Stroke Journal

JANUARY 17, 2025

BACKGROUND:Carotid artery stenting (CAS) is an alternative treatment for patients with carotid artery stenosis who are not eligible for carotid endarterectomy. The primary outcome was a composite of ischemic stroke, gastrointestinal bleeding, and intracranial hemorrhage within 12 months of switching to single antiplatelet therapy.

Stents 49

Stents Stent Hemorrhage Stroke 49

Frontiers in Cardiovascular Medicine

JANUARY 24, 2024

In cervicocephalic plaques, the ASCVD group had more severe stenosis grades ( p  = 0.030) and demonstrated significant differences in LPV, LPR, and CPV ( p  = 0.044, 0.030, 0.020) compared with the non-event group. The plaques were then categorized into culprit plaques, non-culprit plaques, and non-event plaques.

Plaque 45

Plaque Stenosis Hemorrhage Atherosclerosis 45

Stroke Journal

JANUARY 30, 2025

The log-rank test demonstrated that patients with the mutation had a higher risk of progression to MMD (P =0.007), stenosis progression (P =0.010), and symptomatic cerebral infarction or hemorrhage (P =0.026). 95% CI, 2.13731;P= 0.001).

Stenosis 40

Stenosis Risk Factors Hemorrhage Stroke 40

Stroke Journal

JANUARY 30, 2025

Introduction:Moyamoya disease (MMD) is a rare cerebrovascular disease causing nonatherosclerotic intracranial arterial stenosis in children and young adults. This non-terminal ICA stenosis was more frequently observed in Caucasian than in Asian patients (17.5% Stroke, Volume 56, Issue Suppl_1 , Page ATMP11-ATMP11, February 1, 2025.

Stenosis 40

Stenosis Cerebrovascular Disease Hemorrhage Stroke 40

Stroke Journal

FEBRUARY 1, 2024

Background:Assessing carotid artery plaques in stenosis is crucial for treatment strategies and safety. Symptomatic patients or patients with worsening stenosis rates were significantly higher in Group A (75%) than Group B (36%) (p < 0.01).Conclusion:Elevated E-04) compared to non-type VI group (0.70 ± 0.59

Plaque 40

Plaque Stenosis Hemorrhage Stroke 40

EMS 12-Lead

AUGUST 25, 2024

MRI Brain demonstrated Left MCA acute/subacute infarct, MCA/PCA watershed, and no hemorrhagic transformation. No previous medical history was reported. My colleauges and I (interventional cardiology) were asked to consult during workup. Here is the admission ECG.

AFIB 59

AFIB Embolism Atrial Fibrillation RN 59

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

IntroductionVertebral artery stenting represents a viable option in treating symptomatic vertebral artery atherosclerotic stenosis. The most frequent stenosis location was the V1 segment of the vertebral artery (88.4%). Periprocedural ischemic and hemorrhagic complications occurred in 2.1% The mean age was 65 years, and 74.4%

Angioplasty 40

Angioplasty Stents Stent Stenosis 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

The patients were categorized into two groups: those with extracranial ICA stenosis and those with occlusion. Clinical outcomes, including functional independence, hemorrhagic events, and procedural time metrics including puncture to reperfusion time were assessed. vs. 50.6%, aOR 1.07, 95% CI 0.70‐1.64, vs. 48.9%, aOR 0.79, 95% CI 0.52‐1.20,

Outcomes 40

Outcomes Stenosis Hemorrhage Stroke 40

Stroke Journal

FEBRUARY 1, 2024

Compared with contralateral carotid artery plaque, plaque burden at the ipsilateral carotid artery was much heavy, presented with a higher degree of stenosis, smaller lumen area (0.22±0.15 Both lumen stenosis and plaque components were correlated with multiple or recurrent infarcts in this population. of them were male.

Plaque 40

Plaque Atherosclerosis Stroke Strokes 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

MRA head demonstrated multifocal arterial stenosis. Repeat CTA head/neck and CT perfusion showed severe stenosis of bilateral M1 segments and left greater than right A1 segments as well as ischemic penumbra in left ACA/MCA watershed territory. Cerebral vasospasm following EEA has rarely been described.

Blood Pressure 40

Blood Pressure Stenosis Hemorrhage Thrombosis 40

Stroke: Vascular and Interventional Neurology

JANUARY 25, 2024

Most neurointerventionalists (91%) diagnose ICAS‐LVO after a continued or recurrent occlusion or by the presence of fixed focal stenosis after multiple mechanical thrombectomy attempts. However, in patients who achieved recanalization with a severe fixed focal stenosis, most (58%) recommended primary medical management.

