Journal of Neuroradiology最新文献

{"title":"BrainAGE latent representation clustering is associated with longitudinal disease progression in early-onset Alzheimer’s disease","authors":"Dorian Manouvriez ,&nbsp;Grégory Kuchcinski ,&nbsp;Vincent Roca ,&nbsp;Adeline Rollin Sillaire ,&nbsp;Maxime Bertoux ,&nbsp;Xavier Delbeuck ,&nbsp;Jean-Pierre Pruvo ,&nbsp;Simon Lecerf ,&nbsp;Florence Pasquier ,&nbsp;Thibaud Lebouvier ,&nbsp;Renaud Lopes","doi":"10.1016/j.neurad.2025.101365","DOIUrl":"10.1016/j.neurad.2025.101365","url":null,"abstract":"<div><h3>Introduction</h3><div>Early-onset Alzheimer’s disease (EOAD) population is a clinically, genetically and pathologically heterogeneous condition. Identifying biomarkers related to disease progression is crucial for advancing clinical trials and improving therapeutic strategies. This study aims to differentiate EOAD patients with varying rates of progression using Brain Age Gap Estimation (BrainAGE)-based clustering algorithm applied to structural magnetic resonance images (MRI).</div></div><div><h3>Methods</h3><div>A retrospective analysis of a longitudinal cohort consisting of 142 participants who met the criteria for early-onset probable Alzheimer’s disease was conducted. Participants were assessed clinically, neuropsychologically and with structural MRI at baseline and annually for 6 years. A Brain Age Gap Estimation (BrainAGE) deep learning model pre-trained on 3,227 3D T1-weighted MRI of healthy subjects was used to extract encoded MRI representations at baseline. Then, k-means clustering was performed on these encoded representations to stratify the population. The resulting clusters were then analyzed for disease severity, cognitive phenotype and brain volumes at baseline and longitudinally.</div></div><div><h3>Results</h3><div>The optimal number of clusters was determined to be 2. Clusters differed significantly in BrainAGE scores (5.44 [± 8] years vs 15.25 [± 5 years], <em>p</em> &lt; 0.001). The high BrainAGE cluster was associated with older age (<em>p</em> = 0.001) and higher proportion of female patients (<em>p</em> = 0.005), as well as greater disease severity based on Mini Mental State Examination (MMSE) scores (19.32 [±4.62] vs 14.14 [±6.93], <em>p</em> &lt; 0.001) and gray matter volume (0.35 [±0.03] vs 0.32 [±0.02], <em>p</em> &lt; 0.001). Longitudinal analyses revealed significant differences in disease progression (MMSE decline of -2.35 [±0.15] pts/year vs -3.02 [±0.25] pts/year, <em>p</em> = 0.02; CDR 1.58 [±0.10] pts/year vs 1.99 [±0.16] pts/year, <em>p</em> = 0.03).</div></div><div><h3>Conclusion</h3><div>K-means clustering of BrainAGE encoded representations stratified EOAD patients based on varying rates of disease progression. These findings underscore the potential of using BrainAGE as a biomarker for better understanding and managing EOAD.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"52 5","pages":"Article 101365"},"PeriodicalIF":3.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144536133","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}

{"title":"Efficacy and safety of the Neuroform Atlas stent for bifurcation type unruptured cerebral aneurysms: Comparison of single versus Y stents with propensity score matching","authors":"Rintaro Tachi ,&nbsp;Michiyasu Fuga ,&nbsp;Toshihiro Ishibashi ,&nbsp;Kazufumi Horiuchi ,&nbsp;Akihiko Teshigawara ,&nbsp;Ken Aoki ,&nbsp;Issei Kan ,&nbsp;Toshihide Tanaka ,&nbsp;Yuichi Murayama","doi":"10.1016/j.neurad.2025.101369","DOIUrl":"10.1016/j.neurad.2025.101369","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>Y-stent-assisted coiling (Y-SAC) using two stents can provide adequate coverage of the aneurysm neck even in wide-neck bifurcation-type aneurysms, but whether it is more effective and safer than single-stent-assisted coiling (S-SAC) remains unclear. The purpose of this study was to investigate the efficacy and safety of Y-SAC with the Neuroform Atlas stent for bifurcation-type unruptured cerebral aneurysms (UCAs).</div></div><div><h3>Materials and Methods</h3><div>A total of 186 bifurcation-type UCAs treated with the Neuroform Atlas stent were retrospectively reviewed. The aneurysms were divided into Y-SAC and S-SAC groups. Angiographic occlusion status and complication rates were analyzed using 1:2 propensity score matching.</div></div><div><h3>Results</h3><div>Of the 186 UCAs, 17 (9.1 %) were treated by Y-SAC. Propensity score matching was successful for 14 UCAs in the Y-SAC group and 28 UCAs in the S-SAC group. After propensity score matching, the Y-SAC group had a higher rate of complete occlusion immediately after treatment (71.4 % vs. 32.1 %, <em>P</em> = 0.023), a significantly higher volume embolization ratio (33.3 % [IQR: 30.4, 38.5] vs. 28.9 % [IQR: 24.1, 32.4], <em>P</em> = 0.03), and higher device and implant costs ($11,335 [IQR: $10,427, $13,894] vs. $9592 [IQR: $8211, $10,959], <em>P</em> = 0.002) compared to the S-SAC group. However, the rate of complete occlusion at one year (78.6 % vs. 64.3 %, <em>P</em> = 0.485) and the recanalization rate (14.3 % vs. 3.6 %, <em>P</em> = 0.254) did not differ significantly between the two groups. No significant differences in the incidences of any complications were found between the two groups.</div></div><div><h3>Conclusions</h3><div>Y-SAC did not improve the complete occlusion rate at one year or reduce the risk of recanalization compared with S-SAC. Given its procedural simplicity and cost-effectiveness, S-SAC may be the preferred strategy for embolizing bifurcation-type UCAs.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"52 5","pages":"Article 101369"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561797","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}

