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Do we need CT perfusion for stroke patients? Define your terms
‘If you wish to converse with me,’ said Voltaire, ‘define your terms.’ How many a debate would have been deflated into a paragraph if the disputants had dared to define their terms! — Will Durant.1 We love debates. They are entertaining. They sharpen and clarify viewpoints but they could bypass the thought processes behind them. Very often, differences in opinion can be explained by different assumptions and expectations based on available resources. Moreover, those involved in the debate may not be fully aware of their own assumptions and biases often defending the situation in the home insti...
Source: Journal of NeuroInterventional Surgery - August 12, 2022 Category: Neurosurgery Authors: Fiehler, J. Tags: Editor ' s column Source Type: research

Non-contrast head CT alone for thrombectomy in acute ischemic stroke: analysis of the ANGEL-ACT registry
Conclusions In patients selected for MT using NCHCT alone versus NCHCT + NVI, there were improved procedural outcomes and smaller increases in baseline mRS scores at 90 days.
Source: Journal of NeuroInterventional Surgery - August 12, 2022 Category: Neurosurgery Authors: Ren, Z., Ma, G., Mokin, M., Jadhav, A. P., Jia, B., Tong, X., Bauer, C., Liu, R., Wang, A., Zhang, X., Mo, D., Ma, N., Gao, F., Song, L., Sun, X., Huo, X., Deng, Y., Liu, L., Luo, G., Luo, X., Peng, Y., Gui, L., Song, C., Wu, J., Wang, L., Li, C., Jovin, Tags: Ischemic stroke Source Type: research

E-023 Predictors of outcomes in tandem anterior circulation occlusions following mechanical thrombectomy
In this study, we present outcomes of patients undergoing tandem mechanical thrombectomy. We demonstrate that stenting is associated with improved final reperfusion, but increased odds of asymptomatic ICH. Additional clinical trials should be performed to optimize the procedure and improve patient outcomes.Disclosures J. Catapano: None. D. Farhadi: None. A. Naik: None. S. Koester: None. E. Winkler: None. V. Srinivasan: None. K. Karahalios: None. J. Rulney: None. S. Desai: None. A. Jadhav: None. F. Albuquerque: None. A. Ducruet: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Catapano, J., Farhadi, D., Naik, A., Koester, S., Winkler, E., Srinivasan, V., Karahalios, K., Rulney, J., Desai, S., Jadhav, A., Albuquerque, F., Ducruet, A. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

E-045 A case of left internal carotid artery stroke due to fat embolism from novel cosmetic procedure: a case report
A 28-year old woman was transferred to the emergency room following an acute change in mental status after liposuction and fat harvesting transfer into her gluteal region. She had a forced left-gaze, with right sided hemiplegia where the motor movements did not even respond to painful stimulation, and Babinski’s sign was positive on both the sides. The CT brain - stroke protocol scan was 5.5 h after the liposuction procedure showed a hypoattenuation signal in the left hemisphere and a hypodensity within the left Sylvian fissure, signs of grey-white matter differentiation, with 1mm MLS to the right. NIHSS on admission...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Raza, D. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

E-108 Ruptured intracranial aneurysm presenting as isolated acute subdural hemorrhage
ConclusionIn rare cases, ruptured intracranial aneurysms can be associated with isolated subdural hemorrhage. Common treatment options include endovascular coiling and microsurgical clipping. However, endovascular repair is often preferred especially when the patient may not be able to tolerate a surgical procedure, as was the case with this patient. In this case, the patient presented with stroke-like symptoms and was found to have a subdural hemorrhage. After emergent craniotomy to evacuate the hematoma, successful endovascular coiling was performed, and the patient was stabilized for further management>Disclosures D....
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Babici, D., Johansen, P., Newman, S., Packer, E., Snelling, B. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

