- Diagnostic Yield of Catheter Angiography in Patients with Subarachnoid Hemorrhage and Negative Initial Noninvasive Neurovascular Examinations
These authors explored the diagnostic yield of DSA in patients with SAH and previously negative CTA or MRA. A total of 55 patients who presented with diffuse SAH, perimesencephalic SAH, or sulcal SAH received CTA (n= 47) or MRA (n= 8). Despite normal findings on CTA or MRA, DSA showed vascular lesions in 11% of patients with diffuse SAH and in 1 patient with sulcal SAH. The investigators concluded that DSA is a valuable tool in patients with diffuse or sulcal SAH in whom previous noninvasive examinations are negative.
- Evaluation of an Intravenous-Endovascular Strategy in Patients with Acute Proximal Middle Cerebral Artery Occlusion
Here, the safety and efficacy of mechanical thrombectomy after intravenous therapy failure were assessed in 123 patients with acute MCA occlusions. All patients imaged were within 4.5 hours of onset, had DWI ASPECTS greater than 5, and variable NIHSS scores (8–25). The authors found that mechanical thrombectomy after failure of intravenous thrombolysis improves clinical outcomes at 3 months and could represent an alternative in the management of patients with acute MCA occlusion. Additionally, no symptomatic intracranial hemorrhages were detected in patients treated this way, suggesting this protocol is safe.
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