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Keywords
management of thrombolysis ass...
management of thrombolysis associated symptomatic intracerebral hemorrhage
#1
RANDOMIZED CONTROLLED TRIAL
Andrew M Southerland, Stephan A Mayer, Nicole A Chiota-McCollum, Ashley C Bolte, Qi Pauls, L Creed Pettigrew, Thomas P Bleck, Mark Conaway, Karen C Johnston
BACKGROUND AND OBJECTIVES: Baseline hyperglycemia is associated with worse outcomes in acute ischemic stroke (AIS), including higher risk of symptomatic intracerebral hemorrhage (sICH) following treatment with thrombolysis. Prospective data are lacking to inform management of post-thrombolysis hyperglycemia. In a prespecified analysis from the Stroke Hyperglycemia Insulin Network Effort (SHINE) trial of hyperglycemic stroke management, we hypothesized that post-thrombolysis hyperglycemia is associated with a higher risk of sICH...
May 14, 2024: Neurology
#2
JOURNAL ARTICLE
Michael Chen, Krishna C Joshi, Bradley Kolb, Clark W Sitton, Deep Kiritbhai Pujara, Michael G Abraham, Santiago Ortega-Gutierrez, Scott E Kasner, Shazam M Hussain, Leonid Churilov, Spiros Blackburn, Sophia Sundararajan, Yin C Hu, Nabeel Herial, Juan F Arenillas, Jenny P Tsai, Ronald F Budzik, William Hicks, Osman Kozak, Bernard Yan, Dennis Cordato, Nathan W Manning, Mark Parsons, Ricardo A Hanel, Amin Aghaebrahim, Teddy Wu, Pere Cardona Portela, Chirag D Gandhi, Fawaz Al-Mufti, Natalia Perez de la Ossa, Joanna Schaafsma, Jordi Blasco, Navdeep Sangha, Steven Warach, Timothy J Kleinig, Hannah Johns, Faris Shaker, Mohammad A Abdulrazzak, Abhishek Ray, Jeffery Sunshine, Amanda Opaskar, Kelsey R Duncan, Wei Xiong, Faisal K Al-Shaibi, Edgar A Samaniego, Thanh N Nguyen, Johanna T Fifi, Stavropoula I Tjoumakaris, Pascal Jabbour, Vitor Mendes Pereira, Maarten G Lansberg, Cathy Sila, Nicholas C Bambakidis, Stephen Davis, Lawrence Wechsler, Gregory W Albers, James C Grotta, Marc Ribo, Ameer E Hassan, Bruce Campbell, Michael D Hill, Amrou Sarraj
BACKGROUND: The incidence of intracerebral hemorrhage (ICH) and its effect on the outcomes after endovascular thrombectomy (EVT) for patients with large core infarcts have not been well-characterized. METHODS: SELECT2 trial follow-up imaging was evaluated using the Heidelberg Bleeding Classification (HBC) to define hemorrhage grade. The association of ICH with clinical outcomes and treatment effect was examined. RESULTS: Of 351 included patients, 194 (55%) and 189 (54%) demonstrated intracranial and intracerebral hemorrhage, respectively, with a higher incidence in EVT (134 (75%) and 130 (73%)) versus medical management (MM) (60 (35%) and 59 (34%), both P<0...
March 12, 2024: Journal of Neurointerventional Surgery
#3
JOURNAL ARTICLE
Hany Aref, Nevine El Nahas, Gihan Hamdy Elsisi, Hossam Shokri, Tamer Roushdy
INTRODUCTION: Stroke is the second leading cause of mortality worldwide. Five percent of all the disability-adjusted life years (DALYs) lost around the world are attributed to stroke. This study aimed to assess the economic burden of acute ischemic stroke (AIS) in Egypt and reveal the benefits of alteplase treatment by measuring the resource use and costs associated with this treatment compared to the standard of care and extrapolate the overall budget impact of alteplase to the local Egyptian setting over a 5-year time horizon from a societal perspective...
