bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 186: Adverse events and failures with Cerenovus CEREGLIDE 71 Intermediate Catheter: An analytic review of the FDA MAUDE database
Authors: Aljabali A. , Alkhawaldeh I. M. , Abualhayjaa M. , El Din Moawad M. H. 
Published: January 2025

Introduction/Purpose
Recent literature has suggested that direct aspiration catheters as a first‐pass approach are a viable alternative to stent retriever‐based methods in mechanical thrombectomy for acute ischemic stroke. The Cereglide 71 aspiration catheter, launched by Cerenovus with TruCourse Technology, is specifically designed to navigate challenging anatomical conditions with reliable trackability and durable delivery.This study aims to evaluate the safety of the Cereglide 71 aspiration catheter by analyzing reports and data from the Manufacturer and User Facility Device Experience (MAUDE) database.

Methods
All patient‐ and device‐related reports from November 2023 onwards were obtained, screened, and compiled from the MAUDE database using the codes NRY and QJP. The reports were filtered to distinguish between patient‐related (PR) and device‐related (DR) events. Data filtering, organization, and analysis were performed using Microsoft Excel 2021 and Jamovi. Descriptive statistics were used to assess reporting frequency.

Results
During the study period, a total of 36 medical device reports were collected, comprising 27 device‐related problems and 13 patient‐related adverse events.The patient's adverse events included multiple cases of intracranial hemorrhage 5 (38%), thromboembolism 3 (23%), vascular dissections 2 (15%), ischemic stroke 1 (7%), carotid‐cavernous fistula 2 (15%), and cerebral vasospasm (15%). The device problems involved issues such as material twisting, bending, and deformation, often leading to cracks or stretching. Difficulties in advancing or retracting the device were frequently reported, along with fluid or blood leaks, component detachment, and accessory incompatibility. The reports lacked demographic data, with only three reports including patient age and gender. Nineteen reports were submitted by physicians, and only 12 catheters were returned to the manufacturer for further analysis.

Conclusion
This study emphasizes the importance of improved post‐market surveillance to enhance patient outcomes. To the best of our knowledge, this is the first report detailing complications related to the Cereglide 71 aspiration catheter as documented in the FDA MAUDE database. By utilizing real‐world data, the study identifies key complications relevant to clinical practice, Surgeons should be mindful of the range of potential complications to better manage patient expectations and optimize surgical preparedness.
Abstract 190: Anatomical variants in the circle of Willis as a risk factor for intracranial aneurysms: a study in the Mexican Population using diagnostic angiography.
Authors: Arellano P. Martinez , Aburto Y. , Marquez‐Moreno J. , Serrano‐Arias F. , Montenegro‐Rosales H. , Lopez‐Mena D. 
Published: January 2025

Introduction/Purpose
Hemorrhagic stroke due to ruptured intracranial aneurysms comprises one of the lead causes of overall disability in Mexico and Latin America. The relationship between anatomical variants in the Circle of Willis/Cerebral Arterial Circle (CAC) and Intracranial Aneurysms (IA) remains an ongoing research subject.

Materials/Methods
We performed a retrospective study of cerebral digital subtraction angiographies at the Interventional Neuroradiology Department of the National Institute of Neurology and Neurosurgery in México, between July 1, 2020, and January 1, 2022. Data regarding Circle of Willis conformation, Avs and IA incidence, and demographic characteristics was collected.

Results
A total of 150 Diagnostic angiographies were studied, 96 procedures(64 %) belonged to female patients. We registered 144 AVs in the CAC in 96 (64%) angiograms. 75 (50%) were positive for IA. 30 (20%) were reported as non‐pathological. Significant relationships were found between aneurysms in the anterior circulation and A1 segment hypoplasia/ agenesis and IA in the posterior circulation and Posterior Cerebral Artery fetal origin/ hypoplasia. The frequency of angiograms diagnosed without pathology was significantly higher in the category of CAC without variants (80%) than that of pathological angiograms (48.76%) (p=0.003). AVs were found to be more common in patients with aneurismatic pathology than in those without pathology (p=0.048).

