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Combined balloon guide catheter, aspiration catheter, and stent retriever technique versus balloon guide catheter and stent retriever alone technique: a systematic review and meta-analysis
Conclusion There was no significant difference in successful reperfusion and FPE between the combined techniques and the stent retriever and BGC alone groups. Neither was there any difference in functional outcomes, complications, or mortality.
Source: Journal of NeuroInterventional Surgery - January 11, 2023 Category: Neurosurgery Authors: Teo, Y. N., Sia, C.-H., Tan, B. Y. Q., Mingxue, J., Chan, B., Sharma, V. K., Makmur, A., Gopinathan, A., Yang, C., Loh, S., Ng, S., Ong, S. J., Teoh, H.-L., Rathakrishnan, R., Andersson, T., Arnberg, F., Gontu, V. K., Lee, T.-h., Maus, V., Meyer, L., Bhog Tags: Ischemic stroke Source Type: research

Triple therapy versus dual-antiplatelet therapy for dolichoectatic vertebrobasilar fusiform aneurysms treated with flow diverters
Conclusions Patients with DVBFAs treated with FD in the TT group had fewer ischemic strokes, less symptom progression, and overall better outcomes at last follow-up than similar patients in the DAPT group.
Source: Journal of NeuroInterventional Surgery - June 16, 2023 Category: Neurosurgery Authors: Siddiqui, A. H., Monteiro, A., Hanel, R. A., Kan, P., Mohanty, A., Cortez, G. M., Rabinovich, M., Matouk, C., Sujijantarat, N., Romero, C., Stone, J., Ebersole, K., Fry, L., Natarajan, S. K., Owusu-Adjei, B., Ortega-Gutierrez, S., Vivanco-Suarez, J., Wakh Tags: Hemorrhagic stroke Source Type: research

O-041 Primary results of the pRESET for occlusive stroke treatment (PROST) randomized clinical trial
Conclusions and RelevancePROST is the first randomized clinical trial aiming to compare a novel versus an established stent-retriever technology, establishing a new scientific benchmark for stroke device trials. In all primary & secondary endpoints and analysis, the pre-specified threshold of non-inferiority was met.(ClinicalTrials.gov: NCT03994822)Disclosures R. Hanel: 1; C; NIH, Interline Endowment, Microvention, Stryker, CNX, Balt. 2; C; Medtronic, Stryker, Cerenovus, Microvention, Phenox, Rapid Medical, Q’Apel. 4; C; InNeuroCo, Cerebrotech, eLum, Endostream, Three Rivers Medical Inc, Scientia, RisT, BlinkTBI,...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Hanel, R., Klisch, J., Möhlenbruch, M., Vollherbst, D., Ulfert, C., Bozorgchami, H., Samaniego, E., Liebeskind, D., Lobsien, D., Pielenz, D., Sauvageau, E., Aghaebrahim, A., Clark, W., Priest, R., Ortega-Gutierrez, S., Lopes, D., Billingsley, J., Tags: SNIS 20th annual meeting oral abstracts Source Type: research

P-023 Initial experience with transcranial ultrasound through sonolucent cranioplasty after hemicraniectomy for ischemic and hemorrhagic stroke
ConclusionTranscranial ultrasound through large, customized sonolucent cranioplasty is safe and feasible after decompressive hemicraniectomy. This imaging technique may alleviate the cost, transport, and radiation burden of CT in select ICH patients.Abstract P-023 Figure 1Disclosures C. Rossitto: None. H. Tabani: None. A. Reynolds: None. C. Kellner: 1; C; CPK receives research funding from Longeviti Neuro Solutions, Penumbra, Integra, Viz.AI, Minnetronix, Siemens, and Cerebrotech.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Rossitto, C., Tabani, H., Reynolds, A., Kellner, C. Tags: SNIS 20th annual meeting oral poster abstracts Source Type: research

