01 enero 2016

NEUROSURGERY. Clinical and Anatomical Follow-up in Patients With Aneurysms Treated With the WEB Device: 1-Year Follow-up Report in the Cumulated Population of 2 Prospective, Multicenter Series (WEBCAST and French Observatory)

Pierot, Laurent MD, PhD*; Spelle, Laurent MD, PhD‡; Molyneux, Andrew MD§; Byrne, James MD§; for the WEBCAST and French Observatory Investigators

BACKGROUND: Flow disruption with WEB is an innovative endovascular approach for wide-neck bifurcation aneurysms. Initial series have shown a low complication rate with good efficacy.

29 octubre 2015

STROKE. Brief Report. Prediction of Early Reperfusion From Repeated Arterial Spin Labeling Perfusion Magnetic Resonance Imaging During Intravenous Thrombolysis

Shuhei Okazaki, MD; Martin Griebe, MD; Johannes Gregori, PhD; Matthias Günther, PhD; Johannes Sauter-Servaes, MD; Marc E. Wolf, MD; Achim Gass, MD; Michael G. Hennerici, MD; Kristina Szabo, MD; Rolf Kern, MD

Background and Purpose: There are few in vivo data on the pathophysiology of reperfusion during systemic thrombolysis. We monitored the time course of cerebral perfusion changes in patients during thrombolysis with repeated arterial spin labeling perfusion magnetic resonance imaging.

10 noviembre 2015

STROKE. Brief Report. Estimating Weight of Patients With Acute Stroke When Dosing for Thrombolysis

Tom Barrow, BSc; Muhammad S. Khan, MSc; Omid Halse, MRCP; Paul Bentley, PhD; Pankaj Sharma, MD, PhD, FRCP

Background and Purpose: Estimating patient weight forms an important part of emergency ischemic stroke management guiding the dose of alteplase (tissue-type plasminogen activator). Weighing patients with stroke can be logistically challenging and time consuming, potentially delaying treatment times. We aimed to assess the reliability of approximating weight to determine recombinant tissue-type plasminogen activator dose and whether potential inaccurate dosing affected patient outcomes.

10 diciembre 2015

STROKE. Clinical Sciences. Impact of Glucose on Outcomes in Patients Treated With Mechanical Thrombectomy. A Post Hoc Analysis of the Solitaire Flow Restoration With the Intention for Thrombectomy Study

Joon-Tae Kim, MD; Reza Jahan, MD; Jeffrey L. Saver, MD, for the SWIFT Investigators

Background and Purpose: Sparse data are available regarding the association between hyperglycemia and outcomes in acute ischemic stroke patients receiving mechanical thrombectomy (MT). We investigated whether hyperglycemia affected the outcomes of subjects treated with MT in the Solitaire Flow Restoration With the Intention for Thrombectomy (SWIFT) multicenter randomized trial, overall and according to reperfusion status after MT.

24 noviembre 2015

STROKE. Clinical Sciences. Imaging Characteristics of Growing and Ruptured Vertebrobasilar Non-Saccular and Dolichoectatic Aneurysms

Deena M. Nasr, DO; Waleed Brinjikji, MD; Aymeric Rouchaud, MD; Ramanathan Kadirvel, PhD; Kelly D. Flemming, MD; David F. Kallmes, MD

Background and Purpose: Vertebrobasilar, nonsaccular, and dolichoectatic aneurysms generally have a poor natural history. We performed a study examining the natural history of vertebrobasilar, nonsaccular, and dolichoectatic aneurysms receiving serial imaging and studied imaging characteristics associated with growth and rupture.

19 noviembre 2015

STROKE. Clinical Sciences. Reperfusion Beyond 6 Hours Reduces Infarct Probability in Moderately Ischemic Brain Tissue

Hongyu An, DSc*; Andria L. Ford, MD*; Cihat Eldeniz, PhD; Yasheng Chen, DSc; Katie D. Vo, MD; Hongtu Zhu, PhD; William J. Powers, MD; Weili Lin, PhD; Jin-Moo Lee, MD, PhD

Background and Purpose: We aimed to examine perfusion changes between 3 and 6 and 6 and 24 hours after stroke onset and their impact on tissue outcome.

