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Overcoming the evening/weekend effects on time delays and outcomes of endovascular stroke therapy: the Calgary Stroke Program experience
Conclusions Some delays were encountered during evenings and weekend hours. Despite that, it was feasible to achieve a relatively short imaging to reperfusion times during these hours, in comparison to existing literature. A target universal time metric is needed to assess the timeliness of endovascular therapy in stroke centers.
Source: Journal of NeuroInterventional Surgery - November 7, 2014 Category: Neurosurgery Authors: Almekhlafi, M. A., Hockley, A., Desai, J. A., Nambiar, V., Mishra, S., Volny, O., Eesa, M., Demchuk, A. M., Menon, B. K., Goyal, M. Tags: Ischemic stroke Source Type: research

Stroke vision, aphasia, neglect (VAN) assessment--a novel emergent large vessel occlusion screening tool: pilot study and comparison with current clinical severity indices
Conclusions The VAN screening tool accurately identified ELVO patients and outperformed a NIHSS ≥6 severity threshold and may best allow clinical teams to expedite care and mobilize resources for ELVO patients. A larger study to both validate this screening tool and compare with others is warranted.
Source: Journal of NeuroInterventional Surgery - January 12, 2017 Category: Neurosurgery Authors: Teleb, M. S., Ver Hage, A., Carter, J., Jayaraman, M. V., McTaggart, R. A. Tags: Open access, Ischemic stroke Source Type: research

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

Streamlining door to recanalization processes in endovascular stroke therapy
Conclusions This pilot study demonstrates that D2P times can be significantly reduced with a standardized multidisciplinary approach. There was no significant difference in the rate of 3-month good outcome, which is most likely due to the small sample size and confounding baseline patient characteristics.
Source: Journal of NeuroInterventional Surgery - March 15, 2017 Category: Neurosurgery Authors: Aghaebrahim, A., Streib, C., Rangaraju, S., Kenmuir, C. L., Giurgiutiu, D.-V., Horev, A., Saeed, Y., Callaway, C. W., Guyette, F. X., Martin-Gill, C., Pacella, C., Ducruet, A. F., Jankowitz, B. T., Jovin, T. G., Jadhav, A. P. Tags: Ischemic stroke Source Type: research

Distinction between contrast staining and hemorrhage after endovascular stroke treatment: one CT is not enough
Conclusions There are no density thresholds for PCHDs that allow predicting the absence or presence of hemorrhage with 100% specificity and acceptable sensitivity. A CT scan performed at least 19–24 h after endovascular therapy is the only reliable method to differentiate contrast staining from hemorrhage.
Source: Journal of NeuroInterventional Surgery - March 15, 2017 Category: Neurosurgery Authors: Dekeyzer, S., Nikoubashman, O., Lutin, B., De Groote, J., Vancaester, E., De Blauwe, S., Hemelsoet, D., Wiesmann, M., Defreyne, L. Tags: Ischemic stroke Source Type: research

Impact of ASPECT scores and infarct distribution on outcomes among patients undergoing thrombectomy for acute ischemic stroke with the ADAPT technique
Conclusions Patients with moderate-sized core infarcts involving various distributions in either hemisphere can potentially achieve similar good outcomes compared with those with no core infarction at presentation. A treatment algorithm for acute ischemic stroke, which employs hardline ASPECTS thresholds or excludes patients with basal ganglia infarcts, might preclude patients who would potentially benefit from mechanical thrombectomy with ADAPT.
Source: Journal of NeuroInterventional Surgery - August 17, 2017 Category: Neurosurgery Authors: Hungerford, J. P., Hyer, M., Turk, A. S., Turner, R. D., Chaudry, M. I., Fargen, K. M., Spiotta, A. M. Tags: Ischemic stroke Source Type: research

Alberta Stroke Program Early CT Score and collateral status predict target mismatch in large vessel occlusion with delayed time windows
Conclusions NCCT ASPECTS had a strong correlation with CTP core volumes in patients with LVO-AIS in delayed time windows. Combining NCCT ASPECTS with sCTA-CS resulted in a more accurate prediction of target mismatch. If a CTP scan is not available, NCCT ASPECTS combined with sCTA-CS may guide clinicians in making treatment decisions.
Source: Journal of NeuroInterventional Surgery - August 17, 2023 Category: Neurosurgery Authors: Hang, Y., Wang, C. d., Ni, H., Cao, Y., Zhao, L. B., Liu, S., Shi, H.-B., Jia, Z. Tags: Ischemic stroke Source Type: research

Endovascular treatment for M2 occlusions in the era of stentrievers: a descriptive multicenter experience
Conclusions Endovascular treatment of M2 MCA occlusion with stentrievers seems safe. Induced recanalization may double the chances of achieving a favorable outcome, especially for patients with moderate or severe deficit.
Source: Journal of NeuroInterventional Surgery - March 12, 2015 Category: Neurosurgery Authors: Flores, A., Tomasello, A., Cardona, P., de Miquel, M. A., Gomis, M., Garcia Bermejo, P., Obach, V., Urra, X., Marti-Fabregas, J., Canovas, D., Roquer, J., Abilleira, S., Ribo, M., on behalf of the Catalan Stroke Code and Reperfusion Consortium (Cat-SCR) Tags: Ischemic stroke Source Type: research

High-resolution scanning electron microscopy for the analysis of three-dimensional ultrastructure of clots in acute ischemic stroke
Conclusions 3D-SEM provides novel and potentially clinically relevant information on clot components and ultrastructure which may help to inform thrombolytic treatment and medical device design.
Source: Journal of NeuroInterventional Surgery - September 15, 2021 Category: Neurosurgery Authors: Mereuta, O. M., Fitzgerald, S., Christensen, T. A., Jaspersen, A. L., Dai, D., Abbasi, M., Puttappa, T., Kadirvel, R., Kallmes, D. F., Doyle, K. M., Brinjikji, W. Tags: Ischemic stroke Source Type: research

