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Prediction of bleb formation in intracranial aneurysms using machine learning models based on aneurysm hemodynamics, geometry, location, and patient population
Conclusions Based on the premise that aneurysm characteristics prior to bleb formation resemble those derived from vascular reconstructions with their blebs virtually removed, machine learning models can identify aneurysms prone to bleb development with good accuracy. Pending further validation with longitudinal data, these models may prove valuable for assessing the propensity of IAs to progress to vulnerable states and potentially rupturing.
Source: Journal of NeuroInterventional Surgery - September 14, 2022 Category: Neurosurgery Authors: Salimi Ashkezari, S. F., Mut, F., Slawski, M., Cheng, B., Yu, A. K., White, T. G., Woo, H. H., Koch, M. J., Amin-Hanjani, S., Charbel, F. T., Rezai Jahromi, B., Niemelä, M., Koivisto, T., Frosen, J., Tobe, Y., Maiti, S., Robertson, A. M., Cebral, Tags: Hemorrhagic stroke Source Type: research

Predictors of unfavorable outcome in stent-assisted coiling for symptomatic unruptured intracranial spontaneous vertebral artery dissecting aneurysms (uis-VADAs): results from a multicenter study
Conclusions This multicenter study indicated that preprocedural ischemic infarctions, diabetes mellitus, and procedural complications were related to unfavorable clinical outcomes in the reconstructed uis-VADAs.
Source: Journal of NeuroInterventional Surgery - September 14, 2022 Category: Neurosurgery Authors: Zhao, K., Zhao, R., Yang, X., Guan, S., Liang, G., Wang, H.-L., Wang, D., Feng, W., Li, Z., Wang, W., Peng, Y., Xu, J., Wang, L., Zhong, M., Mao, G., Li, T., Zhang, Y., Chen, D., Cai, C., Sun, X., Shi, H., Yu, J., Wang, Y., Gu, Z., Zhu, G., Zhu, Q., Wan, Tags: Hemorrhagic stroke Source Type: research

Predictors of incomplete aneurysm occlusion after treatment with the Pipeline Embolization Device: PREMIER trial 1 year analysis
Conclusions The results of our study are consistent with previous retrospective series and warrant consideration for technique adaptations to achieve higher occlusion rates. Further follow-up is needed to assess progression of aneurysm occlusion and clinical behavior in these cases.
Source: Journal of NeuroInterventional Surgery - September 14, 2022 Category: Neurosurgery Authors: Hanel, R. A., Monteiro, A., Nelson, P. K., Lopes, D. K., Kallmes, D. F. Tags: Hemorrhagic stroke Source Type: research

Endovascular treatment of ruptured anterior communicating aneurysms: a 17-year institutional experience with coil embolization
Conclusions Endovascular treatment of ruptured ACoA aneurysms is safe and is associated with low mortality and retreatment rates. Younger patients with favorable functional status and larger aneurysm size are more likely to be retreated. Ruptured aneurysms <4 mm, although prevalent in the study (29%), never required retreatment.
Source: Journal of NeuroInterventional Surgery - September 14, 2022 Category: Neurosurgery Authors: Catapano, J. S., Karahalios, K., Rumalla, K., Srinivasan, V. M., Rutledge, C., Baranoski, J. F., Cole, T. S., Jadhav, A. P., Ducruet, A. F., Albuquerque, F. C. Tags: Hemorrhagic stroke Source Type: research

Bridging thrombolysis in atrial fibrillation stroke is associated with increased hemorrhagic complications without improved outcomes
Conclusion In this large thrombectomy registry, AF patients exposed to IVT before MT had increased hemorrhagic complications without improved functional outcomes, in contrast with non-AF patients. Prospective trials are warranted to assess whether AF patients represent a subgroup of LVO patients who may benefit from a direct to thrombectomy approach at thrombectomy capable centers.
Source: Journal of NeuroInterventional Surgery - September 14, 2022 Category: Neurosurgery Authors: Akbik, F., Alawieh, A., Dimisko, L., Howard, B. M., Cawley, C. M., Tong, F. C., Nahab, F., Samuels, O. B., Maier, I., Feng, W., Goyal, N., Starke, R. M., Rai, A., Fargen, K. M., Psychogios, M. N., Jabbour, P., De Leacy, R., Keyrouz, S. G., Dumont, T. M., Tags: Ischemic stroke Source Type: research

