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Overcoming the evening/weekend effects on time delays and outcomes of endovascular stroke therapy: the Calgary Stroke Program experience
Conclusions Some delays were encountered during evenings and weekend hours. Despite that, it was feasible to achieve a relatively short imaging to reperfusion times during these hours, in comparison to existing literature. A target universal time metric is needed to assess the timeliness of endovascular therapy in stroke centers.
Source: Journal of NeuroInterventional Surgery - November 7, 2014 Category: Neurosurgery Authors: Almekhlafi, M. A., Hockley, A., Desai, J. A., Nambiar, V., Mishra, S., Volny, O., Eesa, M., Demchuk, A. M., Menon, B. K., Goyal, M. Tags: Ischemic stroke Source Type: research

Severity of leukoaraiosis, leptomeningeal collaterals, and clinical outcomes after intra-arterial therapy in patients with acute ischemic stroke
Conclusions Severity of LA is linked to poor collateral grade in AIS patients undergoing IAT for PAO; however, greater LAv appears not to be a contraindication for acute intervention.
Source: Journal of NeuroInterventional Surgery - April 13, 2015 Category: Neurosurgery Authors: Giurgiutiu, D.-V., Yoo, A. J., Fitzpatrick, K., Chaudhry, Z., Leslie-Mazwi, T., Schwamm, L. H., Rost, N. S. Tags: Ischemic stroke Source Type: research

Stroke vision, aphasia, neglect (VAN) assessment--a novel emergent large vessel occlusion screening tool: pilot study and comparison with current clinical severity indices
Conclusions The VAN screening tool accurately identified ELVO patients and outperformed a NIHSS ≥6 severity threshold and may best allow clinical teams to expedite care and mobilize resources for ELVO patients. A larger study to both validate this screening tool and compare with others is warranted.
Source: Journal of NeuroInterventional Surgery - January 12, 2017 Category: Neurosurgery Authors: Teleb, M. S., Ver Hage, A., Carter, J., Jayaraman, M. V., McTaggart, R. A. Tags: Open access, Ischemic stroke Source Type: research

The 'pit-crew model for improving door-to-needle times in endovascular stroke therapy: a Six-Sigma project
Conclusions A protocol-driven process can significantly improve efficiency of care in time-sensitive stroke interventions.
Source: Journal of NeuroInterventional Surgery - April 13, 2016 Category: Neurosurgery Authors: Rai, A. T., Smith, M. S., Boo, S., Tarabishy, A. R., Hobbs, G. R., Carpenter, J. S. Tags: Open access, Ischemic stroke Source Type: research

Distinction between contrast staining and hemorrhage after endovascular stroke treatment: one CT is not enough
Conclusions There are no density thresholds for PCHDs that allow predicting the absence or presence of hemorrhage with 100% specificity and acceptable sensitivity. A CT scan performed at least 19–24 h after endovascular therapy is the only reliable method to differentiate contrast staining from hemorrhage.
Source: Journal of NeuroInterventional Surgery - March 15, 2017 Category: Neurosurgery Authors: Dekeyzer, S., Nikoubashman, O., Lutin, B., De Groote, J., Vancaester, E., De Blauwe, S., Hemelsoet, D., Wiesmann, M., Defreyne, L. Tags: Ischemic stroke Source Type: research

Impact of ASPECT scores and infarct distribution on outcomes among patients undergoing thrombectomy for acute ischemic stroke with the ADAPT technique
Conclusions Patients with moderate-sized core infarcts involving various distributions in either hemisphere can potentially achieve similar good outcomes compared with those with no core infarction at presentation. A treatment algorithm for acute ischemic stroke, which employs hardline ASPECTS thresholds or excludes patients with basal ganglia infarcts, might preclude patients who would potentially benefit from mechanical thrombectomy with ADAPT.
Source: Journal of NeuroInterventional Surgery - August 17, 2017 Category: Neurosurgery Authors: Hungerford, J. P., Hyer, M., Turk, A. S., Turner, R. D., Chaudry, M. I., Fargen, K. M., Spiotta, A. M. Tags: Ischemic stroke Source Type: research

