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P005/44 Using the pEGASUS-stent with antithrombogenic properties and single antiplatelet therapy in a case of thrombectomy
IntroductionRescue stenting is used more and more in stroke cases with large-vessel-occlusion or medium-vessel-occlusion refractory to mechanical thrombectomy. The pEGASUS-stent(Phenox) represents a device which is equipped with a hydrophilic polymer coating(HPC) with antithrombogenic properties. The coating allows for implantation under single antiplatelet therapy, thus possibly reducing the risk of bleeding in acute stroke cases.Case HistoryA 79-year-old woman was rushed to emergency room due to left-sided hemiparesis and National-Institutes-of-Health-Stroke-Scale(NIHSS) of 14. Computed-tomography-image showed an occlusi...
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Krug, N., Schulze-Zachau, V., Ntoulias, N., Psychogios, M. Tags: 4.3 CASE PROPOSAL - Acute ischemic stroke Source Type: research

E-055 Internal carotid artery reconstruction with flow diverting stents in the treatment of acute ischemic stroke: technical considerations and medical management
ConclusionsFDS appear to be a safe and effective tool for reconstruction of a symptomatic dissection in tortuous cervical ICAs. Their flexibility allows conformation to complex anatomies and they can be traversed multiple times by aspiration catheters/stentrievers. We found excellent patency at follow up. The unique challenges posed by utilization of high-profile stents in acute stroke require appropriate technical execution and medical management.Disclosures E. Orru: None. F. Bounni: None. M. Marosfoi: None. N. Patel: None. A. Wakhloo: 1; C; Philips medical. 2; C; Stryker, Phenox. 4; C; InNeuroCo, EpiEP, Neural Analytics, ThrombX.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Orru, E., Bounni, F., Marosfoi, M., Patel, N., Wakhloo, A. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

E-074 Case report: reconstructive endovascular treatment of symptomatic long segment dissection with pseudo-aneurysm of dominant left vertebral artery
We report a case of 27 year old Caucasian female with no known medical history who presented to our hospital with several days’ history of posterior headache and neck pain. CT head was unremarkable. CTA head and neck showed short segment of severe stenosis secondary to dissection at the V2-V3 junction of dominant left vertebral artery with associated 6 mm pseudo aneurysm. Right vertebral artery was hypoplastic and it ended in PICA. The dissection was presumed to be spontaneous as patient denied any trauma or strenuous neck manipulation or family history of connective tissue disorders. She was started on antiplatelet ...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Soomro, J., Greco, J., Whitis, J., Rao, S., Yoo, A. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

E-094 Trends in endovascular treatment of cervical artery dissections: a nationwide analysis
ConclusionsDespite an increase in the overall use of endovascular therapy for the treatment of cervical artery dissection in patients with ischemic stroke or TIA, there was no significant association with early clinical outcomes. Future studies looking at long term outcomes including stroke-recurrence are warranted.Disclosures M. Bouslama: None. C. Zhang: None. H. Kamel: 1; C; PI for the NIH-funded ARCADIA trial (NINDS U01NS095869) which receives in-kind study drug from the BMS-Pfizer Alliance for Eliquis® and ancillary study support from Roche Diagnostics. 2; C; Deputy Editor for JAMA Neurology, steering committee mem...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Bouslama, M., Zhang, C., Kamel, H., Merkler, A. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

E-204 Outcomes of radial and femoral access in mechanical thrombectomy for posterior circulation occlusions: a multicenter propensity-adjusted analysis
In this study, we compare outcomes for radial and femoral access for MT in posterior circulation strokes.MethodsA retrospective analysis of all patients with a posterior circulation large vessel occlusion whom underwent mechanical thrombectomy at two large comprehensive stroke centers was performed. Data on demographics, clinical presentation, procedural data, including radial or femoral access, and outcomes were tabulated. Outcomes of interest included National Institute of Health Stroke Scale at discharge and 24-hours. The Thrombolysis in Cerebral Infarction (TICI) scale was used to ascertain revascularization after inte...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Catapano, J., Naik, A., Smoot, M., Vitek, G., Koester, S., Winkler, E., Srinivasan, V., Desai, S., Ducruet, A., Albuquerque, F., Jadhav, A. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

