2023
Complications of Intravenous Tenecteplase Versus Alteplase for the Treatment of Acute Ischemic Stroke: A Systematic Review and Meta-Analysis
Rose D, Cavalier A, Kam W, Cantrell S, Lusk J, Schrag M, Yaghi S, Stretz C, de Havenon A, Saldanha I, Wu T, Ranta A, Barber P, Marriott E, Feng W, Kosinski A, Laskowitz D, Poli S, Mac Grory B. Complications of Intravenous Tenecteplase Versus Alteplase for the Treatment of Acute Ischemic Stroke: A Systematic Review and Meta-Analysis. Stroke 2023, 54: 1192-1204. PMID: 36951049, PMCID: PMC10133185, DOI: 10.1161/strokeaha.122.042335.Peer-Reviewed Original ResearchMeSH KeywordsBrain IschemiaFibrinolytic AgentsHumansIntracranial HemorrhagesIschemic StrokeProspective StudiesRetrospective StudiesStrokeTenecteplaseTissue Plasminogen ActivatorTreatment OutcomeConceptsSymptomatic intracranial hemorrhageAcute ischemic strokeIntracranial hemorrhageIschemic strokeSystematic reviewIntravenous tenecteplaseRelative riskHigh-dose groupRisk of complicationsPrior systematic reviewsTenecteplase-treated patientsFull-text articlesWeb of ScienceGastrointestinal hemorrhageAdult patientsExtracranial hemorrhageNoncomparative studySecondary outcomesPooled riskPrimary outcomeTreatment complicationsAbsolute riskCochrane LibraryInterventional studyMedium doseEffect of Alteplase on Ischemic Stroke Mortality Is Dependent on Stroke Severity
de Havenon A, Abbasi M, Yaghi S, Delic A, Bangad A, Johnston K, Tirschwell D, Sheth K. Effect of Alteplase on Ischemic Stroke Mortality Is Dependent on Stroke Severity. Annals Of Neurology 2023, 93: 1106-1116. PMID: 36852919, DOI: 10.1002/ana.26621.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, IntravenousAtrial FibrillationFemaleFibrinolytic AgentsHumansIschemic StrokeStrokeThrombolytic TherapyTissue Plasminogen ActivatorTreatment OutcomeConceptsIV-tPAHigher NIHSSIschemic strokeAtrial fibrillationNational Inpatient Sample (NIS) 2016Non-Hispanic white raceOlder ageBaseline National InstitutesDEFUSE-3 trialsHealth Stroke ScalePost-stroke mortalityIschemic stroke mortalityEffect of alteplaseRisk of mortalityLogistic regression modelsAnn NeurolFAST-MAGIMS IIISevere ISHospital mortalityIntravenous alteplaseSevere strokeStroke ScaleStroke severityFunctional outcome
2021
Effect of Alteplase Use on Outcomes in Patients With Atrial Fibrillation: Analysis of the Initiation of Anticoagulation After Cardioembolic Stroke Study
Yaghi S, Mistry E, de Havenon A, Guerrero C, Nouh A, Liberman AL, Giles J, Liu A, Nagy M, Kaushal A, Azher I, Grory B, Fakhri H, Espaillat K, Asad SD, Pasupuleti H, Martin H, Tan J, Veerasamy M, Esenwa C, Cheng N, Moncrieffe K, Moeini‐Naghani I, Siddu M, Scher E, Trivedi T, Wu T, Khan M, Keyrouz S, Furie K, Henninger N. Effect of Alteplase Use on Outcomes in Patients With Atrial Fibrillation: Analysis of the Initiation of Anticoagulation After Cardioembolic Stroke Study. Journal Of The American Heart Association 2021, 10: e020945. PMID: 34323120, PMCID: PMC8475683, DOI: 10.1161/jaha.121.020945.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeMechanical thrombectomyAlteplase useIschemic strokeHemorrhagic transformationAtrial fibrillationPrimary analysisEfficacy of alteplaseInitiation of anticoagulationComprehensive stroke centerBinary logistic regressionIntravenous alteplaseStroke centersConsecutive patientsStroke StudyAlteplaseMortality ratePatientsSecondary analysisMortalityStrokeLogistic regressionFurther studiesFibrillationIAC studyTelestroke consultation can accurately diagnose ischemic stroke mimics
