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Comparative analysis between 1-D, 2-D and 3-D carotid web quantification
Conclusion CaW dimension quantification (1-D, 2-D and 3-D) is highly reproducible. Linear and volumetric measurements were more strongly associated with symptoms. The impact of CaW size on the presence of LVOS, clot burden and final infarct volume is unclear.
Source: Journal of NeuroInterventional Surgery - January 11, 2023 Category: Neurosurgery Authors: Perry da Camara, C., Nogueira, R. G., Al-Bayati, A. R., Pisani, L., Mohammaden, M., Allen, J. W., Nahab, F., Olive Gadea, M., Frankel, M. R., Haussen, D. C. Tags: Ischemic stroke Source Type: research

Frontline thrombectomy strategy and outcome in acute basilar artery occlusion
Conclusion Among BAO patients, the combined technique effectively contributed to complete revascularization that showed a 90 day favorable outcome with an equivalent complication rate after thrombectomy.
Source: Journal of NeuroInterventional Surgery - December 14, 2022 Category: Neurosurgery Authors: Abdelrady, M., Ognard, J., Cagnazzo, F., Derraz, I., Lefevre, P.-H., Riquelme, C., Gascou, G., Arquizan, C., Dargazanli, C., Cheddad El Aouni, M., Ben Salem, D., Mourand, I., Costalat, V., Gentric, J. C., on behalf of RAMBO (Revascularization via Aspirati Tags: Ischemic stroke Source Type: research

Cost-effectiveness of thrombectomy in patients with minor stroke and large vessel occlusion: effect of thrombus location on cost-effectiveness and outcomes
Conclusions EVT is cost-effective in patients with minor stroke and LVO in the long term (lifetime horizon), considering the poor outcomes and significant disability associated with non-reperfusion. Our study emphasizes the need for caution in interpreting previous observational studies which concluded similar results in EVT versus medical management in patients with minor stroke due to a high proportion of patients with M2 occlusions in the two strategies.
Source: Journal of NeuroInterventional Surgery - December 14, 2022 Category: Neurosurgery Authors: Khunte, M., Wu, X., Koo, A., Payabvash, S., Matouk, C., Heit, J. J., Wintermark, M., Albers, G. W., Sanelli, P. C., Gandhi, D., Malhotra, A. Tags: Socioeconomics Source Type: research

Antiplatelet therapy for standalone coiling of ruptured intracranial aneurysms: a systematic review and meta-analysis
Conclusions Although this study showed no beneficial effect of AT on clinical outcomes, the results suggest that AT could be combined with standalone coiling to avoid thromboembolism during the perioperative period. A large prospective study and/or an additional meta-analysis would be required to further investigate how AT benefits standalone coil embolization in aSAH.
Source: Journal of NeuroInterventional Surgery - November 14, 2022 Category: Neurosurgery Authors: Takase, H., Tatezuki, J., Salem, M. M., Tayama, K., Nakamura, Y., Burkhardt, J.-K., Yamamoto, T. Tags: Hemorrhagic stroke Source Type: research

Real-world outcomes associated with the use of the EmboTrap revascularization device for ischemic stroke in the United States
Conclusions This is the first study in the US to report real-world outcomes sourced by retrospective database analysis among patients with AIS undergoing MT using the EmboTrap device. Further research is needed to better understand performance of the EmboTrap device in real-world settings.
Source: Journal of NeuroInterventional Surgery - October 14, 2022 Category: Neurosurgery Authors: Brinjikji, W., Ikeme, S., Kottenmeier, E., Khaled, A., M, S., Khanna, R. Tags: Ischemic stroke Source Type: research

