2024
Automated 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 cohort
2022
The Stroke Preclinical Assessment Network: Rationale, Design, Feasibility, and Stage 1 Results
Lyden PD, Bosetti F, Diniz MA, Rogatko A, Koenig JI, Lamb J, Nagarkatti KA, Cabeen RP, Hess DC, Kamat PK, Khan MB, Wood K, Dhandapani K, Arbab AS, Leira EC, Chauhan AK, Dhanesha N, Patel RB, Kumskova M, Thedens D, Morais A, Imai T, Qin T, Ayata C, Boisserand LSB, Herman AL, Beatty HE, Velazquez SE, Diaz-Perez S, Sanganahalli BG, Mihailovic JM, Hyder F, Sansing LH, Koehler RC, Lannon S, Shi Y, Karuppagounder SS, Bibic A, Akhter K, Aronowski J, McCullough LD, Chauhan A, Goh A, Siddiqui S, Sheth K, Matouk C, Cruz C, Zhou J, Dawson V, Dawson T, Liang J, van Zijl P, Zeiler S, Taylor Kimberly W, Erdogan T, Yu L, Mandeville J, Whittier J. The Stroke Preclinical Assessment Network: Rationale, Design, Feasibility, and Stage 1 Results. Stroke 2022, 53: 1802-1812. PMID: 35354299, PMCID: PMC9038686, DOI: 10.1161/strokeaha.121.038047.Peer-Reviewed Original ResearchMeSH KeywordsAgedAnimalsBrainBrain IschemiaFeasibility StudiesHumansInfarction, Middle Cerebral ArteryMaleMiceStrokeConceptsPreclinical assessmentStroke treatmentCandidate treatmentMiddle cerebral artery occlusion (MCAO) surgeryClinical stroke trialsSuccessful stroke treatmentInclusion/exclusion criteriaStroke clinical trialsClinical trial designYoung male animalsComorbid diseasesOcclusion surgeryCerebral ischemiaNeurological disabilityComorbid conditionsStroke trialsProtocol adherenceBlinded assessmentSuch therapyClinical trialsClinical studiesExclusion criteriaTrial designAged animalsOutcome assessment
2021
Assessment of Discrepancies Between Follow-up Infarct Volume and 90-Day Outcomes Among Patients With Ischemic Stroke Who Received Endovascular Therapy
Ganesh A, Ospel J, Menon B, Demchuk A, McTaggart R, Nogueira R, Poppe A, Almekhlafi M, Hanel R, Thomalla G, Holmin S, Puetz V, van Adel B, Tarpley J, Tymianski M, Hill M, Goyal M, Barber P, Smith E, Bal S, Subramanian S, Peters S, Couillard P, Klein G, Stys P, Coutts S, Wong J, Mitha A, Eesa M, Morrish W, Alqatani S, Kashani N, Venkatesan P, Teleg E, Sitaram A, Graham B, Gaal S, Moussaddy A, Chakraborty D, Maraj N, Lockey A, Chen S, Singh R, Alsultan A, Asunsian R, Tse D, Doshi D, Volny O, Ojha P, Wadhwa A, Marko M, Singh N, Wasyliw S, Ryckborst K, Kenney C, Save S, Jambula A, Newcommon N, Hull G, Blackstock D, Kiszczak S, Zimmel L, Wright M, Jahraus C, Andersen L, Bohn S, Paul J, Buck B, Butcher K, Shuaib A, Jeerakathil T, Jickling G, Emery D, Rempel J, Ower R, Ashforth R, Yeo T, Kotylak T, O;Kelly C, Chow M, Siddiqui M, Saqqur M, D'Souza A, Lloret M, Butt A, Nomani A, Kalashyan H, Thirunavukkarasu S, Jabs J, Fairall P, Piquette L, Phillips S, Green A, Gubitz G, Heidenreich J, Huynh T, Shankar J, Maloney W, Vandorpe R, Schmidt M, Pickett G, Weeks A, Jarrett J, MacDonald D, Arsenault J, Kinnear R, Mandzia J, Mayich M, Boulton M, Bullrich M, Fridman S, Kiwan R, Lee D, Lownie S, Khaw A, Pandey S, Sharma M, Sposato L, Wade K, Beauchamp B, Lambourn L, Amato-Marziali B, Roy D, Deneault N, Deschaintre Y, Gioia L, Jacquin G, Odier C, Stapf C, Iancu D, Raymond J, Weill A, Lapierre M, Jadil N, Jolteus J, Teitelbaum J, Angle M, Hannouche M, Badawy M, Letourneau J, Cortes M, Linnell G, Tampieri D, Vieira L, Legault C, Durcan L, Moore