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Effect of region-wide use of prehospital stroke triage scale on management of patients with acute stroke
Conclusions Use of prehospital stroke triage scales improved prehospital management and preparation time of intervention among patients with acute stroke.
Source: Journal of NeuroInterventional Surgery - June 16, 2022 Category: Neurosurgery Authors: Araki, H., Uchida, K., Yoshimura, S., Kurisu, K., Shime, N., Sakamoto, S., Aoki, S., Ichinose, N., Kajihara, Y., Tominaga, A., Naka, H., Mizoue, T., Sumida, M., Hirotsune, N., Nomura, E., Matsushige, T., Kanazawa, J., Kato, Y., Kawamoto, Y., Kuroki, K., M Tags: Open access, Vascular neurology Source Type: research

Finnish flow diverter study: 8 years of experience in the treatment of acutely ruptured intracranial aneurysms
Conclusions FD treatment yields high occlusion for acutely ruptured IAs but is associated with a high risk of complications. Considering the high mortality rate of aneurysmal subarachnoid hemorrhage, the prevention of rebleeding is crucial. Thus, FD treatment may be justified as a last resort option.
Source: Journal of NeuroInterventional Surgery - June 16, 2022 Category: Neurosurgery Authors: Alpay, K., Hinkka, T., Lindgren, A. E., Isokangas, J.-M., Raj, R., Parkkola, R., Sinisalo, M., Numminen, J., Pienimäki, J.-P., Saari, P., Seppänen, J., Palosaari, K., Rautio, R. Tags: Open access, Hemorrhagic stroke Source Type: research

Mechanical thrombectomy beyond the circle of Willis: efficacy and safety of different techniques for M2 occlusions
Conclusion Stent-retrievers and a combined approach for M2 occlusions seem more effective than direct aspiration, but with higher rates of iSAH. This leads to no detectable difference in clinical outcome at 3 months.
Source: Journal of NeuroInterventional Surgery - May 13, 2022 Category: Neurosurgery Authors: Renieri, L., Valente, I., Dmytriw, A. A., Puri, A. S., Singh, J., Nappini, S., Nencini, P., Kaliaev, A., Abdalkader, M., Alexandre, A., Garignano, G., Vivekanandan, S., Fong, R. P., Parra-Farinas, C., Spears, J., Gomez-Paz, S., Ogilvy, C., Regenhardt, R. Tags: Ischemic stroke Source Type: research

High-resolution CT with arch/neck/head CT angiography on a mobile stroke unit
Conclusions MSU use of advanced imaging including multiphasic head/neck CTA is feasible, offers high LVO yield and enables full ED bypass.
Source: Journal of NeuroInterventional Surgery - May 13, 2022 Category: Neurosurgery Authors: Alexandrov, A. W., Arthur, A. S., Bryndziar, T., Swatzell, V. M., Dusenbury, W., Hardage, K., McCormick, S., Rhudy, J. P., Maleki, A. H. Z., Singh, S., Krishnaiah, B., Nearing, K., Rubin, M. N., Malkoff, M. D., McKendry, C., Metter, E. J., Alexandrov, A. Tags: Neuroimaging Source Type: research

Treatment of ruptured intracranial aneurysms with the Woven EndoBridge device: a systematic review
The Woven EndoBridge (WEB) device is a barrel-shaped nitinol mesh deployed within the aneurysmal sac. The absence of metallic mesh in the aneurysm’s parent vessel lumen obviates the need for potent antiplatelet therapy, making this device appealing for acutely ruptured aneurysms not amenable to clipping or coiling. To assess the literature regarding WEB treatment of these aneurysms, we performed a comprehensive systematic search of PubMed, MEDLINE, and EMBASE databases following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Keywords were combined with Boolean operators to inc...
Source: Journal of NeuroInterventional Surgery - March 18, 2022 Category: Neurosurgery Authors: Monteiro, A., Lazar, A. L., Waqas, M., Rai, H. H., Baig, A. A., Cortez, G. M., Dossani, R. H., Cappuzzo, J. M., Levy, E. I., Siddiqui, A. H. Tags: Hemorrhagic stroke Source Type: research

