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Effective use of balloon guide catheters in reducing incidence of mechanical thrombectomy related distal embolization
ConclusionsThe risk of distal embolization was significantly decreased with the use of a BGC.
Source: Acta Neurochirurgica - July 9, 2017 Category: Neurosurgery Source Type: research

Factors associated with successful revascularization using the aspiration component of ADAPT in the treatment of acute ischemic stroke
Conclusions Aspiration success was associated with younger age. Our findings suggest that ADAPT can be used for the vast majority of patients but it may be beneficial to use a different method first in the elderly.
Source: Journal of NeuroInterventional Surgery - June 16, 2017 Category: Neurosurgery Authors: Mascitelli, J. R., Kellner, C. P., Oravec, C. S., De Leacy, R. A., Oermann, E. K., Yaeger, K., Paramasivam, S., Fifi, J. T., Mocco, J. Tags: Ischemic stroke Source Type: research

First case of ischemic stroke which happened during continuous intravenous infusion of rt-PA
We present a patient with left lower limb ischemia, treated by CDT, in which symptoms of stroke, proved to have ischemic etiology, started during continuous intra-arterial infusion of rt-PA. As the patient presented with the history of atrial fibrillation, the most probable mechanism of stroke was related to detachment of possible intra-atrial thrombus. Ischemic stroke which happened during intra-arterial thrombolysis with rt-PA has never been mentioned in literature yet and the case stands for the statement that very effective causative treatment of ischemic stroke with rt-PA is not sufficient to “prevent” ischemic st...
Source: Polish Journal of Neurology and Neurosurgery - April 2, 2017 Category: Neurosurgery Source Type: research

Recent time trends in incidence, outcome and premorbid treatment of atrial fibrillation-related stroke and other embolic vascular events: a population-based study
Conclusions We found no reduction in incidence of AF-related vascular events since publication of the BAFTA trial. A third of all disabling/fatal strokes occur in non-anticoagulated patients with known prior AF.
Source: Journal of Neurology, Neurosurgery and Psychiatry - December 14, 2016 Category: Neurosurgery Authors: Yiin, G. S. C., Howard, D. P. J., Paul, N. L. M., Li, L., Mehta, Z., Rothwell, P. M., on behalf of the Oxford Vascular Study Tags: JNNP Patients' choice, Open access, Stroke Cerebrovascular disease Source Type: research

General medical skills on neurology and stroke wards
This study looks at the difference in the general medical care required in neurology and stroke units and the different skill set required. Methods Prospective data regarding diagnosis and medical complications were collected from 100 patients admitted to a neurology and a stroke ward. Results Stroke unit patients were older (mean age 71.4 yrs; standard deviation 16.3) than those on the neurology ward (47.9;16.8, p=<0.001). The primary diagnosis was neurological in all patients on the neurology ward, but 16% of those on the stroke ward had not had a recent stroke. Attention to general medical issues was required ...
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Ingram, G., Hughes, T. Tags: Stroke ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

Acute hemifield room tilt illusion in cerebral ischaemia
We present 2 cases in the setting of acute vertebrobasilar territory ischaemia. Case 1: A 56-year old man was admitted with acute dyspnoea and new atrial fibrillation. On day two while lying in bed, he developed vomiting and suddenly perceived the curtain to his left was lying horizontal along the floor and felt he was sliding towards the left. MRI brain revealed acute multiterritory infarction (Figure 1). He was commenced on therapeutic anticoagulation and was well on follow-up. Case 2: A 47-year old man awoke with acute vertigo, vomiting and ataxia, exacerbated by head movement with dysarthria and diplopia. The worl...
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Kinsella, J., Lonergan, R., Killeen, R., McGuigan, C. Tags: Drugs: CNS (not psychiatric), Stroke, Ophthalmology, Ear, nose and throat/otolaryngology ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

E-039 Comparison of Medical Therapy vs. Intra-Arterial Therapy for Acute Vertebrobasilar Stroke
ConclusionCompared to medical trials in 2015, which demonstrate clinical benefit for IAT over medical therapy for acute ischemic stroke of the anterior circulation, the posterior circulation is less well studied. Important prognostic factors for stroke due to large vessel occlusion of posterior circulation include posterior ASPECTS score and infarct volume in the brainstem. In this small retrospective study, patients treated with IAT had greater stroke severity than the medical cohort, yet they had similar rates of good functional outcome. Parameters of this retrospective analysis may be used to improve triage and treatmen...
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Raymond, S., Leslie-Mazwi, T., Rost, N., Schaefer, P., Hirsch, J., Gonzalez, R., Rabinov, J. Tags: Electronic poster abstracts Source Type: research

E-084 Long-Term Clinical Outcomes in Patients with Acute Ischemic Strokes Treated with Mechanical Thrombectomy who had Moderate or Moderate Severe Disability at 90 Days
ConclusionAmong patients with AIS treated with MT who had moderate or moderate severe disability at 90 days, a considerable minority (30%) demonstrated a reduction in long-term disability with continued outpatient rehabilitation.DisclosuresJ. Delgado Almandoz: 2; C; Medtronic Neurovascular, Penumbra, Inc. S. Hochsprung: None. Y. Kayan: 2; C; Medtronic Neurovascular, Penumbra, Inc. J. Fease: None. J. Scholz: None. A. Milner: None. P. Roohani: None. M. Mulder: None. T. Hehr: None. R. Tarrel: None. D. Chappuis: None. M. Young: None.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Delgado Almandoz, J., Hochsprung, S., Kayan, Y., Fease, J., Scholz, J., Milner, A., Roohani, P., Mulder, M., Hehr, T., Tarrel, R., Chappuis, D., Young, M. Tags: Electronic poster abstracts Source Type: research

