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ESTUDIOS


19 febrero 2019

Glucose Modifies the Effect of Endovascular Thrombectomy in Patients With Acute Stroke

Ángel Chamorro, Scott Brown, Sergio Amaro, Michael D. Hill, Keith W. Muir, Diederik W.J. Dippel, Wim van Zwam, Ken Butcher, Gary A. Ford, Heleen M. den Hertog, Peter J. Mitchell, Andrew M. Demchuk, Charles B.L.M. Majoie, Serge Bracard, Igor Sibon, Ashutosh P. Jadhav, Blanca Lara-Rodriguez, Aad van der Lugt, Elizabeth Osei, Arturo Renú, Sébastien Richard, David Rodriguez-Luna, Geoffrey A Donnan, Anand Dixit, Mohammed Almekhlafi, Sandrine Deltour, Jonathan Epstein, Benoit Guillon, Serge Bakchine, Meritxell Gomis, Richard du Mesnil de Rochemont, Demetrius Lopes, Vivek Reddy, Gernot Rudel, Yvo B.W. E.M. Roos, Alain Bonafe, Hans-Christoph Diener, Olvert A. Berkhemer, Geoffrey C. Cloud, Stephen M. Davis, Robert van Oostenbrugge, Francis Guillemin, Mayank Goyal, Bruce C.V. Campbell, Bijoy K. Menon and for the HERMES Collaborators

Abstract Background and Purpose— Hyperglycemia is a negative prognostic factor after acute ischemic stroke but is not known whether glucose is associated with the effects of endovascular thrombectomy (EVT) in patients with large-vessel stroke. In a pooled-data meta-analysis, we analyzed whether serum glucose is a treatment modifier of the efficacy of EVT in acute stroke.

19 febrero 2019

Impact of Balloon Guide Catheter Use on Clinical and Angiographic Outcomes in the STRATIS Stroke Thrombectomy Registry

Osama O. Zaidat, Nils H. Mueller-Kronast, Ameer E. Hassan, Diogo C. Haussen, Ashutosh P. Jadhav, Michael T. Froehler, Reza Jahan, Mohammad Ali Aziz-Sultan, Richard P. Klucznik, Jeffrey L. Saver, Frank R. Hellinger Jr, Dileep R. Yavagal, Tom L. Yao, Rishi Gupta, Coleman O. Martin, Hormozd Bozorgchami, Ritesh Kaushal, Raul G. Nogueira, Ravi H. Gandhi, Eric C. Peterson, Shervin Dashti, Curtis A. Given II, Brijesh P. Mehta, Vivek Deshmukh, Sidney Starkman, Italo Linfante, Scott H. McPherson, Peter Kvamme, Thomas J. Grobelny, Muhammad Shazam Hussain, Ike Thacker, Nirav Vora, Peng Roc Chen, Stephen J. Monteith, Robert D. Ecker, Clemens M. Schirmer, Eric Sauvageau, Alex Bou Chebl, Colin P. Derdeyn, Lucian Maidan, Aamir Badruddin, Adnan H. Siddiqui, Travis M. Dumont, Abdulnasser Alhajeri, Muhammad A. Taqi, Khaled Asi, Jeffrey Carpenter, Alan Boulos, Gaurav Jindal, Ajit S. Puri, Rohan Chitale, Eric M. Deshaies, David Robinson, David F. Kallmes, Blaise W. Baxter, Mouhammed Jumaa, Peter Sunenshine, Aniel Majjhoo, Joey D. English, Shuichi Suzuki, Richard D. Fessler, Josser Delgado-Almandoz, Jerry C. Martin, David S. Liebeskind and on behalf of the STRATIS Investigators

Abstract Background and Purpose— Mechanical thrombectomy has been shown to improve clinical outcomes in patients with acute ischemic stroke. However, the impact of balloon guide catheter (BGC) use is not well established.

19 febrero 2019

Effects of a Disease Management Program for Preventing Recurrent Ischemic Stroke

Yasuko Fukuoka, Naohisa Hosomi, Takeshi Hyakuta, Toyonori Omori, Yasuhiro Ito, Jyunichi Uemura, Yoshiki Yagita, Kazumi Kimura, Masayasu Matsumoto, Michiko Moriyama and for DMP Stroke Trial Investigators

Abstract Background and Purpose— Disease management is a healthcare strategy that includes self-management education and treatment coordination. We conducted a randomized controlled trial to determine whether a disease management program intervention could improve risk factor profiles and, thus, reduce the recurrence of stroke and other cardiovascular diseases.

21 enero 2019

Association of Perforator Stroke After Basilar Artery Stenting With Negative Remodeling

Ning Ma, Ziqi Xu, Jinhao Lyu, Mingyao Li, Zhikai Hou, Yifan Liu, Ming Yang, Dapeng Mo, Feng Gao, Ligang Song, Xuan Sun, Lian Liu, Xin Liu, Binbin Sui, Mi Shen, Lin Ma, Yilong Wang, Yongjun Wang, Zhongrong Miao and Xin Lou

Abstract Background and Purpose— We try to evaluate whether plaque features and perforator stroke after intracranial stenting is associated with the arterial remodeling patterns in patients with severe basilar artery stenosis.

