bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract Number ‐ 60: Influence of Primary Wind Diameter and Length on Coil Volume: Comparing Stryker and CEREPAK coils
Authors: Grandhi Ramesh , Kottenmeier Emilie , Khaled Alia , Brouwer Patrick 
Published: April 2023

Introduction
Coiling procedures for intracranial aneurysms (IAs) performed in the US have steadily increaseda, and volumetric efficiency may become an important consideration for hospitals. Coil volume depends on length and primary wind diameter (PWD), and volumetric efficiency can be achieved by either inserting more coils or using coils with larger volumetric filling. This scenario analysis evaluates the influence of PWD and length on total coil volume by comparing four similar Stryker and CEREPAK coils.

Methods
In this analysis, we test the influence of PWD (D2) and length (L) on the Coil Volume Formula: [Π(D2/2)2(L)]c. In two hypothetical scenarios, relative percent difference in total coil volume was calculated and compared between four Stryker Target 360 coils and four similar CEREPAK coils that were matched based on closest PWD and L. In scenario I, L remained constant and D2 varied. In scenario II, D2 and L were inversely varied. In both scenarios, coil volume achieved by CEREPAK and Stryker coils was calculated and descriptively compared.

Results
Scenario I: (a) Stryker Target XL 360 10mm x 40cm (D2 = 0.014”, length = 40cm) with volume of 39.726mm3 was matched to the CEREPAK Heliform XL 10mm x 40cm (D2 = 0.015”, length = 40cm) with 15% greater volume of 45.604mm3. (b)Stryker Target 360 3mm x 6cm (D2 = 0.010”, length = 6cm) with volume 3.040mm3 was matched to the CEREPAK Freeform 3mm x 6cm (D2 = 0.012”, length = 6cm) with 44% greater volume of 4.378mm3. Scenario II: (a) Stryker Target XL 360 12mm x 45cm (D2 = 0.014”, length = 45cm) with volume 44.692mm3 was matched to the CEREPAK Heliform XL 12mm x 42cm (D2 = 0.015”, length = 42cm) with 7% greater volume of 47.884mm3. (b)Stryker Target 360 5mm x 20cm (D2 = 0.010”, length = 20cm) with volume 10.134mm3 was matched to the CEREPAK Freeform 5mm x 15cm (D2 = 0.012”, length = 15cm) with 8% greater volume of 10.945mm3.

Conclusions
The four selected CEREPAK coils compared to four equivalent Stryker coils achieved higher total coil volume in all scenarios. An increase in PWD by as little as 0.001”‐0.002”, improved relative coil volume by 15%‐44% (with equivalent coil length) and 7–8% (with varied coil length by 3–5cm). Clinicians evaluate many coil characteristics when treating an IA, however, PWD might be given consideration over length due to its impact on total coil volume.
Abstract Number ‐ 65: US Comprehensive Stroke Center Utilization of FAST and BEFAST Mnemonics for Public Education
Authors: Hogge Christopher , Aroor Sushanth , Goldstein Larry 
Published: April 2023

Introduction
Symptom recognition and timely access to treatment are critical components of acute stroke care systems. Two mnemonics widely used in public educational campaigns for recognizing stroke symptoms include FAST (Face‐Arm‐Speech‐Time) and BEFAST (Balance‐Eyes‐Face‐Arm Speech‐Time). The FAST mnemonic, endorsed by the AHA/ASA can miss up to 14% of strokes. BEFAST includes common posterior circulation stroke symptoms and has been implemented by several Comprehensive Stroke Centers (CSCs).

Methods
We sought to analyze the pattern of public educational materials available on the websites US CSCs. The Joint Commission (JC) quality check website compiles a list containing the names and locations of the country’s 217 JC‐certified CSCs, which was downloaded in August, 2022. Each CSC’s website was searched for educational material containing FAST and BEFAST mnemonics for stroke symptom recognition.

Results
The FAST mnemonic was listed by 35%of CSCs, the BEFAST by 58%, with 7% listing no specific mnemonic. The highest portion of CSCs using BEFAST was in western (65%) and southeastern (63%) states. The highest percentage of CSCs with no listed mnemonic were in the northeastern (14%) and southeastern (13%) states.

