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Predictors of Reperfusion in Patients with Acute Ischemic Stroke BRAIN
CONCLUSIONS: Recanalization and reperfusion are strongly associated but not always equivalent in ischemic stroke. A smaller total ischemic area is the only independent predictor of complete reperfusion.
Source: American Journal of Neuroradiology - June 11, 2015 Category: Radiology Authors: Horsch, A. D., Dankbaar, J. W., Niesten, J. M., van Seeters, T., van der Schaaf, I. C., van der Graaf, Y., Mali, W. P. T. M., Velthuis, B. K., on behalf of the Dutch Acute Stroke Study Investigators Tags: BRAIN Source Type: research

COVID-19 Severity and Stroke: Correlation of Imaging and Laboratory Markers ADULT BRAIN
CONCLUSIONS: Patients with stroke hospitalized with severe COVID-19 are characterized by higher inflammatory, coagulopathy, and tissue-damage biomarkers, supporting proposed pathogenic mechanisms of hyperinflammation activating a prothrombotic state. Cautious balancing of thrombosis and the risk of hemorrhagic transformation is warranted when considering anticoagulation.
Source: American Journal of Neuroradiology - February 9, 2021 Category: Radiology Authors: Katz, J. M., Libman, R. B., Wang, J. J., Filippi, C. G., Sanelli, P., Zlochower, A., Gribko, M., Pacia, S. V., Kuzniecky, R. I., Najjar, S., Azhar, S. Tags: ADULT BRAIN Source Type: research

Characteristics of Large-Vessel Occlusion Associated with COVID-19 and Ischemic Stroke INTERVENTIONAL
SUMMARY: The mechanisms and phenotype of ischemic stroke associated with coronavirus disease 2019 (COVID-19) remain uncertain. A retrospective study was conducted in patients with COVID-19 presenting with ischemic stroke from March 1 to May 25, 2020, and cases with large-vessel occlusion were identified. To provide baseline institutional stroke data within and outside the COVID-19 pandemic, all consecutive ischemic stroke and TIA admissions (COVID and non-COVID) to the hospital during a 10-week period from March 1 to May 10, 2020, were collected and compared with data from the same time period in 2019. Among 20 patients wi...
Source: American Journal of Neuroradiology - December 11, 2020 Category: Radiology Authors: John, S., Kesav, P., Mifsud, V. A., Piechowski-Jozwiak, B., Dibu, J., Bayrlee, A., Elkambergy, H., Roser, F., Elhammady, M. S., Zahra, K., Hussain, S. I. Tags: INTERVENTIONAL Source Type: research

Is Histologic Thrombus Composition in Acute Stroke Linked to Stroke Etiology or to Interventional Parameters? INTERVENTIONAL
CONCLUSIONS: We interpreted the higher macrophage and platelet content in cardioembolic thrombi compared with large-artery atherosclerotic stenosis or embolic stroke of undetermined source thrombi as an indication that the latter type might be derived from an atherosclerotic plaque rather than from an undetermined cardiac source. The extent of thrombus fragmentation was associated with a more challenging mechanical thrombectomy and a higher lymphocyte content of the thrombi. Thus, thrombus fragmentation not only might be caused by the recanalization procedure but also might be a feature of a lymphocyte-rich, difficult-to-r...
Source: American Journal of Neuroradiology - April 8, 2020 Category: Radiology Authors: Goebel, J., Gaida, B.- J., Wanke, I., Kleinschnitz, C., Koehrmann, M., Forsting, M., Moenninghoff, C., Radbruch, A., Junker, A. Tags: INTERVENTIONAL Source Type: research

Multicentric Experience in Distal-to-Proximal Revascularization of Tandem Occlusion Stroke Related to Internal Carotid Artery Dissection INTERVENTIONAL
CONCLUSIONS: Endovascular treatment of internal carotid dissection–related tandem occlusion stroke using the distal-to-proximal recanalization strategy appears to be feasible, with low complication rates and considerable rates of successful recanalization.
Source: American Journal of Neuroradiology - June 13, 2018 Category: Radiology Authors: Marnat, G., Bühlmann, M., Eker, O. F., Gralla, J., Machi, P., Fischer, U., Riquelme, C., Arnold, M., Bonafe, A., Jung, S., Costalat, V., Mordasini, P. Tags: INTERVENTIONAL Source Type: research

