06 agosto 2015

STROKE. Clinical Sciences. Cost-Utility Analysis of Mechanical Thrombectomy Using Stent Retrievers in Acute Ischemic Stroke

Jeban Ganesalingam, MBBS, MRCP (Neuro), PhD*; Elena Pizzo, PhD*; Stephen Morris, PhD; Tom Sunderland, MSc; Diane Ames, MBBS, FRCP; Kyriakos Lobotesis, MBBS, FRCR

Background and Purpose: Recently, 5 randomized controlled trials demonstrated the benefit of endovascular therapy compared with intravenous tissue-type plasminogen activator in acute stroke. Economic evidence evaluating stent retrievers is limited. We compared the cost-effectiveness of intravenous tissue-type plasminogen activator alone versus mechanical thrombectomy and intravenous tissue-type plasminogen activator as a bridging therapy in eligible patients in the UK National Health Service.

06 agosto 2015

STROKE. Clinical Sciences. Intracranial Carotid Calcification on Cranial Computed Tomography. Visual Scoring Methods, Semiautomated Scores, and Volume Measurements in Patients With Stroke

Deepak Subedi, FRCR; Umme Sara Zishan, MBBS; Francesca Chappell, PhD; Maria-Lena Gregoriades, FRCR; Cathie Sudlow, DPhil; Robin Sellar, FRCR; Joanna Wardlaw, FRCR, MD

Background and Purpose: Intracranial internal carotid artery calcification is associated with cerebrovascular risk factors and stroke, but few quantification methods are available. We tested the reliability of visual scoring, semiautomated Agatston score, and calcium volume measurement in patients with recent stroke.

22 julio 2014

STROKE. Clinical Sciences. Flow Diversion Versus Conventional Treatment for Carotid Cavernous Aneurysms

Mario Zanaty, MD; Nohra Chalouhi, MD; Robert M. Starke, MD; Guilherme Barros, BS; Mark Philip Saigh, BA; Eric Winthrop Schwartz, BS; Norman Ajiboye, MD; Stavropoula I. Tjoumakaris, MD; David Hasan, MD; Robert H. Rosenwasser, MD; Pascal Jabbour, MD

Background and Purpose: Several endovascular treatment options are available for cavernous carotid aneurysms. We compared pipeline embolization device (PED) versus conventional endovascular treatment in terms of evolution of mass effect, complications, recurrence, and retreatment rate

31 julio 2014

STROKE. Clinical Sciences. Long-Term Follow-Up Study of Endarterectomy Versus Angioplasty in Patients With Symptomatic Severe Carotid Stenosis Trial

Jean-Louis Mas, MD; Caroline Arquizan, MD; David Calvet, PhD; Alain Viguier, MD; Jean-François Albucher, MD; Philippe Piquet, MD; Pierre Garnier, MD; Fausto Viader, MD; Maurice Giroud, MD; Hassan Hosseini, PhD; Grégoire Hinzelin, MD; Pascal Favrole, MD; Hilde Hénon, MD; Jean-Philippe Neau, MD; Xavier Ducrocq, MD; Raymond Padovani, MD; Loic Milandre, MD†; François Rouanet, MD; Valérie Wolff, MD; Denis Saudeau, MD; Marie-Hélène Mahagne, MD; Denis Sablot, MD; Pierre Amarenco, MD; Vincent Larrue, MD; Bernard Beyssen, MD; Didier Leys, PhD; Thierry Moulin, MD; Michel Lièvre, MD; Gilles Chatellier, MD; on behalf of the EVA-3S Investigators

Background and Purpose: We aimed at comparing the long-term benefit–risk balance of carotid stenting versus endarterectomy for symptomatic carotid stenosis.

15 julio 2014

STROKE. Morphology of Susceptibility Vessel Sign Predicts Middle Cerebral Artery Recanalization After Intravenous Thrombolysis

Shenqiang Yan, MD; Haitao Hu, MD; Zhenghao Shi, MM; Xuting Zhang, MD; Sheng Zhang, PhD; David S. Liebeskind, MD; Min Lou, MD, PhD

Background and Purpose: We aimed to evaluate the predictive value of susceptibility vessel sign (SVS) burden and morphology in middle cerebral artery recanalization.

