scholarly journals A proposed method for outlining occluded intracranial artery using 3D T2-weighted sampling perfection with application optimized contrasts using different flip angle evolution (SPACE)

2021 ◽  
Vol 10 (3) ◽  
pp. 205846012110032
Author(s):  
Saya Ozaki ◽  
Shigetaka Okamoto ◽  
Naoki Shinohara
Keyword(s):  
Ischemic Stroke ◽  
Vessel Wall ◽  
Mechanical Thrombectomy ◽  
Imaging Techniques ◽  
Artery Occlusion ◽  
Flip Angle ◽  
Intracranial Artery ◽  
Artery Disease ◽  
Intracranial Artery Disease ◽  
Wall Imaging

High-resolution vessel wall imaging techniques have been developed for clinical use in various types of intracranial artery disease. Numerous studies have described techniques for evaluating remodeling patterns and plaque character, but few have reported a method for outlining obstructed vessels in intracranial artery occlusion. The course of the vessel affects the success of recanalization and can cause complications in mechanical thrombectomy for acute ischemic stroke. We propose imaging with 3D T2-weighted sampling perfection with application optimized contrasts using different flip angle evolution (SPACE) as a useful tool for describing the course of an occluded artery in ischemic stroke due to intracranial artery occlusion.

High-resolution magnetic resonance vessel wall imaging–guided endovascular recanalization for nonacute intracranial artery occlusion

2021 ◽  
pp. 1-7
Author(s):  
Zhikai Hou ◽  
Long Yan ◽  
Zhe Zhang ◽  
Jing Jing ◽  
Jinhao Lyu ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
High Resolution ◽  
Medical Treatment ◽  
Vessel Wall ◽  
Artery Occlusion ◽  
Vessel Wall Imaging ◽  
Intracranial Artery ◽  
Technical Success ◽  
Endovascular Recanalization ◽  
Wall Imaging

OBJECTIVE On the basis of the characteristics of occluded segments on high-resolution magnetic resonance vessel wall imaging (MR-VWI), the authors evaluated the role of high-resolution MR-VWI–guided endovascular recanalization for patients with symptomatic nonacute intracranial artery occlusion (ICAO). METHODS Consecutive patients with symptomatic nonacute ICAO that was refractory to aggressive medical treatment were prospectively enrolled and underwent endovascular recanalization. High-resolution MR-VWI was performed before the recanalization intervention. The characteristics of the occluded segments on MR-VWI, including signal intensity, occlusion morphology, occlusion angle, and occlusion length, were evaluated. Technical success was defined as arterial recanalization with modified Thrombolysis in Cerebral Infarction grade 2b or 3 and residual stenosis < 50%. Perioperative complications were recorded. The characteristics of the occluded segments on MR-VWI were compared between the recanalized group and the failure group. RESULTS Twenty-five patients with symptomatic nonacute ICAO that was refractory to aggressive medical treatment were consecutively enrolled from April 2020 to February 2021. Technical success was achieved in 19 patients (76.0%). One patient (4.0%) had a nondisabling ischemic stroke during the perioperative period. Multivariable logistic analysis showed that successful recanalization of nonacute ICAO was associated with occlusion with residual lumen (OR 0.057, 95% CI 0.004–0.735, p = 0.028) and shorter occlusion length (OR 0.853, 95% CI 0.737–0.989, p = 0.035). CONCLUSIONS The high-resolution MR-VWI modality could be used to guide endovascular recanalization for nonacute ICAO. Occlusion with residual lumen and shorter occlusion length on high-resolution MR-VWI were identified as predictors of technical success of endovascular recanalization for nonacute ICAO.

scholarly journals Cerebral endothelial cell-derived small extracellular vesicles enhance neurovascular function and neurological recovery in rat acute ischemic stroke models of mechanical thrombectomy and embolic stroke treatment with tPA

2021 ◽  
pp. 0271678X2199298
Author(s):  
Chao Li ◽  
Chunyang Wang ◽  
Yi Zhang ◽  
Owais K Alsrouji ◽  
Alex B Chebl ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Extracellular Vesicles ◽  
Mechanical Thrombectomy ◽  
Infarct Volume ◽  
Artery Occlusion ◽  
Therapeutic Effects ◽  
Vessel Occlusion ◽  
Healthy Human ◽  
Stroke Treatment

