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51. Abstract WP4: Intravenous Thrombolysis And Outcomes In Patients With Large-vessel Stroke Directly Admitted Or Transferred To A Thrombectomy-capable Center

Author

Garcia-Tornel Garcia-Camba, Alvaro, primary, Lozano, Prudencio, additional, Requena, Manuel, additional, Rodriguez-Luna, David, additional, Rodriguez-Villatoro, Noelia, additional, Rubiera, Marta, additional, Muchada, Marian, additional, Olive-Gadea, Marta, additional, Rizzo, Federica, additional, boned, sandra, additional, Ribo, Marc, additional, Molina, Carlos A, additional, Pagola, Jorge, additional, Juega, Jesús, additional, Dorado, Laura, additional, Jimenez-Fabrega, Xavier, additional, Cardona, Pedro, additional, Urra, Xabier, additional, Purroy, Francisco, additional, Terceño, Mikel, additional, Flores, Alan F, additional, Chamorro, Angel, additional, Silva, Yolanda, additional, Ustrell, Xavier, additional, Zaragoza, Jose, additional, Roquer, Jaime, additional, Krupinski, Jerzy, additional, Cocho, Dolores, additional, Palomeras, Ernest, additional, Gomez-Choco, Manuel J, additional, Canovas, David, additional, Martí-Fàbregas, Joan, additional, Mas, Natalia, additional, Fagundez, Olga, additional, Abilleira, Sonia, additional, and Perez de la Ossa, Natalia, additional

Published
2023
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52. International controlled study of revascularization and outcomes following COVID-positive mechanical thrombectomy

Author

North American Neurovascular COVID-19 (NAN-C) Consortium &amp, Dmytriw, Adam A, Ghozy, Sherief, Sweid, Ahmad, Piotin, Michel, Bekelis, Kimon, Sourour, Nader, Raz, Eytan, Vela-Duarte, Daniel, Linfante, Italo, Dabus, Guilherme, Kole, Max, Martínez-Galdámez, Mario, Nimjee, Shahid M, Lopes, Demetrius K, Hassan, Ameer E, Kan, Peter, Ghorbani, Mohammad, Levitt, Michael R, Escalard, Simon, Missios, Symeon, Shapiro, Maksim, Clarençon, Fréderic, Elhorany, Mahmoud, Tahir, Rizwan A, Youssef, Patrick P, Pandey, Aditya S, Starke, Robert M, El Naamani, Kareem, Abbas, Rawad, Mansour, Ossama Y, Galvan, Jorge, Billingsley, Joshua T, Mortazavi, Abolghasem, Walker, Melanie, Dibas, Mahmoud, Settecase, Fabio, Heran, Manraj KS, Kuhn, Anna L, Puri, Ajit S, Menon, Bijoy K, Sivakumar, Sanjeev, Mowla, Ashkan, D'Amato, Salvatore, Zha, Alicia M, Cooke, Daniel, Vranic, Justin E, Regenhardt, Robert W, Rabinov, James D, Stapleton, Christopher J, Goyal, Mayank, Wu, Hannah, Cohen, Jake, Turkel-Parella, David, Xavier, Andrew, Waqas, Muhammad, Tutino, Vincent, Siddiqui, Adnan, Gupta, Gaurav, Nanda, Anil, Khandelwal, Priyank, Tiu, Cristina, Portela, Pere C, Perez de la Ossa, Natalia, Urra, Xabier, de Lera, Mercedes, Arenillas, Juan F, Ribo, Marc, Requena, Manuel, Piano, Mariangela, Pero, Guglielmo, De Sousa, Keith, Al-Mufti, Fawaz, Hashim, Zafar, Nayak, Sanjeev, Renieri, Leonardo, Du, Rose, Aziz-Sultan, Mohamed A, Liebeskind, David, Nogueira, Raul G, Abdalkader, Mohamad, Nguyen, Thanh N, Vigilante, Nicholas, Siegler, James E, Grossberg, Jonathan A, Saad, Hassan, Gooch, Michael R, Herial, Nabeel A, Rosenwasser, Robert H, Tjoumakaris, Stavropoula, Patel, Aman B, Tiwari, Ambooj, and Jabbour, Pascal

Subjects
North American Neurovascular COVID-19 (NAN-C) Consortium &amp, Male, Neurology & Neurosurgery, Endovascular Procedures, Clinical Sciences, Neurosciences, COVID-19, morbidity, mortality, stroke, Society of Vascular and Interventional Neurology (SVIN) Investigators, Brain Ischemia, Treatment Outcome, Cross-Sectional Studies, Good Health and Well Being, Clinical Research, large vessel occlusion, Humans, Thrombectomy, Retrospective Studies
Abstract

Background and purposePrevious studies suggest that mechanisms and outcomes in patients with COVID-19-associated stroke differ from those in patients with non-COVID-19-associated strokes, but there is limited comparative evidence focusing on these populations. The aim of this study, therefore, was to determine if a significant association exists between COVID-19 status with revascularization and functional outcomes following thrombectomy for large vessel occlusion (LVO), after adjustment for potential confounding factors.MethodsA cross-sectional, international multicenter retrospective study was conducted in consecutively admitted COVID-19 patients with concomitant acute LVO, compared to a control group without COVID-19. Data collected included age, gender, comorbidities, clinical characteristics, details of the involved vessels, procedural technique, and various outcomes. A multivariable-adjusted analysis was conducted.ResultsIn this cohort of 697 patients with acute LVO, 302 had COVID-19 while 395 patients did not. There was a significant difference (p

Published
2022

59. Optimal Timing for Cardiac Surgery in Infective Endocarditis with Neurological Complications: A Narrative Review

Author

Siquier-Padilla, Joan, primary, Cuervo, Guillermo, additional, Urra, Xabier, additional, Quintana, Eduard, additional, Hernández-Meneses, Marta, additional, Sandoval, Elena, additional, Lapeña, Pau, additional, Falces, Carles, additional, Mestres, Carlos A., additional, Paez-Carpio, Alfredo, additional, Moreno, Asunción, additional, and Miro, José María, additional

Published
2022
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61. Adjunct Thrombolysis Enhances Brain Reperfusion following Successful Thrombectomy

