Daniel Behme

• Professor
• Head of department at University Hospital Magdeburg

Background To date, all computerised perivascular spaces (PVS) quantification methods require case‐wise, imaging modality, or study‐specific parameter adjustments, and suffer from generalisability problems in clinical settings, and misdetection of other cerebral small vessel disease (CSVD) markers. We propose a deep learning‐based PVS detection met...

For patients with symptomatic acute occlusions of the internal carotid artery below the circle of Willis, endovascular and best medical treatment were both effective and safe therapeutic options.

Objective Subtraction angiographies are calculated using a native and a contrast-enhanced 3D angiography images. This minimizes both bone and metal artifacts and results in a pure image of the vessels. However, carrying out the examination twice means double the radiation dose for the patient. With the help of generative AI, it could be possible to...

Intracranial mirror aneurysms are pathologic dilatations of cerebral arteries that occur at identical locations in both hemispheres. They do not always have identical sizes, shapes, or rupture states, despite identical patient-specific risk factors. As a subgroup of multiple aneurysms and thus small amounts of data, clinical research about their ca...

During neuroradiological interventions such as treating intracranial aneurysms, neuroradiologists have to navigate a catheter in the 3D anatomy while watching a 2D projection of the vessels. To train this visuospatial ability, we present a virtual reality application where the user has to identify anatomically relevant positions on the Circle of Wi...

Background MR perfusion is a standard marker to distinguish progression and therapy-associated changes after surgery and radiochemotherapy for glioblastoma. TRAMs (Treatment Response Assessment Maps) were introduced, which are intended to facilitate the differentiation of vital tumor cells and radiation necrosis by means of late (20–90 min) contras...

We present a framework with two options for selecting a subgroup of training cases for intracranial aneurysm (IA) treatment. Option one, general training, describes training cases that represent a variety of different IAs that represent the diversity of real world cases. This can be achieved via instance selection (IS), which reduces size of a data...

Introduction Creating 3D-DSA scans of the brain results in notable radiation exposure for patients and staff.¹ Nevertheless, the quality of the subtraction series is frequently undermined by patient motion. Aim of Study This study aims to generate subtraction volumes exclusively from contrast-enhanced series using a Generative Adversarial Network...

Introduction The flow characteristics of bifurcation aneurysms of the posterior communicating artery (PCOM) have rarely been studied. Especially in the presence of a fetal posterior circulation (FPC), the likelihood of complete PCOM aneurysm occlusion after endovascular treatment is reduced. Due to this, PCOM aneurysms in anatomical variations of t...

Introduction The emerging use of flow diverters in the treatment of intracranial aneurysms is associated with a risk of neurological morbidity due to their thrombogenicity.⁽¹⁻³⁾ The Derivo 2 Embolization Device (Acandis, Pforzheim, Germany) has proven to be a safe and effective flow diverter.⁽⁴⁻⁵⁾ To overcome the risk of thrombo-embolism, the devic...

Introduction It is not possible to clearly delineate pathological changes in the inner vessel wall with digital subtraction angiography. Angioscopy enables the detection of endothelial pathologies, as demonstrated in the cardiovascular system.[1] In the case of the internal carotid artery, angioscopic imaging has the potential to visualize patholog...

Background: Dementia can be caused by numerous different diseases that present variable clinical courses and reveal multiple patterns of brain atrophy, making its accurate early diagnosis by conventional examinative means challenging. Although highly accurate and powerful, magnetic resonance imaging (MRI) currently plays only a supportive role in d...

Zusammenfassung Kardiovaskuläre Risikofaktoren (Bluthochdruck, Rauchen, Übergewicht, Diabetes mellitus Typ 2, Dyslipidämie, körperliche Inaktivität) steigen mit zunehmendem Alter, insbesondere ab dem mittleren Erwachsenenalter, deutlich an, wobei Frauen wesentlich stärker betroffen sind. In der Bevölkerung Sachsen-Anhalts ist die Prävalenz kardiova...

