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P005/44 Using the pEGASUS-stent with antithrombogenic properties and single antiplatelet therapy in a case of thrombectomy
IntroductionRescue stenting is used more and more in stroke cases with large-vessel-occlusion or medium-vessel-occlusion refractory to mechanical thrombectomy. The pEGASUS-stent(Phenox) represents a device which is equipped with a hydrophilic polymer coating(HPC) with antithrombogenic properties. The coating allows for implantation under single antiplatelet therapy, thus possibly reducing the risk of bleeding in acute stroke cases.Case HistoryA 79-year-old woman was rushed to emergency room due to left-sided hemiparesis and National-Institutes-of-Health-Stroke-Scale(NIHSS) of 14. Computed-tomography-image showed an occlusi...
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Krug, N., Schulze-Zachau, V., Ntoulias, N., Psychogios, M. Tags: 4.3 CASE PROPOSAL - Acute ischemic stroke Source Type: research

E-135 Dejerine-roussy syndrome in the setting of right sigmoid sinus thrombosis: a unique case report
DiscussionThis case illustrates the important clinical aspects and physical findings needed to diagnose DRS. The presence of focal allodynia and hyperalgesia with recent cerebrovascular incidents provides significant evidence for DRS. The purpose of this case is to provide awareness and to increase clinical suspicion of DRS during examination, especially in the setting of cerebral venous sinus occlusion as infarction alone may not present as atypical allodynia.Disclosures S. Nittala: None. C. Jara: None. D. Raza: None. J. Cazzaniga: None. D. Filippi: None.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Nittala, S., Jara, C., Raza, D., Cazzaniga, J., Filippi, D. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

O-021 Concurrent middle meningeal artery embolization for treatment of chronic subdural hematomas
This study provides evidence from a multi-institutional cohort that performing concurrent MMAe in the perioperative period as an adjunct to surgical evacuation is a safe and effective means to reduce surgical recurrence in patients with NASHs.Abstract O-021 Table 1Procedural details of 145 patients (149 NASHs) who underwent concurrent MMAe Characteristic Value (range or%) Antiplatelet/anticoagulation use Antiplatelet 46/147* (31) Anticoagulant 29/148* (20) Both 9/148* (6) Prior SDH evacuation 38/149* (26) Perioperative platelet count < 100K 8/148* (5) Procedure details Anesthesia General 63/149* (42) MAC 57/149* (38) C...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Salah, W., Baker, C., Scoville, J., Hunsaker, J., Ogilvy, C., Moore, J., Riina, H., Levy, E., Spiotta, A., Jankowitz, B., Cawley, C., Khalessi, A., Tanweer, O., Hanel, R., Gross, B., Kuybu, O., Nguyen Hoang, A., Baig, A., Khorasanizadeh, M., Mendez, A., C Tags: SNIS 20th annual meeting oral 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

LB002 Long term effect of field triage on times to endovascular treatment for emergent large vessel occlusion
ConclusionsComparing adjacent states over time, the implementation of severity-based field triage significantly reduced time to EVT and improved clinical outcomes.Disclosures M. Jayaraman: None. G. Baird: None. K. Ouediat: None. G. Paolucci: None. R. Haas: None. R. Torabi: None. K. Moldovan: None. J. Rhodes: None. J. Potvin: None. N. Alexander-Scott: None. S. Yaghi: None. T. Madsen: None. K. Furie: None. R. McTaggart: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2022 Category: Neurosurgery Authors: Jayaraman, M., Baird, G., Ouediat, K., Paolucci, G., Haas, R., Torabi, R., Moldovan, K., Rhodes, J., Potvin, J., Alexander-Scott, N., Yaghi, S., Madsen, T., Furie, K., McTaggart, R. Tags: SNIS 19th annual meeting late-breaking oral abstracts Source Type: research

