2025
Elevated initial blood kynurenine is associated with increased odds of post-stroke infection Kynurenine and post-stroke infection
Dylla L, Reisz J, Poisson S, Herson P, Sansing L, Monte A. Elevated initial blood kynurenine is associated with increased odds of post-stroke infection Kynurenine and post-stroke infection. Journal Of Stroke And Cerebrovascular Diseases 2025, 34: 108268. PMID: 40015349, DOI: 10.1016/j.jstrokecerebrovasdis.2025.108268.Peer-Reviewed Original ResearchConceptsPost-stroke infectionsAssociated with increased oddsTryptophan metabolitesHistory of diabetes mellitusEnd stage renal diseaseNIH Stroke Scale scoreConcentrations of kynurenineAcute ischemic stroke patientsMultivariate logistic regressionStage renal diseaseStroke Scale scoreCirculating kynurenineIschemic stroke onsetIschemic stroke patientsKynurenine concentrationsConcentrations of tryptophanEmergency department admissionsKynurenic acidDiabetes mellitusMortality of ischemic strokeRenal diseaseTryptophan metabolismOdds ratioQuinolinic acidImmune responseEfficacy and Safety of IV Thrombolysis for Acute Ischemic Stroke Patients With Moyamoya Disease
Chen H, Colasurdo M, Khunte M, Malhotra A, Gandhi D. Efficacy and Safety of IV Thrombolysis for Acute Ischemic Stroke Patients With Moyamoya Disease. Neurology 2025, 104: e210243. PMID: 39772663, DOI: 10.1212/wnl.0000000000210243.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeTreated with IV thrombolysisIn-hospital mortalityMoyamoya disease patientsIV thrombolysisMoyamoya diseasePropensity score matchingIntracranial hemorrhageRisk factors of acute ischemic strokeSelf-careIschemic stroke patientsAcute ischemic stroke patientsStroke patientsTreating acute ischemic strokeNationwide Readmissions DatabaseRisk factorsRate of routine dischargeRoutine dischargeEfficacy outcomesAssociated with different ratesProspective studyBypass surgeryRetrospective analysisEstablished treatmentReadmissions Database
2024
Clinically relevant findings on 24-h head CT after acute stroke therapy: The 24-h CT score
Zhang B, King A, Voetsch B, Silverman S, Schwamm L, Ji X, Singhal A. Clinically relevant findings on 24-h head CT after acute stroke therapy: The 24-h CT score. International Journal Of Stroke 2024, 20: 226-234. PMID: 39324561, DOI: 10.1177/17474930241289992.Peer-Reviewed Original ResearchCT scoreCT findingsHead CTClinically relevant findingsFollow-up head CTRoutine head computed tomographyHead CT findingsHead computed tomographyConsecutive acute ischemic stroke patientsBlood pressure goalsAcute ischemic stroke patientsLow-risk groupMedium-risk groupAdministration of mannitolHigh-risk groupMultivariate logistic regressionAcute stroke therapyComprehensive stroke centerIschemic stroke patientsBlood glucose levelsCT abnormalitiesAntithrombotic treatmentRelevant findingsHypertonic salineRetrospective studyThe effect of intravenous thrombolysis in stroke patients with unsuccessful thrombectomy.
Elawady S, Kasem R, Matsukawa H, Cunningham C, Sowlat M, Nawabi N, Orscelik A, Venegas J, Isidor J, Loulida H, Maier I, Jabbour P, Kim J, Wolfe S, Rai A, Starke R, Psychogios M, Samaniego E, Goyal N, Yoshimura S, Cuellar H, Howard B, Alawieh A, Alaraj A, Ezzeldin M, Romano D, Tanweer O, Mascitelli J, Fragata I, Polifka A, Siddiqui F, Osbun J, Grandhi R, Crosa R, Matouk C, Park M, Levitt M, Brinjikji W, Moss M, Daglioglu E, Williamson R, Navia P, Kan P, De Leacy R, Chowdhry S, Altschul D, Spiotta A, Al Kasab S. The effect of intravenous thrombolysis in stroke patients with unsuccessful thrombectomy. Interventional Neuroradiology 2024, 15910199241279009. PMID: 39262342, PMCID: PMC11559907, DOI: 10.1177/15910199241279009.Peer-Reviewed Original ResearchAcute ischemic stroke patientsLarge vessel occlusionAcute ischemic strokeIntracranial hemorrhageBenefit of intravenous thrombolysisMechanical thrombectomyIntravenous thrombolysisMT alone groupAlone groupMT groupSecondary outcomesAnterior circulation large vessel occlusionSymptomatic intracranial hemorrhageEffect of intravenous thrombolysisIVT + MTIntravenous thrombolysis prior to MTPropensity score matchingMedian ageSymptomatic ICHMTICI scoreFailed recanalizationPrimary outcomeFunctional outcomesPatientsVessel occlusionHigher proceduralist stroke thrombectomy volume is associated with reduced inpatient mortality
Koo A, Renedo D, Ney J, Amllay A, Kanzler M, Stogniy S, Alawieh A, Sujijantarat N, Antonios J, Al Kasab S, Malhotra A, Hebert R, Matouk C, de Havenon A. Higher proceduralist stroke thrombectomy volume is associated with reduced inpatient mortality. Journal Of NeuroInterventional Surgery 2024, jnis-2024-022021. PMID: 39214687, DOI: 10.1136/jnis-2024-022021.Peer-Reviewed Original ResearchIn-hospital deathIn-hospital mortalityAcute ischemic strokeCut-pointsAbsolute risk of deathAssociated with lower oddsState Inpatient DatabasesFlorida State Inpatient DatabaseIn-hospital moralityRates of in-hospital mortalityDiagnosis of acute ischemic strokePrimary study outcomeRisk of deathStroke careOptimal cut-pointAssociated with reduced inpatient mortalityEndovascular thrombectomyRetrospective cohort studyLower oddsPotential confoundersAbsolute riskAcute ischemic stroke patientsInpatient mortalityCohort studyInpatient DatabasePrediction of Large Vessel Occlusion Stroke Using Clinical Registries for Research.
de Havenon A, Ayodele I, Alhanti B, Mac Grory B, Xian Y, Fonarow G, Smith E, Worrall B. Prediction of Large Vessel Occlusion Stroke Using Clinical Registries for Research. Neurology 2024, 102: e209424. PMID: 38759133, PMCID: PMC11175650, DOI: 10.1212/wnl.0000000000209424.Peer-Reviewed Original ResearchConceptsLarge vessel occlusionNIH Stroke ScaleConsistent with previous studiesAdult acute ischemic stroke patientsCross-sectional cohort analysisAcute ischemic stroke patientsLarge vessel occlusion strokePosterior circulation strokeDiagnosis of ischemic strokeReceiver operating curveNeuroimagingGWTG-StrokeIschemic stroke patientsVascular neuroimagingAdult patientsAtrial fibrillationCirculation strokeCohort analysisClinical covariatesStroke patientsOcclusion strokeVessel occlusionPrevious studiesCut-pointsStroke ScaleAnesthetic management for large vessel occlusion acute ischemic stroke with tandem lesions
