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3. The Impact of Cerebral Embolic Protection Devices on Characteristics and Outcomes of Stroke Complicating TAVR

Author

Levi, Amos, Linder, Matthias, Seiffert, Moritz, Witberg, Guy, Pilgrim, Thomas, Tomii, Daijiro, Barkan, Yeela Tamlor, Van Mieghem, Nicolas M., Adrichem, Rik, Codner, Pablo, Hildick-Smith, David, Arunothayaraj, Sandeep, Perl, Leor, Finkelstein, Ariel, Loewenstein, Itamar, De Backer, Ole, Barnea, Rani, Tarantini, Giuseppe, Fovino, Luca Nai, Vaknin-Assa, Hana, Mylotte, Darren, Wagener, Max, Webb, John G., Akodad, Mariama, Colombo, Antonio, Mangieri, Antonio, Latib, Azeem, Kargoli, Faraj, Giannini, Francesco, Ielasi, Alfonso, Søndergaard, Lars, Aviram, Itay, Lerman, Tsahi T., Kheifets, Mark, Auriel, Eitan, and Kornowski, Ran

Published
2024
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10. Diagnostic value of lobar microbleeds in individuals without intracerebral hemorrhage

Author

Martinez‐Ramirez, Sergi, Romero, Jose‐Rafael, Shoamanesh, Ashkan, McKee, Ann C, Van Etten, Ellis, Pontes‐Neto, Octavio, Macklin, Eric A, Ayres, Alison, Auriel, Eitan, Himali, Jayandra J, Beiser, Alexa S, DeCarli, Charles, Stein, Thor D, Alvarez, Victor E, Frosch, Matthew P, Rosand, Jonathan, Greenberg, Steven M, Gurol, M Edip, Seshadri, Sudha, and Viswanathan, Anand

Subjects
Biomedical and Clinical Sciences, Neurosciences, Clinical Sciences, Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD), Acquired Cognitive Impairment, Cerebrovascular, Brain Disorders, Vascular Cognitive Impairment/Dementia, Biomedical Imaging, Neurodegenerative, Alzheimer's Disease Related Dementias (ADRD), Rare Diseases, Aging, Stroke, Dementia, Aged, Aged, 80 and over, Brain, Cerebral Amyloid Angiopathy, Cerebral Hemorrhage, Female, Humans, Magnetic Resonance Imaging, Male, Predictive Value of Tests, Cerebral amyloid angiopathy, Microbleed, Intracerebral hemorrhage, Boston criteria, Sensitivity, Specificity, Predictive value, Likelihood ratio, Geriatrics, Clinical sciences, Biological psychology
Abstract

IntroductionThe Boston criteria are the basis for a noninvasive diagnosis of cerebral amyloid angiopathy (CAA) in the setting of lobar intracerebral hemorrhage (ICH). We assessed the accuracy of these criteria in individuals with lobar microbleeds (MBs) without ICH.MethodsWe identified individuals aged >55 years having brain magnetic resonance imaging (MRI) and pathological assessment of CAA in a single academic hospital and a community-based population (Framingham Heart Study [FHS]). We determined the positive predictive value (PPV) of the Boston criteria for CAA in both cohorts, using lobar MBs as the only hemorrhagic lesion to fulfill the criteria.ResultsWe included 102 individuals: 55 from the hospital-based cohort and 47 from FHS (mean age at MRI 74.7 ± 8.5 and 83.4 ± 10.9 years; CAA prevalence 60% and 46.8%; cases with any lobar MB 49% and 21.3%; and cases with ≥2 strictly lobar MBs 29.1% and 8.5%, respectively). PPV of "probable CAA" (≥2 strictly lobar MBs) was 87.5% (95% confidence interval [CI], 60.4-97.8) and 25% (95% CI, 13.2-78) in hospital and general populations, respectively.DiscussionStrictly lobar MBs strongly predict CAA in non-ICH individuals when found in a hospital context. However, their diagnostic accuracy in the general population appears limited.

