2022
A Phase III, prospective, double-blind, randomized, placebo-controlled trial of thrombolysis in imaging-eligible, late-window patients to assess the efficacy and safety of tenecteplase (TIMELESS): Rationale and design
Albers G, Campbell B, Lansberg M, Broderick J, Butcher K, Froehler M, Schwamm L, Nouh A, Liebeskind D, Toy F, Yang M, Massaro L, Schoeffler M, Purdon B. A Phase III, prospective, double-blind, randomized, placebo-controlled trial of thrombolysis in imaging-eligible, late-window patients to assess the efficacy and safety of tenecteplase (TIMELESS): Rationale and design. International Journal Of Stroke 2022, 18: 237-241. PMID: 35262424, DOI: 10.1177/17474930221088400.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeInternal carotid arteryPlacebo-controlled trialRankin Scale scoreSymptom onsetDay 90Scale scoreMiddle cerebral artery occlusionEfficacy of tenecteplaseLate-window patientsSafety of tenecteplaseSymptomatic intracranial hemorrhageCerebral artery occlusionLarge vessel occlusionPhase IIIPrimary efficacy objectiveBetter clinical outcomesAdverse eventsArtery occlusionEndovascular thrombectomyIschemic strokeMCA occlusionClinical outcomesIntracranial hemorrhageSalvageable tissueAssociation Between Endovascular Therapy Time to Treatment and Outcomes in Patients With Basilar Artery Occlusion
Joundi R, Sun J, Xian Y, Alhanti B, Nogueira R, Bhatt D, Fonarow G, Saver J, Schwamm L, Smith E. Association Between Endovascular Therapy Time to Treatment and Outcomes in Patients With Basilar Artery Occlusion. Circulation 2022, 145: 896-905. PMID: 35050693, DOI: 10.1161/circulationaha.121.056554.Peer-Reviewed Original ResearchConceptsBasilar artery occlusionSymptomatic intracranial hemorrhageEndovascular therapySymptom onsetEVT timesHospital mortalityArtery occlusionMedian onsetIntracranial hemorrhageBetter outcomesHealth Stroke Scale scoreIndividual-level patient dataMedian National InstitutesStroke Scale scoreHospital-level factorsProportion of patientsLogistic regression modelsSubstantial reperfusionAnterior circulationPrimary outcomeUS registryMean ageDevastating conditionImproved outcomesTherapy time
2020
Cerebral Small Vessel Diseases and Sleep Related Strokes
Lauer A, Ay H, Bianchi M, Charidimou A, Boulouis G, Ayres A, Vashkevich A, Schwab K, Singhal A, Viswanathan A, Rost N, Goldstein J, Rosand J, Schwamm L, Greenberg S, Gurol M. Cerebral Small Vessel Diseases and Sleep Related Strokes. Journal Of Stroke And Cerebrovascular Diseases 2020, 29: 104606. PMID: 31937490, DOI: 10.1016/j.jstrokecerebrovasdis.2019.104606.Peer-Reviewed Original ResearchConceptsSmall vessel diseaseCerebral small vessel diseaseSmall artery occlusionIntracerebral hemorrhageIschemic strokeHemorrhagic strokeICH patientsVessel diseasePresence of SVDCerebral amyloid angiopathyLobar intracerebral hemorrhageICH cohortArtery occlusionSymptom onsetAmyloid angiopathyHemodynamic changesIS cohortRisk factorsStroke systemsCausative ClassificationStrokePatientsCohortDeep locationDisease
2016
Desmoteplase 3 to 9 Hours After Major Artery Occlusion Stroke
von Kummer R, Mori E, Truelsen T, Jensen J, Grønning B, Fiebach J, Lovblad K, Pedraza S, Romero J, Chabriat H, Chang K, Dávalos A, Ford G, Grotta J, Kaste M, Schwamm L, Shuaib A, Albers G. Desmoteplase 3 to 9 Hours After Major Artery Occlusion Stroke. Stroke 2016, 47: 2880-2887. PMID: 27803391, DOI: 10.1161/strokeaha.116.013715.Peer-Reviewed Original ResearchConceptsPlacebo-treated patientsSymptomatic intracranial hemorrhageSerious adverse eventsAdverse eventsMRS scoreTreatment armsIntracranial hemorrhagePooled analysisDay 90Major artery occlusionIschemic stroke patientsRankin Scale scoreMajor cerebral arteriesHigh-grade stenosisSignificant clinical benefitExtended time windowIntravenous desmoteplaseArterial recanalizationArtery occlusionIntravenous treatmentIschemic strokePrimary outcomeCerebral arteryRecanalization rateStroke patientsEndovascular Stroke Treatment Outcomes After Patient Selection Based on Magnetic Resonance Imaging and Clinical Criteria
