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ESTUDIOS


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.

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.

30 junio 2015

STROKE. Clinical Sciences. Effects of Centralizing Acute Stroke Services on Stroke Care Provision in Two Large Metropolitan Areas in England

Angus I.G. Ramsay, PhD; Stephen Morris, PhD; Alex Hoffman, MSc; Rachael M. Hunter, MSc; Ruth Boaden, PhD; Christopher McKevitt, PhD; Catherine Perry, PhD; Nanik Pursani, MA; Anthony G. Rudd, MB, BChir; Simon J. Turner, PhD; Pippa J. Tyrrell, MD; Charles D.A. Wolfe, MD; Naomi J. Fulop, PhD

Background and Purpose: In 2010, Greater Manchester and London centralized acute stroke care into hyperacute units (Greater Manchester=3, London=8), with additional units providing ongoing specialist stroke care nearer patients’ homes. Greater Manchester patients presenting within 4 hours of symptom onset were eligible for hyperacute unit admission; all London patients were eligible. Research indicates that postcentralization, only London’s stroke mortality fell significantly more than elsewhere in England. This article attempts to explain this difference by analyzing how centralization affects provision of evidence-based clinical interventions.

07 julio 2015

STROKE. Clinical Sciences. Cluster Randomized Controlled Trial. Clinical and Cost-Effectiveness of a System of Longer-Term Stroke Care

Anne Forster, PhD; John Young, MSc; Katie Chapman, PhD; Jane Nixon, PhD; Anita Patel, PhD; Ivana Holloway, MSc; Kirste Mellish, PhD; Shamaila Anwar, PhD; Rachel Breen, PhD; Martin Knapp, PhD; Jenni Murray, PhD; Amanda Farrin, MSc

Background and Purpose: We developed a new postdischarge system of care comprising a structured assessment covering longer-term problems experienced by patients with stroke and their carers, linked to evidence-based treatment algorithms and reference guides (the longer-term stroke care system of care) to address the poor longer-term recovery experienced by many patients with stroke.

09 julio 2015

STROKE. Clinical Sciences. Antithrombotic Treatment Following Intracerebral Hemorrhage in Patients With and Without Atrial Fibrillation

Johanna Pennlert, MD; Kjell Asplund, MD, PhD; Bo Carlberg, MD, PhD; Per-Gunnar Wiklund, MD, PhD; Aase Wisten, MD, PhD; Signild Åsberg, MD, PhD; Marie Eriksson, PhD

Background and Purpose: Patients who survive intracerebral hemorrhage (ICH) often have compelling indications for anticoagulant and antiplatelet medication. This nationwide observational study aimed to determine the extent and predictors of antithrombotic treatment after ICH in Sweden.

28 mayo 2015

STROKE. Clinical Sciences. Different Imaging Strategies in Patients With Possible Basilar Artery Occlusion. Cost-Effectiveness Analysis

Sebastian E. Beyer; Myriam G. Hunink, MD, PhD; Florian Schöberl, MD; Louisa von Baumgarten, MD; Steffen E. Petersen, MD, DPhil; Martin Dichgans, MD; Hendrik Janssen, MD; Birgit Ertl-Wagner, MD; Maximilian F. Reiser, MD; Wieland H. Sommer, MD, MPH

Background and Purpose: This study evaluated the cost-effectiveness of different noninvasive imaging strategies in patients with possible basilar artery occlusion.

11 junio 2015

STROKE. Clinical Sciences. Comparison of Acute Stroke Preparedness Strategies to Decrease Emergency Department Arrival Time in a Multiethnic Cohort. The Stroke Warning Information and Faster Treatment Study

Bernadette Boden-Albala, DrPH; Joshua Stillman, MD; Eric T. Roberts, MPH; Leigh W. Quarles, MPH; M. Maria Glymour, ScD; Ji Chong, MD; Harmon Moats, MPH; Veronica Torrico, MA; Michael C. Parides, PhD

Background and Purpose: Less than 25% of stroke patients arrive to an emergency department within the 3-hour treatment window. Stroke Warning Information and Faster Treatment (SWIFT) compared an interactive intervention (II) with enhanced educational (EE) materials on recurrent stroke arrival times in a prospective cohort of multiethnic stroke/transient ischemic attack survivors.

23 abril 2015

STROKE. Editorial. Reperfusion Versus Recanalization: The Winner Is…

Jenny P. Tsai, MDCM; Gregory W. Albers, MD

The terms reperfusion and recanalization are sometimes erroneously used interchangeably when referring to outcomes of thrombolytic or endovascular therapies. Recanalization and reperfusion are neither discrete nor static measures and although achieving one often implies the other has also occurred. Arterial obstructions and perfusion deficits can both evolve independently over time, in the early hours not only after stroke onset but also after therapeutic interventions. Distinguishing reperfusion from recanalization can be challenging in the clinical arena because currently available noninvasive measurements from multimodal computed tomography or magnetic resonance imaging (MRI) have imperfect sensitivity and specificity.

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