Tzu Chi Medical Journal
Volume 20, Issue 3 , Pages 177-187, September 2008

Current Status of Interventional Neuroradiology (Neurointerventional Surgery)

  • Hon-Man Liu

      Affiliations

    • Corresponding Author InformationCorresponding author. Department of Medical Imaging and Radiology, National Taiwan University Hospital, 7, Chung-Shan South Road, Taipei, Taiwan

Department of Medical Imaging and Radiology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan

Received 20 September 2007; received in revised form 9 October 2007; accepted 1 November 2007.

Article Outline

Abstract 

This article provides an overview of different neurointerventional procedures by reviewing important papers relevant to neurovascular disease and the latest concept of endovascular treatment. The focus was on studies that dealt with cerebral aneurysm, arteriovenous malformation, direct carotidcavernous fistula, dural arteriovenous fistula, intracranial atherosclerosis, and acute symptomatic intracranial arterial occlusion. Studies on extracranial atherosclerosis and other nonvascular part were excluded. Interventional neuroradiology is a well-developed subspecialty that mainly treats neurovascular disease in a less invasive way. Advances in new technology and knowledge will make it an important method to treat different disorders in future.

Keywords:  Aneurysm , Arteriovenous malformation , Fistulae , Interventional , Intracranial atherosclerosis