{"title":"The “Ozone-Strasse” sign: a novel CT finding after intradiscal ozone therapy","authors":"A. Bellelli ,&nbsp;V. D’Andrea ,&nbsp;N.C. Bianco ,&nbsp;B. Beomonte Zobel ,&nbsp;M. Pileri","doi":"10.1016/j.neurad.2025.101368","DOIUrl":"10.1016/j.neurad.2025.101368","url":null,"abstract":"","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"52 5","pages":"Article 101368"},"PeriodicalIF":3.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555578","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}

{"title":"Balloon angioplasty alone in carotid artery dissections: an overlooked therapeutic choice in acute ischemic stroke","authors":"Joe-Marie Abousleiman ,&nbsp;Christophe Cognard ,&nbsp;Fabrice Bonneville ,&nbsp;Gaultier Marnat ,&nbsp;Anne-Christine Januel ,&nbsp;Philippe Tall ,&nbsp;Federico Sacchetti ,&nbsp;Alain Viguier ,&nbsp;Magali Raveneau ,&nbsp;Bertrand Lapergue ,&nbsp;Guillaume Bellanger ,&nbsp;ETIS investigators","doi":"10.1016/j.neurad.2025.101367","DOIUrl":"10.1016/j.neurad.2025.101367","url":null,"abstract":"<div><h3>Background &amp; purpose</h3><div>Carotid dissection is a major cause of ischemic stroke in young patients and its endovascular management is complex and lacks consensus. Our aim was to carry out the first comparative evaluation of balloon angioplasty alone versus stenting in the endovascular treatment of acute carotid artery dissection presenting with acute stroke.</div></div><div><h3>Materials and methods</h3><div>From the national ETIS (Endovascular Treatment of Ischemic Stroke) registry, between January 2015 and 2023, we included patients with acute ischemic stroke secondary to internal carotid artery dissection who underwent endovascular treatment. We compared clinical and imaging outcomes at a 3-month follow-up between two endovascular approaches for managing carotid artery dissection: balloon angioplasty alone versus stenting.</div></div><div><h3>Results</h3><div>Among the 160 patients included, 26 underwent balloon angioplasty alone, and 134 received carotid stenting. At the 3-month follow-up, the distribution of modified Rankin Scale (mRS) scores did not differ significantly between groups (<em>p</em> = 0.73).</div><div>Additionally, at 24 h there were no significant differences observed between the two groups regarding intracranial haemorrhage (31 % angioplasty alone vs. 45 % stenting; <em>p</em> = 0.202), carotid artery patency immediately after endovascular procedure (38.5 % vs 36 %, <em>p</em> = 0.826) or at 24 h (50 % vs. 51 %; <em>p</em> = 0.9), NIHSS scores (11 ± 8 vs. 11 ± 9; <em>p</em> = 0.972) or emboli in new-territory (11.5 % vs. 9 %; <em>p</em> = 0.713).</div></div><div><h3>Conclusion</h3><div>Although infrequently performed, balloon angioplasty alone showed comparable safety and efficacy to stenting and may represent a valid option in selected cases. Nonetheless, the observational design and small sample size warrant caution, and further studies are needed to confirm these findings.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"52 5","pages":"Article 101367"},"PeriodicalIF":3.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530802","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}

