E-070 Acute visual decline treated with urgent venous sinus stenting as opposed to high volume csf diversion in patients with idiopathic intracranial hypotension
Conclusions: Transverse sinus stenting appears to be an effective treatment alternative and may obviate CSF diversion in patients with acute visual deterioration due to IIH. Disclosures: G. Deib: None. A. Moghekar: None. M. Luciano: None. A. El Mekabaty: None. E. Obusez: None. B. Barnett: None. F. Hui: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Deib, G., Moghekar, A., Luciano, M., Mekabaty, A. E., Obusez, E., Barnett, B., Hui, F. Tags: Electronic Poster Abstracts Source Type: research

E-069 Stroke thrombectomy patient selection: sex differences in collateral circulation
Introduction Large multicenter cohorts of thrombolysed stroke patients consistently report a sex disparity in functional outcome that is not age-dependent. Explanations for these sex-dependent outcomes differences are poorly understood. Patients with robust cerebral collaterals have been shown to have better outcomes after mechanical thrombectomy for acute middle cerebral artery occlusions. We hypothesize that differences in collateral circulation contribute to the observed sex disparity in stroke functional outcomes. Methods Consecutive patients with middle cerebral artery occlusions undergoing mechanical thrombectomy at...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Keppetipola, K., Davison, M., Dua, S., Ouyang, B., Chen, M. Tags: Electronic Poster Abstracts Source Type: research

E-068 Assessment of cell yield among different devices for endovascular biopsy to harvest endothelial cells
Conclusion Among devices studied for EC harvesting, PCRs and stentrievers yield more cells than other devices. PCRs appear more suitable for harvesting ECs in small vessels, while stentrievers are better for harvesting from large vessels. Further study of these devices for EC sampling is warranted to initiate and refine its use in humans for this purpose. Abstract E-068 Table 1 ECs by Device Device n Mean ECs Harvested Mean ECs/mm2 Balloon 8 4.5 0.017 Catheter 2 7.0 n/a Coil 45 5.3 n/a Microwire 2 4.0 n/a PCR 2 42 0.88 Plug 3 2.7 n/a Stentriever 8 350 1.3 Disclosures: M. Alexander: 1; C; Joe Niekro Foundation Researc...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Alexander, M., Darflinger, R., McGregor, H., Conrad, M., Sun, Z., Cooke, D. Tags: Electronic Poster Abstracts Source Type: research

E-067 Institutional trends in mechanical thrombectomy: lessons learned
Conclusions: Preliminary data suggest that thrombectomy is a safe procedure that results in extremely low mortality and significant decreases NIH score over time, which may point to better functional outcome. Overall, there was an improvement in NIHSS reduction with time. Additionally, achieving faster times to recanalization resulted in better improvements in NIHSS. There was a significant difference in the ability of different techniques to achieve first-pass recanalization, though this may reflect clinical judgments about when to use each technique. Producing a TICI score of 3 also improved over time, demonstrating incr...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Trott, S., Vsevolozhskaya, O., Alhajeri, A., Fraser, J. Tags: Electronic Poster Abstracts Source Type: research

E-066 Neonate high flow fistula embolization with high volume coil
We present a case series of 3 neonates who presented to our facility in high flow cardiac output failure or pulmonary hypertension within three days of life. The first child had a large right temporal pial arterial venous fistula (Fig 1a), and the second and third child had Vein of Galen malformations. Two patients had high flow cardiac output failure and one patient had pulmonary hypertension attributable to the intracranial fistula. Each patient was treated with high volume coils (0.020) with specific large vessel sacrifice using a Penumbra Occlusion Device (Fig 1b). We found that large volume coils offer safe reduction ...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Bohnstedt, B., Pandav, V., Dandapat, S., Williams, A. Tags: Electronic Poster Abstracts Source Type: research

E-065 Transverse venous sinus stenting for idiopathic intracranial hypertension - a single centre experience
Conclusion Venous sinus stenting is a safe procedure. It helps to relieve papilledema in all cases with significant improvement of headaches in most cases. Disclosures J. Kovoor: None. J. Tejada: None. K. Riley: None. R. Shastri: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Kovoor, J., Tejada, J., Riley, K., Shastri, R. Tags: Electronic Poster Abstracts Source Type: research

E-064 Initial institutional experience with the axium prime extra soft coil for treatment of intracranial aneurysms
Conclusion The Axium Prime ES coil is safe and effective for the treatment of intracranial aneurysms, achieving high packing densities, low risk of major treatment-related complications, high medium-term complete/near-complete aneurysm occlusion rates, and low re-treatment rates. Disclosures: J. Delgado Almandoz: 2; C; Medtronic Neurovascular. Y. Kayan: 2; C; Medtronic Neurovascular. J. Scholz: None. A. Milner: None. A. Wallace: None. J. Fease: None. M. Mulder: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Almandoz, D. J., Kayan, Y., Scholz, J., Milner, A., Wallace, A., Fease, J., Mulder, M. Tags: Electronic Poster Abstracts Source Type: research

