Background and Purpose— Carotid webs have been increasingly recognized as a cause of recurrent stroke, but evidence remains scarce. We aim to report the clinical outcomes first series carotid stenting in cohort patients with strokes from symptomatic webs. Methods— Prospective consecutive data <65 years old cryptogenic stroke admitted within September 2014 May 2017. web was defined by shelf-like/linear filling defect posterior internal artery bulb computed tomographic angiography. Results—...

Background and Purpose— Endovascular therapy is the standard of care for treatment proximal large vessel occlusion strokes. Its safety efficacy in distal intracranial occlusions has not been well studied. Methods— The data that support findings this study are available from corresponding author on reasonable request. Retrospective review a prospectively collected endovascular database (2010–2015, n=949) all patients with treated endovascularly. Distal were defined as any segment anterior...

Background and Purpose— Endovascular therapy is increasingly used in acute ischemic stroke treatment now considered the gold standard approach for selected patient populations. Prior studies have demonstrated that eventual outcomes depend on both patient-specific factors procedural considerations. However, these remain unclear basilar artery occlusion stroke. We sought to determine prognostic of good outcome posterior circulation large vessel strokes treated with endovascular therapy....

Background and Purpose— We aimed to describe the safety efficacy of immediate mechanical thrombectomy (MT) in patients with large vessel occlusions low National Institutes Health Stroke Scale (NIHSS) versus best medical management. Methods— Patients from prospectively collected databases 6 international comprehensive stroke centers (distal intracranial internal carotid, middle cerebral artery-M1 M2 segments, or basilar artery without tandem occlusions) NIHSS 0 5 were identified divided into...

The minimal stroke severity justifying endovascular intervention remains elusive; however, a significant proportion of patients presenting with large vessel occlusion (LVO) and mild symptoms subsequently decline face poor outcomes.To evaluate our experience these by comparing best medical therapy thrombectomy in an intention-to-treat analysis.Analysis prospectively collected data all consecutive National Institutes Health Stroke Scale (NIHSS) score ≤5, LVO on CT angiography, baseline...

Endovascular therapy (ET) is typically not considered for patients with large baseline ischemic cores (irreversibly injured tissue). Computed tomographic perfusion (CTP) imaging may identify a subset of who remain at risk significant infarct expansion and thus could still benefit from reperfusion to reduce their degree disability.To compare the outcomes on CTP undergoing ET matched controls had medical care alone.A case-control study proximal occlusion after stroke (intracranial internal...

Chronic hypoperfusion from athero-stenotic lesions is thought to lead better collateral recruitment compared cardioembolic strokes. It was sought compare flow in stroke patients with atrial fibrillation (AF) versus cervical atherosclerotic steno-occlusive disease (CASOD).This a retrospective review of prospectively collected endovascular database. Patients (i) anterior circulation large vessel occlusion stroke, (ii) pre-treatment computed tomography angiography (CTA) and (iii) intracranial...

Background and Purpose— The semiquantitative noncontrast CT Alberta Stroke Program Early Score (ASPECTS) RAPID automated computed tomography (CT) perfusion (CTP) ischemic core volumetric measurements have been used to quantify infarct extent. We aim determine the correlation between ASPECTS CTP core, evaluate variability of volumes within strata, assess strength their association with clinical outcomes. Methods— Review a prospective, single-center database consecutive thrombectomies middle...

Introduction It remains unclear whether patients presenting with large vessel occlusion strokes and mild symptoms benefit from thrombectomy. Objective To compare outcomes of endovascular therapy versus medical management in National Institute Health Stroke Scale (NIHSS) score ≤5. Methods This was a retrospective analysis combining two prospectively collected datasets including (1) admission NIHSS ≤5, (2) premorbid modified Rankin (mRS) 0–2, (3) middle cerebral-M1/M2, intracranial carotid,...

The Emergency Medical Services field triage to stroke centers has gained considerable complexity with the recent demonstration of clinical benefit endovascular treatment for acute ischemic stroke. We sought describe a new smartphone freeware application designed assist professionals assessment and destination patients stroke.Review application's platform its development as well different variables, assessments, algorithms, assumptions involved.The FAST-ED (Field Assessment Stroke Triage...

Background Longer stent retrievers have recently become available and theoretical advantages over their shorter counterparts. We aim to evaluate whether retriever length impacts reperfusion rates in stroke thrombectomy. Methods This was a retrospective analysis of prospectively collected thrombectomy database which equal diameter (4 mm) were used as the first-line strategy for intracranial internal carotid or middle cerebral artery M1 M2 occlusions along with balloon guide catheter from June...

Pseudo-occlusion (PO) of the cervical internal carotid artery (ICA) refers to an isolated occlusion intracranial ICA that appears as extracranial on computed tomography angiography (CTA) or digital subtraction because blockage distal contrast penetration by a stagnant column unopacified blood. We aim better characterize this poorly recognized entity.Retrospective review endovascular database (2010-2015; n=898). Only patients with occlusions confirmed angiographic exploration were included....