Length of hospital stay in aneurysmal subarachnoid hemorrhage patients without vasospasm on angiography: potential for a fast-track discharge cohort
Conclusion Lack of angiographic vasospasm 5 to 7 days after aSAH is associated with shorter hospitalization, with no increase in 30 day ED visits or poor neurologic outcome.
Source: Journal of NeuroInterventional Surgery - March 18, 2022 Category: Neurosurgery Authors: Catapano, J. S., Srinivasan, V. M., Rumalla, K., Labib, M. A., Nguyen, C. L., Cole, T. S., Baranoski, J. F., Rutledge, C., Rahmani, R., Lawton, M. T., Ducruet, A. F., Albuquerque, F. C. Tags: Hemorrhagic stroke Source Type: research

Endovascular middle cerebral artery embolic stroke model: a novel approach
A video (video 1) describing a novel murine endovascular embolic stroke model is presented. Traditional middle cerebral artery (MCA) occlusion models include a blind insertion of a monofilament string1 2 into the common or external carotid artery with the expectation to selectively occlude the MCA. However, significant mortality occurs due to subarachnoid hemorrhage and variability in stroke size, possibly related to the filament’s malposition—for example, external carotid or proximal internal carotid artery (ICA). Additionally, while the string is in place, it occludes the entire extracranial ICA affecting als...
Source: Journal of NeuroInterventional Surgery - March 18, 2022 Category: Neurosurgery Authors: Gonzalez, L. F., Warner, D. S., Sheng, H., Chaparro, E. Tags: Technical video Source Type: research

Basilar artery trunk aneurysm: clinical and angiographic outcomes of endovascular treatment
Conclusions EVT might be a feasible option for this rare disease entity. Unfavorable angiographic outcome might be expected in a large/giant aneurysm or a long lesion. It can be difficult to treat BA trunk aneurysms by EVT, needing multiple procedures or various techniques due to diverse clinical and angiographic features.
Source: Journal of NeuroInterventional Surgery - February 16, 2022 Category: Neurosurgery Authors: Sim, S. Y., Chung, J., Choi, J. H., Kim, M. J., Shin, Y. S., Lim, Y. C. Tags: Hemorrhagic stroke Source Type: research

Mortality after treatment of intracranial aneurysms with the Pipeline Embolization Device
Conclusions Delayed aneurysm rupture, distal intraparenchymal hemorrhage, and neurological compression were the main causes of mortality in patients with intracranial aneurysms treated with the PED. Large basilar aneurysms are associated with an increased risk of postoperative death and require increased attention and caution.
Source: Journal of NeuroInterventional Surgery - January 18, 2022 Category: Neurosurgery Authors: Kang, H., Luo, B., Liu, J., Zhang, H., Li, T., Song, D., Zhao, Y., Guan, S., Maimaitili, A., Wang, Y., Feng, W., Wang, Y., Wan, J., Mao, G., Shi, H., Wang, K., Yang, X. Tags: Hemorrhagic stroke Source Type: research

Woven EndoBridge device for ruptured aneurysms: perioperative results of a US multicenter experience
Conclusions This study demonstrates the perioperative safety and effectiveness of the WEB device for the treatment of patients with ruptured intracranial aneurysms in the setting of SAH, with low periprocedural morbidity and mortality. Long-term follow-up is warranted.
Source: Journal of NeuroInterventional Surgery - October 15, 2021 Category: Neurosurgery Authors: Cortez, G. M., Akture, E., Monteiro, A., Arthur, A. S., Peterson, J., Dornbos, D., Jabbour, P., Gooch, M. R., Sweid, A., Tjoumakaris, S. I., Delgado Almandoz, J. E., Kayan, Y., Rai, A. T., Boo, S., Fiorella, D., Vachhani, J., Foreman, P., Cress, M., Siddi Tags: Hemorrhagic stroke Source Type: research

EP04* Efficacy and safety in the use of stent-retrievers for treatment of cerebral vasospasms after subarachnoid hemorrhage
ConclusionStent-retrievers are frequently used in interventional stroke therapy and may represent a safe and effective treatment option for intracranial spasmolysis after SAH, especially for the more distal vessel-segments. Compared to conventional balloon-PTA, this method seems promising by its ease of use, low risk of rupture and retained blood flow during dilatation, however further improvement of the radial force is recommended.ReferenceBhogal P, Loh Y, Brouwer P, et al. Treatment of cerebral vasospasm with self-expandable retrievable stents: proof of concept. J Neurointerv Surg 2017;9:52–59. doi:10.1136/neurints...
Source: Journal of NeuroInterventional Surgery - August 24, 2021 Category: Neurosurgery Authors: Hensler, J., Wodarg, F., Madjidyar, J., Peters, S., Cohrs, G., Jansen, O., Larsen, N. Tags: Haemorrhagic Source Type: research

