bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract Number ‐ 187: Short‐term Clinical Outcomes Amongst Patients On Anticoagulation and DAPT Who Underwent Stenting and Mechanical Thrombectomy
Authors: Saei Hamzah M , Desai Sohum , Ghozy Sherief , Aytenfisu Ermias , Dharwadkar Niti , Hassan Ameer 
Published: April 2023

Introduction
Dual antiplatelet therapy has long been established as the preferred treatment option for patients with intracranial or extracranial stenting. Anticoagulation is the preferred treatment option for patients at high risk of stroke with embolic risk factors. There is no data currently available analyzing patients presenting with acute ischemic stroke on anticoagulation who require an intracranial and or extracranial stent (IC/EC), requiring DAPT and anticoagulation with mechanical thrombectomy. Our objective is toinvestigate differences in recanalization and outcomes as well as safety of DAPT and AC in the setting of AIS post MT with stenting when compared to patients without AC.

Methods
A retrospective search at a large comprehensive stroke center was conducted and data was analyzed from 2013 to 2022. Patients presenting with AIS on AC who had MT and required IC/EC stent were selected and compared to patients not on AC. Outcomes were measured as symptomatic ICH and mortality. Patient demographics, stroke risk factors and stroke severity were abstracted amongst other variables.

Results
There were 301 patients out of 917 (42.9% Female) who presented with anticoagulation use prior to mechanical thrombectomy requiring ic/ec stent placement and DAPT therapy. See Table 1 for baseline demographics. Symptomatic ICH was seen in 24 (7.9%) compared to 50 (8.1%), Odds ratio 0.86/ p‐value = 0.573, Mortality was seen in 51 (16.9%) patients who received DAPT and a/c compared to 129 (20.9%) (OR 0.67) p = 0.028. Logistic regression model did not show any significant difference (See Table 2).

Conclusions
There was no statistical difference in symptomatic ICH in acute ischemic stroke patients treated with mechanical thrombectomy and acute stenting on anticoagulation when compared to those without anticoagulation. There was statistical difference in mortality and DAPT/AC actually had lower mortality rates. This data suggests that performing intracranial and extracranial stenting in the acute stroke setting while on anticoagulation and adding DAPT is safe. A larger multicenter study with longer follow up is needed to further confirm these findings.
Abstract Number ‐ 202: Multispecialty Involvement in Neuroendovascular Interventions
Authors: Brown Nolan , Steiger Kyle , Singh Rohin , Shahrestani Shane , Stonnington Henry , Catapano Joshua , Srinivasan Visish , Gendreau Julian , Patel Naresh , Erben Young 
Published: April 2023

Introduction
While neurovascular surgeries have largely been performed by neurosurgeons, the advent of endovascular procedures has produced increasing involvement of other specialists in this arena (i.e. neurologists and radiologists).This study aims to analyzethe involvement of different specialties within theneuroendovascular workforce by characterizingthem by their primary specialty.

Methods
The Medicare Provider Utilization Database was queried from 2013 to 2019 for all primary Current Procedural Terminology (CPT) codes identified by the American Medical Association as pertaining to endovascular procedures of the nervous system (61623, 61624, 61630, 61635, 61626, 61645, and 61650). We counted the number of unique providers in respective fields (neurology, neurosurgery, and radiology) who performed these procedures. Statistical analyses, including data aggregation, exploratory analysis, and propensity adjustment, were performed using R, version 4.0.1 (The R Foundation, Vienna, Austria). The two‐sided Mann‐Kendall trend test, a non‐parametric statistical test that assesses for monotonic trends in either an upward or downward trend, was utilized to assess for trends over time. Within each year analyzed, a Chi‐squared test for trend in proportions was used. A significance level of 0.05 was used.

Results
In 2013, neurosurgeons comprised 45% of the workforce performing these procedures, neurologists were 9%, and radiologists were 47%. By 2019, neurosurgeons decreased to 34.5% of the workforce, while neurologists increased to 21.5%, and radiologists decreased slightly to 44%. Neurologists were the only field in which the proportional shift in providers was noted to have a significant change in trajectory (p:0.04), an upward trajectory. Overall proportional differences between respective specialists were statistically significant each year (p< 0.01).