Farooqui M, Galecio-Castillo M, Hassan A, Divani A, Jumaa M, Ribo M, Petersen N, Abraham M, Fifi J, Guerrero W, Malik A, Siegler J, Nguyen T, Sheth S, Yoo A, Linares G, Janjua N, Quispe-Orozco D, Tekle W, Sabbagh S, Zaidi S, Gadea M, Prasad A, Qureshi A, De Leacy R, Abdalkader M, Salazar-Marioni S, Soomro J, Gordon W, Turabova C, Rodriguez-Calienes A, Vivanco-Suarez J, Mokin M, Yavagal D, Jovin T, Ortega-Gutierrez S. Anesthetic management for large vessel occlusion acute ischemic stroke with tandem lesions. Journal Of NeuroInterventional Surgery 2024, 17: 139-147. PMID: 38429099, DOI: 10.1136/jnis-2023-021360.Peer-Reviewed Original ResearchSymptomatic intracranial hemorrhageModified Rankin scoreFavorable functional outcomeAlberta Stroke Program Early CT ScoreNational Institutes of Health Stroke ScaleEndovascular therapyInternal carotid arteryFunctional outcomesAcute ischemic strokeProcedural sedationExcellent recanalizationTandem lesionsAssociated with superior functional outcomesBaseline Alberta Stroke Program Early CT ScoreAnesthetic strategyRecanalization timeAnterior circulation tandem lesionsGeneral anesthesiaAnesthetic techniqueDegree of internal carotid arteryInternal carotid artery stentingOptimal anesthetic strategyIschemic strokeLarge vessel occlusion acute ischemic strokeAcute ischemic stroke patientsTime-driven activity-based costing (TDABC) of direct-to-angiography pathway for acute ischemic stroke patients with suspected large vessel occlusion
Sangha K, White T, Boltyenkov A, Bastani M, Sanmartin M, Katz J, Malhotra A, Rula E, Naidich J, Sanelli P. Time-driven activity-based costing (TDABC) of direct-to-angiography pathway for acute ischemic stroke patients with suspected large vessel occlusion. Journal Of Stroke And Cerebrovascular Diseases 2024, 33: 107516. PMID: 38183964, DOI: 10.1016/j.jstrokecerebrovasdis.2023.107516.Peer-Reviewed Original ResearchAcute ischemic strokeEndovascular treatmentAcute ischemic stroke patientsAppropriate patient selection criteriaNovel care pathwayIschemic stroke patientsLarge vessel occlusionPatient selection criteriaInstitutional patient databaseTime-driven activity-based costingEligible patientsAnterior circulationIschemic strokeClinical outcomesPatient factorsStroke patientsAIS patientsVessel occlusionCare pathwayPatient costsMain cost driversPatientsPatient databaseAngiography suiteCT pathway
2023
Endovascular treatment of acute ischemic stroke patients with tandem lesions: antegrade versus retrograde approach.
Galecio-Castillo M, Abraham M, Farooqui M, Hassan A, Divani A, Jumaa M, Ribo M, Petersen N, Fifi J, Guerrero W, Malik A, Siegler J, Nguyen T, Sheth S, Yoo A, Linares G, Janjua N, Quispe-Orozco D, Qureshi A, Tekle W, Ikram A, Zaidi S, Zevallos C, Taborda B, Devarajan A, Zhang L, Abdalkader M, Salazar-Marioni S, Soomro J, Gordon W, Rodriguez-Calienes A, Vivanco-Suarez J, Woolfolk K, Mokin M, Yavagal D, Ortega-Gutierrez S. Endovascular treatment of acute ischemic stroke patients with tandem lesions: antegrade versus retrograde approach. Journal Of Neurosurgery 2023, 140: 1726-1735. PMID: 38157542, PMCID: PMC11271811, DOI: 10.3171/2023.10.jns231702.Peer-Reviewed Original ResearchConceptsSymptomatic intracranial hemorrhageFirst-pass effectExcellent recanalizationRetrograde approachMRS scoreRecanalization timePuncture to recanalization timeTreatment of acute ischemic stroke patientsTandem lesionsAcute ischemic stroke patientsMRS score 0Acute ischemic strokeIschemic stroke patientsAntegrade groupIntracranial hemorrhageEndovascular treatmentMulticenter studyGroin punctureSafety profileEndovascular therapyAcute stentingProcedural outcomesScore 0Ordinal shiftTL patientsSafety Outcomes of Antiplatelet Therapy During Endovascular Treatment of Tandem Lesions in Acute Ischemic Stroke Patients