E-063 The pc400 system safely coils large cerebral aneurysms with high packing densities and low retreatment rates
Conclusion The PC400 system is safe and effective for the treatment of large wide-neck intracranial aneurysms, achieving high packing densities, fast procedural times, favorable safety profile and low re-treatment rates compared to conventional coiling. Disclosures: J. Delgado Almandoz: 2; C; Penumbra, Inc. Y. Kayan: 2; C; Penumbra, Inc. J. Fease: None. J. Scholz: None. A. Milner: None. A. Wallace: None. M. Mulder: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Almandoz, D. J., Kayan, Y., Fease, J., Scholz, J., Milner, A., Wallace, A., Mulder, M. Tags: Electronic Poster Abstracts Source Type: research

E-062 Safety and efficacy of the pipeline embolization device for treatment of posterior circulation intracranial aneurysms
Conclusion The PED is a safe and effective treatment for wide-neck posterior circulation intracranial aneurysms, with high long-term complete aneurysm occlusion rates, low re-­treatment rates, and a low rate of major treatment-related complications. Disclosures: J. Delgado Almandoz: 2; C; Medtronic Neurovascular, Accriva Diagnostics. Y. Kayan: 2; C; Medtronic Neurovascular. J. Scholz: None. K. Uittenbogaard: None. A. Milner: None. J. Fease: None. A. Wallace: None. K. Nelson: None. M. Mulder: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Almandoz, D. J., Kayan, Y., Scholz, J., Uittenbogaard, K., Milner, A., Fease, J., Wallace, A., Nelson, K., Mulder, M. Tags: Electronic Poster Abstracts Source Type: research

E-061 Safety and efficacy of the pipeline embolization device for treatment of ruptured intracranial aneurysms
Conclusion The PED is a safe and effective treatment for ruptured intracranial aneurysms, with high medium-term complete aneurysm occlusion rates, low re-­treatment rates, and a low rate of major treatment-related complications. The risk of post-operative aneurysm re-rupture may be minimized by adjunctive use of coils and subacute PED embolization whenever possible. Disclosures: J. Delgado Almandoz: 2; C; Medtronic Neurovascular, Accriva Diagnostics. Y. Kayan: 2; C; Medtronic Neurovascular. K. Uittenbogaard: None. J. Scholz: None. A. Milner: None. J. Fease: None. A. Wallace: None. K. Nelson: None. M. Mulder: None. (S...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Almandoz, J. D., Kayan, Y., Uittenbogaard, K., Scholz, J., Milner, A., Fease, J., Wallace, A., Nelson, K., Mulder, M. Tags: Electronic Poster Abstracts Source Type: research

E-060 Does stent type impact coil embolization outcomes in extended follow-up of small-sized aneurysms (
Conclusions Above findings demonstrate that in addition to occlusive status at time of coil embolization and neck size, stent type may affect follow-up outcomes of stent-assisted coil embolization in small-sized aneurysms. LVIS (vs Enterprise or Neuroform stents) performed best during follow-up monitoring in terms of limiting recanalization. Disclosures Y. Cho: None. H. Kang: None. M. Han: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Cho, Y., Kang, H., Han, M. Tags: Electronic Poster Abstracts Source Type: research

E-059 Distally enlarged feeding artery phenomenon in intracranial dural arteriovenous fistula: alternative access route to transarterial intravenous embolization
Conclusion Abstract E-059 Figure 1 Disclosures D. Shim: None. Y. Kim: None. S. Baik: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Shim, D., Kim, Y., Baik, S. Tags: Electronic Poster Abstracts Source Type: research

E-058 Hemorrhagic manifestation of reversible vascular events due to postpartum angiopathy
Conclusion It is widely acknowledged the postpartum angiopathy may represent a hormonally mediated effect on the brain vessel intima precipitated by acute hypertension, evidently with affection of different territories (Cases 2, 3). Despite of different territorial manifestations the vascular events in this study did demonstrate similar features with an acute self-limited course and clinical symptomatology depending on the location. Various hormonal and biochemical factors have been identified playing a role in the deregulation of cerebral vascular tone of both the postpartum period and the RCVS. Some of them are common fo...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Mironov, Tags: Electronic Poster Abstracts Source Type: research

