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Endovascular treatment beyond 24 hours from the onset of acute ischemic stroke: the Italian Registry of Endovascular Thrombectomy in Acute Stroke (IRETAS)
Conclusions These findings suggest that, in a real world setting, very late endovascular therapy is feasible in appropriately selected patients.
Source: Journal of NeuroInterventional Surgery - November 14, 2022 Category: Neurosurgery Authors: Casetta, I., Fainardi, E., Pracucci, G., Saia, V., Vallone, S., Zini, A., Bergui, M., Cerrato, P., Nappini, S., Nencini, P., Gasparotti, R., Saletti, A., Causin, F., Romano, D., Burdi, N., Giorgianni, A., Mangiafico, S., Toni, D., The Italian Registry of Tags: Ischemic stroke Source Type: research

Incidence and mechanisms of stroke after permanent carotid artery occlusion following temporary occlusion testing
Conclusions The rate of ischemic stroke following carotid sacrifice remains high and most strokes are thromboembolic in nature. Our testing protocol did not eliminate the risk of hypoperfusion-related stroke. Delayed venous phase by angiography may be a better indicator of hemodynamic tolerance than perfusion imaging.
Source: Journal of NeuroInterventional Surgery - May 14, 2015 Category: Neurosurgery Authors: Whisenant, J. T., Kadkhodayan, Y., Cross, D. T., Moran, C. J., Derdeyn, C. P. Tags: Ischemic stroke Source Type: research

Correlation between cerebral blood volume values and outcomes in endovascular therapy for acute ischemic stroke
Conclusions We found that cortical CBV loss is predictive of poor clinical outcomes, whereas basal ganglia CBV loss is predictive of hemorrhagic transformation but without translation into poor clinical outcomes. Our study findings support published results of baseline preintervention CBV as a predictor of outcomes in patients undergoing intra-arterial stroke therapies.
Source: Journal of NeuroInterventional Surgery - September 13, 2015 Category: Neurosurgery Authors: Mokin, M., Morr, S., Fanous, A. A., Shallwani, H., Natarajan, S. K., Levy, E. I., Snyder, K. V., Siddiqui, A. H. Tags: Ischemic stroke Source Type: research

Risk of acute kidney injury associated with neuroimaging obtained during triage and treatment of patients with acute ischemic stroke symptoms
Conclusions This study provides preliminary evidence of the safety and feasibility of obtaining CTSS with additional DSA imaging, whether for diagnosis or intervention, to identify possible acute ischemic stroke.
Source: Journal of NeuroInterventional Surgery - November 14, 2016 Category: Neurosurgery Authors: Hall, S. L., Munich, S. A., Cress, M. C., Rangel-Castilla, L., Levy, E. I., Snyder, K. V., Siddiqui, A. H. Tags: Ischemic stroke Source Type: research

The golden hour of stroke intervention: effect of thrombectomy procedural time in acute ischemic stroke on outcome
Conclusions Our findings suggest that extending mechanical thrombectomy procedure times beyond 60 min increases complications and device cost rates while worsening outcomes. These findings can serve as a time frame of when it is prudent to abort a failed thrombectomy case.
Source: Journal of NeuroInterventional Surgery - August 6, 2014 Category: Neurosurgery Authors: Spiotta, A. M., Vargas, J., Turner, R., Chaudry, M. I., Battenhouse, H., Turk, A. S. Tags: Ischemic stroke Source Type: research

Interhospital variation in reperfusion rates following endovascular treatment for acute ischemic stroke
Conclusions Reperfusion rates vary among hospitals, which may be related to differences in treatment protocols and patient characteristics. Additional studies are needed to identify all of the factors that underlie this variability as this could lead to strategies that reduce interhospital variability in reperfusion rates and improve clinical outcomes.
Source: Journal of NeuroInterventional Surgery - March 12, 2015 Category: Neurosurgery Authors: Liggins, J. T. P., Mlynash, M., Jovin, T. G., Straka, M., Kemp, S., Bammer, R., Marks, M. P., Albers, G. W., Lansberg, M. G., on behalf of the DEFUSE 2 Investigators Tags: Ischemic stroke Source Type: research

Primary acute stroke thrombectomy within 3 h for large artery occlusion (PAST3-LAO): a pilot study
Conclusions Our study demonstrates that primary SRT in AIS from LAO is safe and feasible and is associated with complete recanalization and good outcome. Further study is required.
Source: Journal of NeuroInterventional Surgery - March 15, 2017 Category: Neurosurgery Authors: Lodi, Y., Reddy, V., Petro, G., Devasenapathy, A., Hourani, A., Chou, C.-A. Tags: Ischemic stroke Source Type: research

