2023
Association of Neighborhood-Level Socioeconomic Factors With Delay to Hospital Arrival in Patients With Acute Stroke
Forman R, Okumu R, Mageid R, Baker A, Neu D, Parker R, Peyravi R, Schindler J, Sansing L, Sheth K, de Havenon A, Jasne A, Narula R, Wira C, Warren J, Sharma R. Association of Neighborhood-Level Socioeconomic Factors With Delay to Hospital Arrival in Patients With Acute Stroke. Neurology 2023, 102: e207764. PMID: 38165368, PMCID: PMC10834135, DOI: 10.1212/wnl.0000000000207764.Peer-Reviewed Original ResearchConceptsEmergency department arrival timesEmergency medical servicesLate presentationAcute ischemic stroke therapyYale-New Haven HospitalGuidelines-Stroke registryNeighborhood-level socioeconomic factorsPatient-level factorsRetrospective observational studyIschemic stroke therapyMixed-effects logistic regression modelNon-white patientsNon-white raceUnivariate logistic regressionNew Haven HospitalLogistic regression modelsHospital presentationTreatment ineligibilityStroke RegistryAcute strokeHospital arrivalStroke therapyUnivariate analysisObservational studyPatients
2022
Acute Ischemic Stroke, Depressed Left Ventricular Ejection Fraction, and Sinus Rhythm: Prevalence and Practice Patterns
Baker AD, Schwamm LH, Sanborn DY, Furie K, Stretz C, Mac Grory B, Yaghi S, Kleindorfer D, Sucharew H, Mackey J, Walsh K, Flaherty M, Kissela B, Alwell K, Khoury J, Khatri P, Adeoye O, Ferioli S, Woo D, Martini S, La Rosa F, Demel SL, Madsen T, Star M, Coleman E, Slavin S, Jasne A, Mistry EA, Haverbusch M, Merkler AE, Kamel H, Schindler J, Sansing LH, Faridi KF, Sugeng L, Sheth KN, Sharma R. Acute Ischemic Stroke, Depressed Left Ventricular Ejection Fraction, and Sinus Rhythm: Prevalence and Practice Patterns. Stroke 2022, 53: 1883-1891. PMID: 35086361, PMCID: PMC10214981, DOI: 10.1161/strokeaha.121.036706.Peer-Reviewed Original ResearchConceptsLeft ventricular ejection fractionAcute ischemic strokeDepressed left ventricular ejection fractionVentricular ejection fractionSinus rhythmIschemic strokeEjection fractionPooled prevalenceHealth Stroke Severity ScaleSecondary stroke prevention strategiesMultivariable logistic regression modelAntithrombotic treatment regimensHospital-based cohortRetrospective cohort studySecondary stroke preventionStroke prevention strategiesMulti-center cohortStroke Severity ScaleLogistic regression modelsEchocardiographic characteristicsHospitalization dischargeAntiplatelet therapyStroke preventionCardiac thrombusCohort studyBedside detection of intracranial midline shift using portable magnetic resonance imaging
Sheth KN, Yuen MM, Mazurek MH, Cahn BA, Prabhat AM, Salehi S, Shah JT, By S, Welch EB, Sofka M, Sacolick LI, Kim JA, Payabvash S, Falcone GJ, Gilmore EJ, Hwang DY, Matouk C, Gordon-Kundu B, RN AW, Petersen N, Schindler J, Gobeske KT, Sansing LH, Sze G, Rosen MS, Kimberly WT, Kundu P. Bedside detection of intracranial midline shift using portable magnetic resonance imaging. Scientific Reports 2022, 12: 67. PMID: 34996970, PMCID: PMC8742125, DOI: 10.1038/s41598-021-03892-7.Peer-Reviewed Original ResearchConceptsMidline shiftNeuroscience intensive care unitCare measurementYale-New Haven HospitalValuable bedside toolIntensive care unitPoor clinical outcomeBrain-injured patientsMass effectNew Haven HospitalMagnetic resonance imagingClinical outcomesIll patientsCare unitStroke patientsFunctional outcomeBedside toolObservational studyBedside detectionImaging examsPatientsResonance imagingPortable MRIImaging suiteSignificant concordance
2021
Drip-and-ship versus mothership for endovascular treatment of acute stroke: A comparative effectiveness analysis
Wu X, Wira C, Matouk C, Forman H, Gandhi D, Sanelli P, Schindler J, Malhotra A. Drip-and-ship versus mothership for endovascular treatment of acute stroke: A comparative effectiveness analysis. International Journal Of Stroke 2021, 17: 315-322. PMID: 33759645, DOI: 10.1177/17474930211008701.Peer-Reviewed Original ResearchConceptsComprehensive stroke centerPrimary stroke centerAcute stroke patientsNearest comprehensive stroke centerAcute strokeMothership strategyStroke centersStroke patientsPlace of onsetHealth benefitsMarkov decision-analytic modelComparative effectiveness analysisRecent medical literatureMultiple sensitivity analysesDecision analytic modelMothership modelPrimary outcomeEndovascular treatmentPrehospital triageSudden onsetPatientsMedical literatureStrokeShip strategyTarget population
2020
Cost-effectiveness of endovascular thrombectomy in patients with acute stroke and M2 occlusion
Khunte M, Wu X, Payabvash S, Zhu C, Matouk C, Schindler J, Sanelli P, Gandhi D, Malhotra A. Cost-effectiveness of endovascular thrombectomy in patients with acute stroke and M2 occlusion. Journal Of NeuroInterventional Surgery 2020, 13: 784-789. PMID: 33077578, DOI: 10.1136/neurintsurg-2020-016765.Peer-Reviewed Original ResearchConceptsEndovascular thrombectomyMedical managementProbabilistic sensitivity analysesM2 occlusionsAcute strokeBranch occlusionEVT-treated patientsAcute ischemic strokeQuality-adjusted life yearsLifetime quality-adjusted life yearsDecision analytic modelDecision analytic studyIschemic strokeReperfusion techniquesLifetime horizonBetter outcomesPatientsLife yearsAge groupsPerfect healthSocietal perspectiveCost-effective strategyStrokeHealth benefitsOcclusionEffects of Collateral Status on Infarct Distribution Following Endovascular Therapy in Large Vessel Occlusion Stroke
Al-Dasuqi K, Payabvash S, Torres-Flores GA, Strander SM, Nguyen CK, Peshwe KU, Kodali S, Silverman A, Malhotra A, Johnson MH, Matouk CC, Schindler JL, Sansing LH, Falcone GJ, Sheth KN, Petersen NH. Effects of Collateral Status on Infarct Distribution Following Endovascular Therapy in Large Vessel Occlusion Stroke. Stroke 2020, 51: e193-e202. PMID: 32781941, PMCID: PMC7484023, DOI: 10.1161/strokeaha.120.029892.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overArterial Occlusive DiseasesCerebral InfarctionCohort StudiesCollateral CirculationComputed Tomography AngiographyEndovascular ProceduresFemaleHumansInfarction, Middle Cerebral ArteryLinear ModelsMagnetic Resonance AngiographyMaleMiddle AgedReperfusionRetrospective StudiesStrokeThrombectomyTreatment OutcomeWhite MatterConceptsLarge vessel occlusion strokeFinal infarct volumeCollateral statusPoor collateral statusFavorable outcomeInfarct distributionInfarct volumeReperfusion successIndependent predictorsOcclusion strokeInternal capsuleAnterior circulation large vessel occlusion ischemic strokeLarge vessel occlusion ischemic strokeDeep white matter tractsBaseline collateral statusBorder-zone infarctionEarly favorable outcomeEarly functional outcomesRankin Scale scoreCohort of patientsDegree of reperfusionLarge vessel occlusionComputed tomography angiographyDeep white matterMagnetic resonance imagingStroke 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 hospitalsEfficacy and safety of nerinetide for the treatment of acute ischaemic stroke (ESCAPE-NA1): a multicentre, double-blind, randomised controlled trial
