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ESTUDIOS


01 marzo 2017

STROKE. Declining Incidence of Ischemic Stroke: What Is the Impact of Changing Risk Factors? The Tromsø Study 1995 to 2012

Anne M. Vangen-Lønne, Tom Wilsgaard, Stein Harald Johnsen, Maja-Lisa Løchen, Inger Njølstad and Ellisiv B. Mathiesen

Purpose: It is proposed that 20% to 40% of the decline in first-ever stroke incidence is attributed to the improvement of risk factor control. We estimated the impact of modifiable cardiovascular risk factors on the changing incidence of ischemic stroke (IS) between 1995 and 2012, using individual person data from repeated surveys in a general population.

01 marzo 2017

STROKE. Vessel Wall Enhancement and Blood–Cerebrospinal Fluid Barrier Disruption After Mechanical Thrombectomy in Acute Ischemic Stroke

Arturo Renú, Carlos Laredo, Antonio Lopez-Rueda, Laura Llull, Raúl Tudela, Luis San-Roman, Xabier Urra, Jordi Blasco, Juan Macho, Laura Oleaga, Angel Chamorro and Sergio Amaro

Purpose: Less than half of acute ischemic stroke patients treated with mechanical thrombectomy obtain permanent clinical benefits. Consequently, there is an urgent need to identify mechanisms implicated in the limited efficacy of early reperfusion. We evaluated the predictors and prognostic significance of vessel wall permeability impairment and its association with blood–cerebrospinal fluid barrier (BCSFB) disruption after acute stroke treated with thrombectomy.

01 marzo 2017

STROKE. Acute Cerebral Venous Thrombosis: Three-Dimensional Visualization and Quantification of Hemodynamic Alterations Using 4-Dimensional Flow Magnetic Resonance Imaging

Florian Schuchardt, Anja Hennemuth, Laure Schroeder, Stephan Meckel, Michael Markl, Thomas Wehrum and Andreas Harloff

Purpose: Cerebral venous thrombosis (CVT) affects venous hemodynamics and can provoke severe stroke and chronic intracranial hypertension. We sought to comprehensively analyze 3-dimensional blood flow and hemodynamic alterations during acute CVT including collateral recruitment and at follow-up.

01 marzo 2017

STROKE. Magnetic Resonance Imaging Plaque Hemorrhage for Risk Stratification in Carotid Artery Disease With Moderate Risk Under Current Medical Therapy

Akram A. Hosseini, Richard J. Simpson, Nishath Altaf, Philip M. Bath, Shane T. MacSweeney and Dorothee P. Auer

Purpose: Magnetic resonance imaging (MRI)–defined carotid plaque hemorrhage (MRIPH) can predict recurrent cerebrovascular ischemic events in severe symptomatic carotid stenosis. It is less clear whether MRIPH can improve risk stratification despite optimized medical secondary prevention in those with moderate risk.

01 marzo 2017

STROKE. Cervical Carotid Pseudo-Occlusions and False Dissections: Intracranial Occlusions Masquerading as Extracranial Occlusions

Jonathan A. Grossberg, Diogo C. Haussen, Fabricio B. Cardoso, Leticia C. Rebello, Mehdi Bouslama, Aaron M. Anderson, Michael R. Frankel and Raul G. Nogueira

Purpose: Pseudo-occlusion (PO) of the cervical internal carotid artery (ICA) refers to an isolated occlusion of the intracranial ICA that appears as an extracranial ICA occlusion on computed tomography angiography (CTA) or digital subtraction angiography because of blockage of distal contrast penetration by a stagnant column of unopacified blood. We aim to better characterize this poorly recognized entity.

01 febrero 2017

STROKE. Venous Thrombotic Recurrence After Cerebral Venous Thrombosis: A Long-Term Follow-Up Study

Paola Palazzo, Pierre Agius, Pierre Ingrand, Jonathan Ciron, Matthias Lamy, Aline Berthomet, Paul Cantagrel and Jean-Philippe Neau

Purpose: After cerebral venous thrombosis (CVT), the risk of venous thrombotic events was estimated at 2% to 3% for a new CVT and 3% to 8% for extracranial events. However, because of the paucity of prospective studies, the clinical course of CVT is still largely unknown. We aimed to prospectively evaluate the rate of thrombosis recurrence in a cohort of CVT patients with a long-term follow-up and to detect predisposing factors for recurrence.

01 febrero 2017

STROKE. Intracranial Carotid Artery Calcification Relates to Recanalization and Clinical Outcome After Mechanical Thrombectomy

María Hernández-Pérez, Daniel Bos, Laura Dorado, Karlijn Pellikaan, Meike W. Vernooij, Elena López-Cancio, Natalia Pérez de la Ossa, Meritxell Gomis, Carlos Castaño, Josep Munuera, Josep Puig, Mònica Millán and Antoni Dávalos

Purpose: Intracranial carotid artery calcification (ICAC) is a surrogate marker of intracranial arteriosclerosis, which may impact the revascularization and clinical outcome of acute stroke patients who undergo mechanical thrombectomy.