Treatment of patients with cerebral large vessel occlusion with thrombectomy and tissue plasminogen activator (tPA) leads to incomplete reperfusion. Using rat models of embolic and transient middle cerebral artery occlusion (eMCAO and tMCAO), we investigated the effect on stroke outcomes of small extracellular vesicles (sEVs) derived from rat cerebral endothelial cells (CEC-sEVs) in combination with tPA (CEC-sEVs/tPA) as a treatment of eMCAO and tMCAO in rat. The effect of sEVs derived from clots acquired from patients who had undergone mechanical thrombectomy on healthy human CEC permeability was also evaluated. CEC-sEVs/tPA administered 4 h after eMCAO reduced infarct volume by ∼36%, increased recanalization of the occluded MCA, enhanced cerebral blood flow (CBF), and reduced blood-brain barrier (BBB) leakage. Treatment with CEC-sEVs given upon reperfusion after 2 h tMCAO significantly reduced infarct volume by ∼43%, and neurological outcomes were improved in both CEC-sEVs treated models. CEC-sEVs/tPA reduced a network of microRNAs (miRs) and proteins that mediate thrombosis, coagulation, and inflammation. Patient-clot derived sEVs increased CEC permeability, which was reduced by CEC-sEVs. CEC-sEV mediated suppression of a network of pro-thrombotic, -coagulant, and -inflammatory miRs and proteins likely contribute to therapeutic effects. Thus, CEC-sEVs have a therapeutic effect on acute ischemic stroke by reducing neurovascular damage.

scholarly journals Analysis of factors influencing the complications of Solitaire AB stent mechanical thrombectomy in patients with acute intracranial artery occlusion

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Xin Zong ◽  
Jingmei Li ◽  
Shugai Liu ◽  
Qiuxia Liang ◽  
Xiaojun Luo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cerebral Hemorrhage ◽  
Mechanical Thrombectomy ◽  
Influence Factors ◽  
Artery Occlusion ◽  
Control Group ◽  
Intracranial Artery ◽  
Clinical Factors ◽  
Nihss Score ◽  
Factors Influencing

[Abstract] Objective: To investigate the influence factors of hemorrhage and stroke with retriever with Solitaire AB stent in patients with acute intracranial artery occlusion. Methods: A retrospective of 43 cases of patients with acute intracranial artery occlusion for endovascular treatment with Solitaire AB stent enrolled from March 2016 to June 2018 in our hospital, combining the characteristics of the patients of our city, through the clinical baseline data statistical analysis, complications screening of risk factors of complications. Results: There were 81.4% of patients who were dredged totally. The incidences of cerebral hemorrhage and infarction were 18.6% and 16.3%, cerebral hemorrhage group compared with control group, diabetes, blood pressure, revascularized time, NIHSS score, ASPECTS score had statistically significant differences, when infarction group compared with control group, age, opening time, ASITN_SIR score and grade of mTICI had statistically significant differences. Conclusion: Mechanical thrombectomy with Solitaire AB stent in patients with acute intracranial artery occlusion, the occurred of complications associated with various clinical factors, and the occurrence of complications seriously affect the prognosis of patients, therefore, selecting the indications strictly, and adopt individualized treatment to reduce complications.

Abstract 108: Additional Value of Intracranial Vessel Wall Imaging to Determine the Etiology of Ischemic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Joanna D Schaafsma ◽  
David J Mikulis ◽  
Jonathan Coutinho ◽  
Cheryl S Jaigobin ◽  
Daniel M Mandell
Keyword(s):  
Differential Diagnosis ◽  
Ischemic Stroke ◽  
Vessel Wall ◽  
Stroke Work ◽  
Standard Work ◽  
Additional Information ◽  
Stroke Etiology ◽  
Additional Value ◽  
Work Up ◽  
Wall Imaging

Objective: High-resolution MR-imaging of the intracranial arterial wall is a promising technique for diagnosis of intracranial arteriopathies in patients with ischemic stroke. We aimed to evaluate the additional value of vessel wall imaging (VWI) to the standard work-up of ischemic stroke patients. Methods: We selected all patients with ischemic stroke who had intracranial VWI at our institute to evaluate possible intracranial arteriopathy, such as atherosclerosis, dissection, vasculitis, or reversible cerebral vasoconstriction syndrome. Two observers, who were blinded to the VWI, first determined the most likely stroke etiology based on the standard work-up (clinical history, brain parenchyma imaging, vessel lumen imaging, laboratory results, and cardiac work-up). Then VWI was reviewed to assess whether this would change the suspected stroke etiology or whether the differential diagnosis could be narrowed down. Results: Between 2006 and 2014, 199 patients with ischemic stroke, mean age 55 (IQ-range: 44-67) had VWI. VWI provided additional information to the standard stroke work-up in 128 patients (64%). In 38/199 patients (19%) the conclusion on stroke etiology was altered based on VWI and in 90/199 patients (45%) the differential diagnosis was further narrowed after VWI. VWI did not have additional value when the most likely stroke etiology based on the standard work-up remained the same (50/199 patients; 25%), when the differential diagnosis could not be narrowed down (16/199; 8%), or in case of poor image quality (5/199 patients; 3%). Patients under the age of 46 benefited more often from VWI than older adults (Odds Ratio 3.5; 95%CI: 1.7-7.6). Conclusion: VWI provided additional information to the conventional stroke work-up in almost two-thirds of patients suspected to have intracranial arteriopathy. Next step is to determine how frequently this additional information resulted in altered therapy.

