Article
Clinical Neurology
Conrad W. Liang, Saurav Das, Santiago Ortega-Gutierrez, David S. Liebeskind, James C. Grotta, Tudor G. Jovin, Thanh N. Nguyen, Raul G. Nogueira, Hesham Masoud, Lucas Elijovich, Osama O. Zaidat, Ameer E. Hassan, Italo Linfante, Johanna T. Fifi, Sunil A. Sheth
Summary: The survey revealed that neurology residents lack exposure to neurointervention and a well-defined training pathway, hindering their pursuit of a career in neurointervention. These obstacles must be addressed for the further development of neurointervention as a subspecialty in neurology.
Editorial Material
Clinical Neurology
Huanwen Chen, Jose Marino, Andrew B. Stemer, I. Paul Singh, Michael T. Froehler
Summary: Interventional neurology is a subspecialty that combines neurology, neurosurgery, and neuroradiology to diagnose and treat neurovascular disorders using image-guided endovascular catheter techniques. Recent landmark trials in stroke thrombectomy have had a significant impact on the field, generating increased interest and representation in neurology. However, there is currently a lack of standardization in interventional neurology training and fellowship applications.
Article
Radiology, Nuclear Medicine & Medical Imaging
Yen-Heng Lin, Sung-Chun Tang, Chih-Hao Chen, Chung-Wei Lee, Chi-Ju Lu, Li-Kai Tsai, Jiann-Shing Jeng
Summary: The presence of early hyperemia in cortical regions following endovascular thrombectomy for large vessel occlusion stroke is associated with better clinical outcomes at 90 days post-treatment, without an increased risk of hemorrhagic complications.
EUROPEAN RADIOLOGY
(2021)
Article
Medicine, General & Internal
Gabriel Broocks, Lukas Meyer, Celine Ruppert, Wolfgang Haupt, Tobias D. Faizy, Noel Van Horn, Matthias Bechstein, Helge Kniep, Sarah Elsayed, Andre Kemmling, Ewgenia Barow, Jens Fiehler, Uta Hanning
Summary: This study analyzed the impact of intravenous thrombolytic therapy (IVT) on functional outcome and secondary injury volumes in patients with complete reperfusion after thrombectomy. The results showed that bridging IVT was associated with a lower proportion of functional independence and a higher rate of symptomatic intracerebral hemorrhage (sICH). Multivariable analysis confirmed the independent association of bridging IVT with sICH and edema volume.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Clinical Neurology
Katharina Feil, Marius Matusevicius, Moriz Herzberg, Steffen Tiedt, Clemens Kuepper, Johannes Wischmann, Sonja Schoenecker, Annerose Mengel, Jennifer Sartor-Pfeiffer, Katharina Berger, Konstantin Dimitriadis, Thomas Liebig, Marianne Dieterich, Michael Mazya, Niaz Ahmed, Lars Kellert
Summary: This study compares the effectiveness of endovascular thrombectomy (EVT) with intravenous thrombolysis (IVT) or IVT alone in minor stroke patients. The results suggest similar functional outcomes between IVT alone and EVT with or without IVT.
EUROPEAN JOURNAL OF NEUROLOGY
(2022)
Review
Clinical Neurology
Basile Kerleroux, Kevin Janot, Jean Francois Hak, Johannes Kaesmacher, Wagih Ben Hassen, Joseph Benzakoun, Catherine Oppenheim, Denis Herbreteau, Heloise Ifergan, Nicolas Bricout, Hilde Henon, Takeshi Yoshimoto, Manabu Inoue, Arturo Consoli, Vincent Costalat, Olivier Naggara, Bertrand Lapergue, Federico Cagnazzo, Gregoire Boulouis
Summary: The study revealed that mechanical thrombectomy (MT) treatment in patients with acute ischemic stroke significantly decreased the risk of unfavorable functional outcomes at 90 days and also reduced mortality rates.