Published
2015

11. An injectable implant to stimulate the sphenopalatine ganglion for treatment of acute ischaemic stroke up to 24 h from onset (ImpACT-24B): an international, randomised, double-blind, sham-controlled, pivotal trial

Author

Shuaib, Ashfaq, Hill, Michael, Vaclavik, Daniel, Skoloudik, David, Fiksa, Jan, Andersen, Grethe, Jakala, Pekka, Tatlisumak, Turgut, Kuzmanovski, Igor, Guillon, Benoit, Chabriat, Hugues, Mahagne, Marie Helene, Timsit, Serge, Ronziere, Thomas, Ingorokva, Gocha, Beridze, Maya, Beridze, Mzia, Zarqua, Natia, Kharaishvili, Nino, Kakabadze, Nodar, Janelidze, Tamar, Griewing, Bernd, Hobohm, Carsten, Schneider, Dietmar, Weimar, Christian, Poppert, Holger, Kimmig, Hubert, Berrouschot, Joerg, Ringleb, Peter, Schwab, Stefan, Kohrmann, Martin, Kallmunzer, Bernd, Kollmar, Rainer, Endres, Matthias, Hausler, Karl-Georg, Cheung, Raymond, Wai Hong Leung, Thomas, Dorodnicov, Elena, Halevi, Hen, Auriel, Eitan, Streifler, Jonathan, Leker, Ronen, Schwammenthal, Yvonne, Toni, Danilo, Agnelli, Giancarlo, Caso, Valeria, Słowik, Agnieszka, Czlonkowska, Anna, Lubinski, Ignacy, Kochanowicz, Jan, Sobolewski, Piotr, Brola, Waldemar, Salgado, Antonio Vasco, Correia, Carlos, Azevedo, Elsa, Roriz, Jose, Zarkov, Marija, Savic, Milan, Petrovic, Zarko, Krastev, Georgi, Dvorak, Miloslav, Rodriguez Campello, Ana, Nunez, Antonio Gil, Molina, Carlos, Purroy, Francisco, Marti-Fabregas, Joan, Arenillas, Juan, Alonso, Maria, Cardona, Pedro, Blanco Gonzalez, Miguel, Tur, Silvia, Segura Martin, Tomas, Anzhelika, Payenok, Shownkeen, Harish, Concha, Mauricio, Sethi, Pramod, Sen, Souvik, Zaidi, Syed, Devlin, Thomas, Bornstein, Natan M, Saver, Jeffrey L, Diener, Hans Christoph, Gorelick, Philip B, Solberg, Yoram, Thackeray, Lisa, Yarnitsky, David, and Molina, Carlos A

Published
2019
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12. Efficacy and safety of Apixaban in the treatment of cerebral venous sinus thrombosis: a multi-center study.

Author

Simaan, Naaem, Metanis, Issa, Honig, Asaf, Hallevi, Hen, Filioglo, Andrei, Mendel, Rom, Barnea, Rani, Naftali, Jonathan, Auriel, Eitan, Aladdin, Shorooq, Orion, David, Dally, Najib, Leker, Ronen R., and Molad, Jeremy

Subjects
CRANIAL sinuses, VENOUS thrombosis, SINUS thrombosis, ANTICOAGULANTS, APIXABAN, ORAL medication
Abstract

Background: Information regarding the safety and efficacy of specific direct oral anticoagulants (DOAC) in the treatment of cerebral sinus and venous thrombosis (CSVT) is scarce. Apixaban is one of the most frequently prescribed DOACs. Therefore, we aimed to compare the safety and efficacy of Apixaban with those of vitamin k antagonists (VKA) in patients with CSVT. Methods: Prospective CSVT databases from seven academic medical centers were retrospectively analyzed. Patients treated with Apixaban were compared to those treated with VKA. Data on demographics, clinical presentations, risk factors, radiological and outcome parameters were studied. Results: Overall, 403 patients were included in the analysis. Of them, 48 (12%) were treated with Apixaban, and 355 (88%) were treated with VKA. Rates of coagulopathies were significantly higher in the VKA-treated patients but no other differences between the groups were found in baseline characteristics and underlying etiology. No significant differences were found between groups in efficacy or safety parameters including the rates of recanalization, favorable outcomes, one-year mortality, seizures, intracranial hemorrhage or CSVT recurrences. Conclusion: Our data suggests that Apixaban may be safe and effective for patients with CSVT. These results should be tested in prospective randomized clinical studies. [ABSTRACT FROM AUTHOR]

