bluuebunny/crossref_metadata_2025 huggingface dataset:
Afeto e cultura na construção política da Comunidade de Samba do Pagode da 27
Authors: Musa Nicolau Augusto
Published: January 2025

This article aims to discuss the factors that drive and shape the political struggle of peripheral cultural collectives. To this end, it presents the results of my master’s research, completed in 2023. The ethnographic research was conducted with Pagode da 27, a samba community located in Grajaú, in the southernmost part of São Paulo. Contributing to the debate on peripheral cultural collectives and political agency in the peripheries of large Brazilian cities, the analysis reveals that the affective relationships among the members and their connection with the cultural practice of samba form the foundation of both community building and the political formation of the individuals and the collective. The research methodology involved observing the daily activities of the members and the practices related to the Pagode da 27 samba community, as well as conducting conversations, interviews, and analyzing the group’s songs.
O relatório da DEA sobre os riscos da ayahuasca: a “ciência” a serviço do proibicionismo?
Authors: Labate Beatriz Caiuby , Ermakova Anna , Sloshower Jordan , Galvão-Coelho Nicole , Palhano-Fontes Fernanda , Antunes Henrique Fernandes , Assis Glauber Loures de , Cavnar Clancy , Araújo Dráulio de , Ribeiro Sidarta
Published: January 2025

Em fevereiro de 2023, a Drug Enforcement Administration (DEA) divulgou um documento para a equipe jurídica que representa a Church of the Eagle and the Condor (“CEC”). Essa divulgação ocorreu dois anos depois que a igreja, em conjunto com o Chacruna Institute, enviou duas solicitações baseadas na lei de liberdade de informação [Freedom Of Information Act] à DEA e ao Departamento de Justiça solicitando todos os registros referentes à ayahuasca. Esse relatório, intitulado “Ayahuasca: Risks to Public Health and Safety”, foi publicado em julho de 2020. No presente artigo, contestamos várias alegações feitas no relatório da DEA e destacamos omissões factuais significativas, vieses teóricos e interpretações errôneas dos dados existentes. Demonstraremos que o relatório da DEA minimiza muito o perfil de segurança e o potencial terapêutico da ayahuasca e enfatiza demais os riscos. Ele também não inclui as pesquisas atuais sobre a ayahuasca que demonstram seus benefícios potenciais.
Entre saberes tradicionais, ciência e proibicionismo: contribuições da antropologia para a legitimação do uso da ayahuasca
Authors: Antunes Henrique Fernandes , Labate Beatriz Caiuby
Published: January 2025

This article analyzes the role of anthropology in legitimizing and regulating the use of ayahuasca, highlighting the relationship between traditional knowledge, science and public policy. Since the mid-20th century, the social sciences have been exploring the cultural and social dimensions of the use of psychoactive substances, including ayahuasca. In Brazil, anthropological production was decisive in recognizing the religious use of the drink as part of the Amazon's cultural heritage, as well as providing subsidies for public policies that ensured its practice as a legitimate manifestation. The text also addresses the contemporary work of researchers in criticizing prohibitionist discourses, such as the report published by the US Drug Enforcement Agency on ayahuasca as a risk to public safety and health in the country.
Mergulho interior: raíz d'água fotografias (auto)biográficas
Authors: Silva Iasmim Alice
Published: January 2025

As fotografias deste ensaio soam como um mergulho na própria história, na memória e raiz daquilo presentifica meu corpo no mundo. Eu nasci de uma promessa para Nossa Senhora do Rosário e para louvar e agradecer pelas bençãos “visto” a promessa anualmente na Festa do Rosário, da “Banda Dançante de Congada e Moçambique de N.sra do Rosário e das Mercês” da cidade de Ibertioga/MG. Cresci no berço da tradição. Carrego uma coroa que pertenceu a minha avó, passou para minha mãe e chegou até a mim. “Raiz D’água” se trata de (auto)biografia enquanto potência criativa para a cena. A obra também se materializou como vídeo, uma construção coletiva, realizada em 2021 na cachoeira “Pau de Espinho” na cidade de Barbacena/MG.
Striptease etnográfico: cenas queer de uma favela carioca
Authors: Lino e Silva Moisés , Varjão João Victtor Gomes
Published: January 2025

Este artigo apresenta episódios relacionados à sexualidade não-normativa (e principalmente gay) na vida cotidiana de moradoras(es) da Favela da Rocinha, Rio de Janeiro. Escrevo-o empregando um gênero de escrita que denomino de “striptease etnográfico”, o qual oferece uma imagem menos “clínica” do sexo e mais próxima de uma “arte erótica”. Minha conceptualização é baseada na proposta foucaultiana de distinguir duas formas de produção do conhecimento discutidas na obra História da Sexualidade, Volume 1: “scientia sexualis” e “ars erotica”. Pergunto como seria uma compreensão sobre a sexualidade mais baseada neste último modo de saber apresentado por Foucault. Apresento seis exemplos concretos dessa forma etnográfica, todos inspirados pela “arte erótica”. Em vez de uma análise que se pretende “científica”, as cenas etnográficas são seguidas por comentários pessoais. Ao romper os limites dos gêneros narrativos mais estabelecidos, o artigo oferece uma contribuição para a expansão das formas pelas quais a sexualidade humana pode ser abordada e comunicada. Em um jogo de esconder e revelar, esse “striptease etnográfico” oferece um olhar diferente sobre a vida sexual queer que emerge de uma grande favela no Rio de Janeiro.
La etnomusicología como campo posdisciplinar y los retos de su transmisión
Authors: Alegre González Lizette Amalia , Alviar Cerón Maria José
Published: January 2025

