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 ratesDifferences in Performance on Quality Measures for Thrombectomy‐Capable Stroke Centers Compared With Comprehensive Stroke Centers in 2019 to 2020
Baker D, Schmaltz S, Kolbusz K, Messé S, Jauch E, Schwamm L. Differences in Performance on Quality Measures for Thrombectomy‐Capable Stroke Centers Compared With Comprehensive Stroke Centers in 2019 to 2020. Stroke Vascular And Interventional Neurology 2022, 2 DOI: 10.1161/svin.121.000302.Peer-Reviewed Original ResearchComprehensive stroke centerLarge vessel occlusionMechanical thrombectomyStroke centersSkin punctureCerebral infarctionMedian timeStroke center certificationSymptomatic hemorrhagic complicationsSymptomatic hemorrhagic transformationPercentage of patientsProportion of patientsSuccessful mechanical thrombectomyThrombectomy-capable stroke centersProlonged transport timesWilcoxon rank sum testRank sum testHemorrhagic transformationHemorrhagic complicationsStroke careCenter certificationSigned-rank testCurrent recommendationsPatientsMedian proportionIn 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 ResearchConceptsMechanical thrombectomyRandomized trialsMedical careFavorable resultsThrombectomyStrokeTrialsCareIn 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
Access 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 analysis
2017
Clinical Imaging Factors Associated With Infarct Progression in Patients With Ischemic Stroke During Transfer for Mechanical Thrombectomy
Boulouis G, Lauer A, Siddiqui A, Charidimou A, Regenhardt R, Viswanathan A, Rost N, Leslie-Mazwi T, Schwamm L. Clinical Imaging Factors Associated With Infarct Progression in Patients With Ischemic Stroke During Transfer for Mechanical Thrombectomy. JAMA Neurology 2017, 74: 1361-1367. PMID: 28973081, PMCID: PMC5710581, DOI: 10.1001/jamaneurol.2017.2149.Peer-Reviewed Original ResearchConceptsThrombectomy-capable stroke centersCollateral blood flowIschemic strokeInfarct progressionMechanical thrombectomyCT angiographyMAIN OUTCOMEVessel statusBlood flowImaging factorsHigher adjusted odds ratioVascular imagingFavorable imaging profileHealth Stroke ScoreAcute ischemic strokeHigher National InstitutesAdjusted odds ratioRegional stroke networkStroke care networksStroke centersStroke ScoreConsecutive patientsStroke NetworkClinical severityFutile transfers