E-023 Predictors of outcomes in tandem anterior circulation occlusions following mechanical thrombectomy
In this study, we present outcomes of patients undergoing tandem mechanical thrombectomy. We demonstrate that stenting is associated with improved final reperfusion, but increased odds of asymptomatic ICH. Additional clinical trials should be performed to optimize the procedure and improve patient outcomes.Disclosures J. Catapano: None. D. Farhadi: None. A. Naik: None. S. Koester: None. E. Winkler: None. V. Srinivasan: None. K. Karahalios: None. J. Rulney: None. S. Desai: None. A. Jadhav: None. F. Albuquerque: None. A. Ducruet: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Catapano, J., Farhadi, D., Naik, A., Koester, S., Winkler, E., Srinivasan, V., Karahalios, K., Rulney, J., Desai, S., Jadhav, A., Albuquerque, F., Ducruet, A. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

E-055 Internal carotid artery reconstruction with flow diverting stents in the treatment of acute ischemic stroke: technical considerations and medical management
ConclusionsFDS appear to be a safe and effective tool for reconstruction of a symptomatic dissection in tortuous cervical ICAs. Their flexibility allows conformation to complex anatomies and they can be traversed multiple times by aspiration catheters/stentrievers. We found excellent patency at follow up. The unique challenges posed by utilization of high-profile stents in acute stroke require appropriate technical execution and medical management.Disclosures E. Orru: None. F. Bounni: None. M. Marosfoi: None. N. Patel: None. A. Wakhloo: 1; C; Philips medical. 2; C; Stryker, Phenox. 4; C; InNeuroCo, EpiEP, Neural Analytics, ThrombX.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Orru, E., Bounni, F., Marosfoi, M., Patel, N., Wakhloo, A. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

E-074 Case report: reconstructive endovascular treatment of symptomatic long segment dissection with pseudo-aneurysm of dominant left vertebral artery
We report a case of 27 year old Caucasian female with no known medical history who presented to our hospital with several days’ history of posterior headache and neck pain. CT head was unremarkable. CTA head and neck showed short segment of severe stenosis secondary to dissection at the V2-V3 junction of dominant left vertebral artery with associated 6 mm pseudo aneurysm. Right vertebral artery was hypoplastic and it ended in PICA. The dissection was presumed to be spontaneous as patient denied any trauma or strenuous neck manipulation or family history of connective tissue disorders. She was started on antiplatelet ...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Soomro, J., Greco, J., Whitis, J., Rao, S., Yoo, A. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

E-094 Trends in endovascular treatment of cervical artery dissections: a nationwide analysis
ConclusionsDespite an increase in the overall use of endovascular therapy for the treatment of cervical artery dissection in patients with ischemic stroke or TIA, there was no significant association with early clinical outcomes. Future studies looking at long term outcomes including stroke-recurrence are warranted.Disclosures M. Bouslama: None. C. Zhang: None. H. Kamel: 1; C; PI for the NIH-funded ARCADIA trial (NINDS U01NS095869) which receives in-kind study drug from the BMS-Pfizer Alliance for Eliquis® and ancillary study support from Roche Diagnostics. 2; C; Deputy Editor for JAMA Neurology, steering committee mem...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Bouslama, M., Zhang, C., Kamel, H., Merkler, A. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

E-187 Pipeline embolization stent for treatment of giant supraclinoid aneurysms: a case series
ConclusionThe Pipeline embolization device is a novel technique that can be utilized for treatment of giant cerebrovascular aneurysms with emerging evidence of immediate and long-term success. Further patient enrollment and clinical trials will be required to assess its efficacy in comparison to other endovascular and surgical approaches for the treatment of giant aneurysms.Disclosures M. Fana: None. O. Alsrouji: None. M. Rehman: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Fana, M., Alsrouji, O., Rehman, M. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

E-204 Outcomes of radial and femoral access in mechanical thrombectomy for posterior circulation occlusions: a multicenter propensity-adjusted analysis
In this study, we compare outcomes for radial and femoral access for MT in posterior circulation strokes.MethodsA retrospective analysis of all patients with a posterior circulation large vessel occlusion whom underwent mechanical thrombectomy at two large comprehensive stroke centers was performed. Data on demographics, clinical presentation, procedural data, including radial or femoral access, and outcomes were tabulated. Outcomes of interest included National Institute of Health Stroke Scale at discharge and 24-hours. The Thrombolysis in Cerebral Infarction (TICI) scale was used to ascertain revascularization after inte...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Catapano, J., Naik, A., Smoot, M., Vitek, G., Koester, S., Winkler, E., Srinivasan, V., Desai, S., Ducruet, A., Albuquerque, F., Jadhav, A. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