Conclusions
Consistency is critical in shaping public health education related to stroke symptoms. Our study suggests further effort is needed to unify the public messaging on stroke recognition.
Abstract Number ‐ 67: A case of Carotid blowout syndrome, case report, and review.
Authors: Lakki Vinay Bhushan Reddy , Singh Abhishek 
Published: April 2023

Introduction
Carotid blowout syndrome (CBS) is a potentially fatal carotid artery rupture. It is an unforeseen complication during mechanical thrombectomy that can be catastrophic without timely diagnosis and intervention. CBS develops when a damaged arterial wall cannot sustain its integrity, especially in patients who have undergone surgery or radiotherapy due to cancer. Carotid blowout syndrome is classified as threatened (type1), impending (type2), and acute (type3). Endovascular techniques have emerged as preferable alternatives to surgical ligation for treatment of CBS. Previous systemic reviews and meta‐analyses demonstrated that both coil embolization and stent grafting may be safe treatment options for CBS. This case study aims to show that early detection and endovascular management with transient distal balloon occlusion and stenting are lifesaving measures.

Methods
Case‐report

Results
Case presentation: 60‐year‐old male with past medical history of lung cancer s/p chemotherapy and radiation, hypertension, and methamphetamine abuse presented with left‐sided weakness and dysarthria, onset was 2 hours prior to arrival, his NIHSS was 11, CT head was negative for hemorrhage, CT angiogram of head and neck showed tandem occlusion of right ICA and right MCA bifurcation, he was in window for intravascular thrombolysis without contraindication, so he received Alteplase, he was brought into Angio‐suite for mechanical thrombectomy, On Right CCA injection there was complete occlusion of Right ICA with TICI‐0 flow, distal branches of Right ACA and MCA were not visualized. Mechanical thrombectomy was done on Right ICA and Right MCA. During clot retrieval, flow arrest was achieved by inflating the balloon guide with diluted contrast. Post thrombectomy there was extravasation around the right CCA and ICA, so the balloon guide was reinflated to have a florist around the catheter and hemostasis in the right ICA, two carotid stents were deployed sequentially with rapid exchange technique with overlapping technique, an endovascular graft was introduced and deployed at mid cervical segment at the point of leak and dissection. Post mechanical thrombectomy, TICI‐3 flow in the right ICA, and MCA were achieved, the patient was discharged to rehab in a stable condition on dual antiplatelet regimen.

Conclusions
CBS is a rare complication during mechanical thrombectomy, early and aggressive intervention in CBS is crucial to prevent devastating consequences, Transient balloon occlusion distal to the carotid blowout of the ICA is a reasonable technique for completing endovascular management with stenting.
Abstract Number ‐ 75: Simultaneous Extracranial‐Intracranial Management of Tandem Lesion (Seimless Technique) in Posterior Circulation Stroke
Authors: Kareemchaubal Samer AbdulVarun , Kareem Mustafa Abdul , Lin Eugene , Zaidat Osama 
Published: April 2023

Introduction
Simultaneous extracranial‐intracranial management of Tandem lesion in stroke (Seimless technique) is well published and important technique in treating tandem lesions in anterior circulation. However, this technique has been rarely used in the posterior circulation. We present the case of a 70 year‐old male presented with coma and was found to have right vertebral artery origin stenosis with super‐imposed thrombus and tandem occlusion of the basilar artery. We used endovascular Seimless technique successfully with TICI‐3 reperfusion score and good clinical outcome. To our knowledge, this is the first case report for endovascularSeimless technique used in the post circulation.

Methods
We reviewed our endovascular mechanical thrombectomy data from May 2019 to July 2022 and those with post circulation tandem occlusion were selected. Baseline demographics and clinical presentation were obtained including clinical outcome.

Results
70 year‐old male with history of high blood pressure presented with state of coma was found to have right vertebral artery origin stenosis with superimposed pedunculated thrombus and tandem distal third Basilar artery occlusion. Patient underwent simultaneous extracranial‐intracranial management of tandem lesions (Seimless technique) through right trans radial basilar artery thrombectomy with stent retriever and aspiration as well as right vertebral artery origin aspiration and balloon angioplasty over the wire of the stent retriever. Following day, the patient underwent right trans‐radial vertebral artery origin stenosis stenting. Patient’s neurological exam was improved from NIHSS 30 to 0 at the time of discharge. We performed Basilar artery thrombectomy using Rist catheter, Red 62 reperfusion catheter, Rebar microcatheter and Solitaire stent retriever4 mm x 41 mm. After deploying the stent retriever, we advanced sterling balloon 4 mm x 20 mm over the stent retrieverwire and performed optimal balloon angioplasty.

