898 research outputs found
sj-docx-1-ine-10.1177_15910199221138139 - Supplemental material for Multicenter investigation of technical and clinical outcomes after thrombectomy for Proximal Medium Vessel Occlusion (pMeVO) by frontline technique
No full textSupplemental material, sj-docx-1-ine-10.1177_15910199221138139 for Multicenter investigation of technical and clinical outcomes after thrombectomy for Proximal Medium Vessel Occlusion (pMeVO)
by frontline technique by Jonathan A Grossberg, Reda M Chalhoub, Sami Al Kasab, Dominika Pullmann, Pascal Jabbour, Marios Psychogios, Robert M Starke, Adam S Arthur, Kyle M Fargen, Reade De Leacy, Peter Kan, Travis Dumont, Ansaar Rai, Roberto J Crosa, Kareem E Naamani, Ilko Maier, Nitin Goyal, Stacey Quintero Wolfe, C Michael Cawley, J Mocco, Muhammad Hafeez, Brian M Howard, Laurie Dimisko, Hassan Saad, Christopher S Ogilvy, R Webster Crowley, Justin Mascitelli, Isabel Fragata, Michael Levitt, Alejandro M Spiotta and Ali M Alawieh in Interventional Neuroradiology</p
sj-pdf-1-eso-10.1177_23969873221106907 – Supplemental material for Temporal profiles of systolic blood pressure variability and neurologic outcomes after endovascular thrombectomy
No full textSupplemental material, sj-pdf-1-eso-10.1177_23969873221106907 for Temporal profiles of systolic blood pressure variability and neurologic outcomes after endovascular thrombectomy by Ayush Prasad, Jessica Kobsa, Sreeja Kodali, David Bartolome, Liza Begunova, Darko Quispe-Orozco, Mudassir Farooqui, Cynthia Zevallos, Santiago Ortega-Gutiérrez, Mohammad Anadani, Eyad Almallouhi, Alejandro M Spiotta, James A Giles, Salah G Keyrouz, Joon-Tae Kim, Ilko L Maier, Jan Liman, Marios-Nikos Psychogios, Nolwenn Riou-Comte, Sébastien Richard, Benjamin Gory, Stacey Quintero Wolfe, Patrick A Brown, Kyle M Fargen, Eva A Mistry, Hiba Fakhri, Akshitkumar Mistry, Ka-Ho Wong, Fábio A Nascimento, Peter Kan, Adam de Havenon, Kevin N Sheth and Nils H Petersen in European Stroke Journal</p
Predictors of Angiographic Outcome After Failed Thrombectomy for Large Vessel Occlusion: Insights from the Stroke Thrombectomy and Aneurysm Registry
No full textOutcomes of Mechanical Thrombectomy for Patients With Stroke Presenting With Low Alberta Stroke Program Early Computed Tomography Score in Early and Late Time Windows
No full textBACKGROUND AND OBJECTIVES: This study aimed to compare outcomes of low Alberta Stroke Program Early Computed Tomography Score (ASPECTS) patients with stroke who underwent mechanical thrombectomy (MT) within 6 hours or 6 to 24 hours after stroke onset. METHODS: A retrospective cohort study was conducted using data from a large multicenter international registry from 2013 to 2023. Patients with low ASPECTS (2-5) who underwent MT for anterior circulation intracranial large vessel occlusion were included. A propensity matching analysis was conducted for patients presented in the early (<6 hours) vs late (6-24 hours) time window after symptom onset or last known normal. RESULTS: Among the 10 229 patients who underwent MT, 274 met the inclusion criteria. 122 (44.5%) patients were treated in the late window. Early window patients were older (median age, 74 years [IQR, 63-80] vs 66.5 years [IQR, 54-77]; P < .001), had lower proportion of female patients (40.1% vs 54.1%; P = .029), higher median admission National Institutes of Health Stroke Scale score (20 [IQR, 16-24] vs 19 [IQR, 14-22]; P = .004), and a higher prevalence of atrial fibrillation (46.1% vs 27.3; P = .002). Propensity matching yielded a well-matched cohort of 84 patients in each group. Comparing the matched cohorts showed there was no significant difference in acceptable outcomes at 90 days between the 2 groups (odds ratio = 0.90 [95% CI = 0.47-1.71]; P = .70). However, the rate of symptomatic ICH was significantly higher in the early window group compared with the late window group (odds ratio = 2.44 [95% CI = 1.06-6.02]; P = .04). CONCLUSION: Among patients with anterior circulation large vessel occlusion and low ASPECTS, MT seems to provide a similar benefit to functional outcome for patients presenting <6 hours or 6 to 24 hours after onset
The influence of prestroke disability on outcome in patients with a low Alberta Stroke Program Early CT Score who underwent endovascular thrombectomy
No full textOBJECTIVE The definitive influence of prestroke disability on outcomes in patients with a low Alberta Stroke Program Early CT Score (ASPECTS) treated with endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) due to large-vessel occlusion (LVO) remains unknown. This study aimed to investigate the impact of prestroke disability on outcomes in this specific population. METHODS Data from 32 international centers for AIS-LVO patients with a low ASPECTS who underwent EVT between January 2013 and December 2022 were analyzed retrospectively. Low ASPECTS and prestroke disability were defined as ASPECTS values of 2–5 and prestroke modified Rankin Scale (mRS) score ≥ 2. The primary outcome was a return to the prestroke mRS score at 90 days. Secondary outcomes were independent ambulation (mRS scores of 0–3) or a return to the prestroke mRS score at 90 days, good