Review
Medicine, General & Internal
Tudor G. Jovin, Raul G. Nogueira, Maarten G. Lansberg, Andrew M. Demchuk, Sheila O. Martins, J. Mocco, Marc Ribo, Ashutosh P. Jadhav, Santiago Ortega-Gutierrez, Michael D. Hill, Fabricio O. Lima, Diogo C. Haussen, Scott Brown, Mayank Goyal, Adnan H. Siddiqui, Jeremy J. Heit, Bijoy K. Menon, Stephanie Kemp, Ron Budzik, Xabier Urra, Michael P. Marks, Vincent Costalat, David S. Liebeskind, Gregory W. Albers
Summary: Through individual patient data meta-analysis, we found that thrombectomy is beneficial for patients with anterior circulation proximal large vessel occlusion stroke, and it is effective within the 6-24 hour time window, which is clinically significant.
Article
Clinical Neurology
Raul G. Nogueira, Diogo C. Haussen, David S. Liebeskind, Tudor G. Jovin, Rishi Gupta, Jeffrey L. Saver, Ashutosh P. Jadhav, Ronald F. Budzik, Blaise Baxter, Antonin Krajina, Alain Bonafe, Ali Malek, Ana Paula Narata, Mahmoud H. Mohammaden, Yanchang Zhang, Patricia Morgan, Minyi Ji, Bruno Bartolini, Joey English, Gregory W. Albers, Michael Mlynash, Maarten G. Lansberg, Michael R. Frankel, Vitor M. Pereira, Erol Veznedaroglu
Summary: The study aimed to assess the clinical effectiveness of mechanical thrombectomy in a real-world setting and found that the registry-derived patients had comparable 90-day good outcome rates to those treated in the corresponding randomized clinical trials. Additionally, the registry-derived patients had significantly less disability than the controls from the randomized clinical trials.
INTERNATIONAL JOURNAL OF STROKE
(2022)
Article
Clinical Neurology
Peter B. Sporns, Marios-Nikos Psychogios, Ronald Straeter, Uta Hanning, Jens Minnerup, Rene Chapot, Hans Henkes, Elina Henkes, Astrid Grams, Franziska Dorn, Omid Nikoubashman, Martin Wiesmann, Georg Bier, Anushe Weber, Gabriel Broocks, Jens Fiehler, Alex Brehm, Daniel Kaiser, Umut Yilmaz, Andrea Morotti, Wolfgang Marik, Richard Nolz, Ulf Jensen-Kondering, Michael Braun, Stefan Schob, Oliver Beuing, Friedrich Goetz, Johannes Trenkler, Bernd Turowski, Markus Mohlembruch, Christina Wendl, Peter Schramm, Patricia L. Musolino, Sarah Lee, Marc Schlamann, Alexander Radbruch, Andre Karch, Nicole Rubsamen, Moritz Wildgruber, Andre Kemmling
Summary: Thrombectomy in pediatric ischemic stroke within an extended time window of up to 24 hours after onset of symptoms appears to be safe and associated with generally good neurologic outcomes when patients are selected based on a mismatch between clinical deficit and infarct.
Article
Neurosciences
Wenting Guo, Jiali Xu, Linqing Ma, Jin Ma, Sijie Li, Changhong Ren, Longfei Wu, Chuanjie Wu, Chuanhui Li, Jian Chen, Jiangang Duan, Qingfeng Ma, Haiqing Song, Wenbo Zhao, Xunming Ji
Summary: This study aimed to investigate the impact of different administration routes of a low dose of tirofiban on AIS patients with successful recanalization post EVT. The results showed that a low dose of tirofiban was safe for AIS patients who achieved successful recanalization with EVT, but only IA + IV tirofiban improved clinical outcomes.
CNS NEUROSCIENCE & THERAPEUTICS
(2022)
Article
Radiology, Nuclear Medicine & Medical Imaging
Alexandre Bani-Sadr, Dylan Pavie, Laura Mechtouff, Matteo Cappucci, Marc Hermier, Roxana Ameli, Laurent Derex, Charles De Bourguignon, Tae-Hee Cho, Omer Eker, Norbert Nighoghossian, Yves Berthezene
Summary: The presence of brush sign is associated with infarct growth after successful thrombectomy, while cerebral collateral status is not.
