on the role of WSS is cerebral aneurysm dynamics ． ID this paper ， we report the results of CFD analysis on cerebral aneurysms and we compare our results to other recent papers in the field ． （

Background and purpose: In order to conduct intravenous thrombolysis as soon as possible, a pioneer project in Japan, consisting of stroke coordinate nurse (SCNs), was established. The aim of this study was to investigate whether the SCNs was able to reduce door to needle time (DNT) for an acute ischemic stroke patient who received intravenous thrombolysis. Method: From April 2012 to February 2017, acute ischemic stroke patients with intravenous thrombolysis were enrolled. Patients were divided into two groups, DNT within 60 min (s-DNT group) and a 60 min or more time group (l-DNT group). We compared clinical characteristics including presence or absence of ASCNP services between short-and long-DNT groups. Results: A total of 74 patients (54 males, mean age: 68 years) were retrospectively enrolled and the s-DNT group consisted of 19 patients, and the l-DNT group was 55. The s-DNT group more frequently received SCNs service than that of the l-DNT group (52% vs. 18%, p=0.015). Multivariate logistic regression analysis showed that SCNs service was the only independent factor associated with the s-DNT (OR 3.4, 95%CI 1.1-11.5, p=0.043). Conclusion: SCNs service was contributed to s-DNT in acute ischemic stroke patients with intravenous thrombolysis.

Objective: To evaluate risk in relation to plaque characteristics for estimating thromboembolic events during carotid artery stenting (CAS). Methods: MR imaging of 64 carotid artery stenotic lesions were reviewed retrospectively in patients for CAS with a balloon protection device (Guardwire) and filter (Angioguard XP). Magnetization-prepared rapid acquisition with gradient echo (MPRAGE) was used for MR plaque imaging. Lesions were classified into three types according to the intensities on MPRAGE: high-intensity, intermediate-intensity and isointensity groups. If the plaque displayed signal intensity of 200% compared to sternocleidomastoid muscle intensity, it was categorized as "high signal intensity." Results: Periprocedural adverse events occurred in 10 of 64 procedures (15.6%). Persistent neurological deficit was related to 3 procedures (5.1%). Transient neurological ischemic events occurred in 4 procedures (6.3%). Thromboembolic events of CAS for high-and intermediateintensity plaques on MPRAGE were 21.1% and 16.7%, respectively. Incidence of thromboembolic events for high-intensity plaques (21.1%) was significantly higher than that for iso-intensity plaque (0%) (P=0.013). Incidence of thromboembolic events for high-intensity plaques with use of a filter device (21.1%) was significantly higher than that with a balloon protection device (7%) (P=0.013). Although incidence of neurological ischemic event in CAS with a filter device (26.7%) was significantly higher than that with a balloon protection device (6.1%) (P=0.026), the morbidity rate was not significantly different between the two groups (0% vs 6.1%). Conclusions: High-intensity plaque on MPRAGE is related to a high rate of thromboembolic events during CAS. To avoid thromboembolic complications during CAS, an individual approach is needed for each case.

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