{"title":"Design and optimization of an automatic deep learning-based cerebral reperfusion scoring (TICI) using thrombus localization","authors":"Arthur Folcher ,&nbsp;Jérémy Piters ,&nbsp;Daphné Wallach ,&nbsp;Gwenael Guillard ,&nbsp;Julien Ognard ,&nbsp;Jean-Christophe Gentric","doi":"10.1016/j.neurad.2025.101366","DOIUrl":"10.1016/j.neurad.2025.101366","url":null,"abstract":"<div><h3>Background</h3><div>The Thrombolysis in Cerebral Infarction (TICI) scale is widely used to assess angiographic outcomes of mechanical thrombectomy despite significant variability. Our objective was to create and optimize an artificial intelligence (AI)-based classification model for digital subtraction angiography (DSA) TICI scoring.</div></div><div><h3>Methods</h3><div>Using a monocentric DSA dataset of thrombectomies, and a platform for medical image analysis, independent readers labeled each series according to TICI score and marked each thrombus. A convolutional neural network (CNN) classification model was created to classify TICI scores, into 2 groups (TICI 0,1 or 2a versus TICI 2b, 2c or 3) and 3 groups (TICI 0,1 or 2a versus TICI 2b versus TICI 2c or 3). The algorithm was first tested alone, and then thrombi positions were introduced to the algorithm by manual placement firstly, then after using a thrombus detection module.</div></div><div><h3>Results</h3><div>A total of 422 patients were enrolled in the study. 2492 thrombi were annotated on the TICI-labeled series. The model trained on a total of 1609 DSA series. The classification model into two classes had a specificity of 0.97 ± 0.01 and a sensibility of 0.86 ± 0.01. The 3-class models showed insufficient performance, even when combined with the true thrombi positions, with, respectively, F1 scores for TICI 2b classification of 0.50 and 0.55 ± 0.07. The automatic thrombus detection module did not enhance the performance of the 3-class model, with a F1 score for the TICI 2b class measured at 0.50 ± 0.07.</div></div><div><h3>Conclusion</h3><div>The AI model provided a reproducible 2-class (TICI 0,1 or 2a versus 2b, 2c or 3) classification according to TICI scale. Its performance in distinguishing three classes (TICI 0,1 or 2a versus 2b versus 2c or 3) remains insufficient for clinical practice. Automatic thrombus detection did not improve the model's performance.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"52 5","pages":"Article 101366"},"PeriodicalIF":3.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530803","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}

{"title":"Recent advances in sMRI and artificial intelligence for presurgical planning in focal cortical dysplasia: A systematic review","authors":"AmirHossein Mahmoudi ,&nbsp;Arshia Alizadeh ,&nbsp;Zohreh Ganji ,&nbsp;Hoda Zare","doi":"10.1016/j.neurad.2025.101359","DOIUrl":"10.1016/j.neurad.2025.101359","url":null,"abstract":"<div><h3>Background</h3><div>Focal Cortical Dysplasia (FCD) is a leading cause of drug-resistant epilepsy, particularly in children and young adults, necessitating precise presurgical planning. Traditional structural MRI often fails to detect subtle FCD lesions, especially in MRI-negative cases. Recent advancements in Artificial Intelligence (AI), particularly Machine Learning (ML) and Deep Learning (DL), have the potential to enhance FCD detection's sensitivity and specificity.</div></div><div><h3>Methods</h3><div>This systematic review, following PRISMA guidelines, searched PubMed, Embase, Scopus, Web of Science, and Science Direct for articles published from 2020 onwards, using keywords related to “Focal Cortical Dysplasia,” “MRI,” and “Artificial Intelligence/Machine Learning/Deep Learning.” Included were original studies employing AI and structural MRI (sMRI) for FCD detection in humans, reporting quantitative performance metrics, and published in English. Data extraction was performed independently by two reviewers, with discrepancies resolved by a third.</div></div><div><h3>Results</h3><div>The included studies demonstrated that AI significantly improved FCD detection, achieving sensitivity up to 97.1 % and specificities up to 84.3 % across various MRI sequences, including MPRAGE, MP2RAGE, and FLAIR. AI models, particularly deep learning models, matched or surpassed human radiologist performance, with combined AI-human expertise reaching up to 87 % detection rates. Among 88 full-text articles reviewed, 27 met inclusion criteria. The studies emphasized the importance of advanced MRI sequences and multimodal MRI for enhanced detection, though model performance varied with FCD type and training datasets.</div></div><div><h3>Conclusion</h3><div>Recent advances in sMRI and AI, especially deep learning, offer substantial potential to improve FCD detection, leading to better presurgical planning and patient outcomes in drug-resistant epilepsy. These methods enable faster, more accurate, and automated FCD detection, potentially enhancing surgical decision-making. Further clinical validation and optimization of AI algorithms across diverse datasets are essential for broader clinical translation.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"52 5","pages":"Article 101359"},"PeriodicalIF":3.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303453","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}