Endovascular treatment for M2 occlusions in the era of stentrievers: a descriptive multicenter experience
Conclusions Endovascular treatment of M2 MCA occlusion with stentrievers seems safe. Induced recanalization may double the chances of achieving a favorable outcome, especially for patients with moderate or severe deficit.
Source: Journal of NeuroInterventional Surgery - March 12, 2015 Category: Neurosurgery Authors: Flores, A., Tomasello, A., Cardona, P., de Miquel, M. A., Gomis, M., Garcia Bermejo, P., Obach, V., Urra, X., Marti-Fabregas, J., Canovas, D., Roquer, J., Abilleira, S., Ribo, M., on behalf of the Catalan Stroke Code and Reperfusion Consortium (Cat-SCR) Tags: Ischemic stroke Source Type: research

Non-contrast head CT alone for thrombectomy in acute ischemic stroke: analysis of the ANGEL-ACT registry
Conclusions In patients selected for MT using NCHCT alone versus NCHCT + NVI, there were improved procedural outcomes and smaller increases in baseline mRS scores at 90 days.
Source: Journal of NeuroInterventional Surgery - August 12, 2022 Category: Neurosurgery Authors: Ren, Z., Ma, G., Mokin, M., Jadhav, A. P., Jia, B., Tong, X., Bauer, C., Liu, R., Wang, A., Zhang, X., Mo, D., Ma, N., Gao, F., Song, L., Sun, X., Huo, X., Deng, Y., Liu, L., Luo, G., Luo, X., Peng, Y., Gui, L., Song, C., Wu, J., Wang, L., Li, C., Jovin, Tags: Ischemic stroke Source Type: research

P-016 Relationship between stroke recurrence, infarct pattern, and vascular distribution in patients with symptomatic intracranial stenosis
Conclusion We determined that basilar artery stenosis was most likely to present as a perforator stroke. As expected, patients discharged with suboptimal medical therapy were twice as likely to have a recurrent stroke (29% versus 13%). Among patients with optimal medical therapy, no recurrent strokes were seen in patients with embolic infarct pattern, while 57% recurrence rate was seen in patients with a watershed infarct pattern, suggesting that an embolic infarct pattern on initial presentation is possibly related to underlying plaque instability that is modifiable with optimal medical therapy. On the other hand, initial...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Raghuram, K., Kohlnhofer, J., Durgam, A. Tags: Oral Poster Abstracts Source Type: research

E-046 Procedural Efficiency of the Streamlined Launchpad Stroke Admission Paradigm - A Single Center Experience
ConclusionThe streamlined stroke activation Launchpad protocol demonstrated an increased speed in patient admission and significant reduction in time from presentation to CT scan. This significant improvement in processing time allowed for an increased number of patients to meet the therapeutic window for IV tPA eligibility. A prospective trial will strengthen the current finding and support the implementation of this paradigm amongst other stroke centers.DisclosuresK. Sivakumar: None. S. Feuerwerker: None. D. Turkel-Parrella: None. A. Tiwari: None. J. Farkas: None. K. Arcot: None.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Sivakumar, K., Feuerwerker, S., Turkel-Parrella, D., Tiwari, A., Farkas, J., Arcot, K. Tags: Electronic poster abstracts Source Type: research

P92 Thrombectomy in ischemic stroke patients with extended lesion and time window
ConclusionVessel recanalization in patients with low ASPECTS and extended time window was associated with better functional outcomes in a time window up to 17.6h and ASPECTS of 3–5. The results of this study encourage current randomized trials investigating treatment of patients in the extended stroke lesion and time window.ReferencesNogueira RG, Jadhav AP, Haussen DC, et al. Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct. N Engl J Med.2018;378(1):11–21.Kaesmacher J, Chaloulos-Iakovidis P, Panos L, et al. Mechanical thrombectomy in ischemic stroke patients with alberta strok...
Source: Journal of NeuroInterventional Surgery - August 29, 2022 Category: Neurosurgery Authors: Broocks, G., Hanning, U., Bechstein, M., Kemmling, A., Fiehler, J., Meyer, L. Tags: 14th Congress of the European Society of Minimally Invasive Neurological Therapy 2022 Meeting Abstracts Source Type: research

