Validation of the Charlotte Large Artery Occlusion Endovascular Therapy Outcome Score in a Modern Cohort of Thrombectomy Patients.

Background/objectives: The Charlotte Large artery occlusion Endovascular therapy Outcome Score (CLEOS) predicts neurological outcomes after endovascular thrombectomy (EVT). Given recent expanded indications for EVT, we evaluated CLEOS in a modern cohort of thrombectomy patients.

Methods: We retrospectively analyzed consecutive, anterior circulation EVT patients from January to December 2024 at multiple centers.

Real-world functional outcomes and predictors of futile recanalization in patients meeting criteria for SELECT2.

BackgroundRecent randomized trials have shown that patients presenting with large core infarctions benefit from endovascular thrombectomy compared to medical management. We report real-world outcomes and factors associated with futile recanalization in patients meeting large core criteria for SELECT2.MethodsRetrospective review of health system records from 1/1/2024 to 12/31/2024 for patients presenting with computed tomography (CT) Alberta Stroke Program Early CT Score (ASPECTS) 3-5 or CT perfusion (CTP) core infarction ≥50 milliliters.

Association of hypoperfusion intensity ratio and cerebral blood volume Index with good outcome in patients transferred for thrombectomy.

BackgroundHypoperfusion intensity ratio (HIR) and cerebral blood volume index (CBVI) have been shown to predict clinical outcome, but further validation is needed in patients initially presenting to non-thrombectomy centers.MethodsWe conducted a retrospective study of patients with an anterior circulation large vessel occlusion (ACLVO) who underwent computed tomography perfusion (CTP) scanning at a non-thrombectomy center and were transferred for consideration of thrombectomy. We evaluated the association of three measures of collateral status (HIR, CBVI, and a collateral score combining both measures) to 90-day modified Rankin scale (mRS).

Sensitivity of a Qualitative 5-Element Cortical Sign Screen for Detecting Acute Basilar Artery Occlusion.

Objectives: Large vessel occlusion stroke screens primarily identify anterior circulation large vessel occlusion ischemic strokes. Our primary objective was to assess the sensitivity of FANG-D, which screens for visual Field deficit, Aphasia, Neglect, Gaze preference, and Dense limb weakness, to detect basilar artery occlusion (BAO).

Methods: We conducted a retrospective study of BAO strokes (May 2018-February 2024) to assess sensitivity of the FANG-D screen to detect acute BAO.

Very Early Rehabilitation After Treatment with Intravenous Thrombolysis for Mild Acute Ischemic Stroke.

Background/objectives: The optimal timing of rehabilitation after acute ischemic stroke is unclear. We studied neurological outcomes and safety of early mobilization (EM) within 24 h for patients receiving intravenous thrombolysis.

Methods: This was a retrospective analysis of patients treated at a single Comprehensive Stroke Center from 6/2020-10/2024 with EM versus usual care.

Long-term functional outcomes for elderly patients treated with endovascular thrombectomy.

BackgroundFunctional outcomes in elderly thrombectomy patients have been commonly reported up to 90 days, though long-term neurological status is not as well characterized. We studied 1-year outcomes in patients ≥ 80 years old and identified predictors of functional independence in elderly patients.MethodsRetrospective analysis of anterior circulation thrombectomy patients presenting from November 2016-August 2023 to a large health system.

Predicting poor functional outcomes for patients with large computed tomography perfusion core infarctions treated with endovascular thrombectomy.

Objective: Stroke patients with large core infarctions benefit from endovascular intervention, though only approximately 20% are functionally independent at 90 days. We studied prognostic factors for patients presenting with a large computed tomography perfusion (CTP) core.

Methods: Retrospective analysis from a health system stroke registry, including consecutive thrombectomy patients treated within 24 hours from August 2020-December 2022 with an anterior circulation large vessel occlusion and CTP core infarct ≥50 milliliters.

Early recanalization after tenecteplase versus alteplase: Experience in a large stroke network.

Introduction: Previously published data are conflicting regarding the ability of tenecteplase versus alteplase to produce early recanalization of an intracranial large vessel occlusion. We compared the performance of each thrombolytic in a stroke network.

Methods: We queried our prospectively collected code stroke registry for basilar, internal carotid, or proximal middle cerebral artery occlusion patients treated with intravenous thrombolysis from 11/17/2021-9/16/2023.

Predictors of devastating functional outcome despite successful basilar thrombectomy.

Background: Basilar thrombosis frequently leads to poor functional outcomes, even with good endovascular reperfusion. We studied factors associated with severe disability or death in basilar thrombectomy patients achieving revascularization.

Methods: We retrospectively analyzed records from a health system's code stroke registry, including successful basilar thrombectomy patients from January 2017 to May 2023 who were evaluated with pretreatment computed tomography perfusion.

The Charlotte Large artery occlusion Endovascular therapy Outcome Score predicts independent outcome after thrombectomy.

Background And Purpose: Predicting functional outcomes after endovascular thrombectomy (EVT) is of interest to patients and families as they navigate hospital and post-acute care decision-making. We evaluated the prognostic ability of several scales to predict good neurological function after EVT.

Methods: We retrospectively analyzed records from a health system's code stroke registry, including consecutive successful thrombectomy patients from August 2020 to February 2023 presenting with an anterior circulation large vessel occlusion who were evaluated with pre-EVT CT perfusion.

