AMERICAN JOURNAL OF NEURORADIOLOGY. Risk Factors for Ischemic Complications following Pipeline Embolization Device Treatment of Intracranial Aneurysms: Results from the IntrePED Study

W. Brinjikji, G. Lanzino, H.J. Cloft, A.H. Siddiqui, E. Boccardi, S. Cekirge, D. Fiorella, R. Hanel, P. Jabbour, E. Levy, D. Lopes, P. Lylyk, I. Szikora and D.F. Kallmes

BACKGROUND AND PURPOSE: Risk factors for acute ischemic stroke following flow-diverter treatment of intracranial aneurysms are poorly understood. Using the International Retrospective Study of Pipeline Embolization Device (IntrePED) registry, we studied demographic, aneurysm, and procedural characteristics associated with postoperative acute ischemic stroke following Pipeline Embolization Device (PED) treatment.

AMERICAN JOURNAL OF NEURORADIOLOGY. Prevalence of Intracranial Aneurysms in Patients with Aortic Aneurysms

A. Rouchaud, M.D. Brandt, A.M. Rydberg, R. Kadirvel, K. Flemming, D.F. Kallmes and W. Brinjikji

BACKGROUND AND PURPOSE: Previous studies have suggested an association between aortic aneurysms and intracranial aneurysms with a higher prevalence of intracranial aneurysms in patients with aortic aneurysms. The aims of the present study were to evaluate the incidence of intracranial aneurysms in a large cohort of patients with aortic aneurysms and to identify potential risk factors for intracranial aneurysms in this population.

THE LANCET. Neurology. Mechanical thrombectomy after intravenous alteplase versus alteplase alone after stroke (THRACE): a randomised controlled trial

Prof Serge Bracard, MD, Prof Xavier Ducrocq, MD, Prof Jean Louis Mas, MD, Marc Soudant, MS, Prof Catherine Oppenheim, PhD, Prof Thierry Moulin, MD, Prof Francis Guillemin, PhD on behalf of the THRACE investigators†

Background: Intravenous thrombolysis with alteplase alone cannot reperfuse most large-artery strokes. We aimed to determine whether mechanical thrombectomy in addition to intravenous thrombolysis improves clinical outcome in patients with acute ischaemic stroke.

THE LANCET. Neurology. Effects of alteplase on survival after ischaemic stroke (IST-3): 3 year follow-up of a randomised, controlled, open-label trial

Prof Eivind Berge, MD, Geoffrey Cohen, MSc, Melinda B Roaldsen, MD, Erik Lundström, MD, Eva Isaksson, BN, Ann-Sofie Rudberg, MD, Karsten Bruins Slot, MD, Prof John Forbes, PhD, Joel Smith, PhD, Jonathan Drever, BSc, Prof Joanna M Wardlaw, MD, Prof Richard I Lindley, MD, Prof Peter A G Sandercock, DM, William N Whiteley, MD for the IST-3 Collaborative Group

Background: The effect of alteplase on patient survival after ischaemic stroke is the subject of debate. We report the effect of intravenous alteplase on long-term survival after ischaemic stroke of participants in the Third International Stroke Trial (IST-3).

THE LANCET. Neurology. Efficacy and safety of non-immersive virtual reality exercising in stroke rehabilitation (EVREST): a randomised, multicentre, single-blind, controlled trial

Dr Gustavo Saposnik, MD, Leonardo G Cohen, MD, Muhammad Mamdani, PharmD, Sepideth Pooyania, MD, Michelle Ploughman, PhD, Donna Cheung, OT, Jennifer Shaw, RhT, Judith Hall, MSc, Peter Nord, MD, Sean Dukelow, MD, Yongchai Nilanont, MD, Felipe De los Rios, MD, Lisandro Olmos, MD, Mindy Levin, PhD, Robert Teasell, MD, Ashley Cohen, MSc, Prof Kevin Thorpe, MMath, Prof Andreas Laupacis, MD, Mark Bayley, MD for Stroke Outcomes Research Canada

Background: Non-immersive virtual reality is an emerging strategy to enhance motor performance for stroke rehabilitation. There has been rapid adoption of non-immersive virtual reality as a rehabilitation strategy despite the limited evidence about its safety and effectiveness. Our aim was to compare the safety and efficacy of virtual reality with recreational therapy on motor recovery in patients after an acute ischaemic stroke.

