2019
DEFUSE 3 Non-DAWN Patients
Leslie-Mazwi T, Hamilton S, Mlynash M, Patel A, Schwamm L, Lansberg M, Marks M, Hirsch J, Albers G. DEFUSE 3 Non-DAWN Patients. Stroke 2019, 50: 618-625. PMID: 30727856, PMCID: PMC6768068, DOI: 10.1161/strokeaha.118.023310.Peer-Reviewed Original ResearchConceptsRankin Scale scoreNIHSS 6DEFUSE 3Functional outcomeInfarct volumeLarger patientsDAWN criteriaScale scoreEmergent large vessel occlusionRankin Scale score 0DEFUSE 3 patientsEffect of thrombectomyHealth Stroke ScaleLarge vessel occlusionBenefit of thrombectomyCore infarct volumeBeneficial treatment effectMethods Eligibility criteriaNIHSS scoreStroke ScaleConclusions PatientsEndovascular therapySymptom onsetDAWN trialVessel occlusion
2016
Endovascular Stroke Treatment Outcomes After Patient Selection Based on Magnetic Resonance Imaging and Clinical Criteria
Leslie-Mazwi TM, Hirsch JA, Falcone GJ, Schaefer PW, Lev MH, Rabinov JD, Rost NS, Schwamm L, González RG. Endovascular Stroke Treatment Outcomes After Patient Selection Based on Magnetic Resonance Imaging and Clinical Criteria. JAMA Neurology 2016, 73: 1-7. PMID: 26524074, DOI: 10.1001/jamaneurol.2015.3000.Peer-Reviewed Original ResearchConceptsMagnetic resonance imagingSelection of patientsClinical criteriaFavorable outcomeSuccessful reperfusionMRS scoreLTB patientsIschemic strokeTerminal internal carotid artery occlusionResonance imagingInternal carotid artery occlusionStroke treatment outcomesEndovascular stroke treatmentAcute ischemic strokeCarotid artery occlusionProspective cohort studyMiddle cerebral arterySpecific magnetic resonance imagingInfarct volume determinationArtery occlusionCohort studyStroke treatmentCerebral arteryEndovascular treatmentPatient selection
2014
Combining MRI with NIHSS Thresholds to Predict Outcome in Acute Ischemic Stroke: Value for Patient Selection
Schaefer P, Pulli B, Copen W, Hirsch J, Leslie-Mazwi T, Schwamm L, Wu O, González R, Yoo A. Combining MRI with NIHSS Thresholds to Predict Outcome in Acute Ischemic Stroke: Value for Patient Selection. American Journal Of Neuroradiology 2014, 36: 259-264. PMID: 25258369, PMCID: PMC4462135, DOI: 10.3174/ajnr.a4103.Peer-Reviewed Original ResearchMeSH KeywordsAgedBrainBrain IschemiaCerebral InfarctionDiffusion Magnetic Resonance ImagingFemaleHumansImage Processing, Computer-AssistedMaleMiddle AgedNational Institutes of Health (U.S.)Patient SelectionPrognosisReperfusionROC CurveSensitivity and SpecificitySeverity of Illness IndexStrokeUnited StatesConceptsPositive predictive valueAcute ischemic strokeLarge patient cohortReperfusion therapyPoor outcomeStroke sidePredictive valueNIHSS scoreIschemic strokeClinical outcomesPatient cohortPrognostic yieldAnterior circulation acute ischemic strokeAcute ischemic stroke patientsImaging thresholdsBeneficial treatment responseDiffusion-perfusion mismatchHigh positive predictive valueIschemic stroke patientsRight-sided strokeLeft-sided strokeUntreated patientsStroke onsetConsecutive patientsPatient selection
2012
Economic Impact of Using Additional Diagnostic Tests to Better Select Patients With Stroke for Intravenous Thrombolysis in the United Kingdom
