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The 'pit-crew model for improving door-to-needle times in endovascular stroke therapy: a Six-Sigma project
Conclusions A protocol-driven process can significantly improve efficiency of care in time-sensitive stroke interventions.
Source: Journal of NeuroInterventional Surgery - April 13, 2016 Category: Neurosurgery Authors: Rai, A. T., Smith, M. S., Boo, S., Tarabishy, A. R., Hobbs, G. R., Carpenter, J. S. Tags: Open access, Ischemic stroke Source Type: research

Transradial access in acute ischemic stroke intervention
Conclusions Failure of TFA in the endovascular treatment of AIS is uncommon but leads to unacceptable delays in reperfusion and poor outcomes. Standardization of benchmarks for access switch could serve as a guide for neurointerventionalists. TRA is a valid approach for the endovascular treatment of AIS.
Source: Journal of NeuroInterventional Surgery - February 14, 2016 Category: Neurosurgery Authors: Haussen, D. C., Nogueira, R. G., DeSousa, K. G., Pafford, R. N., Janjua, N., Ramdas, K. N., Peterson, E. C., Elhammady, M. S., Yavagal, D. R. Tags: Ischemic stroke Source Type: research

E-033 The smoking-thrombolysis paradox in large vessel occlusion acute ischemic stroke after endovascular therapy
Conclusion In stroke patients treated with mechanical thrombectomy, smoking does not seem to be associated with outcomes regardless of stroke subtype or location. Disclosures J. Grossberg: None. M. Bouslama: None. L. Rebello: None. D. Haussen: None. M. Frankel: None. R. Nogueira: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Grossberg, J., Bouslama, M., Rebello, L., Haussen, D., Frankel, M., Nogueira, R. Tags: Electronic Poster Abstracts Source Type: research

E-128 five-year endovascular acute ischemic stroke intervention experience at a rural academic medical center
In conclusion, we present our experience at a rural academic setting as a real world test ground for the current guidelines and trends in endovascular stroke intervention.DisclosuresE. Akture: None. C. O'Neill: None. M. Gorman: None. C. Commichau: None. G. Linnell: None. D. Johnson: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Akture, E., O'Neill, C., Gorman, M., Commichau, C., Linnell, G., Johnson, D. Tags: SNIS 12th Annual Meeting Electronic Poster Abstracts Source Type: research

E-039 Comparison of Medical Therapy vs. Intra-Arterial Therapy for Acute Vertebrobasilar Stroke
ConclusionCompared to medical trials in 2015, which demonstrate clinical benefit for IAT over medical therapy for acute ischemic stroke of the anterior circulation, the posterior circulation is less well studied. Important prognostic factors for stroke due to large vessel occlusion of posterior circulation include posterior ASPECTS score and infarct volume in the brainstem. In this small retrospective study, patients treated with IAT had greater stroke severity than the medical cohort, yet they had similar rates of good functional outcome. Parameters of this retrospective analysis may be used to improve triage and treatmen...
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Raymond, S., Leslie-Mazwi, T., Rost, N., Schaefer, P., Hirsch, J., Gonzalez, R., Rabinov, J. Tags: Electronic poster abstracts Source Type: research

P-014 A Six-Sigma Approach for Decreasing Door To Needle Times In Endovascular Stroke Therapy
ConclusionA protocol driven process can significantly improve efficiency of care in the time-sensitive stroke interventions.DisclosuresA. Rai: 1; C; stryker Neurovascular. 2; C; stryker Neurovascular. M. Smith: None. S. Boo: None. A. Tarabishy: None. G. Hobbs: None. J. Carpenter: None.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Rai, A., Smith, M., Boo, S., Tarabishy, A., Hobbs, G., Carpenter, J. Tags: Oral poster abstracts Source Type: research

E-069 Stroke thrombectomy patient selection: sex differences in collateral circulation
Conclusion Although this pilot study did not prove a significant association between poor collateral scores (0-1) and patient sex, there were higher rates of poorer collaterals and lower rates of favorable collaterals among men. Differences in collateral circulation would not appear to explain why women have poorer outcomes after post-thrombectomy, or a clear trend towards poorer collaterals among women would be expected. An analysis of a larger patient sample might yield a stronger association; for now, the sex disparity in stroke functional outcomes among thrombolysed patients remains unclear. Disclosures: K. Keppetipo...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Keppetipola, K., Davison, M., Dua, S., Ouyang, B., Chen, M. Tags: Electronic Poster Abstracts Source Type: research

O-005 Utility of aspects region location in predicting stroke thrombectomy outcomes
Conclusions In the entire cohort, the insula, M5, and lentiform nuclei were the most commonly affected ASPECTS-based regions but were not significantly associated with poor clinical outcomes. The M4 and M6 ASPECTS–based regions were most predictive of decreased long-term functional independence. These results may assist the future use of weighted ASPECTS-based region scoring to improve the utility of this tool for stroke thrombectomy patient selection. Abstract O-005 Figure 1 Disclosures K. Fukuda: None. K. Keppetipola: None. M. Davison: None. M. Chen: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Fukuda, K., Keppetipola, K., Davison, M., Chen, M. Tags: Oral Abstracts Source Type: research