Poon J, Tkach A, de Havenon A, Hoversten K, Johnson J, Hannon P, Chung L, Majersik J. Telestroke consultation can accurately diagnose ischemic stroke mimics. Journal Of Telemedicine And Telecare 2021, 29: 444-450. PMID: 33535915, DOI: 10.1177/1357633x21989558.Peer-Reviewed Original ResearchMeSH KeywordsAgedFemaleHumansIschemic Attack, TransientIschemic StrokeMaleReferral and ConsultationStrokeTissue Plasminogen ActivatorConceptsAIS/transient ischemic attackTransient ischemic attackAcute ischemic strokeStroke mimicsDischarge diagnosisNegative predictive valuePositive predictive valuePredictive valueStroke/transient ischemic attackIntravenous tissue plasminogen activatorAcute neurologic syndromesTissue plasminogen activatorHigh diagnostic agreementMimic diagnosesTelestroke consultationIschemic attackIschemic strokeRetrospective reviewIntracerebral hemorrhageNeurologic syndromeNPV 85Telestroke networkPPV 90Clinical informationTS diagnosisBlood Pressure Management Before, During, and After Endovascular Thrombectomy for Acute Ischemic Stroke
de Havenon A, Petersen N, Sultan-Qurraie A, Alexander M, Yaghi S, Park M, Grandhi R, Mistry E. Blood Pressure Management Before, During, and After Endovascular Thrombectomy for Acute Ischemic Stroke. Seminars In Neurology 2021, 41: 046-053. PMID: 33472269, PMCID: PMC8063274, DOI: 10.1055/s-0040-1722721.Peer-Reviewed Original ResearchMeSH KeywordsBlood PressureBrain IschemiaEndovascular ProceduresHumansIschemic StrokeStrokeThrombectomyTissue Plasminogen ActivatorTreatment OutcomeConceptsBlood pressure managementEndovascular thrombectomyBlood pressurePressure managementLarge vessel occlusion stroke patientsMaximum systolic blood pressureOptimal blood pressure managementAmerican Heart Association guidelinesAcute ischemic strokeHeart Association guidelinesSystolic blood pressurePenumbral perfusionSuccessful recanalizationIschemic strokeGuideline recommendationsStroke patientsHyperacute phaseAssociation guidelinesPatient outcomesClinical scenariosThrombectomyRecanalizationPatientsHgSpecific evidence
2020
Pulse pressure variability is associated with unfavorable outcomes in acute ischaemic stroke patients treated with intravenous thrombolysis
Katsanos A, Alexandrov A, Mandava P, Köhrmann M, Soinne L, Barreto A, Sharma V, Mikulik R, Muir K, Rothlisberger T, Grotta J, Levi C, Molina C, Saqqur M, Palaiodimou L, Psaltopoulou T, Vosko M, Moreira T, Fiebach J, Rubiera M, Sandset E, de Havenon A, Kent T, Alexandrov A, Schellinger P, Tsivgoulis G, Investigators F. Pulse pressure variability is associated with unfavorable outcomes in acute ischaemic stroke patients treated with intravenous thrombolysis. European Journal Of Neurology 2020, 27: 2453-2462. PMID: 32697894, DOI: 10.1111/ene.14447.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, IntravenousBlood PressureBrain IschemiaFibrinolytic AgentsHumansIschemic StrokeStrokeThrombolytic TherapyTissue Plasminogen ActivatorTreatment OutcomeConceptsPatients treated with intravenous thrombolysisAcute ischaemic strokeIndependent functional outcomePulse pressure variabilityIntravenous thrombolysisIntracranial bleedingAssociated with adverse short-termFunctional outcomesBlood pressureStroke patients treated with intravenous thrombolysisTissue plasminogen activator bolusSystemic tissue plasminogen activatorAssociated with unfavorable outcomesAssociated with worse neurological outcomeSymptomatic intracranial bleedingLong-term functional outcomeSafety end pointPulse pressureAcute ischaemic stroke patientsAdverse short-termLysis of thrombiPressure variabilityTissue plasminogen activatorCombined Lysis of ThrombusIntravenous thrombolysis administration
2019
End-of-Treatment Intracerebral and Ventricular Hemorrhage Volume Predicts Outcome
