The move to 24/7 mechanical thrombectomy provision for ischaemic stroke: an observational study of the impact on referrals, activity, procedural efficacy, and safety at a supra-regional centre.

Background: Health systems are striving to improve delivery of mechanical thrombectomy (MT) for ischaemic stroke. With the move to 24/7 provision, we aimed to assess (1) the change in referral and procedural frequency and timing, (2) reasons referrals did not proceed to MT, and (3) nocturnal procedural efficacy and safety.

Methods: This was an observational study comparing 12-month data for an extended daytime service (2021/2022, hours, 0800-2000) to that for a 12-month period delivering 24/7 cover (2023-2024).

Evaluation of effectiveness and safety of the large-format pRESET 6-50 thrombectomy stent-retriever in the endovascular treatment of ischemic stroke: real-world experiences from two tertiary comprehensive stroke centers.

Objective: Mechanical thrombectomy (MT) has become the standard treatment for acute ischemic stroke (AIS) with large vessel occlusion (LVO). First-pass (FP) reperfusion of the occluded vessel and fewer passes with stent retrievers show improvement in functional outcomes in stroke patients, while higher numbers of passes are associated with higher complication rates and worse outcomes. Studies indicate that a larger size of the stent-retriever is associated with a higher rate of first-pass reperfusion and improved clinical outcomes.

Mechanical thrombectomy with Q catheter in stroke caused by primary and secondary distal and medium vessel occlusions.

Background: The MIVI Q aspiration catheters have been shown to achieve significantly greater flow rates than other intracranial aspiration catheters in vitro. We describe our initial real-world experience with the MIVI Q catheter in emergent acute ischemic stroke (AIS) caused by distal and medium vessel occlusions (DMVO).

Methods: Data was collated from a prospectively maintained database which included patients from October 2019 to December 2022.

pCONUS 2 and pCONUS 2-HPC in the treatment of wide-necked intracranial aneurysms: Multicentre UK experience.

Background/purpose: pCONUS 2 and pCONUS 2-HPC are neck-bridging devices that provide coiling support in the endovascular treatment of wide-necked intracranial aneurysms. To date, limited multicentre data has been published. This study provides the first pooled data from multiple UK centres regarding outcomes for these devices covering the periprocedural period to 6-month follow-up.

Diffusion-weighted imaging lesions and risk of recurrent stroke after intracerebral haemorrhage.

Objective: To determine whether the presence of diffusion-weighted imaging-positive (DWI+) lesions is associated with recurrent stroke after intracerebral haemorrhage (ICH).

Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) assessed the effect of restarting versus avoiding antiplatelet therapy after ICH on major vascular events for up to 5 years. We rated DWI sequences of MRI done before randomisation for DWI+ lesion presence, masked to outcome and antiplatelet use.

Something hazy drifting in the air….

-A 7-year-old boy with a background of autism presented to the paediatric emergency department with his left arm 'feeling strange' then became difficult to rouse. On examination, he was found to have left arm weakness and a left-sided facial droop without forehead muscle involvement. Three hours later, his symptoms had completely resolved and he was suspected to have had a first seizure.

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial.

Background: Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy.

Predictive value of flexion and extension diffusion tensor imaging in the early stage of cervical myelopathy.

Purpose: Diffusion tensor imaging (DTI) in flexion (F) and extension (E) may serve as a sensitive diagnostic tool in early symptoms of myelopathy. The aim of this study was to compare values of water diffusion parameters on dynamic cervical DTI in early stage of myelopathy.

Methods: Study enrolled 10 patients with an early stage of cervical myelopathy, in grade I/II of Nurick classification.

Optimizing image registration and infarct definition in stroke research.

Objective: Accurate representation of final infarct volume is essential for assessing the efficacy of stroke interventions in imaging-based studies. This study defines the impact of image registration methods used at different timepoints following stroke, and the implications for infarct definition in stroke research.

Methods: Patients presenting with acute ischemic stroke were imaged serially using magnetic resonance imaging.