bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 116: Initial first in man clinical case experience with the novel adaptive tip Hippo ‐ Cheetah Aspiration system: a review of 58 AIS cases
Authors: Chaudry I. , Vargs J. , Turk A. , Tuner R. 
Published: January 2025

Objective
The Q'Apel Medical Hippo aspiration system is a novel, adaptive tip catheter system that is capable of passively adapting its tip shape to conform to the thrombus. It includes a Cheetah delivery insert to aid in tracking to the intracranial circulation. We performed the first‐in‐human cases with the Hippo and present our initial experience.

Methods
A single center retrospective review of prospectively collected data from consecutive patients who underwent mechanical thrombectomy for anterior circulation LVO is presented from October 1, 2023 (Hippo US approval) to Februraury 28, 2024. All clinical data was prospectively captured by the Stroke Neurology team. Angiography data was adjudicated by two of the authors. All follow up imaging at 24 hrs was reported by Neuroradiology.

Results
45 Anterior Circulation4 Posterior circulation6 ICAD cases3 other cases58 total cases 58 total Hippo AIS cases were identified from 10/1/2023 to 2/28/2024. Of these, 3 cases included a cervical ICA occlusion, bilateral MCA occlusion and one case where guide catheter access could not be achieved and the procedure terminated, 6 cases of underlying ICAD where Hippo was used in combination for aspiration and/or as a conduit to deliver adjunctive devices, 4 posterior circulation LVO aspiration cases and 45 AIS Anterior circulation LVO procedures.
Of the 45 Anterior circulation LVO cases; 16 (36%) of patients receive TNK. Mean presenting NIHSS was 18.9 and mean discharge NIHSS was 7.5. Mean time of onset to groin puncture was 276 mins, mean time to recanalization was 31 mins. 6 patients had tandem occlusions.
First pass TICI □ 2C rate was 22/45 (49%), Final TICI □ 2B: 40/45 (89%), TICI □ 2C: 36/40 (80%), TICI 3 29/45 (64%). 33/45 (73%) were performed with BGC (Walrus).
5 cases required bailout stent‐retriever. In two cases an additional 070 aspiration catheter was used and in total 14 cases required an adjunct aspiration catheter.
A 90 day mRS of 0‐2 was achieved in 21/45 (47%), 4 patients were lost to follow up, 1 patient has not reached a 90 day end point. 14 patients had evidence of hemorrhage vs contrast staining on 24 hr imaging, 1 classified as PH2. There was one SAH, from a vessel perforation, likely catheter related 1/45 (2%).
Hippo was able to achieve its target location in all but two cases. In one case multiple devices were attempted, finally a velocity microcatheter was used to deliver a stent retriever. In the second case, supraclinoid stenosis prevented Hippo from accessing the M1 and it was used to deliver a RED 43 to the target lesion.

Conclusion
Our initial experience with the Hippo Aspiration system demonstrates it to be safe and efficacious with high rates of reperfusion, low complications and low use of adjunctive catheters. A synergistic effect with BGCs maybe present. Further studies are warranted.
Abstract 140: Safety and Efficacy of Trans carotid Intervention in Multiple Scenarios: Medellin Experience using Direct Carotid access
Authors: Mutis J. , Pabon B. , Torres V. , Vergara J. , Brunet F. , Pelaez F. , Patino M. , Cardozo M. , Arteaga J. , Vargas G. 
Published: January 2025

Purpose
Direct Carotid Puncture (DCP) has been validated such as an alternative route to reach the intracranial vasculature. However, this approach has not been considered routinely in INR.This study was conducted to investigate the feasibility and safety of trans carotid Neuro intervention for a variety of pathologies.

Materials and methods
Since 2018 we implemented a DCP under special considerations to perform a therapeutic approach. A total of 28 patients from our centers were analyzed. Patients were divided into a variety of neurovascular conditions: Carotid Stenting CAS (n = 4), Mechanical Thrombectomy MT (n=10), AVM´s treatment (n=4), intracranial Aneurysms treatment (n=10). Patient demographics, technical data, intervention time, type of intervention, closure device used, local or systemic complications and a patient perception assessment were registered.

