Rescue Stent Placement for Acute Ischemic Stroke with Large Vessel Occlusion Refractory to Mechanical Thrombectomy: A Multiethnic Middle Eastern/African/Asian Cohort.

Purpose: To investigate the safety and effectiveness of rescue stent placement in patients who experienced acute stroke in whom mechanical thrombectomy failed.

Methods: This was a retrospective review of a multiethnic stroke database. After stent placement, an aggressive antiplatelet protocol was followed with glycoprotein IIb/IIIa infusion.

The Need for Structured Strategies to Improve Stroke Care in a Rural Telestroke Network in Northern New South Wales, Australia: An Observational Study.

A telestroke network in Northern New South Wales, Australia has been developed since 2017. We theorized that the telestroke network development would drive a progressive improvement in stroke care metrics over time. This study aimed to describe changes in acute stroke workflow metrics over time to determine whether they improved with network experience.

Air vs. Road Decision for Endovascular Clot Retrieval in a Rural Telestroke Network.

Telestroke aims to increase access to endovascular clot retrieval (ECR) for rural areas. There is limited information on transfer workflow for ECR in rural settings. We sought to describe the transfer metrics for ECR in a rural telestroke network with respect to decision making.

No Evidence of the "Weekend Effect" in the Northern New South Wales Telestroke Network.

Admission outside normal business hours has been associated with prolonged door-to-treatment times and poorer patient outcomes, the so called "weekend effect. " This is the examination of the weekend effect in a telestroke service that uses multi-modal computed tomography. To examine differences in workflow and triage between in-hours and out-of-hours calls to a telestroke service.

Medical Management vs Mechanical Thrombectomy for Mild Strokes: An International Multicenter Study and Systematic Review and Meta-analysis.

Importance: The benefit of mechanical thrombectomy (MT) in patients with stroke presenting with mild deficits (National Institutes of Health Stroke Scale [NIHSS] score <6) owing to emergency large-vessel occlusion (ELVO) remains uncertain.

Objective: To assess the outcomes of patients with mild-deficits ELVO (mELVO) treated with MT vs best medical management (bMM).

Data Sources: We retrospectively pooled patients with mELVO during a 5-year period from 16 centers.

Baseline Occlusion Angiographic Appearance on Mechanical Thrombectomy Suggests Underlying Etiology and Outcome.

Etiology of a large vessel occlusion is relevant in the management of acute ischemic stroke patients and often difficult to determine in the acute phase. We aim to investigate whether the angiographic appearance of the occlusion is related to its etiology and outcome. Patients without cervical carotid occlusions who underwent mechanical thrombectomy in our center from April 2015 to September 2018 were studied.

The Impact of Diabetes on Outcomes After Acute Ischemic Stroke: A Prospective Observational Study.

Background: Stroke in diabetics may delay recovery and increases the risk of early recurrence of stroke. We compared the outcomes of patients (with and without diabetes) admitted with an acute ischemic stroke (AIS) in the state of Qatar.

Patients And Methods: We prospectively compared the clinical presentation, complications, discharge outcome, and stroke recurrence at 90 days in patients with and without diabetes.

Correction to: Pre-existing Small Vessel Disease in Patients with Acute Stroke from the Middle East, Southeast Asia, and Philippines.

The author names "Dr. Pablo Garcia Bermejo" and "Dr. Muhammad Faisal Wadiwala" needed to be added as the 6th and 7th authors, respectively.

Relative cerebral blood volume is associated with collateral status and infarct growth in stroke patients in SWIFT PRIME.

Unlabelled: We aimed to evaluate how predefined candidate cerebral perfusion parameters correlate with collateral circulation status and to assess their capacity to predict infarct growth in patients with acute ischemic stroke (AIS) eligible for endovascular therapy. Patients enrolled in the SWIFT PRIME trial with baseline computed tomography perfusion (CTP) scans were included. RAPID software was used to calculate mean relative cerebral blood volume (rCBV) in hypoperfused regions, and hypoperfusion index ratio (HIR).

Pre-existing Small Vessel Disease in Patients with Acute Stroke from the Middle East, Southeast Asia, and Philippines.

Asymptomatic small vessel disease (SVD), including white matter hyperintensities (WMHIs), periventricular hyperintensities (PVHIs), silent stroke (SS), and cerebral microbleeds (CMBs), increases the risk of stroke. There are limited studies of SVD in subjects from the Middle East and Southeast Asia (SA). All patients admitted to stroke service between 2014 and 2015 were reviewed for presence of "pre-existing" SVD.