{"title":"Contour assisted coiling in wide-neck bifurcation intracranial aneurysms","authors":"David Wei Wen ,&nbsp;Feyi Babatola ,&nbsp;Arun Chandran","doi":"10.1016/j.neurad.2025.101358","DOIUrl":"10.1016/j.neurad.2025.101358","url":null,"abstract":"<div><div>Advances in medical devices have increased the options available for endovascular treatment of wide-neck bifurcation aneurysms (WNBA). The Contour Neurovascular System (Cereus Endovascular, California) is a novel intrasaccular device designed for embolization of intracranial aneurysms, including WNBA. The Contour device can be used on its own or in conjunction with coils. When used with coils to treat WNBA it provides dual function; neck-bridging to support the coil mass at the aneurysm neck as well as provide flow diversion due to its mesh design.</div><div>In this technical video we showcase two examples of Contour assisted coiling of WNBA. We will also discuss the technical nuances of this treatment strategy and its advantages.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"52 5","pages":"Article 101358"},"PeriodicalIF":3.0,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267843","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}

{"title":"Pruritus and anxiety symptoms in chronic spontaneous urticaria are associated with altered functional connectivity of the brain","authors":"Ying Zhao ,&nbsp;Han Yang ,&nbsp;Siyi Yu ,&nbsp;Ying Li ,&nbsp;Leixiao Zhang","doi":"10.1016/j.neurad.2025.101355","DOIUrl":"10.1016/j.neurad.2025.101355","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have found differences in spontaneous neural activity in multiple brain regions in CSU patients, such as the inferior orbitofrontal cortex. However, the current research on CSU patients is still dominated by brain region response, and there is a lack of evidence for the correlation between different brain regions. To elucidate the underlying mechanisms of interactions between different brain regions in CSU patients, we compared changes in FC between CSU patients and HCs.</div></div><div><h3>Methods</h3><div>53 patients with CSU and 31 HCs were recruited. The UAS7, VAS-P, DLQI, HAMA, and HAMD were collected to evaluate the changes in clinical symptoms in CSU. ORBinf-L was used as the seed point for whole brain FC analysis. Seed-based FC analysis was used to assess functional changes in the brain regions of the subjects.</div></div><div><h3>Results</h3><div>Compared with HCs, the FC values of the Caudate-L was increased in CSU patients, and the FC values was positively correlated with the VAS-P. CSU patients had decreased FC values in the Hippocampus-R, and were negatively correlated with the values of HAMA.</div></div><div><h3>Conclusions</h3><div>Our results revealed that CSU patients demonstrate aberrant connectivity in specific brain circuits—particularly the ORBinf-L to Caudate-L and ORBinf-L to Hippocampal-R pathways, which correlates with their pruritus severity and anxiety levels.</div></div><div><h3>Trial registration number</h3><div>ChiCTR2200064563</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"52 4","pages":"Article 101355"},"PeriodicalIF":3.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200716","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}