E-057 Endovascular treatment of posterior cerebral artery aneurysms with the pipeline embolization device
Conclusions PED embolization may be a viable treatment option for select PCA aneurysms that may be considered under appropriate clinical circumstances. Disclosures A. Wallace: None. J. Grossberg: None. J. Delgado Almandoz: None. M. Kamran: None. A. Roy: None. Y. Kayan: None. M. Austin: None. B. Howard: None. C. Moran: 2; C; Medtronic Neurovascular, Microvention. M. Cawley: None. D. Cross: None. J. Dion: None. A. Kansagra: None. J. Osbun: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Wallace, , Grossberg, J., Almandoz, J. D., Kamran, M., Roy, A., Kayan, Y., Austin, M., Howard, B., Moran, C., Cawley, M., Cross, D., Dion, J., Kansagra, A., Osbun, J. Tags: Electronic Poster Abstracts Source Type: research

E-056 Safety and effectiveness of preoperative endovascular vertebral artery sacrifice
Conclusion Endovascular vertebral artery sacrifice is a safe and effective treatment for minimizing blood loss during surgeries that involve transection of the vertebral artery. Disclosures A. Wallace: None. M. Austin: None. M. Kamran: None. A. Kansagra: None. J. Osbun: None. D. Cross: None. C. Moran: 2; C; Medtronic Neurovascular, Microvention. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Wallace, , Austin, M., Kamran, M., Kansagra, A., Osbun, J., Cross, D., Moran, C. Tags: Electronic Poster Abstracts Source Type: research

E-055 Intracranial angioplasty and stenting with neuroform atlas stent
The SAMMPRIS Trial showed that medical treatment of intracranial stenosis is safer than intracranial angioplasty and stenting (IAS). One of the reasons for the worse outcome with IAS was the occurrence of ipsilateral cerebral hemorrhage, which may be associated with an intracranial exchange maneuver. Newly developed mini intracranial stents may enhance the safety of IAS by obviating the need for this maneuver. We retrospectively evaluated 7 intracranial stenoses (6 patients, 5 men, mean age 57) which were treated with an Atlas stent. In 5 cases there was a high-grade atherosclerotic stenosis which did not optimally respond...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Cay, F., Senturk, Y., Peker, A., Arsava, E., Topcuoglu, M., Arat, A. Tags: Electronic Poster Abstracts Source Type: research

E-054 Head and neck endovascular repair of vascular malformations
Conclusions Ethanol has proven its consistent curative potential at long-term follow-up for high-flow AVMs and low-flow VM lesions at long-term follow-up as lesions in the periphery. Complication rates remain low. The procedures are tolerated well by the patients and done on an out-patient basis. Prior surgery and embolization procedures can cause difficulty in AVM lesion access, but does not obviate further ethanol endovascular treatment. Disclosures W. Yakes: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Yakes, W. Tags: Electronic Poster Abstracts Source Type: research

E-053 Mandibular avm diagnosis and curative endovascular treatment
Conclusions Endovascular approaches to manage mandibular AVM can be curative. The intraosseous variety is largely a fistula between artery and vein within the bone. All respond well to endovascular ethanol therapy alone. Surgery was not required in any patient. Surprisingly no complications were encountered in this patient series. Long-term cures are noted in this patient series with endovascular approaches alone. No massive surgical resections in any patient, even in patients with multiple AVMs of the soft tissues, mandible and maxilla, was required to effect cure. In patients who suffered hemorrhages from floating teeth,...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Yakes, W. Tags: Electronic Poster Abstracts Source Type: research

E-052 Efficacy of an avm classification system that directs endovascular therapies accurately
Conclusion This never before reported classification system has a direct impact on determining the curative endovascular and direct puncture embolization procedures and also determines the embolic agents that will successfully treat complex AVMS in the body and head and neck anatomies. Disclosures W. Yakes: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Yakes, W. Tags: Electronic Poster Abstracts Source Type: research

E-051 Ear arteriovenous malformation management
Conclusions Ethanol endovascular repair of ear AVMs can achieve cures in this vexing lesion that previously was treated with resection of the ear and reconstructive surgery with recurrence rates. This series documents long-term cures of AVMs of the ear and scalp that were not treatable by endovascular approaches. Permanent treatment of the auricular AVMs is documented and no recurrence occurred in any patient. Only one previous article is published (group from Shanghai, China) emulating this technique, that I taught them, also demonstrates a high cure rate. Disclosures W. Yakes: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Yakes, W. Tags: Electronic Poster Abstracts Source Type: research