2023: Frontiers in Neurology
#4
JOURNAL ARTICLE
Amir Shaban, Sami Al Kasab, Reda M Chalhoub, Eric Bass, Ilko Maier, Marios-Nikos Psychogios, Ali Alawieh, Stacey Q Wolfe, Adam S Arthur, Travis M Dumont, Peter Kan, Joon-Tae Kim, Reade De Leacy, Joshua W Osbun, Ansaar T Rai, Pascal Jabbour, Min S Park, Roberto Javier Crosa, Justin R Mascitelli, Michael R Levitt, Adam J Polifka, Walter Casagrande, Shinichi Yoshimura, Charles Matouk, Richard Williamson, Benjamin Gory, Maxim Mokin, Isabel Fragata, Daniele G Romano, Shakeel Chowdry, Mark Moss, Daniel Behme, Kaustubh Limaye, Alejandro M Spiotta, Edgar A Samaniego
BACKGROUND: Recent clinical trials have shown that mechanical thrombectomy is superior to medical management for large vessel occlusion for up to 24 hours from onset. Our objective is to examine the safety and efficacy of thrombectomy beyond the standard of care window. METHODS: A retrospective review was undertaken of the multicenter Stroke Thrombectomy and Aneurysm Registry (STAR). We identified patients who underwent mechanical thrombectomy for large vessel occlusion beyond 24 hours...
January 2, 2023: Journal of Neurointerventional Surgery
#5
JOURNAL ARTICLE
Francesco Diana, Michele Romoli, Giada Toccaceli, Aymeric Rouchaud, Charbel Mounayer, Daniele Giuseppe Romano, Francesco Di Salle, Paolo Missori, Andrea Zini, Diana Aguiar de Sousa, Simone Peschillo
BACKGROUND: Emergent carotid artery stenting (eCAS) is performed during mechanical thrombectomy for acute ischemic stroke due to tandem occlusion. However, the optimal management strategy in this setting is still unclear. OBJECTIVE: To carry out a systematic review and meta-analysis to investigate the safety and efficacy of eCAS in patients with tandem occlusion. METHODS: Systematic review followed the PRISMA guidelines. Medline, EMBASE, and Scopus were searched from January 1, 2004 to March 7, 2022 for studies evaluating eCAS and no-stenting approach in patients with stroke with tandem occlusion...
April 15, 2022: Journal of Neurointerventional Surgery
#6
JOURNAL ARTICLE
Ossama Yassin Mansour, Ismail Ramadan, Amer Elfatatry, Mohamed Hamdi, Ashraf Abudu, Tamer Hassan, Hany Eldeeb, Hazem Marouf, Mohamed Mogahed, Mohamed Farouk, Mohamed Abas, Mervat Hamed, Mohamed Afify, Tamer Abdallah, Osama Zaidat
Background: In developing countries like Egypt, the clinical workflow of stroke management is poorly established due to the lack of awareness of the stroke patients concerning their need of therapeutic intervention and the poor identification of facilities equipped to treat stroke. Hence, establishing a stroke system of care in developing countries that can efficiently and rapidly triage patients to the appropriate reperfusion therapy center is imperative to improving stroke management and outcomes. Aims: To evaluate a pilot experience in stroke hospital identification and expediting decision-making in AIS treatment through the Alexandria stroke network and Egyptian Stroke Network (ESN)-app...
