2024
Deep learning for prediction of post-thrombectomy outcomes based on admission CT angiography in large vessel occlusion stroke
Sommer J, Dierksen F, Zeevi T, Tran A, Avery E, Mak A, Malhotra A, Matouk C, Falcone G, Torres-Lopez V, Aneja S, Duncan J, Sansing L, Sheth K, Payabvash S. Deep learning for prediction of post-thrombectomy outcomes based on admission CT angiography in large vessel occlusion stroke. Frontiers In Artificial Intelligence 2024, 7: 1369702. DOI: 10.3389/frai.2024.1369702.Peer-Reviewed Original ResearchEnd-to-endComputed tomography angiographyLarge vessel occlusionConvolutional neural networkDeep learning pipelineTrain separate modelsLogistic regression modelsResNet-50Deep learningAdmission computed tomography angiographyNeural networkLearning pipelineAdmission CT angiographyPreprocessing stepDiagnosis of large vessel occlusionsLarge vessel occlusion strokeReceiver operating characteristic areaEnsemble modelAutomated modelPre-existing morbidityCT angiographyReperfusion successNeurological examCross-validationOcclusion strokeAutomated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion
Mak A, Matouk C, Avery E, Behland J, Haider S, Frey D, Madai V, Vajkoczy P, Griessenauer C, Zand R, Hendrix P, Abedi V, Sanelli P, Falcone G, Petersen N, Sansing L, Sheth K, Payabvash S, Malhotra A. Automated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion. PLOS ONE 2024, 19: e0304962. PMID: 38870240, PMCID: PMC11175522, DOI: 10.1371/journal.pone.0304962.Peer-Reviewed Original ResearchConceptsDiffusion-weighted imagingLarge vessel occlusionIrreversible ischemic changesPoor functional outcomeFunctional outcomesIschemic changesInfarct volumeAlberta Stroke Program Early CT ScorePredicting poor functional outcomeVessel occlusionFollow-up diffusion-weighted imagingAnterior circulation LVO strokeCTA source imagesReceiver operating characteristic curveExpert human readersPredicting final infarctionASPECTS regionsAdmission CTANon-inferior performanceBaseline CTACT scoreFinal infarctEndovascular therapyHU attenuationValidation cohortStrokeClassifier: ischemic stroke etiology classification by ensemble consensus modeling using electronic health records
Lee H, Schwamm L, Sansing L, Kamel H, de Havenon A, Turner A, Sheth K, Krishnaswamy S, Brandt C, Zhao H, Krumholz H, Sharma R. StrokeClassifier: ischemic stroke etiology classification by ensemble consensus modeling using electronic health records. Npj Digital Medicine 2024, 7: 130. PMID: 38760474, PMCID: PMC11101464, DOI: 10.1038/s41746-024-01120-w.Peer-Reviewed Original ResearchElectronic health recordsWeighted F1MIMIC-IIIClinical decision support systemsMulti-class classificationNatural language processingMIMIC-III datasetHealth recordsMachine learning classifiersDecision support systemArtificial intelligence toolsVascular neurologistsLearning classifiersBinary classificationCross-validation accuracyLanguage processingMeta-modelIntelligence toolsStroke prevention effortsAcute ischemic strokeStroke etiologySupport systemStroke etiology classificationClassification toolClassifierDisparities in Healthcare Interactions After Intracerebral Hemorrhage: Evidence from the REDUCE Trial (P3-5.020)
Zabinska J, Taylor C, Peasley E, Lalwani D, Schwartz A, Falcone G, Sansing L, Arora R, Mena-Hurtado C, De Havenon A, Okpala M, Bushnell C, Mullen M, Cohen J, Cohen D, Messe S, Forman R, Sheth K. Disparities in Healthcare Interactions After Intracerebral Hemorrhage: Evidence from the REDUCE Trial (P3-5.020). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000206241.Peer-Reviewed Original ResearchExploring the Relationship Between Cerebrospinal Fluid Interleukin-6 and Cerebral Autoregulation After Subarachnoid Hemorrhage (S23.004)
Olexa M, Begunova Y, Gilmore E, Kim J, Herman A, Beekman R, Magid-Bernstein J, Matouk C, Sheth K, Miller E, Gutierrez S, De Havenon A, Sansing L, Petersen N. Exploring the Relationship Between Cerebrospinal Fluid Interleukin-6 and Cerebral Autoregulation After Subarachnoid Hemorrhage (S23.004). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000205692.Peer-Reviewed Original ResearchEvaluating Sleep Apnea Risk in Survivors of Intracerebral Hemorrhage in the REDUCE Cohort (P9-9.002)
