26 marzo 2015

STROKE. Clinical Sciences. Changes in Wall Shear Stress of Cerebral Arteriovenous Malformation Feeder Arteries After Embolization and Surgery

Ali Alaraj, MD; Sophia F. Shakur, MD; Sepideh Amin-Hanjani, MD; Hassan Mostafa, MD; Sajeel Khan, MD; Victor A. Aletich, MD; Fady T. Charbel, MD

Background and Purpose: Wall shear stress (WSS) has been implicated as an important stimulus for vascular remodeling. The purpose of this study is to measure WSS in AVM arterial feeders using quantitative magnetic resonance angiography pre- and post-embolization/surgery.

10 marzo 2015

STROKE. Clinical Sciences. PHASES Score for Prediction of Intracranial Aneurysm Growth

Daan Backes, MD; Mervyn D.I. Vergouwen, MD, PhD; Andreas T. Tiel Groenestege, MD; A. Stijntje E. Bor, MD, PhD; Birgitta K. Velthuis, MD, PhD; Jacoba P. Greving, PhD; Ale Algra, MD, PhD; Marieke J.H. Wermer, MD, PhD; Marianne A.A. van Walderveen, MD, PhD; Karel G. terBrugge, MD; Ronit Agid, MD; Gabriel J.E. Rinkel, MD, FRCPE

Background and Purpose: Growth of an intracranial aneurysm occurs in around 10% of patients at 2-year follow-up imaging and may be associated with aneurysm rupture. We investigated whether PHASES, a score providing absolute risks of aneurysm rupture based on 6 easily retrievable risk factors, also predicts aneurysm growth.

09 abril 2015

STROKE. Clinical Sciences. Twelve-Month Clinical and Quality-of-Life Outcomes in the Interventional Management of Stroke III Trial

Yuko Y. Palesch, PhD; Sharon D. Yeatts, PhD; Thomas A. Tomsick, MD; Lydia D. Foster, MS; Andrew M. Demchuk, MD; Pooja Khatri, MD; Michael D. Hill, MD; Edward C. Jauch, MD; Tudor G. Jovin, MD; Bernard Yan, MD; Rüdiger von Kummer, MD; Carlos A. Molina, MD; Mayank Goyal, MD; Wouter J. Schonewille, MD; Mikael Mazighi, MD, PhD; Stefan T. Engelter, MD; Craig Anderson, MD, PhD; Judith Spilker, RN, BSN; Janice Carrozzella, RN, BA, RT(R); Karla J. Ryckborst, RN, BN; L. Scott Janis, PhD; Annie Simpson, PhD; Kit N. Simpson, DrPH; Joseph P. Broderick, MD; for the Interventional Management of Stroke III Investigators

Background and Purpose: Randomized trials have indicated a benefit for endovascular therapy in appropriately selected stroke patients at 3 months, but data regarding outcomes at 12 months are currently lacking.

19 marzo 2015

STROKE. Clinical Sciences. Surgeon Case Volume and 30-Day Mortality After Carotid Endarterectomy Among Contemporary Medicare Beneficiaries

Hiraku Kumamaru, MD, MPH, ScD; Jessica J. Jalbert, PhD; Louis L. Nguyen, MD, MBA, MPH; Marie D. Gerhard-Herman, MD; Lauren A. Williams, BA; Chih-Ying Chen, PhD; John D. Seeger, PharmD, DrPH; Jun Liu, MD, MPH; Jessica M. Franklin, PhD; Soko Setoguchi, MD, DrPH

Background and Purpose: After the 2005 National Coverage Determination to reimburse carotid artery stenting (CAS) for Medicare beneficiaries, the number of CAS procedures increased and carotid endarterectomy (CEA) decreased. We evaluated trends in surgeons’ past-year CEA case-volume and 30-day mortality after CEA, and their association before and after the National Coverage Determination.

