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Post-reperfusion hyperperfusion after endovascular stroke treatment: a prospective comparative study of TCD versus MRI
Conclusions TCD is a reliable bedside tool to identify post-reperfusion hyperperfusion, correlates well with perfusion MRI, and indicates risk of reperfusion injury after MT.
Source: Journal of NeuroInterventional Surgery - September 15, 2023 Category: Neurosurgery Authors: Kneihsl, M., Hinteregger, N., Nistl, O., Deutschmann, H., Horner, S., Poltrum, B., Fandler-Höfler, S., Hatab, I., Haidegger, M., Pinter, D., Pichler, A., Willeit, K., Knoflach, M., Enzinger, C., Gattringer, T. Tags: Ischemic stroke Source Type: research

Persistent perfusion abnormalities at day 1 correspond to different clinical trajectories after stroke
Conclusion ASL hypoperfusion within the infarct and the surrounding tissue was associated with poor outcome. A more comprehensive view of the mechanisms in the hypoperfused surrounding tissue could help to design new therapeutic approaches during and after reperfusion therapies.
Source: Journal of NeuroInterventional Surgery - August 29, 2023 Category: Neurosurgery Authors: Rosso, C., Belkacem, S., Amor-Sahli, M., Clarencon, F., Leger, A., Baronnet, F., Dormont, D., Alamowitch, S., Lehericy, S., Samson, Y. Tags: Ischemic stroke Source Type: research

Augmentation of perfusion with simultaneous vasodilator and inotropic agents in experimental acute middle cerebral artery occlusion: a pilot study
Conclusion Results suggest that perfusion can be augmented in ischemic stroke with norepinephrine and hydralazine. Perfusion augmentation depends on degree of collateralization and territory in question, with some evidence of vascular steal.
Source: Journal of NeuroInterventional Surgery - August 29, 2023 Category: Neurosurgery Authors: Liu, M., Saadat, N., Jeong, Y. I., Roth, S., Niekrasz, M., Carroll, T., Christoforidis, G. A. Tags: Ischemic stroke Source Type: research

Contrast conservation measures during the global iohexol contrast shortage crisis did not affect stroke thrombectomy outcomes
Conclusions Modifying stroke workflow to adapt to the current global shortage in iohexol is feasible. Using diluted iohexol (50% contrast mixed with 50% heparinized saline) did not affect MT outcomes.
Source: Journal of NeuroInterventional Surgery - August 29, 2023 Category: Neurosurgery Authors: Almallouhi, E., Sattur, M., Lajthia, O., Kicielinski, K. P., Holmstedt, C., Lena, J. R., Al Kasab, S., Spiotta, A. M. Tags: Ischemic stroke Source Type: research

P130/184 Improving door to groin puncture time using AI in a Hub-and-spoke network
ConclusionThe introduction of an AI-based system improved patient workflow by lowering the DGPT in an Italian hub-and-spoke system.Disclosure of InterestNothing to disclose.
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Rizzuti, M. A., Tortora, F., Elefante, A., Buono, G., Marseglia, M., Tarantino, M., Guida, A., Briganti, F. 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

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

O09/90 Thrombectomy in ischemic stroke patients with large core but minor or absent ischemic changes on non-enhanced computed tomography
ConclusionIn patients with ASPECTS≥6, core volumes did not significantly modify the treatment effect of recanalization. Reperfusion and higher core volume were significantly associated with core overestimation which may explain the treatment effect of MT for patients with large ischemic core but minor ischemic changes on NECT.Abstract O09/90 Figure 1Abstract O09/90 Figure 2Disclosure of InterestNA.
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Broocks, G., Kniep, H., Bechstein, M., Paula Hanning, U. M., Kemmling, A., Fiehler, J., Meyer, L. Tags: 2.3 ISCHEMIC - Treatment Source Type: research

O10/94 Ghost infarct core phenomenon after thrombectomy is associated with higher core lesion volume and degree of reperfusion
ConclusionOverestimation of the ischemic core occurred more often in patients presenting with large ICV and was associated with better functional outcomes. Although higher core volumes were associated with worse outcomes, timely vessel recanalization may result in significant treatment effects in this subgroup of patients. Large ICVs should not implicitly exclude patients from MT.Abstract O10/94 Figure 1Abstract O10/94 Figure 2Disclosure of InterestNA.
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Broocks, G., Meyer, L., Heit, J., Fiehler, J., Faizy, T. 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

