Can aqueductal stenosis be treated through a minimally invasive endovascular approach without transgressing brain parenchyma?

In this episode, JNIS Editor-in-Chief, Dr. Michael Chen, speaks with neuro-interventional radiologist Dr. Michal Obrzut¹ about a neurointerventional approach to the management of obstructive hydrocephalus secondary to aqueductal stenosis.

The author describes the underlying concept, technical feasibility in cadaveric models, and potential implications for minimally invasive neurosurgical practice.

Link to the discussed paper: "A novel neurointerventional subarachnoid aqueductoplasty technique for the treatment of aqueductal stenosis: a cadaveric feasibility study"

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(1) Neurosurgery, Cleveland Clinic Florida, Weston, Florida, USA

Medical professionals can oftentimes fall under the category of "second victims", as they experience burnout and moral injury from the impacts of their work. Over the course of a neurointerventionalist's medical career, serious complications in procedures are sadly inevitable. These can be difficult to process, and there are not always the systems in place to provide the support needed, either inside or outside of the hospital. A new survey has been carried out to assess the severity and prevalence of negative psychological effects on physicians who have experienced these complications. Dr. Ansaar Rai¹ joins JNIS Editor-in-Chief Dr. Michael Chen to discuss the original research piece, "Unseen wounds: a multinational investigation of neurointerventionalists on the psychological toll of complications". 

(1) Interventional Neuroradiology, West Virginia University Rockefeller Neuroscience Institute, Morgantown, West Virginia, USA

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Dr Donald Heck (1) and Dr Peter Kan (2) join JNIS Editor-in-Chief Dr. Michael Chen to discuss the commentary “Middle meningeal artery embolization in the routine care of chronic subdural hematoma?” by D.V. Heck et al.

They highlight key debates around efficacy, safety, and workflow integration as embolization moves closer to becoming a routine therapeutic option.

(1) Triad Radiology Associates, Novant Health Forsyth Medical Center, Winston Salem, North Carolina, USA

Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ.

Pulsatile tinnitus — the perception of a rhythmic sound in sync with the heartbeat — can be a key indicator of underlying vascular or structural pathology. In this episode, JNIS new Editor-in-Chief Dr. Michael Chen speaks with Dr. Madhavi Duvvuri and Dr. Matthew Robert Amans, authors of Non-invasive imaging modalities for diagnosing pulsatile tinnitus: a comprehensive review and recommended imaging algorithm. They are both from the University of California San Francisco, USA.

Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ.

In the SCENT trial, researchers investigated the effects of the Surpass flow diverter system for treating wide-necked aneurysms. Five-year results of this trial have recently been published in JNIS, presenting the safety and effectiveness outcomes of treatment with the Surpass Streamline flow diverter system. The study analyses the rates of aneurysm occlusion and adverse events.

Editor-in-Chief of JNIS, Dr. Felipe C. Albuquerque, interviews Dr. Philip Meyers¹, author of the paper: Five-year results of the SCENT trial with Surpass flow diverters to treat large or giant wide-neck aneurysms

1. Radiology and Neurological Surgery, Columbia University, New York, USA

Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ.

High risk factors for stroke such as smoking and blood pressure are not equally represented throughout the patient population. These are just two of the socioeconomic influences on cerebrovascular disease. One way to view this association is through the lens of the Area Deprivation Index (ADI), a measure of neighbourhood-level deprivation, and this was the approach of the study discussed in this episode. The study evaluated the association between the ADI and the treatment of ruptured intracranial aneurysms compared with unruptured intracranial aneurysms across multiple centres. Editor-in-Chief of JNIS, Dr. Felipe C. Albuquerque, interviews Dr. Alexandra Paul¹, author of the paper: Multicenter study of association between socioeconomic status and treatment of ruptured cerebral aneurysms compared to unruptured cerebral aneurysms: insights from 4,517 patients using the area deprivation index

1. Department of Neurosurgery, Albany Medical Center, Albany, New York, USA

Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ.

The "River" stent is a novel stent designed specifically to account for the anatomical and procedural requirements of venous sinus stenosis. A multicentre study of the device's safety and efficacy is underway, comprising 39 subjects across 5 US centres. The 1-year results have been recently published in JNIS. Editor-in-Chief of JNIS, Dr. Felipe C. Albuquerque, interviews Dr. Athos Patsalides¹, author of the paper: The River study: the first prospective multicenter trial of a novel venous sinus stent for the treatment of idiopathic intracranial hypertension

Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ.

Observations from practice and data analysis have shown that the duration of mechanical thrombectomy procedures are a strong predictor of outcome even with successful procedures. A large multicenter study was conducted which gives insight into choices between catheter types, and strategic decisions to be made during prolonged procedures.

Dr Felipe C. Albuquerque, Editor-in-Chief of JNIS, interviews Dr. Ali Alawieh¹ and Dr. Alejandro Spiotta²,  two authors of the paper: 

Prolonged intracranial catheter dwell time exacerbates penumbral stress and worsens stroke thrombectomy outcomes

1. Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA

2. Med Univ S Carolina, Charleston, South Carolina, USA

Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ.

The use of assistive devices when treating unruptured aneurysms is widespread in neurointerventional practice. But there is no standard for how long patients should receive dual anti-platelet therapy after the procedure, to protect them from thrombotic complications. Durations can range from one month to one year. This episode looks at a review of patient data across 12 locations to understand the effect of therapy duration on risk of complications. 

Dr Felipe C. Albuquerque, Editor-in-Chief of JNIS, interviews Dr. Andrew Ringer¹, first author of the paper: 

1. Mayfield Clinic, Cincinnati, Ohio, USA

Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ.

There has been a large increase in the number of non-invasive neurovascular studies performed in the last decade, particularly CT angiograms and MR angiograms. What has this meant for catheter-based angiography? This episode looks at an analysis done on a large claims database in the USA, to observe trends in imaging modalities, as well as the distinctions in use by neurosurgeons and radiologists.

Dr Felipe C. Albuquerque, Editor-in-Chief of JNIS, interviews Dr. Francis Jareczek¹ and Dr. D. Andrew Wilkinson¹, two of the authors of the paper: 

1. Neurosurgery, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA

Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ.