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Proposed methodology and classification of Infarct in New Territory (INT) after endovascular stroke treatment
While the overall complication rates for endovascular treatment for acute stroke has been extremely low in recent trials, it is important to separate out and accurately document complications. One of these complications that is usually related to the endovascular intervention is Infarct in New Territory (INT). We propose a standardized methodology for documenting INT after the procedure. This new classification takes into account variations in vascular anatomy and location of the occlusion. In addition, given that after the recent trials, vascular imaging (eg, CT angiography (CTA)) is now the standard of care in the work u...
Source: Journal of NeuroInterventional Surgery - April 13, 2017 Category: Neurosurgery Authors: Goyal, M., Menon, B. K., Demchuk, A., Saver, J. L., Eesa, M., Majoie, C., Jayaraman, M., Hill, M. D. Tags: Standard Standards Source Type: research

MRI audit of complications in intracranial stenosis treated with Wingspan device
Conclusions ICAS treated by Wingspan stenting using pre-placement balloon angioplasty appears safe and effective with a high technical success rate and favorable outcomes. There is a high incidence of asymptomatic DWI hyperintensites post-procedure, but these do not appear to result in long-term sequelae.
Source: Journal of NeuroInterventional Surgery - April 13, 2017 Category: Neurosurgery Authors: Yeo, L. L. L., Wu, Y. M., Chen, Y. L., Yeh, C. H., Lee, T. H., Wong, H. F. Tags: Ischemic stroke Source Type: research

Streamlining door to recanalization processes in endovascular stroke therapy
Conclusions This pilot study demonstrates that D2P times can be significantly reduced with a standardized multidisciplinary approach. There was no significant difference in the rate of 3-month good outcome, which is most likely due to the small sample size and confounding baseline patient characteristics.
Source: Journal of NeuroInterventional Surgery - March 15, 2017 Category: Neurosurgery Authors: Aghaebrahim, A., Streib, C., Rangaraju, S., Kenmuir, C. L., Giurgiutiu, D.-V., Horev, A., Saeed, Y., Callaway, C. W., Guyette, F. X., Martin-Gill, C., Pacella, C., Ducruet, A. F., Jankowitz, B. T., Jovin, T. G., Jadhav, A. P. Tags: 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

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 modified 'no touch technique in the antegrade endovascular approach for left common carotid artery ostial stenosis stenting
Conclusions The modified ‘no touch’ antegrade endovascular technique is a feasible method for treating LCCA ostial lesions with a satisfactory initial success rate, acceptable procedure time, and comparable mid- and long-term results. This technique could be considered as a complementary option for LCCA ostial stenosis in addition to open surgery and the retrograde endovascular approach.
Source: Journal of NeuroInterventional Surgery - January 12, 2017 Category: Neurosurgery Authors: Tang, X., Long, W. A., Hu, C., Tang, F., Wang, Q., Li, L., Qiu, Sun Tags: Ischemic stroke Source Type: research

Quantitative analysis of hemorrhage clearance and delayed cerebral ischemia after subarachnoid hemorrhage
Conclusions The quantitative clot clearance rate is not an independent predictor for DCI.
Source: Journal of NeuroInterventional Surgery - August 11, 2016 Category: Neurosurgery Authors: Ko, S.-B., Choi, H. A., Helbok, R., Schmidt, J. M., Badjatia, N., Claassen, J., Connolly, E. S., Mayer, S. A., Lee, K. Tags: Hemorrhagic stroke Source Type: research

