Browsing by Author "Vukasinovic, Ivan (54421460600)"

Background/Objectives: Endovascular embolization is an effective treatment option for cerebral arteriovenous malformation (AVM) and dural arteriovenous fistulas (DAVFs). The objective of this study was to assess the safety and efficacy of MenoxTM in patients with cranial dural arteriovenous fistulas. Methods: From January 2021 to January 2023, 19 patients with intracranial DAVFs underwent embolization procedures. All patients were treated by embolization with MenoxTM or/and in combination with other embolization products such as Onyx (Covidien, Irvine, California), PHIL (MicroVention, Tustin, California), and Squid (Balt Extrusion, Montmorency, France). Treatment approaches were selected depending on the anatomical location of the fistula. Patients were monitored and followed-up for 12 months. Results: The patients’ mean age was 56.26 ± 16.49 years. Of these 19 patients, 58% (n = 11) were treated with the MenoxTM liquid embolizing agent (LEA) alone or in combination with different LEAs, while n = 7 were treated with other LEAs and 1 patient was treated solely with coils. Complete occlusion of DAVFs with MenoxTM and other agents was evident in 68.4% (n = 13/19) of patients. Complete occlusion (100%) was observed in the sinus rectus, transverse sinus, and diploic veins of the orbital roof, while complete occlusion was observed in 50% of falcotentorial patients and 60% of superior sagittal sinus patients. The lowest rate of complete fistula obliteration was observed in the dural carotid cavernous fistula (CCF) group (25%). An intra-procedural adverse event occurred in one patient. No other post-procedural adverse events were noted. Furthermore, in patients treated with MenoxTM, total occlusion was achieved in 72.7% (n = 8) of patients, whereas the non-MenoxTM group had 62.5% (n = 5) of patients with 100% occlusion and 37.5% (n = 3) of patients with subtotal occlusion. Conclusions: Outcomes using MenoxTM alone and in combination with other agents were effective, and it is safe for the treatment of dural arteriovenous fistulas. © 2024 by the authors.

Purpose The Thrombolysis in Ischemic Stroke Patients (TRISP) collaboration was a concerted effort initiated in 2010 with the purpose to address relevant research questions about the effectiveness and safety of intravenous thrombolysis (IVT). The collaboration also aims to prospectively collect data on patients undergoing endovascular treatment (EVT) and hence the name of the collaboration was changed from TRISP to EVA-TRISP. The methodology of the former TRISP registry for patients treated with IVT has already been published. This paper focuses on describing the EVT part of the registry. Participants All centres committed to collecting predefined variables on consecutive patients prospectively. We aim for accuracy and completeness of the data and to adapt local databases to investigate novel research questions. Herein, we introduce the methodology of a recently constructed academic investigator-initiated open collaboration EVT registry built as an extension of an existing IVT registry in patients with acute ischaemic stroke (AIS). Findings to date Currently, the EVA-TRISP network includes 20 stroke centres with considerable expertise in EVT and maintenance of high-quality hospital-based registries. Following several successful randomised controlled trials (RCTs), many important clinical questions remain unanswered in the (EVT) field and some of them will unlikely be investigated in future RCTs. Prospective registries with high-quality data on EVT-treated patients may help answering some of these unanswered issues, especially on safety and efficacy of EVT in specific patient subgroups. Future plans This collaborative effort aims at addressing clinically important questions on safety and efficacy of EVT in conditions not covered by RCTs. The TRISP registry generated substantial novel data supporting stroke physicians in their daily decision making considering IVT candidate patients. While providing observational data on EVT in daily clinical practice, our future findings may likewise be hypothesis generating for future research as well as for quality improvement (on EVT). The collaboration welcomes participation of further centres willing to fulfill the commitment and the outlined requirements. © 2021 BMJ Publishing Group. All rights reserved.

