2024
Automated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion
Mak A, Matouk C, Avery E, Behland J, Haider S, Frey D, Madai V, Vajkoczy P, Griessenauer C, Zand R, Hendrix P, Abedi V, Sanelli P, Falcone G, Petersen N, Sansing L, Sheth K, Payabvash S, Malhotra A. Automated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion. PLOS ONE 2024, 19: e0304962. PMID: 38870240, PMCID: PMC11175522, DOI: 10.1371/journal.pone.0304962.Peer-Reviewed Original ResearchConceptsDiffusion-weighted imagingLarge vessel occlusionIrreversible ischemic changesPoor functional outcomeFunctional outcomesIschemic changesInfarct volumeAlberta Stroke Program Early CT ScorePredicting poor functional outcomeVessel occlusionFollow-up diffusion-weighted imagingAnterior circulation LVO strokeCTA source imagesReceiver operating characteristic curveExpert human readersPredicting final infarctionASPECTS regionsAdmission CTANon-inferior performanceBaseline CTACT scoreFinal infarctEndovascular therapyHU attenuationValidation cohortDeviation From Personalized Blood Pressure Targets Correlates With Worse Outcome After Successful Recanalization
Zhang Z, Pu Y, Yu L, Bai H, Duan W, Liu X, Nie X, Wen Z, Zheng L, Hu X, Leng X, Pan Y, Petersen N, Liu L. Deviation From Personalized Blood Pressure Targets Correlates With Worse Outcome After Successful Recanalization. Journal Of The American Heart Association 2024, 13: e033633. PMID: 38533955, PMCID: PMC11179781, DOI: 10.1161/jaha.123.033633.Peer-Reviewed Original ResearchConceptsBlood pressure targetsBlood pressureAutoregulatory limitsWorse outcomesAssociated with symptomatic intracranial hemorrhageAssociated with unfavorable clinical outcomesPressure targetsAssociated with worse outcomesAssociated with poor outcomesSignificant infarction growthSymptomatic intracranial hemorrhageUnfavorable clinical outcomeLarge vessel occlusion strokeAcute ischemic strokeMean velocity indexIntracranial hemorrhageBP management strategiesNeurological deteriorationClinical outcomesInfarct growthPoor outcomeEndovascular thrombectomyOcclusion strokeRecanalizationIschemic stroke
2023
Safety Outcomes of Mechanical Thrombectomy Versus Combined Thrombectomy and Intravenous Thrombolysis in Tandem Lesions
Rodriguez-Calienes A, Galecio-Castillo M, Farooqui M, Hassan A, Jumaa M, Divani A, Ribo M, Abraham M, Petersen N, Fifi J, Guerrero W, Malik A, Siegler J, Nguyen T, Yoo A, Linares G, Janjua N, Quispe-Orozco D, Tekle W, Alhajala H, Ikram A, Rizzo F, Qureshi A, Begunova L, Matsoukas S, Vigilante N, Salazar-Marioni S, Abdalkader M, Gordon W, Soomro J, Turabova C, Vivanco-Suarez J, Mokin M, Yavagal D, Jovin T, Sheth S, Ortega-Gutierrez S. Safety Outcomes of Mechanical Thrombectomy Versus Combined Thrombectomy and Intravenous Thrombolysis in Tandem Lesions. Stroke 2023, 54: 2522-2533. PMID: 37602387, PMCID: PMC10599264, DOI: 10.1161/strokeaha.123.042966.Peer-Reviewed Original ResearchConceptsRisk of sICHParenchymal hematoma type 2Symptomatic intracranial hemorrhageRankin Scale score 0Intravenous antiplatelet therapyIntravenous thrombolysisFavorable functional outcomeMechanical thrombectomyHemorrhagic transformationFunctional outcomeType 2Antiplatelet therapyHospital mortalitySuccessful reperfusionComplete reperfusionScore 0Tandem lesionsAnterior circulation tandem lesionsExcellent functional outcomeIVT treatmentStroke centersMulticenter cohortPrimary outcomeRevascularization techniquesAlone groupImaging biomarkers of cerebral edema automatically extracted from routine CT scans of large vessel occlusion strokes