E-046 Procedural Efficiency of the Streamlined Launchpad Stroke Admission Paradigm - A Single Center Experience
ConclusionThe streamlined stroke activation Launchpad protocol demonstrated an increased speed in patient admission and significant reduction in time from presentation to CT scan. This significant improvement in processing time allowed for an increased number of patients to meet the therapeutic window for IV tPA eligibility. A prospective trial will strengthen the current finding and support the implementation of this paradigm amongst other stroke centers.DisclosuresK. Sivakumar: None. S. Feuerwerker: None. D. Turkel-Parrella: None. A. Tiwari: None. J. Farkas: None. K. Arcot: None.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Sivakumar, K., Feuerwerker, S., Turkel-Parrella, D., Tiwari, A., Farkas, J., Arcot, K. Tags: Electronic poster abstracts Source Type: research

EP41* Which transfer patients with stroke due to a large-vessel occlusion benefit from CT scan reevaluation prior to mechanical thrombectomy?
ConclusionPatients with age ≥80, NIHSS ≥18, ASPECTS ≤8 or reduced collateral score (modified Tan <2) might benefit from CT scan reevaluation after transfer and prior to MT.ReferencesPsychogios MN, et al. One-stop management of acute stroke patients minimizing door-to-reperfusion times. Stroke 2017.Jadhav AP, et al. Interfacility transfer directly to the neuroangiography suite in acute ischemic stroke patients undergoing thrombectomy. Stroke 2017.Mendez B, et al. Direct transfer to Angio-suite to reduce workflow times and increase favorable clinical outcome a case-control study. Stroke 2018.Requena M, et al. Tim...
Source: Journal of NeuroInterventional Surgery - August 24, 2021 Category: Neurosurgery Authors: Sousa, J., Machado, R., Cruz, L., Paiva-Simoes, J., Santos-Martins, L., Almendra, L., Nunes, C., Machado, C., Rodrigues, B., Galego, O., Nunes, C., Veiga, R., Machado, E., Silva, F., Santo, G., Sargento-Freitas, J. Tags: Imaging Source Type: research

O-020 Novel cone beam CT technology improves image quality for stroke assessment: a prospective series
ConclusionsThe latest generation of CB-CT scans & technology allow for exclusion of haemorrhages, stroke core definition and demonstration of brain perfusion and collaterals. These improvements suggest that CB-CT is acceptable for emergency stroke imaging assessment before mechanical thrombectomy, which may reduce door-to-groin puncture times and improve patient outcomes.ReferenceBourcier R, Goyal M, Liebeskind DS, et al. Association of time from stroke onset to groin puncture with quality of reperfusion after mechanical thrombectomy: a meta-analysis of individual patient data from 7 randomized clinical trials. JAMA Ne...
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Cancelliere, N., Nicholson, P., Nijnatten, F., Hummel, E., Withagen, P., van de Haar, P., Agid, R., Hallacoglu, B., van Vlimmeren, M., Mendes Pereira, V. Tags: Oral abstracts Source Type: research

E-054 Correlation between Thrombus Density and Recanalization or Stroke Etiology in Acute Ischemic Stroke
ConclusionIn conclusion, our study found no relationship between thrombus attenuation and recanalization success or stroke etiology. While prior studies have suggested that higher attenuation is associated with good recanalization, our study could not find such a link.4 More studies are required to identify factors that predict successful recanalization in acute ischemic stroke patients.DisclosuresM. Jagani: None. W. Brinjikji: None. D. Kallmes: 1; C; ev3, MicroVention, Sequent, Codman. 2; C; ev3, Medtronic, Codman. 3; C; Microvention.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Jagani, M., Brinjikji, W., Kallmes, D. Tags: Electronic poster abstracts Source Type: research

O16/158 Artificial Intelligence based nationwide centralised decision supporting system for improving stroke case efficiency in Hungary
ConclusionUsing AI based centralized stroke imaging network fast and reliable decision support can be provided to a large nationwide stroke care system. The system was installed with the support of an EU grant EFOP 5.2.6.Disclosure of InterestIstvan Szikora has a consulting agreement with Brainomix Ltd.Zoltan Chadaide is a former employee of Brainomix Ltd.Edvard Benes is owner and CEO of eRAD-BBThe system was built by the support of an EU grant EFOP 5.2.6.The other authors have no relevant conflict of interest.
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Szikora, I., Magyar, B., Papai, G., Szudi, G., Kondor, M., Czencz, M., Nardai, S., Chadaide, Z., Benes, E., Ovary, C., Eross, L. Tags: 2.2 ISCHEMIC - Imaging Source Type: research

E-088 successful mechanical thrombectomy for basilar artery stroke in a 22-month old child
We present the case of a 22-month-old with basilar artery occlusion successfully treated with mechanical thrombectomy.The patient presented to the emergency department with altered mental status and gait ataxia. She "felt limp", her breathing was shallow, and her gaze dysconjugate. Her medical history included congenital heart defects with multiple cardiac procedures.In the emergency department, she fell with attempted ambulation. Labs were normal, as was a chest x-ray, and EKG. A computerized tomography (CT) scan of the head suggested left cerebellar hemisphere attenuation. The differential included arrhythmia, stroke, or...
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Roark, C., Savastano, L., Wilkinson, D., Shastri, R., Vadlamudi, V., Chaudhary, N., Pandey, A., Gemmete, J. Tags: SNIS 12th Annual Meeting Electronic Poster Abstracts Source Type: research

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