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1. Collateral-based selection for endovascular treatment of acute ischaemic stroke in the late window (MR CLEAN-LATE): 2-year follow-up of a phase 3, multicentre, open-label, randomised controlled trial in the Netherlands

Author

van Oostenbrugge, Robert, van Zwam, Wim, Olthuis, Susanne, Pirson, Anne, Hinsenveld, Wouter, Goldhoorn, Robert-Jan, Staals, Julie, Dippel, Diederik, van der Lugt, Aad, van Es, Adriaan, Roozenbeek, Bob, van Doormaal, Pieter-Jan, Roos, Yvo, Majoie, Charles, Coutinho, Jonathan, Emmer, Bart, van der Worp, Bart, Lo, Rob, van Walderveen, Marianne, Wermer, Marieke, van Dijk, Ewoud, Jenniskens, Sjoerd, Boogaarts, Hieronymus, Uyttenboogaart, Maarten, Bokkers, Reinoud, Keizer, Koos, Gons, Rob, Yo, Lonneke, den Hertog, Heleen, van Hasselt, Boudewijn, Schonewille, Wouter, Vos, Jan-Albert, van Tuijl, Julia, Boukrab, Issam, Kortman, Hans, Hofmeijer, Jeannette, Martens, Jasper, van den Wijngaard, Ido, Boiten, Jelis, Lycklama à Nijeholt, Geert, Brouwers, Paul, Sturm, Emiel, Bulut, Tomas, de Laat, Karlijn, van Dijk, Lukas, Remmers, Michel, de Jong, Thijs, Rozeman, Anouk, Elgersma, Otto, Van der Veen, Bas, Sudiono, Davy, Mattle, Heinrich, Fiehler, Jens, van Kuijk, Sander, Nieboer, Daan, Lingsma, Hester, van Nuland, Rick, Roosendaal, Stefan, Krietemeijer, Menno, Postma, Alida, Van den Berg, René, Beenen, Ludo, Hammer, Sebastiaan, Meijer, Anton, van der Hoorn, Anouk, Yoo, Albert, Gerrits, Dick, Jansen, Ben, Truijman, Martine, Manschot, Sanne, Kerkhoff, Henk, Koudstaal, Peter, Chalos, Vicky, Berkhemer, Olvert, Versteeg, Adriaan, Wolff, Lennard, Su, Jiahang, van der Sluijs, Matthijs, van Voorst, Henk, Tolhuisen, Manon, ten Cate, Hugo, de Maat, Moniek, Donse-Donkel, Samantha, van Beusekom, Heleen, Taha, Aladdin, Barakzie, Aarazo, Treurniet, Kilian, van den Berg, Sophie, LeCouffe, Natalie, van de Graaf, Rob, de Ridder, Inger, Pinckaers, Florentina, Ceulemans, Angelique, Knapen, Robrecht, Robbe, Quirien, Sondag, Lotte, Kappelhof, Manon, Reinink, Rik, Silvis, Suzanne, Schreuder, Floris, Uniken Venema, Simone, van Meenen, Laura, Collette, Sabine, van Wijngaarden, Wilma, van der Steen, Wouter, Hoving, Jan, Verheesen, Sabrina, Sterrenberg, Martin, El Ghannouti, Naziha, Sprengers, Rita, van Ahee, Ayla, Zweedijk, Berber, Pellikaan, Wilma, Schonewille, Irati, Blauwendraat, Kitty, Drabbe, Yvonne, Kleine-Kathöfer, Anke, de Meris, Joke, Sandiman, Michelle, Dofferhoff-Vermeulen, Tamara, Simons, Michelle, Bongenaar, Hester, Smallegange, Maylee, van Loon, Anja, Kraus, Karin, Bos-Verheij, Erna, Santegoets, Ester, Kooij, Suze, Slotboom, Annemarie, Ponjee, Eva, Eilander, Rieke, Droste, Hanneke, van Veen, Esther, Visser, Rosalie, Lodico, Jasmijn, de Jong, Marieke, van der Minne, Friedus, Cleophas, Eefje, Muskens, Ernst, Nijst, Amy, Heiligers, Leontien, Martens, Yvonne, Slotboom, Miranda, Hintzen, Rogier, Jacobs, Bart, Huijberts, Ilse, Pinckaers, Florentina M E, Olthuis, Susanne G H, van Kuijk, Sander M J, Postma, Alida A, Boogaarts, Hieronymus D, Roos, Yvo B W E M, Majoie, Charles B L M, Dippel, Diederik W J, van Zwam, Wim H, and van Oostenbrugge, Robert J

