2024
Higher proceduralist stroke thrombectomy volume is associated with reduced inpatient mortality
Koo A, Renedo D, Ney J, Amllay A, Kanzler M, Stogniy S, Alawieh A, Sujijantarat N, Antonios J, Al Kasab S, Malhotra A, Hebert R, Matouk C, de Havenon A. Higher proceduralist stroke thrombectomy volume is associated with reduced inpatient mortality. Journal Of NeuroInterventional Surgery 2024, jnis-2024-022021. PMID: 39214687, DOI: 10.1136/jnis-2024-022021.Peer-Reviewed Original ResearchIn-hospital deathIn-hospital mortalityAcute ischemic strokeCut-pointsAbsolute risk of deathAssociated with lower oddsState Inpatient DatabasesFlorida State Inpatient DatabaseIn-hospital moralityRates of in-hospital mortalityDiagnosis of acute ischemic strokePrimary study outcomeRisk of deathStroke careOptimal cut-pointAssociated with reduced inpatient mortalityEndovascular thrombectomyRetrospective cohort studyLower oddsPotential confoundersAbsolute riskAcute ischemic stroke patientsInpatient mortalityCohort studyInpatient DatabaseStrokeClassifier: ischemic stroke etiology classification by ensemble consensus modeling using electronic health records
Lee H, Schwamm L, Sansing L, Kamel H, de Havenon A, Turner A, Sheth K, Krishnaswamy S, Brandt C, Zhao H, Krumholz H, Sharma R. StrokeClassifier: ischemic stroke etiology classification by ensemble consensus modeling using electronic health records. Npj Digital Medicine 2024, 7: 130. PMID: 38760474, PMCID: PMC11101464, DOI: 10.1038/s41746-024-01120-w.Peer-Reviewed Original ResearchElectronic health recordsWeighted F1MIMIC-IIIClinical decision support systemsMulti-class classificationNatural language processingMIMIC-III datasetHealth recordsMachine learning classifiersDecision support systemArtificial intelligence toolsVascular neurologistsLearning classifiersBinary classificationCross-validation accuracyLanguage processingMeta-modelIntelligence toolsStroke prevention effortsAcute ischemic strokeStroke etiologySupport systemStroke etiology classificationClassification toolClassifierDiffusion‐Weighted Imaging Fluid‐Attenuated Inversion Recovery Mismatch on Portable, Low‐Field Magnetic Resonance Imaging Among Acute Stroke Patients
Sorby‐Adams A, Guo J, de Havenon A, Payabvash S, Sze G, Pinter N, Jaikumar V, Siddiqui A, Baldassano S, Garcia‐Guarniz A, Zabinska J, Lalwani D, Peasley E, Goldstein J, Nelson O, Schaefer P, Wira C, Pitts J, Lee V, Muir K, Nimjee S, Kirsch J, Iglesias J, Rosen M, Sheth K, Kimberly W. Diffusion‐Weighted Imaging Fluid‐Attenuated Inversion Recovery Mismatch on Portable, Low‐Field Magnetic Resonance Imaging Among Acute Stroke Patients. Annals Of Neurology 2024, 96: 321-331. PMID: 38738750, PMCID: PMC11293843, DOI: 10.1002/ana.26954.Peer-Reviewed Original ResearchStroke patientsAcute ischemic strokeCut-pointsIschemic strokeStroke patients <Diagnosis of acute ischemic strokeSignal intensity ratioFluid-attenuated inversion recoveryAcute stroke patientsOptimal cut-pointMagnetic resonance imagingDiffusion-weighted imagingDWI-FLAIR mismatchStroke onsetTrained assessorsNational InstituteStrokeThrombolytic interventionNegative predictive valueFLAIR hyperintensitiesPatientsInterobserver agreementHyperacute strokeDiffusion-weightedPredictive valueImpact of Procedure Time on First Pass Effect in Mechanical Thrombectomy for Anterior Circulation Acute Ischemic Stroke