Conclusions
Neurologists are increasingly performing endovascular procedures. Increased communication and coordination between specialties can improve disparities in care to ensure adequate access to neurovascular care across the US.
Abstract Number ‐ 203: #BEFASTChallenge: Social Media Dance Campaign for Stroke Symptoms Awareness
Authors: Fils Aaron J , Aroor Sushanth , Ramakrishnan Pankajavalli , Ancheta Selina , Tipirneni Anita , El‐Ghanem Mohammad , Al‐Mufti Fawaz , Vora Nirali , Lamb Lisa , Potter‐Vig Jennifer , Moller Mecker , Yavagal Dileep 
Published: April 2023

Introduction
Public stroke education campaigns have traditionally utilized mass media. We hypothesized that a worldwide stroke awareness social media campaign, utilizing dance videos to express the BE‐FAST acronym for stroke signs and symptoms, could reach a large audience at a low cost.

Methods
Mission Thrombectomy 2020+ officially launched the #BEFASTChallenge, a Social Media (SoMe) public stroke educational campaign, on May 15, 2022, World Stroke Thrombectomy Day, after an internal “lead‐in” phase starting the first week of May 2022. The campaign was volunteer designed and implemented. The public and their followers were encouraged to post a video of their dance depicting each letter of BE‐FAST, tag the post with #BEFASTChallenge, and nominate others to participate. We tracked the SoMe posts from May 4th through July 13, 2022, on Facebook (FB), Twitter (TW), and Instagram (IG) platforms by searching #BEFASTChallenge on each SoMe site. We ascertained campaign adoption, public reach, and interaction by measuring original posts, views, likes, retweets, shares, and comments.

Results
There were 4 countries represented in the original posts on SoMe with the vast majority being from the US. The first post was on May 4, and the last was on July 13 (71 days), resulting in a daily average of 0.55 posts. The largest number of posts occurred on the launch date (16 posts). There were 39 original posts, which accumulated 170 retweets, 44 quote tweets, 755 likes, 32 comments, and 14 shares. The videos had 13,821views (Table 1).

Conclusions
We report that the preliminary analysis of a volunteer‐driven SoMe public stroke campaign utilizing dance to express stroke symptoms demonstrates feasibility, reaching a modest audience directly with good interaction. A similar professionally implemented SoMe campaign could lead to increased and more sustained user engagement to raise public stroke symptom awareness.
Abstract Number ‐ 204: Robotics in Neuro‐Endovascular Field: Back to the Future
Authors: Doheim Mohamed F , Mostafa Mohamed Abdelhady , Elfil Mohamed , Kamal Abdallah 
Published: April 2023

Introduction
For more than three decades, robotic assisted surgery has been proposed, studied and put into action clinically. Likewise, it was cleared by the Food and Drug Administration for percutaneous coronary intervention in 2012 (K120834) and peripheral vascular intervention including carotid intervention in 2018 (K173288), but has not yet received clearance for intracranial neurovascular intervention in the USA. Recently, several pilot clinical studies assessed robotically performed neurointerventions.

Methods
We performed comprehensive electronic search till July 2022 on PubMed/Medline to retrieve all relevant studies and data were extracted for baseline characteristics, design, procedure type, safety and feasibility outcomes for qualitative synthesis.

Results
Our results yielded nine single center studies in UK, USA and China performed since 2015. The performed procedures included diagnostic cerebral angiography (36 patients), caroti aartery stenting (37 patients), unspecified robotic assisted intracranial intervention (18 patients) and stent‐assisted coil embolization of a basilar artery aneurysm (one case). The used robotic systems included Corpath GRX (5 studies), Magellan (2 studies), RobEnt (one study) and VIR‐2 (one study). The robotic assisted neurointervention was successful clinically without complications across all studies and for all procedures. The learning curve sounded promising but there were limitations in the design of systems for completing all steps robotically.

