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Procedure: Angiography

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Long-Term Outcomes of Stroke or Transient Ischemic Attack after Non-Emergency Percutaneous Coronary Intervention
Elective percutaneous coronary intervention is increasing in volume, which may be due to an increased use of CT coronary angiography as a first-line investigation for the evaluation of chest pain.1,2 Stroke is a debilitating neurological complication with increasing incidence after PCI in recent years, due to an increasing complexity of patients.3 Large observational and randomized controlled studies found that peri-procedural stroke occurred in 0.13-0.4% of unselected patients who underwent PCI.
Source: Journal of Stroke and Cerebrovascular Diseases - April 14, 2021 Category: Neurology Authors: Jamie SY Ho, Ching-Hui Sia, Andie Hartanto Djohan, Rodney Yu-Hang Soh, Benjamin YQ Tan, Leonard LL Yeo, Hui-Wen Sim, Tiong-Cheng Yeo, Huay-Cheem Tan, Mark Yan-Yee Chan, Joshua Ping-Yun Loh Source Type: research

Platelet Activation and Chemokine Release Are Related to Local Neutrophil-Dominant Inflammation During Hyperacute Human Stroke
This study provides human evidence of cerebral platelet activation and platelet-neutrophil interactions during AIS and points to the relevance of per-ischemic thrombo-inflammatory mechanisms to impaired reperfusion and worse functional outcome following recanalization.
Source: Translational Stroke Research - August 28, 2021 Category: Neurology 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

CT Perfusion Maps Improve Detection of M2-MCA Occlusions in Acute Ischemic Stroke
A growing body of literature supports mechanical thrombectomy-based endovascular therapy for M2-MCA occlusions in eligible patients with acute ischemic stroke (AIS).1 –5 This is because endovascular treatment for M2-MCA occlusions is technically feasible and leads to improved patient outcomes, despite a potential increased risk of hemorrhage.4,5 Not uncommonly, these patients undergo a single or multi-phase CT angiogram (CTA) study for LVO detection. In patient s who present in the late stroke window (6–24 h since last known normal), the CT Perfusion (CTP) study is generally performed along with a CTA study to aid in patient triage.
Source: Journal of Stroke and Cerebrovascular Diseases - April 14, 2022 Category: Neurology Authors: Girish Bathla, Ravishankar Pillenahalli Maheshwarappa, Neetu Soni, Minako Hayakawa, Sarv Priya, Edgar Samaniego, Santiago Ortega-Gutierrez, Colin P. Derdeyn Source Type: research

Hypoperfusion Intensity Ratio is Associated with Stroke Mechanism in Patients Undergoing Mechanical Thrombectomy
Hypoperfusion Intensity Ratio (HIR), defined as Tmax>10s/Tmax>6s on computed tomography perfusion (CTP), and stroke mechanisms have been independently correlated with angiographic collaterals and patient outcomes. Slowly developing atherosclerotic stenosis may foster collateral development, whereas cardioembolic occlusion may occur before collaterals mature. We hypothesized that favorable HIR is associated with large artery atherosclerosis (LAA) stroke mechanism and good clinical outcome.
Source: Journal of Stroke and Cerebrovascular Diseases - May 9, 2022 Category: Neurology Authors: Ahmad A. Ballout, Richard B Libman, Julia R. Schneider, Marc S. Ayoub, Jason J. Wang, Athos Patsalides, Jeffrey M Katz Source Type: research

Feasibility of deconvolution-based multiphase CT angiography perfusion maps in acute ischemic stroke: Simulation and concordance with CT perfusion
Integration of CT perfusion (CTP) with requisite non-contrast CT and CT angiography (CTA) stroke imaging may allow efficient stroke lesion volume measurement. Using surrogate images from CTP, we simulated the feasibility of using multiphase CTA (mCTA) to generate perfusion maps and assess target mismatch profiles.
Source: Journal of Stroke and Cerebrovascular Diseases - October 29, 2022 Category: Neurology Authors: Kevin J. Chung, Alexander V. Khaw, Sachin K. Pandey, Donald H. Lee, Jennifer L. Mandzia, Ting-Yim Lee Source Type: research