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References 

  1. Molyneux A , Kerr R , Stratton I , et al.   International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial . Lancet . 2002;360:1267–1274
  2. Molyneux AJ , Kerr RS , Yu LM , et al.   The International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effect on survival, dependency, seizures, rebleeding, subgroups, analyses occlusion . Lancet . 2005;366:809–817
  3. Macdonald RL , Wallace MC , Kestle JR . The Role of angiography following aneurysm surgery . J Neurosurg . 1993;79:826–832
  4. Debrun GM , Aletich VA , Kehrli P , Misra M , Ausman JI , Charbel F . Selection of cerebral aneurysms for treatment using Guglielmi detachable coils: the preliminary University of Illinois at Chicago experience . Neurosurgery . 1998;43:1281–1297
  5. Fernandez Zubillaga A , Guglielmi G , Vinuela F , Duckwiler GR . Endovascular occlusion of intracranial aneurysms with electrically detachable coils: correlation of aneurysm neck size and treatment results . AJNR Am J Neuroradiol . 1994;15:815–820
  6. Vinuela F , Duckwiler G , Mawad M . Guglielmi detachable coil embolization of acute intracranial aneurysm: perioperative anatomical and clinical outcome in 403 patients . J Neurosurg . 1997;86:475–482
  7. Moret J , Cognard C , Weill A , Castaings L , Rey A . Reconstruction technique in the treatment of wideneck intracranial aneurysms. Long-term angiographic and clinical results. Apropos of 56 cases . J Neuroradiol . 1997;24:30–44 [In French]
  8. Akiba Y , Murayama Y , Vinuela F , Lefkowitz MA , Duckwiler GR , Gobin YP . Balloon-assisted Guglielmi detachable coiling of widenecked aneurysms: part I—Experimental evaluation . Neurosurgery . 1999;45:519–530
  9. Aletich VA , Debrun GM , Misra M , Charbel F , Ausman JI . The remodeling technique of balloonassisted Guglielmi detachable coil placement in widenecked aneurysms: experience at the University of Illinois at Chicago . J Neurosurg . 2000;93:388–396
  10. Lefkowitz MA , Gobin YP , Akiba Y , et al.   Balloon-assisted Guglielmi detachable coiling of widenecked aneurysms: part II—clinical results . Neurosurgery . 1999;45:531–538
  11. Malek AM , Halbach VV , Phatouros CC , et al.   Balloon-assist technique for endovascular coil embolization of geometrically difficult intracranial aneurysms . Neurosurgery . 2000;46:1397–1407
  12. Nelson PK , Levy DI . Balloon-assisted coil embolization of widenecked aneurysms of the internal carotid artery: mediumterm angiographic and clinical followup in 22 patients . AJNR Am J Neuroradiol . 2001;22:19–26
  13. Benitez RP , Silva MT , Klem J , Veznedaroglu E , Rosenwasser RH . Endovascular occlusion of widenecked aneurysms with a new intracranial Microstent (Neuroform) and detachable coils . Neurosurgery . 2004;54:1359–1368
  14. Rosenwasser RH , Armonda RA , Thomas JE , Benitez RP , Gannon PM , Harrop J . Therapeutic modalities for the management of cerebral vasospasm: timing of endovascular options . Neurosurgery . 1999;44:975–980
  15. Fiorella D , Albuquerque FC , Han P , McDougall CG . Preliminary experience using the Neuroform stent for the treatment of cerebral aneurysms . Neurosurgery . 2004;54:6–17
  16. Lylyk P , Ferrario A , Pasbon B , Miranda C , Doroszuk G . Buenos Aires experience with the Neuroform selfexpanding stent for the treatment of intracranial aneurysms . J Neurosurg . 2005;102:235–241
  17. Fiorella D , Albuquerque FC , Deshmukh VR , McDougall CG . In-stent stenosis as a delayed complication of neuroform stentsupported coil embolization of an incidental carotid terminus aneurysm . AJNR Am J Neuroradiol . 2004;25:1764–1767
  18. Murayama Y , Tateshima S , Gonzalez NR , Vinuela F . Matrix and bioabsorbable polymeric coils accelerate healing of intracranial aneurysms: longterm experimental study . Stroke . 2003;34:2031–2037
  19. Murayama Y , Vinuela F , Tateshima S , Song JK , Gonzalez NR , Wallace MP . Bioabsorbable polymeric material coils for embolization of intracranial aneurysms: a preliminary experimental study . J Neurosurg . 2001;94:454–463
  20. Cloft HJ . HydroCoil for Endovascular Aneurysm Occlusion (HEAL) study: periprocedural results . AJNR Am J Neuroradiol . 2006;27:289–292
  21. Fiorella D , Albuquerque FC , McDougall CG . Durability of aneurysm embolization with matrix detachable coils . Neurosurgery . 2006;58:51–59
  22. Niimi Y , Song J , Madrid M , Berenstein A . Endosaccular treatment of intracranial aneurysms using matrix coils: early experience and midterm follow-up . Stroke . 2006;37:1028–1032