A, Cole E, Magnussen C, Salmon K, Khalil S, Desloges I, Waxman L, Abdon W, Lai S, Dowlatshahi D, Shamy M, Stotts G, Blacquiere D, Lesiuk H, Quateen A, Drake B, Dewar B, Daham Z, Kelly M, Hunter G, Peeling L, Graham B, Whelan R, Garner A, Urroz L, Maley S, Silver F, Casaubon L, Pikula A, Campo M, Schaafsma J, Jaigobin C, Krings T, Pereira V, Agid R, Farb R, Kalman L, Cayley A, Williams J, Stewart T, Misquitta K, Bharatha A, Selchen D, Marotta T, Sarma D, Montanera W, Spears J, Saposnik G, Kostyrko P, Li Y, Parra-Farinas C, Diestro J, Camden M, Verreault S, Mackey A, Audet M, Milot G, Lavoie P, Gariépy J, Collard K, Haché A, Sahlas D, Alshanbari A, Baldwin J, Catanese L, Chen B, Sa Boasquevisque D, Deshmukh A, Knapman J, Lamers S, Larrazabal R, MacMillan S, Mai L, Mattai A, Nayar S, Ng K, Oczkowski W, Perera K, Shawawrah M, Shoamanesh A, Sobhi G, Syed N, Yaher N, Vandervelde C, Wang D, Field T, Van Gaal S, Teal P, Benavente O, Wilson L, Mann S, Yip S, Murphy C, Heran M, Rohr A, Settecase F, Redekop G, Haw C, Maclean G, Murray K, Chiu R, Flexman A, Strecha E, Gayton Y, Yip J, Swartz R, Boulos M, Gladstone D, Yu A, Hopyan J, Khosravani H, Manosalva Alzate H, Southwell A, Kamra M, Lopes K, Kapoor A, da Costa L, Yang V, Dyer E, Shah R, Knowles B, Nichols J, Patterson J, Cope K, Dickerson L, Barton K, Gray K, Massengale T, Miller M, Simpson C, Walker S, Tennyson-Yemm C, Frei D, Bellon R, Atchie B, Kaminsky I, Wilson D, Schraeder N, Arias E, Kodis L, Talley M, Edinger A, Talley T, Dempsey I, Williams L, Williams S, Kupniewski S, Fasbinder B, Snead J, Choe H, Mackenzie L, Weisman D, Kozak O, Shah Q, Gzesh D, Kulandaivel K, Khoury J, Klein B, Bussinger P, Griffin L, DePalmo A, Oliva C, Jadhav A, Jovin T, Kenmuir C, Jankowitz B, Gross B, Rocha M, Starr M, Brown M, Hawkes C, Shah K, Tememe D, Walker G, Patel P, Klein B, Ziayee H, Limaye K, Baxendell L, Glichrist V, Feineigle P, Toseki Haibach K, Van Every C, Desai S, Zulfiqar M, Gibson L, Barrett S, Turkel-Parrella D, Arcot K, DiCrescento S, Farkas J, Filipowski G, Frontera J, Joset D, Liff J, Scher E, McDougall C, Kelly C, Patel A, Monteith S, Starkman S, Atchaneeyasakul K, Burgos A, Anne Y. Chua J, Gaines N, Grunberg I, Guzy J, Liu Z, Maluste N, Ramirez L, Sharma L, Heck D, Brown M, McDonald C, Calderon M, Hargis M, Roels C, Emmady P, Alvi T, Jayaraman M, Cutting S, Smith W, Foley S, Paolucci G, Haas R, Quinn K, Fuller L, Brierley R, Watkins C, Demir N, Lopez G, Vargas A, Osteraas N, Holtz B, Sauvageau E, Aghaebrahim A, Chmayssani M, Naval N, Day J, Dellorso S, Ludwig B, Schemmel D, Ebreo N, Bell K, Lewis L, Delucia M, Haussen D, Frankel M, Bhatt N, Bianchi N, Anderson A, Belagaje S, Liberato B, Rangaraju S, Al-Bayati A, Grossber J, Craft L, Schindler K, Schaad E, Schultz M, Sutherly L, Doppelheuer S, Charlton J, Faggard J, Barbret Z, DukSoo Han E, Walters R, Dolia J, El-Jamal S, Eby B, Saleem Y, Pearl H, Patel K, Rahman H, Butt R, English S, Puri A, Howk M, Singh J, Massari F, DeMacedo Rodrigues K, Kuhn A, English J, Barazangi N, Telischak N, Kim W, Ross J, DeVole N, Redford J, Ferreira M, Ponting K, Shen H, Bedenk A, Patel S, Fernandess J, Ke M, Spokoyny I, Gao B, Tong D, Chen C, Wong C, Choe J, Martin C, Summers D, Boutwell C, Olds K, Crandall S, Eatman J, Akhtar N, Holloway W, Halpin J, Donegan B, Schindler J, Hwang D, Gilmore E, Petersen N, Sheth K, Brown