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Woven EndoBridge device shape modification can be mitigated with an appropriate oversizing strategy: a VasoCT based study
Conclusion WShM can be partly overcome by use of an appropriate width oversizing strategy that could lead to improved angiographic results.
Source: Journal of NeuroInterventional Surgery - January 18, 2022 Category: Neurosurgery Authors: Caroff, J., Cortese, J., Girot, J.-B., Mihalea, C., Aguiar, G., Vergara Martinez, J., Ikka, L., Chalumeau, V., Rehem, M., Gallas, S., Ozanne, A., Moret, J., Spelle, L. Tags: Hemorrhagic stroke Source Type: research

Computed tomography-based triage of extensive baseline infarction: ASPECTS and collaterals versus perfusion imaging for outcome prediction
Conclusions The ASCO score was superior to the CTP-based model for the prediction of good functional outcome and could represent a quick, practical, and easily implemented method for the selection of low ASPECTS patients most likely benefit from MT.
Source: Journal of NeuroInterventional Surgery - September 15, 2021 Category: Neurosurgery Authors: McDonough, R., Elsayed, S., Faizy, T. D., Austein, F., Sporns, P. B., Meyer, L., Bechstein, M., van Horn, N., Nawka, M. T., Schön, G., Kniep, H., Hanning, U., Fiehler, J., Heit, J. J., Broocks, G. Tags: Ischemic stroke Source Type: research

Endovascular thrombectomy in patients with large core ischemic stroke: a cost-effectiveness analysis from the SELECT study
Conclusions In a non-randomized prospective cohort study, EVT resulted in better outcomes in large core patients with higher QALYs, NMB and high cost-effectiveness acceptability rates at current WTP thresholds. Randomized trials are needed to confirm these results. Clinical trial registration NCT02446587
Source: Journal of NeuroInterventional Surgery - September 15, 2021 Category: Neurosurgery Authors: Sarraj, A., Pizzo, E., Lobotesis, K., Grotta, J. C., Hassan, A. E., Abraham, M. G., Blackburn, S., Day, A. L., Dannenbaum, M. J., Hicks, W., Vora, N. A., Budzik, R. F., Sharrief, A. Z., Martin-Schild, S., Sitton, C. W., Pujara, D. K., Lansberg, M. G., Gup Tags: Ischemic stroke 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

EP59 Successful mechanical thrombectomy after microsurgical clipping of a ruptured middle cerebral artery aneurysm
We report about a 62 year old woman who was brought to the emergency room after being found down at home. On admission she was somnolent but accessible with mild focal neurological deficits. A computed tomography of the brain revealed a right temporal hematoma with subarachnoid and intraventricular hemorrhage due to a ruptured saccular aneurysm of the MCA trifurcation. A surgical approach was considered best treatment option and microsurgical clipping was performed. Intraoperative microvascular Doppler depicted a spontaneous thrombus formation in M1-Segment and the patient was transferred to the angio-suite for a mechanica...
Source: Journal of NeuroInterventional Surgery - August 24, 2021 Category: Neurosurgery Authors: Boutchakova-Meyer, M., Beyaz, P., Roth, C., Papanagiotou, P. Tags: Treatment 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

O-030 Super-selective middle meningeal artery embolization for chronic subdural hematoma using n-BCA with the sugar push technique: single center experience of 61 consecutive patients
ConclusionMMA embolization using diluted n-BCA with concomitant Dextrose 5% injection (Sugar-Rush) is associated with a high degree of distal penetration and complete branch occlusion and minimal risk of cranial nerve palsy or other thrombo-embolic complications. Clinical trials are warranted to compare long-term efficacy of this procedure with standard of care management.Disclosures S. Majidi: None. S. Matsoukas: None. R. De Leacy: None. P. Morgenstern: None. R. Soni: None. H. Shoirah: None. T. Shigematsu: None. J. Bederson: None. A. Berenstein: None. J. Mocco: None. J. Fifi: None. C. Kellner: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Majidi, S., Matsoukas, S., De Leacy, R., Morgenstern, P., Soni, R., Shoirah, H., Shigematsu, T., Bederson, J., Berenstein, A., Mocco, J., Fifi, J., Kellner, C. Tags: Oral abstracts 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

