Publications by authors named "Lin-Bo Zhao"
Background: In-stent restenosis (ISR) is a potential severe complication that occurs in patients with severe carotid artery narrowing after carotid angioplasty and stent placement. However, this phenomenon has not been fully studied in the context of interventional treatment for chronic internal carotid artery occlusion (CICAO).
Purpose: To quantify the ISR rate and identify the risk factors leading to this event.
Rationale And Objectives: Endovascular recanalization has been attempted in patients with symptomatic chronic intracranial large artery occlusion (CILAO), however, the heterogeneity of recanalization outcomes present challenges for the clinical application.
Objective: To determine the radiological features on high-resolution MR imaging (HR-MRI) for predicting successful recanalization of symptomatic CILAO.
Methods: Seventy-three patients with symptomatic CILAO who underwent endovascular recanalization at our center were retrospectively analyzed.
Article Synopsis
- The study aimed to create a nomogram to forecast early neurological deterioration (END) in patients with mild ischemic strokes, which could help identify candidates for thrombectomy.* -
- Researchers analyzed 248 patients and identified four key risk factors for END (age, fluctuation in symptoms, presence of core infarct, and occlusion site) to build the nomogram, which showed strong predictive accuracy.* -
- The nomogram demonstrated high performance in predicting END, suggesting that patients at risk might need immediate thrombectomy or close monitoring to ensure timely treatment.*
Article Synopsis
- This study aimed to determine if direct endovascular treatment (DEVT) is more effective than bridging therapy (intravenous thrombolysis plus EVT) in improving functional outcomes for patients with acute ischemic stroke from basilar artery occlusion.
- The research involved 153 patients treated within 4.5 hours of stroke onset, comparing outcomes such as functionality at 90 days, number of thrombectomy attempts, and other clinical features between the two methods.
- Results showed that DEVT had a similar functional outcome as bridging therapy, but it required fewer thrombectomy attempts, indicating IVT may simplify the procedure.
Article Synopsis
- The study investigates the link between malnutrition and poor outcomes in patients with vertebrobasilar artery occlusion (VBAO) undergoing endovascular treatment (EVT).
- Researchers analyzed data from 285 patients, using malnutrition assessment tools like CONUT, GNRI, and PNI to evaluate nutritional status.
- The findings revealed that malnutrition significantly increased the risk of poor prognosis at 90 days, making it a valuable predictor when combined with traditional risk factors.
Article Synopsis
- A study investigated the link between perfusion deficits and vessel wall characteristics in patients with chronic anterior circulation large vessel occlusions to assess their risk of recurrent ischemic events.
- The analysis involved 71 patients, of which 21.1% experienced recurrent ischemic events like strokes or transient ischemic attacks over two years. Key predictors included hypertension, specific imaging findings, and high Tmax deficit volumes.
- Findings suggest that hypertension, elevated Tmax >4 s, and hyperintense signals from MRI are significant factors in predicting future ischemic events, indicating a need for further research on revascularization strategies in these high-risk patients.
Article Synopsis
- The study compares clinical outcomes of patients with diffuse angiogram-negative subarachnoid hemorrhage (dan-SAH) versus those with aneurysmal subarachnoid hemorrhage (aSAH), revealing the risks associated with each type.
- Propensity score matching was used to compare 65 patients with dan-SAH to 260 patients with aSAH, highlighting that aSAH patients faced significantly higher risks for rehemorrhage, death, and delayed cerebral ischemia.
- Factors such as higher Hunt-Hess grades, presence of intraventricular hemorrhage, and smoking were linked to worse outcomes, but the type of hemorrhage (dan-SAH vs. aSAH) did not influence unfavorable outcomes.
Purpose: To stratify angiographic images of chronic internal carotid artery occlusion (CICAO) into a newly modified angiographic classification, and identify suitable candidates for endovascular recanalization.
Methods: This study included 51 consecutive patients with symptomatic CICAO who underwent endovascular recanalization at our institution. Patients' clinical information, angiographic findings, procedural results, and outcomes were recorded.
