JNIS Podcast
90 episodes - English - Latest episode: 2 months ago - ★★★★★ - 14 ratingsThe Journal of NeuroInterventional Surgery (JNIS) is a leading peer review journal for scientific research and literature pertaining to the field of neurointerventional surgery. The journal was launched in 2009 following growing professional interest in neurointerventional techniques for the treatment of a range of neurological and vascular problems including stroke, aneurysms, brain tumors, and spinal disorders. JNIS is published by BMJ on behalf of SNIS, it is also the official journal of ESMINT, the Interventional Chapter of ANZSNR, CING, HKSITN, the INR Chapter of NRST and STNI.
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Episodes
GRAFT reduces potential flow diverter malapposition and occasional acute thrombus formation
July 14, 2016 17:06 - 10 minutes - 13.9 MBIn this podcast, Dr Robert Tarr interviews Dr Matthew Gounis and Dr Ajit Puri on their latest study, "Grading of Regional Apposition after Flow-Diverter Treatment (GRAFT): a comparative evaluation of VasoCT and intravascular OCT". GRAFT is a semi-automated image post-processing software, which uses intuitive two-dimensional representations of wall apposition from either high-resolution contrast-enhanced cone-beam CT (VasoCT) or intravascular optical coherence tomography (OCT) images. The te...
Arteriovenous malformation embocure score
June 28, 2016 16:03 - 14 minutes - 19.7 MBIn this podcast, Dr Demetrius Lopes tells Robert Tarr, the Editor of JNIS, the details of the study "Arteriovenous malformation embocure score: AVMES". Demetrius Lopes, a neuroendovascular surgeon at Rush University Medical Center, Chicago, Illinois, USA, is the corresponding author of this study selected as Editor's choice for the July issue of JNIS, which is fully accessible here: http://jnis.bmj.com/content/8/7/685.full
Three-dimensional printing of anatomically accurate patient specific intracranial aneurysm models
June 06, 2016 17:21 - 13 minutes - 18.4 MBIn this podcast, the Editor of JNIS, Robert Tarr, talks to Christof Karmonik, from the Houston Methodist Research Institute, USA, about the details of the study "Three-dimensional printing of anatomically accurate patient specific intracranial aneurysm models". The research concluded that the 3D printed aneurysm models were accurate and able to be produced inhouse. Read the full paper here: http://jnis.bmj.com/content/early/2015/04/10/neurintsurg-2015-011686.full
Endovascular Stroke Therapy: early emergency arrivals effects on collaterals, infarcts and outcomes
May 19, 2016 19:35 - 14 minutes - 20.2 MBIn this podcast, Dr David Liebeskind, explains the details of the paper "Early arrival at the emergency department is associated with better collaterals, smaller established infarcts and better clinical outcomes with endovascular stroke therapy: SWIFT study". Dr David Liebeskind, from the Neurovascular Imaging Research Core, UCLA Department of Neurology, Los Angeles, USA, is interviewed by Dr Robert Tarr, Editor-in-Chief of the JNIS. Read the full article here: http://jnis.bmj.com/content/8...
Stroke treated with mechanical thrombectomy: outcomes of prior use of intravenous thrombolysis
April 19, 2016 16:12 - 38 minutes - 52.3 MBWith multiple RCTs demonstrating clear benefit of mechanical thrombectomy in ELVO, the question of best approach to patients eligible for simultaneous treatment with IV TPA and mechanical thrombectomy has been debated. Dr. Hirsch interviews Drs. Leslie-Mazwi and Weber after their instructive papers on this topic. Read the full papers: “Does the use of IV tPA in the current era of rapid and predictable recanalization by mechanical embolectomy represent good value?” is available here: http://...
Catheter based selective hypothermia reduces stroke volume during focal cerebral ischemia in swine
April 01, 2016 11:27 - 11 minutes - 15.5 MBIn this podcast, Dr Thomas Mattingly explains the details of this study conducted in swines and which gives insights into wether endovascular selective hypothermia can provide neuroprotection within time frames relevant to acute ischemic stroke treatment. Read the full article here: http://jnis.bmj.com/content/8/4.toc .
Predictors of poor outcome despite recanalization: a regression analysis of the NASA registry
March 01, 2016 17:36 - 14 minutes - 19.8 MBIn this podcast, Italo Linfante, Miami Cardiac and Vascular Institute and Neuroscience Center, Baptist Hospital, Miami, USA, tells JNIS’ Editor Robert Tarr, the details of his study “Predictors of poor outcome despite recanalization: a multiple regression analysis of the NASA registry”. To access the full article, click here: http://goo.gl/wNEljN .