Conclusions
We found a significant relationship between the presence of IA and Avs, especially between specific Avs and IA incidence in the anterior and posterior circulation. This study offers new insights into the understanding of AVs for diagnostic and therapeutic purposes in vascular pathology.
Abstract 210: Brain death ancillary testing after the 2023 AAN guidelines: The need for CTA & DSA to focus on the brainstem arteries and veins.
Authors: Kapinos G. , Anderson E. , Roberts M. , Kellner C. , Shoirah H. , Shigematsu T. , Lopez L. Salgado , Farraye J. , Hickman Z. 
Published: January 2025

Purpose
We propose CTA as a stewarding screen and bridge to DSA, TCD or SPECT, for better resource‐utilization in establishing cerebral circulatory arrest (CCA) in scenarios of death by neurologic criteria (DNC) but incomplete clinical exam. French scoring systems focusing on brainstem perfusion are best‐suited to cases with apnea test unavailable, pediatric or trauma cases, or skull base fractures.

Methods
We critically appraised the current American Academy of Neurology (AAN) guidelines advocating for specific brain death ancillary testing (BDAT). Complementing with the World Brain Death Project (WBDP) Lewis A et al. JAMA 2020 and Srairi M et al. report in Eur J Radiol. 2020, our study establishes that a focus on arteries perfusing and veins draining the brainstem on CTA or DSA can yield accuracy with CCA gold standard. We substantiate this viewpoint with illustrations from clinical experience at a level 1 trauma center with clinical pearls and pitfalls in open skull cases, with pediatric and trauma challenges.

Results
The 2023 AAN DNC guidelines specify adult and pediatric metabolic abnormality ranges, but we posit in this scenario that neurophysiologic modalities may be preferred over DSA or SPECT. Trauma and pediatrics with open skull cases are left with DSA as sole accepted modality, with CTA deemed unacceptable by the guidelines, yet DSA is quite resource‐intensive. Preservation of cortical branches on CTA or DSA, SPECT islands of viable tissue under craniectomy sites, TCD not recommended in open skull situations, making angiographic nuclear and sonographic tests illogical choices in many cases in our experience. Skull base fractures and unsafe apnea tests represent the vast majority of scenarios requiring BDAT. In these cases, we used TCD of the VBJ, or CTA‐CTV focusing on the absence of brainstem venous drainage using the French scoring system, as more topographically pertinent and well‐suited.

Conclusions
BDATs have high false positive or negative rates due to particular clinical pitfalls. Our study proposes a new paradigm with topography‐based selection of the BDAT. This appraisal criticizes the guidelines for their blanket exclusion of EEG, N20, BAERs and CTA, especially in pediatric and trauma cases. Our experience applying French scores to CTA‐CTV focusing on the brainstem, when this is the cerebral region at play and clinically appropriate, allowed us to make DNC determinations more accurate and pertinent to each case. We call for a revalidation of CTA and comparison to DSA with same preconceived focus on brainstem arteriovenous flow. further, we look to subsequently prove that DSA is a superfluous tool in this redefined framework.
Abstract 223: Chronic pain prevalence and severity associated with stroke survivorship
Authors: Karim N. , Wang S. , Long‐Mills E. , Tumin D. 
Published: January 2025

Introduction/Purpose
Stroke survivors experience multiple long‐term consequences that significantly impair their quality of life, including chronic pain in some patients. Excess prevalence, severity, and impact of chronic pain among stroke survivors is unknown, as prior studies have lacked comparator groups without a history of stroke. We used nationally representative data to compare the burden of chronic pain according to history of stroke survivorship in a nationally‐representative survey of US adults.

Materials/Methods
This study analyzed deidentified data from adult respondents in the 2019‐ 2021 and 2023 rounds of the National Health Interview Survey (NHIS), a cross‐sectional interview survey conducted by the CDC. The primary outcome was prevalence of chronic pain, defined as pain persisting or recurring over the 3 months before the interview. The primary exposure was lifetime experience of a stroke. Secondary outcomes evaluated among respondents with chronic pain included severity (1‐3 scale), impact on work (1‐4 scale), and impact on family life (1‐4 scale), with higher scale items indicating greater severity or impact.

