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Thrombus imaging characteristics within acute ischemic stroke: similarities and interdependence
Conclusions Thrombus imaging characteristics are significantly intercorrelated – strong correlations should be considered in future predictive modeling studies. Clustering analysis showed there are no distinct thrombus archetypes – novel treatments should consider this thrombus variability.
Source: Journal of NeuroInterventional Surgery - August 29, 2023 Category: Neurosurgery Authors: Arrarte Terreros, N., Bruggeman, A. A., Kappelhof, M., Tolhuisen, M. L., Brouwer, J., Hoving, J. W., Konduri, P. R., van Kranendonk, K. R., Dutra, B. G., Alves, H. C., Dippel, D. W., van Zwam, W. H., Beenen, L. F., Yo, L. S., van Bavel, E., Majoie, C. B., Tags: Open access, Ischemic stroke Source Type: research

Thrombus radiomics in patients with anterior circulation acute ischemic stroke undergoing endovascular treatment
Conclusions TR describing thrombus volume and texture were associated with more attempts to successful reperfusion. Compared with models using CV and MTM, TR had no added value for predicting procedural and functional outcome.
Source: Journal of NeuroInterventional Surgery - August 29, 2023 Category: Neurosurgery Authors: van Voorst, H., Bruggeman, A. A. E., Yang, W., Andriessen, J., Welberg, E., Dutra, B. G., Konduri, P. R., Arrarte Terreros, N., Hoving, J. W., Tolhuisen, M. L., Kappelhof, M., Brouwer, J., Boodt, N., van Kranendonk, K. R., Koopman, M. S., Hund, H. M., Kri Tags: Ischemic stroke Source Type: research

P135/313 Predictive value of CT head and CT angiogram in identifying ICAD associated large vessel occlusion
ConclusionOur findings suggest a significant association between the absence of the hyperdense artery sign and the presence of tapering at the occlusion site with ICAD in patients with LVO. Incorporating these signs in pre-thrombectomy evaluation has the potential to improve stroke care.Disclosure of InterestDr. Joe Leyon has/had consultancy agreements with Microvention Terumo, Medtronic, and Stryker Neurovascular.
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Hassan, A., Leyon, J., Kaya, A. Tags: 2.1 ISCHEMIC - Logistics Source Type: research

P151/175 Direct aspiration with EMBOVAC - first clinical experience and clot composition (results the "PERFECT study)
ConclusionThis is the first clinical evaluation of EMBOVAC. Direct aspiration with EMBOVAC as first line therapy resulted in high rates of reperfusion and favorable clinical outcomes. Clot composition analysis can aid in better understanding of the stroke etiology and means for effective clot removal.Disclosure of InterestAcandis (OJ, CL, JF); Microvention (GM, CC, JF); Stryker (GM, CC, JF); Medtronic (GM, CC, JF); Surge2surgery (BG); MIVI (CC); Phenox (CL, JF); Penumbra (CL, JF); GSK (AS); German Ministry of Science & Education and Economy & Innovation, EU, Hamburgische Investitions-/Förderbank, Philips, B...
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Lobotesis, K., Jansen, O., Marnat, G., Gory, B., Nordmeyer, H., Eckert, B., Alessandro, P., Cognard, C., Loehr, C., Bracco, S., Schaefer, A., Macera, A., Fiehler, J., Doyle, K., Piano, M. Tags: 2.3 ISCHEMIC - Treatment Source Type: research

P164/236 Antithrombotic regimen in emergent carotid stenting for acute ischemic stroke due to tandem lesion: a meta-analysis of aggregate data
ConclusionsIn AIS due to tandem occlusion, the periprocedural antithrombotic regimen of eCAS seems to have a marginal effect on good functional outcome. Overall, high intensity antithrombotic therapy may provide a marginal benefit on good functional outcome and carotid stent patency without a significant increase in risk of sICH.Disclosure of InterestNothing to disclose
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Diana, F., Abdalkader, M., Behme, D., Li, W., Maurer, C. J., Pop, R., Hwang, Y.-H., Bartolini, B., Ros, V. D., Bracco, S., Cirillo, L., Marnat, G., Katsanos, A., Kaesmacher, J., Fischer, U., Sousa, D. A. d., Peschillo, S., Zini, A., Tomasello, A., Ribo, M Tags: 2.3 ISCHEMIC - Treatment Source Type: research

