Publications by authors named "Dapeng Mo"
Background: Restenosis after stenting with a standard bare-metal stent (BMS) is the main cause of stroke recurrence for symptomatic intracranial atherosclerotic stenosis (sICAS). Whether a drug-coated balloon (DCB) could reduce the risk of restenosis for such patients is unknown. We aimed to investigate the efficacy and safety of DCB in reducing 6 month restenosis in patients with sICAS.
View Article and Find Full Text PDFBackground: Endovascular stenting is a promising treatment for patients with idiopathic intracranial hypertension (IIH) and venous sinus stenosis (VSS). However, data on the impact of stenosis type on clinical outcomes of patients undergoing stenting treatment remain limited. This prospective cohort study aimed to compare post-stenting outcomes in patients with IIH and intrinsic versus extrinsic VSS.
View Article and Find Full Text PDFBackground: Venous sinus stenting (VSS) has emerged as a novel treatment option for idiopathic intracranial hypertension (IIH) with transverse sinus stenosis (TSS). However, the efficacy of stenting in atypical IIH patients (body mass index [BMI] < 24 kg/m, ≥ 50 years of age, or male) has not been fully investigated.
Methods: The data of IIH + TSS patients who experienced conventional medical treatment failure and received VSS treatment at Beijing Tiantan Hospital in China between May 2021 and December 2022 were retrospectively reviewed in a prospectively maintained database.
Objectives: This study aimed to identify factors at baseline associated with visual outcomes of patients with idiopathic intracranial hypertension (IIH) with venous sinus stenosis who underwent venous sinus stenting.
Methods: The study eyes were divided into two groups according to mean deviation (MD) at 6-month post-stenting follow-up: MD better than -2.0 dB (the favorable visual outcome group) and equal to -2.
Background: The Hyperdense Middle Cerebral Artery Sign (HMCAS) is an early marker of acute MCA occlusion on non-contrast CT (NCCT), which has been linked with stroke type and thrombus composition.
Aims: To assess the prognostic value of HMCAS in M1 occlusion patients treated with endovascular thrombectomy and explore its predictive value across different patients.
Methods: Patients with M1 occlusion were selected from the ANGEL-ACT registry, which comprised 1793 individuals.
Purpose: This study aimed to investigate the factors influencing favourable clinical outcomes in idiopathic intracranial hypertension (IIH) patients with venous sinus stenosis (VSS) who received stenting treatment.
Methods: In this prospective cohort study, we analyzed a total of 172 IIH patients with VSS treated with venous sinus stenting. Clinical outcomes were categorized as either "complete resolved" or "improved".
Background: Patients with sub-acute cerebral venous sinus thrombosis experience (SA.CVST) severe symptoms compared to two other venous sinus-related diseases, including chronic cerebral venous sinus thrombosis (C.CVST) and idiopathic intracranial hypertension (IIH).
View Article and Find Full Text PDFBackground And Objective: Predicting post-operative flow is essential for assessing the risk of adverse events in cerebrovascular stenosis patients following endovascular treatment (EVT). This study aimed to evaluate the accuracy of the CFD simulation model in predicting post-operative velocity, flow and pressure distal to a stenosis, based on cerebrovascular microcirculatory resistance.
Methods: The patient-specific models of the extracranial and intracranial arteries were reconstructed.
Article Synopsis
- The study examines periprocedural intracranial hemorrhage complications after stent placement for symptomatic intracranial atherosclerotic stenosis, focusing on predictors and long-term patient outcomes.
- Out of 1,849 patients analyzed, 24 (1.3%) experienced hemorrhages, with a higher incidence of poor long-term outcomes in those with non-procedure-related hemorrhage compared to procedure-related hemorrhage.
- Key predictors for non-procedure-related hemorrhage include having anterior circulation involvement, high preprocedural stenosis rates, and recent cerebral infarctions.