Conclusions
This particular technique of treating intracranial and extracranial lesion simultaneously for posterior circulation hasn’t been reported in the literature. By presenting this case, we want to conclude that in selective posterior circulation tandem occlusion strokes “Seimless technique” can be used effectively and safely without many complications.
Abstract Number ‐ 78: An Unusual Cause Of Progressive Visual Loss – Vein Of Galen Malformation
Authors: Santiago Raphael , Chin Allison , Martucci Maria , Obrzut Michal 
Published: April 2023

Introduction
Vein of Galen Malformations (VOGM) are rare vascular conditions resulting from anomalous vascular shunts between primitive choroidal vessels and the Markowski Prosencephalic Vein (MPV). They comprise only 1% of all intracranial vascular malformations with a high mortality rate up to 76.7% if untreated. In this case report, we aim to bring awareness of this condition as a cause of progressive visual loss with the objective of making it relevant in our medical community.

Methods
We discuss the case of a truck driver who progressively and slowly lost his vision as a consequence of a VOGM.

Results
In this case report we present a 49‐year‐old man with a past medical history of hypertension and renal insufficiency who initially presented to his ophthalmologist for progressive vision loss accompanied by headaches. Bilateral papilledema was seen on examination as well as near complete vision loss on the right eye and 20/40 visual acuity on the left eye. He was referred to neurosurgery for suspicion of elevated intracranial pressure. CT angiogram demonstrated multiple areas of fistualization to the VOGM, including branches from the meningeal hypophyseal divisions, bilateral distal PICA divisions, and the thalamic striate divisions. A multisession endovascular treatment with multiple embolizations was pursued. Initially, the patient underwent a transarterial embolization of the left middle meningeal artery (MMA) and left occipital artery (OA) followed by embolization of the 4 branches of the right MMA. Then, he underwent embolization of 8 large feeding branches and three weeks later, transvenous coiling of the MPV was done. Post‐embolization angiograms showed progressive decrease in the size of the malformation, the degree of the shunt and, and in cortical venous reflux with near normalization of the capillary and venous phases timing in the left and right hemispheres. Although, the patient did not recover from prior visual deficits, his symptoms remained stable.

Conclusions
It is important to keep this unusual cause of progressive vision loss within the differential diagnosis. The earlier this diagnosis is made, the quicker patients can receive treatment preventing long term deficits, morbidity and mortality.
Abstract Number ‐ 82: Central Retinal Artery Metallic Embolus After Ophthalmic Segment Internal Carotid Artery Aneurysm Flow‐diverter Embolization
Authors: Chaudhry Thymur A , Niemann David 
Published: April 2023

Introduction
Flow‐diverting stents are effective devices in treating what would have previously been difficult to treat aneurysms such as wide‐necked, fusiform, blood blister, or giant aneurysms. Although generally safe, complications have been reported such as ischemia, in‐stent stenosis, and side branch occlusion, as well as device related complications such as stent migration and incomplete expansion. We present a case report of a patient who was incidentally found to have a reflective metallic embolus within the central retinal artery after two flow‐diverter stent embolization of the ipsilateral ophthalmic segment aneurysm.

Methods
Case report.

Results
A 44 year‐old female presented with incidental discovery of a 4mm paraopthalmic aneurysm. She underwent two flow‐diverter (Pipeline ©) embolizations with decreased although persistent filling of the aneurysm sac. After the second embolization procedure, the patient was referred to Opthalmology after incidental note of a small submillimeter reflective metallic embolus adjacent to the fovea seen on a screening Optometry exam upon workup for reader glasses. The patient was asymptomatic without visual complaints, blurriness, floaters, or change in vision.