Background and Purpose: The e-Stroke Suite software (Brainomix, Oxford, United Kingdom) is a tool designed for the automated quantification of Alberta Stroke Program Early CT Score ischemic core volumes on noncontrast computed tomography (NCCT). We sought to compare prediction postreperfusion infarct clinical outcomes across NCCT versus RAPID (IschemaView, Menlo Park, CA) perfusion measurements. Methods: All consecutive patients with anterior circulation large vessel occlusion stroke...

INTRODUCTION: The performance of select neurosurgical procedures is being transitioned to an ambulatory setting rather than inpatient in order increase healthcare cost-effectiveness. Despite numerous technological advancements the treatment unruptured intracranial aneurysms (UIA), are solely performed setting. METHODS: We a retrospective analysis on data healthy (Charlson Comorbidity index =4) adult patients undergoing elective including endovascular repair UIAs, ACDF, and discectomy between...

INTRODUCTION: Hemorrhagic transformation of the ischemic core following mechanical thrombectomy (MT) for acute strokes can negate benefits procedure. Previous regressions have identified variables suggesting larger and longer procedural times as significant predictors hemorrhagic transformation. Tandem occlusions add another layer complexity, proximal carotid occlusion emergent artery angioplasty stenting (eCAS) introduces additional factors that influence by altering dynamics reperfusion....

INTRODUCTION: The utility of emergent carotid artery stenting (eCAS) during mechanical thrombectomy (MT) for tandem occlusions has been well-described. Single antiplatelet therapy after eCAS in prevents the risk reperfusion hemorrhage, though in-stent occlusion remains, and optimal strategy remains unexplored. METHODS: Retrospective cohort study analyzing an institutional MT database. Patients were dichotomized into those receiving oral aspirin/ticagrelor load (DAPT cohort) versus...

No consensus regarding the ideal sedation treatment for stroke endovascular therapy has been reached, and practices remain largely based on local protocols clinician preferences. Most studies have focused anterior circulation strokes; therefore, little is known optimal anesthesia type vertebrobasilar occlusion strokes.To compare clinical angiographic outcomes between monitored care (MAC) general (GA) in patients presenting with strokes.Retrospective, matched, case-control study of...

The informed consent process is a major limitation for enrollment in acute stroke clinical investigations. We aim to describe the novel application of smartphone electronic consenting (e-Consent) trials cerebral thrombectomy.The e-Consent tool consists secure/Health Insurance Portability and Accountability Act compliant platform based on REDCap (Research Electronic Data Capture; Vanderbilt University, TN) that uses survey project located static webpage. A link webpage sent via text message...

<b><i>Background:</i></b> Endovascular therapy has been proven effective for the treatment of large vessel occlusion strokes (LVOS). However, feasibility and potential benefits repeat thrombectomy recurrent stroke is unclear. We aim to report our experience with LVOS. <b><i>Methods:</i></b> reviewed prospectively collected endovascular database patients who underwent repeated mechanical thrombectomy. Baseline characteristics, procedural data...

Background The Low-profile Visualized Intraluminal Support (LVIS) Junior stent is newly approved for the treatment of wide-necked intracranial aneurysms. Objective To report our multicenter experience with use LVIS Jr device. Methods neurointerventional databases participating institutions were retrospectively reviewed aneurysms treated from time Food and Drug Administration approval until February 2016. All patients in study period included. Clinical presentation, aneurysm location, size,...

Bypassing the emergency department and computed tomography suite by directly transporting to neuroangiography for imaging assessment treatment may shorten reperfusion times while maintaining proper patient selection.To determine whether flat-panel detector multiphase angiography protocol is associated with reduced a similar safety profile as standard protocol.Single-center prospective study of consecutive patients anterior circulation large vessel occlusion strokes transferred our facility...

Expediting notification of lesions in acute ischemic stroke (AIS) is critical. Limited availability experts to assess such and delays large vessel occlusion (LVO) recognition can negatively affect outcomes. Artificial intelligence (AI) may aid LVO treatment. This study aims evaluate the performance an AI-based algorithm for detection AIS.Retrospective analysis a database AIS patients admitted single center between 2014 2019. Vascular neurologists graded computed tomography angiographies...

Computed tomography perfusion (CTP) has played an important role in patient selection for mechanical thrombectomy (MT) acute ischemic stroke. We aimed to investigate the agreement between parametric maps of 3 software packages - RAPID (RapidAI-IschemaView), Viz CTP(Viz.ai), and e-CTP(Brainomix) estimating baseline core volumes near completely/completely reperfused patients.We retrospectively reviewed a prospectively maintained MT database identify patients with anterior circulation large...