The notion and the criticisms of culture are central to the definition of ethnomusicology and other fields, made by both researchers in the area and other academics. This definition is made according to a division of intelectual work, that can be perceived in the conformation of disciplines. In our experience as teachers, we observe that the work of students not only challenges the themes most commonly associated with the field from this division, but also shows the particular ways of questioning the phenomena they face. The ongoing discussion about the historical and intellectual configuration of ethnomusicology, as part of teaching support, leads us to conceive it as a post-disciplinary field. Moreover, we suggest that the possibilities of enrolling in etnomusicoogy and speak using criticism as a practice emerge in the ability to sustain uncertainty.
Bailão em perspectiva: notas sobre identidade, música e lugar a partir de uma festa gaúcha
Authors: Sicca Wagner dos Santos , Noleto Rafael da Silva
Published: January 2025

Este artigo pretende circunscrever o Bailão, tradicional festa gaúcha frequentada por pessoas das classes populares, como um conceito abrangente que, de maneira simultânea, abriga as noções de bailão-lugar, bailão-identidade e bailão-festa, configurando-se como uma categoria discursiva polissêmica. Com base em trabalho de campo realizado em bailões do Rio Grande do Sul, bem como em revisão bibliográfica sobre a temática, o artigo busca problematizar questões relativas à constituição da identidade gaúcha por meio de aspectos sociais e musicais que a conformam. Pensando a partir de uma Antropologia da Festa, entende-se que o Bailão cria perspectivas próprias de mundo, configurando-se como uma modalidade de festa que atua, significativamente, na reconstrução permanente de grande parte do que se entende como identidade gaúcha.
Encontros íntimos: economias afetivas em Cuba e na República Dominicana
Authors: Cabezas Amalia L. , Varjão João Victtor Gomes , Arruda Murilo Souza
Published: January 2025

Resultado de uma pesquisa realizada em Cuba e na República Dominicana, este artigo explora os usos da intimidade tanto no setor corporativo quanto nas relações românticas. Utilizo dados obtidos em entrevistas com trabalhadores de hotéis e com pessoas envolvidas em trocas afetivo-sexuais conectadas ao turismo para relacionar a intimidade às estruturas políticas e econômicas do turismo transnacional. Esses novos campos de análise revelam práticas de intimidade geradas corporativamente, nas quais o amor – ou a exploração emocional dos trabalhadores – e o trabalho se combinam. O objetivo central é entrelaçar o íntimo com o global, desde as políticas formais de atendimento ao cliente em hotéis transnacionais até os encontros informais e cotidianos entre turistas e trabalhadores do setor de hospitalidade. A comercialização da intimidade, incluindo as relações afetivo-sexuais na prestação de serviços de acolhimento, está atrelada aos processos políticos e econômicos que fazem parte das práticas do turismo transnacional. Este artigo desafia a noção de que o turismo sexual e o trabalho sexual são práticas individuais, desconectadas dos espaços de lucro corporativo global. Além disso, sugere que relacionamentos envolvendo dinheiro não são necessariamente desprovidos de cuidado e intimidade.
Abstract 026: Initial Experience with the Walrus BGC results from 300 cases
Authors: Bhogal P.
Published: January 2025

Background

Until recently only the Flowgate2 (Stryker Neurovascular) was available clinically despite multiple advances in aspiration catheter and stent‐retriever technology.

The Walrus BGC (Q'Apel Medical Inc, Fremont, California, USA) is a next generation BGC with improved flexibility and compatibility with large bore aspiration catheters. We report our experience with the Walrus BGC in anterior circulation LVO MT with a focus on procedural aspects related to the vascular anatomy, recanalization efficacy and complications.

Materials and Methods

A retrospective review at two high volume MT centres in the United Kingdom (>300 cases annually) was performed to identify all patients where the Walrus BGC was used between July 2023 and January 2024.

The inclusion criteria included:

•Age ≥18• NIHSS score ≥6•ASPECT score ≥3•mRS 0‐2•Life expectancy of >6months•The Walrus BGC was used 1
st
line during the MT.

All patients underwent plain CT + CTA prior to the MT procedure. Patients received IV tPA if they met the appropriate criteria. The anatomical configuration was recorded as per the ASMET score (Assessment for Mechanical Thrombectomy Score) which assesses and scores the:•Presence of a Bovine arch (0‐1)•The aortic arch confirguration (0‐2)•The degree of dolichoarteriopathy affecting the supra‐aortic vessels (0‐2)•Presence of ICA dolichoarteriopathy (0‐1)The ASMET score gives a range of 0‐6 and higher scores have been previously been shown to be associated with longer procedural times. Positioning of the BGC was divided into either proximal ICA and distal ICA and standard times such as puncture time, time to first angiogram, first pass effect and final eTICI score were recorded.

Results

300 patients that met the inclusion criteria with average age 69.5±15yrs, and 168 (56%) male. The average NIHSS score was 15.8±6.5 and average ASPECT score 7.6±1.9. 51.5% of patients received IV tPA. The vast majority of LVo were located in M1 (60%), ICA 21.5% and M2 17.8%. Tandem lesions were present in 18.1%.

Arch configuration was as follows: I.34.7%II.21.7%III.43.6%

The average ASMET score was 2.6±1.6. Kinked or coiled ICA was seen in 18.1%, tortuous in 53.8% and straight in 28.1%. A distal location of the BGC was achieved in 77.9% and proximal location in 22.1%. FPE was seen in 49% with mFPE in 65.9%. Final eTICI≥2c was 75.9% and ≥2b 92.7%. There was one major complication – a CCF caused by the BGC. Minor non‐flow limiting dissections were seen in 4.3% of cases. With regards to arch configuration and ASMET score there was no statistical significant difference between the puncture to first run time, first pass time, or final angiogram between different arch types.

