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 DatabaseEndovascular Treatment of Acute Ischemic Stroke After Cardiac Interventions in the United States
de Havenon A, Zhou L, Koo A, Matouk C, Falcone G, Sharma R, Ney J, Shu L, Yaghi S, Kamel H, Sheth K. Endovascular Treatment of Acute Ischemic Stroke After Cardiac Interventions in the United States. JAMA Neurology 2024, 81: 264-272. PMID: 38285452, PMCID: PMC10825786, DOI: 10.1001/jamaneurol.2023.5416.Peer-Reviewed Original ResearchNational Institutes of Health Stroke ScaleNational Institutes of Health Stroke Scale scoreOdds of discharge homeDischarged homeIschemic strokeRate of endovascular thrombectomyMultivariate logistic regressionNational Inpatient Sample databaseHealth Stroke ScaleIntervention patientsInpatient Sample databaseMain OutcomesIntervention statusHospitalization of patientsPotential confoundersUS hospitalsEndovascular thrombectomyStroke patientsCohort studySecondary outcomesLogistic regressionCardiac interventionsStroke severityStroke ScaleGroup of hospitalized patientsManagement of Incomplete Microcirculatory Reperfusion After Endovascular Thrombectomy: Focus on Inhibition of the Glycoprotein IIb/IIIa Receptor Pathway
Krothapalli N, Ortel T, McBride D, de Havenon A, Sansing L, Hasan D, Mac Grory B. Management of Incomplete Microcirculatory Reperfusion After Endovascular Thrombectomy: Focus on Inhibition of the Glycoprotein IIb/IIIa Receptor Pathway. Stroke Vascular And Interventional Neurology 2024, 4 DOI: 10.1161/svin.123.001048.Peer-Reviewed Original ResearchMicrocirculatory reperfusionEndovascular thrombectomyAdministration of tirofibanDigital subtraction angiographyLarge-vessel occlusionProportion of casesRescue therapyTherapeutic optionsAntiplatelet therapyClinical outcomesUnfavorable outcomeEndothelial edemaSubtraction angiographyEffective therapyIntraarterial administrationClinical challengeReceptor pathwayPlatelet aggregationTreatment approachesTherapyReperfusionCerebral microvasculatureTissue recoveryNeurological diseasesThrombectomyBlood 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 mortalityTertileLarge Vessel Occlusion Stroke due to Intracranial Atherosclerotic Disease: Identification, Medical and Interventional Treatment, and Outcomes
de Havenon A, Zaidat O, Amin-Hanjani S, Nguyen T, Bangad A, Abbasi M, Anadani M, Almallouhi E, Chatterjee R, Mazighi M, Mistry E, Yaghi S, Derdeyn C, Hong K, Kvernland A, Leslie-Mazwi T, Al Kasab S. Large Vessel Occlusion Stroke due to Intracranial Atherosclerotic Disease: Identification, Medical and Interventional Treatment, and Outcomes. Stroke 2023, 54: 1695-1705. PMID: 36938708, PMCID: PMC10202848, DOI: 10.1161/strokeaha.122.040008.Peer-Reviewed Original ResearchConceptsLarge vessel occlusion strokeIntracranial atherosclerotic diseaseEndovascular thrombectomyAtherosclerotic diseaseOcclusion strokeFunctional outcome benefitsVascular risk factorsAdjunctive medicationsMedical managementPatient factorsInterventional treatmentOutcome benefitsRisk factorsObservational studyEarly identificationTreatment planningThrombectomyUnique considerationsPatientsStrokeLVODiseaseRevascularizationMedicationsReview
2022
Temporal profiles of systolic blood pressure variability and neurologic outcomes after endovascular thrombectomy