Backround The use of flow diverting stents in the treatment of intracranial aneurysms is associated with a risk of neurological morbidity due to their thrombogenicity. To reduce this risk different surface modifications have been developed. The Derivo 2 Embolization Device (Acandis, Pforzheim, Germany) has proven to be a safe and effective flow div...

Objective Epidemiological data indicate a high prevalence of cognitive dysfunction and dementia risk in patients with heart failure with preserved ejection fraction (HFpEF). However, underlying mechanisms are yet not fully understood. Common risk factors for HFpEF and cognitive decline are hypertension and arterial stiffness, which are characterize...

Background Data on impact of COVID‐19 vaccination and outcomes of patients with COVID‐19 and acute ischemic stroke undergoing mechanical thrombectomy are scarce. Addressing this subject, we report our multicenter experience. Methods and Results This was a retrospective analysis of patients with COVID‐19 and known vaccination status treated with me...

INTRODUCTION The Derivo 2 Flow diverter has been previously described for the treatment of intracranial aneurysms. To overcome the risk of in-stent thrombosis and thrombo-embolism as a well-known risk of intracranial flow diverter implantation, the device was modified by adding an antithrombogenic fibrin-heparin coating. The fibrin network aims at...

Background Sporadic cerebral small-vessel disease (CSVD), i.e., hypertensive arteriopathy (HA) and cerebral amyloid angiopathy (CAA), is the main cause of spontaneous intracerebral hemorrhage (ICH). Nevertheless, a substantial portion of ICH cases arises from non-CSVD etiologies, such as trauma, vascular malformations, and brain tumors. While studi...

Background and purpose The value of intravenous thrombolysis (IVT) in eligible tandem lesion patients undergoing endovascular treatment (EVT) is unknown. We investigated treatment effect heterogeneity of EVT + IVT versus EVT‐only in tandem lesion patients. Additional analyses were performed for patients undergoing emergent internal carotid artery (...

Due to their effect on aneurysm hemodynamics, flow diverters (FD) have become a routine endovascular therapy for intracranial aneurysms. Since over- and undersizing affect the device’s hemodynamic abilities, selecting the correct device diameter and accurately simulating FD placement can improve patient-specific outcomes. The purpose of this study...

Minimally-invasive therapies are well-established treatment methods for saccular intracranial aneurysms (SIAs). Knowledge concerning fusiform IAs (FIAs) is low, due to their wide and alternating lumen and their infrequent occurrence. However, FIAs carry risks like ischemia and thus require further in-depth investigation. Six patient-specific IAs, c...

Background Stent-assisted coiling (SAC) is a well-established method for treatment of wide-necked intracranial aneurysms. In this multicenter, retrospective case series we evaluated SAC with a new low-profile, laser-cut stent with an antithrombogenic hydrophilic polymer coating (pEGASUS-HPC) for the treatment of intracranial aneurysms. Methods Pat...

Background Peritumoral edema is an important cause of morbidity and mortality in patients with breast cancer brain metastases (BCBM). The relationship between vasogenic edema and proliferation indices or cell density in BCBM remains poorly understood. Purpose To assess the association between tumor volume and peritumoral edema volume and histopath...

Extent of resection (EOR) predicts progression-free survival (PFS) and may impact overall survival (OS) in patients with glioblastoma. We recently demonstrated that 5-aminolevulinic acid-(5-ALA)-fluorescence-enhanced endoscopic surgery increase the rate of gross total resection. However, it is hitherto unknown whether fluorescence-enhanced endoscop...

BACKGROUND AND OBJECTIVES Spontaneous intracranial hypotension is recognized as a cause for refractory headache. Treatment can range from blind blood patch injection to microsurgical repair of the cerebrospinal fluid (CSF) leak. The objective of the study was to investigate the safety and efficacy of the targeted blood patch injection (TBPI) techni...

The use of 3D printing technology for medical applications is becoming increasingly popular. Recent stereolithography (SLA)-based printing methods allow the generation of complex structures with a high surface quality. This is particularly useful for applications in the neurovascular field, where sophisticated structures are involved. In this study...