EP45* Beyond proximal large vessel occlusions: outcome of mechanical thrombectomy in distal vessel occlusions in the EXCELLENT registry - Interim analysis
ConclusionsIn this interim analysis, patients with DiVO presenting with acute ischemic stroke and undergoing MT had rates of revascularization and clinical and safety outcomes comparable to MeVO. If confirmed in the full dataset, these findings can inform MT case selection.DisclosureEXCELLENT is sponsored by Cerenovus. Dr. Zaidat serves as a consultant for Neuravi, Stryker, Penumbra, and Medtronic.
Source: Journal of NeuroInterventional Surgery - August 24, 2021 Category: Neurosurgery Authors: Zaidat, O., Nogueira, R., Siddiqui, A., Yoo, A., Hanel, R., Hacke, W., Jovin, T., Fiehler, J., De Meyer, S., Liebeskind, D., Haussen, D., Inoa, V., Humphries, W., Woodward, K., Jabbour, P., Francois, O., Levy, E., Bozorgchami, H., Cohen, J., Boor, S., Das Tags: Treatment Source Type: research

EP59 Successful mechanical thrombectomy after microsurgical clipping of a ruptured middle cerebral artery aneurysm
We report about a 62 year old woman who was brought to the emergency room after being found down at home. On admission she was somnolent but accessible with mild focal neurological deficits. A computed tomography of the brain revealed a right temporal hematoma with subarachnoid and intraventricular hemorrhage due to a ruptured saccular aneurysm of the MCA trifurcation. A surgical approach was considered best treatment option and microsurgical clipping was performed. Intraoperative microvascular Doppler depicted a spontaneous thrombus formation in M1-Segment and the patient was transferred to the angio-suite for a mechanica...
Source: Journal of NeuroInterventional Surgery - August 24, 2021 Category: Neurosurgery Authors: Boutchakova-Meyer, M., Beyaz, P., Roth, C., Papanagiotou, P. Tags: Treatment Source Type: research

Republished: Successful treatment of ruptured multiple fusiform middle cerebral artery aneurysms with silk vista baby flow diverter in a 10-months-old infant
We report the successful treatment of multiple ruptured fusiform middle cerebral artery (MCA) aneurysms in a 10-month-old girl. This previously healthy infant presented with subarachnoid haemorrhage and was found to have multiple irregular dilatations of the superior division branch of the right MCA. Cerebral angiography was performed and confirmed the presence of multiple fusiform aneurysms of the MCA. After multidisciplinary team discussion, it was decided to treat the aneurysms with endovascular approach, using a flow-diverter. Microsurgical clipping was deemed risky because of the high likelihood of parent artery occlu...
Source: Journal of NeuroInterventional Surgery - August 13, 2021 Category: Neurosurgery Authors: Barchetti, G., Di Clemente, L., Mazzetto, M., Zanusso, M., Ferrarese, P., Iannucci, G. Tags: Hemorrhagic stroke Source Type: research

P-007 Safety and efficacy of endovascular thrombectomy for distal vessel occlusion (DLV): single center experience
ConclusionThis single center, consecutive real-world experience demonstrates that thrombectomy in DVO stroke patients is safe and leads to high rate of successful recanalization. Further studies are warranted to evaluate the efficacy of thrombectomy in DVO in comparison to best medical management.Disclosures S. Majidi: None. S. Matsoukas: None. R. De Leacy: None. T. Oxley: None. H. Shoirah: None. T. Shigematsu: None. C. Kellner: None. J. Fifi: None. J. Mocco: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Majidi, S., Matsoukas, S., De Leacy, R., Oxley, T., Shoirah, H., Shigematsu, T., Kellner, C., Fifi, J., Mocco, J. Tags: Oral poster abstracts Source Type: research

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