O-022 General Anesthesia, Baseline ASPECTS, Time to Treatment, and IV TPA Impact Intracranial Hemorrhage after Stentriever Thrombectomy: Pooled Analysis from SWIFT PRIME, SWIFT and STAR Trials
ConclusionsHigher baseline ASPECTS, better collaterals and general anesthesia are associated with lower incidence of ICH after neurothrombectomy with Solitaire stentriever. Prolonged time to treatment increases the risk of parenchymal hematoma and hemorrhage in ischemic territory. Parenchymal hematoma is distinctly associated with IV TPA. Of all ICH subtypes, sICH has the strongest impact on functional independence.DisclosuresR. Raychev: None. J. Saver: 2; C; Medtronic, Stryker, Boehrniger, Neuravia. R. Jahan: 1; C; Medtronic. 2; C; Medtronic. R. Nogueira: 2; C; Medtronic, Stryker. M. Goyal: 2; C; Medtronic. V. Pereira: 2;...
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Raychev, R., Saver, J., Jahan, R., Nogueira, R., Goyal, M., Pereira, V., Gralla, J., Levy, E., Yavagal, D., Cognard, C., Liebeskind, D. Tags: Oral abstracts Source Type: research

O-042 Functional Outcome Prediction Model for Carotid Stenting Patients Using Admission Profiles: 29,453 patients using NIS data 2005 to 2013
ConclusionsAge (greater than 80), presence of symptoms including TIA, DM, CHF, COPD and CRF were identified to predict worse functional outcome after CAS.DisclosuresS. Park: None. M. Alexander: 1; C; : Investigator in CREST2 Trial. A. Rosengart: None.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Park, S., Alexander, M., Rosengart, A. Tags: Oral abstracts Source Type: research

P-008 Evaluating Racial/Ethnic Disparity in Endovascular Thrombectomy Outcome for Acute Stroke Patients: 4,763 patients using Premier data 2011 to 2015
ConclusionsThere were no differences in hospital outcome among races/ethnicities in endovascular thrombectomy outcomes for acute stroke patients in the Premier data. Racial/ethnic disparities play role for patients’ selection not for patients’ outcome in endovascular thrombectomy.DisclosuresS. Park: None. M. Pilot: None. M. Alexander: 1; C; Consultant for Stryker Neurovascular, Medtronic, and Penumbra, Inc. A. Rosengart: None.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Park, S., Pilot, M., Alexander, M., Rosengart, A. Tags: Oral poster abstracts Source Type: research

E-004 Factors Associated with Successful Revascularization using the Aspiration Component of ADAPT in the Treatment of Acute Ischemic Stroke
ConclusionsAspiration success was associated with younger age. There was a trend for aspiration failure to be associated with cardiogenic etiology and more difficult vascular anatomy. Our findings suggest that the ADAPT technique can be used for the vast majority of patients but it may be beneficial to use a SR primarily when performing thrombectomy in the elderly. Further research analyzing thrombus characteristics is needed.References1 Turk AS, Frei D, Fiorella D, et al. ADAPT FAST study: a direct aspiration first pass technique for acute stroke thrombectomy. J Neurointerv Surg 2014 ;6(4):260–4.2 Turk AS, Turner R,...
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Mascitelli, J., Kellner, C., Oravec, C., DeLeacy, R., Oermann, E., Paramasivam, S., Fifi, J., Mocco, J. Tags: Electronic poster abstracts Source Type: research

Efficacy of Proximal Aspiration Thrombectomy for Using Balloon-Tipped Guide Catheter in Acute Intracranial Internal Carotid Artery Occlusion.
CONCLUSION: A strategy of PAT before standard MT may result in shorter puncture-to-reperfusion time and better angiographic outcome than a strategy of standard MT for acute intracranial ICA occlusion. PMID: 27446520 [PubMed]
Source: Journal of Korean Neurosurgical Society - July 26, 2016 Category: Neurosurgery Tags: J Korean Neurosurg Soc Source Type: research

Early arrival at the emergency department is associated with better collaterals, smaller established infarcts and better clinical outcomes with endovascular stroke therapy: SWIFT study
Conclusions Time was a critical factor in successful clinical outcomes for neurothrombectomy in the SWIFT trial. Shorter times to presentation were associated with better collaterals, smaller established infarcts, and better clinical outcome after revascularization.
Source: Journal of NeuroInterventional Surgery - May 12, 2016 Category: Neurosurgery Authors: Liebeskind, D. S., Jahan, R., Nogueira, R. G., Jovin, T. G., Lutsep, H. L., Saver, J. L., for the SWIFT Investigators Tags: Editor''s choice, Ischemic stroke Source Type: research

Lesion location, stability, and pretreatment management: factors affecting outcomes of endovascular treatment for vertebrobasilar atherosclerosis
Conclusions Endovascular treatment of symptomatic vertebrobasilar atherosclerosis can be performed safely and with good outcomes. Technical results were better for those with extracranial disease while clinical outcomes were more favorable in those patients with non-progressive symptoms in the subacute period and those receiving statin therapy.
Source: Journal of NeuroInterventional Surgery - April 13, 2016 Category: Neurosurgery Authors: Alexander, M. D., Rebhun, J. M., Hetts, S. W., Kim, A. S., Nelson, J., Kim, H., Amans, M. R., Settecase, F., Dowd, C. F., Halbach, V. V., Higashida, R. T., Cooke, D. L. Tags: Ischemic stroke Source Type: research

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