Hill MD, Goyal M, Menon BK, Nogueira RG, McTaggart RA, Demchuk AM, Poppe AY, Buck BH, Field TS, Dowlatshahi D, van Adel BA, Swartz RH, Shah RA, Sauvageau E, Zerna C, Ospel JM, Joshi M, Almekhlafi MA, Ryckborst KJ, Lowerison MW, Heard K, Garman D, Haussen D, Cutting SM, Coutts SB, Roy D, Rempel JL, Rohr AC, Iancu D, Sahlas DJ, Yu AYX, Devlin TG, Hanel RA, Puetz V, Silver FL, Campbell BCV, Chapot R, Teitelbaum J, Mandzia JL, Kleinig TJ, Turkel-Parrella D, Heck D, Kelly ME, Bharatha A, Bang OY, Jadhav A, Gupta R, Frei DF, Tarpley JW, McDougall CG, Holmin S, Rha JH, Puri AS, Camden MC, Thomalla G, Choe H, Phillips SJ, Schindler JL, Thornton J, Nagel S, Heo JH, Sohn SI, Psychogios MN, Budzik RF, Starkman S, Martin CO, Burns PA, Murphy S, Lopez GA, English J, Tymianski M, Demchuk A, Barber P, Smith E, Bal S, Subramaniam S, Peters S, Couillard P, Klein G, Stys P, Menon B, Coutts S, Almekhlafi M, Hill M, Goyal M, Wong J, Mitha A, Eesa M, Morrish W, Alqatani S, Kashani N, Joshi M, Zerna C, Ospel J, Venkatesan P, Teleg E, Sitaram A, Graham B, Van Gaal S, Moussaddy A, Chakraborty D, Maraj N, Loockey A, Chen S, Singh R, Alsultan A, Asuncion 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, Zhang O, Doram C, Lowerison M, Hanley A, Campbell L, Ure A, Taylor F, Hul D, Wiebe S, Saluzzi M, Blenkin N, Frayne R, Buck B, Butcher K, Shuaib A, Jeerakathil T, Jickling G, Emery D, Rempel J, Owen 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, Poppe A, Roy D, Daneault 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, Moussaddy A, Legault C, Durcan L, Moore A, Cole E, Magnussen C, Salmon K, Khalil S, Desloges I, Waxman L, Abdon W, Lai S, Dowlatshahi D, Iancu 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, Del 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-Farina C, Diestro J, Camden M, Verreault S, Mackey A, Audet M, Milot G, Lavoie P, Gariépy J, Collard K, Haché A, Van Adel B, Sahlas D, Alshanbari A, Baldwin J, Catanese L, Chen B, Boasquevisque D, Deshmukh A, Knapman J, Lamers S, Larrazabal R, MacMillan S, Mai L, Mattia A, Nayar S, Ng K, Oczkowski W, Perera K, Shawawrah M, Shoamanesh A, Sobhi G, Syed N, Taher N, Vandervelde C, Pharm 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, 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, Devlin T, 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, Gilchrist V, Feineigle P, 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, 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, McTaggart R, Jayaraman M, Cutting S, Smith W, Foley S, Paolucci G, Has R, Quinn K, Fuller L, Brierley R, Watkins C, Demir N, Lopez G, Vargas A, Osteraas N, Holtz B, Sauvageau E, Hanel R, Aghaebrahim A, Chmayssani M, Naval N, Day J, Dellorso S, Ludwig B, Schemmel D, Ebreo N, Bell K, Lewis L, Delucia M, Nogueira R, Haussen D, Frankel M, Bhatt N, Bianchi N, Anderson A, Belagaje S, Liberato B, Rangaraju S, Al-Bayati A, Grossberg J, Craft L, Schindler K, Schaad E, Schultz M, Southerly L, Doppelheuer S, Charlton J, Faggard J, Barbret Z, 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, 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, Kuohn L, Orgass H, Leary M, Nye J, Halbert K, Nystrom K, Neuschatz K, Petrucci D, Coppola A, Tarpley J, 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, Gupta R, Bain M, 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, 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, Shah 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, Nurs 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, Holmin S, 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, Thomalla G, Golsari A, Hoppe J, Deb-Chatterji M, Cheng B, Barrow 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, Puetz V, 