108 results match your criteria: "Massachusetts General Hospital-Brigham and Women's Hospital[Affiliation]"
Flow-diverting stents for the treatment of unruptured distal anterior cerebral artery aneurysms: analysis of the CRETA Registry.
J Neurointerv Surg
December 2024
UOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS Roma, Roma, Italy
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.
Cardiometabolic Outcomes in Idiopathic Intracranial Hypertension: An International Matched-Cohort Study.
medRxiv
November 2024
Montefiore-Einstein Cerebrovascular Research Lab, Albert Einstein College of Medicine, Bronx, NY, USA.
Introduction: Idiopathic intracranial hypertension (IIH) has been traditionally viewed as a neuro-ophthalmic disorder, yet emerging evidence suggests broader systemic implications. Our study investigates the cardiometabolic outcomes associated with IIH through a comprehensive matched-cohort analysis.
Methods: We conducted a retrospective analysis of electronic health records from 2009 to 2024.
Semaglutide as an Adjunctive Therapy to Standard Management for Idiopathic Intracranial Hypertension: A Real-World Data-Based Retrospective Analysis.
medRxiv
November 2024
Montefiore-Einstein Cerebrovascular Research Lab, Albert Einstein College of Medicine, Bronx, NY, USA.
Background: Idiopathic intracranial hypertension (IIH) is a neurological disorder characterized by elevated intracranial pressure, predominantly affecting young women with obesity. This study evaluates the effectiveness of semaglutide as an adjunctive therapy to standard IIH management using real-world data.
Methods: We conducted a retrospective cohort analysis comparing IIH patients receiving semaglutide plus standard therapy versus standard therapy alone.
Efficacy of Tirzepatide Dual GIP/GLP-1 Receptor Agonist In Patients with Idiopathic Intracranial Hypertension. A Real-World Propensity Score-Matched Study.
medRxiv
November 2024
Montefiore-Einstein Cerebrovascular Research Lab, Albert Einstein College of Medicine, Bronx, NY, USA.
Introduction: Idiopathic intracranial hypertension (IIH) is a neurological disorder characterized by elevated intracranial pressure, predominantly affecting obese women of reproductive age. While GLP-1 receptor agonists have shown promise in IIH management, the potential of dual GIP/GLP-1 receptor activation through tirzepatide remains unexplored. This study aimed to evaluate tirzepatide's efficacy as an adjunctive therapy in IIH management.
View Article and Find Full Text PDFPretreatment factors associated with symptomatic stroke in Moyamoya disease patients: A multicenter study.
J Clin Neurosci
December 2024
Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA. Electronic address:
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.
View Article and Find Full Text PDFSafety and efficacy of newer liquid embolic agents Squid and PHIL in endovascular embolization of cerebral arteriovenous malformations and dural arteriovenous fistulas: A systematic review and meta-analysis.
Interv Neuroradiol
October 2024
Department of Neurosurgery, Lenox Hill Hospital, New York, NY, USA.
Background: A wide range of liquid embolic agents has been used in endovascular treatment (EVT) of dural arteriovenous fistulas (dAVFs) and cerebral arteriovenous malformations (cAVMs). Newer liquid embolics, Squid (Balt) and PHIL (MicroVention), aim to improve the safety and efficacy of EVT of dAVFs and cAVMs.
Objective: To assess the safety and efficacy of EVT of cAVMs and dAVFs using Squid or PHIL as an embolic agent.
Trans-radial vs. trans-femoral approaches in diagnostic cerebral angiography: A comprehensive systematic review and meta-analysis of practicality and cost-effectiveness.
Clin Neurol Neurosurg
December 2024
Department of Neurology and Neurosurgery, Medical University of South Carolina, Charleston, SC, USA. Electronic address:
Background: Selecting most appropriate approach between the transfemoral access (TFA) and transradial access (TRA) for diagnostic cerebral angiography is a subject of debate.
Objective: To compare the safety and efficacy of TFA and TRA for diagnostic cerebral angiography.
Methods: We performed a systematic search through four databases to find relevant clinical studies.
Comparative Outcomes of Unilateral vs Bilateral Revascularization in Moyamoya Disease: A Multicenter Retrospective Study.
Neurosurgery
October 2024
Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
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.