Author

Fundació La Marató de TV3, European Commission, Instituto de Salud Carlos III, Fundació Privada Cellex, Centro Esther Koplowitz, Generalitat de Catalunya, Ministerio de Ciencia, Innovación y Universidades (España), Laredo, Carlos, Rodríguez, Alejandro, Oleaga, Laura, Hernández-Pérez, María, Renú, Arturo, Puig, Josep, San Román, Luis, Planas, Anna M., Urra, Xabier, Chamorro, Ángel, Fundació La Marató de TV3, European Commission, Instituto de Salud Carlos III, Fundació Privada Cellex, Centro Esther Koplowitz, Generalitat de Catalunya, Ministerio de Ciencia, Innovación y Universidades (España), Laredo, Carlos, Rodríguez, Alejandro, Oleaga, Laura, Hernández-Pérez, María, Renú, Arturo, Puig, Josep, San Román, Luis, Planas, Anna M., Urra, Xabier, and Chamorro, Ángel

Abstract

Objective: This study was undertaken to investigate whether adjunct alteplase improves brain reperfusion following successful thrombectomy. Methods: This single-center, randomized, double-blind, placebo-controlled study included 36 patients (mean [standard deviation] = 70.8 [13.5] years old, 18 [50%] women) with large vessel occlusion undergoing thrombectomy resulting in near-normal (expanded Thrombolysis in Cerebral Infarction [eTICI] b50/67/2c, n = 23, 64%) or normal angiographic reperfusion (eTICI 3, n = 13, 36%). Seventeen patients were randomized to intra-arterial alteplase (0.225mg/kg), and 19 received placebo. At 48 hours, patients had brain perfusion/diffusion-weighted magnetic resonance imaging (MRI) and MRI-spectroscopy. The primary outcome was the difference in the proportion of patients with areas of hypoperfusion on MRI. Secondary outcomes were the infarct expansion ratio (final to initial infarction volume), and the N-acetylaspartate (NAA) peak relative to total creatine as a marker of neuronal integrity. Results: The prevalence of hypoperfusion was 24% with intra-arterial alteplase, and 58% with placebo (adjusted odds ratio = 0.20, 95% confidence interval [CI] = 0.04–0.91, p = 0.03). Among 14 patients with final eTICI 3 scores, hypoperfusion was found in 1 of 7 (14%) in the alteplase group and 3 of 7 (43%) in the placebo group. Abnormal brain perfusion was associated with worse functional outcome at day 90. Alteplase significantly reduced the infarct expansion ratio compared with placebo (median [interquartile range (IQR)] = 0.7 [0.5–1.2] vs 3.2 [1.8–5.7], p = 0.01) and resulted in higher NAA peaks (median [IQR] = 1.13 [0.91–1.36] vs 1.00 [0.74–1.22], p < 0.0001). Interpretation: There is a high prevalence of areas of hypoperfusion following thrombectomy despite successful reperfusion on angiography. Adjunct alteplase enhances brain reperfusion, which results in reduced expansion of the infarction and improved neuronal integrity. ANN NEUROL 2022;92:86

Published
2022

64. Proceso de atención prehospitalaria y resultados hospitalarios del código ictus: estudio comparativo entre unidades de soporte vital básico y avanzado.

Author

Muñoz, Silvia Solà, Escudero Campillo, María del Mar, Borrega, Cristina Soro, Azeli, Youcef, Gil, Soledad Querol, Ruiz, Antoni, Albacete, Gemma, Peral, Olga Moreno, Lluch, Sergi, Delgado, Sergio Amaro, Blas, Yolanda Silva, Urra, Xabier, Calderón, Dolores Cocho, Fàbregas, Joan Martí, Jacobi, Marc Ribó, Portela, Pere Cardona, García, Francisco Purroy, Oller, Esther Duarte, Benítez, Verónica Hidalgo, and Flores, Alan

Published
2023

66. Intravenous thrombolysis or endovascular therapy for acute ischemic stroke associated with cervical internal carotid artery occlusion: the ICARO-3 study

Author

Paciaroni, Maurizio, Inzitari, Domenico, Agnelli, Giancarlo, Caso, Valeria, Balucani, Clotilde, Grotta, James C., Sarraj, Amrou, Sung-Il, Sohn, Chamorro, Angel, Urra, Xabier, Leys, Didier, Henon, Hilde, Cordonnier, Charlotte, Dequatre, Nelly, Aguettaz, Pierre, Alberti, Andrea, Venti, Michele, Acciarresi, Monica, D’Amore, Cataldo, Zini, Andrea, Vallone, Stefano, Dell’Acqua, Maria Luisa, Menetti, Federico, Nencini, Patrizia, Mangiafico, Salvatore, Barlinn, Kristian, Kepplinger, Jessica, Bodechtel, Ulf, Gerber, Johannes, Bovi, Paolo, Cappellari, Manuel, Linfante, Italo, Dabus, Guilherme, Marcheselli, Simona, Pezzini, Alessandro, Padovani, Alessandro, Alexandrov, Andrei V., Shahripour, Reza Bavarsad, Sessa, Maria, Giacalone, Giacomo, Silvestrelli, Giorgio, Lanari, Alessia, Ciccone, Alfonso, De Vito, Alessandro, Azzini, Cristiano, Saletti, Andrea, Fainardi, Enrico, Orlandi, Giovanni, Chiti, Alberto, Gialdini, Gino, Silvestrini, Mauro, Ferrarese, Carlo, Beretta, Simone, Tassi, Rossana, Martini, Giuseppe, Tsivgoulis, Georgios, Vasdekis, Spyros N., Consoli, Domenico, Baldi, Antonio, D’Anna, Sebastiano, Luda, Emilio, Varbella, Ferdinando, Galletti, Giampiero, Invernizzi, Paolo, Donati, Edoardo, De Lodovici, Maria Luisa, Bono, Giorgio, Corea, Francesco, Sette, Massimo Del, Monaco, Serena, Riva, Maurizio, Tassinari, Tiziana, Scoditti, Umberto, and Toni, Danilo

Published
2015
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74. Thrombectomy within 8 Hours after Symptom Onset in Ischemic Stroke

Author

Jovin, Tudor G., Chamorro, Angel, Cobo, Erik, de Miquel, María A., Molina, Carlos A., Rovira, Alex, Román, Luis San, Serena, Joaquín, Abilleira, Sonia, Ribó, Marc, Millán, Mònica, Urra, Xabier, Cardona, Pere, López-Cancio, Elena, Tomasello, Alejandro, Castaño, Carlos, Blasco, Jordi, Aja, Lucía, Dorado, Laura, Quesada, Helena, Rubiera, Marta, Hernandez-Pérez, María, Goyal, Mayank, Demchuk, Andrew M., von Kummer, Rüdiger, Gallofré, Miquel, and Dávalos, Antoni