  23. Crawford PM , West CR , Chadwick DW , Shaw MD . Arteriovenous malformations of the brain: natural history in unoperated patients . J Neurol Neurosurg Psychiatry . 1986;49:1–10
  24. Deruty R , Pelissou-Guyotat I , Morel C , Bascoulergue Y , Turjman F . Reflections on the management of cerebral arteriovenous malformations . Surg Neurol . 1998;50:245–256
  25. Mast H , Young WL , Koennecke HC , et al.   Risk of spontaneous hemorrhage after diagnosis of cerebral arteriovenous malformation . Lancet . 1997;350:1065–1068
  26. Graf CJ , Perrett GE , Torner JC . Bleeding from cerebral arteriovenous malformations as part of their natural history . J Neurosurg . 1983;58:331–337
  27. Itoyama Y , Uemura S , Ushio Y , et al.   Natural course of unoperated arteriovenous malformations: study of 50 cases . J Neurosurg . 1989;71:805–809
  28. Jane JA , Kassell NF , Torner JC , Winn HR . The natural history of aneurysms and arteriovenous malformations . J Neurosurg . 1985;62:321–323
  29. Hamilton MG , Spetzler RF . The prospective application of a grading system for arteriovenous malformations . Neurosurgery . 1994;34:2–7
  30. Heros RC , Korosue K , Diebold PM . Surgical excision of cerebral arteriovenous malformations: late results . Neurosurgery . 1990;26:570–578
  31. Han PP , Ponce FA , Spetzler RF . Intention-to-treat analysis of Spetzler-Martin grade IV and V arteriovenous malformations: natural history and treatment paradigm . J Neurosurg . 2003;98:3–7
  32. Jafar JJ , David AJ , Berenstein A , Choi IS , Kupersmith MJ . The effect of embolization with N-butyl cyanoacrylate prior to surgical resection of cerebral arteriovenous malformations . J Neurosurg . 1993;78:60–69
  33. DeMeritt JS , Pile-Spellman J , Mast H , et al.   Outcome analysis of preoperative embolization with N-butyl cyanoacrylate in cerebral arteriovenous malformations . AJNR Am J Neuroradiol . 1995;16:1801–1807
  34. Miyamoto S , Hashimoto N , Nagata I , et al.   Posttreatment sequelae of palliatively treated cerebral arteriovenous malformations . Neurosurgery . 2000;46:589–595
  35. Wikholm G , Lundqvist C , Svendsen P . The Goteborg cohort of embolized cerebral arteriovenous malformations: a 6-year follow-up . Neurosurgery . 2001;49:799–806
  36. Vinuela F , Duckwiler G , Guglielmi G . Contribution of interventional neuroradiology in the therapeutic management of brain arteriovenous malformations . J Stroke Cerebrovasc Dis . 1997;4:268–271
  37. Gobin YP , Laurent A , Merienne L , et al.   Treatment of brain arteriovenous malformations by embolization and radiosurgery . J Neurosurg . 1996;85:19–28
  38. Fournier D , TerBrugge KG , Willinsky R , Lasjaunias P , Montanera W . Endovascular treatment of intracerebral arteriovenous malformations: experience in 49 cases . J Neurosurg . 1991;75:228–233
  39. Wikholm G , Lundqvist C , Svendsen P . Embolization of cerebral arteriovenous malformations: part I—technique, morphology, and complications . Neurosurgery . 1996;39:448–459
  40. Liu HM , Huang YC , Wang YH . Embolization of cerebral arteriovenous malformations with n-butyl-2-cyanoacrylate . J Formos Med Assoc . 2000;99:906–913
  41. Yu SC , Chan MS , Lam JM , Tam PH , Poon WS . Complete obliteration of intracranial arteriovenous malformation with endovascular cyanoacrylate embolization: initial success and rate of permanent cure . AJNR Am J Neuroradiol . 2004;25:1139–1143
  42. Valavanis A , Christoforidis G . Endovascular management of cerebral arteriovenous malformations . Neurointerventionist . 1999;1:34–40
  43. Jahan R , Murayama Y , Gobin YP , Duckwiler GR , Vinters HV , Vinuela F . Embolization of arteriovenous malformations with Onyx: clinicopathological experience in 23 patients . Neurosurgery . 2001;48:984–997
  44. Murayama Y , Vinuela F , Ulhoa A , et al.   Nonadhesive liquid embolic agent for cerebral arteriovenous malformations: preliminary histopathological studies in swine rete mirabile . Neurosurgery . 1998;43:1164–1175
  45. Frizzel RT , Fisher WS . Cure, morbidity and mortality associated with embolization of brain arteriovenous malformations: a review of 1246 patients in 32 series over a 35-year period . Neurosurgery . 1995;37:1031–1040
  46. Richling B , Killer M . Endovascular management of patients with cerebral arteriovenous malformations . Neurosurg Clin N Am . 2000;11:123–145
  47. Taylor CL , Dutton K , Rappard G , et al.   Complications of preoperative embolization of cerebral arteriovenous malformations . J Neurosurg . 2004;100:810–812