O37/346 Endovascular treatment of cerebral venous thrombosis: a single center experience
ConclusionSince the advent of EVT for the AIS, the improvement of the devices and the endovascular techniques have increased, opening a new scenario for the treatment of the CVT in terms of efficacy and safety.Our study add evidence on the safety and efficacy of the endovascular techniques in the treatment of CVT.Disclosure of Interestnothing to disclose.
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Piano, M., Macera, A., Cervo, A., Vitiello, A., Lozupone, E., Pero, G. Tags: 3.3 OTHER - Miscellaneous Source Type: research

E-093 Carotid webs and stroke: a comprehensive overview of clinical characteristics, risk factors, and treatment modalities
ConclusionThis is the largest systematic review of CWs to date. This study provides novel information not only about risk factors and common treatment modalities for CWs, but also the relationship between CWs and stroke. This data may aid physicians in diagnosis of CWs in younger patients who present with stroke-like symptoms and no cardiovascular risk factors. Furthermore, medical treatment alone may not be as effective as stenting or surgical options.Disclosures N. Gupta: None. V. Kasulla: None. A. Shahbandi: None. J. Gendreau: None. R. Singh: None. N. Brown: None. J. Catapano: None. V. Srinivasan: None.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Gupta, N., Kasulla, V., Shahbandi, A., Gendreau, J., Singh, R., Brown, N., Catapano, J., Srinivasan, V. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-097 Acute ischemic stroke thrombus proteome is associated with time since last known well
ConclusionsThis study points, for the first time, to differences in the proteomic landscapes between thrombi from AIS patients that are related to time since symptom onset. Taken together, the present data support a view of the stroke thrombus as a living, dynamic microenvironment with increasing intracellular protein and RNA processing with increased tLKW. More work is required to further characterize early and late stroke thrombi, as a changing clot landscape may directly underlie responsiveness to treatment.Disclosures S. Akkipeddi: None. R. Rahmani: None. N. Ellens: None. G. Kohli: None. D. Schartz: None. S. Chittaranj...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Akkipeddi, S., Rahmani, R., Ellens, N., Kohli, G., Schartz, D., Chittaranjan, S., Bhalla, T., Mattingly, T., Morrell, C., Bender, M. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-107 Carotid artery stenting in patients with symptomatic non-stenotic carotid artery disease - a case series
ConclusionsIn this case series performed over a 10-year period at a high-volume stroke center we show that CAS is safe and efficient in patients with SyNC. Previous studies have established safety and effectiveness of CES in patients presenting with SyNC, however there is a paucity of reports in the literature regarding the effect of CAS in this patient population. Recent guidelines have brought specific attention to high-risk plaque characteristics which suggest that plaque instability plays a major role in the onset of ischemic events, regardless of lumen narrowing. Advanced imaging techniques, such as Optical Coherence ...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Nedelcu, S., Kuhn, A., Singh, J., Puri, A. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

O-010 Tigertriever in the treatment of acute ischemic stroke in patients with underlying intracranial atherosclerotic disease
ConclusionTigertriever exerts a higher radial force that can be manually tailored to achieve better recanalization in patients with LVO due to ICAD.ReferenceGupta R, Saver JL, Levy E, et al. New class of radially adjustable stentrievers for acute ischemic stroke: primary results of the multicenter TIGER trial. Stroke. May 2021;52(5):1534-1544. doi:10.1161/strokeaha.121.034436Abstract O-010 Figure 1(A) A right Ml occlusion due to underlying ICAD (arrowhead). (B) The Tigertriever is deployed across the stenosis. The device ‘massages’ the thrombus and exerts an increased radial force in stenotic lesions due to ICA...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Ojeda, D., Sanchez, S., Miller, J., Almajali, M., Koul, P., Noboa, L., Ghannam, M., Samaniego, E. Tags: SNIS 20th annual meeting oral abstracts Source Type: research