Atherosclerosis 40

Atherosclerosis Angioplasty Stenosis Biomarkers 40

Stroke Journal

FEBRUARY 1, 2024

Methods:This multicenter, observational study recruited first-ever acute ischemic stroke patients attributed to ICAS (>50% stenosis or occlusion) within 7 days after onset. 8.32%), degree of stenosis (60.25±18.95% Patients with recurrent ipsilateral stroke exhibited higher rates of intraplaque hemorrhage (IPH) (30.0%

Stroke 40

Stroke Strokes Plaque Stenosis 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

In our systemic review and meta‐analysis, we included Sixteen dual arm and seven single arm studies in order to study recanalization rate and compare outcomes following rescue stenting in patients with incomplete reperfusion compared to those managed conservatively (no‐RS).(4,

Stents 40

Stents Stent Stenosis Hemorrhage 40

Stroke Journal

JANUARY 30, 2025

Final infarct segmentation included hemorrhagic transformation. ml/h, P = 0.04), a higher likelihood of parent artery stenosis (65% vs. 20.8%, P < 0.001), and increased need for angioplasty or stenting (50% vs. 17%, P < 0.001). The DWI/ADC volume ratio was calculated by dividing DWI volume by ADC 620 10-6 mm2/s volume.

Outcomes 40

Outcomes Stroke Strokes Angioplasty 40

Stroke Journal

FEBRUARY 1, 2024

The PREMIER study first demonstrated high rates of complete occlusion without parent vessel stenosis or permanent neurological complications after the treatment of wide-necked small and medium-sized intracranial ICA aneurysms with the 48-wire pipeline. Median aneurysm and neck size were 5.8 mm (IQR: 4.0-7.5) At a median 10.1 months (IQR: 6.3-12.6),

Aneurysm 40

Aneurysm Stenosis Academic Stents 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Only dAVFs with cortical venous drainage were included as this aggressive subtype can present with non‐hemorrhagic neurologic deficits. Additionally, there was a significant association between sinus stenosis and dAVF‐CI (OR: 2.85, 95% CI: 1.16‐7.55, The patients with dAVF‐CI had a mean age of 58 ± 18 years. 7.55, p = 0.027).

Hypertension 40

Hypertension Stenosis Dementia Hemorrhage 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Most neurointerventionalists (91%) diagnose ICAS‐LVO after a continued or recurrent occlusion or by the presence of fixed focal stenosis (FFS) after multiple MT attempts. Fear of hemorrhagic complications (70%) was the most compelling reason not to perform RS +/‐ angioplasty. Overall, 40.6%

Atherosclerosis 40

Atherosclerosis Angioplasty Biomarkers Stents 40

Stroke Journal

FEBRUARY 1, 2024

We tested the Plaque-RADS classification in a cohort of patients with embolic stroke of undetermined source (ESUS) and imaged with neck CTAs.Methods:Patients with unilateral anterior circulation ischemic stroke due to ESUS and neck CTAs showing <50% carotid stenosis were retrospectively identified.

Plaque 40

Plaque Embolism Stroke Strokes 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Head CT showed right frontal lobe hemorrhage with bilateral SAHs (Figure1). Brain MRI redemonstrated hemorrhages, numerous scattered foci of restricted diffusion, and a large area of restricted diffusion in the left insular cortex (Figure 2).

Document 40

Document Hemorrhage Aneurysm Stenosis 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

One exclusion criterion for tPA administration is stroke within 3 months due to the presumed increased risk of hemorrhage. One study identified 19 patients who received tPA for ERS and found no symptomatic intracranial hemorrhage. While the rate of early recurrent stroke (ERS) within 3 months is as high as 14.5‐18.3%,

Hemorrhage 40

Hemorrhage Stroke Strokes Hypertension 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Rescue treatment with stenting, balloon angioplasty, and/or intraarterial thrombolysis or antiplatelets are often required to treat the underlying stenosis. Additionally, patients undergoing stenting were less likely to have symptomatic intracranial hemorrhage (sICH) (OR 0.34, 95% CI [0.17 ‐ 0.67]; p = 0.002).

Stents 40

Stents Stent Circulation Stroke 40

Stroke Journal

JANUARY 30, 2025

Receiver operating characteristic (ROC) curve analysis was conducted to identify the most accurate CTP parameter for predicting HPP.Results:Forty-six patients were enrolled; four patients exhibited HPP after CAS, and one patient experienced a cerebral hemorrhage.

Stents 40

Stents Stent Stenosis Risk Factors 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

The ipsilateral cervical ICA was occluded in 11 of 20 patients (55%) and nearly‐occluded (degree of stenosis 90‐99%) in 9 of 20 patients (45%). The degree of cervical ICA stenosis following thrombectomy improved from 96.5% The mean NIHSS was 14 (7‐25) and 40% were treated initially with intravenous thrombolytics.

Stenosis 40

Stenosis Angioplasty Circulation Stents 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

CT head revealed an evolving acute to subacute right MCA infarction with adjacent small volume subarachnoid hemorrhage. Multifocal severe stenosis was noted in the right distal right M1 and right M2 divisions. CTA head revealed a right MCA bifurcation aneurysm measuring 6 x 6 x 7 mm with irregularity of the wall. mm (Figure 1 ‐A,B).

