Journal of Neuroradiology最新文献_第2页

Assessment of glymphatic dysfunction in ulcerative colitis using DKI-ALPS: An innovative imaging biomarker 使用DKI-ALPS评估溃疡性结肠炎的淋巴功能障碍：一种创新的成像生物标志物

IF 3.3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuroradiology

Pub Date : 2025-11-08 DOI: 10.1016/j.neurad.2025.101402

Cuiping Bao , Yue Ma , Muran Li , Yiming Li , Chunze Zhang , Xuehuan Liu , Ran Fan , Weiwei Cui , Xiaomeng Fan , Feifei Zheng , Feng Duan , Jun Liu

Purpose

Ulcerative colitis (UC) is associated with higher anxiety, depression, and cognitive disorders linked to brain glymphatic dysfunction. In this study, we used along-the-perivascular-space (ALPS) index (based on DTI and DKI) to determine if UC relates to glymphatic dysfunction and explore how microbiota dysbiosis and inflammation affect brain glymphatic function.

Materials and Methods

In this study, 63 patients with UC and 68 healthy controls underwent 3-Tesla MRI scans to evaluate DTI-ALPS and DKI-ALPS index. The protocol included diffusion-weighted imaging (DWI) and diffusion kurtosis imaging (DKI) sequences to calculate the ALPS index, which quantifies glymphatic system function. All participants completed cognitive (MMSE) and depression (SAS/SDS) assessments (SAS/SDS). Patients with UC also underwent assessment for inflammation and gut microbiota (based on metagenomic analysis). Data analysis was performed using correlation analysis and linear regression.

Results

Patients with UC showed lower DTI-ALPS index (1.25) and DKI-ALPS index (1.40) compared to controls (1.40 vs. 1.69; P < 0.001). In multi-adjusted linear regression models, UC was associated with lower DTI-ALPS index and DKI-ALPS index (β =-0.142 vs.-0.284), with DKI-ALPS showing higher sensitivity. The results remained significant even after stratification by age and sex. The Mayo score correlated negatively with DTI and DKI-ALPS index. The ALPS index correlates with gut microbiota, particularly those involved in butyrate and short-chain fatty acid (SCFA) production. DTI-ALPS index was significantly correlated with ESR (β =-0.003), CRP (β =-0.035), SII (β =-0.062), INFLA (β =-0.010), and SIRI (β =-0.058). We also observed significant correlations between DKI ALPS index and ESR (β =-0.006), CRP (β =-0.051), SII (β =-0.130), INFLA (β =-0.017), SIRI (β =-0.095), IL-6 (β =-0.081) and NLR (β =-0.108).

Conclusions

UC is associated with brain glymphatic dysfunction, correlating with inflammation level. DKI-ALPS serves as a more sensitive method than DTI-ALPS, offering a new approach for managing ulcerative colitis through glymphatic dysfunction.

目的溃疡性结肠炎（UC）与高度焦虑、抑郁和与脑淋巴功能障碍相关的认知障碍有关。在本研究中，我们使用沿血管周围空间（ALPS）指数（基于DTI和DKI）来确定UC是否与淋巴功能障碍有关，并探讨微生物群失调和炎症如何影响脑淋巴功能。材料与方法本研究对63例UC患者和68名健康对照者进行3-Tesla MRI扫描，评估DTI-ALPS和DKI-ALPS指数。该方案包括弥散加权成像（DWI）和弥散峰度成像（DKI）序列来计算ALPS指数，该指数量化淋巴系统功能。所有参与者完成认知（MMSE）和抑郁（SAS/SDS）评估（SAS/SDS）。UC患者还接受了炎症和肠道微生物群评估（基于宏基因组分析）。数据分析采用相关分析和线性回归。结果UC患者DTI-ALPS指数（1.25）和DKI-ALPS指数（1.40）低于对照组（1.40 vs. 1.69; P < 0.001）。在多元调整线性回归模型中，UC与较低的DTI-ALPS指数和DKI-ALPS指数相关（β =-0.142 vs.-0.284），其中DKI-ALPS具有较高的敏感性。即使在按年龄和性别分层后，结果仍然显著。Mayo评分与DTI、DKI-ALPS指数呈负相关。ALPS指数与肠道微生物群有关，特别是与丁酸盐和短链脂肪酸（SCFA）生产有关的微生物群。DTI-ALPS指数与ESR （β =-0.003）、CRP （β =-0.035）、SII （β =-0.062）、INFLA （β =-0.010）、SIRI （β =-0.058）显著相关。我们还发现DKI ALPS指数与ESR （β =-0.006）、CRP （β =-0.051）、SII （β =-0.130）、INFLA （β =-0.017）、SIRI （β =-0.095）、IL-6 （β =-0.081）和NLR （β =-0.108）之间存在显著相关性。结论血清素与脑淋巴功能障碍有关，与炎症程度相关。DKI-ALPS是一种比DTI-ALPS更灵敏的方法，为通过淋巴功能障碍治疗溃疡性结肠炎提供了新的途径。