Objective: To compare the prognostic value of net water uptake (NWU) and target mismatch (TM) on CT perfusion (CTP) in acute ischemic stroke (AIS) patients with late time window.
Methods: One hundred and nine consecutive AIS patients with anterior-circulation large vessel occlusion presenting within 6-24 h from onset/last seen well were enrolled. Automated Alberta Stroke Program Early CT Score-based NWU (ASPECTS-NWU) was calculated from admission CT.
Objective: To investigate whether truncal-type occlusion based on multiphase computed tomographic angiography (mpCTA) was more effective for predicting intracranial atherosclerotic stenosis-related occlusion (ICAS-O) than occlusion type based on single-phase computed tomographic angiography (spCTA) in patients with acute ischemic stroke with large-vessel occlusion (AIS-LVO) in the middle cerebral artery (MCA).
Methods: Data were retrospectively collected from 72 patients with AIS-LVO in the MCA between January 2018 and December 2019. The occlusion types included truncal-type and branching-site occlusions.
Purpose: The effect of pretreatment infarct location on clinical outcome after successful mechanical thrombectomy is not understood. Our aim was to evaluate the association between computed tomography perfusion (CTP)-based ischemic core location and clinical outcome following excellent reperfusion in late time windows.
Methods: We retrospectively reviewed patients who underwent thrombectomy for acute anterior circulation large vessel occlusion in late time windows from October 2019 to June 2021 and enrolled 65 patients with visible ischemic core on admission CTP who had received excellent reperfusion (modified thrombolysis in cerebral infarction grade 2c/3).
Background: Symptomatic intracranial hemorrhage (sICH) is a common and severe complication in patients with acute ischemic stroke (AIS) after treatment with thrombectomy.
Objective: To explore the ability of admission plasma D-dimer levels to predict sICH after thrombectomy.
Methods: Between February 2018 and August 2021, consecutive patients with AIS who underwent thrombectomy at our single comprehensive stroke center were retrospectively enrolled.
Objective: The predictors of futile recanalization in patients with intracranial atherosclerosis (ICAS)-related stroke are not understood. This study aimed to identify the predictors of futile recanalization after endovascular treatment (EVT) in patients who experience an acute stroke caused by ICAS-related occlusion.
Methods: We retrospectively reviewed the data of patients with ICAS-related stroke who underwent EVT from January 2018 to July 2021.
Article Synopsis
- Traditional methods for treating hard-to-reach aneurysms can be difficult, so researchers explored micro-guidewire electrocoagulation as an alternative approach.
- In a study involving seven patients treated between January 2020 and May 2022, this technique resulted in the complete disappearance of all aneurysms and no cases of rebleeding during follow-up.
- While initial results are promising, further research with larger groups is necessary to better understand the safety and long-term effectiveness of this method.
Background: Oculomotor nerve palsy (ONP) may result from posterior communicating artery (PcomA) aneurysms. We aimed to evaluate the resolution of ONP after endovascular treatment with the intention of clarifying predictors of nerve recovery in a relatively large series.
Methods: A total of 211 patients with ONP caused by PcomA aneurysms underwent endovascular coiling between May 2010 and December 2020 in four tertiary hospitals.
Objective: The standard rescue modality for patients with intracranial atherosclerotic stenosis after failed mechanical thrombectomy (MT) is not well established. We evaluated the safety and efficacy of balloon dilation in combination with tirofiban as the first-line salvage therapy when MT failed in these patients.
Methods: We retrospectively analyzed the records of 47 patients admitted between January 2018 and June 2021, with middle cerebral artery atherosclerotic occlusion, who underwent balloon angioplasty in combination with tirofiban as the first-line salvage therapy after the failure of MT.
Article Synopsis
- Delayed cerebral ischemia (DCI) significantly affects the outcome for patients suffering from aneurysmal subarachnoid hemorrhage (aSAH), prompting a study on the relationship between NT-pro BNP levels and DCI occurrence.
