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Medical professionals can oftentimes fall under the category of "second victims", as they experience burnout and moral injury from the impacts of their work. Over the course of a neurointerventionalist's medical career, serious complications in procedures are sadly inevitable. These can be difficult to process, and there are not always the systems in place to provide the support needed, either inside or outside of the hospital. A new survey has been carried out to assess the severity and prevalence of negative psychological effects on physicians who have experienced these complications. Dr. Ansaar Rai¹ joins JNIS Editor-in-Chief Dr. Michael Chen to discuss the original research piece, "Unseen wounds: a multinational investigation of neurointerventionalists on the psychological toll of complications".  (1) Interventional Neuroradiology, West Virginia University Rockefeller Neuroscience Institute, Morgantown, West Virginia, USA Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ.

. Dr Donald Heck (1) and Dr Peter Kan (2) join JNIS Editor-in-Chief Dr. Michael Chen to discuss the commentary “Middle meningeal artery embolization in the routine care of chronic subdural hematoma?” by D.V. Heck et al. They highlight key debates around efficacy, safety, and workflow integration as embolization moves closer to becoming a routine therapeutic option. (1) Triad Radiology Associates, Novant Health Forsyth Medical Center, Winston Salem, North Carolina, USA (2) Neurosurgery, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA   Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ.

Pulsatile tinnitus — the perception of a rhythmic sound in sync with the heartbeat — can be a key indicator of underlying vascular or structural pathology. In this episode, JNIS new Editor-in-Chief Dr. Michael Chen speaks with Dr. Madhavi Duvvuri and Dr. Matthew Robert Amans, authors of Non-invasive imaging modalities for diagnosing pulsatile tinnitus: a comprehensive review and recommended imaging algorithm. They are both from the University of California San Francisco, USA. They discuss the current evidence base, highlight the strengths and limitations of non-invasive imaging techniques such as MRI, MRA, CT, and CTA, and outline a practical algorithm for streamlining diagnosis.    Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ.

In the SCENT trial, researchers investigated the effects of the Surpass flow diverter system for treating wide-necked aneurysms. Five-year results of this trial have recently been published in JNIS, presenting the safety and effectiveness outcomes of treatment with the Surpass Streamline flow diverter system. The study analyses the rates of aneurysm occlusion and adverse events.   Editor-in-Chief of JNIS, Dr. Felipe C. Albuquerque, interviews Dr. Philip Meyers¹, author of the paper: Five-year results of the SCENT trial with Surpass flow diverters to treat large or giant wide-neck aneurysms   1. Radiology and Neurological Surgery, Columbia University, New York, USA   Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ.

High risk factors for stroke such as smoking and blood pressure are not equally represented throughout the patient population. These are just two of the socioeconomic influences on cerebrovascular disease. One way to view this association is through the lens of the Area Deprivation Index (ADI), a measure of neighbourhood-level deprivation, and this was the approach of the study discussed in this episode. The study evaluated the association between the ADI and the treatment of ruptured intracranial aneurysms compared with unruptured intracranial aneurysms across multiple centres. Editor-in-Chief of JNIS, Dr. Felipe C. Albuquerque, interviews Dr. Alexandra Paul¹, author of the paper: Multicenter study of association between socioeconomic status and treatment of ruptured cerebral aneurysms compared to unruptured cerebral aneurysms: insights from 4,517 patients using the area deprivation index   1. Department of Neurosurgery, Albany Medical Center, Albany, New York, USA   Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ.

The "River" stent is a novel stent designed specifically to account for the anatomical and procedural requirements of venous sinus stenosis. A multicentre study of the device's safety and efficacy is underway, comprising 39 subjects across 5 US centres. The 1-year results have been recently published in JNIS. Editor-in-Chief of JNIS, Dr. Felipe C. Albuquerque, interviews Dr. Athos Patsalides¹, author of the paper: The River study: the first prospective multicenter trial of a novel venous sinus stent for the treatment of idiopathic intracranial hypertension 1. Department of Neurological Surgery, North Shore University Hospital, Manhasset, New York, USA   Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ.

Observations from practice and data analysis have shown that the duration of mechanical thrombectomy procedures are a strong predictor of outcome even with successful procedures. A large multicenter study was conducted which gives insight into choices between catheter types, and strategic decisions to be made during prolonged procedures. Dr Felipe C. Albuquerque, Editor-in-Chief of JNIS, interviews Dr. Ali Alawieh¹ and Dr. Alejandro Spiotta²,  two authors of the paper:  Prolonged intracranial catheter dwell time exacerbates penumbral stress and worsens stroke thrombectomy outcomes   1. Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA 2. Med Univ S Carolina, Charleston, South Carolina, USA   Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ.

The use of assistive devices when treating unruptured aneurysms is widespread in neurointerventional practice. But there is no standard for how long patients should receive dual anti-platelet therapy after the procedure, to protect them from thrombotic complications. Durations can range from one month to one year. This episode looks at a review of patient data across 12 locations to understand the effect of therapy duration on risk of complications.  Dr Felipe C. Albuquerque, Editor-in-Chief of JNIS, interviews Dr. Andrew Ringer¹, first author of the paper:  Impact of duration of dual anti-platelet therapy on risk of complications after stent-assisted coiling of unruptured aneurysms 1. Mayfield Clinic, Cincinnati, Ohio, USA Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ.

