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E-111 Repeat thrombectomy after large vessel occlusion stroke: incidence, clinical and technical outcomes
ConclusionsRepeat EVT for patients with re-occlusion within 30 days of thrombectomy is associated with favorable improvement in NIHSS, similar functional outcomes to patients undergoing single EVT, but has significantly higher risk of hemorrhagic conversion.Disclosures Y. Zohdy: None. H. Saad: None. B. Howard: None. C. Cawley: None. A. Pabaney: None. T. Garzon-Muvdi: None. I. Maier: None. A. Spiotta: None. P. Jabbour: None. S. Wolfe: None. A. Rai: None. J. Kim: None. J. Mascitelli: None. R. Starke: None. A. Shaban: None. S. Yoshimura: None. R. De Leacy: None. P. Kan: None. I. Fragata: None. A. Polifka: None. A. Arthur: Non...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Zohdy, Y., Saad, H., Howard, B., Cawley, C., Pabaney, A., Garzon-Muvdi, T., Maier, I., Spiotta, A., Jabbour, P., Wolfe, S., Rai, A., Kim, J., Mascitelli, J., Starke, R., Shaban, A., Yoshimura, S., De Leacy, R., Kan, P., Fragata, I., Polifka, A., Arthur, A Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-152 Cone-beam CT angiogram acquisition in the angiography suite for LVO detection in acute ischemic stroke
ConclusionDTAS triage workflow with cone-beam head CT and CTA image acquisition in the angiography suite may be a next step to further optimize LVO stroke pathways by bypassing conventional CT/MR. This new workflow has the potential to further decrease door-to-needle times and thereby may improve patient outcome.Disclosures A. Kuhn: None. J. Singh: None. M. Garcia: None. S. Sarid: None. M. Gounis: 1; C; National Institutes of Health (NIH), the United States – Israel Binational Science Foundation, Anaconda, ApicBio, Arsenal Medical, Axovant, Balt, Cerenovus, Ceretrieve, CereVasc LLC, Cook Medical, Gal. 2; C; fee-per-h...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Kuhn, A., Singh, J., Garcia, M., Sarid, S., Gounis, M., Anagnostakou, V., Puri, A. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

O-001 Trends in endovascular mechanical thrombectomy for acute ischemic stroke: a regional comparison analysis using United States national inpatient sample data
ConclusionsThere remain significant regional differences in the outcomes of EVT for AIS. More analysis is required to determine what is driving these differences. More work is needed to ensure optimal and equitable patient outcomes.Abstract O-001 Table 1 Characteristic (p value) East North Central East South Central Middle Atlantic Mountain New England Pacific South Atlantic West North Central West South Central Age in Years Mean (±SD)(p<0.001) 68.69 ± 14.43 67.04 ± 14.85 70.09 ± 14.39 68.72 ± 14.53 70.27 ± 14.92 70.26 ± 14.51 68.81 ± 14.29 69.21 ± 14.51 67...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Brake, A., Fry, L., LeBeau, G., Heskett, C., Lei, C., Alkiswani, A., Le, K., De-Stefano, F., Peterson, J., Ebersole, K. Tags: SNIS 20th annual meeting oral abstracts Source Type: research

E-185 Study design and rationale of THUNDER: an acute ischemic stroke study with the penumbra system including thunderbolt aspiration tubing
ConclusionWe report the design of THUNDER—a multicenter prospective study that examines the use of a novel modulated aspiration thrombectomy system in patients with AIS secondary to LVO.Disclosures D. Fiorella: 1; C; Cerenovus, Medtronic, Siemens, Stryker, Microvention, Penumbra. 2; C; Balt, Marblehead, Medtronic, Stryker, Microvention, Penumbra, Cerenovus. K. Woodward: 2; C; Coviden. E. Levy: None. C. Matouk: 2; C; Silk Road Medical, Penumbra, MicroVention-TERUMO, Medtronic, Stryker. 3; C; Silk Road Medical, Penumbra. I. Kaminsky: 3; C; Penumbra. K. Reuland: None. M. Stiefel: None. A. Kansagra: 1; C; Penumbra. 2; C;...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Fiorella, D., Woodward, K., Levy, E., Matouk, C., Kaminsky, I., Reuland, K., Stiefel, M., Kansagra, A., Frei, D. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-246 Professional board certification for nurses, advanced practice providers, and radiology techs working in neurointerventional labs: the certified neurointerventional clinician™ (CNIC)
ConclusionsAttainment of CNIC™ certification demonstrates expertise in neurointerventional lab competencies that include clinical and neuroimaging diagnosis of stroke, evidence-based management principles for both ischemic and hemorrhagic stroke subtypes, and capabilities to safely support peri-procedural management in the neurointerventional lab.Disclosures A. Doerr: None. B. Fill: None. M. Sabapathypillai: None. C. Ortiz: None. H. Shownkeen: None. A. Alexandrov: None. C. Valasco: None. A. Richardson: None. A. Alexandrov: None.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Doerr, A., Fill, B., Sabapathypillai, M., Ortiz, C., Shownkeen, H., Alexandrov, A., Valasco, C., Richardson, A., Alexandrov, A. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

