Efficacy of Flow Diverters in Managing Multiple Aneurysms: A Clinical Case Report.

Brain aneurysms, also known as cerebral aneurysms, are the growths of the parent artery. Based on their shape, aneurysms can be categorized as saccular or non-saccular. Several factors have been linked to multiple brain aneurysms but the most prevalent is arterial hypertension.

Evolving treatment paradigms of cerebral aneurysm stasis in flow diversion.

Introduction: Flow diversion is an effective first-line treatment for intracranial aneurysms; however, the rate of incomplete occlusion is not insignificant. Data in neuroendovascular literature is limited regarding the implications of persistent incomplete occlusion despite flow diversion.

Methods: We conducted a retrospective analysis of a prospectively maintained database and identified 125 consecutive patients with treatment naïve intracranial aneurysms who underwent flow diversion with the PED from April 2014 - November 2022.

Circulating plasma protein identified as a therapeutic target for intracranial aneurysm through Mendelian Randomization analysis.

Background: Intracranial aneurysms are the main cause of subarachnoid hemorrhage (SAH), a severe stroke with devastating effects. However, there are no existing medications for intracranial aneurysms (IAs) and novel therapeutic targets are required.

Methods: We performed a summary data-based Mendelian Randomization (MR) analysis to explore the causal association between circulating plasma proteins and the risk of IAs and SAH.

LncRNA PVT1 Promotes Intracranial Aneurysm Development via USP10/KLF4/NLRP3 Axis-Mediated Pyroptosis in Human Cerebral Smooth Muscle Cells.

Our previous research identified that lncRNA PVT1 is upregulated in patients with IA. However, the precise functions of PVT1 in IA remain unclear. We compared the levels of PVT1, caspase-3, caspase-1, and NLRP3 in normal and IA patients.

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.

Cross-Circulation Thrombectomy for Acute Middle Cerebral Artery Occlusion from Dislodged Thrombus of a Giant Internal Carotid Aneurysm: A Case Report.

Objective: Giant aneurysms of the cavernous segment of the internal carotid artery presenting as acute ischemic stroke (AIS) are rare and often misdiagnosed. Limited treatment experience further complicates management.

Case Presentation: A 70-year-old female presented with acute right middle cerebral artery (MCA) occlusion due to a dislodged thrombus from a giant internal carotid aneurysm.

Clinical Outcomes of Endovascular Coil Embolization for Ruptured Middle Cerebral Artery Aneurysms.

Objective: Middle cerebral artery (MCA) aneurysms are difficult to treat with coil embolization (CE) due to their location and shape, but the number of CE-treated MCA has gradually increased as treatment techniques have improved. However, the outcomes of CE for ruptured MCA aneurysms are poorly understood. This study aimed to evaluate the outcomes of CE for ruptured MCA aneurysms.

Rapid Development and Rupture of an Infected Intracranial Aneurysm Caused by Streptococcus salivarius Meningitis: A Case Report.

The clinical manifestation of intracranial mycotic aneurysms (ICMAs), which are rare but carry high risks of rupture and early mortality, remains poorly understood. We present a case of an ICMA that rapidly developed and ruptured after the diagnosis of meningitis caused by (), which rarely causes bacterial meningitis. A 54-year-old man presented with a headache that worsened on coughing, without altered consciousness or vomiting.

Accessory middle cerebral artery of distal origin associated with an anterior communicating artery duplication that mimicked an aneurysm.

Purpose: Although both accessory middle cerebral artery (MCA) of distal origin and anterior communicating artery (ACoA) duplication are not rare anatomical variations, their combination is extremely rare and there are only a few reports of such combinations.

Methods: We report a case of distal origin accessory MCA associated with ACoA duplication diagnosed by magnetic resonance angiography (MRA).

Results: A 63-year-old man visited another hospital for screening examinations for cerebrovascular disease.

Exploring robotic advances, applications, and challenges in neuroendovascular surgery: A scoping review of the CorPath GRX system.

Background: The integration of robotics into neuroendovascular surgery has the potential to revolutionize the field by enhancing precision, reducing procedure-related risks, and improving patient outcomes. The CorPath GRX system represents a significant advancement in this domain. In this systematically conducted scoping review, we explore the current applications, advances, and challenges associated with robot-assisted neuroendovascular surgery.

Modifiable lifestyle factors and risk of intracranial aneurysm: A univariate and multivariate Mendelian randomisation study.

The aim of this study was to assess the potential causal relationship between lifestyle factors and intracranial aneurysms (IAs) using a two-sample Mendelian randomization (MR) approach. The study used a pooled dataset from a genome-wide association study that covered information on 24 lifestyle factors, intracranial aneurysm cases, subarachnoid hemorrhage, and unruptured aneurysms. Five MR methods were applied for analysis by selecting single nucleotide polymorphisms as instrumental variables, with the inverse variance weighting method as the main method.

Safety and efficacy of staged primary coiling followed by delayed flow diversion of ruptured intracranial aneurysms: A systematic review and meta-analysis.

Background: Ruptured intracranial aneurysms lead to significant mortality and morbidity. Recent advancements have suggested staged coiling with subsequent flow diverter stent placement may reduce the risk of hemorrhage with dual antiplatelet therapy (DAPT) or stent thrombosis in the acute inflammatory phase after aneurysm rupture while still appropriately mitigating risk of aneurysmal rehemorrhage.

Materials And Methods: A systematic review and single-arm meta-analysis was conducted.

Outcomes of Fenestration of Lamina Terminalis for Hydrocephalus following Clipping of Ruptured Aneurysms of Anterior Circulation.

