Quiz – Day 2, the answers!

 

Here are the answers to our quiz

1. Which of the following answers about stroke care organization is wrong?

a) Typically, the onset-to-reperfusion times were significantly shorter in the mothership group than in the drip-and-ship group
b) Data from randomized controlled trials show the general superiority of the mothership approach over the drip-and-ship approach
c) If the location of the stroke patient is just as far from or closer to a comprehensive stroke center (CSC) than a primary stroke center (PSC), the patient should be transported directly to the CSC by mothership
d) If a PSC is closer to the stroke site than a CSC and the time after the onset of symptoms is within the lysis time window, this decision depends on many variables

Read more on Mothership versus drip and ship for thrombectomy in patients who had an acute stroke: a systematic review and meta-analysis. Ismal M, JNIS, 2019

 

2. Acute stenting in acute ischaemic stroke patients who have failed MT has a low risk of hemorrhage?

a) Yes, it is very low
b) No, the risk is very high
c) The risk is the same of the MT
d) The risk is reported sligtly higher, but available data derived from retrospective series

Read more on Rescue intracranial stenting following failed mechanical thrombectomy for acute ischaemic stroke: a systematic review and meta-analysis. Maingard J, WN, 2019

 

3. What is the natural course of chronically occluded ICA with hemodynamic impairment?

a) Natural history is favorable, and the rate of ischaemic events is negligible
b) The stroke rate is reported between 10% and 20% per year
c) The stroke rate is higher than 50%
d) Chronic occlusion of the ICA is rarely associated with hemodynamic impairment because of the development of collateral anastomosis

Read more on Cognitive and cerebral hemodynamic effects of endovascular recanalization of chronically occluded cervical internal carotid artery: single-center study and review of the literature. Zanaty M, JNS, 2019

 

4. What is the rate of successful revascularization reported in the literature after endovascular treatment of chronically occluded ICA?

a) The probability of succesful revascularization is close to 80%
b) It is difficult to estimate the rate of successful revascularization because it is largely influenced by the lenght and time of the occlusion
c) Based on the available data of the literature, it is quite variable and reported between 25% and 100%
d) b + c

Read more on Feasibility, safety, and changes in systolic blood pressure associated with endovascular revascularization of symptomatic and chronically occluded cervical internal carotid artery using a newly suggested radiographic classification of chronically occluded cervical internal carotid artery: pilot study. Hasan, JNS, 2018

 

5. Based on the available literature, what is the reported rate of complication after endovascular revascularization of chronically occluded ICA?

a) Complications are very low
b) Endovascular revascularization of chronically occluded ICA is technically demanding with complication rate up to 18%
c) Complication rates are mainly related to the type and length of occlusion and it ranges between 0% and 18%
d) b + c

Read more on Feasibility, safety, and changes in systolic blood pressure associated with endovascular revascularization of symptomatic and chronically occluded cervical internal carotid artery using a newly suggested radiographic classification of chronically occluded cervical internal carotid artery: pilot study. Hasan, JNS, 2018

 

6. What are the angiographic signs of chronically occluded ICA?

a) Completely flow arrest at the bulb of the ICA
b) Presence of ECA-ICA anastomosis generally through the Ophthalmic and MMA artery
c) Pial collaterals
d) All of the above reported answers are trues

Read more on Feasibility, safety, and changes in systolic blood pressure associated with endovascular revascularization of symptomatic and chronically occluded cervical internal carotid artery using a newly suggested radiographic classification of chronically occluded cervical internal carotid artery: pilot study. Hasan, JNS, 2018

 

7. Based on the available data from retrospective series, the use of bailout self-expandable stents is associated with a risk of ICH close to …

a) 3%
b) 12%
c) 30%
d) Between 0-8%

Read more on A systematic review and meta-analysis of observational evidence for the use of bailout selfexpandable stents following failed anterior circulation stroke thrombectomy. Wareham J, JNIS, 2019

 

8. Based on the available data from retrospective series, the use of bailout self-expandable stents is associated with a rate of successful recanalization close to …

a) 70%
b) 50%
c) 30%
d) 10%

Read more on A systematic review and meta-analysis of observational evidence for the use of bailout selfexpandable stents following failed anterior circulation stroke thrombectomy. Wareham J, JNIS, 2019

 

9. What about MT for LVO and NIHSS<6?

a) Guidelines recommending treatment for NIHSS ≥6
b) Data from retrospective series are contradictory and we need randomized trials
c) sICH rate is higher compared to conservative treatment
d) a + b + c

Read more on Endovascular Thrombectomy for Mild Strokes: How Low Should We Go? Serraj A, Stroke, 2018 and Endovascular thrombectomy versus medical treatment for large vessel occlusion stroke with mild symptoms: A meta-analysis. Xiong XJ, Plos One, 2018

 

10. What is the rate of functional independence after MT for LVO and NIHSS <6?

a) Close to 60% in retrospective series
b) Less than 30%
c) Close to 90%
d) None of the above reported answers

Read more on Endovascular Thrombectomy for Mild Strokes: How Low Should We Go? Serraj A, Stroke, 2018 and Endovascular thrombectomy versus medical treatment for large vessel occlusion stroke with mild symptoms: A meta-analysis. Xiong XJ, Plos One, 2018

 

11. About tandem occlusions, which of the following sentences are true?

a) There is a high variability in practice about acute management of tandem occlusion
b) Tandem occlusion should be always treated with acute carotid stenting
c) Acute carotid stenting can effective especially for patients with a small infarct core
d) a + c

Read more on Carotid Artery Stenting and Intracranial Thrombectomy for Tandem Cervical and Intracranial Artery Occlusions. Kim B, Neurosurgery, 2019

 

12. Based on retrospective studies, what is the rate of ICH after acute carotid stenting of tandem occlusions?

a) Higher than 30%
b) Approximately 10%
c) Between 40% and 60%
d) Higher than 60%

Read more on Carotid Artery Stenting and Intracranial Thrombectomy for Tandem Cervical and Intracranial Artery Occlusions. Kim B, Neurosurgery, 2019

 

13. What is the proportion of tandem occlusion among LVO patients?

a) Approximately 20%
b) More than 50%
c) Approximately 70%
d) Less than 5%

Read more on Acute ischemic stroke with tandem lesions: technical endovascular management and clinical outcomes from the ESCAPE trial. JNIS, Assis Z. 2018