Results
Based on an analytic sample included 105,329 adults, we estimated 3% had experienced a stroke and 22% were experiencing chronic pain (including 48% of stroke survivors). On adjusted binomial logistic regression, stroke survivorship was associated with higher odds of reporting chronic pain (odds ratio [OR]=1.63, p<0.001). On adjusted ordinal logistic regression, stroke survivorship was also associated with more severe pain, (OR=1.51, p<0.001), greater pain impact on life and work (OR=1.93, p<0.001), and greater pain impact on family life (OR=1.86, p<0.001).

Conclusion
Stroke survivorship is independently associated with a higher prevalence and greater severity of chronic pain compared to the general population. High prevalence of chronic pain among stroke survivors suggests the need for further research on how different types of strokes (not limited to lacunar or thalamic) may result in poststroke chronic pain. These findings emphasize the need for targeted intervention and increased attention to managing chronic pain among stroke survivors.
Abstract 238: Detachment of stent retriever device in mechanical thrombectomy for acute ischemic stroke
Authors: Kati S. Delibas , Hasoğlan M. Gürsoy 
Published: January 2025

Introduction/Purpose
Mechanical thrombectomy in acute ischemic stroke brings out some undesired events during the procedure. Device related complications is one of the challenging problems. The detachment of trevo stent retriever is a rare situation and can be handled in different ways.

Materials/Methods
82 year old male patient was referred to ER with a sudden hemiparesis in the last 70 minutes. He was given apiksaban therapy for atrial fibrillation and known to use regularly. He was diagnosed with left MCA thrombosis which seemed to be the cause of this stroke. As he was under DOAC therapy the only way was to perform EVT. The procedure lasted in 18 minutes and we had a first pass effect. But the final screening showed that the cage of the trevo stent retriever was still in the MCA territory letting the blood flow properly. So instead of removing the remnant stent, we decided to give dual antiplatelet therapy because of the MCA stenosis. The patient covered from this period with mild neurologic defisits but after 2 months he passed away because of rectal bleeding which was suppposed to be the result of a underlying colorectal cancer.

Results
Stent retriever detachment is not common in the literature. Even trevo stent retriever detachments is much more rare. In this case the vascular curves and the ICAD of the arteries seem to cause this complication even the procedure was smooth.

Conclusion
It is important to evaluate the device complications properly. Mechanical removement can be applied if possible but it will be good to remember that sometimes medical approach can also stabilise the situation as well.
Abstract 267: Endovascular Thrombectomy in Patients with Anterior Circulation Stroke Presenting 6 Hours After Last Known Well: A Systematic Review and Meta‐analysis of 10 Randomized Clinical Trials
Authors: Essibayi M. , Mortezaei A. , Hajikarimloo B. , Taghlabi K. , Majidpoor J. , Hasan Z. , Abdalkader M. K. , Dmytriw A. , Rahmani R. , Nguyen T. , Kasab S. Al , Altschul D. 
Published: January 2025

Background
Several randomized trials have evaluated the benefits of endovascular thrombectomy (EVT) for anterior circulation large vessel occlusion strokes presenting beyond 6 hours of the last known well (LKW). We aimed to synthesize the results from these trials to provide high‐level evidence regarding EVT treatment for patients presenting in the late window.

Methods
A systematic search was conducted through four electronic databases, with no language restriction. Binary outcomes were analyzed using the risk ratio (RR) and 95% confidence interval (CI), while continuous outcomes were analyzed using the standardized mean difference (SMD) and 95% CI.

Results
Out of 2824 patients from 10 trials comparing EVT plus BMT and BMT alone among patients with AIS who presented beyond 6 hours of LKW, 1871 patients (n=981 EVT, n=890 BMT) were included in the analysis. The results showed benefits toward the EVT than BMT alone in Modified Rankin Scale (mRS) 0‐1 (RR= 1.84, p‐value < 0.0001), mRS 0‐2 (RR= 2.3, p‐value= 0.0064), and mRS 0‐3 (RR= 1.64, p‐value < 0.0001) at three months. No significant difference between EVT and BMT alone groups was found when analyzing either 90‐day mortality or symptomatic intracranial hemorrhage. Subgroup analysis showed that patients with large core stroke derived more benefits from thrombectomy than patients with non‐large core stroke in terms of 90‐day mRS 0‐2 (RR= 2.5, P‐value < 0.0001). However, we did not find significant difference between perfusion vs non‐perfusion imaging modalities in 90‐day mRS 0‐2 and mortality.

