bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 302: Incidence of moyamoya angiopathy in the United States from 2011‐2020
Authors: Miller R. A. , Anikpezie N. , Hoffman H. , Bako A. , Aneni E. , Wee C. , Albright K. , Latorre J. , Chaturvedi S. , Liu J. , Agarwalla P. , Singla A. , Khandelwal P. , Oliver F. 
Published: January 2025

Introduction
Moyamoya angiopathy (MMA) is a rare cerebrovascular condition characterized by progressive steno‐occlusion of the terminal segments of the internal carotid artery (ICA) and its branches. Contemporary population‐based studies evaluating the incidence of MMA in the United States (US) are lacking.

Materials/Methods
We utilized the State Ambulatory Surgery, Emergency and Inpatient Databases of Florida (2005‐2020), Georgia (2010‐2020), Maryland (2012‐2020) and New York (2005‐2020) to conduct a retrospective study. We validated International Classification of Diseases (ICD) Tenth revision codes for MMA in a single academic center in the US and utilized primary and secondary ICD‐Ninth/Tenth revision discharge codes to identify all new cases of MMA in these four states from 2011‐2020.

Results
From 24,614 MMA hospitalizations over the study period, 4,192 incident cases were identified from 2011‐2020. 67.9% of these admissions were in women. The overall crude incidence of MMA was 0.76 (95%CI 0.74‐0.78) cases/100,000/year. Incidence was higher in Asian (aIRR 2.46, 95%CI 1.88‐3.23)) and Black individuals (aIRR 2.58, 95%CI 2.17‐3.07) compared with Non‐Hispanic White individuals. Incidence increased by 8% annually over time (aIRR 1.08, 95%CI 1.03‐1.02) with most of this increase occurring in individuals 45‐64 years and ≥65 years.

Conclusion
The incidence of MMA in the US over the period 2011‐2020 was 0.76/100,000/year but incidence of detected cases increased over time. Overall incidence in Black individuals is just as high as that of Asian individuals, and both are higher than that of Non‐Hispanic White individuals.
Abstract 318: Its Not (just) Delivery : Multifunctionality of Carrier Delivery Catheter in Middle Meningeal Artery Embolization
Authors: Scarpiello S. , Snyder T. , Haimi J. , Zacharatos H. , Jankowitz B. 
Published: January 2025

Introduction
Delivery catheters are increasingly utilized in neurointerventions to facilitate guide or aspiration catheter deliverability through tortuous anatomy. They are designed to have a tapered, hydrophilic coated, atraumatic tip to reduce the ledge effect while advancing large bore guide catheters with the additional benefit of advancement without a guidewire. The Carrier Delivery Catheter (The Balt Group, Montmorency, France) has the added benefit of having a PTFE liner through the length of the catheter, which raises the possibility that they may have a multimodal role (particle/coil delivery, liquid embolics) in elective cases such as middle meningeal artery (MMA) embolization.

Methods
At our university‐based medical center, the Carrier Delivery Catheter was used in two patients undergoing bilateral MMA embolization for chronic subdural hematomas.

Results
The Carrier Delivery Catheter Small (OD 0.059”) was used in each procedure to deliver a 6F (0.070” and 0.071”) guide catheter up to the ostium of the MMA. This was achieved easily, without a guidewire, and without inducing vasospasm. Carrier was even able to advance over a guidewire into the MMA trunk (diameters 0.16cm, 0.16cm, 0.19cm and 0.18cm), with the tip nosing into the frontal and parietal branches of the MMA. Further, the Carrier Delivery Catheter was utilized to perform the embolizations. It was able to deliver two different types of coils. This included Embold Fibered Coils (2mm and 3mm diameter) and Tornado Coils (3‐2mm diameter), tris‐acryl gelatin microspheres, and the liquid embolic agent, n‐butyl‐cyanoacrylate (nBCA).