Peasley E, Geer J, Zabinska J, Forman R, Lalwani D, Schwartz A, Falcone G, Sansing L, Arora R, Mena-Hurtado C, De Havenon A, Okpala M, Bushnell C, Mullen M, Cohen J, Cohen D, Messe S, Sheth K. Evaluating Sleep Apnea Risk in Survivors of Intracerebral Hemorrhage in the REDUCE Cohort (P9-9.002). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000205685.Peer-Reviewed Original ResearchPrognostication of Outcomes in Stroke Patients Using Inflammatory Biomarkers: Findings from the Yale Post-stroke Epilepsy Research Group (P3-5.010)
Wang E, Misra S, Yan J, Chook P, Kawamura Y, Kitagawa R, Kim J, Gilmore E, De Havenon A, Sivaraju A, Hirsch L, Falcone G, Sansing L, Magid-Bernstein J, Mishra N. Prognostication of Outcomes in Stroke Patients Using Inflammatory Biomarkers: Findings from the Yale Post-stroke Epilepsy Research Group (P3-5.010). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000204783.Peer-Reviewed Original ResearchNeighborhood Deprivation and Functional Outcomes Following Ischemic Stroke (P2-4.007)
Kleinberg L, Clocchiatti-Tuozzo S, Rivier C, Torres-Lopez V, Kim J, Kitlen E, Kampp M, Jasak S, Schindler J, Sansing L, Sheth K, Falcone G. Neighborhood Deprivation and Functional Outcomes Following Ischemic Stroke (P2-4.007). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000205095.Peer-Reviewed Original ResearchManagement of Incomplete Microcirculatory Reperfusion After Endovascular Thrombectomy: Focus on Inhibition of the Glycoprotein IIb/IIIa Receptor Pathway
Krothapalli N, Ortel T, McBride D, de Havenon A, Sansing L, Hasan D, Mac Grory B. Management of Incomplete Microcirculatory Reperfusion After Endovascular Thrombectomy: Focus on Inhibition of the Glycoprotein IIb/IIIa Receptor Pathway. Stroke Vascular And Interventional Neurology 2024, 4 DOI: 10.1161/svin.123.001048.Peer-Reviewed Original ResearchMicrocirculatory reperfusionEndovascular thrombectomyAdministration of tirofibanDigital subtraction angiographyLarge-vessel occlusionProportion of casesRescue therapyTherapeutic optionsAntiplatelet therapyClinical outcomesUnfavorable outcomeEndothelial edemaSubtraction angiographyEffective therapyIntraarterial administrationClinical challengeReceptor pathwayPlatelet aggregationTreatment approachesTherapyReperfusionCerebral microvasculatureTissue recoveryNeurological diseasesThrombectomyRadiomics-Based Prediction of Collateral Status from CT Angiography of Patients Following a Large Vessel Occlusion Stroke
Avery E, Abou-Karam A, Abi-Fadel S, Behland J, Mak A, Haider S, Zeevi T, Sanelli P, Filippi C, Malhotra A, Matouk C, Falcone G, Petersen N, Sansing L, Sheth K, Payabvash S. Radiomics-Based Prediction of Collateral Status from CT Angiography of Patients Following a Large Vessel Occlusion Stroke. Diagnostics 2024, 14: 485. PMID: 38472957, PMCID: PMC10930945, DOI: 10.3390/diagnostics14050485.Peer-Reviewed Original ResearchCollateral statusCollateral scoreLarge vessel occlusionAcute LVO strokeRadiomics modelTest cohortCT angiography of patientsAdmission computed tomography angiographyAnterior circulation territoryAngiography of patientsLong-term outcomesReceiver operating characteristic areaRadiomics-based predictionCollateral arterial circulationOperating characteristics areaAdmission CTACirculation territoryCT angiographyClinical outcomesRadiomic featuresTreatment triageOcclusion strokeVessel occlusionPatientsArterial circulation
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 studyPatientsTrained immunity induced by high‐salt diet impedes stroke recovery