Conclusion

The Walrus BGC is highly navigable and there is no statistically significant difference between the time taken to navigate the Walrus in patients with minimal tortuosity compared to very tortuous anatomy. The use of Walrus is associated with a high degree of first pass success and low complication rates.
Abstract 029: Malondialdehyde as a Clinical Indicator for Oxidative Stress and Functional Outcomes in Acute Ischemic Stroke
Authors: Couture L. , Eagen P. , Petway A. , Cahuiche A. E. , Baskin L. , McCullough L.
Published: January 2025

Introduction

Acute Ischemic stroke (AIS) is a leading cause of death and disability worldwide, with Social Isolation (SI) being a contributing factor to worse functional outcomes. The molecular and metabolic changes that occur after AIS are not fully understood. One mechanism known to trigger systemic inflammatory responses and neuronal death characteristic of stroke is the rapid increase in Reactive Oxygen Species (ROS), leading to oxidative stress (OS). New data reports that SI has been shown to increase OS in mouse models. One emerging biomarker able to reliably measure OS is Malondialdehyde (MDA), a reactive carbonyl compound originating from polyunsaturated fatty acid oxidation and lipid peroxidation. Due to its composition, MDA readily reacts with lipid membranes, making it a sensitive OS biomarker. This study assessed MDA levels in the plasma of AIS patients to evaluate its ability to predict long‐term functional outcomes and complications arising from SI.

Hypothesis

We hypothesized that OS levels correlate with long‐term functional outcomes in AIS patients and varies based on non‐modifiable risk factors such as sex and race.

Methods

In this study, we used peripheral blood plasma from healthy volunteers (HV, N=24), and from AIS patients (N=27) at 3d and 7d post‐stroke to capture the temporal profile of MDA after injury. Social Isolation was measured utilizing ULCA Loneliness scale and Lubben Social Network Scale collected during patients’ hospitalization.

Results

AIS patients had an increase in MDA levels compared to the control group, as seen in prior literature. We found a significant positive correlation with age of AIS patients and higher levels of MDA (p<0.05). There was a positive trend with BMI and levels of MDA. As expected, non‐lonely AIS patients had increased levels of MDA when compared to non‐lonely HV (p<0.05). Interestingly, lonely AIS patients had a decrease in MDA when compared to their lonely HV counterparts (p<0.001). Stroke patients with larger social networks had decreased MDA levels. There was no relationship between levels of MDA during hospitalization and functional outcome at 3 months post discharge.

Conclusion

MDA appears to be a promising biomarker for oxidative stress in AIS patients, with notable associations with age, BMI, and social network and isolation. These findings underscore the complex relationship between OS, social factors, and stroke outcomes. Further research is needed to understand the impact of OS and its correlation with SI so that new treatment plans can be developed for stroke survivors.
Abstract 057: Outcomes in Patients with Aspiration vs Stent Retriever Thrombectomy
Authors: Kaur G. , Rodriguez W. , Scott J. , Esechie A. , Christopher K. , Edgell R. , Linares G.
Published: January 2025

Introduction

There are currently multiple devices cleared by the FDA for endovascular therapy in acute ischemic stroke. While data on the superior efficacy of dual stent retriever and aspiration catheter techniques for mechanical thrombectomy (MT) is mixed, our study compares outcomes between the stent retriever and aspiration techniques.

Method

We reviewed 257 patients with large vessel occlusion (LVO) who underwent mechanical thrombectomy (MT) between 2018 and June 2023. From this cohort, we identified 48 patients: 22 who underwent MT exclusively with a stent retriever and 26 who underwent MT using an aspiration catheter. Patients who received dual‐device MT were excluded from the study. Our primary outcomes included successful recanalization, defined as a modified Thrombolysis in Cerebral Ischemia (TICI) score of greater than or equal to 2b, the duration of intensive care unit (ICU) stay, and a 90‐day modified Rankin Scale (mRS) score of 0‐3. Secondary outcomes included the number of passes and complications, such as intracranial hemorrhage (ICH).

Results

Baseline characteristics, including age and BMI, were comparable between the two groups. The proportion of patients achieving a good outcome (TICI score greater than or equal to 2b) was 90.9% in the stent retriever group compared to 84.6% in the aspiration catheter group. The average ICU stay was 5.6 days for the stent retriever group and 3 days for the aspiration catheter group. The proportion of patients with a favorable 90‐day mRS score (0‐3) was 69.2% in the stent retriever group and 85.7% in the aspiration catheter group. First‐pass effect occurred in 72.7% of patients in the stent retriever group, compared to 57.7% in the aspiration catheter group. Intracranial hemorrhage (ICH) was observed in 28.6% of patients in the stent retriever group and 19.2% in the aspiration catheter group (p=0.45).

Conclusion

Our study found that the stent retriever technique resulted in better recanalization and fewer passes compared to the aspiration catheter. However, the aspiration catheter group had shorter ICU stays, better functional outcomes, and fewer complications. With newer devices, further research with standardized techniques is needed to provide more clarity on these findings.
Abstract 063: A Scoping Review of Drug‐Induced Hypertension in the Endovascular Thrombectomy Era
Authors: Rodriguez-Calienes A. , Chavez-Ecos F. A. , Huynh J. K. , Flores-Boggiano E. A. , Vilca-Salas M. I. , Espíritu-Vilcapoma X. , Aliaga-Cavalcanti C. , Morán-Mariños C. , Ortega-Gutierrez S.
Published: January 2025

Introduction

Since 2015, endovascular thrombectomy (EVT) has become the gold standard for treating large vessel occlusion acute ischemic stroke (LVO‐AIS). Drug‐induced hypertension (DIH) shows promise in enhancing collateral blood flow to the ischemic penumbra, particularly in LVO‐AIS patients with larger penumbral tissue volumes compared to other stroke subtypes. Despite its potential, current AIS guidelines lack specific recommendations regarding the use of DIH in patients undergoing recanalization therapy. This review aims to provide a comprehensive analysis of the existing evidence on DIH in AIS within the context of the EVT era.

