30 julio 2013

STROKE. Clinical Sciences. Endovascular Therapy for Asymptomatic Unruptured Intracranial Aneurysms. JR-NET and JR-NET2 Findings

Tomoyoshi Shigematsu, MD; Toshiyuki Fujinaka, MD, PhD; Toshiki Yoshimine, MD, PhD; Hirotoshi Imamura, MD, PhD; Akira Ishii, MD, PhD; Chiaki Sakai, MD, PhD; Nobuyuki Sakai, MD, DMSc for the JR-NET Investigators

Background and Purpose: National registration studies (the Japanese Registry of Neuroendovascular Therapy [JR-NET] and JR-NET2) have determined the current status and outcomes of neuroendovascular therapy (neuro-EVT). We analyzed short-term outcomes of EVT for asymptomatic unruptured intracranial aneurysms (UIAs).

01 agosto 2013

STROKE. Clinical Sciences. Prospective, Multicenter, Single-Arm Study of Mechanical Thrombectomy Using Solitaire Flow Restoration in Acute Ischemic Stroke

Vitor M. Pereira, MD, MSc; Jan Gralla, MD, MSc; Antoni Davalos, MD; Alain Bonafé, MD; Carlos Castaño, MD, PhD; René Chapot, MD; David S. Liebeskind, MD; Raul G. Nogueira, MD; Marcel Arnold, MD; Roman Sztajzel, MD; Thomas Liebig, MD; Mayank Goyal, MD; Michael Besselmann, MD; Antonio Moreno, MD; Gerhard Schroth, MD

Background and Purpose: Mechanical thrombectomy using stent retriever devices have been advocated to increase revascularization in intracranial vessel occlusion. We present the results of a large prospective study on the use of the Solitaire Flow Restoration in patients with acute ischemic stroke.

20 agosto 2013

STROKE. Clinical Sciences. Higher Risk of Recurrent Ischemic Events in Patients With Intracranial In-Stent Restenosis

Min Jin, MD*; Xian Fu, MD*; Yuzhen Wei, MD; Bin Du, MD; Xiao-Tong Xu, MD; Wei-Jian Jiang, MD

Background and Purpose: Reliable data concerning prognosis of patients with intracranial in-stent restenosis (ISR) is lacking. We prospectively studied long-term outcomes of patients with and without a catheter angiography-verified ISR.

30 julio 2013

STROKE. Clinical Sciences. Risk of Rupture of Small Anterior Communicating Artery Aneurysms Is Similar to Posterior Circulation Aneurysms

Philippe Bijlenga, MD, PhD; Christian Ebeling, PhD; Max Jaegersberg, MD; Paul Summers, PhD; Alister Rogers, MD; Alan Waterworth, PhD; Jimison Iavindrasana, PhD; Juan Macho, MD; Vitor Mendes Pereira, MD, PhD; Peter Bukovics, PhD; Elio Vivas, MD; Miriam C.J.M. Sturkenboom, PhD; Jessica Wright, BSc, MA; Christoph M. Friedrich, PhD; Alejandro Frangi, PhD; James Byrne, MD; Karl Schaller, MD; Daniel Rufenacht, MD*

Background and Purpose: According to the International Study of Unruptured Intracranial Aneurysms (ISUIA), anterior circulation (AC) aneurysms of <7 mm in diameter have a minimal risk of rupture. It is general experience, however, that anterior communicating artery (AcoA) aneurysms are frequent and mostly rupture at <7 mm. The aim of the study was to assess whether AcoA aneurysms behave differently from other AC aneurysms.

03 septiembre 2013

STROKE. Clinical Sciences. Natural History of Small Unruptured Anterior Circulation Aneurysms A Prospective Cohort Study

Erdem Güresir, MD, PhD; Hartmut Vatter, MD, PhD; Patrick Schuss, MD; Johannes Platz, MD; Jürgen Konczalla, MD; Richard Du Mesnil de Rochement, MD, PhD; Joachim Berkefeld, MD, PhD; Volker Seifert, MD, PhD

Background and Purpose. The natural history of small unruptured intracranial aneurysms of the anterior circulation in the European population is unclear. Therefore, the management of unruptured intracranial aneurysms <7 mm in the anterior circulation is controversial.

01 agosto 2013

STROKE. Clinical Sciences. Migraine and Hemorrhagic Stroke

Simona Sacco, MD; Raffaele Ornello, MD; Patrizia Ripa, MD; Francesca Pistoia, MD, PhD; Antonio Carolei, MD, FAHA

Background and Purpose: Several studies have assessed the possible increased risk of hemorrhagic stroke in migraineurs, drawing differing conclusions. No meta-analysis on the topic has been published to date.

29 agosto 2013

STROKE. Clinical Sciences. Carotid Plaque MRI and Stroke Risk

Ajay Gupta, MD; Hediyeh Baradaran, MD; Andrew D. Schweitzer, MD; Hooman Kamel, MD; Ankur Pandya, PhD; Diana Delgado, MLS; Allison Dunning, MS; Alvin I. Mushlin, MD, ScM; Pina C. Sanelli, MD, MPH

Background and Purpose: MRI characterization of carotid plaque has been studied recently as a potential tool to predict stroke caused by carotid atherosclerosis. We performed a systematic review and meta-analysis to summarize the association of MRI-determined intraplaque hemorrhage, lipid-rich necrotic core, and thinning/rupture of the fibrous cap with subsequent ischemic events.