Published
2015
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76. Healthy Life-Year Costs of Treatment Speed From Arrival to Endovascular Thrombectomy in Patients With Ischemic Stroke

Author

Almekhlafi, Mohammed, Goyal, Mayank, Dippel, Diederik, Majoie, Charles, Campbell, Bruce, Muir, Keith, Demchuk, Andrew, Bracard, Serge, Guillemin, Francis, Jovin, Tudor, Mitchell, Peter, White, Philip, Hill, Michael, Brown, Scott, Saver, Jeffrey, Berkhemer, Olvert, Fransen, Puck, Beumer, Debbie, Van Den Berg, Lucie, Lingsma, Hester, Yoo, Albert, Schonewille, Wouter, Vos, Jan, Nederkoorn, Paul, Wermer, Marieke, Van Walderveen, Marianne, Staals, Julie, Hofmeijer, Jeannette, Van Oostayen, Jacques, Lycklama À Nijeholt, Geert, Boiten, Jelis, Brouwer, Patrick, Emmer, Bart, De Bruijn, Sebastiaan, Van Dijk, Lukas, Kappelle, L, Lo, Rob, Van Dijk, Ewoud, de Vries, Joost, De Kort, Paul, Van Rooij, Willem, Van Den Berg, Jan, Van Hasselt, Boudewijn, Aerden, Leo, Dallinga, René, Visser, Marieke, Bot, Joseph, Vroomen, Patrick, Eshghi, Omid, Schreuder, Tobien, Heijboer, Roel, Keizer, Koos, Tielbeek, Alexander, Den Hertog, Heleen, Gerrits, Dick, Van Den Berg-Vos, Renske, Karas, Giorgos, Steyerberg, Ewout, Flach, H, Marquering, Henk, Sprengers, Marieke, Jenniskens, Sjoerd, Beenen, Ludo, Van Den Berg, René, Koudstaal, Peter, Van Zwam, Wim, Roos, Yvo, van der Lugt, Aad, Van Oostenbrugge, Robert, Menon, Bijoy, Eesa, Muneer, Rempel, Jeremy, Thornton, John, Roy, Daniel, Willinsky, Robert, Sapkota, Biggya, Dowlatshahi, Dar, Frei, Donald, Kamal, Noreen, Montanera, Walter, Poppe, Alexandre, Ryckborst, Karla, Silver, Frank, Shuaib, Ashfaq, Tampieri, Donatella, Williams, David, Bang, Oh, Baxter, Blaise, Burns, Paul, Choe, Hana, Heo, Ji-Hoe, Holmstedt, Christine, Jankowitz, Brian, KELLY, Michael, Linares, Guillermo, Mandzia, Jennifer, Shankar, Jai, Sohn, Sung-Il, Swartz, Richard, Coutts, Shelagh, Smith, Eric, Morrish, William, Weill, Alain, Subramaniam, Suresh, Mitha, Alim, Wong, John, Lowerison, Mark, Sajobi, Tolulope, Bonafe, Alain, Diener, Hans, Levy, Elad, Pereira, Vitor, Albers, Gregory, Cognard, Christophe, Cohen, David, Hacke, Werner, Jansen, Olav, Mattle, Heinrich, Nogueira, Raul, Siddiqui, Adnan, Yavagal, Dileep, Devlin, Thomas, Lopes, Demetrius, Reddy, Vivek, du Mesnil de Rochemont, Richard, Singer, Oliver, Jahan, Reza, Kleinig, Timothy, Dewey, Helen, Churilov, Leonid, Yassi, Nawaf, Yan, Bernard, Dowling, Richard, Parsons, Mark, Oxley, Thomas, Wu, Teddy, Brooks, Mark, Simpson, Marion, Miteff, Ferdinand, Levi, Christopher, Krause, Martin, Harrington, Timothy, Faulder, Kenneth, Steinfort, Brendan, Priglinger, Miriam, Ang, Timothy, Scroop, Rebecca, Barber, Philip, McGuinness, Ben, Wijeratne, Tissa, Phan, Thanh, Chong, Winston, Chandra, Ronil, Bladin, Christopher, Badve, Monica, Rice, Henry, de Villiers, Laetitia, Ma, Henry, Desmond, Patricia, Donnan, Geoffrey, Davis, Stephen, Chamorro, Angel, Cobo, Erik, De Miquel, María, Molina, Carlos, Rovira, Alex, San Román, Luis, Serena, Joaquín, Abilleira, Sonia, Ribó, Marc, Millán, Mònica, Urra, Xabier, Cardona, Pere, López-Cancio, Elena, Tomasello, Alejandro, Castaño, Carlos, Blasco, Jordi, Aja, Lucía, Dorado, Laura, Quesada, Helena, Rubiera, Marta, Hernandez-Pérez, María, von Kummer, Rüdiger, Gallofré, Miquel, Dávalos, Antoni, Ford, Gary, Messow, Claudia-Martina, Ford, Ian, Murray, Alicia, Clifton, Andrew, Brown, Martin, Madigan, Jeremy, Lenthall, Rob, Robertson, Fergus, Dixit, Anand, Cloud, Geoffrey, Wardlaw, Joanna, Freeman, Janet, Ducrocq, Xavier, Mas, Jean, Soudant, Marc, Oppenheim, Catherine, Moulin, Thierry, University of Calgary, Erasmus University Medical Center [Rotterdam] (Erasmus MC), Department of Radiology and Nuclear Medicine [Amsterdam], VU University Medical Center [Amsterdam], University of Melbourne, University of Glasgow, Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), The Royal Melbourne Hospital, Newcastle University [Newcastle], Altair Development, David Geffen School of Medicine [Los Angeles], University of California [Los Angeles] (UCLA), and University of California-University of California

Subjects
[INFO.INFO-IM]Computer Science [cs]/Medical Imaging, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; The benefits of endovascular thrombectomy (EVT) are time dependent. Prior studies may have underestimated the time-benefit association because time of onset is imprecisely known. OBJECTIVE To assess the lifetime outcomes associated with speed of endovascular thrombectomy in patients with acute ischemic stroke due to large-vessel occlusion (LVO). DATA SOURCES PubMed was searched for randomized clinical trials of stent retriever thrombectomy devices vs medical therapy in patients with anterior circulation LVO within 12 hours of last known well time, and for which a peer-reviewed, complete primary results article was published by August 1, 2020.