Getting ahead of stroke
In 2015, multiple randomized controlled trials clearly demonstrated that mechanical thrombectomy could save lives and prevent disability in patients with large vessel acute ischemic stroke. Neurointerventional surgeons and stroke neurologists celebrated a great win for our patients. We soon realized, however, that the hard work of implementation lay ahead. Hospitals and emergency medical services (EMS) were not optimally designed to ensure that patients with a stroke were brought to the right hospital rather than the closest one. These shortcomings resulted in patients unnecessarily being transferred between hospitals to r...
Source: Journal of NeuroInterventional Surgery - July 14, 2022 Category: Neurosurgery Authors: Mack, W. J. Tags: Editor ' s column Source Type: research

P-001 Non-contrast CT alone versus combined CT plus CTA or MRA selection for thrombectomy in acute ischemic stroke: analysis of the angel-act registry
DiscussionIn patients selected for MT using non-contrast CT alone versus CT combined with CTA/MRA, we found improved procedural outcomes (shorten door-to-reperfusion time) and similar clinical outcomes and safety profiles. Our real-world findings indicate MT can be safely and effectively performed in hospitals lacking 24/7 access to immediate CTA or MRA. The beneficial effect of using non-contrast CT-only may be present in patients with ultra-early symptoms to ED arrival (within the first hour) and should be further evaluated.Disclosures G. Ma: None. M. Mokin: None. B. Jia: None. A. P. Jadhav: None. X. Tong: None. D. Mo: N...
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Ma, G., Mokin, M., Jia, B., Jadhav, A., Tong, X., Mo, D., Ma, N., Gao, F., Huo, X., Luo, G., Song, L., Sun, X., Deng, Y., Wang, A., Zhang, X., Gui, L., Song, C., Peng, Y., Wu, J., Zhao, S., Zhao, J., Zhou, Z., Miao, Z., Ren, Z. Tags: Oral poster abstracts Source Type: research

P-031 Effect of COVID-19 on acute ischemic stroke: population-level experience
ConclusionIn this population-level study, significant decreases in AIS volume were observed with slightly higher incidence in younger population and higher LVO strokes. Rates of thrombolysis and thrombectomy remained unchanged but patients appeared to have worse outcomes.Disclosures Y. Kim: None. S. Khose: None. S. Salazar-Marioni: None. R. Abdelkhaleq: None. S. Sheth: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Kim, Y., Khose, S., Salazar-Marioni, S., Abdelkhaleq, R., Sheth, S. Tags: Oral poster abstracts Source Type: research

P-043 Elevated D-dimer levels predicts mortality in COVID-19 with stroke: analysis of multi-center electronic health record data
ConclusionsPeak D-dimer levels above 5.15 µg/ml feu are associated with increased mortality in COVID-19 patients with AIS.Disclosures Y. Kim: None. S. Khose: None. R. Abdelkhaleq: None. S. Salazar-Marioni: None. S. Sheth: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Kim, Y., Khose, S., Abdelkhaleq, R., Salazar-Marioni, S., Sheth, S. Tags: Oral poster abstracts Source Type: research

E-010 Strict aspects cutoffs in endovascular therapy selection paradigms may harm patient outcomes
ConclusionASPECT scores at presentation in patients with LVO were associated with 90-day disability outcomes in a continuous fashion. In patients with ASPECTS close to 5, EST continued to provide significant treatment effect. These findings argue against the use of strict ASPECTS cutoffs for EST eligibility.Disclosures R. Abdelkhaleq: None. C. De la Garza: None. Y. Kim: None. S. Khose: None. S. Salazar Marioni: None. S. Sheth: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Abdelkhaleq, R., De la Garza, C., Kim, Y., Khose, S., Salazar Marioni, S., Sheth, S. Tags: Electronic poster abstracts Source Type: research

