Publication spotlight

Your weekly dose of stroke research

The stroke world is an exciting and ever-changing field of research. Be sure to find important updates in the stroke world below, from the utilization of various biomarkers in the stroke workflow to the application of AI in stroke care.

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Influence of Onset to Imaging Time on Radiological Thrombus Characteristics in Acute Ischemic Stroke

This study investigated the influence of time on clot characteristics by measuring clot length, perviousness and density from admission CT imaging.

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Cerebral Edema in Patients With Large Hemispheric Infarct Undergoing Reperfusion Treatment

A secondary analysis of the HERMES dataset shows that patients with large infarction who undergo endovascular thrombectomy are more likely to experience cerebral edema, often with fatal consequences. This suggests that cerebral tissue responds differently depending on the state of the ischemic cascade: beneficial for salvageable tissue and detrimental for infarcted tissue. Thus highlighting the importance of proper patient triaging in acute ischemic stroke care.

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CTA-index as Simplified Measuring Method for Thrombus Perviousness

This study proposes a new imaging metric to measure thrombus perviousness. The metric uses the difference in HU in the CTA scan from the thrombus location with respect to a contralateral vessel. Higher values of the proposed CTA-index were found for patients with favorable outcome.

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Switching to Tenecteplase for Stroke Thrombolysis: Real-World Experience and Outcomes in a Regional Stroke Network

This study reports the implementation of tenecteplase for stroke thrombolysis at six centers in New Zealand. The pilot demonstrated clinician satisfaction and improved patient outcomes thus providing further evidence for its safety and efficacy profile.

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Diagnostic performance of StrokeViewer’s LVO detection algorithm

This study analysed a large cohort of patients (1756) by pooling datasets from the MRCLEAN registry and PRESTO trials. It reports the sensitivity and specificity of StrokeViewer’s LVO detection algorithm.

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Relevance of the cerebral collateral circulation in ischaemic stroke

This review paper from 4 years ago summarises very nicely  the role of collateral flow in ischemic core progression. Since then further research has evaluated the predictive power of collateral score on patient outcome.

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Predictors of Early and Late Infarct Growth in DEFUSE 3

This study analysed 70 cases with late follow-up scans from the DEFUSE 3 trial. It shows that poor collateral flow is associated with increased infarct growth within the first 24 hours, while absence of reperfusion is associated with increased infarct growth beyond 24 hours.

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Clot composition from admission CT imaging

Clot characteristics is an exciting area which is becoming better understood. It opens up a new valuable dimension to diagnosing patients in emergency care to determine which treatment would be best received. AI can play a big role in determining clot composition in the future.

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International Survey on AI in radiology

The paper summarises the results of an extensive survey answered by more than a thousand radiologists.

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Collateral Flow Modifies EVT Efficacy on LVO Strokes

This study investigated the effect of collateral flow on EVT success on more than 600 patients. The results show that good collateral flow is correlated with EVT efficacy. The authors hypothesize that collateral flow may increase distal pressure helping clot retrieval and reducing clot fragmentations.

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Effects of Collateral Status on Infarct Distribution Following EVT in LVO Stroke

This paper analysed the topological distribution of the infarcts in relation to collateral status and reperfusion rates. It suggests that the location of the infarct lesion may be more relevant than final infarct volume for patient triage.

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New Paper Quantifying the Health and Cost Effects of Faster EVT

Currently 20% of LVOs are initially undetected and 40% of patients are treated too late. At Nicolab we are working hard to ensure we help hospitals to reduce this % and streamline the workflow to reduce door to groin puncture time.

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Direct to Angiography vs Repeated Imaging Approaches in Transferred Patients Undergoing EVT

What is the association of direct to angiography (DTA) vs repeated imaging treatment paradigms with stroke management workflow and outcomes in patients transferred to endovascular thrombectomy centers?

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Association of Collateral Status and Ischemic Core Growth in Patients with AIS

The power of collaterals to influence outcome of stroke patients is evident, mainly through slowing down core growth.

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EVT in anterior circulation stroke beyond 6.5 hours after onset: results from MR CLEAN Registry

Treating the acute ischemic stroke victim is highly time-critical with each minute saved in onset-to-treatment time resulting in an average 22 days of healthy life.1 Since adequate treatment should be provided as fast as possible, target time goals have been established by the American Heart Association/American Stroke Association to improve clinical outcomes.

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The widespread availability and utilization of CTP

Treating the acute ischemic stroke victim is highly time-critical with each minute saved in onset-to-treatment time resulting in an average 22 days of healthy life.1 Since adequate treatment should be provided as fast as possible, target time goals have been established by the American Heart Association/American Stroke Association to improve clinical outcomes.

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Generating brain CT images using Disentangled Variational Autoencoders

Treating the acute ischemic stroke victim is highly time-critical with each minute saved in onset-to-treatment time resulting in an average 22 days of healthy life.1 Since adequate treatment should be provided as fast as possible, target time goals have been established by the American Heart Association/American Stroke Association to improve clinical outcomes.

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