Mechanism of Action and Biology of Flow Diverters in the Treatment of Intracranial Aneurysms Dec. 2, 2023, 12:19 p.m.
Flow diverters have drastically changed the landscape of intracranial aneurysm treatment and are now considered first-line therapy for select lesions. Their mechanism of action relies on intrinsic alteration in hemodynamic parameters, both at the parent artery and within the aneurysm sac. Moreover, the device struts act as a nidus for endothelial cell growth across the aneurysm neck ultimately leading to aneurysm exclusion from the circulation. In silico computational analyses and investigations in preclinical animal models have provided valuable insights into the underlying biological basis for flow diverter therapy.
Bioresorbable flow diverters for the treatment of intracranial aneurysms Dec. 2, 2023, 12:16 p.m.
The use of flow diverters is a rapidly growing endovascular approach for the treatment of intracranial aneurysms. All FDA-approved flow diverters are composed of nitinol or cobalt-chromium, which will remain in the patient for the duration of their life. Bioresorbable flow diverters have been proposed by several independent investigators as the next generation of flow diverting devices. These devices aim to serve their transient function of occluding and healing the aneurysm prior to being safely resorbed by the body, eliminating complications associated with the permanent presence of conventional flow diverters.
Usage of computational method for hemodynamic analysis of intracranial aneurysm rupture risk in different geometrical aspects Nov. 27, 2023, 3:13 p.m.
The present study has focused on the impacts of the parent vessel mean diameter on the hemodynamic aspects of the cerebral aneurysm with endovascular coiling. Computational approach is used to model the transient blood flow inside the parent vessel and sac area while it is presumed that the blood is not Newtonian fluid. The contours of pressure, WSS and OSI of three nominated ICA aneurysms are compared to disclose the importance of the parent vessel mean diameter on the probability of aneurysm bleeding. Based on the OSI results at early diastolic, increasing parent vessel mean diameter about 40% would decrease the mean OSI on the sac area about 43%.
Initial Experience with the Solitaire X 3 mm Stent Retriever for the Treatment of Distal Medium Vessel Occlusions Nov. 24, 2023, 10:42 p.m.
The new Solitaire X 3 mm is an effective and safe device for performing EVT in MDVOs, as its use is associated with good recanalization rates and an acceptable safety profile. A more thorough and in-depth analysis of its use with more parameters and in a larger patient group could provide us with important insight into this device. Also, in the future, data from currently recruiting RCTs will enable further study on the efficacy of this device, as well as on the optimization of its usage regarding combined EVT approaches to thrombectomy.
Route 92 raises more than US$31 million in oversubscribed Series F equity financing Nov. 22, 2023, 10:23 p.m.
Route 92 claims to have “reimagined” neurovascular intervention through the development of a suite of reperfusion systems leveraging unique designs, including the Tenzing delivery catheter. These products are designed to work harmoniously as a system to improve the efficiency of endovascular thrombectomy procedures, enabling clinicians to quickly restore blood flow to a patient’s brain following acute ischaemic stroke.
Microvention celebrates 10 years and more than 500,000 procedures with Sofia aspiration catheters Nov. 20, 2023, 4:17 p.m.
Microvention’s Sofia aspiration catheter is designed for tracking to the occlusion site and the aspiration of thrombus. Its “exceptionally” soft distal segment allows for excellent navigability and trackability through tortuous anatomy, enabling Sofia to reliably reach the occlusion site, according to the company. In addition, the device’s hybrid braid coil design provides enhanced control while its coil reinforcement enables “lumen integrity, flexibility and excellent shape retention”.
Stroke: What’s new in the 2023 UK National Clinical Guideline edition? Nov. 6, 2023, 11:55 a.m.
The guideline is an initiative of the Intercollegiate Stroke Working Party. The fifth edition of the guideline was published in 2016. The 2023 edition is a partial update of the 2016 edition and was developed in collaboration with the Scottish Intercollegiate Guidelines Network (SIGN) and the National Clinical Programme for Stroke, Ireland. The 2023 edition is endorsed for use in clinical practice by the Royal College of Physicians of London, SIGN and the RCPI. Out of 538 recommendations in this 2023 guideline, almost 300 have been updated, added or endorsed since the 2016 edition.
High biological age may increase the risk of dementia and stroke Nov. 6, 2023, 11:53 a.m.
People who have a higher biological age than their actual chronological age have a significantly increased risk of stroke and dementia, especially vascular dementia. These are the results of a study from Karolinska Institutet in Sweden published in the Journal of Neurology, Neurosurgery and Psychiatry. The study is titled, "Clinical biomarker-based biological aging and future risk of neurological disorders in the UK Biobank."
Intracranial Atherosclerotic Disease Nov. 3, 2023, 7:04 p.m.
Intracranial atherosclerotic disease is a common cause of ischemic stroke, particularly among minorities. Although treatment tailored for this disease involves aggressive risk factor management coupled with short-term dual antiplatelet therapy, ICAD is still associated with the highest rates of recurrent stroke of any stroke subtype. It is imperative that treating neurologists stay vigilant of this stroke mechanism and the nuances of its evaluation and management.
Imperative Care: Elevating Patient CareFor Stroke Nov. 3, 2023, 6:50 p.m.