Koo A, Reeves B, Renedo D, Maier I, Al Kasab S, Jabbour P, Kim J, Wolfe S, Rai A, Starke R, Psychogios M, Shaban A, Arthur A, Yoshimura S, Cuellar H, Grossberg J, Alawieh A, Romano D, Tanweer O, Mascitelli J, Fragata I, Polifka A, Osbun J, Crosa R, Park M, Levitt M, Brinjikji W, Moss M, Dumont T, Williamson R, Navia P, Kan P, Spiotta A, Sheth K, de Havenon A, Matouk C. Impact of Procedure Time on First Pass Effect in Mechanical Thrombectomy for Anterior Circulation Acute Ischemic Stroke. Neurosurgery 2024, 95: 128-136. PMID: 38483158, DOI: 10.1227/neu.0000000000002900.Peer-Reviewed Original ResearchAnterior circulation large vessel occlusion acute ischemic strokeAcute ischemic strokeLarge vessel occlusion acute ischemic strokeProcedure timeMechanical thrombectomyExcellent reperfusionClinical benefitIschemic strokeAnterior circulation acute ischemic strokeSuccess of mechanical thrombectomyModified Rankin Scale scoreRankin Scale scoreLogistic regression modelsNo significant differencePrimary study exposuresPrimary outcomeFunctional outcomesPotential confoundersStudy exposureThrombectomy devicesScale scoreThrombectomyReperfusionPatientsSignificant differenceBlood Pressure Trajectories and Outcomes After Endovascular Thrombectomy for Acute Ischemic Stroke
Katsanos A, Joundi R, Palaiodimou L, Ahmed N, Kim J, Goyal N, Maier I, de Havenon A, Anadani M, Matusevicius M, Mistry E, Khatri P, Arthur A, Sarraj A, Yaghi S, Shoamanesh A, Catanese L, Psychogios M, Tsioufis K, Malhotra K, Spiotta A, Sandset E, Alexandrov A, Petersen N, Tsivgoulis G. Blood Pressure Trajectories and Outcomes After Endovascular Thrombectomy for Acute Ischemic Stroke. Hypertension 2024, 81: 629-635. PMID: 38164751, PMCID: PMC11289690, DOI: 10.1161/hypertensionaha.123.22164.Peer-Reviewed Original ResearchAcute ischemic strokeEndovascular thrombectomyIschemic strokeSBP trajectoriesOdds ratioSystolic blood pressure trajectoriesEarly neurological deteriorationSevere stroke syndromesVascular risk factorsBlood pressure valuesStudy of patientsBlood pressure trajectoriesTrajectory groupsMixed effects regression modelsStroke syndromeSuccessful recanalizationTotal patientsNeurological deteriorationAdjusted analysisIntracranial hemorrhagePotential confoundersRisk factorsCommon odds ratioHigh prevalenceSBP measurements
2023
Association between blood pressure variability and outcomes after endovascular thrombectomy for acute ischemic stroke: An individual patient data meta-analysis
Palaiodimou L, Joundi R, Katsanos A, Ahmed N, Kim J, Goyal N, Maier I, de Havenon A, Anadani M, Matusevicius M, Mistry E, Khatri P, Arthur A, Sarraj A, Yaghi S, Shoamanesh A, Catanese L, Psychogios M, Malhotra K, Spiotta A, Vassilopoulou S, Tsioufis K, Sandset E, Alexandrov A, Petersen N, Tsivgoulis G. Association between blood pressure variability and outcomes after endovascular thrombectomy for acute ischemic stroke: An individual patient data meta-analysis. European Stroke Journal 2023, 9: 88-96. PMID: 37921233, PMCID: PMC10916831, DOI: 10.1177/23969873231211157.Peer-Reviewed Original ResearchBlood pressure variabilitySymptomatic intracranial hemorrhageAcute ischemic strokeEndovascular thrombectomyFunctional impairmentIschemic strokeHighest tertileAIS patientsPressure variabilityIndividual BP measurementsMean BP levelsDiastolic BP levelsIndividual patient dataLogistic mixed-effects modelsSBP-CVSBP-SDIntravenous thrombolysisStroke outcomeStroke severitySuccessful recanalizationBP levelsIntracranial hemorrhageBP measurementsHigh mortalityTertileEndovascular Therapy for Acute Stroke: New Evidence and Indications
