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E-132 Successful mechanical thrombectomy in an 11-year-old patient with emergent large vessel occlusion acute ischemic stroke related to congenital complete heart block and recent covid-19 infection
ConclusionsThis is a first known report of a successful mechanical thrombectomy in a pediatric patient due to a large vessel occlusion related to congenital complete heart block and recent COVID-19 infection.Disclosures J. Ansari: None. D. Mata Canadas: None. M. Ayub: None. J. Caskey: None. P. Simoncini: None. R. Riel-Romero: None. P. Sharma: None. D. Jordan: None. H. Cuellar: None.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Ansari, J., Mata Canadas, D., Ayub, M., Caskey, J., Simoncini, P., Riel-Romero, R., Sharma, P., Jordan, D., Cuellar, H. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-055 Internal carotid artery reconstruction with flow diverting stents in the treatment of acute ischemic stroke: technical considerations and medical management
ConclusionsFDS appear to be a safe and effective tool for reconstruction of a symptomatic dissection in tortuous cervical ICAs. Their flexibility allows conformation to complex anatomies and they can be traversed multiple times by aspiration catheters/stentrievers. We found excellent patency at follow up. The unique challenges posed by utilization of high-profile stents in acute stroke require appropriate technical execution and medical management.Disclosures E. Orru: None. F. Bounni: None. M. Marosfoi: None. N. Patel: None. A. Wakhloo: 1; C; Philips medical. 2; C; Stryker, Phenox. 4; C; InNeuroCo, EpiEP, Neural Analytics, ThrombX.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Orru, E., Bounni, F., Marosfoi, M., Patel, N., Wakhloo, A. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

E-114 Rescue suction mechanical thrombectomy of medium-small vessel occlusion in a pediatric patient presented with acute ischemic stroke
ConclusionEndovascular aspiration mechanical thrombectomy of MSVO is feasible in pediatric patients presenting with AIS and associated with good functional outcome. Additionally, when acute ongoing neurological deficit is present and CTA is inconclusive, a digital subtraction angiography is deemed needed to identify MSVO as the yields of CTA diminishes significantly beyond LVO. Further studies are required.Disclosures R. Hart: None. A. Singh: None. C. Manzanero: None. Y. Lodi: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Hart, R., Singh, A., Manzanero, C., Lodi, Y. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

Management of Acute Ischemic Thrombosis
Acute ischemic thrombosis in patients who have undergone neurosurgical procedures is a leading cause of mortality and long-term disability. Endovascular therapy has become an important treatment modality for acute ischemic thrombosis in these patients. Noninvasive imaging has dramatically changed the understanding of cerebral blood flow and the concepts of cerebrovascular reserve and salvageable penumbra. Increasingly, reliance on perfusion imaging to discern tissue viability and potential outcomes has become standard of care. With the advent of recent acute ischemic stroke trials, therapy for occlusive cerebrovascular dis...
Source: Neurosurgery Clinics of North America - August 14, 2018 Category: Neurosurgery Authors: Kunal Vakharia, Gursant S. Atwal, Elad I. Levy Source Type: research

Combined interventional and surgical treatment of tandem middle cerebral artery embolus and internal carotid artery occlusion: case report.
Abstract Tandem internal carotid artery (ICA) origin occlusion and middle cerebral artery (MCA) thromboembolism is a life-threatening condition with poor neurological outcome. The authors report on a patient presenting with acute ischemic stroke from a tandem ICA and MCA occlusion with penumbra. Emergency MCA mechanical thrombectomy was performed through percutaneous cervical ICA access due to the inability to cross the cervical carotid occlusion. Emergency carotid endarterectomy to reperfuse the poorly collateralized hemisphere and repair the ICA access site was performed 2 hours after completion of tissue plasmi...
Source: Journal of Neurosurgery - November 17, 2017 Category: Neurosurgery Authors: Frenkel MB, Renfrow JJ, Singh J, Garg N, Wolfe SQ Tags: J Neurosurg Source Type: research

In vitro experiments of cerebral blood flow during aspiration thrombectomy: potential effects on cerebral perfusion pressure and collateral flow
Conclusions These experiments suggest that aspiration is only effective if the catheter tip is in direct contact with the thrombus. If the catheter tip is not in contact with the thrombus, aspirate is drawn from the vessels proximal of the occlusion. This could affect collateral flow in vivo.
Source: Journal of NeuroInterventional Surgery - August 11, 2016 Category: Neurosurgery Authors: Lally, F., Soorani, M., Woo, T., Nayak, S., Jadun, C., Yang, Y., McCrudden, J., Naire, S., Grunwald, I., Roffe, C. Tags: Basic science Source Type: research

E-025 First Reported Case of Mechanical Thrombectomy for Acute Ischemic Stroke in an Individual with a Total Artificial Heart
ConclusionEVT has been proven to be safe and efficacious for AIS. Prior reports have demonstrated benefit for patients with concurrent mechanical circulatory support devices; however, our report is the first case demonstrating efficacy with a TAH device. Presence of mechanical circulatory support devices should not exclude EVT in individuals with AIS.DisclosuresM. Nezhad: None. P. Eboli: None. M. Austin: None. K. Schlick: None. M. Alexander: None.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Nezhad, M., Eboli, P., Austin, M., Schlick, K., Alexander, M. Tags: Electronic poster abstracts Source Type: research

