2022
Ischemic Stroke Systems of Care in California: Evolution in the Organization During the Mechanical Thrombectomy Era
Zachrison K, Hsia R, Li S, Reeves M, Camargo C, Yan Z, Onnela J, Schwamm L. Ischemic Stroke Systems of Care in California: Evolution in the Organization During the Mechanical Thrombectomy Era. Stroke Vascular And Interventional Neurology 2022, 2 DOI: 10.1161/svin.121.000206.Peer-Reviewed Original ResearchEndovascular thrombectomyStroke systemsHospital-level factorsOdds of transferLogistic regression modelsAlteplase useEVT proceduresStroke NetworkObservational studyTimely careRural hospitalsTrial dataHospitalPatientsHospital postsHospital pairsCarePatient transfer networksRegression modelsNumber of encountersLinear regressionThrombectomyAlteplaseRegressionGreater POSTIn Stroke, When Is a Good Outcome Good Enough?
Schwamm L. In Stroke, When Is a Good Outcome Good Enough? New England Journal Of Medicine 2022, 386: 1359-1361. PMID: 35388672, DOI: 10.1056/nejme2201330.Peer-Reviewed Original ResearchIn a hub-and-spoke network, spoke-administered thrombolysis reduces mechanical thrombectomy procedure time and number of passes
Kraft A, Awad A, Rosenthal J, Dmytriw A, Vranic J, Bonkhoff A, Bretzner M, Hirsch J, Rabinov J, Stapleton C, Schwamm L, Rost N, Leslie-Mazwi T, Patel A, Regenhardt R. In a hub-and-spoke network, spoke-administered thrombolysis reduces mechanical thrombectomy procedure time and number of passes. Interventional Neuroradiology 2022, 29: 315-320. PMID: 35317663, PMCID: PMC10369105, DOI: 10.1177/15910199221087498.Peer-Reviewed Original ResearchConceptsLarge vessel occlusion strokeIntravenous thrombolysisIVT-treated patientsMechanical thrombectomyProcedure timePuncture timeImproved reperfusionBaseline characteristicsTICI 2bIVT patientsOcclusion strokeOperative reportsProcedural characteristicsTelestroke networkPatientsReperfusionIncreased proportionThrombolysisTechnical difficultiesNIHSSThrombectomyHospitalStrokeMin
2021
Outcomes of Endovascular Therapy in Patients With Prestroke Mobility Impairment
Beekman R, Sun JL, Alhanti B, Schwamm LH, Smith EE, Bhatt DL, Xian Y, Shah S, Lytle BL, Fonarow GC, Sheth KN. Outcomes of Endovascular Therapy in Patients With Prestroke Mobility Impairment. Stroke 2021, 52: e725-e728. PMID: 34517771, DOI: 10.1161/strokeaha.121.034464.Peer-Reviewed Original ResearchConceptsEndovascular thrombectomyGuidelines-Stroke registrySymptomatic intracranial hemorrhageMobility impairmentsLogistic regression modelsHospital deathEndovascular therapyClinical benefitIntracranial hemorrhageAdverse outcomesClinical trialsThrombectomyPatientsOutcomesFurther studiesImpairmentRegression modelsNational data setsSafetyHemorrhageRegistryTherapyPopulationHospiceTrialsAccess to Mechanical Thrombectomy for Ischemic Stroke in the United States
Kamel H, Parikh N, Chatterjee A, Kim L, Saver J, Schwamm L, Zachrison K, Nogueira R, Adeoye O, Díaz I, Ryan A, Pandya A, Navi B. Access to Mechanical Thrombectomy for Ischemic Stroke in the United States. Stroke 2021, 52: 2554-2561. PMID: 33980045, PMCID: PMC8316281, DOI: 10.1161/strokeaha.120.033485.Peer-Reviewed Original ResearchConceptsIschemic strokeMechanical thrombectomyUnadjusted logistic regression modelsNonfederal emergency departmentsAcute ischemic strokeLarge cerebral vesselsAcute care hospitalsMultiple sensitivity analysesLogistic regression modelsStandard descriptive statisticsIntravenous thrombolysisStroke severityUrban patientsCare hospitalSuch patientsInterhospital transferRural patientsStroke careEmergency departmentPopulation-wide dataCerebral vesselsThrombectomyCalendar year 2016PatientsPrimary analysisCTA Protocols in a Telestroke Network Improve Efficiency for Both Spoke and Hub Hospitals