Objectives: To evaluate the Outcomes of Fenestration of Lamina Terminalis for Hydrocephalus following Clipping of Ruptured Aneurysms of Anterior Circulation.

Methods: A retrospective case series study was conducted at the Punjab Institute of Neurosciences, Lahore from August 2022 to July 2023. Seventy seven patients meeting the inclusion criteria of age group 20-65 years, ruptured saccular aneurysm of anterior circulation with or without lamina terminalis fenestration during clipping, were enrolled through non-probability convenience sampling.

Surgical outcome of clipping in anterior circulation aneurysms.

Objective: To observe the outcome of surgical clipping in anterior circulation aneurysm in a modestly resourced hospital.

Methods: A retrospective cross-sectional study was conducted at Punjab Institute of Neurosciences Lahore, from August 2022 to July 2023. Seventy five patients meeting the inclusion criteria of age <65, saccular aneurysm of anterior circulation, and Hunt and Hess grade one or two were enrolled through non-probability convenience sampling.

Surgical outcomes of delayed clipping in ruptured intracranial aneurysms of anterior circulation: Experience from a low-middle-income country.

Objective: To evaluate the surgical outcomes of delayed microsurgical clipping for ruptured intracranial aneurysms (RICAs) of anterior circulation.

Methods: This retrospective, cross-sectional study assessed the surgical outcomes of 50 patients who underwent surgical clipping for "ruptured aneurysms" with subarachnoid haemorrhage after the 21 post-bleed day, from May 01, 2022, till May 01, 2023, at the Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore, Pakistan.

Results: The mean age of patients was 49.

Development of an indicator framework for assessing nursing quality in interventional therapy for intracranial aneurysms in China.

Objective: The objective of this study is to devise an indicator system to assess the quality of nursing care in the context of interventional therapy for intracranial aneurysms (IA) in China. This will furnish a standardized and quantitative framework for the monitoring and assessment of nursing quality within the IA interventional therapeutic field.

Methods: The indicators and their associated weights within the evaluation system for nursing quality in interventional therapy for IA were determined based on the theoretical framework of the three-dimensional quality model, specifically the "structure-process-outcome" paradigm.

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.

REtrieving thrombi and Separated Coils/catheters Unexpectedly detached during Endovascular therapy: RESCUE - the use of thrombectomy devices for rescue therapy in interventional neuroradiology.

Purpose: Intraprocedural complications during intracranial embolisation include thromboembolic vessel occlusion, catheter tip detachment and coil migration. Stentrievers and aspiration catheters are valuable devices for the management of these complications. We present our experience with the use of these devices.

Reconstructive endovascular treatment of patients with ruptured distal intracranial aneurysms in posterior circulation: a retrospective cohort study.

Background: Cases of ruptured distal intracranial aneurysms (DIAs) in the posterior circulation are rare. Currently, the most commonly used approach in clinical practice to treat this condition is reconstructive endovascular treatment. However, research on endovascular treatment of intracranial posterior circulation ruptured DIAs is currently lacking.

Flow-diverting stents for the treatment of unruptured distal anterior cerebral artery aneurysms: analysis of the CRETA Registry.

Background: Data about the safety and the efficacy of flow diversion for distal anterior cerebral artery (DACA) aneurysms are limited. We present the largest multicenter analysis evaluating the outcomes of flow diversion in unruptured DACA aneurysm treatment.

Methods: Databases from 39 centers were retrospectively reviewed for unruptured DACA aneurysms treated with flow-diverting stents.

Endovascular treatment of high-flow carotid-cavernous fistula secondary to rupture of a carotid-cavernous aneurysm post-flow diverter stent placement.

Carotid-cavernous aneurysms (CCAs) have the potential for growth, and their risk of rupture can lead to severe complications. Treatment is typically recommended to prevent these complications, with endovascular therapy being the preferred approach due to the challenging surgical access. This case presents a rare instance of rupture of a CCA that had been previously treated with a flow-diverting stent, which resulted in the development of a carotid-cavernous fistula, requiring venous access endovascular treatment.

Flow diversion for the treatment of distal circulation aneurysms: A randomized comparison.

Background And Purpose: Flow diversion (FD) has expanded beyond initial indications (proximal carotid artery aneurysms) to include distal circulation aneurysms (on the anterior, middle, or posterior cerebral arteries). Our objective was to examine results obtained from aneurysms in these locations in the Flow Diversion in the Treatment of Intracranial Aneurysms Trial (FIAT) which compared FD with alternative standard management options (ASMO).

Materials And Methods: FIAT was an all-inclusive parallel-group 1:1 randomized study comparing FD with one of 4 ASMOs (coiling +/-stenting, parent vessel occlusion (PVO), clipping, or observation, pre-specified by clinical judgment).

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.

Oculomotor nerve palsy recovery following microsurgery vs. endovascular treatment of posterior communicating artery aneurysms: a comparative meta-analysis of short- and long-term outcomes.

Recent advancements in endovascular treatment (EVT) and different views on optimal management for posterior communicating artery (PComA) aneurysms with oculomotor nerve palsy (ONP) highlight a need to compare recovery timelines between microsurgery and EVT; heterogeneous outcomes and influencing factors may also affect results. A comprehensive systematic review and meta-analysis were conducted by searching PubMed, Embase, Scopus, and Web of Science databases. The extracted data encompassed patient demographics, details on treatment modalities and timing, and characteristics of PComA aneurysms ONP caused by either unruptured or ruptured aneurysms.