IMPORTANCE Intracranial stenosis is one of the most common etiologies stroke.To our knowledge, no randomized clinical trials have compared balloon-expandable stent treatment with medical therapy in symptomatic intracranial arterial stenosis.OBJECTIVE To evaluate efficacy and safety plus vs alone patients (Ն70%). DESIGN, SETTING, AND PATIENTS VISSIT (the Vitesse Stent Study for IschemicStroke Therapy) trial an international, multicenter, 1:1 randomized, parallel group that enrolled from 27...

Background and Purpose- To evaluate the safety effectiveness of Surpass Flow Diverter (Surpass; Stryker Neurovascular, Fremont, CA) in treatment large or giant wide-neck intracranial aneurysms at one year, we hypothesize that with meets improves on historical efficacy end points. Methods- SCENT trial (Surpass Intracranial Aneurysm Embolization System Pivotal Trial to Treat Large Giant Wide Neck Aneurysms) is a multicenter, prospective, single-arm, nonrandomized, interventional for uncoilable...

Treatment consisting of percutaneous transluminal angioplasty (PTA) and stent placement has recently been proposed as an alternative to surgical reexploration in patients with recurrent carotid artery stenosis following endarterectomy. The authors retrospectively reviewed their experience after performing 25 procedures 21 assess the safety efficacy PTA or without for restenosis.The mean interval between endarterectomy endovascular was 57 months (range 8-220 months). Seven arteries five were...

Background and Purpose —Transient or permanent neurological deficits can occur in the periprocedural period following carotid angioplasty stenting (CAS), presumably due to distal embolization and/or hemodynamic compromise. We performed this study identify predictors of associated with stent placement. Methods —We reviewed medical records angiograms a consecutive series patients who underwent CAS for symptomatic asymptomatic cervical internal artery stenosis from June 1996 through December...

<b>BACKGROUND AND PURPOSE:</b> Realistic, population based cerebrovascular replicas are required for the development of neuroendovascular devices. The objective this work was to develop an efficient methodology manufacturing realistic replicas. <b>MATERIALS METHODS:</b> Brain MR angiography data from 20 patients were acquired. centerline vasculature calculated, and geometric parameters measured describe quantitatively internal carotid artery (ICA) siphon. A representative model created on...

Object. The risks associated with carotid endarterectomy (CEA) are increased in the presence of contralateral artery (CA) occlusion. 30-day stroke and death rate for patients North American Symptomatic Carotid Endarterectomy Trial (NASCET) who had CA occlusion was 14.3%. authors analyze their experience angioplasty and/or stent placement to determine safety efficacy endoluminal revascularization this subgroup. Methods. Twenty-six procedures were evaluated 23 high-grade stenosis first 15...

<h3>BACKGROUND AND PURPOSE:</h3> With modern imaging techniques, visualization of neurovascular stents remains challenging. We present a method for contrast-enhanced C-arm CBCT that provides detailed and simultaneous host arteries. <h3>MATERIALS METHODS:</h3> was performed with rotational angiography system by acquiring 620 projection frames over 200° arc at 80 kVp total 260 mAs. A superselective intra-arterial contrast injection protocol optimized in swine experiments implemented 57...

A novel randomized, controlled, unblinded clinical trial comparing 2 procedural interventions for painful osteoporotic vertebral compression fractures.The primary study objective was to evaluate cement leakage a directed kyphoplasty system (CDKS) with anteriorly biased flow and vertebroplasty. The secondary compare adjacent level fracture rates body height these intervention methods.Cement remains significant problem associated vertebroplasty procedures. Uncontrolled in the posterior...

Background and Purpose— Noninvasive imaging identifying a predictive biomarker of the bleeding risk unruptured intracranial aneurysms (UIAs) is needed. We investigated potential UIA instability, myeloperoxidase, in human aneurysm tissue. Methods — Human brain were harvested after clipping histologically biochemically evaluated for presence myeloperoxidase. Of tissue collected, 3 from ruptured 20 UIAs. For each UIA, its 5-year rupture was determined using Population, Hypertension, Age, Size...

✓ Guglielmi detachable coil (GDC) treatment for complicated cerebral aneurysms is an attractive option that has become widely accepted in recent years. This technique usually considered only if the patient harbors aneurysm not a good candidate surgical clipping. However, definition of “surgical candidate” varies among institutions, and many patients worldwide are being treated with GDCs as primary therapy. Although most centers currently perform follow-up angiography at 6 months to 1 year,...

<h3>BACKGROUND AND PURPOSE:</h3> Developments in flat panel angiographic C-arm systems have enabled visualization of both the neurovascular stents and host arteries great detail, providing complementary spatial information addition to conventional DSA. However, visibility these structures may be impeded by artifacts generated adjacent radio-attenuating objects. We report on use a metal artifact reduction algorithm for high-resolution contrast-enhanced conebeam CT follow-up imaging...