THE LANCET. Neurology. Functional outcomes of pre-hospital thrombolysis in a mobile stroke treatment unit compared with conventional care: an observational registry study

Dr Alexander Kunz, MD, Martin Ebinger, MD, Frederik Geisler, MD, Michal Rozanski, MD, Carolin Waldschmidt, MD, Joachim E Weber, MD, Matthias Wendt, MD, Benjamin Winter, MD, Katja Zieschang, MD, Prof Jochen B Fiebach, MD, Kersten Villringer, MD, Hebun Erdur, MD, Jan F Scheitz, MD, Serdar Tütüncü, MD, Kerstin Bollweg, PhD, Ulrike Grittner, PhD, Sabina Kaczmarek, Prof Matthias Endres, MD, Christian H Nolte, MD†, Prof Heinrich J Audebert, MD†

Background: Specialised CT-equipped mobile stroke treatment units shorten time to intravenous thrombolysis in acute ischaemic stroke by starting treatment before hospital admission; however, direct effects of pre-hospital thrombolysis on clinical outcomes have not been shown. We aimed to compare 3-month functional outcomes after intravenous thrombolysis in patients with acute ischaemic who had received emergency mobile care or and conventional care.

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Peripheral Vascular Disease. Long-Term Outcomes of Carotid Artery Stenting in Clinical Practice

Harald Mudra, MD, Stephan Staubach, MD, Ralph Hein-Rothweiler, MD, Manuela Segerer, MD, Henning Strohm, MD, Hannes Weber, MD and Jakob Ledwoch, MD

Background: There is a lack of long-term data and data outside of controlled clinical trials in carotid artery stenting. Thus, we sought to evaluate the long-term effectiveness in stroke prevention by carotid artery stenting in a large number of patients in a real-world setting.

STROKE. Combination of Thrombolysis and Statins in Acute Stroke Is Safe. Results of the STARS Randomized Trial (Stroke Treatment With Acute Reperfusion and Simvastatin)

Joan Montaner, Alejandro Bustamante, Silvia García-Matas, Maite Martínez-Zabaleta, Carmen Jiménez, Javier de la Torre, Francisco R. Rubio, Tomás Segura, Jaime Masjuán, David Cánovas, Mar Freijo, Raquel Delgado-Mederos, Javier Tejada, Aida Lago, Yolanda Bravo, Natália Corbeto, Dolors Giralt, Bárbara Vives-Pastor, Anna de Arce, Francisco Moniche, Pilar Delgado, Marc Ribó and on behalf of the STARS Investigators

Background and Purpose: The STARS trial (Stroke Treatment With Acute Reperfusion and Simvastatin) was conducted to demonstrate the efficacy and safety of simvastatin treatment in acute stroke.

STROKE. First Year After Stroke. An Integrated Approach Focusing on Participation Goals Aiming to Reduce Depressive Symptoms

Christine Graven, Kim Brock, Keith D. Hill, Sue Cotton, Lynette Joubert

Background and Purpose: Depression is a common issue after stroke. A focus on assisting people to achieve their personal participation goals may reduce levels of depression. The aim of this study was to investigate the effectiveness of a person-centered, integrated approach on facilitating goal achievement in the first year poststroke on depressive symptoms.