Raymond-Roy Occlusion Classification of intracranial aneurysms treated with coil embolization
January 29, 2016 17:06 - 10 minutes - 14.5 MBIn this podcast we find the details of the study "An update to the Raymond-Roy Occlusion Classification of intracranial aneurysms treated with coil embolization". Professor Robert Tarr interviews Justin Mascitelli, the author of the article, which can be read here: http://goo.gl/9IEX8L.
Critical assessment of the morbidity associated with ruptured cerebral arteriovenous malformations
January 12, 2016 11:23 - 13 minutes - 18.2 MBIn this podcast Dr Robert Tarr talks to Dr Michael Chen about his editors choice paper "Critical assessment of the morbidity associated with ruptured cerebral arteriovenous malformations". They discuss the reasons for undertaking the study, the controversy surrounding the ARUBA trial and the possibility of continuing the research with a larger sample size. Full paper>> http://jnis.bmj.com/content/early/2015/01/07/neurintsurg-2014-011517.full?sid=2dd0bc6c-36e4-4409-b7bd-c2c173e0dc41
Healing of aneurysm: a comparison of gene expressions
December 02, 2015 11:49 - 11 minutes - 15.5 MBWhat understanding do we have of the rupture risk and healing following aneurysm treatment? Robert Tarr interviews Ram Kardivel, of the Neuroradiology Research Laboratory, Mayo Clinic, USA, on the main conclusions of her study "Gene expression comparison of flow diversion and coiling in an experimental aneurysm model". Read the full article here: goo.gl/WpaqXz
Aneurysm permeability following coil embolization: Packing density and coil distribution
October 08, 2015 11:48 - 12 minutes - 17.1 MBIn this podcast Dr Robert Tarr talks to Dr Matt Gounis and his team Dr Juyu Chueh and Dr Srinivasan Vedantham about their editors choice paper. In this podcast they discuss their methodology and the drawbacks of this kind of study. Full paper >> http://jnis.bmj.com/content/7/9/676.full
Incidence and morbidity of craniocervical arterial dissections
October 06, 2015 13:40 - 12 minutes - 16.7 MBIn this podcast Dr Robert Tarr speaks to Dr Ali Seifi about his recent paper that was selected as editors choice. This podcast covers the differences in mortality and patient outcome between endovascular coiling and surgical clipping and discusses possible chances for a future aneurysm registry. Full paper >> http://jnis.bmj.com/content/7/10/728.full?sid=16c2199c-8711-4039-aab9-aa10a1496033
The trials and tribulations of peer review
June 30, 2015 16:21 - 30 minutes - 21.2 MBBias and peer review are of universal importance to all those that produce scholarly work. Fiona Godlee and Rob Tarr, editors in chief of The BMJ and JNIS respectively, share their insights and experience on these highly topical issues with Joshua Hirsch. Read the related paper: http://jnis.bmj.com/content/early/2015/04/17/neurintsurg-2015-011781.full
Value based healthcare and the specialist
May 13, 2015 13:42 - 36 minutes - 24.7 MBThe system of healthcare delivery in the United States is in the midst of a meaningful transition. Traditional fee for service paradigms are moving towards what has been termed value-based approaches. Doctors Joshua HIrsch, Geraldine Mcginty and Greg Nicola examine recent developments and discuss how specialist can participate and help lead that transition. Listeners to the podcast might enjoy reading the following JNIS articles that are associated with the discussion: The Bundled Payments...
The MRClean trial
February 02, 2015 16:48 - 26 minutes - 18.2 MBOn Dec 17th 2014, the NEJM published the results of MR CLEAN; a Dutch study comparing patients treated with intra-arterial thrombolysis to those of a medically managed cohort. The design of this trial was ingenious; focusing attention on patients who appeared to have failed intravenous thrombolysis. The IAT managed group performed quite favorably with respect to this control group. Three associate editors, Drs. Hirsch, Fiorella and Mocco discuss the impact of MR CLEAN and their personal ...
