2024
Tenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection
Albers G, Jumaa M, Purdon B, Zaidi S, Streib C, Shuaib A, Sangha N, Kim M, Froehler M, Schwartz N, Clark W, Kircher C, Yang M, Massaro L, Lu X, Rippon G, Broderick J, Butcher K, Lansberg M, Liebeskind D, Nouh A, Schwamm L, Campbell B. Tenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection. New England Journal Of Medicine 2024, 390: 701-711. PMID: 38329148, DOI: 10.1056/nejmoa2310392.Peer-Reviewed Original ResearchConceptsModified Rankin ScaleSymptomatic intracranial hemorrhageInternal carotid arteryMiddle cerebral arteryRankin ScalePlacebo groupTenecteplase groupIntracranial hemorrhageIncidence of symptomatic intracranial hemorrhageCerebral arteryIncidence of symptomatic intracerebral hemorrhageCarotid arteryPlacebo-controlled trialSymptomatic intracerebral hemorrhageEvidence of occlusionSafety populationDouble-blindPerfusion-imagingMedian timeClinical outcomesIntracerebral hemorrhagePlaceboPerfusion imagingPrimary outcomeOdds ratio
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
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
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
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 assessment
2005
Arterial occlusion revealed by CT angiography predicts NIH stroke score and acute outcomes after IV tPA treatment.
Sims J, Rordorf G, Smith E, Koroshetz W, Lev M, Buonanno F, Schwamm L. Arterial occlusion revealed by CT angiography predicts NIH stroke score and acute outcomes after IV tPA treatment. American Journal Of Neuroradiology 2005, 26: 246-51. PMID: 15709120, PMCID: PMC7974096.Peer-Reviewed Original ResearchConceptsCT angiographyLocation of occlusionEarly improvementInitial NIHSSArterial occlusionIntravenous tissue-type plasminogen activatorNIH stroke scoreProspective stroke databaseHealth Stroke ScaleAcute stroke patientsMiddle cerebral arteryPatent vasculatureSite of occlusionTissue-type plasminogen activatorLower NIHSSStroke ScaleStroke ScoreSymptomatic hemorrhageRankin ScaleAcute outcomesHemorrhagic riskCerebral arteryClinical outcomesStroke databaseStroke patients
1998
Effects of Induced Hypertension on Transcranial Doppler Ultrasound Velocities in Patients After Subarachnoid Hemorrhage
Manno E, Gress D, Schwamm L, Diringer M, Ogilvy C. Effects of Induced Hypertension on Transcranial Doppler Ultrasound Velocities in Patients After Subarachnoid Hemorrhage. Stroke 1998, 29: 422-428. PMID: 9472884, DOI: 10.1161/01.str.29.2.422.Peer-Reviewed Original ResearchConceptsMiddle cerebral arteryInduced hypertensionTCD velocitiesSubarachnoid hemorrhageTranscranial Doppler ultrasoundIntact autoregulationArterial pressureCerebral vasospasmCerebral arteryCerebral autoregulationTranscranial Doppler ultrasound velocitiesCerebral blood flow velocityContinuous TCD monitoringMean arterial pressureBlood flow velocityLevel of autoregulationDoppler ultrasound velocitiesAdditional patientsClinical evidenceClinical differencesTCD monitoringHypertensionDoppler ultrasoundHemorrhagePatients
1997
Pharmacological elevation of blood pressure in acute stroke. Clinical effects and safety.
Rordorf G, Cramer S, Efird J, Schwamm L, Buonanno F, Koroshetz W. Pharmacological elevation of blood pressure in acute stroke. Clinical effects and safety. Stroke 1997, 28: 2133-8. PMID: 9368553, DOI: 10.1161/01.str.28.11.2133.Peer-Reviewed Original ResearchConceptsBlood pressure thresholdAcute strokeBlood pressureInduced hypertensionCerebral arterySystolic blood pressure thresholdNeurological intensive care unitPhenylephrine-Induced HypertensionAcute cerebral ischemiaSubset of patientsIntensive care unitPressure thresholdCardiac morbidityIschemic deficitsIschemic symptomsPressor agentsBaseline characteristicsIschemic strokeNeurological deficitsCerebral ischemiaCerebral perfusionBrain edemaCare unitClinical effectsIntracerebral hemorrhage