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Lesion stability characteristics outperform degree of stenosis in predicting outcomes following stenting for symptomatic intracranial atherosclerosis
Conclusions Lesion stability features, particularly non-hypoperfusion symptomatology, outperform percentage stenosis in predicting outcomes following treatment of ICAD with stents. Further examination is needed to better classify the natural history of ICAD and more precisely classify lesion stability.
Source: Journal of NeuroInterventional Surgery - December 13, 2015 Category: Neurosurgery Authors: Alexander, M. D., Cooke, D. L., Meyers, P. M., Amans, M. R., Dowd, C. F., Halbach, V. V., Higashida, R. T., Hetts, S. W. Tags: Ischemic stroke Source Type: research

Recanalization of acute basilar artery occlusion improves outcomes: a meta-analysis
Conclusions Recanalization of acute BAO leads to reduction in mortality by two-fold and reduction in the risk of DoD by 1.5-fold. This study underscores the equipoise in acute BAO for comparing systemic and endovascular therapies, and testing different time windows through RCTs.
Source: Journal of NeuroInterventional Surgery - November 13, 2015 Category: Neurosurgery Authors: Kumar, G., Shahripour, R. B., Alexandrov, A. V. Tags: Ischemic stroke Source Type: research

Endovascular treatment of acute intracranial vertebral artery dissection: long-term follow-up results of internal trapping and reconstructive treatment using coils and stents
Conclusions This study suggests that internal trapping is a stable and effective treatment for acute VAD. Reconstructive treatment using stent and coils could also be a feasible alternative modality for hemorrhagic type VAD. However, serial DSA follow-up is essential.
Source: Journal of NeuroInterventional Surgery - October 14, 2015 Category: Neurosurgery Authors: Nam, K. H., Ko, J. K., Cha, S. H., Choi, C. H., Lee, T. H., Lee, J. I. Tags: Hemorrhagic stroke Source Type: research

A reappraisal of the Pipeline embolization device for the treatment of posterior circulation aneurysms
Conclusions Patient selection is essential for safe and effective PED treatment of posterior circulation aneurysms. The PED is equally effective in achieving aneurysm obliteration with an acceptable risk profile as it is in the anterior circulation. Dolichoectatic aneurysms were not included in this treatment cohort. PED may be a preferable alternative to open surgical treatment of posterior circulation aneurysms.
Source: Journal of NeuroInterventional Surgery - August 12, 2015 Category: Neurosurgery Authors: Albuquerque, F. C., Park, M. S., Abla, A. A., Crowley, R. W., Ducruet, A. F., McDougall, C. G. Tags: Hemorrhagic stroke, New devices Source Type: research

Critical assessment of complications associated with use of the Pipeline Embolization Device
Conclusions Despite a low rate of permanent complications associated with the PED in this series, the total complication rate was high. This finding supports the conclusion that this device should be reserved for the most challenging aneurysms. Patients should be advised of this higher rate of transient periprocedural complications. Trial registration number IRB#:14BN027 Q7.
Source: Journal of NeuroInterventional Surgery - August 12, 2015 Category: Neurosurgery Authors: Park, M. S., Albuquerque, F. C., Nanaszko, M., Sanborn, M. R., Moon, K., Abla, A. A., McDougall, C. G. Tags: Hemorrhagic stroke, New devices Source Type: research

O-002 developing an interventional stroke service: improving clinical outcomes and reducing cost and delivering great cost saving benefits to health economy
ConclusionMechanical Thrombectomy has shown benefit in improving clinical outcomes with significant cost saving benefit to our institution and the community care. If the cost saving benefits is extrapolated to the stroke population of the United Kingdom or any other western country with a similar healthcare structure, this will lead to major savings to the healthcare economy. For this to materialize, there needs to a larger government initiative to streamline stroke pathways and provide adequate funding to develop this service uniformly across the country.DisclosuresS. Nayak: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Nayak, S. Tags: SNIS 12th Annual Meeting Oral Abstracts Source Type: research