Endovascular treatment for large vessel stroke
January 14, 2015 14:52 - 39 minutes - 26.8 MBWith advances in device design, patient selection paradigms and other elements of treatment, the neuroendovascular approach to acute ischemic stroke has made great strides forward. In this podcast, Dr Joshua Hirsch interviews Dr Brijesh Mehta on how the implementation of operational improvements can meaningfully impact patient outcomes. Dr Mehta is a neuroInterventional surgeon at the Memorial Neuroscience Institute in south Florida, where he directs the Comprehensive Stroke Center and Ne...
ASPECTS decay during inter-facility transfer predicts patient outcomes
January 02, 2015 14:52 - 8 minutes - 6.04 MBPretreatment Alberta Stroke Program Early CT Scores (ASPECTS) is associated with clinical outcomes. The rate of decline between subsequent images, however, may be more predictive of outcomes as it integrates time and physiology. A paper published in the January issue of JNIS retrospectively looked at patients transferred from six primary stroke centers and treated with intra-arterial therapy (IAT). They found patients with faster rates of ASPECTS decay during inter-facility transfers are ass...
Unruptured intracranial aneurysms conservatively followed with serial CT angiography
December 17, 2014 12:11 - 13 minutes - 9.44 MBCould morphology and growth predict rupture? Despite several landmark studies, the natural history of unruptured intracranial aneurysms (UIA) remains uncertain. Rob Tarr talks to William Mehan, Division of Neuroradiology, Massachusetts General Hospital, about his paper which aimed to identify or confirm factors predictive of rupture of UIA being observed conservatively with serial CT angiography in a North American patient population. Read the full paper (for free): http://jnis.bmj.com/con...
Admission neutrophil–lymphocyte ratio predicts 90 day outcome after endovascular stroke therapy
November 05, 2014 14:23 - 11 minutes - 7.8 MBImmune dysregulation influences outcome following acute ischemic stroke (AIS). Admission white blood cell counts are routinely obtained, making the neutrophil–lymphocyte ratio (NLR) a readily available biomarker of the immune response to stroke. With colleagues Taura Barr, WVU Prevention Research Center, One Medical Center Drive, sought to identify the relationship between NLR and 90 day AIS outcome. Rob Tarr asks her what they found. Read the full paper: http://goo.gl/nGXmYO
Endovascular recanalization of complete subacute to chronic atherosclerotic occlusions
October 10, 2014 14:21 - 16 minutes - 11.6 MBSymptomatic subacute/chronic large artery intracranial occlusive disease represents a common medical dilemma. A recent JNIS paper reports a multicenter experience of endovascular recanalization of intracranial atherosclerotic occlusions refractory to medical therapy. Robb Tarr talks to co-author Raul Nogueira, Department of Neurology, Marcus Stroke and Neuroscience Center/Grady Memorial Hospital/Emory University. Read the full paper: http://jnis.bmj.com/content/6/9/645.full
Safety and predictors of aneurysm retreatment for remnant intracranial aneurysm
October 01, 2014 12:47 - 19 minutes - 13.1 MBAneurysmal subarachnoid hemorrhage (SAH) is a rare but devastating form of stroke. Endovascular therapy has been criticized for its higher rate of recanalization and retreatment. The safety and predictors of retreatment are unknown. A recent study in JNIS reports the clinical outcomes, imaging outcomes and predictors for aneurysm retreatment after initial endovascular embolization. Rob Tarr speaks with co-author Dr Osama Zaidat, Vascular and Interventional Neurology/Department of Neurology...
Affordable care 2014: A tale of two boards
August 12, 2014 16:37 - 36 minutes - 24.9 MBThe Patient Protection and Affordable Care Act (ACA) became law on 23 March 2010. As part of the law, two independent boards were established. The Patient-Centered Outcomes Research Institute embodies national aspirations for employing comparative effectiveness research in healthcare decision-making, and the Independent Payment Advisory Board is focused on the need for a group of impartial experts to establish anticipatable growth rates for Medicare. Approximately 4 years after the bill wa...
Flat detector derived parenchymal blood volume maps to estimate cerebral blood volume
July 28, 2014 13:23 - 8 minutes - 12 MBNewer flat panel angiographic detector (FD) systems have the capability to generate parenchymal blood volume (PBV) maps. The ability to generate these maps in the angiographic suite has the potential to markedly expedite the triage and treatment of patients with acute ischemic stroke. David Fiorella, Department of Neurological Surgery, Stony Brook University Medical Center, NY, and colleagues, have compared FP-PBV maps with cerebral blood volume (CBV) maps derived using standard dynamic CT...
