AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Sep 2019
Multicenter StudyTwo-Center Experience in the Endovascular Treatment of Intracranial Aneurysms Using the Woven EndoBridge 17 Device Including Midterm Follow-Up Results: A Retrospective Analysis.
The Woven EndoBridge device proved its effectiveness in the treatment of ruptured and unruptured intracranial aneurysms as a stand-alone device. Before 2016, Woven EndoBridge deployment required at least a 0.021-inch microcatheter. In 2016, a smaller device, the Woven EndoBridge 17 with finer size increments that used a 0.017-inch microcatheter, was introduced. We retrospectively analyzed our initial and follow-up results with the Woven EndoBridge 17 in ruptured and unruptured aneurysms. ⋯ The Woven EndoBridge 17 device is safe in the treatment of small broad-based aneurysms without the general need for additional devices. The low complication rate and the promising follow-up results underline the value of this technique in a growing range of endovascular treatment options for intracranial aneurysms.
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AJNR Am J Neuroradiol · Aug 2019
The Complex Spine in Children with Spinal Muscular Atrophy: The Transforaminal Approach-A Transformative Technique.
Spinal muscular atrophy, a genetic disease resulting in loss of motor function, presents from in utero to adulthood. Depending on progression and secondary scoliosis, spinal stabilization may be necessary. When planning intrathecal access in these patients, spinal anatomy is the most important factor. Therefore, when planning intrathecal nusinersen injections, we subdivided patients with spinal muscular atrophy into simple-versus-complex spine subgroups. Our purpose was to present our experience with our first 42 transforaminal intrathecal nusinersen injections. ⋯ Our initial experience has resulted in a protocol-driven approach based on simple or complex spinal anatomy. Patients with simple spines do not need preprocedural imaging or imaging-guided intrathecal nusinersen injections. In contrast, the complex spine subgroup requires preprocedural imaging for route planning and imaging guidance for therapy, with the primary approach being the transforaminal approach for intrathecal nusinersen injections.
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AJNR Am J Neuroradiol · Aug 2019
Leukoaraiosis May Confound the Interpretation of CT Perfusion in Patients Treated with Mechanical Thrombectomy for Acute Ischemic Stroke.
Leukoaraiosis frequently coexists in patients with acute stroke. We studied whether leukoaraiosis could confound the interpretation of CTP findings in patients treated with mechanical thrombectomy. ⋯ In patients with stroke, the presence of leukoaraiosis confounds the interpretation of CTP despite proper adjustment of CBF thresholds.
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AJNR Am J Neuroradiol · Jul 2019
Gadolinium Enhancement of the Aneurysm Wall in Unruptured Intracranial Aneurysms Is Associated with an Increased Risk of Aneurysm Instability: A Follow-Up Study.
Previous studies have suggested that gadolinium enhancement of the wall of unruptured intracranial aneurysms on MR imaging may reflect aneurysm wall instability. However, all previous studies were cross-sectional. In this longitudinal study, we investigated whether aneurysm wall enhancement is associated with an increased risk of aneurysm instability. ⋯ Gadolinium enhancement of the aneurysm wall on MR imaging is associated with an increased risk of aneurysm instability. The absence of wall enhancement makes it unlikely that the aneurysm will grow or rupture in the short term. Larger studies are needed to investigate whether aneurysm wall enhancement is an independent predictor of aneurysm instability.
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AJNR Am J Neuroradiol · Jul 2019
Long-Term Results and Follow-Up Examinations after Endovascular Embolization for Unruptured Cerebral Aneurysms.
The appropriate period of follow-up examinations after endovascular embolization for cerebral aneurysms using time-of-flight MR angiography is not well-known. We retrospectively investigated long-term results after endovascular embolization for unruptured cerebral aneurysms and evaluated the periods from embolization to recanalization and retreatment. ⋯ Aneurysms in which recanalization was not observed within 2 years after endovascular coil embolization were stable during a mean follow-up of 7 years. This result may be helpful in considering the appropriate span or frequency of follow-up imaging for embolized cerebral aneurysms.