Flow diverters for the treatment of posterior circulation aneurysms remain controversial. We aimed to identify factors contributing outcome measures in patients treated with Surpass flow diverter this location.We conducted an observational study 53 who underwent flow-diverter at 15 centers. Key were mortality, complete aneurysm occlusion, and modified Rankin Scale score follow-up.At follow-up (median, 11.3 months; interquartile range, 5.9-12.7 months), 9 had died, resulting all-cause...

Background Poor vessel wall apposition of flow diverter (FD) stents poses risks for stroke-related complications when treating intracranial aneurysms, necessitating long-term surveillance imaging. To facilitate quantitative evaluation deployed devices, a novel algorithm is presented that generates intuitive two-dimensional representations from either high-resolution contrast-enhanced cone-beam CT (VasoCT) or intravascular optical coherence tomography (OCT) images. Methods VasoCT and OCT...

Vascular remodeling in response to implantation of a tissue engineering scaffold such as flow diverter (FD) leads the cure intracranial aneurysms. We hypothesize that vascular is dependent on FD design, and CD34+ progenitor cells play an important role endothelialization implant.Sixteen rabbit aneurysms were randomly treated with two different single-layer braided FDs made cobalt-chrome alloys. The FD-48 FD-72 devices had 48 72 wires, respectively. Aneurysm occlusion rate was assessed during...

The authors report their experience with carotid artery stent placement (CASP) in patients concomitant (CA) and coronary (CorA) diseases.In a review of 320 consecutive who underwent CASP, the identified 49 severe CorA disease addition to significant CA stenosis, had undergone CASP before planned bypass grafting (CorABG). average age these was 68 years. In 39 (80%) New York Heart Association functional classification grade IV 10 III. 26 50% or greater stenosis left main found. Seventeen (35%)...

<h3>BACKGROUND AND PURPOSE:</h3> Recanalization is observed in 20–40% of endovascularly treated intracranial aneurysms. To further reduce the recanalization and expand endovascular treatment, we evaluated safety efficacy closed-cell SACE. <h3>MATERIALS METHODS:</h3> Between 2007 2010, 147 consecutive patients (110 women; mean age, 54 years) presenting at 2 centers with 161 wide-neck ruptured unruptured aneurysms were by using Inclusion criteria (&gt;4 mm or a dome/neck ratio ≤2). Clinical...

OBJECTIVE We report the technique of transradial vertebral artery stenting for two patients in whom severe supra-aortic ectasia prevented ready access to right origin. METHODS An Allen test was performed verify ulnar collateral flow hand. After administration local anesthesia, a 6-French sheath introduced into radial artery. To allay induced spasm, mixture heparin (5000 IU/ml), verapamil (2.5 mg), nitroglycerine (400 μg/ml, 0.25 ml), and lidocaine (2%, 1.0 ml) infused through introducer...

Background Intracranial in-stent hyperplasia is a stroke-associated complication that requires routine surveillance. Objective To compare the results of in vivo experiments to determine accuracy and precision measurements obtained with modified C-arm contrast-enhanced, cone-beam CT (CE-CBCT) imaging those by ‘gold standard’ histomorphometry. Additionally, carry out clinical analyses comparing this CE-CBCT protocol digital subtraction angiography (DSA). Methods A non-binned (VasoCT) was used...

Background Rates of durable aneurysm occlusion following coil embolization vary widely, and a better understanding mass mechanics is desired. The goal this study to evaluate the impact packing density uniformity on permeability. Methods Aneurysm models were coiled using either Guglielmi detachable coils or Target coils. permeability was assessed by taking ratio microspheres passing through those in working fluid. Aneurysms containing masses sectioned for image analysis determine surface area...

Progress in clinical development of magnetic resonance imaging (MRI) substrate-sensors enzymatic activity has been slow partly due to the lack human efficacy data. We report here a strategy that may serve as shortcut from bench bedside. tested ultra high-resolution 7T MRI (µMRI) surgical histology sections 3-year IRB approved, HIPAA compliant study surgically clipped brain aneurysms. µMRI was used for assessing detect myeloperoxidase inflammation. The Gd-5HT-DOTAGA, novel (MPO) agent...

Contrast extravasation after intra-arterial thrombolysis for stroke occurs frequently and is identifiable on a computed tomographic (CT) scan, but it often unrecognized or misdiagnosed. Few articles describing this phenomenon have been published. The clinical outcomes of patients contrast are poorly understood. We designed grading system to predict tested the scale prospectively.We studied 27 who had exhibited CT scan immediately thrombolysis. National Institutes Health Stroke Scale was used...