Vascular diseases like aneurysms or atherosclerosis belong to the leading causes of death. For diagnosis and treatment, medical imaging is essential. Standard imaging methods are Ultrasound, X-ray-based Angiography, Computed tomography or Magnet Resonant Imaging. Additionally, Intravascular Ultrasound or Optical Coherence Tomography are available f...

Introduction Clear delineation of intracranial aneurysms (IA) on angiographic working projections is essential for endovascular treatment to achieve successful occlusion and avoid complications. However, only little is known about what different interventional neuroradiologists (INRs) understand as optimal biplane IA working projections and how muc...

Introduction The Derivo 2 Flow diverter has been previously described for the treatment of intracranial aneurysms. To overcome the risk of in-stent thrombosis and thrombo-embolism the device was modified by adding an anti-thrombogenic fibrin-heparin coating. The fibrin network aims at surface passivation, reduction of inflammatory reactions and end...

Introduction 3D-printed vessel trees with intracranial aneurysms (IA) are regularly used for angiographic training of neuroradiologists in endovascular therapies. The anatomically correct orientation is often lost. The actual surrounding skull bone is missing, which in part decisively influences the X-ray visibility of the IAs.Aim of Study: Create...

Introduction In this retrospective case series we evaluated stent-assisted coiling with a new low profile lasercut stent (pegasus, Phenox gmbh, Bochum, Germany) Aim of Study To evaluate the performance of the pegasus stent system for aneurysm treatment. Methods Patients treated with stent assisted coiling for intracranial aneurysm(s), with or wit...

Background The periprocedural antithrombotic regimen might affect the risk-benefit profile of emergent carotid artery stenting (eCAS) in patients with acute ischemic stroke (AIS) due to tandem lesions, especially after intravenous thrombolysis. We conducted a systematic review and meta-analysis to evaluate the safety and efficacy of antithrombotics...

Introduction The NeVa stent retriever has proven it’s safety and performance for treating large vessel occlusion (LVO) in acute ischemic stroke (AIS) across multiple clinical studies including the most recently published CLEAR Trial. This trial was conducted under rigorous scrutiny, with independent boards adjudicating outcomes. Real-world data is...

Introduction For large vessel occlusions of the anterior circulation, mechanical thrombectomy is nowadays considered as standard of care. The favorable outcome depends on the final result of reperfusion and the first pass effect (FPE). The clot composition and distal embolization influence the FPE negatively. To aim those predictors, the new NeVaTM...

Introduction Repeated number of passes, clot fragmentation, and distal embolization during mechanical thrombectomy lead to worse clinical outcomes in acute ischemic stroke. Aim of Study This study aims to assess the recanalization and embolic outcomes of different stent-retrievers (SR): open-tip SR (Solitaire X 6x40 mm), closed-tip SR (Embotrap II...

Introduction CT Perfusion (CTP) can improve diagnostic accuracy and support decision making in patients with acute ischemic stroke (AIS). The usability of CTP software packages is still limited by unreliability of results. Aim of Study To compare core volumes estimate by Cercare Stroke (CP) and syngo.via (SV) with the core volumes segmented on non...

Craniosynostosis is characterized by the premature fusion and ossification of one or more of the sutures of the calvaria, often resulting in abnormal features of the face and the skull. In cases in which growth of the brain supersedes available space within the skull, developmental delay or cognitive impairment can occur. A complex interplay of dif...

Purpose Image-based blood flow simulations are increasingly used to investigate the hemodynamics in intracranial aneurysms (IAs). However, a strong variability in segmentation approaches as well as the absence of individualized boundary conditions (BCs) influence the quality of these simulation results leading to imprecision and decreased reliabili...

Background Repeated number of passes, clot fragmentation, and distal embolization during mechanical thrombectomy lead to worse clinical outcomes in acute ischemic stroke. Objective To assess the recanalization and embolic outcomes of different stent-retrievers (SR): open-tip SR (Solitaire X 6x40mm), closed-tip SR (Embotrap II 5x33mm), and filter-t...