EUROPEAN RADIOLOGY
(2023)
Article
Medicine, General & Internal
L. C. M. Langezaal, Erik J. R. J. van der Hoeven, Francisco J. A. Mont'Alverne, Joao J. F. de Carvalho, Fabricio O. Lima, Diederik W. J. Dippel, Aad van der Lugt, Rob T. H. Lo, Jelis Boiten, Geert J. Lycklama a Nijeholt, Julie Staals, Wim H. van Zwam, Paul J. Nederkoorn, Charles B. L. M. Majoie, Johannes C. Gerber, Mikael Mazighi, Michel Piotin, Andrea Zini, Stefano Vallone, Jeannette Hofmeijer, Sheila O. Martins, Christian H. Nolte, Kristina Szabo, Francisco A. Dias, Daniel G. Abud, Marieke J. H. Wermer, Michel J. M. Remmers, Hauke Schneider, Christina M. Rueckert, Karlijn F. de Laat, Albert J. Yoo, Pieter-Jan van Doormaal, Adriaan C. G. M. van Es, Bart J. Emmer, Patrik Michel, Volker Puetz, Heinrich J. Audebert, Octavio M. Pontes-Neto, Jan-Albert Vos, L. Jaap Kappelle, Ale Algra, Wouter J. Schonewille
Summary: In a randomized trial involving 300 patients with basilar-artery stroke, endovascular thrombectomy was not significantly different from medical therapy with respect to a favorable functional outcome (modified Rankin scale score of 0 to 3) at 90 days, but a clinically significant benefit could not be excluded.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Article
Radiology, Nuclear Medicine & Medical Imaging
Gianluca Brugnara, Adrian Engel, Jessica Jesser, Peter Arthur Ringleb, Jan Purrucker, Markus A. Moehlenbruch, Martin Bendszus, Ulf Neuberger
Summary: In this study, the influence of small vessel disease and cortical atrophy on clinical outcome after acute ischemic stroke was assessed using native cranial computed tomography (NCCT). The results showed that pre-existing brain deterioration was significantly correlated with clinical outcome. Both age-related white matter changes (ARWMC) and cortical atrophy were independent predictors of clinical outcome after endovascular treatment (EVT).
EUROPEAN RADIOLOGY
(2023)
Article
Clinical Neurology
JoonNyung Heo, Hyungwoo Lee, Young Seog, Sungeun Kim, Jang-Hyun Baek, Hyungjong Park, Kwon-Duk Seo, Gyu Sik Kim, Han-Jin Cho, Minyoul Baik, Joonsang Yoo, Jinkwon Kim, Jun Lee, Yoonkyung Chang, Tae-Jin Song, Jung Hwa Seo, Seong Hwan Ahn, Heow Won Lee, Il Kwon, Eunjeong Park, Byung Moon Kim, Dong Joon Kim, Young Dae Kim, Hyo Suk Nam
Summary: In this study, machine learning models were developed and validated to diagnose ischemic stroke patients with cancer using histopathologic images of thrombi. The models showed high accuracy in classifying patients into cancer group and other determined cause group. The models accurately predicted the presence of occult cancer in patients with high probabilities.
Article
Clinical Neurology
Lukas Meyer, Matthias Bechstein, Maxim Bester, Uta Hanning, Caspar Brekenfeld, Fabian Flottmann, Helge Kniep, Noel van Horn, Milani Deb-Chatterji, Gotz Thomalla, Peter Sporns, Leonard Leong-Litt Yeo, Benjamin Yong-Qiang Tan, Anil Gopinathan, Andreas Kastrup, Maria Politi, Panagiotis Papanagiotou, Andre Kemmling, Jens Fiehler, Gabriel Broocks
Summary: This study evaluates the benefit of endovascular treatment (EVT) for patients with extensive baseline stroke compared with best medical treatment, finding that EVT may not be beneficial for low Alberta Stroke Program Early CT Score anterior circulation stroke patients, especially in the elderly. However, first- or second-pass complete recanalization seems to reveal a clinical benefit of EVT, highlighting the vulnerability of the low Alberta Stroke Program Early CT Score subgroup.