2022
Spoke‐Administered Thrombolysis Improves Large‐Vessel Occlusion Early Recanalization: The Real‐World Experience of a Large Academic Hub‐and‐Spoke Telestroke Network
Kraft A, Regenhardt R, Awad A, Rosenthal J, Dmytriw A, Vranic J, Bonkhoff A, Bretzner M, Hirsch J, Rabinov J, Stapleton C, Schwamm L, Singhal A, Rost N, Leslie‐Mazwi T, Patel A. Spoke‐Administered Thrombolysis Improves Large‐Vessel Occlusion Early Recanalization: The Real‐World Experience of a Large Academic Hub‐and‐Spoke Telestroke Network. Stroke Vascular And Interventional Neurology 2022, 3 PMID: 36816048, PMCID: PMC9936963, DOI: 10.1161/svin.122.000427.Peer-Reviewed Original ResearchIntravenous thrombolysisMechanical thrombectomyEarly recanalizationInterhospital transferLarge vessel occlusion strokeLack of efficacyReal-world analysisVessel imagingEligible patientsMedian ageOcclusion strokeRecent trialsStroke NetworkTelestroke networkInclusion criteriaPatientsIVT useReal-world experienceNIHSSThrombolysisRecanalizationHospitalLVOImagingER ratesIn 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
2016
Relationship Between Language Preference and Intravenous Thrombolysis Among Acute Ischemic Stroke Patients
Erfe B, Siddiqui K, Schwamm L, Mejia N. Relationship Between Language Preference and Intravenous Thrombolysis Among Acute Ischemic Stroke Patients. Journal Of The American Heart Association 2016, 5: e003782. PMID: 27881425, PMCID: PMC5210419, DOI: 10.1161/jaha.116.003782.Peer-Reviewed Original ResearchConceptsLanguage preferencePatients' language preferenceAcute ischemic stroke patientsNon-English languageIschemic stroke patientsNIH Stroke ScaleAIS patientsDifferent languagesInitial NIH stroke scaleIntravenous thrombolysisPatient languageStroke ScaleStroke patientsLanguageStepwise logistic regression modelInitial stroke severityAmerican Heart AssociationEnglishLogistic regression modelsStroke severityMultivariable analysisPatient receiptHeart AssociationThrombolysisPatients
2012
Economic Impact of Using Additional Diagnostic Tests to Better Select Patients With Stroke for Intravenous Thrombolysis in the United Kingdom
Earnshaw S, McDade C, Chapman A, Jackson D, Schwamm L. Economic Impact of Using Additional Diagnostic Tests to Better Select Patients With Stroke for Intravenous Thrombolysis in the United Kingdom. Clinical Therapeutics 2012, 34: 1544-1558. PMID: 22695225, DOI: 10.1016/j.clinthera.2012.05.004.Peer-Reviewed Original ResearchConceptsMagnetic resonance imagingMRI selectionUsual careDiagnostic testsFavorable outcomeIncremental cost-effectiveness ratioAcute stroke treatmentPreferred diagnostic testNumber of patientsAdditional diagnostic testsCost-effectiveness ratioDecision analytic modelCTP selectionIntravenous thrombolysisStroke onsetStroke treatmentPatient selectionUK patientsPenumbral patternPatient outcomesPerfusion CTPatient historyThrombolysisPatientsPerfusion imagingTelestroke increases use of acute stroke therapy
Müller-Barna P, Schwamm L, Haberl R. Telestroke increases use of acute stroke therapy. Current Opinion In Neurology 2012, 25: 5-10. PMID: 22157105, DOI: 10.1097/wco.0b013e32834d5fe4.Peer-Reviewed Original ResearchConceptsTelestroke networkStroke careUsage of guidelinesAcute stroke careAcute stroke therapyIschemic stroke patientsRate of thrombolysisNew therapeutic modalitiesStroke teamAcute strokeNeurological examinationStroke unitStroke patientsStroke therapyStroke managementImproved outcomesTherapeutic modalitiesTelestroke servicesRemote reviewUnderserved areasHigh-quality videoconferencingCareIncrease useRegular basisThrombolysisMajor advances across the spectrum of stroke care