S, Beekman R, George B, Kaddouh F, Falcone G, Wira C, Matouk C, Loomis C, Amin H, Stretz H, Narula R, Jasne A, Sansing L, Agarwal T, Jasak S, Fontaine B, King Z, Kouhn L, Orgass H, Leary M, Nye J, Halbert K, Nystrom K, Neuschatz K, Petrucci D, Coppola A, Joyce T, Hou S, Umekubo M, Nakamura C, Ovando R, Zuniga D, Nien Y, Basto F, Arch A, Jong L, Conrad W, Abbott T, Yao J, Caganap S, Jordan J, Teitelbaum G, Darflinger R, Kelly D, Gupta R, Budzik R, Czerniak J, Groezinger K, Hicks W, Kaskar O, Katz B, Loochtan A, Pema P, Rai V, Vora N, Brown A, Goodman D, Danenbergs B, Gossett M, Bang O, Chung J, Jeon P, Kim K, Lim Y, Hoe Heo J, Nam H, Kim Y, Park H, Hwang I, Ha W, Choi J, Jeong K, Rha J, Park H, Yoon C, Kim B, Sohn S, Kim C, Yoo J, Hong J, Park H, Kim S, Choi M, Bae H, Lee J, Lee J, Jun G, Jeon S, Campbell B, Mitchell P, Yassi N, Davis S, Donnan G, Parsons M, Yan B, Dowling R, Bush S, Wu T, Shan D, Zhao H, Salvaris P, Alemseged F, Ng F, Williams C, Balabanski A, dos Santos A, Ng J, McDonald A, Jackson D, Tsoleridis J, Pesavento L, Kleinig T, Drew R, Cranefield J, Scroop R, Cagi L, Harvey J, Waters M, Thornton J, Brennan R, O'Hare A, Power S, Williams D, Boyle K, Moynihan B, Liddy A, Large M, Cullen A, Walsh R, Martin E, Lynch J, McElroy S, Murphy S, Coveney S, Deegan C, Horgan G, Kelly P, Laffan A, Llamas-Osorio Y, Lynch C, Mac Mahon P, Marnane M, McCabe J, Burns P, Tauro S, Cuddy S, Rennie I, Smyth G, Flynn P, Wiggam I, Kerr E, Gordon P, Fearon P, Roberts G, Patterson C, Adams K, Wells B, McFarland M, Moreira T, Sjöstrand C, Mazya M, Almqvist H, Wahlgren N, Steinberg A, Cooray C, Eriksson E, Thorén M, Keselman B, Ahmed N, Holmberg Å, Axelsson M, Berglund A, Golsari A, Hoppe J, Deb-Chatterji M, Cheng B, Barow E, Schlemm E, Lettow I, Jensen M, Otto D, Jaramillo K, Appelbohm H, Fiehler J, Bester M, Schönfeld M, Brekenfeld C, Holst B, Wortmann G, Koch F, Gerber J, Abramyuk A, Kaiser D, Winzer S, Prakapenia A, Pallesen L, Siepmann T, Barlinn K, Haase K, Sauer A, Psychogios M, Liman J, Brehm A, Maus V, Hollstein N, Reinke A, Neitz G, Schnieder M, Schwarz M, Ibrahim A, Müller J, Meister S, Bäumle B, Chapot R, Pilgram-Pastor S, Wallocha M, Stauder M, Celik E, Stracke P, Müller N, Weber R, Veltkamp R, Nagel S, Ringleb P, Heyse M, Amiri H, Mundiyanapurath S, Chen M, Beyrle E, Beck P, Möhlenbruch M. Assessment of Discrepancies Between Follow-up Infarct Volume and 90-Day Outcomes Among Patients With Ischemic Stroke Who Received Endovascular Therapy. JAMA Network Open 2021, 4: e2132376. PMID: 34739060, PMCID: PMC8571657, DOI: 10.1001/jamanetworkopen.2021.32376.Peer-Reviewed Original ResearchConceptsSerious adverse eventsHigher mRS scoreLower mRS scoresMRS scoreInfarct volumeEndovascular therapyPretreatment factorsPosttreatment factorsBlood pressureHemoglobin levelsFunctional outcomeAnterior Circulation Proximal OcclusionDiscrepant casesHighest FIVTomography/magnetic resonance imagingHigher baseline hemoglobinRecanalization Times (ESCAPE) trialAbsence of diabetesStroke unit careSymptomatic intracerebral hemorrhageCongestive heart failureDiastolic blood pressureRankin Scale scoreMagnetic resonance imagingStepwise modelSimilar admission NIHSS may represent larger tissue-at-risk in patients with right-sided versus left-sided large vessel occlusion
