Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

However, there is conflicting data in terms of intracranial hemorrhage risk.Objective: We are reporting the rate of symptomatic intracranial hemorrhage(sICH) in TNK and tPA treated stroke populations across two large hospital systems.MethodsDesign: Retrospective cohort observational study. A total of 431 patients were included.

Hemorrhage 40

Hemorrhage Thrombolysis Stroke Strokes 40

Stroke Journal

FEBRUARY 1, 2024

The role of adjunctive intravenous thrombolysis, such as intravenous tissue plasminogen activator (IVtPA), with MT remains unclear, especially for medium vessel occlusion (MeVO). In univariable regression, all outcomes were comparable between the two groups, except for higher mRS 0-2 rates in the MT+IVtPA group.

Thrombolysis 40

Thrombolysis Academic Hemorrhage Outcomes 40

Stroke Journal

FEBRUARY 5, 2024

BACKGROUND:Timely intravenous thrombolysis and endovascular thrombectomy are the standard reperfusion treatments for large vessel occlusion stroke. METHODS:We enrolled consecutive patients in the multicenter Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke who had received combined thrombolysis (within 4.5

Thrombolysis 75

Thrombolysis Hemorrhage Atrial Fibrillation Stroke 75

Stroke Journal

FEBRUARY 1, 2024

We defined two binary outcomes: (1) functional clinical outcome (modified Rankin Scale 0-2) and (2) early symptomatic intracerebral hemorrhage (sICH). 4.14, p=0.9502), but it was associated with a functional clinical outcome at 90 days (OR 3.39, 95% CI 1.11-10.43, 10.43, p=0.0325).Conclusions:The

Stents 40

Stents Stent Thrombolysis Angioplasty 40

Stroke Journal

FEBRUARY 1, 2024

Recent landmark trials BEST-MSU and B_PROUD have proven that MSUs facilitate quicker thrombolysis times and improved functional outcomes at 90 days when compared to conventional emergency medical services (EMS) for acute ischemic stroke patients. Faster time metrics convey a hypothetical benefit towards improved patient outcomes.

Hemorrhage 40

Hemorrhage Blood Pressure Stroke Strokes 40

DAIC

FEBRUARY 7, 2024

Findings from the highly-anticipated MOST (Multi-Arm Optimization of Stroke Thrombolysis) trial were presented on the first day of the American Stroke Association’s International Stroke Conference, ISC 2024, being held through Feb. The study was looking for improvement in functional outcomes at 90 days. 9 Phoenix, AZ. Adeoye, M.D.,

Stroke 105

Stroke Strokes Outcomes Thrombolysis 105

Stroke Journal

DECEMBER 21, 2023

BACKGROUND:The association of COVID-19 with higher bleeding risk and worse outcomes in acute ischemic stroke (AIS) undergoing revascularization may be related to the presence of infection symptoms. The magnitude of this effect is more pronounced in symptomatic infections, which also present less favorable recanalization outcomes.

COVID-19 40

COVID-19 Outcomes Stroke Strokes 40

Stroke Journal

FEBRUARY 1, 2024

Introduction:Intravenous thrombolysis (IVT) is efficacious treatment of acute ischemic stroke (AIS). Outcomes of interest were symptomatic intracranial hemorrhage (sICH), any ICH, serious systemic bleeding (SSB), and 90-day functional independence (mRS 0-2). Stroke, Volume 55, Issue Suppl_1 , Page A25-A25, February 1, 2024.

Thrombolysis 40

Thrombolysis Stroke Strokes Hemorrhage 40

Stroke Journal

FEBRUARY 1, 2024

Introduction:Collateral status imaging parameters are associated with predicting hemorrhagic transformation (HT) in acute ischemic stroke caused by large vessel occlusions. Stroke, Volume 55, Issue Suppl_1 , Page ATP146-ATP146, February 1, 2024.

Hemorrhage 40

Hemorrhage Thrombolysis Diabetes Biomarkers 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 21, 2023

The patients with successful recanalization defined as modified Thrombolysis in Cerebral Infarction ≥2b at 5, 6, 7, or more passes were compared with unsuccessful recanalization. Primary outcome was a favorable 90‐day outcome (modified Rankin scale score of 0–2). We also compared procedure time, separated by 30 minutes.