Sahoo A, Abdalkader M, Yamagami H, Huo X, Sun D, Jia B, Weyland C, Diana F, Kaliaev A, Klein P, Bui J, Kasab S, de Havenon A, Zaidat O, Zi W, Yang Q, Michel P, Siegler J, Yaghi S, Hu W, Nguyen T. Endovascular Therapy for Acute Stroke: New Evidence and Indications. Journal Of Neuroendovascular Therapy 2023, 17: 232-242. PMID: 38025253, PMCID: PMC10657733, DOI: 10.5797/jnet.ra.2023-0047.Peer-Reviewed Original ResearchRandomized clinical trialsTreatment of patientsIntravenous thrombolysisEndovascular therapyMechanical thrombectomyClinical trialsAcute ischemic strokeDistal vessel occlusionNon-contrast CTExtended windowOngoing studiesCTA collateralsRescue stentingTandem occlusionsAcute strokeCore infarctIschemic strokeTreatment indicationsCore infarctionVessel occlusionRecent trialsThrombectomyPatientsAdvanced imagingNarrative reviewAcute and subacute neurovascular impact of cryptogenic air emboli
Gummerson C, Parasram M, Peng T, Picard J, Kahn P, Angelus E, Bhatt S, de Havenon A, Jasne A, Magid-Bernstein J. Acute and subacute neurovascular impact of cryptogenic air emboli. Surgical Neurology International 2023, 14: 285. PMID: 37680929, PMCID: PMC10481802, DOI: 10.25259/sni_382_2023.Peer-Reviewed Case Reports and Technical NotesMagnetic resonance imagingCortical diffusion restrictionAir emboliMiddle cerebral artery territoryRight anterior cerebral arterySubsequent magnetic resonance imagingDiffusion restrictionClose neurologic monitoringNeurocritical care managementCerebral air embolismAcute ischemic strokeAnterior cerebral arteryInitial radiographic findingsCerebral air emboliType of injuryComputerized tomography scanCourse of careArtery territoryCerebral edemaIschemic strokeNeurologic monitoringCerebral arteryCortical veinsInitial imagingMechanical ventilationRates and reasons for hospital readmission after acute ischemic stroke in a US population-based cohort
Zhou L, Lansberg M, de Havenon A. Rates and reasons for hospital readmission after acute ischemic stroke in a US population-based cohort. PLOS ONE 2023, 18: e0289640. PMID: 37535655, PMCID: PMC10399731, DOI: 10.1371/journal.pone.0289640.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeAcute renal failureHospital readmissionIschemic strokeReadmission ratesRenal failureRisk factorsUS population-based cohortUnplanned hospital readmissionNationwide Readmissions DatabaseRisk of readmissionVascular risk factorsHospital-level characteristicsPopulation-based cohortKaplan-Meyer analysisWorsened patient outcomesState administrative databasesModifiable comorbiditiesRecurrent strokeInitial hospitalizationDisadvantaged patientsLonger initial lengthMedicare insuranceAIS patientsSecondary strokeAssociation of Blood Pressure Variability With Death and Discharge Destination Among Critically Ill Patients With and Without Stroke
