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ESTUDIOS


STROKE. Venous Thrombotic Recurrence After Cerebral Venous Thrombosis: A Long-Term Follow-Up Study

Paola Palazzo, Pierre Agius, Pierre Ingrand, Jonathan Ciron, Matthias Lamy, Aline Berthomet, Paul Cantagrel and Jean-Philippe Neau

Purpose: After cerebral venous thrombosis (CVT), the risk of venous thrombotic events was estimated at 2% to 3% for a new CVT and 3% to 8% for extracranial events. However, because of the paucity of prospective studies, the clinical course of CVT is still largely unknown. We aimed to prospectively evaluate the rate of thrombosis recurrence in a cohort of CVT patients with a long-term follow-up and to detect predisposing factors for recurrence.

STROKE. Intracranial Carotid Artery Calcification Relates to Recanalization and Clinical Outcome After Mechanical Thrombectomy

María Hernández-Pérez, Daniel Bos, Laura Dorado, Karlijn Pellikaan, Meike W. Vernooij, Elena López-Cancio, Natalia Pérez de la Ossa, Meritxell Gomis, Carlos Castaño, Josep Munuera, Josep Puig, Mònica Millán and Antoni Dávalos

Purpose: Intracranial carotid artery calcification (ICAC) is a surrogate marker of intracranial arteriosclerosis, which may impact the revascularization and clinical outcome of acute stroke patients who undergo mechanical thrombectomy.

STROKE. Outcomes After Direct Thrombectomy or Combined Intravenous and Endovascular Treatment Are Not Different

Sònia Abilleira , Aida Ribera , Pedro Cardona , Marta Rubiera , Elena López-Cancio , Sergi Amaro , Ana Rodríguez-Campello , Pol Camps-Renom , David Cánovas , Maria Angels de Miquel , Alejandro Tomasello , Sebastian Remollo , Antonio López-Rueda , Elio Vivas , Joan Perendreu , Miquel Gallofré , and for the Catalan Stroke Code and Reperfusion Consortium* , J. Martí-Fàbregas , R. Delgado-Mederos , A. Martínez-Domeño , R. Marín , J. Roquer , Á. Ois , J. Jiménez-Conde , L. Guimaraens , Á. Chamorro , V. Obach , X. Urra , J.M. Macho , J. Blasco , L. San Roman , A. Martínez-Yélamos , H. Quesada , B Lara , N. Cayuela , L. Aja , P. Mora , C. Molina , M. Ribó , J. Pagola , D. Rodríguez-Luna , M. Muchada , P. Coscojuela , A. Dávalos , M. Millán , N. Pérez de la Ossa , M. Gomis , L. Dorado , C. Castaño , M.C. Garcia , J. Estela , J. Krupinski , S. Huertas-Folch , M.C. Nicolás-Herrerias , M. Gómez-Choco , S. García , R. Martínez , J. Sanahuja , F. Purroy , J. Serena , M. Castellanos , Y. Silva , R. Marés , A. Pellisé , X. Ustrell , J.J. Baiges , M. Garcés , J. Saura , J.M. Soler-Insa , J.M. Aragonés , D. Cocho , and E. Palomeras

Purpose: Whether intravenous thrombolysis adds a further benefit when given before endovascular thrombectomy (EVT) is unknown. Furthermore, intravenous thrombolysis delays time to groin puncture, mainly among drip and ship patients.

STROKE. Cost-Effectiveness of Solitaire Stent Retriever Thrombectomy for Acute Ischemic Stroke: Results From the SWIFT-PRIME Trial

Theresa I. Shireman , Kaijun Wang , Jeffrey L. Saver , Mayank Goyal , Alain Bonafé , Hans-Christoph Diener , Elad I. Levy , Vitor M. Pereira , Gregory W. Albers , Christophe Cognard , Werner Hacke , Olav Jansen , Tudor G. Jovin , Heinrich P. Mattle , Raul G. Nogueira , Adnan H. Siddiqui , Dileep R. Yavagal , Thomas G. Devlin , Demetrius K. Lopes , Vivek K. Reddy , Richard du Mesnil de Rochemont , Reza Jahan , Katherine A. Vilain , John House , Jin-Moo Lee , and David J. Cohen

Purpose: Clinical trials have demonstrated improved 90-day outcomes for patients with acute ischemic stroke treated with stent retriever thrombectomy plus tissue-type plasminogen activator (SST+tPA) compared with tPA. Previous studies suggested that this strategy may be cost-effective, but models were derived from pooled data and older assumptions.

STROKE. Symptomatic Carotid Occlusion Is Frequently Associated With Microembolization

Ava L. Liberman, Ali Zandieh, Caitlin Loomis, Jonathan M. Raser-Schramm, Christina A. Wilson, Jose Torres, Koto Ishida, Swaroop Pawar, Rebecca Davis, Michael T. Mullen, Steven R. Messé, Scott E. Kasner and Brett L. Cucchiara

Purpose: Symptomatic carotid artery disease is associated with significant morbidity and mortality. The pathophysiologic mechanisms of cerebral ischemia among patients with carotid occlusion remain underexplored.

STROKE. Differences in Acute Ischemic Stroke Quality of Care and Outcomes by Primary Stroke Center Certification Organization

Shumei Man, Margueritte Cox, Puja Patel, Eric E. Smith, Mathew J. Reeves, Jeffrey L. Saver, Deepak L. Bhatt, Ying Xian, Lee H. Schwamm and Gregg C. Fonarow

Purpose: Primary stroke center (PSC) certification was established to identify hospitals providing evidence-based care for stroke patients. The numbers of PSCs certified by Joint Commission (JC), Healthcare Facilities Accreditation Program, Det Norske Veritas, and State-based agencies have significantly increased in the past decade. This study aimed to evaluate whether PSCs certified by different organizations have similar quality of care and in-hospital outcomes.