Published
2021
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77. Workflows and Outcomes in Patients With Suspected Large Vessel Occlusion Stroke Triaged in Urban and Nonurban Areas.

Author

Garcia-Tornel, Alvaro, Millan, Monica, Rubiera, Marta, Bustamante, Alejandro, Requena, Manuel, Dorado, Laura, Olivé-Gadea, Marta, Jiménez, Xavier, Soto, Angels, Querol, Marisol, Hernández-Pérez, Maria, Gomis, Meritxell, Cardona, Pere, Urra, Xabier, Purroy, Francesc, Silva, Yolanda, Ustrell, Xavier, Esteve, Patricia, Salvat-Plana, Mercè, and Gallofré, Miquel

Published
2022
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78. Workflow Times and Outcomes in Patients Triaged for a Suspected Severe Stroke.

Author

García‐Tornel, Álvaro, Seró, Laia, Urra, Xabier, Cardona, Pere, Zaragoza, Josep, Krupinski, Jerzy, Gómez‐Choco, Manuel, Sala, Natalia Mas, Catena, Esther, Palomeras, Ernest, Serena, Joaquin, Hernandez‐Perez, Maria, Boned, Sandra, Olivé‐Gadea, Marta, Requena, Manuel, Muchada, Marian, Tomasello, Alejandro, Molina, Carlos A., Salvat‐Plana, Mercè, and Escudero, Mar

Subjects
WORKFLOW, EMERGENCY medical services, TREATMENT effectiveness, STROKE
Abstract

Introduction: Current recommendations for regional stroke destination suggest that patients with severe acute stroke in non‐urban areas should be triaged based on the estimated transport time to a referral thrombectomy‐capable center. Methods: We performed a post hoc analysis to evaluate the association of pre‐hospital workflow times with neurological outcomes in patients included in the RACECAT trial. Workflow times evaluated were known or could be estimated before transport allocation. Primary outcome was the shift analysis on the modified Rankin score at 90 days. Results: Among the 1,369 patients included, the median time from onset to emergency medical service (EMS) evaluation, the estimated transport time to a thrombectomy‐capable center and local stroke center, and the estimated transfer time between centers were 65 minutes (interquartile ratio [IQR] = 43–138), 61 minutes (IQR = 36–80), 17 minutes (IQR = 9–27), and 62 minutes (IQR = 36–73), respectively. Longer time intervals from stroke onset to EMS evaluation were associated with higher odds of disability at 90 days in the local stroke center group (adjusted common odds ratio (acOR) for each 30‐minute increment = 1.03, 95% confidence interval [CI] = 1.01–1.06), with no association in the thrombectomy‐capable center group (acOR for each 30‐minute increment = 1.01, 95% CI = 0.98–1.01, pinteraction = 0.021). No significant interaction was found for other pre‐hospital workflow times. In patients evaluated by EMS later than 120 minutes after stroke onset, direct transport to a thrombectomy‐capable center was associated with better disability outcomes (acOR = 1.49, 95% CI = 1.03–2.17). Conclusion: We found a significant heterogeneity in the association between initial transport destination and neurological outcomes according to the elapse of time between the stroke onset and the EMS evaluation (ClinicalTrials.gov: NCT02795962). ANN NEUROL 2022;92:931–942 [ABSTRACT FROM AUTHOR]

Published
2022
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80. Additional file 1 of Stroke etiologies in patients with COVID-19: the SVIN COVID-19 multinational registry

Author

Ramos-Araque, María E., Siegler, James E., Ribo, Marc, Requena, Manuel, López, Cristina, Lera, Mercedes De, Arenillas, Juan F., Pérez, Isabel Hernández, Gómez-Vicente, Beatriz, Talavera, Blanca, Portela, Pere Cardona, Guillen, Ana Nuñez, Urra, Xabier, Llull, Laura, Renú, Arturo, Nguyen, Thanh N., Jillella, Dinesh, Nahab, Fadi, Nogueira, Raul, Haussen, Diogo, Ryna Then, Thon, Jesse M., Esparragoza, Luis Rodríguez, Hernández-Pérez, Maria, Bustamante, Alejandro, Mansour, Ossama Yassin, Megahed, Mohammed, Hassan, Tamer, Liebeskind, David S., Hassan, Ameer, Bushnaq, Saif, Osman, Mohamed, and Vazquez, Alejandro Rodriguez

Abstract

Additional file 1 Supplementary Table 1. Supplementary Figs. 1 and 2

Published
2021
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81. Effectiveness of Thrombectomy in Stroke According to Baseline Prognostic Factors : Inverse Probability of Treatment Weighting Analysis of a Population-Based Registry

Author

Rudilosso, Salvatore, Ríos, José, Rodríguez, Alejandro, Gomis, Meritxell, Vera, Víctor, Gómez-Choco, Manuel, Renú, Arturo, Matos, Núria, Llull, Laura, Purroy, Francisco, Amaro, Sergio, Terceño, Mikel, Obach, Víctor, Serena, Joaquim, Martí-Fàbregas, Joan, Cardona, Pedro, Molina, Carlos, Rodríguez-Campello, Ana, Cánovas, David, Krupinski, Jerzy, Ustrell, Xavier, Torres, Ferran, Román, Luis San, Salvat-Plana, Mercè, Jiménez-Fàbrega, Francesc Xavier, Palomeras, Ernest, Catena, Esther, Colom, Carla, Cocho, Dolores, Baiges, Juanjo, Aragones, Josep Maria, Diaz, Gloria, Costa, Xavier, Almendros, María Cruz, Rybyeba, Maria, Barceló, Miquel, Carrión, Dolors, Lòpez, Matilde Núria, Sanjurjo, Eduard, Pérez de la Ossa, Natalia, Urra, Xabier, Chamorro, Ángel, Rudilosso, Salvatore, Ríos, José, Rodríguez, Alejandro, Gomis, Meritxell, Vera, Víctor, Gómez-Choco, Manuel, Renú, Arturo, Matos, Núria, Llull, Laura, Purroy, Francisco, Amaro, Sergio, Terceño, Mikel, Obach, Víctor, Serena, Joaquim, Martí-Fàbregas, Joan, Cardona, Pedro, Molina, Carlos, Rodríguez-Campello, Ana, Cánovas, David, Krupinski, Jerzy, Ustrell, Xavier, Torres, Ferran, Román, Luis San, Salvat-Plana, Mercè, Jiménez-Fàbrega, Francesc Xavier, Palomeras, Ernest, Catena, Esther, Colom, Carla, Cocho, Dolores, Baiges, Juanjo, Aragones, Josep Maria, Diaz, Gloria, Costa, Xavier, Almendros, María Cruz, Rybyeba, Maria, Barceló, Miquel, Carrión, Dolors, Lòpez, Matilde Núria, Sanjurjo, Eduard, Pérez de la Ossa, Natalia, Urra, Xabier, and Chamorro, Ángel