Earnshaw S, McDade C, Chapman A, Jackson D, Schwamm L. Economic Impact of Using Additional Diagnostic Tests to Better Select Patients With Stroke for Intravenous Thrombolysis in the United Kingdom. Clinical Therapeutics 2012, 34: 1544-1558. PMID: 22695225, DOI: 10.1016/j.clinthera.2012.05.004.Peer-Reviewed Original ResearchConceptsMagnetic resonance imagingMRI selectionUsual careDiagnostic testsFavorable outcomeIncremental cost-effectiveness ratioAcute stroke treatmentPreferred diagnostic testNumber of patientsAdditional diagnostic testsCost-effectiveness ratioDecision analytic modelCTP selectionIntravenous thrombolysisStroke onsetStroke treatmentPatient selectionUK patientsPenumbral patternPatient outcomesPerfusion CTPatient historyThrombolysisPatientsPerfusion imagingImplementation of a patient selection protocol for intra-arterial therapy increases treatment rates in patients with acute ischemic stroke
Rost N, Smith E, Nogueira R, Fitzpatrick K, Yoo A, Hirsch J, Schwamm L. Implementation of a patient selection protocol for intra-arterial therapy increases treatment rates in patients with acute ischemic stroke. Journal Of NeuroInterventional Surgery 2012, 5: i44. PMID: 22611045, PMCID: PMC3777532, DOI: 10.1136/neurintsurg-2011-010240.Peer-Reviewed Original ResearchConceptsIntra-arterial therapyAcute ischemic strokePatient selection protocolLTB patientsIschemic strokeIntravenous tissue plasminogen activatorNIH Stroke Scale scoreTreatment ratesProximal artery occlusionStroke Scale scoreTissue plasminogen activatorProtocol adoptionStroke durationInfarct volumeArtery occlusionMost patientsMultivariable adjustmentIndependent predictorsPatient selectionStroke databasePatientsScale scorePlasminogen activatorStudy periodBrain imagingPredictors of Increased Intravenous Tissue Plasminogen Activator Use Among Hospitals Participating in the Massachusetts Primary Stroke Service Program
Rost N, Smith E, Pervez M, Mello P, Dreyer P, Schwamm L. Predictors of Increased Intravenous Tissue Plasminogen Activator Use Among Hospitals Participating in the Massachusetts Primary Stroke Service Program. Circulation Cardiovascular Quality And Outcomes 2012, 5: 314-320. PMID: 22534407, PMCID: PMC3361890, DOI: 10.1161/circoutcomes.111.962829.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overEmergency Service, HospitalFemaleFibrinolytic AgentsHealthcare DisparitiesHumansInfusions, IntravenousLinear ModelsLogistic ModelsMaleMassachusettsMiddle AgedMultivariate AnalysisOdds RatioPatient SelectionPractice Guidelines as TopicQuality ImprovementRegional Medical ProgramsRetrospective StudiesRisk AssessmentRisk FactorsStrokeThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorTreatment OutcomeConceptsIntravenous tissue plasminogen activator useTissue plasminogen activator useAcute ischemic strokeTPA useIschemic strokeOlder acute ischemic stroke patientsAcute ischemic stroke patientsGuidelines-Stroke programStroke center designationIschemic stroke patientsRate of thrombolysisQuality improvement initiativesEmergency medical servicesStroke onsetSymptom onsetStroke patientsTreatment disparitiesCenter designationPatientsHospitalMassachusetts DepartmentImprovement initiativesMedical servicesOverall rateFurther studies
2010
Cost-Effectiveness of CT Perfusion for Selecting Patients for Intravenous Thrombolysis: A US Hospital Perspective
Jackson D, Earnshaw S, Farkouh R, Schwamm L. Cost-Effectiveness of CT Perfusion for Selecting Patients for Intravenous Thrombolysis: A US Hospital Perspective. American Journal Of Neuroradiology 2010, 31: 1669-1674. PMID: 20538823, PMCID: PMC7965001, DOI: 10.3174/ajnr.a2138.Peer-Reviewed Original ResearchConceptsHospital perspectiveUnenhanced CTExtent of penumbraLife-year savedUS hospital perspectiveAcute stroke evaluationSelection of patientsCT-based methodClinical trial dataDecision analytic modelCTP selectionIntravenous thrombolysisIschemic strokeClinical outcomesStroke evaluationPatient populationCT perfusionFavorable outcomeRoutine CTClinical trialsPatientsTrial dataMultivariate sensitivity analysisHospitalTPA treatment
