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The PANDA score: External validation and modification of a simple upfront prediction tool for poor outcomes despite successful stroke thrombectomy.
Clin Neurol Neurosurg
January 2025
Department of Interventional Radiology, Oregon Health and Science University, Portland, OR 97239, USA. Electronic address:
Background: While endovascular thrombectomy (EVT) has become standard of care for patients' acute ischemic stroke (AIS) due to large vessel occlusion (LVO), many patients still suffer profound neurological disability, also termed futile recanalization (FR). The BAND score, which incorporates baseline disability, age, stroke severity, and treatment time window, is derived as a simple tool for upfront prediction of FR prior to EVT. This study aims to externally validate the BAND score and to incorporate upfront imaging biomarkers into the prediction tool.
View Article and Find Full Text PDFEvaluating the effect of noise reduction strategies in CT perfusion imaging for predicting infarct core with deep learning.
Neuroradiol J
January 2025
Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY, USA.
This study evaluates the efficacy of deep learning models in identifying infarct tissue on computed tomography perfusion (CTP) scans from patients with acute ischemic stroke due to large vessel occlusion, specifically addressing the potential influence of varying noise reduction techniques implemented by different vendors. We analyzed CTP scans from 60 patients who underwent mechanical thrombectomy achieving a modified thrombolysis in cerebral infarction (mTICI) score of 2c or 3, ensuring minimal changes in the infarct core between the initial CTP and follow-up MR imaging. Noise reduction techniques, including principal component analysis (PCA), wavelet, non-local means (NLM), and a no denoising approach, were employed to create hemodynamic parameter maps.
View Article and Find Full Text PDF[Acute ischemic stroke treatment].
Med Klin Intensivmed Notfmed
January 2025
Neurologische Klinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.
Intravenous thrombolysis (IVT) and endovascular therapy (EVT) are the cornerstones of acute ischemic stroke treatment. While IVT has been an integral part of acute therapy since the mid-1990s, EVT has evolved as one of the most effective treatments in medicine over the past decade. Traditionally, systemic thrombolysis has been performed with alteplase (rtPA).
View Article and Find Full Text PDFCircle of Willis Variants and Their Association with Outcome after Successful Revascularization of Anterior Large Vessel Occlusion.
AJNR Am J Neuroradiol
January 2025
Department of Radiology, University of Cincinnati Medical Center, Cincinnati, Ohio, USA.
Background And Purpose: Leptomeningeal collaterals have been associated with better outcomes in large-vessel stroke, but little is known about how the Circle of Willis (CoW) collaterals affect stroke outcomes. We aimed to determine the relationship between three anatomically distinct CoW subtypes and 90-day outcomes in acute ischemic stroke patients after successful revascularization via endovascular thrombectomy (EVT).
Materials And Methods: We performed a retrospective analysis of patients treated with successful EVT for large-vessel occlusion at a comprehensive stroke center between May 2016 and November 2023.
Effect of prior use of statins on endovascular thrombectomy outcomes in acute ischemic stroke.
Clin Neurol Neurosurg
January 2025
Department of Neurology, Milton S. Hershey Medical Center, Penn State University College of Medicine, Hershey, PA, USA. Electronic address:
Introduction: Acute large vessel occlusions (LVOs) account for up to one-third of acute ischemic strokes (AIS) and are associated with high mortality and severe functional deficits. Animal model research suggests that statins may have a protective effect on vessel wall injury during endovascular thrombectomy (EVT). We conducted a retrospective observational study to assess the impact of statin use on clinical outcomes post-EVT in AIS patients with LVOs.
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