E-016 An Atherosclerotic Plaque Phantom for Medical Imaging
ConclusionA plaque phantom composed of a stenotic vessel wall and plaque components, including fibrous cap and a lipid core, was successfully constructed for multi-center HRMRI standardization.DisclosuresJ. Chueh: None. T. Turan: None. K. van der Marel: None. T. LeMatty: None. T. Brown: None. S. Ansari: None. T. Carroll: None. A. Buck: None. X. Zhou: None. A. Chatterjee: None. R. King: None. S. Zheng: None. R. Swartz: None. E. Feldmann: None. M. Gounis: None.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Chueh, J., Turan, T., van der Marel, K., LeMatty, T., Brown, T., Ansari, S., Carroll, T., Buck, A., Zhou, X., Chatterjee, A., King, R., Zheng, S., Swartz, R., Feldmann, E., Gounis, M. Tags: Electronic poster abstracts Source Type: research

E-019 Outcome of the Patients Presenting with Basilar Occlusions in a Busy Stroke Center Treated with new Generation Stent Retrievers
ConclusionAlthough the successful recanalization rate (TICI 2 b or higher) in basilar occlusions is high (18/23 (78.3%)), the mortality (10/23 (43%)) and morbidity with MRS ≥ 3 (5/23 (22%)) remains disappointingly high. In our study, good clinical outcome (MRS 0–2) was achieved in 30% (7/23) of patients, better than the natural course in basilar occlusions, which is encouraging. This group highlights the value of early presentation and a negative CT as strong predictors of a good outcome. The prognosis in patients with basilar occlusions with positive CT findings and unknown time of onset remain guarded.Disclosure...
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Akhtar, I., Halpin, J., Holloway, W., Martin, C., Akhtar, N. Tags: Electronic 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

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-099 Does Anterior Cerebral Artery Vasospasm after Spontaneous Subarachnoid Hemorrhage Predict Short Term Cognitive Outcome
ConclusionsOur study reaffirms that occurrence of DCI after SAH predicts poor cognitive outcome at 3 months. The fact that cognitive outcomes were not superior in patients treated for CVS suggests that a complex pathophysiology determines outcomes after SAH. Relatively poor cognitive outcome among patients with SAH in locations other than ACA/ACom alludes to involvement of functional neural network apart from frontal lobe based networks that needs further investigation.DisclosuresV. Pandav: None. B. Bohnstedt: None. L. Yearout: None. D. Thompson: None. B. Ray: None.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Pandav, V., Bohnstedt, B., Yearout, L., Thompson, D., Ray, B. Tags: Electronic poster abstracts Source Type: research

P-013 Use of the Solitaire Device for Emergency Revascularization of the Superior Mesenteric Artery
ConclusionsThe techniques and equipment used for acute stroke intervention may be suitable for acute recanalization of peripheral vessels, under the right circumstances. As with many surgical interventions, a multidisciplinary approach may at times yield a novel and effective strategy for a difficult clinical problem.DisclosuresJ. Dalfino: None. A. Paul: None. J. Hnath: None.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Dalfino, J., Paul, A., Hnath, J. Tags: Oral poster abstracts Source Type: research

P-014 A Six-Sigma Approach for Decreasing Door To Needle Times In Endovascular Stroke Therapy
ConclusionA protocol driven process can significantly improve efficiency of care in the time-sensitive stroke interventions.DisclosuresA. Rai: 1; C; stryker Neurovascular. 2; C; stryker Neurovascular. M. Smith: None. S. Boo: None. A. Tarabishy: None. G. Hobbs: None. J. Carpenter: None.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Rai, A., Smith, M., Boo, S., Tarabishy, A., Hobbs, G., Carpenter, J. Tags: Oral poster abstracts Source Type: research

Mechanical thrombectomy using a combined CT/C-arm X-ray system
Conclusions MT using a combined CT/C-arm system is safe and feasible. The potential advantages, particularly time saving and ensuing improvement in patient outcome, need to be assessed in a larger study.
Source: Journal of NeuroInterventional Surgery - May 12, 2016 Category: Neurosurgery Authors: Pfaff, J., Herweh, C., Pham, M., Schönenberger, S., Bösel, J., Ringleb, P. A., Heiland, S., Bendszus, M., Möhlenbruch, M. Tags: Open access, Neuroimaging Source Type: research

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