Methods

We conducted a comprehensive search of five electronic databases, supplemented by gray literature, to identify studies on DIH in AIS between 2015 and 2024. Data extraction focused on key variables including study design, patient population, target blood pressure (BP), pharmacological agents used, dosage, timing and duration of intervention, recanalization strategies (intravenous thrombolysis, EVT), DIH's impact on outcomes, and associated adverse effects.

Results

Seven studies were identified, with sample sizes ranging from 50 to 218 participants (median: 136). Of these, four were retrospective, and three were randomized controlled trials. Two studies focused on patients with lacunar stroke, two on patients with early neurological deterioration, and three on a broader AIS subpopulation. Three studies specifically targeted patients ineligible for recanalization therapy, three included a mixed population of both recanalization and non‐recanalization patients, and only one exclusively studied patients eligible for EVT. Notably, none of the studies involving recanalization therapy detailed the timing of DIH initiation relative to the therapy. The most common target BP was a 20% increase from baseline systolic BP (observed in 4/7 studies). Phenylephrine infusion was the most frequently used agent (4/7 studies), followed by norepinephrine (2/7 studies). Four studies reported achieving primary efficacy outcomes of DIH, including improved functional status and early neurological improvement. Safety outcomes and adverse effects were not associated with DIH in three of the four studies that evaluated these factors.

Conclusion

The current evidence on DIH for AIS in the EVT era remains inconclusive, particularly concerning its benefit in patients undergoing revascularization therapy. Although achieving a 20% increase in baseline systolic BP with phenylephrine infusion is a commonly utilized approach, the variability in protocols and lack of standardized guidelines underscore the need for further research. To establish a definitive role for DIH, well‐designed, prospective studies, with specific focus on timing, AIS subtypes, and standardization of intervention protocols are required.
Abstract 073: ASPECTS decay during interfacility transfers in patients with large vessel occlusion
Authors: Alrohimi A. , Ishaque N. , Wagner A. , Jeerakathil T. , Buck B. , Shuaib A. , Hill M. D. , Almekhlafi M. , Mishra S.
Published: January 2025

Background

Some patients with large vessel occlusion (LVO) are first evaluated at primary stroke centers (PSCs) before transfer to a comprehensive stroke center (CSC) for Endovascular thrombectomy (EVT). A subgroup of those patients experiences rapid infarction growth during transfer limiting the benefit from intervention. We evaluated the incidence, predictors, and outcomes of imaging decay of patients with LVO transferred for EVT.

Methods

A retrospective analysis of all patients with anterior circulation LVO transferred for EVT. ASPECTS decay was defined as 2 ASPECTS points decrement at CSC compared to PSC. Primary outcome was 90 day home time.

Results

182 (44.5% female) patients met the inclusion criteria. Median (IQR) time between baseline and follow up CTs was 250.5 (163‐324.25) minutes. Out of the 182 patients, 66 patients (36%) had ASPECTS decay, and 32/66 patients (48%) underwent EVT. Collateral score was strongly associated with the ASPECTS decay (OR= 0.29, [0.19‐0.46], p<0.001) in multivariate logistic regression. Patients with ASEPCTS decay have a significant lower rate of 90‐day home‐time (P<0.001) and higher risk of 90‐day mortality (P<0.001), and in hospital death (P=0.03). In patients with ASPECTS decay, performing EVT was not associated with improved 90‐day home time (
β
= 0.19, [‐3.2 ‐27.8], p=0.12).

Conclusions

For patients with LVO transferred for thrombectomy, a third of our patients developed ASPECTS decay. Collateral blood flow was the main determinant of ASPECTS decay during inter‐facility transfers. Decay is strongly associated with poor functional outcomes.
Abstract 075: Associations between Glucocorticoid Treatment with Clinical Outcomes and Medical Complications in Patients with Subarachnoid Hemorrhage
Authors: YANG X. , Gallagher A. , Fong C. T. , Walters A. M. , Leslie‐Mazwi T. , Souter M. J. , Levitt M. , Wahlster S. , Lele A. V.
Published: January 2025

Introduction and Purpose

The impact of glucocorticoids (GCs) on outcomes in aneurysmal subarachnoid hemorrhage (aSAH) is insufficiently explored. This study examined associations between GC treatment within one week from aSAH and clinical outcomes.

Methods

Retrospective, observational cohort study of adult patients with aSAH admitted to a comprehensive stroke center between 01/2014‐01/2019. Patients were stratified into two groups: GCs exposure within the first 7‐days from admission versus no GCs during the hospitalization. Propensity matched cohorts adjusted for age, gender, and Hunt‐&‐Hess grade on admission were compared using multivariable regressions to determine associations between GCs treatment and clinical outcomes of: discharge‐to‐home rates, severe vasospasm (defined as Lindegaard ratio > 6.0 on transcranial doppler), delayed cerebral ischemia (DCI, defined as cerebral infarction on magnetic resonance imaging), in‐hospital mortality and medical complications (ventriculostomy‐related infection, ventilator‐associated pneumonia, catheter‐associated urinary tract infection, delirium).

