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The coprimary outcome measure will be reperfusion at 24 h and favorable clinical response (reduction in National Institutes of Health Stroke Scale by ≥8 points or reaching 0-1) at day 3. Secondary outcomes include modified Rankin Scale at day 90, death, and symptomatic intracranial hemorrhage.

Objective We assessed changes in quantitative muscle ultrasound data in boys with Duchenne muscular dystrophy (DMD) and healthy controls to determine if ultrasound can serve as a biomarker of disease progression. Two approaches were used: grey scale level (GSL), measured from the ultrasound image, and quantitative backscatter analysis (QBA) measured directly from the received echoes. Methods GSL and QBA were obtained from six unilateral arm/leg muscles in 36 boys with DMD and 28 healthy boys (age 2–14 years) for up to 2 years. We used a linear mixed-effects model with random intercept and slope terms to compare trajectories of GSL, QBA, and functional assessments. We analyzed separately a subset of boys who initiated corticosteroids. Results Compared to healthy boys, increasing GSL in DMD boys >7.0 years was first identified at 6 months (e.g., anterior forearm slope difference of 1.16 arbitrary units/month p=0.004, 95% confidence interval (CI) [0.38,1.94]); in boys ≤7 years, differences in GSL first appeared at 12 months (0.82 arbitrary units /month, p=0.04 95%CI [0.075,1.565] in rectus femoris). QBA performed similarly to GSL (e.g., DMD boys >7 years of 0.41dB/month, p=0.01, 95%CI [0.096,0.72] in anterior forearm at 6 months). US identified differences earlier than functional measures including 6-minute walk and supine-to-stand tests. However, neither QBA nor GSL showed an effect of corticosteroid initiation. Interpretation QBA performs similarly to GSL and both appear more sensitive than functional assessments for detecting muscle deterioration in DMD. Additional studies will be required to determine if quantitative muscle ultrasound can detect therapeutic efficacy.

BACKGROUND AND PURPOSE:Patients with stroke unsuitable for IV thrombolysis may be considered for endovascular revascularization, particularly when baseline imaging suggests proximal cerebral vessel occlusion associated with minimal established infarction. This retrospective review describes the use of a self-expanding retrievable intracranial stent (Solitaire AB) for thrombectomy in acute ischemic stroke.