01 febrero 2017

STROKE. Outcomes After Direct Thrombectomy or Combined Intravenous and Endovascular Treatment Are Not Different

Sònia Abilleira , Aida Ribera , Pedro Cardona , Marta Rubiera , Elena López-Cancio , Sergi Amaro , Ana Rodríguez-Campello , Pol Camps-Renom , David Cánovas , Maria Angels de Miquel , Alejandro Tomasello , Sebastian Remollo , Antonio López-Rueda , Elio Vivas , Joan Perendreu , Miquel Gallofré , and for the Catalan Stroke Code and Reperfusion Consortium* , J. Martí-Fàbregas , R. Delgado-Mederos , A. Martínez-Domeño , R. Marín , J. Roquer , Á. Ois , J. Jiménez-Conde , L. Guimaraens , Á. Chamorro , V. Obach , X. Urra , J.M. Macho , J. Blasco , L. San Roman , A. Martínez-Yélamos , H. Quesada , B Lara , N. Cayuela , L. Aja , P. Mora , C. Molina , M. Ribó , J. Pagola , D. Rodríguez-Luna , M. Muchada , P. Coscojuela , A. Dávalos , M. Millán , N. Pérez de la Ossa , M. Gomis , L. Dorado , C. Castaño , M.C. Garcia , J. Estela , J. Krupinski , S. Huertas-Folch , M.C. Nicolás-Herrerias , M. Gómez-Choco , S. García , R. Martínez , J. Sanahuja , F. Purroy , J. Serena , M. Castellanos , Y. Silva , R. Marés , A. Pellisé , X. Ustrell , J.J. Baiges , M. Garcés , J. Saura , J.M. Soler-Insa , J.M. Aragonés , D. Cocho , and E. Palomeras

Purpose: Whether intravenous thrombolysis adds a further benefit when given before endovascular thrombectomy (EVT) is unknown. Furthermore, intravenous thrombolysis delays time to groin puncture, mainly among drip and ship patients.

01 febrero 2017

STROKE. Cost-Effectiveness of Solitaire Stent Retriever Thrombectomy for Acute Ischemic Stroke: Results From the SWIFT-PRIME Trial

Theresa I. Shireman , Kaijun Wang , Jeffrey L. Saver , Mayank Goyal , Alain Bonafé , Hans-Christoph Diener , Elad I. Levy , Vitor M. Pereira , Gregory W. Albers , Christophe Cognard , Werner Hacke , Olav Jansen , Tudor G. Jovin , Heinrich P. Mattle , Raul G. Nogueira , Adnan H. Siddiqui , Dileep R. Yavagal , Thomas G. Devlin , Demetrius K. Lopes , Vivek K. Reddy , Richard du Mesnil de Rochemont , Reza Jahan , Katherine A. Vilain , John House , Jin-Moo Lee , and David J. Cohen

Purpose: Clinical trials have demonstrated improved 90-day outcomes for patients with acute ischemic stroke treated with stent retriever thrombectomy plus tissue-type plasminogen activator (SST+tPA) compared with tPA. Previous studies suggested that this strategy may be cost-effective, but models were derived from pooled data and older assumptions.

01 febrero 2017

STROKE. Symptomatic Carotid Occlusion Is Frequently Associated With Microembolization

Ava L. Liberman, Ali Zandieh, Caitlin Loomis, Jonathan M. Raser-Schramm, Christina A. Wilson, Jose Torres, Koto Ishida, Swaroop Pawar, Rebecca Davis, Michael T. Mullen, Steven R. Messé, Scott E. Kasner and Brett L. Cucchiara

Purpose: Symptomatic carotid artery disease is associated with significant morbidity and mortality. The pathophysiologic mechanisms of cerebral ischemia among patients with carotid occlusion remain underexplored.

01 febrero 2017

STROKE. Differences in Acute Ischemic Stroke Quality of Care and Outcomes by Primary Stroke Center Certification Organization

Shumei Man, Margueritte Cox, Puja Patel, Eric E. Smith, Mathew J. Reeves, Jeffrey L. Saver, Deepak L. Bhatt, Ying Xian, Lee H. Schwamm and Gregg C. Fonarow

Purpose: Primary stroke center (PSC) certification was established to identify hospitals providing evidence-based care for stroke patients. The numbers of PSCs certified by Joint Commission (JC), Healthcare Facilities Accreditation Program, Det Norske Veritas, and State-based agencies have significantly increased in the past decade. This study aimed to evaluate whether PSCs certified by different organizations have similar quality of care and in-hospital outcomes.

01 diciembre 2016

STROKE. Power of an Adaptive Trial Design for Endovascular Stroke Studies

Maarten G. Lansberg, Ninad S. Bhat, Sharon D. Yeatts, Yuko Y. Palesch, Joseph P. Broderick, Gregory W. Albers, Tze L. Lai and Philip W. Lavori

Purpose: Adaptive trial designs that allow enrichment of the study population through subgroup selection can increase the chance of a positive trial when there is a differential treatment effect among patient subgroups. The goal of this study is to illustrate the potential benefit of adaptive subgroup selection in endovascular stroke studies.

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