E-237 A 911 continuation of care protocol reduces door in, door out time for transfer patients with emergent large vessel occlusion
ConclusionUtilizing the 911 COC process for EMS transport of patients eligible for MT reduced DIDO time at the sending hospital, which may contribute to improved functional outcome.Disclosures R. Shaw: None. H. Rho: None. N. Sangha: None. J. Saver: 4; C; BrainQ, Clinical Trial Steering Committee. 6; C; Abbott, Clinical Trial Steering Committee, Medtronic, Clinical Trial Steering Committee, BrainsGate, Clinical Trial Steering Committee, Boehringer-Ingelheim (Prevention Only), Clinical Trial Steering Committee, Cerenovus, Clinical Trial Steering Committee, Phagenesis, Clinical Trial Steering Committee. C. Liang: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Shaw, R., Rho, H., Sangha, N., Saver, J., Liang, C. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

Getting ahead of stroke
In 2015, multiple randomized controlled trials clearly demonstrated that mechanical thrombectomy could save lives and prevent disability in patients with large vessel acute ischemic stroke. Neurointerventional surgeons and stroke neurologists celebrated a great win for our patients. We soon realized, however, that the hard work of implementation lay ahead. Hospitals and emergency medical services (EMS) were not optimally designed to ensure that patients with a stroke were brought to the right hospital rather than the closest one. These shortcomings resulted in patients unnecessarily being transferred between hospitals to r...
Source: Journal of NeuroInterventional Surgery - July 14, 2022 Category: Neurosurgery Authors: Mack, W. J. Tags: Editor ' s column Source Type: research

EP40 Teleproctoring in neurointerventionism
6 cases of neurovascular treatment with remote assistance are presented. various techniques (zoom, smart glasses and hospital internal system) 2 aneurysm treatments with flow diversion are presented. 1 case with web device. and 3 cases of stroke.All cases occurred during the covid 19 pandemic.Multiple tests were carried out during the simulation courses. Evaluating communication in real time. mastery of the images and mastery of the software.ReferenceBechstein M, et al. Interhospital teleproctoring of endovascular intracranial aneurysm treatment using a dedicated live-streaming technology: first experiences during the COVI...
Source: Journal of NeuroInterventional Surgery - August 24, 2021 Category: Neurosurgery Authors: Pabon, B., Torres, V., Patino, M., Serna, N., Vargas, O., Estrada, C., Pelaez, J., Mejia, J. Tags: Logistics Source Type: research

P-001 Non-contrast CT alone versus combined CT plus CTA or MRA selection for thrombectomy in acute ischemic stroke: analysis of the angel-act registry
DiscussionIn patients selected for MT using non-contrast CT alone versus CT combined with CTA/MRA, we found improved procedural outcomes (shorten door-to-reperfusion time) and similar clinical outcomes and safety profiles. Our real-world findings indicate MT can be safely and effectively performed in hospitals lacking 24/7 access to immediate CTA or MRA. The beneficial effect of using non-contrast CT-only may be present in patients with ultra-early symptoms to ED arrival (within the first hour) and should be further evaluated.Disclosures G. Ma: None. M. Mokin: None. B. Jia: None. A. P. Jadhav: None. X. Tong: None. D. Mo: N...
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Ma, G., Mokin, M., Jia, B., Jadhav, A., Tong, X., Mo, D., Ma, N., Gao, F., Huo, X., Luo, G., Song, L., Sun, X., Deng, Y., Wang, A., Zhang, X., Gui, L., Song, C., Peng, Y., Wu, J., Zhao, S., Zhao, J., Zhou, Z., Miao, Z., Ren, Z. Tags: Oral poster abstracts Source Type: research

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