Results
Mean age was 64.3 ± 10.3 years. in all cases but two were treated under GA. Major indication to this approach were: anatomical and access limitations in 24 cases and, two patients with Leriche Syndrome. All cases performed with ultrasound US assistance. A 4 Fr. Micro‐ puncture set were used in all procedures and posteriorly a 6Fr. Introducer was inserted. Technical success in all cases (100%) selected. Two patients presented mild vasospasm and resolved using IA vasodilators. All CAS were performed without any complications and none embolic protection device used. For MT(n=10): a SOFIA 6Fr for ADAPT was used in 6 cases with TICI 2b‐3 in all cases. Combined approach was used in four cases, one TICI 2a and one TICI 3. A total of 10 aneurysms were treated with this approach (4 ICA – ophthalmic; 4 MCA and two AcomA) Mean average time of the procedure was 34.5 min. (ranged 9‐59 min) Only one hemorrhagic complication observed at the closure device use. In all cases but one we use Angio‐Seal 6Fr as closure device, in a single case where we used a ProGlide suture device we had a serious complication at the puncture site.

Conclusion
Trans Carotid Intervention TCI. was feasible and safe in selected patients in this small series. A multiple variety of neurovascular conditions would be treated successfully by this way improving the learning curve. Complication rates and clinical outcomes were comparable with those in trans femoral or radial approach.
Abstract 164: Discontinuation and Non‐Publication of Stroke Clinical Studies: A Cross‐Sectional Analysis
Authors: Aljabali A. , Alkhawaldeh I. M. , Abdelhady M. , Hamza A. I. , Ababneh A. , qudah k. , Al‐Amour A. , Shanaah M. , Abualhayjaa M. , Awad H. , Negida A. 
Published: January 2025

Background
Stroke is the second leading cause of both disability and death worldwide, with the highest burden of the disease shared by low‐ and middle‐income countries. In 2022, there are over 101 million people currently living who have experienced stroke globally. Clinical studies in stroke are vulnerable to discontinuation and non‐publication, representing significant sources of research waste in clinical medicine. This study aims to assess stroke clinical studies characteristics and summarize logistic, financial, and practical reasons behind early discontinuation and non‐publications to prevent this in the future.

Methods

ClinicalTrials.gov
was searched for all studies registered between 1 January 2000 and 1 May 2022 and included patients with stroke. Publications from these studies were identified by extensive online searching using the NCT identifier number and other related keywords. Multiple logistic regression analysis was performed to identify characteristics associated with trial discontinuation and non‐publication.

Results
A total of 3720 eligible registered studies were included; 2724 (73.3%) were clinical trials, and 994 (26.7%) were observational studies. Of these, 380 (10.2%) were discontinued. Of the completed studies, there were a total of 1786 (53.5%) non‐published studies. The unadjusted logistic regression analysis revealed that the industrial (OR = 1.37, 95% CI [1.05‐1.79]) and mixed funding (OR = 1.42, 95% CI [1.04‐1.92]) were significant predictors of study discontinuation compared to non‐industrial funding. Furthermore, the small sample size (less than 100) (OR = 2.79, 95% CI [2.13‐3.66]) was also significant. Concerning the non‐publication, a small sample size (less than 100) (OR = 1.68, 95% CI [1.46‐1.93]) was also a significant predictor, while mixed funding (OR = 0,56, 95% CI [0.45‐0.70]) compared to non‐industrial funding has significantly decreased the likelihood of non‐publication. Behavioral interventions were significantly less likely to be discontinued than drug interventions (OR = 0,40, 95% CI [0.27‐0.60]). The Diagnostic interventions were significantly the most likely to be non‐published compared to drug interventions (OR = 3.39, 95% CI [1.85‐6.21]).

Conclusion
There is evidence of non‐dissemination bias in clinical studies of stroke. These biases distort the therapeutic information available to inform clinical practice and raise ethical concerns regarding exposing volunteering participants to potential risks without furthering practice.
Abstract 185: Advancing Acute Ischemic Stroke Treatment: Utilizing Flexible Balloon Guide Catheters via Radial Artery for Thrombectomy
Authors: Radhi H. 
Published: January 2025

Introduction
Acute ischemic stroke is a critical condition requiring prompt and effective intervention. The radial artery approach for endovascular thrombectomy has emerged as a promising alternative to the traditional femoral access, offering several procedural benefits. This abstract summarizes our clinical experiences and observations using balloon guide catheters (BGCs) in treating ischemic stroke through the radial artery.