Stulberg E, Harris B, Zheutlin A, Delic A, Sheibani N, Anadani M, Yaghi S, Petersen N, de Havenon A. Association of Blood Pressure Variability With Death and Discharge Destination Among Critically Ill Patients With and Without Stroke. Neurology 2023, 101: e1145-e1157. PMID: 37487742, PMCID: PMC10513881, DOI: 10.1212/wnl.0000000000207599.Peer-Reviewed Original ResearchConceptsAverage real variabilityNonstroke patientsDischarge destinationHospital deathIschemic strokeIll patientsIllness severityWorse outcomesAdult intensive care unit patientsMinimum mean arterial pressureIntensive care unit patientsIntensive Care III databaseBlood pressure goalsAcute ischemic strokeMean arterial pressureBlood pressure variabilityCare unit patientsRisk of deathMedical Information MartUnit patientsArterial pressureIntracerebral hemorrhageSubarachnoid hemorrhageRisk factorsEffect modificationPerioperative Acute Ischemic Stroke in Patients with Atrial Fibrillation
Shu L, Jiang W, Xiao H, Henninger N, Nguyen T, Siegler J, de Havenon A, Goldstein E, Mandel D, Rana M, Al‐Mufti F, Frontera J, Furie K, Yaghi S. Perioperative Acute Ischemic Stroke in Patients with Atrial Fibrillation. Annals Of Neurology 2023, 94: 321-329. PMID: 37183768, DOI: 10.1002/ana.26678.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeAtrial fibrillationPerioperative acute ischemic strokeDiagnosis-related groupsRisk factors-VASc scoreActive cancerHigher CHA<sub>2</sub> DS<sub>2</sub> VASc score. TheElective proceduresInternational Classification of DiseasesRisk factors of acute ischemic strokeScoring systemIschemic strokeClassification of DiseasesNeurological surgeryDays of dischargeLogistic regression modelsNationwide Readmissions DatabaseElective surgical proceduresAnticoagulant therapyInternational ClassificationPeriprocedural periodRenal failureSurgical typeAdult patientsHSV-2 Retinitis and Encephalitis Masquerading as Giant Cell Arteritis and Acute Ischemic Stroke of the Midbrain (P12-10.002)
Sutherland H, Gummerson C, De Havenon A. HSV-2 Retinitis and Encephalitis Masquerading as Giant Cell Arteritis and Acute Ischemic Stroke of the Midbrain (P12-10.002). Neurology 2023, 100 DOI: 10.1212/wnl.0000000000202537.Peer-Reviewed Original ResearchRecurrence risk in symptomatic intracranial stenosis treated medically in the real world
Yaghi S, Shu L, Goldstein E, Chang A, Kala N, Stretz C, Burton T, Perelstein E, Furie K, Jayaraman M, Torabi R, Moldovan K, de Havenon A, Khatri P, Gebregziabher M, Liebeskind D, Prabhakaran S. Recurrence risk in symptomatic intracranial stenosis treated medically in the real world. Journal Of Stroke And Cerebrovascular Diseases 2023, 32: 107086. PMID: 37030126, DOI: 10.1016/j.jstrokecerebrovasdis.2023.107086.Peer-Reviewed Original ResearchConceptsIntracranial atherosclerotic stenosisSymptomatic intracranial atherosclerotic stenosisClinical trialsRecurrence riskRecurrent strokeInclusion criteriaReal-world settingMaximal medical treatmentRecurrent stroke rateDual antiplatelet therapyAcute ischemic strokeReal-world cohortSymptomatic intracranial stenosisPharmacological treatment strategiesCox regression modelMeeting inclusion criteriaLow event ratesAntiplatelet therapyStroke RegistryIschemic eventsIschemic strokeWorld CohortHospitalized patientsEarly recurrenceIntracranial stenosisComplications of Intravenous Tenecteplase Versus Alteplase for the Treatment of Acute Ischemic Stroke: A Systematic Review and Meta-Analysis