Schwamm L. Major advances across the spectrum of stroke care. Nature Reviews Neurology 2012, 8: 63-64. PMID: 22231192, DOI: 10.1038/nrneurol.2011.225.Peer-Reviewed Original Research
2011
Use of Telemedicine and Other Strategies to Increase the Number of Patients That May Be Treated with Intravenous Thrombolysis
Silva G, Schwamm L. Use of Telemedicine and Other Strategies to Increase the Number of Patients That May Be Treated with Intravenous Thrombolysis. Current Neurology And Neuroscience Reports 2011, 12: 10-16. PMID: 21997715, DOI: 10.1007/s11910-011-0235-6.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeUse of telemedicineIntravenous thrombolysisIschemic strokeIntravenous tissue plasminogen activator useAdult long-term disabilityTissue plasminogen activator useLong-term disabilityAmerican Heart AssociationNumber of patientsRecruitment of patientsRate of treatmentHelp of telemedicineThrombolysis trialsHeart AssociationStroke NetworkStroke systemsTelestroke networkTelestroke systemCurrent evidencePatientsThrombolysisStrokeCareTelemedicine
2010
Intravenous (IV) Thrombolysis
Nogueira R, Schwamm L. Intravenous (IV) Thrombolysis. 2010, 221-243. DOI: 10.1007/978-3-642-12751-9_11.Peer-Reviewed Original ResearchManagement of Thrombolysis-Associated Symptomatic Intracerebral Hemorrhage
Goldstein J, Marrero M, Masrur S, Pervez M, Barrocas A, Abdullah A, Oleinik A, Rosand J, Smith E, Dzik W, Schwamm L. Management of Thrombolysis-Associated Symptomatic Intracerebral Hemorrhage. JAMA Neurology 2010, 67: 965-969. PMID: 20697046, PMCID: PMC3690951, DOI: 10.1001/archneurol.2010.175.Peer-Reviewed Original ResearchConceptsSymptomatic intracerebral hemorrhageIntra-arterial thrombolysisHospital mortalityIntracerebral hemorrhageHealth Stroke Scale scoreIntravenous tissue plasminogen activatorGuidelines-Stroke databaseStroke Scale scoreAcute ischemic strokeMultivariable logistic regressionFresh frozen plasmaTissue plasminogen activatorMulticenter registryAcute strokeDevastating complicationIschemic strokeIndependent predictorsThrombolytic therapyFrozen plasmaAppropriate treatmentRetrospective analysisPatientsScale scoreCoagulopathyThrombolysis
2009
Telestroke: Scientific Results
Audebert H, Schwamm L. Telestroke: Scientific Results. Cerebrovascular Diseases 2009, 27: 15-20. PMID: 19546537, DOI: 10.1159/000213054.Peer-Reviewed Original ResearchConceptsStroke careStroke patientsAcute stroke treatment decisionsPost-stroke careTriage of patientsTelephone-based consultationsUse of telemedicineVideo examinationIntravenous thrombolysisStroke preventionStroke wardAcute strokeClinical outcomesNeurological assessmentInterventional treatmentTreatment decisionsApplication of telemedicineTelemedicine consultationsBrain scansPatientsUnderserved areasHigh-quality videoconferencingThrombolysisCareHospital
2008
CT Angiography-Source Image Hypoattenuation Predicts Clinical Outcome in Posterior Circulation Strokes Treated With Intra-Arterial Therapy
