bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract 243: Distal vs Non‐Distal Middle Meningeal Artery Embolization for Subacute‐Chronic Subdural Hematomas
Authors: Henkel N. , Mierzwa A. T. , Gharaibeh K. , Naz S. , Delcimmuto N. , Chang Y. , Zaidi S. , Jumaa M.
Published: January 2025

Introduction

Subacute‐chronic subdural hematomas have a nearly 25‐30% recurrence rate following appropriate surgical evacuation of the primary hematoma. Recently, middle Meningeal artery (MMA) embolization techniques have demonstrated efficacy in preventing recurrence and has been increasingly adopted as part of mainstay therapy. However, technical considerations are still being established.

Methods

This is a single center retrospective study from January, 2022 through August, 2024 evaluating patients who received MMA embolization for subacute‐chronic SDH. Patients were excluded if they did not have follow up imaging. Patients were dichotomized into whether they received distal or non‐distal MMA embolization. All patients were treated with Onyx embolization. Embolization was considered distal when Onyx material reached membranous branches. Primary efficacy outcome was defined SDH improvement (reduction or completion resolution of SDH compared to discharge).

Results

There were 127 patients included in this study with 12 patients excluded for lacking final radiographic outcomes. Therefore, one‐hundred‐fifteen patients were included in the final analysis who were older (75 years) Caucasian (86%) males (78%). Fifty‐five (52%) and sixty (48%) patients received either a distal or non‐distal MMA embolization, respectively. The distally occluded cohort were more likely to be women (31% vs 13% p = 0.02) compared to the non‐distal cohort; otherwise, there were no significant baseline demographic differences between cohorts. Additionally, anticoagulation and antiplatelet usage were similar between cohorts. Patients had final imaging at a median 44 (IQR 26 ‐ 81) days following the procedure. There were equal rates of radiographic improvement between distally and non‐distally occluded MMA embolization techniques (85.5% vs 73.3% p = 0.11). On multivariate analysis controlling for potentially confounding factors, odds of improvement were similar (OR 1.96 95% CI 0.70 ‐ 5.52; p = 0.20).

Conclusion

Patients had similar rates of radiographic improvement despite choosing distally vs non‐distally occluding the middle meningeal artery. Further prospective research is required to validate our finding.
Abstract 245: Dose‐dependent relationship between periodontal disease and ischemic stroke
Authors: Dumitrascu C. , Grasu R.
Published: January 2025

Introduction

The link between periodontal disease and cerebrovascular disease was reported in various studies, with several mechanistic underpinnings. To determine the predictive value of periodontal disease for cerebrovascular diseases, we aimed to investigate the quantitative association between various degrees of periodontal disease and subtypes of cerebrovascular disease.

Methods

Using Meta‐analyses Of Observational Studies in Epidemiology and PRISMA guidelines, we searched 6 databases through May 2024 for cohort and case‐control studies evaluating the relationship between periodontal disease and ischemic or hemorrhagic stroke. Studies were included if they reported risk ratios (RRs) and 95% confidence intervals or raw patient‐level data (that were computed into RRs). Unadjusted and vascular risk‐factor adjusted ORs were pooled into meta‐analysis using DerSimonian Laird random effects model. Study quality, publication and dissemination biases were assessed and integrated in the analyses (RevMan software).

Results

12 prospective studies encompassing 31, 324 patients were eligible for the qualitative and quantitative syntheses. After vascular risk‐factor adjustment, any degree of periodontitis was associated with an increased risk of ischemic stroke (RR, 2.24, 95% CI [1.67‐2.98], p<0.001, I2=10). Subgroup analysis including subjects with moderate or severe periodontitis showed a higher risk of ischemic stroke (RR, 3.01, 95% CI [1.01‐4.05], p<0.001). Associations remained significant after adjustments for quality and publication biases. Heterogeneity was low (I2<20%) for all syntheses. The reported mechanisms were cardioembolism and thromboembolism. The risk of hemorrhagic stroke could not be synthesized due to limited data.

Conclusions

A dose‐dependent relationship exists between periodontal disease and ischemic stroke, even after adjustment for traditional cerebrovascular risk factors. It remains unknown if the risk of hemorrhagic stroke is increased in subjects with periodontal disease. Periodontal disease prevention and treatment may decrease the incidence of ischemic cerebrovascular disease.
Abstract 268: Endovascular Treatment for Non‐Resectable Meningiomas Encasing the Internal Carotid Artery: A Case Report
Authors: Albanna A. J. , Vismara T. , Idris A. , Reardon T. , Iqbal Z. , Kole M.
Published: January 2025

Introduction

Carotid endovascular treatment with stenting is widely recognized as a safe and effective method for managing carotid stenosis due to underlying atherosclerotic disease. However, there is limited data on the efficacy of carotid stenting in cases where non‐resectable meningiomas encase the internal carotid artery.

Presentation

We report the case of a 50‐year‐old woman who initially presented with numbness in her right arm. Brain MRI revealed bilateral meningiomas encasing the cavernous segments of both internal carotid arteries, leading to mild narrowing. Follow‐up imaging showed that the left‐sided meningioma had enlarged, causing near occlusion of the left internal carotid artery and resulting in recurrent acute infarcts within the left ICA watershed territory. This led to the decision to proceed with a left STA‐MCA bypass. The patient later experienced right‐sided amaurosis fugax, with subsequent MRI showing further enlargement of the right‐sided meningioma encasing the right cavernous ICA. The patient underwent angioplasty and stenting of the right ICA, with no further neurological symptoms.

