2022
In 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 ResearchMeSH KeywordsArterial Occlusive DiseasesBrain IschemiaFibrinolytic AgentsHumansMechanical ThrombolysisStrokeThrombectomyThrombolytic TherapyTreatment OutcomeConceptsLarge vessel occlusion strokeIntravenous thrombolysisIVT-treated patientsMechanical thrombectomyProcedure timePuncture timeImproved reperfusionBaseline characteristicsTICI 2bIVT patientsOcclusion strokeOperative reportsProcedural characteristicsTelestroke networkPatientsReperfusionIncreased proportionThrombolysisTechnical difficultiesNIHSSThrombectomyHospitalStrokeMinAssociation Between Endovascular Therapy Time to Treatment and Outcomes in Patients With Basilar Artery Occlusion
Joundi R, Sun J, Xian Y, Alhanti B, Nogueira R, Bhatt D, Fonarow G, Saver J, Schwamm L, Smith E. Association Between Endovascular Therapy Time to Treatment and Outcomes in Patients With Basilar Artery Occlusion. Circulation 2022, 145: 896-905. PMID: 35050693, DOI: 10.1161/circulationaha.121.056554.Peer-Reviewed Original ResearchMeSH KeywordsAgedArterial Occlusive DiseasesBasilar ArteryEndovascular ProceduresFemaleHumansIntracranial HemorrhagesMaleRetrospective StudiesStrokeThrombectomyTreatment OutcomeConceptsBasilar artery occlusionSymptomatic intracranial hemorrhageEndovascular therapySymptom onsetEVT timesHospital mortalityArtery occlusionMedian onsetIntracranial hemorrhageBetter outcomesHealth Stroke Scale scoreIndividual-level patient dataMedian National InstitutesStroke Scale scoreHospital-level factorsProportion of patientsLogistic regression modelsSubstantial reperfusionAnterior circulationPrimary outcomeUS registryMean ageDevastating conditionImproved outcomesTherapy time
2016
Desmoteplase 3 to 9 Hours After Major Artery Occlusion Stroke
von Kummer R, Mori E, Truelsen T, Jensen J, Grønning B, Fiebach J, Lovblad K, Pedraza S, Romero J, Chabriat H, Chang K, Dávalos A, Ford G, Grotta J, Kaste M, Schwamm L, Shuaib A, Albers G. Desmoteplase 3 to 9 Hours After Major Artery Occlusion Stroke. Stroke 2016, 47: 2880-2887. PMID: 27803391, DOI: 10.1161/strokeaha.116.013715.Peer-Reviewed Original ResearchConceptsPlacebo-treated patientsSymptomatic intracranial hemorrhageSerious adverse eventsAdverse eventsMRS scoreTreatment armsIntracranial hemorrhagePooled analysisDay 90Major artery occlusionIschemic stroke patientsRankin Scale scoreMajor cerebral arteriesHigh-grade stenosisSignificant clinical benefitExtended time windowIntravenous desmoteplaseArterial recanalizationArtery occlusionIntravenous treatmentIschemic strokePrimary outcomeCerebral arteryRecanalization rateStroke patients
2015
FLAIR Vascular Hyperintensity is a Surrogate of Collateral Flow and Leukoaraiosis in Patients With Acute Stroke Due to Proximal Artery Occlusion
Karadeli H, Giurgiutiu D, Cloonan L, Fitzpatrick K, Kanakis A, Ozcan M, Schwamm L, Rost N. FLAIR Vascular Hyperintensity is a Surrogate of Collateral Flow and Leukoaraiosis in Patients With Acute Stroke Due to Proximal Artery Occlusion. Journal Of Neuroimaging 2015, 26: 219-223. PMID: 26250448, PMCID: PMC4744593, DOI: 10.1111/jon.12274.Peer-Reviewed Original ResearchConceptsProximal artery occlusionCollateral flow gradeFlow gradeAIS patientsWhite matter hyperintensitiesWMH volumeCT angiographyFVH scoreVascular hyperintensityArtery occlusionIntravenous tissue plasminogen activator administrationInversion recovery vascular hyperintensityAcute ischemic stroke patientsTissue plasminogen activator administrationAdmission CT angiographyBaseline CT angiographyCollateral vessel statusFLAIR vascular hyperintensityLeptomeningeal collateral statusMedian WMH volumeSalvageable brain tissueConsecutive AIS patientsIschemic stroke patientsWorse clinical outcomesAcute MRI
2014
Determinants of Early Outcomes in Patients with Acute Ischemic Stroke and Proximal Artery Occlusion
