Validation of the Ultimate Stroke Scale (USS): A standardized tool for automated large vessel occlusion screening.

BackgroundPrehospital stroke screening for large vessel occlusions (LVOs) varies across institutions. This study compares manual stroke scale calculations against e-calculated scores using the Ultimate Stroke Scale (USS), a software automating multiple screening scales from a modified National Institutes of Health Stroke Scale (NIHSS) with a hand grip. The USS aims to streamline screening by computing multiple validated stroke scales simultaneously to enhance predictive value.

Balloon guide catheter use for carotid body tumor embolization: A retrospective case series.

BackgroundCarotid body tumors (CBTs) are neuroendocrine tumors that arise from the carotid body. The malignant cases can present with a multitude of complications. Thus, surgical resection is the preferred treatment of choice.

Diagnosis and management of a mild case of cerebral amyloid angiopathy-related inflammation: A case report.

Background: Cerebral amyloid angiopathy (CAA) is a neurological condition characterized by the deposition of amyloid beta particles within the cerebral vasculature over time. A rare complication of CAA is an autoimmune inflammatory syndrome to cerebrovascular amyloid deposits. In this report, we present a case of CAA-related inflammation (CAA-RI) and discuss the diagnostic and management considerations when encountering this pathology.

Flex vs. Vantage Pipeline™ Flow Diverters: Technical analysis in treating complex fusiform basilar artery aneurysm.

We present a case of an adult patient with a large symptomatic fusiform basilar artery aneurysm. This video demonstrates the ease of deploying the new Pipeline™ Vantage Flow Diverter compared to the Flex model in the same vessel. The Flex and Vantage have different deployment techniques-as using the Flex maneuvering technique on the Vantage may damage the braid.

Endovascular thrombectomy for distal medium vessel occlusions: A literature review.

Background: There is a lack of substantial evidence supporting the safety and effectiveness of endovascular thrombectomy in treating distal medium vessel occlusions (DMVOs).

Objective: To summarize the current evidence regarding endovascular thrombectomy for DMVOs.

Methods: We conducted a narrative review of key articles related to the diagnosis and management of DMVOs.

Comparing validated stroke screening scales for identifying large and medium vessel occlusions: a prospective observational cohort study.

Background: Rapid prehospital identification of acute ischemic stroke secondary to large vessel occlusions (AIS-LVO) has been successful in triaging patients, but the use of stroke screening scales often varies. This study aims to compare different stroke screening scales for the detection of anterior and posterior circulation AIS-LVO and AIS secondary to medium vessel occlusions (AIS-MeVO).

Methods: We prospectively analyzed stroke alert activations at a comprehensive stroke center between August 1, 2022 and December 31, 2023.

Use of Onyx Frontier for intracranial stenting in stroke patients: A multicenter retrospective study.

Background: Acute ischemic stroke (AIS) due to intracranial atherosclerotic disease (ICAD) carries a high risk of recurrence despite aggressive medical management. The aim of our study is to present our initial experience with the Onyx Frontier™ balloon-mounted drug-eluting stent (Medtronic, Santa Rosa, CA) for AIS due to ICAD.

Methods: We conducted a multicenter retrospective cohort study describing the technical feasibility, safety, and performance of using the Onyx Frontier™ balloon-mounted drug-eluting stent in patients with acute intracranial vessel occlusion due to ICAD across three comprehensive stroke centers in the United States.

Standardized Criteria to Initiate External Ventricular Drain (EVD) Weaning in a Neurological Intensive Care Unit to Increase the Safety of EVD Discontinuation and Reduce the Need for a Shunt.

Introduction Patients with subarachnoid hemorrhages (SAH) with external ventricular drains (EVD) can develop chronic hydrocephalus (HCP), requiring permanent cerebrospinal fluid (CSF) diversion via an external shunt. Two different strategies have been used to assess for dependence on EVD: 1) prompt closure, and 2) gradual weaning. Gradual weaning of EVDs is performed by increasing drainage resistance to outflow over days.

Early single-center experience with middle meningeal artery embolization using Zoom 45 Catheter.

Background: Middle meningeal artery (MMA) embolization for subdural hematomas (SDH) and dural arteriovenous fistulas (dAVFs) has gained momentum in the neuroendovascular space. However, there is variability in the technique for safe and effective embolization. The aim of this report is to describe the technical feasibility and clinical performance of using Zoom 45 catheter for MMA access to facilitate embolization.

Endovascular Embolization of Traumatic Vessel Injury Using N-butyl Cyanoacrylate: A Case Series.

There is limited evidence of N-butyl cyanoacrylate (n-BCA) use in endovascular embolization of traumatic face and neck vessel injuries. We investigated the safety and effectiveness of n-BCA for this purpose. We retrospectively analyzed consecutive patients presenting to a Level 1 trauma center between April 2021 and July 2022.

The use of PK Papyrus covered coronary stent for carotid reconstruction: an initial institutional experience.

Background: The use of covered stent grafts for the treatment of carotid rupture is increasingly being used given their ability to preserve the parent artery while simultaneously occluding the fistula or rupture point.

Methods: This case series describes the technical feasibility of using, and the performance of, the PK Papyrus covered coronary stent (Biotronik, Inc., Lake Oswego, Oregon, USA) in six patients with carotid rupture, including carotid cavernous fistulas, between July 2021 and October 2023 in a single-center institution in the USA.

Endovascular Thrombectomy with or without Bridging Thrombolysis in Acute Ischemic Stroke: A Cost-Effectiveness Analysis.

Background: There is unclear added benefit of intravenous thrombolysis (IVT) with endovascular thrombectomy (EVT). We performed a cost-effectiveness analysis to assess the cost-effectiveness of comparing EVT with IVT versus EVT alone.

Methods: We used a decision tree to examine the short-term costs and outcomes at 90 days after the occurrence of index stroke to compare the cost-effectiveness of EVT alone with EVT plus IVT for patients with stroke.

Intravenous cangrelor use for neuroendovascular procedures: a two-center experience and updated systematic review.

Background: The optimal antiplatelet therapy regimen for certain neuroendovascular procedures remains unclear. This study investigates the safety and feasibility of intravenous dose-adjusted cangrelor in patients undergoing acute neuroendovascular interventions.

Methods: We conducted a retrospective chart review of all consecutive patients on intravenous cangrelor for neuroendovascular procedures between September 1, 2020, and March 13, 2022.

The Zoom RDL radial access system for neurointervention: An early single-center experience.

Background: The transradial approach (TRA) for neurointerventional procedures is increasingly being used given its technical feasibility and safety. However, catheter trackability and device deliverability are reported barriers to TRA adoption.

Methods: This is the first report describing the technical feasibility and performance of using the Zoom RDL Radial Access System (Imperative Care, Inc.