6,070 results match your criteria: "Anterior Circulation Stroke"

Systolic blood pressure modifies the effect of endovascular thrombectomy in acute ischemic stroke: a mediation analysis.

Am J Hypertens

December 2024

Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.

Background: Systolic blood pressure (BP) is a key factor in the outcomes of patients with acute ischemic stroke (AIS) receiving endovascular thrombectomy (EVT). However, the factors that mediate the association between BP and clinical outcome are unclear.

Methods: Consecutive patients with AIS in the anterior circulation underwent continuous blood pressure monitoring for 24 hours.

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Background: Collateral circulation plays a key role in acute ischemic stroke. We sought to determine the association between the arterial collateral status, estimated by the Hypoperfusion Intensity Ratio (HIR) on perfusion MRI, and stroke etiology in anterior circulation large vessel occlusion (LVO).

Methods: We retrospectively analyzed anterior circulation LVO acute stroke patients with a baseline perfusion MRI performed within 24 h from symptom onset.

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Early infarct growth rate is associated with symptomatic intracranial hemorrhage after endovascular thrombectomy.

Ther Adv Neurol Disord

December 2024

Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing 210000, Jiangsu Province, China.

Background: Time elapsed from stroke onset and baseline infarct volume is influential on endovascular thrombectomy (EVT) outcomes.

Objectives: This study aimed to explore the utility of early infarct growth rate (EIGR) measured by apparent diffusion coefficient (ADC) in predicting symptomatic intracranial hemorrhage (sICH) of ischemic stroke patients after EVT.

Methods: We retrospectively analyzed patients from the prospectively maintained stroke registry admitted between January 2019 and March 2023, presenting with large vessel occlusive stroke in the anterior circulation.

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Background: The pathogenesis of spontaneous cervical artery dissection remains unclear, and no established predictors of recurrence exist. Our goal was to investigate the potential association between cervical artery tortuosity, a characteristic of patients with connective tissue disorder, and spontaneous cervical artery dissection.

Methods: The ReSect study (Risk Factors for Recurrent Cervical Artery Dissection) is an observational study that invited all spontaneous cervical artery dissection patients treated at the Innsbruck University Hospital between 1996 and 2018 for clinical and radiological follow-up.

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Article Synopsis
  • Recent studies indicate that endovascular treatment (EVT) alone is as effective as combining intravenous thrombolysis with EVT (IVT + EVT) for treating acute ischemic stroke due to large-vessel occlusion, although some research suggests specific patient subgroups may benefit more from IVT.
  • This study analyzed data from 238 patients who underwent EVT or IVT + EVT to determine how collateral circulation affects clinical outcomes, using various statistical methods to control for factors like age and stroke severity.
  • Findings revealed that patients with good collateral circulation had significantly better outcomes at 90 days, including lower disability scores, higher success rates of recanalization, and reduced rates of complications such as hemorrhage and mortality.
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Background: The effect of temporary blood flow arrest during endovascular thrombectomy for acute ischemic stroke is uncertain due to the lack of evidence from randomized controlled trials. We aimed to investigate whether temporary blood flow arrest during endovascular thrombectomy using a balloon guide catheter improves intracranial vessel recanalization compared with nonflow arrest.

Methods: The ProFATE trial (Proximal Blood Flow Arrest During Endovascular Thrombectomy) was a multicenter, randomized, participant- and outcome-blinded trial at 4 thrombectomy centers in the United Kingdom.

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Background: Identifying eloquent regions associated with poor outcomes based on CT perfusion (CTP) may help inform personalized decisions on selection for endovascular therapy (EVT) in patients with large vessel occlusion (LVO) ischemic stroke. This study aimed to characterize the relationship between CTP-defined hypoperfusion and National Institutes of Health Stroke Scale (NIHSS) subitem deficits.

Methods: Patients with anterior circulation LVO, baseline CTP, itemized NIHSS at presentation and 24 hours were included.

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Background: Vessel wall MRI (VWMRI) can reveal the morphological features of intracranial artery occlusion (ICAO). This study aimed to investigate the imaging features of ICAO on VWMRI and explore their correlation with perioperative complications of endovascular recanalization for non-acute ICAO.

Methods: The study retrospectively included consecutive patients with recurrent ischemic stroke due to non-acute ICAO in the anterior circulation who underwent preoperative VWMRI evaluation and endovascular recanalization.

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Correlation between P2-PCA volume flow rate and BOLD cerebrovascular reactivity in patients with symptomatic carotid artery occlusion.

AJNR Am J Neuroradiol

December 2024

From the Department of Neurosurgery (AW., J.F., L.M.H., J.P., M.G., V.S., C.H.B.v.N., L.R., G.E., M.S.), Clinical Neuroscience Center (AW., J.F., L.M.H., J.P., T.S., M.G., V.S., C.H.B.v.N., S.W., A.R.L., Z.K., L.R., G.E., M.S.), Department of Neuroradiology (Z.K.) and Department of Neurology (S.W., A.R.L.), University Hospital Zurich, Zurich, Switzerland; University of Zurich (AW., J.F., L.M.H., J.P., T.S., M.G., V.S., C.H.B.v.N., S.W., A.R.L., Z.K., L.R., G.E., M.S.), Zurich, Switzerland; cereneo Center for Neurology and Rehabilitation (A.R.L.), Vitznau, Switzerland.