19 marzo 2015

STROKE. Clinical Sciences. Safety of Intravenous Thrombolysis in Stroke Mimics

Georgios Tsivgoulis, MD; Ramin Zand, MD; Aristeidis H. Katsanos, MD; Nitin Goyal, MD; Ken Uchino, MD; Jason Chang, MD; Efthimios Dardiotis, MD; Jukka Putaala, MD; Anne W. Alexandrov, PhD; Marc D. Malkoff, MD; Andrei V. Alexandrov, MD

Background and Purpose: Shortening door-to-needle time may lead to inadvertent intravenous thrombolysis (IVT) administration in stroke mimics (SMs). We sought to determine the safety of IVT in SMs using prospective, single-center data and by conducting a comprehensive meta-analysis of reported case-series.

21 abril 2015

STROKE. Clinical Sciences. Mechanical Thrombectomy in Cerebral Venous Thrombosis. Systematic Review of 185 Cases

Fazeel M. Siddiqui, MD; Sudeepta Dandapat, MD; Chirantan Banerjee, MBBS; Susanna M. Zuurbier, MD; Mark Johnson, MD; Jan Stam, MD, PhD; Jonathan M. Coutinho, MD, PhD

Background and Purpose: Cerebral venous thrombosis is generally treated with anticoagulation. However, some patients do not respond to medical therapy and these might benefit from mechanical thrombectomy. The aim of this study was to gain a better understanding of the efficacy and safety of mechanical thrombectomy in patients with cerebral venous thrombosis, by performing a systematic review of the literature.

14 abril 2015

STROKE. Clinical Sciences. Hypoxic Viable Tissue in Human Chronic Cerebral Ischemia Because of Unilateral Major Cerebral Artery Steno-Occlusive Disease

Hiroaki Saura, MD; Kuniaki Ogasawara, MD; Takaaki Beppu, MD; Koji Yoshida, MD; Masakazu Kobayashi, MD; Kenji Yoshida, MD; Kazunori Terasaki, PhD; Yoshihiro Takai, MD; Akira Ogawa, MD

Background and Purpose: Positron emission tomography (PET) with radiolabeled 2-nitroimidazoles directly detects hypoxic but viable tissue present in an acute ischemic area in the human brain. This study using PET with 1-(2-18F-fluoro-1-[hydroxymethyl]ethoxy) methyl-2-nitroimidazole (18F-FRP170) aimed to determine whether tissue with an abnormally elevated uptake of 18F-FRP170 exists in human chronic cerebral ischemia because of unilateral atherosclerotic major cerebral artery steno-occlusive disease.

31 marzo 2015

STROKE. Clinical Sciences. Reperfusion of Very Low Cerebral Blood Volume Lesion Predicts Parenchymal Hematoma After Endovascular Therapy

Nishant K. Mishra, MBBS, PhD; Søren Christensen, PhD; Anke Wouters, MD; Bruce C.V. Campbell, MBBS, PhD; Matus Straka, PhD; Michael Mlynash, MD, MS; Stephanie Kemp, BS; Carlo W. Cereda, MD; Roland Bammer, PhD; Michael P. Marks, MD; Gregory W. Albers, MD; Maarten G. Lansberg, MD, PhD; for the DEFUSE 2 Investigators

Background and Purpose: Ischemic stroke patients with regional very low cerebral blood volume (VLCBV) on baseline imaging have increased risk of parenchymal hemorrhage (PH) after intravenous alteplase–induced reperfusion. We developed a method for automated detection of VLCBV and examined whether patients with reperfused-VLCBV are at increased risk of PH after endovascular reperfusion therapy.

19 marzo 2015

STROKE. Clinical Sciences. Differential Effect of Baseline Computed Tomographic Angiography Collaterals on Clinical Outcome in Patients Enrolled in the Interventional Management of Stroke III Trial

Bijoy K. Menon, MD; Emmad Qazi, BSc; Vivek Nambiar, MD; Lydia D. Foster, MS; Sharon D. Yeatts, PhD; David Liebeskind, MD; Tudor G. Jovin, MD; Mayank Goyal, MD; Michael D. Hill, MD; Thomas A. Tomsick, MD; Joseph P. Broderick, MD; Andrew M. Demchuk, MD; for the Interventional Management of Stroke III Investigators

Background and Purpose: In the Interventional Management of Stroke (IMS) III trial, we sought to demonstrate evidence of a differential treatment effect of endovascular treatment of acute ischemic stroke compared with intravenous tissue-type plasminogen activator, according to baseline collateral status measured using computed tomographic angiography.

