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 outcomeSeverity of leukoaraiosis, leptomeningeal collaterals, and clinical outcomes after intra-arterial therapy in patients with acute ischemic stroke
Giurgiutiu D, Yoo A, Fitzpatrick K, Chaudhry Z, Leslie-Mazwi T, Schwamm L, Rost N. Severity of leukoaraiosis, leptomeningeal collaterals, and clinical outcomes after intra-arterial therapy in patients with acute ischemic stroke. Journal Of NeuroInterventional Surgery 2014, 7: 326. PMID: 24721756, DOI: 10.1136/neurintsurg-2013-011083.Peer-Reviewed Original ResearchConceptsIntra-arterial therapyProximal artery occlusionAcute ischemic strokeSeverity of leukoaraiosisGood functional outcomeLA volumeCollateral gradeRecanalization statusArtery occlusionIschemic strokeFunctional outcomeIntravenous tissue plasminogen activator useHealth Stroke Scale scoreLarge cerebral artery occlusionPoor post-stroke outcomesIschemic white matter lesionsTissue plasminogen activator useGood collateral gradesGreater LA volumeGuidelines-Stroke databasePoor collateral gradeStroke Scale scoreSymptomatic intracranial hemorrhageCerebral artery occlusionCerebral small vessels
2012
Assessing variability in neurointerventional practice patterns for acute ischemic stroke
Mehta B, Leslie-Mazwi T, Chandra R, Chaudhry Z, Rabinov J, Hirsch J, Schwamm L, Rost N, Yoo A. Assessing variability in neurointerventional practice patterns for acute ischemic stroke. Journal Of NeuroInterventional Surgery 2012, 5: i52. PMID: 23235960, DOI: 10.1136/neurintsurg-2012-010565.Peer-Reviewed Original ResearchConceptsIntra-arterial therapyPractice patternsHealth Stroke Scale scoreIntravenous tissue plasminogen activatorReal-world practice patternsEvidence-based practice guidelinesComprehensive stroke servicesPosterior circulation strokeStroke Scale scoreAcute ischemic strokeAnterior circulation strokeFirst-line therapyLarge vessel occlusionMedian annual volumeTissue plasminogen activatorAcute strokeIschemic strokeIndependent predictorsSymptom onsetConscious sedationStroke servicesTreatment indicationsVessel occlusionTreatment strategiesPractice guidelinesElderly Patients Are at Higher Risk for Poor Outcomes After Intra-Arterial Therapy
Chandra R, Leslie-Mazwi T, Oh D, Chaudhry Z, Mehta B, Rost N, Rabinov J, Hirsch J, González R, Schwamm L, Yoo A. Elderly Patients Are at Higher Risk for Poor Outcomes After Intra-Arterial Therapy. Stroke 2012, 43: 2356-2361. PMID: 22744644, DOI: 10.1161/strokeaha.112.650713.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overAngioplasty, BalloonCerebral InfarctionCohort StudiesEndovascular ProceduresEndpoint DeterminationFemaleFibrinolytic AgentsHumansInjections, Intra-ArterialMagnetic Resonance ImagingMaleMiddle AgedProspective StudiesReperfusionRiskStentsStrokeThrombolytic TherapyTissue Plasminogen ActivatorTomography, X-Ray ComputedTreatment OutcomeConceptsIntra-arterial therapyParenchymal hematoma type 2Elderly patientsBaseline disabilityClinical outcomesBaseline healthType 2Cerebral infarction 2Worse baseline healthElderly stroke patientsRankin Scale scoreWorse clinical outcomesCoronary artery diseaseAngiographic reperfusionBaseline demographicsStroke severityArtery diseaseStroke patientsAtrial fibrillationPoor outcomeSignificant hemorrhageHigh riskReperfusionPatientsBetter outcomesImplementation 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 imagingInfarct Volume Is a Pivotal Biomarker After Intra-Arterial Stroke Therapy
Yoo A, Chaudhry Z, Nogueira R, Lev M, Schaefer P, Schwamm L, Hirsch J, González R. Infarct Volume Is a Pivotal Biomarker After Intra-Arterial Stroke Therapy. Stroke 2012, 43: 1323-1330. PMID: 22426317, DOI: 10.1161/strokeaha.111.639401.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overBiomarkersBrain InfarctionCohort StudiesDatabases, FactualFemaleFibrinolytic AgentsHumansInfusions, IntravenousMagnetic Resonance ImagingMaleMiddle AgedNeuroimagingPredictive Value of TestsProspective StudiesRetrospective StudiesStrokeThrombolytic TherapyTissue Plasminogen ActivatorTomography, X-Ray ComputedTreatment OutcomeConceptsFinal infarct volumeIntra-arterial therapyAcute ischemic strokeInfarct volumeFunctional outcomeBetter outcomesIschemic strokePoor outcomeAnterior circulation acute ischemic strokeScale scoreHealth Stroke Scale scoreMedian admission National InstitutesMedian final infarct volumesLong-term functional outcomeIntra-arterial stroke therapyAdmission National InstitutesProximal artery occlusionStroke Scale scoreOnly independent predictorRankin Scale scoreArtery occlusionProspective cohortRankin ScaleIndependent predictorsClinical outcomes