View Article and Find Full Text PDFEndovascular therapy versus medical management in isolated posterior cerebral artery acute ischemic stroke: A multinational multicenter propensity score-weighted study.
Eur Stroke J
October 2024
Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Background: Despite the proven effectiveness of endovascular therapy (EVT) in acute ischemic strokes (AIS) involving anterior circulation large vessel occlusions, isolated posterior cerebral artery (PCA) occlusions (iPCAo) remain underexplored in clinical trials. This study investigates the comparative effectiveness and safety of EVT against medical management (MM) in patients with iPCAo.
Methods: This multinational, multicenter propensity score-weighted study analyzed data from the Multicenter Analysis of primary Distal medium vessel occlusions: effect of Mechanical Thrombectomy (MAD-MT) registry, involving 37 centers across North America, Asia, and Europe.
Defining ideal middle cerebral artery bifurcation aneurysm size for Woven EndoBridge embolization.
J Neurosurg
October 2024
3Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard University, Boston, Massachusetts.
Article Synopsis
- The study aimed to identify the optimal sizes for middle cerebral artery (MCA) bifurcation aneurysms that are most suitable for treatment with the Woven EndoBridge (WEB) device, focusing on aneurysm width and neck dimensions.
- Using a large retrospective database, the researchers analyzed unruptured MCA bifurcation aneurysms and established ideal cutoff values of 6.1 mm for width and 4.6 mm for neck size regarding treatment effectiveness.
- Findings indicated that aneurysms smaller than these cutoff values had significantly higher rates of occlusion (93% for width and 90% for neck) and lower retreatment rates compared to larger aneurysms, highlighting the importance of
Bibliometric mapping of the landscape and structure regarding telemedicine in surgery: Visualization analysis.
Asian J Surg
October 2024
Department of Infection Disease, China Medical University, No.92 of Beima Road, Heping District, Shenyang, Liaoning Province, 110122, China. Electronic address:
Cardiac CT vs Echocardiography for Intracardiac Thrombus Detection in Ischemic Stroke: A Systematic Review and Meta-Analysis of 43 Studies.
Neurology
October 2024
From the Departments of Radiology (S.G., H.K., A.M., M.A., D.F.K., R.K.), Neurologic Surgery (S.G., R.K.), and Neurology (M.L., A.A.R., D.N.), Mayo Clinic, Rochester, MN; Evidence-based Practice Center (A.S.A.), Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN; Neuroendovascular Program (A.A.D.), Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Neurovascular Centre, Divisions of Therapeutic Neuroradiology & Neurosurgery (A.A.D.), St. Michael's Hospital, University of Toronto, ON, Canada.
Article Synopsis
- Ischemic stroke, a major cause of death, highlights the need for effective detection methods like echocardiography and emerging alternatives such as cardiac CT (CCT) to identify potential cardiac sources of stroke.
- A systematic review and meta-analysis of 43 studies, involving 9,552 patients, was conducted to compare the effectiveness of CCT against the traditional echocardiography (specifically TEE) in detecting intracardiac thrombus.
- The analysis found that CCT demonstrated high sensitivity (98.38%) and specificity (96.0%) for thrombus detection, with the best results coming from delayed-phase, electrocardiogram-gated CCT, while early-phase, nongated CCT had slightly
The impact of hypertension on clinical outcomes in moyamoya disease: a multicenter, propensity score-matched analysis.
Acta Neurochir (Wien)
September 2024
Department of Neurological Surgery, Thomas Jefferson University Hospital, 901 Walnut street 3rd Floor, Philadelphia, Pennsylvania, 19107, USA.
Article Synopsis
- - Moyamoya disease (MMD) is a rare brain disorder that causes narrowing of blood vessels, often accompanied by high blood pressure, which complicates the condition's outcomes; this study compares MMD patients with and without hypertension.
- - A total of 598 MMD patients were analyzed from multiple institutions, with hypertensive (292) and non-hypertensive (306) groups evaluated for clinical characteristics and outcomes using statistical adjustments to account for differences in their backgrounds.
- - Results indicated that although hypertensive patients showed higher rates of certain risk factors (like diabetes and smoking) and higher stroke rates before adjustments, post-matching analysis revealed no significant differences in stroke rates or recovery outcomes between the two groups, suggesting effective
Predictive value of follow-up infarct volume on functional outcomes in middle cerebral artery M2 segment vessel occlusion stroke treated with mechanical thrombectomy.