2021: Frontiers in Neurology
#7
JOURNAL ARTICLE
Giancarlo Salsano, Giovanni Pracucci, Nicola Mavilio, Valentina Saia, Monica Bandettini di Poggio, Laura Malfatto, Fabrizio Sallustio, Andrea Wlderk, Nicola Limbucci, Patrizia Nencini, Stefano Vallone, Andrea Zini, Guido Bigliardi, Mariano Velo, Isabella Francalanza, Paola Gennari, Rossana Tassi, Mauro Bergui, Paolo Cerrato, Giuseppe Carità, Cristiano Azzini, Roberto Gasparotti, Mauro Magoni, Salvatore Isceri, Christian Commodaro, Francesco Cordici, Roberto Menozzi, Lilia Latte, Mirco Cosottini, Michelangelo Mancuso, Alessio Comai, Enrica Franchini, Andrea Alexandre, Giacomo Della Marca, Edoardo Puglielli, Alfonsina Casalena, Francesco Causin, Claudio Baracchini, Luca Di Maggio, Andrea Naldi, Andrea Grazioli, Stefano Forlivesi, Luigi Chiumarulo, Marco Petruzzellis, Giuseppina Sanfilippo, Gianpaolo Toscano, Nicola Cavasin, Critelli Adriana, Maria Porzia Ganimede, Maria Pia Prontera, Giorgianni Andrea, Marco Mauri, William Auteri, Alfredo Petrone, Carlo Cirelli, Anne Falcou, Simona Corraine, Valeria Piras, Giuseppe Ganci, Tiziana Tassinari, Nunzio Paolo Nuzzi, Manuel Corato, Simona Sacco, Guido Squassina, Paolo Invernizzi, Ivan Gallesio, Delfina Ferrandi, Giovanni Dui, Gianluca Deiana, Pietro Amistà, Monia Russo, Francesco Pintus, Antonio Baule, Giuseppe Craparo, Marina Mannino, Lucio Castellan, Danilo Toni, Salvatore Mangiafico
BACKGROUND: There are limited data concerning procedure-related complications of endovascular thrombectomy for large vessel occlusion strokes. AIMS: We evaluated the cumulative incidence, the clinical relevance in terms of increased disability and mortality, and risk factors for complications. METHODS: From January 2011 to December 2017, 4799 patients were enrolled by 36 centers in the Italian Registry of Endovascular Stroke Treatment. Data on demographic and procedural characteristics, complications, and clinical outcome at three months were prospectively collected...
October 2021: International Journal of Stroke: Official Journal of the International Stroke Society
#8
JOURNAL ARTICLE
Jingcui Qin, Zhijun Zhang
OBJECTIVES: Previous studies have shown inconsistent results regarding the effect of early systolic blood pressure variability (SBPV) after endovascular thrombectomy (EVT) and intravenous thrombolysis (IVT) on functional outcome in acute ischemic stroke (AIS). The systematic review and meta-analysis aimed to determine the effect of early SBPV after EVT and IVT on outcome in AIS. MATERIALS AND METHODS: We searched for articles published before February 2020 in the following databases: PubMed, Web of Science, EMBASE, Medline, and Google Scholar...
December 2020: Brain and Behavior
#9
JOURNAL ARTICLE
Gaultier Marnat, Bertrand Lapergue, Igor Sibon, Florent Gariel, Romain Bourcier, Maeva Kyheng, Julien Labreuche, Cyril Dargazanli, Arturo Consoli, Raphael Blanc, Michel Piotin, Mikael Mazighi, Sebastien Richard, Benjamin Gory
BACKGROUND AND PURPOSE: The efficacy of endovascular therapy in patients with acute ischemic stroke due to tandem occlusion is comparable to that for isolated intracranial occlusion in the anterior circulation. However, the optimal management of acute cervical internal carotid artery lesions is unknown, especially in the setting of carotid dissection, but emergency carotid artery stenting (CAS) is frequently considered. We investigated the safety and efficacy of emergency CAS for carotid dissection in patients with acute stroke with tandem occlusion in current clinical practice...
December 2020: Stroke; a Journal of Cerebral Circulation
#10
JOURNAL ARTICLE
Chih-Hsiang Liao, Nien-Chen Liao, Wen-Hsien Chen, Hung-Chieh Chen, Chiung-Chyi Shen, Shun-Fa Yang, Yuang-Seng Tsuei
Cerebral venous sinus thrombosis (CVST) is a rare cause of cerebral infarction. Once patients survive the acute phase, long-term prognosis is generally satisfactory. CVST patients who harbored risk factors known for poor prognosis (e.g., deterioration of consciousness/neurological functions and seizures) were oftentimes unresponsive to systemic heparin treatment. The advantage of combined endovascular mechanical thrombectomy (EMT) and on-site chemical thrombolysis (OCT) plus systemic heparin for CVST over the heparin treatment alone has not been proved...
