2023
Recent Vitamin K Antagonist Use and Intracranial Hemorrhage After Endovascular Thrombectomy for Acute Ischemic Stroke
Mac Grory B, Holmes D, Matsouaka R, Shah S, Chang C, Rison R, Jindal J, Holmstedt C, Logan W, Corral C, Mackey J, Gee J, Bonovich D, Walker J, Gropen T, Benesch C, Dissin J, Pandey H, Wang D, Unverdorben M, Hernandez A, Reeves M, Smith E, Schwamm L, Bhatt D, Saver J, Fonarow G, Peterson E, Xian Y. Recent Vitamin K Antagonist Use and Intracranial Hemorrhage After Endovascular Thrombectomy for Acute Ischemic Stroke. JAMA 2023, 329: 2038-2049. PMID: 37338878, PMCID: PMC10282891, DOI: 10.1001/jama.2023.8073.Peer-Reviewed Original ResearchConceptsRisk of sICHSymptomatic intracranial hemorrhageVitamin K antagonistsAcute ischemic strokeSecondary end pointsEndovascular thrombectomyVKA useIschemic strokeHospital mortalityEnd pointIntracranial hemorrhageOral vitamin K antagonistsVitamin K antagonist useGuidelines-Stroke programPrior VKA usePrimary end pointObservational cohort studyLarge vessel occlusionRisk of complicationsAmerican Heart AssociationUse of anticoagulantsSignificant differencesHospital presentationSICH riskAntagonist useRationale and design of Tenecteplase Reperfusion Therapy in Acute Ischaemic Cerebrovascular Events III (TRACE III): a randomised, phase III, open-label, controlled trial
Xiong Y, Campbell B, Fisher M, Schwamm L, Parsons M, Li H, Pan Y, Meng X, Zhao X, Wang Y. Rationale and design of Tenecteplase Reperfusion Therapy in Acute Ischaemic Cerebrovascular Events III (TRACE III): a randomised, phase III, open-label, controlled trial. Stroke And Vascular Neurology 2023, 9: 82-89. PMID: 37247876, PMCID: PMC10956103, DOI: 10.1136/svn-2023-002310.Peer-Reviewed Original ResearchLarge vessel occlusionAnterior circulation large vessel occlusionIschemic strokePerfusion-weighted imagingEfficacy outcomesReperfusion therapyMajor neurological improvementSecondary efficacy outcomesStandard medical therapyHealth Stroke ScalePrimary efficacy outcomeSymptomatic intracerebral hemorrhageRankin Scale scoreTissue-type plasminogen activatorDirect thrombectomyNeurological improvementStroke ScaleAnterior circulationMedical therapyMRS scoreIntracerebral hemorrhageSalvageable tissueVessel occlusionCT perfusionClinical trials
2022
Sex Differences in Endovascular Therapy for Ischemic Stroke: Results From the Get With The Guidelines–Stroke Registry
Demel S, Reeves M, Xu H, Xian Y, Mac Grory B, Fonarow G, Matsouaka R, Smith E, Saver J, Schwamm L. Sex Differences in Endovascular Therapy for Ischemic Stroke: Results From the Get With The Guidelines–Stroke Registry. Stroke 2022, 53: 3099-3106. PMID: 35880521, DOI: 10.1161/strokeaha.122.038491.Peer-Reviewed Original ResearchConceptsEndovascular therapyIschemic strokeHealth Stroke Scale scoreTreatment ratesGuidelines-Stroke hospitalsGuidelines-Stroke registryStroke Scale scoreAcute ischemic strokeSex differencesLarge vessel occlusionMultivariable regression analysisIschemic stroke dischargesEVT useHospital deathHospital mortalityASA guidelinesVessel occlusionOdds ratioScale scoreStroke dischargesSignificant sex differencesWomenNational InstituteMenStatistical adjustmentDifferences 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 proportionA Phase III, prospective, double-blind, randomized, placebo-controlled trial of thrombolysis in imaging-eligible, late-window patients to assess the efficacy and safety of tenecteplase (TIMELESS): Rationale and design