Conclusion
This is the first report of the Carrier Delivery Catheter being used as a multimodal catheter for MMA embolizations. It was used to deliver guide catheters and embolic agents in an easy and repeatable fashion without vasospasm. While it accommodates the use of a guidewire, it is not always necessary. In our very limited experience, this novel technique appeared safe and effective for use in accessing and embolizing the MMA and its branches, although additional studies should be performed to support our findings.
Abstract 321: Likelihood of complete reperfusion in patients requiring multiple passes is dependent on technique of first two attempts
Authors: Azeem H. M. , Bajaj R. , Le N. , Iyyangar A. , Ballekere A. , Neal C. , Ebirim E. , Lee E. , Sheth S. A. 
Published: January 2025

Background
Previous research shows that the chances of successful reperfusion during endovascular thrombectomy (EVT) decrease with each additional attempt. However, for patients who require multiple EVT passes, it remains unclear whether the specific techniques used in the first two attempts affect the likelihood of eventually achieving complete reperfusion.

Methods
All consecutive patients treated with EVT from 12 centers across the US were prospectively collected between 10/2018 ‐ 12/2021 (SVIN Registry). Patient were included if they underwent more than 2 passes. Patients were excluded for missing data. The primary outcome was likelihood of final TICI 2c/3 and was compared against three subgroups defined by the technique used for the first 2 passes: contact aspiration (CA), stent retriever (SR), or a combined technique (CT). This outcome was determined using multivariable logistic regression, adjusted for the use of balloon guide catheters, age, history of atrial fibrillation, coronary artery disease, hypertension, and diabetes.

Results
Among 857 patients that met inclusion criteria, median age was 70 years (IQR, 59‐90), 50.6% female and a median NIHSS 17 (IQR, 11‐21). 49.9% of patients achieved TICI 2c/3 in 2 or fewer passes (54.1% SR, 45.5% CA, 48.7% CT). Among patients who did not achieve TICI 2c/3 within the first two passes and in whom additional passes were attempted, final TICI 2c/3 was attained 32.1% with SR, 48.3% with CA, and 42.4% with CT. In multivariable logistic regression, CA for the first two passes was associated with 2.6 times greater OR (95% CI [1.6, 4.3]) of achieving TICI 2c/3 with additional passes compared to those who received SR for their first two passes. Similarly, those who used CT for their first two passes had 1.8OR (95% CI [1.1, 2.8]) of achieving TICI 2c/3 with additional passes compared to those who used SR.

Conclusion
In this SVIN Registry analysis, two failed passes with SR was associated with decreased likelihood of ultimately achieving TICI 2c/3 compared to two passes of CA or CT. These findings support additional attempts at reperfusion particularly in patients who were initially treated with CA or CT.
Abstract 324: Management of Head and Neck Pseudoaneurysms: an Institutional Review
Authors: Begum M. , Miller R. , Blanden A. , Masoud H. 
Published: January 2025

Introduction/Purpose
Intracranial pseudoaneurysms (PSA) are a challenging clinical entity. A variety of endovascular techniques including coiling, vessel occlusion, stent‐assisted coiling, and flow diversion are available treatment options. When aneurysm morphology permits, selective coiling is preferred as it avoids the negative sequelae associated with parent vessel deconstruction. Here we review a series of symptomatic PSAs and outcome their endovascular management.

Materials and Methods
We performed an institutional review of the electronic medical record to identify pseudoaneurysms of the head and neck in order to analyze their disease course and outcome of endovascular therapy.

Results
We identified 6 separate cases of head and neck pseudoaneurysms treated with endovascular management. Four cases were managed by selective coiling. In two instances selective coiling was definitive. In the others, selective endovascular coiling was initially successful, but later required revision with parent vessel occlusion. In each case requiring revision, progression of the original pathologic process which contributed to the initial pseudoaneurysm led to the failure of selective coiling. The two cases managed with flow diversion did not require revision or have any immediate complications.

Conclusion
Selective coiling remains a useful endovascular therapy, however in progressive pathologies such as malignant neoplasms there may be a greater likelihood of revision with parent vessel occlusion.
Abstract 335: National Patterns Of Carotid Artery Stenting Utilization In Mechanical Thrombectomy Stroke Patients in the US
Authors: Ali A. , Otite F. , Sahoo A. , Novakovic N. , Singla A. , Khandelwal P. 
Published: January 2025

Background
Patients with large vessel occlusion due to high‐grade extracranial carotid stenosis may requireadjunctive carotid artery stenting (CAS) plus mechanical thrombectomy (MT) to prevent acuteischemic stroke (AIS) recurrence. Population‐level data on contemporary CAS utilization in MTare lacking. This study describes CAS utilization trends in MT patients in the United States (US)over the last decade.

