Reproducibility for carotid wall segmentation using T1-weighted DANTE-SPACE sequence on high-resolution 3-T carotid MRI.

Background: T1-weighted (T1W) magnetic resonance imaging (MRI) using the delay alternating with nutation for excitation-sampling perfection with application-optimized contrasts using different flip angle evolution (DANTE-SPACE) is the preferred imaging technique for evaluation of the vessel wall.

Purpose: To evaluate the intra- and inter-rater reproducibility of carotid wall segmentation on T1W DANTE-SPACE in patients with symptomatic (acute stroke or transient ischemic attack) internal carotid artery (ICA) stenosis.

Material And Methods: This prospective study included 25 patients with acute (≤3 months) stroke or transient ischemic attack and 50%-99% stenosis of the ICA.

Dual Volume Image Fusion Technique for Anatomical Evaluation of Cavernous Sinus Dural Arteriovenous Fistula: Usefulness for Transvenous Target Segment Embolization.

Objective: In this preliminary study, we investigated the value of fusion techniques by flat detector computed tomography based dual volume rotational angiography (DVRA) for the evaluation of the anatomical relationship of cavernous sinus dural arteriovenous fistula (CSDAVF) and assessed the possibility of transvenous target segment embolization.

Methods: Twenty-six patients with CSDAVF supplied by multiple feeders underwent DVRA for each feeding large vessel separately. We assessed the anatomical relationship of feeders, fistula points, and venous drainage with 3 dual volume image fusion techniques.

Risk Factors for the Recurrence of Distal Anterior Cerebral Artery Aneurysms After Endovascular Treatment.

Objective: We aimed to investigate risk factors for the recurrence of distal anterior cerebral artery (DACA) aneurysms after endovascular treatment (EVT).

Methods: The clinical and radiologic outcomes of DACA aneurysms treated with endovascular methods at a single tertiary hospital from September 2008 to December 2021 were retrospectively reviewed. We measured the angle between 2 distal branches of DACA aneurysms and categorized the angle as follows: 1) wide-angle (≥180°), and 2) narrow-angle type configuration (<180°).

Transvenous embolization along with intraprocedural image fusion technique for complex intracranial dural arteriovenous fistula.

Purpose: This study aimed to investigate the efficacy and safety of an intraprocedural image fusion technique using flat-panel detector computed tomography-based rotational angiography (FDCT-RA) and image fusion (IF) for the transvenous approach in treating intracranial dural arteriovenous fistulas (dAVFs).

Methods: A retrospective review was conducted on patients who underwent transvenous embolization for dural AVFs. The patients were classified into two groups according to the treatment technique used: the FDCT-RA and IF technique group and the conventional technique group.

Image fusion technique using flat panel detector rotational angiography for transvenous embolization of intracranial dural arteriovenous fistula.

Precise evaluation of the feeders, fistulous points, and draining veins plays a key role for successful embolization of intracranial dural arteriovenous fistulas (DAVF). Digital subtraction angiography (DSA) is a gold standard diagnostic tool to assess the exact angioarchitecture of DAVFs. With the advent of new image postprocessing techniques, we lately have been able to apply image fusion techniques with two different image sets obtained with flat panel detector rotational angiography.

Clinical and Radiological Outcomes of Vertebral Artery Dissecting Aneurysms Treated with Endovascular Treatments: A 12-year Single-Center Experience.

Objective: We aimed to compare the clinical and radiological outcomes of vertebral artery dissecting aneurysms (VADAs) stratified using different endovascular treatment methods.

Methods: We retrospectively reviewed 116 patients with VADAs treated at a single tertiary institute between September 2008 and December 2020. We analyzed and compared the clinical and radiological parameters according to different treatment methods.

Comparison of Parent Artery Occlusion and Stent-Assisted Treatments in Ruptured Vertebral Artery Dissecting Aneurysms.

Objective: To assess clinical outcomes of ruptured vertebral artery dissecting aneurysms, focusing on comparing parent artery occlusion (PAO) with stent-assisted treatments, and to identify risk factors for unfavorable outcomes and postprocedural complications.

Methods: This retrospective review included 36 ruptured vertebral artery dissecting aneurysms treated between February 2009 and April 2020. Treatment modalities included PAO without stent and stent-assisted treatments.

Acute Ischemic Stroke Caused by Internal Carotid Artery Occlusion: Impact of Occlusion Type on the Prognosis.

Background: We aimed to compare clinical outcomes of acute ischemic stroke (AIS) due to internal carotid artery (ICA) occlusion following mechanical thrombectomy (MT), focusing on occlusion types.

Methods: We retrospectively reviewed 67 AIS patients who had an ICA occlusion on computed tomography angiography and underwent MT in a single tertiary center. ICA occlusion types were categorized as (1) true cervical ICA (cICA) occlusion (true occlusion), (2) pseudo-occlusion of the cICA (pseudo-occlusion), and (3) distal ICA (dICA) occlusion.