Methods
Our experience is based on a series of ischemic stroke patients treated with thrombectomy via the radial artery approach using BGCs. We documented procedural details, patient comfort, recanalization success, and any encountered complications. Our primary focus was on the practicality, efficacy, and safety of this method.

Results
In our series, we observed that the use of BGCs facilitated effective and rapid clot retrieval, with successful recanalization rates akin to those reported in larger studies (achieving Thrombolysis in Cerebral Infarction [TICI] scores of 2b/3 in the majority of cases). Procedural times were generally efficient, and patients exhibited a notable reduction in procedural discomfort and post‐operative complications compared to traditional femoral access. Observed complications were minimal and typically manageable, further underscoring the viability of this approach.

Conclusion
Based on our clinical experience, the use of balloon guide catheters in thrombectomy procedures via the radial artery presents a viable and effective alternative to femoral access. This approach not only maintains high success rates in vessel recanalization but also enhances patient comfort and reduces complications. These positive outcomes suggest that radial artery access with BGCs deserves further consideration and wider application in the treatment of acute ischemic stroke.
Abstract 198: Association of GLP‐1 Receptor Agonist Use with Clinical Outcomes in Diabetic Patients Hospitalized for Ischemic Stroke
Authors: Iourinets J. , Viswanath V. , Jhaveri A. , Chahine A. , Sehgal N. , Morsi R. Z. , Goicoechea E. Badillo , Thind S. , Desai H. , Kothari S. A. , Siegler J. E. , Coleman E. R. , Brorson J. R. , Prabhakaran S. , Mansour A. , Kass‐Hout T. 
Published: January 2025

Background and Purpose
Glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) have shown cardiovascular benefits in patients with type 2 diabetes mellitus (T2DM). Given the risk factor overlap between neurovascular and cardiovascular disorders, we aimed to evaluate the association of GLP‐1RA use with clinical outcomes in diabetic patients admitted for acute ischemic stroke (AIS).

Methods
This single‐center retrospective study included diabetic patients aged ≥18 years admitted for AIS from 2015‐2023. GLP‐1RA use was defined as a history of taking GLP‐1RA at admission or being prescribed GLP‐1RA at discharge. The primary outcome was the incidence of new ischemic stroke within 1 year. Secondary outcomes included functional independence (modified Rankin Scale score 0‐2) and mortality at 90 days. Propensity score weighting was used to balance covariates between groups. Logistic regression was used to estimate log odds ratios (LORs) for outcomes.

Results
Of 123 patients, 35 (28%) used GLP‐1RA. The GLP‐1RA group had lower incidence of new ischemic stroke at 1 year (2.9% vs 6.8%; adjusted LOR ‐1.13, 95% CI ‐3.21‐0.95, p=0.28) and higher rates of functional independence at 90 days (67% vs 40%; adjusted LOR 2.38, 95% CI ‐0.12‐4.87, p=0.06) compared to the non‐GLP‐1RA group, but these differences were not statistically significant. Mortality at 90 days was similar between groups (25% vs 26%; adjusted LOR 0.078, 95% CI ‐1.51‐1.67, p=0.92).

Conclusions
In this cohort of diabetic patients admitted for AIS, GLP‐1RA use showed a trend toward reduced incidence of recurrent stroke and improved functional outcomes, although not statistically significant. Larger prospective studies are needed to further evaluate the potential neuroprotective effects of GLP‐1RAs in ischemic stroke.
Abstract 230: Comparison of clinical outcomes and complications in patients undergoing Carotid Artery Stenting (CAS) with or without pre and poststent balloon angioplasty.
Authors: Martucci M. , Ezzeldin M. , Delora A. , Hassan A. , Siddiq F. , Sheriff F. , Kan P. , Janjua N. , Asif K. , Grandhi R. , Alaraj A. , Niazi M. , Mansour O. , Chen M. , Bushnaq S. , Tanweer O. , Navpreet B. , Miller S. , Colina G. , Rodriguez G. , Maud A. , AlMajali M. , Barakat B. , Edhayan G. , Froukh M. , Salah W. , Nico E. , Ashraf S. , Radiaideh Y. , Quispe‐Orozco D. , Zaidat O. , Hussain M. 
Published: January 2025

Background and Objective
Carotid artery stenting (CAS) is a procedure that has been established as a safe and effective alternative to carotid endarterectomy in high surgical risk patients. There are procedural questions that remain unanswered, specifically, the safety of pre‐stent balloon angioplasty versus post‐stent versus both. The objective of our study is to understand the risk and safety of these procedural techniques.

