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Long-term effect of field triage on times to endovascular treatment for emergent large vessel occlusion
Conclusions Comparing adjacent states over time, the implementation of severity-based field triage significantly reduced time to EVT.
Source: Journal of NeuroInterventional Surgery - August 29, 2023 Category: Neurosurgery Authors: Jayaraman, M. V., Baird, G., Oueidat, K., Paolucci, G., Haas, R. A., Torabi, R., Moldovan, K., Rhodes, J., Potvin, J., Alexander-Scott, N., Yaghi, S., Madsen, T., Furie, K., McTaggart, R. A. Tags: Ischemic stroke Source Type: research

O-041 Primary results of the pRESET for occlusive stroke treatment (PROST) randomized clinical trial
Conclusions and RelevancePROST is the first randomized clinical trial aiming to compare a novel versus an established stent-retriever technology, establishing a new scientific benchmark for stroke device trials. In all primary & secondary endpoints and analysis, the pre-specified threshold of non-inferiority was met.(ClinicalTrials.gov: NCT03994822)Disclosures R. Hanel: 1; C; NIH, Interline Endowment, Microvention, Stryker, CNX, Balt. 2; C; Medtronic, Stryker, Cerenovus, Microvention, Phenox, Rapid Medical, Q’Apel. 4; C; InNeuroCo, Cerebrotech, eLum, Endostream, Three Rivers Medical Inc, Scientia, RisT, BlinkTBI,...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Hanel, R., Klisch, J., Möhlenbruch, M., Vollherbst, D., Ulfert, C., Bozorgchami, H., Samaniego, E., Liebeskind, D., Lobsien, D., Pielenz, D., Sauvageau, E., Aghaebrahim, A., Clark, W., Priest, R., Ortega-Gutierrez, S., Lopes, D., Billingsley, J., Tags: SNIS 20th annual meeting oral abstracts Source Type: research

P-008 Probabilistic ensemble learning for prediction of stroke thrombectomy outcomes from the neurovascular quality initiative-quality outcomes database (NVQI-QOD) registry
ConclusionsThis study demonstrates the utility of probabilistic ensemble learning in clinical decision-making and prognosis. It can provide robust predictions as well as quantify data uncertainty. Our results regarding NIHSS changes reinforce the substantial benefits of MT, that can improve outcomes in nearly half of patients. The degree of disability relevant to the 90-day follow-up mRS can be determined by probabilistic learning available as early as discharge.Disclosures C. Zhou: None. S. Faruqui: None. A. Patel: None. R. Abdalla: None. A. Shaibani: None. M. Potts: None. B. Jahromi: None. S. Ansari: None. D. Cantrell: None.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Zhou, C., Faruqui, S., Patel, A., Abdalla, R., Shaibani, A., Potts, M., Jahromi, B., Ansari, S., Cantrell, D. Tags: SNIS 20th annual meeting oral poster abstracts Source Type: research

E-248 Rescue intracranial stenting for failed posterior circulation thrombectomy: analysis from saint study
ConclusionIn patients with posterior circulation occlusion stokes who failed mechanical thrombectomy, our study suggests that RS has better outcomes with comparable safety profile. Randomized controlled studies are warranted for more concrete evidence.Abstract E-248 Table 1Baseline demographic, clinical and procedural characteristics among rescue stenting and failed reperfusion groups Rescue stentingN=84 Failed ReperfusionN=68 P value Age 63.6±12.6 69.7±13.5 0.005 Female 18 (21.4%) 35 (51.5%) <0.001 Ethnic BackgroundWhiteAAHispanicAsianOthers 33 (39.3%)20 (23.8%)22 (26.2%)4 (4.8%)5 (6%) 34 (50%)22 (32.4%)...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Mohammaden, M., Tarek, M., Haussen, D., Fifi, J., Matsoukas, S., Farooqui, M., Ortega-Gutierrez, S., Zevallos, C., Galecio-Castillo, M., Hassan, A., Tekle, W., Al-Bayati, A., Salem, M., Burkhardt, J., Pukenas, B., Cortez, G., Hanel, R., Aghaebrahim, A., S Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

