Search

Your search keyword '"Yang Cunli"' showing total 131 results
Start Over Author "Yang Cunli"
Sorry, I don't understand your search. ×
131 results on '"Yang Cunli"'

3. Endovascular coiling versus neurosurgical clipping in the management of aneurysmal subarachnoid haemorrhage in the elderly: a multicenter cohort study

Author

Lee, Keng Siang, Siow, Isabel, Yang, Lily WY, Foo, Aaron SC, Zhang, John JY, Mathews, Ian, Goh, Chun Peng, Teo, Colin, Nagarjun, Bolem, Chen, Vanessa, Lwin, Sein, Teo, Kejia, Low, Shiong Wen, Sun, Ira SY, Pang, Boon Chuan, Yang, Eugene WR, Yang, Cunli, Gopinathan, Anil, Yeo, Tseng Tsai, and Nga, Vincent DW

Published
2024
Full Text
View/download PDF

7. Left Ventricular Diastolic Dysfunction Is Associated with Poor Functional Outcomes after Endovascular Thrombectomy

Author

Li, Tony Y. W., primary, Toh, Emma M. S., additional, Koh, Ying Ying, additional, Leow, Aloysius S. T., additional, Chan, Bernard P. L., additional, Teoh, Hock-Luen, additional, Seet, Raymond C. S., additional, Gopinathan, Anil, additional, Yang, Cunli, additional, Sharma, Vijay K., additional, Yeo, Leonard L. L., additional, Chan, Mark Y., additional, Kong, William K. F., additional, Poh, Kian-Keong, additional, Tan, Benjamin Y. Q., additional, and Sia, Ching-Hui, additional

Published
2024
Full Text
View/download PDF

9. Endovascular Coiling versus Neurosurgical Clipping in the Management of Aneurysmal Subarachnoid Haemorrhage in the Elderly: A Multicenter Cohort Study

Author

Lee, Keng Siang, primary, Siow, Isabel, additional, Yang, Lily, additional, Foo, Aaron, additional, Zhang, John, additional, Matthews, Ian, additional, Goh, Chun Peng, additional, Teo, Colin, additional, Nagarjun, Bolem, additional, Chen, Vanessa, additional, Lwin, Sein, additional, Teo, Kejia, additional, Low, Shiong Wen, additional, Sun, Ira, additional, Pang, Boon Chuan, additional, Yang, Eugene, additional, Yang, Cunli, additional, Gopinathan, Anil, additional, Yeo, Tseng Tsai, additional, and Nga, Vincent, additional

Published
2024
Full Text
View/download PDF

10. Impact of the COVID-19 pandemic on hyperacute stroke treatment: experience from a comprehensive stroke centre in Singapore

Author

Paliwal, Prakash R., Tan, Benjamin Y. Q., Leow, Aloysius S. T., Sibi, Sunny, Chor, Daniel W. P., Chin, Amanda X. Y., Yau, Ying-Wei, Cross, Gail B., Wong, Lily Y. H., Chia, Magdalene L. J., Quak, Zhixuan, Chua, Christopher Y. K., Tang, David K. K., Zune, Ei The, Hung, Jennifer, Goh, Yihui, Jing, Mingxue, Gopinathan, Anil, Yang, Cunli, Ahmad, Aftab, Khoo, Deborah X. L., Lee, Chang-Chuan M., Seet, Raymond C. S., Sharma, Vijay K., Teoh, Hock-Luen, Yeo, Leonard L. L., and Chan, Bernard P. L.

Published
2020
Full Text
View/download PDF

11. Revolutionizing the Management of Large-Core Ischaemic Strokes: Decoding the Success of Endovascular Therapy in the Recent Stroke Trials

Author

Lim, Gareth Zigui, primary, Lai, Jonathan Yexian, additional, Seet, Christopher Ying Hao, additional, Tham, Carol Huilian, additional, Venketasubramanian, Narayanaswamy, additional, Tan, Benjamin Yong Qiang, additional, Jing, Mingxue, additional, Yeo, Joshua Yee Peng, additional, Myint, May Zin, additional, Sia, Ching-Hui, additional, Teoh, Hock Luen, additional, Sharma, Vijay Kumar, additional, Chan, Bernard, additional, Yang, Cunli, additional, Makmur, Andrew, additional, Ong, Shao Jin, additional, and Leong, Leonard Litt Yeo, additional

Published
2023
Full Text
View/download PDF

14. Revolutionizing the Management of Large-Core Ischaemic Strokes: Decoding the Success of Endovascular Therapy in the Recent Stroke Trials.

Author

Lim, Gareth Zigui, Lai, Jonathan Yexian, Seet, Christopher Ying Hao, Tham, Carol Huilian, Venketasubramanian, Narayanaswamy, Tan, Benjamin Yong Qiang, Jing, Mingxue, Yeo, Joshua Yee Peng, Myint, May Zin, Sia, Ching-Hui, Teoh, Hock Luen, Sharma, Vijay Kumar, Chan, Bernard Poon Lap, Yang, Cunli, Makmur, Andrew, Ong, Shao Jin, and Yeo, Leonard Leong Litt

Published
2023
Full Text
View/download PDF

15. Direct dotterising or angioplasty of acute stroke due to tandem atherosclerotic occlusions

Author

Leonard L. L. Yeo, Davide Simonato, Pervinder Bhogal, Anil Gopinathan, Yang Cunli, Samuel W. Q. Ong, Mingxue Jing, Benjamin Y. Q. Tan, Ching-Hui Sia, Tom Jia, Giacomo Cester, Joseph-Domenico Gabrieli, and Tommy Andersson

Abstract

BackgroundTandem occlusions cause 10–15% of LVO acute ischemic strokes but are difficult to treat endovascularly and frequently excluded from clinical trials. The optimum endovascular method is still debated, however going directly through the carotid occlusion can speed up the procedure and reduce procedural risk by eliminating an exchange maneuver.MethodUsing retrospective data from three centers, we compared treating atherosclerotic tandem occlusions using a 0.035'-guidewire and direct dotterisation or angioplasty with a peripheral vascular balloon suitable for the wire, vs. the usual technique of an 0.014'wire. We compared the successful recanalization (mTICI 2b-3) rates, 90 days' functional outcomes (mRS 0–2), and puncture-to-recanalization times between both procedures.ResultsForty-two consecutive patients with atherosclerotic tandem occlusions were included; 25 were treated with the 0.014'wire technique and 17 with the 0.035'-guidewire and direct dotterisation or angioplasty with a peripheral vascular balloon technique. The direct technique achieved a higher rate of successful recanalization (100 vs. 72%, P = 0.018), better functional outcome (88.4 vs. 48.0%, P = 0.044), and faster procedure times (mean 65.1 mins vs. 114.8 mins, P < 0.001). The number of attempts was similar between both groups (median 2 vs 3 attempts, P = 0.101). There was no significant difference in the complication rate between both groups (5.9 vs. 12.0%, P = 0.462).ConclusionCompared to previous endovascular techniques for treating atherosclerotic tandem occlusions, the direct technique using standard 0.035' guidewires and dotterisation or a peripheral vascular balloon is significantly faster with better outcomes. However, this will require further external validation in larger cohorts.