Prasad A, Kobsa J, Kodali S, Bartolome D, Begunova L, Quispe-Orozco D, Farooqui M, Zevallos C, Ortega-Gutiérrez S, Anadani M, Almallouhi E, Spiotta A, Giles J, Keyrouz S, Kim J, Maier I, Liman J, Psychogios M, Riou-Comte N, Richard S, Gory B, Wolfe S, Brown P, Fargen K, Mistry E, Fakhri H, Mistry A, Wong K, Nascimento F, Kan P, de Havenon A, Sheth K, Petersen N. Temporal profiles of systolic blood pressure variability and neurologic outcomes after endovascular thrombectomy. European Stroke Journal 2022, 7: 365-375. PMID: 36478756, PMCID: PMC9720854, DOI: 10.1177/23969873221106907.Peer-Reviewed Original ResearchBlood pressure variabilitySystolic blood pressure variabilityHigh systolic blood pressure variabilityEndovascular thrombectomyFunctional outcomePressure variabilityHigh blood pressure variabilityLower blood pressure variabilityAcute ischemic stroke patientsLarge vessel occlusion strokePoor discharge outcomeIschemic stroke patientsWorse functional outcomePoor functional outcomeBlood pressure dataHigh trajectory groupGroup-based trajectory modelingHemorrhagic transformationNeurologic outcomeDischarge outcomesSBP trajectoriesStroke patientsOcclusion strokePoor outcomeRelevant confounders
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 disabilityBlood Pressure Management After Endovascular Thrombectomy
Peng TJ, Ortega-Gutiérrez S, de Havenon A, Petersen NH. Blood Pressure Management After Endovascular Thrombectomy. Frontiers In Neurology 2021, 12: 723461. PMID: 34539562, PMCID: PMC8446280, DOI: 10.3389/fneur.2021.723461.Peer-Reviewed Original ResearchEndovascular thrombectomyBlood pressureBP targetsAnterior circulation large vessel occlusion strokeImmediate post-stroke periodLower blood pressure targetsLarge vessel occlusion strokeAdequate BP targetsBlood pressure targetsOptimal hemodynamic managementOverall hemodynamic statusPost-stroke periodAcute stroke therapyBlood pressure managementDegree of reperfusionPotential neuroprotective strategiesIndividual patient factorsStandard of careBlood pressure optimizationNovel treatment strategiesWorse clinical recoveryBP controlKey observational studiesSuccessful reperfusionClinical recoveryInvestigating the “Weekend Effect” on Outcomes of Patients Undergoing Endovascular Mechanical Thrombectomy for Ischemic Stroke
Grandhi R, Ravindra VM, Ney JP, Zaidat O, Taussky P, de Havenon A. Investigating the “Weekend Effect” on Outcomes of Patients Undergoing Endovascular Mechanical Thrombectomy for Ischemic Stroke. Journal Of Stroke And Cerebrovascular Diseases 2021, 30: 106013. PMID: 34375859, PMCID: PMC8511062, DOI: 10.1016/j.jstrokecerebrovasdis.2021.106013.Peer-Reviewed Original ResearchMeSH KeywordsAfter-Hours CareAgedAged, 80 and overCross-Sectional StudiesDatabases, FactualEndovascular ProceduresFemaleHospital CostsHospital MortalityHumansInpatientsIschemic StrokeLength of StayMaleMiddle AgedPatient DischargeRetrospective StudiesRisk AssessmentRisk FactorsThrombectomyTime FactorsTreatment OutcomeUnited StatesConceptsAcute ischemic strokeEndovascular thrombectomyIschemic strokeLarge vessel occlusion ischemic strokeHealth Stroke Scale scoreNationwide Inpatient Sample dataStroke Scale scoreExtended hospital stayWorse clinical outcomesCross-sectional analysisLogistic regression modelsHospital deathHospital staySecondary outcomesPrimary outcomeClinical outcomesAIS patientsNormal working hoursPatientsScale scoreFavorable dischargeExposure variablesStrokeWeekends/National InstitutePenumbra Consumption Rates Based on Time-to-Maximum Delay and Reperfusion Status: A Post Hoc Analysis of the DEFUSE 3 Trial
Yaghi S, Raz E, Dehkharghani S, Riina H, McTaggart R, Jayaraman M, Prabhakaran S, Liebeskind DS, Khatri P, Mac Grory B, Al-Mufti F, Lansberg M, Albers G, de Havenon A. Penumbra Consumption Rates Based on Time-to-Maximum Delay and Reperfusion Status: A Post Hoc Analysis of the DEFUSE 3 Trial. Stroke 2021, 52: 2690-2693. PMID: 34157865, DOI: 10.1161/strokeaha.120.033806.Peer-Reviewed Original ResearchConceptsDEFUSE-3 trialsLarge vessel occlusionPenumbral tissueVessel occlusionMismatch volumeAcute large vessel occlusionAnterior circulation occlusionEndovascular thrombectomy patientsAcute ischemic strokePost Hoc AnalysisReperfusion statusThrombectomy patientsTICI 0Cerebral infarctionEndovascular thrombectomyIschemic strokeUntreated patientsPrimary outcomeSalvageable tissueTreatment modalitiesHoc AnalysisPerfusion timePatientsNatural historyOcclusionHigher Systolic Blood Pressure Variability After Endovascular Thrombectomy Is Associated with Poor Functional Outcome (2903)
