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Article ; Online: Another AVM Grading Scale … Really?

Crowley, R Webster

2016 Volume 92, Page(s) 537–539

MeSH term(s)	Humans ; Intracranial Arteriovenous Malformations/surgery ; Radiosurgery ; Treatment Outcome
Language	English
Publishing date	2016
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2016.06.041
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Article ; Online: Femoral access site complications following neurointerventional procedures: economic implications at a single center.

Joshi, Krishna C / Khanna, Ryan / Beer-Furlan, André / McLaughlin, Elizabeth / Chen, Michael / Crowley, R Webster / Munich, Stephan A

Journal of neurosurgery

2023 Volume 139, Issue 4, Page(s) 1078–1082

Abstract: Objective: Transfemoral access (TFA) has been the traditional route of arterial access for neurointerventional procedures. Femoral access site complications may occur in 2%-6% of patients. Management of these complications often requires additional ... ...

Abstract	Objective: Transfemoral access (TFA) has been the traditional route of arterial access for neurointerventional procedures. Femoral access site complications may occur in 2%-6% of patients. Management of these complications often requires additional diagnostic tests or interventions, each of which may increase the cost of care. The economic impact of a femoral access site complication has not yet been described. The objective of this study was to evaluate the economic consequences of femoral access site complications. Methods: The authors conducted a retrospective review of patients undergoing neuroendovascular procedures at their institute and identified those who experienced femoral access site complications. The subset of patients experiencing these complications during elective procedures was matched in a 1:2 fashion to a control group undergoing similar procedures and not experiencing an access site complication. Results: Femoral access site complications were identified in 77 patients (4.3%) over a 3-year period. Thirty-four of these complications were considered major, requiring blood transfusion or additional invasive treatment. There was a statistically significant difference in total cost ($39,234.84 vs $23,535.32, p = 0.001), total reimbursement ($35,500.24 vs $24,861.71, p = 0.020) and reimbursement minus cost (-$3734.60 vs $1326.39, p = 0.011) between the complication and control cohorts in elective procedures, respectively. Conclusions: Although occurring relatively infrequently, femoral artery access site complications increase the cost of care for patients undergoing neurointerventional procedures; how this influences the cost effectiveness of neurointerventional procedures warrants further investigation.
MeSH term(s)	Humans ; Endovascular Procedures/adverse effects ; Endovascular Procedures/methods ; Treatment Outcome ; Femoral Artery/surgery ; Punctures ; Retrospective Studies
Language	English
Publishing date	2023-03-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	3089-2
ISSN	1933-0693 ; 0022-3085
ISSN (online)	1933-0693
ISSN	0022-3085
DOI	10.3171/2023.1.JNS222171
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Article ; Online: Recurrence of a large intracranial fusiform aneurysm treated with overlapping Pipeline embolization devices: illustrative case.

Kumar, Jeyan Sathia / Dabhi, Nisha / Raper, Daniel M S / Capek, Stepan / Crowley, R Webster / Kalani, M Yashar / Kellogg, Ryan T / Park, Min S

Journal of neurosurgery. Case lessons

2023 Volume 6, Issue 12

Abstract: Background: Flow diversion, specifically with the Pipeline embolization device (PED), represents a paradigm shift in the treatment of intracranial aneurysms. Several studies have demonstrated its efficacy and at times superiority to conventional ... ...