Albers G, Campbell B, Lansberg M, Broderick J, Butcher K, Froehler M, Schwamm L, Nouh A, Liebeskind D, Toy F, Yang M, Massaro L, Schoeffler M, Purdon B. A Phase III, prospective, double-blind, randomized, placebo-controlled trial of thrombolysis in imaging-eligible, late-window patients to assess the efficacy and safety of tenecteplase (TIMELESS): Rationale and design. International Journal Of Stroke 2022, 18: 237-241. PMID: 35262424, DOI: 10.1177/17474930221088400.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeInternal carotid arteryPlacebo-controlled trialRankin Scale scoreSymptom onsetDay 90Scale scoreMiddle cerebral artery occlusionEfficacy of tenecteplaseLate-window patientsSafety of tenecteplaseSymptomatic intracranial hemorrhageCerebral artery occlusionLarge vessel occlusionPhase IIIPrimary efficacy objectiveBetter clinical outcomesAdverse eventsArtery occlusionEndovascular thrombectomyIschemic strokeMCA occlusionClinical outcomesIntracranial hemorrhageSalvageable tissue
2021
'Drip-and-ship' intravenous thrombolysis and outcomes for large vessel occlusion thrombectomy candidates in a hub-and-spoke telestroke model
Regenhardt R, Rosenthal J, Awad A, Martinez-Gutierrez J, Nolan N, McIntyre J, Whitney C, Alotaibi N, Dmytriw A, Vranic J, Stapleton C, Patel A, Rost N, Schwamm L, Leslie-Mazwi T. 'Drip-and-ship' intravenous thrombolysis and outcomes for large vessel occlusion thrombectomy candidates in a hub-and-spoke telestroke model. Journal Of NeuroInterventional Surgery 2021, 14: 650-653. PMID: 34326197, PMCID: PMC8799754, DOI: 10.1136/neurintsurg-2021-017819.Peer-Reviewed Original ResearchConceptsEndovascular thrombectomyIntravenous thrombolysisIntracerebral hemorrhageDay mRSEVT candidatesFunctional independenceHealth Stroke Scale scoreEmergent large vessel occlusionRisk of ICHMedian National InstitutesStroke Scale scoreLarge vessel occlusionOutcomes of interestAlteplase useDischarge mRSTelestroke modelThrombectomy candidatesEligible patientsIntravenous alteplaseTICI 2bAdequate reperfusionMedian ageSpoke hospitalsCT scoreVessel occlusionCTA Protocols in a Telestroke Network Improve Efficiency for Both Spoke and Hub Hospitals
Yu A, Regenhardt R, Whitney C, Schwamm L, Patel A, Stapleton C, Viswanathan A, Hirsch J, Lev M, Leslie-Mazwi T. CTA Protocols in a Telestroke Network Improve Efficiency for Both Spoke and Hub Hospitals. American Journal Of Neuroradiology 2021, 42: 435-440. PMID: 33541900, PMCID: PMC7959422, DOI: 10.3174/ajnr.a6950.Peer-Reviewed Original ResearchConceptsEndovascular thrombectomySpoke hospitalsTelestroke networkHub hospitalCTA protocolHealth Stroke Scale scoreEmergent large vessel occlusionStroke Scale scoreRate of patientsLarge vessel occlusionCTA utilizationThrombectomy ratesStroke triageThrombectomyNonsignificant increasePatientsScale scoreHospitalTriage processNational InstituteOverall rateCTAExtended windowHigher numberRetention rate
2019
Ischaemic stroke
Campbell B, De Silva D, Macleod M, Coutts S, Schwamm L, Davis S, Donnan G. Ischaemic stroke. Nature Reviews Disease Primers 2019, 5: 70. PMID: 31601801, DOI: 10.1038/s41572-019-0118-8.Peer-Reviewed Original ResearchConceptsIschemic strokeIntravenous thrombolysisEndovascular thrombectomyStroke onsetSevere symptomatic carotid artery stenosisSymptomatic carotid artery stenosisSalvageable brain tissueBlood pressure controlCardiovascular risk managementLarge vessel occlusionMajority of strokesMechanism of strokeOnset of strokeCarotid artery stenosisCause of disabilitySecond highest causeSystems of careAntithrombotic medicationRapid reperfusionReperfusion therapySecondary preventionStroke symptomsArterial occlusionArtery stenosisCarotid endarterectomyAssociation Between Time to Treatment With Endovascular Reperfusion Therapy and Outcomes in Patients With Acute Ischemic Stroke Treated in Clinical Practice