Femoral Access-Site Complications with Tenecteplase versus Alteplase before Mechanical Thrombectomy for Large-Vessel-Occlusion Stroke INTERVENTIONAL
CONCLUSIONS: Tenecteplase compared with alteplase before mechanical thrombectomy for large-vessel-occlusion stroke is not associated with an alteration in femoral access-site complication rates.
Source: American Journal of Neuroradiology - June 8, 2023 Category: Radiology Authors: Hendrix, P., Collins, M. K., Goren, O., Weiner, G. M., Dalal, S. S., Melamed, I., Kole, M. J., Griessenauer, C. J., Noto, A., Schirmer, C. M. Tags: INTERVENTIONAL Source Type: research

Emergent Endovascular Management of Long-Segment and Flow-Limiting Carotid Artery Dissections in Acute Ischemic Stroke Intervention with Multiple Tandem Stents EXTRACRANIAL VASCULAR
CONCLUSIONS: Emergent stent reconstruction of long-segment and flow-limiting carotid dissections in acute ischemic stroke intervention is safe and effective, with favorable clinical outcomes, allowing successful thrombectomy, vessel salvage, restoration of cerebral perfusion, and/or prevention of recurrent thromboembolic stroke.
Source: American Journal of Neuroradiology - January 10, 2017 Category: Radiology Authors: Ansari, S. A., Kühn, A. L., Honarmand, A. R., Khan, M., Hurley, M. C., Potts, M. B., Jahromi, B. S., Shaibani, A., Gounis, M. J., Wakhloo, A. K., Puri, A. S. Tags: EXTRACRANIAL VASCULAR Source Type: research

Reduced Leukoaraiosis, Noncardiac Embolic Stroke Etiology, and Shorter Thrombus Length Indicate Good Leptomeningeal Collateral Flow in Embolic Large-Vessel Occlusion ADULT BRAIN
CONCLUSIONS: Among patients with embolic large-vessel occlusion, reduced leukoaraiosis, noncardiac embolism mechanisms including embolisms of arterial or undetermined origin, and shorter thrombus length in cardioembolism are indicators of good collateral flow.
Source: American Journal of Neuroradiology - January 13, 2022 Category: Radiology Authors: Hashimoto, T., Kunieda, T., Honda, T., Scalzo, F., Ali, L., Hinman, J. D., Rao, N. M., Nour, M., Bahr-Hosseini, M., Saver, J. L., Raychev, R., Liebeskind, D. Tags: ADULT BRAIN Source Type: research

Imaging and Treatment of Patients with Acute Stroke: An Evidence-Based Review REVIEW ARTICLES
SUMMARY: Evidence-based medicine has emerged as a valuable tool to guide clinical decision-making, by summarizing the best possible evidence for both diagnostic and treatment strategies. Imaging plays a critical role in the evaluation and treatment of patients with acute ischemic stroke, especially those who are being considered for thrombolytic or endovascular therapy. Time from stroke-symptom onset to treatment is a strong predictor of long-term functional outcome after stroke. Therefore, imaging and treatment decisions must occur rapidly in this setting, while minimizing unnecessary delays in treatment. The aim of this ...
Source: American Journal of Neuroradiology - June 11, 2014 Category: Radiology Authors: Sanelli, P. C., Sykes, J. B., Ford, A. L., Lee, J.- M., Vo, K. D., Hallam, D. K. Tags: REVIEW ARTICLES Source Type: research

Postprocedural Antiplatelet Treatment after Emergent Carotid Stenting in Tandem Lesions Stroke: Impact on Stent Patency beyond Day 1 INTERVENTIONAL
CONCLUSIONS: Discontinuation of dual-antiplatelet therapy was not associated with an increased risk of stent thrombosis beyond postprocedural day 1. Further studies are warranted to better assess the additional benefit and optimal duration of dual-antiplatelet therapy after tandem lesion stroke thrombectomy.
Source: American Journal of Neuroradiology - May 12, 2021 Category: Radiology Authors: Pop, R., Hasiu, A., Mangin, P. H., Severac, F., Mihoc, D., Nistoran, D., Manisor, M., Simu, M., Chibbaro, S., Gheoca, R., Quenardelle, V., Rouyer, O., Wolff, V., Beaujeux, R. Tags: INTERVENTIONAL Source Type: research

