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Intracranial hemorrhage in large vessel occlusion patients receiving endovascular thrombectomy with or without intravenous alteplase: a secondary analysis of the DIRECT-MT trial
Conclusions Our data showed that in the DIRECT-MT trial, alteplase did not increase overall ICH for large vessel occlusion patients treated with thrombectomy, but it increased the parenchymal hematoma rate.
Source: Journal of NeuroInterventional Surgery - September 15, 2023 Category: Neurosurgery Authors: Hu, X., Zhou, Y., Ospel, J., Yao, F., Liu, Y., Wang, H., Li, B., Hui, P., Yang, P., Zhang, Y., Zhang, L., Li, Z., Xing, P., Shi, H., Han, H., Wang, S., Fang, Q., Liu, J., for the Direct-MT investigators Tags: Open access, Ischemic stroke Source Type: research

Safety and efficacy of intensive systolic blood pressure lowering after successful endovascular therapy: a post hoc analysis of the BP TARGET trial
Conclusion The effect of SBP lowering treatment was not modified by age, location of occlusion history of hypertension, intravenous thrombolysis, and admission SBP. Diabetes modified the effect of intensive SBP lowering treatment, and there was a trend towards benefit from intensive SBP treatment in diabetic patients. This finding is hypothesis generating and requires further validation.
Source: Journal of NeuroInterventional Surgery - August 29, 2023 Category: Neurosurgery Authors: Anadani, M., Maier, B., Escalard, S., Labreuche, J., de Havenon, A., Sabben, C., Lapergue, B., Mistry, E. A., Gory, B., Spiotta, A. M., Richard, S., Sibon, I., Desilles, J.-P., Blanc, R., Piotin, M., Mazighi, M., of behalf the BP TARGET study group, Mazig Tags: Ischemic stroke Source Type: research

P114/135 Drug-coated balloons for treatment of in-stent restenosis following carotid artery stenting: a major case, single center study
ConclusionIn our practice, DCB offers a straightforward option to treat restenosis of the ACI ostium. The low rate of periprocedural complications and the median time of freedom from symptoms and/or restenosis suggest that DCB angioplasty for ISRS is a viable treatment.Disclosure of InterestNothing to disclose
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Hajiyev, K., Gottberg, P. v., Henkes, H. Tags: 3.1 OTHER - Innovation Source Type: research

P146/118 NeVa ONE registry interim analysis: recanalization outcomes from a large, real-world patient cohort
ConclusionNeVa ONE Registry represents real-world data obtained from LVO AIS subjects treated with NeVa.Disclosure of InterestNothing to disclose
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Bhogal, P., Diaz, J., Gallego, J. I., Dopico, M. S., Pfaff, J., Behme, D., Pero, G., Voormolen, M., John, S., Romero Florez, N. A., Celma, S. M., Waele, T. d., Francois, O., Cotroneo, E., Maleux, G. Tags: 2.3 ISCHEMIC - Treatment Source Type: research

P175/308 Analysis of demographic, procedural and imaging data of patients with acute arteriosclerotic tandem lesion: Age and stroke severity matters most for clinical outcome
ConclusionEVT for TL is safe and effective. Lower age and shorter procedural time both correlate with successful outcomes, but the fact that stroke severity, neurological issues and diabetes are linked to higher mortality shows the connotation of comorbidities with long-term survival.Disclosure of InterestAll authors: Nothing to disclose
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Huber, C., Gruber, P., Berberat, J., Sassenburg, R., Pflugi, S., Anon, J., Diepers, M., Andereggen, L., Kahles, T., Nedeltchev, K., Remonda, L. Tags: 2.3 ISCHEMIC - Treatment Source Type: research