  48. Halbach VV , Hieshima GB , Higashida RT , Reicher M . Carotid cavernous fistulae: indications for urgent treatment . AJR Am J Roentgenol . 1987;149:587–593
  49. Halbach VV , Higashida RT , Hieshima GB , Hardin CW , Yang PJ . Transvenous embolization of direct carotid cavernous fistulas . AJNR Am J Neuroradiol . 1988;9:741–747
  50. Halbach VV , Higashida RT , Hieshima GB , Hardin CW , Pribram H . Transvenous embolization of dural fistulas involving the cavernous sinus . AJNR Am J Neuroradiol . 1989;10:377–383
  51. Halbach VV , Higashida RT , Hieshima GB , Mehringer CM , Hardin CW . Transvenous embolization of dural fistulas involving the transverse and sigmoid sinuses . AJNR Am J Neuroradiol . 1989;10:385–392
  52. Yamashita K , Taki W , Nishi S , et al.   Transvenous embolization of dural caroticocavernous fistulae: technical considerations . Neuroradiology . 1993;35:475–479
  53. Kadyrov NA , Friedman JA , Nichols DA , Cohen-Gadol AA , Link MJ , Piepgras DG . Endovascular treatment of an internal carotid artery pseudoaneurysm following transsphenoidal surgery. Case report . J Neurosurg . 2002;96:624–627
  54. Kocer N , Kizilkilic O , Albayram S , Adaletli I , Kantarci F , Islak C . Treatment of iatrogenic internal carotid artery laceration and carotid cavernous fistula with endovascular stentgraft placement . AJNR Am J Neuroradiol . 2002;23:442–446
  55. Redekop G , Marotta T , Weill A . Treatment of traumatic aneurysms and arteriovenous fistulas of the skull base by using endovascular stents . J Neurosurg . 2001;95:412–419
  56. Weber W , Henkes H , Berg-Dammer E , Esser J , Kuhne D . Cure of a direct carotid cavernous fistula by endovascular stent deployment . Cerebrovasc Dis . 2001;12:272–275
  57. Lewis AI , Tomsick TA , Tew JM , Lawless MA . Long-term results in direct carotidcavernous fistulas after treatment with detachable balloons . J Neurosurg . 1996;84:400–404
  58. Desal H , Leaute F , Auffray-Calvier E , et al.   Direct carotidcavernous fistula. Clinical, radiologic and therapeutic studies. Apropos of 49 cases . J Neuroradiol . 1997;24:141–154
  59. Sergott RC , Grossman RI , Savino PJ , Bosley TM , Schatz NJ . The syndrome of paradoxical worsening of duralcavernous sinus arteriovenous malformations . Ophthalmology . 1987;94:205–212
  60. Morris P . Practical Neuroangiography . Baltimore: Williams & Wilkins; 1997;
  61. Newton TH , Cronqvist S . Involvement of dural arteries in intracranial arteriovenous malformations . Radiology . 1969;93:1071–1078
  62. Newton TH , Hoyt WF . Spontaneous arteriovenous fistula between dural branches of the internal maxillary artery and the posterior cavernous sinus . Radiology . 1968;91:1147–1150
  63. Taniguchi RM , Goree JA , Odom GL . Spontaneous carotidcavernous shunts presenting diagnostic problems . J Neurosurg . 1971;35:384–391
  64. Toya S , Shiobara R , Izumi J , Shinomiya Y , Shiga H , Kimura C . Spontaneous carotidcavernous fistula during pregnancy or in the postpartum stage. Report of two cases . J Neurosurg . 1981;54:252–256
  65. Urtasun F , Biondi A , Casaco A , et al.   Cerebral dural arteriovenous fistulas: percutaneous transvenous embolization . Radiology . 1996;199:209–217
  66. Merland JJ , Bories J , Djindjian R . Normal and pathological blood supply of the cranial vault . J Neuroradiol . 1977;4:95–127
  67. Cognard C , Gobin YP , Pierot L , et al.   Cerebral dural arteriovenous fistulas: clinical and angiographic correlation with a revised classification of venous drainage . Radiology . 1995;194:671–680
  68. Hurst RW , Hackney DB , Goldberg HI , Davis RA . Reversible arteriovenous malformationinduced venous hypertension as a cause of neurological deficits . Neurosurgery . 1992;30:422–425
  69. Higashida RT , Hieshima GB , Halbach VV , Bentson JR , Goto K . Closure of carotid cavernous sinus fistulae by external compression of the carotid artery and jugular vein . Acta Radiol Suppl . 1986;369:580–583
  70. Liu HM , Wang YH , Chen YF , Cheng JS , Yip PK , Tu YK . Longterm clinical outcome of spontaneous carotid cavernous sinus fistulae supplied by dural branches of the internal carotid artery . Neuroradiology . 2001;43:1007–1014
  71. Halbach VV , Higashida RT , Hieshima GB , Reicher M , Norman D , Newton TH . Dural fistulas involving the cavernous sinus: results of treatment in 30 patients . Radiology . 1987;163:437–442
  72. Picard L , Bracard S , Mallet J , et al.   Spontaneous dural arteriovenous fistulas . Semin Interv Radiol . 1987;4:219–240
