Number of Patients with Ischemic Stroke did not Decline in a Regional Stroke Unit After the Implementation of Mechanical Thrombectomy

Stephan Scherzer, MD Andrea Robledo Karin Stahl Sami Nasri, MD Peter Kraft, MD

Abstract Objectives: Since the implementation of mechanical thrombectomy (MT) in 2015 for patients with ischemic stroke and large-vessel occlusion, the question arose as to whether patients should be primarily admitted to the nearest regional stroke unit (SU) for prompt intravenous thrombolysis (IVT) or to a more distant supraregional SU performing MT, to avoid secondary-transfer delays in MT. Although an evidence-based answer is still lacking, a discrepant discussion with potential consequences for the regional flow of stroke patients arose. We aimed to assess if MT implementation was associated with the number and characteristics of patients with stroke/transient ischemic attack (TIA) admitted to a regional SU not offering endovascular treatment.

Antiplatelet Therapy During Emergent Extracranial Internal Carotid Artery Stenting: Comparison of Three Intravenous Antiplatelet Perioperative Strategies

François Delvoye, MD Benjamin Maier, MD Simon Escalard, MD Julien Labreuche, BST Laurie-Anne Thion, MD Soufiane Aknouche, MSc Solène Hebert, MD Hocine Redjem, MD Stanislas Smajda, MD Gabriele Ciccio, MD Julien Allard, MD Candice Sabben, MD Michael Obadia, MD Alain Maertens de Noordhout, MD, PhD Jean-Marc Olivot, MD, PhD Raphael Blanc, MD Michel Piotin, MD, PhD Jean-Philippe Desilles, MD, PhD Mikael Mazighi, MD, PhD Show less

Introduction Guidelines for antiplatelet therapy administration, during emergent stenting for extra-cranial internal carotid artery (EC-ICA) occlusion in the setting of acute ischemic stroke (AIS) are lacking. Different antiplatelet regimen are used in association to endovascular therapy (EVT) for the treatment of EC-ICA lesions. We aimed to compare the clinical and radiological effects of three intravenous antiplatelet agents used during emergent EC-ICA stenting.

Endovascular Treatment of Symptomatic Intracranial Vertebrobasilar Stenosis: A 10-Year Single Centre Experience Using Balloon-Expandable Coronary Artery Stents

Mariangela Piano, MD Luca Milonia, MD Amedeo Cervo, MD Beatrice Modello, MD Antonio Macera, MD Guglielmo Pero, MD Luca Quilici, MD Edoardo Boccardi, MD Luca Valvassori, MD

Background Symptomatic intracranial vertebro-basilar stenoses (SIVBS) are associated with high risk of recurrent ischemic stroke, even in patients receiving the best medical treatment. Although medical treatment is still the standard of care, non-responding patients may require endovascular treatment; balloon-mounted coronary stents (BMCS) could be successfully employed. This study aims to retrospectively analyze our high volume Interventional Neurovascular center ten-year experience in the off-label use of BMCS for the treatment of SIVBS, in order to assess its feasibility and safety.

Repeated Endovascular Thrombectomy in Patients with Acute Ischemic Stroke in a Single Center

Hyun Jin Lee Hyo Sung Kwak, MD, PhD Gyung Ho Chung, MD, PhD Jung-Soo Park, MD, PhD

Background Patients with acute ischemic stroke treated with endovascular thrombectomy may be treated with repeat endovascular thrombectomy (rEVT) in case of recurrent large vessel occlusion (LVO). The purpose of this study is to report the frequency, timing, and outcomes of rEVT in a single center.

