AUGUST 2019 AJNR VOLUME 40 • PP 1251–1436 AUGUST 2019 THE JOURNAL OF DIAGNOSTIC AND VOLUME 40 INTERVENTIONAL NEURORADIOLOGY NUMBER 8 WWW.AJNR.ORG Glymphatic imaging of the brain Automated FLAIR lesion segmentation with CNN Same room flat panel detector CT perfusion and thrombectomy for large-vessel occlusion Official Journal ASNR • ASFNR • ASHNR • ASPNR • ASSR NE AND DONE INDICATIONS FOR USE: The WEB Aneurysm Embolization System is indicated for use at the middle cerebral artery (MCA) bifurcation, internal carotid artery (ICA) terminus, anterior communicating artery (AComm) complex, or basilar artery apex for the endovascular treatment of adult patients with saccular, wide neck bifurcation intracranial aneurysms with dome diameter from 3 mm to 10 mm and either neck size 4 mm or greater or the dome-to-neck ratio is greater than 1 and less than 2. The WEB Aneurysm Embolization System is contraindicated for patients with known bacterial infection that may interfere with or negatively affect the implantation procedure and patients with known hypersensitivity to nickel. For complete indications, contraindications, potential complications, warnings, precautions, and instructions, see instructions for use (IFU provided with the device). The VIA® Catheter is intended for the introduction of non-liquid interventional devices (such as stents/_ ow diverters) and infusion of diagnostic (such as contrast media) or non-liquid therapeutic agents into the neuro, peripheral, and coronary vasculature. The VIA Catheter is contraindicated for use with liquid embolic materials, such as n-butyl 2-cyanoacrylate or ethylene vinyl alcohol & DMSO (dimethyl sulfoxide). The VIA Catheter is contraindicated for use in the pediatric population (<22 yrs of age). Caution: Federal law restricts these devices to sale by or on the order of a physician. MicroVention® delivers the first intrasaccular solution for wide neck bifurcation aneurysms. The world leader and first PMA-approved device in an important new category of intrasaccular flow disruptors. SL Device The WEB® System is a safe and effective single-device solution for treating wide neck bifurcation aneurysms. SLS Device Contact a MicroVention sales associate to learn more MicroVention Worldwide about integrating the WEB® device into your practice. Innovation Center PH +1.714.247.8000 35 Enterprise Aliso Viejo, CA 92656 USA MicroVention UK Limited PH +44 (0) 191 258 6777 MicroVention Europe, S.A.R.L. PH +33 (1) 39 21 77 46 MicroVention Deutschland GmbH PH +49 211 210 798-0 microvention.com MICROVENTION® is a registered trademark of MicroVention, Inc. WEB® and VIA® are registered trademarks of Sequent Medical, Inc. in the United States ©2019 MicroVention, Inc. MM854 US 02/19 ASNR 58th Annual Meeting & The Foundation of the ASNR Symposium 2020 CALL FOR ABSTRACTS Join us May 30-June 4, 2020 at Caesars Palace in Las Vegas to present the best Submission Deadline: Friday, November 1, 2019 (8:00PM EST) of peer review. Submit an abstract for the ASNR 58th Annual Meeting (May 30 - June 4, 2020, Las Vegas, NV) in one of the following presentation categories: • • • • • • Abstract Submissions Information and Criteria 1. Abstracts should describe the learning 5. Submission topic areas include: objectives of the presentation. Adult Brain, Spine, Head and Neck, 2. The American Journal of Neuroradiology Pediatrics, Functional/Advanced Imaging, (AJNR) encourages presenters to submit Interventional, Health Policy, AI/ manuscripts based on their work to AJNR Informatics, and Professional Development. before considering other journals. 6. Submit each abstract in one category only. 3. Presenters of accepted abstracts must 7. Format abstract text using headings required register for the ASNR 58th Annual for submission category. Meeting and/or the Foundation of the 8. Maximum length: 2,500 characters, not ASNR Symposium 2020. 4. Published or previously presented works 9. should NOT be submitted. the system. 10. Changes can be made to the abstract until the deadline. Questions? Contact the ASNR Education Department at [email protected]. Neuroform Atlas® Stent System • Mass effect Cautions / precautions • Myocardial infarction • Take all necessary precautions to limit X-ray radiation doses to clinical RX ONLY • Neurological deficit/intracranial sequelae operators by using sufficient shielding, reducing fluoroscopy times, and See package insert for complete indications, contraindications, • Pseudoaneurysm modifying X-ray technical factors whenever possible. warnings and instructions for use. • Reaction to radiation exposure (i.e., alopecia, burns ranging in severity • The Neuroform Atlas stent may create local field inhomogeneity and from skin reddening to ulcers, cataracts, or delayed neoplasia) susceptibility artifacts