EP41* Which transfer patients with stroke due to a large-vessel occlusion benefit from CT scan reevaluation prior to mechanical thrombectomy?
ConclusionPatients with age ≥80, NIHSS ≥18, ASPECTS ≤8 or reduced collateral score (modified Tan <2) might benefit from CT scan reevaluation after transfer and prior to MT.ReferencesPsychogios MN, et al. One-stop management of acute stroke patients minimizing door-to-reperfusion times. Stroke 2017.Jadhav AP, et al. Interfacility transfer directly to the neuroangiography suite in acute ischemic stroke patients undergoing thrombectomy. Stroke 2017.Mendez B, et al. Direct transfer to Angio-suite to reduce workflow times and increase favorable clinical outcome a case-control study. Stroke 2018.Requena M, et al. Tim...
Source: Journal of NeuroInterventional Surgery - August 24, 2021 Category: Neurosurgery Authors: Sousa, J., Machado, R., Cruz, L., Paiva-Simoes, J., Santos-Martins, L., Almendra, L., Nunes, C., Machado, C., Rodrigues, B., Galego, O., Nunes, C., Veiga, R., Machado, E., Silva, F., Santo, G., Sargento-Freitas, J. Tags: Imaging Source Type: research

O-020 Novel cone beam CT technology improves image quality for stroke assessment: a prospective series
ConclusionsThe latest generation of CB-CT scans & technology allow for exclusion of haemorrhages, stroke core definition and demonstration of brain perfusion and collaterals. These improvements suggest that CB-CT is acceptable for emergency stroke imaging assessment before mechanical thrombectomy, which may reduce door-to-groin puncture times and improve patient outcomes.ReferenceBourcier R, Goyal M, Liebeskind DS, et al. Association of time from stroke onset to groin puncture with quality of reperfusion after mechanical thrombectomy: a meta-analysis of individual patient data from 7 randomized clinical trials. JAMA Ne...
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Cancelliere, N., Nicholson, P., Nijnatten, F., Hummel, E., Withagen, P., van de Haar, P., Agid, R., Hallacoglu, B., van Vlimmeren, M., Mendes Pereira, V. Tags: Oral abstracts Source Type: research

E-054 Correlation between Thrombus Density and Recanalization or Stroke Etiology in Acute Ischemic Stroke
ConclusionIn conclusion, our study found no relationship between thrombus attenuation and recanalization success or stroke etiology. While prior studies have suggested that higher attenuation is associated with good recanalization, our study could not find such a link.4 More studies are required to identify factors that predict successful recanalization in acute ischemic stroke patients.DisclosuresM. Jagani: None. W. Brinjikji: None. D. Kallmes: 1; C; ev3, MicroVention, Sequent, Codman. 2; C; ev3, Medtronic, Codman. 3; C; Microvention.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Jagani, M., Brinjikji, W., Kallmes, D. Tags: Electronic poster abstracts Source Type: research

E-056 Anatomical findings at the circle of willis and cervical carotid arteries during large vessel occlusion stroke: Observations from computed tomography angiography
ConclusionsStroke severity and native collateral during LVO is unrelated to circle of Willis anatomy. Ophthalmic artery calibers show some relationship to stroke severity. Our findings also support the notion of acute progression of moderate and severe NASCET stenoses to near occlusion or complete occlusion at the onset of LVO stroke, such that no cases exhibited moderate or severe 55-95% narrowing.Disclosures R. Kiwan: None. S. Lownie: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Kiwan, R., Lownie, S. Tags: Electronic poster abstracts Source Type: research

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