Abstract	Background: Flow diversion, specifically with the Pipeline embolization device (PED), represents a paradigm shift in the treatment of intracranial aneurysms. Several studies have demonstrated its efficacy and at times superiority to conventional treatment modalities for aneurysms with a fusiform morphology, giant size, or wide neck. However, there may be a nonsignificant risk of recurrence after flow diversion of these historically difficult-to-treat aneurysms, relative to aneurysms with a more favorable morphology and size (i.e., saccular, narrow necked). To date, only three papers in the literature have demonstrated the recurrence of a completely occluded aneurysm on follow-up. Observations: The authors describe a patient with a giant middle cerebral artery fusiform aneurysm treated with multiple telescoping PEDs. On the 3-month follow-up angiogram, there was complete occlusion of the aneurysm. The patient was lost to follow-up and presented 4 years later with a recurrence of the aneurysm between PED segments, requiring retreatment. The patient represented 3 years posttreatment with the need for repeat treatment of the fusiform aneurysm due to separation of the existing PEDs along with stent reconstruction. At the 20-month follow-up after the third treatment, the initial aneurysm target was found to be occluded. Lessons: This case illustrates the need for long-term follow-up, specifically for patients with giant wide-necked or fusiform aneurysms treated with overlapping PEDs.
Language	English
Publishing date	2023-09-18
Publishing country	United States
Document type	Journal Article
ISSN	2694-1902
ISSN (online)	2694-1902
DOI	10.3171/CASE23369
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Article ; Online: Comparison of Radial Versus Femoral Access for Neuroendovascular Procedures in Very High Body Mass Index Individuals.

Kolb, Bradley / Joshi, Krishna / Sim, Justin / Radaideh, Yazan / Chen, Michael / Crowley, R Webster / Munich, Stephan

World neurosurgery

2023 Volume 184, Page(s) e32–e38

Abstract: Background: Femoral access (TFA) for neuroendovascular procedures may present a challenge in very high body mass index (BMI) individuals. Whether radial access (TRA) confers a comparative benefit in this specific population has not been studied.: ... ...

Abstract	Background: Femoral access (TFA) for neuroendovascular procedures may present a challenge in very high body mass index (BMI) individuals. Whether radial access (TRA) confers a comparative benefit in this specific population has not been studied. Methods: We retrospectively identified all patients undergoing neuroendovascular procedures at our center between 2017 and 2021 with BMI ≥35 kg/m Results: The primary outcome of any bleeding complication occurred in 7% of the femoral group and 2% of the radial group (odds ratio 4.2, 95% confidence interval 1.0-18.6, P = 0.0421). Radial access was also associated with significantly shorter mean procedure times (median 43 minutes for radial, median 58 minutes for femoral, P = 0.0009) and mean fluoroscopy exposure times (median 15 minutes for radial, median 20 minutes for femoral, P = 0.0003). There were no significant differences in nonaccess site complications, procedural failure, length of stay, or deaths during hospitalization. Conclusions: When compared to TRA, TFA was associated with a significantly greater rate of bleeding complications in very high BMI patients undergoing neuroendovascular procedures. Procedure time and fluoroscopy time were both significantly longer when using TFA compared to TRA in this patient population.
MeSH term(s)	Humans ; Body Mass Index ; Retrospective Studies ; Treatment Outcome ; Angiography ; Time Factors ; Radial Artery/surgery ; Catheterization, Peripheral/methods
Language	English
Publishing date	2023-12-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2023.12.007
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Article ; Online: Pre-operative embolization followed by clipping of Cognard type V dural arteriovenous fistula.

Joshi, Krishna C / Beer-Furlan, André / Crowley, R Webster / Munich, Stephan A

Journal of neurointerventional surgery

2021

Abstract: This article has been retracted because it describes the use of an investigative agent that has not been approved by the Food and Drug Administration. ...

Abstract	This article has been retracted because it describes the use of an investigative agent that has not been approved by the Food and Drug Administration.
Language	English
Publishing date	2021-03-25
Publishing country	England
Document type	Journal Article
ZDB-ID	2514982-9
ISSN	1759-8486 ; 1759-8478
ISSN (online)	1759-8486
ISSN	1759-8478
DOI	10.1136/neurintsurg-2020-017201
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Article ; Online: A Randomized Clinical Trial of Online Social Intelligence Training With Custodial Grandmothers.

Smith, Gregory C / Infurna, Frank J / Dolbin-MacNab, Megan / Webster, Britney / Castro, Saul / Crowley, Daniel M / Musil, Carol / Hu, Luxin / Hancock, Gregory R

The Gerontologist

2023 Volume 64, Issue 5

Abstract: Background and objectives: In this study, we investigated the efficacy of a self-administered, online Social Intelligence Training (SIT) program aimed at enhancing psychological and relational well-being among a nationwide U.S. sample of custodial ... ...