Prasad A, Kobsa J, Kodali S, Nguyen C, Orozco D, Farooqui M, Zevallos C, Gutierrez S, Anadani M, Almallouhi E, Kim J, Maier I, Riou-Comte N, Wolfe S, Brown P, Fargen K, Mistry E, Fakhri H, Mistry A, Wong K, De Havenon A, Nascimento F, Sheth K, Petersen N. Higher Systolic Blood Pressure Variability After Endovascular Thrombectomy Is Associated with Poor Functional Outcome (2903). Neurology 2021, 96 DOI: 10.1212/wnl.96.15_supplement.2903.Peer-Reviewed Original ResearchElevated Blood Pressure Variability During Transport for Endovascular Thrombectomy is Associated with Worse Functional Outcome (4167)
de Havenon A, Sheibani N, Alexander M, Wong K, Petersen N. Elevated Blood Pressure Variability During Transport for Endovascular Thrombectomy is Associated with Worse Functional Outcome (4167). Neurology 2021, 96 DOI: 10.1212/wnl.96.15_supplement.4167.Peer-Reviewed Original ResearchPredicting neuroimaging eligibility for extended-window endovascular thrombectomy.
de Havenon A, Mickolio K, O'Donnell S, Stoddard G, McNally JS, Alexander M, Taussky P, Awad AW. Predicting neuroimaging eligibility for extended-window endovascular thrombectomy. Journal Of Neurosurgery 2021, 135: 1100-1104. PMID: 33636705, PMCID: PMC8387497, DOI: 10.3171/2020.8.jns20386.Peer-Reviewed Original ResearchLarge vessel occlusionAlberta Stroke Program Early CT ScoreTissue plasminogen activatorEndovascular thrombectomyC-statisticPatients 5Stroke patientsTreatment windowFurther patient careHealth Stroke ScaleIschemic stroke treatmentLarge patient registriesSecond outcomePatients 4.5Stroke ScaleAdvanced imaging toolsStroke treatmentSalvageable penumbraCT scorePatient eligibilityClinical variablesPatient RegistryMultivariable modelMR perfusionTreatment cutoffDuration of symptomatic stroke and successful reperfusion with endovascular thrombectomy for anterior circulation large vessel occlusive stroke
de Havenon A, Alexander MD, Nogueira RG, Haussen DC, Castonguay AC, Linfante I, Johnson MA, Nguyen TN, Mokin M, Zaidat OO. Duration of symptomatic stroke and successful reperfusion with endovascular thrombectomy for anterior circulation large vessel occlusive stroke. Journal Of NeuroInterventional Surgery 2021, 13: 1128-1131. PMID: 33526478, PMCID: PMC8325713, DOI: 10.1136/neurintsurg-2020-016961.Peer-Reviewed Original ResearchConceptsAcute ischemic stroke patientsIschemic stroke patientsSymptomatic strokeSuccessful reperfusionLogistic regression modelsAcute strokeEndovascular therapyStroke patientsLarge vessel occlusive strokeAnterior circulation occlusionCerebral Infarction scoreReal-world cohortLarge vessel occlusionBalloon guide catheterMiddle cerebral arteryIndividual patient dataInternal carotid arteryProbability of reperfusionLower ratesOcclusive strokeEndovascular thrombectomyMechanical thrombectomySecondary outcomesStroke onsetPrimary outcomeBlood Pressure Management Before, During, and After Endovascular Thrombectomy for Acute Ischemic Stroke
de Havenon A, Petersen N, Sultan-Qurraie A, Alexander M, Yaghi S, Park M, Grandhi R, Mistry E. Blood Pressure Management Before, During, and After Endovascular Thrombectomy for Acute Ischemic Stroke. Seminars In Neurology 2021, 41: 046-053. PMID: 33472269, PMCID: PMC8063274, DOI: 10.1055/s-0040-1722721.Peer-Reviewed Original ResearchConceptsBlood pressure managementEndovascular thrombectomyBlood pressurePressure managementLarge vessel occlusion stroke patientsMaximum systolic blood pressureOptimal blood pressure managementAmerican Heart Association guidelinesAcute ischemic strokeHeart Association guidelinesSystolic blood pressurePenumbral perfusionSuccessful recanalizationIschemic strokeGuideline recommendationsStroke patientsHyperacute phaseAssociation guidelinesPatient outcomesClinical scenariosThrombectomyRecanalizationPatientsHgSpecific evidence