E-050 Effect of general anaesthesia on endovenous pressure measurement during dural sinus stenting for idiopathic intracranial hypertension
Conclusion When performed in the same setting, endovascular pressure gradient across transverse stenosis in IIH patients performed under GA shows a sizable reduction (6 mmHg) compared with measurements taken under CS. Further studies are needed to examine the role anesthetic agents and different accompanying factors in regard to the optimal pressure gradient threshold for transverse sinus stenting in IIH patients. Disclosures A. El Mekabaty: None. E. Obusez: None. C. Chung: None. M. Luciano: None. F. Hui: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Mekabaty, E., Obusez, E., Chung, C., Luciano, M., Hui, F. Tags: Electronic Poster Abstracts Source Type: research

E-049 Accuracy of non-invasive and invasive imaging in identifying ica occlusion: a comparative study in 65 patients
Conclusion Our result suggests that there is a lack of correlation between the imaging findings of carotid occlusion on imaging compared with catheter angiography of the ICA during the intervention in acute stroke treatment. Thus, endovascular catheterization of the ICA is often required for the exact characterization and localization of the carotid occlusion and to determine if a dissection is the underlying pathology in such cases. Disclosures A. El Mekabaty: None. Q. Hao: None. E. Cheng-Ching: None. S. Hussain: None. A. Spiotta: None. F. Hui: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Mekabaty, E., Hao, Q., Cheng-Ching, E., Hussain, S., Spiotta, A., Hui, F. Tags: Electronic Poster Abstracts Source Type: research

E-048 Helistroke: helicopter-neurointerventionalist transport for interventional stroke - proof of concept and rationale
Conclusions This proof of concept case is presented for logistical, financial and use-case analysis. As it is a first case, times can likely be improved. We assert that this model may be another option in spoke and hub design of stroke systems of care. Disclosures A. El Mekabaty: None. F. Hui: None. V. Urrutia: None. J. Lynch: None. Z. Naidarashvili: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Mekabaty, E., Hui, F., Urrutia, V., Lynch, J., Naidarashvili, Z. Tags: Electronic Poster Abstracts Source Type: research

E-047 Endovascular cerebellar artery sacrifice: clinical outcomes in 28 patients
Conclusions Similar to open surgical cerebellar artery sacrifice, endovascular cerebellar artery sacrifice is associated with a high risk of infarction, hydrocephalus, and death. Patient # Age Sex Pathology treated Vessel sacrificed Diameter of sacrificed vessel (in mm) Baseline mRS Pre- ICH? Pre- hydrocephalus? Pre- EVD? Post- Neuro deficit? Post- Imaging evidence of infarct? Post- Worsening hydrocephalus? Post- New EVD? Post-Craniectomy? mRS at discharge mRS at 3 months Angio f/u (days) 1 69 F Aneurysm AICA - Left 0.5 0 Yes Yes Yes Yes No Yes Yes No 3 0 311 2 50 F Aneurysm AICA - Right 1 0 Yes Yes Yes Yes No No No No 1 ...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Austin, M., Rimer, R., Chou, C., Wallace, A., Kamran, M., Moran, C., Cross, D., Osbun, J., Zipfel, G., Dacey, R., Kansagra, A. Tags: Electronic Poster Abstracts Source Type: research

E-046 Length of stay in mechanical thrombectomy, and machine learning improvement of predictive analysis
Purpose Machine learning has recently been shown to increase the predictive power for the outcomes of hemorrhage and patient modified Rankin Scale(mRS) from pre-intervention data. Machine learning techniques have not been assessed for prediction of length of stay. Pre-procedural and post-procedural variables were also assessed to determine predictors of length of stay. Methods 600 consecutive patients evaluated with CT perfusion for stroke were retrospectively analyzed. Patients were included if thrombectomy was attempted and excluded if the pre-intervention dataset was incompletely documented, 158 patients were included ...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Arndt, S., Bennett, G., Wojcik, K., Albar, A., Alhasan, M., Ma, J., Gulotta, P., Milburn, J. Tags: Electronic Poster Abstracts Source Type: research

E-045 Nihss and its component subscores are suboptimal predictors with colinearity
Purpose Major trials assessing the clinical efficacy of mechanical thrombectomy show some unexpected variability in statistically significant variables.1-4 This abstract will assess the underlying variability of National Institute of Health stroke scale (NIHSS) subscores, and provide proof of concept for its effect on major clinical trials. Methods 300 consecutive patients evaluated with CT perfusion for stroke were retrospectively analyzed. Patients were included if thrombectomy was attempted and excluded if the pre-intervention dataset was incompletely documented, including incomplete documentation of NIHSS. 53 patients...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Arndt, S., Albar, A., Bennett, G., Lavie, J., Gulotta, P., Milburn, J. Tags: Electronic Poster Abstracts Source Type: research