Evaluation of hyperacute infarct volume using ASPECTS and brain CT perfusion core volume.

Objective: To compare the accuracy of Alberta Stroke Program Early Computed Tomography Score (ASPECTS) and CT perfusion to detect established infarction in acute anterior circulation stroke.

Methods: We performed an observational study in 59 acute anterior circulation ischemic stroke patients who underwent brain noncontrast CT, CT perfusion, and MRI within 100 minutes from CT imaging. ASPECTS scores were calculated by 4 blinded vascular neurologists.

Severe cerebral vasospasm in chronic cocaine users during neurointerventional procedures: A report of two cases.

Cocaine is a widespread recreational drug that has the potential to induce neurological vascular diseases, including ischaemic and haemorrhagic stroke. Although arterial vasospasm has been suggested as a pathogenic factor in the development of neurovascular complications, it remains unclear whether cocaine users carry an increased risk to suffer iatrogenic vasospasm during endovascular procedures. We report the case of two patients with a history of cocaine abuse, who developed unusual severe vasospasms during different interventional procedures.

Endovascular treatment for M2 occlusions in the era of stentrievers: a descriptive multicenter experience.

Background: Patients with M2 middle cerebral artery (MCA) occlusions are not always considered for endovascular treatment.

Objective: To study outcomes in patients with M2 occlusion treated with endovascular procedures in the era of stentrievers.

Methods: We studied patients prospectively included in the SONIIA registry (years 2011-2012)-a mandatory, externally audited registry that monitors the quality of reperfusion therapies in Catalonia in routine practice.

Relative cerebral blood volume as a marker of durable tissue-at-risk viability in hyperacute ischemic stroke.

Background And Purpose: Selection of best responders to reperfusion therapies could be aided by predicting the duration of tissue-at-risk viability, which may be dependant on collateral circulation status. We aimed to identify the best predictor of good collateral circulation among perfusion computed tomography (PCT) parameters in middle cerebral artery (MCA) ischemic stroke and to analyze how early MCA response to intravenous thrombolysis and PCT-derived markers of good collaterals interact to determine stroke outcome.

Methods: We prospectively studied patients with acute MCA ischemic stroke treated with intravenous thrombolysis who underwent PCT before treatment showing a target mismatch profile.

[High performance of an implantable Holter monitor in the detection of concealed paroxysmal atrial fibrillation in patients with cryptogenic stroke and a suspected embolic mechanism].

Introduction: Implantable loop recorders (ILR) may allow detection of occult paroxysmal atrial fibrillation (PAF) in patients with cryptogenic ischemic stroke. However, optimal selection algorithm and ideal duration of monitoring remain unclear. AIM.

Multimodal CT versus MRI in Selecting Acute Stroke Patients for Endovascular Treatment.

Arterial revascularization is the most effective therapy for acute stroke patients. Systemic thrombolysis with recombinant tissue plasminogen activator based on baseline non-contrast CT (NCCT) imaging criteria is the only treatment approved to date, which is limited by severe timing and medical restrictions, and a narrow efficacy. The simple imaging methodology required contrast with the current wide range of imaging modalities available, which permits the physician to rapidly obtain an estimation of the most relevant pathophysiological factors involved in an acute stroke, overcoming the limited capability of NCCT.

Perfusion computed tomography-guided intravenous thrombolysis for acute ischemic stroke beyond 4.5 hours: a case-control study.

Background: Extending the therapeutic window of intravenous thrombolysis for acute ischemic stroke beyond the established 4.5-hour limit is of critical importance in order to increase the proportion of thrombolysed stroke patients. In this setting, the capacity of MRI to select acute stroke patients for reperfusion therapies in delayed time windows has been and is being tested in clinical trials.

Insulin resistance is associated with a poor response to intravenous thrombolysis in acute ischemic stroke.

Objective: Insulin resistance (IR) may not only increase stroke risk, but could also contribute to aggravate stroke prognosis. Mainly through a derangement in endogenous fibrinolysis, IR could affect the response to intravenous thrombolysis, currently the only therapy proved to be efficacious for acute ischemic stroke. We hypothesized that high IR is associated with more persistent arterial occlusions and poorer long-term outcome after stroke thrombolysis.

Multimodal imaging tools for diagnosis of fat embolism.

It is important to consider several differential diagnoses in a patient presenting with altered sensorium following surgery. Fat embolism syndrome (FES) is a serious condition that needs to be excluded. Although criteria for diagnosis of FES are available, all patients may not satisfy them.