Abstract

In real-world practice, the benefit of mechanical thrombectomy (MT) is uncertain in stroke patients with very favorable or poor prognostic profiles at baseline. We studied the effectiveness of MT versus medical treatment stratifying by different baseline prognostic factors. Retrospective analysis of 2,588 patients with an ischemic stroke due to large vessel occlusion nested in the population-based registry of stroke code activations in Catalonia from January 2017 to June 2019. The effect of MT on good functional outcome (modified Rankin Score ≤2) and survival at 3 months was studied using inverse probability of treatment weighting (IPTW) analysis in three pre-defined baseline prognostic groups: poor (if pre-stroke disability, age >85 years, National Institutes of Health Stroke Scale [NIHSS] >25, time from onset >6 hours, Alberta Stroke Program Early CT Score <6, proximal vertebrobasilar occlusion, supratherapeutic international normalized ratio >3), good (if NIHSS <6 or distal occlusion, in the absence of poor prognostic factors), or reference (not meeting other groups' criteria). Patients receiving MT (n=1,996, 77%) were younger, had less pre-stroke disability, and received systemic thrombolysis less frequently. These differences were balanced after the IPTW stratified by prognosis. MT was associated with good functional outcome in the reference (odds ratio [OR], 2.9; 95% confidence interval [CI], 2.0 to 4.4), and especially in the poor baseline prognostic stratum (OR, 3.9; 95% CI, 2.6 to 5.9), but not in the good prognostic stratum. MT was associated with survival only in the poor prognostic stratum (OR, 2.6; 95% CI, 2.0 to 3.3). Despite their worse overall outcomes, the impact of thrombectomy over medical management was more substantial in patients with poorer baseline prognostic factors than patients with good prognostic factors.

Published
2021

82. Stroke etiologies in patients with COVID-19 : the SVIN COVID-19 multinational registry

Author

Ramos-Araque, María E., Siegler, James E., Ribo, Marc, Requena, Manuel, López, Cristina, De Lera Alfonso, Mercedes, Arenillas, Juan F., Hernández Pérez, Isabel, Gómez-Vicente, Beatriz, Talavera, Blanca, Portela, Pere Cardona, Guillen, Ana Nuñez, Urra, Xabier, Llull, Laura, Renú, Arturo, Nguyen, Thanh N., Jillella, Dinesh, Nahab, Fadi, Nogueira, Raul, Haussen, Diogo, Then, Ryna, Thon, Jesse M., Esparragoza, Luis Rodríguez, Hernández-Pérez, María, Bustamante, Alejandro, Mansour, Ossama Yassin, Megahed, Mohammed, Hassan, Tamer, Liebeskind, David S., Hassan, Ameer, Bushnaq, Saif, Osman, Mohamed, Vazquez, Alejandro Rodriguez, Universitat Autònoma de Barcelona, Ramos-Araque, María E., Siegler, James E., Ribo, Marc, Requena, Manuel, López, Cristina, De Lera Alfonso, Mercedes, Arenillas, Juan F., Hernández Pérez, Isabel, Gómez-Vicente, Beatriz, Talavera, Blanca, Portela, Pere Cardona, Guillen, Ana Nuñez, Urra, Xabier, Llull, Laura, Renú, Arturo, Nguyen, Thanh N., Jillella, Dinesh, Nahab, Fadi, Nogueira, Raul, Haussen, Diogo, Then, Ryna, Thon, Jesse M., Esparragoza, Luis Rodríguez, Hernández-Pérez, María, Bustamante, Alejandro, Mansour, Ossama Yassin, Megahed, Mohammed, Hassan, Tamer, Liebeskind, David S., Hassan, Ameer, Bushnaq, Saif, Osman, Mohamed, Vazquez, Alejandro Rodriguez, and Universitat Autònoma de Barcelona

Abstract

Coronavirus disease 2019 (COVID-19) is associated with a small but clinically significant risk of stroke, the cause of which is frequently cryptogenic. In a large multinational cohort of consecutive COVID-19 patients with stroke, we evaluated clinical predictors of cryptogenic stroke, short-term functional outcomes and in-hospital mortality among patients according to stroke etiology. We explored clinical characteristics and short-term outcomes of consecutively evaluated patients 18 years of age or older with acute ischemic stroke (AIS) and laboratory-confirmed COVID-19 from 31 hospitals in 4 countries (3/1/20-6/16/20). Of the 14.483 laboratory-confirmed patients with COVID-19, 156 (1.1%) were diagnosed with AIS. Sixty-one (39.4%) were female, 84 (67.2%) white, and 88 (61.5%) were between 60 and 79 years of age. The most frequently reported etiology of AIS was cryptogenic (55/129, 42.6%), which was associated with significantly higher white blood cell count, c-reactive protein, and D-dimer levels than non-cryptogenic AIS patients (p