Discussion

Meningiomas are the most common tumors affecting the cavernous sinus and can invade the walls of the internal carotid artery, leading to significant stenosis. However, neurological deficits and cerebral ischemia due to reduced cerebral perfusion pressure from such stenosis are uncommon. Tumor resection in these scenarios poses risks, including carotid scarring and third nerve injury, emphasizing the need for alternative treatments. This case illustrates the safety and effectiveness of carotid artery stenting in such complex situations.

Conclusion

Carotid artery stenting is a viable and effective treatment option for patients with non‐resectable meningiomas causing symptomatic narrowing of the internal carotid artery.
Abstract 281: Factors Leading to ICU Stays After Endovascular Treatments for Unruptured Intracranial Aneurysms: A Review Study
Authors: Hamouda A.
Published: January 2025

Background

For unruptured intracranial aneurysms (UIAs), conservative management is often possible. However, when direct treatment is warranted, endovascular treatments (EVTs) provide an effective minimally invasive approach. These procedures still necessitate careful patient monitoring, frequently in the Intensive Care Unit (ICU). The factors leading to ICU admission for these patients remains an area of debate.

Objective

This systematic review aims to highlight existing literature and identify gaps in understanding the factors contributing to ICU admission following EVTs for UIAs.

Methods

We utilized the Nested Knowledge Autolit semi‐automated software to gather studies published before April 2024. We followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines, and included studies that met predetermined population, intervention, control, and outcomes (PICO) criteria. Statistical analysis was performed using R software.

Results

We retrieved 181 studies and 9 met our inclusion criteria. There was significant variability across these studies on what factors they reported. Across included studies there were 8,098 patients, with 5,620 requiring ICU admission following EVTs for UIAs. Analysis revealed that anterior aneurysm location, aneurysm‐related symptoms, and procedure length were significant factors leading to ICU admission. The overall ICU admission rate was approximately 24.61 per 100 patients.

Conclusion

This review underscores the need for further research to understand what factors lead to ICU admission following EVTs for UIAs. Additional studies are needed that use a standardized approach to collect data on patient demographics, aneurysm characteristics, procedural details, and postoperative outcomes. Such studies will allow for concrete recommendations to be made on ICU needs and prognostic calculators to be developed in order to support clinical decisions and lower healthcare costs.
Abstract 302: Incidence of moyamoya angiopathy in the United States from 2011‐2020
Authors: Miller R. A. , Anikpezie N. , Hoffman H. , Bako A. , Aneni E. , Wee C. , Albright K. , Latorre J. , Chaturvedi S. , Liu J. , Agarwalla P. , Singla A. , Khandelwal P. , Oliver F.
Published: January 2025

Introduction

Moyamoya angiopathy (MMA) is a rare cerebrovascular condition characterized by progressive steno‐occlusion of the terminal segments of the internal carotid artery (ICA) and its branches. Contemporary population‐based studies evaluating the incidence of MMA in the United States (US) are lacking.

Materials/Methods

We utilized the State Ambulatory Surgery, Emergency and Inpatient Databases of Florida (2005‐2020), Georgia (2010‐2020), Maryland (2012‐2020) and New York (2005‐2020) to conduct a retrospective study. We validated International Classification of Diseases (ICD) Tenth revision codes for MMA in a single academic center in the US and utilized primary and secondary ICD‐Ninth/Tenth revision discharge codes to identify all new cases of MMA in these four states from 2011‐2020.

Results

From 24,614 MMA hospitalizations over the study period, 4,192 incident cases were identified from 2011‐2020. 67.9% of these admissions were in women. The overall crude incidence of MMA was 0.76 (95%CI 0.74‐0.78) cases/100,000/year. Incidence was higher in Asian (aIRR 2.46, 95%CI 1.88‐3.23)) and Black individuals (aIRR 2.58, 95%CI 2.17‐3.07) compared with Non‐Hispanic White individuals. Incidence increased by 8% annually over time (aIRR 1.08, 95%CI 1.03‐1.02) with most of this increase occurring in individuals 45‐64 years and ≥65 years.

Conclusion

The incidence of MMA in the US over the period 2011‐2020 was 0.76/100,000/year but incidence of detected cases increased over time. Overall incidence in Black individuals is just as high as that of Asian individuals, and both are higher than that of Non‐Hispanic White individuals.
Abstract 318: Its Not (just) Delivery : Multifunctionality of Carrier Delivery Catheter in Middle Meningeal Artery Embolization
Authors: Scarpiello S. , Snyder T. , Haimi J. , Zacharatos H. , Jankowitz B.
Published: January 2025

Introduction

Delivery catheters are increasingly utilized in neurointerventions to facilitate guide or aspiration catheter deliverability through tortuous anatomy. They are designed to have a tapered, hydrophilic coated, atraumatic tip to reduce the ledge effect while advancing large bore guide catheters with the additional benefit of advancement without a guidewire. The Carrier Delivery Catheter (The Balt Group, Montmorency, France) has the added benefit of having a PTFE liner through the length of the catheter, which raises the possibility that they may have a multimodal role (particle/coil delivery, liquid embolics) in elective cases such as middle meningeal artery (MMA) embolization.

