A new generation of highly navigable large-bore aspiration catheters and retriever devices for intracranial mechanical thrombectomy has markedly improved recanalization rates, time clinical outcomes. We report collected data utilizing a technique based on combined large lumen catheter partially resheathed stent (ARTS: Aspiration (catheter)-(stent) Retriever Technique Stroke). This is applied, especially in presence bulky/rubbery emboli, when resistance felt while retracting the retriever; at...

Objective To evaluate the safety and efficacy of ‘Baby Trevo’ (Trevo XP ProVue 3×20 mm Retriever) stent retriever for large vessel occlusions (LVOs) in acute ischemic stroke (AIS). Materials methods We retrospectively analyzed our database included all patients treated with Baby Trevo distal LVOs AIS. Patient gender, mean age, vascular risk factors, National Institutes Health Stroke Scale (NIHSS) score at presentation, modified Rankin (mRS) baseline 90-day follow-up were documented....

Objective Evaluation of the safety and efficacy Pipeline embolization device (PED) when used as second-line treatment for recurrent or residual, pretreated ruptured unruptured intracranial aneurysms (IAs). Methods Retrospective review our database to include all patients who were treated with a PED residual IAs following surgical clipping coiling. We evaluated neurological outcome angiograms at discharge, 6- 12-months’ follow-up assessed intimal hyperplasia follow-up. Results Twenty-four met...

Background Dissecting aneurysms of the vertebral artery (VA) are difficult to treat using current surgical and endovascular techniques. Objective To analyze retrospectively efficacy safety flow diverters in treatment dissecting artery. Methods We identified six patients with unruptured VA either arising from V4 or V3–V4 junction that were treated Pipeline embolization device (PED) at our institution between July 2012 February 2015. Among other parameters, technical feasibility procedure,...

Background Flow diverter (FD) malapposition is associated with stroke-related complications. We document the use of self-expanding nitinol stents to remove/reduce ledge a FD deployed for aneurysm treatment. Methods identified five patients who were treated Pipeline embolization device (PED) in conjunction Neuroform EZ stent inadequate wall apposition ends at our institution between May 2014 and July 2015. Among other parameters, angiographic results, cone-beam computed tomography assessment...

Abstract BACKGROUND Pericallosal artery aneurysm treatment may be challenging using traditional endovascular techniques. OBJECTIVE To demonstrate the feasibility, efficacy, and safety of pericallosal flow diverters. METHODS We performed a retrospective review our institutional database from July 2013 through 2016 identified 7 subjects with treated Pipeline embolization device (ev3 Neurovascular, Medtronic, Dublin, Ireland) at least 1 follow-up angiogram. Technical procedural complication,...

Background Dissecting aneurysms located along the distal segments of posterior inferior cerebellar artery (PICA) are extremely rare, accounting for only 0.5–0.7% all intracranial aneurysms. Treatment these is challenging, both surgically and endovascularly. We present our preliminary experience clinical data utilizing Onyx as an embolization agent in treatment lesions with proximal parent preservation. Methods 7 consecutive ruptured peripheral PICA aneurysms, patients, were treated...

<h3>BACKGROUND AND PURPOSE:</h3> Advancements in medical device and imaging technology as well accruing clinical evidence have accelerated the growth of endovascular treatment cerebrovascular diseases. However, augmented role these procedures raises concerns about radiation dose to patients operators. We evaluated patient doses from an x-ray platform with dose–reduction technology, which combined image noise reduction, motion correction, contrast-dependent temporal averaging optimized...

The endovascular management of acute ischemic stroke (AIS) due to emergency large vessel occlusion (ELVO) has become the standard care after recent publication landmark randomized, controlled trials. Mechanical thrombectomy, in addition intravenous thrombolysis (within 4.5 hours when eligible), is now part algorithm treating AIS patients with ELVO anterior circulation up six symptom onset. A newly introduced device, Arc™ intracranial support catheter (Medtronic, Irvine, USA), specifically...

Isolated middle cerebral artery dissection is a rare clinical entity, with descriptions limited to few case reports and series. Symptomatic in the anterior circulation can present as an ischemic stroke young population; however, it rarely associated subarachnoid hemorrhage. We describe patient who presented acute headache from hemorrhage that was ultimately determined be due vascular artery. The initial angiogram showed irregularities this area stenosis. Repeat imaging 4 days after...

Isolated middle cerebral artery dissection is a rare clinical entity, with descriptions limited to few case reports and series. Symptomatic in the anterior circulation can present as an ischemic stroke young population; however, it rarely associated subarachnoid hemorrhage. We describe patient who presented acute headache from hemorrhage that was ultimately determined be due vascular artery. The initial angiogram showed irregularities this area stenosis. Repeat imaging 4 days after...

Background To evaluate the feasibility and efficacy of pipeline embolization device in treatment unruptured intracranial mirror segment aneurysms. Methods Out a total 338 subjects, 14 were identified harboring 32 internal carotid artery aneurysms that treated with consecutively enrolled into our study. We collected data on patient demographics, modified Rankin scale (mRS) at admission, aneurysm characteristics, clinical outcome discharge, 3–9 12–18 months as well angiography results...