Background: The reorganization of the medical curriculum has increased the demands on medical didactics. For interdisciplinary fields such as radiology this offers the opportunity to be more visible in clinical medical teaching and to emphasize its integrative role in patient care. We present a novel integrative learning concept based on the notio...

For rupture risk assessment of intracranial aneurysms, 3D surface model extraction might be time-consuming but supports calculation of morphological and hemodynamical parameters. We present a geometric deep learning approach to segment the intracranial vascular domain of interest in 3D surface meshes comprising only the aneurysm and surrounding ves...

Cerebral small vessel disease (CSVD) is the main cause of intracerebral hemorrhage (ICH). However, a substantial portion is also caused by non-CSVD etiologies, including trauma, vascular malformations and brain tumors. In this retrospective observational study, we compared factors that predispose to the onset of ICH, namely demographics, antithromb...

Background Repeated number of passes, clot fragmentation, and distal embolization during mechanical thrombectomy (MT) lead to worse clinical outcomes in acute ischemic stroke. This study aimed to assess the recanalization and embolic outcomes of different stent-retrievers (SRs): open-tip SR (Solitaire X 6×40 mm), closed-tip SR (EmboTrap II 5×33 mm)...

Background: Numerous questions regarding procedural details of distal stroke thrombectomy remain unanswered. This study assesses the effect of anesthetic strategies on procedural, clinical and safety outcomes following thrombectomy for distal medium vessel occlusions (DMVOs). Methods: Patients with isolated DMVO stroke from the TOPMOST registry...

Background The periprocedural antithrombotic regimen might affect the risk-benefit profile of emergent carotid artery stenting (eCAS) in patients with acute ischemic stroke (AIS) due to tandem lesions, especially after intravenous thrombolysis. We conducted a systematic review and meta-analysis to evaluate the safety and efficacy of antithrombotics...

Background Mechanical thrombectomy of middle cerebral artery M2 segment occlusion of the middle cerebral artery has reported safety and efficacy in recent post‐hoc and observational studies. However, there is no known benefit of mechanical thrombectomy for patients with M2 segment occlusions in the delayed time window (>6 hours). Methods The Strok...

Purpose: Medical researchers deal with a large amount of patient data to improve future treatment decisions and come up with new hypotheses. To facilitate working with a large database containing many patients and parameters, we propose a virtual data shelf, displaying the 3D anatomical surface models in an immersive VR environment. Methods: The...

Introduction Mechanical thrombectomy (MT) is a widely performed procedure for acute ischemic stroke (AIS) due to large vessel occlusion. Repeated number of passes, clot fragmentation, and distal embolization during MT lead to worse clinical outcomes. We aim to evaluate the impact of different stent‐retriever (SR) distal tip designs on distal emboli...

Objective: The role of endovascular mechanical thrombectomy (MT) in patients presenting with "minor" stroke is uncertain. We aimed to compare outcomes after MT for ischemic stroke patients presenting with National Institutes of Health Stroke Scale (NIHSS) 5 and - within the low NIHSS cohort - identify predictors of a favorable outcome, mortality,...

Background: Mechanical thrombectomy is standard of care for acute ischemic stroke secondary to LVO however MT failure (MTF) occurs in approximately 15% of cases. Objective: Investigate patient and procedural characteristics that predict MTF. Methods: Retrospective review of prospectively collected, Stroke Thrombectomy and Aneurysm Registry. Patient...

Endovascular treatment of intracranial aneurysms with flow diverters (FD) has become one of the most promising interventions. Due to its woven high-density structure they are particularly applicable for challenging lesions. Although several studies have already conducted realistic hemodynamic quantification of the FD efficacy, a comparison with mor...

Purpose Intracranial aneurysms are vascular deformations in the brain which are complicated to treat. In clinical routines, the risk assessment of intracranial aneurysm rupture is simplified and might be unreliable, especially for patients with multiple aneurysms. Clinical research proposed more advanced analysis of intracranial aneurysm, but requi...

