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E-145 Mortality following mechanical thrombectomy for ischemic stroke in patients with COVID-19
ConclusionOverall, this study indicates that COVID-19 is a predictor of mortality among mechanical thrombectomy. This finding is likely multifactorial but may be related to multisystem inflammation, hypercoagulability, and re-occlusion seen in COVID-19 patients. Treatment-related factors, such as delays in care, may also play a role. Additional research would be needed to further delineate these findings.Disclosures J. Dallas: None. T. Wenger: None. K. Liu: None. L. Ding: None. B. Hopkins: None. F. Attenello: None. W. Mack: None.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Dallas, J., Wenger, T., Liu, K., Ding, L., Hopkins, B., Attenello, F., Mack, W. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-150 Mechanical thrombectomy in distal middle cerebral artery occlusions using a novel blind exchange mini-pinning technique: experience in 7 consecutive cases
ConclusionBlind mini-pinning allows for combined use of distal stentriever with a 035 thrombectomy catheter, affording a larger ID than traditional microcatheter engagement of the thrombus with enhanced stability for removal, and improved reperfusion rates in distal occlusions. This technique may be efficacious for the treatment of distal occlusions and further studies are needed to compare outcomes in distal occlusions.Abstract E-150 Figure 1(A) Deployment and blind mini-pinning navigation of 035 aspiration catheter (blue) through 071 (black) and 088 thrombectomy catheter (orange) into the M2 segment with follow-up angiog...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Meyer, B., Campos, J., Zarrin, D., Khan, M., Collard de Beaufort, J., Amin, G., Golshani, K., Beaty, N., Bender, M., Colby, G., Lin, L., Coon, A. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-152 Cone-beam CT angiogram acquisition in the angiography suite for LVO detection in acute ischemic stroke
ConclusionDTAS triage workflow with cone-beam head CT and CTA image acquisition in the angiography suite may be a next step to further optimize LVO stroke pathways by bypassing conventional CT/MR. This new workflow has the potential to further decrease door-to-needle times and thereby may improve patient outcome.Disclosures A. Kuhn: None. J. Singh: None. M. Garcia: None. S. Sarid: None. M. Gounis: 1; C; National Institutes of Health (NIH), the United States – Israel Binational Science Foundation, Anaconda, ApicBio, Arsenal Medical, Axovant, Balt, Cerenovus, Ceretrieve, CereVasc LLC, Cook Medical, Gal. 2; C; fee-per-h...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Kuhn, A., Singh, J., Garcia, M., Sarid, S., Gounis, M., Anagnostakou, V., Puri, A. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-153 Mechanical thrombectomy for patients older than 80 years old with large vessel occlusion stroke: systematic review and meta-analysis
ConclusionOur results suggest that MT in the elderly population is effective to achieve functional independence. Our data was unable to provide information about 90-days mortality, all ICH and sICH. Given our limitations, a RCT comparing MT versus MM in this population would be needed to confirm our results. However, including elderly patients in RCTs is always challenging. So, our results could provide support in the real world to offer this highly effective treatment to this challenging population.Disclosures J. Sequeiros: None. M. Cornejo: None. F. Terry: None. C. Zackbutton: None. M. Rodriguez: None. H. Zaver: None. O....