Methods

At our university‐based medical center, the Carrier Delivery Catheter was used in two patients undergoing bilateral MMA embolization for chronic subdural hematomas.

Results

The Carrier Delivery Catheter Small (OD 0.059”) was used in each procedure to deliver a 6F (0.070” and 0.071”) guide catheter up to the ostium of the MMA. This was achieved easily, without a guidewire, and without inducing vasospasm. Carrier was even able to advance over a guidewire into the MMA trunk (diameters 0.16cm, 0.16cm, 0.19cm and 0.18cm), with the tip nosing into the frontal and parietal branches of the MMA. Further, the Carrier Delivery Catheter was utilized to perform the embolizations. It was able to deliver two different types of coils. This included Embold Fibered Coils (2mm and 3mm diameter) and Tornado Coils (3‐2mm diameter), tris‐acryl gelatin microspheres, and the liquid embolic agent, n‐butyl‐cyanoacrylate (nBCA).

Conclusion

This is the first report of the Carrier Delivery Catheter being used as a multimodal catheter for MMA embolizations. It was used to deliver guide catheters and embolic agents in an easy and repeatable fashion without vasospasm. While it accommodates the use of a guidewire, it is not always necessary. In our very limited experience, this novel technique appeared safe and effective for use in accessing and embolizing the MMA and its branches, although additional studies should be performed to support our findings.
Abstract 321: Likelihood of complete reperfusion in patients requiring multiple passes is dependent on technique of first two attempts
Authors: Azeem H. M. , Bajaj R. , Le N. , Iyyangar A. , Ballekere A. , Neal C. , Ebirim E. , Lee E. , Sheth S. A.
Published: January 2025

Background

Previous research shows that the chances of successful reperfusion during endovascular thrombectomy (EVT) decrease with each additional attempt. However, for patients who require multiple EVT passes, it remains unclear whether the specific techniques used in the first two attempts affect the likelihood of eventually achieving complete reperfusion.

Methods

All consecutive patients treated with EVT from 12 centers across the US were prospectively collected between 10/2018 ‐ 12/2021 (SVIN Registry). Patient were included if they underwent more than 2 passes. Patients were excluded for missing data. The primary outcome was likelihood of final TICI 2c/3 and was compared against three subgroups defined by the technique used for the first 2 passes: contact aspiration (CA), stent retriever (SR), or a combined technique (CT). This outcome was determined using multivariable logistic regression, adjusted for the use of balloon guide catheters, age, history of atrial fibrillation, coronary artery disease, hypertension, and diabetes.

Results

Among 857 patients that met inclusion criteria, median age was 70 years (IQR, 59‐90), 50.6% female and a median NIHSS 17 (IQR, 11‐21). 49.9% of patients achieved TICI 2c/3 in 2 or fewer passes (54.1% SR, 45.5% CA, 48.7% CT). Among patients who did not achieve TICI 2c/3 within the first two passes and in whom additional passes were attempted, final TICI 2c/3 was attained 32.1% with SR, 48.3% with CA, and 42.4% with CT. In multivariable logistic regression, CA for the first two passes was associated with 2.6 times greater OR (95% CI [1.6, 4.3]) of achieving TICI 2c/3 with additional passes compared to those who received SR for their first two passes. Similarly, those who used CT for their first two passes had 1.8OR (95% CI [1.1, 2.8]) of achieving TICI 2c/3 with additional passes compared to those who used SR.

Conclusion

In this SVIN Registry analysis, two failed passes with SR was associated with decreased likelihood of ultimately achieving TICI 2c/3 compared to two passes of CA or CT. These findings support additional attempts at reperfusion particularly in patients who were initially treated with CA or CT.
Abstract 324: Management of Head and Neck Pseudoaneurysms: an Institutional Review
Authors: Begum M. , Miller R. , Blanden A. , Masoud H.
Published: January 2025

Introduction/Purpose

Intracranial pseudoaneurysms (PSA) are a challenging clinical entity. A variety of endovascular techniques including coiling, vessel occlusion, stent‐assisted coiling, and flow diversion are available treatment options. When aneurysm morphology permits, selective coiling is preferred as it avoids the negative sequelae associated with parent vessel deconstruction. Here we review a series of symptomatic PSAs and outcome their endovascular management.

Materials and Methods

We performed an institutional review of the electronic medical record to identify pseudoaneurysms of the head and neck in order to analyze their disease course and outcome of endovascular therapy.

Results

We identified 6 separate cases of head and neck pseudoaneurysms treated with endovascular management. Four cases were managed by selective coiling. In two instances selective coiling was definitive. In the others, selective endovascular coiling was initially successful, but later required revision with parent vessel occlusion. In each case requiring revision, progression of the original pathologic process which contributed to the initial pseudoaneurysm led to the failure of selective coiling. The two cases managed with flow diversion did not require revision or have any immediate complications.

Conclusion

Selective coiling remains a useful endovascular therapy, however in progressive pathologies such as malignant neoplasms there may be a greater likelihood of revision with parent vessel occlusion.
Abstract 335: National Patterns Of Carotid Artery Stenting Utilization In Mechanical Thrombectomy Stroke Patients in the US
Authors: Ali A. , Otite F. , Sahoo A. , Novakovic N. , Singla A. , Khandelwal P.
Published: January 2025

Background

Patients with large vessel occlusion due to high‐grade extracranial carotid stenosis may requireadjunctive carotid artery stenting (CAS) plus mechanical thrombectomy (MT) to prevent acuteischemic stroke (AIS) recurrence. Population‐level data on contemporary CAS utilization in MTare lacking. This study describes CAS utilization trends in MT patients in the United States (US)over the last decade.