Background Recent clinical trials have shown that mechanical thrombectomy is superior to medical management for large vessel occlusion for up to 24 hours from onset. Our objective is to examine the safety and efficacy of thrombectomy beyond the standard of care window. Methods A retrospective review was undertaken of the multicenter Stroke Thrombe...

Background Flow diverters are an increasingly used treatment option for intracranial aneurysms. A recent addition to the European market is the DERIVO®2 Embolization Device (DED2), promising improved radiopacity. We aimed to assess the safety and efficacy of the DED2 regarding angiographic and clinical outcomes in ruptured and unruptured cerebral a...

Contrast-induced encephalopathy (CIE) is a rare complication of coronary and neurointerventional procedures. The condition is believed to arise from endothelial damage secondary to exposure to iodinated contrast media. A wide spectrum of clinical manifestations has been reported including seizures, cortical blindness, and focal neurological deficit...

Background and purpose Flow diverters coated with antithrombogenic substances were recently introduced and showed encouraging results in the preclinical setting. Our aim was to analyze their clinical application in patients with ruptured intracranial aneurysms using single-antiplatelet therapy (SAPT). Data sources We performed a PRISMA–compliant s...

Background Mechanical thrombectomy has become the first‐line treatment strategy for patients with large‐vessel occlusion strokes. Often >1 thrombectomy maneuver is necessary to achieve reperfusion. A first‐pass (FP) effect with improved functional outcomes after mechanical thrombectomy has been described. Aim of the present study is to investigate...

Background and Purpose The ThrombX Retriever is a novel mechanical thrombectomy device that adjusts the distance between two mesh segments to axially hold thrombus. A post-market study assessed safety and performance in acute ischemic stroke patients with large artery occlusion. Methods A single-arm prospective multi-center study enrolled patients...

Clinical history/pre-treatment-imaging We report a successful implantation of a peripheral stent in a dural arteriovenous fistula (dAVF) over a j-shaped 0.035” steel-wire (Rosen). The patient was a 61-year old male presenting with a known dAVF Cognard 2b in the right sigmoid sinus. The jugular vein was thrombosed intracranially. Treatment options/...

Introduction Data on the safety and efficacy of flow diverters (FD) for the treatment of unruptured internal carotid artery (ICA) aneurysms with compressive neuro-ophthalmological symptoms are scarce. Aim of the Study To provide evidence compiling the largest dataset published to date. Methods Data from nine neurointerventional departments, encom...

Introduction Flow diverters have emerged as an effective and widely utilized therapy option for intracranial aneurysms. The DERIVO 2 Embolization Device (DED2) is a new addition to the market and promises better radiopacity.¹ Aim of study The purpose of this study was to evaluate the safety and efficacy of the DED2. Methods We conducted a retrosp...

7T TOF MRI scans provide high resolution images of intracranial vasculature. When segmented, the Circle of Willis is detailed and thus opens up new possibilities, in research but also in education. We propose a segmentation pipeline for the Circle ofWillis, and introduce a prototype that enables exploration of not just the entire Circle of Willis,...

For hemodynamic simulations of intracranial aneurysms boundary conditions (BC) are required. In most cases, these are not patient-specific and thus do not reflect the real flow conditions in the patient. This study investigates the influence of patient-specific inflow BC on intra-aneurysmal hemodynamics. The focus lies on gender and age variations...

In contrast to unstructured meshes, structured meshes yield faster simulation results for bio-medical simulations, but are very time-consuming to create. A preprocessing step in the generation of structured meshes is the manual construction of a blockstructure approximating the vessel. Here, we present an automatic centerline calculation and blocks...

Background Whether thrombectomy alone is equally as effective as intravenous alteplase plus thrombectomy remains controversial. We aimed to determine whether thrombectomy alone would be non-inferior to intravenous alteplase plus thrombectomy in patients presenting with acute ischaemic stroke. Methods In this multicentre, randomised, open-label, bl...