Methods
We conducted a serial cross‐sectional study utilizing the 2010‐2021 National Inpatient Sample.All adult (>=18 years) primary MT admissions with and without CAS were identified usingInternational Classification of Diseases codes. Age and sex‐ specific prevalence of CAS in MTwere computed. Multivariable‐adjusted negative binomial regression models were used tocompare prevalence of CAS between various demographic subgroups and to compare in‐hospitalmortality or good outcome (routine home discharge) rates between CAS versus non‐CAS MTadmissions.

Results
Of 5,927,384 weighted AIS admissions from 2010‐2021, 195,677 (3.3%) underwent MT. 6.4%of these MT admissions underwent CAS but this proportion deferred significantly by age and sex(Figure 1a). Highest frequency of utilization was in men 60‐79 years (10.1%) and lowest use inwomen >=80 years (1.9%). (Figure 1a). Annual CAS volume in MT increased from 186 casesannually in 2010 to 2,340 cases in 2021, but the overall utilization rate of all MTs did notincrease significantly over time (Figure 1b). 85.4% of these procedures were performed on thesame day as MT and only 14.6% were performed on different days. 12.7% of CAS admissionshad carotid dissection vs 2.5% in the non‐CAS group. Only 0.4% of MT had carotidendarterectomy. After multivariable adjustment for clinical and hospital‐level factors, womenhad ≈50% lower prevalence of CAS vs men (adjusted prevalence ratio (APR) 0.51, 95%CI 0.46‐0.55) and Black admissions had 43% lower prevalence of CAS vs White admissions (APR 0.57,95%CI 0.49‐0.66). In multivariable models that included the National Institute of Health StrokeScale and other clinical factors CAS utilization was not associated with in‐hospital mortality(APR 0.86, 95%CI 0.72‐1.03) or good outcome (APR 0.93, 95%CI 0.85‐1.02)

Conclusion
Just over 6% of MT admissions across the period 2010‐2021 in the US underwent CAS. CASutilization rate did not change over time, but volume of utilization has increased by over 10‐fold,accompanying the increase in MT that has occurred over time. CAS is more frequently utilized in men and in White admissions in the US compared to women and Black admissions,respectively.
Abstract 342: Novel “Hyperdense Sign” Window Improves Detection of Hyperdense Sign in Patients Presenting with Ischemic Stroke
Authors: Scarpiello S. , Amireh A. , Snyder T. , Haimi J. , Zacharatos H. , Mehta S. , Jankowitz B. 
Published: January 2025

Introduction
Imaging modalities for acute ischemic stroke patients include non‐contrast CT head (NCCT) and contrast‐based imaging. On NCCT, a hyperdense sign suggestive of underlying thrombus correlates to a large vessel occlusion (LVO) on contrast based imaging. Previous studies show that hyperdense signs are visualized in 30‐52% of patients presenting with an LVO. While standard (5mm) cut CT can miss hyperdense signs, they can be better detected on newer NCCT with thin (0.625mm) cuts. The Hounsfield unit (HU) range of a hyperdense sign is +50 to +75, so the windowing of NCCT images to enhance these HU ranges also improves visualization. Hyperdense signs on NCCT can help guide selection for mechanical thrombectomy (MT) when advanced imaging is unavailable or inadequate.

Methods
At our community‐based university medical center, we conducted a retrospective cohort study of acute ischemic stroke patients presenting with an intracranial LVO and were taken for MT from July 2019 to March 2024. We retrospectively assessed axial standard (5mm) cut and thin (0.625mm) cut NCCT imaging in patients for hyperdense signs spanning from the carotid terminus to the distal M1 segment. To improve visualization, we further used a novel “hyperdense window,” with a window center of 50 and window width of 25. The location of the hyperdense region was confirmed with the location of LVO on contrast‐based imaging including CT angiogram, CT perfusion, and digital subtraction angiography during MT.

Results
The mean age of the patients in the study was 67 years; 54% were male and 46% were female. Of the patients with confirmed intracranial LVO on contrast‐based studies, 77.4% (n=147) had unilateral hyperdense signs on NCCT thin cuts that correlated to area of LVO. Of the remaining 22.6% (n=43) of patients, 58.1% (n=25) had an absence of a hyperdense sign and 41.9% (n=18) of patients had bilateral hyperdense signs on NCCT. Contrast based imaging confirmed LVO in all patients included in the study.

