2023
Association of Neighborhood-Level Socioeconomic Factors With Delay to Hospital Arrival in Patients With Acute Stroke
Forman R, Okumu R, Mageid R, Baker A, Neu D, Parker R, Peyravi R, Schindler J, Sansing L, Sheth K, de Havenon A, Jasne A, Narula R, Wira C, Warren J, Sharma R. Association of Neighborhood-Level Socioeconomic Factors With Delay to Hospital Arrival in Patients With Acute Stroke. Neurology 2023, 102: e207764. PMID: 38165368, PMCID: PMC10834135, DOI: 10.1212/wnl.0000000000207764.Peer-Reviewed Original ResearchConceptsEmergency department arrival timesEmergency medical servicesLate presentationAcute ischemic stroke therapyYale-New Haven HospitalGuidelines-Stroke registryNeighborhood-level socioeconomic factorsPatient-level factorsRetrospective observational studyIschemic stroke therapyMixed-effects logistic regression modelNon-white patientsNon-white raceUnivariate logistic regressionNew Haven HospitalLogistic regression modelsHospital presentationTreatment ineligibilityStroke RegistryAcute strokeHospital arrivalStroke therapyUnivariate analysisObservational studyPatients
2022
Portable, low-field magnetic resonance imaging enables highly accessible and dynamic bedside evaluation of ischemic stroke
Yuen MM, Prabhat AM, Mazurek MH, Chavva IR, Crawford A, Cahn BA, Beekman R, Kim JA, Gobeske KT, Petersen NH, Falcone GJ, Gilmore EJ, Hwang DY, Jasne AS, Amin H, Sharma R, Matouk C, Ward A, Schindler J, Sansing L, de Havenon A, Aydin A, Wira C, Sze G, Rosen MS, Kimberly WT, Sheth KN. Portable, low-field magnetic resonance imaging enables highly accessible and dynamic bedside evaluation of ischemic stroke. Science Advances 2022, 8: eabm3952. PMID: 35442729, PMCID: PMC9020661, DOI: 10.1126/sciadv.abm3952.Peer-Reviewed Original ResearchIschemic strokeMagnetic resonance imagingResonance imagingFluid-attenuated inversion recoveryDiffusion-weighted imaging sequencesStroke volume measurementsStroke pathwayStroke severityFunctional outcomeLow-field magnetic resonance imagingBedside evaluationClinical managementStroke volumeMRI studiesStrokePatientsBrain imagingCerebellar structuresHigh-field MRI studiesHyperintense regionsInversion recoveryInfarctsUseful imagingVolume measurementsBedside detection of intracranial midline shift using portable magnetic resonance imaging
Sheth KN, Yuen MM, Mazurek MH, Cahn BA, Prabhat AM, Salehi S, Shah JT, By S, Welch EB, Sofka M, Sacolick LI, Kim JA, Payabvash S, Falcone GJ, Gilmore EJ, Hwang DY, Matouk C, Gordon-Kundu B, RN AW, Petersen N, Schindler J, Gobeske KT, Sansing LH, Sze G, Rosen MS, Kimberly WT, Kundu P. Bedside detection of intracranial midline shift using portable magnetic resonance imaging. Scientific Reports 2022, 12: 67. PMID: 34996970, PMCID: PMC8742125, DOI: 10.1038/s41598-021-03892-7.Peer-Reviewed Original ResearchConceptsMidline shiftNeuroscience intensive care unitCare measurementYale-New Haven HospitalValuable bedside toolIntensive care unitPoor clinical outcomeBrain-injured patientsMass effectNew Haven HospitalMagnetic resonance imagingClinical outcomesIll patientsCare unitStroke patientsFunctional outcomeBedside toolObservational studyBedside detectionImaging examsPatientsResonance imagingPortable MRIImaging suiteSignificant concordance
2021
Prior Stroke and Age Predict Acute Ischemic Stroke Among Hospitalized COVID-19 Patients: A Derivation and Validation Study
Peng TJ, Jasne AS, Simonov M, Abdelhakim S, Kone G, Cheng YK, Rethana M, Tarasaria K, Herman AL, Baker AD, Yaghi S, Frontera JA, Sansing LH, Falcone GJ, Spudich S, Schindler J, Sheth KN, Sharma R. Prior Stroke and Age Predict Acute Ischemic Stroke Among Hospitalized COVID-19 Patients: A Derivation and Validation Study. Frontiers In Neurology 2021, 12: 741044. PMID: 34675873, PMCID: PMC8524436, DOI: 10.3389/fneur.2021.741044.Peer-Reviewed Original ResearchAcute ischemic strokeHospitalized COVID-19 patientsCOVID-19 patientsCOVID-19 cohortNeurologic symptomsPrior strokeIschemic strokeAIS patientsDerivation cohortControl cohortRisk of AISMultivariable logistic regression modelIschemic stroke riskCOVID-19 severityYale New Haven HealthLogistic regression modelsHospital presentationIndependent predictorsStroke riskMajor health systemsHigh riskPatientsYounger ageCohortStrokeDrip-and-ship versus mothership for endovascular treatment of acute stroke: A comparative effectiveness analysis
