AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · May 2014
Safety of unilateral endovascular occlusion of the cervical segment of the vertebral artery without antecedent balloon test occlusion.
Antecedent balloon test occlusion is often performed prior to vertebral artery sacrifice, but there is limited data to suggest this adds a significant clinical benefit, especially in the setting of trauma. Furthermore, balloon test occlusion can be time-consuming, add to the technical complexity of the procedure, and increase the overall cost of treatment. The purpose of this study was to determine the safety of unilateral vertebral artery occlusion without antecedent balloon test occlusion as part of the treatment regimen in patients with traumatic vertebral artery dissection, cervical tumor, or intracranial aneurysm. ⋯ In this series, endovascular occlusion of a cervical segment of 1 vertebral artery was safely performed without antecedent balloon test occlusion. As long as both vertebral arteries were patent and converged at the vertebrobasilar junction, there was anatomic potential for retrograde filling of the distal intracranial vertebral artery to the level of the posterior inferior cerebellar artery origin, and there was no major vascular supply to the spinal cord arising from the target segment of the affected vessel. Dominant and nondominant vertebral arteries were safely occluded, and no infarcts were attributed to the treatment.
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AJNR Am J Neuroradiol · May 2014
Randomized Controlled Trial Multicenter StudyBioactive versus bare platinum coils in the treatment of intracranial aneurysms: the MAPS (Matrix and Platinum Science) trial.
The ability of polymer-modified coils to promote stable aneurysm occlusion after endovascular treatment is not well-documented. Angiographic aneurysm recurrence is widely used as a surrogate for treatment failure, but studies documenting the correlation of angiographic recurrence with clinical failure are limited. This trial compares the effectiveness of Matrix(2) polyglycolic/polylactic acid biopolymer-modified coils with bare metal coils and correlates the angiographic findings with clinical failure (ie, target aneurysm recurrence), a composite end point that includes any incident of posttreatment aneurysm rupture, retreatment, or unexplained death. ⋯ Tested Matrix(2) coils were not inferior to bare metal coils. Endovascular coiling of intracranial aneurysms was safe, and the rate of technical success was high. Target aneurysm recurrence is a promising clinical outcome measure that correlates well with established angiographic measurements.
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AJNR Am J Neuroradiol · May 2014
Comparative StudySpinal cord injury after blunt cervical spine trauma: correlation of soft-tissue damage and extension of lesion.
In patients with spinal cord injury after blunt trauma, several studies have observed a correlation between neurologic impairment and radiologic findings. Few studies have been performed to correlate spinal cord injury with ligamentous injury. The purpose of this study was to retrospectively evaluate whether ligamentous injury or disk disruption after spinal cord injury correlates with lesion length. ⋯ In cervical spine trauma, a specific pattern of ligamentous injury correlates with the length of the spinal cord lesion in MR imaging studies. Ligamentous injury detected by MR imaging is not a dynamic finding; thus it proved to be useful in predicting neurologic outcome in patients for whom the MR imaging examination was delayed.
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AJNR Am J Neuroradiol · May 2014
Controlled Clinical TrialAcute basilar artery occlusion: outcome of mechanical thrombectomy with Solitaire stent within 8 hours of stroke onset.
Mechanical thrombectomy with a stent retriever applied shortly after symptom onset could increase good functional outcomes and improve survival in patients with acute basilar artery occlusion, but this has not yet been studied. This study evaluated the efficacy and safety of mechanical thrombectomy with a Solitaire stent within 8 hours of stroke onset in patients with acute basilar artery occlusion. ⋯ The current study suggests that mechanical thrombectomy by use of a Solitaire stent within 8 hours of stroke onset increases good outcomes and improves survival in patients with acute basilar artery occlusion.
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AJNR Am J Neuroradiol · May 2014
Comparative StudySubcortical deep gray matter pathology in patients with multiple sclerosis is associated with white matter lesion burden and atrophy but not with cortical atrophy: a diffusion tensor MRI study.
The association between subcortical deep gray matter, white matter, and cortical pathology is not well understood in MS. The aim of this study was to use DTI to investigate the subcortical deep gray matter alterations and their relationship with lesion burden, white matter, and cortical atrophy in patients with MS and healthy control patients. ⋯ These findings suggest that subcortical deep gray matter abnormalities are associated with white matter lesion burden and atrophy, whereas cortical atrophy is not associated with microstructural alterations of subcortical deep gray matter structures in patients with MS.