Methods

We conducted a serial cross‐sectional study utilizing the 2010‐2021 National Inpatient Sample.All adult (>=18 years) primary MT admissions with and without CAS were identified usingInternational Classification of Diseases codes. Age and sex‐ specific prevalence of CAS in MTwere computed. Multivariable‐adjusted negative binomial regression models were used tocompare prevalence of CAS between various demographic subgroups and to compare in‐hospitalmortality or good outcome (routine home discharge) rates between CAS versus non‐CAS MTadmissions.

Results

Of 5,927,384 weighted AIS admissions from 2010‐2021, 195,677 (3.3%) underwent MT. 6.4%of these MT admissions underwent CAS but this proportion deferred significantly by age and sex(Figure 1a). Highest frequency of utilization was in men 60‐79 years (10.1%) and lowest use inwomen >=80 years (1.9%). (Figure 1a). Annual CAS volume in MT increased from 186 casesannually in 2010 to 2,340 cases in 2021, but the overall utilization rate of all MTs did notincrease significantly over time (Figure 1b). 85.4% of these procedures were performed on thesame day as MT and only 14.6% were performed on different days. 12.7% of CAS admissionshad carotid dissection vs 2.5% in the non‐CAS group. Only 0.4% of MT had carotidendarterectomy. After multivariable adjustment for clinical and hospital‐level factors, womenhad ≈50% lower prevalence of CAS vs men (adjusted prevalence ratio (APR) 0.51, 95%CI 0.46‐0.55) and Black admissions had 43% lower prevalence of CAS vs White admissions (APR 0.57,95%CI 0.49‐0.66). In multivariable models that included the National Institute of Health StrokeScale and other clinical factors CAS utilization was not associated with in‐hospital mortality(APR 0.86, 95%CI 0.72‐1.03) or good outcome (APR 0.93, 95%CI 0.85‐1.02)

Conclusion

Just over 6% of MT admissions across the period 2010‐2021 in the US underwent CAS. CASutilization rate did not change over time, but volume of utilization has increased by over 10‐fold,accompanying the increase in MT that has occurred over time. CAS is more frequently utilized in men and in White admissions in the US compared to women and Black admissions,respectively.
Abstract 342: Novel “Hyperdense Sign” Window Improves Detection of Hyperdense Sign in Patients Presenting with Ischemic Stroke
Authors: Scarpiello S. , Amireh A. , Snyder T. , Haimi J. , Zacharatos H. , Mehta S. , Jankowitz B.
Published: January 2025

Introduction

Imaging modalities for acute ischemic stroke patients include non‐contrast CT head (NCCT) and contrast‐based imaging. On NCCT, a hyperdense sign suggestive of underlying thrombus correlates to a large vessel occlusion (LVO) on contrast based imaging. Previous studies show that hyperdense signs are visualized in 30‐52% of patients presenting with an LVO. While standard (5mm) cut CT can miss hyperdense signs, they can be better detected on newer NCCT with thin (0.625mm) cuts. The Hounsfield unit (HU) range of a hyperdense sign is +50 to +75, so the windowing of NCCT images to enhance these HU ranges also improves visualization. Hyperdense signs on NCCT can help guide selection for mechanical thrombectomy (MT) when advanced imaging is unavailable or inadequate.

Methods

At our community‐based university medical center, we conducted a retrospective cohort study of acute ischemic stroke patients presenting with an intracranial LVO and were taken for MT from July 2019 to March 2024. We retrospectively assessed axial standard (5mm) cut and thin (0.625mm) cut NCCT imaging in patients for hyperdense signs spanning from the carotid terminus to the distal M1 segment. To improve visualization, we further used a novel “hyperdense window,” with a window center of 50 and window width of 25. The location of the hyperdense region was confirmed with the location of LVO on contrast‐based imaging including CT angiogram, CT perfusion, and digital subtraction angiography during MT.

Results

The mean age of the patients in the study was 67 years; 54% were male and 46% were female. Of the patients with confirmed intracranial LVO on contrast‐based studies, 77.4% (n=147) had unilateral hyperdense signs on NCCT thin cuts that correlated to area of LVO. Of the remaining 22.6% (n=43) of patients, 58.1% (n=25) had an absence of a hyperdense sign and 41.9% (n=18) of patients had bilateral hyperdense signs on NCCT. Contrast based imaging confirmed LVO in all patients included in the study.

Conclusion

Compared to previous studies, thin cut NCCT combined with a novel “hyperdense window” on NCCT improved visualization of hyperdense signs representing LVO at the internal carotid terminus and/or first segment of the middle cerebral artery. We propose that when combined with a clinical presentation, a hyperdense sign on NCCT may be sufficient evidence to proceed to MT without the need for contrast‐based imaging. While advanced imaging should not be delayed, interpretation of thin cut NCCT may lead to earlier mobilization of the intervention team. More studies are needed to evaluate the utility of thin cut NCCT alone for selection of patients with LVO and whether outcome metrics such as reperfusion time or modified Rankin scale improve.
Abstract 367: Physiologic steal in white matter structures of non‐flow limited cerebral hemispheres as evidenced by observations of acetazolamide challenge arterial spin labeling MR
Authors: Ismail R. , Manganaro M. , Szekeres D. , Bender M. , Wang H.
Published: January 2025

Background

Acetazolamide administration can allow for comparisons between cerebral blood flow (CBF) at baseline and after acetazolamide challenge to evaluate the cerebral vasculature. While effects of augmentation have been studied in vaso‐occlusive hemispheres, little has been reported on physiologic, non‐flow limited hemispheres.