05 marzo 2015

STROKE. Clinical Sciences. Quantitative Assessment of Changes in Cerebral Arteriovenous Malformation Hemodynamics After Embolization

Ali Alaraj, MD; Sepideh Amin-Hanjani, MD; Sophia F. Shakur, MD; Victor A. Aletich, MD; Alexander Ivanov, MD; Andrew P. Carlson, MD; Gerald Oh, MD; Fady T. Charbel, MD

Background and Purpose: Embolization reduces flow in arteriovenous malformations (AVMs) before surgical resection, but achievement of this goal is determined subjectively from angiograms. Here, we quantify effects of embolization on AVM flow.

24 febrero 2015

STROKE. Clinical Sciences. Natural History and Management of Basilar Trunk Artery Aneurysms

Guillaume Saliou, MD, PhD; Raphael H. Sacho, MD; Sarah Power, MD, PhD; Alex Kostynskyy, MD; Robert A. Willinsky, MD; Michael Tymianski, MD, PhD; Karel G. terBrugge, MD, PhD; Sapna Rawal, MD; Timo Krings, MD, PhD

Background and Purpose: Basilar trunk aneurysms (BTAs), defined as aneurysms distal to the basilar origin and proximal to the origin of the superior cerebellar artery, are rare and challenging to manage. We describe the natural history and management in a consecutive series of BTAs.

24 febrero 2015

STROKE. Basic Sciences. Endothelial Trauma From Mechanical Thrombectomy in Acute Stroke

Dayu Teng, PhD; Jeffrey Scott Pannell, MD; Robert C. Rennert, MD; Jieying Li, MS; Yi-Shuan Li, PhD; Victor W. Wong, MD; Shu Chien, MD, PhD; Alexander A. Khalessi, MD, MS

Background and Purpose: Endovascular thrombectomy has shown promise for the treatment of acute strokes resulting from large-vessel occlusion. Reperfusion-related injury may contribute to the observed decoupling of angiographic and clinical outcomes. Iatrogenic disruption of the endothelium during thrombectomy is potentially a key mediator of this process that requires further study.

13 febrero 2015

STROKE. Clinical Sciences. Trends in Endovascular Therapy and Clinical Outcomes Within the Nationwide Get With The Guidelines-Stroke Registry

Bijoy K. Menon, MD; Jeffrey L. Saver, MD; Mayank Goyal, MD; Raul Nogueira, MD; Shyam Prabhakaran, MD; Li Liang, PhD; Ying Xian, MD; Adrian F. Hernandez, MD; Gregg C. Fonarow, MD; Lee Schwamm, MD; Eric E. Smith, MD, MPH

Background and Purpose: We sought to determine hospital and patient characteristics associated with the use of endovascular therapy for acute ischemic stroke and to analyze trends in clinical outcome.

01 febrero 2015

JACC. Ischemic Brain Lesions After Carotid Artery Stenting Increase Future Cerebrovascular Risk

Henrik Gensicke, MD; H. Bart van der Worp, PhD; Paul J. Nederkoorn, PhD; Sumaira Macdonald, PhD; Peter A. Gaines, MBChB; Aad van der Lugt, MD; Willem P.Th.M. Mali, MD; Philippe A. Lyrer, MD; Nils Peters, MD; Roland L. Featherstone, PhD; Gert J. de Borst, MD; Stefan T. Engelter, MD; Martin M. Brown, MD; Leo H. Bonati, MD

Background Brain lesions on diffusion-weighted imaging (DWI) are frequently found after carotid artery stenting (CAS), but their clinical relevance remains unclear.

01 abril 2015

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. The 10-year Trend of Periprocedural Complication Following Carotid Artery Stenting; Single Center Experience

Jeong-Ho Hong, Jihoon Kang, Min-Ju Yeo, Beom Joon Kim, Min Uk Jang, Hee-Joon Bae, O-Ki Kwon, Gyo Jun Hwang, Chang Wan Oh, Cheolkyu Jung, Ji Sung Lee, Moon-Ku Han

Purpose: Carotid endarterectomy and stenting are used to treat carotid stenosis, with the volume of carotid artery procedures increasing over the past decade. We investigated the 10-year trend of periprocedural complications with an increasing procedure volume of carotid stenting at a single tertiary hospital.