27 agosto 2013

STROKE. Clinical Sciences. Modelling the Efficiency of Local Versus Central Provision of Intravenous Thrombolysis After Acute Ischemic Stroke

Peter McMeekin, PhD; Jo Gray, MSc; Gary A. Ford, MBBChir; Helen Rodgers, MBChB; Christopher I. Price, MD

Background and Purpose: Prehospital redirection of stroke patients to a regional center is used as a strategy to maximize the provision of intravenous thrombolysis. We developed a model to quantify the benefit of redirection away from local services that were already providing thrombolysis.

03 septiembre 2013

STROKE. Clinical Sciences. Prediction of Poststroke Hemorrhagic Transformation Using Computed Tomography Perfusion

Nawaf Yassi, MBBS, BSc (Med), FRACP; Mark W. Parsons, PhD, FRACP; Søren Christensen, PhD; Gagan Sharma, MCA; Andrew Bivard, PhD; Geoffrey A. Donnan, MD, FRACP; Christopher R. Levi, FRACP; Patricia M. Desmond, MD, FRANZCR; Stephen M. Davis, MD, FRACP; Bruce C.V. Campbell, MBBS, BMedSc, PhD, FRACP

Background and Purpose: Intracerebral hemorrhage is a serious potential complication of stroke thrombolysis. We investigated the optimal computed tomography perfusion (CTP) parameter to predict cerebral parenchymal hematoma (PH) in acute ischemic stroke.

18 julio 2013

STROKE. Clinical Sciences. Natural History of Unruptured Intracranial Aneurysms

Seppo Juvela, MD, PhD; Kristiina Poussa, MD; Hanna Lehto, MD; Matti Porras, MD, PhD

Background and Purpose: Unruptured intracranial aneurysms are increasingly being detected and are a notable healthcare burden. We investigated the long-term natural history of unruptured intracranial aneurysms and risk factors predictive of subsequent rupture.

06 agosto 2013

STROKE. Clinical Sciences. Refining Angiographic Biomarkers of Revascularization

Albert J. Yoo, MD; Claus Z. Simonsen, MD, PhD; Shyam Prabhakaran, MD*; Zeshan A. Chaudhry, MD; Mohammad A. Issa, MD; Jennifer E. Fugate, DO; Italo Linfante, MD; David S. Liebeskind, MD; Pooja Khatri, MD, MSc; Tudor G. Jovin, MD; David F. Kallmes, MD; Guilherme Dabus, MD; Osama O. Zaidat, MD, MSc for the Cerebral Angiographic Revascularization Grading Collaborators

Background and Purpose: Angiographic revascularization grading after intra-arterial stroke therapy is limited by poor standardization, making it unclear which scale is optimal for predicting outcome. Using recently standardized criteria, we sought to compare the prognostic performance of 2 commonly used reperfusion scales.

23 julio 2013

STROKE. Clinical Sciences. Importance of Cerebral Artery Recanalization in Patients With Stroke With and Without Neurological Improvement After Intravenous Thrombolysis

Tatiana V. Kharitonova, MD, PhD; Teresa P. Melo, MD; Grethe Andersen, MD, DMSc; Jose A. Egido, MD, FESO; José Castillo, MD, PhD; Nils Wahlgren, MD, FESO on behalf of the SITS investigators

Background and Purpose: Recanalization status after intravenous thrombolysis (IVT) in patients with ischemic stroke is a reference point to proceed with a rescue reperfusion intervention, although early neurological improvement (NI) may preclude endovascular procedures. We aimed to evaluate the importance of restoration of blood flow at the arterial occlusion site in subgroups of patients with stroke stratified by early NI after IVT.

04 junio 2013

STROKE. Clinical Sciences. Prospective, Randomized, Open-Label Phase II Trial on Concomitant Intraventricular Fibrinolysis and Low-Frequency Rotation After Severe Subarachnoid Hemorrhage

Nima Etminan, MD*; Kerim Beseoglu, MD*; Sven Oliver Eicker, MD; Bernd Turowski, MD; Hans-Jakob Steiger, MD; Daniel Hänggi, MD

Background and Purpose. The goal of this randomized, open-label phase II study was to investigate the effect of concomitant low-frequency head-motion therapy and intraventricular fibrinolysis in patients after surgical or endovascular treatment for aneurysmal subarachnoid hemorrhage.

06 junio 2013

STROKE. Clinical Sciences. Size Ratio Can Highly Predict Rupture Risk in Intracranial Small (<5 mm) Aneurysms

Daina Kashiwazaki, MD; Satoshi Kuroda, MD, PhD on behalf of the Sapporo SAH Study Group

Background and Purpose. Management strategies for unruptured intracranial aneurysms (UIAs) are controversial. This study aimed to identify surrogate parameters that highly predict the rupture risk of small (<5 mm) UIAs.

28 mayo 2013

STROKE. Clinical Sciences. Alberta Stroke Program Early CT Scale Evaluation of Multimodal Computed Tomography in Predicting Clinical Outcomes of Stroke Patients Treated With Aspiration Thrombectomy

Marios-Nikos Psychogios, MD; Peter Schramm, MD, PhD; Andreas Maximilian Frölich, MD; Kai Kallenberg, MD; Katrin Wasser, MD; Lars Reinhardt, MS; Andreas S. Kreusch, MS; Klaus Jung, PhD; Michael Knauth, MD, PhD

Background and Purpose: Patient selection is crucial in the endovascular treatment of acute ischemic stroke patients. Baseline computed tomographic (CT) images, evaluated with the Alberta Stroke Program Early CT Scale (ASPECTS), are considered significant predictors of outcome. In this study, we evaluated CT images and perfusion parameters, analyzed with ASPECTS, as final outcome predictors after endovascular stroke treatment.