2024
Tenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection
Albers G, Jumaa M, Purdon B, Zaidi S, Streib C, Shuaib A, Sangha N, Kim M, Froehler M, Schwartz N, Clark W, Kircher C, Yang M, Massaro L, Lu X, Rippon G, Broderick J, Butcher K, Lansberg M, Liebeskind D, Nouh A, Schwamm L, Campbell B. Tenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection. New England Journal Of Medicine 2024, 390: 701-711. PMID: 38329148, DOI: 10.1056/nejmoa2310392.Peer-Reviewed Original ResearchConceptsModified Rankin ScaleSymptomatic intracranial hemorrhageInternal carotid arteryMiddle cerebral arteryRankin ScalePlacebo groupTenecteplase groupIntracranial hemorrhageIncidence of symptomatic intracranial hemorrhageCerebral arteryIncidence of symptomatic intracerebral hemorrhageCarotid arteryPlacebo-controlled trialSymptomatic intracerebral hemorrhageEvidence of occlusionSafety populationDouble-blindPerfusion-imagingMedian timeClinical outcomesIntracerebral hemorrhagePlaceboPerfusion imagingPrimary outcomeOdds ratio
2022
Differences 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 proportion
2021
Teleneurology Comprehensive Inpatient Consultations Expedite Access to Care and Decreases Hospital Length of Stay
McCormick R, Estrada J, Whitney C, Hinrichsen M, Lee P, Cohen A, Schwamm L, Matiello M. Teleneurology Comprehensive Inpatient Consultations Expedite Access to Care and Decreases Hospital Length of Stay. The Neurohospitalist 2021, 11: 229-234. PMID: 34163548, PMCID: PMC8182406, DOI: 10.1177/19418744211000951.Peer-Reviewed Original ResearchTeleneurology serviceTertiary careConsult requestsDecrease hospital lengthPercentage of patientsRate of patientsImplementation groupConsult orderHospital lengthDischarge dispositionMedian timeMedian lengthInpatient lengthMedical recordsCommunity hospitalPerson consultationsHospital measuresConsultation databaseIndependent cohortTelestroke careStayConsultation completionPatientsCareSignificant differencesTeleneurology-Enabled Determination of Death by Neurologic Criteria After Cardiac Arrest or Severe Neurologic Injury.
Matiello M, Turner A, Estrada J, Whitney C, Kitch B, Lee P, Girkar U, Palacios R, Singla P, Schwamm L. Teleneurology-Enabled Determination of Death by Neurologic Criteria After Cardiac Arrest or Severe Neurologic Injury. Neurology 2021, 96: e1999-e2005. PMID: 33637632, DOI: 10.1212/wnl.0000000000011751.Peer-Reviewed Original ResearchConceptsIntensive care unitOrgan donorsNeurologic criteriaSevere neurologic damageSevere neurologic deficitsSevere neurologic injuryProportion of patientsDemographic informationPatient demographic informationPotential organ donorsDetermination of prognosisNumber of referralsProportion of donorsTeleneurology consultationsNeurologic deficitsNeurologic injuryMedian timeNeurologic damageCare unitComatose patientsCardiac arrestPatientsRetrospective dataConsultsOrgan donation
2020
Left Atrial Mechanics Assessed Early during Hospitalization for Cryptogenic Stroke Are Associated with Occult Atrial Fibrillation: A Speckle-Tracking Strain Echocardiography Study
Deferm S, Bertrand PB, Churchill TW, Sharma R, Vandervoort PM, Schwamm LH, Yoerger Sanborn DM. Left Atrial Mechanics Assessed Early during Hospitalization for Cryptogenic Stroke Are Associated with Occult Atrial Fibrillation: A Speckle-Tracking Strain Echocardiography Study. Journal Of The American Society Of Echocardiography 2020, 34: 156-165. PMID: 33132019, DOI: 10.1016/j.echo.2020.09.009.Peer-Reviewed Original ResearchConceptsMobile cardiac outpatient telemetryOccult atrial fibrillationBooster pump functionAtrial fibrillationCryptogenic strokeAtrial mechanicsStrain echocardiographyReservoir strainPump functionBaseline cardiovascular risk profileLA booster pump functionPresence of AFCardiovascular risk profileLA volume indexReceiver operator curve analysisOperator curve analysisSpontaneous cardioversionEmbolic strokeClinical characteristicsRetrospective cohortEchocardiography studyLA sizeMedian timeStroke hospitalizationsEchocardiography