Methods

Patients who underwent acetazolamide challenge MRI from 2014‐2021 and a cerebral angiogram within one year were included. Patients with bilateral disease or non‐diagnostic imaging artifacts were excluded. MRIs were obtained after 1 g of acetazolamide administered 5 and 10 minutes prior to acquisition. Augmentation and steal maps were generated by comparing pre and post acetazolamide CBF images. Regression analysis, Pearson correlation coefficient, two sample t‐Test, Spearman and Mann Whitney U analyses were utilized for statistical evaluation.

Results

38 Patients with unilateral cerebral vaso‐occlusive disease underwent the acetazolamide challenge. Steal and T2 hyperintensities were assessed in non‐flow limited hemispheres (NFLH) and flow limited hemispheres (FLH). A moderate correlation was demonstrated between NFLH steal and NFLH T2 hyperintensities (rs=0.48, p=0.0020). A weak correlation without statistical significance was demonstrated between ipsilateral T2 and contralateral T2 hyperintensities (rs= .27, p=.10). No correlation was found between steal severity or T2 hyperintensity and occlusion locations of stenosis.

Conclusion

Vascular steal phenomenon was demonstrated in the distal cerebral vasculature of cerebral white matter even in the absence of upstream flow limiting stenosis, suggesting an inherit vulnerability of these structures to hemodynamic fluctuations and possible contributing etiology to leukoaraiosis.
Abstract 422: The Impact of Household Composition on Acute Ischemic Strokes: Acute and Chronic Implications
Authors: Couture L. , Cahuiche A. E. , Petway A. , Baskin L. , Colpo G. Delevati , McCullough L. D.
Published: January 2025

Introduction

Stroke presents a significant global health challenge, impacting physical and mental well‐being. Social Isolation (SI) is a known risk factor and common complication affecting functional outcomes and impeding recovery. In this study we investigate the role of household composition as a potential social determinant of health after acute ischemic stroke (AIS) that providers can target to identify patients at higher risk for stroke and enhance patient outcomes. We assessed how variations in household composition correlate with the severity of stroke, the occurrence and development of SI, and subsequent functional recovery at 3 months after discharge.

Methods

This study examines the relationship between house composition, depressive symptoms, the Modified Rankin Scale (mRS), and the National Institute of Health Stroke Score (NIHSS) aiming to predict acute stroke severity and functional recovery among AIS patients (N=130). Household composition was defined as the amount of people the patient lives with. Depression was measured via the PHQ‐9, which is a self‐report with higher scores indicating more severe depression. This questionnaire was completed by the patients prior to their discharge.

Results

Our findings showed that AIS patients living with fewer people at admission are more likely to have an increased NIHSS score, indicating more severe strokes (p<0.005). However, we found that regardless of injury severity, increased household composition was associated with a reduced likelihood of depressive symptoms 3 months post hospitalization (p<0.005). When controlling for household size, females were found to be more likely to suffer from depressive symptoms at 3 months compared to their male counterparts (p<0.005).

Conclusion

Controlling post‐stroke depressive symptoms emerged as a statistically significant factor for improved functional outcomes, highlighting the importance of early intervention and management of depression in stroke care. Living with an increased number of people could act as a protective factor for stroke severity due to its positive effect on recovery and post‐stroke outcomes. These findings underscore the necessity of integrating assessments of living conditions, depression and social isolation into stroke care protocols to enhance outcomes and address broader health disparities, ultimately improving the quality of life for stroke survivors.
Abstract 441: Transophthalmic Artery Embolization of Anterior Skull Base Meningiomas: Technical Case Series
Authors: Essibayi M. , Baker A. , Ryvlin J. R. , Pecoraric I. , Fortunel A. , Hamad M. , Khatri D. , Crisman C. , Eskandar E. , Haranhalli N. , Agarwal V. , Altschul D. J.
Published: January 2025

Introduction/Purpose

Preoperative embolization of anterior skull base meningiomas can facilitate surgical resection by reducing tumor vascularity. However, transophthalmic artery embolization carries risks of visual complications. This study aimed to evaluate the safety and efficacy of this technique using modern endovascular tools.

Materials and Methods

This retrospective study included patients with anterior skull base meningiomas who underwent preoperative transophthalmic artery embolization followed by surgical resection between January 2022 and April 2024. Patient demographics, tumor characteristics, embolization details, surgical outcomes, and complications were analyzed.

Results

Seven patients (6 male, 1 female; median age 57 years) were included. Tumor locations were planum sphenoidale (58%), olfactory groove (14%), frontal region (14%), and sphenoid wing (14%). Unilateral embolization was performed in 6 patients, with 1 patient receiving bilateral transophthalmic artery embolization. Embolized branches included anterior ethmoidal (38%), posterior ethmoidal (38%), recurrent meningeal (12%), and complete ophthalmic artery occlusion (12%). Embolic agents used were polyvinyl alcohol particles (71%) and coils (29%). Successful angiographic devascularization was achieved in all patients without any endovascular complications or visual deterioration. Gross total resection was achieved in 71% of cases. The median operative blood loss was 427 cc. At a median follow‐up of 9 months, the median modified Rankin Scale score was 1.