Abstract WMP43: Bright Signals of MCA Plaque on T2 Weighted Vessel Wall Imaging are Associated With Ischemic Stroke

Stroke ◽  
2018 ◽  
Vol 49 (Suppl_1) ◽  
Author(s):  
Yannan Yu ◽  
Mengwei Liu ◽  
Mingli Li ◽  
Yuyuan Xu ◽  
Shan Gao ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Vessel Wall ◽  
Vessel Wall Imaging ◽  
Wall Imaging

scholarly journals Microcatheter infusion of bolus-dose tirofiban for acute ischemic stroke due to distal intracranial artery occlusion

Medicine ◽  
2020 ◽  
Vol 99 (30) ◽  
pp. e21366
Author(s):  
Shao Ju Shao ◽  
Guo Zhen Zhang ◽  
Long Zhao ◽  
Fa Rong Huo ◽  
Hong Bin Ma ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Bolus Dose ◽  
Artery Occlusion ◽  
Intracranial Artery

Magnetic resonance vessel wall imaging predicts morphological deterioration in unruptured intracranial artery dissection

2020 ◽  
Vol 29 (9) ◽  
pp. 105006
Author(s):  
Yukishige Hashimoto ◽  
Toshinori Matsushige ◽  
Koji Shimonaga ◽  
Hiroki Takahashi ◽  
Tatsuya Mizoue ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Vessel Wall ◽  
Vessel Wall Imaging ◽  
Artery Dissection ◽  
Intracranial Artery ◽  
Intracranial Artery Dissection ◽  
Wall Imaging

Initial factors affecting the clinical outcome after successful recanalization via MR-based mechanical thrombectomy in patients with acute ischemic stroke due to basilar artery occlusion

2015 ◽  
Vol 8 (9) ◽  
pp. 889-893 ◽  
Author(s):  
Seungnam Son ◽  
Yong-Won Kim ◽  
Min Kyun Oh ◽  
Soo-Kyoung Kim ◽  
Ki-Jong Park ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Acute Ischemic Stroke ◽  
Basilar Artery ◽  
Mechanical Thrombectomy ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion ◽  
Nihss Score ◽  
Diffusion Weighted Images ◽  
Outcome Group

Background and purposeTo determine the initial factors, including patient characteristics, stroke etiology and severity, time factors, and imaging findings, that could affect the clinical outcome of patients with acute ischemic stroke (AIS) caused by basilar artery occlusion (BAO) where successful recanalization was achieved via mechanical thrombectomy.MethodsBetween March 2011 and December 2014, 35 patients with AIS caused by BAO received MRI/MR angiography-based mechanical thrombectomies, and recanalization was achieved with a Thrombolysis In Cerebral Infarction score of >2b. The patients were divided into a good outcome group (n=19), defined as those with a modified Rankin Scale (mRS) score of 0–2 at 3 months after stroke onset, and a poor outcome group (n=16), defined as a mRS score of 3–6. The differences between the groups were analyzed.ResultsInitial National Institutes of Health Stroke Scale (NIHSS) score (good vs poor: 17.9±8.9 vs 27.6±8.5, p=0.003), posterior circulation Acute Stroke Prognosis Early CT Score (pc-ASPECTS) based on initial diffusion-weighted images (DWI) (good vs poor: 7.8±1.6 vs 5.4±1.8, p=0.001), pc-ASPECTS based on contrast staining on the post-thrombectomy control CT (good vs poor: 9.2±1.5 vs 6.3±2.2, p<0.001), and presence of contrast staining in the brainstem on that CT (good vs poor: 15.8% vs 81.6%, p<0.001) were significantly different between the groups.ConclusionsPatients with AIS caused by BAO with a lower initial NIHSS score, fewer lesions on initial DWI, and less contrast staining on the post-thrombectomy control CT have higher probabilities of a good clinical outcome after successful recanalization via a mechanical thrombectomy.

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