Published
2024
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18. Hemorrhage recurrence risk factors in cerebral amyloid angiopathy: Comparative analysis of the overall small vessel disease severity score versus individual neuroimaging markers

Author

Boulouis, Gregoire, Charidimou, Andreas, Pasi, Marco, Roongpiboonsopit, Duangnapa, Xiong, Li, Auriel, Eitan, van Etten, Ellis S., Martinez-Ramirez, Sergi, Ayres, Alison, Vashkevich, Anastasia, Schwab, Kristin M., Rosand, Jonathan, Goldstein, Joshua N., Gurol, M. Edip, Greenberg, Steven M., and Viswanathan, Anand

Published
2017
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19. Lung cancer is associated with acute ongoing cerebral ischemia: A population-based study.

Author

Naftali, Jonathan, Barnea, Rani, Eliahou, Ruth, Pardo, Keshet, Tolkovsky, Assaf, Adi, Meital, Hasminski, Vadim, Saliba, Walid, Bloch, Sivan, Raphaeli, Guy, Leader, Avi, and Auriel, Eitan

Subjects
CEREBRAL ischemia, LUNG cancer, ISCHEMIC stroke, MEDICAL care, CARDIOVASCULAR diseases risk factors
Abstract

Background and Objectives: Cerebral microinfarcts (CMIs) are the most common type of brain ischemia; however, they are extremely rare in the general population. CMIs can be detected by magnetic resonance diffusion-weighted imaging (MRI-DWI) only for a very short period of approximately 2 weeks after their formation and are associated with an increased stroke risk and cognitive impairment. We aimed to examine CMI detection rate in patients with lung cancer (LC), which is strongly associated with ischemic stroke risk relative to other cancer types. Methods: We used the Clalit Health Services record (representing more than 5 million patients) to identify adults with LC and breast, pancreatic, or colon cancer (non-lung cancer, NLC) who underwent brain magnetic resonance diffusion (MRI) scan within 5 years following cancer diagnosis. All brain MRI scans were reviewed, and CMIs were documented, as well as cardiovascular risk factors. Results: Our cohort contained a total of 2056 MRI scans of LC patients and 1598 of NLC patients. A total of 143 CMI were found in 73/2056 (3.5%) MRI scans of LC group compared to a total of 29 CMI in 22/1598 (1.4%) MRI scans of NLC (p < 0.01). Cancer type (e.g. LC vs NLC) was the only associated factor with CMI incidence on multivariate analysis. After calculating accumulated risk, we found an incidence of 2.5 CMI per year in LC patients and 0.5 in NLC. Discussion: CMIs are common findings in cancer patients, especially in LC patients and therefore might serve as a marker for occult brain ischemia, cognitive decline, and cancer-related stroke (CRS) risk. [ABSTRACT FROM AUTHOR]

Published
2024
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20. Clinicoradiologic Criteria for the Diagnosis of Stroke-like Episodes in MELAS

Author

Khasminsky, Vadim, primary, Auriel, Eitan, additional, Luckman, Judith, additional, Eliahou, Ruth, additional, Inbar, Edna, additional, Pardo, Keshet, additional, Landau, Yuval, additional, Barnea, Rani, additional, Mermelstein, Maor, additional, Shelly, Shahar, additional, Naftali, Jonathan, additional, and Peretz, Shlomi, additional

Published
2023
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23. Cortical atrophy in patients with cerebral amyloid angiopathy: a case-control study

Author

Fotiadis, Panagiotis, van Rooden, Sanneke, van der Grond, Jeroen, Schultz, Aaron, Martinez-Ramirez, Sergi, Auriel, Eitan, Reijmer, Yael, van Opstal, Anna M, Ayres, Alison, Schwab, Kristin M, Alzheimer's Disease Neuroimaging Initiative (ADNI), Hedden, Trey, Rosand, Jonathan, Viswanathan, Anand, Wermer, Marieke, Terwindt, Gisela M, Sperling, Reisa A, Polimeni, Jonathan R, Johnson, Keith A, van Buchem, Mark A, Greenberg, Steven M, and Gurol, M Edip

Published
2016
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26. Effect of time delay in inter-hospital transfer on outcomes of endovascular treatment of acute ischemic stroke.