Conclusion
These findings strengthen the previous evidence for the benefits of thrombectomy over medical treatment in managing patients with stroke, even with large ischemic regions in the late time window.
Abstract 271: Enhancing Medical Student and Trainee Exposure to Neurointervention through Neuroendovascular Simulation: An Educational Interventional Study
Authors: Khalid F. , Lazzari Z. , Desai S. , Kenmuir C. , Anderson A. , Haussen D. , Dolia J. 
Published: January 2025

Introduction
Mechanical thrombectomy (MT) represents a paradigm shift of treatment in modern medicine. However, a significant awareness gap persists amongst medical students and neurology trainees regarding MT and neurointervention, both domestically and globally. This study aimed to evaluate the impact of a targeted educational workshop combining didactic lectures and hands on neuroendovascular simulation to enhance awareness of this subspeciality and as well as global stroke disparities.

Materials/Methods
We conducted a pre and post intervention study involving 43 medical trainees spanning in training from first year of medical school to residents (24% M1, 24% M2, 12% M3, 5% M4, 12% resident) recruited through the Student Interest Group in Neurology (SIGN) at our hospitals’ affiliated medical schools. The intervention comprised of didactic sessions discussing neuroendovascular training pathways, global stroke care disparities and women in Neuro‐IR, followed by a hands on neuroendovascular workshop simulating MT and clot science. Participants completed pre and post intervention surveys assessing knowledge and interest in neuroendovascular procedures. Survey completion rates were 100% pre intervention and 77% post intervention.

Results
Pre‐intervention data revealed limited exposure to neuroendovascular procedures, with only 26% reporting prior exposure during medical training. 62% of participants self‐reported as “not at all knowledgeable” or “not very knowledgeable” about neurointerventional radiology. Only 59% were familiar with mechanical thrombectomy, and 40% were aware of its utilization rate for large vessel occlusions in the USA. Post‐intervention, 100% of participants reported increased awareness of specialties involved in neurointervention and conditions amenable to neuroendovascular treatment. 97% expressed confidence in explaining mechanical thrombectomy to peers. All participants reported enhanced understanding of local and global neurointerventional service needs. Interest in pursuing further training in neurointervention increased by 64%, with 96% indicating likelihood to explore a career in the field. 70% expressed inspiration to consider working in underserved areas. Participants suggested earlier exposure in training, expanding these workshops throughout medical schools, and structuring a medical student elective would impact their understanding and interest within neurointervention.

Conclusion
This study demonstrates the significant impact of a targeted educational intervention on medical trainees’ awareness and interest in neurointerventional radiology. The findings emphasize the importance of early exposure to this subspecialty, particularly given the variability in training center resources. Implementation of similar workshops could address the current knowledge gap and potentially influence career trajectories in this critical field.
Abstract 277: Examining the Impact of Area Deprivation on Endovascular Stroke Therapy Access
Authors: Ebirim E. , Le M. , Ballekere A. , Azeem H. , Iyyangar A. , Lee E. , Sheth S. 
Published: January 2025

Intro & Background
Equitable access to healthcare is heavily impacted by socioeconomic factors, however, the effects of such disparities in accessing life‐saving stroke treatments remain incompletely characterized. Here we explore the impact of disparities on access to endovascular treatments for large vessel occlusion acute ischemic stroke (LVO AIS).

Methods & Materials
From our prospectively maintained multi‐hospital registry of four Comprehensive Stroke Centers, we identified patients 18 years or older with LVO AIS from January 2019‐ June 2020. Patient addresses and zip codes were matched to census‐tract level area deprivation index (ADI) scores obtained from Neighborhood Atlas (U. Of Wisconsin). ADI is a validated neighborhood‐level measure that utilizes variables such as income, education, and employment to quantify the level of deprivation in an area. The primary outcome was utilization of endovascular thrombectomy (EVT) by ADI quartile, adjusted for age, ASPECTS, and NIHSS, and was determined using multivariable logistic regression and expressed as OR [95% CI].