E-108 Endovascular treatment of patients with acute ischemic stroke due to underlying arterial dissection: a nationwide analysis
ConclusionsDespite a similar prevalence among patients admitted for AIS, CA dissections are associated with a higher rate of endovascular intervention and poorer short-term outcomes compared to VA dissections. This study provides essential epidemiologic and outcome data for the cerebrovascular neurosurgeon.Abstract E-108 Table 1Comparison of clinical characteristics and outcomes among patients presenting with acute ischemic stroke due to carotid or vertebral artery dissections Characteristic Vertebral Artery Dissection, N = 2,562 Carotid Artery Dissection, N = 2,789 p-value1 Age (years), Mean (SD) 53 (17) 57 (17) <0.00...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Brandel, M., McCann, C., Wali, A., Wu, V., Esmail, S., Steinberg, J., Olson, S., Pannell, J., Khalessi, A., Santiago-Dieppa, D. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-126 Multicenter flow diversion in 200 patients for treatment of intracranial aneurysms
ConclusionThis report characterizes patient demographics, aneurysm characteristics, procedure complications and long-term angiographic and clinical outcomes for a large patient population across multiple medical centers treated with flow diversion. Overall, procedures resulted in a high rate of occlusion and low rate of serious complications. Continued iterative outcomes analysis is warranted particularly as flow diversion technology evolves. Despite diverse hospital settings, differences in presentation, patient characteristics and the inclusion of off-label treatments, flow diversion procedures remained safe and effectiv...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Meister, R., Lesko, A., Marginean, H., Deshmukh, V. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-150 Mechanical thrombectomy in distal middle cerebral artery occlusions using a novel blind exchange mini-pinning technique: experience in 7 consecutive cases
ConclusionBlind mini-pinning allows for combined use of distal stentriever with a 035 thrombectomy catheter, affording a larger ID than traditional microcatheter engagement of the thrombus with enhanced stability for removal, and improved reperfusion rates in distal occlusions. This technique may be efficacious for the treatment of distal occlusions and further studies are needed to compare outcomes in distal occlusions.Abstract E-150 Figure 1(A) Deployment and blind mini-pinning navigation of 035 aspiration catheter (blue) through 071 (black) and 088 thrombectomy catheter (orange) into the M2 segment with follow-up angiog...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Meyer, B., Campos, J., Zarrin, D., Khan, M., Collard de Beaufort, J., Amin, G., Golshani, K., Beaty, N., Bender, M., Colby, G., Lin, L., Coon, A. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

O-001 Trends in endovascular mechanical thrombectomy for acute ischemic stroke: a regional comparison analysis using United States national inpatient sample data
ConclusionsThere remain significant regional differences in the outcomes of EVT for AIS. More analysis is required to determine what is driving these differences. More work is needed to ensure optimal and equitable patient outcomes.Abstract O-001 Table 1 Characteristic (p value) East North Central East South Central Middle Atlantic Mountain New England Pacific South Atlantic West North Central West South Central Age in Years Mean (±SD)(p<0.001) 68.69 ± 14.43 67.04 ± 14.85 70.09 ± 14.39 68.72 ± 14.53 70.27 ± 14.92 70.26 ± 14.51 68.81 ± 14.29 69.21 ± 14.51 67...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Brake, A., Fry, L., LeBeau, G., Heskett, C., Lei, C., Alkiswani, A., Le, K., De-Stefano, F., Peterson, J., Ebersole, K. Tags: SNIS 20th annual meeting oral abstracts Source Type: research

E-177 Treatment of ischemic stroke in patients diagnosed with covid-19: a matched analysis of the national inpatient sample
ConclusionsIn this matched NIS analysis of patients treated for ischemic stroke with a concomitant COVID diagnosis, we demonstrate that EVT trends towards, although nonsignificant, higher rates of favorable functional outcomes when compared to medically managed patients.Abstract E-177 Table 1Patients with COVID and Acute Ischemic Stroke Comparing medical management vs EVT 1:1 Nearest Neighbor Matching for EVT based on Age, NIHSS, Gender, and Comorbidities Medically Managed N = 495 1 Endovascular ThrombectomyN = 495 1 p-value 2 Age in years at admission 66.82 ± 16.98 (19.00-90.00), (1.77) 65.67 ± 14.81 (28...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Heskett, C., Fry, L., Brake, A., De Stefano, F., Morey, K., Lei, C., Alkiswani, A., Le, K., Peterson, J., Ebersole, K. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

