26Right ventricular (RV) dysfunction can lead to complications following acute inferior 27 myocardial infarction (MI). However, it is unclear how RV failure after MI contributes to left-28 sided dysfunction is unclear. The aim of this study was to investigate the consequences of 29 right coronary artery (RCA) ligation in mice. RCA ligation was performed in 30 C57BL/6JRj mice (n=38). The cardiac phenotypes were characterized using high-resolution 31 echocardiography performed up to 4 weeks post-RCA ligation. Infarct size was measured 32 using 2,3,5-triphenyltetrazolium chloride (TTC)-staining 24h post-RCA ligation and the 33 extent of the fibrotic area was determined 4 weeks after MI. RV dysfunction was confirmed 34 24h post RCA ligation by a decrease in the tricuspid annular plane systolic excursion 35 (p<0.001) and RV longitudinal strain analysis (p<0.001). Infarct size measured ex-vivo 36 represented 45.1±9.1% of RV free wall. RCA permanent ligation increased RV/LV area ratio 37 (p<0.01). Septum hypertrophy (p<0.01) was associated with diastolic septal flattening. During 38 the 4 weeks post-RCA ligation, the LV ejection fraction was preserved, yet it was associated 39 with impaired LV diastolic parameters (E/e', global strain rate during early diastole). 40Histological staining after 4 weeks confirmed the remodelling process with a thin and fibrotic 41 RV. This study validates that RCA ligation in mice is feasible and induces right ventricular 42 heart failure associated with development of LV diastolic dysfunction. Our model offers a 43 new opportunity to study mechanisms and treatments of RV/LV dysfunction after MI. 44 NEW & NOTEWORTHY: 45RV dysfunction frequently causes complications after acute inferior MI. How RV failure 46 contributes to left-sided dysfunction is elusive because of the lack of models to study 47

Introduction Recent randomized clinical trials have demonstrated that endovascular therapy for basilar artery occlusion is safe and effective. However, many people still have poor outcomes despite treatment. The aim of this study was to identify the predictors of good functional outcome in posterior circulation strokes after mechanical thrombectomy from the Trevo Stent‐Retriever Acute Stroke TRACK and the North American Solitaire Stent Retriever Acute Stroke (NASA) registries. Methods Patient‐level data from the TRACK and NASA registries were pooled and patients with posterior circulation stroke were included in the analysis. Patients were dichotomized into those with 90‐day good functional outcome (mRS≤2) and poor functional outcome (mRS>2). Baseline and procedural data were compared between the two cohorts. Multivariate logistic regression was then performed to identify predictors of functional outcome. P‐value < 0.05 was considered significant. Results Out of 119 posterior stroke patients (99 BA, 16 VA, and 4 PCA), a total of 110 patients had mRS data available on follow‐up. Good functional outcome was observed in 44 patients (37%). Patients with mRS≤2 were less likely to have hypertension (61.4% versus 83.3%, p = 0.01), dyslipidemia (38.6% versus 62.1%, p = 0.016), and diabetes (18.2% versus 36.4%, p = 0.040). Patients with mRS≤2 had a lower mean baseline NIHSS (15.2±9.95 versus 22.6±9.50, p< .001). Time to puncture, utilization of BGC, general anesthesia use, number of passes, and successful recanalization (TICI≥ 2B) were not significantly different between the two cohorts. On multivariate analysis, higher baseline NIHSS was associated with worse functional outcome (OR:0.91, CI:0.87‐0.96, P< .001). Use of IV tPA was associated with higher odds of achieving good functional outcomes (OR:2.82, CI:1.06‐7.51, P:0.038). Conclusions In this pooled analysis of the NASA and TRACK Registries, posterior circulation patients achieving good outcome were more likely to have a lower baseline NIHSS and less comorbidities. Use of IV‐tPA and lower baseline NIHSS were independent predictors of functional outcome.