14 marzo 2019

Better Collaterals Are Independently Associated With Post-Thrombolysis Recanalization Before Thrombectomy

Pierre Seners, Pauline Roca, Laurence Legrand, Guillaume Turc, Jean-Philippe Cottier, Tae-Hee Cho, Caroline Arquizan, Serge Bracard, Canan Ozsancak, Wagih Ben Hassen, Olivier Naggara, Stéphanie Lion, Séverine Debiais, Yves Berthezene, Vincent Costalat, Sébastien Richard, Christophe Magni, Jean-Louis Mas, Jean-Claude Baron and Catherine Oppenheim

Abstract Background and Purpose— In acute stroke patients with large vessel occlusion, the goal of intravenous thrombolysis (IVT) is to achieve early recanalization (ER). Apart from occlusion site and thrombus length, predictors of early post-IVT recanalization are poorly known. Better collaterals might also facilitate ER, for instance, by improving delivery of the thrombolytic agent to both ends of the thrombus. In this proof-of-concept study, we tested the hypothesis that good collaterals independently predict post-IVT recanalization before thrombectomy.

04 marzo 2019

Mechanical Thrombectomy in Ischemic Stroke Patients With Alberta Stroke Program Early Computed Tomography Score 0–5

Johannes Kaesmacher, Panagiotis Chaloulos-Iakovidis, Leonidas Panos, Pasquale Mordasini, Patrik Michel, Steven D. Hajdu, Marc Ribo, Manuel Requena, Christian Maegerlein, Benjamin Friedrich, Vincent Costalat, Amel Benali, Laurent Pierot, Matthias Gawlitza, Joanna Schaafsma, Vitor Mendes Pereira, Jan Gralla and Urs Fischer

Abstract Background and Purpose— If anterior circulation large vessel occlusion acute ischemic stroke patients presenting with ASPECTS 0–5 (Alberta Stroke Program Early CT Score) should be treated with mechanical thrombectomy remains unclear. Purpose of this study was to report on the outcome of patients with ASPECTS 0–5 treated with mechanical thrombectomy and to provide data regarding the effect of successful reperfusion on clinical outcomes and safety measures in these patients.

28 febrero 2019

WEAVE Trial

Michael J. Alexander, Alois Zauner, John C. Chaloupka, Blaise Baxter, Richard C. Callison, Rishi Gupta, Shlee S. Song, Wengui Yu and on behalf of the WEAVE Trial Investigators

Abstract Background and Purpose— The WEAVE trial (Wingspan Stent System Post Market Surveillance) is a postmarket surveillance trial mandated by the Food and Drug Administration to assess the periprocedural safety of the Wingspan Stent system in the treatment of symptomatic intracranial atherosclerotic disease.

18 marzo 2019

Impact of Endovascular Therapy in Patients With Large Ischemic Core

Hiroto Kakita, Shinichi Yoshimura, Kazutaka Uchida, Nobuyuki Sakai, Hiroshi Yamagami, Takeshi Morimoto and RESCUE-Japan Registry 2 Investigators

Abstract Background and Purpose— Endovascular therapy (EVT) is strongly recommended for acute cerebral large vessel occlusion with the Alberta Stroke Program Early CT Score (ASPECTS) ≥6 due to occlusion of the internal carotid artery or M1 segment of the middle cerebral artery. However, the effect of EVT for patients who have ischemic core with ASPECTS ≤5 (0–5) was not established. The purpose of this study was to elucidate the outcomes of EVT for patients with large ischemic core.

14 marzo 2019

IER-SICH Nomogram to Predict Symptomatic Intracerebral Hemorrhage After Thrombectomy for Stroke

Manuel Cappellari, Salvatore Mangiafico, Valentina Saia, Giovanni Pracucci, Sergio Nappini, Patrizia Nencini, Daniel Konda, Fabrizio Sallustio, Stefano Vallone, Andrea Zini, Sandra Bracco, Rossana Tassi, Mauro Bergui, Paolo Cerrato, Antonio Pitrone, Francesco Grillo, Andrea Saletti, Alessandro De Vito, Roberto Gasparotti, Mauro Magoni, Edoardo Puglielli, Alfonsina Casalena, Francesco Causin, Claudio Baracchini, Lucio Castellan, Laura Malfatto, Roberto Menozzi, Umberto Scoditti, Chiara Comelli, Enrica Duc, Alessio Comai, Enrica Franchini, Mirco Cosottini, Michelangelo Mancuso, Simone Peschillo, Manuela De Michele, Andrea Giorgianni, Maria Luisa Delodovici, Elvis Lafe, Maria Federica Denaro, Nicola Burdi, Saverio Internò, Nicola Cavasin, Adriana Critelli, Luigi Chiumarulo, Marco Petruzzellis, Marco Doddi, Antonio Carolei, William Auteri, Alfredo Petrone, Riccardo Padolecchia, Tiziana Tassinari, Marco Pavia, Paolo Invernizzi, Gianni Turcato, Stefano Forlivesi, Elisa Francesca Maria Ciceri, Bruno Bonetti, Domenico Inzitari, Danilo Toni and on behalf of the IER Collaborators

Abstract Background and Purpose— As a reliable scoring system to detect the risk of symptomatic intracerebral hemorrhage after thrombectomy for ischemic stroke is not yet available, we developed a nomogram for predicting symptomatic intracerebral hemorrhage in patients with large vessel occlusion in the anterior circulation who received bridging of thrombectomy with intravenous thrombolysis (training set), and to validate the model by using a cohort of patients treated with direct thrombectomy (test set).