Eur Stroke J
September 2024
Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Article Synopsis
- Medium vessel occlusion (MeVO) strokes, especially in the M2 segment of the middle cerebral artery, are a significant challenge in stroke management, necessitating effective prediction of patient outcomes after mechanical thrombectomy (MT).
- This study analyzed data from the MAD-MT registry to evaluate the relationship between follow-up infarct volume (FIV) and 90-day functional outcomes, using the modified Rankin Scale (mRS) as a measurement.
- Results showed that FIV is a strong predictor of outcomes, with specific volume thresholds indicating favorable prognosis; notably, an FIV of ≤15 ml had the best predictive capability, outperforming traditional recanalization scores.
"Insights into vessel perforations during thrombectomy: Characteristics of a severe complication and the effect of thrombolysis".
Eur Stroke J
August 2024
Department of Diagnostic & Interventional Neuroradiology, Radiology & Nuclear Medicine Clinic, University Hospital Basel, Basel, Switzerland.
Article Synopsis
- * Data from 459 patients with vessel perforation showed a 90-day mortality rate of 51.9%, with only 16.3% achieving a favorable recovery (mRS 0-2).
- * The findings indicate that large vessel perforation leads to worse outcomes, while thrombolysis doesn’t worsen prognoses; quick management of bleeding is crucial for survival.
Creation of a predictive calculator to determine adequacy of occlusion of the woven endobridge (WEB) device in intracranial aneurysms-A retrospective analysis of the WorldWide WEB Consortium database.
Interv Neuroradiol
August 2024
Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard University, Boston, MA, USA.
Article Synopsis
- - The study aimed to create a predictive calculator to determine the chances of achieving adequate occlusion (Raymond-Roy classification 1 or 2) when using the woven endobridge (WEB) device for intracranial aneurysms, drawing from a large dataset.
- - Analyzed data from 356 patients across 30 centers worldwide revealed that larger aneurysm neck size and partial thrombosis were linked to lower chances of successful occlusion, while the calculator showed good predictive accuracy.
- - The newly developed tool offers a valuable resource for clinicians to better estimate the success of using the WEB device in treating intracranial aneurysms, helping to enhance patient care.
Assessment of Thrombectomy versus Combined Thrombolysis and Thrombectomy in Patients with Acute Ischemic Stroke and Medium Vessel Occlusion.
Radiology
August 2024
From the Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard University, Boston, Mass (A.A.D., R.W.R., C.J.S., J.D.R., A.B.P.); Departments of Medical Imaging and Neurosurgery, Neurovascular Centre, St. Michael's Hospital, Toronto, ON, Canada M5B 1W8 (A.A.D., N.M.C., T.R.M., V.M.P.); Departments of Neurologic Surgery & Radiology, Mayo Clinic, Rochester, Minn (S.G., H.K., R.K.); Cooper Neurologic Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ (J.E.S., H.S., J.K., A.J.T., A.G.); Departments of Radiology & Neurology, Boston Medical Center, Boston, Mass (M.A., P. Klein, T.N.N.); Department of Interventional Neuroradiology, Stanford Medical Center, Palo Alto, Calif (J.J.H.); Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pa (K.E.N., A.A., S.I.T., P.J.); Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, La (H.A.S., B.M., N.A., H.H.C.S.); Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (L.M., J.F. T.D.F.); Department of Neurology, Hôpital Civil Marie Curie, Charleroi, Belgium (A.D., F.B.); Department of Neuroradiology, University Hospital of Limoges, Université de Limoges, Limoges, France (G.F., A.R., S. Saleme, C.M.); Department of Radiology, Division of Neurointerventional Radiology, University of Massachusetts Medical Center, Worcester, Mass (A.L.K., A.S.P.); Department of Neuroradiology, Sana Kliniken, Lübeck GmbH, Lübeck, Germany (C.D.); Department of Neurosurgery, University of Texas Medical Branch, Galveston, Tex (P.T.K., M.C.); Department of Interventional Neuroradiology, Bordeaux University Hospital, Bordeaux, France (G.M., J.B., X.B.); Department of Neurology, Bordeaux University Hospital, Bordeaux, France (I.S.); Department of Neurology, University of Massachusetts Chan Medical School, Worcester, Mass (S.N., N.H.); Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, Mass (N.H.); Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (N.H.); Department of Neurosurgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan (T.O., S.D.); Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.L.Y., B.Y.Q.T.); Department of Medicine, Division of Neurology, National University Hospital, Singapore (B.Y.Q.T.); Department of Neurology, UTHealth McGovern Medical School, Houston, Tex (J.C.M.G., S.S.M.); Interventistica Neurovascolare, Ospedale Careggi di Firenze, Florence, Italy (S. Sheth, L.R., C.C.); Department of Neurologic Surgery, Division of Stroke and Endovascular Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, Calif (A.M.); Department of Endovascular Neurosurgery and Neuroradiology, Rutgers University New Jersey Medical School in Newark, Newark, NJ (P. Khandelwal); Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY (A.B.); Department of Neuroradiology, Pitié-Salpêtrière Hospital, GRC BioFast, Sorbonne University, Paris, France (F.C., M.E., K.P.); Neurology Department, Faculty of Medicine, Tanta University, Egypt (M.E.); UOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy (I.V., A.P., A.M.A.); Department of Diagnostic and Interventional Neuroradiology, Centro Hospitalar Universitário do Porto, Porto, Portugal (J.P.F.); Department of Neurology, Centro Hospitalar Universitário do Porto, Porto, Portugal (R.V.); Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, Calif (M.Q.C., N.R.G.); Department of Vascular and Interventional Neuroradiology, Universitätsklinikum Heidelberg, Heidelberg, Germany (M.A.M., J.J., C.W.); Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France (V.C., R.A.R.); Department of Neurology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France (A.t.S.); Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Md (V.Y.); Department of Neurology, University of Cincinnati Medical Center, Cincinnati, Ohio (P.H., L.M.C., Y.A.); Department of Interventional Neuroradiology, Nancy University Hospital, Nancy, France (B.G.); INSERM U1254, IADI, Université de Lorraine, Nancy, France (B.G.); Department of Radiology, Section of Interventional Neuroradiology, University Medical Center Münster, Münster, Germany (C.P.S.); Departments of Neurology & Neurosurgery, Christian Doppler Clinic, Paracelsus Medical University, Salzburg, Austria (C.H., M.K.O., C.J.G.); Department of Neurology, Sin-Lau Hospital, Tainan, Taiwan (C.Y.H.); UCLA Stroke Center and Department of Neurology Department, University of California Los Angeles, Los Angeles, Calif (D.S.L.); Department of Medicine, Division of Neurology, The Ottawa Hospital, Ottawa Hospital Research Institute and University of Ottawa, Ottawa, Ontario, Canada (I.T., R.F.); Department of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, Brussels, Belgium (B.L.).
Article Synopsis
- * Data from 670 patients revealed that while IVT may improve some outcomes, such as higher chances of achieving a modified Rankin Scale score of 0-2 in univariable analysis, this benefit was not consistently observed in more rigorous multivariable analyses.
- * Overall, the findings suggest that adjunctive IVT may not significantly enhance clinical outcomes or safety compared to MT alone for this patient population.
Treatment of large intracranial aneurysms using the Woven EndoBridge (WEB): a propensity score-matched analysis.
Neurosurg Rev
July 2024
Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard University, Boston, MA, USA.
Article Synopsis
- - The Woven EndoBridge (WEB) device is used for treating wide-neck intracranial bifurcation aneurysms smaller than 10 mm, but there's limited data on its effectiveness for larger aneurysms.
- - A study reviewed data from the WorldWide WEB Consortium involving 898 patients to compare outcomes between small and large aneurysms, using propensity score matching (PSM) for accuracy.
- - Results showed that large aneurysms had significantly lower rates of adequate occlusion and higher rates of retreatment compared to small aneurysms, suggesting that these findings could influence treatment choices and patient discussions in the future.
Off-Label use of Woven EndoBridge device for intracranial brain aneurysm treatment: Modeling of occlusion outcome.
J Stroke Cerebrovasc Dis
November 2024
Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA; Department of Neuroradiology, Massachusetts General Hospital & Brigham and Women's Hospital, Boston, MA, USA.
Article Synopsis
- The Woven EndoBridge (WEB) device is being studied as a new treatment for intracranial aneurysms, particularly its effectiveness for off-label uses which require further investigation.