STROKE. Cost-Effectiveness of Endovascular Stroke Therapy. A Patient Subgroup Analysis From a US Healthcare Perspective

Wolfgang G. Kunz, M.G. Myriam Hunink, Wieland H. Sommer, Sebastian E. Beyer, Felix G. Meinel, Franziska Dorn, Stefan Wirth, Maximilian F. Reiser, Birgit Ertl-Wagner, Kolja M. Thierfelder

Background and Purpose: Endovascular therapy in addition to standard care (EVT+SC) has been demonstrated to be more effective than SC in acute ischemic large vessel occlusion stroke. Our aim was to determine the cost-effectiveness of EVT+SC depending on patients’ initial National Institutes of Health Stroke Scale (NIHSS) score, time from symptom onset, Alberta Stroke Program Early CT Score (ASPECTS), and occlusion location.

STROKE. Emerging Risk Factors for Recurrent Vascular Events in Patients With Embolic Stroke of Undetermined Source

Yuji Ueno, Kazuo Yamashiro, Ryota Tanaka, Takuma Kuroki, Kenichiro Hira, Naohide Kurita, Takao Urabe, Nobutaka Hattori

Background and Purpose: Underlying embolic causes diagnosed by transesophageal echocardiography could be implicated in mechanisms of embolic stroke of undetermined source. We aimed to explore factors, including underlying embolic causes, related to recurrent vascular events in embolic stroke of undetermined source.

STROKE. Renal Function and the Risk of Stroke and Bleeding in Patients With Atrial Fibrillation. An Observational Cohort Study

Anders Nissen Bonde, Gregory Y.H. Lip, Anne-Lise Kamper, Emil L. Fosbøl, Laila Staerk, Nicholas Carlson, Christian Torp-Pedersen, Gunnar Gislason, Jonas Bjerring Olesen

Background and Purpose: We sought to determine the risk of stroke/thromboembolism and bleeding associated with reduced renal function in patients with atrial fibrillation and the risk of stroke and bleeding associated with warfarin treatment in specific estimated glomerular filtration rate (eGFR) groups.

STROKE. Uric Acid Therapy Prevents Early Ischemic Stroke Progression. A Tertiary Analysis of the URICO-ICTUS Trial (Efficacy Study of Combined Treatment With Uric Acid and r-tPA in Acute Ischemic Stroke)

Sergio Amaro, Carlos Laredo, Arturo Renú, Laura Llull, Salvatore Rudilosso, Víctor Obach, Xabier Urra, Anna M. Planas, Ángel Chamorro and on behalf of the URICO-ICTUS Investigators

Background and Purpose: Identification of neuroprotective therapies in acute ischemic stroke is imperative. We report a predefined analysis of the URICO-ICTUS trial (Efficacy Study of Combined Treatment With Uric Acid and r-tPA in Acute Ischemic Stroke) assessing the efficacy of uric acid (UA) compared with placebo to prevent early ischemic worsening (EIW) and the relevance of collateral circulation.

STROKE. Risk Factors and Cognitive Relevance of Cortical Cerebral Microinfarcts in Patients With Ischemic Stroke or Transient Ischemic Attack

Zhaolu Wang, Susanne J. van Veluw, Adrian Wong, Wenyan Liu, Lin Shi, Jie Yang, Yunyun Xiong, Alexander Lau, Geert Jan Biessels, Vincent C.T. Mok

Background and Purpose: It was recently demonstrated that cerebral microinfarcts (CMIs) can be detected in vivo using 3.0 tesla (T) magnetic resonance imaging. We investigated the prevalence, risk factors, and the longitudinal cognitive consequence of cortical CMIs on 3.0T magnetic resonance imaging, in patients with ischemic stroke or transient ischemic attack.

STROKE. Atrial Fibrillation in Transient Ischemic Attack Versus Ischemic Stroke. A Swedish Stroke Register (Riksstroke) Study

Fredrik Buchwald, Bo Norrving, Jesper Petersson

Background and Purpose: Compared with ischemic stroke (IS), the association of atrial fibrillation (AF) with transient ischemic attack (TIA) is less well established. We aimed to assess the proportion of AF in patients with TIA, and these patients’ characteristics and secondary preventive treatment in comparison to patients with IS.