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引用次数: 0

The rabbit superior mesenteric artery as an in vivo model for perforator artery occlusion assessment after flow diversion 以家兔肠系膜上动脉为动物模型，评价分流后穿支动脉闭塞程度。

IF 3.3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuroradiology

Pub Date : 2025-11-01 DOI: 10.1016/j.neurad.2025.101404

Jonathan Cortese , Esref A Bayraktar , Julien Ognard , Daying Dai , Armin Zarrintan , Sherief Ghozy , Sarah Lortscher , Yong Hong Ding , Juan R Cebral , Waleed Brinjikji , David F Kallmes , Ramanathan Kadirvel

Objective

Covering side branches with flow diverters (FDs) raises concerns regarding side branch occlusion and potentially delayed ischemic complications. Existing preclinical models fail to replicate these risks. We developed a novel preclinical model using the rabbit superior mesenteric artery (SMA) to investigate FD-associated branch occlusion and neointimal changes.

Material and methods

Eighteen rabbits were enrolled; three were excluded for periprocedural complications. Fifteen animals completed follow-up, each with a single FD implanted in the SMA (one of three Pipeline Embolization Devices: 5 Bare-Flex, 4 Shield-Flex, and 6 Vantage). Branch patency (using Digital subtraction angiography DSA and histology) and ostial coverage/neointima (using optical coherence tomography OCT), were assessed at 1 or 3 months. Results were compared between-(FD and time) groups using Mann-Whitney and Kruskal-Wallis test.

Results

Fifteen animals completed the study. Among 35 covered branches, 30 (85.7%) remained patent, 4 (11.4%) were pre-occlusive, and 1 (2.9%) occluded. Median ostium coverage by OCT was 77.0%. Mean in-stent stenosis was 35.0%. No significant difference were found across FD types or timepoints comparing patency, medium ostium coverage, in-stent stenosis. Histology confirmed progressive neointimal maturation and partial to full ostium coverage, with strong correlation to OCT findings. No correlation was found between neointimal thickness and ostium coverage.

Conclusion

The rabbit SMA model successfully detected rare occlusions and common pre-occlusive changes, approaching clinical data. This model may help to evaluate FD safety, optimize design, and investigate endothelial responses.

目的：用分流器（FDs）覆盖侧支引起了对侧支闭塞和潜在的延迟性缺血性并发症的关注。现有的临床前模型无法复制这些风险。我们建立了一种新的临床前模型，利用兔肠系膜上动脉（SMA）来研究fd相关的分支闭塞和内膜变化。材料与方法：入组18只家兔；3例因围手术期并发症被排除。15只动物完成了随访，每只动物在SMA中植入一个FD（三种管道栓塞装置中的一种：5个Bare-Flex， 4个Shield-Flex和6个Vantage）。在1或3个月时评估分支通畅（使用数字减影血管造影DSA和组织学）和口覆盖/新生内膜（使用光学相干断层扫描OCT）。采用Mann-Whitney检验和Kruskal-Wallis检验比较两组间的差异。结果：15只动物完成了研究。在35个被覆盖的分支中，30个（85.7%）保持通畅，4个（11.4%）为预闭塞，1个（2.9%）为闭塞。OCT的中位口覆盖率为77.0%。平均支架内狭窄为35.0%。不同FD类型或时间点比较通畅、中口覆盖、支架内狭窄无显著差异。组织学证实了进行性内膜成熟和部分到完全的口覆盖，与OCT的发现有很强的相关性。新内膜厚度和口覆盖之间没有相关性。结论：家兔SMA模型成功检测出罕见的闭塞和常见的闭塞前病变，接近临床数据。该模型有助于评估FD安全性、优化设计和研究内皮反应。

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引用次数: 0

Computational fluid dynamics analysis of blood blister aneurysms: A comparative study with normal supraclinoid internal carotid arteries 血泡动脉瘤的计算流体动力学分析：与正常的颈内动脉的比较研究。

IF 3.3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuroradiology

Pub Date : 2025-11-01 DOI: 10.1016/j.neurad.2025.101403

Te-Chang Wu , Zhen-Ye Chen , Yi-Lin Wu , Tzu-Ching Shih

Background and Purpose

The purpose of this study was to evaluate hemodynamic differences between blood blister aneurysms (BBAs) and normal supraclinoid internal carotid arteries (ICAs) using patient-specific vascular models.

