AJNR. American journal of neuroradiology
-
AJNR Am J Neuroradiol · Jun 2018
Clinical Outcomes of Endovascular Treatment within 24 Hours in Patients with Mild Ischemic Stroke and Perfusion Imaging Selection.
Endovascular thrombectomy has been accepted as the standard of care for patients with acute ischemic stroke. Our aim was to investigate the clinical outcomes of patients with mild ischemic stroke with acute proximal large-vessel occlusion after endovascular treatment within 24 hours of symptom onset. ⋯ Patients with mild ischemic stroke and large-vessel occlusion in the anterior circulation, an imaging mismatch, and endovascular treatment within 6-24 hours of initial symptoms showed no heterogeneity in the efficacy and safety outcome compared with those treated ≤6 hours from symptom onset.
-
AJNR Am J Neuroradiol · Jun 2018
Use of Diffusional Kurtosis Imaging and Dynamic Contrast-Enhanced MR Imaging to Predict Posttraumatic Epilepsy in Rabbits.
Finding a reliable biomarker to thoroughly assess the brain structure changes in posttraumatic epilepsy is of great importance. Our aim was to explore the value of diffusional kurtosis imaging combined with dynamic contrast-enhanced MR imaging in the evaluation of posttraumatic epilepsy. ⋯ Diffusional kurtosis imaging and dynamic contrast-enhanced MR imaging could be used to predict the occurrence of posttraumatic epilepsy in rabbits exposed to experimental traumatic brain injury.
-
AJNR Am J Neuroradiol · Jun 2018
Treatment of Distal Anterior Cerebral Artery Aneurysms with Flow-Diverter Stents: A Single-Center Experience.
Flow diversion for aneurysms beyond the circle of Willis is still debated. Our aim was to evaluate the safety and efficacy of flow diversion treatment of distal anterior cerebral artery aneurysms. ⋯ Treatment of distal anterior cerebral artery aneurysms with flow-diverter stents is feasible and effective, with high rates of aneurysm occlusion. Flow diversion plus coiling, in the retreatment of lesions previously coiled, allowed higher rates of occlusion compared with flow diverters alone. However, the risk of ischemic complications is not negligible, and flow-diversion treatment should be evaluated only for aneurysms not amenable to simple coil embolization.
-
AJNR Am J Neuroradiol · May 2018
Randomized Controlled Trial Multicenter StudyParent Artery Reconstruction for Large or Giant Cerebral Aneurysms Using the Tubridge Flow Diverter: A Multicenter, Randomized, Controlled Clinical Trial (PARAT).
Although flow diverters have been reported with favorable clinical and angiographic outcomes in various literatures, randomized trials determining their true effectiveness and safety are still in lack. The Parent Artery Reconstruction for Large or Giant Cerebral Aneurysms Using the Tubridge Flow Diverter (PARAT) trial was designed to evaluate the safety and efficacy of the Tubridge flow diverter in the treatment of large or giant aneurysms in comparison with Enterprise stent-assisted coiling. ⋯ This trial showed an obviously higher rate of large and giant aneurysm obliteration with the Tubridge FD over Enterprise stent-assisted coiling. However, this higher obliteration rate came at the cost of a nonsignificantly higher rate of complications. Investigational site comparisons suggested that a learning curve for flow-diverter implantation should be recognized and factored into trial designs.
-
AJNR Am J Neuroradiol · May 2018
Meta Analysis Comparative StudyEndovascular Treatment of Very Large and Giant Intracranial Aneurysms: Comparison between Reconstructive and Deconstructive Techniques-A Meta-Analysis.
The safety and efficacy of reconstructive and deconstructive endovascular treatments of very large/giant intracranial aneurysms are not completely clear. ⋯ Parent artery occlusion allowed high rates of occlusion with an acceptable rate of complications for unruptured, anterior circulation aneurysms. Coiling should be preferred for posterior circulation and ruptured lesions, whereas flow diversion is relatively safe and effective for unruptured anterior circulation aneurysms.