Conclusion

With careful patient selection, advanced microcatheter technology, and meticulous technique, preoperative transophthalmic artery embolization can be safely performed to facilitate resection of anterior skull base meningiomas. These results suggest it is a viable option for well‐selected patients at experienced centers, though larger prospective studies are needed.
Abstract 446: Transvenous Embolization along with Intraprocedural Image Fusion Technique for Complex Intracranial Dural Arteriovenous Fistula.
Authors: Oh S. , Choi J. , Kim B. , Shin Y.
Published: January 2025

Background and purpose

This study aimed to investigate the role and safety of intraprocedural flat‐detector computed tomography‐based rotational angiography and image fusion (FDCT‐RA and IF) in microcatheter navigation during transvenous treatment of dural arteriovenous fistulae (dAVF).

Materials and methods

We retrospectively reviewed 86 cases of dAVF treated by a transvenous approach between January 2009 and April 2023. The patients were classified into two groups according to the treatment technique used: the FDCT‐RA and IF technique group and the conventional technique group. Univariate analyses were performed to compare the two treatment modalities.

Results

The FDCT‐RA and IF technique was used in 37 of the 86 patients (43.0%). The FDCT‐RA and IF group showed significant differences in dAVF location, sinus occlusion state, and access routes compared to the conventional treatment group. The FDCT‐RA and IF technique was commonly used for dAVFs involving the anterior condylar confluence and cavernous sinus with ipsilateral inferior petrosal sinus (IPS) occlusion. The complete occlusion rate was higher in patients treated with this technique (n=34, 91.9%) than in those treated using the conventional technique (n=39, 79.6%). However, the difference was not statistically significant (p=0.136). Implementation of this technique during the treatment procedure showed a tendency to decrease both fluoroscopy duration and radiation dose. The obtained result was not statistically significant (p=0.315, p=0.130).
Abstract 457: Utilizing the Comaneci Device for Dural Venous Sinus Thrombectomy
Authors: Kim V. , Abramyan A. , Berezovsky D. , Afridi M. , Sozio S. , Gupta G. , Roychowdhury S. , Sundararajan S.
Published: January 2025

Purpose:

The treatment of dural venous sinus (DVS) thrombosis is anticoagulation. In select patients, thrombectomy or thrombolysis can be considered based on clinical status. The following case demonstrates the potential benefits of an off‐label application of the Comaneci device for DVS thrombectomy.

Case:

A 47‐year‐old female patient presented with right‐sided weakness, nausea, and vomiting. Imaging revealed thrombosis of the superior sagittal sinus (SSS) extending to the torcula, right transverse sinus (TS), and right sigmoid sinus (SS) with a hemorrhagic venous infarct in the left parietal lobe. The patient was started on anticoagulation. However, her symptoms worsened with repeat imaging showing a new left frontal lobe hemorrhagic infarct. The decision was made to proceed with mechanical thrombectomy. Arterial and venous access was obtained in the right groin. Angiography showed venous sinus thrombosis of most of the SSS and torcula with focal occlusion of the right TS. A Zoom 71TM catheter was advanced into the anterior SSS. Pharmacomechanical thrombolysis was performed using a Scepter balloon that was intermittently inflated along the SSS while 5 mg tPA was infused. This yielded minimal improvement. Therefore a combination of mechanical thrombectomy using a Comaneci 21 device and aspiration thrombectomy using a Zoom 88TM catheter was performed in the SSS torcula, and right TS. The rapid inflation‐deflation (RID) technique of fast cycling the expansion and closure of the Comaneci over a period of time allowed for dislodgment of hard thrombus while concurrent aspiration of dislodged thrombus into the Zoom 71 intermediate and Zoom 88 guide catheters was employed. Post‐treatment angiogram confirmed resolution of occlusive thrombus with improved rate of angiographic arterial to capillary phase transgression. Only small volume non‐occlusive thrombus in the SSS, right TS, and right SS remained.

Result:

The patient was continued on therapeutic systemic anticoagulation post‐procedure. Follow‐up imaging showed stable left parietal and frontal lobe infarcts with stable hemorrhage and near‐complete resolution of prior DVS thrombus. She was discharged on hospital day 6.

Conclusion

Multiple endovascular techniques for DVS thrombosis have been described, which include aspiration, angioplasty, and lysis. To our knowledge, this is the first reported use of the Comaneci device for the treatment of DVS thrombosis. Following suboptimal results from balloon‐assisted thrombolysis, we used the Comaneci device and RID technique to actively macerate hard thrombus and allow for more effective aspiration. The Comaneci device is typically utilized with cerebral aneurysm coiling interventions or treatment of intracranial arterial vasospasm. Our case demonstrates a novel approach of rapid inflation‐deflation utilizing the Comaneci device for a successful DVS thrombectomy.
Description of a New Species of Robertsmyia Bee Fly (Bombyliidae: Bombyliinae) from the South Australian mallee
Authors: NEWTON MARK A , LI XUANKUN
Published: January 2025

