24 results on '"Candelaresi, Paolo"'
Search Results
2. Divergence Between Clinical Trial Evidence and Actual Practice in Use of Dual Antiplatelet Therapy After Transient Ischemic Attack and Minor Stroke
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De Matteis, Eleonora, De Santis, Federico, Ornello, Raffaele, Censori, Bruno, Puglisi, Valentina, Vinciguerra, Luisa, Giossi, Alessia, Di Viesti, Pietro, Inchingolo, Vincenzo, Fratta, Giovanni Matteo, Diomedi, Marina, Bagnato, Maria Rosaria, Cenciarelli, Silvia, Bedetti, Chiara, Padiglioni, Chiara, Tassinari, Tiziana, Saia, Valentina, Russo, Alessandro, Petruzzellis, Marco, Mezzapesa, Domenico Maria, Caccamo, Martina, Rinaldi, Giuseppe, Bavaro, Alessandra, Paciaroni, Maurizio, Mosconi, Maria Giulia, Foschi, Matteo, Querzani, Pietro, Muscia, Francesco, Gallo Cassarino, Serena, Candelaresi, Paolo, De Mase, Antonio, Guarino, Maria, Cupini, Letizia Maria, Sanzaro, Enzo, Zini, Andrea, La Spada, Salvatore, Palmieri, Carmela, Sepe, Federica Nicoletta, Beretta, Simone, Paci, Cristina, Caggia, Emanuele Alessandro, De Angelis, Maria Vittoria, Bonanni, Laura, Volpi, Gino, Tassi, Rossana, Pistoia, Francesca, Scoditti, Umberto, Tonon, Agnese, Viticchi, Giovanna, Ruzza, Giampietro, Nencini, Patrizia, Cavallini, Anna, Toni, Danilo, Ricci, Stefano, Sacco, Simona, Acciarri, Maria Cristina, Alessi, Chiara, Angelocola, Stefania Martina, Ajdinaj, Paola, Barbarini, Leonardo, Barone, Valentina, Baruffi, Maraia Cristina, Bassi, Chiara, Beccia, Mario, Bellavia, Simone, Biscetti, Leonardo, Bonaffini, Novella, Bolamperti, Laura, Bongioanni, Maria Roberta, Brienza, Marianna, Bruzzone, Gian Luca, Cameriere, Valentina, Campagnaro, Alessandro, Cappellani, Roberto, Cappellari, Manuel, Caputi, Luigi, Cardinali, Patrizio, Coppo, Lorenzo, De Boni, Antonella, De Franco, Ivo Giuseppe, De Luca, Cristina, Diamanti, Susanna, Di Blasio, Francesco, Di Carmine, Caterina, Di Lisi, Filomena, Di Giovanni, Anna, Faini, Claudia, Ferrarese, Carlo, Fleetwood, Thomas, Fortini, Alberto, Frisullo, Giovanni, Galotto, Debora, Genovese, Antonio, Gentile, Luana, Invernizzi, Paolo, La Starza, Sara, Letteri, Federica, Manobianca, Giovanni, Mannino, Marina, Marcon, Michela, Masato, Maela, Mazzacane, Federico, Menegazzo, Elisabetta, Menichetti, Chiara, Monaco, Daniela, Naldi, Federica, Nannucci, Serena, Occhipinti, Clorinda, Orsucci, Daniele, Paolucci, Silvia, Passarelli, Francesco, Papiri, Giulio, Pelliccioni, Giuseppe, Perini, Francesco, Pinto, Vincenza, Potente, Eleonora, Puca, Emanuele, Ricciardi, Maria Chiara, Roberti, Cinzia, Romoli, Michele, Rondelli, Francesca, Rota, Eugenia, Russo, Monia, Sacchini, Elisa, Sanna, Alessandra, Scaglione, Gaspare, Scalvini, Andrea, Scala, Irene, Scarpato, Ciro, Servillo, Giovanna, Sgarlata, Eleonora, Silvestrini, Mauro, Simonetto, Marco, Spina, Emanuele, Tarletti, Roberto, Terruso, Valeria, Tocco, Pierluigi, Tudisco, Laura, Valcamonica, Gloria, Valente, Martina, Vista, Marco, Zito, Antonio, and Zivelonghi, Cecilia
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- 2023
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3. Prevention of infections and fever to improve outcome in older patients with acute stroke (PRECIOUS): a randomised, open, phase III, multifactorial, clinical trial with blinded outcome assessment
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AIOS Anesthesiologie, Opleiding Neurologie, Neurologen, Brain, Circulatory Health, Stroke, de Jonge, Jeroen C., Sluis, Wouter M., Reinink, Hendrik, Bath, Philip M., Woodhouse, Lisa J., Zweedijk, Berber, van de Beek, Diederik, Aamodt, Anne Hege, Alpers, Iris, Ciccone, Alfonso, Csiba, Laszlo, Demotes, Jacques, Kõrv, Janika, Kurkowska-Jastrzebska, Iwona, Dawson, Jesse, Macleod, Malcolm R., Ntaios, George, Poli, Sven, Milionis, Haralampos, Ricci, Stefano, Cenciarelli, Silvia, Candelaresi, Paolo, de Bruijn, Sebastiaan FTM, Pathansali, Rohan, Krishnan, Kailash, Clarke, Brian, Thomalla, Götz, van der Worp, H. Bart, Kwa, Vincent IH, Müller, Susanne, Protogerou, Athanasios D., the PRECIOUS investigators, AIOS Anesthesiologie, Opleiding Neurologie, Neurologen, Brain, Circulatory Health, Stroke, de Jonge, Jeroen C., Sluis, Wouter M., Reinink, Hendrik, Bath, Philip M., Woodhouse, Lisa J., Zweedijk, Berber, van de Beek, Diederik, Aamodt, Anne Hege, Alpers, Iris, Ciccone, Alfonso, Csiba, Laszlo, Demotes, Jacques, Kõrv, Janika, Kurkowska-Jastrzebska, Iwona, Dawson, Jesse, Macleod, Malcolm R., Ntaios, George, Poli, Sven, Milionis, Haralampos, Ricci, Stefano, Cenciarelli, Silvia, Candelaresi, Paolo, de Bruijn, Sebastiaan FTM, Pathansali, Rohan, Krishnan, Kailash, Clarke, Brian, Thomalla, Götz, van der Worp, H. Bart, Kwa, Vincent IH, Müller, Susanne, Protogerou, Athanasios D., and the PRECIOUS investigators
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- 2024
4. Baseline clinical and neuroradiological predictors of outcome in patients with large ischemic core undergoing mechanical thrombectomy: a retrospective multicenter study
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Alexandre, Andrea, Monforte, Mauro, Brunetti, Valerio, Scarcia, Luca, Cirillo, Luigi, Zini, Andrea, Scala, Irene, Nardelli, Vincenzo, Arbia, Francesco, Arbia, Giuseppe, Frisullo, Giovanni, Kalsoum, Erwah, Camilli, Arianna, De Leoni, Davide, Francesca, Colò, Abruzzese, Serena, Piano, Mariangela, Rollo, Claudia, Macera, Antonio, Ruggiero, Maria, Lafe, Elvi, Gabrieli, Joseph Domenico, Cester, Giacomo, Limbucci, Nicola, Arba, Francesco, Ferretti, Simone, Da Ros, Valerio, Bellini, Luigi, Salsano, Giancarlo, Mavilio, Nicola, Russo, Riccardo, Bergui, Mauro, Caragliano, Antonio Armando, Vinci, Sergio Lucio, Romano, Daniele Giuseppe, Frauenfelder, Giulia, Semeraro, Vittorio, Porzia, Ganimede Maria, Lozupone, Emilio, Romi, Andrea, Cavallini, Anna, Milonia, Luca, Muto, Massimo, Candelaresi, Paolo, Calabresi, Paolo, Pedicelli, Alessandro, Broccolini, Aldobrando, Arbia, Giuseppe (ORCID:0000-0001-5173-3931), Calabresi, Paolo (ORCID:0000-0003-0326-5509), Pedicelli, Alessandro (ORCID:0000-0002-2558-8838), Broccolini, Aldobrando (ORCID:0000-0001-8295-9271), Alexandre, Andrea, Monforte, Mauro, Brunetti, Valerio, Scarcia, Luca, Cirillo, Luigi, Zini, Andrea, Scala, Irene, Nardelli, Vincenzo, Arbia, Francesco, Arbia, Giuseppe, Frisullo, Giovanni, Kalsoum, Erwah, Camilli, Arianna, De Leoni, Davide, Francesca, Colò, Abruzzese, Serena, Piano, Mariangela, Rollo, Claudia, Macera, Antonio, Ruggiero, Maria, Lafe, Elvi, Gabrieli, Joseph Domenico, Cester, Giacomo, Limbucci, Nicola, Arba, Francesco, Ferretti, Simone, Da Ros, Valerio, Bellini, Luigi, Salsano, Giancarlo, Mavilio, Nicola, Russo, Riccardo, Bergui, Mauro, Caragliano, Antonio Armando, Vinci, Sergio Lucio, Romano, Daniele Giuseppe, Frauenfelder, Giulia, Semeraro, Vittorio, Porzia, Ganimede Maria, Lozupone, Emilio, Romi, Andrea, Cavallini, Anna, Milonia, Luca, Muto, Massimo, Candelaresi, Paolo, Calabresi, Paolo, Pedicelli, Alessandro, Broccolini, Aldobrando, Arbia, Giuseppe (ORCID:0000-0001-5173-3931), Calabresi, Paolo (ORCID:0000-0003-0326-5509), Pedicelli, Alessandro (ORCID:0000-0002-2558-8838), and Broccolini, Aldobrando (ORCID:0000-0001-8295-9271)
- Abstract
Background: Recent randomized trials have shown the benefit of mechanical thrombectomy (MT) also in patients with an established large ischemic core. Aim: The purpose of this study was to define baseline predictors of clinical outcome in patients with large vessel occlusion (LVO) in the anterior circulation and an Alberta Stroke Program Early CT score (ASPECTS) ≤ 5, undergoing MT. Material and methods: The databases of 16 comprehensive stroke centers were retrospectively screened for patients with LVO and ASPECTS ≤ 5 that received MT. Baseline clinical and neuroradiological features, including the differential contribution of all ASPECTS regions to the composite score, were collected. Primary clinical outcome measure was a 90-day modified Rankin Scale (mRS) score of 0-2. Statistical analysis used a logistic regression model and random forest algorithm. Results: 408 patients were available for analysis. In multivariate model, among baseline features, lower age (OR 0.962, 95% CI 0.943-0.982) and lower National Institute of Health Stroke Scale (NIHSS) score (OR 0.911, 95% CI 0.862-0.963) were associated with the mRS score 0-2. Involvement of the M2 (OR 0.398, 95% CI 0.206-0.770) or M4 (OR 0.496, 95% CI 0.260-0.945) ASPECTS regions was associated with an unfavorable outcome. Random forest analysis confirmed that age and baseline NIHSS score are the most important variables influencing clinical outcome, whereas involvement of cortical regions M5, M4, M2 and M1 can have a negative impact. Conclusion: Our retrospective analysis shows that, along with age and baseline clinical impairment, presence of early ischemic changes involving cortical areas has a role in clinical outcome in patients with large ischemic core undergoing MT.