Outcomes 40

Outcomes Stroke Strokes Hemorrhage 40

Stroke Journal

FEBRUARY 1, 2024

Introduction:Real-world data showed that less than half of the acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) presenting with low Alberta Stroke Program Early Computed Tomography Score (ASPECTS) (2-5) achieved favorable outcomes at 90 days after mechanical thrombectomy (MT). was related to 90-day mRS 0-3.

Outcomes 40

Outcomes Stroke Strokes Hemorrhage 40

Stroke Journal

FEBRUARY 1, 2024

Intravenous thrombolysis was administered in 55 patients (22.1%) while general anesthesia was used in 94/248 patients (37.9%). Favorable clinical outcome (90-day mRS 0-3) was achieved in 99/246 patients (40.2%), with mortality affecting 98/246 patients (39.8%). years [SD 11.7], 208 [83.5%] male) were included.

Circulation 40

Circulation Outcomes Thrombolysis Hemorrhage 40

Stroke Journal

FEBRUARY 1, 2024

While DM can reduce the effect of intravenous thrombolysis, metformin can have a positive outcome on AIS patients. The outcomes of stroke in diabetic patients receiving metformin is largely unexplored. There is a trend of favorable outcomes of mRS and Mortality, with a non-statistical significance increase of sICH.

Diabetes 40

Diabetes Stroke Strokes Outcomes 40

Stroke Journal

FEBRUARY 1, 2024

Introduction:Tenecteplase improves reperfusion and functional outcomes in stroke patients with large vessel occlusion. Primary outcome was mRS at 90 days. Secondary outcomes were NIHSS at 24 hours and at discharge. Secondary outcomes were NIHSS at 24 hours and at discharge. Median NIHSS at presentation (18.0 versus 16.0,

Stroke 40

Stroke Strokes Thrombolysis Hemorrhage 40

Stroke Journal

FEBRUARY 1, 2024

Background:Endovascular thrombectomy (EVT) and intravenous thrombolysis (IVT) outcomes are unclear in patients with pre-stroke dementia or cognitive impairment. Primary outcome was defined as favorable 90-day outcome (modified Rankin Scale (mRS) score 0-2). Results:9 articles were included from 825 screened. 95%CI 1.03

Dementia 40

Dementia Outcomes Stroke Strokes 40

Stroke Journal

FEBRUARY 1, 2024

Introduction:Although prior antiplatelet therapy (APT) could potentially contribute to bleeding risk, the influence of prior APT on intravenous thrombolysis outcomes remains controversial. A favorable outcome was defined as a modified Rankin Scale of 0 to 1 at 90-days.

Stroke 40

Stroke Strokes Thrombolysis Hemorrhage 40

Stroke Journal

FEBRUARY 1, 2024

Background:Studies have demonstrated that the addition of alteplase for patients with tandem lesions who underwent mechanical thrombectomy and acute stenting was safe with improved outcomes. Primary outcomes included symptomatic intracranial hemorrhage (sICH) and parenchymal hematoma type 2 (PH-2). of IV TNK vs 58.2%

Stents 40

Stents Stent Outcomes Thrombolysis 40

Stroke Journal

FEBRUARY 1, 2024

Outcomes included sICH, and inpatient mortality, adjusted for confounders which included age, gender, baseline NIHSS, perfusion grade (TICI) intravenous thrombolysis, history of diabetes and HBA1c.Results:A total of 224 patients (mean age was 68.7 years (±14.3); 44.2% were women) underwent endovascular treatment.

Inpatient 40

Inpatient Stroke Strokes Outcomes 40

Stroke Journal

FEBRUARY 1, 2024

Objective:This study aims to evaluate how interhospital transfers impact the correlation between functional outcomes, mortality, reperfusion rates, and workflow time metrics in patients undergoing endovascular thrombectomy (EVT) for acute ischemic stroke caused by large vessel occlusion (LVO).Background:This vs. 70.6 ± 14.5). min vs. 394.5

Stroke 40

Stroke Strokes Thrombolysis ICU 40

Stroke Journal

FEBRUARY 1, 2024

Overall, one in six individuals treated has improved neurologic and functional outcomes. No difference in the rate of intracerebral hemorrhage (ICH) following reperfusion between the TICI 2 and 3 groups (17%).Conclusion:Our 20 (25%) had a TICI 2c and their average mRS was 3.6, and 4 (5%) had a TICI 3 with mRS 3 at discharge.