Abstract	Background and objectives: In this study, we investigated the efficacy of a self-administered, online Social Intelligence Training (SIT) program aimed at enhancing psychological and relational well-being among a nationwide U.S. sample of custodial grandmothers. Research design and methods: A two-arm randomized clinical trial (RCT) was conducted, where 349 grandmothers raising grandchildren aged 11-18 years were assigned to either SIT or an attention control condition (ACC). Participants self-completed online surveys at baseline and immediately postintervention, in addition to follow-ups at 3-, 6-, and 9-month postintervention. First-order latent difference score models were used to compare SIT to ACC, across all times of measurement, along key indicators of psychological and relational well-being on an intent-to-treat basis. Results: Although SIT was largely superior to ACC at yielding positive results, it appears that it attenuated longitudinal declines that occurred among ACC participants. SIT also exerted stronger effects on relational than psychological outcomes, with perceived relations with grandchildren being the most positively affected. Discussion and implications: Given that the historical time of this RCT unpredictably corresponded with the coronavirus disease 2019 pandemic, we suspect that SIT helped offset declines in psychological and relational well-being that are widely documented to have resulted from the pandemic. Our overall positive findings support future use of the inexpensive and easily delivered SIT program under normal environmental conditions, with the vulnerable and geographically disperse population of custodial grandmothers. Clinical trials registration number: NCT03239977.
MeSH term(s)	Humans ; Grandparents/psychology ; Family ; Surveys and Questionnaires ; COVID-19 ; Emotional Intelligence
Language	English
Publishing date	2023-06-24
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	216760-8
ISSN	1758-5341 ; 0016-9013
ISSN (online)	1758-5341
ISSN	0016-9013
DOI	10.1093/geront/gnad079
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Article ; Online: Bifurcation Aneurysm Treatment with PulseRider: Technical Nuances, Device Selection, Positioning Strategies, and Overcoming Geometric Challenges.

Spiotta, Alejandro M / Sattur, Mithun G / Kan, Peter / Crowley, R Webster

World neurosurgery

2020 Volume 142, Page(s) 339–351

Abstract: Background: Endovascular therapy is a viable alternative to surgical clipping for the treatment of intracranial aneurysms; however, aneurysms arising at bifurcations remain a challenge. The purpose of this technical report is to share the nuances of ... ...

Abstract	Background: Endovascular therapy is a viable alternative to surgical clipping for the treatment of intracranial aneurysms; however, aneurysms arising at bifurcations remain a challenge. The purpose of this technical report is to share the nuances of treating aneurysms with the PulseRider (PR), including device selection and positioning strategy, from authors who are highly experienced in its use. Methods: We offer a comprehensive guide for neuroendovascular surgeons less experienced with PR applications to include design, general coil embolization technique, principles of deployment and detachment, positioning options, and geometric challenges and their solutions. Results: In our experience, the PR is well suited for addressing the challenges of treating bifurcation aneurysms. Conclusions: PR use is intuitive and straightforward for use in bifurcation aneurysms with ideal favorable. PR can also be safely and effectively used to address a much broader and more challenging range of geometries.
MeSH term(s)	Blood Vessel Prosthesis/standards ; Embolization, Therapeutic/instrumentation ; Embolization, Therapeutic/methods ; Endovascular Procedures/instrumentation ; Endovascular Procedures/methods ; Humans ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/surgery ; Prosthesis Design/methods ; Stents/standards ; Treatment Outcome
Language	English
Publishing date	2020-04-28
Publishing country	United States
Document type	Journal Article ; Technical Report
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2020.04.126
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Article ; Online: Editorial: Perspective in current neuroprotection strategies.

