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
2022
A Phase III, prospective, double-blind, randomized, placebo-controlled trial of thrombolysis in imaging-eligible, late-window patients to assess the efficacy and safety of tenecteplase (TIMELESS): Rationale and design
Albers G, Campbell B, Lansberg M, Broderick J, Butcher K, Froehler M, Schwamm L, Nouh A, Liebeskind D, Toy F, Yang M, Massaro L, Schoeffler M, Purdon B. A Phase III, prospective, double-blind, randomized, placebo-controlled trial of thrombolysis in imaging-eligible, late-window patients to assess the efficacy and safety of tenecteplase (TIMELESS): Rationale and design. International Journal Of Stroke 2022, 18: 237-241. PMID: 35262424, DOI: 10.1177/17474930221088400.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeInternal carotid arteryPlacebo-controlled trialRankin Scale scoreSymptom onsetDay 90Scale scoreMiddle cerebral artery occlusionEfficacy of tenecteplaseLate-window patientsSafety of tenecteplaseSymptomatic intracranial hemorrhageCerebral artery occlusionLarge vessel occlusionPhase IIIPrimary efficacy objectiveBetter clinical outcomesAdverse eventsArtery occlusionEndovascular thrombectomyIschemic strokeMCA occlusionClinical outcomesIntracranial hemorrhageSalvageable tissue
2014
Time and Diffusion Lesion Size in Major Anterior Circulation Ischemic Strokes
Hakimelahi R, Vachha B, Copen W, Papini G, He J, Higazi M, Lev M, Schaefer P, Yoo A, Schwamm L, González R. Time and Diffusion Lesion Size in Major Anterior Circulation Ischemic Strokes. Stroke 2014, 45: 2936-2941. PMID: 25190444, DOI: 10.1161/strokeaha.114.005644.Peer-Reviewed Original ResearchConceptsAnterior circulation ischemic strokeMiddle cerebral artery occlusionDiffusion-weighted imagingCerebral artery occlusionStroke onsetIschemic strokeInfarct sizeDWI lesionsInfarct volumeArtery occlusionIntravenous tissue-type plasminogen activatorProximal middle cerebral arteryDistal internal carotid arteryAcute infarct volumeDWI lesion volumeMajority of patientsMiddle cerebral arteryInternal carotid arteryAcute infarct sizeSame inclusion criteriaTraditional time windowTissue-type plasminogen activatorCerebral perfusionConsecutive patientsInfarct growth
2013
Ischemic Stroke and Transient Ischemic Attack in Young Adults: Risk Factors, Diagnostic Yield, Neuroimaging, and Thrombolysis
Ji R, Schwamm L, Pervez M, Singhal A. Ischemic Stroke and Transient Ischemic Attack in Young Adults: Risk Factors, Diagnostic Yield, Neuroimaging, and Thrombolysis. JAMA Neurology 2013, 70: 51-57. PMID: 23108720, DOI: 10.1001/jamaneurol.2013.575.Peer-Reviewed Original ResearchConceptsTransient ischemic attackTertiary stroke centerIschemic strokeYoung adultsIschemic attackHospital dischargeStroke centersStroke etiologyRisk factorsIschemic stroke/transient ischemic attackBetter outcomesStroke/transient ischemic attackHealth Stroke Scale scoreTraditional vascular risk factorsDiagnostic testsGuidelines-Stroke databaseMedian National InstitutesSymptomatic brain hemorrhageUndetermined stroke etiologyStroke Scale scoreVascular risk factorsMiddle cerebral arteryShort-term outcomesAge 35 yearsInternal carotid artery
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