Lin T, Jiang D, Chen W, Lin J, Zhang X, Chen C, Hsu C, Lai L, Chen P, Yang K, Sansing L, Chang C. Trained immunity induced by high‐salt diet impedes stroke recovery. EMBO Reports 2023, 24: e57164. PMID: 37965920, PMCID: PMC10702837, DOI: 10.15252/embr.202357164.Peer-Reviewed Original ResearchConceptsInnate immune memoryMonocyte-derived macrophagesStroke recoveryInflammatory responseBone marrowImmune memoryHigh-salt dietCause of morbidityInitial inflammatory responsePotential therapeutic targetLoss of Nr4a1Stroke outcomeStroke brainIntracerebral hemorrhageBrain recoverySterile inflammationHealthy miceTissue injurySevere formTherapeutic targetAlternative activationImmune primingReparative functionsProgenitor cellsNR4A familyClinical Trial Protocol for BEACH: A Phase 2a Study of MW189 in Patients with Acute Nontraumatic Intracerebral Hemorrhage
Avadhani R, Ziai W, Thompson R, Mould W, Lane K, Nanni A, Iacobelli M, Sharrock M, Sansing L, Van Eldik L, Hanley D. Clinical Trial Protocol for BEACH: A Phase 2a Study of MW189 in Patients with Acute Nontraumatic Intracerebral Hemorrhage. Neurocritical Care 2023, 40: 807-815. PMID: 37919545, PMCID: PMC10959780, DOI: 10.1007/s12028-023-01867-2.Peer-Reviewed Original ResearchIntracerebral hemorrhageNontraumatic intracerebral hemorrhageCerebral edemaFunctional outcomeCause mortalitySymptom onsetAcute central nervous system injuryAcute spontaneous intracerebral hemorrhageEnd pointCentral nervous system injuryDays post randomizationExploratory end pointsPhase 2a studyPlacebo-controlled trialSecondary end pointsAcute brain injuryAcute intracerebral hemorrhageFuture larger trialsPhase 1 studyPerihematomal edema volumeNervous system injurySpontaneous intracerebral hemorrhageInflammatory cytokine concentrationsRate of deathClinical trial protocolPolygenic Susceptibility to Hypertension and Blood Pressure Control in Stroke Survivors
Acosta J, Both C, Demarais Z, Conlon C, Leasure A, Torres-Lopez V, de Havenon A, Petersen N, Gill T, Sansing L, Sheth K, Falcone G. Polygenic Susceptibility to Hypertension and Blood Pressure Control in Stroke Survivors. Neurology 2023, 100: e1587-e1597. PMID: 36690452, PMCID: PMC10103110, DOI: 10.1212/wnl.0000000000206763.Peer-Reviewed Original ResearchConceptsWorse BP controlUncontrolled blood pressureDiastolic blood pressureBlood pressureStroke survivorsPolygenic risk scoresBP controlPolygenic susceptibilityMean diastolic blood pressureMean systolic blood pressureStroke Prevention TrialBlood pressure controlSystolic blood pressureResistant hypertensionVascular eventsHemorrhagic strokePrevention trialsVitamin InterventionMultivariable modelRisk scoreGenetic predispositionPressure controlLogistic regressionSurvivorsHypertensionEmbracing Heterogeneity in The Multicenter Stroke Preclinical Assessment Network (SPAN) Trial
Morais A, Locascio J, Sansing L, Lamb J, Nagarkatti K, Imai T, van Leyen K, Aronowski J, Koenig J, Bosetti F, Lyden P, Ayata C, Bosetti F, Koenig J, Lyden P, Lamb J, Nagarkatti K, Hess D, Kamat P, Khan M, Dhandapani K, Arbab A, Siddiqui S, Smith C, Nisar M, Leira E, Chauhan A, Dhanesha N, Patel R, Kumskova M, Thedens D, Wang K, Ayata C, Morais A, Imai T, Qin T, Jin X, Erdogan T, Yu L, Mandeville J, Kimberly W, Whittier J, Lo E, Arai K, Van Leyen K, Sansing L, Hyder F, Mihailovic J, Sanganahalli B, Diaz-Perez S, Velazquez S, Beatty H, Johnson C, Herman A, Boisserand L, Immakavar E, Koehler R, Dawson T, Dawson V, Shi Y, Avery B, Lannon S, Bibic A, Akhter K, Karuppagounder S, Aronowski J, McCullough L, Obertas L, Goh A, Huang S, Chauhan A. Embracing Heterogeneity in The Multicenter Stroke Preclinical Assessment Network (SPAN) Trial. Stroke 2023, 54: 620-631. PMID: 36601951, PMCID: PMC9870939, DOI: 10.1161/strokeaha.122.040638.Peer-Reviewed Original ResearchConceptsTotal anesthesia durationAnesthesia durationIndependent predictorsMultivariable analysisClinical trialsTransient focal cerebral ischemiaFocal cerebral ischemiaCerebral blood flowLaser Doppler flowCentralized randomizationModified intentionTreat populationExperimental strokeCerebral ischemiaDoppler flowRodent modelsMCAOBlood flowNetwork trialFlow dropPreclinical trialsMouse cohortsStudy designTrialsTrial onsetRole of Inflammatory Processes in Hemorrhagic Stroke
