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An Update on the Treatment of Basilar Artery Occlusion
AbstractPurpose of ReviewBasilar artery occlusion (BAO) is one of the most devastating forms of ischemic stroke with historically high mortality and disability rates. Here, we evaluate the current interventions available to clinicians and present the most recent evidence from randomized clinical trials in support of endovascular thrombectomy as the treatment of choice for BAO.Recent FindingsTwo recent randomized clinical trials (ATTENTION and BAOCHE) have provided convincing evidence of the superiority of endovascular thrombectomy over medical management for patients with BAO. Although questions regarding the generalizabil...
Source: Current Treatment Options in Neurology - March 3, 2023 Category: Neurology Source Type: research

Current Evaluation of Intracerebral Hemorrhage
Advanced imaging is currently critical in diagnosing, predicting, and managing intracerebral hemorrhage. MD CT angiography has occupied the first line of evaluating patients with a clinical diagnosis of a stroke, given its rapid acquisition time, high resolution of vascular structures, and sensitivity for secondary causes of ICH.
Source: Radiologic Clinics of North America - February 20, 2023 Category: Radiology Authors: Javier M. Romero, Luisa F. Rojas-Serrano Source Type: research

Caveats to Acute Imaging for Acute Stroke in the Setting of Venoarterial Extracorporeal Membrane Oxygenation
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used for cardiorespiratory support in medically refractory cases. The high rate of neurologic complications, specifically cerebrovascular disorders such as acute ischemic stroke, in VA-ECMO patients frequently prompts the acquisition of neuroimaging studies such as CT with angiography and perfusion imaging. Clinicians must be familiar with the ECMO-related artifacts when interpreting such studies. Here, we describe a case of asymmetric contrast opacification in a VA-ECMO patient with axillary artery cannulation.
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Viamonte, M. A., Yu, J., Echevarria, F. D., Nagae, L., Youn, T. S., Tahsili-Fahadan, P., Simpkins, A. N. Tags: Stroke in young adults, CT, All Cerebrovascular disease/Stroke Case Source Type: research

RapidAI is Set to Acquire EndoVantage for an Undisclosed Sum
M&A is still a thing during the COVID-19 Pandemic. Advanced stroke imaging firm, RapidAI is acquiring EndoVantage, developer of the Find, Track, and Treat comprehensive cerebral aneurysm management platform. Menlo Park, CA-based RapidAI said this acquisition can help it expand its scope, from ischemic stroke to hemorrhagic stroke and now aneurysm. EndoVantage was started at Mayo Clinic and Arizona State University has developed a powerful award-winning computational platform that provides comprehensive cerebral aneurysm management, automating the entire workflow from initial assessment, growth monitoring, to treatment ...
Source: MDDI - June 10, 2020 Category: Medical Devices Tags: Business Cardiovascular Source Type: news

A “one-stop-shop” 4D CTA protocol using 320-row CT for advanced imaging in acute ischemic stroke: a technical note
AbstractThis technical note describes a novel CT scan protocol that includes a non-enhanced CT, dynamic CTA, and perfusion of the whole brain and CTA of the carotid arteries using a 320-row area detector CT scanner, with a unique contrast injection and acceptable radiation exposure dose in patients presenting with acute ischemic stroke. The acquisition parameters and reconstruction parameters will be discussed including the use of model-based iterative reconstruction (MBIR), time summing (tMIP), and subtraction techniques to optimize the results of this protocol.Key Points• Scanning on a 320-row area detector CT can achi...
Source: European Radiology - August 5, 2019 Category: Radiology Source Type: research

IschemaView launches Rapid Angio neuroimaging system
Medical imaging dev IschemaView said yesterday that it launched its Rapid Angio neuroimaging system designed for use in the angiography suite. The Menlo Park, Calif.-based company said that it partnered with Siemens (NYSE:SI) to integrate the Rapid software with Siemens’ SyngoDynaCT multiphase system for the newly launched imaging solution. Siemens’ SyngoDyna CT Multiphase is a 3D image acquisition technique which uses multiple rotations of a C-arm system to acquire multi-phasic 3D representation of the brain and its perfusion. “The Rapid Angio module, by combining the best-in-class syngoDynaCT system...
Source: Mass Device - March 1, 2019 Category: Medical Devices Authors: Fink Densford Tags: Business/Financial News Imaging Neurological ischemaview Source Type: news

All bleeding stops — but does idarucizumab (Praxbind) make it stop faster?
3.5 out of 5 stars Persistent life-threatening hemorrhage after administration of idarucizumab. Alhashem HM et al. Am J Emerg Med 2016 June 30 [Epub ahead of print] Reference Dabigatran (Pradaxa) is a direct thrombin inhibitor approved for stroke and embolism prophylaxis in patients with non-valve-related atrial fibrillation. When it was first released in 2008, a major disincentive to widespread use was the lack of a reliable reversal agent to treat major bleeds, or to administer before necessary invasive procedures. In October 2015, the U.S. Food and Drug Administration approved idarucizumab (Praxbind), a monoclonal ant...
Source: The Poison Review - July 27, 2016 Category: Toxicology Authors: Leon Gussow Tags: Medical anticoagulant hemorrhage idarucizumab pradaxa praxbind reversal agent Source Type: news

Low-flow vascular malformation: Contribution of sequential postcontrast MRI acquisitions
A 50-year-old man was referred for subacute intracranial hypertension. MRI revealed a well-circumscribed lesion in the posterior fossa that was hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging (figure 1, A and E). Cerebral blood volume map and sequential postcontrast T1-weighted images showed progressive increase in the homogeneity of the contrast enhancement, indicating that the lesion had low but substantial flow (figure 1, B–D). Digital subtraction angiography showed a vascular lesion with a central to peripheral pattern of vascularity and absence of early venous return (figure 1, F&ndash...
Source: Neurology - June 30, 2014 Category: Neurology Authors: Heck, O., Krainik, A., Boubagra, K., Tahon, F., Attye, A., Le Bas, J. F., Boutonnat, J., Grand, S. Tags: MRI, Other cerebrovascular disease/ Stroke NEUROIMAGES Source Type: research

Dynamic Iterative Reconstruction for Interventional 4-D C-Arm CT Perfusion Imaging
We present a dynamic, iterative reconstruction (DIR) approach to reconstruct TACs described by a weighted sum of basis functions. To reduce noise, a regularization technique based on joint bilateral filtering (JBF) is introduced. We evaluated the algorithm with a digital dynamic brain phantom and with data from six canine stroke models. With our dynamic approach, we achieve an average Pearson correlation (PC) of the PCCT canine blood flow maps to co-registered perfusion CT maps of 0.73. This PC is just as high as the PC achieved in a recent PCCT study, which required repeated injections and acquisitions.
Source: IEE Transactions on Medical Imaging - June 28, 2013 Category: Biomedical Engineering Source Type: research