Journal of neurointerventional surgery
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We sought to investigate the risk factors of blood-brain barrier (BBB) disruption, and its potential impact on 90-day clinical outcome in acute ischemic stroke (AIS) patients after reperfusion therapy. ⋯ BBBP in both the hypoperfusion region and its contralateral mirror region are associated with stroke severity, but only increased BBBP in the contralateral mirror hypoperfusion region relates to worse outcome after reperfusion therapy.
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Cerebral hyperperfusion has been related to the risk of intracranial hemorrhage (ICH) in stroke patients after vessel recanalization therapy. We hypothesized that after successful mechanical thrombectomy for acute anterior circulation stroke, hemodynamics detectable by transcranial Duplex (TCD) sonography would vary, and that increased blood flow velocities would be associated with ICH. ⋯ A high MCA MBF velocity index on TCD after successful recanalization therapy for anterior circulation stroke indicates a risk for postinterventional ICH and worse prognosis.
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The pathogenesis of venous outflow stenosis associated with cerebral arteriovenous malformation (AVM) draining veins is poorly understood. We sought to determine the relationship between venous stenosis and atherosclerotic risk factors. ⋯ Venous stenosis is associated with several atherosclerotic risk factors, suggesting that cerebral AVM venous outflow stenosis occurs by a degenerative process. Additional studies can show whether these modifiable risk factors may be targeted to prevent draining vein stenosis and AVM rupture.
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Multicenter Study Observational Study
Safety and effectiveness of the Low Profile Visualized Intraluminal Support (LVIS and LVIS Jr) devices in the endovascular treatment of intracranial aneurysms: results of the TRAIL multicenter observational study.
To evaluate the safety and effectiveness of the low-profile braided intracranial stents called the Low Profile Visualized Intraluminal Support (LVIS) devices for stent-assisted coil embolization of wide-necked intracranial aneurysms. ⋯ The LVIS/LVIS Jr endovascular devices are safe and effective in the treatment of ruptured and unruptured intracranial aneurysms, with acceptable complication rates, very high immediate total occlusion rates, and stable angiographic results.
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Extracranial internal carotid artery (ICA) occlusion can be overestimated on emergent single phase CT angiography (CTA) of stroke patients with isolated intracranial ICA occlusion. We aimed to measure the ability of identifying the extracranial site of presumed tandem ICA occlusions on pre-procedural CTA relative to catheter angiography during acute endovascular stroke therapy. ⋯ Emergency single phase CTA is highly sensitive but has reduced specificity to identify extracranial ICA occlusion in patients with intracranial ICA occlusion, which may confound planning for acute endovascular stroke therapy and cause over exclusion of patients with isolated ICA terminus occlusion from clinical trials.