Jahan R, Saver J, Schwamm L, Fonarow G, Liang L, Matsouaka R, Xian Y, Holmes D, Peterson E, Yavagal D, Smith E. Association Between Time to Treatment With Endovascular Reperfusion Therapy and Outcomes in Patients With Acute Ischemic Stroke Treated in Clinical Practice. JAMA 2019, 322: 252-263. PMID: 31310296, PMCID: PMC6635908, DOI: 10.1001/jama.2019.8286.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeEndovascular reperfusion therapySymptomatic intracranial hemorrhageLarge vessel occlusionRoutine clinical practiceHospice dischargePuncture timeClinical practiceSubstantial reperfusionIschemic strokeArterial punctureVessel occlusionLarge vessel occlusion acute ischemic strokeMedian pretreatment scoreHealth Stroke ScaleRetrospective cohort studyRandomized clinical trialsHigher likelihoodAssociation of speedAmbulatory statusReperfusion therapyStroke ScaleAdverse eventsCohort studyHospital arrivalDEFUSE 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 occlusionUse, Temporal Trends, and Outcomes of Endovascular Therapy After Interhospital Transfer in the United States
Shah S, Xian Y, Sheng S, Zachrison KS, Saver JL, Sheth KN, Fonarow GC, Schwamm LH, Smith EE. Use, Temporal Trends, and Outcomes of Endovascular Therapy After Interhospital Transfer in the United States. Circulation 2019, 139: 1568-1577. PMID: 30700144, PMCID: PMC6816244, DOI: 10.1161/circulationaha.118.036509.Peer-Reviewed Original ResearchConceptsEndovascular therapyInterhospital transferHospital outcomesIschemic strokeMultivariable logistic regression modelSymptomatic intracranial hemorrhageAcute ischemic strokeComprehensive stroke centerLarge vessel occlusionRisk-adjusted modelsLogistic regression modelsEVT outcomesGuidelines-StrokeHospital mortalityStroke centersIndependent ambulationPivotal trialsStroke careIntracranial hemorrhageVessel occlusionEVT casesStroke systemsWhite racePatientsFurther evaluationComponents and Trends in Door to Treatment Times for Endovascular Therapy in Get With The Guidelines-Stroke Hospitals
Menon B, Xu H, Cox M, Saver J, Goyal M, Peterson E, Xian Y, Matsuoka R, Jehan R, Yavagal D, Gupta R, Mehta B, Bhatt D, Fonarow G, Schwamm L, Smith E. Components and Trends in Door to Treatment Times for Endovascular Therapy in Get With The Guidelines-Stroke Hospitals. Circulation 2019, 139: 169-179. PMID: 30586703, DOI: 10.1161/circulationaha.118.036701.Peer-Reviewed Original ResearchConceptsGuidelines-Stroke hospitalsEndovascular therapyHospital-level variablesShorter doorArterial accessCase volumeFirst pass timeArterial puncture timeComprehensive stroke centerLarge vessel occlusionCalendar year quarterWorkflow timesSignificant linear time trendsIschemic strokeLonger doorMedian doorStroke centersArterial punctureDiabetes mellitusMultivariable analysisPuncture timeFaster doorEmergency departmentClinical trialsMultivariable modeling
2018
Optimizing Prehospital Triage for Patients With Stroke Involving Large Vessel Occlusion: The Road Less Traveled
Schwamm L. Optimizing Prehospital Triage for Patients With Stroke Involving Large Vessel Occlusion: The Road Less Traveled. JAMA Neurology 2018, 75: 1467-1469. PMID: 30193286, DOI: 10.1001/jamaneurol.2018.2323.Peer-Reviewed Original ResearchConceptsLarge vessel occlusionIntravenous thrombolysis in unwitnessed stroke onset: MR WITNESS trial results
Schwamm L, Wu O, Song S, Latour L, Ford A, Hsia A, Muzikansky A, Betensky R, Yoo A, Lev M, Boulouis G, Lauer A, Cougo P, Copen W, Harris G, Warach S, Investigators O. Intravenous thrombolysis in unwitnessed stroke onset: MR WITNESS trial results. Annals Of Neurology 2018, 83: 980-993. PMID: 29689135, PMCID: PMC6095471, DOI: 10.1002/ana.25235.Peer-Reviewed Original ResearchConceptsMagnetic resonance imagingSymptomatic intracranial hemorrhageLarge vessel occlusionIntravenous thrombolysisSymptom discoveryVessel occlusionAcute ischemic stroke patientsFluid-attenuated inversion recovery magnetic resonance imagingInversion recovery magnetic resonance imagingDiffusion-weighted magnetic resonance imagingIschemic stroke patientsStroke durationAnn NeurolSymptomatic edemaUnwitnessed onsetUnwitnessed strokeIntravenous alteplaseRankin ScaleSecondary outcomesStroke onsetSymptom onsetPrimary outcomeIntracranial hemorrhageProspective studyStroke patients
2017
