SVIN 2021 Annual Meeting Late‐Breaking Abstracts

HomeStroke: Vascular and Interventional NeurologyAhead of PrintSVIN 2021 Annual Meeting Late‐Breaking Abstracts Open AccessAbstractPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citations ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toOpen AccessAbstractPDF/EPUBSVIN Originally published31 Jan 2023https://doi.org/10.1161/SVIN.01.suppl_1.000254Stroke: Neurology. 2023;0:e000155Continuous Non‐Invasive Monitoring Vasospasm in Subarachnoid Hemorrhage Using Next‐Generation Optical SpectroscopyTigran Khachatryan, MD, PhD1, Masih Rafi, MD1, Amit Chaudhari, Ariana Aini, BS1, Shirin M Dara, Tyler Irani, MS1, Kevin Wei, Megan Keys, Robert V Warren, Yukio Ueda, MD2, Wilson, Yama Akbari, PhD11University California, irvine, Irvine, United States America; 2Central Research Laboratory, Hamamatsu Photonics K. K., City, JapanIntroductionDelayed Ischemic Neurological Deficit from cerebral vasospasm is responsible for 19.7% mortality after aneurysmal subarachnoid hemorrhage (aSAH) results permanent disability 25% survivors1.2. Time‐Resolved Spectroscopy (TRS) a promising method early detection because it can provide continuous monitoring tissue hemodynamics, as compared with Transcranial Doppler (TCD) ultrasound, which provides only spot reading. TRS diffuse optical that analyzes the temporal profile detected photons separately quantify absorption (μa) scattering (μs’) coefficients. This technique allows more rigorous characterization hemodynamics (related μa) morphology μs’) than conventional Near Infrared (NIRS). Ohmae et al.3 used system measure blood volume oxygenation differences before administering acetazolamide healthy subjects. Yokose al.4 monitored hemodynamic changes SAH using TRS. However, these previous studies 3‐wavelength systems, whereas our study is, knowledge, first use next‐generation 6‐wavelength device monitor water lipid content along SAH. Here we validate against TCD, heart rate, pressure patients.MethodsThis an IRB‐approved case series aSAH patients stages enrollment. Patients were treated by standard pathway underwent TCD ultrasound day one admission until discharge intensive care unit. After obtaining written consent legal representative, was applied forehead 4 hours per over 1 week post‐SAH period.The enables measurements oxyhemoglobin, deoxyhemoglobin, total hemoglobin concentrations (ctHbO2, ctHb, ctHbTot), representative perfusion. We data other parameters affecting perfusion (intracranial pressure, mean arterial (MAP), status).ResultsAs this report, 2 (Hunt&Hess‐2, Fisher‐3) enrolled. Patient#1 developed mild asymptomatic MCA velocities increased 186 153 on right left hemispheres, MAPrespectively, Day 12 post‐SAH. correlated negatively ctHbO2, ctHbTot. During same period, patient maintained positive fluid balance experienced gradual increase indicating not related lower cardiac output but (Figure 1). Patient#2 did develop elevated velocity remained asymptomatic, stable TRS‐measured throughout period.ConclusionsPreliminary suggest promise non‐invasively cortical microcirculation aSAH. More are being enrolled assess validity reproducibility presented results.Key Words: CBF Monitoring, Neuromonitoring, Hemorrhage, VasospasmFinancial Disclosures: The authors had no disclosures.Grant Support: funded investigator‐initiated sponsored contract (HP‐5568330; Co‐PIs Akbari Wilson) Photonics.Establishing Last Electrically Well: Identification Intra‐Operative Early Cerebral Ischemia through Neurophysiologic MonitoringKeiko A Fukuda, Ammar Bata, Alaina Giacobbe, Jacob Frenchman, BS2, Katherine Anetakis, Donald J Crammond, Jeffrey Balzer, Bradley Gross, Ashutosh Jadhav, PhD3, Parthasarathy D Thirumala, MD11University Pittsburgh Medical Center, Pittsburgh, Pennsylvania, 2University 3Barrow Institute, Phoenix, Arizona, AmericaIntroductionTimely ischemia critical favorable post‐procedural outcomes. clear guidelines application intra‐operative neurophysiological (IONM) surgical cases exist. IONM detect onset neurological dysfunction define when last electrically well (LEW). Determining LEW particular interest identify potential candidates endovascular thrombectomy (EVT) post‐operative typically eligible thrombolytic therapy. In series, aim better establish its triaging, optimizing