Conclusions
Robotics assisted procedures appear to be feasible and safe in neuro‐intevention field. Advantages include high accuracy, stability, safety, simplicity, versatility, monitoring, endothelial protection, and potential for remote access for procedures such as mechanical thrombectomy for acute ischemic stroke. However, there are many challenges including cost, manual steps, lack of manual resistance feeling, irrationality in the spatial arrangement of the robotic system and operating table. Additionally, most of the included studies were retrospective with small sample size and short term follow up and more well‐designed comparative prospective studies are needed to confirm these results.
Abstract Number ‐ 205: Impact of Automated Neuroimaging Triage Platform on Time Metrics at a Thrombectomy Capable Stroke Center
Authors: Desai Shashvat M , Bravo Randy , Catapano Joshua , Cooper Angelina , Jadhav Ashutosh P 
Published: April 2023

Introduction
Rapid detection and appropriate triage of large vessel occlusion (LVO) strokes, upon arrival to a hospital system, is key to achieving better outcomes after endovascular thrombectomy (EVT) mediated recanalization of LVO strokes . Automated neuroimaging analyses has the potential to streamline intra‐ hospital workflow. We aim to study the change in vital intra‐hospital time metrics before and after adoption of an automated neuroimaging triage platform (ANTP).

Methods
We performed a retrospective analysis of prospectively collected data at our EVT capable stroke center between April 2019 and November 2021. IschemaView’s Rapid software was adopted in October 2020 for triage of stroke patients. Patients treated before were our control cohort and patients treated after were our intervention cohort. Confirmed LVO strokes presenting to our center within 24 hours of stroke onset were included.

Results
A total of 305 patients were included‐ control (n = 150) and intervention cohort (n = 155). Age (70±15 vs 72 ±15,p = .40), NIHSS score (13 ±8 vs 14 ±7, p = .24), and last‐known‐well to arrival (392 ±464 vs 376 ±427 min, p = .38) were comparable between the two groups. Time from arrival to non‐contrast CT head was also comparable between the two groups (150 ±712 vs 161 ±794, p = .89). Time from non‐contrast CT head to decision to EVT (36 ±54 vs 22 ±58, p = .06) and time from non‐contrast CT to groin puncture (41 ±61 vs 61 ±65, p = .01) were shorter in the intervention cohort compared to control cohort. Length of stay and discharge mRS score were similar between the two cohorts.

Conclusions
Automated neuroimaging triage platform has the potential to improve workflow by decreasing time from non‐contrast CT to EVT decision and groin puncture. Further studies are required to study impact on patient outcomes.
Abstract Number ‐ 211: Flow Diversion in Direct Carotid‐Cavernous Fistulas: Case Report and Literature Review
Authors: Awad Amine , Regenhardt Robert W , Dmytriw Adam A , Vranic Justin E , Marciano Rudolph D , Patel Aman B , Stapleton Christopher J 
Published: April 2023

Introduction
Direct carotid‐cavernous fistulas (dCCF) are acquired, abnormal high‐flow connections between the internal carotid artery and cavernous sinus. Interventions are often required due to the high risk of incipient morbidity and mortality if left untreated. Treatment approaches have rapidly evolved over time, and have included the use of detachable balloons, liquid embolic agents, and coil embolization through transarterial, transvenous, or combined approaches. Case series level data support an emerging role for the use of flow diversion (FD) as a stand‐alone or adjunctive treatment in dCCFs. We describe a case of FD use as an adjunctive treatment in a patient with a treatment‐resistant dCCF, and review the literature on FD use in dCCF.

Methods
We describe the clinical course, imaging findings, and outcomes of a 25‐year old patient who presented with a traumatic carotid‐cavernous fistula requiring multiple interventions. We also performed a literature review of Pubmed and Embase databases using combinations of MeSH and key terms to include all relevant full‐text publications of FD use in the treatment of dCCFs, up to and including February 2022.

Results
Our patient achieved angiographic cure and significant improvement in symptoms at 6‐month follow‐up. A total of 24 papers were identified and included, for a total number of 53 cases (23 male, 23 female, 7 unspecified). The median age of patients was 44 years (Interquartile range (IQR) 23–62). The etiology of the dCCF was traumatic (acute or as a delayed presentation) in 31 cases (58%), spontaneous in 10 cases (19%), and iatrogenic in 12 cases (23%). FD was the primary mode of treatment of the CCF in approximately half of cases (27, 51%), and was a stand‐alone treatment modality in one third of cases (18, 34%). The median number of FD devices used on initial treatment was 1 device, though retreatment was needed in 42% of cases.Angiographic resolution was achieved in 90% of cases at a median follow‐up duration of 6 months.One half of all patients had complete resolution of symptoms and a further third noted clinical improvement in at least some of their symptoms. In 10% of cases, symptoms persisted, or other complications developed that were attributed to concurrent injuries.