E-021 Pathophysiology, stroke types, collateral formation and aneurysms in moyamoya disease/moya moya syndrome
ConclusionsMMD is presented most commonly with ischemic stroke in the pediatric age group and with hemorrhagic stroke in the adult age group. MMD-associated intracranial aneurysms frequently occur in patients presenting with hemorrhagic unilateral MMD and are associated with an extremely high rate of rupture. Long-standing hemodynamic stress might contribute to the formation of an aneurysm.Disclosures S. Ahmad: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Ahmad, S. Tags: Electronic poster abstracts Source Type: research

E-044 Stenting of intracranial stenosis through an angioplasty balloon catheter - A case series
ConclusionDeploying self-expanding stents through an angioplasty balloon catheter is feasible, safe, and can greatly simplify the procedure. The Neuroform Atlas stent is strong enough to prevent immediate recoil of intracranial stenosis after angioplasty.Disclosures A. Takayanagi: None. J. Fields: None. K. Chao: None. D. Rex: None. P. Cheng: None. L. Feng: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Takayanagi, A., Fields, J., Chao, K., Rex, D., Cheng, P., Feng, L. Tags: Electronic poster abstracts Source Type: research

Congenital anomaly of the posterior arch of the atlas: a rare risk factor for posterior circulation stroke
We report an extremely rare case involving a posterior arch anomaly of the atlas, causing a vertebral artery dissection (VAD) induced posterior circulation stroke. A 16-year-old girl was admitted to hospital because of new onset dizziness. VAD related multiple infarction in the posterior circulation was revealed. The congenital posterior arch anomaly of the atlas, along with instability of the atlantoaxial joint, were discovered accidentally during follow-up. This is the first case of ischemic stroke related to atlantal posterior arch aplasia and atlantoaxial instability. Although rare, it reminds us that investigation of ...
Source: Journal of NeuroInterventional Surgery - June 16, 2017 Category: Neurosurgery Authors: Ouyang, Z.-y., Qiu, M.-j., Zhao, Z., Wu, X.-b., Tong, L.-s. Tags: Neuroimaging Source Type: research

E-057 Process Improvement in Door-to-Groin Puncture Times at a Comprehensive Stroke Center Shows a Trend Towards Reduced Mortality at 90 Days
ConclusionOur systematic process improvement initiative significantly reduced door-to-groin puncture times and showed a trend towards reduced mortality at 90 days. A multidisciplinary approach and ensuring hospital system investment are key to an effective process.DisclosuresY. Kayan: 2; C; Medtronic, Penumbra. J. Delgado Almandoz: 2; C; Medtronic, Penumbra. M. Young: None. J. Fease: None. J. Scholz: None. A. Milner: None. T. Hehr: None. M. Mulder: None. P. Roohani: None. R. Tarrel: None.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Kayan, Y., Delgado Almandoz, J., Young, M., Fease, J., Scholz, J., Milner, A., Hehr, T., Mulder, M., Roohani, P., Tarrel, R. Tags: Electronic poster abstracts Source Type: research

P-012 Longer Working Length of the Solitaire Retrieval Device Improves Revascularization
ConclusionsThe Solitaire 4 x 40 device showed a statistical trend for achieving better recanalization compared to the shorter devices. However due to our small sample size of patients undergoing treatment with the 4 x 40, further investigation is warranted to determine whether this result is maintained in larger sample size such as the STRATUS registry.DisclosuresW. Holloway: None. I. Akhtar: None. J. Halpin: None. C. Martin: None. N. Akhtar: None.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Holloway, W., Akhtar, I., Halpin, J., Martin, C., Akhtar, N. Tags: Oral poster abstracts Source Type: research

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