Published
2024
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2. Endovascular treatment versus no endovascular treatment after 6–24 h in patients with ischaemic stroke and collateral flow on CT angiography (MR CLEAN-LATE) in the Netherlands: a multicentre, open-label, blinded-endpoint, randomised, controlled, phase 3 trial

Author

Olthuis, Susanne G H, Pirson, F Anne V, Pinckaers, Florentina M E, Hinsenveld, Wouter H, Nieboer, Daan, Ceulemans, Angelique, Knapen, Robrecht R M M, Robbe, M M Quirien, Berkhemer, Olvert A, van Walderveen, Marianne A A, Lycklama à Nijeholt, Geert J, Uyttenboogaart, Maarten, Schonewille, Wouter J, van der Sluijs, P Matthijs, Wolff, Lennard, van Voorst, Henk, Postma, Alida A, Roosendaal, Stefan D, van der Hoorn, Anouk, Emmer, Bart J, Krietemeijer, Menno G M, van Doormaal, Pieter-Jan, Roozenbeek, Bob, Goldhoorn, Robert-Jan B, Staals, Julie, de Ridder, Inger R, van der Leij, Christiaan, Coutinho, Jonathan M, van der Worp, H Bart, Lo, Rob T H, Bokkers, Reinoud P H, van Dijk, Ewoud I, Boogaarts, Hieronymus D, Wermer, Marieke J H, van Es, Adriaan C G M, van Tuijl, Julia H, Kortman, Hans G J, Gons, Rob A R, Yo, Lonneke S F, Vos, Jan-Albert, de Laat, Karlijn F, van Dijk, Lukas C, van den Wijngaard, Ido R, Hofmeijer, Jeannette, Martens, Jasper M, Brouwers, Paul J A M, Bulut, Tomas, Remmers, Michel J M, de Jong, Thijs E A M, den Hertog, Heleen M, van Hasselt, Boudewijn A A M, Rozeman, Anouk D, Elgersma, Otto E H, van der Veen, Bas, Sudiono, Davy R, Lingsma, Hester F, Roos, Yvo B W E M, Majoie, Charles B L M, van der Lugt, Aad, Dippel, Diederik W J, van Zwam, Wim H, and van Oostenbrugge, Robert J

Published
2023
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7. Endovascular treatment versus no endovascular treatment after 6–24 h in patients with ischaemic stroke and collateral flow on CT angiography (MR CLEAN-LATE) in the Netherlands:a multicentre, open-label, blinded-endpoint, randomised, controlled, phase 3 trial

Author

Olthuis, Susanne G.H., Pirson, F. Anne V., Pinckaers, Florentina M.E., Hinsenveld, Wouter H., Nieboer, Daan, Ceulemans, Angelique, Knapen, Robrecht R.M.M., Robbe, M. M.Quirien, Berkhemer, Olvert A., van Walderveen, Marianne A.A., Lycklama à Nijeholt, Geert J., Uyttenboogaart, Maarten, Schonewille, Wouter J., van der Sluijs, P. Matthijs, Wolff, Lennard, van Voorst, Henk, Postma, Alida A., Roosendaal, Stefan D., van der Hoorn, Anouk, Emmer, Bart J., Krietemeijer, Menno G.M., van Doormaal, Pieter Jan, Roozenbeek, Bob, Goldhoorn, Robert Jan B., Staals, Julie, de Ridder, Inger R., van der Leij, Christiaan, Coutinho, Jonathan M., van der Worp, H. Bart, Lo, Rob T.H., Bokkers, Reinoud P.H., van Dijk, Ewoud I., Boogaarts, Hieronymus D., Wermer, Marieke J.H., van Es, Adriaan C.G.M., van Tuijl, Julia H., Kortman, Hans G.J., Gons, Rob A.R., Yo, Lonneke S.F., Vos, Jan Albert, de Laat, Karlijn F., van Dijk, Lukas C., van den Wijngaard, Ido R., Hofmeijer, Jeannette, Martens, Jasper M., Brouwers, Paul J.A.M., den Hertog, Heleen M., Lingsma, Hester F., van der Lugt, Aad, Dippel, Diederik W.J., Olthuis, Susanne G.H., Pirson, F. Anne V., Pinckaers, Florentina M.E., Hinsenveld, Wouter H., Nieboer, Daan, Ceulemans, Angelique, Knapen, Robrecht R.M.M., Robbe, M. M.Quirien, Berkhemer, Olvert A., van Walderveen, Marianne A.A., Lycklama à Nijeholt, Geert J., Uyttenboogaart, Maarten, Schonewille, Wouter J., van der Sluijs, P. Matthijs, Wolff, Lennard, van Voorst, Henk, Postma, Alida A., Roosendaal, Stefan D., van der Hoorn, Anouk, Emmer, Bart J., Krietemeijer, Menno G.M., van Doormaal, Pieter Jan, Roozenbeek, Bob, Goldhoorn, Robert Jan B., Staals, Julie, de Ridder, Inger R., van der Leij, Christiaan, Coutinho, Jonathan M., van der Worp, H. Bart, Lo, Rob T.H., Bokkers, Reinoud P.H., van Dijk, Ewoud I., Boogaarts, Hieronymus D., Wermer, Marieke J.H., van Es, Adriaan C.G.M., van Tuijl, Julia H., Kortman, Hans G.J., Gons, Rob A.R., Yo, Lonneke S.F., Vos, Jan Albert, de Laat, Karlijn F., van Dijk, Lukas C., van den Wijngaard, Ido R., Hofmeijer, Jeannette, Martens, Jasper M., Brouwers, Paul J.A.M., den Hertog, Heleen M., Lingsma, Hester F., van der Lugt, Aad, and Dippel, Diederik W.J.