Results

Overall, 339 patients (mean age 54.7 ± 12.9) were included. Propensity matched cohort analysis was performed in 298 patients (mean age 54.4 ± 13.2). Most aneurysms (239, 80.2%) were located in the anterior circulation and 59 (19.8%) were in the posterior circulation; 152 (51%) underwent surgical clipping, 150 (50.3%) underwent endovascular coiling, and 4 underwent both procedures. Patients in the GCs group received a calculated median dose of dexamethasone of 114.7mg (IQR = 38‐295.6). Treatment with GCs was associated with higher discharge‐to‐home rates (z = 2.21, 95% confidence interval (CI) 0.28‐0.76), but also a higher frequency of severe vasospasm (z = 3.01, 95% CI 0.78‐1.56). A non‐significant trend towards lower frequency of DCI was noted in the GCs group (z = ‐1.8, 95% CI (‐0.68) ‐ (‐0.2)). No difference was found in all‐cause in‐hospital mortality or any of the medical complications between groups.

Conclusion

GCs treatment within the first 7‐days was associated with higher discharge‐to‐home rates, but mixed results were observed regarding the incidence of vasospasm and DCI. From a safety side‐effect profile, GCs appeared to be well tolerated. Our findings highlight the need for further studies to determine the utility of GCs in aSAH.
Abstract 097: Endovascular Treatment of Refractory Vasospasm in Aneurysmal Subarachnoid Hemorrhage: A Single Center 16‐year Experience
Authors: Behzadi F. , Tsiang J. , Jani R. , Payman A. , Bond B. , Kam A. , Pasquale D. , Serrone J.
Published: January 2025

Introduction

Refractory post‐hemorrhagic cerebral vasospasm (PHCV) in patients with aneurysmal subarachnoid hemorrhage (aSAH) is a morbid and possibly fatal condition that often requires endovascular treatment with either intra‐arterial (IA) vasodilator therapy or percutaneous transluminal balloon angioplasty (PTA). This study aims to evaluate the efficacy of these treatments and explore the risk factors of poor clinical outcomes amongst patients with refractory PHCV receiving endovascular therapy.

Methods

All adult patients who received IA vasodilators or PTA for PHCV due to aSAH from 2007 to 2023 at our institution were included. Patients were divided into Good and Poor outcome cohorts based on 6‐month modified Rankin of > 2 cutoff and were compared for all identifiable risk factors using multivariate analysis. Radiographic changes in vessel diameter and cerebral circulation time (CCT) were measured and compared between individual PTA and IA sessions using various metrics.

Results

A total of 83 refractory vasospasm patients with an average age of 52.0 years old, 66% of whom were female. Poor outcomes were seen in 65% of patients. Female sex (p=0.045) and initial vasospasm symptom of only headaches (p=0.044) were protective factors against poor outcomes. History of hypertension (p=0.010), earlier onset of vasospasm (p=0.008), requiring systemic hypertensive therapy (p=0.012), and longer initial pre‐treatment CCT (p=0.042) were risk factors of poor outcomes. PTA was superior to IA vasodilators pre‐ to post‐treatment vessel diameter (0.44 mm in PTA compared to 0.23 mm in IA; p=0.017) but CCT was similarly improved with both modalities.

Conclusions

In this single‐center retrospective review, most patients (65%) treated with endovascular therapy for PHCV experienced poor outcomes. A history of hypertension, earlier onset of vasospasm, and longer initial pre‐treatment CCT were predictive of poor outcome. Female sex and headache presentation were predictive of good outcomes. PTA had a statistically superior intra‐treatment improvement in vessel diameter compared to IA vasodilators. All other radiographic parameters were similar between PTA and IA therapy.
Abstract 172: A Machine Learning Model for Prediction of Short‐Term Functional Outcomes in Cerebral Venous Thrombosis
Authors: Govind A. , Meghana B. , Byadarhaly K. , Kenchaiah R.
Published: January 2025

Background

Dural Sinus and Cerebral Vein Thrombosis (CVT) represents a rare yet significant cause of stroke, with distinct pathophysiological mechanisms compared to arterial strokes. Despite the progress in machine learning‐based predictive models for arterial stroke, which have significantly advanced prognostication and treatment strategies, there remains a notable absence of similar models for CVT.

Methods

A single‐center, retrospective cohort study of adult patients diagnosed with acute CVT confirmed on contrast‐enhanced CT/MR Imaging at admission was carried out at a specialized tertiary care center. Patients with a known history of recent or active infections or inflammatory conditions or missing data were excluded. Baseline clinical and demographic data, laboratory data including blood cell counts, Serum Homocysteine and Folate levels measured before the initiation of anticoagulation, and modified Rankin Scale (mRS) scores at discharge were collected. To study short‐term functional outcomes, patients were dichotomized into good (mRS 2 or less, encoded as output class 1) and poor (mRS >2 encoded as output class 0) functional outcome groups. Machine learning models were built in order to predict if patients belonged to good or poor function outcome groups (mRS2). The classifiers were validated using K‐fold cross validation to pick the best hyperparameters and were tested using a holdout data. The classifiers built include Support Vector Machine (SVM), Logistic Regression Regression (LR), Random Forests (RF) and Gradient Boosting. The performance of the classifiers are compared based on the Area Under the Receiver Operating Characteristic (AUROC) and Sensitivity.

Results

162 patients were included in the final dataset, 32 of whom had a significant disability (mRS>2) at discharge. The top variables for predicting the functional outcome groups were Platelet count, Serum Homocysteine, Neutrophil‐to‐Lymphocyte ratio, and Total Leucocyte Count at the time of admission. Support Vector Machine (SVM) was found to be the best‐performing algorithm with an accuracy of 0.86 and AUC of 0.643.