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- 2024
5. Sex differences in cerebral venous sinus thrombosis after adenoviral vaccination against COVID-19
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Scutelnic, Adrian, primary, van de Munckhof, Anita, additional, Krzywicka, Katarzyna, additional, van Kammen, Mayte Sánchez, additional, Lindgren, Erik, additional, Cordonnier, Charlotte, additional, Kleinig, Timothy J, additional, Field, Thalia S, additional, Poli, Sven, additional, Lemmens, Robin, additional, Middeldorp, Saskia, additional, Aaron, Sanjith, additional, Borhani-Haghighi, Afshin, additional, Arauz, Antonio, additional, Kremer Hovinga, Johanna A, additional, Günther, Albrecht, additional, Putaala, Jukka, additional, Wasay, Mohammad, additional, Conforto, Adriana Bastos, additional, de Sousa, Diana Aguiar, additional, Jood, Katarina, additional, Tatlisumak, Turgut, additional, Ferro, José M, additional, Coutinho, Jonathan M, additional, Arnold, Marcel, additional, Heldner, Mirjam R, additional, Antonenko, Kateryna, additional, Mbroh, Joshua, additional, Brodard, Justine, additional, Hooshmandi, Etrat, additional, Dizonno, Vanessa, additional, Devroye, Annemie, additional, Ciccone, Alfonso, additional, Wittstock, Matthias, additional, Zimmermann, Julian, additional, Bode, Felix J., additional, Skjelland, Mona, additional, Duan, Jiangang, additional, Hiltunen, Sini, additional, Zuurbier, Susanna M., additional, Petruzzellis, Marco, additional, Sharma, Aarti R., additional, Ghoreishi, Abdoreza, additional, Elkady, Ahmed, additional, Negro, Alberto, additional, Gutschalk, Alexander, additional, Schoenenberger, Silvia, additional, Nagel, Simon, additional, Buture, Alina, additional, Cervera, Alvaro, additional, Paiva Nunes, Ana, additional, Romina Montané Baños, Ana, additional, Tiede, Andreas, additional, Puthuppallil, Anemon, additional, Tuladhar, Anil M., additional, Mengel, Annerose, additional, Medina, Antonio, additional, Hellström Vogel, Åslög, additional, Tawa, Audrey, additional, Aujayeb, Avinash, additional, Ramasamy, Balakrishnan, additional, Casolla, Barbara, additional, Lim Alvin Chew, Beng, additional, Ziaadini, Bentalhoda, additional, Varkey Maramattom, Boby, additional, Buck, Brian, additional, Zanferrari, Carla, additional, Garcia-Esperon, Carlos, additional, Vayne, Caroline, additional, Legault, Catherine, additional, Jacobi, Christian, additional, Pfrepper, Christian, additional, Pelz, Johann, additional, Wahl, Christoph, additional, Kern, Rolf, additional, Tracol, Clement, additional, Soriano, Cristina, additional, Guisado-Alonso, Daniel, additional, Bougon, David, additional, Bal, Deepti, additional, Sergio Zimatore, Domenico, additional, Michalski, Dominik, additional, Blacquiere, Dylan, additional, Johansson, Elias, additional, Cuadrado-Godia, Elisa, additional, Sadeghi-Hokmabadi, Elyar, additional, Carrera, Emmanuel, additional, De Maistre, Emmanuel, additional, Saxhaug Kristoffersen, Espen, additional, Bonneville, Fabrice, additional, Geeraerts, Thomas, additional, Vuillier, Fabrice, additional, Giammello, Fabrizio, additional, D’Onofrio, Florindo, additional, Grillo, Francesco, additional, Caparros, François, additional, Susen, Sophie, additional, Maier, Frank, additional, Tsivgoulis, Georgios, additional, Gulli, Giosue, additional, Frisullo, Giovanni, additional, Franchineau, Guillaume, additional, Cangür, Hakan, additional, Katzberg, Hans, additional, Mozhdehipanah, Hossein, additional, Sibon, Igor, additional, Baharoglu, M. Irem, additional, Masjuan, Jaime, additional, Brar, Jaskiran, additional, Payen, Jean-Francois, additional, Burrow, Jim, additional, Fernandes, João, additional, Octavio López Esparza, Jorge, additional, Oen, Joyce, additional, Schouten, Judith, additional, Ng, Karl, additional, Chatterton, Sophie, additional, Wronski, Miriam, additional, Althaus, Katharina, additional, Garambois, Katia, additional, Derex, Laurent, additional, Puy, Laurent, additional, Poorsaadat, Leila, additional, Valler, Lenise, additional, Januzi de Almeida Rocha, Letícia, additional, Humbertjean, Lisa, additional, Lebrato Hernandez, Lucia, additional, Murillo-Bonilla, Luis, additional, Kellermair, Lukas, additional, Morin Martin, Mar, additional, Sofia Cotelli, Maria, additional, Hernandez Perez, Maria, additional, Zedde, Marialuisa, additional, Carvalho Dias, Mariana, additional, Dubois, Marie-Cecile, additional, Carvalho, Marta, additional, Ghiasian, Masoud, additional, Umaiorubahan, Meenakshisundaram, additional, Kumar Karunakaran, Ravi, additional, Roozbeh, Mehrdad, additional, Romoli, Michele, additional, Miranda, Miguel, additional, Saadatnia, Mohammad, additional, Bandettini di Poggio, Monica, additional, Scholz, Moritz J., additional, Kahnis, Robert, additional, Almasi-Dooghaee, Mostafa, additional, Hoseininejad Mir, Nahid, additional, Ichaporia, Nasli R., additional, Kumar Paramasivan, Naveen, additional, Erat Sreedharan, Sapna, additional, Sylaja, PN, additional, Raposo, Nicolas, additional, Fadakar, Nima, additional, Kruyt, Nyika, additional, Detante, Olivier, additional, Cuisenier, Pauline, additional, Huet, Olivier, additional, Sharma, Pankaj, additional, Candelaresi, Paolo, additional, Scoppettuolo, Pasquale, additional, Reiner, Peggy, additional, Nemati, Reza, additional, Vieira, Ricardo, additional, Goh, Rudy, additional, Murphy, Seán, additional, Timsit, Serge, additional, Coutts, Shelagh, additional, Sharma, Shyam S., additional, Bal, Simerpreet, additional, Kaul, Subhash, additional, Karapanayiotides, Theodoros, additional, Cox, Thomas, additional, Gattringer, Thomas, additional, Mathew, Thomas, additional, Bartsch, Thorsten, additional, Shaygannejad, Vahid, additional, Garcia-Talavera, Veronica, additional, Palma, Vincenzo, additional, Arslan, Yıldız, additional, Mirzaasgari, Zahra, additional, Yavari, Zeinab, additional, Zamani, Zohreh, additional, Bakchoul, Tamam, additional, Levi, Marcel, additional, and van Gorp, Eric C.M., additional
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- 2023
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6. Intra-Arterial Thrombolysis to Improve Final Thrombolysis in Cerebral Infarction Score after Thrombectomy: A Case-Series Analysis
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Mase, Antonio De, primary, Candelaresi, Paolo, additional, Spina, Emanuele, additional, Giordano, Flavio, additional, Barbato, Stefano, additional, Servillo, Giovanna, additional, Prestipino, Elio, additional, Fasolino, Alessandra, additional, Guarnieri, Gianluigi, additional, Leone, Giuseppe, additional, Muto, Massimo, additional, Muto, Mario, additional, and Andreone, Vincenzo, additional
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- 2023
- Full Text
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7. Sex differences in cerebral venous sinus thrombosis after adenoviral vaccination against COVID-19