Outcomes 40

Outcomes Stroke Strokes Thrombolysis 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

IntroductionCurrent literature suggests a benefit in functional outcomes and reperfusion rates when carotid artery stenting (CAS) and mechanical thrombectomy (MT) are performed emergently. However, rates of symptomatic intracranial hemorrhages have been inconclusive. Seven (26%) patients had symptomatic intracranial hemorrhages.

Stents 40

Stents Stent Hemorrhage Inpatient 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Also, we compared favorable outcomes following EVT in those with a core infarct at baseline of more than 70 ml, delayed thrombectomy of more than 6 hours, older than 75 years, and those who received concomitant IV thrombolysis. EVT results in favorable outcome by a delayed thrombectomy for a large core infarct and in older patients.

Stroke 40

Stroke Strokes Thrombolysis Hemorrhage 40

Stroke: Vascular and Interventional Neurology

JANUARY 31, 2024

The primary outcome was routine discharge (home or self‐care). Secondary outcomes were in‐hospital mortality, intracerebral hemorrhage, and length of stay. In multivariable models, intravenous thrombolysis was independently associated with higher odds of routine discharge (adjusted OR, 1.78; 95% CI, 1.57–2.01;P<0.001)

Inpatient 40

Inpatient Circulation Stroke Strokes 40

Journal of the American Heart Association

JANUARY 31, 2024

BackgroundPrevious clinical trials found improved outcome of thrombolytic treatment in patients with ischemic wake‐up stroke (WUS) selected by advanced imaging techniques. Functional outcomes were assessed by the modified Rankin Scale (mRS) at 3 months. Symptomatic intracranial hemorrhage after thrombolytic treatment occurred in 4.4%

Stroke 40

Stroke Strokes Hemorrhage Thrombolysis 40

Stroke Journal

MARCH 11, 2024

Background:The efficacy of thrombolysis (IVT) in minor stroke (National Institutes of Health Stroke Scale score, 0–5) remains inconclusive. The primary outcome was an excellent functional outcome, defined as a modified Rankin Scale score of 0 or 1 at 90 days. 2.80]), symptomatic intracranial hemorrhage (OR, 7.48 [95% CI, 3.55–15.76]),

Stroke 40

Stroke Strokes Hemorrhage Thrombolysis 40

Stroke Journal

FEBRUARY 1, 2024

This study aims to investigate the impact of the number of passes on the outcomes of patients who underwent failed MT.Methods:We used Data from the Stroke Thrombectomy and Aneurysm Registry (STAR) from 2013 to August 2023. Primary outcome was 90- day modified Rankin Scale (mRS) 0-2.

Stroke 40

Stroke Strokes Thrombolysis Aneurysm 40

Stroke Journal

FEBRUARY 1, 2024

Background:Prior studies have shown that individuals who have an in-hospital stroke are less likely to receive thrombolysis. Overall, in-hospital strokes were more likely to be hemorrhagic in 2015 than in 1993/94; 12 % in 2015 vs. 3.6% Stroke, Volume 55, Issue Suppl_1 , Page AWMP42-AWMP42, February 1, 2024. in1993/94 (p=0.003).

Hospital 40

Hospital Stroke Strokes Thrombolysis 40

Stroke Journal

FEBRUARY 1, 2024

Background:Measurement of “final” lesion volume at 24hr following endovascular therapy (post-EVT) has been used in multiple studies as a surrogate for clinical outcome. Successful recanalization was achieved in 86% and 67% had complete reperfusion, with an overall favorable clinical outcome rate of 54%.

