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P83 The relationship of functional outcome after mechanical thrombectomy and serum glucose is partially mediated by edema formation
ConclusionEdema formation explains 15% of the total adverse effects of high blood glucose levels. Major pathways might include other direct effects of high blood glucose, such as altered vessel wall and thrombus characteristics and higher thrombogenicity of the cerebral blood flow.ReferencesThorén, M., et al. "Predictors for Cerebral Edema in Acute Ischemic Stroke Treated with Intravenous Thrombolysis." Stroke 2017;48(9): 2464–2471. Do you have any conflict of interest to declare?: YesConflict of Interest StatementHelge Kniep is a consultant for Eppdata.Jens Fiehler received research support from: German Minis...
Source: Journal of NeuroInterventional Surgery - August 29, 2022 Category: Neurosurgery Authors: Kniep, H., Meyer, L., Bechstein, M., Hanning, U., Fiehler, J., Broocks, G. Tags: 14th Congress of the European Society of Minimally Invasive Neurological Therapy 2022 Meeting Abstracts Source Type: research

P89 "Not only Carotid: two unusual cases of treatment of steno-obstructions
ConclusionsThe persistence of fetal anastomosis between carotid and basilar artery would represent a posterior cerebral circulation risk for ischemia and embolic infarction; in these cases the menagement of carotid steno-obstructions is challenging and requires special considerations.ReferencesJin X, Sun L, Feng Z, Li X, et. al. Persistent Hypoglossal Artery as a Potential Risk Factor for Simultaneous Carotid and Vertebrobasilar Infarcts. Front Neurol. 2018 Oct 11;9:837.Burgard M, Psathas E, Mordasini P, et. al. Symptomatic Internal Carotid Artery Stenosis in the Presence of a Persistent Primary Hypoglossal Artery. Vascula...
Source: Journal of NeuroInterventional Surgery - August 29, 2022 Category: Neurosurgery Authors: Corraine, S., Ledda, V., Schirru, F., Erta, M., Ferrari, A., Fusaro, F., Comelli, S. Tags: 14th Congress of the European Society of Minimally Invasive Neurological Therapy 2022 Meeting Abstracts Source Type: research

Cerebral venous thrombosis after COVID-19 vaccination: the role for endovascular treatment
Cerebral venous thrombosis (CVT) is a unique cause of stroke. Population-based studies demonstrate an incidence of clinically significant CVT of 1.3–1.5 per 100 000 per year.1 2 This may be an underestimated incidence, as these studies were not based on review of imaging and the often benign nature of this entity may lead to underdiagnoses. In the JNIS paper published by Cleaver et al,3 the authors describe their experience with endovascular treatment (EVT) in patients with cerebral venous sinus thrombosis in patients following COVID-19 vaccination. CVT-related stroke primarily affects young adult and middle-aged pat...
Source: Journal of NeuroInterventional Surgery - August 12, 2022 Category: Neurosurgery Authors: Mahajan, A., Hirsch, J. A. Tags: COVID-19 Commentary Source Type: research

Efficacy of combined use of a stent retriever and aspiration catheter in mechanical thrombectomy for acute ischemic stroke
Conclusions SCBT increases the SRFP rate and shortens the puncture-to-reperfusion time without increasing procedural complications.
Source: Journal of NeuroInterventional Surgery - August 12, 2022 Category: Neurosurgery Authors: Okuda, T., Arimura, K., Matsuo, R., Tokunaga, S., Hara, K., Yamaguchi, S., Yoshida, H., Kurogi, R., Kameda, K., Ito, O., Tsumoto, T., Iihara, K., Mizokami, T., Uwatoko, T., Nishimura, A., Iwaki, K., Mizoguchi, M., QNET investigators Tags: Ischemic stroke Source Type: research

O-012 Peri-procedural complications, clinical outcomes and recurrence/retreatment rates after endovascular versus surgical treatment of intracranial aneurysms: a real-world assessment from the NVQI-QOD cerebral aneurysm registry
ConclusionEndovascular treatment of intracranial aneurysms was associated with better overall clinical outcomes than surgical clipping with improved disability free survival and better disposition at discharge or follow-up, across both ruptured and unruptured aneurysms. Although intraoperative complications were higher for ruptured aneurysms treated with endovascular treatment, there was no difference in unruptured aneurysms versus surgical clipping. Post-operative complications were lower for the endovascular cohort regardless of presentation. Overall, these data support ongoing primary adoption of endovascular treatment ...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Bauknight, W., Noorani, S., Abdalla, R., Tejada, J., Church, E., Sahlein, D., Howington, J., Ansari, S. Tags: SNIS 19th annual meeting oral abstracts Source Type: research

