BACKGROUND AND PURPOSE: Emergent carotid artery stenting (eCAS) performed during endovascular treatment (EVT) for acute ischemic stroke (AIS) is associated with increased rates of stent thrombosis. Very limited data is available regarding long-term carotid stent patency or target lesion revascularization (TLR) rates beyond the first 24 hours post EVT. MATERIALS AND METHODS: We retrospectively analyzed a prospectively maintained stroke EVT database at Strasbourg University Hospitals, including all consecutive patients treated with eCAS during EVT for AIS with tandem lesions (TL) or isolated carotid artery occlusion (ICAO), between November 2009–September 2024. RESULTS: A total of 220 patients were included in the study, of which 207 TL and 13 ICAO. Stent occlusion or severe stenosis at 24 hours was observed in 8.6% of cases. Follow-up imaging beyond day 1 (median 112 days, IQR 30-216) revealed two additional cases of stent occlusion (1.3%) at day 4 and 5. In-stent restenosis (at least 5

BACKGROUND AND PURPOSE: The non-contrast CT (NCCT) appearance of liquid embolic material post-middle meningeal artery embolization (MMAE) for chronic subdural hematomas (cSDH) is poorly described. We aimed to categorize the spectrum of post-procedural liquid embolic distribution and determine whether embolic penetration impacts resorption. MATERIALS AND METHODS: We retrospectively reviewed patients with cSDH >5 mm at a single institution from 2019-2024. Patients with <1 month of follow-up imaging or embolization with coils or particles were excluded. Embolic membrane penetration during angiography was recorded, and the postprocedural appearance of embolic material was classified. Regression analyses were performed to assess if specific embolic distributions were associated with greater resorption. RESULTS: Eighty-eight patients (73.9% male; mean age 73.5±11.2 years) with 109 unilateral cSDHs were included. Membrane penetration occurred in 39 cases (35.8%). On follow-up NCCT, liquid emb

BACKGROUND: Middle meningeal artery embolization (MMAE) has emerged as a novel treatment for non-acute subdural hematoma (SDH), particularly for reducing the risk of SDH recurrence. Recently, five randomized controlled trials (RCT) of MMAE as an adjunct to conventional management (surgical or observant) have concluded their investigation and reported their outcomes. PURPOSE: To synthesize trial results to provide more definitive guidance on the role of MMAE in the management of non-acute SDH. DATA SOURCES: MEDLINE database from inception up to November 23, 2024. English-language clinical articles reporting large randomized controlled trials (n=100 or more) investigating the efficacy and safety of MMAE for non-acute subdural hematoma patients were identified. STUDY SELECTION: Five trials were identified – EMBOLISE, STEM, MAGIC-MT, EMPROTECT, and MEMBRANE. DATA ANALYSIS: The primary efficacy endpoint was SDH treatment failure (broadly defined as SDH recurrence or requirement of surgical

Background: This review critically analyzed recent publications on large-core Randomized Controlled Trials (RCTs). Six RCTs demonstrated the superiority of mechanical thrombectomy over the best medical treatment in patients with low ASPECTs. However, the use of ASPECTs to define the ischemic core has limitations in detecting ischemic changes beyond the middle cerebral artery (MCA) territory. This review evaluates the implications of this choice on the external validity of the trials. Methods: The study evaluated ASPECTS reliability by examining the anatomical details of occlusion location, collateral blood flow, and perfusion imaging. An analysis comparing the HERMES collaboration with six RCTs on large-core infarcts was conducted to investigate how the occlusion site affects infarct size and salvageable brain tissue, as well as to support pathophysiological assessment. Key Message: RCTs indicated a trend toward more proximal occlusions in large-core trials compared to HERMES collabora

SUMMARY: Mechanical thrombectomy devices have potential to injure the vessel during treatment of acute ischemic stroke. The goal of the current work was to tailor in vitro endothelialized silicone models for stent retriever assessment and to evaluate endothelial injury following treatment by various stent retriever designs and sizes. Clinically relevant neurovascular geometries were first modeled out of silicone, then sterilized, coated with fibronectin, placed in bioreactors, seeded with human endothelial cells, and cultivated under flow. Several sizes of 2 different commercially available stent retrievers were then deployed in, and retracted through, vessels. Vessels were immediately harvested and stained. Endothelial injury, identified as denudation, was quantified by using ImageJ. Results illustrated that endothelial injury ranged from 16%–18% in wire/microcatheter-only treated vessels, 37%–61% in 1-pass treatments, and 52%–70% in 2-pass treatments. Overall, this work showcases an