Abstract

Background: Endovascular treatment for anterior circulation ischaemic stroke is effective and safe within a 6 h window. MR CLEAN-LATE aimed to assess efficacy and safety of endovascular treatment for patients treated in the late window (6–24 h from symptom onset or last seen well) selected on the basis of the presence of collateral flow on CT angiography (CTA). Methods: MR CLEAN-LATE was a multicentre, open-label, blinded-endpoint, randomised, controlled, phase 3 trial done in 18 stroke intervention centres in the Netherlands. Patients aged 18 years or older with ischaemic stroke, presenting in the late window with an anterior circulation large-vessel occlusion and collateral flow on CTA, and a neurological deficit score of at least 2 on the National Institutes of Health Stroke Scale were included. Patients who were eligible for late-window endovascular treatment were treated according to national guidelines (based on clinical and perfusion imaging criteria derived from the DAWN and DEFUSE-3 trials) and excluded from MR CLEAN-LATE enrolment. Patients were randomly assigned (1:1) to receive endovascular treatment or no endovascular treatment (control), in addition to best medical treatment. Randomisation was web based, with block sizes ranging from eight to 20, and stratified by centre. The primary outcome was the modified Rankin Scale (mRS) score at 90 days after randomisation. Safety outcomes included all-cause mortality at 90 days after randomisation and symptomatic intracranial haemorrhage. All randomly assigned patients who provided deferred consent or died before consent could be obtained comprised the modified intention-to-treat population, in which the primary and safety outcomes were assessed. Analyses were adjusted for predefined confounders. Treatment effect was estimated with ordinal logistic regression and reported as an adjusted common odds ratio (OR) with a 95% CI. This trial was registered with the ISRCTN, ISRCTN19922220. Findings: Between Feb 2, 2

Published
2023

9. Effect of Intravenous Alteplase Treatment on First-Line Stent Retriever Versus Aspiration Alone During Endovascular Treatment

