Shorter Reperfusion Time in Stroke is Associated with Better Cognition.

Background: Cognitive changes that result from cerebrovascular disease contribute to a poor functional outcome with reduced quality of life. Among patients undergoing endovascular therapy (EVT), we aim to assess cognitive function and evaluate the impact of reperfusion time in cognitive performance.

Methods: Patients with acute right anterior circulation strokes that underwent EVT between January 2018 and August 2020 at Centro Hospitalar de Vila Nova de Gaia/Espinho, participated in the study.

Ultra-early improvement after endovascular thrombectomy and long-term outcome in anterior circulation acute ischemic stroke.

Background: The use of post-treatment measures after acute ischemic stroke is important to predict good functional outcome. The most studied is 24 h National Institutes of Health Stroke Scale (NIHSS) score and existing literature is scarce regarding the use of earlier indicators, namely NIHSS immediately after endovascular thrombectomy (EVT). We hypothesized that an immediate neurological improvement after EVT, that we called ultra-early neurological improvement (UENI), would be a reliable functional independence predictor in anterior circulation acute ischemic stroke patients.

Primary Thrombectomy Versus Combined Mechanical Thrombectomy and Intravenous Thrombolysis in Large Vessel Occlusion Acute Ischemic Stroke.

Mechanical thrombectomy (MT) in combination with intravenous thrombolysis (IVT) is the standard of care for patients with acute ischemic stroke with anterior circulation large vessel occlusion. The particular benefit of IVT in these patients is unknown. We performed a retrospective analysis of patients submitted to MT at our center between January 2015 and June 2017.

NCCT and CTA-based imaging protocol for endovascular treatment selection in late presenting or wake-up strokes.

Introduction: Recently, the benefit of selecting patients for endovascular treatment (EVT) beyond the 6-hour time window using a tissue-based approach was demonstrated in two randomized trials. The optimal imaging protocol for selecting patients is under debate, and it is still unknown if a simpler and faster protocol may adequately select patients with wake-up stroke (WUS) and late-presenting stroke (LPS) for EVT.

Objective: To compare outcomes of patients submitted to EVT presenting within 6 hours of symptom onset or 6-24 hours after last seen well, selected using non-contrast computed tomography (NCCT) and CT angiography (CTA).

Is the Efficacy of Endovascular Treatment for Acute Ischemic Stroke Sex-Related.

Background: Several reports refer to differences in stroke between females and males, namely in incidence and clinical outcome, but also in response to treatments. Driven by a recent analysis of the MR CLEAN trial, which showed a higher benefit from acute stroke endovascular treatment (EVT) in males, we intended to determine if clinical outcomes after EVT differ between sexes, in a setting.

Methods: We analyzed 145 consecutive patients submitted to EVT for anterior circulation large-vessel occlusion, between January 2015 and September 2016, and compared the outcomes between sexes.

Emergent carotid artery stenting in atherosclerotic disease of the internal carotid artery with tandem intracranial occlusion.

Background: Several randomized clinical trials have proven the safety and efficacy of mechanical thrombectomy (MT) in large vessel occlusions; nonetheless, there is still no consensus concerning hyperacute management of tandem occlusions. Recent studies have suggested that emergent carotid artery stenting (eCAS), along with mechanical thrombectomy, is an effective and safe treatment option.

Aims: To characterize the safety and short-term outcome of patients treated with eCAS during endovascular treatment of acute ischaemic stroke.

Need for refining successful revascularization in endovascular treatment of acute ischemic stroke: Data from real-world.

Introduction: Modified TICI (mTICI) score≥2b has been largely used as a definition of successful revascularization in acute stroke endovascular treatment (EVT). However, mTICI 2b encompasses a broad range of different revascularization states and its clinical relevance, comparing to mTICI 3, has been questioned. We aimed to compare clinical outcomes between these two reperfusion groups, in patients submitted to EVT for anterior circulation large-vessel occlusion, in a real-world setting.

Endovascular Stroke Treatment of Patients Over 80 Years Old: Cumulative Evidence from the "Real World".

Background: Evidence on stent retriever-based thrombectomy (SRT) efficacy in elderly patients is controversial. This study aimed to analyze safety and efficacy outcomes in octogenarians submitted to SRT.

Methods: Analysis was based on a prospective observational registry of patients with stroke because of anterior circulation large-vessel occlusion treated with SRT at our center between January 2015 and September 2016.

Mechanical Thrombectomy in Acute Ischemic Stroke: Initial Single-Center Experience and Comparison with Randomized Controlled Trials.

Background: Until recently, intravenous thrombolysis was the only reperfusion therapy with proven efficacy in patients with acute ischemic stroke. However, this treatment option has low recanalization rates in large-vessel occlusions. The search for additional treatments continued until 5 randomized trials (MR CLEAN, ESCAPE, EXTEND-IA, SWIFT PRIME, and REVASCAT) revealed the superiority of mechanical thrombectomy for anterior circulation large-vessel occlusion.