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O-042 Complications of DAPT cessation at 3 months versus 6 months after flow diversion of unruptured intracranial aneurysms
ConclusionsOnly 0.6% (n=1) of patients exhibited complications after 3 month follow-up. We conclude that DAPT duration of 3 months after endoluminal flow diversion of unruptured cerebral aneurysms of the anterior circulation is not associated with increased rates of hemorrhagic or thromboembolic complications compared to a traditional 6-month regimen.Disclosures S. Srinivasan: None. A. White: None. M. Al-Abdulkareem: None. J. Barr: None. L. Pride: None. J. White: None. R. Novakovic-White: None. R. Sillero: None. B. Welch: None.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Srinivasan, S., White, A., Al-Abdulkareem, M., Barr, J., Pride, L., White, J., Novakovic-White, R., Sillero, R., Welch, B. Tags: SNIS 20th annual meeting oral abstracts Source Type: research

O10 The necessity of monitoring platelet response and adjusting antiplatelet agents for endovascular treatment of unruptured intracranial aneurysms: a single-center, retrospective, cohort study
ConclusionActive monitoring and adjustment antiplatelet agents did not reduce ischemic complications in endovascular treatment; however, tended to reduce the ischemic complication, especially in flow diversion. Low-dose prasugrel may be feasible without increasing hemorrhage in the endovascular treatment of unruptured intracranial aneurysms.ReferencesLi W. Effect of Adjusted Antiplatelet Therapy on Preventing Ischemic Events after Stenting for Intracranial Aneurysms. Stroke. 2021 Dec;52(12):3815–3825. DOI: 10.1161/StrokeAHA.120.032989. EPUB 2021 SEP 20. PMID: 34538087.Hwang G. Standard vs Modified Antiplatelet Prepar...
Source: Journal of NeuroInterventional Surgery - August 29, 2022 Category: Neurosurgery Authors: Moon, E., Kwon, B., Song, Y., Lee, D., Park, J., Suh, D. Tags: 14th Congress of the European Society of Minimally Invasive Neurological Therapy 2022 Meeting Abstracts Source Type: research

E-058 An alternative reduced dose regimen of ticagrelor for neuroendovascular patients
ConclusionA lower dose of ticagrelor (45 mg twice daily) appears to be a safe and effective in this small cohort of patients who are resistant to clopidogrel per P2Y12 testing and who have increased risk of ischemic or hemorrhagic strokes due to neurovascular pathologies and implants. Further randomized studies are required to confirm these findings.Disclosures S. Thind: None. R. Morsi: None. O. Kass-Hout: None. J. Stern: None. R. Tangonan: None. T. Kass-Hout: None. L. Guterman: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Thind, S., Morsi, R., Kass-Hout, O., Stern, J., Tangonan, R., Kass-Hout, T., Guterman, L. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

E-187 Pipeline embolization stent for treatment of giant supraclinoid aneurysms: a case series
ConclusionThe Pipeline embolization device is a novel technique that can be utilized for treatment of giant cerebrovascular aneurysms with emerging evidence of immediate and long-term success. Further patient enrollment and clinical trials will be required to assess its efficacy in comparison to other endovascular and surgical approaches for the treatment of giant aneurysms.Disclosures M. Fana: None. O. Alsrouji: None. M. Rehman: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Fana, M., Alsrouji, O., Rehman, M. Tags: SNIS 19th annual meeting electronic poster 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

E-248 Postpartum vertebral artery dissections: a report of 7 cases and literature review
ConclusionA limited cohort of 33 ppVADs exist in the literature. This study contributes 7 additional cases and suggests that, despite heterogenous management of ppVAD, the resulting outcomes were favorable.Disclosures V. Lazarov: None. A. Monteiro: None. F. Almayman: None. M. Waqas: None. J. Cappuzzo: None. E. Levy: None. A. Siddiqui: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Lazarov, V., Monteiro, A., Almayman, F., Waqas, M., Cappuzzo, J., Levy, E., Siddiqui, A. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

Clopidogrel Bolus is Inferior to Sustained Clopidogrel Pretreatment in Patients Undergoing Carotid Artery Stent Placement
BACKGROUND: Clopidogrel bolus is an option used before carotid artery stent (CAS) placement when sustained clopidogrel pretreatment is not used. OBJECTIVE: To compare the effect of clopidogrel bolus (450 mg administered ≥4 hours) with sustained clopidogrel pretreatment (48 hours or greater) before CAS among patients recruited in the Carotid Revascularization Endarterectomy versus Stenting Trial. METHODS: We compared the rates of primary end point (either any stroke, myocardial infarction, or death during the periprocedural period or any ipsilateral stroke within 4 years) between patients who received cl...
Source: Neurosurgery - May 25, 2022 Category: Neurosurgery Tags: Research—Human—Clinical Studies: Endovascular Source Type: research

