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E-139 in vivo perfusion imaging using magnetic particle imaging
ConclusionMPI shows great promise as a sensitive, high-contrast, and radiation-free technique for measuring brain perfusion, brain vasculature, and organ perfusion.AcknowledgmentsThe authors acknowledge support from the following research grants: NIH 5R01EB013689–03, CIRM RT2–01893, Keck Foundation 034317, NIH 1R24MH106053–01, NIH 1R01EB019458–01, ACTG 037829, and NIH 2R42EB013520–02A1.ReferencesWintermark M, et al. Stroke, 2005:e83Weizenecker J, et al. PMB 2009;54(5)Rahmer J, et al. PMB 2013;58(12):3965–77Saritas E, et al. JMR 2013;229:116–26Ferguson, et alet al. IEEE-TMI, in pres...
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Goodwill, P., Ferguson, M., Yu, E., Zheng, B., Lu, K., Khandhar, A., Kemp, S., Krishnan, K., Conolly, S. Tags: SNIS 12th Annual Meeting Electronic Poster Abstracts 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

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

Extracranial carotid artery stenting followed by intracranial stent-based thrombectomy for acute tandem occlusive disease
Conclusions In acute tandem ICA–MCA/distal ICA occlusions, extracranial stenting followed by intracranial stent-based thrombectomy appears feasible, effective, and safe. Further evaluation of this treatment strategy is warranted.
Source: Journal of NeuroInterventional Surgery - May 14, 2015 Category: Neurosurgery Authors: Cohen, J. E., Gomori, J. M., Rajz, G., Itshayek, E., Eichel, R., Leker, R. R. 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

A research roadmap of future endovascular stroke trials
The recent completion of the MR CLEAN trial1 and news of early stoppage of other stroke trials demonstrates the ability for the neurointerventional community to address a crucial question that has hindered the ability of intra-arterial therapy (IAT) to be offered more widely. The focus of future studies will now shift towards improving clinical outcomes in patients undergoing IAT. Patient selectionImaging There is currently no consensus regarding the optimal imaging strategy for the selection of patients for intervention. The modality must be efficient, accurate, available and repeatable. Non-contrast CT using Alberta Stro...
Source: Journal of NeuroInterventional Surgery - January 13, 2015 Category: Neurosurgery Authors: Gupta, R., Rai, A. T., Hirsch, J. A., Linfante, I., Mack, W., Mocco, J., Albuquerque, F., Chen, M., Fiorella, D., Tarr, R. W. Tags: Commentary 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

E-005 Short-term Outcomes of Acute Ischemic Stroke Patients with MCA/ICA Occlusion Excluded for Intra-arterial Reperfusion Therapy
Conclusion In this cohort of patients, we observed relatively high mortality rate and poor short-term clinical outcomes in AIS patients with large vessel occlusion who were not selected for IAT. Patients excluded from receiving IAT using imaging-based methods, generally had worse outcomes compared with those patients who were selected based on clinical evaluation. Efforts should be made to develop a standard and accurate patient selection method for identification of the optimum number of AIS patients with large vessel occlusion who may benefit from IAT. Disclosures A. Honarmand: None. R. Beck: None. M. Soltanolkotabi: No...
Source: Journal of NeuroInterventional Surgery - July 26, 2014 Category: Neurosurgery Authors: Honarmand, A., Beck, R., Soltanolkotabi, M., Ansari, S., Shaibani, A., Daruwalla, V., Hurley, M. Tags: Electronic poster abstracts Source Type: research

E-063 Physicians Use Perfusion Imaging to Aid in Diagnosis and Treatment Decisions for Acute Ischemic Stroke
Conclusion Perfusion imaging can be used in the real world setting as a tool to guide patient diagnosis and treatment, to select patients with salvageable tissue to receive intra-arterial treatment outside the standard intravenous time window. Disclosures K. Seifert: None. J. Wiener: None. D. DeOrchis: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2014 Category: Neurosurgery Authors: Seifert, K., Wiener, J., DeOrchis, D. Tags: Electronic poster abstracts Source Type: research

O-002 Single Center Experience Comparing Outcomes of Strokes Treated with Mechanical Thrombectomy vs Without Mechanical Thrombectomy Using CTP for Patient Selection
Conclusion Patients who presented with high NIHSS, LVO, and favorable CT-Perfusion data who underwent neuroendovascular reperfusion treatment had significantly better outcomes and decreased mortality in our patient population, despite having similar stroke severity at presentation. This highlights the importance reperfusion, time to treatment, and collateral flow to maintain tissue viability. This study also suggests that CT-Perfusion imaging may be useful to select patients who will benefit from neuroendovascular reperfusion therapy for LVO ischemic stroke. Disclosures G. Vidal: 3; C; Penumbra Inc, Covidien. J. Milburn: ...
Source: Journal of NeuroInterventional Surgery - July 26, 2014 Category: Neurosurgery Authors: Vidal, G., Milburn, J., Pansara, A., Jennings, B., Sabharwal, V. Tags: Oral abstracts Source Type: research