Leslie-Mazwi TM, Hirsch JA, Falcone GJ, Schaefer PW, Lev MH, Rabinov JD, Rost NS, Schwamm L, González RG. Endovascular Stroke Treatment Outcomes After Patient Selection Based on Magnetic Resonance Imaging and Clinical Criteria. JAMA Neurology 2016, 73: 1-7. PMID: 26524074, DOI: 10.1001/jamaneurol.2015.3000.Peer-Reviewed Original ResearchConceptsMagnetic resonance imagingSelection of patientsClinical criteriaFavorable outcomeSuccessful reperfusionMRS scoreLTB patientsIschemic strokeTerminal internal carotid artery occlusionResonance imagingInternal carotid artery occlusionStroke treatment outcomesEndovascular stroke treatmentAcute ischemic strokeCarotid artery occlusionProspective cohort studyMiddle cerebral arterySpecific magnetic resonance imagingInfarct volume determinationArtery occlusionCohort studyStroke treatmentCerebral arteryEndovascular treatmentPatient selection
2015
FLAIR Vascular Hyperintensity is a Surrogate of Collateral Flow and Leukoaraiosis in Patients With Acute Stroke Due to Proximal Artery Occlusion
Karadeli H, Giurgiutiu D, Cloonan L, Fitzpatrick K, Kanakis A, Ozcan M, Schwamm L, Rost N. FLAIR Vascular Hyperintensity is a Surrogate of Collateral Flow and Leukoaraiosis in Patients With Acute Stroke Due to Proximal Artery Occlusion. Journal Of Neuroimaging 2015, 26: 219-223. PMID: 26250448, PMCID: PMC4744593, DOI: 10.1111/jon.12274.Peer-Reviewed Original ResearchConceptsProximal artery occlusionCollateral flow gradeFlow gradeAIS patientsWhite matter hyperintensitiesWMH volumeCT angiographyFVH scoreVascular hyperintensityArtery occlusionIntravenous tissue plasminogen activator administrationInversion recovery vascular hyperintensityAcute ischemic stroke patientsTissue plasminogen activator administrationAdmission CT angiographyBaseline CT angiographyCollateral vessel statusFLAIR vascular hyperintensityLeptomeningeal collateral statusMedian WMH volumeSalvageable brain tissueConsecutive AIS patientsIschemic stroke patientsWorse clinical outcomesAcute MRISafety and efficacy of desmoteplase given 3–9 h after ischaemic stroke in patients with occlusion or high-grade stenosis in major cerebral arteries (DIAS-3): a double-blind, randomised, placebo-controlled phase 3 trial
Albers G, von Kummer R, Truelsen T, Jensen J, Ravn G, Grønning B, Chabriat H, Chang K, Davalos A, Ford G, Grotta J, Kaste M, Schwamm L, Shuaib A, Investigators D. Safety and efficacy of desmoteplase given 3–9 h after ischaemic stroke in patients with occlusion or high-grade stenosis in major cerebral arteries (DIAS-3): a double-blind, randomised, placebo-controlled phase 3 trial. The Lancet Neurology 2015, 14: 575-584. PMID: 25937443, DOI: 10.1016/s1474-4422(15)00047-2.Peer-Reviewed Original ResearchConceptsMajor cerebral arteriesHigh-grade stenosisRankin Scale scoreIschemic strokeSymptom onsetCerebral arteryDay 90Scale scorePlacebo-controlled phase 3 trialComputer-generated randomisation listMajor cerebral artery occlusionModified Rankin Scale scoreSymptomatic cerebral edemaSymptomatic intracranial hemorrhageBaseline National InstitutesHealth Stroke ScaleSerious adverse eventsCerebral artery occlusionPhase 3 trialModified Rankin ScaleRandomisation listStroke ScaleStudy drugAdverse eventsArtery occlusion
2014
Determinants of Early Outcomes in Patients with Acute Ischemic Stroke and Proximal Artery Occlusion
LaBuzetta J, Yoo A, Ali S, Fitzpatrick K, Leslie-Mazwi T, Hirsch J, Schwamm L, Rost N. Determinants of Early Outcomes in Patients with Acute Ischemic Stroke and Proximal Artery Occlusion. Journal Of Stroke And Cerebrovascular Diseases 2014, 23: 2527-2532. PMID: 25238927, PMCID: PMC4256100, DOI: 10.1016/j.jstrokecerebrovasdis.2014.03.020.