2009
Cost-Effectiveness of Patient Selection Using Penumbral-Based MRI for Intravenous Thrombolysis
Earnshaw S, Jackson D, Farkouh R, Schwamm L. Cost-Effectiveness of Patient Selection Using Penumbral-Based MRI for Intravenous Thrombolysis. Stroke 2009, 40: 1710-1720. PMID: 19286581, DOI: 10.1161/strokeaha.108.540138.Peer-Reviewed Original ResearchMeSH KeywordsAgedAlgorithmsCerebral HemorrhageCost-Benefit AnalysisDecision Support TechniquesFemaleFibrinolytic AgentsHumansImage Processing, Computer-AssistedInfusions, IntravenousMagnetic Resonance ImagingMalePatient SelectionProportional Hazards ModelsQuality-Adjusted Life YearsStrokeThrombolytic TherapyTomography, X-Ray ComputedTreatment OutcomeConceptsMRI selection
2008
Quantitative Assessment of Core/Penumbra Mismatch in Acute Stroke
Schaefer P, Barak E, Kamalian S, Gharai L, Schwamm L, Gonzalez R, Lev M. Quantitative Assessment of Core/Penumbra Mismatch in Acute Stroke. Stroke 2008, 39: 2986-2992. PMID: 18723425, DOI: 10.1161/strokeaha.107.513358.Peer-Reviewed Original ResearchConceptsCT perfusionPatient selectionInfarct coreAcute middle cerebral artery strokeMiddle cerebral artery strokePreferred imaging methodStroke clinical trialsAcute strokeArtery strokeStroke trialsTrial enrollmentClinical trialsLesion volumeMR perfusionIschemic regionBlood volumeTime abnormalitiesVolume thresholdLesion sizeQuantitative CTPerfusionAdvanced MRCT coverageLesionsMR diffusionFunctional CT and MR Imaging for Evaluation of Acute Stroke
Miller J, Lev M, Schwamm L, Thrall J, Lee S. Functional CT and MR Imaging for Evaluation of Acute Stroke. Journal Of The American College Of Radiology 2008, 5: 67-70. PMID: 18180014, DOI: 10.1016/j.jacr.2007.07.018.Peer-Reviewed Original Research
2005
The Evolving Role of Acute Stroke Imaging in Intravenous Thrombolytic Therapy: Patient Selection and Outcomes Assessment
Sims J, Schwamm L. The Evolving Role of Acute Stroke Imaging in Intravenous Thrombolytic Therapy: Patient Selection and Outcomes Assessment. Neuroimaging Clinics Of North America 2005, 15: 421-440. PMID: 16198950, DOI: 10.1016/j.nic.2005.06.001.Peer-Reviewed Original ResearchConceptsPatient selectionIntravenous thrombolytic therapyStroke pathophysiologyThrombolytic trialsPenumbral tissueAcute strokeLarge infarctionCerebral ischemiaRisk stratificationThrombolytic therapyCT perfusionStroke mechanismBrain hemorrhageTherapeutic successCT angiographyUnenhanced CTOutcome assessmentPotential future roleEarly signsEarly trialsMR imagingThrombolysisInfarctionTrialsEvolving role
1998
Effects of Induced Hypertension on Transcranial Doppler Ultrasound Velocities in Patients After Subarachnoid Hemorrhage
Manno E, Gress D, Schwamm L, Diringer M, Ogilvy C. Effects of Induced Hypertension on Transcranial Doppler Ultrasound Velocities in Patients After Subarachnoid Hemorrhage. Stroke 1998, 29: 422-428. PMID: 9472884, DOI: 10.1161/01.str.29.2.422.Peer-Reviewed Original ResearchConceptsMiddle cerebral arteryInduced hypertensionTCD velocitiesSubarachnoid hemorrhageTranscranial Doppler ultrasoundIntact autoregulationArterial pressureCerebral vasospasmCerebral arteryCerebral autoregulationTranscranial Doppler ultrasound velocitiesCerebral blood flow velocityContinuous TCD monitoringMean arterial pressureBlood flow velocityLevel of autoregulationDoppler ultrasound velocitiesAdditional patientsClinical evidenceClinical differencesTCD monitoringHypertensionDoppler ultrasoundHemorrhagePatients