Mak A, Matouk C, Avery EW, Behland J, Frey D, Madai VI, Vajkoczy P, Malhotra A, Karam A, Sanelli P, Falcone GJ, Petersen NH, Sansing L, Sheth KN, Payabvash S. Similar admission NIHSS may represent larger tissue-at-risk in patients with right-sided versus left-sided large vessel occlusion. Journal Of NeuroInterventional Surgery 2021, 14: 985-991. PMID: 34645705, DOI: 10.1136/neurintsurg-2021-017785.Peer-Reviewed Original ResearchMeSH KeywordsBrain IschemiaCerebral InfarctionHumansRetrospective StudiesStrokeThrombectomyTreatment OutcomeConceptsLarge vessel occlusionFinal infarct volumeLarger final infarct volumeWorse discharge outcomesInfarct volumeAdmission NIHSSDischarge outcomesVessel occlusionScale scoreMultivariate analysisAnterior large vessel occlusionLower admission NIHSS scoreHealth Stroke Scale scoreAdmission National InstitutesAdmission stroke severityPoor discharge outcomeStroke Scale scoreLarger infarct volumesAdmission NIHSS scoreRankin Scale scoreVoxel-wise analysisIncomplete reperfusionInfarct distributionOcclusion sideNIHSS scoreIschemic Stroke, Inflammation, and Endotheliopathy in COVID-19 Patients
McAlpine LS, Zubair AS, Maran I, Chojecka P, Lleva P, Jasne AS, Navaratnam D, Matouk C, Schindler J, Sheth KN, Chun H, Lee AI, Spudich S, Sharma R, Sansing LH. Ischemic Stroke, Inflammation, and Endotheliopathy in COVID-19 Patients. Stroke 2021, 52: e233-e238. PMID: 33966492, PMCID: PMC8140646, DOI: 10.1161/strokeaha.120.031971.Peer-Reviewed Original Research
2020
Plasma neurofilament light predicts mortality in patients with stroke
Gendron TF, Badi MK, Heckman MG, Jansen-West KR, Vilanilam GK, Johnson PW, Burch AR, Walton RL, Ross OA, Brott TG, Miller TM, Berry JD, Nicholson KA, Wszolek ZK, Oskarsson BE, Sheth KN, Sansing LH, Falcone GJ, Cucchiara BL, Meschia JF, Petrucelli L. Plasma neurofilament light predicts mortality in patients with stroke. Science Translational Medicine 2020, 12 PMID: 33177179, PMCID: PMC9534269, DOI: 10.1126/scitranslmed.aay1913.Peer-Reviewed Original ResearchConceptsBlood neurofilament lightNeurofilament lightStroke typeNeuroaxonal injuryHigher NfL concentrationsMini-Mental State ExaminationStroke brain injuryAcute cerebral infarctionModified Rankin ScaleEarly ischemic injuryNontraumatic intracerebral hemorrhageNIH Stroke ScaleBrain tissue damagePlasma neurofilament lightIntracranial hemorrhage volumeClinical trial efficiencyBlood biomarker studiesStroke therapeuticsCause mortalityStroke ScaleCerebral infarctionRankin ScaleFunctional disabilityIntracerebral hemorrhageIschemic injuryStroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic
Jasne AS, Chojecka P, Maran I, Mageid R, Eldokmak M, Zhang Q, Nystrom K, Vlieks K, Askenase M, Petersen N, Falcone GJ, Wira CR, Lleva P, Zeevi N, Narula R, Amin H, Navaratnam D, Loomis C, Hwang DY, Schindler J, Hebert R, Matouk C, Krumholz HM, Spudich S, Sheth KN, Sansing LH, Sharma R. Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic. Stroke 2020, 51: 2664-2673. PMID: 32755347, PMCID: PMC7446978, DOI: 10.1161/str.0000000000000347.