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"Abstraction."
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Architecture and abstraction
\"A history of the relationship between modern architecture and abstraction\"-- Provided by publisher.
Book
ABSTRACT NUMBER: ESOC2026A2458 OCCLUSION SITE AND TREATMENT EFFECT IN VERTEBROBASILAR ARTERY OCCLUSION: A POOLED ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
Abstract
Background and aims
Vertebrobasilar artery occlusions (VBAO) are anatomically heterogeneous, and the occlusion site may influence both prognosis and response to endovascular therapy (EVT). We evaluated the association between occlusion location and outcomes and assessed whether EVT benefit varies by anatomical site.
Methods
We performed an individual patient data meta-analysis pooling randomized controlled trial data from BASICS, BEST, ATTENTION, and BAOCHE. Occlusion sites were classified as vertebral artery V4, proximal basilar artery (BA), mid-BA, and distal BA (reference). The primary outcome was a favorable functional outcome (modified Rankin Scale [mRS] 0–3) at 90 days. Multivariable logistic regression assessed associations between occlusion site and outcomes, with interaction testing between occlusion site and treatment.
Results
Among 832 patients with documented occlusion sites, 5.5% had V4, 33.8% proximal BA, 31.0% mid-BA, and 29.7% distal BA occlusions. Intracranial atherosclerosis was more frequent in proximal locations (V4: 67.4%; proximal BA: 65.6%) than distal BA (19.0%; P<0.001). Favorable outcomes occurred in 41.3% of V4, 32.4% of proximal BA, 34.5% of mid-BA, and 48.2% of distal BA occlusions (P=0.001). Compared with distal BA, proximal BA (adjusted OR [aOR] 0.46, 95% CI 0.31–0.70) and mid-BA (aOR 0.45, 95% CI 0.30–0.69) were associated with worse outcomes (P<0.001). However, a significant interaction between occlusion site and treatment was observed (P=0.004), with greater relative EVT benefit in proximal occlusions (interaction OR 2.77, 95% CI 1.38–5.58).
Conclusions
Occlusion site strongly influences prognosis in VBAO. Despite worse baseline outcomes, proximal occlusions appear to derive greater relative benefit from EVT compared with distal occlusions.
Conflict of interest
No relevant disclosures to this work.
Journal Article
Wallace Stevens and the aesthetics of abstraction
\"Edward Ragg's study re-considers the role of abstraction in the work of Wallace Stevens. By tracing the poet's interest in abstraction from Harmonium through to his later works, Ragg argues that Stevens only fully appreciated and refined this interest within his later career. Ragg's detailed close-readings highlight the poet's absorption of late nineteenth century and early twentieth century painting, as well as the examples of philosophers and other poets' work. Wallace Stevens and the Aesthetics of Abstraction will appeal to those studying Stevens as well as anyone interested in the relations between poetry and painting. This valuable study embraces revealing philosophical and artistic perspectives, analyzing Stevens' place within and resistance to Modernist debates concerning literature, painting, representation and 'the imagination'\"-- Provided by publisher.
Book
ABSTRACT NUMBER: ESOC2026LB113 THE PROGNOSIS OF VASCULAR DEMENTIA DEVELOPMENT IN PATIENTS WHO HAVE HAD AN ISCHEMIC STROKE
Abstract
Background and aims
Reducing vascular dementia in patients who have had a stroke
Methods
A retrospective review of cohort studies, clinical trials, and meta-analyses published in recent years was conducted. Demographic, clinical, and neuroimaging predictors were analyzed with statistical significance at p<0.05
Results
Stroke severity (high NIHSS), recurrence, dominant hemisphere lesions, advanced age, hypertension, diabetes, atrial fibrillation, leukoaraiosis, silent infarcts, and cerebral atrophy were confirmed as major predictors.
Conclusions
Combined evaluation of clinical and MRI markers allows early prediction and prevention of post-stroke vascular dementia.
Conflict of interest
Journal Article
ABSTRACT NUMBER: ESOC2026YS237 SOCIOECONOMIC INEQUALITIES IN POST-STROKE OUTCOMES PERSIST, BUT CAUSAL MECHANISMS REMAIN UNCLEAR. WE USED COUNTERFACTUAL MEDIATION ANALYSIS TO QUANTIFY THESE PATHWAYS
Abstract
Background and aims
Socioeconomic inequalities in post-stroke outcomes persist, but causal mechanisms remain unclear. We used counterfactual mediation analysis to quantify these pathways.