Farooqui M, Divani A, Galecio-Castillo M, Hassan A, Jumaa M, Ribo M, Abraham M, Petersen N, Fifi J, Guerrero W, Malik A, Siegler J, Nguyen T, Sheth S, Yoo A, Linares G, Janjua N, Quispe-Orozco D, Ikram A, Tekle W, Zaidi S, Zevallos C, Rizzo F, Barkley T, De Leacy R, Khalife J, Abdalkader M, Salazar-Marioni S, Soomro J, Gordon W, Rodriguez-Calienes A, Vivanco-Suarez J, Turabova C, Mokin M, Yavagal D, Ortega-Gutierrez S. Safety Outcomes of Antiplatelet Therapy During Endovascular Treatment of Tandem Lesions in Acute Ischemic Stroke Patients. Translational Stroke Research 2023, 1-11. PMID: 38017258, PMCID: PMC11271812, DOI: 10.1007/s12975-023-01214-9.Peer-Reviewed Original ResearchSymptomatic intracranial hemorrhageEndovascular therapyIn-stent thrombosisTandem lesionsAnterior circulation tandem lesionsRate of symptomatic hemorrhageFavorable functional statusTreatment of tandem lesionsRisk of hemorrhageAcute ischemic stroke patientsNo significant associationExcellent reperfusionIschemic stroke patientsSymptomatic hemorrhageMRS 0Intracranial hemorrhageAntiplatelet strategiesEndovascular treatmentMulticenter studyAntiplatelet therapyAntiplatelet medicationsAntiplatelet regimensMTICI 2c/3Carotid stentingPrimary outcomeHigher Procedural Volumes Are Associated with Faster Treatment Times, Better Functional Outcomes, and Lower Mortality in Patients Undergoing Endovascular Treatment for Acute Ischemic Stroke
Nogueira R, Haussen D, Smith E, Sun J, Xian Y, Alhanti B, Blanco R, Mac Grory B, Doheim M, Bhatt D, Fonarow G, Hassan A, Joundi R, Mocco J, Frankel M, Schwamm L. Higher Procedural Volumes Are Associated with Faster Treatment Times, Better Functional Outcomes, and Lower Mortality in Patients Undergoing Endovascular Treatment for Acute Ischemic Stroke. Annals Of Neurology 2023, 95: 146-155. PMID: 37731004, DOI: 10.1002/ana.26803.Peer-Reviewed Original ResearchHigh procedural volumeProcedural volumeEndovascular therapyHospital mortalityPrimary cohortAIS patientsFaster treatment timesAcute ischemic stroke patientsGood discharge outcomeGuidelines-Stroke registryPretreatment National InstitutesHealth Stroke ScaleAcute ischemic strokeIschemic stroke patientsObservational cohort studyHospital procedural volumeLower ratesStroke ScaleCohort studyIschemic strokeArterial punctureDischarge outcomesEndovascular treatmentInterhospital transferStroke patientsAbstract TP47: Impact Of Prehospital Care And Patient Presentation On In-hospital Treatment Of Acute Ischemic Stroke
DYLLA L, Higgins H, Ravare B, Jeppson K, Bina H, Rice J, Herson P, Monte A, Poisson S. Abstract TP47: Impact Of Prehospital Care And Patient Presentation On In-hospital Treatment Of Acute Ischemic Stroke. Stroke 2023, 54: atp47-atp47. DOI: 10.1161/str.54.suppl_1.tp47.Peer-Reviewed Original ResearchEmergency medicine servicesDoor-to-CT timeAmerican Heart AssociationLinear regression modelsDoor-to-computed tomographyIn-hospital quality of careQuality-of-care metricsGuideline concordant careQuality of careAcute stroke careDoor-to-CTIn-hospital careRegression modelsMultivariate linear regression modelConcordant careProvider compliancePrehospital careStroke careStroke guidelinesIschemic stroke patientsMedicine serviceStroke symptomsIn-hospital outcomesComprehensive stroke centerAcute ischemic stroke patients
2022
Cost-effectiveness of endovascular thrombectomy in acute stroke patients with large ischemic core
Sanmartin M, Katz J, Wang J, Malhotra A, Sangha K, Bastani M, Martinez G, Sanelli P. Cost-effectiveness of endovascular thrombectomy in acute stroke patients with large ischemic core. Journal Of NeuroInterventional Surgery 2022, 15: e166-e171. PMID: 36175016, DOI: 10.1136/jnis-2022-019460.Peer-Reviewed Original ResearchConceptsQuality-adjusted life yearsIncremental cost-effectiveness ratioNet monetary benefitProbabilistic sensitivity analysesEconomic evaluation studiesCost-effectiveness analysisCost-effectiveness ratioSensitivity analysisTwo-way sensitivity analysesLifetime healthcare costsMonetary benefitsLife yearsLifetime costsLifetime benefitsLarge ischemic coreStandard careCost-effective strategyEVTIschemic coreStroke patientsAIS patientsPatient's lifetimeAcute ischemic stroke patientsCostEndovascular thrombectomy treatmentTemporal profiles of systolic blood pressure variability and neurologic outcomes after endovascular thrombectomy