- A study of 162 patients utilizing machine learning developed predictive models for successful occlusion after off-label WEB treatment, analyzing various factors linked to outcomes.
- Findings indicated that larger neck diameter and the presence of daughter sacs significantly predicted poorer occlusion results, emphasizing the need for further validation to refine patient selection and treatment strategies.
Correction to: Endovascular thrombectomy for ischemic stroke with large infarct, short‑ and long‑term outcomes: a meta‑analysis of 6 randomised control trials.
Neurol Sci
December 2024
Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 2910 North Third Avenue, Phoenix, AZ, 85013, USA.
Comparative Efficacy of Flow Diverter Devices in the Treatment of Carotid Sidewall Intracranial Aneurysms: a Retrospective, Multicenter Study.
Clin Neuroradiol
December 2024
Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Baton Rouge, LA, USA.
Article Synopsis
- - The study compared the effectiveness and safety of four first-generation flow diverters (FDs) used for treating sidewall ICA intracranial aneurysms, which include Pipeline, Silk, FRED, and Surpass devices, using data from 444 patients across 18 institutions from 2009-2016.
- - Analysis revealed no significant differences in retreatment rates or complications among the devices; however, the Surpass device showed the highest probability of achieving effective occlusion at follow-up, followed by FRED, Pipeline, and Silk.
- - Although all devices had good clinical outcomes, the study highlights the need for prospective research to further clarify the differences and long-term effects of these flow diverters.
Endovascular thrombectomy for ischemic stroke with large infarct, short- and long-term outcomes: a meta-analysis of 6 randomised control trials.
Neurol Sci
December 2024
Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 2910 North Third Avenue, Phoenix, AZ, 85013, USA.
Article Synopsis
- The study investigates the effectiveness of Endovascular Thrombectomy (EVT) versus Best Medical Treatment (BMT) for patients with large core ischemic infarcts, analyzing data from six randomized control trials (RCTs) involving 1918 patients.
- Results show that EVT combined with BMT significantly improves 90-day outcomes, yielding higher rates of favorable results (mRS scores), lower mortality rates, and better neurological recovery compared to BMT alone, although it also increases the risk of symptomatic intracerebral hemorrhage (sICH).
- Specifically, EVT led to a notable absolute improvement in mRS scores (0-1, 0-2, 0-3) by
Management of failed flow diversion for intracranial aneurysm beyond the first 6 months of follow-up: an international Delphi consensus.
J Neurosurg
November 2024
5Department of Neurosurgery, Cooper University Health Care, Cooper Medical School of Rowan University, Camden, New Jersey.
Objective: The placement of flow-diverting devices has become a common method of treating unruptured intracranial aneurysms of the internal carotid artery. The progressive improvement of aneurysm occlusion after treatment-with low complication and rupture rates-has led to a dilemma regarding the management of aneurysms in which occlusion has not occurred within 6-24 months. The authors aimed to identify clinical consensus regarding management of intracranial aneurysms displaying persistent filling 6-24 months after flow diversion and to ascertain questions that may drive future investigation.
View Article and Find Full Text PDFRisk of adjacent level fracture after percutaneous vertebroplasty and kyphoplasty vs natural history for the management of osteoporotic vertebral compression fractures: a network meta-analysis of randomized controlled trials.
Eur Radiol
November 2024
Neurovascular Centre, Divisions of Therapeutic Neuroradiology & Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
Objectives: Percutaneous vertebroplasty and kyphoplasty are common interventions for osteoporotic vertebral compression fractures. However, there is concern about an increased risk of adjacent-level fractures after treatment. This study aimed to compare the risk of adjacent-level fractures after vertebroplasty and kyphoplasty with the natural history after osteoporotic vertebral compression fractures.
View Article and Find Full Text PDFOutcomes of mechanical thrombectomy in anticoagulated patients with acute distal and medium vessel stroke.
Eur Stroke J
December 2024
Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Background: Stroke remains a major health concern globally, with oral anticoagulants widely prescribed for stroke prevention. The efficacy and safety of mechanical thrombectomy (MT) in anticoagulated patients with distal medium vessel occlusions (DMVO) are not well understood.
Methods: This retrospective analysis involved 1282 acute ischemic stroke (AIS) patients who underwent MT in 37 centers across North America, Asia, and Europe from September 2017 to July 2023.