E-160 Detailed evaluation of brain cone-beam CT imaging artifacts: a prospective stroke series
ConclusionsRecent developments in CB-CT imaging protocols have significantly improved image artifacts, which has improved diagnostic confidence for stroke and support a direct-to-angiosuite transfer approach for acute ischemic stroke patients.Disclosures N. Cancelliere: None. E. Hummel: 5; C; Philips. F. van Nijnatten: 5; C; Philips. P. Nicholson: None. M. van Vlimmeren: 5; C; Philips. B. Hallacoglu: 5; C; Philips. V. Mendes Pereira: 1; C; Philips.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Cancelliere, N., Hummel, E., van Nijnatten, F., Nicholson, P., van Vlimmeren, M., Hallacoglu, B., Mendes Pereira, V. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

E-161 Optimal parameter for predicting final infarct volume and outcome after complete recanalization of medium vessel stroke
ConclusionTMax>10sec volume on baseline CTP predicts final-infarct-volume and progression as-well-as clinical outcome after MT recanalization for AIS with DMVO.Disclosures A. Guenego: None. B. Lubicz: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Guenego, A., Lubicz, B. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

E-176 Endovascular stent retriever thrombectomy of medium and small vessel occlusion of the middle cerebral artery with acute ischemic stroke: a case series
ConclusionsOur case series demonstrated that SRMT in SVO with disabling NIHSS is feasible and safe if performed carefully. All patient achieved TICI 3 perfusion and first pass effect was better observed in trap technique and use of long solitaire STD. Good function outcomes were achieved in all cases irrespective of the types of SRD used and passes required to achieve TICI 3 perfusion. Further studies are required.Disclosures Y. Lodi: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Lodi, Y. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

E-192 Association of myeloperoxidase-DNA complexes and high mobility group box 1 protein with delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage
High mobility group box 1 protein (HMGB1) serves as a key player in aseptic inflammation. Admission serum HMGB1 has been identified as a biomarker predictive of delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage (aSAH). Released by leucocytes and platelets, HMGB1 induces neutrophils to release condensed chromatin and protein granules, termed neutrophil extracellular traps (NETs). Myeloperoxidase (MPO)-DNA complexes are one major NET biomarker and have been associated with arterial and venous thrombosis formation. The prevalence and role of MPO-DNA in aSAH remains to be determined.A post-hoc analysis of ...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Hendrix, P., Witsch, J., Spalart, V., Martinod, K., Schneider, H., Oertel, J., Geisel, J., Hemmer, S. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

O-064 AI based gaze deviation detection to aid LVO diagnosis in NCCT
ConclusionsIpsiversive Gaze deviation on NCCT is a good predictor of LVO due to proximal vessel occlusions in ICA terminus and M1 occlusions. However, it is a poor predictor of LVO due to M2 occlusion. We report an AI algorithm that can identify this clinical sign on NCCT. These findings can aid in the triage of LVO patients and expedite the identification of EVT candidates.Abstract O-064 Figure 1Disclosures U. Upadhyay: None. S. Golla: None. S. Kumar: None. K. Szweda: None. R. Shahripour: None. J. Tarpley: 2; C; Qure.ai – Modest, Medtronic – Modest, Stryker – Modest.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Upadhyay, U., Golla, S., Kumar, S., Szweda, K., Shahripour, R., Tarpley, J. Tags: SNIS 19th annual meeting oral abstracts Source Type: research