E-044 Safety and outcome of combined endovascular and surgical management of low grade cerebral arteriovenous malformations in children compared to surgery alone
Conclusion Our results suggest no significant difference in the treatment complications and outcomes between combined endovascular and surgical management of low grade cerebral AVMs in children compared to surgical management alone. Disclosures A. Al-Smadi: None. T. Shokuhfar: None. A. Malani: None. S. Ansari: None. M. Hurley: None. B. Jahromi: None. M. Potts: None. A. Shaibani: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Al-Smadi, , Shokuhfar, T., Malani, A., Ansari, S., Hurley, M., Jahromi, B., Potts, M., Shaibani, A. Tags: Electronic Poster Abstracts Source Type: research

E-043 Diagnostic accuracy of 3d black blood mr imaging with high resolution t1 space in the evaluation of intracranial arterial thrombosis
Conclusion 3D BBMRI with T1 SPACE imaging is a valuable sensitive and specific technique for the evaluation of intracranial arterial thrombosis. This technique provides an adjunctive mechanism to confidently diagnose complete arterial occlusions in the setting of low resolution conventional MRI findings and absent flow enhancement on TOF-MRA imaging prone to overestimation. Abstract E-043 Figure 1 Disclosures A. Al-Smadi: None. A. Elmokadem: None. A. Shaibani: None. M. Hurley: None. M. Potts: None. B. Jahromi: None. S. Anasari: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Al-Smadi, , Elmokadem, A., Shaibani, A., Hurley, M., Potts, M., Jahromi, B., Anasari, S. Tags: Electronic Poster Abstracts Source Type: research

E-042 Clinical and cost effectiveness of using evolving ace reperfusion catheters as first-line treatment of acute ischemic stroke due to large vessel occlusions
Introduction Larger bore reperfusion catheters have been designed to increase the effectiveness of direct aspiration for treatment of acute ischemic stroke due to large vessel occlusions. The present study has two goals: 1. To compare the reperfusion rate of the newest large bore reperfusion catheter, ACE68, with previous generations of ACE catheters, ACE64 and ACE60, and 2. To compare the cost associated with three first-line approaches to mechanical thrombectomy: ADAPT using evolving ACE technology, Solumbra, and stent-retriever (SR) with balloon-guide catheter (BGC). Methods The prospectively populated acute stroke int...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Kayan, Y., Almandoz, J. D., Young, M., Fease, J., Scholz, J., Milner, A., Roohani, P., Mulder, M., Wallace, A., Tarrel, R. Tags: Electronic Poster Abstracts Source Type: research

E-041 Early recanalization rate after iv-tpa and treatment results of additional intra-arterial thrombolysis in large artery intracranial occlusion disease patients
Conclusion The recanalization rate after IV-tPA in LAICOD patients was low. Additional IA-Tx for non-recanalized patients after IV-tPA could improve the patient outcomes. And P/D-mismatch on acute stroke MR, which taken before the IA-Tx. was good indicator for the safety and effectiveness for additional IA-Tx. Disclosures Y. Won: None. D. Yoo: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Won, Y., Yoo, D. Tags: Electronic Poster Abstracts Source Type: research

E-040 Flat panel imaging of occlusion site and collateral scores for emergent large vessel occlusion
Conclusion FP-CTA correlates well with standard CTA in determining site of occlusion and CS in the setting of ELVO. This angiographic tool may have potential applications for both triage and patient selection of patients with ELVO. Disclosures L. Elijovich: 1; C; Siemens. 2; C; Stryker, Codman, Medtronic, Microvention, Penumbra. A. Choudhri: None. V. Inoa-Acosta: None. A. Arthur: 1; C; Siemens. 2; C; Microvention, Codman, Penumbra, Stryker, Medtronic. 4; C; Cerebrotech, Synchron. D. Hoit: 2; C; Medtronic, Microvention. C. Nickele: 1; C; Microvention. J. DiNitto: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Elijovich, L., Choudhri, A., Inoa-Acosta, V., Arthur, A., Hoit, D., Nickele, C., DiNitto, J. Tags: Electronic Poster Abstracts Source Type: research

E-039 Comparison of predictive grading systems for procedural risk in endovascular treatment of brain arteriovenous malformations - analysis of 104 consecutive patients
Conclusion Our independent analysis of 104 patients with brain AVMs treated with endovascular embolization validates the predictive capacity of the Buffalo score, but not AVMN or SM grades, for endovascular embolization procedural risk. This will allow for better stratification of brain AVM patients by procedural risk, and will ultimately result in safer care of these patients. Complications(n=25) No complications(n=79) P-value Age ± SD 46.0±16.9 42.3±15.9 0.33 Female gender, N (%) 7 (28) 38 (48) 0.12 Left side, N (%) 14 (56) 41 (52) 0.90 Spetzler-Martin grade, median (IQR) 3 (2–3) 2 (2–...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Pulli, B., Stapleton, C., Koch, M., Patel, A. Tags: Electronic Poster Abstracts Source Type: research

