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ESTUDIOS


01 abril 2019

Rapid Neurologic Improvement Predicts Favorable Outcome 90 Days After Thrombectomy in the DEFUSE 3 Study

Jeremy J. Heit, Michael Mlynash, Stephanie M. Kemp, Maarten G. Lansberg, Soren Christensen, Michael P. Marks, Santiago Ortega-Gutierrez and Gregory W. Albers

Abstract Background and Purpose— Thrombectomy in late time windows leads to improved outcomes in patients with ischemic stroke due to large vessel occlusion. We determined whether patients with rapid neurological improvement (RNI) 24 hours after thrombectomy were more likely to have a favorable clinical outcome in the DEFUSE 3 study (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3).

20 marzo 2019

Acute Stroke With Large Ischemic Core Treated by Thrombectomy

Pietro Panni, Benjamin Gory, Yu Xie, Arturo Consoli, Jean-Philippe Desilles, Mikael Mazighi, Julien Labreuche, Michel Piotin, Francis Turjman, Omer Faruk Eker, Serge Bracard, René Anxionnat, Sébastien Richard, Gabriela Hossu, Raphael Blanc, Bertrand Lapergue and on behalf of the ETIS (Endovascular Treatment in Ischemic Stroke) Investigators

Abstract Background and Purpose— Acute stroke patients with a large ischemic core may still benefit from mechanical thrombectomy (MT), but the predictors of clinical outcome are not well known after MT. We investigated the clinical and imaging factors associated with good outcome and mortality at 90 days in acute stroke patients with a large baseline ischemic core treated with MT.

11 abril 2019

Per-Pass Analysis of Thrombus Composition in Patients With Acute Ischemic Stroke Undergoing Mechanical Thrombectomy

Sharon Duffy, Ray McCarthy, Michael Farrell, Sunitha Thomas, Paul Brennan, Sarah Power, Alan O’Hare, Liam Morris, Eleanor Rainsford, Eugene MacCarthy, John Thornton and Michael Gilvarry

Abstract Background and Purpose— Mechanical thrombectomy may involve multiple attempts to retrieve the occluding thrombus. This study examined the composition of thrombus fragments retrieved with each pass of a device during the thrombectomy procedure. Second, the per-pass composition was compared with procedural and clinical data including angiographic outcome and stroke etiology.

04 abril 2019

Blood Flow Lateralization and Collateral Compensatory Mechanisms in Patients With Carotid Artery Stenosis

Laleh Zarrinkoob, Anders Wåhlin, Khalid Ambarki, Richard Birgander, Anders Eklund and Jan Malm

Abstract Background and Purpose— Four-dimensional phase-contrast magnetic resonance imaging enables quantification of blood flow rate (BFR; mL/min) in multiple cerebral arteries simultaneously, making it a promising technique for hemodynamic investigation in patients with stroke. The aim of this study was to quantify the hemodynamic disturbance and the compensatory pattern of collateral flow in patients with symptomatic carotid stenosis.

09 abril 2019

Risk Factors for Acute Ischemic Stroke Caused by Anterior Large Vessel Occlusion

Philipp Hendrix, Nelson Sofoluke, Matthew D. Adams, Saran Kunaprayoon, Ramin Zand, Amy N. Kolinovsky, Thomas N. Person, Mudit Gupta, Oded Goren, Clemens M. Schirmer, Natalia S. Rost, James E. Faber and Christoph J. Griessenauer

Abstract Background and Purpose— Accurate prediction of acute ischemic stroke (AIS) caused by anterior large vessel occlusion (LVO) that is amendable to mechanical thrombectomy remains a challenge. We developed and validated a prediction model for anterior circulation LVO stroke using past medical history elements present on admission and neurological examination.