- The study analyzed data from 415 aSAH patients, finding that higher NT-pro BNP levels correlated with increased cardiac troponin T levels and abnormal ECG results, with 12.8% experiencing DCI.
- Importantly, high NT-pro BNP levels, alongside the modified Fisher scale, were identified as strong independent predictors of DCI, enhancing prediction accuracy when combined.
Background: The Alberta Stroke Program Early CT Score (ASPECTS) and collateral score (CS) are two readily available imaging metrics for the evaluation of acute ischemic stroke (AIS) with large vessel occlusion (LVO).
Objective: To investigate the predictive value of the ASPECTS combined with CS in detecting patients with CT perfusion (CTP) target mismatch in delayed time windows.
Methods: One hundred and sixty-four patients with LVO-AIS were included.
Background: Computed tomography perfusion (CTP) parameters have been shown to have predictive value for functional outcomes of patients with basilar artery occlusion (BAO). We report the predictive value of CTP-based software (CTP-Rapid Processing of Perfusion and Diffusion (RAPID); iSchemia View) for functional outcomes of patients with BAO after endovascular therapy (EVT).
Methods: Patients with BAO who underwent EVT were retrospectively analyzed in our center from December 2019 to July 2021.
Background: Intracranial atherosclerosis-related large vessel occlusion (ICAS+LVO) poses an important technical challenge for endovascular thrombectomy (EVT).
Purpose: To evaluate the value of D-dimer in predicting ICAS+LVO alone and in combination with other clinical and imaging predictors.
Material And Methods: Consecutive patients who underwent EVT at our center between January 2018 and June 2021 were retrospectively reviewed.
Article Synopsis
- - The study investigated the safety and effectiveness of stent-assisted coil embolization for treating unruptured wide-necked paraclinoid aneurysms, comparing outcomes based on whether the aneurysms were located on the dorsal or ventral walls.
- - Out of 267 aneurysms treated, those on the dorsal wall were found to be larger and had higher rates of unsuccessful treatment outcomes compared to ventral wall aneurysms, indicating a significant difference in effectiveness between the two groups.
- - The findings suggest that stent-assisted coiling is more reliable for ventral wall aneurysms, whereas dorsal wall aneurysms may require alternative treatment methods due to higher recurrence rates and complications.
Objective: To evaluate the safety and efficacy of an overlapped stenting-assisted coiling technique in treating vertebral artery dissecting aneurysm (VADA) via Low-profile Visualized Intraluminal Support (LVIS) stent-within-Neuroform EZ stent.
Methods: From January 2017 to June 2019, 18 consecutive patients with VADAs (ruptured : unruptured=5 : 13) were treated with the overlapping stents assisted-coiling technique in our center. The overlapping manner was a Neuroform EZ stent being deployed first, followed by LVIS stents placement using the 'shelf' technique.
Background And Purpose: DIRECT-MT showed that endovascular thrombectomy was noninferior to thrombectomy preceded by intravenous alteplase with regard to functional outcome in patients with acute ischemic stroke. In this post hoc analysis, we examined whether infarct size modified the effect of alteplase.
Methods: All patients with baseline Alberta Stroke Program Early Computed Tomography Score (ASPECTS) grades were included.
Objective: To evaluate the prognostic significance of high-sensitivity cardiac troponin T (hs-cTnT) elevation in acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) in the anterior circulation treated with endovascular thrombectomy (ET) in late time windows and identify the factors associated with hs-cTnT elevation.
Methods: A total of 152 AIS patients treated with ET in late time windows between January 2018 and August 2020 were included in this study. Patients were stratified into either normal or elevated hs-cTnT groups according to a cutoff value of 14 ng/L on admission.
Background: The benefit of endovascular thrombectomy for patients with in-hospital stroke remains unclear. Thus, the aim of this study was to compare the endovascular thrombectomy outcomes between in-hospital stroke and community-onset stroke among patients with acute ischemic stroke.
Methods: From January 2015 to July 2019, 362 consecutive patients with acute ischemic stroke with large vessel occlusion in the anterior circulation received endovascular thrombectomy in our centre.