Posterior circulation cerebral infarction: A review of clinical, imaging features, management, and outcomes.

Objective: This narrative review discusses posterior circulation cerebral infarcts (PCCI) and provides an update given recent randomized trials in the management of basilar artery occlusion (BAO). We examine clinical characteristics, imaging protocols, management updates, and outcomes of PCCI. Methods: The following databases were searched: MEDLINE, Scopus, Google Scholar, and Web of Science for articles on PCCI. We included randomized trials and observational studies in humans. We also reviewed relevant references from the literature identified. Results: PCCI and BAO is associated with high morbidity and mortality. Early assessment and accurate diagnosis of PCCI remains a clinical challenge. Neuroimaging advances have improved early detection, but barriers remain due to costs and availability. Recent randomized trials provide new insights for BAO patients and support the efficacy of endovascular thrombectomy. Discussion: PCCI requires specific diagnostic and management that is distinct from anterior circulation stroke. While further studies are needed in varied populations and in the subset of BAO patients presenting with milder deficits, growing randomized data support the treatment of BAO patients with endovascular thrombectomy.

Basilar artery occlusion: A review of clinicoradiologic features, treatment selection, and endovascular techniques.

Basilar artery occlusion (BAO) is an infrequent but often fatal subtype of stroke. Predicting outcomes and selecting patients for endovascular therapy (EVT) remains challenging. Advances in neuroimaging and the development of prognostic scoring systems have augmented clinical decision-making over time. Recent randomized trials, BEST (Basilar Artery Occlusion Endovascular Intervention vs. Standard Medical Treatment), BASICS (Basilar Artery International Cooperation Study), BAOCHE (Basilar Artery Occlusion CHinese Endovascular Trial) and ATTENTION (Endovascular Treatment for Acute Basilar Artery Occlusion), compared EVT and medical management for patients with BAO. These trials yielded mixed results. The former two suggested unclear benefit while the latter two supported a benefit of EVT. While all had limitations, most providers agree caution should be exercised when excluding patients from EVT who may stand to benefit. Further studies are therefore needed to determine the effectiveness, safety, selection criteria, and optimal technical approach for EVT among patients with BAO. Hyperacute-phase advanced imaging can offer several benefits to aid decision making. It is reasonable to exclude patients with low National Institutes of Health Stroke Scale (NIHSS), large imaging-proven cores, and evidence of perforator occlusion by branch atheromatous disease. Herein, we review the clinical presentation, imaging work-up, treatments, and clinical outcomes for BAO, while highlighting knowledge gaps in treatment selection and technique.

Selective Extraction of Trace Arsenite Ions Using a Highly Porous Aluminum Oxide Membrane with Ordered Nanopores.

Metal ion extraction and determination at trace level concentration are challenging due to sample complexity or spectral interferences. Herein, we prepared a through-hole aluminum oxide membrane (AOM) by electrochemical anodization of aluminum substrates. The prepared AOM was characterized by scanning electron microscopy, surface area analysis, porosity measurements, and X-ray photoelectron spectroscopy. The AOM with ordered nanopores was highly porous and possess inherent binding sites for selective arsenite sorption. The AOM was used as a novel sorbent for solid-phase microextraction and preconcentration of arsenite ions in water samples. The AOM's sub-micrometer thickness allows water molecules to flow freely across the pores. Before instrumental determination, the suggested microextraction approach removes spectral interferents and improves the analyte ion concentration, with a detection limit of 0.02 µg L-1. Analyzing a standard reference material was used to validate the procedure. Student's t-test value was less than critical Student's t-value of 4.303 at a 95% confidence level. With coefficients of variation of 3.25%, good precision was achieved.