de Havenon A, Joyce E, Yaghi S, Ansari S, Delic A, Taussky P, Alexander M, Tirschwell D, Grandhi R. End-of-Treatment Intracerebral and Ventricular Hemorrhage Volume Predicts Outcome. Stroke 2019, 51: 652-654. PMID: 31842688, PMCID: PMC7000178, DOI: 10.1161/strokeaha.119.028199.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCerebral HemorrhageCombined Modality TherapyFemaleFibrinolytic AgentsHematomaHumansMaleMiddle AgedMinimally Invasive Surgical ProceduresTissue Plasminogen ActivatorConceptsIntraventricular hemorrhage volumeIntracerebral hemorrhageClot evacuationHemorrhage volumeBetter outcomesVolume scoreInvasive clot evacuationMISTIE III trialSurgical clot evacuationGood neurological outcomePotential clinical benefitNeurological outcomeIII trialsPrimary outcomeClinical benefitHematoma volumePoor outcomeFunctional outcomeSurgical armICH sizeTherapeutic planningSecondary analysisPatientsStrong associationStratification scaleDiurnal Variations in the First 24/7 Mobile Stroke Unit
Zaidat OO, Changal KH, Sultan-Qurraie A, de Havenon A, Calderon VJ, Goins-Whitmore J, Patterson MS, Lin E. Diurnal Variations in the First 24/7 Mobile Stroke Unit. Stroke 2019, 50: 1911-1914. PMID: 31104620, DOI: 10.1161/strokeaha.119.024950.Peer-Reviewed Original ResearchConceptsStroke unitResults One hundred ninetyEvening shiftsMorning shiftPrehospital stroke careMobile stroke unitMSU patientsProspective databaseIntravenous thrombolyticsMechanical thrombectomyPatient characteristicsStroke treatmentStroke careTreatment metricsTherapeutic interventionsNocturnal shiftPatients
2018
Increased blood pressure variability after endovascular thrombectomy for acute stroke is associated with worse clinical outcome
Bennett AE, Wilder MJ, McNally JS, Wold JJ, Stoddard GJ, Majersik JJ, Ansari S, de Havenon A. Increased blood pressure variability after endovascular thrombectomy for acute stroke is associated with worse clinical outcome. Journal Of NeuroInterventional Surgery 2018, 10: 823. PMID: 29352059, DOI: 10.1136/neurintsurg-2017-013473.Peer-Reviewed Original ResearchConceptsModified Rankin ScaleBlood pressure variabilityIntra-arterial therapyIntravenous tissue plasminogen activatorPressure variabilityTissue plasminogen activatorLogistic regression modelsOrdinal logistic regression modelsIschemic strokeWorse outcomesMean age 63.2 yearsMedian admission National InstitutesMultivariable ordinal logistic regression modelsSystolic blood pressure variabilityPlasminogen activatorAdmission National InstitutesWorse neurologic outcomeWorse clinical outcomesLogistic regression analysisOrdinal logistic regression analysisIndependent predictive abilitySuccessive variationAcute strokeEndovascular thrombectomyNeurologic outcome
2016
Treatment of Carotid Intramural Thrombus With TPA
Bennett A, Wold J, de Havenon A. Treatment of Carotid Intramural Thrombus With TPA. JAMA Neurology 2016, 73: 1496. PMID: 27802501, DOI: 10.1001/jamaneurol.2016.3223.Peer-Reviewed Original Research
2015
Tissue Plasminogen Activator Prescription and Administration Errors within a Regional Stroke System
Chung LS, Tkach A, Lingenfelter EM, Dehoney SB, Rollo J, de Havenon A, DeWitt LD, Grantz MR, Wang H, Wold JJ, Hannon PM, Weathered NR, Majersik JJ. Tissue Plasminogen Activator Prescription and Administration Errors within a Regional Stroke System. Journal Of Stroke And Cerebrovascular Diseases 2015, 25: 565-571. PMID: 26698642, PMCID: PMC4779727, DOI: 10.1016/j.jstrokecerebrovasdis.2015.11.014.Peer-Reviewed Original ResearchConceptsComprehensive stroke centerRegional stroke systemAcute ischemic strokeCommunity hospitalAdministration errorsStroke systemsWeight-based dosingMean age 68Ischemic strokeStroke centersStroke outcomeAIS patientsCH patientsAge 68Infusion rateSystemic hemorrhageAIS casesBody weightPharmacy informationPatientsIncorrect dosageOutcomesPrescriptionTPAAssociation