Contrast-induced encephalopathy(CIE)is a rare neurological complication of the intravascular application of a contrast media.The clinical manifestation of CIE which is easily misdiagnosed in clinical is not specific.Recently,with the extensive development of interventional diagnosis and therapy in different disciplines,case report of CIE patient is increasing yearly.At present,there is not a uniform diagnosis and treatment standard for CIE in China and abroad.Chinese Federation of Interventional Clinical Neurosciences organized relevant experts in China and developed the expert consensus,to provide suggestions and references for clinicians at all levels to prevent,identify and treat CIE.

Stroke is a major disease that endangers the health of human beings.Since 2015,mechanical thrombectomy has emerged as the primary therapeutic method for acute ischemic stroke.Present guidelines lean towards treating patients with mechanical thrombectomy within a therapeutic window,while the efficacy of thrombectomy beyond 24-hour remains a matter of contention.The authors manuscript undertook a retrospective review of extant clinical research,scrutinizing its safety and efficacy from the standpoint of research design,and offering a detailed synthesis concerning on predictive factors and imaging modalities for selection.

Ischemic stroke is characterized by high rates of prevalence,mortality and recurrence.Atrial fibrillation(AF)is the most common arrhythmia in adults.AF significantly increases the risk of ischemic stroke and stroke recurrence.This review summarized the current research progress on AF screening in ischemic stroke patients,the relationship between AF characteristics,biomarkers and ischemic stroke,as well as the research progress on secondary prevention strategies for patients with concomitant AF,aiming to assist clinicians detect AF at an early stage and prevent stroke recurrence.

With the advancement of medical diagnostic technology and the continuous increase of the elderly population in China,chronic internal carotid artery occlusion(CICAO)is becoming increasingly common in clinical practice.Symptomatic CICAO patients with severe hemodynamic disorders have a high risk of recurrent ischemic stroke.Cognitive impairment related to chronic ischemia in CICAO is also receiving increasing attention.However,there is currently a lack of unified evaluation and treatment plans for CICAO patients in clinical practice.This expert consensus summarized the latest clinical trials and research related to CICAO,and combined the clinical practice experience of domestic experts in related fields to provide targeted opinions on the evaluation,treatment and perioperative management of CICAO patients,in order to further standardize the clinical diagnosis and treatment process of the patients with CICAO in China.

In recent years,endovascular intervention therapy has gained popularity due to its advantages of minimal trauma and quick recovery,and become an essential method for treating cerebrovascular diseases.As a crucial surgical instrument in interventional therapy,catheters often require precise control of their tips to navigate through tortuous positions.Traditional catheters have shortages of fixed tip shapes,limited proximal torque transmission,and difficulty of manipulation,increasing the risk of complications during interventional procedures and prolonging surgical exposure time.With the rapid development of materials science and engineering,steerable catheter systems have become the spotlight of interventional physicians,making precise"bend control"possible.This article systematically explained the classification of steerable catheter systems,focusing on their application in neurointerventional therapy,and provided an outlook on the future development of steerable catheters.

Objective To investigate the efficacy and safety of hybrid surgery for the recanalization of carotid artery occlusion after stenting.Methods Clinical data and results of 17 patients with occlusion after carotid artery stenting and treated with hybrid surgery from June 2016 to April 2023 at the Department of Neurosurgery Cerebral Blood Flow Reconstruction Center of Xuanwu Hospital,Capital Medical University were retrospectively analyzed.According to whether the recanalization was successful,17 patients were divided into the the successful recanalization group and the failed recanalization group.Successful recanalization was defined as achieving modified thrombolysis in cerebral infarction(mTICI)grade ≥2b and residual stenosis＜50％.Baseline data(age,sex,body mass index,smoking history,alcohol consumption history,hypertension history,diabetes history,hyperlipidemia history,coronary heart disease history),clinical data(National Institutes of Health Stroke Scale[NIHSS]score at admission,fasting blood glucose,low density lipoprotein,high density lipoprotein,total cholesterol,triglyceride,occlusion side and segment,combination with severe stenosis or occlusion of the contralateral carotid artery,opening of the anterior communicating artery,opening of the posterior communicating artery,compensation of the external and internal carotid artery,compensation of the pia artery,stump morphology,and time from imaging diagnosis of occlusion to recanalization)were documented and compared between groups.The recanalization of occlusive vessels and perioperative complications were recorded.Imaging and clinical follow-up were performed 3,6 months and≥1 year after surgery.Results Among the 17 patients,the ratio of successful recanalization was 13/17.One patient had re-occlusion after operation,which was re-opened after thrombolysis,but neck hematoma with dyspnea occurred,and recovered after emergency operation.There was no postoperative stroke or death.The incidence of perioperative complications was 1/17.Compared with the successful recanalization group,the levels of high density lipoprotein and total cholesterol in the failed recanalization group were higher,and the differences between the groups were statistically significant(high density lipoprotein[1.3±0.3]mmol/L vs.[0.9±0.3]mmol/L,t=-2.139;total cholesterol:[4.2±0.8]mmol/L vs.[3.1±0.7]mmol/L,t=-2.649;both P＜0.05);There were no significant differences in other baseline data and clinical data(all P＞0.05).Imaging follow-up was completed in 9 of the 13 patients in the successful recanalization group,and the follow-up time was 3.8-36.9 months,with a median follow-up time of 22.8(12.8,34.7)months.Among them,1 patient(1/9)developed restenosis of recanalization vessels at 33.0 months after surgery and underwent stent implantation again.Conclusions The preliminary analysis showed that the occlusion after carotid artery stenting had better recanalization success and lower perioperative complications.In patients with chronic occlusion after carotid stenting,the application of a hybrid surgery for opening may be attempted under multimodal imaging assessment.

