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ESTUDIOS


STROKE. Hemodynamic Markers in the Anterior Circulation as Predictors of Recurrent Stroke in Patients With Intracranial Stenosis

Matthew J. Gounis , Giovanni J. Ughi , Miklos Marosfoi , Demetrius K. Lopes , David Fiorella , Hiram G. Bezerra , Conrad W. Liang and Ajit S. Puri

Background and Purpose— Although aggressive medical therapy was superior to stenting in the SAMMPRIS trial (Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis), the stroke rate in the medical arm was still high. The aim of this study was to determine the association between hemodynamic markers (borderzone infarct pattern and impaired collateral flow on baseline imaging) and rates of recurrent stroke in patients treated medically in SAMMPRIS.

STROKE: Intravascular Optical Coherence Tomography for Neurointerventional Surgery

Matthew J. Gounis , Giovanni J. Ughi , Miklos Marosfoi , Demetrius K. Lopes , David Fiorella , Hiram G. Bezerra , Conrad W. Liang and Ajit S. Puri

Optical coherence tomography (OCT) is a high-resolution imaging modality that uses backscattered light to produce cross-sectional images of biological tissue with micrometer resolution. The first publication using the term OCT appeared in 1991 and arose as a collaboration between the Massachusetts Institute of Technology (MIT) and Harvard University.

STROKE. Emergent Large Vessel Occlusion Stroke During New York City’s COVID-19 Outbreak

Shahram Majidi

The 2019 novel coronavirus outbreak and its associated disease (coronavirus disease 2019 [COVID-19]) have created a worldwide pandemic. Early data suggest higher rate of ischemic stroke in severe COVID-19 infection. We evaluated whether a relationship exists between emergent large vessel occlusion (ELVO) and the ongoing COVID-19 outbreak.

STROKE. Early Outcomes in the ROADSTER 2 Study of Transcarotid Artery Revascularization in Patients With Significant Carotid Artery Disease

Vikram S. Kashyap

Transcarotid artery revascularization (TCAR) is comprised of carotid artery stent placement with cerebral protection via proximal carotid artery clamping and reversal of cerebral arterial flow. The aim of the present study was to evaluate the safety and efficacy of TCAR performed by a broad group of physicians with variable TCAR experience.

STROKE. Anticoagulation Type and Early Recurrence in Cardioembolic Stroke

Shadi Yaghi

In patients with acute ischemic stroke and atrial fibrillation, treatment with low molecular weight heparin increases early hemorrhagic risk without reducing early recurrence, and there is limited data comparing warfarin to direct oral anticoagulant (DOAC) therapy. We aim to compare the effects of the treatments above on the risk of 90-day recurrent ischemic events and delayed symptomatic intracranial hemorrhage.

STROKE. Clot-Based Radiomics Predict a Mechanical Thrombectomy Strategy for Successful Recanalization in Acute Ischemic Stroke

Jeremy Hofmeister

Mechanical thrombectomy (MTB) is a reference treatment for acute ischemic stroke, with several endovascular strategies currently available. However, no quantitative methods are available for the selection of the best endovascular strategy or to predict the difficulty of clot removal. We aimed to investigate the predictive value of an endovascular strategy based on radiomic features extracted from the clot on preinterventional, noncontrast computed tomography to identify patients with first-attempt recanalization with thromboaspiration and to predict the overall number of passages needed with an MTB device for successful recanalization.

STROKE. Treatment of Acute Ischemic Stroke due to Large Vessel Occlusion With COVID-19

Simon Escalard

Higher rates of strokes have been observed in patients with coronavirus disease 2019 (COVID-19), but data regarding the outcomes of COVID-19 patients suffering from acute ischemic stroke due to large vessel occlusion (LVO) are lacking. We report our initial experience in the treatment of acute ischemic stroke with LVO in patients with COVID-19.