Schaefer P, Yoo A, Bell D, Barak E, Romero J, Nogueira R, Lev M, Schwamm L, Gonzalez R, Hirsch J. CT Angiography-Source Image Hypoattenuation Predicts Clinical Outcome in Posterior Circulation Strokes Treated With Intra-Arterial Therapy. Stroke 2008, 39: 3107-3109. PMID: 18703807, DOI: 10.1161/strokeaha.108.517680.Peer-Reviewed Original ResearchConceptsIntra-arterial thrombolysisVertebrobasilar occlusionClinical outcomesParenchymal hypoattenuationRankin scorePosterior circulation strokeHealth Stroke ScaleIntra-arterial therapyOnly independent predictorIndependent outcome predictorsMedial temporal lobeInferior parietal lobeStroke ScaleClot locationPatient ageCTA-SIIndependent predictorsOutcome predictorsOccipital lobeHypoattenuationTemporal lobeThrombolysisParietal lobePatientsMidbrain
2006
Thrombolytic therapy of acute ischemic stroke during pregnancy
Murugappan A, Coplin W, Al-Sadat A, McAllen K, Schwamm L, Wechsler L, Kidwell C, Saver J, Starkman S, Gobin Y, Duckwiler G, Krueger M, Rordorf G, Broderick J, Tietjen G, Levine S. Thrombolytic therapy of acute ischemic stroke during pregnancy. Neurology 2006, 66: 768-770. PMID: 16534124, DOI: 10.1212/01.wnl.0000201272.90216.15.Peer-Reviewed Original Research
2005
The Evolving Role of Acute Stroke Imaging in Intravenous Thrombolytic Therapy: Patient Selection and Outcomes Assessment
Sims J, Schwamm L. The Evolving Role of Acute Stroke Imaging in Intravenous Thrombolytic Therapy: Patient Selection and Outcomes Assessment. Neuroimaging Clinics Of North America 2005, 15: 421-440. PMID: 16198950, DOI: 10.1016/j.nic.2005.06.001.Peer-Reviewed Original ResearchConceptsPatient selectionIntravenous thrombolytic therapyStroke pathophysiologyThrombolytic trialsPenumbral tissueAcute strokeLarge infarctionCerebral ischemiaRisk stratificationThrombolytic therapyCT perfusionStroke mechanismBrain hemorrhageTherapeutic successCT angiographyUnenhanced CTOutcome assessmentPotential future roleEarly signsEarly trialsMR imagingThrombolysisInfarctionTrialsEvolving role
2004
768 First-pass Quantitative Computed Tomographic Perfusion Identifies Salvageable Penumbra in Acute Stroke Patients Treated with Intra-arterial Thrombolysis
Hoh B, Roccatagliata L, Lev M, Ledezma C, Schwamm L, Koroshetz W, Schaefer P. 768 First-pass Quantitative Computed Tomographic Perfusion Identifies Salvageable Penumbra in Acute Stroke Patients Treated with Intra-arterial Thrombolysis. Neurosurgery 2004, 55: 475. DOI: 10.1097/00006123-200408000-00104.Peer-Reviewed Original Research768 First-pass Quantitative Computed Tomographic Perfusion Identifies Salvageable Penumbra in Acute Stroke Patients Treated with Intra-arterial Thrombolysis
Hoh B, Roccatagliata L, Lev M, Ledezma C, Schwamm L, Koroshetz W, Schaefer P. 768 First-pass Quantitative Computed Tomographic Perfusion Identifies Salvageable Penumbra in Acute Stroke Patients Treated with Intra-arterial Thrombolysis. Neurosurgery 2004, 55: 475-475. DOI: 10.1227/00006123-200408000-00104.Peer-Reviewed Original ResearchCharacterization and evolution of diffusion MR imaging abnormalities in stroke patients undergoing intra-arterial thrombolysis.
Schaefer P, Hassankhani A, Putman C, Sorensen A, Schwamm L, Koroshetz W, Gonzalez R. Characterization and evolution of diffusion MR imaging abnormalities in stroke patients undergoing intra-arterial thrombolysis. American Journal Of Neuroradiology 2004, 25: 951-7. PMID: 15205129, PMCID: PMC7975652.Peer-Reviewed Original ResearchConceptsIntra-arterial thrombolysisDiffusion-weighted imagingDWI findingsDWI ratioADC ratioReperfusion therapyAcute strokeApparent diffusion coefficientInitial diffusion-weighted imagingPretreatment diffusion-weighted imagingADC valuesRespective mean changesEventual infarctionAcute occlusionAnterior circulationStroke patientsLesion volumeMean changePatientsThrombolysisLesion growthMR imagingTissue viabilityLesionsInfarction