Conclusions
Treatment approaches for dCCFs have evolved over time as safer and more effective treatments become available. There is an emerging role for FD as a safe stand‐alone or adjunctive treatment option for dCCFs. Our case further supports its role in treatment‐resistant fistulas with high‐risk features. As treatment approaches continue to evolve, prospective randomized data is needed to better establish the role of flow divertors among the hierarchy of available treatment options for dCCFs.
Abstract Number ‐ 222: Spontaneous Simultaneous Bilateral Putaminal Hemorrhages in a Young Woman
Authors: Paixao Luis , Padalia Arjun , Kim Tae , Wang Yan , Holder Derek , Keyrouz Salah 
Published: April 2023

Introduction
Spontaneous simultaneous bilateral basalganglia hemorrhage is an exceedingly rare condition with significant morbidity and mortality. Hypertension is the most common underlying etiology followed by intoxication and metabolic causes1.

Methods
Here we describe a 39‐year‐old woman with a spontaneous simultaneous bilateral putaminal hemorrhages believed to be secondary to amphetamine (Adderall) use and undiagnosed hypertension.

Results
A 39‐year‐old right‐handed woman with history of attention‐deficit/hyperactivity disorder (ADHD) on dextroamphetamine‐amphetamine (Adderall), white coat hypertension and prior gestational hypertension was brought to the emergency department due to sudden‐onset left hemiparesis, left foot numbness, gait instability, and an abnormal sensation in her right ear. On arrival, blood pressure was 239/139 mmHg. Patient was noted to be somewhat drowsybut was consistently regarding,able to respond, and had anosognosia, hypophonia, a right gaze preference, mild dysarthria, left arm and leg hypotonia, left hemiparesis and hypoesthesia involving face, arm and leg and brisk reflexes on the left side.Head CT revelated bilateral putaminal hemorrhages measuring 10mL on the right and 3mL on the left,with no intraventricular hemorrhage and minimal right‐to‐left midline shift.Patient was admitted to the neuro ICU and treated with a nicardipine infusion. CTA/MRI/MRV/MRA and catheter angiography revealed no underlying structural pathology. Furthermore, patient had a normal platelet count and coagulation profile. Urine drug screen was positive for amphetamines, and serum metanephrines (0.59 nmol/L) and normetanephrines (1.2nmol/L) were elevated in the setting ofAdderall use. Nicardipine infusion was discontinued on day one and she was started on carvedilol 12 mg bid and amlodipine 5mg daily. Adderall was discontinued and patient was counseled on avoiding stimulant medications use. At time of discharge her dysarthria had resolved but her left hemiplegia remained unchanged. She was discharged on day 5 of hospital stay to an inpatient rehabilitation facility. She was started on fluoxetine 20 mg daily for motor recovery at the rehabilitation facility. At her two months follow‐up visit, she was noted to have significant improvement in her left‐sided strength, hypoesthesia and left facial droop but had developed left arm and leg spasticity. She was started on a trial of dry needling with physical therapy prior to consideration of anti‐spasmodic medications or Botox injections. At her office visit, her blood pressure had been well controlled on lisinopril 10 mg and amlodipine 10 mg daily.

Conclusions
Overall, this case report highlights that amphetamine (Adderall) use is a potential cause of spontaneoussimultaneousbilateralbasalgangliahemorrhage.
Abstract Number ‐ 240: Association of intravenous thrombolysis and pre‐interventional reperfusion: a post‐hoc analysis of the SWIFT DIRECT trial
Authors: Mujanovic Adnan , Eker Omer , Marnat Gaultier , Strbian Daniel , Ijäs Petra , Preterre Cécile , Triquenot Aude , Albucher Jean François , Gauberti Maxime , Weisenburger‐Lile David , Ernst Marielle , Nikoubashman Omid , Mpotsaris Anastasios , Gory Benjamin , Hua Vi Tuan , Ribo Marc , Liebeskind David , Dobrocky Tomas , Meinel Thomas , Bütikofer Lukas , Gralla Jan , Fischer Urs , Kaesmacher Johannes 
Published: April 2023

Introduction
One potential benefit of intravenous thrombolysis (IVT) before mechanical thrombectomy (MT) is pre‐interventional reperfusion. Currently, there is a paucity of data regarding the occurrence of pre‐interventional reperfusion in patients randomized to IVT or no‐IVT before MT.

