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E-003 delayed reocclusion of recanalized intracranial arteries after mechanical thrombectomy in acute stroke patients
ConclusionsWe reviewed these patients and found that delayed reocclusion of recanalized vessels were noted within 24 h after first mechanical thrombectomy. The factors contributed to these results are assumed as TICI grade before and after the first mechanical thrombectomy. But, further evaluation of factors such as NIHSS score, underlying disease, laboratory findings and follow-up angiogram are needed. Also, procedural complications as vasospasm, dissection and hemorrhage should be investigated.DisclosuresK. Jang: None. S. Park: None. D. Jang: None. B. Moon: None. Y. Han: None. Y. Park: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Jang, K., Park, S., Jang, D., Moon, B., Han, Y., Park, Y. Tags: SNIS 12th Annual Meeting Electronic Poster Abstracts Source Type: research

E-013 unchanged utilization of endovascular treatment in acute ischemic stroke patients in the post ims-iii era
ConclusionContrary to expectations, there has been no reduction in the utilization of endovascular treatment among acute ischemic stroke patients after IMS-III, MR RESCUE and SYNTHESIS EXPANSION results were published.Abstract E-013 Table 1Pre and Post IMS III Pre-IMS III Post-IMS III P-value Patients with ischemic stroke (%)6765 (50.5)6643 (49.5)Mechanical thrombectomy155 (2.3)161 (2.4)0.6IV tPA483 (7.1)520 (7.8)0.1Discharge dispositionHome or self care3135 (46.6)3079 (46.3)Skilled nursing facility1529 (22.6)1486 (22.4)Expired268 (4.0)253 (3.8)0.3Length of stay in hospital3.8 ± 4.13.6 ± 3.50.02Hospital c...
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Hassan, A., Bezzina, C., Malik, A., Sanchez, C., Tekle, W., Qureshi, A. Tags: SNIS 12th Annual Meeting Electronic Poster Abstracts Source Type: research

E-033 variety of clot types and their implication on technique during endovascular stroke therapy
ConclusionOur data indicate that thrombectomy with a stent-retriever and balloon guide system provides the best opportunity for good outcomes. Because of the risks of shearing off part or all of a clot when aspirating an oversized thrombus into an intermediate catheter and further retrieving against the flow in the internal carotid, our strategy is to use intermediate catheters in conjunction with a balloon guide whenever possible to achieve flow-arrest. We did not have a large enough sample size to draw conclusions about the impact of technique on the number of passes. Further evaluation of how to optimize techniques in d...
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Andersson, T. Tags: SNIS 12th Annual Meeting Electronic Poster Abstracts 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

E-075 neurosarcoidosis presenting as aneurysmal subarachnoid hemorrhage: an interesting case and novel treatment
Neurosarcoidosis, the term used for sarcoidosis involving the central nervous system, represents an uncommon form of sarcoidosis, found in a 5% of patients with systemic sarcoidosis. Clinically evident cerebrovascular involvement in neurosarcoidosis has been reported but appears to be an extremely rare manifestation of neurosarcoidosis. The literature describes these cerebral vasculopathic changes as areas of stenosis and/or vascular irregularity, with clinical manifestations including headache, ischemic stroke, and parenchymal hemorrhage. Neurosarcoidosis has even been described as the etiology for a case of moyamoya synd...
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Gaughen, J. Tags: SNIS 12th Annual Meeting Electronic Poster Abstracts Source Type: research

E-127 intra-arterial thrombolysis for central retinal artery occlusion: a systematic review and meta-analysis
ConclusionIAT therapy for CRAO remains controversial. Pooled analysis of the retrospective studies supports IAT therapy whereas a single RCT does not support intervention. Other authors have suggested significant methodological concerns for the EAGLE study calling into question its conclusions that conflict with favorable studies of presumably lower levels of evidence.7 Additional study, potentially with stricter IAT time to treatment criteria may be warranted.ReferencesAhn SJ. Invest Ophthalmol Vis Sci. 2013;54(12):7746–55Aldrich EM. Stroke 2008;39:1746–50Arnold M J. Neurol Neurosurg Psychiatry 2005;76:196&nda...
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Page, P., Cambon, A., James, R. Tags: SNIS 12th Annual Meeting Electronic Poster Abstracts Source Type: research

Posterior circulation flow diversion: a single-center experience and literature review
Conclusions Flow diversion may be a possible treatment in carefully selected patients with high-risk atypical posterior circulation aneurysms, with poor natural history and no optimal treatment strategy. Symptomatic and fusiform large aneurysms appear to carry the highest risk. Further studies are necessary to assess the role of flow diversion in the posterior circulation.
Source: Journal of NeuroInterventional Surgery - July 14, 2015 Category: Neurosurgery Authors: Toth, G., Bain, M., Hussain, M. S., Moskowitz, S., Masaryk, T., Rasmussen, P., Hui, F. Tags: Hemorrhagic stroke Source Type: research

Early experience in high-resolution MRI for large vessel occlusions
Conclusions HRMRI of vascular occlusions can identify wall characteristics and characterize the course and caliber of the vasculature distal to the occluded segment. This information may be useful in determining preferred approaches for endovascular revascularization.
Source: Journal of NeuroInterventional Surgery - June 11, 2015 Category: Neurosurgery Authors: Hui, F. K., Zhu, X., Jones, S. E., Uchino, K., Bullen, J. A., Hussain, M. S., Lou, X., Jiang, W.-J. Tags: Neuroimaging Source Type: research