2010
Risk of Thrombolytic Therapy for Acute Ischemic Stroke in Patients With Current Malignancy
Masrur S, Abdullah A, Smith E, Hidalgo R, El-Ghandour A, Rordorf G, Schwamm L. Risk of Thrombolytic Therapy for Acute Ischemic Stroke in Patients With Current Malignancy. Journal Of Stroke And Cerebrovascular Diseases 2010, 20: 124-130. PMID: 20598579, DOI: 10.1016/j.jstrokecerebrovasdis.2009.10.010.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBostonBrain IschemiaChi-Square DistributionComorbidityFemaleFibrinolytic AgentsHospital MortalityHumansIntracranial HemorrhagesLogistic ModelsMaleNeoplasmsOdds RatioRetrospective StudiesRisk AssessmentRisk FactorsStrokeThrombolytic TherapyTissue Plasminogen ActivatorTreatment OutcomeConceptsIntra-arterial therapyTissue plasminogen activatorSymptomatic intracranial hemorrhageCurrent malignancyHospital mortalityMedical comorbiditiesThrombolytic therapyIntracranial hemorrhageIndependent predictorsAIS patientsIntravenous (IV) tPAHealth Stroke Scale scoreStroke Scale scoreAcute ischemic strokeConsecutive AIS patientsHistory of hypertensionHistory of malignancyAmerican Stroke AssociationOnly independent predictorRisks of thrombolysisMost clinical trialsStepwise logistic regressionBrain metastasesIschemic strokePerformance status
2009
Case volumes of intra-arterial and intravenous treatment of ischemic stroke in the USA
Hirsch J, Yoo A, Nogueira R, Verduzco L, Schwamm L, Pryor J, Rabinov J, González R. Case volumes of intra-arterial and intravenous treatment of ischemic stroke in the USA. Journal Of NeuroInterventional Surgery 2009, 1: 27. PMID: 21994101, DOI: 10.1136/jnis.2009.000166.Peer-Reviewed Original ResearchConceptsIntra-arterial therapyNumber of patientsT-PA useStroke centersIschemic strokeCase volumeStroke therapyIntra-arterial reperfusion therapyIntravenous tissue plasminogen activatorIntra-arterial stroke therapyPercentage of patientsLarge vessel occlusionCases/yearTissue plasminogen activatorMassachusetts General HospitalReperfusion therapyIntravenous treatmentStroke casesGeneral HospitalNumber of casesPatientsTherapyStrokeLiterature searchPlasminogen activator
2008
CT Angiography-Source Image Hypoattenuation Predicts Clinical Outcome in Posterior Circulation Strokes Treated With Intra-Arterial Therapy
Schaefer P, Yoo A, Bell D, Barak E, Romero J, Nogueira R, Lev M, Schwamm L, Gonzalez R, Hirsch J. CT Angiography-Source Image Hypoattenuation Predicts Clinical Outcome in Posterior Circulation Strokes Treated With Intra-Arterial Therapy. Stroke 2008, 39: 3107-3109. PMID: 18703807, DOI: 10.1161/strokeaha.108.517680.Peer-Reviewed Original ResearchConceptsIntra-arterial thrombolysisVertebrobasilar occlusionClinical outcomesParenchymal hypoattenuationRankin scorePosterior circulation strokeHealth Stroke ScaleIntra-arterial therapyOnly independent predictorIndependent outcome predictorsMedial temporal lobeInferior parietal lobeStroke ScaleClot locationPatient ageCTA-SIIndependent predictorsOutcome predictorsOccipital lobeHypoattenuationTemporal lobeThrombolysisParietal lobePatientsMidbrain
2006
First-pass quantitative CT perfusion identifies thresholds for salvageable penumbra in acute stroke patients treated with intra-arterial therapy.
Schaefer P, Roccatagliata L, Ledezma C, Hoh B, Schwamm L, Koroshetz W, Gonzalez R, Lev M. First-pass quantitative CT perfusion identifies thresholds for salvageable penumbra in acute stroke patients treated with intra-arterial therapy. American Journal Of Neuroradiology 2006, 27: 20-5. PMID: 16418350, PMCID: PMC7976067.Peer-Reviewed Original ResearchConceptsCerebral blood volumeAcute stroke patientsCT perfusionStroke patientsCBF ratioGray matterWhite matterAbsolute cerebral blood volumeCBV ratioIntra-arterial therapyIschemic brain tissueQuantitative CT perfusionDynamic CT perfusionIA therapyRecanalization therapyStroke onsetSalvageable penumbraInfarct coreIschemic tissueUninvolved regionsIschemic regionBlood volumeCBF valuesPatientsBrain tissue