Methods
We included all first-ever stroke patients from the South London Stroke Register (1995-2025), stratified by decade. Socioeconomic status (SES) was measured using Index of Multiple Deprivation quintiles (1-2 vs 3-5). Outcomes at 3-months, 1-year and 5-years included disability (Barthel Index), dependency (Frenchay Activities Index), quality of life (SF-12), and depression/anxiety (HADS). We estimated total effects using regression models adjusted for age and sex, then conducted counterfactual mediation analysis where inequalities existed. Mediators included cardiovascular risk factors (hypertension, diabetes, smoking, atrial fibrillation, alcohol, hypercholesterolaemia) at baseline and follow-up, stroke severity, stroke unit access, secondary prevention medications, and rehabilitation. Multiple imputation addressed missing data.
Results
Preeliminary results, analysis ongoing.
Conflict of interest
Camila Pantoja-Ruiz: Nothing to disclose
Journal Article
ABSTRACT NUMBER: ESOC2026A646 DRUG-ELUTING VERSUS BARE-METAL BALLOON-MOUNTED STENT FOR ACUTE INTRACRANIAL STENTINGS: INSIGHTS FROM THE RESISTANT REGISTRY
Abstract
Background and aims
Rescue intracranial stenting is increasingly used in patients with large vessel occlusion (LVO) when reperfusion fails or when severe stenosis is present. This study aimed to evaluate the influence of drug-eluting technology on clinical and radiological outcomes from the RESISTANT registry.
Methods
The RESISTANT registry is a multicenter and international which includes patients who underwent intracranial stenting during endovascular treatment for acute ischemic stroke (2016–2023). The primary endpoint was good functional outcome at 90 days (mRS 0–2). Secondary endpoints included successful reperfusion (eTICI 2b–3), 24-hour stent patency, complications, and in-hospital mortality. Outcomes were compared between drug-eluting (DE) and bare-metal (BM) balloon-mounted stents.
Results
Among the balloon-mounted stents, 97 (55.1%) were DE and 79 (44.9%) were BM. Baseline clinical and radiological characteristics were similar between groups.
During the procedure, the number of thrombectomy attempts (1.0 (0.0-2.0) vs 2.0 (1.0-3.0), p=0.008) were lower in BM group. Moreover, pre-stenting successful recanalization was higher in BM group (56.6% vs 31.5%, p=0.004). Finally, procedural antiplatelet treatment differed between groups with a higher rate of double antiplatelet therapy in DE group (BM 35.4% vs DE 68.0%, p<0.001).
No differences were found at procedural or 90 days clinical outcomes. Symptomatic intracranial hemorrhage was more frequent in DE group (13.4% vs 3.1%, p=0.026) without a significant association (aOR (95%CI) 2.446 (0.214 - 27.989); p=0.472).
Conclusions
In our cohort, the use of DE technology was not a predictor of clinical outcome. Symptomatic intracranial hemorrhage was more frequent in DE group probably related to a more aggressive antiplatelet strategy.
Conflict of interest
All authors: nothing to disclose.
Journal Article
ABSTRACT NUMBER: ESOC2026A1972 SPONTANEOUS CHANGES IN RESTING-STATE BOLD MRI WITH END-TIDAL CO2 AS A NON-INVASIVE ALTERNATIVE TO GAS CHALLENGE FOR ASSESSING CEREBROVASCULAR REACTIVITY
Abstract
Background and aims
Cerebrovascular reactivity (CVR) is impaired in cerebral small vessel disease (CSVD), commonly assessed using CO₂ inhalation during MRI. However, this is methodologically challenging and uncomfortable. We assessed whether resting-state BOLD may provide a non-invasive alternative.
Methods
The crossover-design OxHARP trial tested three weeks of sildenafil versus placebo on MRI-CVR, assessed by 6%-CO₂ gas challenge. Resting-state, high-frequency BOLD-MRI (TR=0.4s, multiband 6) was also acquired with concurrent measurement of end-tidal CO2. After motion correction, high-pass filtering, brain extraction and voxel-wise correction for temporal delays, CVR was determined as correlation between standardised BOLD per mmHg change in etCO2, within grey (GM) and white matter (WM). Agreement between scans was determined by ICC and linear regression, and effects of drug treatment by mixed-effects linear models.
Results
Across 93 scans, there was significant agreement between challenge-CVR and resting-state CVR in GM (r=0.629, p<0.001, ICC=0.773) and WM (r=0.598, p<0.001, ICC=0.749). There was a similar voxel-wise pattern of increased CVR on sildenafil with both acquisitions, but the average difference by ROIs was only significant with challenge-CVR (Challenge: GM p=0.0108, WM p=0.0020; Resting-state: GM p=0.20, WM: p=0.099).