O-040 Initial clinical experience with the bendit steerable articulating tip microcatheter for intracranial access and intervention
ConclusionsInitial clinical experience with the controlled articulation that permits flexion at the tip of the microcatheter demonstrated it to be safe. Access to difficult proximal origin curves, and distal clinoidal/ophthalmic segment anatomy may be improved due to the high torque transmission, and acute angulation of this microcatheter. Further experience with the delivery of therapeutic devices will be necessary to better understand the potential role that the present catheter may play in modern neurointerventional procedures.Abstract O-040 Table 1 Patient/Indication/Comorbidities/Treatment/Bendit 21 Role 60s F Cerebr...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Qiao, Y., Zhang, Y., Tsappidi, S., Mehta, T., Hui, F. Tags: SNIS 20th annual meeting oral abstracts Source Type: research

E-197 Use of balloon-mounted stents and drug eluting stents in intracranial atherosclerotic disease: single center experience
ConclusionDES appears effective and relatively safe with good long-term outcomes in treating intracranial atherosclerosis and secondary stroke prevention and is associated with lower delayed in-stent stenosis on follow up imaging compared to BMS and Wingspan stents. Use of DES for symptomatic ICAD in acute and non-emergent settings warrants further investigation.Balloon mounted stent, drug eluting stent, Wingspan, intracranial atherosclerotic disease, outcomes.Disclosures N. Turan: None. A. Malek: 2; C; CereVasc Inc.. 4; C; CereVasc Inc.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Turan, N., Malek, A. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-260 Bilateral cerebral arteriovenous shunting through pial and perforating vessels with multiple strokes and intraparenchymal hemorrhages in a patient with hepatopulmonary syndrome
This study presents a unique case of a 54-year-old male patient with a history of stroke, liver cirrhosis, portal vein thrombosis, hypertension, diabetes, and bladder cancer, who experienced multiple episodes of intracranial hemorrhages, stroke and worsening confusion over the past five years. The patient‘s clinical presentation raised suspicion for an underlying occult vasculopathy. Digital subtraction angiography (DSA) revealed multiple curvilinear, irregular, bilateral pial vessels with early high-flow arteriovenous shunting, consistent with vascular shunting that is associated with liver cirrhosis. The patient&ls...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Aljeradat, B., Koneru, M., Oliveira, R., Shaikh, H. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-261 Variability of response on prophylactic prasugrel for endovascular treatment of intracranial aneurysms: clinical implications
ConclusionIn the neurointerventional field, high BMI and prior use of antithrombotic agents were related to HTPR, and low BMI was associated with LTPR on prophylactic prasugrel. High hematocrit levels decreased the risk of HTPR. When preparing endovascular treatment for intracranial aneurysms, attention to patients with these clinical features is required to address the possibility of ischemic or bleeding complications.Abstract E-261 Table 1Risk factor analysis of high on-treatment platelet reactivity (HTPR) Variables Univariate Analysis Multivariate Analysis OR (95% CI) P OR (95% CI) P Age 1.02 (0.97-1.06) 0.53 Female o...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Son, Y., Hong, N. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

Prediction of 90 day home time among patients with low baseline ASPECTS undergoing endovascular thrombectomy: results from Albertas Provincial Stroke Registry (QuICR)
Conclusions Patients with low ASPECTS who are selected for EVT using demographic and clinical profiles similar to higher ASPECTS patients achieved comparable outcomes.
Source: Journal of NeuroInterventional Surgery - July 14, 2023 Category: Neurosurgery Authors: Singh, N., Holodinsky, J. K., Kashani, N., McDonough, R. V., Bala, F., Horn, M., Stang, J., Demchuk, A. M., Hill, M. D., Almekhlafi, M. A. Tags: Vascular neurology Source Type: research

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