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JOURNAL ARTICLE
Bettina L Serrallach, Mattia Branca, Adnan Mujanovic, Anna Boronylo, Julie M Hanke, Arsany Hakim, Sara Pilgram-Pastor, Eike I Piechowiak, Jan Gralla, Thomas Meine, Johannes Kaesmacher, Tomas Dobrocky
BACKGROUND AND PURPOSE: Flat-panel detector computed tomography (FDCT) immediately after mechanical thrombectomy (MT) can detect complications including early hemorrhagic transformation and subarachnoid hyperdensities (SH). The clinical significance of SH in patients undergoing MT remains unclear. MATERIALS AND METHODS: We studied 223 patients who underwent MT for anterior circulation stroke, had FDCT performed immediately after the procedure, and had follow-up imaging within 24 hours...
April 8, 2024: AJNR. American Journal of Neuroradiology
#22
Keita Tamada, Hiroki Sato, Satoshi Iihoshi, Yukihiro Imaoka, Shinichiro Yoshikawa, Hiroki Kurita, Shinya Kohyama
An 85-year-old female with situs inversus totalis presented with right hemiplegia, right facial nerve palsy, eye deviation to the left, and aphasia. Magnetic resonance imaging revealed acute ischemic lesions in the left insular cortex and the frontal lobe. Magnetic resonance angiography revealed an occlusion of the left internal carotid artery. Reversed-image mechanical thrombectomy achieved complete reperfusion in three passes within 54 minutes. Six months post-intervention, the patient could walk indoors independently...
March 2024: Curēus
#23
JOURNAL ARTICLE
Cheng-Cai Lai, Yin-Dan Yao, Xia Li, Ao-Fei Liu, Chen Li, Yun-E Liu, Chang-Chun Jiang, Ying-Ying Zhang, Min Jin, Jin Lv, Wei-Jian Jiang
BACKGROUND AND OBJECTIVE: Futile recanalization (FR) is defined as patients with acute ischemic stroke (AIS) due to large vessel occlusion who still exhibits functional dependence although undergoing successful mechanical thrombectomy (MT). We aimed to develop and validate a simple nomogram for predicting the probability of FR after MT treatment in AIS patients. METHODS: Clinical data of AIS patients in the Jrecan clinical trial in China from March 2018 to June 2019 were collected as the derivation set ( n = 162)...
2024: Frontiers in Neurology
#24
JOURNAL ARTICLE
Xiaohong Qiao, Fuhao Zheng, Manman Wei, Zhenming Zhao
BACKGROUND: It is challenging yet critical to differentiate between hemorrhagic transformation (HT) and contrast extravasation on non-contrast-enhanced computed tomography (NCCT) scans following mechanical thrombectomy (MT) in patients with acute ischemic stroke. We propose a new method called the ratio of maximum density values (RMDV) to minimize the confusion of contrast extravasation and to evaluate the diagnostic significance of RMDV in predicting HT on immediate post-interventional NCCT scans...
2024: Frontiers in Neurology
#25
JOURNAL ARTICLE
Lufei Feng, Mengying Yu, Mo Zheng, Wangle Huang, Fei Yao, Chaomin Qiu, Ru Lin, Ying Zhou, Haoyu Wu, Guoquan Cao, Dexing Kong, Yunjun Yang, Haoli Xu
BACKGROUND AND PURPOSE: A significant decrease of cerebral blood flow (CBF) is a risk factor for hemorrhagic transformation (HT) in acute ischemic stroke (AIS). This study aimed to ascertain whether the ratio of different CBF thresholds derived from computed tomography perfusion (CTP) is an independent risk factor for HT after mechanical thrombectomy (MT). METHODS: A retrospective single center cohort study was conducted on patients with AIS undergoing MT at the First Affiliated Hospital of Wenzhou Medical University from August 2018 to December 2023...
April 3, 2024: Journal of Neuroradiology. Journal de Neuroradiologie
#26
JOURNAL ARTICLE
Ryosuke Shintoku, Tatsuya Shimizu, Masanori Aihara, Hirofumi Asano, Rei Yamaguchi, Haruka Tsuneoka, Hiroya Shimauchi-Ohtaki, Masahiko Tosaka, Yuhei Yoshimoto
OBJECTIVES: This study aimed to evaluate the factors associated with decreasing diffusion-weighted imaging (DWI) positive areas in patients with large early ischemic changes after mechanical thrombectomy (MT). MATERIALS AND METHODS: This retrospective single-center clinical study was conducted between January 2013 and December 2022. We included consecutive patients who underwent MT for acute large-vessel occlusion of the anterior circulation with low pretreatment DWI-Alberta Stroke Program Early Computed Tomography Scores (ASPECTS) (0-5), effective recanalization [thrombolysis in cerebral infarction (TICI) 2b or TICI3], and magnetic resonance imaging (MRI) acquired before and after MT...