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Sequeiros, J., Cornejo, M., Terry, F., Zackbutton, C., Rodriguez, M., Zaver, H., Saeed, O., Goyal, N., Inoa, V. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-166 The effect of covid-19 on treatment and outcomes following ischemic stroke: a national assessment
ConclusionThis study identified a relationship between COVID-19 diagnosis and worse outcomes for each metric assessed. Most notably, even when controlling for disease-related factors, patients with COVID-19 were significantly less likely to undergo mechanical thrombectomy. Further, COVID-19 was associated with increased in-hospital mortality and worsened discharge disposition, although the exact causal relationship of this is unclear. Several factors might underly this, ranging from systemic/multisystem inflammation and worsened disease severity to logistical barriers to treatment caused by COVID-19. Further research is ne...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Dallas, J., Liu, K., Wenger, T., Lin, M., Ding, L., Attenello, F., Mack, W. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-173 Thrombectomy passes and clinical outcomes in patients with stroke intervention beyond 24 hours
ConclusionIn our patients undergoing MT beyond the 24-hour window, the number of device passes was not associated with functional outcome, successful recanalization, or sICH. This may be due to the delayed intervention window, small sample size, or other factors. A larger study and further investigation is warranted.Disclosures A. Pandhi: None. A. Alrohimi: None. M. Abdulrazzak: None. M. Bain: None. N. Moore: None. M. Hussain: None. D. Wadden: None. J. Bullen: None. G. Toth: None.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Pandhi, A., Alrohimi, A., Abdulrazzak, M., Bain, M., Moore, N., Hussain, M., Wadden, D., Bullen, J., Toth, G. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-185 Study design and rationale of THUNDER: an acute ischemic stroke study with the penumbra system including thunderbolt aspiration tubing
ConclusionWe report the design of THUNDER—a multicenter prospective study that examines the use of a novel modulated aspiration thrombectomy system in patients with AIS secondary to LVO.Disclosures D. Fiorella: 1; C; Cerenovus, Medtronic, Siemens, Stryker, Microvention, Penumbra. 2; C; Balt, Marblehead, Medtronic, Stryker, Microvention, Penumbra, Cerenovus. K. Woodward: 2; C; Coviden. E. Levy: None. C. Matouk: 2; C; Silk Road Medical, Penumbra, MicroVention-TERUMO, Medtronic, Stryker. 3; C; Silk Road Medical, Penumbra. I. Kaminsky: 3; C; Penumbra. K. Reuland: None. M. Stiefel: None. A. Kansagra: 1; C; Penumbra. 2; C;...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Fiorella, D., Woodward, K., Levy, E., Matouk, C., Kaminsky, I., Reuland, K., Stiefel, M., Kansagra, A., Frei, D. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-186 Assessing congruency of first pass effect on outcomes in mechanical thrombectomy for large vessel occlusions via unsupervised machine learning
This study was approved by the local institutional review board (IRB). Clustered outcomes to formulate clusters included the number of passes, the final reperfusion obtained, the discharge NIHSS, and complications. FPE was defined as TICI 2C or 3 reperfusions on the first pass. Uniform manifold approximations and projections (UMAP) and K-means unsupervised clustering were done to identify outcome clusters. Logistic regression with and without interaction coefficients was used to determine associated factors with cluster membership or FPE. P-values less than 0.05 were considered significant.Results287 consecutive patients w...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Catapano, J., Naik, A., Koester, S., Singh, R., Ostinnington, H., Rangel, I., Desai, S., Winkler, E., Ducruet, A., Albuquerque, F., Jadhav, A. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-189 Outcomes of tenecteplase versus alteplase after mechanical thrombectomy in a multiethnic stroke consortium registry
ConclusionIn this prospective, multi-center stroke consortium study, IV TNK in comparison to tPA prior to MT for ischemic stroke resulted in non-inferior outcomes related to angiographic reperfusion and functional status at discharge. These findings compliment the current literature and include a large Hispanic US cohort. Further analysis will include expansion of contributing centers and use of propensity scoring.Abstract E-189 Table 1 and 2Disclosures M. Gaub: None. D. Ramaswamy: None. A. Cardentey: None. S. Bandela: None. G. Gealogo: None. J. Mascitelli: None. F. Al Saiegh: None. L. Birnbaum: 2; C; Rapid AI, Imperative Care.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Gaub, M., Ramaswamy, D., Cardentey, A., Bandela, S., Gealogo, G., Mascitelli, J., Al Saiegh, F., Birnbaum, L. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-197 Use of balloon-mounted stents and drug eluting stents in intracranial atherosclerotic disease: single center experience