Conclusion
Compared to previous studies, thin cut NCCT combined with a novel “hyperdense window” on NCCT improved visualization of hyperdense signs representing LVO at the internal carotid terminus and/or first segment of the middle cerebral artery. We propose that when combined with a clinical presentation, a hyperdense sign on NCCT may be sufficient evidence to proceed to MT without the need for contrast‐based imaging. While advanced imaging should not be delayed, interpretation of thin cut NCCT may lead to earlier mobilization of the intervention team. More studies are needed to evaluate the utility of thin cut NCCT alone for selection of patients with LVO and whether outcome metrics such as reperfusion time or modified Rankin scale improve.
Abstract 367: Physiologic steal in white matter structures of non‐flow limited cerebral hemispheres as evidenced by observations of acetazolamide challenge arterial spin labeling MR
Authors: Ismail R. , Manganaro M. , Szekeres D. , Bender M. , Wang H. 
Published: January 2025

Background
Acetazolamide administration can allow for comparisons between cerebral blood flow (CBF) at baseline and after acetazolamide challenge to evaluate the cerebral vasculature. While effects of augmentation have been studied in vaso‐occlusive hemispheres, little has been reported on physiologic, non‐flow limited hemispheres.

Methods
Patients who underwent acetazolamide challenge MRI from 2014‐2021 and a cerebral angiogram within one year were included. Patients with bilateral disease or non‐diagnostic imaging artifacts were excluded. MRIs were obtained after 1 g of acetazolamide administered 5 and 10 minutes prior to acquisition. Augmentation and steal maps were generated by comparing pre and post acetazolamide CBF images. Regression analysis, Pearson correlation coefficient, two sample t‐Test, Spearman and Mann Whitney U analyses were utilized for statistical evaluation.

Results
38 Patients with unilateral cerebral vaso‐occlusive disease underwent the acetazolamide challenge. Steal and T2 hyperintensities were assessed in non‐flow limited hemispheres (NFLH) and flow limited hemispheres (FLH). A moderate correlation was demonstrated between NFLH steal and NFLH T2 hyperintensities (rs=0.48, p=0.0020). A weak correlation without statistical significance was demonstrated between ipsilateral T2 and contralateral T2 hyperintensities (rs= .27, p=.10). No correlation was found between steal severity or T2 hyperintensity and occlusion locations of stenosis.

Conclusion
Vascular steal phenomenon was demonstrated in the distal cerebral vasculature of cerebral white matter even in the absence of upstream flow limiting stenosis, suggesting an inherit vulnerability of these structures to hemodynamic fluctuations and possible contributing etiology to leukoaraiosis.
Abstract 422: The Impact of Household Composition on Acute Ischemic Strokes: Acute and Chronic Implications
Authors: Couture L. , Cahuiche A. E. , Petway A. , Baskin L. , Colpo G. Delevati , McCullough L. D. 
Published: January 2025

Introduction
Stroke presents a significant global health challenge, impacting physical and mental well‐being. Social Isolation (SI) is a known risk factor and common complication affecting functional outcomes and impeding recovery. In this study we investigate the role of household composition as a potential social determinant of health after acute ischemic stroke (AIS) that providers can target to identify patients at higher risk for stroke and enhance patient outcomes. We assessed how variations in household composition correlate with the severity of stroke, the occurrence and development of SI, and subsequent functional recovery at 3 months after discharge.

Methods
This study examines the relationship between house composition, depressive symptoms, the Modified Rankin Scale (mRS), and the National Institute of Health Stroke Score (NIHSS) aiming to predict acute stroke severity and functional recovery among AIS patients (N=130). Household composition was defined as the amount of people the patient lives with. Depression was measured via the PHQ‐9, which is a self‐report with higher scores indicating more severe depression. This questionnaire was completed by the patients prior to their discharge.