Wu X, Wira C, Matouk C, Forman H, Gandhi D, Sanelli P, Schindler J, Malhotra A. Drip-and-ship versus mothership for endovascular treatment of acute stroke: A comparative effectiveness analysis. International Journal Of Stroke 2021, 17: 315-322. PMID: 33759645, DOI: 10.1177/17474930211008701.Peer-Reviewed Original ResearchConceptsComprehensive stroke centerPrimary stroke centerAcute stroke patientsNearest comprehensive stroke centerAcute strokeMothership strategyStroke centersStroke patientsPlace of onsetHealth benefitsMarkov decision-analytic modelComparative effectiveness analysisRecent medical literatureMultiple sensitivity analysesDecision analytic modelMothership modelPrimary outcomeEndovascular treatmentPrehospital triageSudden onsetPatientsMedical literatureStrokeShip strategyTarget populationPrehospital Blood Pressure Reductions Are Associated with Neurologic Worsening in Patients With Large-vessel Occlusion Stroke (2844)
Kobsa J, Prasad A, Soto A, Kodali S, Nguyen C, Peshwe K, Orozco D, Farooqui M, Zevallos C, Sansing L, Schindler J, Matouk C, Sheth K, Ortega-Gutierrez S, Petersen N. Prehospital Blood Pressure Reductions Are Associated with Neurologic Worsening in Patients With Large-vessel Occlusion Stroke (2844). Neurology 2021, 96 DOI: 10.1212/wnl.96.15_supplement.2844.Peer-Reviewed Original Research
2020
Cost-effectiveness of endovascular thrombectomy in patients with acute stroke and M2 occlusion
Khunte M, Wu X, Payabvash S, Zhu C, Matouk C, Schindler J, Sanelli P, Gandhi D, Malhotra A. Cost-effectiveness of endovascular thrombectomy in patients with acute stroke and M2 occlusion. Journal Of NeuroInterventional Surgery 2020, 13: 784-789. PMID: 33077578, DOI: 10.1136/neurintsurg-2020-016765.Peer-Reviewed Original ResearchConceptsEndovascular thrombectomyMedical managementProbabilistic sensitivity analysesM2 occlusionsAcute strokeBranch occlusionEVT-treated patientsAcute ischemic strokeQuality-adjusted life yearsLifetime quality-adjusted life yearsDecision analytic modelDecision analytic studyIschemic strokeReperfusion techniquesLifetime horizonBetter outcomesPatientsLife yearsAge groupsPerfect healthSocietal perspectiveCost-effective strategyStrokeHealth benefitsOcclusionSpecial Populations
Amin H, Schindler J. Special Populations. 2020, 135-155. DOI: 10.1007/978-3-030-52552-1_11.ChaptersIntracranial Hemorrhage
Amin H, Schindler J. Intracranial Hemorrhage. 2020, 165-175. DOI: 10.1007/978-3-030-52552-1_13.ChaptersIntracranial hemorrhageCauses of ICHTreatment of ICHMost intracranial hemorrhagesSecondary preventionClinical presentationVascular neurologistsMild headacheVariable presentationDiagnostic evaluationBest treatmentHemorrhageNeurologistsHigh rateTreatmentPresentationHypertensionMorbidityHeadachePatientsStrokeMortalityNeurosurgeonsHematologic Disorders
Amin H, Schindler J. Hematologic Disorders. 2020, 193-201. DOI: 10.1007/978-3-030-52552-1_15.ChaptersHematological conditionsStrong family historyHypercoagulable panelStroke therapeuticsIschemic strokeSecondary preventionStroke neurologistsYounger patientsAcute treatmentHypercoagulable conditionsHematologic disordersFamily historyHematological disordersClot formationCoagulation cascadeStrokePatientsDisordersNeurologistsPreventionPharmacology
Amin H, Schindler J. Pharmacology. 2020, 235-241. DOI: 10.1007/978-3-030-52552-1_19.ChaptersConcomitant medical comorbiditiesManagement of patientsStroke therapeuticsMedical comorbiditiesAcute strokeSecondary preventionCerebrovascular diseaseVascular neurologistsClinical indicationsPharmacological basisNeurologistsTherapeuticsHypertensionComorbiditiesHyperlipidemiaThrombosisOutpatientsPatientsInternistsCardiologistsStrokeDiseaseSeverityPreventionPharmacologyInitial Stroke Evaluation
Amin H, Schindler J. Initial Stroke Evaluation. 2020, 5-9. DOI: 10.1007/978-3-030-52552-1_2.ChaptersStroke evaluationLarge vessel occlusionAcute stroke evaluationIntra-cerebral hemorrhageIntravenous thrombolysisStroke neurologistsEmergency departmentPhysical examinationVessel occlusionEmergency physiciansCT scanPatientsTimely assessmentSystematic evaluationThrombectomyThrombolysisHemorrhageNeurologistsEvaluationNursesPhysiciansOcclusionStroke Pathophysiology