Author

Rinkel, Leon A., primary, Treurniet, Kilian M., additional, Nieboer, Daan, additional, Kappelhof, Manon, additional, LeCouffe, Natalie E., additional, Bruggeman, Agnetha A.E., additional, van Zwam, Wim H., additional, Lycklama à Nijeholt, Geert J., additional, Ghariq, Elyas, additional, Uyttenboogaart, Maarten, additional, Dippel, Diederik W.J., additional, Roos, Yvo B.W.E.M., additional, Coutinho, Jonathan M., additional, Majoie, Charles B.L.M., additional, Emmer, Bart J., additional, Roozenbeek, Bob, additional, van Es, Adriaan, additional, de Ridder, Inger, additional, van der Worp, Bart, additional, Lo, Rob, additional, Keizer, Koos, additional, Gons, Rob, additional, Yo, Lonneke, additional, Boiten, Jelis, additional, van den Wijngaard, Ido, additional, Hofmeijer, Jeanette, additional, Martens, Jasper, additional, Schonewille, Wouter, additional, Albert Vos, Jan, additional, Tuladhar, Anil, additional, Schreuder, Floris, additional, Boogaarts, Jeroen, additional, Jenniskens, Sjoerd, additional, de Laat, Karlijn, additional, van Dijk, Lukas, additional, den Hertog, Heleen, additional, van Hasselt, Boudewijn, additional, Brouwers, Paul, additional, Sturm, Emiel, additional, Bulut, Tomas, additional, Remmers, Michel, additional, van Norden, Anouk, additional, de Jong, Thijs, additional, Rozeman, Anouk, additional, Elgersma, Otto, additional, Bokkers, Reinoud, additional, van Tuijl, Julia, additional, Boukrab, Issam, additional, Kortman, Hans, additional, Costalat, Vincent, additional, Arquizan, Caroline, additional, Lemmens, Robin, additional, Demeestere, Jelle, additional, Desfontaines, Philippe, additional, Brisbois, Denis, additional, Clarençon, Frédéric, additional, Samson, Yves, additional, Brown, Martin, additional, White, Phil, additional, Gregson, John, additional, van Nuland, Rick, additional, van der Lugt, Aad, additional, Jacobi, Linda, additional, van den Berg, René, additional, Beenen, Ludo, additional, van Doormaal, Pieter-Jan, additional, Yoo, Albert, additional, Hammer, Bas, additional, Roosendaal, Stefan, additional, Meijer, Anton, additional, Krietemeijer, Menno, additional, van der Hoorn, Anouk, additional, Gerrits, Dick, additional, van Oostenbrugge, Robert, additional, Jansen, Ben, additional, Manschot, Sanne, additional, Kerkhof, Henk, additional, Koudstaal, Peter, additional, Lingsma, Hester, additional, Chalos, Vicky, additional, Berkhemer, Olvert, additional, Versteeg, Adriaan, additional, Wolff, Lennard, additional, Su, Jiahang, additional, Tolhuisen, Manon, additional, van Voorst, Henk, additional, ten Cate, Hugo, additional, de Maat, Moniek, additional, Donse-Donkel, Samantha, additional, van Beusekom, Heleen, additional, Taha, Aladdin, additional, van den Berg, Sophie, additional, van de Graaf, Rob, additional, Goldhoorn, Robert-Jan, additional, Hinsenveld, Wouter, additional, Pirson, Anne, additional, Sondag, Lotte, additional, Reinink, Rik, additional, Brouwer, Josje, additional, Collette, Sabine, additional, van der Steen, Wouter, additional, Sprengers, Rita, additional, Sterrenberg, Martin, additional, El Ghannouti, Naziha, additional, Verheesen, Sabrina, additional, Pellikaan, Wilma, additional, Blauwendraat, Kitty, additional, Drabbe, Yvonne, additional, de Meris, Joke, additional, Simons, Michelle, additional, Bongenaar, Hester, additional, van Loon, Anja, additional, Ponjee, Eva, additional, Eilander, Rieke, additional, Kooij, Suze, additional, de Jong, Marieke, additional, Santegoets, Esther, additional, Roodenburg, Suze, additional, van Ahee, Ayla, additional, Moynier, Marinette, additional, Devroye, Annemie, additional, Marcis, Evelyn, additional, Iezzi, Ingrid, additional, David, Annie, additional, Talbi, Atika, additional, Heiligers, Leontien, additional, and Martens, Yvonne, additional

Published
2022
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10. A giant basilar artery perforator aneurysm

Author

Mutlu, Unal, Kortman, Hans, Boukrab, Issam, Mutlu, Unal, Kortman, Hans, and Boukrab, Issam

Abstract

Basilar artery perforator aneurysms (BAPA's) are a rare entity. Their natural history and treatment are unclear. We describe the largest BAPA reported thus far in literature in a 64-year-old Caucasian woman. This patient did not present with subarachnoid hemorrhage, but with left hemiparesis due to pontine ischemia. The aneurysm was initially misdiagnosed as a tumoral mass in a referring center. Angiography confirmed the presence of a BAPA and a flow diverter was successfully placed. This case shows us that a BAPA can mimic a tumoral mass and can cause ischemia due to mass effect without having ruptured. Both conservative and flow diverter placement seems viable treatment options. Individual patient characteristics and preferences should be considered in decision-making for treatment.