April 5, 2024: Interventional Neuroradiology
#27
JOURNAL ARTICLE
Melina Gassenhuber, Maximilian E Lochschmidt, Johannes Hammel, Tobias Boeckh-Behrens, Benno Ikenberg, Silke Wunderlich, Friederike Liesche-Starnecker, Jürgen Schlegel, Franz Pfeiffer, Marcus R Makowski, Claus Zimmer, Isabelle Riederer, Daniela Pfeiffer
BACKGROUND: Nowadays, there is no method to quantitatively characterize the material composition of acute ischemic stroke thrombi prior to intervention, but dual-energy CT (DE-CT) offers imaging-based multimaterial decomposition. We retrospectively investigated the material composition of thrombi ex vivo using DE-CT with histological analysis as a reference. METHODS: Clots of 70 patients with acute ischemic stroke were extracted by mechanical thrombectomy and scanned ex vivo in formalin-filled tubes with DE-CT...
April 5, 2024: European Radiology Experimental
#28
JOURNAL ARTICLE
Frosti Palsson, Nils D Forkert, Lukas Meyer, Gabriel Broocks, Fabian Flottmann, Máté E Maros, Matthias Bechstein, Laurens Winkelmeier, Eckhard Schlemm, Jens Fiehler, Susanne Gellißen, Helge C Kniep
INTRODUCTION: In acute ischemic stroke, prediction of the tissue outcome after reperfusion can be used to identify patients that might benefit from mechanical thrombectomy (MT). The aim of this work was to develop a deep learning model that can predict the follow-up infarct location and extent exclusively based on acute single-phase computed tomography angiography (CTA) datasets. In comparison to CT perfusion (CTP), CTA imaging is more widely available, less prone to artifacts, and the established standard of care in acute stroke imaging protocols...
2024: Frontiers in Neurology
#29
JOURNAL ARTICLE
Daniele Morosetti, Alfredo Paolo Mascolo, Renato Argirò, Valerio Da Ros, Marco Nezzo, Sara Crociati, Gianluca Cecchi, Luca Funari, Marina Diomedi, Roberto Floris
OBJECTIVES: Few experiences on vertebrobasilar occlusion over underlying intracranial atherosclerotic disease have been reported in literature and the optimal strategy on how to perform a mechanical thrombectomy is unclear. The aim of this paper is to bring our experience based on patients admitted with acute vertebrobasilar occlusion with underlying atheromatous lesions. MATERIALS AND METHODS: Several data were collected from August 2009 to October 2022 including clinical history, pre- and post-treatment neurological objectivity, diagnostic images and angiographic procedural images, and clinical outcome at 6 months...
April 1, 2024: Neuroradiology Journal
#30
JOURNAL ARTICLE
Gabriele Prandin, Giovanni Furlanis, Ilario Scali, Federica Palacino, Laura Mancinelli, Emanuele Vincis, Paola Caruso, Giulia Mazzon, Marinella Tomaselli, Marcello Naccarato, Paolo Manganotti
BACKGROUND: Convulsive (CSE) and non-convulsive (NCSE) Status Epilepticus are a complication in 0.2-0.3% ischemic strokes. Large stroke and cortical involvement are the main risk factors for developing SE. This study evaluates the prevalence of SE in patients treated with endovascular thrombectomy (EVT) through EEG recording within 72- h from admission. Moreover, we compared clinical, radiological, and outcome measures in SE and no-SE patients. MATERIALS AND METHODS: We collected retrospectively demographical and clinical characteristics of acute ischemic stroke patients who underwent EVT, admitted in the Stroke Unit (SU) of the University Hospital of Trieste between January 2018 and March 2020 who underwent EEG recording within 72- h from the symptoms' onset...
March 12, 2024: Epilepsy Research
#31
JOURNAL ARTICLE
Kartik D Bhatia, Elizabeth Pulcine, Ian Andrews, Sachin Gupta, Richard Webster, Christopher Troedson, Russell C Dale, Michelle Lorentzos, Carmen Parra-Farinas, John Worthington, Kylie Tastula, Timothy Ang, Andrew Cheung, Nathan Manning, Prakash Muthusami
Pediatric large-vessel occlusion has a poor natural history. Recent retrospective studies have demonstrated the potential benefits, feasibility, and safety profile of mechanical thrombectomy in children. However, the role of thrombectomy in pediatric M2 occlusions remains uncertain. In this clinical report, we present a multicenter series of 6 pediatric patients with acute M2 occlusion (female = 1, male = 5; age range, 0.9-16.0 years, mean = 9.2). All 6 patients having undergone thrombectomy had excellent clinical outcomes (pediatric mRS = 0-1) at 3 months and final available follow-up (median, 12 months; range, 3-72 months)...