Yu A, Regenhardt R, Whitney C, Schwamm L, Patel A, Stapleton C, Viswanathan A, Hirsch J, Lev M, Leslie-Mazwi T. CTA Protocols in a Telestroke Network Improve Efficiency for Both Spoke and Hub Hospitals. American Journal Of Neuroradiology 2021, 42: 435-440. PMID: 33541900, PMCID: PMC7959422, DOI: 10.3174/ajnr.a6950.Peer-Reviewed Original ResearchConceptsEndovascular thrombectomySpoke hospitalsTelestroke networkHub hospitalCTA protocolHealth Stroke Scale scoreEmergent large vessel occlusionStroke Scale scoreRate of patientsLarge vessel occlusionCTA utilizationThrombectomy ratesStroke triageThrombectomyNonsignificant increasePatientsScale scoreHospitalTriage processNational InstituteOverall rateCTAExtended windowHigher numberRetention rate
2017
Visual Aids for Patient, Family, and Physician Decision Making About Endovascular Thrombectomy for Acute Ischemic Stroke
Tokunboh I, Vales Montero M, Zopelaro Almeida M, Sharma L, Starkman S, Szeder V, Jahan R, Liebeskind D, Gonzalez N, Demchuk A, Froehler M, Goyal M, Lansberg M, Lutsep H, Schwamm L, Saver J. Visual Aids for Patient, Family, and Physician Decision Making About Endovascular Thrombectomy for Acute Ischemic Stroke. Stroke 2017, 49: 90-97. PMID: 29222229, DOI: 10.1161/strokeaha.117.018715.Peer-Reviewed Original ResearchConceptsAcute cerebral ischemiaEndovascular thrombectomyBetter disability outcomesCerebral ischemiaDisability outcomesTPA-eligible patientsAcute ischemic strokeLarge vessel occlusionReperfusion treatmentTerritory infarctsIschemic strokeRankin ScaleVessel occlusionThrombectomyPatientsPhysician's decisionHealthcare providersTrial dataAdverse effectsOutcomesTreatment effectsIschemiaVisual decision aidsTPADecision aidIncrease in Endovascular Therapy in Get With The Guidelines-Stroke After the Publication of Pivotal Trials
Smith E, Saver J, Cox M, Liang L, Matsouaka R, Xian Y, Bhatt D, Fonarow G, Schwamm L. Increase in Endovascular Therapy in Get With The Guidelines-Stroke After the Publication of Pivotal Trials. Circulation 2017, 136: 2303-2310. PMID: 28982689, DOI: 10.1161/circulationaha.117.031097.Peer-Reviewed Original ResearchConceptsEndovascular thrombectomyEVT useEligible patientsIschemic strokePivotal trialsCase volumeStroke systemsHealth Stroke Scale scoreGuidelines-Stroke programStroke Scale scoreMean case volumeGuidelines-StrokeEndovascular therapyMore patientsPatient eligibilityPatientsClinical practiceScale scoreHospitalStrokeTrialsNational InstituteStroke durationLinear regressionThrombectomy
2016
Telestroke—the promise and the challenge. Part two—expansion and horizons
Akbik F, Hirsch J, Chandra R, Frei D, Patel A, Rabinov J, Rost N, Schwamm L, Leslie-Mazwi T. Telestroke—the promise and the challenge. Part two—expansion and horizons. Journal Of NeuroInterventional Surgery 2016, 9: 361. PMID: 26984867, DOI: 10.1136/neurintsurg-2016-012340.Peer-Reviewed Original ResearchConceptsSpecialist careMajor public health concernAcute ischemic strokeTime-sensitive therapiesExamination of patientsUse of telemedicinePublic health concernNovel therapeutic platformIntravenous thrombolysisStroke preventionEndovascular thrombectomyIschemic strokeStroke presentationStroke expertiseTreatment benefitVideo consultationsTreatment ratesHealth concernTelestrokeCarePotential roleStrokeSensitive therapyTherapeutic platformThrombectomy