Journal of neurosurgery
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Journal of neurosurgery · Sep 2023
Natural history of antiplatelet nonresponders undergoing carotid artery stenting.
Routine antiplatelet responsiveness testing for patients undergoing carotid artery stenting procedures is not performed at most endovascular centers and remains a topic of controversy within the neurointerventional community. The objective of this study was to determine if nonresponsiveness to acetylsalicylic acid or clopidogrel was associated with the development of symptomatic thromboembolic events in patients undergoing carotid stenting procedures. ⋯ This study demonstrated that patients who were identified as clopidogrel nonresponders, using whole blood impedance aggregometry, were at an increased risk of developing thromboembolic events. Larger studies are needed to assess the utility of routine platelet function testing prior to carotid artery stenting procedures.
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Journal of neurosurgery · Sep 2023
Single-session stereotactic radiosurgery for large perioptic meningiomas.
Meningiomas close to the optic pathway are commonly candidates for microsurgical decompression, more so if they are large perioptic meningiomas. However, microsurgery itself imposes risk to vision, and the larger the tumor, the more the risk and the lower the possibility of postoperative visual recovery. Fractionated stereotactic radiotherapy is usually reserved for such cases. The purpose of this study was to assess the long-term efficacy and safety of single-session stereotactic radiosurgery (SRS) for large (≥ 10 cm3) perioptic intracranial benign meningiomas. ⋯ SRS provides an effective and safe treatment option for large perioptic meningiomas.
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Journal of neurosurgery · Sep 2023
Enhanced brain entry of checkpoint-inhibitory therapeutic antibodies facilitated by intraarterial NEO100 in mouse models of brain-localized malignancies.
Immune checkpoint-inhibitory therapeutic antibodies have shown striking activity against several types of cancers but are less effective against brain-localized malignancies, in part due to the protective effect of the blood-brain barrier (BBB). The authors hypothesized that intraarterial (IA) delivery of a novel compound, NEO100, has the potential to safely and reversibly open the BBB to enable brain-targeted therapeutic activity of checkpoint-inhibitory antibodies. ⋯ BBB opening by IA NEO100 facilitates brain tumor access by checkpoint-inhibitory antibodies and enables their therapeutic activity, along with increased levels of T-cell recruitment.
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Journal of neurosurgery · Sep 2023
Review Meta AnalysisEndovascular treatment versus standard medical treatment for basilar artery occlusion: a meta-analysis of randomized controlled trials.
Acute ischemic stroke caused by basilar artery occlusion (BAO) is devastating, but the optimal treatment for patients with BAO remains controversial. In this study, the authors aimed to investigate the safety and efficacy of endovascular treatment (ET) versus standard medical treatment (SMT) in patients with BAO. ⋯ ET may improve the functional outcome and reduce mortality at 90 days but increase the risk of sICH compared with SMT in patients with BAO. This conclusion needs to be confirmed in non-Asian populations in future studies. Systematic review registration no.: CRD42022357718 (https://www.crd.york.ac.uk/prospero/).