management, improving clinical outcomes following complications, such stroke (IOS).MethodsWe performed retrospective analysis prospectively database September 2013‐December 2019. included if they met criteria: (a) repair both ruptured unruptured aneurysms, arteriovenous malformations, or fistulas under general anesthesia including EEG and/or SSEP; (b) significant defined >50% decrease amplitude background activity SSEP either > 50% reduction baseline 10% latency prolongation upper extremity N20 complex P40 (c) large vessel occlusion, vasospasm, rupture neuro‐imaging.ResultsForty‐four identified. Such identified 20 occlusion (LVO) anterior circulation, prompting intra‐arterial (IA) thrombolysis resultant successful recanalization. Six IA vasodilation. Four received combined Eight intraoperative embolization. intervention pursued 6 due spontaneous recanalization distal embolization resolution associated neurophysiologic changes. treatment closure time ranged 8 167 minutes cases.ConclusionsPreviously reported showed OR 43 174 known (LKW) 66 321 minutes.1 suggests successfully rapidly treat suffering ischemia. may be appropriate marker workflows ischemia, LVO, highly effective treatment, EVT. Given challenges recognizing IOS, surrogate quickly triage patients.Key Aneurysm Embolization, Avm RecanalizationFinancial None.Global Gender Diversity Authorship Cochrane Review Stroke: AnalysisAhmad Ozair, MBBS(c)1, Vivek Bhat, MBBS(c)2, Shreyas Bellur, MBBS2, Nishanth R Subash, MBBS(c)11King George's University, India, Lucknow, India; 2St John's College, Bangalore, IndiaIntroductionThe need equitable representation research increasingly recognized field neurology neurointervention. Cochrane, non‐profit collaborative group, publishes high‐quality systematic reviews meta‐analyses. Because their standardized methodology, globally perceived amongst highest kinds evidence available conclusions frequently influencing health policy practice several nations worldwide. Previously, certain countries have been disproportionately higher specialties. unknown what current state authorship diversity stroke. aimed determine country‐based gender‐based patterns, global author collaborations stroke.MethodsWe searched Library (CL) 1st topic 'stroke’, published reviews, protocols unpublished publications withdrawn CL updation non‐completion. extracted details online gender, attempting capture at least webpage, institutional profile, demonstrated gender. Authors whose gender could definitively ascertained excluded analysis. Author affiliations captured divided into high‐income (HICs) LMICs based World Bank 2022 classification. dataextracted cross‐verified second accuracy.ResultsA 209 having 1, 2021, 950 co‐authors cumulatively. These coauthors found high (HICs), top‐5 Kingdom (33.3%), China (16.7%), Australia (8.2%), Netherlands Italy (6.74%). Extremely low lower‐middle‐income (LMICs) (Fig.1). Women represented number (48.5%), (50.6%), corresponding (50.3%).ConclusionsAuthors continue biggest contributors highest‐quality stroke, UK China. Despite contribution literature, US Canada find surprisingly much reviews. Capacity‐building efforts warranted involvement neurointerventionalists Cochrane.Key Acute Stroke, Clinical Trial, Epidemiology, And Hemorrhagic StrokeFinancial Disparities Access Mechanical Thrombectomy Large Vessel Occlusion An MT2020+ ReportKaiz S Asif, Fadar O Otite, Nabeel Herial, MD3, Siddharth Galav, Associate Consultant4, Shashvat Desai, MD5, Adam Dmytriw, MD6, Priyank Khandelwal, MD7, Jennifer Potter‐Vig, PhD8, MD9, Santiago Ortega, MD10, Violiza Inoa, MD11, Fawaz Al‐Mufti, MD12, Viktor Szeder, MD13, Tanzila Kulman, MD14, Victor C Urrutia, MD15, Hesham Masoud, MD16, Gabor Toth, MD17, Kaustubh Limaye, MD18, Alicia Castonguay, PhD19, Mehari Gebreyohanns, MD20, Carlos Molina, MD21, Thomas Leung, MD22, Ossama Y Mansour, MD23, Andrew Demchuk, MD24, Sheila Martins, MD25, P.N Sylaja, MD26, Zhongrong Miao, MD27, Dileep Yavagal, MD28, Global Executive Committee MT 2020+, Members291AMITA Health University Illinois ‐ Chicago (UIC), naperville, 2State New York Upstate York, 3Sidney Kimmel Jefferson Philadelphia, 4Orbees Medical, Hyderabad, 5Barrow 6Brigham Women's Hospital, Boston, Massachusetts, 7Rutgers Jersey School, Jersey, 8MT2020+, Miami, 9Barrow 10University Iowa