Published
2023

16. Bridging thrombolysis improves survival rates at 90 days compared with direct mechanical thrombectomy alone in acute ischemic stroke due to basilar artery occlusion: a systematic review and meta- analysis of 1096 patients.

Author

Lee, Keng Siang, Siow, Isabel, Zhang, John JY, Syn, Nicholas, Gillespie, Conor S., Yuen, Linus ZH, Anil, Gopinathan, Yang, Cunli, Chan, Bernard PL, Sharma, Vijay Kumar, Teoh, Hock- Luen, Mingxue, Jing, Teo, Kevin Soon Hwee, Myint, May Zin, Bhogal, Pervinder, and Meyer, Lukas

Subjects
MEDICAL databases, RELATIVE medical risk, META-analysis, MEDICAL information storage & retrieval systems, CONFIDENCE intervals, ISCHEMIC stroke, SYSTEMATIC reviews, INTRACRANIAL hemorrhage, THROMBOLYTIC therapy, BASILAR artery, SURVIVAL rate, TREATMENT effectiveness, SUBARACHNOID hemorrhage, MEDICAL emergencies, MEDICAL protocols, THROMBECTOMY, DESCRIPTIVE statistics, DISABILITIES, MEDLINE, ODDS ratio, DATA analysis software, CEREBRAL arteriosclerosis, DISEASE complications
Abstract

Background Mechanical thrombectomy (MT) is an effective treatment for patients with acute ischemic stroke (AIS) from basilar artery occlusion (BAO). Objective To compare the clinical outcomes of MT, with and without bridging intravenous thrombolysis (IVT), in acute BAO through a systematic review and meta- analysis of the current literature. Methods Systematic searches of Medline, EMBASE, and Cochrane Central were undertaken on August 1, 2022. Good functional outcome defined as 90- day modified Rankin Scale score 0--2 was the primary outcome measure. Secondary outcome measures were 90- day mortality, successful post- thrombectomy recanalization (modified Thrombolysis in Cerebral Infarction score ≥2b), symptomatic intracranial hemorrhage (sICH), and subarachnoid hemorrhage (SAH). Results Three studies reporting 1096 patients with BAO AIS were included in the meta- analysis. No significant differences in good functional outcome were detected between the two groups (RR=1.28 (95% CI 0.86 to 1.92); p=0.117). However, specifically patients with large artery atherosclerosis (LAA) benefited from bridging IVT (OR=2.52 (95% CI 1.51 to 4.22); p<0.001) with better functional outcomes. There was a significantly lower 90- day mortality rate for patients who underwent bridging IVT compared with MT alone (RR=0.70 (95% CI 0.62 to 0.80); p=0.008). No significant differences were detected in rates of post- treatment recanalization (RR=1.01 (95% CI 0.35 to 2.91); p=0.954), sICH (RR=0.96 (95% CI 0.66 to 1.42); p=0.724), and SAH (RR=0.93 (95% CI 0.31 to 2.83); p=0.563). Conclusions In patients with AIS due to BAO, bridging IVT was associated with lower mortality rates at 90 days, compared with direct MT. There were no improved functional outcomes or increased sICH or SAH between both arms, However, patients with LAA benefited from bridging IVT, with better functional outcomes. [ABSTRACT FROM AUTHOR]

Published
2023
Full Text
View/download PDF

17. Thrombectomy for distal medium vessel occlusion stroke: Combined vs. single-device techniques - A systematic review and meta-analysis

Author

Loh, Enver De Wei, primary, Kwok, Gabriel Yi Ren, additional, Toh, Keith Zhi Xian, additional, Koh, Ming Yi, additional, Teo, Yao Hao, additional, Teo, Yao Neng, additional, Chan, Bernard P. L., additional, Sharma, Vijay Kumar, additional, Ng, Megan Bi-Jia, additional, Lim, Hui Shi, additional, Soon, Betsy, additional, Gopinathan, Anil, additional, Yang, Cunli, additional, Sia, Ching-Hui, additional, Bhogal, Pervinder, additional, Brouwer, Patrick A., additional, Meyer, Lukas, additional, Fiehler, Jens, additional, Andersson, Tommy, additional, Tan, Benjamin Y. Q., additional, and Yeo, Leonard L. L., additional

Published
2023
Full Text
View/download PDF

19. The Role of Interventional Radiology in the Diagnosis and Treatment of Pulmonary Arteriovenous Malformations

Author

Yap, Chee Woei, primary, Wee, Bernard B. K., additional, Yee, Sze Ying, additional, Tiong, Vincent, additional, Chua, Yi Xiu, additional, Teo, Lycia, additional, Lohan, Rahul, additional, Tan, Amos, additional, Singh, Pavel, additional, Rajendran, Prapul Chander, additional, Yang, Cunli, additional, Yee, Yong Chen, additional, Anil, Gopinathan, additional, and Ong, Shao Jin, additional

Published
2022
Full Text
View/download PDF

20. Bridging thrombolysis improves survival rates at 90 days compared with direct mechanical thrombectomy alone in acute ischemic stroke due to basilar artery occlusion: a systematic review and meta-analysis of 1096 patients

Author

Lee, Keng Siang, primary, Siow, Isabel, additional, Zhang, John JY, additional, Syn, Nicholas L, additional, Gillespie, Conor S, additional, Yuen, Linus ZH, additional, Anil, Gopinathan, additional, Yang, Cunli, additional, Chan, Bernard PL, additional, Sharma, Vijay Kumar, additional, Teoh, Hock-Luen, additional, Mingxue, Jing, additional, Teo, Kevin Soon Hwee, additional, Myint, May Zin, additional, Bhogal, Pervinder, additional, Meyer, Lukas, additional, Schob, Stefan, additional, Sia, Ching-Hui, additional, Mpotsaris, Anastasios, additional, Maus, Volker, additional, Andersson, Tommy, additional, Arnberg, Fabian, additional, Gontu, Vamsi Krishna, additional, Lee, Tsong-Hai, additional, Tan, Benjamin Y Q, additional, and Yeo, Leonard LL, additional

Published
2022
Full Text
View/download PDF

21. Effect of frailty on outcomes of endovascular treatment for acute ischaemic stroke in older patients

Author

Tan, Benjamin Y Q, primary, Ho, Jamie S Y, additional, Leow, Aloysius S, additional, Chia, Magdalene L J, additional, Sia, Ching Hui, additional, Koh, Ying Ying, additional, Seetharaman, Santhosh K, additional, Yang, Cunli, additional, Gopinathan, Anil, additional, Teoh, Hock Luen, additional, Sharma, Vijay K, additional, Seet, Raymond C S, additional, Chan, Bernard P L, additional, Yeo, Leonard L L, additional, and Tan, Li Feng, additional

Published
2022
Full Text
View/download PDF

22. Deep Cerebral Venous Thrombosis Treatment

Author

Andrew Fw Ho, Tu Tian Ming, Leonard L.L. Yeo, Kong Wan Yee, Anil Gopinathan, Benjamin Yong-Qiang Tan, Yang Cunli, Priscillia Ps Lye, Vivek Sharma, and Bernard P.L. Chan