Background And Purpose: Identifying and assessing hemodynamic and flow status in patients with symptomatic internal carotid artery (ICA) occlusion is crucial for evaluating recurrent stroke risk. The aim of this study was to analyze the correlation between two quantitative imaging modalities: (1) blood oxygenation level-dependent (BOLD) cerebrovascular reactivity (CVR) and (2) quantitative magnetic resonance angiography (qMRA) with non-invasive optimal vessel analysis (NOVA), measuring volume flow rate (VFR). Comparing these modalities is relevant for assessing collateral circulation and hemodynamic impairment.

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Background: There are still some patients with acute anterior circulation large vessel occlusion stroke (LVOS) experienced unsuccessful recanalization after endovascular thrombectomy. The efficacy of intravenous alteplase before thrombectomy for such patients is unknown. We performed this study to investigate whether prior intravenous alteplase could affect the outcome of patients with unsuccessful recanalization.

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Background And Purpose: Mechanical thrombectomy (MT) has become the standard of care for treatment of acute ischemic stroke secondary to large vessel occlusion up to 24 h from the last known normal time. With ADAPT and SOLUMBRA techniques, classically, a large bore aspiration catheter is delivered over a microcatheter and microwire crossing the clot to perform thrombectomy. Recently, a novel macrowire (Colossus 035 in.

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The relative level of functional impairment in stroke patients is a significant determinant of post-acute care. The Activity Measure for Post Acute Care 6-Clicks (AM-PAC) scores for basic mobility and daily activity are rapid standardized assessments whose utilities in predicting long-term stroke outcomes have not yet been studied. We performed a retrospective analysis of acute ischemic stroke patients and their outcomes.

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Argatroban plus alteplase in posterior versus anterior circulation stroke.

Ann Clin Transl Neurol

December 2024

Department of Neurology, General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenhe District, Shenyang, 110016, China.

Objective: ARAIS trial failed to demonstrate benefit of argatroban as an adjunct to alteplase for stroke. Given differences between anterior circulation stroke (ACS) and posterior circulation stroke (PCS), we performed prespecified secondary analysis to investigate whether benefit of argatroban was different between ACS and PCS.

Methods: In secondary analysis of ARAIS, patients with definite stroke territories based on responsible vessel examination were classified into ACS and PCS.

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No clear relationship between circadian rhythm and cerebral perfusion parameters in pediatric and early adult populations.

J Neurol Sci

December 2024

Department of Neurology - Division of Vascular Neurology, Stanford Hospital, Palo Alto, CA, United States of America. Electronic address:

Background: Recent literature suggests circadian rhythm influences cerebral perfusion parameters in adults experiencing an acute large vessel occlusion, but this has never been investigated in the pediatric and young adult populations.

Methods: We queried the United States RAPID Insights database (10/05/2018-09/29/2023) for unique patients between 2 and 25 years with computed tomography perfusion (CTP). Included scans had a minimum ischemic core volume (rCBF <30 %) of >0 cc and a Tmax volume of >0 cc.

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Objective: The Antiplatelet versus R-tPA for Acute Mild Ischaemic Stroke trial has demonstrated the non-inferiority of dual antiplatelet therapy (DAPT) to alteplase in minor non-disabling stroke. This prespecified secondary analysis aimed to investigate whether the treatment effects were similar across stroke territories.

Methods: Participants were divided according to stroke territory, which were subdivided into DAPT and alteplase.

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Purpose: To investigate the clinical feasibility of a CT collateral map compared with an MRA collateral map, focusing on collateral perfusion (CP) estimation and baseline lesion assessment in acute ischemic stroke (AIS).

Materials And Methods: This retrospective analysis used selected data from a prospectively collected database. We generated CT collateral maps derived from CT perfusion, encompassing images of arterial, capillary, early venous (CMEV), late venous, and delay phases.

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Purpose: To develop an end-to-end DL model for automated classification of affected territory in DWI of stroke patients.

Materials And Methods: In this retrospective multicenter study, brain DWI studies from January 2017 to April 2020 from Center 1, from June 2020 to December 2020 from Center 2, and from November 2019 to April 2020 from Center 3 were included. Four radiologists labeled images into five classes: anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior circulation (PC), and watershed (WS) regions, as well as normal images.

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Introduction: Recent literature continues to demonstrate the successful role of large-bore aspiration catheters in thrombus ingestion during mechanical thrombectomy. However catheter-to-microwire step-off and distal navigation are ongoing challenges in thrombectomy. A new to market 0.

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Rationale: The benefit of tenecteplase in the treatment of large vessel occlusion (LVO) patients presenting within 24 hours of symptom onset remains unclear.

Aim: To assess the effectiveness and safety of tenecteplase, compared to standard of care, in patients presenting within the first 24 hours of symptom onset with a LVO and target mismatch on perfusion CT.

