Background Previous studies have shown that when thrombectomy has failed, rescue intracranial stenting is associated with better clinical outcomes compared with failed reperfusion. However, comparative data regarding stent type are lacking. Objective To compare the procedural and clinical outcomes of balloon-mounted stents (BMS) with those of self-expandable stents (SES). Methods Retrospective analysis of a prospectively collected database from the Stenting and Angioplasty in NeuroThrombectomy (SAINT) consortium. Patients were included if thrombectomy had failed and they then underwent rescue emergency stenting. Patients treated with SES or BMS were compared using inverse probability of treatment weighting. The primary outcome was the final reperfusion as measured by the modified Thrombolysis in Cerebral Infarction (mTICI) Scale. Safety measures included rates of symptomatic intracranial hemorrhage, procedural complications, and 90-day mortality. Results A total of 328 patients were in

Background Previous studies have shown that when thrombectomy has failed, rescue intracranial stenting is associated with better clinical outcomes compared with failed reperfusion. However, comparative data regarding stent type are lacking. Objective To compare the procedural and clinical outcomes of balloon-mounted stents (BMS) with those of self-expandable stents (SES). Methods Retrospective analysis of a prospectively collected database from the Stenting and Angioplasty in NeuroThrombectomy (SAINT) consortium. Patients were included if thrombectomy had failed and they then underwent rescue emergency stenting. Patients treated with SES or BMS were compared using inverse probability of treatment weighting. The primary outcome was the final reperfusion as measured by the modified Thrombolysis in Cerebral Infarction (mTICI) Scale. Safety measures included rates of symptomatic intracranial hemorrhage, procedural complications, and 90-day mortality. Results A total of 328 patients were in

The Society of NeuroInterventional Surgery (SNIS) convened the inaugural Neuro Interventional Oncology (NIO) summit at M D Anderson Cancer Center in Houston, Texas on April 26–27, 2024. Physician, scientist, and industry attendees discussed the state of the field and established goals for multidisciplinary, multi-institutional clinical research investigation in this increasingly important field. SNIS members and guests in attendance are listed at the end of this commentary. Here we describe the motivation for this meeting and outline goals for NIO. Although transcatheter (primarily intracarotid) delivery of chemotherapeutic agents to the brain has been previously piloted,1 2 several recent developments have reinvigorated interest in this approach. First, enhanced molecular/genetic testing has greatly enhanced our biologic understanding of central nervous system (CNS) and CNS-adjacent malignancies. Second, improvements in neurointerventional techniques and imaging, driven by growth of e

Background Previous studies have shown that when thrombectomy has failed, rescue intracranial stenting is associated with better clinical outcomes compared with failed reperfusion. However, comparative data regarding stent type are lacking. Objective To compare the procedural and clinical outcomes of balloon-mounted stents (BMS) with those of self-expandable stents (SES). Methods Retrospective analysis of a prospectively collected database from the Stenting and Angioplasty in NeuroThrombectomy (SAINT) consortium. Patients were included if thrombectomy had failed and they then underwent rescue emergency stenting. Patients treated with SES or BMS were compared using inverse probability of treatment weighting. The primary outcome was the final reperfusion as measured by the modified Thrombolysis in Cerebral Infarction (mTICI) Scale. Safety measures included rates of symptomatic intracranial hemorrhage, procedural complications, and 90-day mortality. Results A total of 328 patients were in

Background The optimal anesthetic method for endovascular therapy in acute large core stroke remains unclear. This study aimed to evaluate the impact of anesthetic methods on outcomes in patients with large core stroke. Methods This study was a subanalysis of a prospective, multicenter registry at 38 stroke centers in China. Patients with large core stroke, defined as an Alberta Stroke Program Early CT Score (ASPECTS) of 0–5 within 24 hours of witnessed symptom onset, were analyzed. The primary outcome was favorable functional outcome (modified Rankin Scale score 0–3) at 90 days. Results 484 eligible patients were included in this analysis. General anesthesia (GA) was used in 84 patients (17.4%), while non-general anesthesia (non-GA) was used in 400 patients (82.6%). Non-GA was comparable to GA in the primary outcome (37.8% vs 32.1%; adjusted odds ratio (aOR) 1.07, 95% confidence interval (95% CI) 0.60 to 1.91, P=0.83). Mortality at 90 days was 40% in the non-GA and 52.4% in the GA (aO

Background Intrasaccular devices are increasingly used in endovascular therapy of intracranial aneurysms, in particular wide-necked and ruptured aneurysms. The Trenza Embolization Device (TED) is an innovative intrasaccular device for medium- to large-sized aneurysms. Currently, literature about the TED is scarce. Methods In eight participating European centers, 25 aneurysms (3 ruptured) in 25 patients (18 females, mean age 62.4 years) treated with the TED outside the currently recruiting prospective, post-market, multicenter study were included in this retrospective, multicenter analysis. Primary endpoints for clinical safety were the absence of stroke and death. Primary endpoint for technical success was implantation of TED without necessity of adjunct stenting. Primary and secondary endpoints for efficacy were adequate angiographic occlusion according to the Modified Raymond–Roy Classification (MRRC) immediately after the procedure and at first follow-up (FU). Results Stent-assistan

Background This study assessed caliber and flow changes of covered cortical middle cerebral artery (MCA) branches using the new Caliber-Flow Status Scale (CFSS), postoperative diffusion-weighted imaging (DWI) lesions, and clinical outcome following flow diverter (FD) treatment of MCA aneurysms. Methods This single-center retrospective study collected data from patients treated with FD between January 2016 and March 2024, including patient characteristics, aneurysm features, postoperative DWI lesions, and clinical outcomes. Vessel status was assessed using CFSS: 1a (normal caliber and flow), 1b (normal caliber, reduced flow), 2a (reduced caliber, normal flow), 2b (reduced caliber and flow), and 3 (occlusion). Results Thirty-nine patients with 41 aneurysms with 63 covered MCA branches were included. Immediately after FD deployment, 63.5% of covered branches retained normal caliber and flow (CFSS 1a) while the remaining branches with compromised caliber and flow (CFSS >1a) showed signific

The Single Pedicle Embolization of the Distal Middle Meningeal Artery using n-butyl cyanoacrylate (n-BCA) (SPEED-n technique) offers an innovative approach to treating chronic subdural hematomas by targeting the pathological subdural membranes with precise and efficient embolization.[1 2][1] ,[3][2] This technical video demonstrates the SPEED-n technique, which employs a single catheter and dilute n-BCA (15–20%) to achieve distal penetration of the middle meningeal artery (MMA) network while minimizing procedure time and risks ([3]). Video 1 – Key features include a stepwise embolization strategy, leveraging inherent MMA anastomoses to ensure comprehensive vascular coverage and reduced non-target embolization. The method’s success hinges on careful anatomical considerations, precise imaging to delineate safety margins, and the advantages of dilute glue for delayed polymerization, facilitating safe catheter removal and preventing tip retention.[4][4] ,[5][5] ,[6][6] This video