ResearchPad - 10178 https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Endovascular Therapy for Patients With Acute Ischemic Stroke During the COVID-19 Pandemic: A Proposed Algorithm]]> https://www.researchpad.co/article/N88feb4c6-7b47-4f51-b29f-d7e84105fbd7 <![CDATA[Mechanical Thrombectomy in the Era of the COVID-19 Pandemic: Emergency Preparedness for Neuroscience Teams]]> https://www.researchpad.co/article/Nd57439ab-81e0-4aad-be56-fa7ab1033679 <![CDATA[Causal Associations Between Serum Bilirubin Levels and Decreased Stroke Risk]]> https://www.researchpad.co/article/N1b66b827-33c1-42e5-8aeb-dc77a4a9dd2d

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<![CDATA[Thrombus Migration Paradox in Patients With Acute Ischemic Stroke]]> https://www.researchpad.co/article/N12515289-2304-4cfb-8be6-ef48dd6d35e6

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<![CDATA[Leveraging Human Genetics to Estimate Clinical Risk Reductions Achievable by Inhibiting Factor XI]]> https://www.researchpad.co/article/N618e22b8-eac7-4dfa-b8c9-a1089a913b67

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<![CDATA[Observer Agreement on Computed Tomography Perfusion Imaging in Acute Ischemic Stroke]]> https://www.researchpad.co/article/Nd6a2b2c5-56e8-4d2e-a201-2dd1dbfafa8b

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<![CDATA[Exploring the Cost-Effectiveness of Mechanical Thrombectomy Beyond 6 Hours Following Advanced Imaging in the United Kingdom]]> https://www.researchpad.co/article/N332c09ea-a3ac-4fe8-b522-077b45a7ad4c

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<![CDATA[Prognostic Hemostasis Biomarkers in Acute Ischemic Stroke]]> https://www.researchpad.co/article/5c973ad1d5eed0c4849661bc

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<![CDATA[Severe Lesions Involving Cortical Cholinergic Pathways Predict Poorer Functional Outcome in Acute Ischemic Stroke]]> https://www.researchpad.co/article/5c94e6e8d5eed0c48465358e

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<![CDATA[Intracranial Carotid Artery Calcification and Effect of Endovascular Stroke Treatment]]> https://www.researchpad.co/article/5c94e6ead5eed0c4846535df

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<![CDATA[Description of a Novel Phosphodiesterase (PDE)-3 Inhibitor Protecting Mice From Ischemic Stroke Independent From Platelet Function]]> https://www.researchpad.co/article/5c800fc1d5eed0c484a96508

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<![CDATA[Endovascular Treatment]]> https://www.researchpad.co/article/5c800faad5eed0c484a96323

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<![CDATA[Personalized Prehospital Triage in Acute Ischemic Stroke]]> https://www.researchpad.co/article/5c800fa4d5eed0c484a96277

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<![CDATA[Safety of Carotid Revascularization in Patients With a History of Coronary Heart Disease]]> https://www.researchpad.co/article/5c800f9dd5eed0c484a961ba

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<![CDATA[Antiplatelet Treatment After Transient Ischemic Attack and Ischemic Stroke in Patients With Cerebral Microbleeds in 2 Large Cohorts and an Updated Systematic Review]]> https://www.researchpad.co/article/5c032125d5eed0c4844e77f9

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<![CDATA[Brain Ischemia Induces Diversified Neuroantigen-Specific T-Cell Responses That Exacerbate Brain Injury]]> https://www.researchpad.co/article/5c032123d5eed0c4844e77b1

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<![CDATA[NOR-SASS (Norwegian Sonothrombolysis in Acute Stroke Study)]]> https://www.researchpad.co/article/5b365c45463d7e5448d9f699

Background and Purpose—

The NOR-SASS (Norwegian Sonothrombolysis in Acute Stroke Study) aimed to assess effect and safety of contrast-enhanced ultrasound treatment in an unselected acute ischemic stroke population.

