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Interventional Neuroradiology

2024
2023
2022
2021
2020

本篇文献由机器智能翻译

【Online】2024年4月速览
  • Stent-assisted Woven EndoBridge embolization for the treatment of pulsatile tinnitus caused by an ipsilateral high-riding jugular bulb

    支架辅助WEB栓塞治疗同侧高位颈静脉球引起的搏动性耳鸣

    Pulsatile tinnitus can be caused by a high-riding jugular bulb (HRJB), characterized by the superior position of the jugular bulb in the petrous temporal bone. The anatomical position and morphology of this entity make it challenging for endovascular treatment. We report our experience with two patients successfully treated with a stent-assisted Woven EndoBridge (WEB; Microvention, Tustin, CA, USA) device. Among patients with pulsatile tinnitus caused by an ipsilateral HRJB, a stent-assisted WEB device seems to be a viable endovascular option with angiographic and clinical success.

    搏动性耳鸣可能是由高位颈静脉球 (HRJB) 引起的,其特征是颈静脉球在颞骨颞骨中的位置较高。该实体的解剖位置和形态使其对血管内治疗具有挑战性。我们报告了两名使用支架辅助WEB (WEB; Microvention,Tustin,CA,USA) 设备成功治疗的患者的经验。在由同侧HRJB引起的搏动性耳鸣患者中,支架辅助网状装置似乎是血管造影和临床成功的可行血管内选择。

    REF: Zur G, Charbonnier G, Fageeh A, et al. Stent-assisted Woven EndoBridge embolization for the treatment of pulsatile tinnitus caused by an ipsilateral high-riding jugular bulb. Interv Neuroradiol. Published online April 5, 2024. doi:10.1177/15910199241245156 PMID: 38576332

  • Factors associated with decreasing diffusion-weighted imaging-positive area volume after mechanical thrombectomy in patients with large early ischemic changes

    早期缺血性改变较大的患者机械取栓后弥散加权成像阳性面积减少的相关因素

    This study aimed to evaluate the factors associated with decreasing diffusion-weighted imaging (DWI) positive areas in patients with large early ischemic changes after mechanical thrombectomy (MT). The mean ADC level before-MT correlated with the after/before-MT DWI-positive area-volume ratio. A mean pretreatment ADC cutoff level of 649 × 106 mm2/s predicted a decreased DWI-positive area after MT.

    本研究旨在评估机械取栓 (MT) 后早期缺血性改变较大的患者扩散加权成像 (DWI) 阳性区域减少的相关因素。MT前的平均ADC水平与MT后/前DWI阳性面积-体积比相关。649 × 106平方毫米/s的平均预处理ADC截止水平预测MT后DWI阳性面积减少。

    REF: Shintoku R, Shimizu T, Aihara M, et al. Factors associated with decreasing diffusion-weighted imaging-positive area volume after mechanical thrombectomy in patients with large early ischemic changes. Interv Neuroradiol. Published online April 5, 2024. doi:10.1177/15910199241245279 PMID: 38576326

  • Endovascular revascularization of vertebrobasilar tandem occlusions in comparison to isolated basilar artery occlusions: A multi-center experience

    与孤立的基底动脉闭塞相比,椎基底动脉串联闭塞的血管内血运重建: 多中心经验

    Acute basilar artery occlusion (BAO) is a severe disease that is associated with an 85% mortality rate if untreated. Several studies have analyzed the use of mechanical thrombectomy (MT) in the different scenarios of BAO. However, the results remain conflicting and the role of MT as standard of care for vertebrobasilar tandem occlusions (VBTO) has not been confirmed. Our goal was to assess technical feasibility, safety, and functional outcome of endovascular treatment of VBTO in comparison to isolated BAO (IBAO). Endovascular treatment of VBTO is technically feasible and safe with similar rates of successful recanalization, favorable functional outcome, and mortality to those in patients with IBAO.