07 marzo 2019

Hypoperfusion Intensity Ratio Is Correlated With Patient Eligibility for Thrombectomy

Adrien Guenego, David G. Marcellus, Blake W. Martin, Soren Christensen, Gregory W. Albers, Maarten G. Lansberg, Michael P. Marks, Max Wintermark and Jeremy J. Heit

Abstract Background and Purpose— Hypoperfusion intensity ratio (HIR) is associated with collateral status in acute ischemic stroke patients with anterior circulation large vessel occlusion. We assessed whether HIR was correlated to patient eligibility for mechanical thrombectomy (MT).

13 marzo 2019

Effect of Interhospital Transfer on Endovascular Treatment for Acute Ischemic Stroke

Esmee Venema, Adrien E. Groot, Hester F. Lingsma, Wouter Hinsenveld, Kilian M. Treurniet, Vicky Chalos, Sanne M. Zinkstok, Maxim J.H.L. Mulder, Inger R. de Ridder, Henk A. Marquering, Wouter J. Schonewille, Marieke J.H. Wermer, Charles B.L.M. Majoie, Yvo B.W.E.M. Roos, Diederik W.J. Dippel, Jonathan M. Coutinho, Bob Roozenbeek and for the MR CLEAN Registry Investigators

Abstract Background and Purpose— To assess the effect of inter-hospital transfer on time to treatment and functional outcome after endovascular treatment (EVT) for acute ischemic stroke, we compared patients transferred from a primary stroke center to patients directly admitted to an intervention center in a large nationwide registry.

14 marzo 2019

Comparative Effectiveness of Endovascular Thrombectomy in Elderly Stroke Patients

Ajay Malhotra, Xiao Wu, Seyedmehdi Payabvash, Charles C. Matouk, Howard P. Forman, Dheeraj Gandhi, Pina Sanelli and Joseph Schindler

Abstract Background and Purpose— Strokes in patients aged ≥80 years are common, and advanced age is associated with relatively poor poststroke functional outcome. The current guidelines do not recommend an upper age limit for endovascular thrombectomy (EVT). The purpose of this study is to evaluate the effectiveness of EVT in acute stroke because of large vessel occlusion for elderly patients >age 80 years.

22 febrero 2019

Intraarterial Thrombolysis as Rescue Therapy for Large Vessel Occlusions

Syed F. Zaidi, Alicia C. Castonguay, Mouhammad A. Jumaa, Tim W. Malisch, Italo Linfante, Franklin A. Marden, Michael G. Abraham, Alex Bou Chebl, Roberta Novakovic, M. Asif Taqi, Raul G. Nogueira, Coleman O. Martin, William E. Holloway, Nils Mueller-Kronast, Joey D. English, Guilherme Dabus, Hormozd Bozorgchami, Andrew Xavier, Ansaar T. Rai, Michael T. Froehler, Aamir Badruddin, Thanh N. Nguyen, Albert J. Yoo, Hashem Shaltoni, Vallabh Janardhan, Peng R. Chen, Gavin W. Britz, Ritesh Kaushal, Ashish Nanda, Rishi Gupta and Osama O. Zaidat

Abstract Background and Purpose— Mechanical thrombectomy (MT) devices have led to improved reperfusion and clinical outcomes in acute ischemic stroke patients with emergent large vessel occlusions; however, less than one-third of patients achieve complete reperfusion. Use of intraarterial thrombolysis in the context of MT may provide an opportunity to enhance these results. Here, we evaluate the use of intraarterial rtPA (recombinant tissue-type plasminogen activator) as rescue therapy (RT) after failed MT in the North American Solitaire Stent-Retriever Acute Stroke registry.

26 marzo 2019

Familial Cerebral Cavernous Malformations

Atif Zafar, Syed A. Quadri, Mudassir Farooqui, Asad Ikram, Myranda Robinson, Blaine L. Hart, Marc C. Mabray, Catherine Vigil, Alan T. Tang, Mark L. Kahn, Howard Yonas, Michael T. Lawton, Helen Kim and Leslie Morrison

Cerebral cavernous malformations (CCM) or cavernomas are collections of structurally abnormal slow-flow capillaries predominantly in the central nervous system.1,2 These are multiple mulberry-like distended caverns of dilated thin-walled capillaries without the normal intervening brain parenchymal architecture. Often, individual cavernomas are surrounded by hemosiderin representing remote oozing due to the abnormal capillaries.

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