01 marzo 2022

Mechanical Thrombectomy in Patients Presenting with NIHSS Score <6: A Safety and Efficacy Analysis

Rawad Abbas, MD Nabeel A. Herial, MD, MPH Kareem El Naamani, MD Ahmad Sweid, MD Joshua H. Weinberg, MD Karl John Habashy, BS Stavropoula Tjoumakaris, MD Michael R. Gooch, MD Robert H. Rosenwasser, MD, MBA Pascal Jabbour, MD

Background and Objectives Groundbreaking trials have shown the tremendous efficacy of mechanical thrombectomy for large vessel occlusions. Currently, mechanical thrombectomy is limited to patients with NIHSS scores ≥6. We investigated the feasibility and safety of MT in patients presenting with NIHSS scores <6.

30 diciembre 2021

Geometric Features Associated with Middle Cerebral Artery Bifurcation Aneurysm Formation: A Matched Case-Control Study

Jian Zhang, MD 1 Anil Can, MD 1 Pui Man Rosalind Lai, MD Srinivasan Mukundan, MD, PhD Victor M. Castro, MS Dmitriy Dligach, PhD Sean Finan, BS Vivian S. Gainer, MS Nancy A. Shadick, MD, MPH Guergana Savova, PhD Shawn N. Murphy, MD, PhD Tianxi Cai, PhD Scott T. Weiss, MD, MS Rose. Du, MD, PhD

Objectives The pathogenesis of intracranial aneurysms is multifactorial and includes genetic, environmental, and anatomic influences. We aimed to identify image-based morphological parameters that were associated with middle cerebral artery (MCA) bifurcation aneurysms.

31 diciembre 2021

Platelet Distribution Width: A Significant Predictor of Poor Outcome After Mechanical Thrombectomy

Ye Li, PhD Tao Li, PhD Lili Zhao, PhD Yiheng Zhang, MD Xiaoya Wang, MD Yulun Wu, MD Ziwei Lu, MD Jialiang Lu, MD Meijuan Dang, PhD Heying Wang, MD Yating Jian, MD Xiaoyun Lu, PhD Xiaofei Yang, PhD Songhua Fan, MD, PhD Lei Zhang, MD Yu Jiang, MD, PhD Guogang Luo, MD, PhD Guilian Zhang, MD, PhD

Objectives Elevated platelet distribution width (PDW) is a recognized marker of platelet activity. Herein, we investigated the association between admission PDW values and clinical outcome at 3 months in acute ischemic stroke (AIS) patients undergoing mechanical thrombectomy (MT).

23 diciembre 2021

Histological Analysis of Carotid Plaques: The Predictors of Stroke Risk

Norbert Svoboda, MD Richard Voldřich, MD Václav Mandys Tomas Hrbáč, PhD Petra Kešnerová, MD Martin Roubec, PhD David Školoudík David Netuka

Highlights • Foamy macrophages and thrombosis are significant predictors of symptomatic carotid artery stenosis. • Symptomatic plaques were significantly more frequently classified as AHA type VI than AHA type IV-V compared to asymptomatic ones. • A complex plaque structure (AHA type VI) is, rather than the single histological features, predictive of plaque instability.

23 diciembre 2021

Association Between CT Angiogram Collaterals and CT Perfusion in Delayed Time Windows for Large Vessel Occlusion Ischemic Strokes

Sriharsha Voleti, BS Yasmin N Aziz, MD Johnathan Vidovich, MD Brendan Corcoran, MD Bin Zhang, PhD Eva Mistry, MBBS Vivek Khandwala, PhD Pooja Khatri, MD, MSc Thomas Tomsick, MD Lily Wang, MBBS Abdelkader Mahammedi, MD Achala Vagal, MD, MS

Objectives Recent endovascular trials have established the use of CT perfusion (CTP) in endovascular treatment selection for patients with large vessel occlusions (LVO). However, the relationship between CTP and collateral circulation is unclear in delayed time windows. We explored the relationship between CT Angiogram (CTA) collaterals and CTP parameters in delayed time windows (6-24 hours).