P-009 trends and outcomes of mechanical thrombectomy in patients with acute ischemic stroke: a review of national in-patient database
ConclusionIntroduction of stent retrievers for mechanical thrombectomy in acute stroke intervention has significantly decreased the overall mortality as well as age-specific mortality, especially in patients with 65–79 and ≥80 years-of-age. Our findings suggest that age alone should not be an exclusion criterion for mechanical thrombectomy in an appropriate clinical setting.DisclosuresS. Boddu: None. X. Sun: None. M. Crimmins: None. D. Kimball: None. J. Knopman: None. A. Patsalides: None. P. Gobin: None. N. Lin: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Boddu, S., Sun, X., Crimmins, M., Kimball, D., Knopman, J., Patsalides, A., Gobin, P., Lin, N. Tags: SNIS 12th Annual Meeting Oral Poster Abstracts Source Type: research

E-063 validation of the interventional stroke assessment scale for eligibility in endovascular therapy (isas-et)
ConclusionThe use ISAS-ET scale appears to be appropriate in this single center study at predicting outcome using parameters prior to intervention. This data may help determine the urgency of transfer for intervention in hospitals without endovascular capabilities while helping determine which patients will benefit significantly from intervention.DisclosuresH. Dababneh: None. K. Sivakumar: None. T. Sibharwal: None. R. Kumar: None. G. Jain: None. A. Tiwari: None. K. Arcot: None. J. Farkas: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Dababneh, H., Sivakumar, K., Sibharwal, T., Kumar, R., Jain, G., Tiwari, A., Arcot, K., Farkas, J. Tags: SNIS 12th Annual Meeting Electronic Poster Abstracts Source Type: research

E-088 successful mechanical thrombectomy for basilar artery stroke in a 22-month old child
We present the case of a 22-month-old with basilar artery occlusion successfully treated with mechanical thrombectomy.The patient presented to the emergency department with altered mental status and gait ataxia. She "felt limp", her breathing was shallow, and her gaze dysconjugate. Her medical history included congenital heart defects with multiple cardiac procedures.In the emergency department, she fell with attempted ambulation. Labs were normal, as was a chest x-ray, and EKG. A computerized tomography (CT) scan of the head suggested left cerebellar hemisphere attenuation. The differential included arrhythmia, stroke, or...
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Roark, C., Savastano, L., Wilkinson, D., Shastri, R., Vadlamudi, V., Chaudhary, N., Pandey, A., Gemmete, J. Tags: SNIS 12th Annual Meeting Electronic Poster Abstracts Source Type: research

M1 is not M1 in ischemic stroke: the disability-free survival after mechanical thrombectomy differs significantly between proximal and distal occlusions of the middle cerebral artery M1 segment
Conclusions Proximal occlusions of the M1 segment of the MCA incorporating the lenticulostriate perforators are associated with a poorer clinical outcome than distal M1 occlusions that spare these perforators. Involvement of these perforators might become an additional predictor of clinical outcome after mechanical thrombectomy in ischemic stroke.
Source: Journal of NeuroInterventional Surgery - July 14, 2015 Category: Neurosurgery Authors: Behme, D., Kowoll, A., Weber, W., Mpotsaris, A. Tags: Ischemic stroke Source Type: research

M2 occlusions as targets for endovascular therapy: comprehensive analysis of diffusion/perfusion MRI, angiography, and clinical outcomes
Conclusions If suitable as targets of ET, M2 occlusions should be given the same consideration as M1 occlusions.
Source: Journal of NeuroInterventional Surgery - June 11, 2015 Category: Neurosurgery Authors: Sheth, S. A., Yoo, B., Saver, J. L., Starkman, S., Ali, L. K., Kim, D., Gonzalez, N. R., Jahan, R., Tateshima, S., Duckwiler, G., Vinuela, F., Liebeskind, D. S., for the UCLA Comprehensive Stroke Center 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

P-008 Loading Doses of Aspirin and Clopidogrel Prior to Enterprise Stent-assisted Repair of Intracranial Aneurysm-A Single Center Experience
Conclusions Using loading doses of aspirin and clopidogrel in Enterprise stent-assisted repair of intracranial aneurysm is not only safe and feasible but associated with good clinical outcome. Therefore, loading doses of aspirin and clopidogrel is an alternative option for patients who are candidates for stent-assisted repair of intracranial aneurysm. Disclosures Y. Lodi: None. V. Reddy: None. A. Devasenapathy: None. J. Chou: None. K. Shehades: None. K. Sethi: None. D. Galyon: None. S. Bajwa: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2014 Category: Neurosurgery Authors: Lodi, Y., Reddy, V., Devasenapathy, A., Chou, J., Shehades, K., Sethi, K., Galyon, D., Bajwa, S. Tags: Oral poster abstracts Source Type: research

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