Dhar R, Kumar A, Chen Y, Begunova Y, Olexa M, Prasad A, Carey G, Gonzalez I, Bhatia K, Hamed M, Heitsch L, Mainali S, Petersen N, Lee J. Imaging biomarkers of cerebral edema automatically extracted from routine CT scans of large vessel occlusion strokes. Journal Of Neuroimaging 2023, 33: 606-616. PMID: 37095592, PMCID: PMC10524672, DOI: 10.1111/jon.13109.Peer-Reviewed Original ResearchConceptsLarge vessel occlusion strokeMidline shiftCSF ratioMalignant edemaCerebral edemaOcclusion strokeCerebrospinal fluidAlberta Stroke Program Early CT ScoreCSF volumeTissue plasminogen activator treatmentHealth Stroke ScalePlasminogen activator treatmentRoutine CT scansNet water uptakeDecompressive surgeryInfarct volumeStroke ScaleOsmotic therapyBaseline CTCT scoreHemispheric volumeRoutine CTSerial CTContralateral regionsCT scan
2020
Fixed Compared With Autoregulation-Oriented Blood Pressure Thresholds After Mechanical Thrombectomy for Ischemic Stroke
Petersen NH, Silverman A, Strander SM, Kodali S, Wang A, Sansing LH, Schindler JL, Falcone GJ, Gilmore EJ, Jasne AS, Cord B, Hebert RM, Johnson M, Matouk CC, Sheth KN. Fixed Compared With Autoregulation-Oriented Blood Pressure Thresholds After Mechanical Thrombectomy for Ischemic Stroke. Stroke 2020, 51: 914-921. PMID: 32078493, PMCID: PMC7050651, DOI: 10.1161/strokeaha.119.026596.Peer-Reviewed Original ResearchConceptsSystolic BP thresholdMean arterial pressureArterial pressureEndovascular thrombectomyIschemic strokeSystolic BPFunctional outcomePercent timeFurther brain injuryModified Rankin ScaleBlood pressure changesPoor functional outcomeBP thresholdAutoregulatory indexHemorrhagic transformationMechanical thrombectomyRankin ScaleBlood pressureBP targetsHemodynamic managementAcute phaseBP managementStroke patientsCerebral autoregulationWorse outcomes
2019
Changes on Dynamic Cerebral Autoregulation Are Associated with Delayed Cerebral Ischemia in Patients with Aneurysmal Subarachnoid Hemorrhage
Ortega-Gutierrez S, Samaniego E, Reccius A, Huang A, Zheng-Lin B, Masukar A, Marshall R, Petersen N. Changes on Dynamic Cerebral Autoregulation Are Associated with Delayed Cerebral Ischemia in Patients with Aneurysmal Subarachnoid Hemorrhage. Acta Neurochirurgica Supplement 2019, 127: 149-153. PMID: 31407076, DOI: 10.1007/978-3-030-04615-6_22.Peer-Reviewed Original ResearchMeSH KeywordsBrain IschemiaCohort StudiesHomeostasisHumansSubarachnoid HemorrhageVasospasm, IntracranialConceptsDynamic cerebral autoregulationAneurysmal subarachnoid hemorrhageCerebral blood flow velocityBlood pressureSymptomatic vasospasmCerebral ischemiaSAH patientsCerebral autoregulationSubarachnoid hemorrhageCerebral blood flow regulationGlasgow Coma ScoreSystemic blood pressureDelayed Cerebral IschemiaLarge cohort studyBlood flow regulationBlood flow velocityRecording periodDCA assessmentCohort studyComa ScoreEntire recording periodSymptom onsetMedian timeDay 3Early identificationDecreases in Blood Pressure During Thrombectomy Are Associated With Larger Infarct Volumes and Worse Functional Outcome
Petersen NH, Ortega-Gutierrez S, Wang A, Lopez GV, Strander S, Kodali S, Silverman A, Zheng-Lin B, Dandapat S, Sansing LH, Schindler JL, Falcone GJ, Gilmore EJ, Amin H, Cord B, Hebert RM, Matouk C, Sheth KN. Decreases in Blood Pressure During Thrombectomy Are Associated With Larger Infarct Volumes and Worse Functional Outcome. Stroke 2019, 50: 1797-1804. PMID: 31159701, PMCID: PMC6787912, DOI: 10.1161/strokeaha.118.024286.Peer-Reviewed Original ResearchConceptsFinal infarct volumeWorse functional outcomeInfarct volumeEndovascular thrombectomyFunctional outcomeOcclusion strokeCerebral infarction 2b/3 reperfusionPressure reductionLarge vessel intracranial occlusionsGreater infarct growthBlood pressure reductionComprehensive stroke centerPercent of patientsBlood pressure managementLarger infarct volumesModified Rankin ScaleRankin Scale scoreMultivariable logistic regressionRelative hypotensionSustained hypotensionInfarct progressionNinety patientsInfarct growthIschemic penumbraIschemic stroke