Conclusion

Using the SVM machine learning algorithm, a predictive model consisting of baseline platelet count, serum homocysteine, total leucocyte count, and the inflammatory marker Neutrophil‐to‐Lymphocyte Ratio was developed to predict short‐term functional outcomes in acute CVT. The high value of accuracy (0.86) indicates that the algorithm is able to reliably detect short‐term functional outcomes.
Abstract 181: Acute Ischemic Stroke And Endovascular Thrombectomy During COVID‐19 Pandemic: A Nationwide Analysis
Authors: Reddi P. , Mehta A. , Shafizadeh M. , Kellner C. , Dangayach N. , Fifi J. , Mocco J. , Majidi S.
Published: January 2025

Introduction

COVID‐19 may be linked to higher rates of severe strokes and strokes in younger patients through distinct pathophysiological processes.

Objectives

To investigate characteristics and outcomes in COVID‐19 related acute ischemic stroke (AIS) and endovascular thrombectomy (EVT) in the 2020‐2021 National Inpatient Sample (NIS) database.MethodsNIS was queried for patients admitted in relation to AIS or who underwent EVT, stratifying patients based on COVID‐19 diagnosis. Demographics, co‐morbidities, and outcomes were compared between groups using univariate analyses. Propensity score matching was used for multivariable analyses. Primary outcomes were age difference and the difference in the prevalence of cardiovascular risk factors between the two groups. Secondary outcomes include rates of favorable hospital outcome, in‐hospital mortality, and the length of hospital stay.

Results

In the AIS cohort of 1,381,039 patients, 58,525 had COVID‐19. Mean age for COVID‐19 patients with AIS was lower (67.55 vs 69.40 years; SMD=0.134). There was a higher proportion of Black (21.1% vs 17.9%) and Hispanic patients (15.0% vs 8.5%) amongst COVID‐19 patients with AIS. In adjusted multivariable analyses, the presence of COVID‐19 in AIS patients was significantly associated with a higher rate of inpatient mortality (AOR:2.79; 95% CI[2.61‐2.98]; p<0.001) and a lower rate of favorable hospital outcome (AOR:0.66; 95% CI[0.62‐0.70]; p<0.001). 83,650 patients underwent EVT. 3,075 of these patients were diagnosed with COVID‐19. The COVID‐19 group in patients who underwent EVT presented with a younger average age (64.02 years vs 69.25 years; SMD=0.368) and a greater proportion of Black (19.0% vs 15.1%;SMD=0.277) and Hispanic patients (14.9% vs 8.4%; SMD=0.277). COVID‐19 in patients who underwent EVT was associated with higher in‐hospital mortality rate (AOR:2.21, 95% CI[1.65‐2.98], p<0.001).

Conclusions

This nationally representative analysis demonstrates patients with AIS and concomitant COVID‐19 infection were younger, with less cardiovascular risk factors, disproportionately Black and Hispanic, with worse neurological deficit and worse hospital outcome.
Abstract 229: Comparative Diagnostic Yield of Cardiac Computed Tomography Versus Echocardiography for Identifying Cardioembolic Sources in Ischemic Stroke: A Retrospective Single‐center Cohort Study
Authors: Liu M. , Ghozy S. , Osman K. , Nasr D.
Published: January 2025

Background

Ischemic stroke remains a leading cause of morbidity and mortality worldwide. Understanding stroke etiology is critical in future stroke prevention. A cardioembolic etiology of stroke makes up a significant proportion of all ischemic stroke. Part of the evaluation for a cardioembolic etiology requires a structural evaluation of the heart to evaluate for sources of thrombus. Traditionally, transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) have been utilized for this purpose, although both have limitations. Cardiac computed tomography (CCT) has emerged as a potential alternative, offering non‐invasive imaging with high sensitivity and specificity for detecting intracardiac thrombi.

This study aimed to evaluate the diagnostic yield of CCT compared to TTE and TEE in detecting high‐risk cardioaortic sources of embolism, including left ventricular (LV) thrombus, left atrial (LA) thrombus, valvular sources of thrombus, and ulcerated aortic plaques, in patients with ischemic stroke.

Methods

We conducted a retrospective, single‐center cohort study at Mayo Clinic, Rochester, MN, on patients who underwent CCT within 30 days of stroke onset between March 2019 and June 2023. We compared the diagnostic yields of CCT, TTE, and TEE in detecting structural cardiac sources of embolism.

Results

426 patients were included in our study. 87 patients underwent both CCT and TEE, 257 underwent CCT and TTE, and 82 only underwent CCT. The overall diagnostic yield of CCT for detecting high‐risk cardioaortic sources was 15.5%. Specifically, CCT identified LV thrombus in 2.3% of patients, LA thrombus in 4.0%, valvular thrombus in 2.8%, and ulcerated aortic plaques in 7.0%. In comparative analysis, CCT demonstrated a higher yield than TTE (16.0% vs. 3.5%) and a comparable or higher yield than TEE (25.3% vs. 20.7%) in detecting these sources.

Conclusions

CCT proved to be a viable and potentially superior alternative to traditional echocardiography for identifying some high‐risk structural sources of cardioembolism in ischemic stroke patients. Its non‐invasive nature, coupled with the ability to perform imaging soon after stroke onset, underscores its clinical utility. However, further prospective and blinded studies are required to validate these findings and fully establish the efficacy of CCT in this context.
Abstract 235: Cyclic Aspiration in Mechanical Thrombectomy: Influencing Factors and Experimental Validation
Authors: Jablonska M. , Li J. , Tiberi R. , Tomasello A. , Ribo M.
Published: January 2025

Introduction/Purpose

Mechanical thrombectomy is a fundamental intervention for acute ischemic stroke treatment. While conventional techniques are effective, cyclic aspiration (CyA) shows potential for better recanalization rates. We aim to investigate factors affecting CyA and compare them with static aspiration (StA).