Hospitalsand Clinics, Iowa, 11Semmes Murphey Clinic, Memphis, Tennessee, 12Westchester 13Ronald Reagan UCLA Los Angeles, 14MidAtlantic Epilepsy Sleep Bethesda, Maryland, 15The Johns Hopkins Baltimore, 16SUNY 17Cleveland Cleveland, Ohio, 18Indiana School Medicine, Indianapolis, Indiana, 19University Toledo, 20UT Southwestern Dallas, Texas, 21Hospital Universitari Vall d'Hebron, Barcelona, Spain; 22The Chinese Hong Kong, Kong; 23Alexandria Alexandria, Egypt; 24Cumming Calgary, Canada; 25Medical Universidade Federal do Rio Grande Sul, Porto Alegre, Brazil; 26Sree Chitra Tirunal Institute Sciences Technology (SCTIMST), Trivandrum, 27Beijing Tiantan hospital, Beijing, China; 28University Miami & Jackson Memorial Hospitals, Florida, 29Worlwide, Worldwide, AmericaIntroductionMechanical (MT) At level, inequities access studied. conducted survey cohort factors estimate operators centers needed country‐wise meet deficit.MethodsAn electronic distributed 75 Regional Committees between November 22, 2020, February 28, 2021. rate proportion estimated LVO receiving MT. Determinants analyzed regression assumed each country's incidence 20% incident ischemic strokes burden disease (GBD) database. Also, assumption optimal operator 50 center 150, indices: index [(one operator/optimal LVO) x 100 = 1/50 × 2] center/optimal 1/150 0.67]. indices then calculated country [(Current centers/Optimal ×100].ResultsA 887 responses 67 response 89% (67/75). Complete (702) 59 analyzed. median 2.76% (interquartile range [IQR] 0.66–14.70). There grouped capita gross national income (GNI) 23.01% (IQR, 10.04–32.65), Upper middle‐income (UMICs) 1.36–6.24) low/lower‐middle‐income 0.48% 0.00–1.13). On multivariate models, GNI (comparing HICs β: ‐1.97; 95% CI, ‐2.70 ‐1.24, P <0.001), reimbursement (β 0.69; CI 0.19 1.19, 0.008), (β: 0.85%, 0.30 1.39, 0.003) 2.01, 0.96 3.06, <0.001). <1.0% 18 (70%) zero 7 (11%) them. India largest absolute deficit.ConclusionsMT worldwide vast disparities countries. determinants GNI, availability MT, indices. initiatives critically address deficits.Key Stroke Intervention, Endovascular Therapy, None.Identifying Appropriate Treatment For Aneurysms Elderly Patients: Clipping Versus CoilingAndrew Lekarczyk, Student1, Arjun Adapa, Sreehari Panicker, Student11University Michigan Ann Arbor, Michigan, AmericaIntroductionCerebral aneurysms major cause morbidity 60 years age. Currently, most common modalities neurosurgical clipping coiling. While numerous choice elderly population remains understudied question. hypothesize will result rates outcome coiling.MethodsA meta‐analysis accordance PRISMA guidelines. Five hundred fifty literature search, assessed relevance. Of these, 337 eliminated title abstract review. remaining 213 reviewed full, 13 suitable meta‐analysis.ResultsPatients who coiling significantly decreased odds complete (Odds ratio [OR] 0.37; 0.19–0.71). good (OR, 0.91; 0.24–3.43), mRS (modified Rankin scale) 0–2, death 1.26; 0.14–11.29), findings statistically significant. shown figures.ConclusionsNeurosurgical probability difference seen approaches. Consequently, should determined clinician's expertise preference, giving consideration size location aneurysm.Key Aneurysm, Clipping, Coiling, EndovascularFinancial None.Mechanical Patient With Severe Pre‐Stroke Disability: Case ReportPrateeka Koul, Neurology1, Prateeka Shah, Neurosurgery1, Timothy White, Athos Patsalides, Richard Libman, Neurology11Northwell Health, Manhasset, AmericaIntroductionSeveral mechanical trials acute since 2015 instrumental expanding window outlining selection those occlusions. there randomized date evaluating scores (i.e. preexisting disability). Several observational exist demonstrate pre‐stroke 3 (or moderate disability) 0–2 (none present severe thrombectomy.MethodsCase report review.Results78‐year‐old man history Parkinson's disease, HTN, HLD, transfer rescue hemiparesis anisocoria. Upon examination dysarthria, expressive aphasia, nasolabial flattening, arm leg drift. Initial CT angiography head neck outside hospital thrombus basilar artery. He tPA his anisocoria resolved administration. His NIHSS upon arrival institution discussion nursing home, 5. Repeat noncontrast occipital subacute infarct, re‐demonstrated non‐occlusive thrombus, 0 cc core infarct 119 penumbra. taken suite