Automated Segmentation of Intracranial Thrombus on NCCT and CTA in Patients with Acute Ischemic Stroke Using a Coarse-to-Fine Deep Learning Model ADULT BRAIN
CONCLUSIONS: The proposed deep learning method can reliably detect and measure thrombi on NCCT and CTA in patients with acute ischemic stroke.
Source: American Journal of Neuroradiology - June 8, 2023 Category: Radiology Authors: Zhu, K., Bala, F., Zhang, J., Benali, F., Cimflova, P., Kim, B. J., McDonough, R., Singh, N., Hill, M. D., Goyal, M., Demchuk, A., Menon, B. K., Qiu, W. Tags: ADULT BRAIN Source Type: research

The Curved MCA: Influence of Vessel Anatomy on Recanalization Results of Mechanical Thrombectomy after Acute Ischemic Stroke INTERVENTIONAL
CONCLUSIONS: This retrospective analysis showed that mechanical thrombectomy in the anterior circulation was significantly less often successful in patients with large vessel angles. Therefore, vessel curvature significantly influences the results of mechanical thrombectomy with stent retrievers for treatment of acute ischemic stroke. Further work is needed to understand the underlying causality.
Source: American Journal of Neuroradiology - May 15, 2015 Category: Radiology Authors: Schwaiger, B. J., Gersing, A. S., Zimmer, C., Prothmann, S. Tags: INTERVENTIONAL Source Type: research

Susceptibility Vessel Sign on MRI Predicts Favorable Clinical Outcome in Patients with Anterior Circulation Acute Stroke Treated with Mechanical Thrombectomy ADULT BRAIN
CONCLUSIONS: Our study strongly suggests that the susceptibility vessel sign on MR imaging before treatment is predictive of favorable clinical outcome for patients presenting with anterior circulation acute stroke and treated with mechanical thrombectomy.
Source: American Journal of Neuroradiology - December 15, 2015 Category: Radiology Authors: Bourcier, R., Volpi, S., Guyomarch, B., Daumas-Duport, B., Lintia-Gaultier, A., Papagiannaki, C., Serfaty, J. M., Desal, H. Tags: ADULT BRAIN Source Type: research

Risk of Thrombus Fragmentation during Endovascular Stroke Treatment INTERVENTIONAL
CONCLUSIONS: Younger age, easy-to-retrieve thrombi, and bridging thrombolysis may be risk factors for periprocedural thrombus fragmentation. Findings from standard histologic stains did not provide insight into thrombectomy-relevant thrombus stability. However, higher neutrophil levels in the thrombus tissue were related to an increased risk of periprocedural thrombus fragmentation. This observation aligns with the proposed thrombolytic capacity of neutrophil elastase and points to its potential clinical relevance in the context of stroke thrombectomy.
Source: American Journal of Neuroradiology - May 15, 2017 Category: Radiology Authors: Kaesmacher, J., Boeckh-Behrens, T., Simon, S., Maegerlein, C., Kleine, J. F., Zimmer, C., Schirmer, L., Poppert, H., Huber, T. Tags: INTERVENTIONAL Source Type: research

Mobile Stroke Unit Reduces Time to Image Acquisition and Reporting INTERVENTIONAL
SUMMARY: Timely administration of thrombolytic therapy is critical to maximizing the likelihood of favorable outcomes in patients with acute ischemic stroke. Although emergency medical service activation overall improves the timeliness of acute stroke treatment, the time from emergency medical service dispatch to hospital arrival unavoidably decreases the timeliness of thrombolytic administration. Our mobile stroke unit, a new-generation ambulance with on-board CT scanning capability, reduces key imaging time metrics and facilitates in-the-field delivery of IV thrombolytic therapy.
Source: American Journal of Neuroradiology - July 9, 2018 Category: Radiology Authors: Nyberg, E. M., Cox, J. R., Kowalski, R. G., Vela-Duarte, D., Schimpf, B., Jones, W. J. Tags: INTERVENTIONAL Source Type: research

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