    急性基底动脉闭塞 (BAO) 是一种严重的疾病,如果不治疗,死亡率为85%。几项研究分析了机械取栓 (MT) 在不同场景下的使用情况。然而,结果仍然相互矛盾,MT作为椎基底动脉串联闭塞 (VBTO) 的护理标准的作用尚未得到证实。我们的目标是评估VBTO与单独BAO (IBAO) 血管内治疗的技术可行性,安全性和功能结果。VBTO的血管内治疗在技术上是可行且安全的,其成功再通率,良好的功能结局和死亡率与IBAO患者相似。

    REF: Klail T, Piechowiak EI, Krug N, et al. Endovascular revascularization of vertebrobasilar tandem occlusions in comparison to isolated basilar artery occlusions: A multi-center experience. Interv Neuroradiol. Published online April 5, 2024. doi:10.1177/15910199241240045 PMID: 38576395

  • Microsnare retrieval as a bail-out technique of Detached Woven EndoBridge device: Illustrative series

    使用微型抓捕器取回脱落WEB装置的挽救性技术:说明性病例系列

    The Woven EndoBridge (WEB) device (MicroVention, Tustin, CA, USA) has an excellent safety profile. While major complications such as device malposition and migration are rare, they can have serious consequences if not addressed promptly. Our case series describes the safety and efficacy of Amplatz goose neck microsnare device (Medtronic in Irvine, CA, USA) in endovascular retrieval of a detached WEB device. Our experience suggests that detached WEB devices can be safely retrieved using an Amplatz microsnare. Apart from addressing device migration, direct removal of an undersized or malpositioned WEB from the aneurysm sac appears to be a safe option that can be considered when all other rescue techniques have been exhausted.

    Woven EndoBridge(WEB)装置(MicroVention)具有出色的安全性。虽然诸如WEB移位或迁移等严重并发症很少,但它们一旦发生可能造成严重后果。我们的病例系列描述了Amplatz“鹅颈”式微型抓捕器(Medtronic)用于血管内取回脱落WEB装置的安全性和有效性。我们的经验表明,使用Amplatz微型抓捕器可以安全地取回脱落的WEB装置。除了解决WEB迁移的问题外,从动脉瘤囊中直接移除尺寸过小或移位的WEB似乎是一种安全的选择,当其他所有挽救技术无用时可以考虑使用。

    REF: Chew HS, Altibi M, Al-Ali S, et al. Microsnare retrieval as a bail-out technique of Detached Woven EndoBridge device: Illustrative series. Interv Neuroradiol. Published online April 5, 2024. doi:10.1177/15910199241242170 PMID: 38576409

    由人工翻译修正

  • Fubuki XF Long Sheath guide catheter use in neuroendovascular procedures: Institutional experience in 60 cases

    Fubuki XF长鞘引导导管在神经血管内手术中的使用: 60例的机构经验

    Endovascular treatment devices require compatible guide catheters to navigate complex vessels and anatomy. The Fubuki XF Long Sheath guide catheter (Fubuki XF) was developed with a 0.090-inch internal diameter with hydrophilic coating, an atraumatic rounded tip, and enhanced trackability and support with gradual shaft transition zones. We used Fubuki XF to safely and effectively deliver a variety of compatible neuroendovascular devices. Fubuki XF was stable in all cases and locations, and there were no device-related complications or dissections.

    血管内治疗装置需要兼容的引导导管来导航复杂的血管和解剖结构。Fubuki XF长护套导向导管 (Fubuki XF) 的开发具有0.090英寸的内径,带有亲水涂层,无创伤的圆形尖端,并具有增强的可跟踪性和逐渐的轴过渡区的支撑。我们使用Fubuki XF安全有效地提供各种兼容的神经血管内装置。Fubuki XF在所有病例和位置均稳定,并且没有与设备相关的并发症或夹层。

    REF: Saei HM, Miller SE, Pope HM, Hassan AE. Fubuki XF Long Sheath guide catheter use in neuroendovascular procedures: Institutional experience in 60 cases. Interv Neuroradiol. Published online April 9, 2024. doi:10.1177/15910199241245601 PMID: 38592015

  • Timing of acute carotid artery stenting for tandem lesions in patients with acute ischemic stroke: A Maastricht Stroke Quality Registry (MaSQ-Registry) study

    急性缺血性卒中患者串联病变的急性颈动脉支架置入时机: 马斯特里赫特卒中质量注册 (masq-registry) 研究

    To better understand the influence of treatment strategies on outcomes for patients with tandem lesions undergoing acute internal carotid artery (ICA) stenting during endovascular treatment (EVT), this study compared clinical, technical, and safety outcomes in patients with acute ischemic stroke due to a large vessel occlusion (LVO) who underwent ICA stenting before versus after intracranial thrombectomy. ICA stenting after intracranial thrombectomy in patients with tandem lesions undergoing EVT did not lead to better patient outcomes compared to stenting before intracranial thrombectomy, despite shorter reperfusion times.