10 enero 2022

Outcomes of Mechanical Thrombectomy for Ischemic Stroke in Nonagenarians: A 10-Year Institutional Experience

Fareed Jumah, MD Bharath Raju, MD Elizabeth E. Ginalis, MD Omar Ashraf, MD Michael S. Rallo, B.S. Vinayak Narayan, MD Taha Nisar, MD Priyank Khandelwal, MD Sudipta Roychowdhury, MD Emad Nourollah-Zadeh, MD Gaurav Gupta, MD Anil Nanda, M.D., M.P.H. Hai Sun, MD, PhD

Background Nonagenarians have been underrepresented in stroke trials that established endovascular treatment as the standard for acute ischemic stroke (AIS). Evidence remains inconclusive regarding the efficacy of thrombectomy in this population.

07 enero 2022

Flow Diversion for Acutely Ruptured Intracranial Aneurysms Treatment: A Retrospective Study and Literature Review

Andrea Giorgianni, MD Edoardo Agosti, MD Stefano Molinaro, MD Alberto Vito Terrana, MD Francesco Alberto Vizzari, MD Luca Nativo, MD Kanwaljeet Garg, MCh Giuseppe Craparo, MD Vinicio Conti, MD Davide Locatelli, MD Fabio Baruzzi, MD Luca Valvassori, MD Giuseppe Lanzino, MD

Objective Flow diversion is becoming an increasingly established practice for the treatment of acutely ruptured intracranial aneurysms. In this study the authors present a literature review and meta-analysis, adding a retrospective review of institutional registry on emergency treatment of aRIA with flow diverter stent.

10 diciembre 2021

Red Cell Distribution Width as a Predictor of One-Year Prognosis and Mortality of Endovascular Therapy for Acute Anterior Circulation Ischemic Stroke

Zhengyang Wang ,Yin Liu

Objectives To investigate if Red cell distribution width (RDW) can predict long-term prognosis in patients with acute ischemic stroke (AIS) receiving endovascular therapy (EVT).

12 diciembre 2021

Acute Treatment of Isolated Posterior Cerebral Artery Occlusion: Single Center Experience

runo Cunha Mariana Baptista Jaime Pamplona Rui Carvalho Catarina Perry da Câmara Marta Alves Ana Luísa Papoila Ana Paiva Nunes João Reis Isabel Fragata

Background and objectives Randomized trials for mechanical thrombectomy (MT) excluded patients with ischemic strokes due to isolated posterior cerebral artery occlusion (IPCAO), and there is no evidence for best acute treatment strategy in these patients. We aimed to assess the effectiveness and safety of MT in acute IPCAO.

01 febrero 2022

Influence of Thrombocytopenia on the Outcome of Mechanical Thrombectomy in Patients with Acute Ischemic Stroke

Mirjana Ždraljević Tatjana Pekmezović Predrag Stanarčević Ivan Vukašinović Ivana Berisavac Marko Ercegovac Filip Vitošević Dragoslav Nestorović Vladimir Cvetić Višnja Padjen Maja Stefanović- Budimkić Tamara Švabić Medjedović Dejana R. Jovanović

Objectives Mechanical thrombectomy (MT) has become leading treatment option for acute ischemic stroke (AIS) due to large vessels occlusion (LVO). Platelet counts may affect outcome in patients with AIS or transient ischemic attack. The aim of our study was to determine the influence of thrombocytopenia on the safety and efficacy of MT in patients with AIS due to anterior circulation LVO.

16 diciembre 2021

Usefulness of Silent Magnetic Resonance Angiography in the Follow-Up of Endovascular-Treated Intracranial Aneurysm: A Prospective Study

Song Tan, MD Yuzhao Lu, MD Bin Li, MD Qin Wu, MD Xiaobing Zhou, MD Yang Wang, MD

Objectives To prospectively evaluate the clinical usefulness of Silent magnetic resonance angiography (Silent MRA) in the follow-up of endovascular-treated intracranial aneurysms by comparing it with time-of-flight magnetic resonance angiography (TOF MRA) and digital subtraction angiography (DSA).

