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. Perioperative complications included ischemic and hemorrhagic strokes within 30 days after operation. Imaging features of the occluded segments were evaluated on precontrast and post-contrast VWMRI, including occlusion length and site, vessel wall area, signal intensity, angle, and shape of the occluded segment. The associations between the clinical and imaging features and perioperative complications were examined. Results One hundred and four patients were included in the a

Background Complete clot ingestion (CCI) is defined as full ingestion of the clot into the catheter or pump canister without any external clot remnants at the catheter tip. The aim of this study was to demonstrate that using the CCI metric in vitro, partially ingested (‘corked’) clots pose a higher risk of distal emboli given distal emboli may exist in the setting of Thrombolysis In Cerebral Infarction 3 (TICI 3) revascularization. Methods Thrombectomies using an in vitro synthetic clot analog were conducted across six catheters using the novel ALGO Smart Pump with Adaptive Pulsatile Aspiration (APA) (Von Vascular Inc, Sunrise, FL) and compared against the Penumbra static Engine Pump (Alameda, CA). Results A total of 360 aspiration thrombectomies were completed with an overall CCI rate of 56.9%. Cases achieving CCI were significantly faster (P<0.001) and those with successful CCI had no instances of distal embolization, whereas cases with incomplete clot ingestion (‘corking’) showed a

Background Middle meningeal artery embolization (MMAE) is a safe and effective treatment for chronic subdural hematoma (cSDH); however, the appropriate level of postoperative care is unknown. Objective To evaluate whether elective MMAE for cSDH could be safely performed in an outpatient setting. Methods This was a multicenter, retrospective study of patients with cSDH who underwent elective MMAE. Patients were categorized as either inpatient (admitted for ≥1 night of hospitalization after MMAE) or outpatient (discharged on the same day of MMAE). Patient demographics, radiological data, procedural details, and follow-up data were collected. The primary endpoint was periprocedural complications, and secondary outcomes included emergency department (ED) visits or unplanned readmission within 24 hours, 1–7 days, and 8–30 days after MMAE. Results Elective MMAE procedures were carried out in 190 patients, of which 45.3% (n=86) were outpatient procedures and 54.7% (n=104) inpatient. There wer

Background Ticagrelor, a P2Y12 inhibitor, offers a rapid onset and consistent platelet inhibition, making it a viable alternative for dual antiplatelet therapy (DAPT). The optimal ticagrelor dose for neurointerventional procedures, however, remains unclear. We report our experience with ticagrelor 60 mg twice daily plus aspirin 81 mg daily compared with the standard aspirin and clopidogrel regimen for intracranial stenting. Methods We conducted a retrospective analysis of a prospectively maintained database, identifying consecutive patients who underwent intracranial stenting for aneurysm treatment or intracranial atherosclerosis. Patients received either ticagrelor 60 mg with aspirin or aspirin with clopidogrel 75 mg daily. Primary outcomes included peri-procedural ischemic and/or hemorrhagic events within 30 days. Secondary outcomes were the median P2Y12 reaction unit and in-stent stenosis rates at 6-month follow-up. Results Among 119 patients, 59 received ticagrelor and 60 (50.4%) r

Introduction Mechanical thrombectomy is a highly effective treatment for acute ischemic stroke (AIS) caused by large vessel occlusions (LVO). However, our understanding of the pathophysiology of AIS is still limited, particularly regarding the ischemic microenvironment distal to the occlusion. Aim To investigate the relationship between the intracerebral blood pressure (BP) distal to an LVO and clinical and imaging parameters. Methods In this single-center prospective study, intracerebral BPs proximal and distal to the occluding clot were measured during thrombectomy in patients with AIS of the anterior circulation caused by LVO. BPs were correlated with imaging parameters and clinical data using Spearman’s rank correlation and linear regression. Results 25 patients were included. A significant correlation was found between the mean arterial pressure (MAP) distal to the occlusion and the baseline Alberta Stroke Program Early CT Score (Spearman r=0.503, P=0.014) and baseline National In

Background Regression or disappearance of MRI abnormalities is usually observed after treatment of spinal dural arteriovenous fistulae (sDAVF). Objective To assess the correlation between spinal MRI (sMRI) changes with sDAVF exclusion and clinical outcome. Methods Imaging data of patients treated with endovascular embolization for sDAVF between 2007 and 2023 were retrospectively analyzed. Spinal cord edema and perimedullary flow voids at baseline and 3-months’ follow-up were compared between patients with and without sDAVF persistent occlusion and clinical improvement on the Aminoff and Logue Scale. Results Twenty-five patients were included in this study. At 3-months’ follow-up, regression of spinal cord edema was significantly associated with sDAVF persistent occlusion (P=0.038). The combination of edema and flow voids regression was significantly associated with higher odds of a cured sDAVF (P<0.001) and clinical improvement (P<0.01). Improvement in the combination of the above-ment

Background Isolated anterior cerebral artery occlusions (ACAo) in patients with acute ischemic stroke present significant challenges due to their rarity. The efficacy and safety of endovascular therapy (EVT) in comparison with best medical therapy (BMT) for ACAo remains unclear. This study aimed to assess the outcomes of these treatments. Methods This multinational, multicenter study analyzed data from the MAD-MT registry. Data were collected retrospectively from 37 sites across North America, Asia, and Europe. Inverse probability of treatment weighting (IPTW) was applied to balance confounding variables. The primary outcome was functional independence (modified Rankin Scale (mRS) scores of 0–2) at 90 days. Secondary outcomes included excellent outcomes (mRS 0–1), mortality at 90 days, and NIH Stroke Scale (NIHSS) score on day 1 post treatment. Results Of the 108 patients, 36 received BMT and 72 underwent EVT. The median age was 75 years, and 56% were male. At 90 days, 40% of patients