    为了更好地了解治疗策略对血管内治疗 (EVT) 期间接受急性颈内动脉 (ICA) 支架置入术的串联病变患者结局的影响,本研究比较了由于大血管闭塞 (LVO) 导致的急性缺血性卒中患者的临床,技术和安全性结局颅内血栓切除术前后接受ICA支架置入术的患者。尽管再灌注时间较短,但与颅内血栓切除术前支架置入术相比,接受EVT的串联病变患者颅内血栓切除术后ICA支架置入术并未导致更好的患者预后。

    REF: Simon SR, Knapen RRMM, Truijman MTB, et al. Timing of acute carotid artery stenting for tandem lesions in patients with acute ischemic stroke: A Maastricht Stroke Quality Registry (MaSQ-Registry) study. Interv Neuroradiol. Published online April 9, 2024. doi:10.1177/15910199241245166 PMID: 38592266

  • A large UK single-centre experience in the long-term safety and efficacy of Woven Endobridge in the treatment of wide-neck intracranial aneurysms and risk factors associated with re-bleeding and re-treatment

    WEB治疗颅内宽颈动脉瘤的长期安全性和有效性以及与再出血和再治疗相关的危险因素的大型英国单中心经验

    Endovascular treatment of wide neck aneurysms remains complicated with a determined and continuous technological effort towards treatment options that can offer safer and efficacious outcomes. The Woven Endobridge device was introduced in 2010 and has become a mainstay endovascular treatment for wide neck and large intracranial aneurysms. A recent review of the Woven Endobridge Clinical Assessment of Intrasaccular Aneurysm Therapy (WEBCAST) and WEBCAST2 trials and the five-year follow-up of patients was published. Our aim is to demonstrate real-life experience of aneurysms and patients treated with Woven Endobridge from a large high-volume specialist centre. Woven Endobridge treatment of wide-neck intracranial aneurysms offers a safe and efficacious outcome. This large UK single-centre experience demonstrates congruity with recent five-year outcomes of WEBCAST and WEBCAST2 trials.

    宽颈动脉瘤的血管内治疗仍然很复杂,需要坚定而持续的技术努力才能提供更安全有效的治疗方案。WEB装置于2010年推出,已成为宽颈和大颅内动脉瘤的主要血管内治疗方法。最近发表了对囊内动脉瘤治疗的WEB临床评估 (WEBCAST) 和WEBCAST2试验以及患者五年随访的综述。我们的目标是展示动脉瘤的真实生活经验,并从大型高容量专科中心接受WEB治疗的患者。WEB治疗颅内宽颈动脉瘤可提供安全有效的结果。这项大型的英国单中心经验证明了与最近五年的网络广播和WEBCAST2试验结果的一致性。

    REF: Moughal S, Islim FI, Nejadhamzeeigilani H, Saleem N, Goddard T, Patankar T. A large UK single-centre experience in the long-term safety and efficacy of Woven Endobridge in the treatment of wide-neck intracranial aneurysms and risk factors associated with re-bleeding and re-treatment. Interv Neuroradiol. Published online April 13, 2024. doi:10.1177/15910199241236818 PMID: 38613373

  • Multicenter US clinical experience with the Scepter Mini balloon catheter

    Scepter迷你球囊导管的多中心美国临床经验

    Distal navigability and imprecise delivery of embolic agents are two limitations encountered during liquid embolization of cerebrospinal lesions. The dual-lumen Scepter Mini balloon (SMB) microcatheter was introduced to overcome these conventional microcatheters' limitations with few small single-center reports suggesting favorable results. The SMB microcatheter is a useful new adjunctive device for balloon-assisted embolization of cerebrospinal lesions with a high technical success rate, favorable outcomes, and a reasonable safety profile.