Introduction Endovascular coiling for intracerebral aneurysms has been evolving. Yet, large, and giant aneurysms (LAGA) remain a significant challenge for treatment and carry a high rate of morbidity and mortality. Previous studies have demonstrated 72–76% long‐term adequate occlusion and up to 34% retreatment rate in patients undergoing reconstructive treatment for LAGA. Methods The SMART registry, a prospective, multicenter outcome trial was used to identify patients with LAGA (Sac 10–24mm for large and ≥ 25mm for giant aneurysms) treated with the Penumbra SMART COIL® (SMART) system in the US and Canada. Patients’ characteristics and outcomes were then compared to patients with smaller aneurysms (SA) (Sac≤10mm). Primary effectiveness endpoint was aneurysm occlusion using Raymond‐Roy (RR) scale and safety endpoints included mortality and stroke outcomes. Fisher exact test and T‐test were used to compare categorical and continuous variables, respectively. P‐value < 0.05 was considered significant. Results A total of 131/903 (14.5%) patients had LAGA and 42 (32.1%) of those were ruptured. Patients with LAGA were older than SA (mean age: 61.9 vs 59.4, p = 0.04). Large aneurysms were mainly saccular in 75.6% of the cases (vs 87.7% of the ≤ 10 mm ones, p < 0.001). Fusiform LAGA were 8.4% (vs 1.4% of the ≤ 10 mm ones, p < 0.001). Furthermore, they are more likely to have wide neck (69.5% vs 59.7%, p = 0.042). They are less likely to have A‐Com aneurysm (10.7% vs 28%, p < 0.001), and more likely to have basilar tip aneurysms (3.1% vs 0.8%, p = 0.044) and cavernous aneurysms (4.6% vs 0.6%, p = 0.002) compared to patients with SA. Primary coiling was the main treatment modality for both SA and LAGA (43.3% vs 43.5%, respectively, p = 1.0). However, LAGA were more likely to be treated with flow diversion in addition to coiling (6.1% vs 1.0%, p < 0.001). Packing density was significantly lower in LAGA (mean (SD) = 21.2(13.1) vs 34.1(18.3), p < 0.001). Surprisingly, long‐term aneurysm RR occlusion Class I‐II on follow‐up imaging was 82.5% in LAGA vs 91.2% in SA, p = 0.016. Retreatment rates was 11.7% in LAGA vs 6.4% in SA, p = 0.063. mRS0‐2 score was 73.6% in LAGA vs 86.4% in SA, p = 0.007. All‐cause 1‐year mortality was 9.2% in LAGA vs 4.7% in SA, p = 0.054. Conclusions Despite challenges with treating Large and giant aneurysms, SMART coiling registry demonstrated high adequate aneurysm occlusion rate on follow‐up imaging, as well as a good independent functional outcome.

Objective: To provide an overview of retractions of research papers contributed by authors from the Arab region. Method: Papers in which the first author was affiliated to an Arabian country were selected from the Retraction Watch database covering the period 1 January 1998 to 31 December 2018. The retrieved records were divided into nine categories based on the reasons for retraction. Results: The search yielded 322 retractions, and the most frequent reason for retraction was plagiarism (34.5%). The median time from publication to retraction was 14 (25%-75% percentile 5-30) months. The number of papers retracted each year as well as the number of papers published in a given year but subsequently retracted increased steadily over the 21 years. The proportion of retracted papers to the total number of published papers (0.17%) was higher than the global proportion and was the highest for Algeria (1%) and the lowest for Lebanon (0.03%). Of the countries within the Arab region, 12 out of 14 countries showed either plagiarism or duplication as the most common reason for retraction; however, the countries differed in terms of the number of retractions and the time from publishing to retraction. Conclusion: Plagiarism was the most common cause of retraction in the Arab countries. The increase in the number of papers retracted each year was probably because searches now extend farther in the past, whereas the increase in the number of papers published in a given year but subsequently retracted can be attributed to the overall increase in the number of papers published.