P-019 Clinical significance of contrast staining after mechanical thrombectomy for acute ischemic stroke
ConclusionContrast staining is associated with the development of ICH, particularly in the early period after MT and worse clinical outcomes. While patients with ICH had worse functional outcomes at discharge, contrast staining itself was not associated with worse outcomes. Lasty, larger diameter clot retriever devices and catheters were not significantly correlated with the presence of contrast staining.Disclosures T. Lazaro: None. P. Cotton: None. C. English: None. K. Katlowitz: None. O. Tanweer: None. D. Raper: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Lazaro, T., Cotton, P., English, C., Katlowitz, K., Tanweer, O., Raper, D. Tags: Oral poster abstracts Source Type: research

P-025 Large scale, CT evaluation can improve access to imaging studies within multi-center stroke trials
ConclusionsViz ICH VOLUME can screen large numbers of CT scans and send alerts within minutes to medical professionals searching for clinical trial candidates in time-sensitive environments. Studies relying on radiographic selection criteria may benefit from automated screening.Disclosures B. Jankowitz: 2; C; Stryker, Medtronic. J. Davies: None. J. Day: None. S. Chowdhry: None. C. Schirmer: None. N. Levkovitz: 5; C; Viz.ai. O. Bibas: 5; C; Viz.ai. E. Blanc: 5; C; Viz.ai. G. Pradilla: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Jankowitz, B., Davies, J., Day, J., Chowdhry, S., Schirmer, C., Levkovitz, N., Bibas, O., Blanc, E., Pradilla, G. Tags: Oral 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

E-057 Prospective prehospital evaluation of VAN and RACE large vessel occlusion prediction instruments on a mobile stroke unit
ConclusionsBoth VAN and RACE demonstrated measurable but limited benefit in predicting LVO in the field. In patients with LKW times of ≤1.5 hours, RACE showed a high NPV of 0.96. In this subset of patients, RACE could be used to rule out LVO in the prehospital setting, avoiding delays in care due to unnecessary transport to a thrombectomy-capable facility.Disclosures J. Hosny: None. J. Lynch: None. A. De Havenon: None. M. Tanweer: None. M. Alahmad: None. O. Zaidat: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Hosny, J., Lynch, J., De Havenon, A., Tanweer, M., Alahmad, M., Zaidat, O. Tags: Electronic poster abstracts Source Type: research

Successful recanalization in acute basilar artery occlusion treated with endovascular therapy is independent of thrombus length
Conclusions Successful recanalization does not depend on thrombus length in patients with BAO treated with EVT. Recanalization can therefore be achieved despite high clot burden. Additionally, a high density of thrombi was a strong predictor of a favorable outcome.
Source: Journal of NeuroInterventional Surgery - October 13, 2017 Category: Neurosurgery Authors: Shu, L., Riedel, C., Meyne, J., Jansen, O., Jensen-Kondering, U. 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

O-037 Comparative safety and efficacy of combined intravenous thrombolysis and mechanical thrombectomy with mechanical thrombectomy alone in emergent large vessel occlusion
Conclusions Our multicenter study appears to provide observational evidence that IVT pretreatment may improve MT outcomes in ELVO patients. The comparative efficacy of MT+IVT vs. MT monotherapy can be established only in the settings of a randomized-controlled clinical trial. Disclosures N. Goyal: None. G. Tsivgoulis: None. D. Frei: None. A. Turk: None. B. Baxter: None. M. Froehler: None. J. Mocco: None. M. Ishfaq: None. D. Hoit: None. L. Elijovich: None. D. Loy: None. R. Turner: None. J. Mascitelli: None. K. Espaillat: None. A. Alexandrov: None. A. Alexandrov: None. A. Arthur: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Goyal, N., Tsivgoulis, G., Frei, D., Turk, A., Baxter, B., Froehler, M., Mocco, J., Ishfaq, M., Hoit, D., Elijovich, L., Loy, D., Turner, R., Mascitelli, J., Espaillat, K., Alexandrov, A., Alexandrov, A., Arthur, A. Tags: Oral Abstracts Source Type: research

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