Symptomatic ischemic complications following endovascular treatment of vertebral artery dissecting aneurysms.

Purpose: The aim of this study is to investigate the clinical and radiological features related to the symptomatic ischemic complications of vertebral artery dissecting aneurysm (VADA) following endovascular treatment (EVT).

Methods: The clinical and radiological features of 127 VADAs, which were treated in a single tertiary institute between September 2008 and December 2020, were retrospectively reviewed. We defined a thrombosed aneurysm as being one which the thrombus was in the aneurysm in magnetic resonance imaging (MRI).

A Single Flow Re-direction Endoluminal Device for the Treatment of Large and Giant Anterior Circulation Intracranial Aneurysms.

Purpose: The purpose of this study was to report the author's experiences in treating large (10-25 mm) and giant (>25 mm) intracranial aneurysms (IAs) using a single Flow Re-direction Endoluminal Device (FRED) without assistant coiling, with a focus on procedure-related complications.

Materials And Methods: A total of 33 patients who were treated with FRED between January 2018 and July 2020 were retrospectively reviewed. The timing of procedure-related complications was chronologically categorized as acute (within 7 days), subacute (8 to 21 days), and delayed (after 21 days) periods.

Low-Dose Three-Dimensional Rotational Angiography for Evaluating Intracranial Aneurysms: Analysis of Image Quality and Radiation Dose.

Objective: This study aimed to evaluate the image quality and dose reduction of low-dose three-dimensional (3D) rotational angiography (RA) for evaluating intracranial aneurysms.

Materials And Methods: We retrospectively evaluated the clinical data and 3D RA datasets obtained from 146 prospectively registered patients (male:female, 46:100; median age, 58 years; range, 19-81 years). The subjective image quality of 79 examinations obtained from a conventional method and 67 examinations obtained from a low-dose (5-seconds and 0.

Long-term clinical and angiographic outcome from angioplasty and stenting for intracranial stenosis.

Background: Severe intracranial atherosclerotic stenosis (ICAS) is a major cause of stroke. Although percutaneous transluminal angioplasty and stenting (PTAS) treatment methods have increased over the last decade as alternative therapies, there is debate regarding the best method of treatment, with medical and surgical therapies often suggested.

Methods: We analyzed the long-term follow-up results from 5 years of intracranial stenting for intracranial stenosis from three stroke centers.

Clinical and radiological risk factors for rupture of vertebral artery dissecting aneurysm: significance of the stagnation sign.

Objective: The aim of this study was to investigate the clinical and radiological factors associated with the rupture of a vertebral artery dissecting aneurysm (VADA) and to evaluate whether the stagnation sign is a significant risk factor for rupture of VADA.

Methods: Clinical and radiological variables of 117 VADAs treated in a tertiary hospital from September 2008 to December 2020 were retrospectively reviewed. The stagnation sign is defined as the finding of contrast agent remaining in the lesion until the venous phase of angiography.

Basilar artery trunk aneurysm: clinical and angiographic outcomes of endovascular treatment.

Background: Basilar artery (BA) trunk aneurysms are rare, and the clinical characteristics and outcomes of endovascular treatment (EVT) remain unclear. The purpose of this study was to report clinical and angiographic outcomes of BA trunk aneurysm treated with EVT and to analyze risk factors for unfavorable outcomes.

Methods: From October 2004 to December 2020, a total of 40 patients with BA trunk aneurysms underwent EVT.

Multiple anterior choroidal arteries and perioperative ischemic complications in unruptured anterior choroidal artery aneurysms treated with microsurgical clipping.

Background: This study aimed to identify the association between the number of anterior choroidal arteries (AchoAs) and procedure-related ischemic complications in microsurgical clipping of unruptured AchoA aneurysms.

Methods: We retrospectively reviewed the clinical, radiological, and intraoperative findings of 153 patients with unruptured AchoA aneurysms treated with microsurgical clipping between January 2012 and November 2020 in a single tertiary institution. Intraoperative video clips were reviewed, and the AchoA type was categorized into two according to the number of AchoAs: (1) single-type group with single origin and single branch and (2) multiple-type group with duplicated origin or divided multiple branches.

Risk Factors for the Recurrence of Posterior Communicating Artery Aneurysm: The Significance of Fetal-Type Posterior Cerebral artery.

Objectives: The purpose of this study was to investigate the risk factors associated with recurrence of posterior communicating artery aneurysms after treatment and to evaluate the significance of fetal-type posterior cerebral artery as an independent risk factor for recurrence of posterior communicating artery aneurysms.

Materials And Methods: The clinical and radiological findings of 220 posterior communicating artery aneurysms treated between January 2009 and December 2016 in a single tertiary institute were retrospectively reviewed. Univariate and multivariate analyses were performed to evaluate the association between clinical and radiological variables and recurrence.