functional outcome (mRS scores of 0–2) or a return to the prestroke mRS score at 90 days, successful recanalization, and 90-day mortality. Safety outcomes were any intracranial hemorrhage or symptomatic intracranial hemorrhage. A symptomatic intracranial hemorrhage was defined as an intracranial hemorrhage with an associated worsening of ≥ 4 points in the National Institutes of Health Stroke Scale score. Outcomes were compared between patients with and without prestroke disability. RESULTS Of 293 patients, 50 (17.1%) had a prestroke disability. Of 50 patients, 20 (40.0%), 24 (48.0%), and 6 (12.0%) had prestroke mRS scores of 2, 3, and 4, respectively. The primary outcome showed no significant difference between the two groups. Compared with patients without prestroke disability, those with prestroke disability had a significantly smaller proportion of independent ambulation or return to prestroke mRS score (adjusted OR 0.13, 95% CI 0.03–0.53) and good functional outcome or return to prestroke mRS score (adjusted OR 0.21, 95% CI 0.05–0.91). Other secondary and safety outcomes showed no significant difference between the two groups. CONCLUSIONS The present study indicated that prestroke disability was not associated with a return to the prestroke mRS score at 90 days or intracranial hemorrhage. Physicians should not routinely exclude AIS-LVO patients with a low ASPECTS who have prestroke disability from EVT based on prestroke disability alone
Clinical and radiographic outcomes after mechanical thrombectomy in medium-vessel posterior cerebral artery occlusions: Subgroup analysis from STAR
No full textBackground Whereas mechanical thrombectomy (MT) has become standard-of-care treatment for patients with salvageable brain tissue after acute stroke caused by large-vessel occlusions, the results of MT in patients with medium-vessel occlusions (MEVOs), particularly in the posterior cerebral artery (PCA), are not well known. Methods Using data from the international Stroke Thrombectomy and Aneurysm Registry (STAR), we assessed presenting characteristics and clinical outcomes for patients who underwent MT for primary occlusions in the P2 PCA segment. As a subanalysis, we compared the PCA MeVO outcomes with STAR's anterior circulation MeVO outcomes, namely middle cerebral artery (MCA) M2 and M3 segments. Results Of the 9812 patients in STAR, 43 underwent MT for isolated PCA MeVOs. The patients’ median age was 69 years (interquartile range 61–79), and 48.8% were female. The median NIH Stroke Scale score was 9 (range 6–17). After recanalization, 67.4% of patients achieved successful recanalization (modified treatment in cerebral infarction score [mTICI] ≥ 2b), with a first-pass success rate of 44.2%, and 39.6% achieved a modified Rankin score of 0–2 at 90 days. Nine patients (20.9%) had died by the 90-day follow-up. In comparison with M2 and M3 MeVOs, there were no differences in presenting characteristics among the three groups. Patients with PCA MeVOs were less likely to undergo intra-arterial thrombolysis (4.7% PCA vs. 10.1% M2 vs. 16.2% M3, p = 0.046) or to achieve successful recanalization (mTICI ≥ 2b, 67.4%, 86.7%, 82.3%, respectively, p < 0.001); however, there were no differences in the rates of successful first-pass recanalization (44.2%, 49.8%, 52.3%, respectively, p = 0.65). Conclusions We describe the STAR experience performing MT in patients with PCA MeVOs. Our analysis supports that successful first-pass recanalization can be achieved in PCA MEVOs at a rate similar to that in MCA MeVOs, although further study and possible innovation may be necessary to improve successful PCA MeVO recanalization rates.Brain Aneurysm Foundation https://doi.org/10.13039/100013490MedtronicRapidAIStryker https://doi.org/10.13039/100008894MicroventionPenumbra https://doi.org/10.13039/10002050
Earlier endovascular thrombectomy and mortality in patients with anterior circulation large vessel occlusion: a propensity-matched analysis of the Stroke Thrombectomy and Aneurysm Registry (STAR)
No full textOutcomes and differences by occluded vessel after endovascular thrombectomy for isolated medium vessel occlusions
No full texthttp://dx.doi.org/10.13039/100020501 Penumbra Inchttp://dx.doi.org/10.13039/100008894 Stryker Corphttp://dx.doi.org/10.13039/100016304 Medtronic In
Editorial. Developing systems of care: association of time to craniectomy with survival in patients with severe combat-related brain injuries
No full textA Qualitative Analysis of an Age Friendly Community Initiative
No full textIn this article, Alex Quintero discusses an age-friendly community initiative in Tallahassee, Florida where, although the planning process allowed information to be gathered efficiently, inclusion of a wider public wsa prevented by the narrow approach, lack of resources, centralized decision-making, and strategic selection of stakeholders. The author concludes by noting that existing partnerships can be used to broaden citizen involvement and ensure inclusive foundations for age-friendly initiatives to become solidified in the political, economic, and built enviromnent
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