  73. Turjman F , Bascoulergue Y , Rosenberg M , Laharotte JC , Tournut P , Duguesnel J . Dural fistulae of the cavernous sinus treated by embolization. Ten cases . J Neuroradiol . 1992;19:256–270
  74. Houdart E , Saint-Maurice JP , Chapot R , et al.   Transcranial approach for venous embolization of dural arteriovenous fistulas . J Neurosurg . 2002;97:280–286
  75. Teng MM , Lirng JF , Chang T , et al.   Embolization of carotid cavernous fistula by means of direct puncture through the superior orbital fissure . Radiology . 1995;194:705–711
  76. Cheng KM , Chan CM , Cheung YL . Transvenous embolisation of dural carotidcavernous fistulas by multiple venous routes: a series of 27 cases . Acta Neurochir (Wien) . 2003;145:17–29
  77. Gobin YP , Houdart E , Rogopoulos A , Casasco A , Bailly AL , Merland JJ . Percutaneous transvenous embolization through the thrombosed sinus in transverse sinus dural fistula . AJNR Am J Neuroradiol . 1993;14:1102–1105
  78. Endo S , Kuwayama N , Takaku A , Nishilima M . Direct packing of the isolated sinus in patients with dural arteriovenous fistulas of the transversesigmoid sinus . J Neurosurg . 1998;88:449–456
  79. Liu HM , Huang YC , Wang YH , Tu YK . Transarterial embolisation of complex cavernous sinus dural arteriovenous fistulae with lowconcentration cyanoacrylate . Neuroradiology . 2000;42:766–770
  80. Meyers PM , Halbach VV , Dowd CF , et al.   Dural carotid cavernous fistula: definitive endovascular management and longterm follow-up . Am J Ophthalmol . 2002;134:85–92
  81. Aihara N , Mase M , Yamada K , et al.   Deterioration of ocular motor dysfunction after transvenous embolization of dural arteriovenous fistula involving the cavernous sinus . Acta Neurochir (Wien) . 1999;141:707–710
  82. Kupersmith MJ , Berenstein A , Choi IS , Warren F , Flamm E . Management of nontraumatic vascular shunts involving the cavernous sinus . Ophthalmology . 1988;95:121–130
  83. Huang Q , Li T , Duan C , et al.   Interventional treatment of dural arteriovenous fistula . Zhonghua Wai Ke Za Zhi . 2002;40:682–684
  84. Bhatt DL , Fox KA , Hacke W , et al.   Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events . N Engl J Med . 2006;354:1706–1717
  85. Diener HC , Cunha L , Forbes C , Sivenius J , Smets P , Lowenthal A . European Stroke Prevention Study. 2 Dipyridamole and acetylsalicylic acid in the secondary prevention of stroke . J Neurol Sci . 1996;143:1–13
  86. CAPRIE Steering Committee  . A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE) . Lancet . 1996;348:1329–1339
  87. Chimowitz MI , Lynn MJ , Howlett-Smith H , et al.   Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis . N Engl J Med . 2005;352:1305–1316
  88. Ecker RD , Levy EI , Sauvageau E , Hanel RA , Hopkins LN . Current concepts in the management of intracranial atherosclerotic disease . Neurosurgery . 2006;59(5 Suppl 3):S210–S218
  89. SSYLVIA Study Investigators  . Stenting of Symptomatic Atherosclerotic Lesions in the Vertebral or Intracranial Arteries (SSYLVIA): study results . Stroke . 2004;35:1388–1392
  90. Jiang WJ , Wang YJ , Du B , et al.   Stenting of symptomatic M1 stenosis of middle cerebral artery: an initial experience of 40 patients . Stroke . 2004;35:1375–1380
  91. Bose A , Hartmann M , Henkes H , et al.   A novel, selfexpanding, nitinol stent in medically refractory intracranial atherosclerotic stenoses: the Wingspan study . Stroke . 2007;38:1531–1537
  92. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group  . Tissue plasminogen activator for acute ischaemic stroke . N Engl J Med . 1995;333:1581–1587
  93. Ibers GW , Amarenco P , Easton JD , Sacco RL , Teal P . Antithrombotic and thrombolytic therapy for ischemic stroke: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy . Chest . 2004;126:483S–512S
  94. Clark WM , Wissman S , Albers GW , Jhamandas JH , Madden KP , Hamilton S . Recombinant tissuetype plasminogen activator (alteplase) for ischemic stroke 3 to 5 hours after symptom onset. The ATLANTIS Study: a randomized controlled trial. Alteplase Thrombolysis for Acute Noninterventional Therapy in Ischemic Stroke . JAMA . 1999;282:2019–2026
  95. Donnan GA , Davis SM , Chambers BR , et al.   Streptokinase for acute ischemic stroke with relationship to time of administration: Australian Streptokinase (ASK) Trial Study Group . JAMA . 1996;276:961–966
  96. Hacke W , Kaste M , Fieschi C , et al.   Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke. The European Cooperative Acute Stroke Study (ECASS) . JAMA . 1995;274:1017–1025