O-012 Relationship between clot composition and procedural results for ischemic stroke aspiration thrombectomy: subset analysis from the INSIGHT registry
ConclusionsClot removed during neuroendovascular procedures can differ in consistency and removability, leading to an increased focus on thrombus composition as a crucial variable for improving outcomes of ischemic stroke. In this study, good final revascularization (mTICI 2b-3 at the final angiogram) occurred after aspiration thrombectomy regardless of clot composition. Ongoing analysis of collected specimens is expected to provide valuable information regarding thrombus biology and etiology and to aid in diagnosis, prognosis, and drug development.Abstract O-012 Table 1Clot composition vs procedural results for ischemic s...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Kellner, C., Dabney, A., Baltan, S., Sohrabji, F., Pennypacker, K., Nanda, A., Woodward, K., Rivet, D., Fraser, J. Tags: SNIS 20th annual meeting oral abstracts Source Type: research

O-035 Endovascular treatment of cerebral venous thrombosis involving the deep venous system
ConclusionsAlthough deep venous involvement of CVT is uncommon, these patients are at risk of quickly becoming critically ill with an elevated rate of death or dependency. Although these patients may develop stroke, hemorrhage, or neurologic decline prompting consideration of endovascular therapy, the deep cerebral venous system is not easily accessible with catheters due to small lumens and risk of perforation. It has been proposed that deep cerebral veins may have a higher chance of recanalization if venous thrombus burden is reduced in other parts of the dural venous sinuses. Current literature has not fully explored th...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Morel, B., Hoffman, J., Folzenlogen, Z., Roark, C., Seinfeld, J., Case, D. Tags: SNIS 20th annual meeting oral abstracts Source Type: research

P-003 The zoomTMRDL radial access system for neurointervention: an early single-center experience
ConclusionsThe use of Zoom RDLTM Radial Access System is technically feasible and effective for complex neurointerventional procedures with low complication rates.Disclosures R. Morsi: None. S. Kothari: None. S. Thind: None. H. Desai: None. S. Polster: None. F. Goldenberg: None. E. Coleman: None. J. Brorson: None. S. Mendelson: None. A. Mansour: None. S. Prabhakaran: None. T. Kass-Hout: 2; C; Brainomix: Consultant, Cerenovus: Consultant, Imperative Care: Consultant, Medtronic Inc.: Consultant, Microvention: Consultant, Stryker Neurovascular: Consultant.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Morsi, R., Kothari, S., Thind, S., Desai, H., Polster, S., Goldenberg, F., Coleman, E., Brorson, J., Mendelson, S., Mansour, A., Prabhakaran, S., Kass-Hout, T. Tags: SNIS 20th annual meeting oral poster abstracts Source Type: research

E-006 U.S. health care system-wide transition from alteplase to tenecteplase before mechanical thrombectomy: functional outcomes, early reperfusion rates, intracranial bleeding and femoral access site complications
ConclusionsThe first-year experience demonstrates the effectiveness and safety of the transitioning from TPA to TNK. The higher early recanalization rates with TNK are striking. Additional studies are required to investigate whether TNK is superior to TPA in the setting of LVO stroke.Disclosures M. Collins: None. C. Schirmer: None. G. Weiner: None. O. Goren: None. I. Melamed: None. S. Dalal: None. M. Kole: None. A. Noto: None. P. Hendrix: None.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Collins, M., Schirmer, C., Weiner, G., Goren, O., Melamed, I., Dalal, S., Kole, M., Noto, A., Hendrix, P. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-049 Complications of middle meningeal artery embolization - a systematic review
ConclusionThe published literature suggests that MMA embolization is a generally well-tolerated procedure, but with a low risk of significant complications, including, but not limited to stroke, seizures, visual obscurations, and facial palsy. Further studies and sub-analyses are needed to fully characterize the incidence of such complications.Disclosures J. Gerstl: None. M. Shafi: None. S. Badikol: None. N. Nawabi: None. R. Mekary: None. M. Sukumaran: None. A. Kappel: None. A. Feroze: None. T. Smith: None. M. Aziz-Sultan: None.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Gerstl, J., Shafi, M., Badikol, S., Nawabi, N., Mekary, R., Sukumaran, M., Kappel, A., Feroze, A., Smith, T., Aziz-Sultan, M. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

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