Travel time and distance for bypass and non-bypass routing of stroke patients in the USA
Conclusions Bypass routing offers modest travel time benefits for LVO patients and incurs modest penalties for non-LVO patients. Differences are greatest in rural areas. A majority of Americans live in areas for which current guidelines recommend bypass.
Source: Journal of NeuroInterventional Surgery - June 16, 2023 Category: Neurosurgery Authors: Yu, C. Y., Panagos, P. D., Kansagra, A. P. Tags: Ischemic stroke Source Type: research

Correspondence on "Unplanned readmission after carotid stenting versus endarterectomy: analysis of the United States Nationwide Readmissions Database" by Nazari et al
We read the article by Nazari et al1 comparing carotid endarterectomy and carotid artery stenting. Most of the patients in the article were asymptomatic patients. Asymptomatic carotid stenosis is considered one of the most significant causes of ischemic stroke. The management of asymptomatic carotid stenosis ranges from open surgical approaches to minimally invasive endovascular interventions and medical therapeutics.2 With the advances in the neurosurgical field within the last decade, various surgical interventions have emerged. However, to date, the evidence regarding the optimal interventional strategies for asymptomat...
Source: Journal of NeuroInterventional Surgery - February 14, 2023 Category: Neurosurgery Authors: Azzam, A. Y., Ghozy, S., Kallmes, K. M., Dmytriw, A. A., Kadirvel, R., Kallmes, D. F. Tags: Letter Source Type: research

Unplanned readmission after carotid stenting versus endarterectomy: analysis of the United States Nationwide Readmissions Database
Conclusions Readmission is not uncommon after carotid revascularization, occurs more often after CAS, and is predicted by baseline factors and by preventable adverse events at initial admission.
Source: Journal of NeuroInterventional Surgery - February 14, 2023 Category: Neurosurgery Authors: Nazari, P., Golnari, P., Ansari, S. A., Cantrell, D. R., Potts, M. B., Jahromi, B. S. Tags: Open access, Ischemic stroke Source Type: research

Economic evaluation of intravenous alteplase for stroke with the time of onset between 4.5 and 9 hours
Conclusion For patients with AIS with a time of onset between 4.5 and 9 hours, perfusion imaging-guided intravenous alteplase was likely to be cost-effective in China and was cost-effective in the US when compared with placebo.
Source: Journal of NeuroInterventional Surgery - December 14, 2022 Category: Neurosurgery Authors: Chen, J., Liang, X., Tong, X., Han, M., Ji, L., Zhao, S., Hu, Z., Liu, A. Tags: Open access, Socioeconomics Source Type: research

Real-world outcomes associated with the use of the EmboTrap revascularization device for ischemic stroke in the United States
Conclusions This is the first study in the US to report real-world outcomes sourced by retrospective database analysis among patients with AIS undergoing MT using the EmboTrap device. Further research is needed to better understand performance of the EmboTrap device in real-world settings.
Source: Journal of NeuroInterventional Surgery - October 14, 2022 Category: Neurosurgery Authors: Brinjikji, W., Ikeme, S., Kottenmeier, E., Khaled, A., M, S., Khanna, R. Tags: Ischemic stroke Source Type: research

Endoluminal flow diverting stents for middle cerebral artery bifurcation aneurysms: multicenter cohort
Conclusion FDS treatment for MCA bifurcation aneurysms is feasible, with comparable safety and efficacy profiles to other available endovascular options when utilized in carefully selected aneurysms. Jailing of M2 branches was not associated with a higher risk of post-procedural ischemic complications.
Source: Journal of NeuroInterventional Surgery - October 14, 2022 Category: Neurosurgery Authors: Salem, M. M., Khorasanizadeh, M., Lay, S. V., Renieri, L., Kuhn, A. L., Sweid, A., Massari, F., Moore, J. M., Tjoumakaris, S. I., Jabbour, P., Puri, A. S., Ogilvy, C. S., Jankowitz, B. T., Burkhardt, J.-K., Kan, P., Limbucci, N., Cognard, C., Thomas, A. J Tags: Hemorrhagic stroke Source Type: research