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Scutelnic, Adrian, van de Munckhof, Anita, Krzywicka, Katarzyna, van Kammen, Mayte Sánchez, Lindgren, Erik, Cordonnier, Charlotte, Kleinig, Timothy J., Field, Thalia S., Poli, Sven, Lemmens, Robin, Middeldorp, Saskia, Aaron, Sanjith, Borhani-Haghighi, Afshin, Arauz, Antonio, Kremer Hovinga, Johanna A., Günther, Albrecht, Putaala, Jukka, Wasay, Mohammad, Conforto, Adriana Bastos, de Sousa, Diana Aguiar, Jood, Katarina, Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Heldner, Mirjam R., Antonenko, Kateryna, Mbroh, Joshua, Brodard, Justine, Hooshmandi, Etrat, Dizonno, Vanessa, Devroye, Annemie, Ciccone, Alfonso, Wittstock, Matthias, Zimmermann, Julian, Bode, Felix J., Skjelland, Mona, Duan, Jiangang, Hiltunen, Sini, Zuurbier, Susanna M., Petruzzellis, Marco, Sharma, Aarti R., Ghoreishi, Abdoreza, Elkady, Ahmed, Negro, Alberto, Gutschalk, Alexander, Schoenenberger, Silvia, Nagel, Simon, Buture, Alina, Cervera, Alvaro, Paiva Nunes, Ana, Romina Montané Baños, Ana, Tiede, Andreas, Puthuppallil, Anemon, Tuladhar, Anil M., Mengel, Annerose, Medina, Antonio, Hellström Vogel, Åslög, Tawa, Audrey, Aujayeb, Avinash, Ramasamy, Balakrishnan, Casolla, Barbara, Lim Alvin Chew, Beng, Ziaadini, Bentalhoda, Varkey Maramattom, Boby, Buck, Brian, Zanferrari, Carla, Garcia-Esperon, Carlos, Vayne, Caroline, Legault, Catherine, Jacobi, Christian, Pfrepper, Christian, Pelz, Johann, Wahl, Christoph, Kern, Rolf, Tracol, Clement, Soriano, Cristina, Guisado-Alonso, Daniel, Bougon, David, Bal, Deepti, Sergio Zimatore, Domenico, Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, Sadeghi-Hokmabadi, Elyar, Carrera, Emmanuel, De Maistre, Emmanuel, Saxhaug Kristoffersen, Espen, Bonneville, Fabrice, Geeraerts, Thomas, Vuillier, Fabrice, Giammello, Fabrizio, D’Onofrio, Florindo, Grillo, Francesco, Caparros, François, Susen, Sophie, Maier, Frank, Tsivgoulis, Georgios, Gulli, Giosue, Frisullo, Giovanni, Franchineau, Guillaume, Cangür, Hakan, Katzberg, Hans, Mozhdehipanah, Hossein, Sibon, Igor, Baharoglu, M. Irem, Masjuan, Jaime, Brar, Jaskiran, Payen, Jean Francois, Burrow, Jim, Fernandes, João, Octavio López Esparza, Jorge, Oen, Joyce, Schouten, Judith, Ng, Karl, Chatterton, Sophie, Wronski, Miriam, Althaus, Katharina, Garambois, Katia, Derex, Laurent, Puy, Laurent, Poorsaadat, Leila, Valler, Lenise, Januzi de Almeida Rocha, Letícia, Humbertjean, Lisa, Lebrato Hernandez, Lucia, Murillo-Bonilla, Luis, Kellermair, Lukas, Morin Martin, Mar, Sofia Cotelli, Maria, Hernandez Perez, Maria, Zedde, Marialuisa, Carvalho Dias, Mariana, Dubois, Marie Cecile, Carvalho, Marta, Ghiasian, Masoud, Umaiorubahan, Meenakshisundaram, Kumar Karunakaran, Ravi, Roozbeh, Mehrdad, Romoli, Michele, Miranda, Miguel, Saadatnia, Mohammad, Bandettini di Poggio, Monica, Scholz, Moritz J., Kahnis, Robert, Almasi-Dooghaee, Mostafa, Hoseininejad Mir, Nahid, Ichaporia, Nasli R., Kumar Paramasivan, Naveen, Erat Sreedharan, Sapna, Sylaja, P. N., Raposo, Nicolas, Fadakar, Nima, Kruyt, Nyika, Detante, Olivier, Cuisenier, Pauline, Huet, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Scoppettuolo, Pasquale, Reiner, Peggy, Nemati, Reza, Vieira, Ricardo, Goh, Rudy, Murphy, Seán, Timsit, Serge, Coutts, Shelagh, Sharma, Shyam S., Bal, Simerpreet, Kaul, Subhash, Karapanayiotides, Theodoros, Cox, Thomas, Gattringer, Thomas, Mathew, Thomas, Bartsch, Thorsten, Shaygannejad, Vahid, Garcia-Talavera, Veronica, Palma, Vincenzo, Arslan, Yıldız, Mirzaasgari, Zahra, Yavari, Zeinab, Zamani, Zohreh, Bakchoul, Tamam, Levi, Marcel, van Gorp, Eric C.M., Scutelnic, Adrian, van de Munckhof, Anita, Krzywicka, Katarzyna, van Kammen, Mayte Sánchez, Lindgren, Erik, Cordonnier, Charlotte, Kleinig, Timothy J., Field, Thalia S., Poli, Sven, Lemmens, Robin, Middeldorp, Saskia, Aaron, Sanjith, Borhani-Haghighi, Afshin, Arauz, Antonio, Kremer Hovinga, Johanna A., Günther, Albrecht, Putaala, Jukka, Wasay, Mohammad, Conforto, Adriana Bastos, de Sousa, Diana Aguiar, Jood, Katarina, Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Heldner, Mirjam R., Antonenko, Kateryna, Mbroh, Joshua, Brodard, Justine, Hooshmandi, Etrat, Dizonno, Vanessa, Devroye, Annemie, Ciccone, Alfonso, Wittstock, Matthias, Zimmermann, Julian, Bode, Felix J., Skjelland, Mona, Duan, Jiangang, Hiltunen, Sini, Zuurbier, Susanna M., Petruzzellis, Marco, Sharma, Aarti R., Ghoreishi, Abdoreza, Elkady, Ahmed, Negro, Alberto, Gutschalk, Alexander, Schoenenberger, Silvia, Nagel, Simon, Buture, Alina, Cervera, Alvaro, Paiva Nunes, Ana, Romina Montané Baños, Ana, Tiede, Andreas, Puthuppallil, Anemon, Tuladhar, Anil M., Mengel, Annerose, Medina, Antonio, Hellström Vogel, Åslög, Tawa, Audrey, Aujayeb, Avinash, Ramasamy, Balakrishnan, Casolla, Barbara, Lim Alvin Chew, Beng, Ziaadini, Bentalhoda, Varkey Maramattom, Boby, Buck, Brian, Zanferrari, Carla, Garcia-Esperon, Carlos, Vayne, Caroline, Legault, Catherine, Jacobi, Christian, Pfrepper, Christian, Pelz, Johann, Wahl, Christoph, Kern, Rolf, Tracol, Clement, Soriano, Cristina, Guisado-Alonso, Daniel, Bougon, David, Bal, Deepti, Sergio Zimatore, Domenico, Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, Sadeghi-Hokmabadi, Elyar, Carrera, Emmanuel, De Maistre, Emmanuel, Saxhaug Kristoffersen, Espen, Bonneville, Fabrice, Geeraerts, Thomas, Vuillier, Fabrice, Giammello, Fabrizio, D’Onofrio, Florindo, Grillo, Francesco, Caparros, François, Susen, Sophie, Maier, Frank, Tsivgoulis, Georgios, Gulli, Giosue, Frisullo, Giovanni, Franchineau, Guillaume, Cangür, Hakan, Katzberg, Hans, Mozhdehipanah, Hossein, Sibon, Igor, Baharoglu, M. Irem, Masjuan, Jaime, Brar, Jaskiran, Payen, Jean Francois, Burrow, Jim, Fernandes, João, Octavio López Esparza, Jorge, Oen, Joyce, Schouten, Judith, Ng, Karl, Chatterton, Sophie, Wronski, Miriam, Althaus, Katharina, Garambois, Katia, Derex, Laurent, Puy, Laurent, Poorsaadat, Leila, Valler, Lenise, Januzi de Almeida Rocha, Letícia, Humbertjean, Lisa, Lebrato Hernandez, Lucia, Murillo-Bonilla, Luis, Kellermair, Lukas, Morin Martin, Mar, Sofia Cotelli, Maria, Hernandez Perez, Maria, Zedde, Marialuisa, Carvalho Dias, Mariana, Dubois, Marie Cecile, Carvalho, Marta, Ghiasian, Masoud, Umaiorubahan, Meenakshisundaram, Kumar Karunakaran, Ravi, Roozbeh, Mehrdad, Romoli, Michele, Miranda, Miguel, Saadatnia, Mohammad, Bandettini di Poggio, Monica, Scholz, Moritz J., Kahnis, Robert, Almasi-Dooghaee, Mostafa, Hoseininejad Mir, Nahid, Ichaporia, Nasli R., Kumar Paramasivan, Naveen, Erat Sreedharan, Sapna, Sylaja, P. N., Raposo, Nicolas, Fadakar, Nima, Kruyt, Nyika, Detante, Olivier, Cuisenier, Pauline, Huet, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Scoppettuolo, Pasquale, Reiner, Peggy, Nemati, Reza, Vieira, Ricardo, Goh, Rudy, Murphy, Seán, Timsit, Serge, Coutts, Shelagh, Sharma, Shyam S., Bal, Simerpreet, Kaul, Subhash, Karapanayiotides, Theodoros, Cox, Thomas, Gattringer, Thomas, Mathew, Thomas, Bartsch, Thorsten, Shaygannejad, Vahid, Garcia-Talavera, Veronica, Palma, Vincenzo, Arslan, Yıldız, Mirzaasgari, Zahra, Yavari, Zeinab, Zamani, Zohreh, Bakchoul, Tamam, Levi, Marcel, and van Gorp, Eric C.M.
- Abstract
Introduction: Cerebral venous sinus thrombosis associated with vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) is a severe disease with high mortality. There are few data on sex differences in CVST-VITT. The aim of our study was to investigate the differences in presentation, treatment, clinical course, complications, and outcome of CVST-VITT between women and men. Patients and methods: We used data from an ongoing international registry on CVST-VITT. VITT was diagnosed according to the Pavord criteria. We compared the characteristics of CVST-VITT in women and men. Results: Of 133 patients with possible, probable, or definite CVST-VITT, 102 (77%) were women. Women were slightly younger [median age 42 (IQR 28–54) vs 45 (28–56)], presented more often with coma (26% vs 10%) and had a lower platelet count at presentation [median (IQR) 50x109/L (28–79) vs 68 (30–125)] than men. The nadir platelet count was lower in women [median (IQR) 34 (19–62) vs 53 (20–92)]. More women received endovascular treatment than men (15% vs 6%). Rates of treatment with intravenous immunoglobulins were similar (63% vs 66%), as were new venous thromboembolic events (14% vs 14%) and major bleeding complications (30% vs 20%). Rates of good functional outcome (modified Rankin Scale 0-2, 42% vs 45%) and in-hospital death (39% vs 41%) did not differ. Discussion and conclusions: Three quarters of CVST-VITT patients in this study were women. Women were more severely affected at presentation, but clinical course and outcome did not differ between women and men. VITT-specific treatments were overall similar, but more women received endovascular treatment.