O10 The necessity of monitoring platelet response and adjusting antiplatelet agents for endovascular treatment of unruptured intracranial aneurysms: a single-center, retrospective, cohort study
ConclusionActive monitoring and adjustment antiplatelet agents did not reduce ischemic complications in endovascular treatment; however, tended to reduce the ischemic complication, especially in flow diversion. Low-dose prasugrel may be feasible without increasing hemorrhage in the endovascular treatment of unruptured intracranial aneurysms.ReferencesLi W. Effect of Adjusted Antiplatelet Therapy on Preventing Ischemic Events after Stenting for Intracranial Aneurysms. Stroke. 2021 Dec;52(12):3815–3825. DOI: 10.1161/StrokeAHA.120.032989. EPUB 2021 SEP 20. PMID: 34538087.Hwang G. Standard vs Modified Antiplatelet Prepar...
Source: Journal of NeuroInterventional Surgery - August 29, 2022 Category: Neurosurgery Authors: Moon, E., Kwon, B., Song, Y., Lee, D., Park, J., Suh, D. Tags: 14th Congress of the European Society of Minimally Invasive Neurological Therapy 2022 Meeting Abstracts Source Type: research

O23 Mechanical thrombectomy using a modified ADAPT (a direct aspiration first pass technique) in a patient with m1-occlusion and concomitant mca-aneurysm
We present a case in which a patient with a right-sided MCA M1 occlusion (NIHSS 30) and concomitant mediabifurcation aneurysm was fully recanalized (TICI 3) using a modified ADAPT technique, without prior passage of the thrombus as previously described by Turc et al.2. To us, the avoidance of blind aneurysm passage by microwire and microcatheter appears to be a major advantage of the method used. Instead, the aspiration catheter was advanced via a 0.035 Terumo guide wire for proximal stabilization. Thrombus was aspirated with proximally inflated BGC and repeated imaging series up to visualization of the aneurysm neck. Thus...
Source: Journal of NeuroInterventional Surgery - August 29, 2022 Category: Neurosurgery Authors: Demerath, T., Elbaz, A., Urbach, H., Taschner, C. Tags: 14th Congress of the European Society of Minimally Invasive Neurological Therapy 2022 Meeting Abstracts Source Type: research

P08 Detection of cerebral aneurysms in unenhanced CT images of patients with subarachnoid hemorrhage using the sparing aneurysm sign (SAS)
ConclusionsThe aneurysm location and size can be determined in unenhanced CT images in many cases using the new SAS (sparing aneurysm sign). Whereas quantitative measurements of HU can support the aneurysm detection.ReferencesConnolly ES, Rabinstein AA, Carhuapoma JR, et al. Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage. Stroke. 2012;43. Do you have any conflict of interest to declare?: No
Source: Journal of NeuroInterventional Surgery - August 29, 2022 Category: Neurosurgery Authors: Peters, S., Klintz, T., Larsen, N., Hensler, J., Wodarg, F., Jansen, O. Tags: 14th Congress of the European Society of Minimally Invasive Neurological Therapy 2022 Meeting Abstracts Source Type: research

P16 Semi-emergent management of ruptured intracranial blood blister-like aneurysms: single centre experience
ConclusionsOur endovascular treatment approach for ruptured blister aneurysms is safe and effective, with a low risk of procedural complications and favourable clinical outcomes.ReferencesPeschillo, S et al. "A Systematic Review and Meta-analysis of Treatment and Outcome of Blister-like Aneurysms." AJNR. American Journal of Neuroradiology Vol. 37,5 (2016): 856–61. DOI:10.3174/AJNR.A4606.Nasra, Mohamed et al. "Contemporary Treatment of Intracranial Blood Blister Aneurysms – A Systematic Review." Journal of Stroke and Cerebrovascular Diseases: The Official Journal of National Stroke Association Vol. 30,9 (2021): ...
Source: Journal of NeuroInterventional Surgery - August 29, 2022 Category: Neurosurgery Authors: Abou-Foul, M., Balian, V., Chotai, A., Demetriou, V., White, P., Padmanabhan, R., Gan, C. Tags: 14th Congress of the European Society of Minimally Invasive Neurological Therapy 2022 Meeting Abstracts Source Type: research

P18 Acute flow diversion with Pipeline Flex and Pipeline Vantage with Shield technology with single antiplatelet cover - short term results
ConclusionPipeline Flex and Vantage with Shield technology with phosphoryl choline surface modification is safe with no mortality and acceptable morbidity with single antiplatelet intra-operative cover. Initial results showed excellent occlusion and good clinical outcomes.ReferencesMahajan A, Das B, Narang KS, et al. Surpass Flow Diverter in the Treatment of Ruptured Intracranial Aneurysms-A Single-Center Experience. World Neurosurg. 2018 Dec;120:E1061-E1070. DOI: 10.1016/J.WNEU.2018.09.011. EPUB 2018 Sep 11. PMID: 30213677.Gopinathan A, Jain S, Lwin S, et al. Flow diversion in acute sub arachnoid haemorrhage: a single cen...
Source: Journal of NeuroInterventional Surgery - August 29, 2022 Category: Neurosurgery Authors: Skinner, N., Galea, J., Van Beijnum, J., Mattar, G., Sastry, A. Tags: 14th Congress of the European Society of Minimally Invasive Neurological Therapy 2022 Meeting Abstracts Source Type: research