Published
2021

83. Cerebrovascular events and outcomes in hospitalized patients with COVID-19: The SVIN COVID-19 Multinational Registry

Author

Siegler. James E., Cardona, Pere, Arenillas, Juan F., Talavera, Blanca, Guillén, Ana N., Chavarría-Miranda, Alba, Lera Alfonso, Mercedes de, Khandelwal, Priyank, Bach, Ivo, Patel, Pratit, Singla, Amit, Requena, Manuel, Ribó, Marc, Jillella, Dinesh V., Rangaraju, Srikant, Nogueira, Raúl G., Haussen, Diogo C., Vázquez, Alejandro R., Urra, Xabier, Chamorro, Ángel, Román, Luis S., Thon, Jesse M., Then, Ryna, Sanborn, Emma, Ossa, Natalia P de la, Millán, Mónica, Ruiz, Isaac N ., Mansour, Ossama Y., Megahed, Mohammed, Tiu, Cristina, Terecoasa, Elena O., Radu, Razvan A., Nguyen, Thanh N., Curiale, Gioacchino, Kaliaev, Artem, Czap, Alexandra L., Sebaugh, Jacob, Zha, Alicia M., Liebeskind, David, Ortega-Gutiérrez, Santiago, Farooqui, Mudassir, Hassan, Ameer E., Preston, Laurie, Patterson, Mary S., Bushna, Saif, Zaidat, Osama, Jovin, Tudor G., Siegler. James E., Cardona, Pere, Arenillas, Juan F., Talavera, Blanca, Guillén, Ana N., Chavarría-Miranda, Alba, Lera Alfonso, Mercedes de, Khandelwal, Priyank, Bach, Ivo, Patel, Pratit, Singla, Amit, Requena, Manuel, Ribó, Marc, Jillella, Dinesh V., Rangaraju, Srikant, Nogueira, Raúl G., Haussen, Diogo C., Vázquez, Alejandro R., Urra, Xabier, Chamorro, Ángel, Román, Luis S., Thon, Jesse M., Then, Ryna, Sanborn, Emma, Ossa, Natalia P de la, Millán, Mónica, Ruiz, Isaac N ., Mansour, Ossama Y., Megahed, Mohammed, Tiu, Cristina, Terecoasa, Elena O., Radu, Razvan A., Nguyen, Thanh N., Curiale, Gioacchino, Kaliaev, Artem, Czap, Alexandra L., Sebaugh, Jacob, Zha, Alicia M., Liebeskind, David, Ortega-Gutiérrez, Santiago, Farooqui, Mudassir, Hassan, Ameer E., Preston, Laurie, Patterson, Mary S., Bushna, Saif, Zaidat, Osama, and Jovin, Tudor G.

Abstract

[Background]: Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has been associated with a significant risk of thrombotic events in critically ill patients. [Aim]: To summarize the findings of a multinational observational cohort of patients with SARS-CoV-2 and cerebrovascular disease. [Methods]: Retrospective observational cohort of consecutive adults evaluated in the emergency department and/or admitted with coronavirus disease 2019 (COVID-19) across 31 hospitals in four countries (1 February 2020–16 June 2020). The primary outcome was the incidence rate of cerebrovascular events, inclusive of acute ischemic stroke, intracranial hemorrhages (ICH), and cortical vein and/or sinus thrombosis (CVST). [Results]: Of the 14,483 patients with laboratory-confirmed SARS-CoV-2, 172 were diagnosed with an acute cerebrovascular event (1.13% of cohort; 1130/100,000 patients, 95%CI 970–1320/100,000), 68/171 (40.5%) were female and 96/172 (55.8%) were between the ages 60 and 79 years. Of these, 156 had acute ischemic stroke (1.08%; 1080/100,000 95%CI 920–1260/100,000), 28 ICH (0.19%; 190/100,000 95%CI 130–280/100,000), and 3 with CVST (0.02%; 20/100,000, 95%CI 4–60/100,000). The in-hospital mortality rate for SARS-CoV-2-associated stroke was 38.1% and for ICH 58.3%. After adjusting for clustering by site and age, baseline stroke severity, and all predictors of in-hospital mortality found in univariate regression (p < 0.1: male sex, tobacco use, arrival by emergency medical services, lower platelet and lymphocyte counts, and intracranial occlusion), cryptogenic stroke mechanism (aOR 5.01, 95%CI 1.63–15.44, p < 0.01), older age (aOR 1.78, 95%CI 1.07–2.94, p ¼ 0.03), and lower lymphocyte count on admission (aOR 0.58, 95%CI 0.34–0.98, p ¼ 0.04) were the only independent predictors of mortality among patients with stroke and COVID-19. [Conclusions]: COVID-19 is associated with a small but significant risk of clinically relevant cerebrovascular events, particularly ischemic

Published
2021

84. Functional Outcome After Primary Endovascular Therapy or IV Thrombolysis Alone for Stroke. An Observational, Comparative Effectiveness Study

Author

Abilleira, Sònia, Ribera, Aida, Dávalos, Antonio, Ribó, Marc, Chamorro, Angel, Cardona, Pere, Molina, Carlos A., Martínez-Yélamos, Antonio, Urra, Xabier, Dorado, Laura, Roquer, Jaume, Martí-Fàbregas, Joan, Aja, Lucía, Tomasello, Alejandro, Castaño, Carlos, Blasco, Jordi, Cánovas, David, Castellanos, Mar, Krupinski, Jerzy, Guimaraens, Leopoldo, Perendreu, Joan, Ustrell, Xavier, Purroy, Francisco, Gómez-Choco, Manuel, Baiges, Joan Josep, Cocho, Dolores, Saura, Júlia, and Gallofré, Miquel

Published
2014
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85. Outcomes of a Contemporary Cohort of 536 Consecutive Patients With Acute Ischemic Stroke Treated With Endovascular Therapy

Author

Abilleira, Sònia, Cardona, Pere, Ribó, Marc, Millán, Mònica, Obach, Víctor, Roquer, Jaume, Cánovas, David, Martí-Fàbregas, Joan, Rubio, Francisco, Álvarez-Sabín, José, Dávalos, Antoni, Chamorro, Ángel, de Miquel, Maria Angeles, Tomasello, Alejandro, Castaño, Carlos, Macho, Juan M., Ribera, Aida, Gallofré, Miquel, Sanahuja, Jordi, Purroy, Francisco, Serena, Joaquín, Castellanos, Mar, Silva, Yolanda, van Eendenburg, Cecile, Pellisé, Anna, Ustrell, Xavier, Marés, Rafael, Baiges, Juanjo, Garcés, Moisés, Saura, Júlia, Soler Insa, Josep Maria, Aragonés, Josep Maria, Otermín, Pilar, Cocho, Dolores, Palomeras, Ernest, Pérez de la Ossa, Natalia, Gomis, Meritxell, López-Cancio, Elena, Dorado, Laura, Aleu, Aitzíber, García-Bermejo, Pablo, Rubiera, Marta, Santamarina, Esteban, Pagola, Jorge, Molina, Carlos, Coscojuela, Pilar, Quesada, Helena, Cano, Lluis, Aja, Lucia, Mora, Paloma, Cervera, Álvaro, Amaro, Sergio, Urra, Xabier, Blasco-Andaluz, Jordi, San Roman, Luis, Delgado-Mederos, Raquel, Dinia, Lavinia, Carrera-Giraldo, David, Rodríguez-Campello, Ana, Ois, Ángel, Cuadrado-Godia, Elisa, Vivas, Elio, del Carmen Garcia, Maria, Estela, Jordi, Perendreu, Joan, Krupinski, Jerzy, Huertas-Folch, Sonia, Nicolás-Herrerias, M. Carme, Gómez-Choco, Manuel, García, Sonia, and Martínez, Raul