Subjects
medicine.medical_specialty, Neurology, medicine.medical_treatment, Cranial Sinuses, 030218 nuclear medicine & medical imaging, law.invention, Sinus Thrombosis, Intracranial, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Modified Rankin Scale, law, medicine, Humans, Radiology, Nuclear Medicine and imaging, Neuroradiology, Venous Thrombosis, business.industry, Thrombosis, Thrombolysis, medicine.disease, Surgery, Venous thrombosis, Treatment Outcome, Neurology (clinical), Neurosurgery, Intracranial Thrombosis, business, 030217 neurology & neurosurgery
Abstract

Deep cerebral venous thrombosis (CVT) is an uncommon condition with a high morbidity and mortality. The optimal treatment approach for deep CVT remains uncertain and due to its low prevalence, randomized trials are not feasible. We showcase a straight sinus thrombosis treated with a large bore aspiration and performed a meta-analysis of the available literature to characterize and evaluate the various treatment modalities for patients with deep CVT. We conducted a systematic search in PubMed, EMBASE and Ovid Medline using appropriate keywords/MESH terms search strategy. All patients with thrombosis involving the deep venous sinuses were included if treatment records were available. Outcome measures included recanalization of the affected sinus, good functional outcome assessed by a modified Rankin scale (mRS) of 0–2 or reported independent functional outcomes, permanent neurological deficits, further hemorrhage and mortality. A total of 69 studies comprising 120 patients were included in the analysis. Anticoagulation was the most common treatment (85.8%), whilst local intrasinus thrombolysis was performed in 40.0% of the patients and mechanical endovascular modalities were employed in 20.0% of the patients. Recanalization of the occluded sinus was seen in 83.5% of the patients while 62.6% patients achieved good functional outcome. There was considerable morbidity with 60.7% having a permanent neurological deficit, 23.3% having further hemorrhage after admission and 18.6% mortality. In the cohort receiving anticoagulation, 65.3% achieved good outcome but intracranial hemorrhage at presentation was associated with poorer outcome, permanent deficits, further bleeding and mortality. Anticoagulation is an effective treatment strategy for deep CVT; however, patients with intracranial hemorrhage at presentation often have poorer outcomes and early endovascular strategies could be considered in this subgroup.

Published
2020

23. Significant aortic stenosis associated with poorer functional outcomes in patients with acute ischaemic stroke undergoing endovascular therapy

Author

Benjamin Yong-Qiang Tan, Gopinathan Anil, Kian Keong Poh, Nicholas Jh Ngiam, Vijay Sharma, Staffan Holmin, Leonard L.L. Yeo, Bernard P.L. Chan, Yang Cunli, Ching-Hui Sia, and Tommy Anderssen

Subjects
medicine.medical_specialty, 030204 cardiovascular system & hematology, Endovascular therapy, Brain Ischemia, 03 medical and health sciences, 0302 clinical medicine, Ischemia, Internal medicine, Ischaemic stroke, Humans, Medicine, In patient, Endovascular treatment, Aged, Ischemic Stroke, Retrospective Studies, Thrombectomy, Acute stroke, business.industry, Endovascular Procedures, Aortic Valve Stenosis, medicine.disease, Functional recovery, Stroke, Stenosis, Treatment Outcome, Heart failure, cardiovascular system, Cardiology, business, 030217 neurology & neurosurgery
Abstract

Background and aim Bi-directional feedback mechanisms exist between the heart and brain, which have been implicated in heart failure. We postulate that aortic stenosis may alter cerebral haemodynamics and influence functional outcomes after endovascular thrombectomy for acute ischaemic stroke. We compared clinical characteristics, echocardiographic profile and outcomes in patients with or without aortic stenosis that underwent endovascular thrombectomy for large vessel occlusion acute ischaemic stroke. Methods Consecutive acute ischaemic stroke patients with anterior and posterior circulation large vessel occlusion (internal carotid artery, middle cerebral artery and basilar artery) who underwent endovascular thrombectomy were studied. Patients were divided into those with significant aortic stenosis (aortic valve area 2) and without. Univariate and multivariate analyses were employed to compare and determine predictors of functional outcomes measured by modified Rankin scale at three months. Results We identified 26 (8.5%) patients with significant aortic stenosis. These patients were older (median age 76 (interquartile range 68–84) vs. 67 (interquartile range 56–75) years, p = 0.001), but similar in terms of medical comorbidities and echocardiographic profile. Rates of successful recanalisation (73.1% vs. 78.0%), symptomatic intracranial haemorrhage (7.7% and 7.9%) and mortality (11.5% vs. 12.6%) were similar. Significant aortic stenosis was independently associated with poorer functional outcome (modified Rankin scale >2) at three months (adjusted odds ratio 2.7, 95% confidence interval 1.1–7.5, p = 0.048), after adjusting for age, door-to-puncture times, stroke severity and rates of successful recanalisation. Conclusion In acute ischaemic stroke patients managed with endovascular thrombectomy, significant aortic stenosis is associated with poor functional outcome despite comparable recanalisation rates. Larger cohort studies are needed to explore this relationship further.

Published
2020

24. Bridging Thrombolysis versus Direct Mechanical Thrombectomy in Stroke Due to Basilar Artery Occlusion

Author

Siow, Isabel Tan, Benjamin Y. Q. Lee, Keng Siang Ong, Natalie Toh, Emma Gopinathan, Anil Yang, Cunli Bhogal, Pervinder Lam, Erika Spooner, Oliver Meyer, Lukas Fiehler, Jens Papanagiotou, Panagiotis Kastrup, Andreas Alexandrou, Maria Zubel, Seraphine Wu, Qingyu Mpotsaris, Anastasios Maus, Volker Anderson, Tommy Gontu, Vamsi Arnberg, Fabian Lee, Tsong Hai Chan, Bernard P. L. Seet, Raymond C. S. Teoh, Hock Luen Sharma, Vijay K. Yeo, Leonard L. L.

Abstract

BACKGROUND AND PURPOSE: Mechanical thrombectomy (MT) is an effective treatment for patients with basilar artery occlusion (BAO) acute ischemic stroke. It remains unclear whether bridging intravenous thrombolysis (IVT) prior to MT confers any benefit. This study compared the outcomes of acute BAO patients who were treated with direct MT versus combined IVT plus MT. METHODS: This multicenter retrospective cohort study included patients who were treated for acute BAO from eight comprehensive stroke centers between January 2015 and December 2019. Patients received direct MT or combined bridging IVT plus MT. Primary outcome was favorable functional outcome defined as modified Rankin Scale 0-3 measured at 90 days. Secondary outcome measures included mortality and symptomatic intracranial hemorrhage (sICH). RESULTS: Among 322 patients, 127 (39.4%) patients underwent bridging IVT followed by MT and 195 (60.6%) underwent direct MT. The mean±standard deviation age was 67.5±14.1 years, 64.0% were male and median National Institutes of Health Stroke Scale was 16 (interquartile range, 8 to 25). At 90-day, the rate of favorable functional outcome was similar between the bridging IVT and direct MT groups (39.4% vs. 34.4%, P=0.361). On multivariable analyses, bridging IVT was not as Comorbidisociated with favorable functional outcome, mortality or sICH. In subgroup analyses, patients with underlying atherosclerosis treated with bridging IVT compared to direct MT had a higher rate of favorable functional outcome at 90 days (37.2% vs. 15.5%, P=0.013). CONCLUSIONS: Functional outcomes were similar in BAO patients treated with bridging IVT versus direct MT. In the subgroup of patients with underlying large-artery atherosclerosis stroke mechanism, bridging IVT may potentially confer benefit and this warrants further investigation.

