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P089/268 Safety and efficacy of the fourth-generation Acandis Acclino Flex Plus stent in managing complex intracranial aneurysms
ConclusionThe AFP stent demonstrated feasibility and favourable safety and efficacy in the treatment of complex aneurysms. These results support its clinical use and highlight the need for further studies to evaluate its performance in different aneurysm subsets and to determine its specific role in the endovascular treatment of aneurysms.Disclosure of InterestCK serves as consultants for Acandis GmbH (Pforzheim, Germany) and proctor for MicroVention Inc./Sequent Medical (Aliso Viejo, CA, USA). David Zopfs is on the speaker’s bureau of Philips (Amsterdam, the Netherlands) and lecturer for Amboss GmbH (Cologne, Germany).
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Goertz, L., Zopfs, D., Schönfeld, M., Schlamann, M., Kabbasch, C. Tags: 1.1 HAEMORRHAGIC - Aneurysms Source Type: research

P090/269 Comparative analysis between a second-generation (acandis acclino) and a first-generation (enterprise) stent system
ConclusionAdvanced stents offer reduced thromboembolic risk and comparable aneurysm occlusion to first-generation stents due to their flexible design and surface modification. These results support the clinical use of advanced stent systems, but further comparative studies are needed to conclusively evaluate the efficacy of stent-assisted coiling with the Acclino stent and other systems.Disclosure of InterestCK serves as consultants for Acandis GmbH (Pforzheim, Germany) and proctor for MicroVention Inc./Sequent Medical (Aliso Viejo, CA, USA). David Zopfs is on the speaker’s bureau of Philips (Amsterdam, the Netherlan...
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Goertz, L., Zopfs, D., Schönfeld, M., Turowski, B., Schlamann, M., Kabbasch, C. Tags: 1.1 HAEMORRHAGIC - Aneurysms Source Type: research

In ischemic stroke, adding EVT to usual care at 6 to 24 h improved functional status at 90 d
Ann Intern Med. 2023 Jul 4. doi: 10.7326/J23-0050. Online ahead of print.ABSTRACTOlthuis SGH, Pirson FAV, Pinckaers FME, et al; MR CLEAN-LATE investigators. Endovascular treatment versus no endovascular treatment after 6-24 h in patients with ischaemic stroke and collateral flow on CT angiography (MR CLEAN-LATE) in the Netherlands: a multicentre, open-label, blinded-endpoint, randomised, controlled, phase 3 trial. Lancet. 2023;401:1371-1380. 37003289.PMID:37399551 | DOI:10.7326/J23-0050
Source: Annals of Internal Medicine - July 3, 2023 Category: Internal Medicine Authors: Barnet Eskin Source Type: research

Endovascular treatment for isolated posterior cerebral artery occlusion stroke in the MR CLEAN registry
Conclusions EVT should be considered in selected patients with AIS with an isolated PCA occlusion, presenting with moderate–severe neurological deficits, as EVT was technically feasible in most of our patients and about half had good clinical outcome. In case of lower NIHSS score, a more conservative approach seems warranted, since periprocedural complications are not uncommon. Nonetheless, EVT seems reasonably safe considering the absence of sICH in our study.
Source: Journal of NeuroInterventional Surgery - March 14, 2023 Category: Neurosurgery Authors: Brouwer, J., Ergezen, S., Mulder, M. J. H. L., Lycklama a Nijeholt, G. J., van Es, A. C. G. M., van der Lugt, A., Dippel, D. W. J., Majoie, C. B. L. M., Roos, Y. B. W. E. M., Coutinho, J. M., Emmer, B. J., on behalf of the MR CLEAN Registry investigators, Tags: Ischemic stroke Source Type: research