Current Procedural Terminology
April 09, 2014 10:05 - 30 minutes - 21.1 MBUS physicians nearly universally use the CPT coding system. This code set communicates medical, procedural, surgical and diagnostic services and is a critical component of describing the work we do. Drs. Josh Hirsch, Jackie Bello and Raymond Tu are actively involved in the world of physician reimbursement through their associations with the Relative-Value Update Committee (RUC) and Current Procedural Terminology (CPT) committees. In this podcast they discuss the role CPT plays in physicia...
The ADAPT technique in the clinic: A direct aspiration first pass technique for stroke thrombectomy
April 07, 2014 16:27 - 17 minutes - 12.3 MBThe development of new revascularization devices has improved recanalization rates and time but not clinical outcomes. In a paper in May's JNIS, Aquilla Turk, Department of Radiology, Medical University of South Carolina, ad colleagues, report their initial results with a new technique utilizing a direct aspiration first pass technique with a large bore aspiration catheter as the primary method for vessel recanalization. Rob Tarr discusses the findings with Dr Turk and also Marc Chimowitz, ...
Evidence based neurointervention
March 20, 2014 14:47 - 30 minutes - 21.1 MBDrs. Hirsch, Meyers and Jayaraman discuss the evolving and at times complex role of Evidence Based Medicine (EBM) in contemporary neurointerventional practice. The discussants contrast EBM with Comparative Effectiveness Research and the role it plays in coverage decisions. The podcast directly links to the following articles: http://www.ncbi.nlm.nih.gov/pubmed/24578482?dopt=Abstract General considerations: http://www.ncbi.nlm.nih.gov/pubmed/22166819 http://jnis.bmj.com/content/4/1/11....
Size and location of ruptured intracranial aneurysms in patients with single and multiple aneurysms
March 14, 2014 13:50 - 14 minutes - 10.2 MBThe difference in the relationship between the size of intracranial aneurysms (IAs) and their risk of rupture in patients with singe IAs versus those with multiple IAs is unclear. A recent JNIS paper retrospectively analysed the size of ruptured IAs (RIAs) in patients with single and multiple IAs, in order to study this relationship further. JNIS editor Rob Tarr spoke to author Bharathi Jagadeesan, Department of Radiology, University of Minnesota, about the outcome. Read the paper here: h...
Endovascular reperfusion and cooling in cerebral acute ischemia
February 04, 2014 16:23 - 11 minutes - 7.64 MBThe efficacy of hypothermia as a neuroprotectant has yet to be demonstrated in acute ischemic stroke. Researchers at Emory University School of Medicine conducted a phase I pilot study to assess the feasibility and safety of performing intravascular hypothermia after definitive intra-arterial reperfusion therapy (IAT), and in this podcast co-author Rishi Gupta tells Rob Tarr what they found. Read the full paper: Endovascular Reperfusion and Cooling in Cerebral Acute Ischemia (ReCCLAIM I)...
The hyperdense vessel sign predicts successful recanalization in acute ischemic stroke
July 26, 2013 14:29 - 13 minutes - 17.9 MBJNIS editor-in-chief Rob Tarr talks to Mike Froehler, Department of Neurology, University of Iowa Hospital, about his paper which revealed the hyperdense vessel sign on CT in acute ischemic stroke was strongly predictive of successful recanalization using the Merci device. Read the full paper here: http://goo.gl/D7klFb
The sustainable growth rate
June 11, 2013 15:19 - 25 minutes - 35.3 MBNearly annually, US healthcare providers face a significant downward revision to their Medicare fee schedule secondary to the application of the sustainable growth rate formula. Recent developments raise the possibility that this unsustainable situation might soon change; for the better. Drs Josh Hirsch, David Rosman and Raymond Liu review the sustainable growth rate and discuss how it works. In closing out the podcast, they review the circumstances that are potentially leading to an end of...
AVM angioarchitecture and hemorrhagic presentation in children with cerebral AVMs
April 25, 2013 12:06 - 19 minutes - 26.5 MBJNIS editor Rob Tarr talks to Darren Orbach, Department of Neurointerventional Radiology, Children's Hospital Boston, about his recent editor's choice paper: Angioarchitectural features associated with hemorrhagic presentation in pediatric cerebral arteriovenous malformation.