Published
2022

25. Combined balloon guide catheter, aspiration catheter, and stent retriever technique versus balloon guide catheter and stent retriever alone technique: a systematic review and meta-analysis

Author

Teo, Yao Neng, primary, Sia, Ching-Hui, additional, Tan, Benjamin Y Q, additional, Mingxue, Jing, additional, Chan, Bernard, additional, Sharma, Vijay Kumar, additional, Makmur, Andrew, additional, Gopinathan, Anil, additional, Yang, Cunli, additional, Loh, Stanley, additional, Ng, Sheldon, additional, Ong, Shao Jin, additional, Teoh, Hock-Luen, additional, Rathakrishnan, Rahul, additional, Andersson, Tommy, additional, Arnberg, Fabian, additional, Gontu, Vamsi Krishna, additional, Lee, Tsong-hai, additional, Maus, Volker, additional, Meyer, Lukas, additional, Bhogal, Pervinder, additional, Spooner, Oliver, additional, Li, Tony YW, additional, Soh, Rodney YH, additional, and Yeo, Leonard LL, additional

Published
2022
Full Text
View/download PDF

26. Bridging Thrombolysis versus Direct Mechanical Thrombectomy in Stroke Due to Basilar Artery Occlusion

Author

Siow, Isabel, primary, Tan, Benjamin Y.Q., additional, Lee, Keng Siang, additional, Ong, Natalie, additional, Toh, Emma, additional, Gopinathan, Anil, additional, Yang, Cunli, additional, Bhogal, Pervinder, additional, Lam, Erika, additional, Spooner, Oliver, additional, Meyer, Lukas, additional, Fiehler, Jens, additional, Papanagiotou, Panagiotis, additional, Kastrup, Andreas, additional, Alexandrou, Maria, additional, Zubel, Seraphine, additional, Wu, Qingyu, additional, Mpotsaris, Anastasios, additional, Maus, Volker, additional, Anderson, Tommy, additional, Gontu, Vamsi, additional, Arnberg, Fabian, additional, Lee, Tsong Hai, additional, Chan, Bernard P.L., additional, Seet, Raymond C.S., additional, Teoh, Hock Luen, additional, Sharma, Vijay K., additional, and Yeo, Leonard L.L., additional

Published
2022
Full Text
View/download PDF

27. Effect of Sex on Outcomes of Mechanical Thrombectomy in Basilar Artery Occlusion: A Multicentre Cohort Study

Author

Tan, Benjamin Y.Q., primary, Siow, Isabel, additional, Lee, Keng Siang, additional, Chen, Vanessa, additional, Ong, Natalie, additional, Gopinathan, Anil, additional, Yang, Cunli, additional, Bhogal, Pervinder, additional, Lam, Erika, additional, Spooner, Oliver, additional, Meyer, Lukas, additional, Fiehler, Jens, additional, Papanagiotou, Panagiotis, additional, Kastrup, Andreas, additional, Alexandrou, Maria, additional, Zubel, Seraphine, additional, Wu, Qingyu, additional, Mpotsaris, Anastasios, additional, Maus, Volker, additional, Andersson, Tommy, additional, Gontu, Vamsi, additional, Arnberg, Fabian, additional, Lee, Tsong-Hai, additional, Chan, Bernard, additional, Teoh, Hock Luen, additional, Seet, Raymond C.S., additional, Sharma, Vijay, additional, and Yeo, Leonard L.L., additional

Published
2022
Full Text
View/download PDF

28. Combined balloon guide catheter, aspiration catheter, and stent retriever technique versus balloon guide catheter and stent retriever alone technique: a systematic review and meta-analysis.

Author

Yao Neng Teo, Ching-Hui Sia, Tan, Benjamin Y. Q., Jing Mingxue, Chan, Bernard, Sharma, Vijay Kumar, Makmur, Andrew, Gopinathan, Anil, Yang, Cunli, Loh, Stanley, Ng, Sheldon, Shao Jin Ong, Hock-Luen Teoh, Rathakrishnan, Rahul, Andersson, Tommy, Arnberg, Fabian, Gontu, Vamsi Krishna, Tsong-hai Lee, Maus, Volker, and Meyer, Lukas

Subjects
ONLINE information services, MEDICAL databases, META-analysis, MEDICAL information storage & retrieval systems, CONFIDENCE intervals, ISCHEMIC stroke, SYSTEMATIC reviews, INTRACRANIAL hemorrhage, SURGICAL stents, SURGICAL complications, TREATMENT effectiveness, THROMBECTOMY, CATHETERIZATION, REPERFUSION, MEDLINE, ODDS ratio, CATHETERS, CEREBRAL ischemia
Abstract

Background The use of a combination of balloon guide catheter (BGC), aspiration catheter, and stent retriever in acute ischemic stroke thrombectomy has not been shown to be better than a stent retriever and BGC alone, but this may be due to a lack of power in these studies. We therefore performed a meta-analysis on this subject. Methods A systematic literature search was performed on PubMed, Scopus, Embase/Ovid, and the Cochrane Library from inception to October 20, 2021. Our primary outcomes were the rate of successful final reperfusion (Treatment in Cerebral Ischemia (TICI) 2c-3) and first pass effect (FPE, defined as TICI 2c-3 in a single pass). Secondary outcomes were 3 month functional independence (modified Rankin Scale score of 0-2), mortality, procedural complications, embolic complications, and symptomatic intracranial hemorrhage (SICH). A meta-analysis was performed using RevMan 5,4, and heterogeneity was assessed using the I2 test. Results Of 1629 studies identified, five articles with 2091 patients were included. For the primary outcomes, FPE (44.9% vs 45.4%, OR 1.04 (95% CI 0.90 to 1.22), I²=57%) or final successful reperfusion (64.5% vs 68.6%, OR 0.98 (95% CI 0.81% to 1.20%), I²=85%) was similar between the combination technique and stent retriever only groups. However, the combination technique had significantly less rescue treatment (18.8% vs 26.9%; OR 0.70 (95% CI 0.54 to 0.91), I²=0%). This did not translate into significant differences in secondary outcomes in functional outcomes, mortality, emboli, complications, or SICH. Conclusion There was no significant difference in successful reperfusion and FPE between the combined techniques and the stent retriever and BGC alone groups. Neither was there any difference in functional outcomes, complications, or mortality. [ABSTRACT FROM AUTHOR]