Materials and Methods

Thirteen models of ruptured BBA and 13 models of normal ICA were constructed from the petrous ICA proximally to M1 and A1 segments distally via 3D rotational angiography or MR angiography. Computational fluid dynamics (CFD) simulation was employed to calculate hemodynamic parameters, including time-average wall shear stress (TAWSS), wall shear stress gradient (WSSG), pressure difference (PD), oscillatory shear index (OSI), and relative residence time (RRT). Mann-Whitney U Test was used to identify differences between BBA and normal ICAs

Results

Compared with normal ICAs, BBAs exhibited significantly higher OSI (average and maximum: 0.0097/ 0.22 vs 0.0035/ 0.0135, p < 0.01), higher RRT (average and maximum: 0.60/ 8.50 vs 0.28/ 0.54, p = 0.018 & < 0.01), higher maximum WSSG (20,492 vs 9208, p = 0.012), higher maximum PD (1.34 vs 0.89, p = 0.027) and lower minimum TAWSS (0.35,Pa vs 2.55,Pa, P < 0.01). A swirling TAWSS pattern was identified in three of the four BBAs with early rebleeding post-treatment and in the two cases with in-hospital mortality.

Conclusions

BBAs demonstrated low and multi-directional wall shear stress on the aneurysmal wall with higher OSI and RRT compared to normal ICAs. A swirling pattern in the TAWSS map was identified as a poor prognostic factor. The findings support CFD as a promising tool for assessing rupture risk and guiding clinical decisions of BBAs.

背景和目的：本研究的目的是通过患者特异性血管模型来评估血泡动脉瘤（BBAs）和正常的颈内动脉（ICAs）之间的血流动力学差异。材料和方法：采用三维旋转血管造影或MR血管造影方法，从岩质ICA近端至M1和A1段，构建13个BBA破裂模型和13个正常ICA模型。采用计算流体力学（CFD）模拟计算血流动力学参数，包括时间平均壁面剪切应力（TAWSS）、壁面剪切应力梯度（WSSG）、压差（PD）、振荡剪切指数（OSI）和相对停留时间（RRT）。结果：与正常ica相比，BBA表现出更高的OSI（平均值和最大值分别为0.0097/ 0.22 vs 0.0035/ 0.0135）。结论：BBA对动脉瘤壁表现出低且多向的壁剪应力，与正常ica相比，BBA具有更高的OSI和RRT。TAWSS图中的漩涡模式被确定为不良预后因素。研究结果支持CFD作为一个有前途的工具来评估破裂风险和指导临床决策的BBAs。

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引用次数: 0

Sporadic progressive ataxia and palatal tremor syndrome 散发性进行性共济失调和腭震颤综合征

IF 3.3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuroradiology

Pub Date : 2025-10-24 DOI: 10.1016/j.neurad.2025.101392

Iasmim Portela Maifrede , Daniel Sabino de Oliveira , Thiago Cardoso Vale

引用次数: 0

Optimizing imaging protocols and clinical correlation in pediatric MRgLITT: A constructive appraisal of Hu et al 优化儿童MRgLITT的成像方案和临床相关性：对Hu等人的建设性评价。

IF 3.3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuroradiology

Pub Date : 2025-10-21 DOI: 10.1016/j.neurad.2025.101393

Parth Aphale, Himanshu Shekhar, Shashank Dokania

引用次数: 0

Time-of-day study on brain metabolism using proton magnetic resonance spectroscopy 利用质子磁共振波谱技术研究脑代谢。

IF 3.3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuroradiology

Pub Date : 2025-10-18 DOI: 10.1016/j.neurad.2025.101395

Clément Giraud , Arnaud Poinas , Landoline Bonnin , Luc Pellerin , Carole Guillevin , Rémy Guillevin

Most human physiological processes follow circadian rhythms such as glucose metabolism and neuronal activity, thereby playing a major role in brain metabolism regulation. Proton Magnetic Resonance Spectroscopy (¹H-MRS) has become a valuable tool for quantification of brain metabolism in clinical settings. Nonetheless, only limited evidence of brain metabolism variation throughout the day has been found, restricted to specific brain regions or limited by a sample size. The aim of this study was to investigate time-of-day effect on brain metabolism in ¹H-MRS of different brain regions associated with circadian rhythms in healthy adults.