There has been a large increase in the number of non-invasive neurovascular studies performed in the last decade, particularly CT angiograms and MR angiograms. What has this meant for catheter-based angiography? This episode looks at an analysis done on a large claims database in the USA, to observe trends in imaging modalities, as well as the distinctions in use by neurosurgeons and radiologists. Dr Felipe C. Albuquerque, Editor-in-Chief of JNIS, interviews Dr. Francis Jareczek¹ and Dr. D. Andrew Wilkinson¹, two of the authors of the paper:  National trends in catheter angiography and cerebrovascular imaging in a group of privately insured patients in the US. 1. Neurosurgery, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ.  

Although many U.S. neurointerventionalists report at least one stressful malpractice claim over their career, the majority conclude without any court proceedings or direct repercussions in their practice. In this podcast, we look at the prevalence and causes of malpractice claims and complaints filed with state medical boards against neurointerventionalists, and some of the risk factors in an increasingly busier field. Dr Felipe C. Albuquerque, Editor-in-Chief of JNIS, interviews Dr Kyle M. Fargen (Wake Forest University, Winston-Salem); and Dr Joshua A. Hirsch (Massachusetts General Hospital, Boston), both members of the editorial board of the journal and the authors of the paper:  Medical malpractice claims and state medical board complaints among United States neurointerventionalists. Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ.

Single-stent assisted coiling techniques such as ‘L-stenting’ are an alternative to intrasaccular devices for wide-neck bifurcation aneurysms. In this episode, Aliya Siddiqui¹ and Dr. Reade De Leacy² join JNIS editor-in-chief Dr. Felipe Albuquerque to discuss the background and findings of their recent study, regarding the efficacy and safety of the 'L-stenting' technique.  Read the paper: A core-lab adjudicated analysis of single-stent assisted coiling of wide-neck bifurcation aneurysms 1. Medical College of Wisconsin, Milwaukee, USA 2. Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, USA Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ. Thank you for listening! This episode was produced and edited by Brian O'Toole. 

Patients with good motor function outcomes after aneurysmal subarachnoid hemorrhage treatment may still be left with neuropsychiatric effects. They can suffer from such difficult conditions as cognitive dysfunction, depression and sexual dysfunction. Not all of these patients will volunteer their symptoms unprompted on follow-up. This outcome type has had limited study, and became an interest of today's guest, Dr. Jose Danilo Bengzon Diestro (1). JNIS editor-in-chief Dr. Felipe Albuquerque speaks with him on this subject, based on the recently published paper, "Long-term neuropsychiatric complications of aneurysmal subarachnoid hemorrhage: a narrative review".   (1) Department of Medicine, University of Toronto, Toronto, Canada   Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ. Thank you for listening! This episode was produced and edited by Brian O'Toole. 

Alis Dicpinigaitis (1) and Dr. Fawaz Al-Mufti (2) join JNIS Editor-in-Chief, Dr. Felipe C. Albuquerque, to discuss the study, "Mapping geographic disparities in treatment and clinical outcomes of high-grade aneurysmal subarachnoid hemorrhage in the United States". They explain the findings of their study, covering the predictive impact of factors including age, insurance status, race, and hospital ownership. Read the paper: https://jnis.bmj.com/content/early/2024/02/19/jnis-2023-021330  (1) New York Presbyterian - Weill Cornell Medical Center, New York, New York, USA (2) Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, New York, USA Please subscribe to the JNIS Podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest episodes. Also, please consider leaving us a review or a comment on the JNIS Podcast iTunes page: https://podcasts.apple.com/gb/podcast/jnis-podcast/id942473767  Thank you for listening! This episode was produced and edited by Brian O'Toole. 

Dr. Michael Veldeman (1) joins JNIS Editor-in-Chief, Dr. Felipe C. Albuquerque, to discuss the study, "Intra-arterial nimodipine for the treatment of refractory delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage". Dr. Veldeman explains the methods of the study, the growing significance of computerised tomography perfusion imaging in diagnosis of unconscious patients, the use of induced hypertension, and interventional complications that arose when treating subarachnoid hemorrhage patients. Read the paper: https://jnis.bmj.com/content/early/2023/12/16/jnis-2023-021151  (1) Department of Neurosurgery, RWTH Aachen University Hospital Aachen, Aachen, Germany Please subscribe to the JNIS Podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest episodes. Also, please consider leaving us a review or a comment on the JNIS Podcast iTunes page: https://podcasts.apple.com/gb/podcast/jnis-podcast/id942473767  Thank you for listening! This episode was produced and edited by Brian O'Toole. 

JNIS Editor-in-Chief, Dr. Felipe C. Albuquerque, is joined from New York by Prof. David Fiorella (1) to discuss the paper, "Safety and effectiveness of the Woven EndoBridge (WEB) system for the treatment of wide necked bifurcation aneurysms: final 5 year results of the pivotal WEB Intra-saccular Therapy study (WEB-IT)". Prof. Fiorella explains the results of this extensive study across 27 locations, with the WEB device proving to be a durably effective and safe endovascular treatment option for wide-necked bifurcation aneurysms. Read the paper: https://jnis.bmj.com/content/15/12/1175  (1) Department of Neurosurgery, State University of New York at Stony Brook, Stony Brook, New York, USA Please subscribe to the JNIS Podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest episodes. Also, please consider leaving us a review or a comment on the JNIS Podcast iTunes page: https://podcasts.apple.com/gb/podcast/jnis-podcast/id942473767  Thank you for listening! This episode was produced and edited by Brian O'Toole.