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E-089 Rural versus metropolitan stroke activation incidence: using Viz.ai to determine disease penetrance
ConclusionCompared to a metropolitan PSC in our network, two rural PSCs had significantly higher per capita incidence of stroke activations. There was a trend toward higher per capita thrombectomy alerts as well. Given the known health disparities in rural regions of the US, these findings provide clear confirmation of the importance of stroke care protocols in rural areas, and the value of rapid identification and triage for rural communities. Our future studies will examine more detailed patient-specific factors based on geographic region.Disclosures J. Fraser: None. J. Frank: None. A. Chen: None. M. Campbell: None. L. W...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Fraser, J., Frank, J., Chen, A., Campbell, M., Wise, L., Krein, B., Silvernail, R., Dornbos, D., Pahwa, S., Lee, J. 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

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

O-065 Multicenter investigation into presentation, management and outcome of infectious intracranial aneurysms
ConclusionPatients with IIAs are at high risk of aneurysm rupture or re-hemorrhage despite treatment with antibiotics. Antibiotic failure occurred in 43% of medically treated patients, and failure was associated with 6 times higher odds of mortality in 1 year.Disclosures A. Alawieh: None. L. Dimisko: None. Y. Zohdy: None. H. Saad: None. S. Newman: None. J. Grossberg: None. C. Cawley: None. G. Pradilla: None. C. Fox: None. C. Perez-Vaga: None. J. Burkhardt: None. M. Salem: None. P. Jabbour: None. K. El Naamani: None. R. Schmidt: None. M. Gooch: None. R. Starke: None. A. Abdelsalam: None. V. Lu: None. M. Levitt: None. A. Spi...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Alawieh, A., Dimisko, L., Zohdy, Y., Saad, H., Newman, S., Grossberg, J., Cawley, C., Pradilla, G., Fox, C., Perez-Vaga, C., Burkhardt, J., Salem, M., Jabbour, P., El Naamani, K., Schmidt, R., Gooch, M., Starke, R., Abdelsalam, A., Lu, V., Levitt, M., Spi Tags: SNIS 20th annual meeting oral abstracts Source Type: research

Using a CT Angiography Artificial Intelligence Carotid Plaque Morphology Model to Predict Stroke
The gold standard for determining carotid artery stenosis is to calculate stenosis using the North American Symptomatic Carotid Endarterectomy Trial criteria and ultimately plan for medical vs surgical management based on percent stenosis and symptomatic status. Few studies have assessed plaque morphology as an additive tool for stroke prediction. Our study uses an artificial intelligence software in conjunction with a patient's computed tomography (CT) scan of the neck to create a three-dimensional (3D) model of the carotid artery and assess plaque morphology including calcification, intraplaque hemorrhage, matrix, and pe...
Source: Journal of Vascular Surgery - May 23, 2023 Category: Surgery Authors: Rohini J. Patel, Daniel Willie-Permor, Sina Zarrintan, Austin Fan, Mahmoud Malas Tags: Poster Competition Source Type: research

When does life end? New organ donation strategy fuels debate
On a chilly holiday Monday in January 2020, a medical milestone passed largely unnoticed. In a New York City operating room, surgeons gently removed the heart from a 43-year-old man who had died and shuttled it steps away to a patient in desperate need of a new one. More than 3500 people in the United States receive a new heart each year. But this case was different—the first of its kind in the country. “It took us 6 months to prepare,” says Nader Moazami, surgical head of heart transplantation at New York University (NYU) Langone Health, where the operation took place. The run-up included oversight from an ethi...
Source: ScienceNOW - May 11, 2023 Category: Science Source Type: news

Increased Versus Appropriate Neuroimaging Utilization in Stroke: A Complex Matter
We read with great interest the study by Wang et  al [1], in which they reported updated trends, sociodemographic disparities, and the impact of stroke neuroimaging on mortality across the United States from 2012 to 2019. They found a significantly increased utilization for CT angiography (250%), CTP (428%), and MRI (18%) as a well as a decreasin g rate for MR angiography use (−33%) in stroke patients. The way that the authors present consistent and extensive data on disparities across specific demographic groups (ie, rural patients, ≥80 years, female and black patients) has a significant value in designing effective ...
Source: Journal of the American College of Radiology : JACR - July 31, 2022 Category: Radiology Authors: Ángela Guarnizo, Javier Romero, Sonia Bermúdez Tags: Letters to the Editor Source Type: research