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, Velktamp R, Nagel S, Ringleb P, Heyse M, Amiri H, Mundiyanapurath S, Chen M, Bevrle E, Beck P, Möhlenbruch M, Tymianski M, Potvin A, Harris C, Wang C, Adams C, Mayor D, Garman D, Chau D, Wu J, Lunn J, Heard K, Bermanis L, Teyes L, Constant M, Galsim M, Helbin M, Leroux M, Felix N, Bendre N, Cuthbert S, Brokx S, Zhang Y, Lingham T, Kohli Y, Salter M, Liebeschuetz J, Hofmann F, Constant J, Soeder T, Snoke K, Bologa M, Stahl K, Graziewicz M. Efficacy and safety of nerinetide for the treatment of acute ischaemic stroke (ESCAPE-NA1): a multicentre, double-blind, randomised controlled trial. The Lancet 2020, 395: 878-887. PMID: 32087818, DOI: 10.1016/s0140-6736(20)30258-0.Peer-Reviewed Original ResearchConceptsAlberta Stroke Program Early CT ScoreAcute ischemic strokeIschemic strokeEndovascular thrombectomySecondary outcomesScale scoreHealth Stroke Scale scoreModified Rankin Scale scorePost-synaptic density protein 95H treatment windowIntravenous alteplase treatmentBaseline National InstitutesPlacebo-controlled studySerious adverse eventsStroke Scale scoreExcellent functional outcomeProportion of patientsTime of randomisationLarge vessel occlusionPreclinical stroke modelsRankin Scale scoreBetter clinical outcomesMultiphase CT angiographyAcute care hospitalsGood collateral fillingFixed 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 outcomesCT Angiography for Triage of Patients with Acute Minor Stroke: A Cost-effectiveness Analysis.
Wu X, Hughes DR, Gandhi D, Matouk CC, Sheth K, Schindler J, Wira C, Wintermark M, Sanelli P, Malhotra A. CT Angiography for Triage of Patients with Acute Minor Stroke: A Cost-effectiveness Analysis. Radiology 2020, 294: 580-588. PMID: 31934828, DOI: 10.1148/radiol.2019191238.Peer-Reviewed Original ResearchConceptsLarge vessel occlusionAcute minor strokeBest medical managementMinor strokeCT angiographyMedical managementProbabilistic sensitivity analysesLower health benefitsImmediate thrombectomyHealth benefitsHealth outcomesVascular imagingAcute ischemic strokeMarkov decision-analytic modelWorse health outcomesImproved health outcomesDecision analytic modelNet monetary benefitIntravenous thrombolysisIschemic strokeYounger patientsThrombectomy strategyPatientsAngiographyStroke
2019
Carotid Endarterectomy and Carotid Artery Stenting for Patients With Crescendo Transient Ischemic Attacks
Fereydooni A, Gorecka J, Xu J, Schindler J, Dardik A. Carotid Endarterectomy and Carotid Artery Stenting for Patients With Crescendo Transient Ischemic Attacks. JAMA Surgery 2019, 154: 1055-1063. PMID: 31483458, DOI: 10.1001/jamasurg.2019.2952.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsCrescendo transient ischemic attacksTransient ischemic attackIschemic attackUrgent carotid endarterectomyCarotid endarterectomyTiming of interventionMedical managementSingle transient ischemic attackIntravenous heparin therapyPreoperative medical managementTiming of revascularizationDual antiplatelet therapyAcute neurological eventsOptimal medical managementProhibitive surgical riskCarotid artery stentingHours of presentationMultiple recurrent episodesRandomized clinical trialsAnalysis of patientsCarotid artery plaquesDays of presentationEnglish-language articlesEvidence-based medicineAntiplatelet therapyDecreases in Blood Pressure During Thrombectomy Are Associated With Larger Infarct Volumes and Worse Functional Outcome