Results
Our findings showed that AIS patients living with fewer people at admission are more likely to have an increased NIHSS score, indicating more severe strokes (p<0.005). However, we found that regardless of injury severity, increased household composition was associated with a reduced likelihood of depressive symptoms 3 months post hospitalization (p<0.005). When controlling for household size, females were found to be more likely to suffer from depressive symptoms at 3 months compared to their male counterparts (p<0.005).

Conclusion
Controlling post‐stroke depressive symptoms emerged as a statistically significant factor for improved functional outcomes, highlighting the importance of early intervention and management of depression in stroke care. Living with an increased number of people could act as a protective factor for stroke severity due to its positive effect on recovery and post‐stroke outcomes. These findings underscore the necessity of integrating assessments of living conditions, depression and social isolation into stroke care protocols to enhance outcomes and address broader health disparities, ultimately improving the quality of life for stroke survivors.
Abstract 441: Transophthalmic Artery Embolization of Anterior Skull Base Meningiomas: Technical Case Series
Authors: Essibayi M. , Baker A. , Ryvlin J. R. , Pecoraric I. , Fortunel A. , Hamad M. , Khatri D. , Crisman C. , Eskandar E. , Haranhalli N. , Agarwal V. , Altschul D. J. 
Published: January 2025

Introduction/Purpose
Preoperative embolization of anterior skull base meningiomas can facilitate surgical resection by reducing tumor vascularity. However, transophthalmic artery embolization carries risks of visual complications. This study aimed to evaluate the safety and efficacy of this technique using modern endovascular tools.

Materials and Methods
This retrospective study included patients with anterior skull base meningiomas who underwent preoperative transophthalmic artery embolization followed by surgical resection between January 2022 and April 2024. Patient demographics, tumor characteristics, embolization details, surgical outcomes, and complications were analyzed.

Results
Seven patients (6 male, 1 female; median age 57 years) were included. Tumor locations were planum sphenoidale (58%), olfactory groove (14%), frontal region (14%), and sphenoid wing (14%). Unilateral embolization was performed in 6 patients, with 1 patient receiving bilateral transophthalmic artery embolization. Embolized branches included anterior ethmoidal (38%), posterior ethmoidal (38%), recurrent meningeal (12%), and complete ophthalmic artery occlusion (12%). Embolic agents used were polyvinyl alcohol particles (71%) and coils (29%). Successful angiographic devascularization was achieved in all patients without any endovascular complications or visual deterioration. Gross total resection was achieved in 71% of cases. The median operative blood loss was 427 cc. At a median follow‐up of 9 months, the median modified Rankin Scale score was 1.

Conclusion
With careful patient selection, advanced microcatheter technology, and meticulous technique, preoperative transophthalmic artery embolization can be safely performed to facilitate resection of anterior skull base meningiomas. These results suggest it is a viable option for well‐selected patients at experienced centers, though larger prospective studies are needed.
Abstract 446: Transvenous Embolization along with Intraprocedural Image Fusion Technique for Complex Intracranial Dural Arteriovenous Fistula.
Authors: Oh S. , Choi J. , Kim B. , Shin Y. 
Published: January 2025

Background and purpose
This study aimed to investigate the role and safety of intraprocedural flat‐detector computed tomography‐based rotational angiography and image fusion (FDCT‐RA and IF) in microcatheter navigation during transvenous treatment of dural arteriovenous fistulae (dAVF).

Materials and methods
We retrospectively reviewed 86 cases of dAVF treated by a transvenous approach between January 2009 and April 2023. The patients were classified into two groups according to the treatment technique used: the FDCT‐RA and IF technique group and the conventional technique group. Univariate analyses were performed to compare the two treatment modalities.

Results
The FDCT‐RA and IF technique was used in 37 of the 86 patients (43.0%). The FDCT‐RA and IF group showed significant differences in dAVF location, sinus occlusion state, and access routes compared to the conventional treatment group. The FDCT‐RA and IF technique was commonly used for dAVFs involving the anterior condylar confluence and cavernous sinus with ipsilateral inferior petrosal sinus (IPS) occlusion. The complete occlusion rate was higher in patients treated with this technique (n=34, 91.9%) than in those treated using the conventional technique (n=39, 79.6%). However, the difference was not statistically significant (p=0.136). Implementation of this technique during the treatment procedure showed a tendency to decrease both fluoroscopy duration and radiation dose. The obtained result was not statistically significant (p=0.315, p=0.130).