JVIR. Risk Factors for New Vertebral Fractures after Percutaneous Vertebroplasty in Patients with Osteoporosis: A Prospective Study

Wen-Gui Liu, MD , Shi-Cheng He, MD , Gang Deng, MD , Jin-He Guo, MD , Wen Fang, MD , Guang-Yu Zhu, MD , Gao-Jun Teng, MD, PhD

Purpose: To determine the risk factors for new vertebral compression fractures (VCFs) following percutaneous vertebroplasty (PV) in patients with osteoporosis. Journal of Vascular and Interventional Radiology Volume 23, Issue 9 , Pages 1143-1149, September 2012. Copyright © SIR, 2012

FLAIR Vascular Hyperintensities/DWI Mismatch Predicts Penumbra in Proximal Middle Cerebral Artery Occlusion FVH/DWI Ratio Predicts Penumbra in MCA Occlusion

Mary Boullet, MD , Gaultier Marnat, MD, Aurélie Boyer, MD, Matthieu F. Bastide, MD, PhD, Pierre Briau, MD, Sabrina Debruxelles, MD, Mathilde Poli, MD, … Show All … , and Stéphane Olindo, MD

Perfusion imaging used to select patients for extended-window stroke therapy is not widely available. We investigated whether fluid-attenuated inversion recovery vascular hyperintensities (FVHs) on routine magnetic resonance imaging could serve as a reliable surrogate for perfusion imaging by predicting the mismatch between hypoperfused tissue volume (perfusion-weighted imaging [PWI]) and infarct core volume (diffusion-weighted imaging [DWI]) in patients with proximal middle cerebral artery occlusion

Peri-Stenotic Stagnation Associates With Red Blood Cell-Rich Thrombi, Linked to Stroke Recurrence and Lesion Volume

Dong Young Jeong

Despite antiplatelet therapy, plaque-induced strokes recur frequently. This recurrence may reflect thrombus heterogeneity driven by peri-stenotic stagnation and red blood cell (RBC) entrapment. The clinical implications of such variations for stroke outcomes remain unclear. We investigated whether plaque-derived RBC-rich thrombi, indicated by the clot sign, were associated with recurrence, lesion volume, and stenosis-related hemodynamics

Targeting Brain Networks for Recovery: Multimodal Innovations in Poststroke Therapy

Shahrzad Latifi

Stroke disrupts brain networks across multiple spatiotemporal scales, producing structural and functional deficits that extend beyond focal injury. Peri-infarct networks are particularly vulnerable yet provide a foundation for neurological recovery driven by neuroplasticity mechanisms, including synaptic remodeling, axonal sprouting, and neuronal network reorganization. This review highlights emerging therapeutic strategies aimed at targeting these networks

Hypoperfusion on Early MRI Despite Successful Thrombectomy: A Prospective Imaging and Inflammatory Biomarkers Study

Adrien ter Schiphorst, MD

Persistent hypoperfusion despite successful endovascular treatment (EVT) for acute ischemic stroke (AIS) due to large-vessel occlusion is increasingly recognized as associated with poor outcome. It may result from residual distal macrovascular occlusion or microvascular dysfunction (no-reflow). We aimed to characterize early post-EVT hypoperfusion on magnetic resonance imaging and assessed its relationship with a panel of inflammatory biomarkers

Microvascular and Macrovascular Cerebral Disease Profiles and Their Association With Cognitive Abilities: A Cross-Sectional Clinical Pathological Study

Raul dos Reis Ururahy

Cerebrovascular disease is prevalent in older adults and is associated with cognitive impairment. Although the association between brain infarcts and cognition has been widely investigated, the contribution of vascular disease to cognitive impairment has been less studied, particularly in non-White populations. We investigated the epidemiological and clinical characteristics of vascular disease phenotypes and their association with cognitive abilities in a diverse population

14 abril 2016

AMERICAN JOURNAL OF NEURORADIOLOGY. Centripetal Propagation of Vasoconstriction at the Time of Headache Resolution in Patients with Reversible Cerebral Vasoconstriction Syndrome

M. Shimoda, S. Oda, A. Hirayama, M. Imai, F. Komatsu, K. Hoshikawa, H. Shigematsu, J. Nishiyama and T. Osada

BACKGROUND AND PURPOSE: Reversible cerebral vasoconstriction syndrome is characterized by thunderclap headache and diffuse segmental vasoconstriction that resolves spontaneously within 3 months. Previous reports have proposed that vasoconstriction first involves small distal arteries and then progresses toward major vessels at the time of thunderclap headache remission. The purpose of this study was to confirm centripetal propagation of vasoconstriction on MRA at the time of thunderclap headache remission compared with MRA at the time of reversible cerebral vasoconstriction syndrome onset.

