Clinical Outcomes of Shifting from Transfemoral-First to Transradial-First Approach in Carotid Artery Stenting: A Retrospective Two-Timeframe Comparison at a Single Center.

Carotid artery stenting (CAS) has traditionally been performed using the transfemoral approach (TFA). Recently, the transradial approach (TRA) has gained attention for its lower invasiveness and reduced complication risk. This study compares outcomes between two access strategy timeframes, TFA-first and TRA-first, to evaluate how this shift influences outcomes in a real-world setting.

Randomized Controlled Trial of Cilostazol Addition for In-Stent Restenosis After Carotid Artery Stenting.

Background: Restenosis after carotid artery stenting (CAS) is associated with the risk of developing ischemic stroke. We aimed to evaluate the inhibitory effect of cilostazol addition on in-stent restenosis (ISR) in patients treated with CAS.

Methods: In a randomized, open-label, blind-end point trial, patients with symptomatic and asymptomatic carotid artery stenosis and scheduled for CAS were randomly assigned to adding cilostazol (50 or 100 mg, twice per day) on other antiplatelets from 3 days before CAS or not adding cilostazol.

Optimal antithrombotic therapy in ischemic stroke patients with non-valvular atrial fibrillation and atherothrombosis: study protocol for a randomized controlled trial.

Background: The addition of antiplatelet therapy to anticoagulant therapy in patients with stroke with non-valvular atrial fibrillation (NVAF) and atherothrombotic disease may increase bleeding risk without reducing recurrent stroke risk.

Aims: To evaluate the clinical benefits of anticoagulant monotherapy compared to combination therapy with anticoagulants and antiplatelet agents.

Methods And Design: This is an investigator-initiated prospective multicenter, randomized, open-label, parallel-group clinical trial.

Effects of paroxetine, a P2X4 inhibitor, on cerebral aneurysm growth and recanalization after coil embolization: the NHO Drug for Aneurysm Study.

Objective: Rupture of cerebral aneurysms has a poor prognosis, and growing aneurysms are prone to rupture. Although the number of coil embolization procedures is increasing worldwide, they are more prone to recurrence than clipping surgeries. However, there is still no drug that prevents aneurysm growth or recanalization after coil embolization.

Impact of Intracranial Hemorrhage After Endovascular Treatment for Medium Vessel Occlusion.

Background And Objectives: Endovascular treatment (EVT) for medium vessel occlusion (MeVO) raises concern about hemorrhagic complications; however, its clinical impact has not been elucidated. Therefore, we investigated the association between intracranial hemorrhage (ICH) after EVT for MeVO and functional outcomes.

Methods: We conducted a post hoc analysis of the Japan Registry of NeuroEndovascular Therapy 4, a nationwide registry in Japan from 2015 to 2019 including 13 479 patients who underwent EVT for acute ischemic stroke.

Trends and Progress in Neuroendovascular Treatment in Japan: Japanese Registry of Neuroendovascular Therapy (JR-NET) 4. Main Report.

We reported the main results of the Japanese Registry of Neuroendovascular Therapy (JR-NET) 4, a nationwide surveillance of therapy (NET) in Japan from January 2015 to December 2019. JR-NET 4 registered consecutive patients who underwent NETs by Japan Society of Neuroendovascular Therapy (JSNET) -certified specialists. The primary endpoint was functional independence (mRS score of 0-2) at 30 days post-NET, with secondary endpoints focusing on technical success and major adverse events within 30 days.

Sex differences in outcomes of carotid artery stenting.

Objective: Existing evidence is inconclusive on whether women after carotid artery stenting (CAS) experience worse outcomes than men.

Methods: The outcomes of women and men were compared using the data from nationwide retrospective registry between 2015 and 2019. The primary outcome was the incidence of ischemic stroke and all-cause death.

Safety and clinical outcomes of endovascular therapy versus medical management in late presentation of large ischemic stroke.

Introduction: The benefit of endovascular therapy (EVT) among stroke patients with large ischemic core (ASPECTS 0-5) in the extended time window outside of trial settings remains unclear. We analyzed the effect of EVT among these stroke patients in real-world settings.

Patients And Methods: The CT for Late Endovascular Reperfusion (CLEAR) study recruited patients from 66 centers in 10 countries between 01/2014 and 05/2022.

Differences in mechanical thrombectomy for acute ischemic stroke on weekdays versus nights/ weekends in a Japanese primary stroke core center.

Objective: The term "weekend effect" refers to an increase in the mortality rate for hospitalizations occurring on weekends versus weekdays. In this study, we investigated whether such an effect exists in patients undergoing mechanical thrombectomy for acute ischemic stroke with large vessel occlusion (currently the standard treatment for this condition) at a single center in Japan.

Methods: We surveyed 151 patients who underwent mechanical thrombectomy for acute ischemic stroke with large vessel occlusion (75 and 76 patients were treated during daytime and nighttime, respectively) from January 2019 to June 2021.

Endovascular Therapy for an Aneurysm of a Distal Posterior Inferior Cerebellar Artery via the Ipsilateral Persistent Primitive Proatlantal Artery: A Case Report.

Objective: We describe the rare case of a patient who was treated for a ruptured distal posterior inferior cerebellar artery (PICA) aneurysm via an ipsilateral persistent primitive proatlantal artery (PPPA).

Case Presentation: An 86-year-old female with a medical history of hypertension presented with headache and nausea. CT showed subarachnoid hemorrhage in the posterior cranial fossa, and CTA revealed an aneurysm at the left-side distal PICA.

Usefulness of three-dimensional fast imaging employing steady-state acquisition MRI of large vessel occlusion for detecting occluded middle cerebral artery and internal carotid artery before acute mechanical thrombectomy.

Objective: Acute mechanical thrombectomy (AMT) in patients with acute ischemic stroke from large vessel occlusion (LVO) is performed without directly identifying the occluded vessels. In this study, we evaluated whether 1.5 T magnetic resonance imaging (MRI) with 3D-fast imaging employing steady-state acquisition (FIESTA) could visualize the occluded intracranial middle cerebral artery (MCA) and internal carotid artery (ICA) before AMT.

[A Case of Moyamoya Disease with Postoperative Cerebral Hyperperfusion Syndrome Followed by Cerebral Infarction due to Watershed Shift].

The concept of "watershed shift"(WS)has been proposed as a cause of the ischemic complications following a superficial temporal artery-middle cerebral artery(STA-MCA)bypass operation performed for the management of moyamoya disease. Previous reports have observed that only 1.2-5.