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P124/272 Initial encounter with a cutting-edge mobile head CT scanner (Somatom On.site) in a neuro-intensive care unit
ConclusionThe study demonstrates the clinical effectiveness of modern mobile CT scanners in neurointensive care units. The Somatom On.site provides sufficient image quality, saves time and supports timely decision making. The integration of mobile CT scanners in NICUs improves patient care and workflow. Prospective studies are needed to validate these findings and assess the long-term impact in NICUs and other units, such as stroke units.Disclosure of InterestCK serves as consultants for Acandis GmbH (Pforzheim, Germany) and proctor for MicroVention Inc./Sequent Medical (Aliso Viejo, CA, USA).
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Goertz, L., Al-Sewaidi, Y., Habib, M., Ranft, A., Kabbasch, C. Tags: 3.1 OTHER - Innovation Source Type: research

P131/196 Comparison of accuracy of CT perfusion software packages in patients with acute ischemic stroke. Can we get closer to the core?
ConclusionCore volume estimations and accuracy vary significantly between CTP software packages and should be acknowledged. Best agreement with segmented infarct volumes was provided by CP. SV method B with smoothing showed the best results for syngo.via.Disclosure of Interestnothing to disclose
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Thormann, M., Faltass, M., Schwab, R., Stefan, K., Behme, D. Tags: 2.2 ISCHEMIC - Imaging Source Type: research

P163/235 Thrombolysis and collateral flow in interhospital transfer for thrombectomy: implications for recanalization and infarct growth
ConclusionCollateral flow and thrombolysis may have a positive interaction in macrovascular recanalization. However, thrombolysis does not appear to interfere with collateral-mediated infarct growthDisclosure of InterestNothing to disclose
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Sousa, J., Bernardo-Castro, S., Machado, R. B., Maia, C., Cruz, L., Simoes, J., Martins, A. I., Bras, A., Almendra, L., Nunes, C., Machado, C., Rodrigues, B., Veiga, R., Nunes, C., Silva, F., Pereira R Cordeiro Santo, G. A., Machado, E., Freitas, J. S. Tags: 2.3 ISCHEMIC - Treatment Source Type: research

O05/57 Validation of a novel multiphase CTA perfusion tool compared to CTP in patients with suspected acute ischemic stroke
Conclusion mCTAp shows similar performance compared to CTP in assisting readers to detect ischemia and its side/location, requiring less radiation exposure, acquisition time and contrast-dose compared to additional-CTP, but mainly as it relates to proximal vessel occlusions.Disclosure of InterestDr. Menon holds patents on systems of triage in acute stroke, for LVO detection and for mCTAp, and stock ownership in Circle Cardiovascular Inc. Dr. Bala has nothing to declare. Dr. Duszynski is an employee of, and holds stock options for Circle Cardiovascular Imaging Inc. Dr. Nayem Pinky, Dr. Golan and Luis A Souto Maior Neto are ...
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Benali, F., Zhang, J., Pinky, N., Bala, F., Alhabli, I., Golan, R., Neto, S., Elebute, I., Duszynski, C., Qiu, W., Menon, B. Tags: 2.2 ISCHEMIC - Imaging Source Type: research

O16/158 Artificial Intelligence based nationwide centralised decision supporting system for improving stroke case efficiency in Hungary
ConclusionUsing AI based centralized stroke imaging network fast and reliable decision support can be provided to a large nationwide stroke care system. The system was installed with the support of an EU grant EFOP 5.2.6.Disclosure of InterestIstvan Szikora has a consulting agreement with Brainomix Ltd.Zoltan Chadaide is a former employee of Brainomix Ltd.Edvard Benes is owner and CEO of eRAD-BBThe system was built by the support of an EU grant EFOP 5.2.6.The other authors have no relevant conflict of interest.
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Szikora, I., Magyar, B., Papai, G., Szudi, G., Kondor, M., Czencz, M., Nardai, S., Chadaide, Z., Benes, E., Ovary, C., Eross, L. Tags: 2.2 ISCHEMIC - Imaging Source Type: research

P023/222 Traveler, there is no path. The path is made by walking
ConclusionCT angiography showed an apparent lack of access to reach the basilar artery. Nevertheless, the active search for unconventional roads led us to take advantage of an, a priori, non-navigable vessel, with successful recanalization. This underlines that patients should not be refused endovascular treatment based on the apparent lack of access to the cerebral circulation.Disclosure of InterestNothing to disclose
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Rodriguez-Ares, T., Baptista, M., Fragata, I., Reis, J. Tags: 4.4 CASE PROPOSAL - Complications Source Type: research

Alberta Stroke Program Early CT Score and collateral status predict target mismatch in large vessel occlusion with delayed time windows
Conclusions NCCT ASPECTS had a strong correlation with CTP core volumes in patients with LVO-AIS in delayed time windows. Combining NCCT ASPECTS with sCTA-CS resulted in a more accurate prediction of target mismatch. If a CTP scan is not available, NCCT ASPECTS combined with sCTA-CS may guide clinicians in making treatment decisions.
Source: Journal of NeuroInterventional Surgery - August 17, 2023 Category: Neurosurgery Authors: Hang, Y., Wang, C. d., Ni, H., Cao, Y., Zhao, L. B., Liu, S., Shi, H.-B., Jia, Z. Tags: Ischemic stroke Source Type: research

E-115 Trans-radial versus trans-femoral access routes for diagnostic cerebral angiograms: a large single-center comparative cost-analysis study
ConclusionOverall, our study shows that the TR approach can be less a less expensive option for patients undergoing diagnostic cerebral angiograms, especially if complications occur. Future studies can corroborate our findings and potentially lead to the adoption of TR as a low-cost, efficient, gold-standard technique for cerebral angiography.Costs (dollars) Associated with Trans-Radial Versus Trans-Femoral AccessAbstract E-115 Table 1 Variable Trans-Femoral (n=314) Trans-Radial(n=612) P-value Total Cost, mean (SD) 12591.8 (19128) 12789.5 (18424) .88 Catheters, median (range) 12.4 (12.4-1900) 55.2 (12.4-369) .03 Closure d...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: El Naamani, K., Atallah, E., Momin, A., Jain, P., Hunt, A., Sambangi, A., Carreras, A., El Fadel, O., Gooch, M., Tjoumakaris, S., Zarzour, H., Schmidt, R., Herial, N., Rosenwasser, R., Jabbour, P. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

O-017 Viz LVO versus rapid LVO in detection of large vessel occlusion on computed tomography angiography for acute stroke
ConclusionViz LVO and Rapid LVO had similar NPV, but Rapid LVO produced a significantly larger number of false positive values. False positive values can be a source of alarm desensitization, leading to missed alarms or delayed responses. EF and intracranial atherosclerosis were significant predictors of incorrect predictions in both software packages. We hope this data will be used to improve future algorithms.Disclosures A. Delora: None. C. Hadjialiakbari: None. E. Percenti: None. A. Hassan: 1; C; LVO SYNCHRONIZE-Viz.ai. 2; C; Viz.ai. Y. Alderazi: None. J. Torres: None. M. Ezzeldin: None.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Delora, A., Hadjialiakbari, C., Percenti, E., Hassan, A., Alderazi, Y., Torres, J., Ezzeldin, M. Tags: SNIS 20th annual meeting oral 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

Republished:Delayed aneurysm rupture following treatment with the WEB embolization device
We present a case of a multiply ruptured anterior communicating artery aneurysm treated via WEB embolization. A post-treatment CT scan confirmed no evidence of rebleeding during treatment. Four hours after treatment, the patient developed an acute, significant increase in intracranial pressure with bloody ventriculostomy output, with CT scan demonstrating new parenchymal and intraventricular hemorrhage. The aneurysm was subsequently treated via microsurgical clipping that did not identify an "uncovered" bleb or rupture source.
Source: Journal of NeuroInterventional Surgery - February 14, 2023 Category: Neurosurgery Authors: Gross, B. A., Lang, M. J. Tags: Hemorrhagic stroke Source Type: research

The butterfly effect: improving brain cone-beam CT image artifacts for stroke assessment using a novel dual-axis trajectory
Conclusions Recent developments in CBCT imaging protocols have significantly improved image artifacts, which has improved diagnostic confidence for stroke and supports a direct-to-angiography suite transfer approach for patients with acute ischemic stroke.
Source: Journal of NeuroInterventional Surgery - February 14, 2023 Category: Neurosurgery Authors: Cancelliere, N. M., Hummel, E., van Nijnatten, F., van de Haar, P., Withagen, P., van Vlimmeren, M., Hallacoglu, B., Agid, R., Nicholson, P., Mendes Pereira, V. Tags: Open access, Neuroimaging Source Type: research

AI software detection of large vessel occlusion stroke on CT angiography: a real-world prospective diagnostic test accuracy study
Conclusions These accuracy metrics support Viz LVO as a useful adjunct tool in stroke diagnostics. Fast and accurate diagnosis with high negative predictive value mitigates missing potentially salvageable patients.
Source: Journal of NeuroInterventional Surgery - December 14, 2022 Category: Neurosurgery Authors: Matsoukas, S., Morey, J., Lock, G., Chada, D., Shigematsu, T., Marayati, N. F., Delman, B. N., Doshi, A., Majidi, S., De Leacy, R., Kellner, C. P., Fifi, J. T. Tags: New devices New devices and techniques Source Type: research

Carotid artery direct access for mechanical thrombectomy: the Carotid Artery Puncture Evaluation (CARE) study
Conclusion In this large multicentric study, DCP was scantly performed for vascular access to perform MT (0.39%) in patients with AIS-LVO and had a high rate of complications (18.5%). Our results provide arguments for not closing the cervical access by manual compression after MT.
Source: Journal of NeuroInterventional Surgery - November 14, 2022 Category: Neurosurgery Authors: Dumas, V., Kaesmacher, J., Ognard, J., Forestier, G., Dargazanli, C., Janot, K., Behme, D., Shotar, E., Chabert, E., Velasco, S., Bricout, N., Ben Hassen, W., Veunac, L., Geismar, M., Eugene, F., Detraz, L., Darcourt, J., L'Allinec, V., Eker, O. F., Conso Tags: Ischemic stroke Source Type: research

Quantification of clot spatial heterogeneity and its impact on thrombectomy
Conclusions Clot heterogeneity can affect the clot response to thrombectomy devices and is associated with lower FPE. SHI can be a useful metric to quantify clot heterogeneity.
Source: Journal of NeuroInterventional Surgery - November 14, 2022 Category: Neurosurgery Authors: Liu, Y., Brinjikji, W., Abbasi, M., Dai, D., Arturo Larco, J. L., Madhani, S. I., Shahid, A. H., Mereuta, O. M., Nogueira, R. G., Kvamme, P., Layton, K. F., Delgado Almandoz, J. E., Hanel, R. A., Mendes Pereira, V., Almekhlafi, M. A., Yoo, A. J., Jahromi, Tags: Basic science Source Type: research

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