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Neil Majmundar, Pratit Patel, Vincent Dodson, Ivo Bach, James K. Liu, Luke Tomycz and Priyank Khandelwal

T he transradial approach (TRA) for neurointerventional procedures has recently garnered interest as an alternative to the traditional transfemoral approach (TFA) in adult patients. 2 , 4 , 13 , 17 , 22 Over the past few decades, radial access for coronary angiography has become widely used by interventional cardiologists due to its reduced access site complications, lower costs, and patient preference. 6 , 10 , 11 Use of the TRA for neurointerventional procedures, which has only recently been advocated, has not been as extensively investigated. Over the past

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Marcelo Magaldi Ribeiro de Oliveira, Arthur Nicolato, Marcilea Santos, Joao Victor Godinho, Rafael Brito, Alexandre Alvarenga, Ana Luiza Valle Martins, André Prosdocimi, Felipe Padovani Trivelato, Abdulrahman J. Sabbagh, Augusto Barbosa Reis and Rolando Del Maestro

training model should be inexpensive, readily available, and have haptic characteristics similar to those encountered in the endovascular treatment of human disorders. Animal and computer-based models have been developed for this purpose. 3 , 5 , 7 While each model has certain advantages and disadvantages, it is difficult to reproduce all the haptic qualities necessary for these procedures using virtual simulators or animal models. 4 , 6–8 Thus, it is necessary to continue to develop and research new techniques for neurointerventional training. In this article, we

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Christopher S. Ogilvy, Xinyu Yang, Osama A. Jamil, Erik F. Hauck, L. Nelson Hopkins, Adnan H. Siddiqui and Elad I. Levy

stents were used (all were unlabeled/unapproved devices): Xpert (Abbott), Jostent (Abbott), Vision (Abbott), MiniVision (Guidant Corporation), Magic Wall (Boston Scientific), and S 7 (Medtronic). Patients undergoing procedures in which flow-diversion devices were used or open surgery was performed were excluded from the study. This study was approved by the institutional review board at the University at Buffalo. TABLE 1: Yearly statistics for numbers of new patients, unruptured aneurysms, and neurointerventional procedures * Year New Patients

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Tahaamin Shokuhfar, Michael C. Hurley, Anas Al-Smadi, Sameer A. Ansari, Matthew B. Potts, Babak S. Jahromi, Tord D. Alden and Ali Shaibani

femoral artery dissection (which was managed nonsurgically). They confirmed that lower BMI and larger sheath size are independent predictors of device failure in their practice. 8 To the best of our knowledge, the current study is the first report of the use of the MynxGrip vascular closure device in the pediatric population. We found MynxGrip to be safe and effective in achieving hemostasis at the CFA arteriotomy site in children undergoing diagnostic or neurointerventional procedures. The low rate of complications in our practice is consistent with previous studies

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Ashish Sonig, Hussain Shallwani, Bennett R. Levy, Hakeem J. Shakir and Adnan H. Siddiqui

for not only all publications that are part of the h index but also the cumulative citations of these publication. Thus, it provides information on ignored citations. Other indices that have been used are the g index 3 and the m quotient. 8 The number of neuroendovascular and neurointerventional fellowship training programs in the US has increased in recent years. 7 In this scenario, in which more than 50 neurosurgical programs offer these fellowships, it is of paramount importance to assess the academic productivity of such training programs and to know if

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L. Ian Taylor, James C. Dickerson, Robert J. Dambrino, M. Yashar S. Kalani, Philipp Taussky, Chad W. Washington and Min S. Park

diabetes. 2 , 32 However, the use of 3 antiplatelet agents has not been described in the neurointerventional literature. In addition to modifications to the traditional aspirin and P2Y12 inhibitor combination, single-drug therapies such as the GP-IIb/IIIa inhibitors abciximab and tirofiban have been described. In the setting of PED, tirofiban has several proven benefits, including a good safety profile, reversibility in a matter of hours, cost effectiveness compared with other GP-IIb/IIIa inhibitors, and no need for PFT. 11 Antiplatelet Drug Resistance Determining the

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Osama N. Kashlan, Thomas J. Wilson, Neeraj Chaudhary, Joseph J. Gemmete, William R. Stetler Jr., N. Reed Dunnick, B. Gregory Thompson and Aditya S. Pandey

of this controversy, once a decision has been made to pursue endovascular management, measures should be undertaken to minimize costs while continuing to provide quality care. Costs associated with neurointerventional procedures can broadly be thought of in 3 categories: preoperative evaluation costs, procedure-related costs, and postoperative care costs. Within each category, several possible means exist for keeping costs down. At the University of Michigan, 3 simple policy changes were made to implement cost-cutting measures for procedure-related items: 1

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Philip M. Meyers, H. Christian Schumacher, Michael J. Alexander, Colin P. Derdeyn, Anthony J. Furlan, Randall T. Higashida, Christopher J. Moran, Robert W. Tarr, Donald V. Heck, Joshua A. Hirsch, Mary E. Jensen, Italo Linfante, Cameron G. McDougall, Gary M. Nesbit, Peter A. Rasmussen, Thomas A. Tomsick, Lawrence R. Wechsler, John A. Wilson and Osama O. Zaidat

have been written and approved by multiple neuroscience societies which historically have been directly involved in the medical, surgical and endovascular care of patients with acute stroke. These organizations include the Neurovascular Coalition and its participating societies including Society of Neuro-Interventional Surgery, American Academy of Neurology, American Association of Neurological Surgeons/Congress of Neurological Surgeons Cerebrovascular Section, and Society of Vascular & Interventional Neurology. Minimum Training Requirement for Acute Stroke

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Ning Lin, Edward R. Smith, R. Michael Scott and Darren B. Orbach

are also smaller in caliber than those in adults and are therefore more vulnerable to thrombosis from partial obstruction, and they are more fragile, especially early in life. Recent reports have described the risks of endovascular embolization in children with specific individual diagnoses, 1 , 6 , 10 , 31 but an overall evaluation of the safety profile of all neurointerventional procedures in children has not been performed. In the present study, we reviewed our experience with diagnostic cerebral angiography and neurointerventions in children to assess whether

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Lakshmi Leishangthem and Sudhakar R. Satti

than general anesthesia. Case Report Clinical Presentation A n 8 2-year-old f emale p resented to our hospital with non–ST elevation myocardial infarction. She underwent urgent cardiac catheterization. After a diagnostic left coronary angiogram was performed, it was noted that the patient was aphasic and had left hemiparesis. A stroke alert was initiated, and the patient was found to have a baseline National Institutes of Health Stroke Scale (NIHSS) score of at least 10. The patient was transferred to the neurointerventional suite, and a DynaCT scan did