P25 Short- and long-term mortality of subarachnoid hemorrhage according to hospital volume and severity using a nationwide multicenter stroke registry
ConclusionShort- and long-term mortality in patients with SAH differed according to hospital volume. In the modern endovascular era, clipping and coiling can lead to better outcomes in facilities with high stroke-care capabilities.ReferencesPobereskin LH. Incidence and outcome of subarachnoid haemorrhage: a retrospective population based study. J Neurol Neurosurg Psychiatry 2001;70:340–3. DOI:10.1136/JNNP.70.3.340.Lee JY, Heo NH, Lee MR, Ahn JM, Oh HJ, Shim JJ, et al. Short and long-term outcomes of subarachnoid hemorrhage treatment according to hospital volume in korea: a nationwide multicenter registry. J Korean Me...
Source: Journal of NeuroInterventional Surgery - August 29, 2022 Category: Neurosurgery Authors: Oh, J. Tags: 14th Congress of the European Society of Minimally Invasive Neurological Therapy 2022 Meeting Abstracts Source Type: research

P29 FD use in acutely presented dissecting aneurysms, 2 years follow up of 53 cases
ConclusionsFlow diverters might be a feasible, alternative treatment option for acutely symptomatic dissecting aneurysms and may effectively prevent rebleeding in ruptured aneurysms.ReferencesWalcott B.P., Koch M.J., Stapleton C.J., Patel A.B. Blood flow diversion as a primary treatment method for ruptured brain aneurysms-concerns, controversy, and future directions. Neurocritical Care 2017;26:465–473. DOI: 10.1007/S12028-016-0318-Y. -Cagnazzo F., Di Carlo D.T., Cappucci M., Lefevre P.H., Costalat V., Perrini P. Acutely ruptured intracranial aneurysms treated with flow-diverter stents: a systematic review and meta-an...
Source: Journal of NeuroInterventional Surgery - August 29, 2022 Category: Neurosurgery Authors: Mansour, O., Hassan, T., Hassan, F. Tags: 14th Congress of the European Society of Minimally Invasive Neurological Therapy 2022 Meeting Abstracts Source Type: research

P34 Artificial intelligence in stroke networking: early experience in building networks of care
ConclusionsWhile Viz. ai is intended to identify and triage thrombectomy patients, the messaging app provides an opportunity to collaborate between institutions; care recommendations without transfer were provided in just as many cases as thrombectomy. In addition, the majority of stroke cases did not require transfer. Do you have any conflict of interest to declare?: No
Source: Journal of NeuroInterventional Surgery - August 29, 2022 Category: Neurosurgery Authors: Fraser, J., Campbell, M., Wise, L., Krein, B., Silvernail, R., Dornbos, D., Pahwa, S., Lee, J. Tags: 14th Congress of the European Society of Minimally Invasive Neurological Therapy 2022 Meeting Abstracts Source Type: research

P62 Continuing early mTICI 2b reperfusion during mechanical thrombectomy is not beneficial for all patients
ConclusionContinuing MT after early mTICI2b might improve functional outcome of the patients who are successfully converted to mTICI2c/3 but an increase in complications due to further retrieval attempts may diminish the potential functional benefit.ReferencesGoyal M, Menon BK, Van Zwam WH, et al. Endovascular Thrombectomy after Large-vessel Ischaemic Stroke: A Meta-analysis of Individual Patient Data from Five Randomised Trials. Lancet. 2016;387(10029):1723–31.Flottmann F, Brekenfeld C, Broocks G, et al. Good Clinical Outcome Decreases with Number of Retrieval Attempts in Stroke Thrombectomy: Beyond the First-Pass E...
Source: Journal of NeuroInterventional Surgery - August 29, 2022 Category: Neurosurgery Authors: Steffen, P., van Horn, N., McDonough, R., Deb-Chatterji, M., Alegiani, A., Thomalla, G., Fiehler, J., Flottmann, F. Tags: 14th Congress of the European Society of Minimally Invasive Neurological Therapy 2022 Meeting Abstracts Source Type: research

P65 "Direct Transfer to Angio Suite" (DTAS) enabling via utilization of Philips advanced 3D neuro-imaging prototype technology
Conclusions3D neuro-imaging prototype technology has provided an almost multi-detector CT level of anatomical structures spatial and contrast resolution, during pre-procedural ASPECT assessment, clot localization, collaterals and post-procedural hemorrhagic components evaluation during DTAS for mechanical thrombectomy, significantly reducing the door-to-puncture timing. This new technology significantly improves and maximizes the triaging of these LVO patients in the DTAS pathway.ReferencesPatrick Nicholson, Nicole M Cancelliere, John Bracken, et al. Novel flat-panel cone-beam ct compared to multi-detector ct for assessmen...
Source: Journal of NeuroInterventional Surgery - August 29, 2022 Category: Neurosurgery Authors: Massari, F., Singh, J., Kuhn, A., Anagnostakou, V., Gounis, M., Puri, A. Tags: 14th Congress of the European Society of Minimally Invasive Neurological Therapy 2022 Meeting Abstracts Source Type: research

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