- Published
- 2023
8. Cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia in middle-income countries
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van de Munckhof, Anita, Borhani-Haghighi, Afshin, Aaron, Sanjith, Krzywicka, Katarzyna, van Kammen, Mayte Sánchez, Cordonnier, Charlotte, Kleinig, Timothy J., Field, Thalia S., Poli, Sven, Lemmens, Robin, Scutelnic, Adrian, Lindgren, Erik, Duan, Jiangang, Arslan, Yıldız, van Gorp, Eric C.M., Kremer Hovinga, Johanna A., Günther, Albrecht, Jood, Katarina, Tatlisumak, Turgut, Putaala, Jukka, Heldner, Mirjam R., Arnold, Marcel, de Sousa, Diana Aguiar, Wasay, Mohammad, Arauz, Antonio, Conforto, Adriana Bastos, Ferro, José M., Coutinho, Jonathan M., Mbroh, Joshua, Ciccone, Alfonso, Wittstock, Matthias, Zimmermann, Julian, Bode, Felix J., Skjelland, Mona, Dizonno, Vanessa, Devroye, Annemie, Hiltunen, Sini, Petruzzellis, Marco, Bakchoul, Tamam, Levi, Marcel, Middeldorp, Saskia, Sharma, Aarti R., Ghoreishi, Abdoreza, Elkady, Ahmed, Negro, Alberto, Gutschalk, Alexander, Buture, Alina, Cervera, Alvaro, Paiva Nunes, Ana, Romina Montané Baños, Ana, Tiede, Andreas, Tuladhar, Anil M., Mengel, Annerose, Medina, Antonio, Aujayeb, Avinash, Ramasamy, Balakrishnan, Casolla, Barbara, Spratt, Neil, Ziaadini, Bentolhoda, Varkey Maramattom, Boby, Buck, Brian, Garcia-Esperon, Carlos, Vayne, Caroline, Jacobi, Christian, Pfrepper, Christian, Bal, Deepti, Sergio Zimatore, Domenico, Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, Sadeghi-Hokmabadi, Elyar, Carrera, Emmanuel, Maistre, Emmanuel De, Saxhaug Kristoffersen, Espen, Hooshmandi, Etrat, Bonneville, Fabrice, Vuillier, Fabrice, Giammello, Fabrizio, D’Onofrio, Florindo, Tsivgoulis, Georgios, Gulli, Giosue, Katzberg, Hans, Sibon, Igor, Baharoglu, Irem, Masjuan, Jaime, Fernandes, João, Pelz, Johann, Octavio López Esparza, Jorge, Schouten, Judith, Ng, Karl, Derex, Laurent, Puy, Laurent, Poorsaadat, Leila, Valler, Lenise, Januzi de Almeida Rocha, Letícia, Murillo-Bonilla, Luis, Kellermair, Lukas, Morin Martin, Mar, Sofia Cotelli, Maria, Hernandez Perez, Maria, Zedde, Marialuisa, Carvalho Dias, Mariana, Carvalho, Marta, Ghiasian, Masoud, Umaiorubahan, Meenakshisundaram, Roozbeh, Mehrdad, Romoli, Michele, Miranda, Miguel, Wronski, Miriam, Saadatnia, Mohammad, Bandettini di Poggio, Monica, Almasi-Dooghaee, Mostafa, Hoseininejad Mir, Nahid, Ichaporia, Nasli R., Kumar Paramasivan, Naveen, Raposo, Nicolas, Fadakar, Nima, Kruyt, Nyika, Detante, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Scoppettuolo, Pasquale, Reiner, Peggy, Sylaja, P. N., Kumar Karunakaran, Ravi, Vieira, Ricardo, Kern, Rolf, Goh, Rudy, Erat Sreedharan, Sapna, Murphy, Seán, Timsit, Serge, Coutts, Shelagh, Sharma, Shyam S., Schoenenberger, Silvia, Nagel, Simon, Kaul, Subhash, Karapanayiotides, Theodoros, Gattringer, Thomas, Mathew, Thomas, Bartsch, Thorsten, Palma, Vincenzo, Mirzaasgari, Zahra, Zamani, Zohreh, Mirahmadizadeh, Alireza, Gutierrez-Romero, Alonso, Iván Valdes-Ferrer, Ivan, Elizabeth Ceballos-Liceaga, Santa, Maria Santibañez-Copado, Ana, van de Munckhof, Anita, Borhani-Haghighi, Afshin, Aaron, Sanjith, Krzywicka, Katarzyna, van Kammen, Mayte Sánchez, Cordonnier, Charlotte, Kleinig, Timothy J., Field, Thalia S., Poli, Sven, Lemmens, Robin, Scutelnic, Adrian, Lindgren, Erik, Duan, Jiangang, Arslan, Yıldız, van Gorp, Eric C.M., Kremer Hovinga, Johanna A., Günther, Albrecht, Jood, Katarina, Tatlisumak, Turgut, Putaala, Jukka, Heldner, Mirjam R., Arnold, Marcel, de Sousa, Diana Aguiar, Wasay, Mohammad, Arauz, Antonio, Conforto, Adriana Bastos, Ferro, José M., Coutinho, Jonathan M., Mbroh, Joshua, Ciccone, Alfonso, Wittstock, Matthias, Zimmermann, Julian, Bode, Felix J., Skjelland, Mona, Dizonno, Vanessa, Devroye, Annemie, Hiltunen, Sini, Petruzzellis, Marco, Bakchoul, Tamam, Levi, Marcel, Middeldorp, Saskia, Sharma, Aarti R., Ghoreishi, Abdoreza, Elkady, Ahmed, Negro, Alberto, Gutschalk, Alexander, Buture, Alina, Cervera, Alvaro, Paiva Nunes, Ana, Romina Montané Baños, Ana, Tiede, Andreas, Tuladhar, Anil M., Mengel, Annerose, Medina, Antonio, Aujayeb, Avinash, Ramasamy, Balakrishnan, Casolla, Barbara, Spratt, Neil, Ziaadini, Bentolhoda, Varkey Maramattom, Boby, Buck, Brian, Garcia-Esperon, Carlos, Vayne, Caroline, Jacobi, Christian, Pfrepper, Christian, Bal, Deepti, Sergio Zimatore, Domenico, Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, Sadeghi-Hokmabadi, Elyar, Carrera, Emmanuel, Maistre, Emmanuel De, Saxhaug Kristoffersen, Espen, Hooshmandi, Etrat, Bonneville, Fabrice, Vuillier, Fabrice, Giammello, Fabrizio, D’Onofrio, Florindo, Tsivgoulis, Georgios, Gulli, Giosue, Katzberg, Hans, Sibon, Igor, Baharoglu, Irem, Masjuan, Jaime, Fernandes, João, Pelz, Johann, Octavio López Esparza, Jorge, Schouten, Judith, Ng, Karl, Derex, Laurent, Puy, Laurent, Poorsaadat, Leila, Valler, Lenise, Januzi de Almeida Rocha, Letícia, Murillo-Bonilla, Luis, Kellermair, Lukas, Morin Martin, Mar, Sofia Cotelli, Maria, Hernandez Perez, Maria, Zedde, Marialuisa, Carvalho Dias, Mariana, Carvalho, Marta, Ghiasian, Masoud, Umaiorubahan, Meenakshisundaram, Roozbeh, Mehrdad, Romoli, Michele, Miranda, Miguel, Wronski, Miriam, Saadatnia, Mohammad, Bandettini di Poggio, Monica, Almasi-Dooghaee, Mostafa, Hoseininejad Mir, Nahid, Ichaporia, Nasli R., Kumar Paramasivan, Naveen, Raposo, Nicolas, Fadakar, Nima, Kruyt, Nyika, Detante, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Scoppettuolo, Pasquale, Reiner, Peggy, Sylaja, P. N., Kumar Karunakaran, Ravi, Vieira, Ricardo, Kern, Rolf, Goh, Rudy, Erat Sreedharan, Sapna, Murphy, Seán, Timsit, Serge, Coutts, Shelagh, Sharma, Shyam S., Schoenenberger, Silvia, Nagel, Simon, Kaul, Subhash, Karapanayiotides, Theodoros, Gattringer, Thomas, Mathew, Thomas, Bartsch, Thorsten, Palma, Vincenzo, Mirzaasgari, Zahra, Zamani, Zohreh, Mirahmadizadeh, Alireza, Gutierrez-Romero, Alonso, Iván Valdes-Ferrer, Ivan, Elizabeth Ceballos-Liceaga, Santa, and Maria Santibañez-Copado, Ana
- Abstract
Background: Adenovirus-based COVID-19 vaccines are extensively used in low- and middle-income countries (LMICs). Remarkably, cases of cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) have rarely been reported from LMICs. Aims: We studied the frequency, manifestations, treatment, and outcomes of CVST-VITT in LMICs. Methods: We report data from an international registry on CVST after COVID-19 vaccination. VITT was classified according to the Pavord criteria. We compared CVST-VITT cases from LMICs to cases from high-income countries (HICs). Results: Until August 2022, 228 CVST cases were reported, of which 63 were from LMICs (all middle-income countries [MICs]: Brazil, China, India, Iran, Mexico, Pakistan, Turkey). Of these 63, 32 (51%) met the VITT criteria, compared to 103 of 165 (62%) from HICs. Only 5 of the 32 (16%) CVST-VITT cases from MICs had definite VITT, mostly because anti-platelet factor 4 antibodies were often not tested. The median age was 26 (interquartile range [IQR] 20–37) versus 47 (IQR 32–58) years, and the proportion of women was 25 of 32 (78%) versus 77 of 103 (75%) in MICs versus HICs, respectively. Patients from MICs were diagnosed later than patients from HICs (1/32 [3%] vs. 65/103 [63%] diagnosed before May 2021). Clinical manifestations, including intracranial hemorrhage, were largely similar as was intravenous immunoglobulin use. In-hospital mortality was lower in MICs (7/31 [23%, 95% confidence interval (CI) 11–40]) than in HICs (44/102 [43%, 95% CI 34–53], p = 0.039). Conclusions: The number of CVST-VITT cases reported from LMICs was small despite the widespread use of adenoviral vaccines. Clinical manifestations and treatment of CVST-VITT cases were largely similar in MICs and HICs, while mortality was lower in patients from MICs.
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- 2023
9. Initial Experience Using the New pHLO 0.072-inch Large-Bore Catheter for Direct Aspiration Thrombectomy in Acute Ischemic Stroke
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Leone, Giuseppe, primary, Muto, Massimo, additional, Giordano, Flavio, additional, Guarnieri, Gianluigi, additional, Donna, Antonio Di, additional, Russo, Camilla, additional, Romano, Daniele Giuseppe, additional, Candelaresi, Paolo, additional, Servillo, Giovanna, additional, Spina, Emanuele, additional, Mase, Antonio De, additional, Andreone, Vincenzo, additional, and Muto, Mario, additional
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- 2023
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10. Thrombolysis after dabigatran reversal: A nation-wide Italian multicentre study, systematic review and meta-analysis
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Romoli, Michele, primary, Matteo, Eleonora, additional, Migliaccio, Ludovica, additional, Gentile, Mauro, additional, Mosconi, Maria Giulia, additional, Scura, Giuseppe Maria, additional, Naccarato, Marcello, additional, Colangeli, Enrico, additional, Candelaresi, Paolo, additional, Andreone, Vincenzo, additional, Giammello, Fabrizio, additional, Fortunata Musolino, Rosa, additional, Dell’Aera, Cristina, additional, Sepe, Federica Nicoletta, additional, Pronello, Edoardo, additional, Barbarini, Leonardo, additional, Caggiula, Marcella, additional, Rizzo, Federica, additional, Petruzzellis, Marco, additional, Giorli, Elisa, additional, Zedde, Maria Luisa, additional, Anticoli, Sabrina, additional, Mangiardi, Marilena, additional, Muto, Mario, additional, Diana, Francesco, additional, De Angelis, Maria Vittoria, additional, Digiovanni, Anna, additional, Concari, Letizia, additional, La Gioia, Sara, additional, Sessa, Maria, additional, Biguzzi, Sara, additional, Cordici, Francesco, additional, Longoni, Marco, additional, Ruggiero, Maria, additional, Cenciarelli, Silvia, additional, Eusebi, Paolo, additional, Sacco, Simona, additional, Caso, Valeria, additional, Paciaroni, Maurizio, additional, Ricci, Stefano, additional, Zini, Andrea, additional, Toni, Danilo, additional, and Giannandrea, David, additional
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- 2022
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11. Intra-Arterial Thrombolysis to Improve Final Thrombolysis in Cerebral Infarction Score after Thrombectomy: A Case-Series Analysis.