Petersen NH, Ortega-Gutierrez S, Wang A, Lopez GV, Strander S, Kodali S, Silverman A, Zheng-Lin B, Dandapat S, Sansing LH, Schindler JL, Falcone GJ, Gilmore EJ, Amin H, Cord B, Hebert RM, Matouk C, Sheth KN. Decreases in Blood Pressure During Thrombectomy Are Associated With Larger Infarct Volumes and Worse Functional Outcome. Stroke 2019, 50: 1797-1804. PMID: 31159701, PMCID: PMC6787912, DOI: 10.1161/strokeaha.118.024286.Peer-Reviewed Original ResearchConceptsFinal infarct volumeWorse functional outcomeInfarct volumeEndovascular thrombectomyFunctional outcomeOcclusion strokeCerebral infarction 2b/3 reperfusionPressure reductionLarge vessel intracranial occlusionsGreater infarct growthBlood pressure reductionComprehensive stroke centerPercent of patientsBlood pressure managementLarger infarct volumesModified Rankin ScaleRankin Scale scoreMultivariable logistic regressionRelative hypotensionSustained hypotensionInfarct progressionNinety patientsInfarct growthIschemic penumbraIschemic strokeComparative Effectiveness of Endovascular Thrombectomy in Elderly Stroke Patients
Malhotra A, Wu X, Payabvash S, Matouk CC, Forman HP, Gandhi D, Sanelli P, Schindler J. Comparative Effectiveness of Endovascular Thrombectomy in Elderly Stroke Patients. Stroke 2019, 50: 963-969. PMID: 30908156, DOI: 10.1161/strokeaha.119.025031.Peer-Reviewed Original ResearchConceptsQuality-adjusted life yearsIntravenous thrombolysisEndovascular thrombectomyLarge vessel occlusionAge 80 yearsEVT strategyVessel occlusionModified Rankin Scale scorePoststroke functional outcomeAcute ischemic strokeRankin Scale scoreElderly stroke patientsMarkov decision-analytic modelYears of ageDecision analytic modelMultiple sensitivity analysesPurpose- StrokeAcute strokeBaseline disabilityElderly patientsIschemic strokeStroke patientsFunctional outcomeHealthy patientsAdvanced age
2016
Validation of TURN, a simple predictor of symptomatic intracerebral hemorrhage after IV thrombolysis
Asuzu D, Nystrӧm K, Amin H, Schindler J, Wira C, Greer D, Fang NF, Halliday J, Sheth KN. Validation of TURN, a simple predictor of symptomatic intracerebral hemorrhage after IV thrombolysis. Clinical Neurology And Neurosurgery 2016, 146: 71-75. PMID: 27152469, DOI: 10.1016/j.clineuro.2016.04.017.Peer-Reviewed Original ResearchConceptsSymptomatic intracerebral hemorrhageIntracerebral hemorrhageRt-PAOdds ratioYale-New Haven HospitalNINDS rt-PA trialIschemic stroke patientsNew Haven HospitalTwo-sample t-testStroke patientsCharacteristic curveThrombolysisHemorrhageSignificant differencesPatientsT-testScoresExternal datasetSimple predictorInternal datasetHospitalRisk rtPA: An iOS mobile application based on TURN for predicting 90-day outcome after IV thrombolysis
Asuzu D, Nystrӧm K, Schindler J, Wira C, Greer D, Halliday J, Sheth KN. Risk rtPA: An iOS mobile application based on TURN for predicting 90-day outcome after IV thrombolysis. Clinical Neurology And Neurosurgery 2016, 142: 148-152. PMID: 26875069, DOI: 10.1016/j.clineuro.2016.01.030.Peer-Reviewed Original ResearchMissed Ischemic Stroke Diagnosis in the Emergency Department by Emergency Medicine and Neurology Services
Arch AE, Weisman DC, Coca S, Nystrom KV, Wira CR, Schindler JL. Missed Ischemic Stroke Diagnosis in the Emergency Department by Emergency Medicine and Neurology Services. Stroke 2016, 47: 668-673. PMID: 26846858, DOI: 10.1161/strokeaha.115.010613.Peer-Reviewed Original ResearchConceptsEmergency departmentLarge community hospitalCommunity hospitalIschemic strokeStroke diagnosisAcademic hospitalNausea/vomitingSecondary prevention therapiesAcute ischemic strokeRetrospective chart reviewIschemic stroke diagnosisAcademic teaching hospitalEndovascular considerationsChart reviewPrompt treatmentSymptom onsetPosterior circulationPrevention therapyNeurology serviceAcute interventionAnterior strokeAtypical symptomsStroke historyPosterior strokeTeaching hospital