  97. Hacke W , Kaste M , Fieschi C , et al.   Randomised doubleblind placebocontrolled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II). Second European-Australasian Acute Stroke Study Investigators . Lancet . 1998;352:1245–1251
  98. The Multicentre Acute Stroke Trial-Europe Study Group  . Thrombolytic therapy with streptokinase in acute ischemic stroke . N Engl J Med . 1996;335:145–150
  99. Multicentre Acute Stroke Trial-Italy (MAST-I) Group  . Randomised controlled trial of streptokinase, aspirin, and combination of both in treatment of acute ischaemic stroke . Lancet . 1995;346:1509–1514
  100. Del Zoppo GJ , Higashida RT , Furlan AJ , Pessin MS , Rowley HA , Gent M . PROACT: a phase II randomized trial of recombinant prourokinase by direct arterial delivery in acute middle cerebral artery stroke. PROACT Investigators. Prolyse in Acute Cerebral Thromboembolism . Stroke . 1998;29:4–11
  101. Furlan A , Higashida R , Wechsler L , et al.   Intra-arterial prourokinase for acute ischemic stroke. The PROACT II study: a randomized controlled trial. Prolyse in Acute Cerebral Thromboembolism . JAMA . 1999;282:2003–2011
  102. Qureshi AI , Siddiqui AM , Kim SH , et al.   Reocclusion of recanalized arteries during intraarterial thrombolysis for acute ischemic stroke . AJNR Am J Neuroradiol . 2004;25:322–328
  103. Ringer AJ , Qureshi AI , Fessler RD , Guterman LR , Hopkins LN . Angioplasty of intracranial occlusion resistant to thrombolysis in acute ischemic stroke . Neurosurgery . 2001;48:1282–1290
  104. Fitzsimmons BF , Becske T , Nelson PK . Rapid stentsupported revascularization in acute ischemic stroke . AJNR Am J Neuroradiol . 2006;27:1132–1134
  105. Gobin YP , Starkman S , Duckwiler GR , et al.   MERCI 1: a phase 1 study of Mechanical Embolus Removal in Cerebral Ischemia . Stroke . 2004;35:2848–2854
  106. Gupta R , Vora NA , Horowitz MB , et al.   Multimodal reperfusion therapy for acute ischemic stroke: factors predicting vessel recanalization . Stroke . 2006;37:986–990
  107. Levy EI, Ecker RD, Hanel RA, Sauvageau E, Wehman JC, Guterman LR, et al. Acute M2 bifurcation stenting for cerebral infarction. Lessons learned from the heart: technical case report . Neurosurgery . 2006;58:E588
  108. Levy EI , Ecker RD , Horowitz MB , et al.   Stent-assisted intracranial recanalization for acute stroke: early results . Neurosurgery . 2006;58:458–463
  109. Ramee SR , Subramanian R , Felberg RA , et al.   Catheterbased treatment for patients with acute ischemic stroke ineligible for intravenous thrombolysis . Stroke . 2004;35:e109–e111
  110. Sauvageau E , Levy EI . Self-expanding stentassisted middle cerebral artery recanalization: technical note . Neuroradiology . 2006;48:405–408
  111. Smith WS , Sung G , Starkman S , et al.   Safety and efficacy of mechanical embolectomy in acute ischemic stroke: results of the MERCI trial . Stroke . 2005;36:1432–1438
  112. Kase CS , Furlan AJ , Wechsler LR , et al.   Cerebral hemorrhage after intraarterial thrombolysis for ischemic stroke: the PROACT II trial . Neurology . 2001;57:1603–1610
  113. Suarez JI , Sunshine JL , Tarr R , et al.   Predictors of clinical improvement, angiographic recanalization, and intracranial hemorrhage after intraarterial thrombolysis for acute ischemic stroke . Stroke . 1999;30:2094–2100
  114. Smith S , for the Multi-MERCI Investigators  . Results of the Multi-MERCI trial . Stroke . 2006;37:711–712
  115. Levy EI , Sauvageau E , Hanel RA , Parikh R , Hopkins LN . Self-expanding versus balloonmounted stent-assisted recanalization following embolic occlusion in the canine model: technical feasibility study . AJNR Am J Neuroradiol . 2006;27:2069–2072
  116. Levy EI , Mehta R , Gupta R , et al.   Self-expanding stents for recanalization of acute cerebrovascular occlusions . AJNR Am J Neuroradiol . 2007;28:816–822
  117. Alexandrov AV , Molina CA , Grotta JC , et al.   Ultrasoundenhanced systemic thrombolysis for acute ischemic stroke . N Engl J Med . 2004;351:2170–2178
  118. Ng PP , Higashida RT , Cullen SP , Malek R , Dowd CF , Halbach VV . Intraarterial thrombolysis trials in acute ischaemic stroke . J Vasc Interv Radiology . 2004;15:S77–S85
  119. Mandava P , Kent TA . Intraarterial therapies for acute ischemic stroke . Neurology . 2007;68:2132–2139

PII: S1016-3190(08)60033-6

doi:10.1016/S1016-3190(08)60033-6

Tzu Chi Medical Journal
Volume 20, Issue 3 , Pages 177-187, September 2008

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