E-038 Multiphase cta and collateral scores: experience of a single comprehensive stroke center
Conclusion Collateral scores of 4 and 5 have over 80% rate of inclusion for thrombectomy in the setting of a large vessel occlusion. Transfer of patients is correlated with statistically significant poorer collateral scores. Reference . Menon BK, d’Esterre CD, Qazi EM, et al. Multiphase CT Angiography: A New Tool for the Imaging Triage of Patients with Acute Ischemic Stroke. Radiology2015May; 275(2):510–20 Disclosures G. Bennett: None. S. Arndt: None. J. Lavie: None. A. Albar: None. G. Vidal: 3; C; Penumbra. J. Milburn: 3; C; Penumbra. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Bennett, G., Arndt, S., Lavie, J., Albar, A., Vidal, G., Milburn, J. Tags: Electronic Poster Abstracts Source Type: research

E-037 Coil embolization of branch incorporated cerebral aneurysms using modified waffle cone technique
Conclusion The modified waffle-cone technique may enhance the possibilities of the coil embolization of these selected cases. However, its safety and technical feasibility should be further evaluated by larger case series and long-term follow-up. Disclosures J. Jung: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Jung, J. Tags: Electronic Poster Abstracts Source Type: research

E-036 Idiopathic intracranial hypertension evaluation and treatment: patient selection, venous sinus stenting technique, and post-stenting follow-up protocol: university of colorado technique
We describe selection criteria, stenting technique, and post-stenting follow-up for IIH patients at our institution. Methods Patient charts, selection criteria, operative/procedure notes, and post-stenting follow-up records from January 1999 to March 2017 were reviewed, during which time we deployed 53 stents in 40 patients. Eight patients underwent one to three restenting procedures. Results Pre-procedure selection criteria Patients have an established diagnosis of IIH, preferably made by a neuro-optholmolagist, with clearly documented papilledema and lumbar puncture opening pressure>25 cm H20. Usually diagnostic w...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Case, D., Seinfeld, J., Roark, C., Kumpe, D. Tags: Electronic Poster Abstracts Source Type: research

E-035 Ct perfusion outcomes may lead to better clinical outcomes following endovascular therapy in large vessel occlusion stroke
Background and Purpose Different imaging paradigms have been used to select patients for endovascular therapy (ET) in large vessel occlusion stroke (LVOS). We sought to determine whether CT perfusion (CTP) selection improves ET outcomes as compared to non-contrast CT (NCCT) alone. Methods Review of a prospective single-center interventional database of consecutive patients between September 2010 and March 2016. Patients with anterior circulation strokes undergoing stent-retriever thrombectomy were categorized according to imaging selection: (1) CTP and (2) NCCT alone. Two separate analyses were performed to assess the imp...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Grossberg, J., Bouslama, M., Haussen, D., Rebello, L., Frankel, M., Nogueira, R. Tags: Electronic Poster Abstracts Source Type: research

E-034 Beyond large vessel occlusion strokes: distal occlusion thrombectomy
Conclusions Distal intracranial occlusions can be treated safely and successfully with endovascular therapy. Although promising our results need to be corroborated by larger prospective controlled studies. Disclosures J. Grossberg: None. L. Rebello: None. M. Bouslama: None. D. Haussen: None. M. Frankel: None. R. Nogueira: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Grossberg, J., Rebello, L., Bouslama, M., Haussen, D., Frankel, M., Nogueira, R. Tags: Electronic Poster Abstracts Source Type: research

E-033 The smoking-thrombolysis paradox in large vessel occlusion acute ischemic stroke after endovascular therapy
Introduction The smoking-thrombolysis paradox has been well described in myocardial infarction. However, its existence in the stroke population remains elusive. In the past decade, several studies have investigated the phenomenon with mixed results. We sought to determine whether clinical outcomes differ between smokers and non-smokers with acute ischemic stroke undergoing endovascular therapy. Methods We reviewed our prospectively collected endovascular database at a tertiary care academic institution. All patients who underwent endovascular therapy for large vessel occlusion acute ischemic stroke were categorized into c...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Grossberg, J., Bouslama, M., Rebello, L., Haussen, D., Frankel, M., Nogueira, R. Tags: Electronic Poster Abstracts Source Type: research

