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Proatlantal intersegmental artery with internal carotid artery stenosis
A 56-year-old man presented with vertigo of 4 days duration. Neurologic examination was unremarkable. CT angiograms revealed a right internal carotid artery (ICA) stenosis and an ipsilateral proatlantal intersegmental artery (PIA, type 1). The PIA arose from the ICA, ran upward, then took a dorsal course, and continued as the vertebral artery, serving as the major contributor of the posterior circulation (figure, A–C). Catheter-based angiogram showed ICA stenosis of 60% (figure, D). He chose drug therapy and remained asymptomatic on follow-up. Such combination can lead to TIA of the vertebrobasilar system; treatment ...
Source: Neurology - July 3, 2017 Category: Neurology Authors: Yu, W., Feng, Z., Zhao, C., Fu, C. Tags: CT, All Clinical Neurology, All Cerebrovascular disease/Stroke NEUROIMAGES Source Type: research

Body mass index and outcome after revascularization for symptomatic carotid artery stenosis
Conclusions: BMI is not associated with periprocedural risk of stroke or death; however, BMI 25–<30 is associated with lower postprocedural risk than BMI 20–<25. These observations were similar for CAS and CEA.
Source: Neurology - May 22, 2017 Category: Neurology Authors: Volkers, E. J., Greving, J. P., Hendrikse, J., Algra, A., Kappelle, L. J., Becquemin, J.-P., Bonati, L. H., Brott, T. G., Bulbulia, R., Calvet, D., Eckstein, H.-H., Fraedrich, G., Gregson, J., Halliday, A., Howard, G., Jansen, O., Roubin, G. S., Brown, M. Tags: Stroke prevention, Clinical trials Systematic review/meta analysis, Risk factors in epidemiology, Infarction ARTICLE Source Type: research

Neurointerventional management in web vessels (P5.279)
Conclusions:Although few cases are reported in the literature, the stroke rate is high in this group of patients. Therefore all patients with this diagnosis must be treated. Endovascular treatment is presented as an effective form of treatment associated to a low morbidity rate and no ischemic event recurrences.Disclosure: Dr. Piske has nothing to disclose. Dr. Schmid has nothing to disclose. Dr. Pereira has nothing to disclose. Dr. Tosello has nothing to disclose. Dr. Batista has nothing to disclose. Dr. Sandes has nothing to disclose. Dr. Teixeira has nothing to disclose. Dr. Baeta has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Piske, R., Schmid, M., Pereira, B., Tosello, R., Batista, U., Sandes, J., Teixeira, H., Baeta, A. Tags: SubAcute Interventional Therapies in Cerebrovascular Disease Source Type: research

Recurrent Spells of Unresponsiveness Secondary to Bilateral Carotid Stenosis Caused by Giant Cell Arteritis (P4.373)
Conclusions: The presence of bilateral carotid stenosis in patients with GCA is strongly associated with future risk of neurologic deficits. A vertebrobasilar steal syndrome may be a manifestation of bilateral, severe carotid stenosis. It may be difficult to separate atherosclerotic lesions from vasculitic lesions related to GCA, however, the presence of localized focal stenosis with relatively healthy arteries above and below the lesions may point to a vasculitic process. Rigorous attention should be given to modification of atherosclerotic risk factors as well as recognizing and treating the rare manifestation of GCA.Dis...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Wahba, M. Tags: Cerebrovascular Case Reports Source Type: research

Intraarterial Treatment for Acute Ischemic Stroke due to Dissection: Retrospective Series of 24 Cases (P4.382)
Conclusions: Despite the additional intravascular risk, these results suggest the utility of IAT in patients with dissection.Disclosure: Dr. Jensen has nothing to disclose. Dr. Salottolo has nothing to disclose. Dr. McCarthy has nothing to disclose. Dr. Frei has received personal compensation for activities with Microvention, Covidien, Stryker, Siemens, and Penumbra as a consultant. Dr. Loy has nothing to disclose. Dr. Wagner has received personal compensation for activities with Genentech, Inc., as a speakers bureau member. Dr. Whaley has received personal compensation for activities with Clinical Data Management/Neurobas...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Jensen, J., Salottolo, K., McCarthy, K., Frei, D., Loy, D., Wagner, J., Whaley, M., Bar-Or, D. Tags: Non-Atherosclerotic Arteriopathies Source Type: research

Prevalence, Risk Factors, and Clinical Significance of Asymptomatic Extracranial Vertebral Artery Disease in Patients with Symptomatic Internal Carotid Artery Stenosis: Analysis of Stent-Protected Angioplasty versus Carotid Endarterectomy (SPACE) Trial (S42.002)
Conclusions: There appears to be an increased risk of stroke and death in patients with symptomatic internal carotid artery stenosis with concurrent asymptomatic extracranial vertebral artery stenosis. Key words: Extracranial vertebral artery; carotid stenosis; vertebral artery stenosis; vertebral artery occlusion; stroke; death.Disclosure: Dr. Qureshi has nothing to disclose. Dr. Chaudhry has nothing to disclose. Dr. Jansen has nothing to disclose. Dr. Eckstein has nothing to disclose. Dr. Ringleb has nothing to disclose.
Source: Neurology - February 7, 2016 Category: Neurology Authors: Qureshi, A., Chaudhry, S., Jansen, O., Eckstein, H.-H., Ringleb, P. Tags: Stroke Mechanism and Modifiers Source Type: research