21 abril 2016

AMERICAN JOURNAL OF NEURORADIOLOGY. Association of Automatically Quantified Total Blood Volume after Aneurysmal Subarachnoid Hemorrhage with Delayed Cerebral Ischemia

I.A. Zijlstra, C.S. Gathier, A.M. Boers, H.A. Marquering, A.J. Slooter, B.K. Velthuis, B.A. Coert, D. Verbaan, R. van den Berg, G.J. Rinkel and C.B. Majoie

BACKGROUND AND PURPOSE: The total amount of extravasated blood after aneurysmal subarachnoid hemorrhage, assessed with semiquantitative methods such as the modified Fisher and Hijdra scales, is known to be a predictor of delayed cerebral ischemia. However, prediction rates of delayed cerebral ischemia are moderate, which may be caused by the rough and observer-dependent blood volume estimation used in the prediction models. We therefore assessed the association between automatically quantified total blood volume on NCCT and delayed cerebral ischemia.

02 junio 2016

AMERICAN JOURNAL OF NEURORADIOLOGY. Endovascular Coiling of Wide-Neck and Wide-Neck Bifurcation Aneurysms: A Systematic Review and Meta-Analysis

B. Zhao, R. Yin, G. Lanzino, D.F. Kallmes, H.J. Cloft and W. Brinjikji

BACKGROUND AND PURPOSE: We present the results of a systematic review and meta-analysis examining outcomes of endovascular coiling of wide-neck and wide-neck bifurcation aneurysms with and without stent assistance. The aim of our study was to assess angiographic and clinical outcomes.

14 abril 2016

AMERICAN JOURNAL OF NEURORADIOLOGY. Incidence and Clinical Significance of Acute Reocclusion after Emergent Angioplasty or Stenting for Underlying Intracranial Stenosis in Patients with Acute Stroke

G.E. Kim, W. Yoon, S.K. Kim, B.C. Kim, T.W. Heo, B.H. Baek, Y.Y. Lee and N.Y. Yim

BACKGROUND AND PURPOSE: A major concern after emergent intracranial angioplasty in cases of acute stroke with underlying intracranial stenosis is the acute reocclusion of the treated arteries. This study reports the incidence and clinical outcomes of acute reocclusion of arteries following emergent intracranial angioplasty with or without stent placement for the management of patients with acute stroke with underlying intracranial atherosclerotic stenosis.

04 agosto 2016

STROKE. Inflammatory Biomarkers in Childhood Arterial Ischemic Stroke. Correlates of Stroke Cause and Recurrence

Heather J. Fullerton, Gabrielle A. deVeber, Nancy K. Hills, Michael M. Dowling, Christine K. Fox, Mark T. Mackay, Adam Kirton, Jerome Y. Yager, Timothy J. Bernard, Eldad A. Hod, Max Wintermark, Mitchell S.V. Elkind, the VIPS Investigators, Susan L. Benedict, Neil R. Friedman, Warren D. Lo, Rebecca N. Ichord, Marilyn A. Tan, Marta I. Hernandez-Chavez, Peter Humphreys, Lori C. Jordan, Sally Sultan, Michael J. Rivkin, Mubeen F. Rafay, Luigi Titomanlio, Gordana S. Kovacevic, Catherine Amlie-Lefond, Nomazulu Dlamini, John Condie, Ann Yeh, Rachel Kneen, Bruce Bjornson, Paola Pergami, Li Ping Zou, Jorina M. Elbers, Abdalla Abdalla, Anthony K. Chan, Osman Farooq, Mingming J. Lim, Jessica L. Carpenter, Steven Pavlakis, Virginia C. Wong and Robert Forsyth

Background and PurposeAmong children with arterial ischemic stroke (AIS), those with arteriopathy have the highest recurrence risk. We hypothesized that arteriopathy progression is an inflammatory process and that inflammatory biomarkers would predict recurrent AIS.