Prasad A, Kobsa J, Kodali S, Bartolome D, Begunova L, Quispe-Orozco D, Farooqui M, Zevallos C, Ortega-Gutiérrez S, Anadani M, Almallouhi E, Spiotta A, Giles J, Keyrouz S, Kim J, Maier I, Liman J, Psychogios M, Riou-Comte N, Richard S, Gory B, Wolfe S, Brown P, Fargen K, Mistry E, Fakhri H, Mistry A, Wong K, Nascimento F, Kan P, de Havenon A, Sheth K, Petersen N. Temporal profiles of systolic blood pressure variability and neurologic outcomes after endovascular thrombectomy. European Stroke Journal 2022, 7: 365-375. PMID: 36478756, PMCID: PMC9720854, DOI: 10.1177/23969873221106907.Peer-Reviewed Original ResearchBlood pressure variabilitySystolic blood pressure variabilityHigh systolic blood pressure variabilityEndovascular thrombectomyFunctional outcomePressure variabilityHigh blood pressure variabilityLower blood pressure variabilityAcute ischemic stroke patientsLarge vessel occlusion strokePoor discharge outcomeIschemic stroke patientsWorse functional outcomePoor functional outcomeBlood pressure dataHigh trajectory groupGroup-based trajectory modelingHemorrhagic transformationNeurologic outcomeDischarge outcomesSBP trajectoriesStroke patientsOcclusion strokePoor outcomeRelevant confoundersThe relationship between stroke system organization and disparities in access to stroke center care in California
Zachrison K, Samuels‐Kalow M, Li S, Yan Z, Reeves M, Hsia R, Schwamm L, Camargo C. The relationship between stroke system organization and disparities in access to stroke center care in California. Journal Of The American College Of Emergency Physicians Open 2022, 3: e12706. PMID: 35316966, PMCID: PMC8921441, DOI: 10.1002/emp2.12706.Peer-Reviewed Original ResearchIschemic stroke patientsInterhospital transferStroke patientsReperfusion interventionsCenter careEthnic disparitiesAcute ischemic stroke patientsNon-Hispanic black patientsAsian/Pacific Islander patientsAcute ischemic strokeComprehensive stroke centerOdds of dischargeHospital-level characteristicsPacific Islander patientsNon-Hispanic Asian/Pacific IslandersNon-Hispanic blacksAsian/Pacific IslandersInterhospital patient transfersOutcomes of interestNon-Hispanic whitesHierarchical logistic regressionReperfusion therapyHospital dischargeIschemic strokeStroke centers
2021
Exploring the Unmet Need in Acute Ischemic Stroke Patients Not Treated With Intravenous Alteplase: The Get With The Guidelines‐Stroke Registry
Mac Grory B, Xian Y, Solomon N, Matsouaka R, Decker‐Palmer M, Fonarow G, Smith E, Schwamm L. Exploring the Unmet Need in Acute Ischemic Stroke Patients Not Treated With Intravenous Alteplase: The Get With The Guidelines‐Stroke Registry. Stroke Vascular And Interventional Neurology 2021, 2 DOI: 10.1161/svin.121.000226.Peer-Reviewed Original ResearchGuidelines-Stroke registryAcute ischemic strokeIschemic strokePatient populationCommon reasonUnmet needAcute ischemic stroke patientsIntravenous tissue plasminogen activatorAcute ischemic stroke careGuidelines-Stroke hospitalsIschemic stroke patientsIschemic stroke careLong-term outcomesTissue plasminogen activatorAlteplase deliveryHospital mortalityIntravenous alteplaseClinical characteristicsConclusions PatientsReadmission ratesEarly administrationPostdischarge costsStroke careStroke patientsFunctional outcomeIpsilateral internal carotid artery web and acute ischemic stroke: A cohort study, systematic review and meta-analysis