Low fixed dose of IV heparin as adjunct to internal carotid artery angioplasty and stent placement in patients with recent ischemic symptoms: A prospective protocol (P2.263)
CONCLUSION: Fixed low dose intravenous heparin as adjunct to CAS in patients with carotid artery stenosis and recent ischemic symptoms is associated with acceptable rates of adverse events and low rates of bleeding complications.Disclosure: Dr. Suri has nothing to disclose. Dr. Jahangir has nothing to disclose. Dr. Qureshi has nothing to disclose. Dr. Qureshi has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Suri, M., Jahangir, N., Qureshi, M., Qureshi, A. Tags: Cerebrovascular Disease and Interventional Neurology: Carotid Disease and IMT Source Type: research

Endovascular management and outcome of acute middle cerebral artery stroke in the setting of spontaneous carotid dissection (P1.012)
Conclusion: This study provides additional evidence that endovascular management of carotid artery dissection in acute middle cerebral artery is effective and safe to maintain distal revascularization. Revascularization can be achieved with a combination of stenting, large catheter mediated angioplasty and thrombectomy. Further studies are warranted to investigate the role of endovascular recanalization for this stroke subtypeDisclosure: Dr. Gulati has nothing to disclose. Dr. Aghaebrahim has nothing to disclose. Dr. Ducruet has nothing to disclose. Dr. Jankowitz has nothing to disclose. Dr. Jovin has received personal com...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Gulati, D., Aghaebrahim, A., Ducruet, A., Jankowitz, B., Jovin, T., Jadhav, A. Tags: Cerebrovascular Disease and Interventional Neurology I ePosters Source Type: research

The Cost Per Stroke Prevented (CPSP) from Symptomatic Carotid Artery Stenosis in Ontario, Canada (S51.006)
CONCLUSIONS: The CPSP if done within the recommended time-frame for our virtual population would be $25,326. Recent data from Ontario demonstrates that between 8-36% of carotid artery revascularizations occur within the suggested timeframe. Most carotid artery revascularizations in Ontario have a CPSP of $75,978 (median time for revascularization is between 1-3 months). This represents a clear inefficiency in the system. Further research and government wide initiatives could be aimed at increasing the awareness of the CPSP in order to facilitate policy makers and other stakeholders to develop pathways to ensure prompt trea...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Turkel-Parrella, D., de Oliveira Manoel, A., Marotta, T., Spears, J. Tags: Cerebrovascular Disease and Interventional Neurology: Large Vessel Atherosclerotic Disease Source Type: research

Can Patient or Arterial Characteristics Guide the Choice between Carotid Angioplasty and Carotid Endarterectomy? The Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST) (P01.225)
CONCLUSIONS: Beyond the previously described differential treatment efficacy by age, there were no other patient or arterial characteristic detected to identify patient subgroups that would differentially benefit from the choice of CAS versus CEA. Our inability to identify factors to guide treatment choices could be due to the low number of stroke and death events, incomplete information regarding arterial characteristics in the CEA population, or the potential exclusion of "high risk" groups (such as those with severe arterial tortuosity) from the study.Disclosure: Dr. Moore has nothing to disclose. Dr. Roubin has receive...
Source: Neurology - February 14, 2013 Category: Neurology Authors: Moore, W., Roubin, G., Rosenfield, K., Altafullah, I., Ansel, G., Voeks, J., Meschia, J., Lal, B., Howard, G., Brott, T. Tags: P01 Cerebrovascular Disease I Source Type: research

Management of Tandem Occlusion Stroke with Endovascular Therapy (P01.230)
CONCLUSIONS: In cases of tandem occlusions of ICA and MCA, multimodal therapy consistent of intravenous thrombolysis and/or extracranial ICA stenting and intracranial thrombectomy to achieve recanalization may be a safe and efficacious therapeutic option for recanalization. Further prospective studies are warranted.Disclosure: Dr. Guerrero has nothing to disclose. Dr. Dababneh has nothing to disclose. Dr. Mocco has received personal compensation for activities with Concentric Inc as a consultant. Dr. Peters has received personal compensation for activities with Toshiba as a speakers bureau member. Dr. Waters has nothing to disclose.
Source: Neurology - February 14, 2013 Category: Neurology Authors: Guerrero, W., Dababneh, H., Mocco, J., Peters, K., Waters, M. Tags: P01 Cerebrovascular Disease I Source Type: research