Low-Dose 3D Rotational Angiography in Measuring the Size of Intracranial Aneurysm: In Vitro Feasibility Study Using Aneurysm Phantom.

Purpose: Three-dimensional (3D) measurement of intracranial aneurysms is important in planning endovascular treatment, and 3D rotational angiography (RA) is effective in accurate measurement. The purpose of this study was to evaluate the feasibility of low dose 3D RA (5 seconds 0.10 μGy/frame) in measuring an intracranial aneurysm using an in vitro phantom.

Endovascular Treatment of Intracranial Vertebral Artery Dissection.

Intracranial vertebral artery dissection (VAD) is the most common arterial dissection in intracranial arteries. Some types of VAD can heal spontaneously after reconstitution of the vessel lumen with excellent prognosis, whereas others can progress to stroke that needs treatment. Recently, endovascular treatment (EVT) has emerged and is suggested as a treatment option for VADs due to perceived low rates of procedure-related morbidity with good efficacy.

Association of Anterior Cerebral Artery Variants and Cerebral Infarction in Patients with Balloon-Assisted Coil Embolization for Unruptured Internal Carotid Artery Aneurysms.

Background: Balloon-assisted coiling (BAC) is an endovascular treatment that may be associated with increased complications and thromboembolic events compared with other coiling techniques. We compared clinical outcomes of endovascular treatment (simple coiling, stent-assisted coiling, and BAC) in patients with unruptured intracranial aneurysms at the internal carotid artery and assessed risk factors that could cause cerebral infarction in patients who underwent BAC.

Methods: We retrospectively reviewed the records of 528 patients with 544 aneurysms who underwent endovascular treatment for unruptured intracranial aneurysms between January 2013 and November 2019.

Treatment outcomes of large and giant intracranial aneurysms according to various treatment modalities.

Purpose: This study aimed to compare the treatment outcomes of large (15-25 mm) and giant (> 25 mm) intracranial aneurysms (IAs), according to different treatment modalities.

Methods: In total, 112 patients with large and giant IAs treated with various treatment modalities between January 2009 and December 2018 were retrospectively reviewed. Clinical and radiological parameters were analyzed and correlated with the treatment modality.

Treatment outcome after coiling or clipping for elderly patients with unruptured intracranial aneurysms.

Objective: The purpose of this study was to analyze treatment outcomes according to treatment modality for elderly patients over 75 years with unruptured intracranial aneurysm.

Methods: Fifty-four elderly patients treated in a single tertiary institute between January 2010 and December 2018 were retrospectively reviewed. We compared clinical outcome, radiological results, and complications between the coiling and clipping groups.

Multiphasic Computed Tomography Angiography Findings for Identifying Pseudo-Occlusion of the Internal Carotid Artery.

Background And Purpose: Differentiation between pseudo-occlusion and true occlusion of internal carotid artery (ICA) is important in treatment planning for acute ischemic stroke patients. We compared the findings of multiphasic computed tomography angiography between cervical ICA pseudo-occlusion and true occlusion at the cervical ICA in patients with anterior circulation acute ischemic stroke to determine their diagnostic value.

Methods: Thirty patients with nonvisualization of the proximal ICA were included.

Clinical and morphological risk factors for the recurrence of anterior communicating artery aneurysms after clipping or coiling.

Background: The aim of this study was to evaluate clinical and morphological factors associated with recurrence in anterior communicating artery (AcomA) aneurysms after clipping or coiling.

Methods: We retrospectively reviewed the clinical and radiologic features of consecutive 214 patients with AcomA aneurysms treated between January 2012 and December 2016 in a single tertiary institute. Univariate and multivariate analyses were performed to identify the relationship between clinical and morphological variables and recurrence.

Immediate Postoperative Angiographic Stagnation of Contrast Media and T2-Weighted Magnetic Resonance Imaging Features within Aneurysmal Sac Are Associated with Early Regression of Large or Giant Aneurysm After Flow Diversion Only.

Background: We hypothesized that the immediate postoperative imaging features would be associated with early regression of flow-diverted aneurysms. We compared the imaging features from digital subtraction angiography and spin echo T2-weighted magnetic resonance imaging between those with early total regression and partial regression.

Methods: A total of 30 consecutive patients with large and giant aneurysms were treated with pipeline embolization devices and divided into 2 groups according to the follow-up angiographic findings at 3-6 months.

Primary Brainstem Angiosarcoma Mimicking Cavernous Malformation.

Background: Cerebral angiosarcoma is an extremely rare malignant tumor that originates from vascular endothelial cells of the brain or meninges. Especially, primary brainstem angiosarcoma has not been reported.

Case Description: A 64-year-old man presented with left subjective weakness, hypesthesia, and dizziness.