Aneurysm 40

Aneurysm Embolism Hemorrhage Stenosis 40

Stroke Journal

FEBRUARY 1, 2024

Inclusion criteria were age ≥18 years, EVT for intracranial occlusion, and underwent treatment for extracranial ICA lesions with >70% stenosis. 5.02; p=0.86), petechial hemorrhages (OR: 0.79, CI: 0.10-6.05; Patients were divided into ASPECTS 0-5 and 6-10 groups. vs 48%, OR: 0.52, CI:0.29-0.97; vs 3.6%, OR: 3.18, CI: 1.07-9.49;

Stents 40

Stents Stent Stroke Strokes 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

ICAD was present if at least ≥ one of the following features were observed: (1) angiographic evidence of taper‐shape occlusion, (2) presence of arterial calcific lesions, and/or (3) remnant stenosis > 70% after mechanical thrombectomy (MT). There were no symptomatic hemorrhages. mm vs 1.88 ± 0.67 mm, p < 0.01).

Stroke 40

Stroke Strokes Laboratory Atherosclerosis 40

Stroke Journal

JANUARY 30, 2025

Introduction:Current guidelines recommend 24-hours of high-intensity monitoring (HIM) for acute ischemic stroke patients post-intravenous thrombolysis (IVT) due to risk of bleeding complications including symptomatic intracranial hemorrhage (sICH).

Thrombolysis 40

Thrombolysis ICU Stroke Strokes 40

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

History sounds concerning for ACS (could be critical stenosis, triple vessel), but differential also includes dissection, GI bleed, etc. 2 cases of Aortic Stenosis: Diffuse Subendocardial Ischemia on the ECG. His response: “subendocardial ischemia. Anything more on history? POCUS will be helpful.” Left main? 3-vessel disease?

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Patient underwent emergent mechanical thrombectomy with ADAPT to TICI3 revascularization with future plan for possible angioplasty and stenting of R vertebral stenosis. Initially maintained on aspirin and Cangrelor infusion, then transitioned to aspirin and Plavix without hemorrhagic conversion.

Angioplasty 40

Angioplasty Stroke Strokes Circulation 40

Dr. Smith's ECG Blog

APRIL 26, 2017

Low LV filling pressures are due to several etiologies, most commonly due to volume depletion (dehydration or hemorrhage), but also due to other etiologies including, but not limited to: mitral stenosis, pulmonary hypertension (chronic, or due to pulmonary embolism), or poor RV performance.

Chest Pain 52

Chest Pain STEMI Ultrasound Pulmonary 52

Stroke Journal

FEBRUARY 1, 2024

Primary outcomes included stroke, intracerebral hemorrhage (ICH), and mortality rates at 1-, 6-, 12-, and 18-month follow-ups, and in-stent restenosis. Multivariable logistic regression identified predictors of stroke and mortality.

Stents 40

Stents Stent Stenosis Hemorrhage 40

Circulation

NOVEMBER 11, 2024

Due to the high risk of hemorrhagic conversion, the loading of antiplatelets was deferred. A 2D echocardiogram revealed an ejection fraction of 43%, hypokinesia of the anterior and intraventricular septum from base to apex, and severe mitral stenosis. ml subcutaneously once daily. An open-heart surgery was considered.

Pulmonary 40

Pulmonary Open-Heart Surgery Atrial Fibrillation Myocardial Infarction 40

Stroke Journal

JANUARY 24, 2025

Patients with unilateral anterior circulation stroke and <50% carotid stenosis on CTA were retrospectively identified. A semiautomated segmentation software measured intraplaque hemorrhage volumes. Maximum plaque thickness and ulceration were assessed by a neuroradiologist blinded to the stroke side.

Plaque 40

Plaque Embolism Stroke Strokes 40

Stroke Journal

JANUARY 30, 2025

We performed this analysis to identify the prevalence of atrial fibrillation and associated outcomes in symptomatic internal carotid artery stenosis patients undergoing CAS or CEA.Methods:We analyzed the data from the National inpatient sample (NIS) between January 2016 to December 2021. versus 18.8% for CAS or CEA, respectively, p=0.50].

Atrial Fibrillation 40

Atrial Fibrillation Stents Stent Outcomes 40

Circulation: Arrhythmia and Electrophysiology

DECEMBER 19, 2024

There were 4 primary safety events in 4 patients (4.9%, 4/82); 1 nonembolic stroke due to exacerbated cardiac tamponade secondary to catheter perforation and 3 hemorrhagic vascular access complications. Eighty patients (98%) underwent remapping.

Atrial Fibrillation 40

Atrial Fibrillation Ablation Arrhythmia Outcomes 40

Stroke Journal

JANUARY 21, 2024

Men exhibited more unstable plaques (P<0.001), characterized by increased plaque hemorrhage, larger lipid core, and inflammation (P<0.001), along with less favorable circulating profiles. Adipokine, lipid, and immune profiling was conducted. Plaque stability was determined by gold-standard histological classifications.

Plaque 40

Plaque Circulation Atherosclerosis Hemorrhage 40

Dr. Smith's ECG Blog

AUGUST 9, 2019

61,62) The interventional community defines occlusive LM disease as >50% by FFR, or ≥75% stenosis,(63) but urgent or emergent intervention on lesions not meeting these thresholds is only imperative if it is a thrombotic lesion and the patient has refractory ischemic symptoms (i.e. TIMI 0/1 flow).(61,62) Knotts et al.

Myocardial Infarction 52

Myocardial Infarction Ischemia STEMI Cardiogenic Shock 52