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De Mase, Antonio, Candelaresi, Paolo, Spina, Emanuele, Giordano, Flavio, Barbato, Stefano, Servillo, Giovanna, Prestipino, Elio, Fasolino, Alessandra, Guarnieri, Gianluigi, Leone, Giuseppe, Muto, Massimo, Muto, Mario, and Andreone, Vincenzo
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CEREBRAL infarction , *THROMBECTOMY , *STROKE patients , *THROMBOLYTIC therapy , *TISSUE plasminogen activator - Abstract
Endovascular thrombectomy is the standard treatment in selected patients with acute ischemic stroke and large vessel occlusion, but continuous improvement in angiographic and clinical outcome is still needed. Intra-arterial thrombolysis has been tested as a possible rescue tool in unsuccessful thrombectomy, or as an adjuvant therapy after the endovascular procedure, to pursue complete recanalization. Here we present a case series analysis of intra-arterial alteplase administration (5 mg bolus, repeated up to 15 mg if Thrombolysis in Cerebral Infarction (TICI) scale ≥2c is not achieved) in 15 consecutive anterior circulation stroke patients after unsuccessful thrombectomy, defined as TICI score ≤2b after at least 3 passes or if unsuitable for further endovascular attempts, with the aim of improving recanalization. An improvement of final TICI score was achieved in 10 of 15 patients (66.7%). TICI score ≥2c was achieved after 5 mg intra-arterial tissue plasminogen activator (iaTPA) in 4 patients, and after 10 mg iaTPA in 5 cases. Six of 15 patients received 15 mg iaTPA: 1 of 6 showed angiographical improvement. A major effect of intra-arterial alteplase was observed for distally migrated emboli. None of the patients experienced any symptomatic hemorrhagic transformation or other major bleeding. Our report shows, in a very small cohort, a high rate of final TICI score improvement, encouraging the development of randomized controlled trials of rescue intra-arterial thrombolysis in patients with suboptimal angiographic results after mechanical thrombectomy. [ABSTRACT FROM AUTHOR]
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- 2023
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12. sj-docx-1-eso-10.1177_23969873221131635 – Supplemental material for Thrombolysis after dabigatran reversal: A nation-wide Italian multicentre study, systematic review and meta-analysis
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Romoli, Michele, Matteo, Eleonora, Migliaccio, Ludovica, Gentile, Mauro, Mosconi, Maria Giulia, Scura, Giuseppe Maria, Naccarato, Marcello, Colangeli, Enrico, Candelaresi, Paolo, Andreone, Vincenzo, Giammello, Fabrizio, Fortunata Musolino, Rosa, Dell’Aera, Cristina, Sepe, Federica Nicoletta, Pronello, Edoardo, Barbarini, Leonardo, Caggiula, Marcella, Rizzo, Federica, Petruzzellis, Marco, Giorli, Elisa, Zedde, Maria Luisa, Anticoli, Sabrina, Mangiardi, Marilena, Muto, Mario, Diana, Francesco, De Angelis, Maria Vittoria, Digiovanni, Anna, Concari, Letizia, La Gioia, Sara, Sessa, Maria, Biguzzi, Sara, Cordici, Francesco, Longoni, Marco, Ruggiero, Maria, Cenciarelli, Silvia, Eusebi, Paolo, Sacco, Simona, Caso, Valeria, Paciaroni, Maurizio, Ricci, Stefano, Zini, Andrea, Toni, Danilo, and Giannandrea, David
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FOS: Clinical medicine ,Cardiology ,Medicine ,110904 Neurology and Neuromuscular Diseases - Abstract
Supplemental material, sj-docx-1-eso-10.1177_23969873221131635 for Thrombolysis after dabigatran reversal: A nation-wide Italian multicentre study, systematic review and meta-analysis by Michele Romoli, Eleonora Matteo, Ludovica Migliaccio, Mauro Gentile, Maria Giulia Mosconi, Giuseppe Maria Scura, Marcello Naccarato, Enrico Colangeli, Paolo Candelaresi, Vincenzo Andreone, Fabrizio Giammello, Rosa Fortunata Musolino, Cristina Dell’Aera, Federica Nicoletta Sepe, Edoardo Pronello, Leonardo Barbarini, Marcella Caggiula, Federica Rizzo, Marco Petruzzellis, Elisa Giorli, Maria Luisa Zedde, Sabrina Anticoli, Marilena Mangiardi, Mario Muto, Francesco Diana, Maria Vittoria De Angelis, Anna Digiovanni, Letizia Concari, Sara La Gioia, Maria Sessa, Sara Biguzzi, Francesco Cordici, Marco Longoni, Maria Ruggiero, Silvia Cenciarelli, Paolo Eusebi, Simona Sacco, Valeria Caso, Maurizio Paciaroni, Stefano Ricci, Andrea Zini, Danilo Toni and David Giannandrea in European Stroke Journal
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- 2022
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13. sj-docx-2-eso-10.1177_23969873221131635 – Supplemental material for Thrombolysis after dabigatran reversal: A nation-wide Italian multicentre study, systematic review and meta-analysis
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Romoli, Michele, Matteo, Eleonora, Migliaccio, Ludovica, Gentile, Mauro, Mosconi, Maria Giulia, Scura, Giuseppe Maria, Naccarato, Marcello, Colangeli, Enrico, Candelaresi, Paolo, Andreone, Vincenzo, Giammello, Fabrizio, Fortunata Musolino, Rosa, Dell’Aera, Cristina, Sepe, Federica Nicoletta, Pronello, Edoardo, Barbarini, Leonardo, Caggiula, Marcella, Rizzo, Federica, Petruzzellis, Marco, Giorli, Elisa, Zedde, Maria Luisa, Anticoli, Sabrina, Mangiardi, Marilena, Muto, Mario, Diana, Francesco, De Angelis, Maria Vittoria, Digiovanni, Anna, Concari, Letizia, La Gioia, Sara, Sessa, Maria, Biguzzi, Sara, Cordici, Francesco, Longoni, Marco, Ruggiero, Maria, Cenciarelli, Silvia, Eusebi, Paolo, Sacco, Simona, Caso, Valeria, Paciaroni, Maurizio, Ricci, Stefano, Zini, Andrea, Toni, Danilo, and Giannandrea, David
- Subjects
FOS: Clinical medicine ,Cardiology ,Medicine ,110904 Neurology and Neuromuscular Diseases - Abstract
Supplemental material, sj-docx-2-eso-10.1177_23969873221131635 for Thrombolysis after dabigatran reversal: A nation-wide Italian multicentre study, systematic review and meta-analysis by Michele Romoli, Eleonora Matteo, Ludovica Migliaccio, Mauro Gentile, Maria Giulia Mosconi, Giuseppe Maria Scura, Marcello Naccarato, Enrico Colangeli, Paolo Candelaresi, Vincenzo Andreone, Fabrizio Giammello, Rosa Fortunata Musolino, Cristina Dell’Aera, Federica Nicoletta Sepe, Edoardo Pronello, Leonardo Barbarini, Marcella Caggiula, Federica Rizzo, Marco Petruzzellis, Elisa Giorli, Maria Luisa Zedde, Sabrina Anticoli, Marilena Mangiardi, Mario Muto, Francesco Diana, Maria Vittoria De Angelis, Anna Digiovanni, Letizia Concari, Sara La Gioia, Maria Sessa, Sara Biguzzi, Francesco Cordici, Marco Longoni, Maria Ruggiero, Silvia Cenciarelli, Paolo Eusebi, Simona Sacco, Valeria Caso, Maurizio Paciaroni, Stefano Ricci, Andrea Zini, Danilo Toni and David Giannandrea in European Stroke Journal
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- 2022
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14. Thrombolysis after dabigatran reversal: A nation-wide Italian multicentre study, systematic review and meta-analysis.