24 noviembre 2015

STROKE. Clinical Sciences. Large Volumes of Critically Hypoperfused Penumbral Tissue Do Not Preclude Good Outcomes After Complete Endovascular Reperfusion

Raul G. Nogueira, MD*; Diogo C. Haussen, MD*; Seena Dehkharghani, MD; Leticia C. Rebello, MD; Andrey Lima, MD; Meredith Bowen, BA; Samir Belagaje, MD; Aaron Anderson, MD; Michael Frankel, MD

Background and Purpose: Acute ischemic stroke patients with large volumes of severe hypoperfusion (Tmax>10 s>100 mL) on magnetic resonance imaging have a higher likelihood of intracranial hemorrhage and poor outcomes after reperfusion. We aim to evaluate the impact of the extent of Tmax>10 s CTP lesions in patients undergoing successful treatment.

22 octubre 2015

STROKE. Brief Report. Time From Symptoms to Carotid Endarterectomy or Stenting and Perioperative Risk

James F. Meschia, MD; L. Nelson Hopkins, MD; Irfan Altafullah, MD; Lawrence R. Wechsler, MD; Grant Stotts, MD; Nicole R. Gonzales, MD; Jenifer H. Voeks, PhD; George Howard, Dr PH; Thomas G. Brott, MD

Background and Purpose: Prior meta-analysis showed that carotid endarterectomy benefits decline with increasing surgical delay following symptoms. For symptomatic patients in the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST), we assessed if differences in time between symptoms and carotid endarterectomy or carotid artery stenting are associated with differences in risk of periprocedural stroke or death.

15 octubre 2015

STROKE. Brief Report. Endovascular Treatment for Acute Ischemic Stroke in the Setting of Anticoagulation

Letícia C. Rebello, MD; Diogo C. Haussen, MD; Samir Belagaje, MD; Aaron Anderson, MD; Michael Frankel, MD; Raul G. Nogueira, MD

Background and Purpose: Oral anticoagulation (OAC) plays a major role in atrial fibrillation stroke prevention but represents a contraindication to intravenous tissue-type plasminogen activator. Intra-arterial therapy remains a potential reperfusion strategy in these patients; however, supporting data are scarce.

27 octubre 2015

STROKE. Clinical Sciences. Mechanical Thrombectomy in and Outside the REVASCAT Trial

Xabier Urra, MD, PhD*; Sònia Abilleira, MD, PhD*; Laura Dorado, MD, PhD; Marc Ribó, MD, PhD; Pere Cardona, MD; Mònica Millán, MD, PhD; Angel Chamorro, MD, PhD; Carlos Molina, MD, PhD; Erik Cobo, PhD; Antoni Dávalos, MD, PhD; Tudor G. Jovin, MD; Miquel Gallofré, MD, PhD, Catalan Stroke Code and Reperfusion Consortium

Background and Purpose: Recent trials have shown the superiority of endovascular thrombectomy (EVT) over medical therapy alone in certain stroke patients with proximal arterial occlusion. Using data from the Randomized Trial of Revascularization With Solitaire FR Device Versus Best Medical Therapy in the Treatment of Acute Stroke due to Anterior Circulation Large Vessel Occlusion Presenting Within 8-Hours of Symptom Onset (REVASCAT) and a parallel reperfusion treatment registry, we sought to assess the utilization of EVT in a defined patient population, comparing the outcomes of patients treated in and outside the REVASCAT trial.

15 octubre 2015

STROKE. Clinical Sciences. Summary of Evidence on Early Carotid Intervention for Recently Symptomatic Stenosis Based on Meta-Analysis of Current Risks

Paola De Rango, MD, PhD; Martin M. Brown, MD; Seemant Chaturvedi, MD; Virginia J. Howard, PhD; Tudor Jovin, MD; Michael V. Mazya, MD, PhD; Maurizio Paciaroni, MD, PhD; Alessandra Manzone, MS; Luca Farchioni, MD; Valeria Caso, MD, PhD

Background and Purpose: This study aimed to assess the evidence on the periprocedural (<30 days) risks of carotid intervention in relation to timing of procedure in patients with recently symptomatic carotid stenosis.