01 noviembre 2021

Optimal Management of Asymptomatic Carotid Stenosis in 2021: The Jury is Still Out. An International, Multispecialty, Expert Review and Position Statement

Kosmas I. Paraskevas, MD Dimitri P. Mikhailidis, MD, FFPM, FRCP, FRCPath Pier Luigi Antignani, MD, PhD, FIUA Hediyeh Baradaran, MD Reinoud P.H. Bokkers, MD, PhD, EBIR Richard P. Cambria, MD, FACS Alan Dardik, MD, PhD, FACS, DFSVS, FAHA Alun H. Davies, MA, DM, FRCS Hans-Henning Eckstein, MD, PhD, FEBVS Gianluca Faggioli, MD, PhD Jose Fernandes e Fernandes, MD, PhD, FACS, FRCS Eng., FESC, FEBVS Gustav Fraedrich, MD George Geroulakos, MD, PhD, FRCS Peter Gloviczki, MD Jonathan Golledge, MB, BChir, MA, MChir, FRCS, FRACS Ajay Gupta, MD, MS Mateja K. Jezovnik, MD, PhD Stavros K. Kakkos, MD, DM, MSc, PhD, RVT Niki Katsiki, MD, MSc, PhD Michael Knoflach, MD, PhD M. Eline Kooi, PhD Gaetano Lanza, MD, PhD Christos D. Liapis, MD, FEBVS, FACS, FRCS Ian M. Loftus, BSc, MBChB, MD, FRCS Armando Mansilha, MD, PhD, FIUA, FEBVS Antoine Millon, MD, PhD Andrew N. Nicolaides, MD, PhD Rodolfo Pini, MD, PhD Pavel Poredos, MD, PhD Jean-Baptiste Ricco, MD, PhD, FEBVS Thomas S. Riles, MD, FACS Peter Arthur Ringleb, MD Tatjana Rundek, MD, PhD Luca Saba, MD Felix Schlachetzki, MD Mauro Silvestrini, MD Francesco Spinelli, MD Francesco Stilo, MD, PhD Sherif Sultan, MD, FACS, FRCS, PhD Jasjit S. Suri, PhD, MBA, FIEEE, FAIMBE, FAIUM, FSVM, FAPVS Clark J. Zeebregts, MD, PhD Seemant Chaturvedi, MD

Objectives The recommendations of international guidelines for the management of asymptomatic carotid stenosis (ACS) often vary considerably and extend from a conservative approach with risk factor modification and best medical treatment (BMT) alone, to a more aggressive approach with a carotid intervention plus BMT. The aim of the current multispecialty position statement is to reconcile the conflicting views on the topic.

21 octubre 2021

Stent Opening Visualization During Mechanical Thrombectomy; Relationship with the Retrieved Clot and Procedural Success

Ilah Shin, MD, PhD Byung Moon Kim, MD, PhD Dong Joon Kim, MD, PhD

Purpose: The angiographic visualization of the stent during mechanical thrombectomy (MT) may provide information regarding the characteristics of the underlying occluding clot, device-clot interaction, and recanalization. The purpose of this study was to evaluate the open stent sign in relation to the retrieved clot and recanalization.

24 octubre 2021

Novel Imaging Biomarker Prediction of Parenchymal Hemorrhage after Mechanical Thrombectomy in Patients with Large Ischemic Core

Yiqi Wang, MS 1 Peng Wang, BS 1 Sheng Zhang, MD Zongjie Shi, MS Jiangyong Min, MD Yu Geng, MD

Background Recently studies have shown that select acute ischemic stroke (AIS) patients with large ischemic core could be deemed as reasonable candidates to receive mechanical thrombectomy (MT) with low risk of developing parenchymal hemorrhage (PH) or symptomatic intracerebral hemorrhage (sICH); however, the selection criterion remains lacking. Our study aims to investigate the relationship between a novel imaging biomarker of largest core mass volume (LCMV) and development of PH in stroke patients with large ischemic core who have undergone MT.

12 noviembre 2022

Comparison of the Safety, Efficacy, and Procedural Characteristics Associated with Proximal and Distal Radial Access for Diagnostic Cerebral Angiography

Haydn Hoffman, MD Katherine M. Bunch, MD Tatiana Mikhailova, BA John R. Cote, BA Apeksha Ashok Kumar, BA Hesham E. Masoud, MD Grahame C. Gould, MD

Objectives Radial access is an increasingly popular approach for performing cerebral angiography. There are two sites for radial artery puncture: proximal transradial access (pTRA) in the wrist and distal transradial access (dTRA) in the snuffbox. These approaches have not been directly compared.