Published
2014
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88. sj-pdf-3-wso-10.1177_1747493020959216 - Supplemental material for Cerebrovascular events and outcomes in hospitalized patients with COVID-19: The SVIN COVID-19 Multinational Registry

Author

Siegler, James E, Cardona, Pere, Arenillas, Juan F, Talavera, Blanca, Guillen, Ana N, Chavarría-Miranda, Alba, Lera, Mercedes De, Priyank Khandelwal, Bach, Ivo, Pratit Patel, Singla, Amit, Requena, Manuel, Ribo, Marc, Jillella, Dinesh V, Srikant Rangaraju, Nogueira, Raul G, Haussen, Diogo C, Vazquez, Alejandro R, Urra, Xabier, Chamorro, Ángel, Román, Luis S, Thon, Jesse M, Ryna Then, Sanborn, Emma, Ossa, Natalia P De La, Mònica Millàn, Ruiz, Isaac N, Mansour, Ossama Y, Megahed, Mohammed, Tiu, Cristina, Terecoasa, Elena O, Răzvan A Radu, Nguyen, Thanh N, Curiale, Gioacchino, Kaliaev, Artem, Czap, Alexandra L, Sebaugh, Jacob, Zha, Alicia M, Liebeskind, David S, Ortega-Gutierrez, Santiago, Mudassir Farooqui, Hassan, Ameer E, Preston, Laurie, Patterson, Mary S, Bushnaq, Saif, Zaidat, Osama, and Jovin, Tudor G

Subjects
FOS: Clinical medicine, Cardiology, Medicine, 110904 Neurology and Neuromuscular Diseases
Abstract

Supplemental material, sj-pdf-3-wso-10.1177_1747493020959216 for Cerebrovascular events and outcomes in hospitalized patients with COVID-19: The SVIN COVID-19 Multinational Registry by James E Siegler, Pere Cardona, Juan F Arenillas, Blanca Talavera, Ana N Guillen, Alba Chavarría-Miranda, Mercedes de Lera, Priyank Khandelwal, Ivo Bach, Pratit Patel, Amit Singla, Manuel Requena, Marc Ribo, Dinesh V Jillella, Srikant Rangaraju, Raul G Nogueira, Diogo C Haussen, Alejandro R Vazquez, Xabier Urra, Ángel Chamorro, Luis S Román, Jesse M Thon, Ryna Then, Emma Sanborn, Natalia P de la Ossa, Mònica Millàn, Isaac N Ruiz, Ossama Y Mansour, Mohammed Megahed, Cristina Tiu, Elena O Terecoasa, Răzvan A Radu, Thanh N Nguyen, Gioacchino Curiale, Artem Kaliaev, Alexandra L Czap, Jacob Sebaugh, Alicia M Zha, David S Liebeskind, Santiago Ortega-Gutierrez, Mudassir Farooqui, Ameer E Hassan, Laurie Preston, Mary S Patterson, Saif Bushnaq, Osama Zaidat and Tudor G Jovin in International Journal of Stroke

Published
2020
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89. Acute Stroke Care Is at Risk in the Era of COVID-19

Author

Rudilosso, Salvatore, Laredo, Carlos, Vera, Víctor, Vargas, Martha, Renú, Arturo, Llull, Laura, Obach, Víctor, Amaro, Sergio, Urra, Xabier, Torres, Ferrán, Jiménez-Fàbrega, Francesc Xavier, Chamorro, Ángel, Rudilosso, Salvatore, Laredo, Carlos, Vera, Víctor, Vargas, Martha, Renú, Arturo, Llull, Laura, Obach, Víctor, Amaro, Sergio, Urra, Xabier, Torres, Ferrán, Jiménez-Fàbrega, Francesc Xavier, and Chamorro, Ángel

Abstract

The purpose of the study is to analyze how the coronavirus disease 2019 (COVID-19) pandemic affected acute stroke care in a Comprehensive Stroke Center. On February 28, 2020, contingency plans were implemented at Hospital Clinic of Barcelona to contain the COVID-19 pandemic. Among them, the decision to refrain from reallocating the Stroke Team and Stroke Unit to the care of patients with COVID-19. From March 1 to March 31, 2020, we measured the number of emergency calls to the Emergency Medical System in Catalonia (7.5 million inhabitants), and the Stroke Codes dispatched to Hospital Clinic of Barcelona. We recorded all stroke admissions, and the adequacy of acute care measures, including the number of thrombectomies, workflow metrics, angiographic results, and clinical outcomes. Data were compared with March 2019 using parametric or nonparametric methods as appropriate. At Hospital Clinic of Barcelona, 1232 patients with COVID-19 were admitted in March 2020, demanding 60% of the hospital bed capacity. Relative to March 2019, the Emergency Medical System had a 330% mean increment in the number of calls (158 005 versus 679 569), but fewer Stroke Code activations (517 versus 426). Stroke admissions (108 versus 83) and the number of thrombectomies (21 versus 16) declined at Hospital Clinic of Barcelona, particularly after lockdown of the population. Younger age was found in stroke admissions during the pandemic (median [interquartile range] 69 [64-73] versus 75 [73-80] years, P =0.009). In-hospital, there were no differences in workflow metrics, angiographic results, complications, or outcomes at discharge. The COVID-19 pandemic reduced by a quarter the stroke admissions and thrombectomies performed at a Comprehensive Stroke Center but did not affect the quality of care metrics. During the lockdown, there was an overload of emergency calls but fewer Stroke Code activations, particularly in elderly patients. Hospital contingency plans, patient transport systems, and pop

Published
2020

90. Webinar del CSIC: El verano llegó, ¿Se termina la pandemia?

Author

Fernández de Lis, Patricia, Urra, Xabier, Briones, Carlos, Montoya, María, Planas, Anna M., Gabinete de Presidencia CSIC, Departamento de Comunicación CSIC, Fernández de Lis, Patricia, Urra, Xabier, Briones, Carlos, Montoya, María, Planas, Anna M., Gabinete de Presidencia CSIC, and Departamento de Comunicación CSIC

Abstract

En este webinar varios investigadores del CSIC y otras instituciones, abordarán, desde distintos puntos de vista, aquellos aspectos relacionados con la llegada del verano en plena pandemia de la Covid-19.