Materials/Methods

StA setup consisted of an aspiration pump connected to pressure transducer. CyA was tested with five setups: single solenoid valve with air+saline (1) or saline alone (2) as aspiration medium; two solenoid valves with air+saline (3) as aspiration medium; complete air removal and saline feeding (4); pressurized saline feeding (5). To assess the efficacy of clot ingestion, the pressure transducer was replaced with a distal aspiration catheter. Moderately stiff clot analogs (15 mm) were used to investigate the ingestion quantified as clot relative weight loss. Additionally, the aspiration flow rate was assessed for each setup.

Results

With CyA setup 1, the amplitude of the achieved negative pressure waves declined with increasing frequencies but progressively increased with each subsequent iteration, achieving a maximum amplitude of 81 kPa for setup 5 at 1Hz. Relative clot weight loss was significantly higher with setup 5 at 5Hz than with StA (100% vs. 37,8%; p=0.05). Aspiration flow rate was lower with CyA than with StA (setup 5 at 5Hz: 199,8ml/min vs. StA: 311ml/min; p<0.01).

Conclusion

Cyclic aspiration with the appropriate setup may represent an encouraging innovation in mechanical thrombectomy, offering a promising pathway for improving efficacy in clot ingestion and recanalization. The observed benefits warrant confirmation in a clinical setting.
Abstract 255: Effect of Oral Glibenclamide on Delaying Peak Onset of Malignant Cerebral Edema in Large Hemispheric Infarctions
Authors: Oei M. , Hollar M. , Giurgiutiu D. , Shah M. , Garcia K.
Published: January 2025

Title

Delayed Peak of Malignant Cerebral Edema in Large Hemispheric Infarction with Oral Glyburide Treatment: A Case Study

Introduction

Malignant cerebral edema (MCE) is a severe complication of large hemispheric infarction, often leading to poor outcomes and high mortality rates. Invasive measures, such as decompressive craniotomy, are both reactive in nature and have limited applicability. Other medical therapies are also used, but are reactive and have mixed results with limited evidence of efficacy. A growing body of evidence has indicated that glyburide, a sulfonylurea receptor 1 (SUR1) inhibitor, may prevent or delay the onset of MCE. This case study explores the effects of oral glyburide on the timing and severity of MCE in a patient with a large hemispheric infarction.

Methods

A 53‐year‐old woman with a large left middle cerebral artery territory infarction was treated prophylactically with oral glyburide (2.5 mg daily) for five days. Standard care, including hyperosmolar therapy, was administered. The patient's neurological status and midline shift were monitored using serial CT imaging from post‐stroke day (PSD) 0 to PSD 18.

Results

Initial imaging showed large hemispheric infarction without midline shift. However, a gradual increase in midline shift was observed, peaking at 13 mm on PSD 14, which is later than the typical 3‐5‐day peak in similar cases. Despite this delayed peak swelling, the patient's clinical status remained stable, and no further escalation of care was needed. The patient tolerated glyburide without adverse effects, such as symptomatic hypoglycemia.

Discussion

The delay in the peak of MCE observed in this case suggests that glyburide may extend the window for effective management of edema. While the exact mechanism remains unclear, the early stabilization of neurological status with delayed significant edema warrants further investigation into glyburide as a potential prophylactic therapeutic option. This case aligns with earlier research indicating that glyburide can mitigate ischemia‐induced edema, potentially improving outcomes in stroke patients.

Conclusion

This case suggests that glyburide may delay the peak of malignant cerebral edema in large hemispheric infarctions, offering a new avenue for proactive management of this condition. Further studies are needed to confirm these findings and establish glyburide's role in acute stroke management.
Abstract 270: Endovascular Versus Medical Management of Acute Ischemic Strokes Due to Distal Medium Vessel Occlusions
Authors: Rehman M. Aemaz ur , Javairia F. , Shaikh M. , Ejaz R. , Abid M. , Fatmi W. , Malik A. A. , Imran A. , Ali R. , Aladawi M.
Published: January 2025

Introduction

Although endovascular treatment (EVT) is highly effective for acute ischemic strokes due to proximal large vessel occlusions (LVOs), its efficacy and safety in distal medium vessel occlusions (DMVOs) has shown conflicting results. EVT in distal medium vessel occlusions is considered high‐risk due to reduced vessel size and tortuosity, but newer techniques and recent efforts to explore the EVT potential have encouraged us to revisit thrombectomy indications. We thus performed a systematic review and meta‐analysis to compare its efficacy and safety with the best medical treatment (BMT) in treating primary DMVOs.

Methods

A comprehensive search was performed on Embase, PubMed, and Cochrane from inception to April 2024. Efficacy outcomes of interest included functional independence (90‐day modified Rankin scale (mRS) 0‐2) and excellent functional outcomes (90‐day mRS 0‐1). Safety outcomes were symptomatic intracranial hemorrhage (sICH) and 90‐day mortality. Statistical analysis was performed on Review Manager (RevMan) version 5.3.