Predicting severe disability or death in endovascular thrombectomy with large computed tomography perfusion core infarction and limited penumbra.

Background: Patients presenting with large core infarctions benefit from treatment with endovascular thrombectomy (EVT), with a notable 50% reduction in rates of severe disability (modified Rankin Scale [mRS] 5) at 90 days. We studied the ability of previously reported prognostic scales to predict devastating outcomes in patients with a large ischemic core and limited salvageable brain tissue.

Methods: Retrospective analysis from a health system's code stroke registry, including consecutive thrombectomy patients from November 2017 to December 2022 with an anterior circulation large vessel occlusion, computed tomography perfusion core infarct ≥ 50 ml, and mismatch volume < 15 ml or mismatch ratio < 1.

The charlotte large artery occlusion endovascular therapy outcome score compares favorably to the critical area perfusion score for prognostication before basilar thrombectomy.

Introduction: The Critical Area Perfusion Score (CAPS) predicts functional outcomes in vertebrobasilar thrombectomy patients based on computed tomography perfusion (CTP) hypoperfusion. We compared CAPS to the clinical-radiographic Charlotte Large artery occlusion Endovascular therapy Outcome Score (CLEOS).

Methods: Acute basilar thrombosis patients from January 2017-December 2021 were included in this retrospective analysis from a health system's stroke registry.

The Charlotte Large Artery Occlusion Endovascular Therapy Outcome Score Predicts Poor Outcomes 1 Year After Endovascular Thrombectomy.

Objective: We evaluated the ability of several outcome prognostic scales to predict poor 1-year outcomes and mortality after endovascular thrombectomy.

Methods: In this retrospective analysis from the stroke registry of a large integrated health system, consecutive patients presenting from August 2020 to September 2021 with an anterior circulation large-vessel occlusion stroke treated with endovascular thrombectomy were included. Multivariable logistic regression was performed to determine the ability of each scale to predict the primary outcome (1-year modified Rankin Scale [mRS] score of 4-6) and the secondary outcome (1-year mortality).

Automated detection of intracranial large vessel occlusions using Viz.ai software: Experience in a large, integrated stroke network.

Background And Purpose: Endovascular thrombectomy is an evidence-based treatment for large vessel occlusion (LVO) stroke. Commercially available artificial intelligence has been designed to detect the presence of an LVO on computed tomography angiogram (CTA). We compared Viz.

Brain venography performance following the pause of Ad.26.COV2.S COVID-19 vaccine administration.

Cases of cerebral venous thrombosis (CVT) associated with vaccine induced thrombotic thrombocytopenia (VITT) were reported following administration of the adenoviral vector COVID-19 vaccines, resulting in a pause in Ad.26.COV2.

Case series demonstrating the value of computed tomography perfusion in differentiating ischemic strokes from seizures in patients with isolated aphasia.

The value of computed tomography perfusion (CTP) imaging in suspected stroke patients who are not candidates for mechanical thrombectomy is promising. This case series demonstrates how CTP imaging aided in distinguishing seizure from stroke in 5 patients who presented to the emergency department with acute onset of isolated aphasia.

Expandable Interbody Spacers: A Two-Year Study Evaluating Radiologic and Clinical Outcomes With Patient-Reported Outcomes.

Background: Posterior and transforaminal lumbar interbody fusion (PLIF and TLIF) have gained significant popularity for management of lumbar degenerative spine over the last 3 decades. Expandable interbody spacers are a newer technology that can increase in size after placement, theoretically minimizing the operative risks of static spacers without sacrificing radiographic correction. The goal of this study is to further evaluate the radiographic and clinical outcomes of expandable spacers.

Outcomes After Decompressive Craniectomy for Ischemic Stroke: A Volumetric Analysis.

Background: Decompressive hemicraniectomy (DHC) is a treatment of space-occupying hemispheric infarct. Current surgical guidelines use criteria of age <60 years and surgery within 48 hours of stroke onset.

Objective: The purpose of this study was to evaluate the neurologic outcome after DHC and evaluate the relationship of stroke volume and outcomes.

Assessment of Vessel Density on Non-Contrast Computed Tomography to Detect Basilar Artery Occlusion.

Introduction: Basilar artery occlusion (BAO) may be clinically occult due to variable and non-specific symptomatology. We evaluated the qualitative and quantitative determination of a hyperdense basilar artery (HDBA) on non-contrast computed tomography (NCCT) brain for the diagnosis of BAO.

Methods: We conducted a case control study of patients with confirmed acute BAO vs a control group of suspected acute stroke patients without BAO.

Prospective randomized study of cervical arthroplasty and anterior cervical discectomy and fusion with long-term follow-up: results in 74 patients from a single site.

Object: The purpose of this study was to evaluate the long-term results of cervical total disc replacement (TDR) and anterior cervical discectomy and fusion (ACDF) in the treatment of single-level cervical radiculopathy.

Methods: The results of 2 separate prospective, randomized, US FDA Investigational Device Exemption pivotal trials (Bryan Disc and Kineflex|C) from a single investigational site were combined to evaluate outcomes at long-term follow-up. The primary clinical outcome measures included the Neck Disability Index (NDI), visual analog scale (VAS), and neurological examination.