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ESTUDIOS


01 febrero 2017

STROKE. Arterial Obstruction on Computed Tomographic or Magnetic Resonance Angiography and Response to Intravenous Thrombolytics in Ischemic Stroke

Grant Mair, Rüdiger von Kummer, Alessandro Adami, Philip M. White, Matthew E. Adams, Bernard Yan, Andrew M. Demchuk, Andrew J. Farrall, Robin J. Sellar, Eleni Sakka, Jeb Palmer, David Perry, Richard I. Lindley, Peter A.G. Sandercock and Joanna M. Wardlaw

Purpose: Computed tomographic angiography and magnetic resonance angiography are used increasingly to assess arterial patency in patients with ischemic stroke. We determined which baseline angiography features predict response to intravenous thrombolytics in ischemic stroke using randomized controlled trial data.

01 enero 2017

STROKE. Lipoprotein(a) Levels and Recurrent Vascular Events After First Ischemic Stroke

Kristin S. Lange, Alexander H. Nave, Thomas G. Liman, Ulrike Grittner, Matthias Endres and Martin Ebinger

Purpose: The association of elevated lipoprotein(a) (Lp(a)) levels and the incidence of cardiovascular disease, especially coronary heart disease and ischemic stroke, is well established. However, evidence on the association between Lp(a) levels and residual vascular risk in stroke survivors is lacking. We aimed to elucidate the risk for recurrent cardiovascular and cerebrovascular events in the patients with first-ever ischemic stroke with elevated Lp(a).

01 diciembre 2016

STROKE. Impact of Clinical Trial Results on the Temporal Trends of Carotid Endarterectomy and Stenting From 2002 to 2014

Mohamad A. Hussain, Muhammad Mamdani, Jack V. Tu, Gustavo Saposnik, Zeyad Khoushhal, Badr Aljabri, Subdoh Verma and Mohammed Al-Omran

Purpose: Randomized trials provide conflicting data for the efficacy of carotid-artery stenting compared with endarterectomy. The purpose of this study was to examine the impact of conflicting clinical trial publications on the utilization rates of carotid revascularization procedures.

01 diciembre 2015

STROKE. Shear-Activated Nanoparticle Aggregates Combined With Temporary Endovascular Bypass to Treat Large Vessel Occlusion

Miklos G. Marosfoi , Netanel Korin , Matthew J. Gounis , Oktay Uzun , Srinivasan Vedantham , Erin T. Langan , Anne-Laure Papa , Olivia W. Brooks , Chris Johnson , Ajit S. Puri , Deen Bhatta , Mathumai Kanapathipillai , Ben R. Bronstein , Ju-Yu Chueh , Donald E. Ingber and Ajay K. Wakhloo

Purpose: The goal of this study is to combine temporary endovascular bypass (TEB) with a novel shear-activated nanotherapeutic (SA-NT) that releases recombinant tissue-type plasminogen activator (r-tPA) when exposed to high levels of hemodynamic stress and to determine if this approach can be used to concentrate r-tPA at occlusion sites based on high shear stresses created by stent placement.

01 diciembre 2015

STROKE. Time From Symptoms to Carotid Endarterectomy or Stenting and Perioperative Risk

James F. Meschia, L. Nelson Hopkins, Irfan Altafullah, Lawrence R. Wechsler, Grant Stotts, Nicole R. Gonzales, Jenifer H. Voeks, George Howard and Thomas G. Brott

Purpose: Prior meta-analysis showed that carotid endarterectomy benefits decline with increasing surgical delay following symptoms. For symptomatic patients in the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST), we assessed if differences in time between symptoms and carotid endarterectomy or carotid artery stenting are associated with differences in risk of periprocedural stroke or death.

01 diciembre 2015

STROKE. Phone and Video-Based Modalities of Central Blinded Adjudication of Modified Rankin Scores in an Endovascular Stroke Trial

Elena López-Cancio, Mercè Salvat, Neus Cerdà, Marta Jiménez, Javier Codas, Laura Llull, Sandra Boned, Luis M. Cano, Blanca Lara, Carlos Molina, Erik Cobo, Antoni Dávalos, Tudor G. Jovin and Joaquín Serena

Purpose: The standard outcome measure in stroke research is modified Rankin scale (mRS) evaluated by local blinded investigators. We aimed to assess feasibility and reliability of 2 central adjudication methods of mRS in the setting of a randomized endovascular stroke trial.

01 diciembre 2015

STROKE. Endovascular Therapy Is Effective and Safe for Patients With Severe Ischemic Stroke

Joseph P. Broderick , Olvert A. Berkhemer , Yuko Y. Palesch , Diederik W.J. Dippel , Lydia D. Foster , Yvo B.W.E.M. Roos , Aad van der Lugt , Thomas A. Tomsick , Charles B.L.M. Majoie , Wim H. van Zwam , Andrew M. Demchuk , Robert J. van Oostenbrugge , Pooja Khatri , Hester F. Lingsma , Michael D. Hill , Bob Roozenbeek , Edward C. Jauch , Tudor G. Jovin , Bernard Yan , Rüdiger von Kummer , Carlos A. Molina , Mayank Goyal , Wouter J. Schonewille , Mikael Mazighi , Stefan T. Engelter , Craig S. Anderson , Judith Spilker , Janice Carrozzella , Karla J. Ryckborst , L. Scott Janis , Kit N. Simpson and for the IMS III and MR CLEAN Investigators

Purpose: We assessed the effect of endovascular treatment in acute ischemic stroke patients with severe neurological deficit (National Institutes of Health Stroke Scale score, >=20) after a prespecified analysis plan.