E-059 Endovascular thrombectomy after acute ischemic stroke of the basilar artery: a meta-analysis of four randomized controlled trials
ConclusionsEVT conferred significant patient benefit over MEDT alone in the treatment of PC-LVO. Future studies should better define patients in whom EVT is futile and determine factors that contribute to higher rates of sICH.Disclosures G. Adusumilli: None. H. Kobeissi: None. S. Ghozy: None. N. Hardy: 4; C; Nested Knowledge, Inc. 5; C; Nested Knowledge, Inc. K. Kallmes: 4; C; Nested Knowledge, Inc, Superior Medical Experts, Inc. 5; C; Nested Knowledge, Inc, Conway Medical LLC. K. Hutchison: 5; C; Nested Knowledge, Inc. D. Kallmes: 1; C; MicroVention, Medtronic, Balt, Insera Therapeutics. 2; C; Vesalio. 4; C; Nested Knowle...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Adusumilli, G., Kobeissi, H., Ghozy, S., Hardy, N., Kallmes, K., Hutchison, K., Kallmes, D., Brinjikji, W., Albers, G., Heit, J. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-275 Endovascular therapy for acute stroke with a large ischemic region: a systematic review and meta-analysis
ConclusionOur study suggests that EVT might be an effective and relatively safe treatment option for the treatment of patients with large core infarcts, although more large-scale trials are needed to consolidate the results and to make inclusion criteria and the patient selection process clearer.Disclosures A. Mowla: 2; C; Speakers Bureau/Consultant to Cerenovus, Stryker, Wallaby Medical, RapidAI , BALT USA,LLC.. 3; C; Speakers Bureau/Consultant to Cerenovus, Stryker, Wallaby Medical, RapidAI , BALT USA,LLC.. S. Abdollahifard: None. E. Taherifard: None. A. Sadeghi: None. P. Rakhshandeh Hassan Kiadeh: None. O. Yousefi: None.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Mowla, A., Abdollahifard, S., Taherifard, E., Sadeghi, A., Rakhshandeh Hassan Kiadeh, P., Yousefi, O. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

Rethinking the role of CT perfusion in the management of emergent large vessel ischemic stroke
The treatment of emergent large vessel occlusion (ELVO) was revolutionized by endovascular thrombectomy (EVT). The identification of eligible patients for EVT has sparked significant interest in determining the neuroimaging modality that offers optimal results. The American Stroke Association recommend the use of both non-contrast CT and CT angiogram for patients coming in the early window (0–6 hours).1 In the late window (6–24 hours) the randomized trials, DAWN and DEFUSE 3, showed clinical benefit utilized some form of quantitative estimation of the core infarct.2 3 Consequently the society recommends automat...
Source: Journal of NeuroInterventional Surgery - August 17, 2023 Category: Neurosurgery Authors: Diestro, J. D. B. Tags: Editor ' s column Source Type: research

Clinical evidence comparing bridging and direct endovascular thrombectomy: progress and controversies
This study aimed to analyze the progress and controversies in clinical evidence based on current meta-analyses. Three databases, including MEDLINE, EMBASE, and the Cochrane Library, were searched. Relevant data were extracted and reviewed from the pooled studies. The Assessment of Multiple Systematic Review (AMSTAR-2) was used for quality assessment. Twenty-five meta-analyses were finally included. There were 56% (14/25) from Asian countries, 20% (5/25) from North America, and 24% (6/25) from Europe. The majority (72%, 18/25) of evidence arose in a short period from 2020 to 2022 with the serial publication of four randomiz...
Source: Journal of NeuroInterventional Surgery - August 17, 2023 Category: Neurosurgery Authors: Bai, X., Fu, Z., Wang, X., Song, C., Xu, X., Li, L., Feng, Y., Dmytriw, A. A., Regenhardt, R. W., Sun, Z., Yang, B., Jiao, L. Tags: Ischemic stroke Source Type: research

Long-term outcomes of flow diversion for unruptured intracranial aneurysms: a systematic review and meta-analysis
Conclusion Flow diverters are safe and effective in short- and long-term follow-up and rarely cause serious delayed side effects.
Source: Journal of NeuroInterventional Surgery - August 17, 2023 Category: Neurosurgery Authors: Shehata, M. A., Ibrahim, M. K., Ghozy, S., Bilgin, C., Jabal, M. S., Kadirvel, R., Kallmes, D. F. Tags: Hemorrhagic stroke Source Type: research

Intracranial hemorrhage in large vessel occlusion patients receiving endovascular thrombectomy with or without intravenous alteplase: a secondary analysis of the DIRECT-MT trial
Conclusions Our data showed that in the DIRECT-MT trial, alteplase did not increase overall ICH for large vessel occlusion patients treated with thrombectomy, but it increased the parenchymal hematoma rate.
Source: Journal of NeuroInterventional Surgery - September 15, 2023 Category: Neurosurgery Authors: Hu, X., Zhou, Y., Ospel, J., Yao, F., Liu, Y., Wang, H., Li, B., Hui, P., Yang, P., Zhang, Y., Zhang, L., Li, Z., Xing, P., Shi, H., Han, H., Wang, S., Fang, Q., Liu, J., for the Direct-MT investigators Tags: Open access, Ischemic stroke Source Type: research