Carotid I's, L's and T's: collaterals shape the outcome of intracranial carotid occlusion in acute ischemic stroke
Conclusions Collateral flow patterns distinguish the nature and impact of ICA occlusions on expected revascularization and subsequent clinical outcomes in acute ischemic stroke. The nomenclature of terminal ICA occlusions introduced here (carotid I's, L's, and T's) may enhance future endovascular trials targeting such proximal occlusions. Trial registration number NCT00318071 (http://clinicaltrials.gov). MERCI was not registered because enrollment began before July 1, 2005.
Source: Journal of NeuroInterventional Surgery - May 14, 2015 Category: Neurosurgery Authors: Liebeskind, D. S., Flint, A. C., Budzik, R. F., Xiang, B., Smith, W. S., Duckwiler, G. R., Nogueira, R. G., for the MERCI and Multi-MERCI Investigators Tags: Ischemic stroke Source Type: research

Embolectomy for stroke with emergent large vessel occlusion (ELVO): report of the Standards and Guidelines Committee of the Society of NeuroInterventional Surgery
Introduction Stroke is the leading cause of adult disability in North America and is the fifth most common cause of death.1 2 The natural history of patients with acute ischemic stroke and occlusion of a major intracranial vessel such as the internal carotid artery (ICA), middle cerebral artery (MCA), or basilar artery is dismal, with high rates of mortality and low rates of disability-free survival.3 4 We introduce the term ‘Emergent Large Vessel Occlusion (ELVO)’ to describe this clinical scenario. Among acute ischemic stroke, ELVO accounts for the greatest proportion of patients with long-term disability. Fo...
Source: Journal of NeuroInterventional Surgery - April 13, 2015 Category: Neurosurgery Authors: Jayaraman, M. V., Hussain, M. S., Abruzzo, T., Albani, B., Albuquerque, F. C., Alexander, M. J., Ansari, S. A., Arthur, A. S., Baxter, B., Bulsara, K. R., Chen, M., Delgado-Almandoz, J. A., Fraser, J. F., Heck, D. V., Hetts, S. W., Kelly, M., Lee, S.-K., Tags: Standard Standards Source Type: research

A novel model of large vessel ischemic stroke in rabbits: microcatheter occlusion of the posterior cerebral artery
Conclusions Image-guided microcatheter induction of PCA occlusion in rabbits can consistently produce time-dependent infarction of cortical and subcortical structures that is reliably detected by diffusion-weighted MRI, and thus may be a useful model for therapeutic studies in acute ischemic stroke.
Source: Journal of NeuroInterventional Surgery - April 13, 2015 Category: Neurosurgery Authors: English, J. D., Hetts, S. W., El-Ali, A., Kolli, P., Do, L., Wilson, M. W., Saeed, M. Tags: Basic science Source Type: research

Endovascular treatment of unruptured wide-necked intracranial aneurysms: comparison of dual microcatheter technique and stent-assisted coil embolization
Conclusions DMT and SAC are effective endovascular approaches for unruptured, wide-necked aneurysms; however, DMT may result in less morbidity. Further long-term studies are necessary to determine the optimal indications for these treatment options.
Source: Journal of NeuroInterventional Surgery - March 12, 2015 Category: Neurosurgery Authors: Starke, R. M., Durst, C. R., Evans, A., Ding, D., Raper, D. M. S., Jensen, M. E., Crowley, R. W., Liu, K. C. Tags: Hemorrhagic stroke Source Type: research

Treatment of ruptured blood blister-like aneurysms with flow diverter SILK stents
Conclusions Implantation of flow diverter stents seems to be a safe and feasible alternative for treatment of ruptured BBAs.
Source: Journal of NeuroInterventional Surgery - February 12, 2015 Category: Neurosurgery Authors: Aydin, K., Arat, A., Sencer, S., Hakyemez, B., Barburoglu, M., Sencer, A., Izgi, N. Tags: Hemorrhagic stroke Source Type: research

Thrombus density predicts successful recanalization with Solitaire stent retriever thrombectomy in acute ischemic stroke
Conclusions In acute stroke treated with Solitaire stent retriever thrombectomy, higher thrombus HU values are predictive of successful recanalization. Such information can be used in decision making when estimating recanalization success rate with different endovascular treatment approaches.
Source: Journal of NeuroInterventional Surgery - January 13, 2015 Category: Neurosurgery Authors: Mokin, M., Morr, S., Natarajan, S. K., Lin, N., Snyder, K. V., Hopkins, L. N., Siddiqui, A. H., Levy, E. I. Tags: Ischemic stroke Source Type: research

Evolution of thrombectomy approaches and devices for acute stroke: a technical review
While intravenous administration of tissue plasminogen activator (tPA) remains the only FDA-approved treatment modality for acute ischemic stroke, many patients do not meet the criteria for intravenous tPA and are offered intra-arterial therapy. Rapid advances in devices and approaches have marked the evolution of thrombectomy over the past decade from rudimentary mechanical disruption, followed by intra-arterial thrombolytic infusions to increasingly effective thrombectomy devices. We review the critical advancements in thrombectomy technique that have evolved and the key anatomic and technical challenges they address, fr...
Source: Journal of NeuroInterventional Surgery - December 11, 2014 Category: Neurosurgery Authors: Spiotta, A. M., Chaudry, M. I., Hui, F. K., Turner, R. D., Kellogg, R. T., Turk, A. S. Tags: Ischemic stroke Source Type: research

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