Published
2022

14. A Randomized Trial of Intravenous Alteplase before Endovascular Treatment for Stroke

Author

LeCouffe, Natalie E., primary, Kappelhof, Manon, additional, Treurniet, Kilian M., additional, Rinkel, Leon A., additional, Bruggeman, Agnetha E., additional, Berkhemer, Olvert A., additional, Wolff, Lennard, additional, van Voorst, Henk, additional, Tolhuisen, Manon L., additional, Dippel, Diederik W.J., additional, van der Lugt, Aad, additional, van Es, Adriaan C.G.M., additional, Boiten, Jelis, additional, Lycklama à Nijeholt, Geert J., additional, Keizer, Koos, additional, Gons, Rob A.R., additional, Yo, Lonneke S.F., additional, van Oostenbrugge, Robert J., additional, van Zwam, Wim H., additional, Roozenbeek, Bob, additional, van der Worp, H. Bart, additional, Lo, Rob T.H., additional, van den Wijngaard, Ido R., additional, de Ridder, Inger R., additional, Costalat, Vincent, additional, Arquizan, Caroline, additional, Lemmens, Robin, additional, Demeestere, Jelle, additional, Hofmeijer, Jeannette, additional, Martens, Jasper M., additional, Schonewille, Wouter J., additional, Vos, Jan-Albert, additional, Uyttenboogaart, Maarten, additional, Bokkers, Reinoud P.H., additional, van Tuijl, Julia H., additional, Kortman, Hans, additional, Schreuder, Floris H.B.M., additional, Boogaarts, Hieronymus D., additional, de Laat, Karlijn F., additional, van Dijk, Lukas C., additional, den Hertog, Heleen M., additional, van Hasselt, Boudewijn A.A.M., additional, Brouwers, Paul J.A.M., additional, Bulut, Tomas, additional, Remmers, Michel J.M., additional, van Norden, Anouk, additional, Imani, Farshad, additional, Rozeman, Anouk D., additional, Elgersma, Otto E.H., additional, Desfontaines, Philippe, additional, Brisbois, Denis, additional, Samson, Yves, additional, Clarençon, Frédéric, additional, Krietemeijer, G. Menno, additional, Postma, Alida A., additional, van Doormaal, Pieter-Jan, additional, van den Berg, René, additional, van der Hoorn, Anouk, additional, Beenen, Ludo F.M., additional, Nieboer, Daan, additional, Lingsma, Hester F., additional, Emmer, Bart J., additional, Coutinho, Jonathan M., additional, Majoie, Charles B.L.M., additional, and Roos, Yvo B.W.E.M., additional

Published
2021
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16. A randomized trial of intravenous alteplase before endovascular treatment for stroke

Author

LeCouffe, Natalie E., Kappelhof, Manon, Treurniet, Kilian M., Rinkel, Leon A., Bruggeman, Agnetha E., Berkhemer, Olvert A., Wolff, Lennard, van Voorst, Henk, Tolhuisen, Manon L., Dippel, Diederik W.J., van der Lugt, Aad, van Es, Adriaan C.G.M., Boiten, Jelis, Lycklama à Nijeholt, Geert J., Keizer, Koos, Gons, Rob A.R., Yo, Lonneke S.F., van Oostenbrugge, Robert J., van Zwam, Wim H., Roozenbeek, Bob, van der Worp, H. Bart, Lo, Rob T.H., van den Wijngaard, Ido R., de Ridder, Inger R., Costalat, Vincent, Arquizan, Caroline, Lemmens, Robin, Demeestere, Jelle, Hofmeijer, Jeannette, Martens, Jasper M., Schonewille, Wouter J., Vos, Jan Albert, Uyttenboogaart, Maarten, Bokkers, Reinoud P.H., van Tuijl, Julia H., Kortman, Hans, Schreuder, Floris H.B.M., Boogaarts, Hieronymus D., de Laat, Karlijn F., van Dijk, Lukas C., den Hertog, Heleen M., van Hasselt, Boudewijn A.A.M., Brouwers, Paul J.A.M., Bulut, Tomas, Remmers, Michel J.M., Imani, Farshad, van Doormaal, Pieter Jan, Nieboer, Daan, Lingsma, Hester F., Emmer, Bart J., Majoie, Charles B.L.M., Roos, Yvo B.W.E.M., LeCouffe, Natalie E., Kappelhof, Manon, Treurniet, Kilian M., Rinkel, Leon A., Bruggeman, Agnetha E., Berkhemer, Olvert A., Wolff, Lennard, van Voorst, Henk, Tolhuisen, Manon L., Dippel, Diederik W.J., van der Lugt, Aad, van Es, Adriaan C.G.M., Boiten, Jelis, Lycklama à Nijeholt, Geert J., Keizer, Koos, Gons, Rob A.R., Yo, Lonneke S.F., van Oostenbrugge, Robert J., van Zwam, Wim H., Roozenbeek, Bob, van der Worp, H. Bart, Lo, Rob T.H., van den Wijngaard, Ido R., de Ridder, Inger R., Costalat, Vincent, Arquizan, Caroline, Lemmens, Robin, Demeestere, Jelle, Hofmeijer, Jeannette, Martens, Jasper M., Schonewille, Wouter J., Vos, Jan Albert, Uyttenboogaart, Maarten, Bokkers, Reinoud P.H., van Tuijl, Julia H., Kortman, Hans, Schreuder, Floris H.B.M., Boogaarts, Hieronymus D., de Laat, Karlijn F., van Dijk, Lukas C., den Hertog, Heleen M., van Hasselt, Boudewijn A.A.M., Brouwers, Paul J.A.M., Bulut, Tomas, Remmers, Michel J.M., Imani, Farshad, van Doormaal, Pieter Jan, Nieboer, Daan, Lingsma, Hester F., Emmer, Bart J., Majoie, Charles B.L.M., and Roos, Yvo B.W.E.M.

