owing to the evolution of devices. In this procedure, the choice of the protection device and stent for each case is the main concern. Embolic protection devices(EPD)that prevent distal embolization can be divided into proximal and distal types.

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.

Primary results of mechanical thrombectomy for acute ischemic stroke: The K-NET registry in the Japanese metropolitan area.

Background: Endovascular treatment (EVT) for acute large vessel occlusion has proven to be effective in randomized controlled trials. We conducted a prospective cohort study to evaluate the real-world efficacy of EVT in a metropolitan area with a large number of comprehensive stroke centers and to compare it with the results of other registries and randomized controlled trials (RCTs).

Methods: We analyzed the Kanagawa Intravenous and Endovascular Treatment of Acute Ischemic Stroke registry, a prospective, multicenter observational study of patients treated by EVT and/or intravenous tissue-type plasminogen activator (tPA).

Fluid-attenuated inversion recovery vascular hyperintensity-diffusion-weighted imaging mismatch and functional outcome after endovascular reperfusion therapy for acute ischemic stroke.

Background: Fluid-attenuated inversion recovery vascular hyperintensity (FVH) outside of the diffusion-weighted imaging (DWI) lesion, termed FVH-DWI mismatch, may represent penumbral tissue with good collateral status.

Methods: Consecutive patients who underwent endovascular reperfusion therapy (EVT) for acute internal carotid artery (ICA) or middle cerebral artery (MCA)-M1 occlusion were enrolled. FVH-DWI mismatch score was defined as the number of cortical Alberta Stroke Program Early CT Score areas (I and M1 to M6) that involved FVH but no DWI lesion (0 to 7 points).

Mechanical thrombectomy and carotid artery stenting for stenosis of the internal carotid artery with free-floating thrombosis: illustrative case.

Background: The authors report a case in which mechanical thrombectomy and carotid artery stenting (CAS) were performed for acute cerebral infarction with free-floating thrombosis (FFT) in left internal carotid artery (ICA) stenosis. Good results were obtained.

Observations: A 63-year-old man developed sudden disturbance of consciousness and right hemiplegia.

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.

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.

Intraplaque high-intensity signal on time-of-flight magnetic resonance angiography and restenosis after carotid artery stenting.

Objective: To test the hypothesis that intraplaque hemorrhage is a predictor of restenosis after carotid artery stenting (CAS), the association between intraplaque high-intensity signal (HIS) on time-of-flight MR angiography (TOF-MRA), as a marker of intraplaque hemorrhage, and restenosis after CAS was assessed in the present observational study.

Methods: Consecutive patients who underwent initial CAS for atherosclerotic stenosis in the cervical internal carotid artery in the authors' department were enrolled. Of these, patients without preprocedural cervical TOF-MRA were excluded.

Efficacy of combined use of a stent retriever and aspiration catheter in mechanical thrombectomy for acute ischemic stroke.

Background: The efficacy of combined stent retriever (SR) and aspiration catheter (AC; combined technique: CBT) use for acute ischemic stroke (AIS) is unclear. We investigated the safety and efficacy of single-unit CBT (SCBT)-retrieving the thrombus as a single unit with SR and AC into the guide catheter-compared with single use of either SR or contact aspiration (CA).

Methods: We analysed 763 consecutive patients who underwent mechanical thrombectomy for AIS between January 2013 and January 2020, at six comprehensive stroke centers.

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.

Ruptured Cerebral Arteriovenous Malformation During Fifth Pregnancy: Case Report and Literature Review.

Background: Whether the risk of rupture of a cerebral arteriovenous malformation (AVM) increases during pregnancy remains controversial. Moreover, it is unclear whether the number of pregnancies correlates with AVM rupture risk. We report a case of ruptured AVM during the fifth pregnancy.

Efficacy and Safety of REVIVE SE Thrombectomy Device for Acute Ischemic Stroke: River JAPAN (Reperfuse Ischemic Vessels with Endovascular Recanalization Device in Japan).

REVIVE SE (REVIVE) is a closed-ended, self-expanding stent retriever used in the RIVER JAPAN study. We present our early experience with REVIVE for revascularization of acute ischemic stroke (AIS) in patients who have failed or are ineligible for intravenous recombinant tissue plasminogen activator treatment. This prospective, single-arm, non-randomized, multicenter registry study followed up patients undergoing mechanical thrombectomy with REVIVE for 90 days.

Impact of antithrombotic treatment on clinical outcomes after craniotomy for unruptured intracranial aneurysm.

Objective: Patients receiving antithrombotic treatment occasionally undergo craniotomy. We aimed to explore the impact of perioperative use of antithrombotic agents on the occurrence of surgical complications and clinical outcomes in patients with unruptured intracranial aneurysm (UIA).

Patients And Methods: We retrospectively analyzed 401 consecutive patients who had undergone craniotomy for UIA at our institution between January 2006 and December 2016.

Interaction between the stent strut and thrombus characterized by contrast-enhanced high-resolution cone beam CT during deployment of the Solitaire stent retriever.

Background: The mechanism by which a stent retriever removes intraluminal thrombus from an occluded vessel in humans has not previously been studied. This study performed contrast-enhanced high-resolution cone beam CT (CE-HRCBCT) during deployment of the stent retriever to observe the interaction between the strut and intraluminal thrombus intraoperatively. We also discuss the mechanism by which the thrombus is retrieved.

Dermatitis caused by metal allergy after coil embolization for unruptured cerebral aneurysm.

We report a rare case of metal-induced dermatitis after coil embolization for cerebral aneurysm. A 51-year-old woman experienced a rash around the lips and neck 3 weeks after coil embolization. Judging from the clinical course and results of several patch tests, platinum coils were considered to have induced the dermatitis.

Dermatitis caused by metal allergy after coil embolization for unruptured cerebral aneurysm.

We report a rare case of metal-induced dermatitis after coil embolization for cerebral aneurysm. A 51-year-old woman experienced a rash around the lips and neck 3 weeks after coil embolization. Judging from the clinical course and results of several patch tests, platinum coils were considered to have induced the dermatitis.

[Impact of comprehensive stroke team combined with vascular neurologist, neurosurgeon and endovascular interventionist for acute stroke].

The stroke center with endovascular intervention has been developed with advances in acute stroke therapy. Vascular neurologists who intend to perform endovascular intervention should receive advanced clinical training in a neurosurgical department, as well as experience in cardiovascular medicine for a prescribed period. A stroke team combined with vascular neurologists, neurosurgeons, and endovascular interventionists would be essential for a regional core comprehensive stroke center in the future.

The clinical results of transcervical carotid artery stenting and frequency chosen as the approach route of carotid artery stenting in 1,067 consecutive cases.

Background: Carotid artery stenting (CAS) is generally performed via a transfemoral approach. A transbrachial approach is usually chosen as an alternative when CAS via a transfemoral approach is difficult. At our institutions, a transcervical approach is chosen when the previous two approach routes are not available.