Rose D, Cavalier A, Kam W, Cantrell S, Lusk J, Schrag M, Yaghi S, Stretz C, de Havenon A, Saldanha I, Wu T, Ranta A, Barber P, Marriott E, Feng W, Kosinski A, Laskowitz D, Poli S, Mac Grory B. Complications of Intravenous Tenecteplase Versus Alteplase for the Treatment of Acute Ischemic Stroke: A Systematic Review and Meta-Analysis. Stroke 2023, 54: 1192-1204. PMID: 36951049, PMCID: PMC10133185, DOI: 10.1161/strokeaha.122.042335.Peer-Reviewed Original ResearchConceptsSymptomatic intracranial hemorrhageAcute ischemic strokeIntracranial hemorrhageIschemic strokeSystematic reviewIntravenous tenecteplaseRelative riskHigh-dose groupRisk of complicationsPrior systematic reviewsTenecteplase-treated patientsFull-text articlesWeb of ScienceGastrointestinal hemorrhageAdult patientsExtracranial hemorrhageNoncomparative studySecondary outcomesPooled riskPrimary outcomeTreatment complicationsAbsolute riskCochrane LibraryInterventional studyMedium doseChange in Smoking Behavior and Outcome After Ischemic Stroke: Post-Hoc Analysis of the SPS3 Trial
Anadani M, Turan T, Yaghi S, Spiotta A, Gory B, Sharma R, Sheth K, de Havenon A. Change in Smoking Behavior and Outcome After Ischemic Stroke: Post-Hoc Analysis of the SPS3 Trial. Stroke 2023, 54: 921-927. PMID: 36876480, PMCID: PMC10050138, DOI: 10.1161/strokeaha.121.038202.Peer-Reviewed Original ResearchConceptsMajor adverse cardiovascular eventsAdverse cardiovascular eventsAcute ischemic strokeIschemic strokeCardiovascular eventsPersistent smokersPersistent smokingSPS3 trialSmoking statusMyocardial infarctionMajor adverse cardiovascular events outcomesCardiovascular event outcomesMajor cardiovascular outcomesSubsequent cardiovascular eventsHistory of hypertensionRisk of strokeEnd of studyPost Hoc AnalysisPrior smokersRandomization armCardiovascular outcomesFormer smokersMonth 3Primary outcomeTotal cohortComposition, Treatment, and Outcomes by Radiologically Defined Thrombus Characteristics in Acute Ischemic Stroke
Das S, Goldstein E, de Havenon A, Abbasi M, Nguyen T, de Sousa D, Yaghi S. Composition, Treatment, and Outcomes by Radiologically Defined Thrombus Characteristics in Acute Ischemic Stroke. Stroke 2023, 54: 1685-1694. PMID: 36661035, DOI: 10.1161/strokeaha.122.038563.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeIschemic strokeAdvanced imaging modalitiesStroke treatmentOcclusive thrombusThrombus characteristicsTreatment modalitiesArterial thrombiNeurovascular imagingClot compositionPrevention strategiesTherapy modalitiesThrombusImaging modalitiesPatientsStrokeModalitiesFuture studiesFurther testingTreatmentReview articleClassification systemPathomechanismEpidemiologyImportant clues
2022
Borderzone infarction and recurrent stroke in intracranial atherosclerosis
Kvernland A, Torres J, Raz E, Nossek E, de Havenon A, Gebregziabher M, Khatri P, Prabhakaran S, Liebeskind D, Yaghi S. Borderzone infarction and recurrent stroke in intracranial atherosclerosis. Journal Of Stroke And Cerebrovascular Diseases 2022, 32: 106897. PMID: 36402094, DOI: 10.1016/j.jstrokecerebrovasdis.2022.106897.Peer-Reviewed Original ResearchConceptsRecurrent cerebrovascular eventsIntracranial stenosisBorderzone infarctsInfarct patternsIschemic strokeBorderzone infarctionRetrospective single-center studyAcute ischemic strokeRecurrent ischemic strokeSingle-center studySymptomatic intracranial stenosisHigh-risk cohortBinary logistic regression analysisDistal blood flowAlternative treatment strategiesLogistic regression analysisLogistic regression modelsCerebrovascular eventsRecurrent strokeIntracranial atherosclerosisPrimary outcomeCenter studyMean ageSurrogate markerTreatment strategiesDirect cost analysis of rapid MRI in the emergency department evaluation of patients suspected of having acute ischemic stroke**