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBetacoronavirusBrain IschemiaCohort StudiesComorbidityConnecticutCoronary Artery DiseaseCoronavirus InfectionsCOVID-19DyslipidemiasEmergency Medical ServicesEthnicityFemaleHumansHypertensionIncomeInsurance, HealthIntracranial HemorrhagesMaleMedically UninsuredMiddle AgedOutcome and Process Assessment, Health CarePandemicsPneumonia, ViralRetrospective StudiesSARS-CoV-2Severity of Illness IndexStrokeSubstance-Related DisordersTelemedicineThrombectomyThrombolytic TherapyTime-to-TreatmentConceptsComprehensive stroke centerStroke codePatient characteristicsStroke severityStroke code patientsHistory of hypertensionStroke-like symptomsCoronary artery diseaseCoronavirus disease 2019 (COVID-19) pandemicPatient-level dataLower median household incomePublic health initiativesDisease 2019 pandemicCOVID-19 pandemicRace/ethnicityCode patientsHospital presentationPublic health insuranceRankin ScaleStroke centersArtery diseaseReperfusion timeStroke symptomsEarly outcomesConnecticut hospitalsFixed Compared With Autoregulation-Oriented Blood Pressure Thresholds After Mechanical Thrombectomy for Ischemic Stroke
Petersen NH, Silverman A, Strander SM, Kodali S, Wang A, Sansing LH, Schindler JL, Falcone GJ, Gilmore EJ, Jasne AS, Cord B, Hebert RM, Johnson M, Matouk CC, Sheth KN. Fixed Compared With Autoregulation-Oriented Blood Pressure Thresholds After Mechanical Thrombectomy for Ischemic Stroke. Stroke 2020, 51: 914-921. PMID: 32078493, PMCID: PMC7050651, DOI: 10.1161/strokeaha.119.026596.Peer-Reviewed Original ResearchConceptsSystolic BP thresholdMean arterial pressureArterial pressureEndovascular thrombectomyIschemic strokeSystolic BPFunctional outcomePercent timeFurther brain injuryModified Rankin ScaleBlood pressure changesPoor functional outcomeBP thresholdAutoregulatory indexHemorrhagic transformationMechanical thrombectomyRankin ScaleBlood pressureBP targetsHemodynamic managementAcute phaseBP managementStroke patientsCerebral autoregulationWorse outcomesDepletion of CD4 T cells provides therapeutic benefits in aged mice after ischemic stroke
Harris NM, Roy-O'Reilly M, Ritzel RM, Holmes A, Sansing LH, O'Keefe LM, McCullough LD, Chauhan A. Depletion of CD4 T cells provides therapeutic benefits in aged mice after ischemic stroke. Experimental Neurology 2020, 326: 113202. PMID: 31954116, PMCID: PMC7059209, DOI: 10.1016/j.expneurol.2020.113202.Peer-Reviewed Original ResearchConceptsIP-10 levelsMiddle cerebral artery occlusionCD4 T cellsT cellsIschemic strokeStroke patientsIsotype controlBrain-infiltrating T cellsCD4 T-cell depletionCerebral artery occlusionT-cell depletionAged mouse modelAged male micePro-inflammatory factorsT cell dysfunctionPro-inflammatory cytokinesAnti-CD4 antibodiesAged stroke patientsIgG isotype controlCD4 treatmentDepletion antibodyArtery occlusionExperimental strokeStroke onsetSham surgeryAging exacerbates neutrophil pathogenicity in ischemic stroke
Roy-O'Reilly MA, Ahnstedt H, Spychala MS, Munshi Y, Aronowski J, Sansing LH, McCullough LD. Aging exacerbates neutrophil pathogenicity in ischemic stroke. Aging 2020, 12: 436-461. PMID: 31927534, PMCID: PMC6977697, DOI: 10.18632/aging.102632.Peer-Reviewed Original ResearchConceptsIschemic stroke patientsIschemic strokeNeutrophil-activating cytokineStroke patientsNeutrophil functionNeutrophil reactive oxygen speciesPoor post-stroke outcomesDepletion of neutrophilsPro-inflammatory functionsStrong risk factorExperimental mouse modelPost-stroke outcomesHigher stroke mortalityStroke outcomePoor outcomeFunctional outcomeStroke mortalityLong-term benefitsRisk factorsSpecific monoclonal antibodiesNeutrophil trafficTissue injuryYoung miceAged subjectsMouse model