Author

Pardo, Keshet, Naftali, Jonathan, Barnea, Rani, Findler, Michael, Perlow, Alain, Brauner, Ran, Auriel, Eitan, and Raphaeli, Guy

Subjects
ISCHEMIC stroke, ENDOVASCULAR surgery, INTRACRANIAL hemorrhage, PATIENT selection, TREATMENT effectiveness
Abstract

Background: Endovascular treatment (EVT) with mechanical thrombectomy is the standard of care for large vessel occlusion (LVO) in acute ischemic stroke (AIS). The most common approach today is to perform EVT in a comprehensive stroke center (CSC) and transfer relevant patients for EVT from a primary stroke center (PSC). Rapid and efficient treatment of LVO is a key factor in achieving a good clinical outcome. Methods: We present our retrospective cohort of patients who underwent EVT between 2018 and 2021, including direct admissions and patients transferred from PSC. Primary endpoints were time intervals (door-topuncture, onset-to-puncture, door-to-door) and favorable outcome (mRS ≤ 2) at 90 days. Secondary outcomes were successful recanalization, mortality rate, and symptomatic intracranial hemorrhage (sICH). Additional analysis was performed for transferred patients not treated with EVT; endpoints were time intervals, favorable outcomes, and reason for exclusion of EVT. Results: Among a total of 405 patients, 272 were admitted directly to our EVT center and 133 were transferred; there was no significant difference between groups in the occluded vascular territory, baseline NIHSS, wake-up strokes, or thrombolysis rate. Directly admitted patients had a shorter doorto-puncture time than transferred patients (190 min vs. 293 min, p < 0.001). The median door-to-door shift time was 204 min. We found no significant difference in functional independence, successful recanalization rates, or sICH rates. The most common reason to exclude transferred patients from EVT was clinical or angiographic improvement (55.6% of patients). Conclusion: Our results show that transferring patients to the EVT center does not affect clinical outcomes, despite the expected delay in EVT. Reassessment of patients upon arrival at the CSC is crucial, and patient selection should be done based on both time and tissue window. [ABSTRACT FROM AUTHOR]

Published
2024
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28. Prognosis and Outcome of Cerebral Sinus Venous Thrombosis—A Multicenter Cohort Study

Author

Simaan, Naaem, primary, Honig, Asaf, additional, Hallevi, Hen, additional, Seyman, Estelle, additional, Rotschild, Ofer, additional, Assayag, Einor Ben, additional, Filioglo, Andrei, additional, Peretz, Shlomi, additional, Mendel, Rom, additional, Barnea, Rani, additional, Auriel, Eitan, additional, Aladdin, Shorooq, additional, Orion, David, additional, Darawsha, Khalil, additional, Shbat, Fadi, additional, Leker, Ronen R., additional, and Molad, Jeremy, additional

Published
2023
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29. Efficacy and safety of endovascular treatment in patients older than 90 with acute ischemic stroke: A retrospective cohort study

Author

Friedman, Itamar, Naftali, Jonathan, Pardo, Keshet, Findler, Michael, Barnea, Rani, Brauner, Ran, Perlow, Alin, Auriel, Eitan, and Raphaeli, Guy