<h3>Introduction</h3> Pipeline Embolization Device (PED) has proven to be an effective treatment for intracranial aneurysm with high rates of long-term complete occlusion.^1,2 However, some aneurysms either do not achieve occlusion^3–6 or heal in a delayed fashion⁷ during which the is protected from rupture. Recent scientific reports animal models show that poor wall apposition PED devices can lead occlusion aneurysms.^8,9 The purpose this study was...

<h3>Introduction/purpose</h3> Dissecting aneurysms of the vertebral artery (VA) are difficult to treat using current surgical and endovascular techniques. Currently, there is no consensus on management strategies dissecting VA aneurysms. The characteristics flow diverter stents appear have ideal requirements for treatment In this study, we retrospectively analyzed efficacy safety diverters in such lesions. <h3>Materials methods</h3> We identified six patients with either arising from V4 or...

<h3>Objectives</h3> To characterize carotid stent platform usage, features of the atherosclerotic lesion to be treated, and outcomes patients who underwent artery stenting (CAS) deemed too high-risk for endarterectomy (CEA). The primary were stroke death related a neurologic or cardiac event during in-hospital period as well at 30 90 days following CAS. Stroke was defined new deficits (motor, sensitive, cognitive) documented on patient's medical records procedure and/or MRI evidence...

<h3>Introduction</h3> Interventional neuroradiology provides increasingly safe and minimally invasive treatment options for neurovascular diseases, but the growing use of diagnostic complicated fluoroscopy-guided procedures has led to heightened concerns over ionizing radiation exposure patients staff. AlluraClarity (Philips Healthcare) is a new commercially available angiographic imaging platform that addresses these by employing novel algorithm- hardware adjustments allow dose reduction...

<h3>Background</h3> The development of a new generation highly navigable large bore aspiration catheters and retriever devices, dedicated to the revascularization intracranial vessel occlusions in context acute ischemic stroke (AIS), has improved recanalization rates time, with significant impact on clinical outcomes. We report retrospectively collected data utilizing technique based combined lumen catheter partially resheathed stent retrievers for thrombectomy (ARTS: ACE-Retriever Technique...

<h3>Objective</h3> The efficacy of stent-retrievers in achieving recanalization the setting acute ischemic stroke (AIS) secondary to an emergency large vessel occlusion (ELVO) has now been conclusively proven several randomized clinical trials. However, a small subset these patients may not be achieved by means mechanical thrombectomy with and/or thromboaspiration bore catheters. In selected cases this type recalcitrant occlusion, intracranial stenting safe and effective as last final effort...

<h3>Purpose</h3> To evaluate safety and efficacy of the pipeline embolization device (PED) in patients different age groups with incidentally found or recanalised (previously coiled clipped) aneurysms. <h3>Materials methods</h3> All an aneurysm treated PED at our institution between 2011 2016 were included. We then divided patient cohort into three representing young (Y, ≤45 years), middle (M, 46- &lt;65 years) older (O, ≥65 individuals. Information on patient's vascular risk factors,...

<h3>Purpose</h3> Flow diverter malapposition as a technical complication with the use of pipeline embolization device has been described and maybe is associated delayed ischemic events or potentially life-threatening aneurysm rupture. We describe our endovascular techniques for manipulation flow diverters in order to achieve proper vessel wall apposition. <h3>Materials methods</h3> retrospectively analyzed database included all patients whom was detected on follow-up angiography immediately...

<h3>Background/objective</h3> Pericallosal artery aneurysm treatment is challenging using traditional endovascular techniques due to the small caliber of parent vessel and distal access. Wide neck bifurcation aneurysms in this location require manipulation with 2 catheters for balloon assisted or stent coil embolization increased friction limited margin error. We demonstrate feasibility, efficacy safety pericallosal flow diversion technology. <h3>Methods</h3> performed a retrospective review...

<h3>Introduction</h3> Recent meta-analysis of randomized clinical trials has shown that endovascular intervention yields higher rates revascularization and superior functional outcomes as compared to standard medical therapy in the setting emergent large vessel occlusion causing stroke. However, there remained approximately 20% patients whom successful (mTICI score, 2b or 3) was not achieved after stent-retriever thrombectomy [1, 2]. Revascularization with devices depends part upon...

<h3>Background</h3> Intracranial aneurysms (IAs) associated with dural arteriovenous shunts (DAVSs) are rare and infrequently discussed in conjunction brain malformation (bAVM). We studied at two cerebrovascular centers IAs DAVSs. <h3>Patients methods</h3> Between 2005 2018, 103 subjects DAVSs were retrospectively analyzed for the presence of remote IAs. Demographics, clinical symptoms, aneurysm DAVS location, treatment outcomes studied. Pertinent literature on was also reviewed....