Background and Purpose The ThrombX Retriever is a novel mechanical thrombectomy device that adjusts the distance between two mesh segments to axially hold thrombus. A post-market study assessed safety and performance in acute ischemic stroke patients with large artery occlusion. Methods A single-arm prospective multi-center study enrolled patients...

Background The role of endovascular mechanical thrombectomy (MT) in patients presenting with ‘minor’ stroke is uncertain. There are also variable definitions reported for ‘minor’ stroke based on the National Institutes of Health Stroke Scale (NIHSS) Objective To compare various cohorts of ‘low’ and ‘high’ NIHSS using cutoff threshold values for NI...

Background Mechanical thrombectomy (MT) is the standard of care for acute ischemic stroke secondary to large vessel occlusion (LVO). MT success (MTS) is associated with a five times greater chance of achieving a favorable clinical outcome. Despite major advances in catheter and stent retriever (SR) technology, MT failure (MTF) still occurs in appro...

Background The utility of intravenous thrombolysis (IVT) before mechanical thrombectomy (MT) remains a matter of debate. The data regarding the safety and efficacy of IVT prior to MT in patients with large core infarct is scarce. Objective To compare the functional and safety outcomes between patients with large core infarct due to LVO treated wit...

Background The safety and efficacy of mechanical thrombectomy (MT) for the M2 segment of the middle cerebral artery (MCA) has been shown to be effective and safe in recent post-hoc or observational studies. There is, however, no known benefit to MT for the M2 segment in the delayed time window (>6 hours). Here, we perform a propensity score analysi...

Background and purpose: Flow diversion is an effective treatment for aneurysms of the ICA with compression-related neuro-ophthalmologic symptoms, especially when treatment is initiated early after symptom onset and aneurysm occlusion is complete. However, non-negligible complication rates have been reported. Our aim was to identify risk factors fo...

Objective Cerebral vasospasm (CVS) represents one of the multiple contributors to delayed cerebral ischemia (DCI) in patients with aneurysmal subarachnoid hemorrhage (aSAH). Especially the management of CVS, refractory to medical treatment, is a challenging task during the acute phase after aSAH. Endovascular rescue therapies (ERT), such as medical...

Background: The optimal endovascular strategy for reperfusing distal medium-vessel occlusions (DMVO) remains unknown. This study evaluates angiographic and clinical outcomes of thrombectomy strategies in DMVO stroke of the posterior circulation. Methods: TOPMOST (Treatment for Primary Medium Vessel Occlusion Stroke) is an international, retrospe...

Background Data on the frequency and outcome of mechanical thrombectomy (MT) for large vessel occlusion (LVO) in patients with COVID-19 is limited. Addressing this subject, we report our multicenter experience. Methods A retrospective cohort study was performed of consecutive acute stroke patients with COVID-19 infection treated with MT at 26 tert...

The Subdural Hematoma in the Elderly (SHE) score was developed as a model to predict 30-day mortality from acute, chronic, and mixed subdural hematoma in the elderly population after minor or no trauma. Emerging evidence suggests frailty to be predictive of mortality and morbidity in the elderly. In this study, we aim to externally validate the SHE...

Numerous studies assess intracranial aneurysm rupture risk based on morphological and hemodynamic parameter analysis in addition to clinical information such as aneurysm localization, age, and sex. However, intracranial aneurysms mostly occur with a saccular shape located either lateral to the parent artery or at a bifurcation. In contrast, fusifor...

Purpose Ruptured basilar artery perforator aneurysms (BAPAs) represent a very rare cause of subarachnoid hemorrhage and an under-reported subtype of cerebral aneurysm. There is no consensus for the optimal treatment strategy (conservative vs. surgical vs. various endovascular approaches). We aim to present a multicenter experience of BAPA treatment...