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, IntravenousAgedAged, 80 and overArterial Occlusive DiseasesBrain IschemiaCombined Modality TherapyEndovascular ProceduresFemaleFibrinolytic AgentsHumansInjections, Intra-ArterialLogistic ModelsMaleMiddle AgedPatient DischargeProspective StudiesRegional Blood FlowStrokeStroke RehabilitationTime FactorsTissue Plasminogen ActivatorTreatment OutcomeConceptsIntra-arterial therapyProximal artery occlusionArtery occlusionIndependent predictorsAIS patientsPoststroke outcomesFavorable outcomeAcute ischemic stroke patientsIntravenous tissue plasminogen activatorInstitutional stroke databaseAcute ischemic strokeIschemic stroke patientsOnly independent predictorTissue plasminogen activatorEligible patientsHospital mortalityTPA administrationIschemic strokeStroke databaseAtrial fibrillationEarly outcomesPrespecified protocolStroke patientsPatient subgroupsUnfavorable outcomeTime and Diffusion Lesion Size in Major Anterior Circulation Ischemic Strokes
Hakimelahi R, Vachha B, Copen W, Papini G, He J, Higazi M, Lev M, Schaefer P, Yoo A, Schwamm L, González R. Time and Diffusion Lesion Size in Major Anterior Circulation Ischemic Strokes. Stroke 2014, 45: 2936-2941. PMID: 25190444, DOI: 10.1161/strokeaha.114.005644.Peer-Reviewed Original ResearchConceptsAnterior circulation ischemic strokeMiddle cerebral artery occlusionDiffusion-weighted imagingCerebral artery occlusionStroke onsetIschemic strokeInfarct sizeDWI lesionsInfarct volumeArtery occlusionIntravenous tissue-type plasminogen activatorProximal middle cerebral arteryDistal internal carotid arteryAcute infarct volumeDWI lesion volumeMajority of patientsMiddle cerebral arteryInternal carotid arteryAcute infarct sizeSame inclusion criteriaTraditional time windowTissue-type plasminogen activatorCerebral perfusionConsecutive patientsInfarct growthSeverity of leukoaraiosis, leptomeningeal collaterals, and clinical outcomes after intra-arterial therapy in patients with acute ischemic stroke
Giurgiutiu D, Yoo A, Fitzpatrick K, Chaudhry Z, Leslie-Mazwi T, Schwamm L, Rost N. Severity of leukoaraiosis, leptomeningeal collaterals, and clinical outcomes after intra-arterial therapy in patients with acute ischemic stroke. Journal Of NeuroInterventional Surgery 2014, 7: 326. PMID: 24721756, DOI: 10.1136/neurintsurg-2013-011083.Peer-Reviewed Original ResearchConceptsIntra-arterial therapyProximal artery occlusionAcute ischemic strokeSeverity of leukoaraiosisGood functional outcomeLA volumeCollateral gradeRecanalization statusArtery occlusionIschemic strokeFunctional outcomeIntravenous tissue plasminogen activator useHealth Stroke Scale scoreLarge cerebral artery occlusionPoor post-stroke outcomesIschemic white matter lesionsTissue plasminogen activator useGood collateral gradesGreater LA volumeGuidelines-Stroke databasePoor collateral gradeStroke Scale scoreSymptomatic intracranial hemorrhageCerebral artery occlusionCerebral small vessels
2013
Determinants of Early Outcomes in Patients with Acute Ischemic Stroke and Proximal Artery Occlusion (S02.005)
Labuzetta J, Yoo A, Ali S, Fitzpatrick K, Hirsch J, Schwamm L, Rost N. Determinants of Early Outcomes in Patients with Acute Ischemic Stroke and Proximal Artery Occlusion (S02.005). Neurology 2013, 80 DOI: 10.1212/wnl.80.7_supplement.s02.005.Peer-Reviewed Original Research
2012
Rapid identification of a major diffusion/perfusion mismatch in distal internal carotid artery or middle cerebral artery ischemic stroke
Hakimelahi R, Yoo A, He J, Schwamm L, Lev M, Schaefer P, González R. Rapid identification of a major diffusion/perfusion mismatch in distal internal carotid artery or middle cerebral artery ischemic stroke. BMC Neurology 2012, 12: 132. PMID: 23121836, PMCID: PMC3519648, DOI: 10.1186/1471-2377-12-132.Peer-Reviewed Original ResearchConceptsDiffusion/perfusion mismatchDWI lesion volumeInternal carotid arteryLesion volumePerfusion mismatchConsecutive patientsCarotid arteryMiddle cerebral artery ischemic strokeDiffusion/perfusion MRITerminal internal carotid arteryProximal middle cerebral arteryDistal internal carotid arteryLarger mismatch volumeProximal MCA occlusionMiddle cerebral arteryDiffusion lesion volumeSame inclusion criteriaTerminal ICAArtery occlusionIschemic strokeMCA occlusionStroke onsetCerebral arteryStroke patientsPatient assessmentImplementation of a patient selection protocol for intra-arterial therapy increases treatment rates in patients with acute ischemic stroke