Published
2023
Full Text
View/download PDF

29. Bridging thrombolysis versus direct mechanical thrombectomy in stroke due to basilar artery occlusion

Author

Tan, Benjamin, Siow, Isabel, Gopinathan, Anil, Yang, Cunli, Bhogal, Pervinder, Lam, Erika, Spooner, Oliver, Meyer, Lukas, Fiehler, Jens, Papanagiotou, Panagiotis, Alexandrou, Maria, Kastrup, Andreas, Zubel, Seraphine, Wu, Qingyu, Mpotsaris, Anastasios, Maus, Volker, Anderson, Tommy, Gontu, Vamsi, Arnberg, Fabian, Lee, Tsong Hai, Teoh, Hock Luen, Chan, Bernard Pl, Sharma, Vijay, Seet, Raymond Cs, and Yeo, Leonard

Published
2021
Full Text
View/download PDF

31. Preprocedural Imaging

Author

Jing, Mingxue, primary, Yeo, Joshua Y.P., additional, Holmin, Staffan, additional, Andersson, Tommy, additional, Arnberg, Fabian, additional, Bhogal, Paul, additional, Yang, Cunli, additional, Gopinathan, Anil, additional, Tu, Tian Ming, additional, Tan, Benjamin Yong Qiang, additional, Sia, Ching Hui, additional, Teoh, Hock Luen, additional, Paliwal, Prakash R., additional, Chan, Bernard P.L., additional, Sharma, Vijay, additional, and Yeo, Leonard L.L., additional

Published
2021
Full Text
View/download PDF

32. The effectiveness of the Safety in Interventional Radiology (SIR) Shield in reducing droplet transmission and its effect on image quality and radiation dose

Author

Ong, Shao Jin, primary, Anil, Gopinathan, additional, Chia, Koon Liang, additional, Khoo, Deborah, additional, Lee, Joseph KT, additional, Chen, Priscilla XH, additional, Nares, Teddy M, additional, Koh, Calvin J, additional, Su, Peijing, additional, Yang, Cunli, additional, Singh, Pavel, additional, Rajendran, Prapul C, additional, Fotheringham, Timothy, additional, Quek, Swee T, additional, and Renfrew, Ian, additional

Published
2021
Full Text
View/download PDF

34. Internal cerebral vein asymmetry is an independent predictor of poor functional outcome in endovascular thrombectomy

Author

Myint, May Zin, primary, Yeo, Leonard LL, additional, Tan, Benjamin Y Q, additional, The, Ei Zune, additional, Lim, Mei Chin, additional, Sia, Ching-Hui, additional, Teoh, Hock-Luen, additional, Sharma, Vijay Kumar, additional, Chan, Bernard, additional, Ahmad, Aftab, additional, Paliwal, Prakash, additional, Gopinathan, Anil, additional, Yang, Cunli, additional, Makmur, Andrew, additional, Andersson, Tommy, additional, Arnberg, Fabian, additional, and Holmin, Staffan, additional

Published
2021
Full Text
View/download PDF

35. Outcomes in Young Adults With Acute Ischemic Stroke Undergoing Endovascular Thrombectomy : A Multi-Centre Experience

Author

Chen, Vanessa, Tan, Benjamin, Tan, Aloysius, Meyer, Lukas, Fiehler, Jens, Tu, Tian-Ming, Tham, Carol Huilian, Sia, Ching-Hui, Jamous, Ala, Behme, Daniel, Kastrup, Andreas, Papanagiotou, Panagiotis, Styczen, Hanna, Forsting, Michael, Lee, Tsong-Hai, Chu, Chan-Lin, Fischer, Sebastian, Maus, Volker, Abdullayev, Nuran, Kabbasch, Christoph, Mönch, Sebastian, Maegerlein, Christian, Arnberg, Fabian, Andersson, Tommy, Holmin, Staffan, Paliwal, Prakash R., Ahmad, Aftab, Gopinathan, Anil, Yang, Cunli, Seet, Raymond C., Sharma, Vijay, Chan, Bernard P., and Yeo, Leonard

Subjects
Medizin
Published
2021

36. Outcomes in young adults with acute ischemic stroke undergoing endovascular thrombectomy: A real-world multicenter experience

Author

Yeo, Leonard Leong-Litt, Chen, Vanessa Hui En, Leow, Aloysius Sheng-Ting, Meyer, Lukas, Fiehler, Jens, Tu, Tian-Ming, Tham, Carol Huilian, Sia, Ching-Hui, Jamous, Ala, Behme, Daniel, Kastrup, Andreas, Papanagiotou, Panagiotis, Styczen, Hanna, Forsting, Michael, Lee, Tsong-Hai, Chu, Chan-Lin, Fischer, Sebastian, Maus, Volker, Abdullayev, Nuran, Kabbasch, Christoph, Moench, Sebastian, Maegerlein, Christian, Arnberg, Fabian, Andersson, Tommy, Holmin, Staffan, Teoh, Hock-Luen, Paliwal, Prakash, Ahmad, Aftab, Gopinathan, Anil, Yang, Cunli, Seet, Raymond Chee-Seong, Chan, Bernard Poon-Lap, Sharma, Vijay K., Tan, Benjamin Yong-Qiang, Yeo, Leonard Leong-Litt, Chen, Vanessa Hui En, Leow, Aloysius Sheng-Ting, Meyer, Lukas, Fiehler, Jens, Tu, Tian-Ming, Tham, Carol Huilian, Sia, Ching-Hui, Jamous, Ala, Behme, Daniel, Kastrup, Andreas, Papanagiotou, Panagiotis, Styczen, Hanna, Forsting, Michael, Lee, Tsong-Hai, Chu, Chan-Lin, Fischer, Sebastian, Maus, Volker, Abdullayev, Nuran, Kabbasch, Christoph, Moench, Sebastian, Maegerlein, Christian, Arnberg, Fabian, Andersson, Tommy, Holmin, Staffan, Teoh, Hock-Luen, Paliwal, Prakash, Ahmad, Aftab, Gopinathan, Anil, Yang, Cunli, Seet, Raymond Chee-Seong, Chan, Bernard Poon-Lap, Sharma, Vijay K., and Tan, Benjamin Yong-Qiang

Abstract

Endovascular thrombectomy (EVT) is the standard of care for anterior circulation acute ischemic stroke (AIS) with large vessel occlusion (LVO). Young patients with AIS-LVO have distinctly different underlying stroke mechanisms and etiologies. Much is unknown about the safety and efficacy of EVT in this population of young AIS-LVO patients. All consecutive AIS-LVO patients aged 50 years and below were included in this multicenter cohort study. The primary outcome measured was functional recovery at 90 days, with modified Rankin Scale of 0-2 deemed as good functional outcome. A total of 275 AIS-LVO patients that underwent EVT from 10 tertiary centers in Germany, Sweden, Singapore, and Taiwan were included. Successful reperfusion was achieved in 85.1% (234/275). Good functional outcomes were achieved in 66.0% (182/275). Arterial dissection was the most prevalent stroke etiology (42/195, 21.5%). National Institutes of Health Stroke Scale (NIHSS) score at presentation was inversely related to good functional outcomes (aOR: 0.92, 95% CI: 0.88-0.96 per point increase, p < 0.001). Successful reperfusion (aOR: 3.22, 95% CI: 1.44-7.21, p = 0.005), higher ASPECTS (aOR: 1.21, 95% CI: 1.01-1.44, p = 0.036), and bridging intravenous thrombolysis (aOR: 2.37, 95% CI: 1.29-4.34, p = 0.005) independently predicted good functional outcomes. Successful reperfusion was inversely associated with in-hospital mortality (aOR: 0.14, 95% CI: 0.03-0.57, p = 0.006). History of hypertension strongly predicted in-hospital mortality (aOR: 4.59, 95% CI: 1.10-19.13, p = 0.036). While differences in functional outcomes exist across varying stroke aetiologies, high rates of successful reperfusion and good outcomes are generally achieved in young AIS-LVO patients undergoing EVT.