March 28, 2024: AJNR. American Journal of Neuroradiology
#32
JOURNAL ARTICLE
Andrea Alexandre, Mauro Monforte, Valerio Brunetti, Luca Scarcia, Luigi Cirillo, Andrea Zini, Irene Scala, Vincenzo Nardelli, Francesco Arbia, Giuseppe Arbia, Giovanni Frisullo, Erwah Kalsoum, Arianna Camilli, Davide De Leoni, Colò Francesca, Serena Abruzzese, Mariangela Piano, Claudia Rollo, Antonio Macera, Maria Ruggiero, Elvis Lafe, Joseph Domenico Gabrieli, Giacomo Cester, Nicola Limbucci, Francesco Arba, Simone Ferretti, Valerio Da Ros, Luigi Bellini, Giancarlo Salsano, Nicola Mavilio, Riccardo Russo, Mauro Bergui, Antonio Armando Caragliano, Sergio Lucio Vinci, Daniele Giuseppe Romano, Giulia Frauenfelder, Vittorio Semeraro, Ganimede Maria Porzia, Emilio Lozupone, Andrea Romi, Anna Cavallini, Luca Milonia, Massimo Muto, Paolo Candelaresi, Paolo Calabresi, Alessandro Pedicelli, Aldobrando Broccolini
BACKGROUND: Recent randomized trials have shown the benefit of mechanical thrombectomy (MT) also in patients with an established large ischemic core. AIM: The purpose of this study was to define baseline predictors of clinical outcome in patients with large vessel occlusion (LVO) in the anterior circulation and an Alberta Stroke Program Early CT score (ASPECTS) ≤ 5, undergoing MT. MATERIAL AND METHODS: The databases of 16 comprehensive stroke centers were retrospectively screened for patients with LVO and ASPECTS ≤ 5 that received MT...
March 28, 2024: International Journal of Stroke: Official Journal of the International Stroke Society
#33
JOURNAL ARTICLE
Givi Lengvenis, Julius Drachneris, Edvardas Žurauskas, Aleksandra Ekkert, Andrius Berūkštis, Marius Kurminas, Rokas Girčius, Kipras Mikelis, Andrej Afanasjev, Kristina Ryliškienė, Arvydas Laurinavičius, Algirdas Edvardas Tamošiūnas
BACKGROUND: Acute embolic ischemic stroke poses a significant healthcare challenge. Histological clot features' variability among patients with acute ischemic stroke treated by mechanical thrombectomy has potential implications for determining treatment and etiology. This study investigated the clot histological feature differences among patients who experienced cardioembolic stroke and embolic stroke of undetermined source with different left atrial appendage (LAA) morphologies. METHODS: We conducted a prospective observational study involving 79 patients with acute embolic ischemic stroke undergoing mechanical thrombectomy...
March 17, 2024: Journal of Clinical Medicine
#34
JOURNAL ARTICLE
Ji Sun Lim, Shin Kim, Mee-Na Park, Hyunsu Lee, Hye Suk Baek, Jin Kyung Kim, Hae Won Kim, Jeong-Ho Hong
Background and Objectives : Therapeutic hypothermia (TH) shows promise as an approach with neuroprotective effects, capable of reducing secondary brain damage and intracranial pressure following successful mechanical thrombectomy in the acute phase. However, its effect on cognitive impairment remains unclear. This study investigated whether TH can improve cognitive impairment in a mouse model of transient middle cerebral artery occlusion followed by reperfusion (tMCAO/R). Materials and Methods : Nine-week-old C57BL/6N mice (male) were randomly assigned to three groups: sham, tMCAO/R, and tMCAO/R with TH...
February 20, 2024: Medicina
#35
JOURNAL ARTICLE
Kévin Premat, Agnès Dechartres, Amandine Baptiste, Alexis Guedon, Mikael Mazighi, Laurent Spelle, Christian Denier, Titien Tuilier, Hassan Hosseini, Bertrand Lapergue, Federico Di Maria, Nicolas Bricout, Hilde Henon, Benjamin Gory, Sébastien Richard, Cyril Chivot, Audrey Courselle, Stéphane Velasco, Mathias Lamy, Vincent Costalat, Caroline Arquizan, Gaultier Marnat, Igor Sibon, Stephanie Lenck, Eimad Shotar, Julien Allard, Nader Sourour, Vincent Degos, Sonia Alamowitch, Frédéric Clarençon
BACKGROUND: Mechanical thrombectomy (MT) has become a standard treatment for acute ischemic strokes (AIS). However, MT failure occurs in approximately 10-30% of cases, leading to severe repercussions (with mortality rates up to 40% according to observational data). Among the available rescue techniques, rescue intracranial stenting (RIS) appears as a promising option. OBJECTIVE: This trial is poised to demonstrate the superiority of RIS in addition to the best medical treatment (BMT) in comparison with BMT alone, in improving the functional outcomes at 3 months for patients experiencing an AIS due to a large vessel occlusion refractory to MT (rLVO)...
