September 2021 | Issue 43
www.neuronewsinternational.com
7
Featured in this issue:
Jeffrey Saver Ethical challenges in remote stroke interventions
Profile Else Charlotte Sandset
Neuromodulation:
page 14
page 19
“Welcome and exciting”: Evidence mounts in favour of flow diversion technologies
assessment and comparative effectiveness analysis. The good news is that patients have many options. Physicians and surgeons must help patients select the best strategies to address their unique situations based on best medical and scientific evidence.” The use of flow diverter devices to treat intracranial aneurysms dates back roughly a full decade to the US Food and Drug Administration (FDA) granting Covidien premarket approval for its Pipeline embolisation device (PED) in 2011—a company and, therefore, a technology, that has since been acquired by Medtronic. This has made Medtronic and the PED frontrunners in the field, and fresh evidence on this device is still emerging 10 years on, with data on 1,000 aneurysms from a single-centre registry, published in Neurosurgery in June 2021, concluding that it is safe and effective at up to 13 years of follow-up. Multiple pieces of clinical research supporting And, even in the short window of time since these the use of flow diverter devices to treat results were published, key data on other intracranial aneurysms have come to flow diverter products have been light so far in 2021. In the past few weeks presented to the neurointervention alone, data from a multicentre pivotal trial world. This year’s SNIS annual Five-year assessing the Flow redirection endoluminal meeting saw Alexander L Coon results from (director of Cerebrovascular & device (FRED; MicroVention/Terumo) stent system have been published in the Journal Neurosurgery, SCENT trial= Endovascular of NeuroInterventional Surgery (JNIS), Carondelet Neurological while five-year results from the SCENT Institute, St Joseph’s Hospital, (Surpass intracranial aneurysm embolisation Tucson, USA) present five-year system pivotal trial to treat large or results from the SCENT giant wide-neck aneurysms; Stryker trial of the Surpass Neurovascular) study were presented Streamline device—the at the Society of NeuroInterventional largest prospective flow Surgery’s 18th annual meeting (SNIS; diversion study in this 26–29 July 2021, Colorado Springs, space to date, he claimed. USA and virtual). This trial, which was set up to evaluate the incidence frequency of he growing body of evidence in favour safety and effectiveness of aneurysm unchanged or of using flow diversion technologies for of Stryker’s device retreatment improved reported functional this indication—and the emergence of for the endovascular outcomes several different devices in this space in recent treatment of patients times—is a “welcome and exciting development”, with unruptured large or according to Philip M Meyers of the Neurointervention giant intracranial aneurysms Clinic at St Luke’s Health System in Boise, USA, who of the internal carotid artery (ICA) to the is also past president of SNIS and editor-in-chief of ICA terminus, involved 180 patients NeuroNews. from 26 centres in the USA. Coon “There have been numerous important publications noted in his late-breaking abstract in the neurointerventional space over the past year,” presentation that the SCENT trial Philip M he adds. “Tremendous growth in applications of new Meyers techniques and devices requires ongoing technology Continued on page 2
2.8%
80.7%
T
Special edition Spinal cord stimulation innovations and insights
Study indicates clinical benefit of non-paraesthesiabased approaches in burst SCS lead placement A study published in Neuromodulation: Technology at the Neural Interface has found that equivalent clinical benefits can be achieved in lead placement for burst spinal cord stimulation (SCS) using either conventional paraesthesia mapping, or anatomic landmarkbased approaches, in patients with chronic low back pain. IN REPORTING THE ONE-YEAR safety and efficacy results from the CRISP (Comparison of paraesthesia mapping to anatomic midline-based burst programming strategies) study, Adnan Al-Kaisy (Pain & Neuromodulation Academic Research Centre, Guy’s & St Thomas’ NHS Foundation Trust, London, UK) and colleagues write: “The results exhibit the feasibility of anatomic placement as a procedure that can potentially establish a more streamlined and time-efficient treatment continuum with minimal patient discomfort. “Also, physicians could have the option to choose the most appropriate lead implantation strategy to suit their patient’s characteristics when employing the burst SCS modality. This study can serve as a fundamental knowledge Continued on page 19
CLASSICAL OPEN AND ENDOVASCULAR SOLUTIONS
A O RT I C VIENNA
CARDIAC, VASCULAR AND ENDOVASCULAR AORTIC ADVANCES
5 – 7 O C T O B E R 2 0 21 BROADCAST
REGISTRATION OPEN www.cxaortic.com