Methods
Multicenter retrospective data related to angioplasty balloons, stents, complications due to pre and post‐stent angioplasty along with the modified Rankin score (mRS) before and after the procedure were collected from January of 2015 until December of 2022. Statistical analysis was performed to correlate this data with risks of complications and clinical outcomes.

Results
A total of 1355 patients were enrolled. We found that patients who underwent pre‐stent angioplasty, or both (pre and post‐stent angioplasty) had a higher risk of complications compared to those who only had post‐stent angioplasty. There were more complications in patients who did not undergo post‐stent angioplasty as compared to those who did undergo angioplasty (p=0.018, OR=0.513). Follow‐up MRS at 30‐90 days was higher if the balloons in both pre‐stent angioplasty (p=0.016) and post‐stent angioplasty (p=0.020) stent angioplasty were not inflated to nominal pressure. Follow up MRS was statistically higher (p=0.01) in patients with open‐cell stents than closed‐cell stents. Open‐cell stents were more likely to undergo post‐stent angioplasty (p<0.001) while closed‐cell stents were more likely to undergo pre‐stent angioplasty (p=0.002).

Conclusions
Patients who underwent post‐stent angioplasty alone had less risks of complications compared to pre‐stent angioplasty or combination. This is contrary to prior studies published on this subject and could be related to improvement in technique and in technology in recent years. There is a higher rate of post‐stent angioplasty in patient who received open cell stents, but these also had higher mRS at 30‐90 days compared to closed cell stents.
Abstract 234: Current Stroke Solutions Using Artificial Intelligence: A Review of the Literature
Authors: Elrefaei A. , Al‐Janabi O. M. , Bakir D. , Mahmood Y. M. , Elgazzar T. , Gajjar A. , Alateya A. , Jha S. K. , Ghozy S. , Kallmes D. F. , Brinjikji W. 
Published: January 2025

Introduction
Recently, artificial intelligence (AI) has emerged as a tool for improving stroke diagnosis, enhancing critical decision‐making, and improving acute ischemic stroke (AIS) care. AI‐based platforms such as RapidAI, Brainomix® and Viz.ai, amongst others, have been studied to improve image analysis, detect large vessel occlusions (LVO), and predict patient outcomes in a timely manner. However, there is limited data pertaining to the impact of these AI platforms on real‐world patient care and management. The objective of this literature review is to evaluate the effectiveness and accuracy of AI platforms in facilitating the treatment of AIS.

Methods
Following the PRISMA guidelines, a comprehensive systematic review was conducted using PubMed, Embase, Web of Science, and Scopus databases. Studies that meet the inclusion criteria were included. The final selection comprised studies that provided detailed analyses of AI tools, focusing on their sensitivity, specificity, accuracy, and comparative effectiveness.

Results
A total of 31 studies were included of which 29 studies primarily focused on detecting AIS or LVO, and 2 studies explored the use of AI in hemorrhagic strokes. AI tools including Viz.ai, RapidAI, and Brainomix®, demonstrated great utility in stroke management. These tools contributed to significant reductions in door‐to‐puncture times, enhanced accuracy in estimating core and penumbra volumes, and provided reliable assessments of ASPECT scores and the presence of intracranial hemorrhage. RapidAI was noted for its ability to rapidly identify LVOs. Viz.ai showed high accuracy in detecting both AIS and LVO, with sensitivity and specificity comparable to expert human interpretation. Brainomix® offered advantages in evaluating stroke severity and predicting outcomes, thereby aiding in the decision‐making process for intravenous thrombolysis and endovascular thrombectomy.