2018
Intravenous tPA (Tissue-Type Plasminogen Activator) in Patients With Acute Ischemic Stroke Taking Non–Vitamin K Antagonist Oral Anticoagulants Preceding Stroke
Jin C, Huang R, Peterson E, Laskowitz D, Hernandez A, Federspiel J, Schwamm L, Bhatt D, Smith E, Fonarow G, Xian Y. Intravenous tPA (Tissue-Type Plasminogen Activator) in Patients With Acute Ischemic Stroke Taking Non–Vitamin K Antagonist Oral Anticoagulants Preceding Stroke. Stroke 2018, 49: 2237-2240. PMID: 30354981, PMCID: PMC6706353, DOI: 10.1161/strokeaha.118.022128.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, IntravenousAdministration, OralAntibodies, Monoclonal, HumanizedAnticoagulantsAntidotesAntithrombinsBrain IschemiaDabigatranFactor Xa InhibitorsFibrinolytic AgentsHumansIntracranial HemorrhagesOdds RatioPractice Guidelines as TopicPyrazolesPyridonesRivaroxabanStrokeTissue Plasminogen ActivatorConceptsSymptomatic intracranial hemorrhageAcute ischemic strokeIntravenous tPAIntracranial hemorrhageFavorable outcomeIschemic strokeThrombin timeAnti-Xa assaySensitive laboratory testsNOAC patientsOral anticoagulantsTPA administrationProhibitive riskSymptom onsetPatient characteristicsMedian timeMedication intakeCurrent guidelinesAnticoagulant effectLarge cohortClinical carePatientsOverall observed rateNOACsHemorrhage
2015
Treatment and Outcome of Thrombolysis-Related Hemorrhage: A Multicenter Retrospective Study
Yaghi S, Boehme A, Dibu J, Guerrero C, Ali S, Martin-Schild S, Sands K, Noorian A, Blum C, Chaudhary S, Schwamm L, Liebeskind D, Marshall R, Willey J. Treatment and Outcome of Thrombolysis-Related Hemorrhage: A Multicenter Retrospective Study. JAMA Neurology 2015, 72: 1-7. PMID: 26501741, PMCID: PMC4845894, DOI: 10.1001/jamaneurol.2015.2371.Peer-Reviewed Original ResearchConceptsSymptomatic intracerebral hemorrhageRecombinant tissue plasminogen activatorMulticenter retrospective studyHematoma expansionHospital mortalityMedian timeRetrospective studyIntravenous recombinant tissue plasminogen activatorHealth Stroke Scale scoreParenchymal hematoma type 2Code status changeOutcome of thrombolysisStroke-Monitoring StudyComprehensive stroke centerHospital mortality rateOutcomes of patientsStroke Scale scoreTissue plasminogen activatorIschemic strokePrimary outcomeRtPA therapySecondary outcomesStroke centersSymptom onsetIntracerebral hemorrhage
2004
ASPECTS on CTA Source Images Versus Unenhanced CT
Coutts S, Lev M, Eliasziw M, Roccatagliata L, Hill M, Schwamm L, Pexman J, Koroshetz W, Hudon M, Buchan A, Gonzalez R, Demchuk A. ASPECTS on CTA Source Images Versus Unenhanced CT. Stroke 2004, 35: 2472-2476. PMID: 15486327, DOI: 10.1161/01.str.0000145330.14928.2a.Peer-Reviewed Original ResearchConceptsAlberta Stroke Program Early CT ScoreCTA-SI Alberta Stroke Program Early CT ScoreCT angiography source imagesBaseline Alberta Stroke Program Early CT ScoreIschemic changesFavorable outcomeNCCT-Alberta Stroke Program Early CT ScoreAcute ischemic strokeFinal infarct sizeFinal infarct volumeFavorable patient outcomesNormal CT scanRate ratioCTA source imagesM2 occlusionsInfarct volumeIschemic strokeProximal occlusionSymptom onsetClinical outcomesMedian timeCT scoreInfarct sizePatient outcomesBaseline NCCT