23 abril 2019

Comparison of Rupture Risk of Intracranial Aneurysms Between Familial and Sporadic Patients

Liselore A. Mensing, Jacoba P. Greving, Tessa A. Verhoeff, Gabriel J.E. Rinkel and Ynte M. Ruigrok

Abstract Background and Purpose A much higher rupture rate for patients with familial intracranial aneurysms (IA) compared with patients with sporadic IA has been reported in a study with highly selected familial aneurysms using sporadic patients from other populations a controls. We aimed to validate these findings in a large independent series of Dutch patients with familial and sporadic IA.

02 mayo 2019

Risk of Brain Arteriovenous Malformation Hemorrhage Before and After Stereotactic Radiosurgery

Dale Ding, Ching-Jen Chen, Robert M. Starke, Hideyuki Kano, John Y.K. Lee, David Mathieu, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S. Grills, Douglas Kondziolka, Gene H. Barnett, L. Dade Lunsford and Jason P. Sheehan

Abstract Background and Purpose— Understanding the hemorrhage risks associated with brain arteriovenous malformations (AVMs) before and after stereotactic radiosurgery (SRS) is important. The aims of this multicenter, retrospective cohort study are to evaluate and compare the rates of pre- and post-SRS AVM hemorrhage and identify risk factors.

16 mayo 2019

Response to Late-Window Endovascular Revascularization Is Associated With Collateral Status in Basilar Artery Occlusion

Fana Alemseged, Erik Van der Hoeven, Francesca Di Giuliano, Darshan Shah, Fabrizio Sallustio, Francesco Arba, Timothy J. Kleinig, Steven Bush, Richard J. Dowling, Bernard Yan, Gagan Sharma, Nicola Limbucci, Roberto Floris, Geoffrey A. Donnan, Volker Puetz, Marina Diomedi, Mark W. Parsons, Peter J. Mitchell, Stephen M. Davis, Nawaf Yassi, Wouter J. Schonewille, Bruce C.V. Campbell and on behalf of the Basilar Artery Treatment and Management (BATMAN) Collaboration

Abstract Background and Purpose— The benefit of endovascular therapy in extended time windows has been demonstrated in patients with anterior circulation large vessel occlusion ischemic stroke and favorable imaging profile. We evaluated whether collaterals and thrombus burden influence the associations between revascularization, time-to-treatment, and outcome in endovascular therapy-treated patients with basilar artery occlusion.

14 mayo 2019

Thrombectomy Outcomes of Intracranial Atherosclerosis-Related Occlusions

Anderson Chun On Tsang, Emanuele Orru, Jesse M. Klostranec, I-Hsiao Yang, Kui Kai Lau, Frederick Chun Pong Tsang, Wai Man Lui, Vitor Mendes Pereira and Timo Krings

Abstract Background and Purpose— Intracranial atherosclerosis (ICAS) is an important cause of large vessel occlusion and poses unique challenges for emergent endovascular thrombectomy. The risk factor profile and therapeutic outcomes of patients with ICAS-related occlusions (ICAS-O) are unclear. We performed a systematic review and meta-analysis of studies reporting the clinical features and thrombectomy outcomes of large vessel occlusion stroke secondary to underlying ICAS (ICAS-O) versus those of other causes (non–ICAS-O).

22 mayo 2019

Timing and Relevance of Clinical Improvement After Mechanical Thrombectomy in Patients With Acute Ischemic Stroke

Salvatore Rudilosso, Xabier Urra, Sergio Amaro, Laura Llull, Arturo Renú, Carlos Laredo, Victor Obach and Ángel Chamorro

Abstract Background and Purpose— The clinical course in patients with ischemic stroke treated with mechanical thrombectomy (MT) is heterogeneous. We aimed to study the relevance of the timing of clinical improvement in the prediction of long-term outcome in patients treated with MT.