Methods And Design: The "Extending the time window for Tenecteplase by Effective Reperfusion of peNumbrAL tissue in patients with Large Vessel Occlusion" (ETERNAL-LVO) trial is a prospective, randomized, open-label, blinded endpoint, phase 3, parallel-group, superiority trial with covariate-adjusted 1:1 randomization, and adaptive sample size re-estimation.

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Association Between Time to Treatment and Outcomes of Endovascular Therapy vs Medical Management in Patients With Large Ischemic Stroke.

Neurology

January 2025

From the Department of Emergency (G.Y., Lei Liu, H.X., J.W., C.L., J.X., F.H., B.H., D.W., H.W., C.F., Y.L., X.Z., W.Y., Z.H., Y.X., Libo Lei), Xiangtan Central Hospital (The Affiliated Hospital of Hunan University); Department of Neurology (H.S.), Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, China; Department of Neurology and Radiology (T.N.N.), Boston Medical Center, MA; Cerebrovascular Disease Department (X.H.), Beijing Anzhen Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (X.H., Y.P., M.W., Z.M.), Beijing; Interventional Neuroradiology (Y.P., M.W., Z.M.), Department of Neurology, Beijing Tiantan Hospital, Capital Medical University; Department of Neurology (Z.Q.), The 903rd Hospital of the People's Liberation Army, Hangzhou, China; Department of Neurology (J.L.S.), David Geffen School of Medicine at UCLA, Los Angeles, CA; and Department of Neurology (X.C.), the Central Hospital of Lishui, the Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, Zhejiang, China.

Background And Objectives: Randomized trials have proven the benefit of endovascular therapy (EVT) for acute large ischemic stroke. This study was to characterize the effect of time to treatment on benefit of EVT vs medical management (MM) among patients with large ischemic stroke.

Methods: This was a post hoc analysis of the Endovascular Therapy in Acute Anterior Circulation Large Vessel Occlusive Patients with a Large Infarct Core randomized trial.

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Studying turn performance, trunk control, and mobility in acute stroke subjects: a cross-sectional study.

PeerJ

December 2024

Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Background: Stroke leads to various impairments like motor deficits, impaired trunk control and restricted mobility. However, rehabilitation professionals often underestimate the fundamental function of turning, which is essential for daily living activities like walking, cooking, or performing household chores. Impaired turning can be attributed to motor deficits post-stroke, resulting in restricted mobility and impaired trunk movement.

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Carotid endarterectomy in the setting of persistent hypoglossal artery.

J Vasc Surg Cases Innov Tech

February 2025

Division of Vascular Surgery, Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at UTHealth Houston, Houston, TX.

Persistent hypoglossal artery (PHA) is a rare, anatomical variant in which the posterior cerebral circulation is primarily supplied by a branch of the carotid artery, rather than the vertebral arteries. This case report discusses carotid endarterectomy performed on a man, 67 years of age, with high-grade, asymptomatic carotid artery stenosis and ipsilateral PHA. Preoperative computed tomography angiography identified the PHA arising from the internal carotid artery, compensating for atretic bilateral vertebral arteries and providing primary perfusion to anterior spinal artery.

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Relevance of peripheral inflammation indexes in different collateral circulation for intracranial hemorrhage in acute anterior circulation ischemic stroke patients undergoing endovascular treatment.

J Stroke Cerebrovasc Dis

December 2024

1(st) school of clinical medicine, Southern Medical University, China; Stroke center and Department of Neurology, 10(th) Affiliate Hospital of Southern Medical University, China; Guangdong Medical University, China. Electronic address:

Background: Asymptomatic intracranial hemorrhage (aICH) is common after endovascular thrombectomy (EVT). Collateral circulation could modify the association between aICH with functional outcome and we aimed to investigate the impact of systemic inflammation index on 3-month outcome under different collateral circulation.

Method: Consecutive patients undertaken EVT were enrolled and classified into non-intracranial hemorrhage (non-ICH), aICH and symptomatic intracranial hemorrhage (sICH) groups according to the neurological status and National Institutes of Health Stroke Scale (NIHSS) changes within 72 hours after EVT.

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Objectives: This study evaluates the feasibility, safety, and efficiency of using a balloon guide catheter (BGC) through transradial access (TRA) for mechanical thrombectomy (MT) in patients with anterior circulation strokes.

Methods: A retrospective case series of patients who underwent MT using BGC through TRA for acute ischemic stroke in the anterior circulation was conducted. Data collected included procedural times (from puncture to revascularization), technical success, complication rates, and clinical outcomes.

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Background: Very limited data indicate that patients with stroke from cancer-associated NBTE (Ca-NBTE) exhibit a characteristic pattern of widely distributed ischemic lesions of varying sizes.

Methods: An electronic search of Mayo Clinic records (03/31/2002-06/30/2022) with ensuing manual review of brain magnetic resonance imaging (MRI) was performed to identify topographic characteristics of stroke from Ca-NBTE.

Results: In 112 patients with Ca-NBTE, 92 (82.

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