Conclusions
Optimised resting-state scanning demonstrates strong agreement with CO₂ gas challenge measures of CVR and may provide a feasible alternative for large-scale CVR assessment, or in populations where individuals are less able to tolerate a gas challenge. However, gas challenges remain optimal for cleanly detecting drug-induced CVR changes in clinical trials.
Conflict of interest
Vanessa Hyde: nothing to disclose
Figure 1 - belongs to Results
Figure 2 - belongs to Results
Journal Article
ABSTRACT NUMBER: ESOC2026A1295 ASSOCIATIONS OF PREHOSPITAL BLOOD PRESSURE PARAMETERS AND KEY OUTCOMES IN ACUTE INTRACEREBRAL HEMORRHAGE: POST-HOC ANALYSIS OF THE INTERACT4 TRIAL
Abstract
Background and aims
Uncertainty remains about the optimal BP parameters for ICH patients in prehospital settings. We aimed to assess the associations between prehospital BP parameters and clinical outcomes in ICH.
Methods
A post-hoc analysis of the ICH patients from INTERACT4, which randomized suspected stroke patients in prehospital settings to intensive BP lowering group (targeted 130-140 mmHg) or usual care. The SBP parameters included pre-hospital reduction, pre-hospital minimal, and difference between ambulance and hospital arrival. Major outcomes included mRS 3-6, 90-day mortality, and death or neurological deterioration within 7 days. The associations were determined in logistic or linear regression models adjusting for baseline covariates.
Results
Among 1029 patients (mean age 64.9[12.3] y, 32.3% female), median time from randomization to hospital arrival was 13(8-23) min. The prehospital SBP reduction was 17 (5-35) mmHg and prehospital minimal SBP was 163.7(SD 26.6) mmHg. Prehospital SBP reduction was negatively associated with 90-day mortality(aOR 0.91, 95%CI 0.84-0.99, p=0.03), while prehospital minimal SBP was positively associated with death within 90 days (aOR 1.09, 95%CI 1.01-1.19, p=0.03). Elevated SBP difference between ambulance and hospital arrival was associated with increased risk of death within 90 days (aOR 1.07, 95%CI 1.00-1.14, p=0.04).
Conclusions
Lower achieved SBP and larger reduction were associated with decreased risk of death, but larger SBP rebound was associated with higher risk of worse outcomes, highlighting the importance of ultra-early intensive BP lowering in the ambulance and keep stability during transference for patients with ICH.
Conflict of interest
nothing to disclose
Journal Article
ABSTRACT NUMBER: ESOC2026LB131 THREE-MONTH HEMORRHAGIC PROGRESSION ON 7-TESLA MRI IN CEREBRAL AMYLOID ANGIOPATHY: A BATMAN SUBSTUDY
Abstract
Background and aims
Dutch-type (D-CAA) and sporadic cerebral amyloid angiopathy (sCAA) are characterized by cerebral microbleeds (CMBs) and cortical superficial siderosis (cSS). The BATMAN trial was a randomized, placebo-controlled trial of minocycline that investigated inflammatory cerebrospinal fluid biomarkers. Here, we aimed to assess short-term hemorrhagic radiological progression and the effect of minocycline on CMB progression.
Methods
The BATMAN trial included 58 participants who were randomized to minocycline or placebo. Participants underwent 7-Tesla MRI at baseline and after three months (n=46). Descriptive statistics were used to evaluate the frequency and extent of progression of CMBs and cSS. We used quasi-Poisson regression to estimate adjusted relative risks (aRRs) for an increase in the number of CMBs, with treatment group as independent variable and baseline microbleed count as a covariate.
Results
All patients had one or more CMBs at baseline. During follow-up, progression of microbleeds was observed in 42 (91%) of 46 patients (range 1-73, median 6). There was no difference in the aRR between the minocycline and placebo groups (aRR = 0.96, 95% CI 0.66-1.39; p=0.82). Among 34 participants with cSS at baseline, progression of cSS during follow-up was observed in 10 (29%) participants, while no incident cases occurred among those without baseline cSS.
Conclusions
Radiological progression of hemorrhagic markers occurred in the majority of patients within three months, underscoring the progressive nature of CAA. Minocycline had no effect on the progression of cerebral microbleeds. This study shows that CMBs, used as a marker of CAA progression, are sensitive to change even in short-duration therapeutic trials.
Conflict of interest
Figure 1 - belongs to Results
Figure 2 - belongs to Conclusions
Journal Article