Results

Two randomized controlled trials and twenty observational studies were included in this meta‐analysis with a total sample size of 4081; 1858 (46%) patients were included in the EVT arm and 2223 (54%) belonged to the BMT arm. In the overall cohort, EVT was comparable to BMT in terms of functional independence (OR 0.97, 95% CI 0.74 to 1.28, p=0.86), symptomatic ICH (OR 1.38, 95% CI 0.75 to 2.53), and mortality (OR 1.23, 95% CI: 0.88 to 1.70). A trend towards the superiority of EVT for excellent functional outcomes in strokes with NIHSS score >6 was observed but this finding missed statistical significance by a narrow margin (OR 1.22, 95% CI 0.96 to 1.56, p=0.10). An analysis of studies with mild strokes (NIHSS <6) showed that EVT leads to significantly lower rates of functional independence (OR 0.57, 95% CI 0.33 to 0.99, p=0.05) and also leads to significantly higher rates of sICH in these patients (OR 6.35, 95% CI 1.56 to 25.83, p=0.010).

Conclusion

BMT is comparable to EVT for distal medium vessel ischemic strokes (AIS‐DMVO). There may be a trend towards EVT achieving higher rates of excellent functional outcomes (mRS 0‐1) in patients with NIHSS score >6 but BMT is superior to EVT in patients with NIHSS score <6.
Abstract 296: Impact of Statin Initiation and Resumption on Mortality Following Intracranial Hemorrhage: A Meta‐Analysis
Authors: Baskaran A. B. , Atlaw S. , Morsi R. , Kozel O. A. , Smith M. , Nugent J. , Aldaher B. , Agwu C. , Chahine A. , Karar L. , Jhaveri A. , Penagos J. C. , Kothari S. , Siddiqui O. , Najam N. , Desai H. , Metman O. V. , Rana R. , Thind S. , Sehgal N. , Lawrence M. , Iourinets J. , Patel S. , Amin A. , Jafary H. , Lis P. , Prabhakaran S. , Kass‐Hout T.
Published: January 2025

Background

The use of statins following intracranial hemorrhage (ICH) is disputed. Prior studies have found inconsistent effects of statins on the risk of subsequent ICH and other outcome measures. Moreover, many previous studies do not distinguish between post‐ICH statin treatment in patients resuming previous statin therapy versus initiation in statin‐naïve patients. This meta‐analysis consolidates the evidence surrounding the use of therapies following ICH, with a focus on mortality in these two subgroups.

Methods

A comprehensive search of MEDLINE, EMBASE, and The Cochrane Library was conducted up to 2024 to identify studies on statin initiation or resumption versus no statin use in intracerebral/intraparenchymal hemorrhage patients, yielding 8 studies meeting inclusion/exclusion criteria. The protocol was registered with PROSPERO, and data were analyzed using a Pairwise Meta Analysis on R, applying common and random effects models with heterogeneity assessed via I² statistics. Mortality outcomes were categorized into “short‐term” (≤90 days) and “long‐term” (>90 days to 1 year) mortality.

Results

Mortality events occurred in 2946 out of 9501 patients (31.0%) in the control group, 123 out of 2248 patients (5.5%) in the statin initiation group, and 787 out of 3944 patients (20.0%) in the statin resumption group. For the ≤90 days timeframe, the random effects model showed a significant reduction in mortality with statin initiation, with a relative risk (RR) of 0.15 (95% CI [0.081; 0.26], p < 0.0001), and with statin resumption, the RR was 0.32 (95% CI [0.18; 0.55], p < 0.0001). Heterogeneity was high, with an I² of 84.3%. For the >90 days up to 1 year timeframe, statin initiation was associated with a reduction in mortality, with an RR of 0.39 (95% CI [0.29; 0.53], p < 0.0001). Statin resumption also showed a reduction in mortality, with an RR of 0.65 (95% CI [0.46; 0.92], p = 0.0145). Heterogeneity was moderate, with an I² of 41.7%.

Conclusion

Statin therapy following ICH, whether through initiation or resumption, is associated with a significant reduction in mortality both within 90 days and beyond 90 days up to one year. Interestingly, statin initiation showed a stronger effect compared to resumption. These findings support the continuation or initiation of statins in the acute phases of ICH management regardless of previous statin use.
Abstract 314: Intracisterna Magna (ICM) Injection
Authors: Kim V. , Roychowdhury S.
Published: January 2025

Introduction/Purpose

Intracisterna magna (ICM) injection is used as a route to deliver intrathecal gene therapy to treat neuropathies and lysosomal storage disorders. This allows requiring smaller doses than if therapy was delivered through other routes of vector delivery in the brain and spinal cord. This procedure had never been performed in humans before, only animals, at the time of procedure.

Case description and technique

The procedure was performed under general anesthesia. It was vital that the patient did not move during the entirety of the procedure. This is generally a high risk procedure due to the surrounding vasculature and risk of stroke. Contraindications include anatomic variability where the posterior inferior cerebellar artery (PICA) or vertebral artery would be obstructing the area for access. Other contraindications include the presence of an occipital sinus, Chiari I malformation or low lying tonsils. Potential complications include soft tissue injury, vascular injury, bleeding, and CSF leak. The pediatric patient's head was flexed to open the pathway to the cisterna magna. Cross sectional imaging with CT with contrast was used to identify the vertebral artery, PICA, and veins. The patient was positioned lateral decubitus with the right side down. The posterior craniocervical junction was sterilely prepped and draped. Xylocaine was used for local anesthesia. 25G 3 inch spinal needle was advanced into posterior neck, progressing into the cisterna magna using 2mm cuts until CSF was seen draining through needle. 0.5cc Isovue‐180 contrast was injected showing uptake in the cisterna magna. 5cc CSF removed was removed followed by introduction of 5cc of the experimental drug per protocol followed by a saline chaser. There was no immediate complication and the patient was admitted to the pediatric intensive care unit (PICU) for ongoing cardiorespiratory and neurologic monitoring.

Outcome

This was the first patient with GM1 gangliosidosis to be treated via ICM injection of a viral vector at the time of procedure.