Intracranial non-occlusive intraluminal thrombus may indicate underlying etiology of large vessel occlusion in patients undergoing endovascular therapy
Conclusions The presence of iNOT may reflect an underlying ICAS related LVO in patients undergoing EVT.
Source: Journal of NeuroInterventional Surgery - September 14, 2022 Category: Neurosurgery Authors: Jang, S. H., Park, H., Yoo, J., Hong, J.-H., Lee, J. S., Lee, S.-J., Kim, Y.-W., Hong, J. M., Choi, J. W., Kang, D.-H., Kim, Y.-S., Hwang, Y.-H., Sohn, S.-I. 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

O18 Causes and impact of incomplete reperfusion in eTICI 2b: insights from the ESCAPE-NA1 trial
ConclusionIncomplete reperfusion was most often caused by multiple small non-MT-accessible occlusions and was associated with development of infarct on follow-up imaging in more than half of the patients.ReferencesTung EL, Mctaggart RA, Baird GL, et al. Rethinking Thrombolysis in Cerebral Infarction 2b: which Thrombolysis in Cerebral Infarction Scales Best Define Near Complete Recanalization in the Modern Thrombectomy Era? Stroke; A Journal of Cerebral Circulation 2017;48(9):2488–93.Kaesmacher J, Ospel JM, Meinel TR, et al. Thrombolysis in Cerebral Infarction 2b Reperfusions: To Treat or to Stop? Stroke 3461–34...
Source: Journal of NeuroInterventional Surgery - August 29, 2022 Category: Neurosurgery Authors: Cimflova, P., Kappelhof, M., Singh, N., Sehgal, A., Ospel, J., Bala, F., Almekhlafi, M., Tymianski, M., Hill, M., Goyal, M. 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

P51 Case report of P1 segment occlusion with unilateral origin of posterior thalamoperforatoring arteries: the importance of basilar tip anatomy
ConclusionThis case highlights the importance of detection and treatment of a P1 occlusion, especially with unilateral origin of posterior thalamoperforating arteries, regardless of a dominant posterior communicating artery.
Source: Journal of NeuroInterventional Surgery - August 29, 2022 Category: Neurosurgery Authors: Pinto, E., Carneiro, A. Tags: 14th Congress of the European Society of Minimally Invasive Neurological Therapy 2022 Meeting Abstracts Source Type: research

P61 Double stent-retriever as first-line approach in mechanical thrombectomy - a randomized in vitro evaluation
ConclusionsUnder certain anatomical conditions, the double-SR technique combined with distal aspiration may induce a higher%FPE than single-SR. The perks of using double-SR as the primary approach are highlighted when treating saddle occlusions.ReferencesKlisch J, Sychra V, Strasilla C, et al. Double solitaire mechanical thrombectomy in acute stroke: effective rescue strategy for refractory artery occlusions? Ajnr Am J Neuroradiol 2015;36:552–6. Doi:10.3174/Ajnr.A4133Asadi H, Brennan P, Martin A, Looby S, O’hare A, Thornton J. Double stent-retriever technique in endovascular treatment of middle cerebral artery ...
Source: Journal of NeuroInterventional Surgery - August 29, 2022 Category: Neurosurgery Authors: Li, J., Tiberi, R., Vargas, D., Tomasello, A., Ribo, M., on behalf of the FLOWCAT Research Team Tags: 14th Congress of the European Society of Minimally Invasive Neurological Therapy 2022 Meeting Abstracts Source Type: research