Published
2021

37. Left ventricular systolic dysfunction is associated with poor functional outcomes after endovascular thrombectomy

Author

Tan, Benjamin Y. Q., Leow, Aloysius S. T., Lee, Tsong-Hai, Gontu, Vamsi Krishna, Andersson, Tommy, Holmin, Staffan, Wong, Ho-Fai, Lin, Chuan-Min, Cheng, Chih-Kuang, Sia, Ching-Hui, Ngiam, Nicholas, Ng, Zhi-Xuan, Yeo, Joshua, Chan, Bernard, Teoh, Hock-Luen, Seet, Raymond, Paliwal, Prakash, Anil, Gopinathan, Yang, Cunli, Maus, Volker, Abdullayev, Nuran, Mpotsaris, Anastasios, Bhogal, Pervinder, Wong, Ken, Makalanda, Hegoda Levansri Dilrukshan, Spooner, Oliver, Amlani, Sageet, Campbell, Daniel, Michael, Robert, Quaschling, Ulf, Schob, Stefan, Maybaum, Jens, Sharma, Vijay Kumar, Yeo, Leonard L. L., Tan, Benjamin Y. Q., Leow, Aloysius S. T., Lee, Tsong-Hai, Gontu, Vamsi Krishna, Andersson, Tommy, Holmin, Staffan, Wong, Ho-Fai, Lin, Chuan-Min, Cheng, Chih-Kuang, Sia, Ching-Hui, Ngiam, Nicholas, Ng, Zhi-Xuan, Yeo, Joshua, Chan, Bernard, Teoh, Hock-Luen, Seet, Raymond, Paliwal, Prakash, Anil, Gopinathan, Yang, Cunli, Maus, Volker, Abdullayev, Nuran, Mpotsaris, Anastasios, Bhogal, Pervinder, Wong, Ken, Makalanda, Hegoda Levansri Dilrukshan, Spooner, Oliver, Amlani, Sageet, Campbell, Daniel, Michael, Robert, Quaschling, Ulf, Schob, Stefan, Maybaum, Jens, Sharma, Vijay Kumar, and Yeo, Leonard L. L.

Abstract

Background Endovascular thrombectomy (ET) has transformed acute ischemic stroke (AIS) therapy in patients with large vessel occlusion (LVO). Left ventricular systolic dysfunction (LVSD) decreases global cerebral blood flow and predisposes to hypoperfusion. We evaluated the relationship between LVSD, as measured by LV ejection fraction (LVEF), and clinical outcomes in patients with anterior cerebral circulation LVO who underwent ET. Methods This multicenter retrospective cohort study examined anterior circulation LVO AIS patients from six international stroke centers. LVSD was measured by assessment of the echocardiographic LVEF using Simpson's biplane method of discs according to international guidelines. LVSD was defined as LVEF <50%. The primary outcome was defined as a good functional outcome using a modified Rankin Scale (mRS) of 0-2 at 3 months. Results We included 440 AIS patients with LVO who underwent ET. On multivariate analyses, pre-existing diabetes mellitus (OR 2.05, 95% CI 1.24 to 3.39;p=0.005), unsuccessful reperfusion (Treatment in Cerebral Infarction (TICI) grade 0-2a) status (OR 4.21, 95% CI 2.04 to 8.66; p<0.001) and LVSD (OR 2.08, 95% CI 1.18 to 3.68; p=0.011) were independent predictors of poor functional outcomes at 3 months. On ordinal (shift) analyses, LVSD was associated with an unfavorable shift in the mRS outcomes (OR 2.32, 95% CI 1.52 to 3.53; p<0.001) after adjusting for age and ischemic heart disease. Conclusion Anterior circulation LVO AIS patients with LVSD have poorer outcomes after ET, suggesting the need to consider cardiac factors for ET, the degree of monitoring and prognostication post-procedure.

Published
2021

38. Combined balloon guide catheter, aspiration catheter, and stent retriever technique versus balloon guide catheter and stent retriever alone technique: a systematic review and meta-analysis

Author

Teo, Yao Neng, Sia, Ching-Hui, Tan, Benjamin Y Q, Mingxue, Jing, Chan, Bernard, Sharma, Vijay Kumar, Makmur, Andrew, Gopinathan, Anil, Yang, Cunli, Loh, Stanley, Ng, Sheldon, Ong, Shao Jin, Teoh, Hock-Luen, Rathakrishnan, Rahul, Andersson, Tommy, Arnberg, Fabian, Gontu, Vamsi Krishna, Lee, Tsong-hai, Maus, Volker, Meyer, Lukas, Bhogal, Pervinder, Spooner, Oliver, Li, Tony YW, Soh, Rodney YH, and Yeo, Leonard LL

Abstract

BackgroundThe use of a combination of balloon guide catheter (BGC), aspiration catheter, and stent retriever in acute ischemic stroke thrombectomy has not been shown to be better than a stent retriever and BGC alone, but this may be due to a lack of power in these studies. We therefore performed a meta-analysis on this subject.MethodsA systematic literature search was performed on PubMed, Scopus, Embase/Ovid, and the Cochrane Library from inception to October 20, 2021. Our primary outcomes were the rate of successful final reperfusion (Treatment in Cerebral Ischemia (TICI) 2c–3) and first pass effect (FPE, defined as TICI 2c–3 in a single pass). Secondary outcomes were 3 month functional independence (modified Rankin Scale score of 0–2), mortality, procedural complications, embolic complications, and symptomatic intracranial hemorrhage (SICH). A meta-analysis was performed using RevMan 5,4, and heterogeneity was assessed using the I2test.ResultsOf 1629 studies identified, five articles with 2091 patients were included. For the primary outcomes, FPE (44.9% vs 45.4%, OR 1.04 (95% CI 0.90 to 1.22), I2=57%) or final successful reperfusion (64.5% vs 68.6%, OR 0.98 (95% CI 0.81% to 1.20%), I2=85%) was similar between the combination technique and stent retriever only groups. However, the combination technique had significantly less rescue treatment (18.8% vs 26.9%; OR 0.70 (95% CI 0.54 to 0.91), I2=0%). This did not translate into significant differences in secondary outcomes in functional outcomes, mortality, emboli, complications, or SICH.ConclusionThere was no significant difference in successful reperfusion and FPE between the combined techniques and the stent retriever and BGC alone groups. Neither was there any difference in functional outcomes, complications, or mortality.