March 27, 2024: Journal of Neurointerventional Surgery
#36
JOURNAL ARTICLE
Alice Hung, Emeka Ejimogu, Kathleen Ran, Sumil Nair, Wuyang Yang, Ryan Lee, Vivek Yedavalli, Argye Hillis, Philippe Gailloud, Justin Caplan, Fernando Gonzalez, Risheng Xu
BACKGROUND: Hemorrhagic conversion (HC) is a known complication following acute ischemic stroke(AIS) in patients undergoing mechanical thrombectomy(MT). While symptomatic HC(sHC) has been shown to lead to poor neurologic outcomes, the effect of asymptomatic HC(aHC) is unclear. This study aims to identify predictors of aHC and to determine the short-term outcomes. METHODS: This is a single-institution retrospective study of patients with anterior circulation stroke(AIS) who underwent MT between January 2016 and September 2022...
March 25, 2024: World Neurosurgery
#37
JOURNAL ARTICLE
Bin Xu, Tengkun Yin, Tanggui Sun, Zhongchen Li, Zhiyuan Zhang, Hang Lv, Chonghui Tian, Jiyue Wang, Jiheng Hao, Liyong Zhang
BACKGROUND: Previously, we revealed noticeable dynamic fluctuations in syndecan-1 levels in the peripheral blood of post-stroke patients. We further investigated the clinical prognostic value of syndecan-1 as a biomarker of glycoprotein damage in patients with acute ischaemic stroke (AIS). METHODS: We examined 105 patients with acute large vessel occlusion in the anterior circulation, all of whom underwent mechanical thrombectomy (MT). Peripheral blood syndecan-1 levels were measured 1 day after MT, and patients were categorised into favourable and unfavourable prognostic groups based on the 90-day modified Rankin Scale (mRS) score...
March 27, 2024: Acta Neurochirurgica
#38
REVIEW
Narayanaswamy Venketasubramanian, Leonard L L Yeo, Benjamin Tan, Bernard P L Chan
Stroke is a major cause of death and disability globally, with ischemic stroke being the predominant mechanism. While spontaneous recanalization may occur, significant neuronal injury would have occurred in the interim. Intravenous thrombolysis administered within the first 4.5 h after stroke onset and endovascular thrombectomy within 24 h in patients with a salvageable penumbra improves functional independence. Ultrasound has been shown in both in vivo and in vitro models to enhance clot lysis, even more-so in the presence of thrombolytic agents...
February 22, 2024: Journal of Cardiovascular Development and Disease
#39
JOURNAL ARTICLE
Dhairya A Lakhani, Aneri B Balar, Manisha Koneru, Sijin Wen, Burak Berksu Ozkara, Richard Wang, Meisam Hoseinyazdi, Mehreen Nabi, Ishan Mazumdar, Andrew Cho, Kevin Chen, Sadra Sepehri, Nathan Hyson, Risheng Xu, Victor Urrutia, Licia Luna, Argye E Hillis, Jeremy J Heit, Greg W Albers, Ansaar T Rai, Vivek S Yedavalli
BACKGROUND: Collateral status (CS) is an important biomarker of functional outcomes in patients with acute ischemic stroke secondary to large vessel occlusion (AIS-LVO). Pretreatment CT perfusion (CTP) parameters serve as reliable surrogates of collateral status (CS). In this study, we aim to assess the relationship between the relative cerebral blood flow less than 38% (rCBF <38%), with the reference standard American Society of Interventional and Therapeutic Neuroradiology (ASITN) collateral score (CS) on DSA...
March 25, 2024: Neuroradiology Journal
#40
JOURNAL ARTICLE
Bettina L Serrallach, Adnan Mujanovic, Nikolaos Ntoulias, Michael Manhart, Mattia Branca, Alex Brehm, Marios-Nikos Psychogios, Christoph C Kurmann, Eike I Piechowiak, Sara Pilgram-Pastor, Thomas Meinel, David Seiffge, Pasquale Mordasini, Jan Gralla, Tomas Dobrocky, Johannes Kaesmacher
PURPOSE: Flat-panel detector computed tomography (FDCT) is increasingly used in (neuro)interventional angiography suites. This study aimed to compare FDCT perfusion (FDCTP) with conventional multidetector computed tomography perfusion (MDCTP) in patients with acute ischemic stroke. METHODS: In this study, 19 patients with large vessel occlusion in the anterior circulation who had undergone mechanical thrombectomy, baseline MDCTP and pre-interventional FDCTP were included...
March 25, 2024: Clinical Neuroradiology
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