CIRCULATION. Interhospital Transfer Before Thrombectomy Is Associated With Delayed Treatment and Worse Outcome in the STRATIS Registry (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke)

Michael T. Froehler , Jeffrey L. Saver , Osama O. Zaidat , Reza Jahan , Mohammad Ali Aziz-Sultan , Richard P. Klucznik, Diogo C. Haussen , Frank R. Hellinger Jr. , Dileep R. Yavagal , Tom L. Yao , David S. Liebeskind , Ashutosh P. Jadhav , Rishi Gupta , Ameer E. Hassan , Coleman O. Martin , Hormozd Bozorgchami , Ritesh Kaushal , Raul G. Nogueira , Ravi H. Gandhi , Eric C. Peterson , Shervin R. Dashti , Curtis A. GivenII , Brijesh P. Mehta , Vivek Deshmukh, Sidney Starkman , Italo Linfante , Scott H. McPherson , Peter Kvamme , Thomas J. Grobelny , Muhammad S. Hussain , Ike Thacker , Nirav Vora , Peng Roc Chen , Stephen J. Monteith , Robert D. Ecker , Clemens M. Schirmer , Eric Sauvageau , Alex Abou-Chebl , Colin P. Derdeyn , Lucian Maidan , Aamir Badruddin , Adnan H. Siddiqui , Travis M. Dumont , Abdulnasser Alhajeri , M. Asif Taqi , Khaled Asi , Jeffrey Carpenter , Alan Boulos , Gaurav Jindal , Ajit S. Puri , Rohan Chitale , Eric M. Deshaies , David H. Robinson , David F. Kallmes , Blaise W. Baxter , Mouhammad A. Jumaa , Peter Sunenshine , Aniel Majjhoo , Joey D. English , Shuichi Suzuki , Richard D. Fessler , Josser E. Delgado Almandoz , Jerry C. Martin and Nils H. Mueller-Kronast

Background: Endovascular treatment with mechanical thrombectomy (MT) is beneficial for patients with acute stroke suffering a large-vessel occlusion, although treatment efficacy is highly time-dependent. We hypothesized that interhospital transfer to endovascular-capable centers would result in treatment delays and worse clinical outcomes compared with direct presentation.

CIRCULATION. Increase in Endovascular Therapy in Get With The Guidelines-Stroke After the Publication of Pivotal Trials

Eric E. Smith, Jeffrey L. Saver, Margueritte Cox, Li Liang, Roland Matsouaka, Ying Xian, Deepak L. Bhatt, Gregg C. Fonarow and Lee H. Schwamm

Background: Beginning in December 2014, a series of pivotal trials showed that endovascular thrombectomy (EVT) was highly effective, prompting calls to reorganize stroke systems of care. However, there are few data on how these trials influenced the frequency of EVT in clinical practice. We used data from the Get With The Guidelines-Stroke program to determine how the frequency of EVT changed in US practice.

CIRCULATION. Cerebral Perfusion and the Risk of Dementia: A Population-Based Study

Frank J. Wolters, Hazel I. Zonneveld, Albert Hofman, Aad van der Lugt, Peter J. Koudstaal, Meike W. Vernooij and M. Arfan Ikram

Background: Cerebral hypoperfusion has previously been associated with mild cognitive impairment and dementia in various cross-sectional studies, but whether hypoperfusion precedes neurodegeneration is unknown. We prospectively determined the association of cerebral perfusion with subsequent cognitive decline and development of dementia.

01 febrero 2017

AMERICAN JOURNAL OF NEURORADIOLOGY. Endovascular Stroke Treatment of Nonagenarians

M. Möhlenbruch, J. Pfaff, S. Schönenberger, S. Nagel, J. Bösel, C. Herweh, P. Ringleb, M. Bendszus and S. Stampfl

BACKGROUND AND PURPOSE: Although endovascular treatment has become a standard therapy in patients with acute stroke, the benefit for very old patients remains uncertain. The purpose of this study was the evaluation of procedural and outcome data of patients >=90 years undergoing endovascular stroke treatment.

01 febrero 2017

AMERICAN JOURNAL OF NEURORADIOLOGY. Diffusion-Weighted Imaging–Detected Ischemic Lesions following Endovascular Treatment of Cerebral Aneurysms: A Systematic Review and Meta-Analysis

K.M. Bond, W. Brinjikji, M.H. Murad, D.F. Kallmes, H.J. Cloft and G. Lanzino

BACKGROUND AND PURPOSE: Endovascular treatment of intracranial aneurysms is associated with the risk of thromboembolic ischemic complications. Many of these events are asymptomatic and identified only on diffusion-weighted imaging. We performed a systematic review and meta-analysis to study the incidence of DWI positive for thromboembolic events following endovascular treatment of intracranial aneurysms.

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