Studies have shown that vertebral artery hypoplasia(VAH)is associated with posterior circulation ischemic stroke,but it is difficult to distinguish VAH from atherosclerotic stenosis in cerebrovascular angiography and other imaging examinations,and there is currently no unified diagnostic standard for intracranial VAH.The authors reviewed the definition and incidence of intracranial VAH from the aspects of autopsy and imaging,and summarized its relationship with posterior circulation ischemic stroke,in order to improve the clinicians'understanding of intracranial VAH.

In recent years,radiation therapy has become a cornerstone in the treatment of head and neck tumors,significantly improving patient survival rates.However,the issue of radiation-induced carotid artery stenosis has garnered increasing attention.Characterized by multiple,long-segment,and unstable lesions,radiation-induced carotid stenosis presents unique challenges that traditional therapeutic approaches struggle to address.This review systematically summarized the pathological features and underlying mechanisms of radiation-induced carotid stenosis,with a focus on the roles of endothelial cells,smooth muscle cells,and vasa vasorum damage.Future research directions and preventive strategies are also discussed.

Objective To explore the influencing factors of hyperlipidemia in 18-80 years old in Ningxia by structural equation model, and to analyze the direct and indirect effects of influencing factors of hyperlipidemia, so as to provide a basis for the formulation of prevention and treatment measures. Methods A total of 925 patients with hyperlipidemia from a chronic disease survey in 4 counties of Ningxia in April 2017 were selected as the case group (n=925), and residents without hyperlipidemia matched by sex and age were selected as the control group (n=925). A self-designed questionnaire was used to investigate the two groups of subjects. SPSS 22.0 software was used to conduct single factor T or Z test or χ² test for the possible influencing factors of hyperlipidemia, and Amos22.0 was used to construct structural equation model. Results The structural equation model showed that physiological condition had the greatest effect on hyperlipidemia, and the standardized regression coefficient was -0.351. The second was the monitoring of three key blood indicators (three-high indicators), and the total effect value was 0.082, while personal condition and dietary status had no direct influence on the prevalence of hyperlipidemia. Conclusion Physiological status is the most important factor affecting the prevalence of hyperlipidemia in 18 ~ 80 years old in Ningxia, followed by the monitoring of the three-high indicators. In the future, residents should be encouraged to strengthen health management, especially people with overweight, high uric acid, high blood glucose and hypertension, to control the level of blood lipids and reduce the incidence of hyperlipidemia.

Heart sound is one of the common medical signals for diagnosing cardiovascular diseases. This paper studies the binary classification between normal or abnormal heart sounds, and proposes a heart sound classification algorithm based on the joint decision of extreme gradient boosting (XGBoost) and deep neural network, achieving a further improvement in feature extraction and model accuracy. First, the preprocessed heart sound recordings are segmented into four status, and five categories of features are extracted from the signals based on segmentation. The first four categories of features are sieved through recursive feature elimination, which is used as the input of the XGBoost classifier. The last category is the Mel-frequency cepstral coefficient (MFCC), which is used as the input of long short-term memory network (LSTM). Considering the imbalance of the data set, these two classifiers are both improved with weights. Finally, the heterogeneous integrated decision method is adopted to obtain the prediction. The algorithm was applied to the open heart sound database of the PhysioNet Computing in Cardiology(CINC) Challenge in 2016 on the PhysioNet website, to test the sensitivity, specificity, modified accuracy and F score. The results were 93%, 89.4%, 91.2% and 91.3% respectively. Compared with the results of machine learning, convolutional neural networks (CNN) and other methods used by other researchers, the accuracy and sensibility have been obviously improved, which proves that the method in this paper could effectively improve the accuracy of heart sound signal classification, and has great potential in the clinical auxiliary diagnosis application of some cardiovascular diseases.
Algorithms ; Databases, Factual ; Heart Sounds ; Neural Networks, Computer