during magnetic resonance angiography (MRA), Indications for use which may degrade the diagnostic quality to assess effective intracranial The Neuroform Atlas Stent System is indicated for use with neurovascular • Reactions to anti-platelet/anti-coagulant agents aneurysm occlusion. embolization coils in the anterior circulation of the neurovasculature for • Renal failure • Safety and effectiveness of the Neuroform Atlas Stent System in patients the endovascular treatment of patients ≥ 18 years of age with saccular • Seizure below the age of 18 has not been established. wide-necked (neck width ≥ 4 mm or a dome-to-neck ratio of < 2) intracranial • Stent fracture, migration/embolization, or misplacement • The benefits may not outweigh the risks of device use in patients with aneurysms arising from a parent vessel with a diameter of ≥ 2.0 mm and • Stent thrombosis small and medium asymptomatic extradural intracranial aneurysms, ≤ 4.5 mm. • Stroke including those located in the cavernous internal carotid artery. Contraindications • Transient ischemic attack • Carefully weigh the benefits vs. risks of device treatment for each • Patients in whom the parent vessel size does not fall within the indicated • Vasospasm individual patient based on their medical health status and risk factors range. • Vessel occlusion or closure including parent vessel or non-target side- for intracranial aneurysm rupture during their expected life time such • Patients in whom antiplatelet and/or anticoagulation therapy (e.g., aspirin branches as age, comorbidities, history of smoking, intracranial aneurysm size, location, and morphology, family history, history of prior asymptomatic and clopidogrel) is contraindicated. • Vessel perforation/rupture, dissection, trauma or damage subarachnoid hemorrhage (aSAH), documented growth of intracranial • Patients who have not received anti-platelet agents prior to stent • Vessel thrombosis aneurysm on serial imaging, presence of multiple intracranial aneurysms, implantation. • Visual impairment and presence of concurrent pathology. The benefits may not outweigh the • Patients with an active bacterial infection. • Other procedural complications including but not limited to anesthetic and risks associated with device use in certain patients; therefore, judicious • Patients in whom angiography demonstrates the anatomy is not contrast media risks, hypotension, hypertension, access site complications patient selection is recommended based on clinical practice guidelines or appropriate for endovascular treatment due to conditions such as: (including pain, hematoma, local bleeding, local infection, and injury to the tools to assess the life time risk of intracranial aneurysm rupture. • Severe intracranial vessel tortuosity or stenosis; artery (i.e. dissection), vein, or adjacent nerves) • Intracranial vasospasm not responsive to medical therapy. • Unplanned intervention Safety Information Magnetic Resonance Conditional • Patients in whom a pre-existing stent is in place in the parent artery at the Non-clinical testing and analysis have demonstrated that the Neuroform target intracranial aneurysm location. Warnings Atlas Stent is MR Conditional alone, or when overlapped with a second Contents supplied STERILE using an ethylene oxide (EO) process. Do not stent, and adjacent to a Stryker Neurovascular coil mass. A patient with the Potential adverse events use if sterile barrier is damaged. If damage is found, call your Stryker Neuroform Atlas Stent can be safely scanned immediately after placement of The potential adverse events listed below, as well as others, may be associated Neurovascular representative. this implant, under the following conditions: with the use of the Neuroform Atlas Stent System or with the procedure: For single use only. Do not reuse, reprocess or resterilize. Reuse, reprocessing • Static magnetic field of 1.5 and 3.0 Tesla • Aphasia or resterilization may compromise the structural integrity of the device and/ • Maximum spatial gradient field up to 2500 Gauss/cm (25 Tesla/m) • Allergic reaction to Nitinol metal and medications or lead to device failure which, in turn, may result in patient injury, illness • Maximum MR system reported whole body averaged specific absorption • Aneurysm perforation/rupture, leak or contrast extravasation or death. Reuse, reprocessing or resterilization may also create a risk of rate of 2 W/kg (Normal Operating Mode) and head averaged specific contamination of the device and/or cause patient infection or cross-infection, • Blindness absorption rate of 3.2 W/kg. including, but not limited to, the transmission of infectious disease(s) from Under the scan conditions defined above, the Neuroform Atlas Stent is • Cardiac arrhythmia one patient to another. Contamination