Active management of the target P2Y12 reaction unit range in patients undergoing stent-assisted coil embolization for unruptured cerebral aneurysms
Conclusion Active target PRU management can achieve control of optimal PRU values and may decrease perioperative ischemic and hemorrhagic events among patients undergoing SAC.
Source: Journal of NeuroInterventional Surgery - October 15, 2021 Category: Neurosurgery Authors: Nakagawa, I., Park, H. S., Kotsugi, M., Yokoyama, S., Nakase, K., Furuta, T., Myouchin, K., Yamada, S., Nakase, H. Tags: Hemorrhagic stroke Source Type: research

Review of Toyoda K, et al. Dual antiplatelet therapy using cilostazol for secondary prevention in patients with high-risk ischemic stroke in Japan. Lancet Neurol. 2019 Jun;18(6):539-548.
Conclusion: This RCT demonstrated the safety of dual therapy, consisting of cilostazol/aspirin or cilostazol/ clopidogrel, in preventing secondary ischemic stroke in a high-risk Japanese population. Further studies are required to generalize these findings to other patient populations worldwide. PMID: 32363048 [PubMed]
Source: Surgical Neurology International - May 5, 2020 Category: Neurosurgery Tags: Surg Neurol Int Source Type: research

Use of Antiplatelet Agents in the Neurosurgical Patient
This article presents the relevant data supporting the use of antiplatelet agents in vascular neurosurgery and recommendations based on the described studies.
Source: Neurosurgery Clinics of North America - September 15, 2018 Category: Neurosurgery Authors: Amanda S. Zakeri, Shahid M. Nimjee Source Type: research

O-012 Acute clot formation on the surface of flow diverters can be reduced by using phosphoryl-choline surface modification
Conclusion Our preliminary study supported our hypothesis that using phosphoryl-choline surface modified flow diverter can be useful to decrease the occurrence of micro-clot formation, especially post-angioplasty. Importantly, S-PED reduced clot formation at the origin of covered side-branches. References . AJNR 2015;36:98–107. . J. Neurosurg 2016;1–6. Disclosures M. Marosfoi: None. F. Clarencon: None. E. Langan: None. R. King: None. O. Brooks: None. T. Tamura: None. M. Gounis: 1; C; Medtronic Neurovascular. A. Puri: 1; C; Medtronic Neurovascular.
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Marosfoi, M., Clarencon, F., Langan, E., King, R., Brooks, O., Tamura, T., Gounis, M., Puri, A. Tags: Oral Abstracts Source Type: research

P-010 Practice variations in addressing acute tandem carotid occlusions in emergent large vessel occlusion strokes
Conclusion For tandem occlusions with cervical ICA involvement, acute stenting with adjunctive angioplasty, is a current prevailing practice for recanalization of the extracranial ICA. There is considerable variability in antiplatelet protocols, with a slight favoring of the administration of loading doses of aspirin and clopidogrel before stent deployment. Variability is also present for anesthesia, with general anesthesia having a significant role. Disclosures S. Coffman: None. S. Trott: None. A. Alhajeri: None. J. Fraser: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Coffman, S., Trott, S., Alhajeri, A., Fraser, J. Tags: Oral 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

E-088 Investigation of safety termination of antiplatelet therapy after lvis stent-assisted cerebral aneurysm coiling
Conclusion Termination of AT at 3 months postoperatively did not result in ischemic events among patients who underwent LSAC. Neointimal formation of Lvis stent may be a criterion for termination of AT without increasing the risk of ischemic event. Disclosures: K. Takayama: None. K. Myouchin: None. T. Wada: None. S. Kurokawa: None. K. Kichikawa: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Takayama, K., Myouchin, K., Wada, T., Kurokawa, S., Kichikawa, K. Tags: Electronic Poster Abstracts Source Type: research

Dream a little dream: an update on genetics guided therapy for stroke in australia
Conclusions The current evidence does not support pharmacogenetic guided therapy in stroke in Australia. However, a one-size fits all approach does not work and there is a definite dearth of Australian based pharmacogenetic research, which must be addressed.
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 8, 2017 Category: Neurosurgery Authors: Johnson, K., Haque, S., Shaffi, M. Tags: Abstracts Source Type: research

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