{"title":"Sleep deprivation as a risk factor for cortical gray matter reduction in new medical residents","authors":"Nahum Antonio Alvarez-Ornelas ,&nbsp;Hilda Elizabeth Macías-Cervantes ,&nbsp;Patricia Rodríguez-Villaseñor ,&nbsp;Omar Sánchez-Figueroa ,&nbsp;Roberto Flores-Rodríguez ,&nbsp;Zyanya Guadalupe García-Cisneros ,&nbsp;Alberto Aguilar-Chávez ,&nbsp;Oscar Pérez-Sánchez ,&nbsp;Erica García-Valadez ,&nbsp;Javier Medrano-Sánchez ,&nbsp;Martha Alicia Hernández-González ,&nbsp;José Guadalupe Rivera-Chávez","doi":"10.1016/j.neurad.2025.101357","DOIUrl":"10.1016/j.neurad.2025.101357","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Sleep is an essential physiological condition for the proper functioning of humans, both physiologically, cognitively, and psychologically. Sleep deprivation leads to a loss of psychomotor skills in humans. It is important to evaluate the structural changes experienced by medical residents who are sleep-deprived due to extensive work shifts, including night shifts, assigned during their training program. Therefore, the main outcome was to evaluate the structural changes in the cortical gray matter and the hippocampus assessed by brain magnetic resonance imaging (MRI) in newly admitted medical residents four months after the start of the medical specialty.</div></div><div><h3>Material and methods</h3><div>Forty-one newly admitted medical residents were enrolled, and an initial questionnaire was administered to assess sleep quality. All participants underwent a brain MRI study, utilizing an advanced MRI sequence: a 3D inversion recovery (IR)-prepped fast spoiled gradient-recalled (SPGR) high-resolution T1-weighted sequence. The images were then anonymized and reformatted, and volumetric analyses of gray matter and hippocampus were performed using an open-access platform for MRI brain analysis (volBrain). This process was repeated four months later with the acquisition of a new brain MRI study for each participant.</div></div><div><h3>Results</h3><div>For gray matter volume, a baseline value of 728.04 ± 63.95 cm³ and a final value of 715.11 ± 59.38 cm³ were found (<em>p</em> &lt; 0.01), and the frontal lobe showed the greatest reduction, with an initial value of 181.92 ± 15.58 cm³ and a final volume of 176.45 ± 17.35 cm³ (<em>p</em> = &lt;0.001). We found an OR of 1.52 (95 % CI 0.93–4.14, <em>p</em> = 0.01) between working night shifts and gray matter reduction.</div></div><div><h3>Conclusions</h3><div>The results of this study show a statistically significant reduction in gray matter volume in first-year residents after four months of shift work, with the greatest reduction in the frontal lobe.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"52 4","pages":"Article 101357"},"PeriodicalIF":3.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192369","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}

{"title":"Radial vs femoral access in mechanical thrombectomy: Implications for clinical practice – A systematic review and meta-analysis","authors":"Ali Mortezaei ,&nbsp;Ahmed Abdelsalam ,&nbsp;Alireza Oladaskari ,&nbsp;Ahmed Y. Azzam ,&nbsp;MEng, Christina Tran ,&nbsp;Sai Sanikommu ,&nbsp;Tiffany Eatz ,&nbsp;Michael A. Silva ,&nbsp;Luis Guada ,&nbsp;Caleigh S. Roach ,&nbsp;Jayro Toledo ,&nbsp;Gurkirat Singh Kohli ,&nbsp;Derrek Schartz ,&nbsp;Adam A Dmytriw ,&nbsp;Redi Rahmani ,&nbsp;Matthew Bender ,&nbsp;Robert M. Starke","doi":"10.1016/j.neurad.2025.101356","DOIUrl":"10.1016/j.neurad.2025.101356","url":null,"abstract":"<div><h3>Background</h3><div>Multiple studies have demonstrated lower access complications associated with transradial access (TRA) compared to transfemoral access (TFA) for endovascular procedures. The feasibility and safety of TRA versus TFA for mechanical thrombectomy (MT) for large vessel occlusions in acute ischemic stroke (AIS) is a subject of current debate.</div></div><div><h3>Methods</h3><div>We performed a systematic search in four databases. Binary outcomes were analyzed through odds ratios (OR) and 95 % confidence intervals (CI), while the continuous outcomes were analyzed through the standardized mean difference (SMD) and 95 % CI. Publication bias was visually assessed with a funnel plot and confirmed by Egger’s test.</div></div><div><h3>Results</h3><div>There were 5048 total patients undergoing MT from 15 studies in our analyses. In these patients, 984 MT were via TRA and 4064 via TFA. Access-site complications (OR = 0.16, P-value &lt; 0.01) was significantly lower in TRA than TFA. No significant difference was found in 90-day functional independence (mRS 0–2) in the primary analysis (OR = 0.83, <em>P</em> = 0.23), although sensitivity analysis indicated significant difference after resolving heterogeneity. There were no statistically significant distinctions observed between the TRA group and TFA group concerning successful recanalization (OR = 1.07, P-value = 0.5), access-to-reperfusion time (MD = -2.4, P-value = 0.43), first-pass effect (OR = 0.84, P-value = 0.06), mean number of passes (MD = 0.032, P-value = 0.66), symptomatic intracerebral hemorrhage (OR = 0.95, P-value = 0.8), and 90-day mortality (OR = 1.24, P-value = 0.28).</div></div><div><h3>Conclusion</h3><div>TRA was associated with fewer access-site complications compared to TFA. Although no significant difference in 90-day functional independence was observed in the primary meta-analysis, sensitivity analysis indicated potential superiority of TFA. Our findings highlighted optimizing the patient selection to maximize the benefits of thrombectomy through radial access. Further randomized trials and prospective studies are required to confirm these findings.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"52 5","pages":"Article 101356"},"PeriodicalIF":3.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217338","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}