Quiz – Day 3, the answers!

 

Here are the answers to our quiz

1. What is the percentage of SVS – occlusion on GRE imaging (not SWI or SWAN) ?

a) 70%
b) 40%
c) Less than 30%
d) More than 90%

Read more on Predictive Value of Susceptibility Vessel Sign for Arterial Recanalization and Clinical Improvement in Ischemic Stroke. Darcout J, Stroke, 2019

 

2. From retrospective studies, what would be the preferred first line MT strategy in case of SVS + occlusion on GRE MRI?

a) Contact aspiration
b) Stent retriever
c) SVS is a predictor of lower recanalization after MT
d) Contact aspiration but exclusively in patient receiving IVT

Read more on Predictive Value of Susceptibility Vessel Sign for Arterial Recanalization and Clinical Improvement in Ischemic Stroke. Darcout J, Stroke, 2019 and Susceptibility vessel sign on MRI predicts better clinical outcome in patients with anterior circulation acute stroke treated with stent retriever as first-line strategy. Bourcier R, JNIS, 2019 and Susceptibility Vessel Sign in the ASTER Trial: Higher Recanalization Rate and More Favourable Clinical Outcome after First Line Stent Retriever Compared to Contact Aspiration. Bourcier R, J Stroke, 2018

 

3. An irregular phenotype of M1-MCA occlusion is associated with …

a) Higher recanalization rates if aspiration is used as first-line technique
b) Higher recanalization rates if stent is used as first-line technique
c) Higher complications rates
d) No differences between the two techniques

Read more on Effect of the phenotype of the M1-middle cerebral artery occlusion on the recanalization rates in the ASTER trial. Consoli A, JNIS, 2019

 

4. The better clinical outcome in patients with irregular phenotype occlusions treated by stent as first line approach could be explained by …

a) The lower number of maneuvers needed
b) The higher first pass effect rate
c) The shorter procedure time
d) a + b + c

Read more on Effect of the phenotype of the M1-middle cerebral artery occlusion on the recanalization rates in the ASTER trial. Consoli A, JNIS, 2019

 

5. From the DAWN trial we know now that in the “late time window” …

a) Size of the penumbra on CTP is an important measure to select patients for thrombectomy
b) Patients with a small core on CTP have no benefit from thrombectomy
c) Patients with a small core and severe symptoms benefit from thrombectomy
d) Young patients with mild symptoms benefit from thrombectomy

Read more on Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct. Nogueira RG, 2018, NJM

 

6. The result of ASTER’s primary outcome was …

a) Aspiration first shows similar technical result (mTICI score) as stent retriever first
b) Stent retriever first leads to better clinical outcome (mRS score) than aspiration first
c) Aspiration first is associated with more distal emboli than stent retriever first
d) Early neurologic recovery (measured with NIHSS) was non-significantly higher in aspiration first

Read more on Effect of Endovascular Contact Aspiration vs Stent Retriever on Revascularization in Patients With Acute Ischemic Stroke & Large Vessel Occlusion – The ASTER Randomized Clinical Trial. Lapergue B, 2017, JAMA

 

7. SVS+ is associated with better clinical outcome at 3 months follow-up …

a) It is completely true
b) It is true, but data derived from retrospective series
c) It is not true
d) Very few patients are SVS+ and there is not available data in the literature

Read more on Predictive Value of Susceptibility Vessel Sign for Arterial Recanalization and Clinical Improvement in Ischemic Stroke. Darcout J, Stroke, 2019 and Susceptibility vessel sign on MRI predicts better clinical outcome in patients with anterior circulation acute stroke treated with stent retriever as first-line strategy. Bourcier R, JNIS, 2019 and Susceptibility Vessel Sign in the ASTER Trial: Higher Recanalization Rate and More Favourable Clinical Outcome after First Line Stent Retriever Compared to Contact Aspiration. Bourcier R, J Stroke, 2018

 

8. SVS is observed in case of …

a) Red blood cell-dominant clots
b) Higher fibrin content
c) Atherosclerotic plaque
d) None of the above reported answers

Read more on Predictive Value of Susceptibility Vessel Sign for Arterial Recanalization and Clinical Improvement in Ischemic Stroke. Darcout J, Stroke, 2019 and Susceptibility vessel sign on MRI predicts better clinical outcome in patients with anterior circulation acute stroke treated with stent retriever as first-line strategy. Bourcier R, JNIS, 2019 and Susceptibility Vessel Sign in the ASTER Trial: Higher Recanalization Rate and More Favourable Clinical Outcome after First Line Stent Retriever Compared to Contact Aspiration. Bourcier R, J Stroke, 2018

 

9. Based on the classic anatomical nomenclature of the MCA segments, lenticulostriate arteries originate from …

a) Horizontal segment (M1 or basal)
b) M1 and M2 segments
c) M3 (opercular)
d) M4 (cortical)

Read more on Rhoton: Cranial Anatomy and Surgical Approaches: Neurosurgery

 

10. Acute ischemic stroke involving lenticulostriate arteries …

a) Infarction of the Lentiform nucleus is detected in 60% of cases
b) The basal ganglia are vulnerable to ischemia
c) Hemorrhagic transformation often occurs in the lentiform nucleus without a mass effect
d) a + b + c

Read more on Impact of basal ganglia damage after successful endovascular recanalization for acute ischemic stroke involving lenticulostriate arteries. Horie, JNS, 2019

 

11. What is the rate of hemorrhagic transformation in basal ganglia after reperfusion?

a) It is close to 5%
b) It is quite high (close to 45%) but without a significant neurological impact
c) It is quite high with a significant neurological impact
d) It is close to 80%

Read more on Impact of basal ganglia damage after successful endovascular recanalization for acute ischemic stroke involving lenticulostriate arteries. Horie, JNS, 2019

 

12. What are the imaging thrombus characteristics potentially related with reperfusion and good functional outcome?

a) Distal location, higher CBS, and shorter length
b) Pervious thrombus
c) T carotid occlusion
d) a + b

Read more on Thrombus Imaging Characteristics and Outcomes in Acute Ischemic Stroke Patients Undergoing Endovascular Treatment. Dutra BG, Stroke, 2019