14 mayo 2019

SCENT Trial

Philip M. Meyers, Alexander L. Coon, Peter T. Kan, Ajay K. Wakhloo and Ricardo A. Hanel

Abstract Background and Purpose— To evaluate the safety and effectiveness of the Surpass Flow Diverter (Surpass; Stryker Neurovascular, Fremont, CA) in the treatment of large or giant wide-neck intracranial aneurysms at one year, we hypothesize that treatment with Surpass meets or improves on historical safety and efficacy end points.

02 mayo 2019

Balloon Guide Catheter Is Beneficial in Endovascular Treatment Regardless of Mechanical Recanalization Modality

Jang-Hyun Baek, Byung Moon Kim, Dong-Hun Kang, Ji Hoe Heo, Hyo Suk Nam, Young Dae Kim, Yang-Ha Hwang, Yong-Won Kim, Yong-Sun Kim, Dong Joon Kim, Hyo Sung Kwak, Hong Gee Roh, Young-Jun Lee, Sang Heum Kim, Seung Kug Baik, Pyoung Jeon, Joonsang Yoo, Sang Hyun Suh, Byungjun Kim, Jin Woo Kim, Sangil Suh and Hong-Jun Jeon

Abstract Background and Purpose— Based on its mechanism, the use of balloon guide catheters (BGCs) may be beneficial during endovascular treatment, regardless of the type of mechanical recanalization modality used—stent retriever thrombectomy or thrombaspiration. We evaluated whether the use of BGCs can be beneficial regardless of the first-line mechanical endovascular modality used.

02 mayo 2019

Ischemic Diffusion Lesion Reversal After Endovascular Treatment

Joonsang Yoo, Jin Wook Choi, Seong-Joon Lee, Ji Man Hong, Jeong-Ho Hong, Chang-Hyun Kim, Yong-Won Kim, Dong-Hun Kang, Yong-Sun Kim, Yang-Ha Hwang, Bruce Ovbiagele, Andrew M. Demchuk, Jin Soo Lee and Sung-Il Sohn

Abstract Background and Purpose— Several studies have reported partial reversal of diffusion-weighted imaging (DWI) lesions after acute stroke reperfusion treatment. However, factors associated with DWI reversal have not yet been systematically investigated. We evaluated the factors associated with DWI reversal after endovascular treatment (EVT).

30 abril 2019

Does Small Vessel Disease Burden Impact Collateral Circulation in Ischemic Stroke Treated by Mechanical Thrombectomy?

Omer Faruk Eker, Lucie Rascle, Tae-Hee Cho, Laura Mechtouff, Laurent Derex, Elodie Ong, Yves Berthezene and Norbert Nighoghossian

Abstract Background and Purpose— The development of leptomeningeal collateral artery network might be adversely affected by small vessel wall alteration. We sought to determine whether small vessel disease (SVD) burden may impact collateral development in patients treated by mechanical thrombectomy for anterior circulation acute ischemic stroke.

07 mayo 2019

Imaging Findings After Mechanical Thrombectomy in Acute Ischemic Stroke

Julien Puntonet, Marie-Edith Richard, Myriam Edjlali, Wagih Ben Hassen, Laurence Legrand, Joseph Benzakoun, Christine Rodriguez-Régent, Denis Trystram, Olivier Naggara, Jean-Francois Méder, Grégoire Boulouis and Catherine Oppenheim

Mechanical thrombectomy (MT) therapy has become the standard of care for selected patients with acute ischemic stroke (AIS) due to emergent large vessel occlusion.1 After MT, the scheme for follow-up brain imaging is currently similar to that for patients treated with intravenous thrombolysis (IVT) or medical treatment: it is performed in emergency in cases of neurological worsening and within 24 hours1 to detect hemorrhagic transformation (HT), guide antithrombotic treatment regimen, and evaluate arterial patency and final infarct volume. Follow-up brain imaging findings nonetheless differ in patients who received MT from those who only received IVT, because of the arterial injection of iodine contrast in the target vessel, direct clot manipulations, and intracranial/cervical catheterization, as well as specific MT-related complications.

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