Ohashi S, DeLong J, Kozberg M, Mazur-Hart D, van Veluw S, Alkayed N, Sansing L. Role of Inflammatory Processes in Hemorrhagic Stroke. Stroke 2023, 54: 605-619. PMID: 36601948, DOI: 10.1161/strokeaha.122.037155.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsHemorrhagic strokeIntracerebral hemorrhageInflammatory processCerebral amyloid angiopathy-related haemorrhageAngiopathy-related hemorrhageRole of inflammationCerebral amyloid angiopathyInflammatory immune responseEffective therapeutic strategyCentral nervous systemBrain residentAmyloid angiopathyImmune cellsTissue injuryCommon causeImmune responseHemorrhageTherapeutic strategiesNervous systemMajor subtypesDisease pathologyStrokeOlder individualsTissue recoveryDeadliest form
2022
Association of Soluble ST2 With Functional Outcome, Perihematomal Edema, and Immune Response After Intraparenchymal Hemorrhage
Bevers M, Booraem C, Li K, Sreekrishnan A, Sastre C, Falcone G, Sheth K, Sansing L, Kimberly W. Association of Soluble ST2 With Functional Outcome, Perihematomal Edema, and Immune Response After Intraparenchymal Hemorrhage. Neurology 2022, 100: e1329-e1338. PMID: 36549913, PMCID: PMC10065211, DOI: 10.1212/wnl.0000000000206764.Peer-Reviewed Original ResearchConceptsSoluble ST2Deep intraparenchymal hemorrhageIntraparenchymal hemorrhagePerihematomal edemaImmune responseHematoma volumePoor outcomeFunctional outcomeMedian admission Glasgow Coma Scale scoreScale scoreAdmission Glasgow Coma Scale scorePeripheral innate immune responseModified Rankin Scale scoreGlasgow Coma Scale scoreHours of ictusPeripheral immune responseSecondary brain injuryRankin Scale scoreInnate immune cellsImmune cell populationsIntracerebral Hemorrhage ScoreSerial CT scansInnate immune responseHuman brain tissueSST2 levelsTechnical Dissonance in Home Blood Pressure Monitoring After Stroke: Having the Machine, but Not Using Correctly.
Forman R, Viscoli C, Meurer K, Sheth K, Sansing L, de Havenon A, Sharma R, Mariscal M, Kernan W. Technical Dissonance in Home Blood Pressure Monitoring After Stroke: Having the Machine, but Not Using Correctly. American Journal Of Hypertension 2022, 36: 195-200. PMID: 36520024, PMCID: PMC10016067, DOI: 10.1093/ajh/hpac129.Peer-Reviewed Original ResearchConceptsHome blood pressure monitoringBlood pressure monitoringBlood pressurePressure monitoringNon-Hispanic white patientsProportion of patientsCross-sectional studyNon-Hispanic white participantsStroke recurrenceRate of useMost patientsPrimary outcomeWhite patientsRate of possessionPatientsUnderrepresented patientsArm cuffHypertensionStrokeCorrect useWhite participantsSignificant disparitiesEthnic groupsParticipantsQuality of techniqueBaseline Serum Biomarkers of Inflammation and Subsequent Visit-to-Visit Blood Pressure Variability: A Post Hoc Analysis of MESA
Wong KH, Muddasani V, Peterson C, Sheibani N, Arkin C, Cheong I, Majersik JJ, Biffi A, Petersen N, Falcone GJ, Sansing LH, de Havenon AH. Baseline Serum Biomarkers of Inflammation and Subsequent Visit-to-Visit Blood Pressure Variability: A Post Hoc Analysis of MESA. American Journal Of Hypertension 2022, 36: 144-147. PMID: 36315490, DOI: 10.1093/ajh/hpac122.Peer-Reviewed Original ResearchConceptsBlood pressure variabilityHigh blood pressure variabilitySerum inflammatory markersPlasmin-antiplasmin complexC-reactive proteinInterleukin-6Inflammatory markersBlood pressureStudy visitPressure variabilityBaseline serum IL-6Visit blood pressure variabilityLipid-lowering medicationsMean blood pressureSerum IL-6Markers of inflammationSystolic blood pressureBaseline study visitBody mass indexOnly IL-6Major vascular diseasesMulti-Ethnic StudyBaseline serum biomarkersPatient age categoryPost Hoc AnalysisNeuroimmune interactions in health and disease
Hafler DA, Sansing LH. Neuroimmune interactions in health and disease. Seminars In Immunopathology 2022, 44: 565-567. PMID: 36171280, DOI: 10.1007/s00281-022-00963-3.Peer-Reviewed Original Research