March 18, 2020: Scientific Reports
#11
JOURNAL ARTICLE
Adam A Dmytriw, Kevin Phan, Julian Maingard, Ralph J Mobbs, Mark Brooks, Karen Chen, Victor Yang, Hong Kuan Kok, Joshua A Hirsch, Christen D Barras, Ronil V Chandra, Hamed Asadi
PURPOSE: Strokes associated with cervical artery dissection have been managed primarily with antithrombotics with poor outcomes. The additive role of endovascular thrombectomy remains unclear. The objective was to perform systematic review and meta-analysis to compare endovascular thrombectomy and medical therapy for acute ischemic stroke associated with cervical artery dissection. METHODS: Studies from six electronic databases included outcomes of patient cohorts with acute ischemic stroke secondary to cervical artery dissection who underwent treatment with endovascular thrombectomy...
July 2020: Neuroradiology
#12
JOURNAL ARTICLE
P Alan Barber, Teddy Y Wu, Annemarei Ranta
OBJECTIVE: To assess the frequency and utilization trends of dabigatran reversal with idarucizumab and compare associated complications, outcomes, and door-to-needle times to those of patients not exposed to idarucizumab in a nationwide cohort of thrombolyzed patients over a 24-month period. METHODS: This is an observational cohort study of all New Zealand patients with stroke treated with stroke reperfusion entered into a mandatory online national registry. Each hospital records data including patient demographics, treatment delays, complications, 7-day outcomes, and idarucizumab use...
May 12, 2020: Neurology
#13
JOURNAL ARTICLE
Pablo Reyes S, Lautaro Badilla O, Daniel Andreu, Valentina Besa, Rodrigo Rivera, Gabriel Sordo, Gonzalo Bustamante, Juan A Pasten, Gabriel Vargas, Paula Silva, Rodrigo Guerrero, Walter Feuerhake
BACKGROUND: Recently, five randomized controlled trials confirmed the efficacy and safety of endovascular treatment with or without intravenous thrombolysis in acute ischemic stroke with large-vessel occlusion. AIM: To report patients with ischemic stroke treated with endovascular methods. MATERIAL AND METHODS: Retrospective analysis of 104 patients aged 61 ± 15 years (54% males) with ischemic stroke who received endovascular treatment at a single medical center between 2009 and 2017...
June 2018: Revista Médica de Chile
#14
REVIEW
Babikir Kheiri, Mohammed Osman, Ahmed Abdalla, Tarek Haykal, Sahar Ahmed, Mustafa Hassan, Ghassan Bachuwa, Mohammed Al Qasmi, Deepak L Bhatt
Tenecteplase is a genetically mutated variant of alteplase with superior pharmacodynamic and pharmacokinetic properties. However, its efficacy and safety in acute ischemic strokes are limited. Hence, we conducted a study to evaluate the efficacy and safety of tenecteplase compared with alteplase in acute ischemic stroke. Electronic databases were searched for randomized clinical trials (RCTs) comparing tenecteplase with alteplase in acute ischemic stroke patients eligible for thrombolysis. We evaluated various efficacy and safety outcomes using random-effects models for both pairwise and Bayesian network meta-analyses along with meta-regression analyses...
November 2018: Journal of Thrombosis and Thrombolysis
#15
REVIEW
Wenbo Zhao, Jing Zhang, Mordechai G Sadowsky, Ran Meng, Yuchuan Ding, Xunming Ji
BACKGROUND: Remote ischaemic conditioning (RIC) has been developed as a neuroprotective strategy to prevent and treat ischaemic stroke. It usually involves restricting blood flow to limbs and then releasing the ischaemic blood to promote a neuroprotective effect. Preclinical studies have suggested that RIC may have beneficial effects in ischaemic stroke patients and those at risk of ischaemic stroke. However, existing evidence is insufficient to demonstrate the efficacy and safety of RIC in preventing and treating ischaemic stroke...
