Neurointervention for the Peripheral Radiologist: Tips and Tricks

Chewning, Rush H.; Wyse, Gerald; Murphy, Kieran

doi:10.1055/s-2008-1052305

Cited by 8 publications

(4 citation statements)

References 11 publications

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“…Hydrophilic wires are preferred for diagnostic procedures, whereas stiff wires are chosen for navigating tortuous vessels and for catheter exchanges. Microwires, specifically, are employed to guide microcatheters, stents, and other intracranial neurointerventional devices [22] . The wire selection hinges on the intended application and the specific vessel to be navigated.…”

Section: Wiresmentioning

confidence: 99%

Navigating the crossroads: Insights into cardiology’s influence on neurointerventional procedures

Azab,

Pierre,

Lucke-Wold

2023

Cardiac. Cardiovasc. Res.

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<p>Since Egaz Moniz introduced angiography, neurovascular interventions have undergone significant advancements. The integration of advanced biomaterials has refined endovascular devices and techniques for complex vascular lesions. The domain of neurointerventions includes neuroendovascular surgery, endovascular neurosurgery, and interventional neurology. Notably, in regions with limited neurointerventional specialists, interventional cardiologists are increasingly treating cerebrovascular strokes. The congruence between coronary and carotid interventions has facilitated the development of adaptable cerebrovascular tools, many inspired by those in cardiac catheter labs. This article provides an overview of key developments in neurointerventions, with a focus on the adaptation of tools between coronary and cerebrovascular procedures.</p>

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Section: Wiresmentioning

confidence: 99%

Navigating the crossroads: Insights into cardiology’s influence on neurointerventional procedures

Azab,

Pierre,

Lucke-Wold

2023

Cardiac. Cardiovasc. Res.

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show abstract

Section: Wiresmentioning

confidence: 99%

Untitled

2023

Card. Cardiovasc. Res.

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Since Egaz Moniz introduced angiography, neurovascular interventions have undergone significant advancements.The integration of advanced biomaterials has refined endovascular devices and techniques for complex vascular lesions.The domain of neurointerventions includes neuroendovascular surgery, endovascular neurosurgery, and interventional neurology. Notably, in regions with limited neurointerventional specialists, interventional cardiologists are increasingly treating cerebrovascular strokes. The congruence between coronary and carotid interventions has facilitated the development of adaptable cerebrovascular tools, many inspired by those in cardiac catheter labs. This article provides an overview of key developments in neurointerventions, with a focus on the adaptation of tools between coronary and cerebrovascular procedures.

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“…Long arterial sheaths are commonly used in neurovascular interventions in adults for providing increased support and the ability to deliver multiple intracranial devices. 1,2 Long sheaths have traditionally been avoided in pediatric neu-roendovascular practice, and more so in infants and small children. In each case, the added benefits must be weighed against the larger caliber size and stiffness of these sheaths.…”

Section: Introductionmentioning

confidence: 99%

Long Vascular Sheaths for Transfemoral Neuroendovascular Procedures in Children

Dmytriw¹,

Ha²,

Bickford³

et al. 2021

Neurointervention

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Purpose: To evaluate the safety and efficacy of long vascular sheaths for transfemoral neuroendovascular procedures in children.Materials and Methods: A retrospective evaluation of transfemoral neuroendovascular procedures in children <18 years, using long sheaths was undertaken analyzing procedure type, fluoroscopic times, technical success, access site and systemic complications. Twenty-seven consecutive procedures were included over a two-year period. Mean age was 8.4 years (standard deviation [SD] 6.3) (range 17.0 months–16.3 years).Results: Patients were 44% female and mean weight was 35.0 kg (SD 22.8) (range 9.8–72.2 kg). A third of the procedures were performed in ≤15 kg children. The most common procedure was for embolization (n=13, 48.1%) and the most common indication was dual microcatheter technique (52%). The most common device used was the 5 Fr Cook Shuttle sheath. Mean fluoroscopy time was 61.9 minutes (SD 43.1). Of these procedures, 93% were technically successful. Femoral vasospasm, when present, was self-limiting. Complications (3/27, 11.1%) included groin hematoma (n=1), neck vessel spasm that resolved with verapamil (n=1), and intracranial thromboembolism (n=1), with no significant difference between the ≤15 kg and >15 kg subcohorts. There were no aorto-femoro-iliac or limb-ischemic complications.Conclusion: Long vascular sheaths without short femoral sheaths can be safely used for pediatric neuroendovascular procedures as they effectively increase inner diameter access without increasing the outer sheath diameter. This property increases the range of devices used and intracranial techniques that can be safely performed without arterial compromise, thus increasing the repertoire of the neurointerventionalist.

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Neurointervention for the Peripheral Radiologist: Tips and Tricks

Cited by 8 publications

References 11 publications

Navigating the crossroads: Insights into cardiology’s influence on neurointerventional procedures

Navigating the crossroads: Insights into cardiology’s influence on neurointerventional procedures

Untitled

Long Vascular Sheaths for Transfemoral Neuroendovascular Procedures in Children

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