This prospective monocentric study included 39 healthy volunteers aged between 25 and 40 years. They underwent three 3T MRI examinations the same day at 7:30, 13:30 and 17:30. Two CSI MRS sequences were acquired to study brain regions of the basal ganglia and semi-oval center. A linear mixed model was used to investigate differences between session times, sex and brain hemisphere on acquired total Choline (tCho), total N-Acetyl-Aspartate (tNAA), and Lactate (Lac).

Models showed a significant decrease in tCho/tNAA in the last session of -1.60% (p = 0.017) and a lower value of tCho/tCr of -9.74% (p = 0.014) and tCho/tNAA of -7.98% (p = 0.044) for women as compared with men. In the right hemisphere a higher value of tNAA/tCr of +2.84% (p < 0.001) was found, while tCho/tNAA was lower by -1.60% (p = 0.003) compared to the left hemisphere.

The metabolite ratios under investigation were not affected by circadian rhythms, except for a small decrease of tCho/tNAA at 17:30. However, sex and brain hemispheres had a significant impact on brain metabolism. While brain MRS examination for most common metabolites could be carried out at any time of day, it is still important to consider the patient’s sex and the side of the brain being examined.

人类大多数生理过程都遵循昼夜节律，如葡萄糖代谢和神经元活动，因此在脑代谢调节中起着重要作用。质子磁共振波谱（1H-MRS）已成为临床定量脑代谢的一种有价值的工具。尽管如此，只有有限的证据表明全天大脑代谢的变化，仅限于特定的大脑区域或受样本量的限制。本研究的目的是研究时间对健康成人与昼夜节律相关的不同脑区1H-MRS脑代谢的影响。这项前瞻性单中心研究包括39名年龄在25至40岁之间的健康志愿者。当天分别于7:30、13:30和17:30进行了3次3T MRI检查。获得两组CSI MRS序列，对基底节区和半卵圆中心区进行研究。采用线性混合模型研究了获得性总胆碱（tCho）、总n -乙酰-天冬氨酸（tNAA）和乳酸（Lac）在训练时间、性别和脑半球之间的差异。模型显示，与男性相比，女性的tCho/tNAA在最后一段时间显著下降-1.60% (p = 0.017)，tCho/tCr为-9.74% (p = 0.014)，tCho/tNAA为-7.98% （p = 0.044）。右半球tNAA/tCr值较高，为+2.84% (p < 0.001)，而tCho/tNAA值较左半球低-1.60% （p = 0.003）。所研究的代谢物比率不受昼夜节律的影响，除了17:30时tCho/tNAA略有下降。然而，性别和大脑半球对大脑代谢有显著影响。虽然对大多数常见代谢物的脑磁共振检查可以在一天中的任何时间进行，但考虑患者的性别和被检查的大脑一侧仍然很重要。