Bridging thrombolysis improves survival rates at 90 days compared with direct mechanical thrombectomy alone in acute ischemic stroke due to basilar artery occlusion: a systematic review and meta-analysis of 1096 patients
Conclusions In patients with AIS due to BAO, bridging IVT was associated with lower mortality rates at 90 days, compared with direct MT. There were no improved functional outcomes or increased sICH or SAH between both arms, However, patients with LAA benefited from bridging IVT, with better functional outcomes.
Source: Journal of NeuroInterventional Surgery - September 15, 2023 Category: Neurosurgery Authors: Lee, K. S., Siow, I., Zhang, J. J., Syn, N. L., Gillespie, C. S., Yuen, L. Z., Anil, G., Yang, C., Chan, B. P., Sharma, V. K., Teoh, H.-L., Mingxue, J., Teo, K. S. H., Myint, M. Z., Bhogal, P., Meyer, L., Schob, S., Sia, C.-H., Mpotsaris, A., Maus, V., An Tags: Vascular neurology Source Type: research

Persistent perfusion abnormalities at day 1 correspond to different clinical trajectories after stroke
Conclusion ASL hypoperfusion within the infarct and the surrounding tissue was associated with poor outcome. A more comprehensive view of the mechanisms in the hypoperfused surrounding tissue could help to design new therapeutic approaches during and after reperfusion therapies.
Source: Journal of NeuroInterventional Surgery - August 29, 2023 Category: Neurosurgery Authors: Rosso, C., Belkacem, S., Amor-Sahli, M., Clarencon, F., Leger, A., Baronnet, F., Dormont, D., Alamowitch, S., Lehericy, S., Samson, Y. Tags: Ischemic stroke Source Type: research

Stroke imaging modality for endovascular therapy in the extended window: systematic review and meta-analysis
Conclusions Our study suggests that, in anterior circulation LVO, the rates of functional independence may be similar when patients are selected using ADVI or NCCT for EVT in the extended time window. A simplified triage protocol does not seem to increase mortality or sICH. Protocol registration number (PROSPERO ID: CRD42021236092).
Source: Journal of NeuroInterventional Surgery - August 29, 2023 Category: Neurosurgery Authors: Sequeiros, J. M., Rodriguez-Calienes, A., Chavez-Malpartida, S. S., Moran-Marinos, C., Alvarado-Gamarra, G., Malaga, M., Quincho-Lopez, A., Hernadez-Fernandez, W., Pacheco-Barrios, K., Ortega-Gutierrez, S., Hoit, D., Arthur, A. S., Alexandrov, A. V., Alva Tags: Ischemic stroke Source Type: research

Influence of time metrics on the treatment effect of intravenous alteplase prior to endovascular treatment in MR CLEAN-NO IV
Conclusion In MR CLEAN-NO IV, the effect of IVT prior to EVT was not modified by OTR, OTN, DTG or NTG times. Our results do not support the use of these metrics to guide IVT treatment decisions prior to EVT in comprehensive stroke centres. Trial registration number ISRCTN80619088.
Source: Journal of NeuroInterventional Surgery - August 29, 2023 Category: Neurosurgery Authors: Rinkel, L. A., Treurniet, K. M., Kappelhof, M., LeCouffe, N. E., Bruggeman, A. A. E., Nieboer, D., van Zwam, W. H., Uyttenboogaart, M., Dippel, D. W. J., Emmer, B. J., Roos, Y. B. W. E. M., Majoie, C. B. L. M., Coutinho, J. M., on behalf of the MR CLEAN-N Tags: Ischemic stroke Source Type: research

Impact of aspiration catheter size on clinical outcomes in aspiration thrombectomy
Conclusions Larger aspiration catheters are associated with a higher rate of FPE, final recanalization with only an aspiration catheter, and in cases with rescue modalities, though with a higher rate of hemorrhagic complications. These findings confirm that aspiration catheter size functions as a variable in aspiration thrombectomy, which should be considered in future study and trial design.
Source: Journal of NeuroInterventional Surgery - August 29, 2023 Category: Neurosurgery Authors: Schartz, D., Ellens, N., Kohli, G. S., Rahmani, R., Akkipeddi, S. M. K., Colby, G. P., Hui, F., Bhalla, T., Mattingly, T., Bender, M. T. Tags: Ischemic stroke Source Type: research

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