Published
2023
Full Text
View/download PDF

39. Outcomes in young adults with acute ischemic stroke undergoing endovascular thrombectomy: A real‐world multicenter experience

Author

Yeo, Leonard Leong‐Litt, primary, Chen, Vanessa Hui En, additional, Leow, Aloysius Sheng‐Ting, additional, Meyer, Lukas, additional, Fiehler, Jens, additional, Tu, Tian‐Ming, additional, Tham, Carol Huilian, additional, Sia, Ching‐Hui, additional, Jamous, Ala, additional, Behme, Daniel, additional, Kastrup, Andreas, additional, Papanagiotou, Panagiotis, additional, Styczen, Hanna, additional, Forsting, Michael, additional, Lee, Tsong‐Hai, additional, Chu, Chan‐Lin, additional, Fischer, Sebastian, additional, Maus, Volker, additional, Abdullayev, Nuran, additional, Kabbasch, Christoph, additional, Mönch, Sebastian, additional, Maegerlein, Christian, additional, Arnberg, Fabian, additional, Andersson, Tommy, additional, Holmin, Staffan, additional, Teoh, Hock‐Luen, additional, Paliwal, Prakash, additional, Ahmad, Aftab, additional, Gopinathan, Anil, additional, Yang, Cunli, additional, Seet, Raymond Chee‐Seong, additional, Chan, Bernard Poon‐Lap, additional, Sharma, Vijay K., additional, and Tan, Benjamin Yong‐Qiang, additional

Published
2021
Full Text
View/download PDF

40. Endovascular Thrombectomy with and without Bridging Intravenous Tissue Plasminogen Activator in Acute Ischemic Stroke Patients with Basilar Artery Occlusion (2491)

Author

Siow, Isabel, primary, Ong, Natalie, additional, Gopinathan, Anil, additional, Yang, Cunli, additional, Chan, Bernard, additional, Sharma, Vijay, additional, Bhogal, Paul, additional, Meyer, Lukas, additional, Kutschke, Seraphine, additional, Wu, Qingyu, additional, Mpotsaris, Anastasios, additional, Maus, Volker, additional, Tan, Benjamin Yong Qiang, additional, and Yeo, Leonard, additional

Published
2021
Full Text
View/download PDF

42. Abstract P493: Outcomes in Young Adults With Acute Ischemic Stroke Undergoing Endovascular Thrombectomy: A Multi-Centre Experience

Author

Chen, Vanessa, primary, Tan, Benjamin, additional, Tan, Aloysius, additional, Meyer, Lukas, additional, Fiehler, Jens, additional, Tu, Tian-Ming, additional, Tham, Carol Huilian, additional, Sia, Ching-hui, additional, Jamous, Ala, additional, Behme, Daniel, additional, Kastrup, Andreas, additional, Papanagiotou, Panagiotis, additional, Styczen, Hanna, additional, Forsting, Michael, additional, Lee, Tsong-hai, additional, Chu, Chan-Lin, additional, Fischer, Sebastian, additional, Maus, Volker, additional, Abdullayev, Nuran, additional, Kabbasch, Christoph, additional, Mönch, Sebastian, additional, Maegerlein, Christian, additional, Arnberg, Fabian, additional, Andersson, Tommy, additional, Holmin, Staffan, additional, Paliwal, Prakash R, additional, Ahmad, Aftab, additional, Gopinathan, Anil, additional, Yang, Cunli, additional, Seet, Raymond C, additional, Sharma, Vijay, additional, Chan, Bernard P, additional, and Yeo, Leonard, additional

Published
2021
Full Text
View/download PDF

43. Abstract P108: Impact of the Covid-19 Pandemic on Hyperacute Stroke Treatment: Experience From a Comprehensive Stroke Centre in Singapore

Author

Paliwal, Prakash R, primary, Tan, Benjamin Y, additional, Leow, Aloysius, additional, Sibi, Sunny, additional, Chor, Daniel, additional, Chin, Amanda, additional, Yau, Ying-Wei, additional, Cross, Gail, additional, Wong, Lily, additional, Chia, Magdalene, additional, Quak, Zhixuan, additional, Chua, Christopher, additional, Tang, David, additional, Zune, Ei T, additional, Hung, Jennifer, additional, Goh, Yihui, additional, Jing, Mingxue, additional, Gopinathan, Anil, additional, Yang, Cunli, additional, Ahmad, Aftab, additional, Khoo, Deborah, additional, Lee, Chang-Chuan, additional, Seet, Raymond C, additional, Sharma, Vijay K, additional, Teoh, Hock-Luen, additional, Yeo, Leonard L, additional, and Chan, Bernard P, additional

Published
2021
Full Text
View/download PDF

44. Abstract P471: Ipsilateral Asymmetrical Internal Cerebral Vein on Multiphasic Computed Tomography for Acute Anterior Circulation Ischemic Stroke Thrombectomy is an Independent Predictor of Poor Functional Outcome

Author

Myint, May Zin, primary, Tan, Benjamin Yong Qiang, additional, Leow, Aloysius Sheng Ting, additional, The, Ei Zune, additional, Yang, Cunli, additional, Gopinathan, Anil, additional, Sharma, Vijay, additional, and Yeo, Leonard L, additional

Published
2021
Full Text
View/download PDF

45. Abstract WMP64: From Static Imaging to Hemodynamic Modelling: Validation of Intracranial Blood Flow Simulations Against Population-Based PC-MRI Studies

Author

Melih Engin, Yang Cunli, Milad Mohammadzadeh, Tian Ming Tu, Vivek Sharma, Leonard L.L. Yeo, Sadaf Monajemi, Robin Lange, Chin Kong Goh, David K Tang, and Sethu R Boopathy

Subjects
Advanced and Specialized Nursing, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Cerebral arteries, Hemodynamics, Magnetic resonance imaging, Population based, Blood flow, medicine.disease, Stenosis, Internal medicine, medicine, Cardiology, Neurology (clinical), Cardiology and Cardiovascular Medicine, business, Stroke
Abstract

Purpose: Modelling blood flow in cerebral arteries presents an opportunity to go beyond current luminal stenosis. These models could improve stroke prognostication by adding hemodynamic biomarkers such as translesional shear stress and pressure gradient. Such models, however, are rarely validated against real clinical data. We evaluated the accuracy of a computational fluid dynamics (CFD) model which uses allometric scaling laws against population-based Phase Contrast MRI (PC-MRI) measurements of blood flow in the brain. Methods: 3D models of the anterior circulation of 23 healthy subjects were reconstructed based on their MRA Time of Flight (TOF) images and CFD was used for modelling the blood flow. Lumped parameter Windkessel models were used as boundary conditions and allometric scaling laws were used to divide the flow and tune these boundary conditions, i.e. the resistance at each boundary was automatically adjusted based on the dimensions and branching of upstream vasculature. The results were compared against 4 PC-MRI studies from literature, covering a combined number of 417 healthy subjects. Results: The flow rate across 3 major intracranial arteries (ICA, MCA, and ACA) was obtained from the CFD simulations and was in good agreement with population-based PC-MRI studies. The agreement was 82.6% for the ICA, 85.9% for the MCA, and 80.4% for the ACA when comparing the average flow rate. The inter-patient variability of the flow rate (i.e. standard deviation) obtained from CFD simulations matched closely with the variation range measured in the literature. Allometric scaling enabled the model to accurately divide the flow at bifurcations (MCA/ICA flow ratio was 58.6% for the model vs 56.3% in the literature). We observed an average of 8 mmHg in pressure drop along the anterior circulation of healthy subjects (from ICA to MCA-M1 and ACA-A1), which agrees with the physiological range reported in the literature. Conclusion: This study shows the potential of accurately modelling blood flow based only on static images and demonstrates the validity of using allometric scaling in intracranial CFD simulations. The current modelling approach can potentially assist in stroke prognostication by obtaining hemodynamic risk factors from standard MRA TOF or CTA.