{"title":"Time-of-day study on brain metabolism using proton magnetic resonance spectroscopy","authors":"Clément Giraud , Arnaud Poinas , Landoline Bonnin , Luc Pellerin , Carole Guillevin , Rémy Guillevin","doi":"10.1016/j.neurad.2025.101395","DOIUrl":"10.1016/j.neurad.2025.101395","url":null,"abstract":"<div><div>Most human physiological processes follow circadian rhythms such as glucose metabolism and neuronal activity, thereby playing a major role in brain metabolism regulation. Proton Magnetic Resonance Spectroscopy (<sup>1</sup>H-MRS) has become a valuable tool for quantification of brain metabolism in clinical settings. Nonetheless, only limited evidence of brain metabolism variation throughout the day has been found, restricted to specific brain regions or limited by a sample size. The aim of this study was to investigate time-of-day effect on brain metabolism in <sup>1</sup>H-MRS of different brain regions associated with circadian rhythms in healthy adults.</div><div>This prospective monocentric study included 39 healthy volunteers aged between 25 and 40 years. They underwent three 3T MRI examinations the same day at 7:30, 13:30 and 17:30. Two CSI MRS sequences were acquired to study brain regions of the basal ganglia and semi-oval center. A linear mixed model was used to investigate differences between session times, sex and brain hemisphere on acquired total Choline (tCho), total N-Acetyl-Aspartate (tNAA), and Lactate (Lac).</div><div>Models showed a significant decrease in tCho/tNAA in the last session of -1.60% (p = 0.017) and a lower value of tCho/tCr of -9.74% (p = 0.014) and tCho/tNAA of -7.98% (<em>p</em> = 0.044) for women as compared with men. In the right hemisphere a higher value of tNAA/tCr of +2.84% (p < 0.001) was found, while tCho/tNAA was lower by -1.60% (p = 0.003) compared to the left hemisphere.</div><div>The metabolite ratios under investigation were not affected by circadian rhythms, except for a small decrease of tCho/tNAA at 17:30. However, sex and brain hemispheres had a significant impact on brain metabolism. While brain MRS examination for most common metabolites could be carried out at any time of day, it is still important to consider the patient’s sex and the side of the brain being examined.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"53 1","pages":"Article 101395"},"PeriodicalIF":3.3,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Response to optimizing imaging protocols and clinical correlation in pediatric MRgLITT: A constructive appraisal of Hu et al 对优化儿童MRgLITT成像方案和临床相关性的反应：对Hu等人的建设性评价

IF 3.3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuroradiology

Pub Date : 2025-10-18 DOI: 10.1016/j.neurad.2025.101394

Alice Hu , Lelio Guida , Thomas Blauwblomme , Nathalie Boddaert , Volodia Dangouloff-Ros

引用次数: 0

Deep learning models based on DWI-MRI for prognosis prediction in acute ischemic stroke receiving intravenous thrombolysis: Development and validation 基于DWI-MRI的深度学习模型用于急性缺血性脑卒中静脉溶栓治疗的预后预测：开发与验证。

IF 3.3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuroradiology

Pub Date : 2025-10-09 DOI: 10.1016/j.neurad.2025.101391

Huan Yang , Wenxi Wang , Xin Zhao , Qi Xuan , Cao Jiang , Bo Zhao

Objective

To develop and validate predictive models based on diffusion-weighted imaging MRI (DWI-MRI) for assessing the prognosis of patients with acute ischemic stroke (AIS) treated with intravenous thrombolysis, and to compare the performance of deep learning versus traditional machine learning methods.

Materials and methods

A retrospective analysis was conducted on 682 AIS patients from two hospitals. Data from Hospital 1 were divided into a training set (70 %) and a test set (30 %), while data from Hospital 2 were used for external validation. Five predictive models were developed: Model A (clinical features), Model B (radiomic features based on DWI-MRI), Model C (deep learning features), Model D (clinical + radiomic features), and Model E (clinical + deep learning features). Performance metrics included Area Under the Curve (AUC), sensitivity, specificity, and accuracy.

Results

In the test set, Models A, B, and C achieved AUCs of 0.760, 0.820, and 0.857, respectively. The combined models, D and E, showed superior performance with AUCs of 0.904 and 0.925, respectively. Model E outperformed Model D and also demonstrated robust performance in external validation (AUC = 0.937).

Conclusion

Deep learning models integrating DWI-MRI and clinical features outperformed traditional methods, demonstrating strong generalizability in external validation. These models may support clinical decision-making in AIS prognosis.

目的：建立并验证基于弥散加权成像MRI （DWI-MRI）的预测模型，用于评估急性缺血性卒中（AIS）患者静脉溶栓治疗的预后，并比较深度学习与传统机器学习方法的性能。材料与方法：对两所医院682例AIS患者进行回顾性分析。医院1的数据分为训练集（70%）和测试集（30%），而医院2的数据用于外部验证。建立了5个预测模型：A模型（临床特征）、B模型（基于DWI-MRI的放射学特征）、C模型（深度学习特征）、D模型（临床 + 放射学特征）和E模型（临床 + 深度学习特征）。性能指标包括曲线下面积（AUC）、灵敏度、特异性和准确性。结果：在测试集中，模型A、B、C的auc值分别为0.760、0.820、0.857。组合模型D和E的auc分别为0.904和0.925，表现出较好的性能。模型E优于模型D，在外部验证中也表现出稳健的性能（AUC = 0.937）。结论：融合DWI-MRI和临床特征的深度学习模型优于传统方法，在外部验证中具有较强的泛化能力。这些模型可以为AIS预后的临床决策提供支持。