Mac Grory B, Nossek E, Reznik ME, Schrag M, Jayaraman M, McTaggart R, de Havenon A, Yaghi S, Feng W, Furie K, Boyanpally A. Ipsilateral internal carotid artery web and acute ischemic stroke: A cohort study, systematic review and meta-analysis. PLOS ONE 2021, 16: e0257697. PMID: 34534252, PMCID: PMC8448368, DOI: 10.1371/journal.pone.0257697.Peer-Reviewed Original ResearchConceptsCarotid artery webCarotid webIschemic stroke patientsCryptogenic strokeComputed tomography angiographyStroke patientsSystematic reviewCohort studyIschemic strokeRelative riskSimilar cohortAcute ischemic stroke patientsCompelling potential mechanismsCryptogenic stroke patientsComprehensive stroke centerAcute ischemic strokeEmbolic ischemic strokeEligible patientsSecondary preventionStroke centersStroke subtypesYounger patientsPooled prevalenceTomography angiographyPatientsFrequency, Characteristics, and Outcomes of Endovascular Thrombectomy in Patients With Stroke Beyond 6 Hours of Onset in US Clinical Practice
Zachrison K, Schwamm L, Xu H, Matsouaka R, Shah S, Smith E, Xian Y, Fonarow G, Saver J. Frequency, Characteristics, and Outcomes of Endovascular Thrombectomy in Patients With Stroke Beyond 6 Hours of Onset in US Clinical Practice. Stroke 2021, 52: 3805-3814. PMID: 34470490, DOI: 10.1161/strokeaha.121.034069.Peer-Reviewed Original ResearchConceptsAcute ischemic stroke patientsEndovascular thrombectomyIschemic stroke patientsStroke patientsEVT casesGuidelines-Stroke hospitalsUS clinical practiceLower stroke severityClinical practice settingEVT outcomesEVT timesHospital mortalityNontrial settingDischarge dispositionIschemic strokePatient characteristicsStroke severityAtrial fibrillationFunctional outcomeClinical registryHospital characteristicsPatientsClinical practicePractice settingsStudy periodBlack Patients with Ischemic Stroke and Hyperglycemia have Worse outcome than Whites if given Intensive Glucose Control
de Havenon A, Muddasani V, Castillo M, Sheth KN, Delic A, Herman A, Conaway M, Johnston KC, Investigators F. Black Patients with Ischemic Stroke and Hyperglycemia have Worse outcome than Whites if given Intensive Glucose Control. Journal Of Stroke And Cerebrovascular Diseases 2021, 30: 106065. PMID: 34455151, PMCID: PMC8511272, DOI: 10.1016/j.jstrokecerebrovasdis.2021.106065.Peer-Reviewed Original ResearchConceptsIntensive glucose controlAcute ischemic strokeWorse functional outcomeBlack patientsGlucose controlIschemic strokeWhite patientsExcellent outcomesFunctional outcomeTreatment armsWorse outcomesAcute ischemic stroke patientsStroke Hyperglycemia Insulin Network Effort (SHINE) trialIntensive treatment armStandard treatment armIschemic stroke patientsExcellent functional outcomeMixed effects logistic regression modelsLogistic regression modelsPrimary outcomeStroke patientsPotential confoundersOdds ratioFunctional impairmentPatientsAnticonvulsant Primary and Secondary Prophylaxis for Acute Ischemic Stroke Patients
Jones F, Sanches P, Smith J, Zafar S, Hernandez-Diaz S, Blacker D, Hsu J, Schwamm L, Westover M, Moura L. Anticonvulsant Primary and Secondary Prophylaxis for Acute Ischemic Stroke Patients. Stroke 2021, 52: 2782-2791. PMID: 34126758, PMCID: PMC8384723, DOI: 10.1161/strokeaha.120.033299.Peer-Reviewed Original ResearchConceptsQuality-adjusted life expectancySecondary prophylaxisAdverse drug reactionsADR riskLate seizuresPrimary prophylaxisMale patientsFemale patientsLifetime riskLS riskAcute ischemic stroke hospitalizationsLong-term secondary prophylaxisAcute ischemic stroke patientsHigher ADR risksAcute ischemic strokeIschemic stroke patientsIschemic stroke hospitalizationsCommon clinical scenariosShort-term therapyAnticonvulsant prophylaxisLifetime prophylaxisPersistent seizuresSeizure prophylaxisEarly seizuresIschemic stroke
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