A new species, Robertsmyia aureola sp. nov., of Bombyliinae is added to the previously monotypic genus Robertsmyia Li & Yeates, 2018. Specimens of both sexes were collected in mallee habitat from the Riverland near Cadell and Waikerie, South Australia. The generic diagnosis of Robertsmyia is revised and a key to species of the genus is provided.
1. Why do we learn statistics
Authors: Navarro Danielle , Foxcroft David
Published: January 2025

This chapter introduces the critical role of statistics in psychological and social sciences, emphasizing its importance despite students’ frequent apprehension toward the subject. Statistics is central to science because it serves as a safeguard against the biases and fallibilities inherent in human reasoning. The chapter begins by addressing common questions about why scientists rely so heavily on statistical methods, explaining that human intuition, while valuable, is unreliable for evaluating evidence impartially. Examples such as belief bias in logical reasoning illustrate how pre-existing beliefs can cloud judgment, making statistical tools essential for uncovering objective truths. Through examples like Simpson's Paradox, the chapter highlights the counterintuitive traps in data interpretation that necessitate a structured, statistical approach. Statistics is positioned not just as a technical tool, but as a vital instrument to navigate the complexities of human behavior and social phenomena.

The chapter also extends its discussion to the broader context of research methods, underscoring that while statistics is fundamental, it is only one part of the methodological toolbox. In the sciences robust statistical literacy is essential to ensure rigour in research design and data interpretation. The chapter concludes with a reflection on the universality of statistical principles across various types of research while acknowledging the domain-specific nuances of research design. Ultimately, it advocates for statistics as both a practical necessity for academic success and a critical life skill in an increasingly data-driven world, dispelling fears and misconceptions about its complexity and relevance.
3. Getting started with jamovi
Authors: Navarro Danielle , Foxcroft David
Published: January 2025

Chapter 3 of the book introduces readers to the statistical software jamovi, guiding them through the initial steps of downloading, installing, and familiarising themselves with its interface. The chapter emphasises the advantages of using jamovi for statistical analysis, including its user-friendly design, compatibility with the R statistical programming language, and open-source nature, which helps avoid the constraints of costly proprietary software. A significant portion of the chapter is devoted to exploring jamovi’s graphical user interface, with explanations on managing datasets, working with variables, and understanding the program's layout. Readers are introduced to basic operations such as entering data, importing various file formats, and using jamovi's features to manipulate and configure variables.

In addition, the chapter highlights practical aspects like installing add-on modules, handling uncommon data file formats, and saving work effectively. It also discusses the benefits of jamovi's APA-styled outputs, its integration with R syntax, and its utility for computed variables, making it a powerful tool for data analysis. While the focus remains on operational familiarity rather than statistical concepts, the chapter lays a robust foundation for users to navigate jamovi confidently and prepares them for subsequent chapters that delve deeper into statistical methodologies and analyses.
14. Factorial ANOVA
Authors: Navarro Danielle , Foxcroft David
Published: January 2025

Chapter 14 explores the extension of ANOVA to factorial designs, allowing for the analysis of data influenced by multiple categorical predictor variables. This chapter builds on previous concepts introduced in simpler ANOVA and regression models, integrating the use of factorial designs to examine interactions between factors. By employing examples such as the effects of gender and school on student reading comprehension, the chapter demonstrates how factorial ANOVA (specifically two-way ANOVA) provides insights into main effects and interactions between factors. It introduces balanced factorial designs and systematically guides the reader through hypothesis formulation, model interpretation, and statistical testing using jamovi. Detailed explanations of sums of squares, degrees of freedom, and how to compute F-statistics further demystify the underlying mechanics of factorial ANOVA.

Subsequent sections delve into practical applications, such as interpreting interaction effects and understanding the implications of significant main effects in the presence of interactions. The chapter also contrasts factorial ANOVA with regression, highlighting their equivalence in linear modeling. It addresses complex scenarios, such as unbalanced designs, by examining different hypothesis testing strategies, including Type I, II, and III sum of squares. Through visual aids, practical examples, and clear step-by-step analyses, this chapter equips readers with the theoretical and practical tools necessary to perform and interpret factorial ANOVA effectively, fostering a deeper understanding of its power and versatility in experimental research.
Patterns of Early Risk Factors for Juvenile Justice Outcomes in Youth with High-Incidence Disabilities
Authors: Cho Minhae , Koo Doyun , Rief Rachael Marie , Makau Dennis
Published: January 2025

This study aimed to identify early risk factors experienced by youth with high-incidence disabilities (HID) and investigate their juvenile justice outcomes. Using statewide administrative data in a Midwestern U.S. state, this study identified that 9% of students ( n = 5,377) were diagnosed with an HID condition in the special education system. Latent class analysis revealed three meaningful subgroups of youth with HID, based on underlying patterns of early risks they experienced: low risk (47.6%), academic risk (37.5%), and child welfare risk (14.9%). These within-group differences accounted for the varying developmental outcomes among these youth. The odds were 4 times and 19 times higher for youth with HID in the Academic Risks and Child Welfare Risks class, respectively.
Utilisation of a cultural perspective in child welfare expert assessments in Norway
Authors: Evans McGinn Polly , Nordanger Dag Øystein , Mæhle Magne Olav , Christiansen Øivin , Braarud Hanne Cecilie
Published: January 2025