Hemorrhage 40

Hemorrhage Thrombolysis Biomarkers Outcomes 40

Stroke Journal

FEBRUARY 1, 2024

Introduction:Despite comparable outcomes for different frontline techniques in mechanical thrombectomy (MT) for acute ischemic stroke (AIS), there are sparse data regarding if and when to switch techniques if the first pass is unsuccessful. 3.86, P = 0.002) and 90-day good clinical outcome (adjusted odds ratio 2.10, 95% CI: 1.15-3.85,

Circulation 40

Circulation Stroke Strokes Thrombolysis 40

Stroke: Vascular and Interventional Neurology

JULY 6, 2023

There was no significant association between technique and secondary outcomes in the propensity‐score matched adjusted models.ConclusionIn this large, diverse, multinational medium vessel occlusion cohort, we found no significant difference in imaging or clinical outcomes with aspiration versus stent‐retriever thrombectomy.

Stents 40

Stents Stent Thrombolysis Outcomes 40

Stroke Journal

DECEMBER 28, 2023

Patients with acute ischemic stroke aged between 18 and 80 years who were eligible for standard intravenous thrombolysis were enrolled from 17 centers in China and randomly assigned (1:1:1) to receive intravenous reteplase 12+12 mg, intravenous reteplase 18+18 mg, or intravenous alteplase 0.9 Four patients did not receive the study agent.

Stroke 40

Stroke Strokes Hemorrhage Thrombolysis 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 2, 2023

Patient demographics, clinical considerations, technical details, and radiographic outcomes were collected. Rates of successful aspiration catheter delivery without adjunctive devices and of successful reperfusion (Thrombolysis in Cerebral Infarction≥2B) were collected.RESULTSForty‐five patients met inclusion criteria (mean age 72.2±13.2

Thrombolysis 40

Thrombolysis Academic Hemorrhage Stroke 40

Journal of the American Heart Association

JANUARY 31, 2024

BackgroundMicrovascular obstruction (MVO) and intramyocardial hemorrhage (IMH) are well‐established imaging biomarkers of failed myocardial tissue reperfusion in patients with ST‐segment elevation–myocardial infarction treated with percutaneous coronary intervention. MVO and IMH were found in 299 (58%) and 182 (35%) patients.

Myocardial Infarction 40

Myocardial Infarction Thrombolysis Biomarkers Hemorrhage 40

Stroke Journal

FEBRUARY 1, 2024

Baseline characteristics, treatments, and outcomes were compared, dichotomizing DIDO at 90 min based in the American Heart Association goal for DIDO ≤90 min for 50% of transfers. The median NIHSS was 16 (10-20), 50% were treated with intravenous thrombolysis at a spoke, and TICI 2B-3 reperfusion was achieved in 87% at the hub.

Stroke 40

Stroke Strokes Thrombolysis Atrial Fibrillation 40

Stroke Journal

FEBRUARY 1, 2024

MCA tortuosity was calculated using Inflection Count Metric(ICM) by two blinded readers to angiographical/clinical outcomes. The primary efficacy end point was achievement of modified Thrombolysis in Cerebral Ischemia (mTICI) reperfusion scores of ≥2b on first pass. Good functional outcomes was defined as mRS0-2 on 90-day followup.

Atrial Fibrillation 40

Atrial Fibrillation Thrombolysis Ischemia Stroke 40

Stroke: Vascular and Interventional Neurology

OCTOBER 2, 2023

BackgroundSoutheast Asia accounts for approximately 10% of stroke‐related mortalities worldwide, yet there are limited data regarding mechanical thrombectomy (MT) outcomes in this region. Safety end points included symptomatic intracerebral hemorrhage, emboli in new territory at 24 hours, and all‐cause mortality at 90 days.

Stroke 40

Stroke Strokes Hemorrhage Thrombolysis 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Baseline characteristics, treatments, and outcomes were compared, dichotomizing DIDO at 90 min based in the American Heart Association goal for DIDO ≤90 min for 50% of transfers. The median NIHSS was 16 (10‐20), 50% were treated with intravenous thrombolysis at a spoke, and TICI 2B‐3 reperfusion was achieved in 87% at the hub.

Stroke 40

Stroke Strokes Thrombolysis Atrial Fibrillation 40