E-032 High resolution cone beam ct for the assessment of stent apposition after flow diverterstent treatment
Conclusions The combination of high resolution CBCT acquisitions provided clear visualization of 3D structures of both stent and parent artery after the FD treatment. This imaging modality may contribute to the better understanding of stent apposition after the FD treatment. Abstract E-032 Figure 1 Disclosures I. Yuki: 1; C; Siemens Research Grant. T. Ishibashi: None. C. Dahmani: 5; C; employee : Siemens Healthcare Japan. Y. Abe: None. S. Hataoka: None. A. Ikemura: None. I. Kan: None. Y. Murayama: 1; C; Siemens Research Grant. 2; C; Stryker Japan. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Yuki, , Ishibashi, T., Dahmani, C., Abe, Y., Hataoka, S., Ikemura, A., Kan, I., Murayama, Y. Tags: Electronic Poster Abstracts Source Type: research

E-031 Mri selected elvo patients show favorable response to therapy at extended time from last seen well
Background Presently accepted criteria for ELVO intervention rely on time from last seen well (LSW) following conformation of LVO diagnosis and favorable baseline imaging. Many patients however present outside established treatment windows or with unknown LSW, and thus, represent a population of great relevance. Here we present in hospital and 90 day outcomes of a large patient cohort, many treated at extended LSW, after MRI assessment. Population ELVO patients with isolated occlusion of the carotid terminus or M1 segment, baseline mRS ≤2, age ≥18, and no MRI contraindication. Methods Regression analysis with prima...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Cristiano, B., Cicilioni, K., Pond, M., Lee, J., Promod, P., Oyoyo, U., Jacobson, J. Tags: Electronic Poster Abstracts Source Type: research

E-030 A rare case of subarachnoid hemorrhage caused by ruptured venous varix due to dural arteriovenous fistula at the foramen magnum
Conclusion D-AVFs at the foramen magnum, although extremely rare, should be considered as a possible cause of SAH. Detailed inspection of cerebral angiography is mandatory to prevent misdiagnosis. Onyx embolization can be a feasible treatment option to treat such D-AVF. When the D-AVF is fed by neuromeningeal trunk of APA, precise recognition of anatomical location of the lesion by superselective angiography and precise delivery of embolic materials to the fistulous point are required for successful and safe embolization, because there exist dangerous anastomoses between the APA and carotid and vertebral arteries and it ca...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Lee, Y., Suh, S., Seo, S. Tags: Electronic Poster Abstracts Source Type: research

E-029 Progressively soft coils for treatment of intracerebral aneurysms - an initial experience with the smart coil at two centers
Conclusion The progressive design of SMART Coils offered appreciable clinical advantages during deployment. In addition, SMART demonstrated satisfactory safety and efficacy outcomes in treatment of a wide variety aneurysms, both ruptured and unruptured. Abstract E-029 Table 1 Comparison of aneurysm characteristics, treatment, and outcome SMART Exclusively n=32 SMART with other Devices n=27 Ruptured, n (%) 15 (46.9%) 12 (44.4%) Aneurysm Size, mm 5.9 x 4.2x5.7 5.1 x 4.9x4.9 Stent-Assisted Coiling, n (%) 14 (43.8%) 14 (51.9%) Balloon-Assisted Coiling, n (%) 11 (34.4%) 21 (77.8%) Raymond Roy Classification (n (%)) I 9 (28.1...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Spiotta, , Fargen, K., Lena, J., Chaudry, I., Turner, R., Turk, A., Huddle, D., David, L., Bellon, R., Frei, D. Tags: Electronic Poster Abstracts Source Type: research

E-028 Treatment of endovascular-impractical vertebrobasilar insufficiency with hybrid operation
Conclusions For some endovascular-therapy-impractical vertebrobasilar insufficiencies, including VAO stenosis with V1 tortuosity, BA stenosis with bilateral VAs tortuosity, and BA stenosis with bilateral VAs occlusion, hybrid operations of combining surgical manipulation of V1 and endovascular technique can be safe and Disclosures X. Lu: None. Y. Ma: None. B. Yang: None. Y. Wang: None. P. Gao: None. L. Jiao: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Lu, X., Ma, Y., Yang, B., Wang, Y., Gao, P., Jiao, L. Tags: Electronic Poster Abstracts Source Type: research

E-027 Matricidal cavernous aneurysms: a multicenter case series
Conclusion Matricidal aneurysms require careful consideration and planning. The restricted anatomy of the cavernous sinus can make successful execution of endovascular interventions difficult. Direct elastic compression of the parent artery does not respond to angioplasty and stenting the way that atherosclerotic stenosis does. Because of this, planning for possible parent vessel sacrifice is important. Abstract E-027 Table 1 Intended Treatments and Outcomes n Intended Treatment Failed Treatment (rate) All Patients 37 10 (27%) Flow Diversion 18 5 (28%) Parent Vessel Sacrifice 11 With Bypass 4 2 (50%) Without Bypass 7 0 ...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Roberts, M., Nickele, C., Welch, B., Ban, V., Ringer, A., Kim, L., Levitt, M., Lanzino, G., Kan, P., Shallwani, H., Siddiqui, A., Elijovich, L., Arthur, A. Tags: Electronic Poster Abstracts Source Type: research

