Circulation, Hemorrhage and Thrombolysis

Intravenous Thrombolysis Before Endovascular Treatment in Posterior Circulation Occlusions: A MR CLEAN Registry Study

Stroke Journal

JANUARY 4, 2024

BACKGROUND:The effectiveness of intravenous thrombolysis (IVT) before endovascular treatment (EVT) has been investigated in randomized trials and meta-analyses. These studies mainly concerned anterior circulation occlusions. All patients with a posterior circulation occlusion were included.

Thrombolysis

Thrombolysis Circulation Hemorrhage Outcomes

Abstract 85: One-year Outcomes After Endovascular Treatment for Posterior Circulation Tandem Occlusions: A Multicenter Experience of 249 Patients

Stroke Journal

FEBRUARY 1, 2024

Posterior circulation tandem occlusion was defined as stroke due to intracranial vertebral (V4), basilar, or posterior cerebral artery (PCA) occlusions, with tandem steno-occlusive lesion >70% of the extracranial vertebral artery and impaired distal flow or partial filling of the VA from collaterals.

Circulation

Circulation Outcomes Thrombolysis Hemorrhage

Abstract 225: Rescue Stenting for Posterior Circulation Strokes

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

IntroductionIntracranial atherosclerotic disease (ICAD) is associated with up to 32% of posterior circulation strokes.1 Rescue treatment with stenting, balloon angioplasty, and/or intraarterial thrombolysis or antiplatelets are often required to treat the underlying stenosis.

Stents

Stents Stent Circulation Stroke

Anterior Circulation Thrombectomy in Patients With Low National Institutes of Health Stroke Scale Score: Analysis of the National Inpatient Sample

Stroke: Vascular and Interventional Neurology

JANUARY 31, 2024

Secondary outcomes were in‐hospital mortality, intracerebral hemorrhage, and length of stay. In multivariable models, intravenous thrombolysis was independently associated with higher odds of routine discharge (adjusted OR, 1.78; 95% CI, 1.57–2.01;P<0.001) The primary outcome was routine discharge (home or self‐care).

Inpatient

Inpatient Circulation Stroke Strokes

Abstract WP179: Clinical Outcomes in Acute Stroke in Patients Undergoing Emergency Intracranial Stenting Receiving IV Thrombolysis

Stroke Journal

FEBRUARY 1, 2024

We defined two binary outcomes: (1) functional clinical outcome (modified Rankin Scale 0-2) and (2) early symptomatic intracerebral hemorrhage (sICH). Among patients who underwent emergency intracranial stenting, 66 (30.6%) received intravenous thrombolytic treatment.

Stents

Stents Stent Thrombolysis Angioplasty

Abstract WP192: Impact of Second Line Thrombectomy Technique Following Failed First Pass Thrombectomy for Anterior Circulation Stroke: To Switch or Not to Switch?

Stroke Journal

FEBRUARY 1, 2024

The primary outcome measure was successful recanalization defined as modified Thrombolysis in Cerebral Ischemia (mTICI) score of 2b or higher. 90-day modified Rankin score (mRS) 0-2, mortality and symptomatic hemorrhage were used as secondary outcomes.

Stroke

Stroke Strokes Circulation Thrombolysis

Abstract WP154: Factors Associated With Prolonged Length of Intensive Unit Stay Following Mechanical Thrombectomy for Acute Ischemic Stroke

Stroke Journal

FEBRUARY 1, 2024

Prolonged ICU stay were more likely to have higher baseline median NIHSS score (19 vs. 14%, p < 0.0001), posterior circulation stroke (12.6% vs. 6.1%, p = 0.0326), and symptomatic intracerebral hemorrhage (7.3% Patients receiving thrombolysis prior to thrombectomy were less likely to have a prolonged LOS (27.8%

ICU

ICU Stroke Strokes Thrombolysis

Abstract 089: A Case of Complicated Dissection: Vertebral Artery Sacrifice for Recurrent Stroke Prevention

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

IntroductionPosterior circulation strokes account for 20% of ischemic strokes (1). Optimal management for posterior circulation strokes has been studied less than for anterior circulation strokes (2). Following embolization, repeat imaging showed no new infarcts and no new or worsening hemorrhage.

Stroke

Stroke Strokes Embolism Hemorrhage

Abstract WP182: Effect of Prior Anticoagulation With Non-Vitamin K Oral Anticoagulants in Patients With Atrial Fibrillation on Functional and Procedural Outcomes in Patients Undergoing Thrombectomy

Stroke Journal

FEBRUARY 1, 2024

Background:Atrial fibrillation (AF) has been shown to be associated with better procedural outcomes in patients with anterior circulation large vessel occlusion (aLVO) undergoing endovascular therapy (EVT). Forty-four percent of the no AC group received intravenous thrombolysis (IVT). In the NOAC group, 59.5%

Atrial Fibrillation

Atrial Fibrillation Outcomes Thrombolysis Hemorrhage

Abstract TP188: Diving MCA and First-Pass Reperfusion: A Subgroup Analysis of the Arise II Study

Stroke Journal

FEBRUARY 1, 2024

Here, we investigate the association of middle cerebral artery(MCA) tortuosity on radiographic and functional outcome.Methods:The Analysis of Revascularization in Ischemic Stroke with EmboTrap II was utilized to identify patients with anterior circulation stroke. Likewise, the rate of mTICI≥2c was higher in group A (54.5%) vs 36.4%