29 julio 2014

STROKE. Clinical Sciences. Thrombolysis in Ischemic Stroke Without Arterial Occlusion at Presentation

Sourabh Lahoti, MD; Sankalp Gokhale, MD; Louis Caplan, MD; Patrik Michel, MD; Yves Samson, MD; Charlotte Rosso, MD, PhD; Kaustubh Limaye, MD; Archana Hinduja, MD; Aneesh Singhal, MD; Syed Ali, MD; Luther Creed Pettigrew, MD; Richard Kryscio, PhD; Nikita Dedhia, MD; Shirish Hastak, MD, DM; David S. Liebeskind, MD

Background and Purpose: None of the randomized trials of intravenous tissue-type plasminogen activator reported vascular imaging acquired before thrombolysis. Efficacy of tissue-type plasminogen activator in stroke without arterial occlusion on vascular imaging remains unknown and speculative.

08 julio 2014

STROKE. Clinical Sciences. Family History as a Risk Factor for Carotid Artery Stenosis

Mahyar Khaleghi, MD; Iyad N. Isseh, MBBS; Hayan Jouni, MD; Sunghwan Sohn, PhD; Kent R. Bailey, PhD; Iftikhar J. Kullo, MD

Background and Purpose: We investigated whether family history of stroke or coronary heart disease (CHD) is associated with presence of carotid artery stenosis (CAS).

08 julio 2014

STROKE. Clinical Sciences. Pittsburgh Outcomes After Stroke Thrombectomy Score Predicts Outcomes After Endovascular Therapy for Anterior Circulation Large Vessel Occlusions

Srikant Rangaraju, MBBS; John T.P. Liggins, MSc; Amin Aghaebrahim, MD; Christopher Streib, MD; Chung-Huan Sun, BS; Rishi Gupta, MD; Raul Nogueira, MD; Michael Frankel, MD; Michael Mlynash, MD; Maarten Lansberg, MD; Gregory Albers, MD; Ashutosh Jadhav, MD; Tudor G. Jovin, MD

Background and Purpose: Prognostication tools that predict good outcome in patients with anterior circulation large vessel occlusions after endovascular therapy are lacking. We aim to develop a tool that incorporates clinical and imaging data to predict outcomes after endovascular therapy.

24 junio 2014

STROKE. Clinical Sciences. Vessel Wall Magnetic Resonance Imaging in Acute Ischemic Stroke. Effects of Embolism and Mechanical Thrombectomy on the Arterial Wall

Sarah Power, MB, PhD; Charles Matouk, MD; Leanne K. Casaubon, MD; Frank L. Silver, MD; Timo Krings, MD, PhD; David J. Mikulis, MD; Daniel M. Mandell, MD, PhD

Background and Purpose: The aim of the study was to determine the effects of thromboembolism and mechanical thrombectomy on the vessel wall magnetic resonance imaging (VW-MRI) appearance of the intracranial arterial wall.

01 julio 2014

STROKE. Brief Report. Hemodynamic Quantification in Brain Arteriovenous Malformations With Time-Resolved Spin-Labeled Magnetic Resonance Angiography

Hélène Raoult, MD; Elise Bannier, PhD; Pierre Maurel, PhD; Clément Neyton, MS; Jean-Christophe Ferré, MD, PhD; Peter Schmitt, PhD; Christian Barillot, PhD; Jean-Yves Gauvrit, MD, PhD

Background and Purpose: Unenhanced time-resolved spin-labeled magnetic resonance angiography enables hemodynamic quantification in arteriovenous malformations (AVMs). Our purpose was to identify quantitative parameters that discriminate among different AVM components and to relate hemodynamic patterns with rupture risk.

12 junio 2014

STROKE. Clinical Sciences. Features Predictive of Brain Arteriovenous Malformation Hemorrhage

Daniel H. Sahlein, MD; Paloma Mora, MD; Tibor Becske, MD; Paul Huang, MD; Jafar J. Jafar, MD; E. Sander Connolly, MD; Peter K. Nelson, MD

Background and Purpose: Although there is generally thought to be a 2% to 4% per annum rupture risk for brain arteriovenous malformations (bAVMs), there is no way to estimate risk for an individual patient.