Endovascular treatment for isolated posterior cerebral artery occlusion stroke in the MR CLEAN registry
Conclusions EVT should be considered in selected patients with AIS with an isolated PCA occlusion, presenting with moderate–severe neurological deficits, as EVT was technically feasible in most of our patients and about half had good clinical outcome. In case of lower NIHSS score, a more conservative approach seems warranted, since periprocedural complications are not uncommon. Nonetheless, EVT seems reasonably safe considering the absence of sICH in our study.
Source: Journal of NeuroInterventional Surgery - March 14, 2023 Category: Neurosurgery Authors: Brouwer, J., Ergezen, S., Mulder, M. J. H. L., Lycklama a Nijeholt, G. J., van Es, A. C. G. M., van der Lugt, A., Dippel, D. W. J., Majoie, C. B. L. M., Roos, Y. B. W. E. M., Coutinho, J. M., Emmer, B. J., on behalf of the MR CLEAN Registry investigators, Tags: Ischemic stroke Source Type: research

Automated detection of arterial landmarks and vascular occlusions in patients with acute stroke receiving digital subtraction angiography using deep learning
Conclusion These results may serve as an unbiased standard for clinical stroke trials, as optimal standardization would be useful for core laboratories in endovascular thrombectomy studies, and also expedite decision-making during DSA-based procedures.
Source: Journal of NeuroInterventional Surgery - May 16, 2023 Category: Neurosurgery Authors: Khankari, J., Yu, Y., Ouyang, J., Hussein, R., Do, H. M., Heit, J. J., Zaharchuk, 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

Prognostic Value of Venous Outflow Profiles on Multiphase CT Angiography for the Patients with Acute Ischemic Stroke After Endovascular Thrombectomy
This study supports that favorable peak venous VO profiles on mCTA might be a promising biomarker in predicting the good outcome in patients with AIS after EVT.
Source: Translational Stroke Research - September 5, 2023 Category: Neurology Source Type: research

Preprocedural determination of an occlusion pathomechanism in endovascular treatment of acute stroke: a machine learning-based decision
Conclusions An ML-PM could accurately determine an occlusion pathomechanism with common preprocedural findings. A decision flowchart consisting of the four most influential findings was clinically applicable and superior to single common preprocedural findings for determining an occlusion pathomechanism.
Source: Journal of NeuroInterventional Surgery - August 29, 2023 Category: Neurosurgery Authors: Baek, J.-H., Kim, B. M., Kim, D. J., Heo, J. H., Nam, H. S., Kim, Y. D., Rho, M. H., Chung, P.-W., Won, Y. S., Chung, Y. Tags: Ischemic stroke Source Type: research

P013/117 A case of delayed post-hypoxic leukoencephalopathy after ischemic stroke
ConclusionThis case illustrates that the manifestation of clinical symptoms and morphological alterations observed on MRI, indicative of DPHL, may not exclusively result from global hypoxia. Rather, such changes can also manifest in patients with a large vessel occlusion within the corresponding vascular territories.Disclosure of InterestNothing to disclose
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Park, S., Kwon, B., Song, Y., Lee, D. H. Tags: 4.3 CASE PROPOSAL - Acute ischemic stroke Source Type: research

Evolution of Reperfusion Therapies for Acute Brain and Acute Myocardial Ischemia: A Systematic, Comparative Analysis Original Contributions
Conclusions— Reperfusion therapies developed more slowly and remain less effective for cerebral than cardiac ischemia. Further, cerebral circulation–specific technical advances are required for physicians to become as capable at safely restoring blood flow to the ischemic brain as the ischemic heart.
Source: Stroke - December 24, 2012 Category: Neurology Authors: Patel, R. D., Saver, J. L. Tags: Catheter-based coronary interventions: stents, Acute coronary syndromes, Acute myocardial infarction, Acute Cerebral Infarction, Acute Stroke Syndromes, Thrombolysis Original Contributions Source Type: research

An endovascular canine stroke model: middle cerebral artery occlusion with autologous clots followed by ipsilateral internal carotid artery blockade
& Hai-Bin Shi
Source: Laboratory Investigation AOP - May 6, 2013 Category: Laboratory Medicine Authors: Qing-Quan ZuSheng LiuXiao-Quan XuShan-Shan LuLei SunHai-Bin Shi Tags: angiography beagle embolism model stroke Source Type: research

Role of Balloon-Expandable Stents in Intracranial Atherosclerotic Disease in a Series of 182 Patients Brief Reports
Conclusions— Treatment of intracranial atherosclerotic disease with balloon-expandable intracranial stents is a safe and effective method with acceptable adverse events, especially in patients who failed medical therapy and were symptomatic despite being on optimum medical therapy.
Source: Stroke - June 24, 2013 Category: Neurology Authors: Alurkar, A., Karanam, L. S. P., Oak, S., Nayak, S., Sorte, S. Tags: Angiography, Angioplasty and Stenting, Other Stroke Brief Reports Source Type: research