E-026 Thromboembolic complications in endovascular treatment of middle cerebral artery aneurysms
Conclusion In the endovascular treatment of MCA aneurysms, the use of balloons or stents and aneurysm complexity such as bifurcation origin or vessel arising from the neck can carry a high risk of thromboembolic complication. If surgeons are aware of this risk, utilize delayed angiograms at the end of the case to ensure that no thrombus has formed, and have thrombolytic drugs or mechanical thrombectomy devices readily available, permanent complications can be safely avoided. Disclosures T. Link: None. S. Boddu: None. N. Lin: None. P. Gobin: None. J. Knopman: None. A. Patsalides: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Link, T., Boddu, S., Lin, N., Gobin, P., Knopman, J., Patsalides, A. Tags: Electronic Poster Abstracts Source Type: research

E-025 The development of a pre-clinical stroke model for stent-retriever thrombectomy
Conclusion The development of a stroke model amendable to mechanical thrombectomy provides a potential paradigm to study neuroprotection strategies coupled with clinical standard-of-care endovascular treatment. Further reproducibility studies are underway. References . JNIS 2012;4:307–313. . Stroke 2015;46:1099–1106. . AJNR2012;33:353–358. Disclosures O. Brooks: None. R. King: None. J. Chueh: None. M. Marosfoi: None. E. Nossek: 2; C; Rapid Medical. R. Eckhouse: 5; C; Rapid Medical. M. Gedulter: 5; C; Rapid Medical. M. Gounis: 1; C; Rapid Medical. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Brooks, O., King, R., Chueh, J., Marosfoi, M., Nossek, E., Eckhouse, R., Gedulter, M., Gounis, M. Tags: Electronic Poster Abstracts Source Type: research

E-024 Intra-arterial nimodipine injection for the treatment of cerebral vasospasm following aneurysm subarachnoid hemorrhageand the factors associated with delayed cerebral infarction
Conclusions IAN seems to be reasonable treatment for symptomatic vasospasm after aneurysm subarachnoid hemorrhage. However, the treatment is not always prevent delayed cerebral infarction. The premorbid cerebral atherosclerosis and the pattern of vasospasm is likely to affect the treatment results of IAN. Disclosures K. Park: None. B. Kim: None. D. Park: None. N. Lee: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Park, K., Kim, B., Park, D., Lee, N. Tags: Electronic Poster Abstracts Source Type: research

E-023 Patient access site preference in cerebral angiography
Conclusion Transradial access is preferred in a majority of patients, especially those who have undergone prior transfemoral angiography. Furthermore, a majority of patients experience little to no discomfort following transradial access for cerebral angiography. This data adds to a growing body of literature supporting a re-evaluation of the radial approach for neurointervention. Disclosures B. Snelling: None. R. Haniff: None. J. Caplan: None. S. Sur: None. P. Khandelwal: None. D. Yavagal: None. R. Starke: None. E. Peterson: None. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Snelling, B., Haniff, R., Caplan, J., Sur, S., Khandelwal, P., Yavagal, D., Starke, R., Peterson, E. Tags: Electronic Poster Abstracts Source Type: research

E-022 Low dose eptifibatide for acute icad intervention results in high incidence of acute reocclusion
Conclusion The low dose eptifibatide protocol employed here was safe in that no hemorrhages occurred. However, three of six target vessels re-occluded acutely. While the data are limited, the protocol appears to lack adequate potency to prevent re-occlusion of acutely treated ICAD lesions. Disclosures C. Roels: None. M. Brown: None. R. Janjua: None. D. Heck: 2; C; Stryker. (Source: Journal of NeuroInterventional Surgery)
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Roels, C., Brown, M., Janjua, R., Heck, D. Tags: Electronic Poster Abstracts Source Type: research

E-021 Safety and efficacy of a low dose eptifibatide infusion during endovascular treatment of tandem occlusions
Conclusions The low dose eptifibatide infusion resulted in a low incidence of SICH (5%) in the endovascular treatment of tandem intracranial occlusions. The infusion was not potent enough to maintain patency of the carotid artery in all patients. However, re-occlusion of the carotid artery was asymptomatic in the 4 patients where it occurred. This underscores that extracranial re-occlusion of the carotid artery is the lesser of evils compared with hemorrhagic stroke conversion. Limitations of the study include retrospective data collection, a low incidence of intravenous t-PA use, and lack of independent adjudication of an...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Roels, C., Brown, M., Janjua, R., Heck, D. Tags: Electronic Poster Abstracts Source Type: research