O-007 First US multicenter experience using the pipeline flex embolization device with shield technology for treatment of intracranial aneurysms - periprocedural outcomes and early safety profile
ConclusionOur study is the first to report the early experience with the newly FDA-approved PED Flex with Shield technology amongst US centers. Our results are comparable with non-US, international studies showing a high technical success rate and safe peri-procedural angiographic and patient outcome. Long-term follow-up will be needed to provide more robust data on angiographic and patient outcomes.Disclosures A. Kuhn: None. J. Singh: None. A. Abdelsalam: None. V. Saini: None. J. Burks: None. G. Cortez: None. R. Abbas: None. M. Pervez: None. H. Saei: None. S. Burke: None. V. Naragum: None. F. Massari: None. S. Marwah: Non...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Kuhn, A., Singh, J., Abdelsalam, A., Saini, V., Burks, J., Cortez, G., Abbas, R., Pervez, M., Saei, H., Burke, S., Naragum, V., Massari, F., Marwah, S., Gounis, M., Hassan, A., Malek, A., Dabus, G., Linfante, I., Tjoumakaris, S., Jabbour, P., Hanel, R., S Tags: SNIS 19th annual meeting oral abstracts Source Type: research

O-052 The pennsylvania post-market multicenter experience with flow re-direction endoluminal device (FRED)
ConclusionThe results of the early post-market experience with the FRED device show reasonable safety and adequate aneurysmal occlusion rates comparable to other flow diverters. However, more extensive multicenter studies with more extended follow-up data are needed to assess the long-term safety and durability of the device.Abstract O-052 Table 1Baseline descriptive statistics Number of patients n=61 Gender Male 11 (18%) Female 50 (82%) Age (Years: median; IQR) 58 (51 – 68) Multiple Intracranial Aneurysms 21 (34.4%) Family history of aneurysms 9 (14.8%) Smoking History Never smokers 26 (42.6%) Past smokers 13 (21.3...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Salem, M., Kvint, S., Hendrix, P., Al Saiegh, F., Gajjar, A., Goren, O., Gross, B., Jabbour, P., Lang, M., Schirmer, C., Tjoumakaris, S., Griessenauer, C., Burkhardt, J. Tags: SNIS 19th annual meeting oral abstracts Source Type: research

O-067 Super large-bore ingestion of clot (SLIC) leads to high first-pass effect in thrombectomy for large vessel occlusion
ConclusionOur initial experience with the SLIC technique resulted in achieving first-pass effect (mTICI≥2C) in 70.5%. Navigation of the SLBA catheter extender over the Tenzing insert was successful and safe in this early experience.Disclosures F. Massari: None. G. Dabus: 2; C; Medtronic, Microvention, Cerenovus, Penumbra, Stryker, InNeuroCo, Route 92. G. Cortez: None. J. Singh: None. A. Kuhn: None. V. Naragum: None. V. Anagnostakou: None. R. Hanel: 1; C; NIH, Interline Endowment, Microvention, Stryker and CNX. 2; C; Medtronic, Balt, Stryker, Q’Apel medical, Codman Neuro (J&J), Cerenovus, Microvention, Imperati...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Massari, F., Dabus, G., Cortez, G., Singh, J., Kuhn, A., Naragum, V., Anagnostakou, V., Hanel, R., Gounis, M., Puri, A. Tags: SNIS 19th annual meeting oral abstracts Source Type: research

P-013 Designing and prototyping a novel balloon-stent device for minimally invasive temporary aneurysm occlusion and embolization
ConclusionA balloon-stent device allows for longer neuro-interventional procedures by providing continuous perfusion without arresting blood flow during balloon inflation. In addition, this novel medical device provides a smooth surface at the aneurysm neck for consistent device placement, minimization of parent vessel trauma, elimination of ischemic effects distal to the parent artery, and minimization of intra-saccular flow remnants pre- and post-treatment.Abstract P-013 Figure 1a) FPR results from theoretical estimation, benchtop modeling, and computational fluid dynamic (CFD) simulation. B) balloon component of the bal...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Asgari, O., Fennell, B., Norris, N., Ducruet, A., Becker, T. Tags: SNIS 19th annual meeting oral poster abstracts Source Type: research

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