Conclusions
We present a case of a tiny submillimeter reflective metallic embolus after flow‐diverter stent placement within the ipsilateral ophthalmic artery. This is the first report we are aware of describing such a complication after the use of flow‐diverter stent deployment. It is possible that the increased friction from two apposing stents could cause microfractures and subclinical emboli.
Abstract Number ‐ 87: Successfull thrombectomy followed by balloon mount stent placement on acute basilar artery occlusion
Authors: Ota Riichi , Neves Gabriel , Montalvan Victor , Bushnaq Saif 
Published: April 2023

Introduction
Basilar artery occlusion accounts for 10% of all ischemic stroke caused by intracranial large vessel occlusion (LVO) with high morbidity and mortality. Endovascular intervention has been shown effective in the anterior circulation LVO but multiple trials, however a few trials failed to demonstrate the benefit of endovascular intervention over medical therapy, furthermore, there is no trial regarding the benefit of permanent stent deployment in the basilar artery over maximized medical therapy. Here we present a patient who presented with right side hemiplegia, facial droop, and dysmetria with National Institute of Health Stroke Scale of 19. CT head and neck angiography revealed acute basilar occlusion. Endovascular procedure was performed with successful thrombectomy utilizing stent retriever followed by placement of balloon mounted stent due to persistent critical basilar stenosis.

Methods
A case report

Results
MRI of the brain revealed acute ischemic stroke of bilateral cerebellar hemisphere, mid and left pons, left cerebral peduncles, and left thalamus. Repeat non‐contrast CT head revealed small bilateral thalamic hemorrhage but due to small size, dual antiplatelet therapy with aspirin and ticagrelor was initiated. After discharge, the patient developed upper extremity deep vein thrombosis for which apixaban was started. Despite dual antiplatelet therapy and anticoagulation, the patient continued to improve. Clinical follow‐up at 6 weeks the patient remained stable with mild residual weakness of the right extremities.

Conclusions
Thrombectomy with subsequent deployment of permanent stent can be considered as a safe and effective measure of basilar artery occlusion.
Abstract Number ‐ 92: Successful thrombectomy with Indigo Aspiration System on diffuse cerebral sinus thrombosis
Authors: Bushnq Saif , Ota Riichi , Neves Gabriel , Montalvan Victor , Windisch Thomas 
Published: April 2023

Introduction
Endovascular treatment for venous sinus thrombosis is challenging. Commonly utilized aspiration catheters in neuro‐interventional procedures have diameters ranging from 2–3 mm and are much smaller than the average diameter of the major cerebral venous sinuses. Penumbra’s Indigo Aspiration System (Penumbra Inc., Place Alameda, CA) is a trackable, large‐lumen (Indigo System CAT7, 7F) catheter and aspiration system that is used for aspiration of thrombi and emboli involving the peripheral venous and arterial systems, as well as pulmonary emboli. Here, we show that this large‐lumen system may safely retrieve and successfully recanalize cerebral venous thrombosis (CVT), addressing the problem of available tools for complete thrombus removal.

Methods
Case report. I wanted to submit this abstract for: ‐Young Investigator Award ‐Best Scientific Abstract Award

Results
Here, we present the first reported case of successful endovascular thrombectomy of cerebral venous sinus thrombosis utilizing Penumbra’s Indigo System (Penumbra Inc., Place Alameda, CA), a minimally‐invasive system with a large‐lumen (Indigo System CAT7, 7F) catheter predominantly used for the removal of thrombi and emboli involving the peripheral arterial and venous systems and for the treatment of pulmonary embolism. A 30‐year‐old female presented with a hemorrhagic infarct of the left posterior temporal lobe secondary to an extensive cerebral venous thrombosis (CVT) extending from the left transverse sinus to the ipsilateral internal jugular bulb. In addition to a continuous heparin infusion, we performed an endovascular thrombectomy with the device mentioned above, resulting in a technically successful radiographic recanalization of the involved sinuses. The patient was discharged home in a stable condition. This case demonstrates that this trackable, atraumatic, large‐bore system can be safe and efficacious, permitting near complete thrombus removal.