Background: This report contributes to VASCUNET data on treating peripheral artery disease (PAD) in Serbia, addressing sex differences, revascularization types, procedure characteristics, and morbidity and mortality. Methods: SerbVasc, part of the VASCUNET collaboration, includes vascular procedures from 27 Serbian hospitals. Data from 1681 PAD patients were analyzed, focusing on sex disparities, diabetes prevalence, previous procedures, infection and tissue loss, and morbidity and mortality rates. Results: Males formed the majority, comprising 1169 (69.5%) of the patients. Men were significantly more often treated open surgically compared to women (77.6% vs 68.0%; p=0.000). Diabetes stood at 40.2% prevalence. Smoking history was noted in 61.9% of patients, predominantly males. Complication rates stood at 7.5%, with diabetic patients more prone to reinterventions and graft restenosis. The in-hospital mortality rate was 1.6%, with significant predictors of mortality including urgent procedures and recent myocardial infarction. The severity of the infection was correlated with diabetes (r=0.250, p=0.000) and previous amputations (r=0.186, p=0.000). Patients undergoing revascularization followed by minor amputations had a significantly lower incidence of major amputation (0.1% vs 2.9%, p=0.000). Conclusions: SerbVasc data provides a comprehensive overview of PAD management, highlighting the significant impact of diabetes and smoking on disease progression and outcomes. Clinical Impact: This study highlights critical aspects of PAD management in developing countries, emphasizing sex differences, risk factors, and outcomes. Males predominated and are more likely to undergo open surgery. Diabetes and smoking significantly influenc disease progression, with diabetic patients experiencing higher rates of graft restenosis and reinterventions. Urgent procedures and recent myocardial infarctions are key predictors of in-hospital mortality. Combining revascularization with minor amputations reduced major amputation rates. These findings provide valuable data for tailoring treatment strategies, optimizing resource allocation, and improving outcomes for PAD patients, with implications extending beyond Serbia to similar healthcare systems. © The Author(s) 2024.

The incidence of concomitant extracranial carotid artery stenosis and ipsilateral intracranial carotid aneurysm has been reported to vary between 2.8% and 5%. These complex lesions may present a challenge for treatment decision-making. This case report describes an asymptomatic male patient with severe carotid bifurcation stenosis, coupled with an unruptured supraclinoid internal carotid aneurysm. Both lesions were treated simultaneously. Patient underwent carotid stenting followed by aneurysm coiling in the same setting without any complication. © SAGE Publications.

Introduction: Developmental venous anomaly (DVA) is a common cerebral vascular variant, typically considered benign and clinically silent. We report an exceptional case of a symptomatic infratentorial DVA in a 9-year-old child that became clinically evident after a minor head trauma. Case Report: The patient presented with neurological symptoms indicative of posterior fossa involvement, including headache, nausea, and ataxia. MRI revealed a cluster of abnormally dilated medullary veins in the right cerebellar hemisphere converging into an enlarged collector vein, consistent with a DVA. Significant cerebellar edema was identified in association with detected vascular malformation. The patient was managed conservatively with antiedematous therapy and analgesics, which led to rapid resolution of symptoms and complete recovery. Conclusion: This case demonstrates that DVAs can become acutely symptomatic secondary to significant vasogenic edema following even minor head trauma, likely due to transient hemodynamic disturbance without thrombosis or hemorrhage. Our findings challenge the perception of DVAs as invariably benign entities and warrant further investigation into their post-traumatic pathophysiology. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2025.

Introduction: Developmental venous anomaly (DVA) is a common cerebral vascular variant, typically considered benign and clinically silent. We report an exceptional case of a symptomatic infratentorial DVA in a 9-year-old child that became clinically evident after a minor head trauma. Case Report: The patient presented with neurological symptoms indicative of posterior fossa involvement, including headache, nausea, and ataxia. MRI revealed a cluster of abnormally dilated medullary veins in the right cerebellar hemisphere converging into an enlarged collector vein, consistent with a DVA. Significant cerebellar edema was identified in association with detected vascular malformation. The patient was managed conservatively with antiedematous therapy and analgesics, which led to rapid resolution of symptoms and complete recovery. Conclusion: This case demonstrates that DVAs can become acutely symptomatic secondary to significant vasogenic edema following even minor head trauma, likely due to transient hemodynamic disturbance without thrombosis or hemorrhage. Our findings challenge the perception of DVAs as invariably benign entities and warrant further investigation into their post-traumatic pathophysiology. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2025.