Results
Among 637 patients with LVO AIS, the median age was 68, 46% were female, 64% were white, 28% were black, and 19% identified as Hispanic. Median ADI was 57 IQR [32‐78]. Notably, non‐Hispanic Black (NH‐Black) patients had the largest proportion 48.9% (N=66) of those with the highest ADI scores ranging from 79‐100. Comparatively, non‐Hispanic White (NH‐White) patients represented the largest population 67.7% (N=84), of those with the lowest ADI scores of ≤31. Greater ADI scores were associated with a higher prevalence of stroke risk factors, including hypertension, type 2 diabetes, prior stroke, and hyperlipidemia. NIHSS, pMRS, ASPECTS, final TICI scores, 90‐day disability outcomes, and discharge disposition were comparable across the ADI quartiles. In the univariable analysis, patients with AIS LVO in greater ADI neighborhoods were less likely to undergo EVT (61% vs 67% vs 61% vs. 50%, ADI quartiles least to greatest respectively, p=0.01). In the multivariable analysis adjusted for age, ASPECTS, and NIHSS [1], higher ADI regions were less likely to receive EVT intervention (OR 0.73, 95% CI (0.59‐0.91), p<0.01).

Conclusion
Patients residing in disadvantaged neighborhoods (greater ADI regions) may have reduced access to EVT, despite comparable acute stroke presentation symptoms. These findings are consistent with prior studies demonstrating poorer health outcomes in these populations.
Abstract 279: Factors Affecting Oral Anticoagulation Use Amongst Patients With Atrial Fibrillation
Authors: Shaikh A. , Kandel A. , Ouf A. 
Published: January 2025

Introduction/Purpose
Atrial fibrillation (AF) is a common cardiac arrhythmia that increases the risk of stroke. Oral anticoagulants (OACs) are highly effective in reducing this risk. Despite the proven efficacy of OACs, non‐compliance remains a significant issue, often due to lack of health literacy amongst patients. Furthermore, a considerable number of eligible patients are not even prescribed OACs. Although various factors contribute to the underuse of OACs, limited research has explored the impact of patients’ attitudes and knowledge about OACs. Thus, the primary aim of this study is to identify the compliance rate of OACs among AF patients, and to explore the differences in attitude, education level, and knowledge that may influence OAC usage.

Methods
The research involved a prospective questionnaire‐based survey, conducted among patients with a known history of AF who presented at our institution. Descriptive statistics were used to describe patient characteristics, adherence to OACs, knowledge regarding OACs, and attitudes toward OACs. Values were expressed as medians for continuous data, and as counts and percentages for categorical data. Bivariate analyses, such as analysis of variance and t‐tests, were used to assess the relationships between these variables for both categorical and continuous data. Additionally, a binary logistic regression was employed to evaluate whether patients’ perceptions and socioeconomic status could predict non‐adherence to OAC therapy.

Results
In the OAC knowledge section, participants answered 65% of questions correctly on average, with a range of 45‐80%. Additionally, 71.4% reported missing more than one dose of their medication, with the most common reason being forgetfulness. Of these participants, 71.4% feared stroke more than severe bleeding, while 14% feared bleeding and another 14% were undecided. When asked about the level of stroke risk that would justify OAC use, responses varied: 14% said their risk of stroke would not influence OAC use, and 14% were uncertain. Of those who provided risk estimates, 28% chose a >2% risk threshold, 7% chose 5%, 28% selected 25%, and 7% opted for a 50% risk threshold.

Conclusion
Non‐adherence to OAC therapy is a persistent issue that requires further investigation. While the small sample size limited the ability to draw statistically significant conclusions, the preliminary data revealed trends in patient attitudes and compliance. Forgetfulness was the most frequently cited reason for non‐adherence. Interestingly, most non‐adherent patients feared stroke more than bleeding but did not fully understand the purpose of anticoagulation therapy. A larger sample size is necessary to better evaluate the correlation between OAC compliance, patient knowledge, and socioeconomic status.