Atrial Fibrillation

Atrial Fibrillation Thrombolysis Stroke Strokes

Abstract 235: General Anesthesia vs. Non?General Anesthesia in Endovascular Treatment for Patients with Acute Ischemic Stroke

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

IntroductionCurrent evidence supports endovascular therapy (EVT) for eligible patients with acute ischemic stroke in the anterior and posterior circulation. 1.56, P= 0.28; I2 = 26%, Figure A) and the results of the anterior circulation subgroup showed non‐statistically significant difference (OR = 1.22, 95% CI: 0.90–1.67,

Stroke

Stroke Strokes Circulation Thrombolysis

Abstract TP212: 2b or Not 2b? TICI 2b Reperfusion Score in Endovascular Thrombectomy for Acute Ischemic Stroke Carries a Poor Functional Outcome

Stroke Journal

FEBRUARY 1, 2024

Reperfusion following thrombectomy in the anterior cerebral circulation has long been graded by the modified Thrombolysis in Cerebral Infarction (mTICI) scale-and the score of mTICI (2b, or, “partial filling of more than 50% of the affected vascular territory” is considered the benchmark for “good” outcomes in EVT.

Outcomes

Outcomes Stroke Strokes Thrombolysis

Abstract 231: Rescue Stenting for Failed Mechanical Thrombectomy in Acute Ischemic Stroke:An Analysis of the SVIN Registry

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

A failed MT was defined as a modified Thrombolysis in Cerebral Infarction (mTICI) score of 0 to 2a after multiple attempts to clot retrieval. Additional outcomes included functional independence (defined as a 90‐day mRS score of 0‐2), symptomatic intracranial hemorrhage (sICH), and mortality at 90 days.

Stents

Stents Stent Angioplasty Thrombolysis

Abstract 221: EARLY EXPERIENCE OF EMBOGUARD BALLOON GUIDE CATHETER IN LARGE VESSEL OCCLUSION THROMBECTOMY

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Outcomes included complications, NIHSS at discharge, final modified TICI (thrombolysis in cerebral ischemia) scores including the first‐pass effect (FPE, defined as mTICI 2c/3 after first pass), modified‐FPE (defined as, mTICI 2b‐3 after first pass), symptomatic intracranial hemorrhage (SITS‐MOST definition), and death at discharge.

Thrombolysis

Thrombolysis Ischemia Hemorrhage Stroke

International Stroke Conference 2024 to Present High-Profile Late-Breaking Science

DAIC

JANUARY 22, 2024

Best Medical Therapy in Acute Ischemic Stroke due to Large VEssel OcclusioN Trial in the Extended Time Window: Raul Nogueira, University of Pittsburgh, Pittsburgh, PA MOST Multi-Arm Optimization of Stroke Thrombolysis Trial: Opeolu Adeoye, Washington University, Saint Louis, MO Thurs.,

Stroke

Stroke Strokes Hospital Thrombolysis

Cardiovascular Update

Intravenous Thrombolysis Before Endovascular Treatment in Posterior Circulation Occlusions: A MR CLEAN Registry Study

Abstract 85: One-year Outcomes After Endovascular Treatment for Posterior Circulation Tandem Occlusions: A Multicenter Experience of 249 Patients

Abstract 225: Rescue Stenting for Posterior Circulation Strokes

Anterior Circulation Thrombectomy in Patients With Low National Institutes of Health Stroke Scale Score: Analysis of the National Inpatient Sample

Abstract WP179: Clinical Outcomes in Acute Stroke in Patients Undergoing Emergency Intracranial Stenting Receiving IV Thrombolysis

Abstract WP192: Impact of Second Line Thrombectomy Technique Following Failed First Pass Thrombectomy for Anterior Circulation Stroke: To Switch or Not to Switch?

Abstract WP154: Factors Associated With Prolonged Length of Intensive Unit Stay Following Mechanical Thrombectomy for Acute Ischemic Stroke

Abstract 089: A Case of Complicated Dissection: Vertebral Artery Sacrifice for Recurrent Stroke Prevention

Abstract WP182: Effect of Prior Anticoagulation With Non-Vitamin K Oral Anticoagulants in Patients With Atrial Fibrillation on Functional and Procedural Outcomes in Patients Undergoing Thrombectomy

Abstract TP188: Diving MCA and First-Pass Reperfusion: A Subgroup Analysis of the Arise II Study

Abstract 235: General Anesthesia vs. Non?General Anesthesia in Endovascular Treatment for Patients with Acute Ischemic Stroke

Abstract TP212: 2b or Not 2b? TICI 2b Reperfusion Score in Endovascular Thrombectomy for Acute Ischemic Stroke Carries a Poor Functional Outcome

Abstract 231: Rescue Stenting for Failed Mechanical Thrombectomy in Acute Ischemic Stroke:An Analysis of the SVIN Registry

Abstract 221: EARLY EXPERIENCE OF EMBOGUARD BALLOON GUIDE CATHETER IN LARGE VESSEL OCCLUSION THROMBECTOMY

International Stroke Conference 2024 to Present High-Profile Late-Breaking Science

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