Background In acute ischemic stroke due to anterior large vessel occlusion (AIS-LVO), accessing the target occluded vessel for mechanical thrombectomy (MT) is sometimes impossible through the femoral approach. We aimed to evaluate the safety and efficacy of direct carotid artery puncture (DCP) for MT in patients with failed alternative vascular acc...

Background: Patients with large vessel occlusion stroke (LVOS) eligible for mechanical thrombectomy (MT) are at risk for stroke- and non-stroke-related complications resulting in the need for tracheostomy (TS). Risk factors for TS have not yet been systematically investigated in this subgroup of stroke patients. Methods: Prospectively derived data...

Purpose The treatment of intracranial arteriovenous malformations (AVM) is challenging due to their complex anatomy. For this vessel pathology, arteries are directly linked to veins without a capillary bed in between. For endovascular treatment, embolization is carried out, where the arteries that supply the AVM are consecutively blocked. A virtual...

Background Scientific data on the safety and efficacy of flow diverter stents (FDS) for the treatment of unruptured internal carotid artery (ICA) aneurysms with compressive neuro-ophthalmological symptoms are scarce. We studied this subject in a retrospective international multicenter series, pooling data of 9 tertiary care neurointerventional depa...

Introduction : The grade of reperfusion after endovascular treatment of ischemic stroke e.g. mechanical thrombectomy is determined based on the mTICI score. The mTICI score shows significant interrater variability; it is usually biased towards better reperfusion results if selfassessed by the operator. We therefore developed a semiautomated image p...

Intracranial aneurysms at the anterior communicating artery (AcomA) are associated with a higher rupture risk and a more challenging therapy since they are supplied with blood from both sides of the anterior vasculature. Since the standard imaging modality, i.e. digital subtraction angiography, involves the contrast agent injection into a single ce...

Interdisciplinary exchange of medical datasets between clinicians and engineers is essential for clinical research. Due to the Data Protection Act, which preserves the rights of patients, full anonymization is necessary before any exchange can take place. Due to the continuous improvement of image quality of tomographic datasets, anonymization of p...

Background For wide-necked intracranial aneurysms, endo-saccular flow disruption can be a viable alternative to coiling or flow diverters. The Contour Neurovascular System is an intrasaccular flow diverter device targeting the neck of the aneurysm. Until now, the system had to be delivered through a 0.027″ microcatheter. We report the first implant...

Background and Purpose We aimed to compare outcome of endovascular thrombectomy in acute ischemic stroke in patients with and without cerebral amyloid angiopathy (CAA). Methods We included patients with and without possible or probable CAA based on the modified Boston criteria from an observational multicenter cohort of patients with acute ischemi...

Background and Purpose Endovascular therapy for tandem occlusion strokes of the anterior circulation is an effective and safe treatment. The best treatment approach for the cervical internal carotid artery (ICA) lesion is still unknown. In this study, we aimed to compare the functional and safety outcomes between different treatment approaches for...

Background Endovascular therapy (EVT) has become the first line treatment strategy for patients with large vessel occlusion strokes (LVOS). However, often more than one thrombectomy maneuver - either using stent-retrievers, thrombus aspiration or combined approaches - is necessary to achieve reperfusion. A true first pass effect with improved funct...

Introduction/Purpose The discrimination between hemodynamically stable and unstable intracranial aneurysms remains challenging. Recent studies reveal the potential existence of intra-aneurysmal velocity fluctuations, which appear at high frequency. Since these flow disturbances might promote the vessel wall remodeling process, indications regarding...

Introduction/Purpose Interventional treatment of arteriovenous malformations (AVMs) using liquid embolics is challenging especially in larger AVMs with multiple feeding arteries. Premature occlusion of the draining vein(s) may lead to fatal AVM rupture and sequential occlusion of different feeding arteries is associated with the risks of incomplete...

Introduction/Purpose Counseling of patients harboring unruptured intracranial aneurysms (UIAs) has remained challenging despite the availability of several risk scores assessing the aneurysm rupture risk for individual patients. However, besides aneurysm size and simple morphological features no advanced hemodynamic or geometric factors have been u...