P-024 Balloon guide catheter use for stroke intervention: does the access site matter?
ConclusionsPatients treated with MT via TFA or sTRA had similar angiographic and clinical outcomes, differing only in the rate of crossover from one approach to another.Abstract P-024 Table 1TFA and sTRA Variable RadialN=30 FemoralN=63 P-value Age; mean (SD) 70.9 (13.9) 72.7 (11.4) 0.504 Women, n (%) 13 (43.3) 35 (55.6) 0.375 Diabetes, n (%) 7 (23.3) 18 (28.6) 0.629 Hypertension, n (%) 22 (73.3) 52 (82.5) 0.409 Hyperlipidemia, n (%) 18 (60) 30 (47.6) 0.278 Atrial fibrillation, n (%) 13 (43.3) 24 (38.1) 0.656 NIHSS at admission; mean (SD) 15 (8) 16 (6) 0.131 Intravenous alteplase, n (%) 10 (33.3) 20 (31.7) 1 ICA occlusion,...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Waqas, M., Monteiro, A., Cappuzzo, J., Dossani, R., Almayman, F., Metcalf-Doetsch, W., Snyder, K., Davies, J., Siddiqui, A., Levy, E. Tags: SNIS 19th annual meeting oral poster abstracts Source Type: research

P-025 Evaluation of pure subarachnoid hemorrhage after mechanical thrombectomy in a series of 781 consecutive patients
ConclusionSubarachnoid hyperdensity in head CT scans within the first 24 hours after mechanical thrombectomy is relatively archetypal. The issue arises in discriminating between pure contrast stagnation and other bleeding types to conduct a more specific treatment for patients with such complications, even though SAH post-thrombectomy carries a favorable prognosis.Disclosures V. Benalia: None. G. Cortez: None. A. Aghaebrahim: None. E. Sauvageau: None. R. Hanel: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Benalia, V., Cortez, G., Aghaebrahim, A., Sauvageau, E., Hanel, R. Tags: SNIS 19th annual meeting oral poster abstracts Source Type: research

Outcomes of endovascular thrombectomy in patients selected by computed tomography perfusion imaging - a matched cohort study comparing nonagenarians to younger patients
Conclusions Nonagenarians were noted to have greater mortality and sICH rates following EVT compared with matched younger patients, which may be ameliorated by selecting patients with smaller CTP core volumes. Nonagenarians undergoing EVT had similar rates of successful reperfusion and functional independence compared with the younger cohort.
Source: Journal of NeuroInterventional Surgery - July 14, 2022 Category: Neurosurgery Authors: Rahangdale, R., Hackett, C. T., Cerejo, R., Fuller, N. M., Malhotra, K., Williamson, R., Hentosz, T., Tayal, A. H., Rana, S. S. Tags: Editor''s choice, Ischemic stroke Source Type: research

Definition and time course of pericavity edema after minimally invasive endoscopic intracerebral hemorrhage evacuation
Conclusions We present a detailed and accurate method for measuring PCE volume with semi-automatic, threshold-guided segmentation software in the postoperative patient with ICH. Decrease in PCE after MIS evacuation correlated with evacuation percentage, and relative PCE remained stable after minimally invasive endoscopic ICH evacuation.
Source: Journal of NeuroInterventional Surgery - January 18, 2022 Category: Neurosurgery Authors: Horowitz, M. E., Ali, M., Chartrain, A. G., Allen, O. S., Scaggiante, J., Glassberg, B., Sakai, Y., Turkheimer, L., Song, R., Martini, M. L., Zhang, X., Mocco, J., Kellner, C. P. Tags: Hemorrhagic stroke Source Type: research

Dynamics of cerebral perfusion and oxygenation parameters following endovascular treatment of acute ischemic stroke
Conclusions Our study demonstrates that the ischemic penumbra is the key target of successful EVT in patients with AIS and largely determines its efficacy on a tissue level. Furthermore, we confirm the validity of the mTICI score as a surrogate parameter of interventional success on a tissue perfusion level.
Source: Journal of NeuroInterventional Surgery - January 18, 2022 Category: Neurosurgery Authors: Brugnara, G., Herweh, C., Neuberger, U., Bo Hansen, M., Ulfert, C., Mahmutoglu, M. A., Foltyn, M., Nagel, S., Schönenberger, S., Heiland, S., Ringleb, P. A., Bendszus, M., Möhlenbruch, M., Pfaff, J. A. R., Vollmuth, P. Tags: Open access, Neuroimaging Source Type: research

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