de Havenon A, Orlando C, Delic A, McNally JS, Majersik JJ, Harman T, Alexander M, Reddy V, Lyden S, Anzai Y. Direct cost analysis of rapid MRI in the emergency department evaluation of patients suspected of having acute ischemic stroke**. The Neuroradiology Journal 2022, 36: 142-147. PMID: 35701745, PMCID: PMC10034695, DOI: 10.1177/19714009221108681.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeHospital lengthIschemic strokeBrain attackRapid MRIAIS patientsEmergency departmentCT perfusionMRI cohortRapid MRI protocolTotal hospital lengthEmergency department evaluationDirect costsNeurologic symptom onsetTotal direct costsDirect cost analysisHospital LOSSequential patientsSymptom onsetDepartment evaluationED LOSPrimary outcomeDischarge diagnosisPatientsMRI protocol2022 Brief Practice Update on Intravenous Thrombolysis Before Thrombectomy in Patients With Large Vessel Occlusion Acute Ischemic Stroke: A Statement from Society of Vascular and Interventional Neurology Guidelines and Practice Standards (GAPS) Committee
Masoud H, de Havenon A, Castonguay A, Asif K, Nguyen T, Mehta B, Abdalkader M, Gutierrez S, Leslie‐Mazwi T, Mansour O, Ma A, Czap A, Kenmuir C, Sheth S, Novakovic‐White R, Nour M, Jadhav A, Janardhan V, Hassan A, Liebeskind D, Malik A, Zaidat O. 2022 Brief Practice Update on Intravenous Thrombolysis Before Thrombectomy in Patients With Large Vessel Occlusion Acute Ischemic Stroke: A Statement from Society of Vascular and Interventional Neurology Guidelines and Practice Standards (GAPS) Committee. Stroke Vascular And Interventional Neurology 2022, 2 DOI: 10.1161/svin.121.000276.Peer-Reviewed Original ResearchSociety of VascularAcute ischemic strokeLarge vessel occlusionIntravenous thrombolysisNeurology guidelinesPractice UpdateIschemic strokeMechanical thrombectomyVessel occlusionClinical trialsLarge vessel occlusion acute ischemic strokeEmergent large vessel occlusionIschemic stroke patientsRecent clinical trialsClass of recommendationRecent clinical dataClinical trial resultsLevel of evidenceClinical trial dataClinical decision makingStroke patientsCombination therapyClinical dataThrombolysisCurrent evidence
2021
Prestroke Disability and Outcome After Thrombectomy for Emergent Anterior Circulation Large Vessel Occlusion Stroke
de Havenon A, Castonguay A, Nogueira R, Nguyen TN, English J, Satti SR, Veznedaroglu E, Saver JL, Mocco J, Khatri P, Mistry E, Zaidat OO. Prestroke Disability and Outcome After Thrombectomy for Emergent Anterior Circulation Large Vessel Occlusion Stroke. Neurology 2021, 97: e1914-e1919. PMID: 34544817, PMCID: PMC8601211, DOI: 10.1212/wnl.0000000000012827.Peer-Reviewed Original ResearchConceptsPremorbid mRS scoreAnterior circulation acute ischemic strokeLarge vessel occlusion strokeAcute ischemic strokeEndovascular thrombectomyMRS scoreIschemic strokePrimary outcomeOcclusion strokeOdds ratioAnterior circulation large vessel occlusion strokeMiddle cerebral artery occlusionAcute Stroke RegistryCerebral artery occlusionClass II evidenceStudy of patientsPrestroke disabilityStroke RegistryArtery occlusionConsecutive patientsEndovascular therapyPremorbid disabilityFurther disabilityTrevo deviceMore disability