Abstract

The value of administering intravenous alteplase before endovascular treatment (EVT) for acute ischemic stroke has not been studied extensively, particularly in non-Asian populations. METHODS We performed an open-label, multicenter, randomized trial in Europe involving patients with stroke who presented directly to a hospital that was capable of providing EVT and who were eligible for intravenous alteplase and EVT. Patients were randomly assigned in a 1:1 ratio to receive EVT alone or intravenous alteplase followed by EVT (the standard of care). The primary end point was functional outcome on the modified Rankin scale (range, 0 [no disability] to 6 [death]) at 90 days. We assessed the superiority of EVT alone over alteplase plus EVT, as well as noninferiority by a margin of 0.8 for the lower boundary of the 95% confidence interval for the odds ratio of the two trial groups. Death from any cause and symptomatic intracerebral hemorrhage were the main safety end points. RESULTS The analysis included 539 patients. The median score on the modified Rankin scale at 90 days was 3 (interquartile range, 2 to 5) with EVT alone and 2 (interquartile range, 2 to 5) with alteplase plus EVT. The adjusted common odds ratio was 0.84 (95% confidence interval [CI], 0.62 to 1.15; P=0.28), which showed neither superiority nor noninferiority of EVT alone. Mortality was 20.5% with EVT alone and 15.8% with alteplase plus EVT (adjusted odds ratio, 1.39; 95% CI, 0.84 to 2.30). Symptomatic intracerebral hemorrhage occurred in 5.9% and 5.3% of the patients in the respective groups (adjusted odds ratio, 1.30; 95% CI, 0.60 to 2.81). CONCLUSIONS In a randomized trial involving European patients, EVT alone was neither superior nor noninferior to intravenous alteplase followed by EVT with regard to disability outcome at 90 days after stroke. The incidence of symptomatic intracerebral hemorrhage was similar in the two groups.

Published
2021

18. Radial vs. Femoral Artery Access for Procedural Success in Diagnostic Cerebral Angiography

Author

Bhatia, Kartik, primary, Guest, William, additional, Lee, Hubert, additional, Klostranec, Jesse, additional, Kortman, Hans, additional, Orru, Emanuele, additional, Qureshi, Ayman, additional, Kostynskyy, Alexander, additional, Agid, Ronit, additional, Farb, Richard, additional, Radovanovic, Ivan, additional, Nicholson, Patrick, additional, Krings, Timo, additional, and Pereira, Vitor Mendes, additional

Published
2020
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27. Deep venous communication in vein of Galen malformations: incidence, Imaging, and Implications for treatment.