Subjects
Neurology, Neurology (clinical)
Abstract

BackgroundEndovascular treatment (EVT) for acute ischemic stroke (AIS) with large vessel occlusion (LVO) is the standard of care treatment today. Although elderly patients comprise the majority of stroke patients, octogenarians and non-agenarians are often poorly represented or even excluded in clinical trials. We looked at the safety and efficacy of EVT for AIS with LVO in patients over 90 (Non-agenarians), in comparison to patients aged 80–89 (Octogenarians) and to patients younger than 80 years (MethodsA retrospective analysis of patients who underwent EVT in a single stroke center during 2015–2019. Patients were divided into three subgroups based on their age: Non-agenarians, Octogenarians, and patients ResultsThree hundred and forty seven patients were included, 20 (5.7%) of them were non-agenarians, 96 (27.7%) were octogenarians and 231 (66.6%) were p-value = 0.3). Favorable outcome (mRS 0–2) was 15% in non-agenarians vs. 13.54% in octogenarians (p-value = 1) and 40.2% in p-value = 1) and 2.6% in p-value = 0.03) and to ConclusionEVT in nonagenarians demonstrated a high rate of successful revascularization, whilst also showing an increased rate of sICH when compared to octogenarians. Mortality rates showed an age-related correlation. Although further studies are needed to clarify the patient selection algorithm and identify sub-groups of elderly patients that could benefit from EVT, we showed that some patients do benefit from EVT therefore exclusion should not be based on age alone.

Published
2022
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32. Clinical improvement of a toddler with COVID-19 focal cerebral arteriopathy possibly due to intra-arterial nimodipine

Author

Avital, Dekel, primary, Peretz, Shlomi, additional, Perlow, Eliauh, additional, Konen, Osnat, additional, Inbar, Edna, additional, Bulkowstein, Yarden, additional, Nahum, Elhanan, additional, Aharoni, Sharon, additional, Vig, Lital Cohen, additional, Nevo, Yoram, additional, Auriel, Eitan, additional, and Straussberg, Rachel, additional

Published
2022
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33. Management and Outcome of Acute Ischemic Stroke Complicating Transcatheter Aortic Valve Replacement

Author

Levi, Amos, primary, Linder, Matthias, additional, Seiffert, Moritz, additional, Witberg, Guy, additional, Pilgrim, Thomas, additional, Tomii, Daijiro, additional, Talmor-Barkan, Yeela, additional, Van Mieghem, Nicolas M., additional, Adrichem, Rik, additional, Codner, Pablo, additional, Smith, David Hildick, additional, Arunothayaraj, Sandeep, additional, Perl, Leor, additional, Finkelstein, Ariel, additional, Loewenstein, Itamar, additional, Findler, Michael, additional, Søndergaard, Lars, additional, De Backer, Ole, additional, Wang, Christina, additional, Barnea, Rani, additional, Tarantini, Giuseppe, additional, Fovino, Luca Nai, additional, Vaknin-Assa, Hana, additional, Mylotte, Darren, additional, Lunardi, Mattia, additional, Raphaeli, Guy, additional, Webb, John G., additional, Akodad, Mariama, additional, Colombo, Antonio, additional, Mangieri, Antonio, additional, Latib, Azeem, additional, Kargoli, Faraj, additional, Giannini, Francesco, additional, Ielasi, Alfonso, additional, Cockburn, James, additional, Higgen, Focko L., additional, Aviram, Itay, additional, Gitto, Mauro, additional, Hokken, Thijmen W., additional, Auriel, Eitan, additional, and Kornowski, Ran, additional

Published
2022
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42. Management and Outcome of Acute Ischemic Stroke Complicating Transcatheter Aortic Valve Replacement