E-055 Endovascular Therapy for Patients with Acute Large MCA Territory Ischemia: Its Effect on the Risk of Subsequent Development of Deep Venous Thrombosis
ConclusionsIn patients with acute large MCA territory ischemia, endovascular recanalization therapy appeared to decrease the risk of developing subsequent DVT or PE. However, a larger sample size is needed to demonstrate statistical significance. Interestingly, majority of DVT were developed on the side of the extremity contralateral to the affected cerebral hemisphere.DisclosuresZ. Li: None. M. Cox: None.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Li, Z., Cox, M. Tags: Electronic poster abstracts Source Type: research

O-012 Emergent Endovascular Management of Long-segment Carotid Artery Dissections in Acute Ischemic Stroke Intervention with Multiple Tandem Stents
ConclusionTandem stent reconstruction for the treatment of long segment and flow limiting carotid dissections is technically safe and effective with favorable clinical outcomes in acute ischemic stroke intervention, allowing for successful thrombectomy, vessel salvage, restoration of cerebral perfusion, and prevention of recurrent thromboembolic stroke.DisclosuresS. Ansari: None. A. Kuhn: None. A. Honarmand: None. S. Hou: None. M. Khan: None. J. Chueh: None. I. van der Bom: None. M. Hurley: None. A. Shaibani: None. M. Gounis: None. M. Potts: None. B. Jahromi: None. A. Wakhloo: None. A. Puri: None.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Ansari, S., Kuhn, A., Honarmand, A., Hou, S., Khan, M., Chueh, J., Bom, I. v. d., Hurley, M., Shaibani, A., Gounis, M., Potts, M., Jahromi, B., Wakhloo, A., Puri, A. Tags: Oral abstracts Source Type: research

Successful outcome after endovascular thrombolysis for acute ischemic stroke with basis on perfusion-diffusion mismatch after 24 h of symptoms onset.
CONCLUSIONS: We report the case of a successful thrombolytic therapy following AIS performed more than 24 h after the initial symptoms based on the presence of a perfusion-diffusion mismatch. This report is expected to stimulate the development of future prospective studies with special focus on the role of perfusion-diffusion mismatch in patient selection for treatment of AIS, especially in those presenting outside the traditional time window. PMID: 27313971 [PubMed]
Source: Surgical Neurology International - June 19, 2016 Category: Neurosurgery Tags: Surg Neurol Int Source Type: research

Reversible changes in diffusion- and perfusion-based imaging in cerebral venous sinus thrombosis
We present a patient with CVST whose abnormal findings on MRI and CT perfusion images were largely reversed after endovascular treatment.
Source: Journal of NeuroInterventional Surgery - January 13, 2016 Category: Neurosurgery Authors: Lin, N., Wong, A. K., Lipinski, L. J., Mokin, M., Siddiqui, A. H. Tags: Electronic pages Source Type: research

Evaluation of Cerebral Perfusion in Patients Undergoing Intravenous Recombinant Tissue Plasminogen Activator Thrombolysis.
Authors: Hirano T Abstract Currently, the indication for thrombolytic therapy using intravenous recombinant tissue plasminogen activator (rt-PA) is restricted strictly to patients with acute ischemic stroke within 4.5 h of onset. The effect of rt-PA declines over time; therefore, we need to minimize the time delay while generating imaging information. The use of cerebral blood flow imaging is not recommended within this time window. Conversely, the balance of efficacy and the risk of bleeding complications differ among patients > 4.5 h after onset. Several ongoing studies are using mismatch concepts to extend th...
Source: Neurologia Medico-Chirurgica - September 16, 2015 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Emergency Superficial Temporal Artery to Middle Cerebral Artery Bypass After Intravenous Administration of Tissue Plasminogen Activator for Stroke.
We described three cases of emergency superficial temporal artery to middle cerebral artery bypass performed within 24 hours of IVtPA administration, and discussed the safety of such procedures. We believe that superficial temporal artery to middle cerebral artery bypass can be safely performed even within 24 hours after IVtPA administration. PMID: 26242342 [PubMed - in process]
Source: Turkish Neurosurgery - August 7, 2015 Category: Neurosurgery Authors: Takeuchi S, Wada K, Arimoto H, Kumagai K, Osada H, Otani N, Mori K Tags: Turk Neurosurg Source Type: research

E-071 initial experiences with the 5max ace 64 in the endovascular management of acute ischemic stroke
ConclusionIn our experience, this new version of the 5Max is very efficient in the aspiration of the thrombus. Due to its larger lumen, it’s more difficult to navigate over the smaller microcatheters through tortuous segments of the target vessels, especially the ophthalmic region of the ICA. Using the 3Max instead, the navigation gets easy, but it’s very difficult to get a roadmap or perform an angiogram through the ACE, due to the larger OD of the 3Max. Partially retrieving the 3Max, or preparing the roadmap while the 3Max is still in the proximal part of the ACE has solved this issue in our experience.Disclo...
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Gal, G. Tags: SNIS 12th Annual Meeting Electronic Poster Abstracts Source Type: research

Acute Stroke After Carotid Endarterectomy: Time for a Paradigm Shift? Multicenter Experience With Emergent Carotid Artery Stenting With or Without Intracranial Tandem Occlusion Thrombectomy
CONCLUSION: Emergent endovascular evaluation in the setting of acute post--carotid endarterectomy thrombosis is a safe and timely treatment option, with the benefit of detecting and treating embolic intracranial lesions. Immediate angiography and intervention in this rare surgical complication show promising initial results. ABBREVIATIONS: CAS, carotid artery stenting CEA, carotid endarterectomy ICA, internal carotid artery NASCET, North American Symptomatic Carotid Endarterectomy Trial
Source: Neurosurgery - March 19, 2015 Category: Neurosurgery Tags: Research-Human-Clinical Studies Source Type: research

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