E-040 Factors associated with failed mechanical thrombectomy in acute ischemic stroke
ConclusionFailed MT was encountered in approximately 12% of cases. The most common location of failed MT was intracranial and this was predominantly due to ICAS. Further studies to evaluate better treatment modalities of ICAS related LVO are warranted.Disclosures O. Lajthia: None. H. Ali: None. R. Neyes: None. E. Almallouhi: None. R. Chalhoub: None. K. Kicielinski: None. J. Lena: None. M. Sattur: None. G. Porto: None. A. Spiotta: None. S. Al Kasab: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Lajthia, O., Ali, H., Neyes, R., Almallouhi, E., Chalhoub, R., Kicielinski, K., Lena, J., Sattur, M., Porto, G., Spiotta, A., Al Kasab, S. Tags: SNIS 19th annual meeting electronic poster abstracts 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

P-030 Mechanical thrombectomy in medium vessel occlusions using the novel aspiration MIVI Q catheters: an international multicenter experience
ConclusionsTreatment of MeVO patients with Q catheters resulted in optimal angiographic and clinical outcomes. Though angiographic results were similar between primary and secondary MeVOs, the first had less severe presentation and better outcomes at 90-days than the latter.Disclosures A. Monteiro: None. L. Makalanda: None. J. Wareham: None. J. Jones: None. P. Dhillon: None. P. Bhogal: None. W. Brinjikji: None. M. Mokin: None. A. Siddiqui: 1; C; Co-investigator for NIH – 1R01EB030092–01, Project Title: High Speed Angiography at 1000 frames per second; Mentor for Brain Aneurysm Foundation Carol W. Harvey Chair o...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Monteiro, A., Makalanda, L., Wareham, J., Jones, J., Dhillon, P., Bhogal, P., Brinjikji, W., Mokin, M., Siddiqui, A. Tags: SNIS 19th annual meeting oral poster abstracts Source Type: research

Influence of the Danish Co-morbidity Index Score on the Treatment and Outcomes of 2.5 Million Patients Admitted With Acute Myocardial Infarction in the United States
This study aimed to determine the association between the Danish Co-morbidity Index for Acute Myocardial Infarction (DANCAMI) and restricted DANCAMI (rDANCAMI) scores and clinical outcomes in patients hospitalized with AMI. Using the National Inpatient Sample, all AMI hospitalizations were stratified into four groups based on their DANCAMI and rDANCAMI score (0; 1 to 3; 4 to 5; ≥6). The primary outcome was all-cause mortality, whereas secondary outcomes were major adverse cardiovascular/cerebrovascular events, major bleeding, ischemic stroke, and receipt of coronary angiography or percutaneous coronary intervention.
Source: The American Journal of Cardiology - July 14, 2022 Category: Cardiology Authors: Balamrit Singh Sokhal, Andrija Mateti ć, Abhishek, Philip Freeman, Jan Walter Dhillon Shanmuganathan, Mohamed O. Mohamed, Christian Mallen, Mamas A. Mamas Source Type: research

Intracranial Large Artery Stenosis and Past Infectious Exposures: Results From the NOMAS Cohort
CONCLUSIONS: Chronic infectious exposures, specifically herpes simplex virus 2 and cytomegalovirus were associated with asymptomatic ILAS as seen on magnetic resonance angiogram imaging. This may represent an additional target of intervention in the ongoing effort to stem the substantial global burden of strokes related to ILAS.PMID:35105181 | DOI:10.1161/STROKEAHA.121.036793
Source: Herpes - February 2, 2022 Category: Infectious Diseases Authors: Amol Mehta Farid Khasiyev Clinton B Wright Tatjana Rundek Ralph L Sacco Mitchell S V Elkind Jose Gutierrez Source Type: research

Comparative study of on-label versus off-label treatment of intracranial aneurysms with the Pipeline embolization device
CONCLUSIONS: In real-world practice, off-label use of PED is common and can achieve similar efficacy as on-label use. However, in aggregate, off-label use was found to carry an increased rate of ischemic complications. With judicious attention to safety and individual patient characteristics, these results highlight the scale and general feasibility of off-label PED use by experts.PMID:35090133 | DOI:10.3171/2021.11.JNS212481
Source: Journal of Neurosurgery - January 28, 2022 Category: Neurosurgery Authors: Samuel J Cler David C Lauzier Arindam R Chatterjee Joshua W Osbun Christopher J Moran Akash P Kansagra Source Type: research

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