Published
2020

91. Abstract P75: Cerebrovascular Events and Outcomes in Hospitalized Patients With Covid-19: The Society of Vascular and Interventional Neurology Multinational Registry

Author

Siegler, James E, primary, Portela, Pere, additional, Arenillas, Juan F, additional, Chavarria-Miranda, Alba, additional, Guillen, Ana, additional, de Lera, Mercedes, additional, Khandelwal, Priyank, additional, Bach, Ivo, additional, Patel, Pratit, additional, Singla, Amit, additional, Requena, Manuel, additional, Ribo, Marc, additional, Jillella, Dinesh V, additional, Nogueira, Raul G, additional, Haussen, Diogo C, additional, Vazquez, Alejandro R, additional, Urra, Xabier, additional, San Roman, Luis, additional, Thon, Jesse M, additional, Then, Ryna, additional, Perez de la Ossa, Natalia, additional, Millan, Monica, additional, Mansour, Ossama, additional, Tiu, Cristina, additional, Nguyen, Thanh, additional, Kaliaev, Artem, additional, Czap, Alexandra L, additional, Zha, Alicia, additional, Liebeskind, David S, additional, Ortega-Gutierrez, Santiago, additional, Farooqui, Mudassir, additional, Hassan, Ameer E, additional, Bushnaq, Saif, additional, Zaidat, Osama O, additional, and Jovin, Tudor G, additional

Published
2021
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92. Abstract P94: Stroke Etiologies in Patients With Covid-19: The Svin Covid-19 Multinational Registry

Author

Ramos-Araque, Maria Esther, primary, Siegler, James E, additional, Ribo, Marc, additional, Requena, Manuel, additional, López, Cristina, additional, de Lera, Mercedes, additional, Arenillas, Juan F, additional, Pérez-Hernández, Isabel, additional, Beatriz, Gómez-Vicente, additional, Talavera, Blanca, additional, Cardona, Pedro, additional, Guillén, Ana, additional, Urra, Xabier, additional, Lull, Laura, additional, Renu, Arturo, additional, Nguyen, Thanh, additional, Jillella, Dinesh, additional, Nahab, Fadi B, additional, Nogueira, Raul G, additional, Haussen, Diogo C, additional, Then, Ryna, additional, Thon, Jesse M, additional, Rodriguez Esparragoza, Luis, additional, Hernández-Pérez, Maria, additional, Bustamante, Alejandro, additional, Mansour, Ossama, additional, Mohammed, Megahed, additional, Hassan, Tamer, additional, Liebeskind, David S, additional, Hassan, Ameer E, additional, Bushnaq, Saif, additional, Osman, Mohamed, additional, and Rodriguez Vazquez, Alejandro, additional

Published
2021
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93. Effect of Direct Transportation to Thrombectomy-Capable Center vs Local Stroke Center on Neurological Outcomes in Patients With Suspected Large-Vessel Occlusion Stroke in Nonurban Areas: The RACECAT Randomized Clinical Trial.

Author

Pérez de la Ossa, Natalia, Abilleira, Sònia, Jovin, Tudor G., García-Tornel, Álvaro, Jimenez, Xavier, Urra, Xabier, Cardona, Pere, Cocho, Dolores, Purroy, Francisco, Serena, Joaquin, San Román Manzanera, Luis, Vivanco-Hidalgo, Rosa Maria, Salvat-Plana, Mercè, Chamorro, Angel, Gallofré, Miquel, Molina, Carlos A., Cobo, Erik, Davalos, Antoni, Ribo, Marc, and RACECAT Trial Investigators

Abstract

Importance: In nonurban areas with limited access to thrombectomy-capable centers, optimal prehospital transport strategies in patients with suspected large-vessel occlusion stroke are unknown.Objective: To determine whether, in nonurban areas, direct transport to a thrombectomy-capable center is beneficial compared with transport to the closest local stroke center.Design, Setting, and Participants: Multicenter, population-based, cluster-randomized trial including 1401 patients with suspected acute large-vessel occlusion stroke attended by emergency medical services in areas where the closest local stroke center was not capable of performing thrombectomy in Catalonia, Spain, between March 2017 and June 2020. The date of final follow-up was September 2020.Interventions: Transportation to a thrombectomy-capable center (n = 688) or the closest local stroke center (n = 713).Main Outcomes and Measures: The primary outcome was disability at 90 days based on the modified Rankin Scale (mRS; scores range from 0 [no symptoms] to 6 [death]) in the target population of patients with ischemic stroke. There were 11 secondary outcomes, including rate of intravenous tissue plasminogen activator administration and thrombectomy in the target population and 90-day mortality in the safety population of all randomized patients.Results: Enrollment was halted for futility following a second interim analysis. The 1401 enrolled patients were included in the safety analysis, of whom 1369 (98%) consented to participate and were included in the as-randomized analysis (56% men; median age, 75 [IQR, 65-83] years; median National Institutes of Health Stroke Scale score, 17 [IQR, 11-21]); 949 (69%) comprised the target ischemic stroke population included in the primary analysis. For the primary outcome in the target population, median mRS score was 3 (IQR, 2-5) vs 3 (IQR, 2-5) (adjusted common odds ratio [OR], 1.03; 95% CI, 0.82-1.29). Of 11 reported secondary outcomes, 8 showed no significant difference. Compared with patients first transported to local stroke centers, patients directly transported to thrombectomy-capable centers had significantly lower odds of receiving intravenous tissue plasminogen activator (in the target population, 229/482 [47.5%] vs 282/467 [60.4%]; OR, 0.59; 95% CI, 0.45-0.76) and significantly higher odds of receiving thrombectomy (in the target population, 235/482 [48.8%] vs 184/467 [39.4%]; OR, 1.46; 95% CI, 1.13-1.89). Mortality at 90 days in the safety population was not significantly different between groups (188/688 [27.3%] vs 194/713 [27.2%]; adjusted hazard ratio, 0.97; 95% CI, 0.79-1.18).Conclusions and Relevance: In nonurban areas in Catalonia, Spain, there was no significant difference in 90-day neurological outcomes between transportation to a local stroke center vs a thrombectomy-capable referral center in patients with suspected large-vessel occlusion stroke. These findings require replication in other settings.Trial Registration: ClinicalTrials.gov Identifier: NCT02795962. [ABSTRACT FROM AUTHOR]

Published
2022
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