Okada, Hideo / Matsuda, Yoshikazu / Chung, Joonho / Webster Crowley, R / Lopes, Demetrius K

Neurosurgical focus

2017 Volume 42, Issue 4, Page(s) E5

Language	English
Publishing date	2017
Publishing country	United States
Document type	Editorial
ZDB-ID	2026589-X
ISSN	1092-0684 ; 1092-0684
ISSN (online)	1092-0684
ISSN	1092-0684
DOI	10.3171/2017.1.FOCUS1728
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Article ; Online: Endovascular Stenting versus Carotid Endarterectomy for Treatment of Severe Carotid Stenosis: Recent Results from ACT I and the Updated CREST Studies.

Hong, Christopher S / Starke, Robert M / Crowley, R Webster

World neurosurgery

2016 Volume 92, Page(s) 473–475

MeSH term(s)	Carotid Stenosis ; Endarterectomy, Carotid ; Humans ; Stents ; Stroke ; Treatment Outcome
Language	English
Publishing date	2016-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2016.05.088
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Article ; Online: Transradial approach for neurointerventions: a systematic review of the literature.

Joshi, Krishna C / Beer-Furlan, André / Crowley, R Webster / Chen, Michael / Munich, Stephan A

Journal of neurointerventional surgery

2020 Volume 12, Issue 9, Page(s) 886–892

Abstract: Background: Despite the recent increase in the number of publications on diagnostic cerebral angiograms using transradial access (TRA), there have been relatively few regarding TRA for neurointerventional cases. Questions of feasibility and safety may ... ...

Abstract	Background: Despite the recent increase in the number of publications on diagnostic cerebral angiograms using transradial access (TRA), there have been relatively few regarding TRA for neurointerventional cases. Questions of feasibility and safety may still exist among physicians considering TRA for neurointerventional procedures. Methods: A systematic literature review was performed following PRISMA guidelines. Three online databases (MedLine via PubMed, Scopus and Embase) were searched for articles published between January 2000 and December 2019. Search terms included "Transradial access", "Radial Access", "Radial artery" AND "Neurointerventions". The reference lists of selected articles and pertinent available non-systematic analysis were reviewed for other potential citations. Primary outcomes measured were access site complications and crossover rates. Results: Twenty-one studies (n=1342 patients) were included in this review. Two of the studies were prospective while the remaining 19 were retrospective. Six studies (n=616 patients) included TRA carotid stenting only. The rest of the studies included treatment for cerebral aneurysms (n=423), mechanical thrombectomy (n=127), tumor embolization (n=22), and other indications (n=154) such as angioplasty and stenting for vertebrobasilar stenosis, balloon test occlusion, embolization of dural arteriovenous fistula and arteriovenous malformation, chemotherapeutic drug delivery, intra-arterial thrombolysis, and arterial access during a venous stenting procedure. Two (0.15%) major complications and 37 (2.75%) minor complications were reported. Sixty-four (4.77%) patients crossed over to transfemoral access for completion of the procedure. Seven (0.52%) patients crossed over due to access failure and 57 (4.24%) patients crossed over to TFA due to inability to cannulate the target vessel. Conclusion: This systematic review demonstrates that TRA has a relatively low rate of access site complications and crossovers. With increasing familiarity, development of TRA-specific neuroendovascular devices, and the continued reports of its success in the literature, TRA is expected to become more widely used by neurointerventionalists.
MeSH term(s)	Angioplasty/methods ; Catheterization/methods ; Catheterization, Peripheral/methods ; Cerebral Angiography/methods ; Embolization, Therapeutic/methods ; Female ; Humans ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/surgery ; Male ; Neurosurgical Procedures/methods ; Prospective Studies ; Radial Artery/diagnostic imaging ; Radial Artery/surgery ; Randomized Controlled Trials as Topic/methods ; Retrospective Studies ; Stents
Language	English
Publishing date	2020-03-09
Publishing country	England
Document type	Journal Article ; Systematic Review
ZDB-ID	2514982-9
ISSN	1759-8486 ; 1759-8478
ISSN (online)	1759-8486
ISSN	1759-8478
DOI	10.1136/neurintsurg-2019-015764
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