Methods
SWIFT DIRECT was a randomized controlled trial including acute ischemic stroke IVT‐eligible patients being directly admitted to a comprehensive stroke center, with allocation to either MT alone or IVT + MT. Primary endpoint of this analysis was the occurrence of pre‐interventional reperfusion defined as pre‐interventional expanded Thrombolysis in Cerebral Infarction score ≥ 2a. The effect of IVT and potential treatment effect heterogeneity were analyzed using logistic regression analyses.

Results
Out of the 396 patients analyzed, pre‐interventional reperfusion occurred in 20 (10.0%) of patients randomized to IVT+MT, and 7 (3.6%) of patients randomized to MT alone. Receiving IVT favored the occurrence of pre‐interventional reperfusion (aOR 2.91 [95% CI 1.23 – 6.87]). There was no IVT treatment effect heterogeneity on the occurrence of pre‐interventional reperfusion with different strata of Randomization‐to‐Groin‐Puncture (p for interaction = 0.33), although the effect tended to be stronger in patients with Randomization‐to‐Groin‐Puncture >28 minutes (aOR 4.65 [95% CI 1.16 – 18.68]). There were no significant difference in rates of functional outcomes between patients with and without pre‐interventional reperfusion.

Conclusions
Even for patients with proximal large vessel occlusions and direct access to MT, IVT leads towards an absolute increase of 6.9% (95% CI 1.7‐12.2%) in the rates of pre‐interventional reperfusion. The effect of IVT tended to be more pronounced when Randomization‐to‐Groin‐Puncture intervals were longer, but this heterogeneity did not reach statistical significance.
Abstract Number ‐ 243: The Non‐stenosing Carotid Artery Plaque in Embolic Stroke of Undetermined Source: A Retrospective Study
Authors: Jumah Ammar , Nour Hassan Aboul , Intikhab Osama , Choudhury Omar , Gagi Karam , Fana Michael , Alhajala Hisham , Alkhoujah Mohammad , Alsrouji Owais , Latack Katie , Schultz Lonni , Eltous Lara , Walsh Megan , Chebl Alex , Marin Horia , MIller Daniel 
Published: April 2023

Introduction
Atherosclerotic cervical internal carotid artery disease is one of the major causes of ischemic stroke and transient ischemic attacks. The risk of stroke from mild to moderate stenoses (i.e., < 50% stenosis) might be underestimated, and further investigation is mandated to describe the association between high‐risk plaque features and ESUS.

Methods
This was a retrospective observational study. Using the stroke registry of our hospital’s system between June 20th 2016 and June 20th 2021. We reviewed data for patients diagnosed with ESUS according to previously published definition criteria. Using computed tomography angiography (CTA), we analyzed laterality of high‐risk plaque features in relation to the stroke side, and then we identified the incidence of recurrent stroke events.

Results
Out of 1779 patients with cryptogenic ischemic stroke, only 152 met the inclusion criteria for ESUS. We Compared high‐risk plaque features ipsilateral to stroke side as to contralaterally. There were significantly more ulcerations defined as >1 mm depression (19.08% vs 5.26%, p< .0001), plaque thickness >3 mm (19.08% vs 7.24%, p = 0.001), and plaque length >1cm (13.16% vs 5.92%, p = 0.0218).Also, there was a significant difference in stenosis of ipsilateral to stroke when compared contralaterally, especially for stenoses of 10–30% and 31–49% (17.76% vs 10.53% and 5.26% vs 2.63%, respectively. p = 0.0327). There was also a significant difference in plaque component; both components (soft and calcified) and only soft plaque (42.76% vs 23.68% and 17.76% vs 9.21%, respectively. p< .0001) were more prevalent ipsilaterally. In total, 17patients were found to have a recurrent stroke event, 8 patients had an ipsilateral stroke to the index event, 7 had a bilateral and 2 had a contralateral event.

Conclusions
ESUS is more commonly found ipsilateral to high‐risk plaque features. Qualitative assessment of plaque features using CTA could be easily implemented in clinical practice. The small number of our sample is definitely a limitation. Further large and multicenter studies aiming to form precise prediction models and scoring systems are needed to help guide treatment with carotid artery stenting or carotid endarterectomy versus maximizing medical therapy.