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Romoli, Michele, Matteo, Eleonora, Migliaccio, Ludovica, Gentile, Mauro, Mosconi, Maria Giulia, Scura, Giuseppe Maria, Naccarato, Marcello, Colangeli, Enrico, Candelaresi, Paolo, Andreone, Vincenzo, Giammello, Fabrizio, Fortunata Musolino, Rosa, Dell'Aera, Cristina, Sepe, Federica Nicoletta, Pronello, Edoardo, Barbarini, Leonardo, Caggiula, Marcella, Rizzo, Federica, Petruzzellis, Marco, and Giorli, Elisa
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- 2023
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15. Characteristics and Outcomes of Patients with Cerebral Venous Sinus Thrombosis in SARS-CoV-2 Vaccine-Induced Immune Thrombotic Thrombocytopenia
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Sánchez Van Kammen, Mayte, Aguiar De Sousa, Diana, Poli, Sven, Cordonnier, Charlotte, Heldner, Mirjam R., Van De Munckhof, Anita, Krzywicka, Katarzyna, Van Haaps, Thijs, Ciccone, Alfonso, Middeldorp, Saskia, Levi, Marcel M., Kremer Hovinga, Johanna A., Silvis, Suzanne, Hiltunen, Sini, Mansour, Maryam, Arauz, Antonio, Barboza, Miguel A., Field, Thalia S., Tsivgoulis, Georgios, Nagel, Simon, Lindgren, Erik, Tatlisumak, Turgut, Jood, Katarina, Putaala, Jukka, Ferro, Jose M., Arnold, Marcel, Coutinho, Jonathan M., Sharma, Aarti R., Elkady, Ahmed, Negro, Alberto, Günther, Albrecht, Gutschalk, Alexander, Schönenberger, Silvia, Buture, Alina, Murphy, Sean, Paiva Nunes, Ana, Tiede, Andreas, Puthuppallil Philip, Anemon, Mengel, Annerose, Medina, Antonio, Hellström Vogel, Åslög, Tawa, Audrey, Aujayeb, Avinash, Casolla, Barbara, Buck, Brian, Zanferrari, Carla, Garcia-Esperon, Carlos, Vayne, Caroline, Legault, Catherine, Pfrepper, Christian, Tracol, Clement, Soriano, Cristina, Guisado-Alonso, Daniel, Bougon, David, Zimatore, Domenico S., Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, De Maistre, Emmanuel, Carrera, Emmanuel, Vuillier, Fabrice, Bonneville, Fabrice, Giammello, Fabrizio, Bode, Felix J., Zimmerman, Julian, D'Onofrio, Florindo, Grillo, Francesco, Cotton, Francois, Caparros, François, Puy, Laurent, Maier, Frank, Gulli, Giosue, Frisullo, Giovanni, Polkinghorne, Gregory, Franchineau, Guillaume, Cangür, Hakan, Katzberg, Hans, Sibon, Igor, Baharoglu, Irem, Brar, Jaskiran, Payen, Jean-François, Burrow, Jim, Fernandes, João, Schouten, Judith, Althaus, Katharina, Garambois, Katia, Derex, Laurent, Humbertjean, Lisa, Lebrato Hernandez, Lucia, Kellermair, Lukas, Morin Martin, Mar, Petruzzellis, Marco, Cotelli, Maria, Dubois, Marie-Cécile, Carvalho, Marta, Wittstock, Matthias, Miranda, Miguel, Skjelland, Mona, Bandettini Di Poggio, Monica, Scholz, Moritz J., Raposo, Nicolas, Kahnis, Robert, Kruyt, Nyika, Huet, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Reiner, Peggy, Vieira, Ricardo, Acampora, Roberto, Kern, Rolf, Leker, Ronen, Coutts, Shelagh, Bal, Simerpreet, Sharma, Shyam S., Susen, Sophie, Cox, Thomas, Geeraerts, Thomas, Gattringer, Thomas, Bartsch, Thorsten, Kleinig, Timothy J., Dizonno, Vanessa, Arslan, Yildiz, Sánchez Van Kammen, Mayte, Aguiar De Sousa, Diana, Poli, Sven, Cordonnier, Charlotte, Heldner, Mirjam R., Van De Munckhof, Anita, Krzywicka, Katarzyna, Van Haaps, Thijs, Ciccone, Alfonso, Middeldorp, Saskia, Levi, Marcel M., Kremer Hovinga, Johanna A., Silvis, Suzanne, Hiltunen, Sini, Mansour, Maryam, Arauz, Antonio, Barboza, Miguel A., Field, Thalia S., Tsivgoulis, Georgios, Nagel, Simon, Lindgren, Erik, Tatlisumak, Turgut, Jood, Katarina, Putaala, Jukka, Ferro, Jose M., Arnold, Marcel, Coutinho, Jonathan M., Sharma, Aarti R., Elkady, Ahmed, Negro, Alberto, Günther, Albrecht, Gutschalk, Alexander, Schönenberger, Silvia, Buture, Alina, Murphy, Sean, Paiva Nunes, Ana, Tiede, Andreas, Puthuppallil Philip, Anemon, Mengel, Annerose, Medina, Antonio, Hellström Vogel, Åslög, Tawa, Audrey, Aujayeb, Avinash, Casolla, Barbara, Buck, Brian, Zanferrari, Carla, Garcia-Esperon, Carlos, Vayne, Caroline, Legault, Catherine, Pfrepper, Christian, Tracol, Clement, Soriano, Cristina, Guisado-Alonso, Daniel, Bougon, David, Zimatore, Domenico S., Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, De Maistre, Emmanuel, Carrera, Emmanuel, Vuillier, Fabrice, Bonneville, Fabrice, Giammello, Fabrizio, Bode, Felix J., Zimmerman, Julian, D'Onofrio, Florindo, Grillo, Francesco, Cotton, Francois, Caparros, François, Puy, Laurent, Maier, Frank, Gulli, Giosue, Frisullo, Giovanni, Polkinghorne, Gregory, Franchineau, Guillaume, Cangür, Hakan, Katzberg, Hans, Sibon, Igor, Baharoglu, Irem, Brar, Jaskiran, Payen, Jean-François, Burrow, Jim, Fernandes, João, Schouten, Judith, Althaus, Katharina, Garambois, Katia, Derex, Laurent, Humbertjean, Lisa, Lebrato Hernandez, Lucia, Kellermair, Lukas, Morin Martin, Mar, Petruzzellis, Marco, Cotelli, Maria, Dubois, Marie-Cécile, Carvalho, Marta, Wittstock, Matthias, Miranda, Miguel, Skjelland, Mona, Bandettini Di Poggio, Monica, Scholz, Moritz J., Raposo, Nicolas, Kahnis, Robert, Kruyt, Nyika, Huet, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Reiner, Peggy, Vieira, Ricardo, Acampora, Roberto, Kern, Rolf, Leker, Ronen, Coutts, Shelagh, Bal, Simerpreet, Sharma, Shyam S., Susen, Sophie, Cox, Thomas, Geeraerts, Thomas, Gattringer, Thomas, Bartsch, Thorsten, Kleinig, Timothy J., Dizonno, Vanessa, and Arslan, Yildiz
- Abstract
Importance: Thrombosis with thrombocytopenia syndrome (TTS) has been reported after vaccination with the SARS-CoV-2 vaccines ChAdOx1 nCov-19 (Oxford-AstraZeneca) and Ad26.COV2.S (Janssen/Johnson & Johnson). Objective: To describe the clinical characteristics and outcome of patients with cerebral venous sinus thrombosis (CVST) after SARS-CoV-2 vaccination with and without TTS. Design, Setting, and Participants: This cohort study used data from an international registry of consecutive patients with CVST within 28 days of SARS-CoV-2 vaccination included between March 29 and June 18, 2021, from 81 hospitals in 19 countries. For reference, data from patients with CVST between 2015 and 2018 were derived from an existing international registry. Clinical characteristics and mortality rate were described for adults with (1) CVST in the setting of SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia, (2) CVST after SARS-CoV-2 vaccination not fulling criteria for TTS, and (3) CVST unrelated to SARS-CoV-2 vaccination. Exposures: Patients were classified as having TTS if they had new-onset thrombocytopenia without recent exposure to heparin, in accordance with the Brighton Collaboration interim criteria. Main Outcomes and Measures: Clinical characteristics and mortality rate. Results: Of 116 patients with postvaccination CVST, 78 (67.2%) had TTS, of whom 76 had been vaccinated with ChAdOx1 nCov-19; 38 (32.8%) had no indication of TTS. The control group included 207 patients with CVST before the COVID-19 pandemic. A total of 63 of 78 (81%), 30 of 38 (79%), and 145 of 207 (70.0%) patients, respectively, were female, and the mean (SD) age was 45 (14), 55 (20), and 42 (16) years, respectively. Concomitant thromboembolism occurred in 25 of 70 patients (36%) in the TTS group, 2 of 35 (6%) in the no TTS group, and 10 of 206 (4.9%) in the control group, and in-hospital mortality rates were 47% (36 of 76; 95% CI, 37-58), 5% (2 of 37; 95% CI, 1-18), and 3.9% (8 of 207; 95% CI
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- 2021
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16. Left atrial appendage thrombus on full-dose dabigatran treatment: a case report
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Candelaresi, Paolo, primary, Iannuzzi, Angela, primary, Servillo, Giovanna, primary, and Gottilla, Rossella, primary
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- 2020
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17. Some minutes matter more: Groin-to-recanalization is the main time-related predictor of outcome in acute ischemic stroke
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De Mase, Antonio, Spina, Emanuele, Servillo, Giovanna, Barbato, Stefano, Leone, Giuseppe, Giordano, Flavio, Renna, Rosaria, Ranieri, Angelo, Iorio, Walter Di, Muto, Massimo, Guarnieri, Gianluigi, Muto, Mario, Candelaresi, Paolo, and Andreone, Vincenzo
- Abstract
Introduction Endovascular thrombectomy (EVT) is the standard of care for selected patients with acute ischemic stroke (AIS) and large vessel occlusion (LVO), associated with intravenous thrombolysis, when indicated. While many studies focused on pre-hospital and in-hospital pathways, only few analyzed the relationship between groin-to-recanalization (GTR) time and functional outcome.Aim To explore whether GTR time is an independent predictor of outcome in patients undergoing EVT.Methods All patients with anterior circulation stroke treated with EVT at a high-volume center from January 2021 to December 2023 were included. The cohort was divided into two groups according to GTR time shorter or longer than 30 min. Regression analysis assessed the association between GTR time and 3-month good outcome, defined as modified Rankin Scale 0–2.Results The study included 419 patients. The groups had similar baseline characteristics and similar onset to recanalization (OTR) time. Regression analysis showed shorter GTR time is an independent predictor of favorable outcome (OR 2.49 [95% CI 1.26–4.94]). Age, baseline NIHSS, ASPECT score and bridging IVT were also found to be independently associated with outcome.Discussion and conclusions Our study showed GTR time is an independent predictor of good outcome in patients undergoing EVT with similar OTR time, emphasizing procedural time as a key prognostic factor, even greater than other well-known pre-hospital and in-hospital time-dependent variables. These findings may raise the issue of developing alternative approaches or early “rescue” strategies for complicated procedures.
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- 2024
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18. Characteristics and outcomes of cerebral venous thrombosis associated with COVID-19
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Scutelnic, Adrian, van de Munckhof, Anita, Miraclin, Angel T., Aaron, Sanjith, Hameed, Sajid, Wasay, Mohammad, Grosu, Oxana, Krzywicka, Katarzyna, Sánchez van Kammen, Mayte, Lindgren, Erik, Moreira, Tiago, Acampora, Roberto, Negro, Alberto, Karapanayiotides, Theodoros, Yaghi, Shadi, Revert, Anna, Cuadrado Godia, Elisa, Garcia-Madrona, Sebastian, La Spina, Paolino, Grillo, Francesco, Giammello, Fabrizio, Nguyen, Thanh N., Abdalkader, Mohamad, Buture, Alina, Sofia Cotelli, Maria, Raposo, Nicolas, Tsivgoulis, Georgios, Candelaresi, Paolo, Ciacciarelli, Antonio, Mbroh, Joshua, Batenkova, Tatiana, Scoppettuolo, Pasquale, Zedde, Marialuisa, Pascarella, Rosario, Antonenko, Kateryna, Kristoffersen, Espen S., Kremer Hovinga, Johanna A., Jood, Katarina, Aguiar de Sousa, Diana, Poli, Sven, Tatlisumak, Turgut, Putaala, Jukka, Coutinho, Jonathan M., Ferro, José M., Arnold, Marcel, and Heldner, Mirjam R.