Author

Kortman, Hans, Navaei, Ershad, Raybaud, Charles A., Bhatia, Kartik Dev, Shroff, Manohar, terBrugge, Karel, Armstrong, Derek, Pereira, Vitor M., Dirks, Peter B., Krings, Timo, and Muthusami, Prakash

Subjects
ENDOVASCULAR surgery, BRAIN, CARDIOVASCULAR system abnormalities, CEREBRAL veins, DIGITAL subtraction angiography, MAGNETIC resonance imaging, NEURORADIOLOGY, RETROSPECTIVE studies, DESCRIPTIVE statistics
Abstract

Background Failure to appreciate deep venous drainage pathways is a major cause of severe complications in the endovascular treatment of vein of Galen aneurysmal malformations (VOGMs). Objective To report deep venous drainage patterns in patients with VOGM, emphasizing the internal cerebral veins, and to describe the challenges in evaluating these. Methods Patients with VOGM presenting to our institute between 2000 and 2018 were retrospectively analyzed. Patients with complete and good quality imaging datasets were included in the study. Three neuroradiologists with expertise in the subject independently analyzed the deep venous drainage patterns on multi-sequence MRI and digital subtraction angiography. Follow-up imaging studies were analyzed for alterations in deep venous drainage patterns that occurred following endovascular treatment. Descriptive statistics were used to report findings. results Twenty-three patients had optimal quality MRI imaging and 25 had optimal quality DSA imaging available. In 14/23 (61%) patients, internal cerebral vein (ICV) communication could be reliably identified on MRI and in 8/25 (32%) patients on DSA. Deep venous communication with the VOGM was demonstrated in 8/26 (30.8%) patients. One (3.8%) patient demonstrated ICV communication with the VOGM only on postoperative imaging, while in 2 (8%) patients the ICV drainage route changed from VOGM to alternative pathways after the procedure. Other variant pathways included lateral mesencephalic vein, superior or inferior sagittal sinus, anterior mesencephalic vein, tentorial sinus, deep Sylvian vein, and superior vermian vein. Conclusion ICV communication with the VOGM is not uncommon and requires dedicated preprocedural imaging to identify it. However, there are significant challenges in assessing this communication in the presence of high-flow fistulae, vessel tortuosity and size, and contrast limitations in this population. [ABSTRACT FROM AUTHOR]

Published
2021
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28. Procedural success with radial access for carotid artery stenting: systematic review and meta-analysis.

Author

Tanaporn Jaroenngarmsamer, Bhatia, Kartik Dev, Kortman, Hans, Orru, Emanuele, and Krings, Timo

Subjects
CAROTID artery surgery, SURGICAL complication risk factors, MORTALITY risk factors, STROKE risk factors, CONFIDENCE intervals, FOREARM, HEMATOMA, META-analysis, RISK assessment, SURGICAL stents, SYSTEMATIC reviews, TRANSIENT ischemic attack, TREATMENT effectiveness, RADIAL artery, DISEASE risk factors
Abstract

Background Femoral access is the traditional approach for endovascular carotid artery stenting. Radial access is increasingly used as an alternative approach due to its known anatomical advantages in patients with unfavorable aortic arch morphology via the femoral approach and its excellent access site safety profile. Our objective was to analyze procedural success using radial access for carotid artery stenting as reported in the literature. Methods Three online databases were systematically searched following PRISMA guidelines for studies (n ≥ 20) using radial artery access for carotid artery stenting (1999-2018). Random-effects meta-analysis was used to pool the procedural success (successful stent placement with no requirement for crossover to femoral access), mortality, and complication rates associated with radial access. Results Seven eligible studies reported procedural success outcomes with a pooled meta-analysis rate of 90.8% (657/723; 95% CI 86.7% to 94.2%; I²=53.1%). Asymptomatic radial artery occlusion occurred in 5.9% (95% CI 4.1% to 8.0%; I²=0%) and forearm hematoma in 1.4% (95% CI 0.4% to 2.9%; I²=0%). Risk of minor stroke/transient ischemic attack was 1.9% (95% CI 0.6% to 3.8%; I²=42.3%) and major stroke was 1.0% (95% CI 0.4% to 1.8%; I²=0%). There were three deaths across the seven studies (0.6%; 95% CI 0.2% to 1.3%; I²=0%). The meta-analysis was limited by statistically significant heterogeneity for the primary outcome of procedural success. Conclusion Radial access for carotid artery stenting has a high procedural success rate with low rates of mortality, access site complications, and cerebrovascular complications. The potential benefits of this approach in patients with unfavorable aortic arch access should be explored in a prospective randomized trial. [ABSTRACT FROM AUTHOR]

Published
2020
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29. Procedural success with radial access for carotid artery stenting: systematic review and meta-analysis