Component coding and the RUC
April 23, 2013 15:29 - 51 minutes - 70.5 MBDrs Josh Hirsch, Bill Donovan and Zeke Silva are actively involved in the world of physician reimbursement through their volunteer associations with organizations like the ACR, ASNR and the RUC, amongst others. This podcast is suitable for beginners or aficionados as the physician discussions will range from the history of the RUC to nuances of the erosion of component coding. The authors will use this platform to discuss the following two articles: The RUC: a primer for neurointerventiona...
Management of subarachnoid hemorrhage with intracerebral hematoma
April 23, 2013 15:28 - 17 minutes - 23.5 MBRob Tarr, JNIS editor, talks to Jennifer Frontera, Neurosurgery, Mount Sinai School of Medicine, about her study showing aneurysm coiling followed by ICH evacuation is a viable alternative to clipping and ICH evacuation, for subarachnoid hemorrhage with intracerebral hematoma. See also: Management of subarachnoid hemorrhage with intracerebral hematoma: clipping and clot evacuation versus coil embolization followed by clot evacuation http://bit.ly/XnJABz
Simulator based angiography education in neurosurgery
April 23, 2013 15:27 - 14 minutes - 19.6 MBJNIS editor Rob Tarr talks to Kyle Fargen, Department of Neurosurgery, University of Florida, about his pilot study looking at simulator based angiography education, and the potential of the technique. See also: Simulator based angiography education in neurosurgery: results of a pilot educational program http://bit.ly/TMPoOC
CT perfusion-guided patient selection for endovascular treatment of acute ischemic stroke
April 23, 2013 15:26 - 13 minutes - 5.27 MBJNIS editor Rob Tarr talks to Aquilla Turk (Medical University of South Carolina) about his study into CT perfusion-guided patient selection for endovascular treatment of ischemic stroke, which has shown it is safe and effective. See also: CT perfusion-guided patient selection for endovascular treatment of acute ischemic stroke is safe and effective http://bit.ly/Oti4yf
The Trevo device
April 23, 2013 15:25 - 17 minutes - 7.23 MBJNIS editor Rob Tarr talks to Raul Nogueria (Emory University School of Medicine, Atlanta) about the new Trevo device, and the results of of his preclinical study on it. See also: The Trevo device: preclinical data of a novel stroke thrombectomy device in two different animal models of arterial thrombo-occlusive disease http://bit.ly/11hulZv
Treatment of ruptured, and unruptured, cerebral aneurysms in the USA
April 23, 2013 15:24 - 16 minutes - 6.61 MBJNIS editor Rob Tarr talks to Ning Lin (Brigham and Women’s Hospital, Boston) about the paradigm shift in treatment of ruptured, and unruptured, cerebral aneurysms in the USA. See also: Treatment of ruptured and unruptured cerebral aneurysms in the USAhttp://bit.ly/11ALqOO
Neucrylate - a new treatment for berry aneuryms
April 23, 2013 15:21 - 13 minutes - 12.3 MBJNIS editor Rob Tarr talks to Charles Kerber (University of California San Diego Medical Center) about Neucrylate, a new treatment for berry aneurysms. Dr Kerber describes how his company developed the liquid embolic device, the results they’ve had using it, and future plans to get it into practice. See also: 1-Hexyl n-cyanoacrylate compound (Neucrylate™ AN), a new berry aneurysm treatment. II. Rabbit implant studies: technique and histology http://bit.ly/17g34e7 1-Hexyl n-cyanoacrylate ...
Diabetes and the extent of pial collaterals
April 23, 2013 15:19 - 10 minutes - 7.36 MBIn this podcast, Robert Tarr, JNIS editor, talks to Marc Lazzaro, Medical College of Wisconsin, about his paper The impact of diabetes on the extent of pial collaterals in acute ischemic stroke patients - September’s Editor’s Choice. See also: Ischemic stroke - The impact of diabetes on the extent of pial collaterals in acute ischemic stroke patients http://bit.ly/12FlgNg
Novel Non-Occlusive Temporary Endoluminal Neck Protection Device
April 23, 2013 15:17 - 12 minutes - 8.4 MBIn the monthly JNIS podcast, we will hear from some of the researchers who have published in the journal about their work. In this inaugural podcast, Robert Tarr, JNIS editor, talks to Raymond Turner, Medical University of South Carolina, about his paper Novel Non-Occlusive Temporary Endoluminal Neck Protection Device to Assist in the Treatment of Aneurysms in a Canine Model - September’s Editor’s Choice. See also: New devices - Novel non-occlusive temporary endoluminal neck protection de...