P-014 Improvement in Angiographic Transit Times Post Endovascular Vasospasm Treatment in Patients with Aneurysmal Subarachnoid Haemorrhage
Conclusion The DSA TT correlated with improvements in neurological status in patients with clinical vasospasm. TT might reflect a better way to assess vasospasm severity and response to treatment as compared to vessel diameter. This method may serve as a useful indirect technique for cerebral blood flow assessment in the angiography suite. Abstract P-014 Figure 1Transit time (T-100-10) in major cerebral arteries in patient with severe vasospasm before (A) and after (B) endovascular treatment Abstract P-014 Figure 2ACA and MCA transit time100-10(TT-100-10) values in patients before and after endovascular treatment D...
Source: Journal of NeuroInterventional Surgery - July 26, 2014 Category: Neurosurgery Authors: Ivanov, A., Hsu, C., Linninger, A., Amin-Hanjani, S., Aletich, V., Charbel, F., Alaraj, A. Tags: Oral poster abstracts Source Type: research

P-017 M2 Occlusions as a Target for Endovascular Therapy: Comprehensive Analysis of Diffusion/Perfusion MRI, Angiography, and Clinical Outcomes
Conclusion In patients undergoing ERT compared to those with M1 occlusions, patients with M2 occlusions presented with smaller infarcts and developed less haemorrhage. In patients with M2 occlusions, successful reperfusion with ERT was associated with smaller final infarcts, decreased infarct expansion, and improved clinical outcomes. IV tPA was not sufficient in recanalizing many M2 occlusions. Patients with M2 occlusions benefit from ERT when tPA cannot be given or has failed to recanalise the vessel. Disclosures S. Sheth: None. J. Saver: None. R. Jahan: None. S. Starkman: None. G. Duckwiler: None. S. Tateshima: None. N...
Source: Journal of NeuroInterventional Surgery - July 26, 2014 Category: Neurosurgery Authors: Sheth, S., Saver, J., Jahan, R., Starkman, S., Duckwiler, G., Tateshima, S., Gonzalez, N., Liebeskind, D., Stroke Investigators, U. Tags: Oral poster abstracts Source Type: research

P-020 Emergent Carotid Artery Stenting with or without Intracranial Tandem Occlusion Lesions Following Carotid Endarterectomy
Conclusion Emergent endovascular evaluation in the setting of acute post CEA thrombosis is a safe and timely treatment option, with the benefit of detecting and treating embolic intracranial lesions. More investigation is necessary to define the role of immediate angiography and intervention in this rare surgical complication. Abstract P-020 Table 1Patient demographics AgeGender% Carotid stenosisSymptomaticCase 166M90NCase 273M80–99YCase 378M70YCase 459F80–99YCase 555M80–99NCase 680MUnknownUnknown Abstract P-020 Table 2Pre procedural metrics Time from CEA to symptoms (hrs)Time from last normal to throm...
Source: Journal of NeuroInterventional Surgery - July 26, 2014 Category: Neurosurgery Authors: Vargas, J., Zuckerman, S., Chaudry, I., Turner, R., Turk, A., Spiotta, A. Tags: Oral poster abstracts Source Type: research

Intraprocedural parenchymal blood volume as a marker of reperfusion status in acute ischemic stroke intervention
We present two cases of acute middle cerebral artery (MCA) occlusion to demonstrate how PBV may: (1) be used in acute stroke; (2) influence intraprocedural decision-making; and (3) potentially serve as a predicator of clinical outcome. Both cases were successfully recanalized with endovascular embolectomy. Intraprocedural PBV maps were obtained immediately before and after recanalization. Pre-intervention reductions in PBV were seen throughout the MCA territory in both cases, with significant improvement in PBV in one case with good radiographic and clinical outcome and a lack of improvement in PBV in the second case with ...
Source: Journal of NeuroInterventional Surgery - June 28, 2014 Category: Neurosurgery Authors: Elijovich, L., Doss, V. T., Theessen, H., Khan, M., Arthur, A. S. Tags: Electronic pages Source Type: research

A prospective, multicenter pilot study investigating the utility of flat detector derived parenchymal blood volume maps to estimate cerebral blood volume in stroke patients
Conclusions PBV maps can be generated using FP systems. The average radiation dose is similar to a standard CTP examination. PBV maps have a high sensitivity for detecting CBV deficits defined by conventional CTP. PBV maps often overestimate the size of CBV deficits. We hypothesize that the FP protocol initiates PBV imaging prior to complete saturation of the blood volume in areas perfused via indirect pathways (ie, leptomeningeal collaterals), resulting in an overestimation of CBV deficits, particularly in the setting of large vessel occlusion.
Source: Journal of NeuroInterventional Surgery - June 28, 2014 Category: Neurosurgery Authors: Fiorella, D., Turk, A., Chaudry, I., Turner, R., Dunkin, J., Roque, C., Sarmiento, M., Deuerling-Zheng, Y., Denice, C. M., Baumeister, M., Parker, A. T., Woo, H. H. Tags: Open access, Editor''s choice, Neuroimaging Source Type: research

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