Endovascular thrombectomy beyond 24 hours from ischemic stroke onset: a propensity score matched cohort study
Conclusion In this real world study, EVT beyond 24 hours from stroke onset or last known well appeared to be feasible, with comparable safety and functional outcomes to EVT initiation between 6 and 24 hours. Randomized trials assessing the efficacy of EVT in the VL window are warranted, but may only be feasible with a large international collaborative approach.
Source: Journal of NeuroInterventional Surgery - February 14, 2023 Category: Neurosurgery Authors: Dhillon, P. S., Butt, W., Podlasek, A., Barrett, E., McConachie, N., Lenthall, R., Nair, S., Malik, L., James, M. A., Dineen, R. A., England, T. J. 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

Infarct growth despite full reperfusion in endovascular therapy for acute ischemic stroke
Conclusions Despite full reperfusion, infarct growth is relatively frequent and may explain poor clinical outcomes in this setting. Ethnicity was found to influence SIG. Use of IV t-PA and stent-retrievers were associated with less infarct core expansion.
Source: Journal of NeuroInterventional Surgery - January 13, 2016 Category: Neurosurgery Authors: Haussen, D. C., Nogueira, R. G., Elhammady, M. S., Yavagal, D. R., Aziz-Sultan, M. A., Johnson, J. N., Gaynor, B. G., Jen, S., Dehkharghani, S., Peterson, E. C. Tags: Ischemic stroke Source Type: research

Relative CBV ratio on perfusion-weighted MRI indicates the probability of early recanalization after IV t-PA administration for acute ischemic stroke
Conclusions The results of this study suggest that the rCBV ratio on PWI might serve as a useful indicator of ER after IV t-PA administration.
Source: Journal of NeuroInterventional Surgery - February 14, 2016 Category: Neurosurgery Authors: Sohn, S.-W., Park, H.-S., Cha, J.-K., Kim, D.-H., Kang, M.-J., Choi, J.-H., Nah, H.-W., Huh, J.-T. Tags: Ischemic stroke Source Type: research

Endovascular reperfusion outcomes in patients with a stroke and low ASPECTS is highly dependent on baseline infarct volumes
Conclusions Outcomes may vary significantly in the same ASPECTS category depending on infarct volume. Patients with ASPECTS ≤5 but baseline infarct volumes ≤70 cc may achieve independence in nearly 40% of the cases and thus should not be excluded from treatment.
Source: Journal of NeuroInterventional Surgery - January 18, 2022 Category: Neurosurgery Authors: Bouslama, M., Barreira, C. M., Haussen, D. C., Rodrigues, G. M., Pisani, L., Frankel, M. R., Nogueira, R. G. Tags: Ischemic stroke 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

M2 occlusions as targets for endovascular therapy: comprehensive analysis of diffusion/perfusion MRI, angiography, and clinical outcomes
Conclusions If suitable as targets of ET, M2 occlusions should be given the same consideration as M1 occlusions.
Source: Journal of NeuroInterventional Surgery - June 11, 2015 Category: Neurosurgery Authors: Sheth, S. A., Yoo, B., Saver, J. L., Starkman, S., Ali, L. K., Kim, D., Gonzalez, N. R., Jahan, R., Tateshima, S., Duckwiler, G., Vinuela, F., Liebeskind, D. S., for the UCLA Comprehensive Stroke Center Tags: Ischemic stroke Source Type: research

POSITIVE: Perfusion imaging selection of ischemic stroke patients for endovascular therapy
Conclusion POSITIVE supports the already established practice of delayed thrombectomy for appropriately selected patients presenting within 0–12 hours selected by perfusion imaging from any vendor. The results of the POSITIVE trial are consistent with other thrombectomy trials. The statistically significant effect on functional improvement, despite the small number of patients, reinforces the robust benefits of thrombectomy. Clinical trial registration NCT01852201
Source: Journal of NeuroInterventional Surgery - January 18, 2022 Category: Neurosurgery Authors: Mocco, J., Siddiqui, A. H., Fiorella, D., Alexander, M. J., Arthur, A. S., Baxter, B. W., Budzik, R. F., Froehler, M. T., Hanel, R. A., Lena, J., Persaud, S., Puri, A. S., Rai, A. T., Wintermark, M., Woodward, K., Zhang, X., Turk, A. Tags: Ischemic stroke Source Type: research

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