01 diciembre 2015

STROKE. Summary of Evidence on Early Carotid Intervention for Recently Symptomatic Stenosis Based on Meta-Analysis of Current Risks

Paola De Rango, Martin M. Brown, Seemant Chaturvedi, Virginia J. Howard, Tudor Jovin, Michael V. Mazya, Maurizio Paciaroni, Alessandra Manzone, Luca Farchioni and Valeria Caso

Purpose: This study aimed to assess the evidence on the periprocedural (<30 days) risks of carotid intervention in relation to timing of procedure in patients with recently symptomatic carotid stenosis.

01 marzo 2016

STROKE. Significance of Cerebral Small-Vessel Disease in Acute Intracerebral Hemorrhage

Shoichiro Sato, Candice Delcourt, Emma Heeley, Hisatomi Arima, Shihong Zhang, Rustam Al-Shahi Salman, Christian Stapf, Daniel Woo, Matthew L. Flaherty, Achala Vagal, Christopher Levi, Leo Davies, Jiguang Wang, Thompson Robinson, Pablo M. Lavados, Richard I. Lindley, John Chalmers, Craig S. Anderson and on behalf of the INTERACT2 Investigators

Purpose: The significance of structural changes associated with cerebral small-vessel disease (SVD), including white matter lesions (WML), lacunes, and brain atrophy, to outcome from acute intracerebral hemorrhage is uncertain. We determined associations of computed tomographic radiological manifestations of cerebral SVD and outcomes, and in terms of any differential effect of early intensive blood pressure–lowering treatment, in the large-scale Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2).

01 marzo 2016

STROKE. Flow Diverter Therapy With the Pipeline Embolization Device Is Associated With an Elevated Rate of Delayed Fluid-Attenuated Inversion Recovery Lesions

Mina G. Safain, Marie Roguski, Robert S. Heller and Adel M. Malek

Purpose: Flow diversion using the Pipeline Embolization Device is reported as a safe treatment of aneurysms. Complete aneurysm occlusion, however, occurs in a delayed fashion with initial persistent filling of the aneurysm dome. We hypothesized that this transflow across metallic struts may be associated with thromboembolic events.

01 marzo 2016

STROKE. Safety and Efficacy of Solitaire Stent Thrombectomy: Individual Patient Data Meta-Analysis of Randomized Trials

Bruce C.V. Campbell , Michael D. Hill , Marta Rubiera , Bijoy K. Menon , Andrew Demchuk , Geoffrey A. Donnan , Daniel Roy , John Thornton , Laura Dorado , Alain Bonafe , Elad I. Levy , Hans-Christoph Diener , María Hernández-Pérez , Vitor Mendes Pereira , Jordi Blasco , Helena Quesada , Jeremy Rempel , Reza Jahan , Stephen M. Davis , Bruce C. Stouch , Peter J. Mitchell , Tudor G. Jovin , Jeffrey L. Saver and Mayank Goyal

Purpose: Recent positive randomized trials of endovascular therapy for ischemic stroke used predominantly stent retrievers. We pooled data to investigate the efficacy and safety of stent thrombectomy using the Solitaire device in anterior circulation ischemic stroke.

01 marzo 2016

STROKE. Pediatric Cortical Vein Thrombosis: Frequency and Association With Venous Infarction

Zak Ritchey, Amanda L. Hollatz, David Weitzenkamp, Laura Z. Fenton, Emily C. Maxwell, Timothy J. Bernard and Nicholas V. Stence

Purpose: Cortical vein thrombosis (CVT) is an uncommon site of involvement in cerebral sinovenous thrombosis. Few reports have described pediatric CVT, and none has differentiated its unique attributes. This study assessed the clinical features and radiographic outcome of a cohort of children with cerebral sinovenous thrombosis, comparing those with CVT to those without CVT.

01 enero 2016

STROKE. Large Volumes of Critically Hypoperfused Penumbral Tissue Do Not Preclude Good Outcomes After Complete Endovascular Reperfusion

Raul G. Nogueira, Diogo C. Haussen, Seena Dehkharghani, Leticia C. Rebello, Andrey Lima, Meredith Bowen, Samir Belagaje, Aaron Anderson and Michael Frankel

Purpose: Acute ischemic stroke patients with large volumes of severe hypoperfusion (Tmax>10 s>100 mL) on magnetic resonance imaging have a higher likelihood of intracranial hemorrhage and poor outcomes after reperfusion. We aim to evaluate the impact of the extent of Tmax>10 s CTP lesions in patients undergoing successful treatment.

01 enero 2016

STROKE. Imaging Characteristics of Growing and Ruptured Vertebrobasilar Non-Saccular and Dolichoectatic Aneurysms

Deena M. Nasr, Waleed Brinjikji, Aymeric Rouchaud, Ramanathan Kadirvel, Kelly D. Flemming and David F. Kallmes

Purpose: Vertebrobasilar, nonsaccular, and dolichoectatic aneurysms generally have a poor natural history. We performed a study examining the natural history of vertebrobasilar, nonsaccular, and dolichoectatic aneurysms receiving serial imaging and studied imaging characteristics associated with growth and rupture.

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