Aagesenbooth9986

INTRODUCTION Despite increasing interest in endovascular therapy (EVT) for large-core strokes, little is known about the predictors of good outcome in these patients. The aim of this study was to analyze patients with large core strokes post-EVT and to define the predictors of favorable outcome in this population. METHODS A retrospective analysis of prospectively-collected data on anterior circulation strokes undergoing EVT between January 2015 and February 2018 was performed. Patients with good baseline functional status who underwent EVT for occlusion of an anterior circulation artery and achieved successful recanalization (mTICI ≥2b) but had large follow-up infarcts (FIV ≥70 cm3) were included in the study. learn more Demographic characteristics, clinical and radiological data, treatment and post-procedural outcomes were extracted and analyzed. The primary outcome was 90-day mRS, stratified by favorable (mRS 0-3) versus unfavorable (mRS 4-6). RESULTS Of 355 patients meeting inclusion criteria, 85 (24%) had large FIV on follow-up imaging after EVT and constituted the study cohort. No patients achieved mRS 0-2 at hospital discharge; 32% had 90-day mRS 0-3. On multivariate logistic regression analysis, lower FIV [OR-0.96 (0.95-0.99), p=0.007], male sex [OR-1.29 (1.07-12.3), p=0.026] and IV t-PA use [OR=3.6 (2.01-8.9), p=0.003] were independent predictors of favorable outcome. Independent predictors of mortality on multivariate analysis were higher FIV [OR-1.01 (1.007-1.02), p=0.001] and female sex [OR=4.08 (1.25-13.3), p=0.02]. CONCLUSION For patients with large-core strokes (≥70 cm3) after EVT, approximately one-third have favorable outcome at 90 days. Independent predictors of favorable 90-day outcomes include male sex, IV-tPA use, and lower FIV. INTRODUCTION Management of small unruptured aneurysms is controversial. Small aneurysms and those with low PHASES scores are often observed. The primary aim of this study was to assess whether the PHASES score classified our subarachnoid hemorrhage patients as high risk for rupture. MATERIALS AND METHODS We retrospectively reviewed a consecutive series of 628 aneurysmal subarachnoid hemorrhage neurosurgical cases over a 10-year period between 2008 and 2018. We collected patient and aneurysm characteristics and calculated PHASES scores. RESULTS The median aneurysm size was 5.3 (IQR 3.5-7). 75% (473/628) of aneurysms were less than 7 mm in size. Nearly half of aneurysms were less than 5 mm (48%, 302/628). The median PHASES score was 5 (IQR 4-6), corresponding to a 5-year risk of rupture of only 1.3%. Discussion The majority of ruptured aneurysms in our series were small with low PHASES scores, suggesting a low risk of rupture. Many of these patients would have been conservatively managed. CONCLUSIONS PHASES is inadequate in management of unruptured aneurysms, as it fails to identify many patients at risk for subarachnoid hemorrhage. A more nuanced assessment of rupture risk should be undertaken. PURPOSE To evaluate the agreement between detection of activity of choroidal neovascularization (CNV) in neovascular age-related macular degeneration (AMD) by fundus fluorescein angiography (FFA) and spectral domain (SD)- optical coherence tomography (OCT) in the HARBOR study. Most retina specialists rely on OCT to guide treatment decisions in neovascular AMD. However, OCT may not always detect exudative activity. Traditionally, FFA was frequently performed in clinical practice, but its use has diminished due to reliance on OCT. DESIGN Retrospective Post Hoc Analysis of Prospective Clinical Trial (HARBOR; clinicaltrials.gov identifier, NCT00891735) PARTICIPANTS Baseline to Month 24 data from all randomized study eyes in HARBOR with both FFA and SD-OCT data were analyzed for 1) Evidence of CNV activity on SD- OCT (presence of subretinal fluid, intraretinal fluid, and/or cystoid spaces); 2) Evidence of CNV activity on FFA identified by the presence of leakage 3) Cross tabulation of CNV activity identified by FFns that appear quiescent on SD-OCT, as this type of lesion may show leakage on FFA. BACKGROUND & Aims There is debate over the optimal method for colonoscopic surveillance of patients with inflammatory bowel diseases. Guidelines recommend chromoendoscopy, but the value of chromoendoscopy in high-definition colonoscopy has not been proven. Furthermore, the value of random biopsies is controversial. METHODS We performed a prospective study of 305 patients with ulcerative colitis or Crohn's colitis referred for surveillance colonoscopy at a university hospital in Sweden, from March 2011 through April 2016. Patients randomly assigned to a group that received high-definition chromoendoscopy with indigo carmine (HD-CE, n=152), collection of 32 random biopsies, and targeted biopsies or polypectomies or to a group that received high-definition white light endoscopy (HD-WLE, n=153), collection of 32 random biopsies, and targeted biopsies or polypectomies. The primary endpoint was number of patients with dysplastic lesions. RESULTS Dysplastic lesions were detected in 17 patients with HD-CE and 7 patients with HD-WLE (P =.032). Dysplasias in random biopsies (n=9760) were detected in 9 patients 6 (3.9%) in the HD-CE group and 3 (2.0%) in the HD-WLE group (P=.72). Of the 9 patients with dysplasia, 3 patients (33%) had primary sclerosing cholangitis-only 18% of patients (54/305) included in the study had primary sclerosing cholangitis. The number of dysplastic lesions per 10 min of withdrawal time was 0.066 with HD-CE and 0.027 with HD-WLE (P=.056). CONCLUSION In a randomized trial, we found HD-CE with collection of random biopsies to be superior to HD-WLE with random biopsies for detection of dysplasia per colonoscopy. These results support the use of chromoendoscopy for surveillance of patients with inflammatory bowel diseases. ClinicalTrials.gov no NCT01505842. BACKGROUND & AIMS We compared rates of relapse of hepatitis B virus (HBV) infection between patients with HBV genotype B vs genotype C infection after cessation of entecavir or tenofovir disoproxil fumarate (TDF) therapy. All patients included in the study were HB e antigen (HBeAg)-negative. METHODS We performed a retrospective study of 460 HBeAg-negative patients without cirrhosis in Taiwan who had stopped entecavir or TDF treatment for at least 12 months; data were collected from 2007 through 2015. All patients fulfilled the stopping criteria proposed by the APASL 2012 guidelines. Patients were evaluated every 1-3 months during the first 6 months after stopping therapy and then every 3 months until their last hospital visit; HB surface antigen (HBsAg) was measured in serum samples collected before treatment, after 12 months of treatment, and at the end of treatment. Virologic relapse was defined as a serum level of HBV DNA >2000 IU/mL after the cessation of treatment; clinical relapse was defined as increase in alanine aminotransferase more than 2-fold the upper limit of normal (40 U/L) and level of HBV DNA >2000 IU/mL after stopping treatment.