Rost N, Smith E, Nogueira R, Fitzpatrick K, Yoo A, Hirsch J, Schwamm L. Implementation of a patient selection protocol for intra-arterial therapy increases treatment rates in patients with acute ischemic stroke. Journal Of NeuroInterventional Surgery 2012, 5: i44. PMID: 22611045, PMCID: PMC3777532, DOI: 10.1136/neurintsurg-2011-010240.Peer-Reviewed Original ResearchConceptsIntra-arterial therapyAcute ischemic strokePatient selection protocolLTB patientsIschemic strokeIntravenous tissue plasminogen activatorNIH Stroke Scale scoreTreatment ratesProximal artery occlusionStroke Scale scoreTissue plasminogen activatorProtocol adoptionStroke durationInfarct volumeArtery occlusionMost patientsMultivariable adjustmentIndependent predictorsPatient selectionStroke databasePatientsScale scorePlasminogen activatorStudy periodBrain imagingInfarct Volume Is a Pivotal Biomarker After Intra-Arterial Stroke Therapy
Yoo A, Chaudhry Z, Nogueira R, Lev M, Schaefer P, Schwamm L, Hirsch J, González R. Infarct Volume Is a Pivotal Biomarker After Intra-Arterial Stroke Therapy. Stroke 2012, 43: 1323-1330. PMID: 22426317, DOI: 10.1161/strokeaha.111.639401.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overBiomarkersBrain InfarctionCohort StudiesDatabases, FactualFemaleFibrinolytic AgentsHumansInfusions, IntravenousMagnetic Resonance ImagingMaleMiddle AgedNeuroimagingPredictive Value of TestsProspective StudiesRetrospective StudiesStrokeThrombolytic TherapyTissue Plasminogen ActivatorTomography, X-Ray ComputedTreatment OutcomeConceptsFinal infarct volumeIntra-arterial therapyAcute ischemic strokeInfarct volumeFunctional outcomeBetter outcomesIschemic strokePoor outcomeAnterior circulation acute ischemic strokeScale scoreHealth Stroke Scale scoreMedian admission National InstitutesMedian final infarct volumesLong-term functional outcomeIntra-arterial stroke therapyAdmission National InstitutesProximal artery occlusionStroke Scale scoreOnly independent predictorRankin Scale scoreArtery occlusionProspective cohortRankin ScaleIndependent predictorsClinical outcomes
2011
CT angiography predicts use of tertiary interventional services in acute ischemic stroke patients
Thomas L, Goldstein J, Hakimelahi R, Chang Y, Yoo A, Schwamm L, Gonzalez R. CT angiography predicts use of tertiary interventional services in acute ischemic stroke patients. International Journal Of Emergency Medicine 2011, 4: 62. PMID: 21967677, PMCID: PMC3203028, DOI: 10.1186/1865-1380-4-62.Peer-Reviewed Original ResearchCerebral artery occlusionProximal cerebral artery occlusionEmergent CT angiographyIschemic stroke patientsCT angiographyProximal occlusionArtery occlusionNegative predictive valuePositive predictive valueIndependent predictorsStroke patientsNeurointerventional servicesInitial NIH Stroke Scale scorePredictive valueConsecutive ischemic stroke patientsAcute ischemic stroke patientsNIH Stroke Scale scoreInterventional servicesMechanical clot retrievalTertiary care interventionsIntra-arterial thrombolysisStroke Scale scoreAcute ischemic strokeTertiary care centerHistorical cohort study
2008
An Acute Ischemic Stroke Classification Instrument That Includes CT or MR Angiography: The Boston Acute Stroke Imaging Scale
Torres-Mozqueda F, He J, Yeh I, Schwamm L, Lev M, Schaefer P, González R. An Acute Ischemic Stroke Classification Instrument That Includes CT or MR Angiography: The Boston Acute Stroke Imaging Scale. American Journal Of Neuroradiology 2008, 29: 1111-1117. PMID: 18467521, PMCID: PMC8118840, DOI: 10.3174/ajnr.a1000.Peer-Reviewed Original ResearchConceptsAlberta Stroke Program Early CT ScoreAcute ischemic strokeMinor stroke groupIschemic strokeMajor strokeMinor strokeStroke groupNoncontrast CTBoston Acute Stroke Imaging ScaleProximal cerebral artery occlusionMR angiographyCerebral artery occlusionLength of hospitalizationClassification instrumentCTA patientsArtery occlusionDischarge dispositionConsecutive patientsParenchymal ischemiaCT scorePatient outcomesStroke survivorsRehabilitation facilityPatientsStroke