TICI 2B reperfusion. improvement language fluency side moving gravity without given severity he truncal instability, thus requiring assistance. dysarthria fluctuated course flattening unchanged. discharged 5 back home physical therapy services.ConclusionsExpanding has Defining disability, however, nuanced, benefit prevent progression established well‐studied. Randomized evaluate thrombectomy.Key Functional Recovery Ethics, NeuroradiologyFinancial None.Reduced Racial Ethnic Care TelestrokeMark McDonald , Theresa Sevilis, DO1, Amanda Avila, Gregory Heath, DHSc, MPH2, Hsiong Chen, Michelle Boudreau, Mohammed Zaman, Devlin, PhD31TeleSpecialists, LLC, Fort Myers, Tennessee‐Chattanooga, Chattanooga, 3University Tennessee Science AmericaIntroductionPrevious ethnic racial rates. conflicting statewide programs telestroke mitigate disparities. evaluates within multi‐state program.MethodsData consultations emergency department 203 facilities 23 states January 2012 April 30, extracted. age, race, ethnicity, sex, normal time, therapy, door‐to‐needle (DTN) reasons treating NIH Scale score, premorbid modified Score. Race Black, Other. Ethnicity Hispanic non‐Hispanic. Thrombolytic among race groups.ResultsA 221 study. Among 2,048 9,890 1,283 classified 934 12,287 White (7.9%) versus non‐White (7.4%), p 0.36, Black (8.1%) non‐Black (7.8%), 0.59. DTN times differ race. LKN‐to‐arrival interval greater (194 minutes) (166 minutes), < 0.01. arrival‐to‐notification longer (9.4 (9.0 (6.3%) non‐Hispanic (odds ratio, 0.78; 0.59–1.02, 0.0719). DTN, LKN‐to‐arrival, patients.ConclusionsDespite delay arrival, system. ethnicity reach statistical significance although limited potentially impacts power. ethnicity. Further understand how reduces traditional delivery.Key Door To Needle, Thrombolytics, TreatmentFinancial Financial support provided TeleSpecialists, LLC Neuroscience Innovation FoundationSafety Effectiveness Single Plane AngiographyKrishna Amuluru, Jimmy Nguyen, MS2, John Scott, Denardo, Daniel Sahlein, MD11Goodman Campbell Brain Spine, 2Indiana AmericaIntroductionThe pivotal studying nearly all biplane (BP) fluoroscopy systems. single‐plane (SP) systems resources situations necessitate cases. whether SP safe BP systems.MethodsWe control consecutive 7/2/20 7/29/21at high‐volume practice, dichotomized use. primary follow‐up Score (mRS; 2–5 months), (mRS ≤ 2; ‘good’ outcome). Secondary contrast volume, groin‐puncture reperfusion final (‘successful’ ≥TICI 2B), 24‐hour NIHSS, procedural peri‐procedural complications (including embolization, intra‐ hemorrhage, new/recurrent injury). Mann‐Whitney U‐test variables. Fishers exact test categorical data. Multiple logistic accounted confounders hypertension, atrial fibrillation, diabetes, hyperlipidemia, technique, prior IV thrombolysis, onset‐to groin puncture time. Seven separate models created, secondary outcome.ResultsBaseline Characteristics: 176 emergent thrombectomy, data, (38%) 109 (62%) respectively. Baseline characteristics regards demographics, imaging presentations technique. Procedural Details: Procedure (from initial reperfusion) comparing (31 32 minutes; 0.7 uni‐ analysis). (15 19 0.09 0.05 analysis, respectively). required volumes (104 mL 65 mL; 0.01). Radiation dosage different (696 mGy 1000 mGy; 0.01) univariate Technical Outcomes: Successful (≥TICI 2B) (87% 88%; Complication (33% 41%; 0.3 0.23, Discharge (7 8; 0.16 0.43 however slightly chance ‘good outcome’ (p 0.01).ConclusionsThe similar complications. similar, improved functional outcome. times, overall procedure similar. important implications maximization care, domestically internationally.Key Investigations, Thrombectomy, TechniqueFinancial None.FootnotesSome meeting abstracts removed OA licensing requirements journal. Those listed here: https://www.svin.org/files/Abstracts/SVIN_2021_Abstracts_Late_Breaking.pdf Previous Back top Next FiguresReferencesRelatedDetails Article InformationMetrics © 2023 Authors. Published behalf American Heart Association, Inc., Society Neurology Wiley Periodicals LLC.This open article terms Creative Commons Attribution‐NonCommercial License, permits use, distribution reproduction any medium, original work properly cited commercial purposes.https://doi.org/10.1161/SVIN.01.suppl_1.000254 publishedJanuary 31, PDF download