Published
2020

46. Very Late Leptomeningeal Collaterals—Potential New Way to Subdivide Modified Thrombolysis in Cerebral Ischemia (mTICI) 2B

Author

Yang Cunli, Sandra Cornelissen, Staffan Holmin, Pervinder Bhogal, Michael Söderman, Vamsi Gontu, Anil Gopinathan, Anastasios Mpotsaris, Amedeo Cervo, Leonard L.L. Yeo, Tommy Andersson, and Åke Holmberg

Subjects
Univariate analysis, medicine.medical_specialty, business.industry, medicine.medical_treatment, Ischemia, Odds ratio, Thrombolysis, Revascularization, medicine.disease, Confidence interval, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Modified Rankin Scale, Internal medicine, medicine, Cardiology, Radiology, Nuclear Medicine and imaging, Neurology (clinical), business, 030217 neurology & neurosurgery, Neuroradiology
Abstract

Studies have shown that the modified thrombolysis in cerebral ischemia (mTICI) 2B score is associated with better functional outcome; however, 50–99% reperfusion is a large range and there may be factors which can differentiate this further. The effects of very late leptomeningeal collaterals (VLLC) on mTICI-2B patients were studied. A prospectively collected registry of anterior circulation AIS patients treated with the EmboTrap revascularization device from 2013 to 2016 was evaluated. Imaging parameters and timings, including the mTICI score were verified by an external core laboratory blinded to the clinical data. The final angiogram was examined for the appearance of VLLC in predicting 3‑month outcomes including excellent functional outcomes, defined as modified Rankin scale (mRS) 0–1, bleeding risk and mortality. A total of 177 consecutive anterior circulation stroke patients were included in the analysis. Of these 94 (53.1%) achieved only mTICI-2B reperfusion, 16/94 (17.0%) patients achieved excellent functional outcomes at 3 months and 26 (27.7%) had hyperdensity on follow-up computed tomography (CT). On univariate analysis, the presence of VLLC was inversely associated with excellent functional outcomes at 3 months and positively associated with mortality in patients with mTICI-2B reperfusion. On multivariate analysis VLLC was inversely associated with excellent outcomes (odds ratio 0.075, 95% confidence interval 0.007–0.765, P = 0.029) but not associated with mortality. The mTICI-2B grade may be further refined by secondary radiological markers. The VLLC sign is associated with the loss of excellent functional outcomes at 3 months. It is a simple sign to discriminate mTICI-2B into different grades but should be verified in larger populations from other centers.

Published
2018

47. Left ventricular systolic dysfunction is associated with poor functional outcomes after endovascular thrombectomy

Author

Tan, Benjamin Y Q, primary, Leow, Aloysius ST, additional, Lee, Tsong-Hai, additional, Gontu, Vamsi Krishna, additional, Andersson, Tommy, additional, Holmin, Staffan, additional, Wong, Ho-Fai, additional, Lin, Chuan-Min, additional, Cheng, Chih-Kuang, additional, Sia, Ching-Hui, additional, Ngiam, Nicholas, additional, Ng, Zhi-Xuan, additional, Yeo, Joshua, additional, Chan, Bernard, additional, Teoh, Hock-Luen, additional, Seet, Raymond, additional, Paliwal, Prakash, additional, Anil, Gopinathan, additional, Yang, Cunli, additional, Maus, Volker, additional, Abdullayev, Nuran, additional, Mpotsaris, Anastasios, additional, Bhogal, Pervinder, additional, Wong, Ken, additional, Makalanda, Hegoda Levansri Dilrukshan, additional, Spooner, Oliver, additional, Amlani, Sageet, additional, Campbell, Daniel, additional, Michael, Robert, additional, Quäschling, Ulf, additional, Schob, Stefan, additional, Maybaum, Jens, additional, Sharma, Vijay Kumar, additional, and Yeo, Leonard LL, additional

Published
2020
Full Text
View/download PDF

48. Abstract WP80: Thrombus Imaging Characteristics and Association With Functional Outcomes in Patients Undergoing Endovascular Treatment

Author

Tang, David K, primary, Ng, Zhi-Xuan, additional, Yeo, Joshua, additional, Tan, Benjamin Y, additional, Chua, Christopher Y, additional, Sunny, Sibi, additional, Chia, Magdalene L, additional, Wong, Lily Y, additional, Widjaja, Louis, additional, Gopinathan, Anil, additional, Yang, Cunli, additional, Chan, Bernard P, additional, Teoh, Hock Luen, additional, Seet, Raymond C, additional, Paliwal, Prakash R, additional, Sharma, Vijay K, additional, and Yeo, Leonard L, additional

Published
2020
Full Text
View/download PDF

49. Abstract WP13: Left Ventricular Systolic Dysfunction is Associated With Poor Functional Outcomes and Mortality After Endovascular Thrombectomy for Acute Ischemic Stroke

Author

Tan, Benjamin Y, primary, Leow, Aloysius ST, additional, Sia, Ching-Hui, additional, Sunny, Sibi, additional, Ng, Zhi-Xuan, additional, Yeo, Joshua YP, additional, Chia, Magdalene LJ, additional, Wong, Lily YH, additional, Widjaja, Louis, additional, Gopinathan, Anil, additional, Yang, Cunli, additional, Chan, Bernard PL, additional, Teoh, Hock Luen, additional, Seet, Raymond CS, additional, Paliwal, Prakash R, additional, Sharma, Vijay K, additional, and Yeo, Leonard LL, additional

Published
2020
Full Text
View/download PDF

50. High incidence of under-treated atrial fibrillation: perspectives from an Asian Stroke Endovascular Thrombectomy Registry

Author

Tan, Benjamin Yong-Qiang, primary, Leow, Aloysius Sheng-Ting, additional, Teoh, Hock Luen, additional, Gopinathan, Anil, additional, Yang, Cunli, additional, Paliwal, Prakash R., additional, Sharma, Vijay K., additional, Seet, Raymond Chee-Seong, additional, Chan, Bernard Poon-Lap, additional, and Yeo, Leonard Leong-Litt, additional

Published
2019
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results