P64 NIMBUS geometric clot extractor for tough clots: SPERO study results and clot composition
ConclusionsIn challenging cases with tough clot, first pass of NIMBUS retrieved clot richer in fibrin and lower in RBC content than clot retrieved with the first pass of standard MT devices.ReferencesFennell VS, Setlur Nagesh SV, Meess KM, Gutierrez L, James RH, Springer ME, Siddiqui AH. What to Do about Fibrin Rich ‘Tough Clots’? Comparing the Solitaire Stent Retriever with a Novel Geometric Clot Extractor in an in vitro Stroke Model. J Neurointerv Surg 2018 Sep;10(9):907–910. DOI: 10.1136/Neurintsurg-2017-013507. EPUB 2018 Jan 19. PMID: 29352061. Do you have any conflict of interest to declare?: YesConf...
Source: Journal of NeuroInterventional Surgery - August 29, 2022 Category: Neurosurgery Authors: van den Berg, R., Ribo, M., Arnberg, F., Estrade, L., Thornton, J., Tomasello Weitz, A., Gontu, V., Karam, A., Hernandez, D., Clarencon, F., Buhk, J.-H., Wiesmann, M., Nouri, N., Bricout, N., Desal, H., Januel, A., Doyle, K., Liebeskind, D., Brouwer, P., Tags: 14th Congress of the European Society of Minimally Invasive Neurological Therapy 2022 Meeting Abstracts Source Type: research

P74 Keep it simple: MAC (Manual Aspiration with Contrast) technique for the endovascular management of acute ischemic stroke (LVO & MVO)
We report a prospectively collected clinical experience with a simple technique: MAC (Manual Aspiration Contrast Enhancement) as the primary method for vessel recanalization.Gently contrast injection while the aspiration catheter is advancedto the thrombus and subsequentlycreating a closed-loop system with the contrast column within the cathetercan result in better visualization during the aspiration, thus improving the FPEavoiding clot fragmentation, multiple passes and blind movements of catheter by a single operator.Methods47 prospectively patients with ELVO and 3 cases of middle vessel occlusion (MVO) at four instituti...
Source: Journal of NeuroInterventional Surgery - August 29, 2022 Category: Neurosurgery Authors: Pabon, B., Torres, V., Patino, M., Pelaez, F., Mutis, J. Tags: 14th Congress of the European Society of Minimally Invasive Neurological Therapy 2022 Meeting Abstracts Source Type: research

P76 Fate of incomplete reperfusion caused by multiple small occlusions or slow flow in eTICI 2b reperfusion grade: insights from the ESCAPE-NA1 trial
ConclusionThe majority of incomplete reperfusion caused by multiple small occlusions or slow flow was associated with new infarction on follow-up imaging. In half of these cases, distal occlusions (meniscus sign) were detected, which could be potential targets for intra-arterial thrombolysis.ReferencesKaesmacher J, Ospel JM, Meinel TR, et al. Thrombolysis un Cerebral Infarction 2b Reperfusions. Stroke. September 2020. Do you have any conflict of interest to declare?: No
Source: Journal of NeuroInterventional Surgery - August 29, 2022 Category: Neurosurgery Authors: Cimflova, P., Singh, N., Kappelhof, M., Sehgal, A., Ospel, J., Bala, F., Almekhlafi, M., Tymianski, M., Hill, M., Goyal, M. Tags: 14th Congress of the European Society of Minimally Invasive Neurological Therapy 2022 Meeting Abstracts Source Type: research

P81 Novel synthetic clot analogs for in-vitro stroke modelling
ConclusionSelected synthetic clots can successfully be implemented in an in-vitro training environment of mechanical thrombectomy. The clots’ different properties might serve to mimic fibrin-rich and red blood cell human thrombi.ReferencesNadine Wortmann, Thomas Andersek, Helena Guerreiro, et al. Development of Synthetic Thrombus Models to Simulate Stroke Treatment in a Physical Neurointerventional Training Model, All Life 2022;15:1, 283–301, DOI:10.1080/26895293.2022.2046181Spallek J, Kuhl J, Wortmann N, et al. Design for Mass Adaptation of the Neurointerventional Training Model Hannes with Patient-specific An...
Source: Journal of NeuroInterventional Surgery - August 29, 2022 Category: Neurosurgery Authors: Guerreiro, H., Wortmann, N., Andersek, T., Ngo, T., Frölich, A., Krause, D., Fiehler, J., Kyselyova, A., Flottmann, F. Tags: 14th Congress of the European Society of Minimally Invasive Neurological Therapy 2022 Meeting Abstracts Source Type: research

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