10 junio 2014

STROKE. Clinical Sciences. Six-Minute Magnetic Resonance Imaging Protocol for Evaluation of Acute Ischemic Stroke

Kambiz Nael, MD; Rihan Khan, MD; Gagandeep Choudhary, MD; Arash Meshksar, MD; Pablo Villablanca, MD; Jennifer Tay, MD; Kendra Drake, MD; Bruce M. Coull, MD; Chelsea S. Kidwell, MD

Background and Purpose: If magnetic resonance imaging (MRI) is to compete with computed tomography for evaluation of patients with acute ischemic stroke, there is a need for further improvements in acquisition speed.

22 abril 2014

STROKE. Clinical Sciences. Geomagnetic Storms Can Trigger Stroke. Evidence From 6 Large Population-Based Studies in Europe and Australasia

Valery L. Feigin, MD, MSc, PhD; Priya G. Parmar, MSc; Suzanne Barker-Collo, PhD; Derrick A. Bennett, PhD; Craig S. Anderson, MD, PhD; Amanda G. Thrift, BSci (Hons), PhD; Birgitta Stegmayr, PhD; Peter M. Rothwell, MD, PhD; Maurice Giroud, MD, PhD; Yannick Bejot, MD; Phillip Carvil, MSc; Rita Krishnamurthi, PhD; Nikola Kasabov, PhD; for the International Stroke Incidence Studies Data Pooling Project Collaborators

Background and Purpose: Although the research linking cardiovascular disorders to geomagnetic activity is accumulating, robust evidence for the impact of geomagnetic activity on stroke occurrence is limited and controversial.

29 julio 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Pharmacology. Halofuginone Stimulates Adaptive Remodeling and Preserves Re-Endothelialization in Balloon-Injured Rat Carotid Arteries

Lian-Wang Guo, PhD*, Bowen Wang, BS*, Shakti A. Goel, MBBS*, Christopher Little, BS, Toshio Takayama, MD, PhD, Xu Dong Shi, MD, PhD, Drew Roenneburg, MS, Daniel DiRenzo, PhD and K. Craig Kent, MD

Background: Three major processes, constrictive vessel remodeling, intimal hyperplasia (IH), and retarded re-endothelialization, contribute to restenosis after vascular reconstructions. Clinically used drugs inhibit IH but delay re-endothelialization and also cause constrictive remodeling. Here we have examined halofuginone, an herbal derivative, for its beneficial effects on vessel remodeling and differential inhibition of IH versus re-endothelialization.

23 junio 2015

STROKE. Clinical Sciences. Futile Interhospital Transfer for Endovascular Treatment in Acute Ischemic Stroke. The Madrid Stroke Network Experience

Blanca Fuentes, MD, PhD; María Alonso de Leciñana, MD, PhD; Alvaro Ximénez-Carrillo, MD; Patricia Martínez-Sánchez, MD, PhD; Antonio Cruz-Culebras, MD; Gustavo Zapata-Wainberg, MD; Gerardo Ruiz-Ares, MD, PhD; Remedios Frutos, MD; Eduardo Fandiño, MD; Jose L. Caniego, MD; Andrés Fernández-Prieto, MD; Jose C. Méndez, MD; Eduardo Bárcena, MD; Begoña Marín, MD; Andrés García-Pastor, MD; Fernando Díaz-Otero, MD; Antonio Gil-Núñez, MD, PhD; Jaime Masjuán, MD, PhD; Jose Vivancos, MD, PhD; Exuperio Díez-Tejedor, MD, PhD; on behalf of the Madrid Stroke Network

Background and Purpose: The complexity of endovascular revascularization treatment (ERT) in acute ischemic stroke and the small number of patients eligible for treatment justify the development of stroke center networks with interhospital patient transfers. However, this approach might result in futile transfers (ie, the transfer of patients who ultimately do not undergo ERT). Our aim was to analyze the frequency of these futile transfers and the reasons for discarding ERT and to identify the possible associated factors.