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引用次数: 0

Distal vessel aspiration (DIVA) with the RED 043 catheter in acute ischaemic stroke RED 043导管在急性缺血性卒中中的远端血管抽吸（DIVA）。

IF 3.3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuroradiology

Pub Date : 2025-10-08 DOI: 10.1016/j.neurad.2025.101390

Vinicius Carraro do Nascimento , Strahan Teoh , Permesh Singh Dhillon , Laetitia de Villiers , Hal Rice

Acute ischaemic stroke (AIS) due to medium vessel occlusion (MeVO) is increasingly recognised as the next frontier for endovascular mechanical thrombectomy (EMT).¹^,²

A recognized method of recanalisation of MeVOs is the blind exchange/mini-pinning (BEMP), employing a stent retriever and a low profile aspiration catheter, such as the Penumbra 3MAX Reperfusion Catheter.³

One potential disadvantage of this technique is the necesssity of stent retriever (SR), which may increase procedural risks, considering the smaller calibre and tortuous arteries.⁴^,⁵ In addition, this may carry increased costs.

This technical video highlights the "DIVA" technique: RED 043 aspiration catheter navigate to the target occlusion over he Aristotle 24 200 cm microwave, without the use of a microcatheter or SR, as far as A4, M4 and P4 segments.

由于中血管闭塞（MeVO）引起的急性缺血性卒中（AIS）越来越被认为是血管内机械取栓（EMT）的下一个前沿领域1,2一种公认的MeVOs再通方法是盲交换/迷你钉钉（BEMP），使用支架回收器和低尺寸的抽吸导管，如半阴影3MAX再灌注导管。该技术的一个潜在缺点是支架回收器（SR）的必要性，考虑到更小的动脉和弯曲的动脉，这可能增加手术风险此外，这可能会增加成本。本技术视频重点介绍了“DIVA”技术：RED 043抽吸导管通过亚里士多德24 200厘米微波导航到目标闭塞处，无需使用微导管或SR，直至A4， M4和P4段。

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引用次数: 0

Rescue technique for proximal flow diverter foreshortening leading to dislodgement into aneurysm 近端分流器提前缩短导致动脉瘤内移位的抢救技术。

IF 3.3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuroradiology

Pub Date : 2025-09-12 DOI: 10.1016/j.neurad.2025.101389

Yong Zhang , Xiguang Fu , Haoyu Zhu , Chuhan Jiang

Flow diverters (FDs) are an established treatment method for dissecting aneurysms.1, 2, 3 However, device shortening post-deployment and subsequent migration into the aneurysm may pose significant risks.⁴^,⁵ In this technical video (Video 1), we present a case of Pipeline Flex Shield deployment for a dissecting aneurysm in the M1 segment of the left middle cerebral artery, where proximal segment shortening with subsequent device migration into the aneurysm sac was observed during the 9-month follow-up evaluation. In this procedure, we successfully advanced a microwire-guided microcatheter through the proximal portion of the compromised stent. Utilizing an exchange technique, the original delivery catheter was replaced to facilitate deployment of a Lattice flow diverter. Final angiography confirmed adequate overlap between the two stents with re-established luminal patency in the parent artery. n analogous clinical scenarios, telescoping stent deployment within the shortened endoprosthesis may constitute a viable salvage strategy.

分流器（FDs）是一种成熟的动脉瘤解剖治疗方法[1-3]。然而，装置缩短后部署和随后迁移到动脉瘤可能会带来重大风险4,5。在本技术视频（视频1）中，我们报告了一例在左侧大脑中动脉M1段的夹层动脉瘤中使用管道柔性屏蔽部署的病例，在9个月的随访评估中，观察到近端段缩短并随后装置迁移到动脉瘤囊中。在这个过程中，我们成功地将微丝引导的微导管通过受损支架的近端部分。利用交换技术，取代了原始的输送导管，以促进晶格流分流器的部署。最终的血管造影证实两个支架之间有足够的重叠，并在母动脉中重新建立了腔内通畅。在类似的临床情况下，在缩短的假体内部署伸缩支架可能是一种可行的抢救策略。

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引用次数: 0