Conclusion
Integrating AI tools in stroke care proves to be a valuable tool for aid diagnostic and management measures for greater accuracy and faster decision‐making, leading to improved patient outcomes. Considering the advancement in technology, AI‐based platforms are escalating to become vital assets for personalized care, providing a new level of hand‐tailored and expedited stroke management in the near future.
Abstract 258: Efficacy and Safety of Trans‐radial Versus Trans‐femoral Access for Mechanical Thrombectomy in Acute Ischemic Stroke
Authors: Rehman M. Aemaz ur , Rehman M. U. , Rehman A. U. , Ali H. , Rahman M. U. , Ghozy S. , Tariq M. , Kallmes D. F. 
Published: January 2025

Introduction
Mechanical thrombectomy for ischemic stroke has traditionally been performed via transfemoral access (TFA). However, newer literature on the subject suggests that trans‐radial access (TRA) may be equally efficacious.

Materials and Methods
Using relevant keywords, online databases (including Pubmed, Google Scholar, Embase, and Cochrane) were queried from inception until May 2024. Abstracts and full texts were screened according to Preferred Reporting Items for Systematic Reviews and Meta‐analysis (PRISMA) guidelines to shortlist studies that met the inclusion criteria. Risk of bias assessment was performed according to the New Castle Ottawa Scale and Cochrane risk of bias tool 2.0. All dichotomous outcomes were reported as odds ratio (OR) with 95% confidence interval (CI). RevMan software was used to perform the statistical analysis.

Results

Thirteen observational studies and one randomized clinical trial were included in this meta‐analysis. The total sample size was 4973, of which 4074 patients (81.2%) were included in the TFA group and 899 (18.8%) were included in the TRA group. No significant differences were observed between the two groups in terms of successful recanalization (OR=0.92; 95% CI 0.66‐1.27;
p
=0.60), first‐pass recanalization (OR=0.84; 95% CI 0.69‐1.01,
p
=0.06), access to reperfusion time (mean difference ‐2.99 minutes; 95% CI ‐8.33 to 2.44,
p
=0.27) and favorable functional outcome. Mortality and rates of intracranial hemorrhage were comparable between the two groups as well, but access site complications were significantly lower in the TRA group (OR=0.57; 95% CI 0.37‐0.88;
p
=0.01).

Conclusion
Trans‐radial access for thrombectomy in large vessel acute ischemic strokes is comparable to trans‐femoral access in terms of efficacy and has a lower incidence of access site complications. Randomized clinical trial data on head‐to‐head comparison of two techniques is limited, underscoring the importance of conducting pragmatic clinical trials.
Abstract 276: Evaluating the Frequency of Prestroke Cognitive Impairment Among Stroke Patients: Neurological and Functional Correlates
Authors: Elsayed M. M. , Khabiry H. , Mohamed Y. , Swelam K. , Ramdan S. 
Published: January 2025

Introduction
Prestroke cognitive impairment is a critical factor that can significantly impact stroke recovery, yet it is often underrecognized. This study aims to quantify the frequency of prestroke cognitive impairment among stroke patients and to explore its neurological and functional correlates.

Methods
We conducted a comprehensive assessment of 520 stroke patients, employing the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) to diagnose cognitive impairment prior to stroke. Neurological evaluations included the assessment of neuropsychiatric symptoms using the Neuropsychiatric Inventory Questionnaire (NPI‐Q), while functional abilities were measured through Activities of Daily Living (ADL) scales. Additionally, neuroimaging analyses were performed to identify structural brain abnormalities.

Results
Our study found that 32.5% of stroke patients exhibited cognitive impairment prior to their stroke. This impairment was strongly associated with more severe neuropsychiatric symptoms, as evidenced by higher NPI‐Q scores (5.5 ± 4.9 vs. 1.7 ± 2.3, p < 0.001), and greater functional limitations, reflected in ADL scores (1.8 ± 1.9 vs. 0.3 ± 0.8, p < 0.001). Regression analyses further identified older age, the presence of white matter lesions, and medial temporal lobe abnormalities as significant neurological correlates of cognitive impairment.

Conclusion
The study highlights a substantial prevalence of prestroke cognitive impairment in stroke patients and its strong association with both neuropsychiatric symptoms and functional limitations. These findings underscore the importance of early and proactive cognitive assessments in stroke populations. By identifying cognitive impairment before a stroke, healthcare providers can tailor rehabilitation strategies more effectively, potentially leading to improved outcomes for stroke survivors. Integrating routine cognitive evaluations into stroke care protocols may enhance patient recovery and overall quality of life.