Association between anesthesia modality and clinical outcomes following endovascular stroke treatment in the extended time window
Conclusion LA without sedation during EVT was associated with improved functional outcomes compared with GA, but not CS, within and beyond 6 hours from stroke onset. Prospective studies assessing anesthesia-related outcomes in the extended time window are warranted.
Source: Journal of NeuroInterventional Surgery - April 13, 2023 Category: Neurosurgery Authors: Dhillon, P. S., Butt, W., Podlasek, A., McConachie, N., Lenthall, R., Nair, S., Malik, L., Hewson, D. W., Bhogal, P., Makalanda, H. L. D., James, M. A., Dineen, R. A., England, T. J. Tags: Vascular neurology Source Type: research

Association between time to treatment and clinical outcomes in endovascular thrombectomy beyond 6 hours without advanced imaging selection
Conclusion In this real-world study, there was minimal change in functional disability, sICH and in-hospital mortality within and across the late window. While confirmatory randomized trials are needed, these findings suggest that EVT remains feasible and safe when performed in AIS patients selected without advanced neuroimaging between 6–24 hours from stroke onset.
Source: Journal of NeuroInterventional Surgery - March 14, 2023 Category: Neurosurgery Authors: Dhillon, P. S., Butt, W., Podlasek, A., McConachie, N., Lenthall, R., Nair, S., Malik, L., Bhogal, P., Makalanda, H. L. D., Spooner, O., Krishnan, K., Sprigg, N., Mortimer, A., Booth, T. C., Lobotesis, K., White, P., James, M. A., Bath, P., Dineen, R. A., Tags: Ischemic stroke Source Type: research

Endovascular treatment of acute ischemic stroke in patients with pre-morbid disability: a meta-analysis
Conclusion In eligible patients with pre-morbid disability, observational studies suggest that EVT carries a higher chance of return to baseline mRS compared with patients treated with MM or without pre-morbid disability, although with higher mortality than patients without pre-morbid disability. These findings argue against the routine exclusion of such patients from EVT and merit validation with randomized trials.
Source: Journal of NeuroInterventional Surgery - March 14, 2023 Category: Neurosurgery Authors: Bala, F., Beland, B., Mistry, E., Almekhlafi, M. A., Goyal, M., Ganesh, A. Tags: Ischemic stroke Source Type: research

Effects of endovascular therapy for mild stroke due to proximal or M2 occlusions: meta-analysis
Conclusions For patients with mild AIS, observational data suggest that EVT may be beneficial for proximal ICA or M1 but not for distal M2 occlusions. Randomized trials are needed to confirm these findings. PROSPERO registration number CRD42021281034.
Source: Journal of NeuroInterventional Surgery - March 14, 2023 Category: Neurosurgery Authors: Lin, C.-H., Saver, J. L., Ovbiagele, B., Tang, S.-C., Lee, M., Liebeskind, D. S. Tags: Open access, Ischemic stroke Source Type: research

Endovascular therapy may not be beneficial for patients with mild acute ischemic stroke compared to best medical management
We read with great interest the meta-analysis by Lin et al on the comparison of the clinical effectiveness between endovascular therapy (EVT) and best medical management (BMM) in patients with mild acute ischemic stroke (AIS).1 The study is of profound academic importance, and there are some points that we would like to address. In the "Statistical analyses" section, the authors described how they pooled data across studies by using the fixed effects model based on an inverse variance method. Subsequently, in the "Results – Primary outcome" section, the authors stated that for AIS patients with National Institutes of...
Source: Journal of NeuroInterventional Surgery - March 14, 2023 Category: Neurosurgery Authors: Zheng, F., von Spreckelsen, N., Hu, W. Tags: Letter Source Type: research

Cost-effectiveness of thrombectomy in patients with minor stroke and large vessel occlusion: effect of thrombus location on cost-effectiveness and outcomes
Conclusions EVT is cost-effective in patients with minor stroke and LVO in the long term (lifetime horizon), considering the poor outcomes and significant disability associated with non-reperfusion. Our study emphasizes the need for caution in interpreting previous observational studies which concluded similar results in EVT versus medical management in patients with minor stroke due to a high proportion of patients with M2 occlusions in the two strategies.
Source: Journal of NeuroInterventional Surgery - December 14, 2022 Category: Neurosurgery Authors: Khunte, M., Wu, X., Koo, A., Payabvash, S., Matouk, C., Heit, J. J., Wintermark, M., Albers, G. W., Sanelli, P. C., Gandhi, D., Malhotra, A. Tags: Socioeconomics Source Type: research

