- Artery of Davidoff and Schechter Supply in Dural Arteriovenous Fistulas
The artery of Davidoff and Schechter is a dural branch of the posterior cerebral artery that can supply the meninges close to the falcotentorial junction. It is usually not identified on angiography except when enlarged in the setting of a dural AVF or meningioma. The impact on treatment of the artery of Davidoff and Schechter supply to a fistula is not well-described in the literature. The authors' retrospective analysis of patients with dural AVFs treated at the Toronto Western Hospital between 2006 and 2018 identified 6 patients with dural AVFs receiving supply from the artery of Davidoff and Schechter (of a total of 173 patients with dural AVFs). All patients were initially treated by transarterial embolization using liquid embolic agents. Three patients required a second endovascular procedure partly due to residual supply from the artery of Davidoff and Schechter.
- Assessment of a Bayesian Vitrea CT Perfusion Analysis to Predict Final Infarct and Penumbra Volumes in Patients with Acute Ischemic Stroke: A Comparison with RAPID
Data were retrospectively collected for 105 patients with acute ischemic stroke (55 patients with successful recanalization [TICI 2b/2c/3] and large-vessel occlusions and 50 patients without interventions). Final infarct volumes were calculated using DWI and FLAIR 24 hours following CTP imaging. RAPID and the Vitrea Bayesian CTP algorithm (with 3 different settings) predicted infarct and penumbra volumes for comparison with final infarct volumes to assess software performance. RAPID and Vitrea default setting had the most accurate final infarct volume prediction in patients with interventions. Default Vitrea and RAPID were the most and least accurate in determining final infarct volume for patients without an intervention, respectively. Compared with RAPID, the Vitrea default setting was noninferior for patients with interventions and superior in penumbra estimation for patients without interventions as indicated by mean infarct differences and correlations with final infarct volumes.
- Flow-Diversion Treatment for Unruptured Nonsaccular Intracranial Aneurysms of the Posterior and Distal Anterior Circulation: A Meta-Analysis
The authors’ aim was to analyze the outcomes after flow diversion among nonsaccular unruptured lesions. Fifteen studies (213 aneurysms) were included in the analysis. The long-term adequate occlusion rate was 85.3%. Treatment-related complications were 17.4%. Overall, 15% were ischemic events. They conclude that unruptured nonsaccular aneurysms located in the posterior and distal anterior circulations can be effectively treated with a flow-diversion strategy. Nevertheless, treatment-related complications are not negligible, with about 15% ischemic events and 8% morbidity. Larger size (>10 mm) significantly increased the risk of procedure-related adverse events among nonsaccular lesions.
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