Article Synopsis
- Recent trials have found no advantage of endovascular stenting over aggressive medical management for patients with symptomatic intracranial atherosclerotic stenosis (sICAS), but balloon angioplasty has not yet been conclusively tested.
- This study aimed to compare the effectiveness of balloon angioplasty plus aggressive medical management against aggressive medical management alone in sICAS patients.
- Results showed that patients who received balloon angioplasty had a significantly lower incidence of strokes or death within the follow-up period compared to those receiving only medical management (4.4% versus 13.5%).
Article Synopsis
- Cognard type IIa+b dural arteriovenous fistulas (DAVFs) in lateral sinuses often lead to complications like venous sinus obstruction, which results in clinical symptoms and increased hemorrhage risk.
- This study retrospectively analyzed patients who underwent venous sinus stenting for type IIa+b DAVFs between April 2017 and June 2019, focusing on the outcomes of those with associated sinus occlusion.
- Results showed that stent placement improved symptoms in most patients, restored proper blood drainage, and reduced the likelihood of intracranial hemorrhage, making it a promising treatment option for complex cases.
Background: Blood pressure (BP) management at the initial stage of stroke caused by large-vessel occlusion (LVO) remains challenging. We assessed the association between baseline BP and clinical and safety outcomes of endovascular treatment (EVT) in different stroke etiologies.
Methods: Patients with acute ischemic stroke and anterior circulation LVO were screened from a prospective, multicenter registry of EVT from November 2017 to March 2019.
Background: Although endovascular stenting is considered an effective and safe therapeutic option for symptomatic intracranial atherosclerotic disease (sICAD), an elevated rate of restenosis remains an important issue for the conventional bare-metal stent (BMS). Recent evidence from observational studies suggests that applying drug-coated balloons (DCB) in sICAD may decrease restenosis occurrence. Additional large randomised studies are warranted to provide firmer evidence and to determine which patients would benefit most from DCB.
View Article and Find Full Text PDFAim: We conducted a matched-control analysis to compare the outcomes of large vessel occlusion (LVO) patients treated with mechanical thrombectomy (MT) plus Intra-arterial thrombolysis (IAT) versus those treated with MT alone.
Methods: The subjects of this study were chosen from ANGEL-ACT registry. All patients who received MT were identified and categorized into two groups: "MT + IAT" and "MT," based on whether or not they received additional intra-arterial medication IAT during the MT procedure.
Objectives: We investigated whether patients with large infarct and the presence or absence of perfusion mismatch are associated with endovascular treatment benefit.
Methods: This is a post-hoc analysis of the Endovascular Therapy in Anterior Circulation Large Vessel Occlusion with a Large Infarct (ANGEL-ASPECT) randomized trial, which enrolled patients within 24 hours of onset with ASPECTS 3 to 5 or ASPECTS 0 to 2 with an infarct core 70 to 100 ml. Mismatch ratio was defined as time-to-maximum (T) >6 s cerebral volume/ischemic core volume, and mismatch volume was defined as T >6 s volume minus ischemic core volume.
Article Synopsis
- * FPE was observed in 14.6% and modified FPE (mFPE) in 36.3% of the 226 patients studied, with mFPE linked to older age and better functional outcomes after 90 days.
- * Patients achieving mFPE had a higher likelihood of being functionally independent and ambulating independently, while showing potential reductions in rates of intracranial hemorrhage and 90-day mortality.
Article Synopsis
- - The study investigated the potential benefits of bailout angioplasty or stenting (BAOS) for patients with large vessel occlusion acute ischemic stroke (LVO-AIS) who experienced unsuccessful recanalization after thrombectomy, as poor outcomes are common in such cases.
- - This randomized controlled trial involved 348 participants from 36 hospitals across China, who were either assigned to the BAOS intervention group or a control group receiving standard therapy, with outcomes measured by changes in the modified Rankin Scale at 90 days.