In Norway, legislation requires consideration of a child’s culture in all phases of child welfare work. Through a quantitative content analysis of 285 child welfare expert assessment reports, we explored experts’ utilisation of a cultural perspective, comparing reports concerning immigrant and non-immigrant background children. We found that experts were rarely instructed to employ a cultural perspective but do so more frequently in reports concerning immigrant than non-immigrant background children. We found little evidence of critical reflection and interpreters were used rarely. The article discusses the possible explanations for and implications of a limited cultural perspective in child welfare expert assessments.
Chinese Adolescents’ Belief in a Just World: Social Class and Age Disparities
Authors: Lyu Sa-Sa , Wang Ya-Meng , Liu Chang-Jiang , Wang Qing-Hai , Ding Duo-Duo , Wang Zuo-Jun , Wang Deming
Published: January 2025

This cross-sectional study examined how Chinese adolescents’ belief in a just world (BJW) varied across social class and age. A sample of 2,748 adolescents aged 10 to 18 years (47.2% female; 99.1% Han ethnicity) from diverse socioeconomic backgrounds in China completed the Belief in a Just World Scale and the Socioeconomic Status Survey. Adolescents from higher social-class backgrounds were found to have higher general and personal BJW compared to their peers from lower social-class backgrounds, with the difference being more pronounced for personal BJW. Additionally, SES moderated age-related changes in BJW: for adolescents from middle- or higher-class backgrounds, BJW decreased with age, whereas for those from lower-class backgrounds, BJW remained relatively stable across adolescence. These findings suggest that BJW functions as a psychological defense mechanism, shaped by an individual’s perceived access to fairness and opportunity within their social environment.
Causes of Emotional and Psychological Reactions to Adventitious Blindness
Authors: Hudson D.
Published: January 2025

This review of the literature found that of the 27 works investigated, 23 emphasized the impact of society or a combination of societal and personal factors, rather than solely the personal experience of blindness, on the emotional and psychological reactions to adventitious blindness. The implications of this finding regarding the types of services that rehabilitation agencies should offer are presented.
Braille Literacy: Preservice Training and Teachers’ Attitudes
Authors: Wittenstein S.H.
Published: January 2025

This article reports on a study of the perceptions of 1,663 teachers of blind and visually impaired students regarding their competence in braille and in teaching braille, their attitudes toward braille, and their preservice training in braille. The study found that the majority of the teachers were confident in their braille abilities, clearly recognized the importance of braille, and strongly supported the use of braille with their students.
Effectiveness of an Independent Living Services Program for Older Persons Who Are Blind
Authors: Parish J. , Wen S.-S
Published: January 2025

This study evaluated the gains in capacity and mode of performance made by 57 elderly blind persons who were clients of an Independent Living Services Program in Mississippi. It was found that the gains in capacity were significant in all areas and the gains in mode of performance were significant for 41 of the 47 skill areas that were assessed.
Fostering innovation in smart library services: An in-depth exploration of empowered capabilities and dynamic strategies among university librarians in Pakistan
Authors: Aslam Sanila , Jabeen Munazza , Jabeen Misbah
Published: January 2025

Purpose

The need to implement innovative smart services in libraries is becoming more widely recognized. This paper investigates the current status of innovation in smart library services, how university librarians can support innovation in library services through their capacities and dynamic strategies, the implications that innovative initiatives have on overall effectiveness, and the challenges that university librarians perceive.

Methodology

A mixed-method approach was employed in this study. In the qualitative method, in-depth interviews were conducted with 10 chief librarians of university libraries and 150 university library professionals made up the sample for the quantitative investigation from throughout Pakistan.

Findings

The provision of smart services is clearly in the plans for the growth of university libraries in Pakistan, and the majority of university librarians also discuss the challenges in implementing innovations and provide solutions to these problems. The study uncovers significant barriers to adopting innovative library services, such as the fear of job displacement due to technology and financial constraints. However, it underscores the potential of focused training, AI, and IoT technologies to enhance library services.

Originality

These advancements can boost user engagement and operational efficiency and are crucial for aligning library services with global educational and sustainability goals. The research stresses the need for strategic planning and investment in financing and infrastructure, advocating that these measures can enhance educational outcomes and reduce information access disparities, thereby benefiting the entire community.
Empowering Novice Programmers: Redesigning Documentation for Effective Informal Learning
Authors: Zhang Icy (Yunyi) , Jia Yunqi (Ruby) , Cheng Xiaoxuan (Alicia) , Son Ji Y. , Stigler James W.
Published: January 2025

Although programming is often learned through formal instruction or self-paced tutorials, informal learning, for example, through publicly available online documentation, is also a significant resource for skill development among novices. However, many novices struggle to extract useful information from documentation. This work aims to answer two key questions: (1) What specific elements of documentation make it difficult for novice learners? (2) What are some design features that could enhance the effectiveness of documentation for novices? Study 1 aims to qualitatively explore the impact of three hypothesized design changes on novice programmers’ learning experience: moving examples to the top of the documentation, ordering examples in increasing argument complexity, and displaying example outputs next to example codes. We propose these design changes should facilitate novices’ learning from the documentation, enhancing its accessibility and effectiveness. Studies 2 and 3 evaluate the effectiveness of the redesigned documentation on novices’ learning outcomes through a quantitative method. Our results demonstrate that these design changes help novices navigate and apply documentation more effectively.