July 5, 2018: Cochrane Database of Systematic Reviews
#16
JOURNAL ARTICLE
Michael V Mazya, Niaz Ahmed, Elsa Azevedo, Antoni Davalos, Laura Dorado, Michal Karlinski, Svetlana Lorenzano, Jiří Neumann, Danilo Toni, Tiago P Moreira
BACKGROUND AND PURPOSE: Diagnostic transcranial Doppler ultrasound (TCD) is commonly used in patients with acute stroke before or during treatment with intravenous thrombolysis (IVT). We aimed to assess how much TCD delays IVT initiation and whether TCD influences outcomes. METHODS: We analyzed data from the SITS-ISTR (Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register) collected from December 2002 to December 2011. Outcomes were door-to-needle time, symptomatic intracerebral hemorrhage, functional outcome per the modified Rankin Scale, and mortality at 3 months...
July 2018: Stroke; a Journal of Cerebral Circulation
#17
RANDOMIZED CONTROLLED TRIAL
Guofang Chen, Xia Wang, Thompson G Robinson, Miriam Pikkemaat, Richard I Lindley, Shengkui Zhou, Lei Ping, Weiwei Liu, Leijing Liu, John Chalmers, Craig S Anderson
BACKGROUND AND PURPOSE: History of prior stroke (PS) and diabetes mellitus (DM) are considered relative contraindications to the use of intravenous alteplase in patients with acute ischemic stroke (AIS). We aimed to assess whether a history of PS and DM modified the comparative effects of low- versus standard-dose alteplase in patients who participated in the alteplase-dose arm of the Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED). METHODS: Data from an international, multi-center, prospective, randomized, open-label, blinded-endpoint trial were used to assess the benefits and risks of low (0...
April 15, 2018: Journal of the Neurological Sciences
#18
JOURNAL ARTICLE
Lars Kellert, Christian Hametner, Niaz Ahmed, Geraldine Rauch, Mary J MacLeod, Francesco Perini, Kennedy R Lees, Peter A Ringleb
BACKGROUND AND PURPOSE: Significance and management of blood pressure (BP) changes in acute stroke care are unclear. Here, we aimed to investigate the impact of 24-hour BP variability (BPV) on outcome in patients with acute ischemic stroke treated with intravenous thrombolysis. METHODS: From the Safe Implementation of Treatment in Stroke International Stroke Thrombolysis registry, 28 976 patients with documented pre-treatment systolic BP at 2 and 24 hours were analyzed...
July 2017: Stroke; a Journal of Cerebral Circulation
#19
RANDOMIZED CONTROLLED TRIAL
Steven L Gogela, Yair M Gozal, Bin Zhang, Thomas A Tomsick, Andrew J Ringer, Joseph P Broderick, Pooja Khatri, Todd A Abruzzo
OBJECTIVE The impact of extracranial carotid stenosis on interventional revascularization of acute anterior circulation stroke is unknown. The authors examined the effects of high-grade carotid stenosis on the results of endovascular treatment of patients in the Interventional Management of Stroke (IMS)-III trial. METHODS The 278 patients in the endovascular arm of the IMS-III trial were categorized according to the degree of carotid stenosis as determined by angiography. In comparing patients with severe stenosis or occlusion (≥ 70%) to those without severe stenosis (< 70%), the authors evaluated the time to endovascular reperfusion, modified Thrombolysis in Cerebrovascular Infarction (mTICI) scores, 24-hour mean infarct volumes, symptomatic intracerebral hemorrhage rates, and modified Rankin Scale (mRS) scores at 90 days...
January 2018: Journal of Neurosurgery
#20
JOURNAL ARTICLE
Renata Dal-Prá Ducci, Marcos Christiano Lange, Viviane de Hiroki Flumignan Zétola
Early risk stratification of mortality and dependence is important for guiding medical decision-making in stroke care. The study aim is to evaluate whether there are any differences between risk factors for in-hospital mortality and dependence at discharge in patients with first-episode ischemic stroke in the middle cerebral artery (MCA) receiving intravenous thrombolysis (IVT) treatment. The study comprised a single-center cohort of patients admitted consecutively for first-episode MCA ischemic stroke. A logistic regression analysis was performed to determine the variables associated with in-hospital mortality and dependence at discharge...
June 2017: Internal and Emergency Medicine
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