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Introduction: Previous reports and meta-analyses derived from small case series reported a mortality rate of up to 40% in patients with coronavirus disease 2019 associated cerebral venous thrombosis (COVID-CVT). We assessed the clinical characteristics and outcomes in an international cohort of patients with COVID-CVT.Patients and methods: This was a registry study of consecutive COVID-CVT patients diagnosed between March 2020 and March 2023. Data collected by the International Cerebral Venous Thrombosis Consortium from patients with CVT diagnosed between 2017 and 2018 served as a comparison. Outcome analyses were adjusted for age and sex.Results: We included 70 patients with COVID-CVT from 23 hospitals in 15 countries and 206 controls from 14 hospitals in 13 countries. The proportion of women was smaller in the COVID-CVT group (50% vs 68%, p< 0.01). A higher proportion of COVID-CVT patients presented with altered mental state (44% vs 25%, p< 0.01), the median thrombus load was higher in COVID-CVT patients (3 [IQR 2–4] vs 2 [1–3], p< 0.01) and the length of hospital stay was longer compared to controls (11 days [IQR 7–20] vs 8 [4–15], p= 0.02). In-hospital mortality did not differ (5/67 [7%, 95% CI 3–16] vs 7/206 [3%, 2–7], aOR 2.6 [95% CI 0.7–9]), nor did the frequency of functional independence after 6 months (modified Rankin Scale 0–2; 45/58 [78%, 95% CI 65–86] vs 161/185 [87%, 81–91], aOR 0.5 [95% CI 0.2–1.02]).Conclusion: In contrast to previous studies, the in-hospital mortality rate and functional outcomes during follow-up did not differ between COVID-CVT patients and the pre-COVID-19 controls.
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- 2024
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19. Beyond RCTs: Short-term dual antiplatelet therapy in secondary prevention of ischemic stroke and transient ischemic attack
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De Matteis, Eleonora, Ornello, Raffaele, De Santis, Federico, Foschi, Matteo, Romoli, Michele, Tassinari, Tiziana, Saia, Valentina, Cenciarelli, Silvia, Bedetti, Chiara, Padiglioni, Chiara, Censori, Bruno, Puglisi, Valentina, Vinciguerra, Luisa, Guarino, Maria, Barone, Valentina, Zedde, Marialuisa, Grisendi, Ilaria, Diomedi, Marina, Bagnato, Maria Rosaria, Petruzzellis, Marco, Mezzapesa, Domenico Maria, Di Viesti, Pietro, Inchingolo, Vincenzo, Cappellari, Manuel, Zenorini, Mara, Candelaresi, Paolo, Andreone, Vincenzo, Rinaldi, Giuseppe, Bavaro, Alessandra, Cavallini, Anna, Moraru, Stefan, Querzani, Pietro, Terruso, Valeria, Mannino, Marina, Pezzini, Alessandro, Frisullo, Giovanni, Muscia, Francesco, Paciaroni, Maurizio, Mosconi, Maria Giulia, Zini, Andrea, Leone, Ruggiero, Palmieri, Carmela, Cupini, Letizia Maria, Marcon, Michela, Tassi, Rossana, Sanzaro, Enzo, Paci, Cristina, Viticchi, Giovanna, Orsucci, Daniele, Falcou, Anne, Diamanti, Susanna, Tarletti, Roberto, Nencini, Patrizia, Rota, Eugenia, Sepe, Federica Nicoletta, Ferrandi, Delfina, Caputi, Luigi, Volpi, Gino, Spada, Salvatore La, Beccia, Mario, Rinaldi, Claudia, Mastrangelo, Vincenzo, Di Blasio, Francesco, Invernizzi, Paolo, Pelliccioni, Giuseppe, De Angelis, Maria Vittoria, Bonanni, Laura, Ruzza, Giampietro, Caggia, Emanuele Alessandro, Russo, Monia, Tonon, Agnese, Acciarri, Maria Cristina, Anticoli, Sabrina, Roberti, Cinzia, Manobianca, Giovanni, Scaglione, Gaspare, Pistoia, Francesca, Fortini, Alberto, De Boni, Antonella, Sanna, Alessandra, Chiti, Alberto, Barbarini, Leonardo, Caggiula, Marcella, Masato, Maela, Del Sette, Massimo, Passarelli, Francesco, Roberta Bongioanni, Maria, Toni, Danilo, Ricci, Stefano, and Sacco, Simona
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Background and purpose: Randomized controlled trials (RCTs) proved the efficacy of short-term dual antiplatelet therapy (DAPT) in secondary prevention of minor ischemic stroke or high-risk transient ischemic attack (TIA). We aimed at evaluating effectiveness and safety of short-term DAPT in real-world, where treatment use is broader than in RCTs.Methods: READAPT (REAl-life study on short-term Dual Antiplatelet treatment in Patients with ischemic stroke or Transient ischemic attack) (NCT05476081) was an observational multicenter real-world study with a 90-day follow-up. We included patients aged 18+ receiving short-term DAPT soon after ischemic stroke or TIA. No stringent NIHSS and ABCD2score cut-offs were applied but adherence to guidelines was recommended. Primary effectiveness outcome was stroke (ischemic or hemorrhagic) or death due to vascular causes, primary safety outcome was moderate-to-severe bleeding. Secondary outcomes were the type of ischemic and hemorrhagic events, disability, cause of death, and compliance to treatment.Results: We included 1920 patients; 69.9% started DAPT after an ischemic stroke; only 8.9% strictly followed entry criteria or procedures of RCTs. Primary effectiveness outcome occurred in 3.9% and primary safety outcome in 0.6% of cases. In total, 3.3% cerebrovascular ischemic recurrences occurred, 0.2% intracerebral hemorrhages, and 2.7% bleedings; 0.2% of patients died due to vascular causes. Patients with NIHSS score ⩽5 and those without acute lesions at neuroimaging had significantly higher primary effectiveness outcomes than their counterparts. Additionally, DAPT start >24 h after symptom onset was associated with a lower likelihood of bleeding.Conclusions: In real-world, most of the patients who receive DAPT after an ischemic stroke or a TIA do not follow RCTs entry criteria and procedures. Nevertheless, short-term DAPT remains effective and safe in this population. No safety concerns are raised in patients with low-risk TIA, more severe stroke, and delayed treatment start.
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- 2024
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20. Trends of recanalization therapies and state of art for ischemic stroke treatment in Campania region, Italy
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Emanuele Spina, Paolo Candelaresi, Giampiero Volpe, Florindo D’Onofrio, Daniele Spitaleri, Gioacchino Martusciello, Giovanni Piccirillo, Francesco Briganti, Mario Muto, Michele Feleppa, Marco Sparaco, Andrea Manto, Teresa Cuomo, Salvatore Ascione, Patrizia Ripa, Daniele Giuseppe Romano, Vincenzo Andreone, Fiore Manganelli, Rosa Napoletano, Spina, Emanuele, Candelaresi, Paolo, Volpe, Giampiero, D'Onofrio, Florindo, Spitaleri, Daniele, Martusciello, Gioacchino, Piccirillo, Giovanni, Briganti, Francesco, Muto, Mario, Feleppa, Michele, Sparaco, Marco, Manto, Andrea, Cuomo, Teresa, Ascione, Salvatore, Ripa, Patrizia, Romano, Daniele Giuseppe, Andreone, Vincenzo, Manganelli, Fiore, and Napoletano, Rosa
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Epidemiology ,Dermatology ,General Medicine ,Brain Ischemia ,Stroke ,Psychiatry and Mental health ,Treatment Outcome ,Fibrinolytic Agents ,Trend ,Humans ,Thrombolytic Therapy ,Neurology (clinical) ,Campania ,Recanalization therapie ,Thrombectomy ,Ischemic Stroke - Abstract
Background According to the last Italian report by the Ministry of Health in 2018, the estimated number of acute ischemic strokes (AIS) in Campania is 10,000/year, with an expected number of 1390 intravenous thrombolysis (IVT) and 694 mechanical thrombectomies (MT). In 2017, only 1.5% of expected patients received IVT and 0.2% MT. This study analyzed the trend of IVT and MT in 2019–2020 and depicted the state of art of Stroke Care in Campania. Methods From the regional health task force, we obtained the hospital discharge forms from all private and public hospitals in Campania; we selected patients with a principal diagnosis of AIS and measured the rate of patients admitted to neurology units and the rate of IVT, MT, and IVT + MT for both 2019 and 2020. Results In 2019, we observed 4817 admissions for AIS; 2858/4817 (59.3%) patients were admitted to neurology units. Out of 4817 patients, 192 received IVT, 165 MT, and 131 IVT + MT (488 treated patients; 10.1%). In 2020, we observed 4129 admissions for AIS; 2502/4129 (62.7%) patients were admitted to neurology units. Out of 4129 patients, 198 received IVT, 250 MT, and 180 IVT + MT (628 treated patients; 15.2%). These results showed that despite a reduction of AIS admissions in 2020, the relative and absolute rate of recanalization treatments increased. However, the number of patients who were not admitted to neurology units nor received acute treatments remained dramatically high. Conclusion Despite the development of acute treatments, the Campania Stroke Network still needs significative efforts to improve.
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- 2022
21. Combining Intravenous Thrombolysis and Dual Antiplatelet Treatment in Patients With Minor Ischemic Stroke: A Propensity Matched Analysis of the READAPT Study Cohort.
