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Journal of NeuroInterventional Surgery podcast

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Neurothrombectomy in the late time window: continued benefit in trial ineligible patients

There are two editor's choice papers of the November issue of JNIS are discussed in this podcast. Editor-in-Chief of JNIS, Felipe de Albuquerque, talks to Ashutosh Jadhav and Shashvat Desai, both from the Department of Neurology, University of Pittsburgh Medical Center, Pennsylvania, USA. They are co-authors of the papers: Thrombectomy 6-24 hours after stroke in trial ineligible patients ( Thrombectomy 24 hours after stroke: beyond DAWN...


Unruptured intracranial aneurysms conservatively followed with serial CT angiography

Could morphology and growth predict rupture? Despite several landmark studies, the natural history of unruptured intracranial aneurysms (UIA) remains uncertain. Rob Tarr talks to William Mehan, Division of Neuroradiology, Massachusetts General Hospital, about his paper which aimed to identify or confirm factors predictive of rupture of UIA being observed conservatively with serial CT angiography in a North American patient population. Read the full paper (for free):...


Admission neutrophil–lymphocyte ratio predicts 90 day outcome after endovascular stroke therapy

Immune dysregulation influences outcome following acute ischemic stroke (AIS). Admission white blood cell counts are routinely obtained, making the neutrophil–lymphocyte ratio (NLR) a readily available biomarker of the immune response to stroke. With colleagues Taura Barr, WVU Prevention Research Center, One Medical Center Drive, sought to identify the relationship between NLR and 90 day AIS outcome. Rob Tarr asks her what they found. Read the full paper:


Endovascular recanalization of complete subacute to chronic atherosclerotic occlusions

Symptomatic subacute/chronic large artery intracranial occlusive disease represents a common medical dilemma. A recent JNIS paper reports a multicenter experience of endovascular recanalization of intracranial atherosclerotic occlusions refractory to medical therapy. Robb Tarr talks to co-author Raul Nogueira, Department of Neurology, Marcus Stroke and Neuroscience Center/Grady Memorial Hospital/Emory University. Read the full paper:


Safety and predictors of aneurysm retreatment for remnant intracranial aneurysm

Aneurysmal subarachnoid hemorrhage (SAH) is a rare but devastating form of stroke. Endovascular therapy has been criticized for its higher rate of recanalization and retreatment. The safety and predictors of retreatment are unknown. A recent study in JNIS reports the clinical outcomes, imaging outcomes and predictors for aneurysm retreatment after initial endovascular embolization. Rob Tarr speaks with co-author Dr Osama Zaidat, Vascular and Interventional Neurology/Department of...


Affordable care 2014: A tale of two boards

The Patient Protection and Affordable Care Act (ACA) became law on 23 March 2010. As part of the law, two independent boards were established. The Patient-Centered Outcomes Research Institute embodies national aspirations for employing comparative effectiveness research in healthcare decision-making, and the Independent Payment Advisory Board is focused on the need for a group of impartial experts to establish anticipatable growth rates for Medicare. Approximately 4 years after the bill...


Flat detector derived parenchymal blood volume maps to estimate cerebral blood volume

Newer flat panel angiographic detector (FD) systems have the capability to generate parenchymal blood volume (PBV) maps. The ability to generate these maps in the angiographic suite has the potential to markedly expedite the triage and treatment of patients with acute ischemic stroke. David Fiorella, Department of Neurological Surgery, Stony Brook University Medical Center, NY, and colleagues, have compared FP-PBV maps with cerebral blood volume (CBV) maps derived using standard dynamic...


Current Procedural Terminology

US physicians nearly universally use the CPT coding system. This code set communicates medical, procedural, surgical and diagnostic services and is a critical component of describing the work we do. Drs. Josh Hirsch, Jackie Bello and Raymond Tu are actively involved in the world of physician reimbursement through their associations with the Relative-Value Update Committee (RUC) and Current Procedural Terminology (CPT) committees. In this podcast they discuss the role CPT plays in...


The ADAPT technique in the clinic: A direct aspiration first pass technique for stroke thrombectomy

The development of new revascularization devices has improved recanalization rates and time but not clinical outcomes. In a paper in May's JNIS, Aquilla Turk, Department of Radiology, Medical University of South Carolina, ad colleagues, report their initial results with a new technique utilizing a direct aspiration first pass technique with a large bore aspiration catheter as the primary method for vessel recanalization. Rob Tarr discusses the findings with Dr Turk and also Marc...