O-019 Initial clinical experience with a novel mechanical thrombectomy device-the thrombX retriever
ConclusionThis preliminary study suggests the ThrombX Retriever is safe and has a high rate of substantial reperfusion. A larger prospective trial to assess the device effectiveness is planned.Disclosures D. Behme: 2; C; Thromb X Medical, Phenox, Penumbra, Balt, Vesalio, Acandis. M. Wiesmann: 1; C; Stryker Neurovascular. 2; C; Stryker Neurovascular. 6; C; AB Medica, Acandis, Cerenovus, Kaneka Pharmaceuticals, Medtronic, Mentice AB, Phenox, Philips Healthcare, Stryker Neurovascular. O. Nikoubashman: 1; C; Stryker Neurovascular. 6; C; Phenox, Stryker Neurovascular. H. Ridwan: 2; C; ThrombX Medical. D. Hassan: None. T. Liebig...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Behme, D., Wiesmann, M., Nikoubashman, O., Ridwan, H., Hassan, D., Liebig, T., Trumm, C., Holtmannspötter, M., Marks, M., Szikora, I. Tags: SNIS 19th annual meeting oral abstracts Source Type: research

O-020 The tigertriever 13 distals study: distal ischemic stroke treatment with adjustable low-profile stentriever
ConclusionThe TIGERTRIEVER 13 device with operator controllability and high fluoroscopy visibility and its small size can potentially provide a safe and effective clot removal in patients with distal vessels occlusion.Disclosures D. Fiorella: 1; C; Rapid Medical. R. Gupta: None. R. Chapot: None. J. Saver: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Fiorella, D., Gupta, R., Chapot, R., Saver, J. Tags: SNIS 19th annual meeting oral abstracts Source Type: research

O-052 The pennsylvania post-market multicenter experience with flow re-direction endoluminal device (FRED)
ConclusionThe results of the early post-market experience with the FRED device show reasonable safety and adequate aneurysmal occlusion rates comparable to other flow diverters. However, more extensive multicenter studies with more extended follow-up data are needed to assess the long-term safety and durability of the device.Abstract O-052 Table 1Baseline descriptive statistics Number of patients n=61 Gender Male 11 (18%) Female 50 (82%) Age (Years: median; IQR) 58 (51 – 68) Multiple Intracranial Aneurysms 21 (34.4%) Family history of aneurysms 9 (14.8%) Smoking History Never smokers 26 (42.6%) Past smokers 13 (21.3...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Salem, M., Kvint, S., Hendrix, P., Al Saiegh, F., Gajjar, A., Goren, O., Gross, B., Jabbour, P., Lang, M., Schirmer, C., Tjoumakaris, S., Griessenauer, C., Burkhardt, J. Tags: SNIS 19th annual meeting oral abstracts Source Type: research

O-061 Predictors of failed mechanical thrombectomy for large vessel occlusion: insights from the stroke thrombectomy and aneurysm registry (STAR)
ConclusionIn one of the largest studies to evaluate factors associated with failure MT in real world practice, we demonstrate that MTF is associated with significantly more complications and worse outcome. Final use of aspiration and rescue intracranial stenting may increase chances of recanalization.Disclosures M. Webb: None. M. Essibayi: None. S. Al Kasab: None. I. Maier: None. M. Psychogios: None. A. Alawieh: None. S. Wolfe: None. A. Arthur: None. T. Dumont: None. P. Kan: None. J. Kim: None. R. De Leacy: None. J. Osbun: None. A. Rai: None. P. Jabbour: None. M. Park: None. R. Crosa: None. M. Levitt: None. A. Polifka: Non...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Webb, M., Essibayi, M., Al Kasab, S., Maier, I., Psychogios, M., Alawieh, A., Wolfe, S., Arthur, A., Dumont, T., Kan, P., Kim, J., De Leacy, R., Osbun, J., Rai, A., Jabbour, P., Park, M., Crosa, R., Levitt, M., Polifka, A., Casagrande, W., Yoshimura, S., Tags: SNIS 19th annual meeting oral abstracts Source Type: research

O-066 Actin imparts thrombolysis resistance in acute ischemic stroke clots - gelsolin accelerates TPA mediated thrombolysis
ConclusionActin is one of the major structural components of AIS clots and could be responsible for fibrinolytic resistance. Targeting actin molecules would positively impact improving the outcome of recanalization of LVO-AIS.Abstract O-066 Figure 1Disclosures S. Arul: None. D. Dai: None. O. Mereuta: None. S. Ghozy: None. W. Brinjikji: None. D. Kallmes: None. R. Kadirvel: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Arul, S., Dai, D., Mereuta, O., Ghozy, S., Brinjikji, W., Kallmes, D., Kadirvel, R. Tags: SNIS 19th annual meeting oral abstracts Source Type: research

P-001 Evaluation of cerebrovascular flow parameters relative to guide catheter position during acute ischemic stroke treatment
ConclusionDramatically reduced MCA flow can significantly reduce downstream migration of thrombus during thrombectomy. This study demonstrates that Zoom 88 positioned distal to the PComm achieved similar rates of flow control as balloon guide catheters inflated in the proximal ICA. In all cases, flow compensation within the CoW affected the outflow rates of the ipsilateral and contralateral ACA branches, posterior cerebral arteries, and contralateral MCA.Abstract P-001 Figure 1Disclosures H. Berns: 5; C; Northern Arizona University. O. Fisher: 5; C; Northern Arizona University. B. Fennell: 5; C; Northern Arizona University...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Berns, H., Fisher, O., Fennell, B., Ponugupaty, A., Merritt, W., Ducruet, A., Becker, T. Tags: SNIS 19th annual meeting oral poster abstracts Source Type: research