Visual Aids for Patient, Family, and Physician Decision Making About Endovascular Thrombectomy for Acute Ischemic Stroke
Tokunboh I, Vales Montero M, Zopelaro Almeida M, Sharma L, Starkman S, Szeder V, Jahan R, Liebeskind D, Gonzalez N, Demchuk A, Froehler M, Goyal M, Lansberg M, Lutsep H, Schwamm L, Saver J. Visual Aids for Patient, Family, and Physician Decision Making About Endovascular Thrombectomy for Acute Ischemic Stroke. Stroke 2017, 49: 90-97. PMID: 29222229, DOI: 10.1161/strokeaha.117.018715.Peer-Reviewed Original ResearchConceptsAcute cerebral ischemiaEndovascular thrombectomyBetter disability outcomesCerebral ischemiaDisability outcomesTPA-eligible patientsAcute ischemic strokeLarge vessel occlusionReperfusion treatmentTerritory infarctsIschemic strokeRankin ScaleVessel occlusionThrombectomyPatientsPhysician's decisionHealthcare providersTrial dataAdverse effectsOutcomesTreatment effectsIschemiaVisual decision aidsTPADecision aidImplementation of Rapid Treatment and Interfacility Transport for Patients With Suspected Stroke by Large-Vessel Occlusion: In One Door and Out the Other
Zachrison K, Schwamm L. Implementation of Rapid Treatment and Interfacility Transport for Patients With Suspected Stroke by Large-Vessel Occlusion: In One Door and Out the Other. JAMA Neurology 2017, 74: 765-766. PMID: 28492814, PMCID: PMC5937116, DOI: 10.1001/jamaneurol.2017.0324.Peer-Reviewed Original Research
2016
Acute Stroke Imaging Research Roadmap III Imaging Selection and Outcomes in Acute Stroke Reperfusion Clinical Trials
Warach S, Luby M, Albers G, Bammer R, Bivard A, Campbell B, Derdeyn C, Heit J, Khatri P, Lansberg M, Liebeskind D, Majoie C, Marks M, Menon B, Muir K, Parsons M, Vagal A, Yoo A, Alexandrov A, Baron J, Fiorella D, Furlan A, Puig J, Schellinger P, Wintermark M, Ansari S, Aviv R, Barreto A, Broderick J, Christensen S, Davis S, Demchuk A, Dippel D, Donnan G, Fiebach J, Fiehler J, Houser G, Grotta J, Hacke W, Hill M, Hsia A, Jovin T, Köhrmann M, Latour L, Leigh R, Lees K, Lev M, Marshall R, Mocco J, Nadareishvili Z, Nogueira R, Olivot J, Palesch Y, Pedraza S, Sasaki M, Saver J, Savitz S, Schwamm L, Simpkins A, Smith W, Thijs V, Thomalla G, Wechsler L, Wu O, Zaharchuk G, Zaidat O. Acute Stroke Imaging Research Roadmap III Imaging Selection and Outcomes in Acute Stroke Reperfusion Clinical Trials. Stroke 2016, 47: 1389-1398. PMID: 27073243, PMCID: PMC6058693, DOI: 10.1161/strokeaha.115.012364.Peer-Reviewed Original ResearchConceptsClinical trialsEndovascular trialsImaging Working GroupFinal infarct volumeLarge vessel occlusionProspective clinical trialsImaging sessionAmerican SocietyOptimal imaging methodInfarct volumeStroke neurologistsEndovascular treatmentPooled analysisTherapy clinical trialsVessel occlusionImaging selectionGood collateralsNeurovascular imagingConsensus recommendationsUS FoodDrug AdministrationNeurological disordersPooled dataTrialsNational InstituteTelestroke—the promise and the challenge. Part one: growth and current practice
Akbik F, Hirsch J, Chandra R, Frei D, Patel A, Rabinov J, Rost N, Schwamm L, Leslie-Mazwi T. Telestroke—the promise and the challenge. Part one: growth and current practice. Journal Of NeuroInterventional Surgery 2016, 9: 357. PMID: 26984868, DOI: 10.1136/neurintsurg-2016-012291.Peer-Reviewed Original ResearchConceptsSpecialist careMajor public health concernAcute ischemic strokeLarge vessel occlusionManagement of patientsTime-sensitive therapiesExamination of patientsUse of telemedicinePublic health concernIntravenous thrombolysisEndovascular thrombectomyIschemic strokeStroke presentationStroke expertiseVessel occlusionTreatment benefitVideo consultationsTreatment ratesHealth concernTelestrokeCurrent practicePatientsStrokeSensitive therapyCare
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 guidelines
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