- - Findings indicated a diverse participant demographic, primarily male, with a median age of 63, and both safety and efficacy of the BAOS procedure were evaluated without loss to follow-up for the primary outcomes.
Background And Purpose: Adjunctive tirofiban administration in patients undergoing endovascular treatment (EVT) for acute large vessel occlusion (LVO) has been investigated in several studies. However, the findings are conflict. This study aimed to compare the effect of different administration pathways of tirofiban on patients undergoing EVT for acute LVO with intracranial atherosclerotic disease (ICAD).
View Article and Find Full Text PDFObjectives: To investigate whether single or dual antiplatelet therapy (SAPT or DAPT) within 24 hours before endovascular treatment (EVT) could improve the clinical outcomes of patients with large vessel occlusion (LVO).
Methods: Patients from the ANGEL-ACT registry were divided into antiplatelet therapy (APT) and non-APT groups. The APT group was divided into SAPT and DAPT groups.
Purpose: The outcomes of patients with large ischemic core who fail to recanalize with endovascular therapy (EVT) compared to medical management (MM) are uncertain. The objective was to evaluate the clinical and safety outcomes of patients who underwent EVT in patients with large ischemic core and unsuccessful recanalization.
Methods: This was a post hoc analysis of the ANGEL-ASPECT randomized trial.
Background: The pulsatility index (PI) derived from transcranial Doppler (TCD) assessment may represent the cerebral resistance and altered cerebral blood flow. The purpose of this study was to assess the performance of the TCD PI in correlation with wire-based fractional pressure ratio (FPR).
Methods: This study included 33 patients with symptomatic atherosclerotic lesions of the extracranial and intracranial large arteries, specifically the internal carotid artery, middle cerebral artery (MCA), vertebral artery (VA) V4 segment, and basilar artery (BA), all of which exhibited luminal stenosis ranging from 50% to 70%.
Article Synopsis
- The study focused on developing a radiomics model based on magnetic resonance venography (MRV) to predict high trans-stenotic pressure gradient (TPG) in patients with idiopathic intracranial hypertension (IIH) associated with venous sinus stenosis.
- A total of 105 IIH patients were analyzed using MRV and other imaging techniques, identifying three key shape features from the MRV images that helped construct a predictive score for high TPG.
- The model showed strong performance in predicting high TPG with an area under the receiver operating characteristic curve (AUROC) of 0.906 for the training dataset and 0.877 for the test dataset, indicating its potential clinical usefulness.
Rescue angioplasty and/or stenting after mechanical thrombectomy: who can benefit?
J Neurointerv Surg
November 2024
Background: Angioplasty and/or stenting is a rescue therapy for mechanical thrombectomy (MT) in acute intracranial large vessel occlusion. This study was undertaken to determine whether rescue angioplasty and/or stenting improves the outcome after MT and to investigate whether outcomes differ by subgroup of rescue indication.
Methods: We performed propensity score matching (PSM) with data from a prospective multicenter registry of patients with acute large vessel occlusion receiving endovascular treatment.
Importance: Endovascular therapy (EVT) demonstrated better outcomes compared with medical management in recent randomized clinical trials (RCTs) of patients with large infarct.
Objective: To compare outcomes of EVT vs medical management across different strata of the Alberta Stroke Program Early Computed Tomography Score (ASPECTS) and infarct core volume in patients with large infarct.
Design, Setting, And Participants: This prespecified secondary analysis of subgroups of the Endovascular Therapy in Acute Anterior Circulation Large Vessel Occlusive Patients With a Large Infarct Core (ANGEL-ASPECT) RCT included patients from 46 stroke centers across China between October 2, 2020, and May 18, 2022.
Background: Understanding sex disparities in stroke can identify gaps in clinical care. The objective of this study was to investigate whether sex differences could influence clinical outcomes of patients with acute vertebrobasilar artery occlusion (VBAO) who underwent endovascular therapy (EVT).
Methods: Patients were selected from the ANGEL-ACT Registry.