Etiology of Large Vessel Occlusion Posterior Circulation Stroke: Results of the MR CLEAN Registry
CONCLUSIONS: Unlike the anterior circulation, most frequent cause in our posterior large vessel occlusion stroke cohort is LAA followed by cardioembolism, dissection, and ESUS. Patients with cardioembolism and ESUS have a better prognosis for functional outcome after endovascular thrombectomy than patients with LAA.PMID:35543130 | DOI:10.1161/STROKEAHA.121.038054
Source: Atherosclerosis - May 11, 2022 Category: Cardiology Authors: F A V Anne Pirson Nikki Boodt Josje Brouwer Agnetha A E Bruggeman Wouter H Hinsenveld Julie Staals Wim H van Zwam Christiaan van der Leij Rutger J B Brans Charles B L M Majoie Diederik W J Dippel Aad van der Lugt Wouter J Schonewille Robert J van Oostenbr Source Type: research

Expediting workflow in the acute stroke pathway for endovascular thrombectomy in the northern Netherlands: a simulation model
Conclusions In our region, the proposed workflow improvements might reduce time to treatment by about 1 hour and increase the number of patients regaining functional independence by 6%. Simulation modelling is useful for assessing the potential effects of interventions aimed at reducing time from onset to EVT.
Source: BMJ Open - April 6, 2022 Category: General Medicine Authors: Maas, W. J., Lahr, M. M. H., Uyttenboogaart, M., Buskens, E., van der Zee, D.-J., On behalf of CONTRAST investigators Tags: Open access, Neurology Source Type: research

Diagnostic reference levels and median doses for common clinical indications of CT: findings from an international registry
ConclusionsDRLs for CTDIvol and DLP for EUCLID clinical indications from diverse organizations were established and can contribute to dose optimization. These values were usually significantly higher in the US than in Europe.Key Points•Registry data were used to create benchmarks for 10 common indications for CT identified by the European Society of Radiology.•Observed US radiation doses were higher than European for 9 of 10 indications (except chronic sinusitis).•The presented diagnostic reference levels and median doses highlight potentially unnecessary variation in radiation dose.
Source: European Radiology - October 13, 2021 Category: Radiology Source Type: research

Influence of Onset to Imaging Time on Radiological Thrombus Characteristics in Acute Ischemic Stroke
Conclusion: In our population of acute ischemic stroke patients, we found no clear association between onset-to-imaging time and radiological thrombus characteristics. This suggests that elapsed time from stroke onset plays a limited role in the interpretation of radiological thrombus characteristics and their effect on treatment results, at least in the early time window.
Source: Frontiers in Neurology - June 18, 2021 Category: Neurology Source Type: research

Prediction of long-term recurrent ischemic stroke: the added value of non-contrast CT, CT perfusion, and CT angiography
ConclusionData from CT imaging significantly improved the discriminatory performance and reclassification in predicting ischemic stroke recurrence beyond a model incorporating clinical risk factors only.
Source: Neuroradiology - March 17, 2021 Category: Radiology Source Type: research

Peripheral Artery Disease in Acute Ischemic Stroke Patients Treated With Endovascular Thrombectomy; Results From the MR CLEAN Registry
Conclusion: In the absence of an association between the presence of PAD and collateral scores or outcomes after EVT, it may be questioned whether PAD leads to RIPC in patients with acute ischemic stroke due to large vessel occlusion.
Source: Frontiers in Neurology - October 6, 2020 Category: Neurology Source Type: research

Radiology workload in clinical implementation of thrombectomy for acute ischemic stroke: experience from The Netherlands
ConclusionOur study estimated the number of stroke patients undergoing CTA for suspected LVO and those eligible for thrombectomy in relation to the population. Numbers were essentially the same throughout the week, and during office and on-call hours. Our data can be used to make adequate staffing plans.
Source: Neuroradiology - April 4, 2020 Category: Radiology Source Type: research

Blunt cerebrovascular injury: incidence and long-term follow-up
ConclusionsImproved CTA diagnostic modalities have increased BCVI incidence. Furthermore, BCVI patients reported significant functional impairment at long-term follow-up. Antiplatelet therapy showed a significant effect on in-hospital stroke rate reduction.
Source: European Journal of Trauma and Emergency Surgery - June 12, 2019 Category: Emergency Medicine Source Type: research

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