Author

Levi, Amos, Linder, Matthias, Seiffert, Moritz, Witberg, Guy, Pilgrim, Thomas, Tomii, Daijiro, Talmor-Barkan, Yeela, Van Mieghem, Nicolas M., Adrichem, Rik, Codner, Pablo, Smith, David Hildick, Arunothayaraj, Sandeep, Perl, Leor, Finkelstein, Ariel, Loewenstein, Itamar, Findler, Michael, Søndergaard, Lars, De Backer, Ole, Wang, Christina, Barnea, Rani, Tarantini, Giuseppe, Fovino, Luca Nai, Vaknin-Assa, Hana, Mylotte, Darren, Lunardi, Mattia, Raphaeli, Guy, Webb, John G., Akodad, Mariama, Colombo, Antonio, Mangieri, Antonio, Latib, Azeem, Kargoli, Faraj, Giannini, Francesco, Ielasi, Alfonso, Cockburn, James, Higgen, Focko L., Aviram, Itay, Gitto, Mauro, Hokken, Thijmen W., Auriel, Eitan, Kornowski, Ran, Levi, Amos, Linder, Matthias, Seiffert, Moritz, Witberg, Guy, Pilgrim, Thomas, Tomii, Daijiro, Talmor-Barkan, Yeela, Van Mieghem, Nicolas M., Adrichem, Rik, Codner, Pablo, Smith, David Hildick, Arunothayaraj, Sandeep, Perl, Leor, Finkelstein, Ariel, Loewenstein, Itamar, Findler, Michael, Søndergaard, Lars, De Backer, Ole, Wang, Christina, Barnea, Rani, Tarantini, Giuseppe, Fovino, Luca Nai, Vaknin-Assa, Hana, Mylotte, Darren, Lunardi, Mattia, Raphaeli, Guy, Webb, John G., Akodad, Mariama, Colombo, Antonio, Mangieri, Antonio, Latib, Azeem, Kargoli, Faraj, Giannini, Francesco, Ielasi, Alfonso, Cockburn, James, Higgen, Focko L., Aviram, Itay, Gitto, Mauro, Hokken, Thijmen W., Auriel, Eitan, and Kornowski, Ran

Abstract

Background: Despite advances in transcatheter aortic valve replacement (TAVR), periprocedural acute ischemic stroke remains a concern. Objectives: The aims of this study were to investigate acute ischemic stroke complicating TAVR (AISCT) and to describe the indications and outcomes of interventions to treat AISCT. Methods: An international multicenter registry was established focusing on AISCT within 30 days of TAVR. Stroke severity was assessed using the National Institutes of Health Stroke Scale. Primary outcomes were 1-year all-cause death and neurologic disability status at 90 days according to modified Rankin scale score. Results: Of 16,615 TAVR procedures, 387 patients with AISCT were included (2.3%). Rates of 1-year death were 28.9%, 35.9%, and 77.5% in patients with mild, moderate, and severe stroke, respectively (P < 0.001). Although 348 patients were managed conservatively, 39 patients (10.1%) underwent neurointervention (NI) with either mechanical thrombectomy (n = 26) or thrombolytic therapy (n = 13). In a subanalysis excluding patients with mild stroke, there was no clear 1-year survival benefit for NI compared with conservative management (47.6% vs 41.1%, respectively; P = 0.78). In a logistic regression model controlling for stroke severity, NI was associated with 2.9-fold odds (95% CI: 1.2-7.0; P = 0.016) of independent survival at 90 days. Conclusions: AISCT carries significant morbidity and mortality, which is correlated with stroke severity. The present findings suggest that neurologic disability for patients with moderate or worse stroke could potentially be improved by timely intervention and highlight the importance of collaboration between cardiologists and neurologists to optimize AISCT outcomes.

Published
2022

47. Validation of Clinicoradiological Criteria for the Diagnosis of Cerebral Amyloid Angiopathy–Related Inflammation

Author

Auriel, Eitan, Charidimou, Andreas, Gurol, M. Edip, Ni, Jun, Van Etten, Ellis S., Martinez-Ramirez, Sergi, Boulouis, Gregoire, Piazza, Fabrizio, DiFrancesco, Jacopo C., Frosch, Matthew P., Pontes-Neto, Octvio M., Shoamanesh, Ashkan, Reijmer, Yael, Vashkevich, Anastasia, Ayres, Alison M., Schwab, Kristin M., Viswanathan, Anand, and Greenberg, Steven M.

Published
2016
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50. Estimating Total Cerebral Microinfarct Burden From Diffusion-Weighted Imaging

Author

Auriel, Eitan, Westover, M. Brandon, Bianchi, Matt T., Reijmer, Yael, Martinez-Ramirez, Sergi, Ni, Jun, Van Etten, Ellis, Frosch, Matthew P., Fotiadis, Panagiotis, Schwab, Kris, Vashkevich, Anastasia, Boulouis, Grégoire, Younger, Alayna P., Johnson, Keith A., Sperling, Reisa A., Hedden, Trey, Gurol, M. Edip, Viswanathan, Anand, and Greenberg, Steven M.

Published
2015
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