    远端可导航性和栓塞剂的不精确递送是在脑脊髓病变的液体栓塞期间遇到的两个限制。引入了双管腔小球囊 (SMB) 微导管,以克服这些常规微导管的局限性,很少有小的单中心报告提示良好的结果。SMB微导管是一种有用的新型辅助设备,用于球囊辅助栓塞脑脊髓病变,具有很高的技术成功率,良好的结果和合理的安全性。

    REF: Salem MM, Kelmer P, Sioutas GS, et al. Multicenter US clinical experience with the Scepter Mini balloon catheter. Interv Neuroradiol. Published online April 13, 2024. doi:10.1177/15910199241246135 PMID: 38613371

  • Cangrelor for neurointerventional procedures: A systematic review

    用于神经介入手术的Cangrelor: 系统评价

    Thromboembolism is a complication of neurointerventional procedures that requires patients to be placed under antiplatelet therapy. Current options for antiplatelet therapies have a delayed onset of action that prevents a rapid door to puncture transition for patents presenting in acute settings. Cangrelor (Kengreal, Chiesi, USA) is an intravenous P2Y12 platelet inhibitor approved in percutaneous coronary interventions that has an immediate onset of action and half-life between 2 and 6 min. Thus, the goal of this study is to report on the safety, effectiveness, and indications for using Cangrelor in neurointerventional procedures. A systematic review of studies describing the use of Cangrelor in neurointervention was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search was conducted on PubMed, Ovid Medline, and Embase databases through June 2023. Seventeen studies with 314 patients met inclusion criteria. The most common indication for Cangrelor use was acute ischemic strokes: 70% followed by aneurysms 27.4%. The Infusion protocol varied from 5 to 30 μg/kg bolus and 1 to 4 µg/kg/min infusion with 30 μg/kg bolus and 4 µg/kg/min infusion being reported in 64.7% of studies. Intra-operative platelet reacting unit levels were below 200 in all the studies that reported it, and the percentage of hemorrhagic, thromboembolic, and deaths occurrence in this patient cohort was respectively 11.1%, 4.8%, and 8.6%. Cangrelor appears to be a promising P2Y12 platelet inhibitor for neurointerventional procedures. However, large, randomized trials are needed to determine the full range of its effects in neurointerventional procedures.

    血栓栓塞是神经介入手术的并发症,需要患者接受抗血小板治疗。抗血小板疗法的当前选择具有延迟的起效作用,从而阻止了在急性情况下出现的专利的快速穿刺转变。Cangrelor (Kengreal,Chiesi,USA) 是一种静脉内P2Y12血小板抑制剂,已批准用于经皮冠状动脉介入治疗,可立即起效,半衰期为2至6分钟。因此,这项研究的目的是报告在神经介入手术中使用Cangrelor的安全性,有效性和适应症。使用系统评价和荟萃分析的首选报告项目 (PRISMA) 对描述Cangrelor在神经干预中的使用的研究进行系统评价。检索在PubMed、Ovid Medline和Embase数据库中进行,直到2023年6月。17项314例患者的研究符合纳入标准。使用Cangrelor的最常见适应症是急性缺血性中风: 70% 其次是动脉瘤27.4%。在64.7% 研究中,输注方案从5到30 μ g/kg推注和1到4 μ g/kg/min输注,其中30 μ g/kg推注和4 μ g/kg/min输注。在所有报道的研究中,术中血小板反应单位水平均低于200,该患者队列中出血,血栓栓塞和死亡的发生率分别为11.1%,4.8% 和8.6%。Cangrelor似乎是用于神经介入手术的有希望的P2Y12血小板抑制剂。然而,需要大规模的随机试验来确定其在神经介入手术中的全部效果。

    REF: Coulibaly NJ, Elgouhari MH, Arshad MH, Waqas M, Shallwani H, Shakir HJ. Cangrelor for neurointerventional procedures: A systematic review. Interv Neuroradiol. Published online April 13, 2024. doi:10.1177/15910199241247255 PMID: 38613377

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