Author

Jaroenngarmsamer, Tanaporn, Bhatia, Kartik Dev, Kortman, Hans, Orru, Emanuele, and Krings, Timo

Abstract

BackgroundFemoral access is the traditional approach for endovascular carotid artery stenting. Radial access is increasingly used as an alternative approach due to its known anatomical advantages in patients with unfavorable aortic arch morphology via the femoral approach and its excellent access site safety profile. Our objective was to analyze procedural success using radial access for carotid artery stenting as reported in the literature.MethodsThree online databases were systematically searched following PRISMA guidelines for studies (n ≥20) using radial artery access for carotid artery stenting (1999–2018). Random-effects meta-analysis was used to pool the procedural success (successful stent placement with no requirement for crossover to femoral access), mortality, and complication rates associated with radial access.ResultsSeven eligible studies reported procedural success outcomes with a pooled meta-analysis rate of 90.8% (657/723; 95% CI 86.7% to 94.2%; I2=53.1%). Asymptomatic radial artery occlusion occurred in 5.9% (95% CI 4.1% to 8.0%; I2=0%) and forearm hematoma in 1.4% (95% CI 0.4% to 2.9%; I2=0%). Risk of minor stroke/transient ischemic attack was 1.9% (95% CI 0.6% to 3.8%; I2=42.3%) and major stroke was 1.0% (95% CI 0.4% to 1.8%; I2=0%). There were three deaths across the seven studies (0.6%; 95% CI 0.2% to 1.3%; I2=0%). The meta-analysis was limited by statistically significant heterogeneity for the primary outcome of procedural success.ConclusionRadial access for carotid artery stenting has a high procedural success rate with low rates of mortality, access site complications, and cerebrovascular complications. The potential benefits of this approach in patients with unfavorable aortic arch access should be explored in a prospective randomized trial.

Published
2020
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32. [Vertebroplasty for chronic back pain due to osteoporotic vertebral compression fractures].

Author

Boukrab I, Venmans A, Kortman HGJ, Donga E, Depauw PRAM, and Lohle PNM

Subjects
Humans, Female, Aged, Male, Prospective Studies, Pain Measurement, Middle Aged, Treatment Outcome, Chronic Pain etiology, Aged, 80 and over, Fractures, Compression surgery, Fractures, Compression complications, Vertebroplasty methods, Spinal Fractures surgery, Spinal Fractures complications, Osteoporotic Fractures surgery, Osteoporotic Fractures complications, Quality of Life, Back Pain etiology
Abstract

Objective: Evidence regarding percutaneous vertebroplasty (PV) for chronic painful osteoporotic vertebral compression fractures (OVCFs) remains limited. To compare pain relief, quality of life, and disability between PV and active control (anesthetic infiltration) interventions for chronic OVCF., Design: Randomized controlled trial., Methods: This prospective randomized clinical trial was conducted between May 2013 and June 2019 in participants with pain due to OVCF lasting longer than 3 months with bone marrow edema present at MRI. Study participants were randomly assigned to undergo PV (n = 40) or active control intervention (n = 40). The primary outcome was pain severity, assessed with the visual analog scale (VAS) (range, 0-10) during 12 months after treatment. Secondary outcomes included Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO) score (range, 0-100) and Roland Morris Disability Questionnaire (RMDQ) score (range, 0-100). Outcomes were analyzed according to a longitudinal multilevel model used to test the difference between groups in change from baseline across follow-up., Results: The mean age of the 80 participants (54 women) was 69 years ± 10 (SD) in the PV group and 71 years ± 10 in the active control group. VAS score was 7.6 (95% CI: 7.0, 8.2) in the PV group and 7.3 (95% CI: 6.9, 7.8) in the active control group at baseline (P = .47) and 3.9 (95% CI: 3.1, 4.8) and 5.1 (95% CI: 4.3, 6.0), respectively, at month 12 (P = .045). At month 12, the group difference from baseline was 1.3 (95% CI: 0.1, 2.6; P = .02) for VAS, 5.2 (95% CI: 0.9, 9.4; P = .02) for QUALEFFO, and 7.1 (95% CI: -3.3, 17.5; P = .18) for RMDQ, favoring the PV group., Conclusion: In the treatment of pain caused by chronic OVCFs, PV is more effective for pain relief and quality of life improvement than anesthetic injection alone, with similar improvement for disability between the groups.

Published
2024

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