LaBuzetta J, Yoo A, Ali S, Fitzpatrick K, Leslie-Mazwi T, Hirsch J, Schwamm L, Rost N. Determinants of Early Outcomes in Patients with Acute Ischemic Stroke and Proximal Artery Occlusion. Journal Of Stroke And Cerebrovascular Diseases 2014, 23: 2527-2532. PMID: 25238927, PMCID: PMC4256100, DOI: 10.1016/j.jstrokecerebrovasdis.2014.03.020.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, IntravenousAgedAged, 80 and overArterial Occlusive DiseasesBrain IschemiaCombined Modality TherapyEndovascular ProceduresFemaleFibrinolytic AgentsHumansInjections, Intra-ArterialLogistic ModelsMaleMiddle AgedPatient DischargeProspective StudiesRegional Blood FlowStrokeStroke RehabilitationTime FactorsTissue Plasminogen ActivatorTreatment OutcomeConceptsIntra-arterial therapyProximal artery occlusionArtery occlusionIndependent predictorsAIS patientsPoststroke outcomesFavorable outcomeAcute ischemic stroke patientsIntravenous tissue plasminogen activatorInstitutional stroke databaseAcute ischemic strokeIschemic stroke patientsOnly independent predictorTissue plasminogen activatorEligible patientsHospital mortalityTPA administrationIschemic strokeStroke databaseAtrial fibrillationEarly outcomesPrespecified protocolStroke patientsPatient subgroupsUnfavorable outcome
2008
Low-pressure balloon angioplasty with adjuvant pharmacological therapy in patients with acute ischemic stroke caused by intracranial arterial occlusions
Nogueira R, Schwamm L, Buonanno F, Koroshetz W, Yoo A, Rabinov J, Pryor J, Hirsch J. Low-pressure balloon angioplasty with adjuvant pharmacological therapy in patients with acute ischemic stroke caused by intracranial arterial occlusions. Neuroradiology 2008, 50: 331-340. PMID: 18172631, DOI: 10.1007/s00234-007-0340-z.Peer-Reviewed Original ResearchConceptsRecanalization rateIntracranial arteriesLow-pressure balloon angioplastyGlycoprotein IIb-IIIa inhibitorsInternal carotid artery terminusT-PAAdjuvant pharmacological therapyIntravenous t-PAOverall recanalization rateAcute ischemic strokeIIb-IIIa inhibitorsIntracranial arterial occlusionProcedure-related morbidityHigher recanalization ratesChances of recanalizationIA urokinaseSymptomatic hemorrhageAcute strokeCerebral infarctionCoronary balloonIschemic strokeConsecutive patientsPharmacological therapyArterial occlusionMechanical thrombolysis
2005
Hypoattenuation on CT angiographic source images predicts risk of intracerebral hemorrhage and outcome after intra-arterial reperfusion therapy.
Schwamm L, Rosenthal E, Swap C, Rosand J, Rordorf G, Buonanno F, Vangel M, Koroshetz W, Lev M. Hypoattenuation on CT angiographic source images predicts risk of intracerebral hemorrhage and outcome after intra-arterial reperfusion therapy. American Journal Of Neuroradiology 2005, 26: 1798-803. PMID: 16091532, PMCID: PMC7975152.Peer-Reviewed Original ResearchMeSH KeywordsAgedArterial Occlusive DiseasesBasilar ArteryCerebral AngiographyCerebral HemorrhageCerebral InfarctionFemaleFibrinolytic AgentsHematomaHumansMaleMiddle AgedMiddle Cerebral ArteryPredictive Value of TestsRetrospective StudiesRisk AssessmentTissue Plasminogen ActivatorTomography, X-Ray ComputedConceptsIntra-arterial reperfusion therapyHemorrhagic transformationPoor clinical outcomeCTA source imagesReperfusion therapyClinical outcomesCT angiographic source imagesCatheter-based reperfusionReal-time risk stratificationSymptomatic hemorrhagic transformationReceiver operator characteristic curveBlood glucose levelsOperator characteristic curveAxial source imagesNormal contralateral tissueConsecutive patientsVascular insufficiencyIntracerebral hemorrhageRisk stratificationStroke patientsPoor outcomeSignificant complicationsRisk factorsContralateral tissueLesion volume
1998
Regional Ischemia and Ischemic Injury in Patients With Acute Middle Cerebral Artery Stroke as Defined by Early Diffusion-Weighted and Perfusion-Weighted MRI
Rordorf G, Koroshetz W, Copen W, Cramer S, Schaefer P, Budzik R, Schwamm L, Buonanno F, Sorensen A, Gonzalez G. Regional Ischemia and Ischemic Injury in Patients With Acute Middle Cerebral Artery Stroke as Defined by Early Diffusion-Weighted and Perfusion-Weighted MRI. Stroke 1998, 29: 939-943. PMID: 9596239, DOI: 10.1161/01.str.29.5.939.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAdultAgedAged, 80 and overArterial Occlusive DiseasesBrain IschemiaCerebral ArteriesCerebral InfarctionCerebrovascular CirculationCerebrovascular DisordersDiffusionFemaleHumansMagnetic Resonance AngiographyMagnetic Resonance ImagingMaleMiddle AgedPerfusionReperfusion InjuryConceptsPerfusion-weighted imagingMiddle cerebral artery strokeDiffusion-weighted imagingCerebral blood volumeMCA strokeArtery strokeMR angiographyCBV abnormalityRegional ischemiaAcute middle cerebral artery strokeInitial diffusion-weighted imagingAcute stroke syndromeDistal branch occlusionDWI lesion volumeInitial DWI lesionMCA stem occlusionGroup 2 patientsMRI techniquesFinal infarct sizeFinal infarct volumeHours of onsetIntravenous contrast bolusAbnormal tissue perfusionProgression of infarctionPerfusion-Weighted MRI