Amin H, Schindler J. Stroke Pathophysiology. 2020, 57-65. DOI: 10.1007/978-3-030-52552-1_6.Peer-Reviewed Original ResearchClassification of Stroke
Amin H, Schindler J. Classification of Stroke. 2020, 67-83. DOI: 10.1007/978-3-030-52552-1_7.Peer-Reviewed Original ResearchStroke Treatment, Early Management, and Secondary Prevention
Amin H, Schindler J. Stroke Treatment, Early Management, and Secondary Prevention. 2020, 85-105. DOI: 10.1007/978-3-030-52552-1_8.Peer-Reviewed Original ResearchSecondary preventionStroke treatmentAcute ischemic patientsMost stroke patientsStent retrieval deviceAcute stroke treatmentModifiable risk factorsOnset of symptomsAmerican Heart AssociationStroke neurologistsAcute strokeSelect patientsMost strokesStroke patientsAcute interventionCerebrovascular diseaseStroke managementTherapeutic optionsHeart AssociationIschemic patientsEarly managementRisk factorsTreatment windowPatientsManagement guidelinesDeployment of Portable, Bedside, Low-field Magnetic Resonance Imaging for Evaluation of Stroke Patients (272)
Cahn B, Shah J, Dyvorne H, O’Halloran R, Poole M, Yuen M, Mazurek M, Ward A, Payabvash S, Beekman R, Brown S, Falcone G, Gobeske K, Petersen N, Jasne A, Sharma R, Schindler J, Sansing L, Gilmore E, Wira C, Matouk C, Sze G, Rosen M, Kimberly W, Sheth K. Deployment of Portable, Bedside, Low-field Magnetic Resonance Imaging for Evaluation of Stroke Patients (272). Neurology 2020, 94 DOI: 10.1212/wnl.94.15_supplement.272.Peer-Reviewed Original ResearchRisk of Worse Outcome in Stroke Patients with High Blood Pressure Variability After Endovascular Thrombectomy May Be Amplified by Impaired Cerebral Autoregulation (4457)
Nguyen C, Silverman A, Wang A, Kodali S, Strander S, Kimmel A, Peshwe K, de Havenon A, Gilmore E, Sansing L, Schindler J, Matouk C, Sheth K, Petersen N. Risk of Worse Outcome in Stroke Patients with High Blood Pressure Variability After Endovascular Thrombectomy May Be Amplified by Impaired Cerebral Autoregulation (4457). Neurology 2020, 94 DOI: 10.1212/wnl.94.15_supplement.4457.Peer-Reviewed Original ResearchCT Angiography for Triage of Patients with Acute Minor Stroke: A Cost-effectiveness Analysis.
Wu X, Hughes DR, Gandhi D, Matouk CC, Sheth K, Schindler J, Wira C, Wintermark M, Sanelli P, Malhotra A. CT Angiography for Triage of Patients with Acute Minor Stroke: A Cost-effectiveness Analysis. Radiology 2020, 294: 580-588. PMID: 31934828, DOI: 10.1148/radiol.2019191238.Peer-Reviewed Original ResearchConceptsLarge vessel occlusionAcute minor strokeBest medical managementMinor strokeCT angiographyMedical managementProbabilistic sensitivity analysesLower health benefitsImmediate thrombectomyHealth benefitsHealth outcomesVascular imagingAcute ischemic strokeMarkov decision-analytic modelWorse health outcomesImproved health outcomesDecision analytic modelNet monetary benefitIntravenous thrombolysisIschemic strokeYounger patientsThrombectomy strategyPatientsAngiographyStroke
2019
Management of Hyperlipidemia After Stroke
Brooks DC, Schindler JL. Management of Hyperlipidemia After Stroke. Current Treatment Options In Cardiovascular Medicine 2019, 21: 93. PMID: 31840196, DOI: 10.1007/s11936-019-0774-8.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsManagement of hyperlipidemiaKey therapeutic targetCardiovascular diseaseTherapeutic targetAggressive LDL-C reductionStroke risk reductionLDL-C reductionAtherosclerotic vascular diseaseAvailable treatment optionsGeneral cardiovascular diseaseRecent FindingsStatinsIschemic strokePCSK9 inhibitorsHemorrhagic strokeRisk modificationTreatment optionsVascular diseaseRecent trialsNovel agentsNew agentsMost subtypesHyperlipidemiaStrokePatientsDiseasePercutaneous Trans-Carotid Puncture for Mechanical Thrombectomy in Acute Ischemic Stroke Patients is Safe and Effective: A Large, Single-Center Case Series
Cord B, Wang A, Chouairi F, Koo A, Porto C, Silverman A, Kodali S, Strander S, Falcone G, Sheth K, Hebert R, Sansing L, Schindler J, Petersen N, Matouk C. Percutaneous Trans-Carotid Puncture for Mechanical Thrombectomy in Acute Ischemic Stroke Patients is Safe and Effective: A Large, Single-Center Case Series. Neurosurgery 2019, 66: 310-167. DOI: 10.1093/neuros/nyz310_167.Peer-Reviewed Original Research