Conclusions
Cerebral Venous Thrombosis (CVT) recanalization is an important outcome measure in trials investigating endovascular therapies for dural venous sinus clots.Most endovascular tools used for aspiration of CVT are designed for arterial, not venous, vasculature.Penumbra’s Indigo Aspiration System, a large‐lumen catheter can be considered as a valid, safe, and effective alternative for the treatment of diffuse CVT.
Abstract Number ‐ 95: Common Data Elements Analysis of Mechanical Thrombectomy Clinical Trials for Acute Ischemic Large Core Stroke
Authors: Jabal Mohamed Sobhi , Ibrahim Mohamed , Thurnham Jade , Kallmes Kevin , Kobeissi Hassan , Ghozy Sherief , Hardy Nicole , Tarchand Ranita , Bilgin Cem , Heit Jeremy , Brinjikji Waleed , Kallmes David 
Published: April 2023

Introduction
Various clinical trials addressing large core acute ischemic stroke (AIS) are ongoing from multiple international groups. Future development of clinical guidelines depends on meta‐analyses of these trials calling for a degree of homogeneity of elements across the different studies. The aim of this common data element study was to provide an overview of the key features of pertinent large core infarct trials.

Methods
PubMed and ClinicalTrials.gov databases were screened for published and ongoing clinical trials assessing mechanical thrombectomy in patients with AIS with large core infarct. Nested Knowledge AutoLit living review platform was utilized to categorize primary and secondary outcomes as well as inclusion and exclusion criteria for patient selection in the clinical trials.

Results
The most reported data element was ASPECTS score, but with varied definitions of what compromises large core. Non‐utility‐weighted modified Rankin Score (mRS) was reported in 6/7 studies as the primary outcome, while the utility‐weighted mRS was the outcome of interest in the TESLA trial, all of them at the 3‐months mark, with only LASTE looking for mRS shift at the 6‐months mark. Secondary outcomes had more variations. Mortality is reported separately only in 4/7 trials, all at the 3‐month mark. Additionally, the TENSION trial reports the frequency of serious adverse events, including mortality, at the 1‐week and 12‐month mark.

Conclusions
In the published and the ongoing large core trials, there is a large degree of variability in the collected data elements. Differences in definition and timepoints renders reaching a unified standard difficult, which hinders high quality meta‐analyses and cohesive evidence‐driven synthesis.
Abstract Number ‐ 96: The COGNITIVE study: Cognition and Imaging with Tigertriever
Authors: Singer Justin , Mufti Fawaz Al , Tateshima Satoshi 
Published: April 2023

Introduction
Results of systematic reviews and studies evaluating treatment effects of cerebrovascular interventions on the prevalence of post‐stroke cognitive impairment vary likely due to heterogeneity in populations, sample size, variable treatment effect, and time and methods of cognitive examination. Like thrombolytic therapy, endovascular therapy (EVT) in large vessel occlusion (LVO) stroke is strongly associated with successful reperfusion, reduced mortality, and good clinical outcomes. Nevertheless, the effect of successful reperfusion after EVT on cognitive function remains unexplored.

Methods
Four hundred (400) patients aged 18–75 will be enrolled in the USA and outside USA clinical centers. The primary endpoint will be the association between successful reperfusion, defined as eTICI ≥ 2b50, and cognitive benefit, defined as delta Montreal Cognitive Assessment (MoCA) from 4 days to 180 days post‐EVT or MoCA ≥ 26 at 180 days post‐EVT. Secondary endpoints will include first pass successful revascularization, reduction in hypoperfusion volumes within 24 h, functional evaluations (NIHSS, mRS), MoCA and cognitive battery evaluations, and QOLs at various timepoints, baseline to 180 days post‐EVT. The correlation between cognitive function and stroke characteristics, imaging variables, functional ability, and demographic and socio‐behavioral factors will be explored. Safety endpoints will include all‐cause mortality, symptomatic intracranial hemorrhage within 24 h, and device‐related serious adverse events. Key inclusion criteria are per instructions for use (IFU) and pre‐stroke mRS ≤1. Key exclusion criteria are per IFU, prior hemorrhage or stroke within 3 months, and pre‐existing cognitive impairment and/or dementia.

Results
More study details including the statistical analysis plan and study status will be discussed.

Conclusions
COGNITIVE is a very first multi‐center, post‐market, prospective, single‐arm EVT study to evaluate whether successful reperfusion with the Tigertriever device is associated with cognitive benefit in subjects with LVO. The study is a superiority design to evaluate whether Tigertriever treatment significantly reduces cognitive impairment.