Endovascular recanalization of complete subacute to chronic atherosclerotic occlusions of intracranial arteries
Conclusions Endovascular recanalization can be performed with an acceptable safety profile in selected patients with symptomatic complete subacute to chronic intracranial atherosclerotic occlusion. Additional studies are warranted to investigate whether this treatment compares favorably with best medical management.
Source: Journal of NeuroInterventional Surgery - October 7, 2014 Category: Neurosurgery Authors: Aghaebrahim, A., Jovin, T., Jadhav, A. P., Noorian, A., Gupta, R., Nogueira, R. G. Tags: Editor''s choice, Ischemic stroke Source Type: research

O-010 Clinical imaging mismatch versus perfusion imaging mismatch selection for stroke patients undergoing mechanical thrombectomy
Conclusion We were unable to demonstrate a difference between the PIM and CCM selection modalities in the prediction of clinical outcomes. However, PIM seems to unjustifiably disqualify a significant proportion of patients that still benefit from reperfusion. In contrast with CCM, the existence of PIM does not seem to be a good discriminator of good outcomes. Future prospective studies are warranted. Disclosures J. Grossberg: None. M. Bouslama: None. D. Haussen: None. L. Rebello: None. M. Frankel: None. R. Nogueira: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Grossberg, J., Bouslama, M., Haussen, D., Rebello, L., Frankel, M., Nogueira, R. Tags: Oral Abstracts Source Type: research

Perceived acceptable uncertainty regarding comparability of endovascular treatment alone versus intravenous thrombolysis plus endovascular treatment
Conclusion Physicians would generally feel comfortable skipping IVT before EVT at different certainty thresholds. Most physicians would treat with EVT alone if randomized trial data suggested that the number of patients achieving functional independence at 90 days was similar between the two groups, and one could be sufficiently sure that no more than 3 out of 100 patients would not achieve functional independence at 90 days due to skipping IVT.
Source: Journal of NeuroInterventional Surgery - February 14, 2023 Category: Neurosurgery Authors: Kaesmacher, J., Mujanovic, A., Treurniet, K., Kappelhof, M., Meinel, T. R., Yang, P., Liu, J., Zhang, Y., Zi, W., Yang, Q., Nogueira, R. G., Kimura, K., Matsumaru, Y., Suzuki, K., Yan, B., Mitchell, P. J., Miao, Z., Roos, Y. B. W. E. M., Majoie, C. B. L. 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

A survey of neurointerventionalists on thrombectomy practices for emergent large vessel occlusions
Conclusions This survey of predominantly academic SNIS physicians indicates that inpatient consultations, hospital to hospital transfers, and thrombectomy procedural volumes have increased modestly since the publication of the five major stroke trials this year. In addition, many respondents indicated an increase in aggressiveness in pursuing thrombectomy based on selection criteria.
Source: Journal of NeuroInterventional Surgery - January 12, 2017 Category: Neurosurgery Authors: Fargen, K. M., Arthur, A. S., Spiotta, A. M., Lena, J., Chaudry, I., Turner, R. D., Turk, A. S. Tags: Ischemic stroke Source Type: research

Multicenter assessment of morbidity associated with cerebral arteriovenous malformation hemorrhages
Conclusions The morbidity associated with cerebral AVM rupture appeared to be higher in our study than previously reported. Morbidity from AVM rupture should be considered as an important factor, together with variables such as risk of AVM rupture and procedural risk, in determining the optimal treatment strategy for unruptured cerebral AVMs.
Source: Journal of NeuroInterventional Surgery - June 16, 2017 Category: Neurosurgery Authors: Fukuda, K., Majumdar, M., Masoud, H., Nguyen, T., Honarmand, A., Shaibani, A., Ansari, S., Tan, L. A., Chen, M. Tags: Hemorrhagic stroke Source Type: research

E-008 Variation in subarachnoid hemorrhage presentation and demographics in California during the COVID-19 pandemic: A UC stroke consortium study
ConclusionsCOVID19(+) patients presenting with SAH were younger than COVID(-) controls, and there was a trend toward underrepresentation of Hispanic patients in the COVID(+) group. Recognizing COVID19 status as a factor in SAH presentation is important to mitigate healthcare disparities in California.Disclosures A. Gautam: None. T. Caton: None. K. Narsinh: None. A. Baker: None. S. Hetts: None. D. Cooke: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Gautam, A., Caton, T., Narsinh, K., Baker, A., Hetts, S., Cooke, D. Tags: Electronic poster abstracts Source Type: research

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