ConclusionDES appears effective and relatively safe with good long-term outcomes in treating intracranial atherosclerosis and secondary stroke prevention and is associated with lower delayed in-stent stenosis on follow up imaging compared to BMS and Wingspan stents. Use of DES for symptomatic ICAD in acute and non-emergent settings warrants further investigation.Balloon mounted stent, drug eluting stent, Wingspan, intracranial atherosclerotic disease, outcomes.Disclosures N. Turan: None. A. Malek: 2; C; CereVasc Inc.. 4; C; CereVasc Inc.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Turan, N., Malek, A. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-211 Association of cerebrovascular injury and secondary vascular insult with poor outcomes following gunshot wound to the head in a large civilian population
ConclusionThese data suggest that intracranial CVI from GSWH and associated secondary vascular insult are associated with poor outcomes. Given the high prevalence and potentially reversible nature of these secondary injuries, early screening with vascular imaging and treatment of underlying cerebrovascular injury may prove critical to improve outcomes by reducing the rate of stroke and re-hemorrhage.Abstract E-211 Figure 1Disclosures J. Lamanna: None. J. Gutierrez: None. A. Alawieh: None. C. Funk: None. R. Rindler: None. F. Ahmad: None. B. Howard: None. S. Gupta: None. D. Gimbel: None. R. Smith: None. G. Pradilla: None. J. Grossberg: None.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Lamanna, J., Gutierrez, J., Alawieh, A., Funk, C., Rindler, R., Ahmad, F., Howard, B., Gupta, S., Gimbel, D., Smith, R., Pradilla, G., Grossberg, J. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-212 A comparison of outcomes between transfemoral versus transradial access for carotid stenting
ConclusionThe TR approach is safe, feasible, and provides similar rates of complications and high rates of successful stent deployment compared with the TF route. Neurointerventionalists adopting the radial first approach should carefully assess the pre-procedural computed tomography angiography to identify patients amenable to TR approach for carotid stenting.Abstract E-212 Table 2Comparison of outcomes between trans-radial vs trans-femoral access Outcome Trans-Femoral (n=232) Trans-Radial(n=110) Odds Ratioβ(95% CI) p-valueβ Odds Ratio*(95% CI) p-value* Primary Outcome: Any Complication, n (%) 15 (6.5%) 3 (2.7%...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: El Naamani, K., Khanna, O., Syal, A., Momin, A., Abbas, R., Amllay, A., Sambangi, A., Hunt, A., Dougherty, J., Lawall, C., Tjoumakaris, S., Gooch, M., Herial, N., Rosenwasser, R., Zarzour, H., Schmidt, R., Jabbour, P. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-219 Direct vs indirect revascularization for moyamoya: a large multicenter study
ConclusionSince both modalities showed comparable rates of overall total strokes, both modalities of revascularization can be performed depending on the patient’s risk assessment.Abstract E-219 Table 1Direct Indirect Effect variable Value (95% confidence interval) P-value Primary Outcome Symptomatic stroke, n (%) 23/198 (11.6) 19/198 (9.6) Odds ratio 1.238 (0.651 - 2.354) 0.514 Secondary Outcomes Symptomatic ischemic stroke, n (%) 23/198 (11.6) 16/198 (8.1) Odds ratio 1.495 (0.764 - 2.924) 0.240 Symptomatic hemorrhagic stroke, n (%) 0/198 (0) 3/198 (1.5) –– –– 0.248 Peri-operative stroke,...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: El Naamani, K., Chen, C., Jabre, R., Saad, H., Grissberg, J., Dmytriw, A., Patel, A., Khorasanizadeh, M., Ogilvy, C., Thomas, A., Monteiro, A., Siddiqui, A., Cortez, G., Hanel, R., Porto, G., Spiotta, A., Piscopo, A., Hasan, D., Ghorbani, M., Weinberg, J. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-222 Endovascular thrombectomy for basilar artery occlusion - a national inpatient sample analysis
ConclusionsIn this NIS analysis of patients with BAO presenting with an NIHSS ≥ 20, demonstrates that EVT trends towards, although nonsignificant, rates of favorable functional outcomes.Disclosures L. Fry: None. A. Alkisawni: None. G. LeBeau: None. C. Heskett: None. F. DeStefano: None. C. Lei: None. K. Le: None. A. Brake: None. J. Peterson: None. A. Rouse: None. K. Ebersole: None.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Fry, L., Alkisawni, A., LeBeau, G., Heskett, C., DeStefano, F., Lei, C., Le, K., Brake, A., Peterson, J., Rouse, A., Ebersole, K. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

E-223 Improved time to diagnosis with portable MR imaging
ConclusionPortable MRI is a promising innovation with the aim to expand patient access and improve diagnostic times so that critical and potential lifesaving imaging diagnoses can be promptly treated with the urgency that is required. While initial analysis provides evidence that portable MRI has advantages over conventional MRI systems including workflow efficiency and improved patient imaging times, this will need to be compared to the unfortunate negative drawbacks of lessened image resolution and limited imaging sequences that come with the convenience of portable MRI systems. If the hypothesis is further corroborated,...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Richardson, O., Richardson, A., Mukherjee, S. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

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