STROKE. Power of an Adaptive Trial Design for Endovascular Stroke Studies

Maarten G. Lansberg, Ninad S. Bhat, Sharon D. Yeatts, Yuko Y. Palesch, Joseph P. Broderick, Gregory W. Albers, Tze L. Lai and Philip W. Lavori

Purpose: Adaptive trial designs that allow enrichment of the study population through subgroup selection can increase the chance of a positive trial when there is a differential treatment effect among patient subgroups. The goal of this study is to illustrate the potential benefit of adaptive subgroup selection in endovascular stroke studies.

STROKE. Dissociation of Early and Delayed Cerebral Infarction After Aneurysmal Subarachnoid Hemorrhage

Oliver G.S. Ayling, George M. Ibrahim, Naif M. Alotaibi, Peter A. Gooderham and R. Loch Macdonald

Purpose: Cerebral infarction after aneurysmal subarachnoid hemorrhage is a significant cause of substantial morbidity and mortality. Because early and delayed cerebral infarction after aneurysmal subarachnoid hemorrhage may be mediated by different processes, we evaluated whether aneurysm-securing methods contributed to infarcts and whether long-term outcomes differ between early and delayed infarcts.

STROKE. Infarct in a New Territory After Treatment Administration in the ESCAPE Randomized Controlled Trial (Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT to Recanalization Times)

Aravind Ganesh , Fahad S. Al-Ajlan , Farahna Sabiq , Zarina Assis , Jeremy L. Rempel , Kenneth Butcher , John Thornton , Peter Kelly , Daniel Roy , Alexandre Y. Poppe , Tudor G. Jovin , Thomas Devlin , Blaise W. Baxter , Timo Krings , Leanne K. Casaubon , Donald F. Frei , Hana Choe , Donatella Tampieri , Jeanne Teitelbaum , Cheemun Lum , Jennifer Mandzia , Stephen J. Phillips , Oh Young Bang , Mohammed A. Almekhlafi , Shelagh B. Coutts , Philip A. Barber , Tolulope Sajobi , Andrew M. Demchuk , Muneer Eesa , Michael D. Hill , Mayank Goyal , and Bijoy K. Menon

Purpose: Infarct in a new previously unaffected territory (INT) is a potential complication of endovascular treatment. We applied a recently proposed methodology to identify and classify INTs in the ESCAPE randomized controlled trial (Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT to Recanalization Times).

STROKE. Histopathologic Analysis of Retrieved Thrombi Associated With Successful Reperfusion After Acute Stroke Thrombectomy

Tetsuya Hashimoto, Mikito Hayakawa, Naoko Funatsu, Hiroshi Yamagami, Tetsu Satow, Jun C. Takahashi, Kazuyuki Nagatsuka, Hatsue Ishibashi-Ueda, Jun-ichi Kira and Kazunori Toyoda

Purpose: Histopathologic evaluation of occlusive thrombi retrieved from cerebral arteries using endovascular therapy is possible. We investigated the relationship between successful reperfusion after thrombectomy and histopathologic characteristics of retrieved thrombi.

01 febrero 2017

AMERICAN JOURNAL OF NEURORADIOLOGY. Intracranial Vessel Wall MRI: Principles and Expert Consensus Recommendations of the American Society of Neuroradiology

D.M. Mandell, M. Mossa-Basha, Y. Qiao, C.P. Hess, F. Hui, C. Matouk, M.H. Johnson, M.J.A.P. Daemen, A. Vossough, M. Edjlali, D. Saloner, S.A. Ansari, B.A. Wasserman and D.J. Mikulis on behalf of the Vessel Wall Imaging Study Group of the American Society of Neuroradiology

Intracranial vessel wall MR imaging is an adjunct to conventional angiographic imaging with CTA, MRA, or DSA. The technique has multiple potential uses in the context of ischemic stroke and intracranial hemorrhage. There remain gaps in our understanding of intracranial vessel wall MR imaging findings and research is ongoing, but the technique is already used on a clinical basis at many centers. This article, on behalf of the Vessel Wall Imaging Study Group of the American Society of Neuroradiology, provides expert consensus recommendations for current clinical practice.

01 febrero 2017

AMERICAN JOURNAL OF NEURORADIOLOGY. Middle Cerebral Artery Bifurcation Aneurysms Treated by Extrasaccular Flow Diverters: Midterm Angiographic Evolution and Clinical Outcome

C. Iosif, C. Mounayer, K. Yavuz, S. Saleme, S. Geyik, H.S. Cekirge and I. Saatci

PURPOSE: Flow diverters have been increasingly used lately in off-label, distal intracranial aneurysm treatments. Our aim was to evaluate the effectiveness of flow diverters in the treatment of middle cerebral artery bifurcation aneurysms and to analyze midterm angiographic patterns of regional flow modifications for safety and clinical outcomes.

01 febrero 2017

AMERICAN JOURNAL OF NEURORADIOLOGY. The Prevalence of Malformations of Cortical Development in a Pediatric Hereditary Hemorrhagic Telangiectasia Population

G.J. Palagallo, S.R. McWilliams, L.A. Sekarski, A. Sharma, M.S. Goyal and A.J. White

PURPOSE: Brain AVM, cerebral abscess, and ischemic stroke are among the well known neurologic manifestations of hereditary hemorrhagic telangiectasia. However, recently reported data suggest an additional association with malformations of cortical development. The purpose of this study was to determine the prevalence of malformations of cortical development in a population of pediatric patients with hereditary hemorrhagic telangiectasia.

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