O-012 Peri-procedural complications, clinical outcomes and recurrence/retreatment rates after endovascular versus surgical treatment of intracranial aneurysms: a real-world assessment from the NVQI-QOD cerebral aneurysm registry
ConclusionEndovascular treatment of intracranial aneurysms was associated with better overall clinical outcomes than surgical clipping with improved disability free survival and better disposition at discharge or follow-up, across both ruptured and unruptured aneurysms. Although intraoperative complications were higher for ruptured aneurysms treated with endovascular treatment, there was no difference in unruptured aneurysms versus surgical clipping. Post-operative complications were lower for the endovascular cohort regardless of presentation. Overall, these data support ongoing primary adoption of endovascular treatment ...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Bauknight, W., Noorani, S., Abdalla, R., Tejada, J., Church, E., Sahlein, D., Howington, J., Ansari, S. Tags: SNIS 19th annual meeting oral abstracts Source Type: research

E-176 Endovascular stent retriever thrombectomy of medium and small vessel occlusion of the middle cerebral artery with acute ischemic stroke: a case series
ConclusionsOur case series demonstrated that SRMT in SVO with disabling NIHSS is feasible and safe if performed carefully. All patient achieved TICI 3 perfusion and first pass effect was better observed in trap technique and use of long solitaire STD. Good function outcomes were achieved in all cases irrespective of the types of SRD used and passes required to achieve TICI 3 perfusion. Further studies are required.Disclosures Y. Lodi: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Lodi, Y. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

E-216 Stroke thrombectomy outcomes by biological sex - a multicenter study from the star collaboration
ConclusionsOlder females with higher baseline disability are more likely to undergo mechanical thrombectomy compared to males. Biological sex is not an independent predictor of thrombectomy outcomes in acute stroke when controlling for baseline and comorbid variables. Future studies will explore the determinants underlying differences in presentations and outcomes betweenDisclosures L. Dimisko: 1; C; T32NR012715. V. Hertzberg: None. J. Grossberg: None. B. Howard: None. C. Cawley: None. F. Tong: None. P. Jabbour: 2; C; Medtronic, MicroVention, Cerus Endovascular, and Balt. I. Maier: None. S. Wolfe: None. A. Rai: None. R. St...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Dimisko, L., Hertzberg, V., Grossberg, J., Howard, B., Cawley, C., Tong, F., Jabbour, P., Maier, I., Wolfe, S., Rai, A., Starke, R., Gory, B., Psychogios, M., Shaban, A., Arthur, A., Kim, J., Yoshimura, S., Kan, P., De Leacy, R., Fragata, I., Polifka, A., Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

P-006 The 'hub-spoke telemedicine model in a large cohort of stroke patients
ConclusionTele-stroke networks have proven to be a pivotal development in the treatment of strokes, especially those that are remote. With the additional expertise and the shorter duration from onset to diagnosis to treatment, these networks have substantially improved patient care and decreased healthcare costs, avoiding unnecessary transfers from spoke hospitals to hub.Abstract P-006 Figure 1Abstract P-006 Figure 2Disclosures K. El Naamani: None. N. Herial: None. R. Abbas: None. G. Sioutas: None. A. Amllay: None. A. Munoz: None. A. Sweid: None. C. Morse: None. D. Moylan: None. D. Joffe: None. M. Knapp: None. S. Tjoumakar...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: El Naamani, K., Herial, N., Abbas, R., Sioutas, G., Amllay, A., Munoz, A., Sweid, A., Morse, C., Moylan, D., Joffe, D., Knapp, M., Tjoumakaris, S., Gooch, M., Rosenwasser, R., Jabbour, P. Tags: SNIS 19th annual meeting oral poster abstracts Source Type: research

Device size selection can enhance Y-stentrieving efficacy and safety as a rescue strategy in stroke thrombectomy
Conclusion Y-stentrieving is an effective and safe bail-out strategy for refractory bifurcation clots. Longer stents may promote better angiographic outcomes, whereas avoidance of disproportionately large retrievers may mitigate intracranial hemorrhage. Future studies should account for these factors when evaluating alternative stentriever techniques.
Source: Journal of NeuroInterventional Surgery - May 13, 2022 Category: Neurosurgery Authors: Cabral, L. S., MontAlverne, F., Silva, H. C., Passos Filho, P. E., Magalhaes, P. S. C., Bianchin, M. M., Nogueira, R. G. Tags: Ischemic stroke Source Type: research

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