2015
On- versus Off-Hour Patient Cohorts at a Primary Stroke Center: Onset-to-Treatment Duration and Clinical Outcomes after IV Thrombolysis
Asuzu D, Nystrӧm K, Amin H, Schindler J, Wira C, Greer D, Fang NF, Halliday J, Sheth KN. On- versus Off-Hour Patient Cohorts at a Primary Stroke Center: Onset-to-Treatment Duration and Clinical Outcomes after IV Thrombolysis. Journal Of Stroke And Cerebrovascular Diseases 2015, 25: 447-451. PMID: 26654664, DOI: 10.1016/j.jstrokecerebrovasdis.2015.10.017.Peer-Reviewed Original ResearchConceptsSymptomatic intracerebral hemorrhagePrimary stroke centerClinical outcomesStroke centersStroke severitySymptom onsetStroke careStroke patientsPatient cohortIntravenous recombinant tissue plasminogen activator (rt-PA) therapyTreatment durationRecombinant tissue plasminogen activator therapyHealth Stroke Scale scoreTissue plasminogen activator therapyConsistent quality careBaseline National InstitutesStroke Scale scoreAcute stroke careIschemic stroke patientsPlasminogen activator therapyMann-Whitney testSICH rateAcute strokeIschemic strokeConsecutive patientsTURN Score Predicts 24-Hour Cerebral Edema After IV Thrombolysis
Asuzu D, Nyström K, Sreekrishnan A, Schindler J, Wira C, Greer D, Halliday J, Kimberly WT, Sheth KN. TURN Score Predicts 24-Hour Cerebral Edema After IV Thrombolysis. Neurocritical Care 2015, 24: 381-388. PMID: 26341364, DOI: 10.1007/s12028-015-0198-6.Peer-Reviewed Original ResearchConceptsSymptomatic intracerebral hemorrhageBrain swellingIntracerebral hemorrhageCerebral edemaPoor outcomeSevere outcomesOdds ratioLogistic regression reporting odds ratiosNINDS rt-PA trialIschemic stroke patientsReporting odds ratioNew brainNew onsetMidline shiftStroke patientsRt-PAEdemaThrombolysisMortalityOutcomesMass effectCharacteristic curveHemorrhagePatientsStatistical associationTURN Score Predicts 90-day Outcome in Acute Ischemic Stroke Patients After IV Thrombolysis
Asuzu D, Nyström K, Schindler J, Wira C, Greer D, Halliday J, Sheth KN. TURN Score Predicts 90-day Outcome in Acute Ischemic Stroke Patients After IV Thrombolysis. Neurocritical Care 2015, 23: 172-178. PMID: 26032809, DOI: 10.1007/s12028-015-0154-5.Peer-Reviewed Original ResearchConceptsSymptomatic intracerebral hemorrhageGOS scoreSevere outcomesConfidence intervalsOdds ratioLogistic regression reporting odds ratiosScale scoreAcute ischemic stroke patientsGlasgow Outcome Scale scoreSPAN-100NINDS rt-PA trialIschemic stroke patientsBarthel Index scoreRankin Scale scoreReporting odds ratioStroke-TPIMRS scoreIntracerebral hemorrhageClinical scoresStroke patientsExcellent outcomesRt-PABI scoreIndex scoreOutcomesTURN: A Simple Predictor of Symptomatic Intracerebral Hemorrhage After IV Thrombolysis
Asuzu D, Nyström K, Amin H, Schindler J, Wira C, Greer D, Chi NF, Halliday J, Sheth KN. TURN: A Simple Predictor of Symptomatic Intracerebral Hemorrhage After IV Thrombolysis. Neurocritical Care 2015, 23: 166-171. PMID: 25869481, DOI: 10.1007/s12028-015-0131-z.Peer-Reviewed Original ResearchConceptsSymptomatic intracerebral hemorrhageBaseline NIHSS scorePrestroke mRS scoreNIHSS scoreMRS scoreIntracerebral hemorrhageRt-PAOdds ratioYale-New Haven HospitalNINDS rt-PA trialIschemic stroke patientsIschemic stroke treatmentIndependent predictorsStroke treatmentStroke patientsClinical parametersPlatelet countHyperacute strokeDerivation datasetThrombolysisLogistic regressionSubstantial riskNew scoreCharacteristic curveHemorrhage