Methods—

Patients treated with intravenous thrombolysis within 4.5 hours after symptom onset were randomized 1:1 to either contrast-enhanced sonothrombolysis (CEST) or sham CEST. A visible arterial occlusion on baseline computed tomography angiography was not a prerequisite for inclusion. Pulse-wave 2 MHz ultrasound was given for 1 hour and contrast (SonoVue) as an infusion for ≈30 minutes. Magnetic resonance imaging and angiography were performed after 24 to 36 hours. Primary study end points were neurological improvement at 24 hours defined as National Institutes of Health Stroke Scale score 0 or reduction of ≥4 National Institutes of Health Stroke Scale points compared with baseline National Institutes of Health Stroke Scale and favorable functional outcome at 90 days defined as modified Rankin scale score 0 to 1.

Results—

A total of 183 patients were randomly assigned to either CEST (93 patient) or sham CEST (90 patients). The rates of symptomatic intracerebral hemorrhage, asymptomatic intracerebral hemorrhage, or mortality were not increased in the CEST group. Neurological improvement at 24 hours and functional outcome at 90 days was similar in the 2 groups both in the intention-to-treat analysis and in the per-protocol analysis.

Conclusions—

CEST is safe among unselected ischemic stroke patients with or without a visible occlusion on computed tomography angiography and with varying grades of clinical severity. There was, however, statistically no significant clinical effect of sonothrombolysis in this prematurely stopped trial.

Clinical Trial Registration—

URL: http://www.clinicaltrials.gov. Unique identifier: NCT01949961.

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<![CDATA[Safety and Efficacy of Solitaire Stent Thrombectomy]]> https://www.researchpad.co/article/5af95fce463d7e15dad13f50

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<![CDATA[Long-Term Survival After Intravenous Thrombolysis for Ischemic Stroke]]> https://www.researchpad.co/article/5bfaa64fd5eed0c48473a53f

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<![CDATA[Multiparametric Magnetic Resonance Imaging for Prediction of Parenchymal Hemorrhage in Acute Ischemic Stroke After Reperfusion Therapy]]> https://www.researchpad.co/article/5bd8c7e9d5eed0c4841e7440

Background and Purpose—

Patients with acute ischemic stroke are at increased risk of developing parenchymal hemorrhage (PH), particularly in the setting of reperfusion therapies. We have developed a predictive model to examine the risk of PH using combined magnetic resonance perfusion and diffusion parameters, including cerebral blood volume (CBV), apparent diffusion coefficient, and microvascular permeability (K2).

Methods—

Voxel-based values of CBV, K2, and apparent diffusion coefficient from the ischemic core were obtained using pretreatment magnetic resonance imaging data from patients enrolled in the MR RESCUE clinical trial (Mechanical Retrieval and Recanalization of Stroke Clots Using Embolectomy). The associations between PH and extreme values of imaging parameters were assessed in univariate and multivariate analyses. Receiver-operating characteristic curve analysis was performed to determine the optimal parameter(s) and threshold for predicting PH.

Results—

In 83 patients included in this analysis, 20 developed PH. Univariate analysis showed significantly lower 10th percentile CBV and 10th percentile apparent diffusion coefficient values and significantly higher 90th percentile K2 values within the infarction core of patients with PH. Using classification tree analysis, the 10th percentile CBV at threshold of 0.47 and 90th percentile K2 at threshold of 0.28 resulted in overall predictive accuracy of 88.7%, sensitivity of 90.0%, and specificity of 87.3%, which was superior to any individual or combination of other classifiers.

Conclusions—

Our results suggest that combined 10th percentile CBV and 90th percentile K2 is an independent predictor of PH in patients with acute ischemic stroke with diagnostic accuracy superior to individual classifiers alone. This approach may allow risk stratification for patients undergoing reperfusion therapies.

Clinical Trial Registration—

URL: https://www.clinicaltrials.gov. Unique identifier: NCT00389467.

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