Imperative Care is addressing gaps across the entire patient journey — from detection through recovery — to elevate care for patients suffering from stroke and other devastating vascular diseases.
Surface Treatment of Polymeric Materials Controlling the Adhesion of Biomolecules Nov. 3, 2023, 2:09 p.m.
For the future many materials can be used for different biomedical applications. Nevertheless, in order to satisfy the conditions of biocompatibility, their surface needs to be modified. The final prospect of the material will determine the properties of the surface and the strategy chosen for its modification. The modification routes have been shown to be strongly dependent on the biologic fluid nature and composition. Depending on the type of the biomolecule(s) and its (their) physicochemical properties, one specific surface modification must be chosen and in our knowledge, no universal surface elaboration has been applied up to this point.
Understanding protein adsorption phenomena at solid surfaces Nov. 3, 2023, 2 p.m.
Protein adsorption at solid surfaces plays a key role in many natural processes and has therefore promoted a widespread interest in many research areas. Despite considerable progress in this field there are still widely differing and even contradictive opinions on how to explain the frequently observed phenomena such as structural rearrangements, cooperative adsorption, overshooting adsorption kinetics, or protein aggregation. In this review recent achievements and new perspectives on protein adsorption processes are comprehensively discussed. The main focus is put on commonly postulated mechanistic aspects and their translation into mathematical concepts and model descriptions.
33,425 Will Have A Stroke On World Stroke Day. Only 1,000 Will Get Lifesaving Treatments Nov. 2, 2023, 5:24 p.m.
There’s an urgent need to re-organize healthcare systems to prioritize stroke treatment, secure adequate funding, and build a well-trained workforce to make this treatment universally accessible,” Dr. Al-Mufti stated. “We call upon policymakers worldwide, especially in low and middle-income countries to direct their attention to this, because a cure for stroke exists.
Smart ‘brain-wave cap’ could help diagnose stroke patients accurately in ambulances Oct. 25, 2023, 12:45 a.m.
Between 2018 and 2022, the smart brain-wave cap was tested in 12 Dutch ambulances, with data being collected from almost 400 patients. The study results now published in Neurology show that the brain-wave cap can recognise patients with a large ischaemic stroke with a high level of accuracy. “This study shows that the brain-wave cap performs well in an ambulance setting,” Coutinho added. “For example, with the measurements of the cap, we can distinguish between a large or small ischaemic stroke.”
Clinical Benefit of First-Pass Recanalization Is Time-Dependent in Endovascular Treatment of Acute Ischemic Stroke Oct. 24, 2023, 1:22 a.m.
Recanalization status by FPR and P-to-R time was significantly and independently associated with functional outcome after mechanical thrombectomy. FPR was associated with functional outcome in a time-dependent manner. Even for patients who achieved FPR, their functional outcome might not be favorable if the P-to-R time was > 30 min. To secure the benefit from FPR, recanalization should be as rapid as possible even in cases with FPR.
Endovascular Device Choice and Tools for Recanalization of Medium Vessel Occlusions Oct. 24, 2023, 1:20 a.m.
Endovascular treatment (EVT) for stroke due to medium vessel occlusion (MeVO) can be technically challenging. Devices and tools are rapidly evolving. We aimed to gain insight into preferences and global perspectives on the usage of endovascular tools in treating MeVOs.
Wall enhancement as a biomarker of intracranial aneurysm instability: a histo‑radiological study Oct. 18, 2023, 2:02 p.m.
Aneurysms with WE present multiple histopathological changes that may contribute to wall disruption and represent the pathophysiological basis of radiological WE. Moreover, WE is an independent diagnostic predictor of aneurysm symptoms and rupture.
"The tables have turned"—US FDA regulation is becoming the envy of Europe Oct. 18, 2023, 1:59 p.m.
Discussions at this year’s European Society of Minimally Invasive Neurological Therapy (ESMINT) congress (4–6 September, Marseille, France) revealed the extent of the disparities between the current regulatory systems in Europe and the USA, with experts and attendees outlining how “the tables have turned” over the past few years, potentially enticing more neurovascular device manufacturers to seek US Food and Drug Administration (FDA) clearance as their first port of call.
Anaconda Biomed granted additional patents for novel stroke thrombectomy technology Oct. 17, 2023, 7:30 a.m.
The focal point of Anaconda’s product portfolio is the ANA5 advanced neurovascular access thrombectomy device, which is specifically designed for use in the anterior and posterior neurovascular vessels—including the internal carotid artery, the M1 and M2 segments of the middle cerebral artery, the basilar artery, the posterior cerebral artery, and the vertebral arteries. ANA5 comprises an aspiration funnel catheter featuring variable stiffness sections to be used in conjunction with a stent retriever. The funnel catheter consists of a radiopaque nitinol braid covered with a silicone coating to enable local flow restriction.
Successful Mechanical Thrombectomy for Basilar Artery Occlusion in a Pediatric Patient: A Case Report Oct. 17, 2023, 7:26 a.m.
Studies have shown the benefits of endovascular treatment (EVT) in adult stroke cases, but its application in pediatric stroke remains controversial. Despite evidence of improved outcomes in adults, there are no established recommendations for EVT in children. Conducting individual case reports and case series is vital to understanding its potential advantages and disadvantages in this context.