2020
Benefit of endovascular thrombectomy for M2 middle cerebral artery occlusion in the ARISE II study
de Havenon A, Narata AP, Amelot A, Saver JL, Bozorgchami H, Mattle HP, Ribo M, Andersson T, Zaidat OO, investigators A. Benefit of endovascular thrombectomy for M2 middle cerebral artery occlusion in the ARISE II study. Journal Of NeuroInterventional Surgery 2020, 13: 779-783. PMID: 33219148, PMCID: PMC8134506, DOI: 10.1136/neurintsurg-2020-016427.Peer-Reviewed Original ResearchConceptsMiddle cerebral artery occlusionM2 occlusionsCerebral artery occlusionM1 occlusionEndovascular thrombectomyAdverse eventsBetter outcomesArtery occlusionIschemic strokeReperfusion ratesM2-segment middle cerebral artery occlusionM2 middle cerebral artery occlusionsScale scoreHealth Stroke Scale scoreBaseline National InstitutesStroke Scale scoreAcute ischemic strokeMajor adverse eventsRankin Scale scorePaucity of dataLogistic regression modelsII trialSuccessful reperfusionII studyPrespecified analysisPrediction of death after endovascular thrombectomy in the extended window: a secondary analysis of DEFUSE 3 "
Taussky P, Agnoletto G, Grandhi R, Alexander MD, Wong KH, Albers GW, de Havenon A. Prediction of death after endovascular thrombectomy in the extended window: a secondary analysis of DEFUSE 3 ". Journal Of NeuroInterventional Surgery 2020, 13: 805-808. PMID: 33077580, PMCID: PMC8093992, DOI: 10.1136/neurintsurg-2020-016548.Peer-Reviewed Original ResearchConceptsEndovascular thrombectomyDEFUSE 3Statin usePrimary outcomeInclusion criteriaPredictive scoreHealth Stroke Scale scoreDEFUSE 3 studyEVT-treated patientsSecondary cohort analysisBaseline National InstitutesStroke Scale scoreHistory of diabetesPrediction of deathSelective inclusion criteriaUnivariate regression analysisHigh-risk categoryPotential predictive variablesEVT patientsPatient ageEndovascular therapyImaging evaluationPreprocedural variablesClinical trialsLethal outcomeEndovascular thrombectomy in acute ischemic stroke patients with COVID-19: prevalence, demographics, and outcomes
de Havenon A, Yaghi S, Mistry EA, Delic A, Hohmann S, Shippey E, Stulberg E, Tirschwell D, Frontera JA, Petersen NH, Anadani M. Endovascular thrombectomy in acute ischemic stroke patients with COVID-19: prevalence, demographics, and outcomes. Journal Of NeuroInterventional Surgery 2020, 12: 1045-1048. PMID: 32989032, PMCID: PMC7523171, DOI: 10.1136/neurintsurg-2020-016777.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge FactorsAgedAged, 80 and overBrain IschemiaComorbidityCoronavirus InfectionsCOVID-19Endovascular ProceduresEthnicityFemaleHospital MortalityHumansMaleMiddle AgedPandemicsPneumonia, ViralRetrospective StudiesSex FactorsSocioeconomic FactorsStrokeStroke RehabilitationThrombectomyTreatment OutcomeYoung AdultConceptsCOVID-19 infectionAcute ischemic stroke patientsEndovascular thrombectomyIschemic stroke patientsHospital deathAIS patientsEVT patientsFavorable dischargeStroke patientsLower oddsCOVID-19Intensive care unit lengthLaboratory-confirmed COVID-19Vizient Clinical Data BaseComorbid COVID-19Acute coronary syndromeAcute renal failurePotential adverse eventsICD-10 codesMixed-effects logistic regressionClinical data baseCoronary syndromeLonger hospitalSystemic complicationsAdverse eventsQuality of Life for Younger Versus Older Patients Following Endovascular Thrombectomy in the Extended Window: A Secondary Analysis of DEFUSE 3 (1397)
de Havenon A, Majersik J, Terrill A, Taylor K, Albers G. Quality of Life for Younger Versus Older Patients Following Endovascular Thrombectomy in the Extended Window: A Secondary Analysis of DEFUSE 3 (1397). Neurology 2020, 94 DOI: 10.1212/wnl.94.15_supplement.1397.Peer-Reviewed Original Research