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Ornello R, Foschi M, De Santis F, Romoli M, Tassinari T, Saia V, Cenciarelli S, Bedetti C, Padiglioni C, Censori B, Puglisi V, Vinciguerra L, Guarino M, Barone V, Zedde M, Grisendi I, Diomedi M, Bagnato MR, Petruzzellis M, Mezzapesa DM, Di Viesti P, Inchingolo V, Cappellari M, Zivelonghi C, Candelaresi P, Andreone V, Rinaldi G, Bavaro A, Cavallini A, Moraru S, Querzani P, Terruso V, Mannino M, Pezzini A, Frisullo G, Muscia F, Paciaroni M, Mosconi MG, Zini A, Leone R, Palmieri C, Cupini LM, Marcon M, Tassi R, Sanzaro E, Paci C, Viticchi G, Orsucci D, Falcou A, Beretta S, Tarletti R, Nencini P, Rota E, Sepe FN, Ferrandi D, Caputi L, Volpi G, La Spada S, Beccia M, Rinaldi C, Mastrangelo V, Di Blasio F, Invernizzi P, Pelliccioni G, De Angelis MV, Bonanni L, Ruzza G, Caggia EA, Russo M, Tonon A, Acciarri MC, Anticoli S, Roberti C, Manobianca G, Scaglione G, Pistoia F, Fortini A, De Boni A, Sanna A, Chiti A, Barbarini L, Caggiula M, Masato M, Del Sette M, Passarelli F, Bongioanni MR, Toni D, Ricci S, De Matteis E, and Sacco S
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- Humans, Female, Male, Aged, Prospective Studies, Middle Aged, Treatment Outcome, Fibrinolytic Agents administration & dosage, Fibrinolytic Agents adverse effects, Time Factors, Administration, Intravenous, Risk Assessment, Drug Therapy, Combination, Aged, 80 and over, Risk Factors, Ischemic Stroke diagnosis, Ischemic Stroke drug therapy, Propensity Score, Platelet Aggregation Inhibitors administration & dosage, Platelet Aggregation Inhibitors adverse effects, Thrombolytic Therapy methods, Thrombolytic Therapy adverse effects, Dual Anti-Platelet Therapy methods
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Background: The optimal treatment for acute minor ischemic stroke is still undefined. and options include dual antiplatelet treatment (DAPT), intravenous thrombolysis (IVT), or their combination. We aimed to investigate benefits and risks of combining IVT and DAPT versus DAPT alone in patients with MIS., Methods and Results: This is a prespecified propensity score-matched analysis from a prospective multicentric real-world study (READAPT [Real-Life Study on Short-Term Dual Antiplatelet Treatment in Patients With Ischemic Stroke or Transient Ischemic Attack]). We included patients with MIS (National Institutes of Health Stroke Scale score at admission ≤5), without prestroke disability (modified Rankin scale [mRS] score ≤2). The primary outcomes were 90-day mRS score of 0 to 2 and ordinal mRS distribution. The secondary outcomes included 90-day risk of stroke and other vascular events and 24-hour early neurological improvement or deterioration (≥2-point National Institutes of Health Stroke Scale score decrease or increase from the baseline, respectively). From 1373 patients with MIS, 240 patients treated with IVT plus DAPT were matched with 427 patients treated with DAPT alone. At 90 days, IVT plus DAPT versus DAPT alone showed similar frequency of mRS 0 to 2 (risk difference, 2.3% [95% CI -2.0% to 6.7%]; P =0.295; risk ratio, 1.03 [95% CI 0.98-1.08]; P =0.312) but more favorable ordinal mRS scores distribution (odds ratio, 0.57 [95% CI 0.41-0.79]; P <0.001). Compared with patients treated with DAPT alone, those combining IVT and DAPT had higher 24-hour early neurological improvement (risk difference, 20.9% [95% CI 13.1%-28.6%]; risk ratio, 1.59 [95% CI 1.34-1.89]; both P <0.001) and lower 90-day risk of stroke and other vascular events (hazard ratio, 0.27 [95% CI 0.08-0.90]; P =0.034). There were no differences in safety outcomes., Conclusions: According to findings from this observational study, patients with MIS may benefit in terms of better functional outcome and lower risk of recurrent events from combining IVT and DAPT versus DAPT alone without safety concerns., Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT05476081.
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- 2024
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22. Neurovascular Issues in Antiphospholipid Syndrome: Arterial Vasculopathy from Small to Large Vessels in a Neuroradiological Perspective.
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Zedde M, Grisendi I, Assenza F, Napoli M, Moratti C, Lara B, Di Cecco G, D'Aniello S, Pavone C, Pezzella FR, Candelaresi P, Andreone V, Valzania F, and Pascarella R
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Antiphospholipid syndrome (APS) is an autoimmune prothrombotic condition characterized by venous thromboembolism, arterial thrombosis, and pregnancy morbidity. Among neurological manifestations, arterial thrombosis is only one of the possible associated clinical and neuroradiological features. The aim of this review is to address from a neurovascular point of view the multifaceted range of the arterial side of APS. A modern neurovascular approach was proposed, dividing the CNS involvement on the basis of the size of affected arteries, from large to small arteries, and corresponding clinical and neuroradiological issues. Both large-vessel and small-vessel involvement in APS were detailed, highlighting the limitations of the available literature in the attempt to derive some pathomechanisms. APS is a complex disease, and its neurological involvement appears multifaceted and not yet fully characterized, within and outside the diagnostic criteria. The involvement of intracranial large and small vessels appears poorly characterized, and the overlapping with the previously proposed inflammatory manifestations is consistent.
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- 2024
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23. Prevention of infections and fever to improve outcome in older patients with acute stroke (PRECIOUS): a randomised, open, phase III, multifactorial, clinical trial with blinded outcome assessment.
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de Jonge JC, Sluis WM, Reinink H, Bath PM, Woodhouse LJ, Zweedijk B, van de Beek D, Aamodt AH, Alpers I, Ciccone A, Csiba L, Demotes J, Kõrv J, Kurkowska-Jastrzebska I, Dawson J, Macleod MR, Ntaios G, Poli S, Milionis H, Ricci S, Cenciarelli S, Candelaresi P, de Bruijn SF, Pathansali R, Krishnan K, Clarke B, Thomalla G, and van der Worp HB
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Background: Infections and fever after stroke are associated with poor functional outcome or death. We assessed whether prophylactic treatment with anti-emetic, antibiotic, or antipyretic medication would improve functional outcome in older patients with acute stroke., Methods: We conducted an international, 2∗2∗2-factorial, randomised, controlled, open-label trial with blinded outcome assessment in patients aged 66 years or older with acute ischaemic stroke or intracerebral haemorrhage and a score on the National Institutes of Health Stroke Scale ≥ 6. Patients were randomly allocated (1:1) to metoclopramide (oral, rectal, or intravenous; 10 mg thrice daily) vs. no metoclopramide, ceftriaxone (intravenous; 2000 mg once daily) vs. no ceftriaxone, and paracetamol (oral, rectal, or intravenous; 1000 mg four times daily) vs. no paracetamol, started within 24 h after symptom onset and continued for four days. All participants received standard of care. The target sample size was 3800 patients. The primary outcome was the score on the modified Rankin Scale (mRS) at 90 days analysed with ordinal logistic regression and reported as an adjusted common odds ratio (an acOR < 1 suggests benefit and an acOR > 1 harm). This trial is registered (ISRCTN82217627)., Findings: From April 2016 through June 2022, 1493 patients from 67 European sites were randomised to metoclopramide (n = 704) or no metoclopramide (n = 709), ceftriaxone (n = 594) or no ceftriaxone (n = 482), and paracetamol (n = 706) or no paracetamol (n = 739), of whom 1471 were included in the intention-to-treat analysis. Prophylactic use of study medication did not significantly alter the primary outcome at 90 days: metoclopramide vs. no metoclopramide (adjusted common odds ratio [acOR], 1.01; 95% CI 0.81-1.25), ceftriaxone vs. no ceftriaxone (acOR 0.99; 95% CI 0.77-1.27), paracetamol vs. no paracetamol (acOR 1.19; 95% CI 0.96-1.47). The study drugs were safe and not associated with an increased incidence of serious adverse events., Interpretation: We observed no sign of benefit of prophylactic use of metoclopramide, ceftriaxone, or paracetamol during four days in older patients with a moderately severe to severe acute stroke., Funding: This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No: 634809., Competing Interests: LJW, BZ, IA, LC, IKJ, JeD, GN, HM, SR, SC, PC, SFTMdB, RP, KK, BC: none related. JCdJ, WMS, HR, JaD and MM report grants from the European Union, all paid to their institution. PMB reports having received grants from the UK National Institute of Health Research, and fees as consultant from CoMind, DiaMedica, Phagenesis and Roche. DvdB reports having received research grants from the European Union, The Netherlands for Health Research and Development, ItsMe Foundation, AMC Foundation and Roche; none related. AHA reports research grants from Boehringer Ingelheim, lectures fee from Abbvie, BMS/Pfizer, Novartis, Roche and Teva and participation in Advisory Board for Lundbeck, Abbvie and MSD; none related. AC reports grants from the European Union and Lombardy Region, for research paid to his institution, and fees as consultant or lecturer from Alexion Pharma, Daiichi Sanky, and Italfarmaco. JK reports lecturer fees from Boehringer Ingelheim, Pfizer and Servier, and travel grants from Boehringer Ingelheim and Servier, none related. SP received research support from BMS/Pfizer, Boehringer-Ingelheim, Daiichi Sankyo, European Union, German Federal Joint Committee Innovation Fund, and German Federal Ministry of Education and Research, Helena Laboratories and Werfen as well as speakers’ honoraria/consulting fees from Alexion, AstraZeneca, Bayer, Boehringer-Ingelheim, BMS/Pfizer, Daiichi Sankyo, Portola, and Werfen (all outside the submitted work). GT reports grants from the European Union, German Research Foundation, German Federal Ministry of Education and Research, German Innovation Fund for research paid to his institution, and fees as consultant or lecturer from Acandis, Alexion, Amarin, Bayer, Boehringer Ingelheim, Daiichi Sanky, BristolMyersSqibb/Pfizer, and Stryker. HBvdW reports having received grants from the European Union, the Dutch Heart Foundation, and Stryker for research, and funding for consultancy from Bayer and TargED, all paid to his institution., (© 2023 The Author(s).)
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- 2023
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24. Left atrial appendage thrombus on full-dose dabigatran treatment: a case report.
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Candelaresi P, Iannuzzi A, Servillo G, and Gottilla R
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Background: Dabigatran is a direct competitive thrombin inhibitor approved for stroke prevention in non-valvular atrial fibrillation. At full-dose, dabigatran showed similar rates of bleedings and higher efficacy compared to warfarin., Case Summary: We report a case of acute ischaemic stroke in a patient treated with dabigatran 150 mg b.i.d. for atrial fibrillation. After an off-label treatment with idarucizumab, a humanized monoclonal antibody approved for dabigatran reversal, we performed a successful intravenous thrombolysis (IVT). Transoesophageal echocardiography showed a left atrial appendage (LAA) thrombus, despite full-dose dabigatran and an adequate therapy adherence., Discussion: There are few cases of LAA thrombus during dabigatran treatment reported in literature till date. We analyse the possible pathogenetic mechanisms involved in dabigatran failure, including drug interactions and unexpected genetic variations interfering with dabigatran serum levels suggesting periodical assessment of direct Oral Anticoagulant levels. Furthermore, we confirm initial reports of safety and efficacy of intravenous thrombolysis after idarucizumab, in case of dabigatran failure., (© The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.)
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- 2020
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