20 octubre 2015

STROKE. Clinical Sciences. Endovascular Therapy Is Effective and Safe for Patients With Severe Ischemic Stroke. Pooled Analysis of Interventional Management of Stroke III and Multicenter Randomized Clinical Trial of Endovascular Therapy for Acute Ischemic Stroke in the Netherlands Data

Joseph P. Broderick, MD; Olvert A. Berkhemer, MD; Yuko Y. Palesch, PhD; Diederik W.J. Dippel, MD, PhD; Lydia D. Foster, MS; Yvo B.W.E.M. Roos, MD, PhD; Aad van der Lugt, MD, PhD; Thomas A. Tomsick, MD; Charles B.L.M. Majoie, MD, PhD; Wim H. van Zwam, MD, PhD; Andrew M. Demchuk, MD; Robert J. van Oostenbrugge, MD, PhD; Pooja Khatri, MD; Hester F. Lingsma, PhD; Michael D. Hill, MD; Bob Roozenbeek, MD, PhD; Edward C. Jauch, MD; Tudor G. Jovin, MD; Bernard Yan, MD; Rüdiger von Kummer, Dr. Med; Carlos A. Molina, MD; Mayank Goyal, MD; Wouter J. Schonewille, MD, PhD; Mikael Mazighi, MD, PhD; Stefan T. Engelter, MD; Craig S. Anderson, MD, PhD; Judith Spilker, RN, BSN; Janice Carrozzella, RN, BA, RT (R); Karla J. Ryckborst, RN, BN; L. Scott Janis, PhD; Kit N. Simpson, PhD, for the IMS III and MR CLEAN Investigators

Background and Purpose: We assessed the effect of endovascular treatment in acute ischemic stroke patients with severe neurological deficit (National Institutes of Health Stroke Scale score, ≥20) after a prespecified analysis plan.

27 octubre 2015

STROKE. Clinical Sciences. Benefits of Stroke Treatment Using a Mobile Stroke Unit Compared With Standard Management

Ritvij Bowry, MD; Stephanie Parker, RN; Suja S. Rajan, PhD; Jose-Miguel Yamal, PhD; Tzu-Ching Wu, MD; Laura Richardson, BS; Elizabeth Noser, MD; David Persse, MD; Kamilah Jackson, RT; James C. Grotta, MD

Background and Purpose: Faster treatment with intravenous tissue-type plasminogen activator (tPA) is likely to improve outcomes. Optimizing prehospital triage by mobile stroke units (MSUs) may speed treatment times. The Benefits of Stroke Treatment Delivered Using a Mobile Stroke Unit (BEST-MSU) study was launched in May 2014 using the first MSU in the United States to compare stroke management using an MSU versus standard management (SM). Herein, we describe the results of the prespecified, nonrandomized run-in phase designed to obtain preliminary data on study logistics.

01 octubre 2015

JACC: CARDIOVASCULAR INTERVENTIONS. Paclitaxel-Coated Balloon in Infrapopliteal Arteries. 12-Month Results From the BIOLUX P-II Randomized Trial (BIOTRONIK´S-First in Man study of the Passeo-18 LUX drug releasing PTA Balloon Catheter vs. the uncoated Passeo-18 PTA balloon catheter in subjects requiring revascularization of infrapopliteal arteries

Thomas Zeller, MD∗; Ulrich Beschorner, MD†; Ernst Pilger, MD‡; Marc Bosiers, MD§; Koen Deloose, MD§; Patrick Peeters, MD‖; Dierk Scheinert, MD, PhD¶; Karl-Ludwig Schulte, MD, PhD#; Aljoscha Rastan, MD∗; Marianne Brodmann, MD, PhD‡

Objectives: The aim of BIOLUX P-II (BIOTRONIK´S–First in Man study of the Passeo-18 LUX drug releasing PTA Balloon Catheter vs. the uncoated Passeo-18 PTA balloon catheter in subjects requiring revascularization of infrapopliteal arteries) trial was to compare the safety and efficacy of a novel paclitaxel-coated drug-eluting balloon (DEB) versus an uncoated balloon (percutaneous transluminal angioplasty [PTA]) in de novo or native restenotic lesions of the infrapopliteal arteries in patients with claudication and critical limb ischemia.

01 noviembre 2015

JACC: CARDIOVASCULAR INTERVENTIONS. Safety and Efficacy of Stent Retrievers for the Management of Acute Ischemic Stroke. Comprehensive Review and Meta-Analysis

Konstantinos Marmagkiolis, MD∗,†; Abdul Hakeem, MD‡; Mehmet Cilingiroglu, MD§,‖; Betul Gundogdu, MD¶; Cezar Iliescu, MD#; Despina Tsitlakidou∗∗; Angelos Katramados, MD††

Objectives: This study sought to evaluate the safety and efficacy of stent retriever for the management of acute ischemic stroke.