P-017 Triple therapy versus dual antiplatelet therapy for dolichoectatic vertebrobasilar fusiform aneurysms treated with flow-diverters: the last frontier?
ConclusionsPatients with dolichoectatic VBFAs treated with flow-diversion and kept under triple therapy had less ischemic strokes, less progression of symptoms and overall better outcomes at last follow-up than similar patients kept under DAPT.Disclosures A. Siddiqui: 2; C; Amnis Therapeutics, Apellis Pharmaceuticals, Inc., Boston Scientific, Canon Medical Systems USA, Inc., Cardinal Health 200, LLC, Cerebrotech Medical Systems, Inc., Cerenovus, Cerevatech Medical, Inc.. 4; C; Adona Medical, Inc., Amnis Therapeutics, Bend IT Technologies, Ltd., BlinkTBI, Inc, Buffalo Technology Partners, Inc., Cardinal Consultants, LLC, Ce...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Siddiqui, A., Monteiro, A., Hanel, R., Kan, P., Mohanty, A., Cortez, G., Rabinovich, M., Matouk, C., Sujijantarat, N., Ebersole, K., Fry, L., Natarajan, S., Owusu-Adjei, B., Ortega-Gutierrez, S., Vivanco-Suarez, J., Wakhloo, A., Levy, E. Tags: SNIS 19th annual meeting oral poster abstracts Source Type: research

P-019 Comparative effectiveness of stent-assisted coiling and woven endobridge (WEB) embolization for the treatment of unruptured wide-neck bifurcation intracranial aneurysms
ConclusionMid-term complete and adequate occlusion rates were similar between patients treated with WEB and SAC. Given the comparable outcomes, there may be equipoise in treatment options for WNBAs.Abstract P-019 Table 1Baseline patient and aneurysm morphology parameters between treatment groups Aneurysm parameters* WEB (n=27) Stent-coil (n=54) p-value Age 63 (50–69) 65 (57–69) 0.511 Gender, male 6 (22%) 12 (22%) 1.000 Smoking Status Current smoker 9 (33%) 9 (17%) 0.235 Prior Smoker 9 (33%) 22 (41%) Never Smoker 9 (33%) 23 (43%) Location Acomm 9 (33%) 20 (37%) 0.772 Basilar apex 6 (22%) 17 (32%) Carotid termin...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Kashkoush, A., Desai, A., Davison, M., Achey, R., Mahapatra, A., Patterson, T., Moore, N., Bain, M. Tags: SNIS 19th annual meeting oral poster abstracts Source Type: research

P-031 End artery location of thrombus predicts poor neurological outcome despite successful thrombectomy for anterior circulation stroke
ConclusionsDespite similar vascular territories, concurrent occlusion of the MCA and ACA segments results in worse clinical outcomes compared to more proximal ICA occlusion. The likely explanation for fast progression of infarct in the MCA+ACA group is the higher likelihood of end-artery involvement and lower contribution of collateral flow. Reperfusion of both territories; however, does add to the risk of symptomatic post-procedural hemorrhage.Disclosures S. Eshraghi: None. S. Saperian: None. A. Alawieh: None. B. Howard: None. J. Grossberg: None. F. Tong: None. P. Jabbour: None. I. Maier: None. S. Wolfe: None. A. Rai: Non...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Eshraghi, S., Saperian, S., Alawieh, A., Howard, B., Grossberg, J., Tong, F., Jabbour, P., Maier, I., Wolfe, S., Rai, A., Starke, R., Gory, B., Psychogios, M., Shaaban, A., Arthur, A., Kim, J., Yoshimura, S., Kan, P., DeLeacy, R., Fragata, I., Polifka, A. Tags: SNIS 19th annual meeting oral poster abstracts Source Type: research

P-032 Underlying intracranial atherosclerotic disease is associated with worse outcomes in acute large vessel occlusion undergoing endovascular therapy
ConclusionUnderlying ICAD is associated with a 2.7-fold increase in the odds of mortality and a 4.5-fold (1/0.22) increase in unfavorable functional outcome at 90 days in patients with LVO undergoing traditional MT. Further research is warranted to understand factors associated with poor outcomes and investigate alternative interventional approaches and medical management in this high-risk population.Disclosures S. Thind: None. R. Morsi: None. T. Karrison: None. E. Coleman: None. J. Brorson: None. C. McKoy: None. S. Mendelson: None. A. Mansour: None. S. Prabhakaran: None. T. Kass-Hout: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Thind, S., Morsi, R., Karrison, T., Coleman, E., Brorson, J., McKoy, C., Mendelson, S., Mansour, A., Prabhakaran, S., Kass-Hout, T. Tags: SNIS 19th annual meeting oral poster abstracts Source Type: research

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