Rethinking the role of CT perfusion in the management of emergent large vessel ischemic stroke
The treatment of emergent large vessel occlusion (ELVO) was revolutionized by endovascular thrombectomy (EVT). The identification of eligible patients for EVT has sparked significant interest in determining the neuroimaging modality that offers optimal results. The American Stroke Association recommend the use of both non-contrast CT and CT angiogram for patients coming in the early window (0–6 hours).1 In the late window (6–24 hours) the randomized trials, DAWN and DEFUSE 3, showed clinical benefit utilized some form of quantitative estimation of the core infarct.2 3 Consequently the society recommends automat...
Source: Journal of NeuroInterventional Surgery - August 17, 2023 Category: Neurosurgery Authors: Diestro, J. D. B. Tags: Editor ' s column 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

LB-005 Hemera 1 carboxyhemoglobin oxygendelivery for revascularization in acute stroke: a prospective, randomized phase 1 clinical trial
ConclusionNo significant safety concerns were identified for the adjunctive use of PP-007in patients undergoing MT (ClinicalTrials.gov NCT04677777).DisclosuresI. Linfante: 2; C; Penumbra, Stryker, Q’Appel, Cerenovus. 3; C; Penumbra, Stryker, Q’Appel, Cerenovus. 4; C; Prolong Pharmaceuticals, InNeuroCo,Three Rivers, InNeuroFine, Deinde. W. Clark: None. D. Houssen: None. R. Hanel: None. R. Reshi: None. G. Dabus: 4; C; three rivers, InNeuroCo, synchron. R. Jubin: 5; C; Prolong Pharmaceuticals. T. Nguyen: None. J. Grotta: None. R. Wicks: None. M. Pervez: None. M. Cipolla: None. D. Liebeskind: None. R. Nogueira: None.
Source: Journal of NeuroInterventional Surgery - August 3, 2023 Category: Neurosurgery Authors: Linfante, I., Clark, W., Houssen, D., Hanel, R., Reshi, R., Dabus, G., Jubin, R., Nguyen, T., Grotta, J., Wicks, R., Pervez, M., Cipolla, M., Liebeskind, D., Nogueira, R. Tags: SNIS 20th annual meeting late-breaking oral abstracts Source Type: research

O-018 Utilizing DSC MR perfusion images for evaluation of hemorrhagic transformation after mechanical thrombectomy with Heidelberg grading and comparison to SWI, GRE, and CT
ConclusionAmong the 3 acquisitions, HT was identified more often on SWI/GRE than on CT or MR perfusion. For HT more likely to be clinically significant (Heidelberg grade 2 or higher), both SWI/GRE and DSC-MR perfusion performed similarly to CT. Thus, when obtaining DSC MR perfusion images for ischemic stroke imaging, SWI/GRE may not be necessary for evaluating HT.Abstract O-018 Figure 1Disclosures C. Reynolds: None. B. Renshaw: None. S. Vedantham: None. S. Rogers: None.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Reynolds, C., Renshaw, B., Vedantham, S., Rogers, S. Tags: SNIS 20th annual meeting oral abstracts Source Type: research

O-026 Incremental value of arterial spin labeling (ASL) over conventional MRI sequences in the detection of intracranial arteriovenous malformations in patients with hereditary hemorrhagic telangiectasia (HHT)
ConclusionsOur findings underscore the incremental value of ASL in addition to conventional MRI sequences as a screening tool in the detection of brain AVMs in patients with HHT. ASL was more sensitive than conventional contrast-enhanced MRI alone, potentially improving diagnostic accuracy in this patient population with many small AVMs. These findings further highlight the need for further research to explore the benefits of integrating ASL sequences into the initial evaluation and routine follow-up of patients with sporadic and HHT-related brain AVMs.Abstract O-026 Figure 1Disclosures W. Han: None. A. Alyafaie: None. Y. ...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Han, W., Alyafaie, A., Li, Y., Hetts, S. Tags: SNIS 20th annual meeting oral abstracts Source Type: research

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