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2. Pragmatic solutions to reduce the global burden of stroke: a World Stroke Organization–Lancet Neurology Commission

Author

Feigin, V, Owolabi, M, Abd-Allah, F, Akinyemi, R, Bhattacharjee, N, Brainin, M, Cao, J, Caso, V, Dalton, B, Davis, A, Dempsey, R, Duprey, J, Feng, W, Ford, G, Gall, S, Gandhi, D, Good, D, Hachinski, V, Hacke, W, Hankey, G, Ishida, M, Johnson, W, Kim, J, Lavados, P, Lindsay, P, Mahal, A, Martins, S, Murray, C, Nguyen, T, Norrving, B, Olaiya, M, Olalusi, O, Pandian, J, Phan, H, Platz, T, Ranta, A, Rehman, S, Roth, G, Sebastian, I, Smith, A, Suwanwela, N, Sylaja, P, Thapa, R, Thrift, A, Uvere, E, Vollset, S, Yavagal, D, Yaria, J, Abera, S, Ibrahim, N, Liu, L, Ovbiagele, B, Piradov, M, Abanto, C, Addissie, A, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar de Sousa, D, Akhmetzhanova, Z, Akpalu, A, El Alaoui-Faris, M, Ameriso, S, Andonova, S, Arsovska, A, Awoniyi, F, Bakhiet, M, Barboza, M, Basri, H, Bath, P, Bereczki, D, Beretta, S, Berkowitz, A, Bernhardt, J, Berzina, G, Bhavsar, B, Bisharyan, M, Bohara, M, Bovet, P, Budincevic, H, Cadilhac, D, Cerimagic, D, Charway-Felli, A, Chen, C, Chin, J, Christensen, H, Chwojnicki, K, Conforto, A, Correia, M, Mora Cuervo, D, Czlonkowska, A, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Demchuk, A, Dichgans, M, Dokova, K, Donnan, G, Duran, J, Ekeng, G, Elkind, M, Endres, M, Fischer, U, Flomin, Y, Gankpe, F, Gavidia, M, Gaye Saavedra, A, Gebreyohanns, M, George, M, Gierlotka, M, Giroud, M, Gnedovskaya, E, Goncalves, I, Gongora-Rivera, F, Gunaratne, P, Hamadeh, R, Hamzat, T, Heldner, M, Ibrahim, E, Ihle-Hansen, H, Jee, S, Jiann-Shing, J, Johnston, S, Jovanovic, D, Jurjans, K, Kalani, R, Kalkonde, Y, Kamenova, S, Karaszewski, B, Kelly, P, Kiechl, S, Kondybayeva, A, Korv, J, Kozera, G, Kravchenko, M, Krespi, Y, Krishnamurthi, R, Kruja, J, Kutluk, K, Langhorne, P, Law, Z, Lebedynets, D, Lee, T, Leung, T, Liebeskind, D, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, M, Maia, L, Malojcic, B, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Miglane, E, Mihejeva, I, Mikulik, R, Mirrakhimov, E, Mohl, S, Munakomi, S, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, Ocampo, C, O'Donnell, M, Ogun, Y, Ogunniyi, A, Oraby, M, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Pereira, T, Peeters, A, Potpara, T, Proios, H, Rathore, F, Sacco, R, Sahathevan, R, Sandset, E, Renato Santos, I, Saposnik, G, Sarfo, F, Sargento-Freitas, J, Sharma, M, Shaw, L, Sheth, K, Shin, Y, Shobhana, A, Silva, S, Tedim Cruz, V, Thakur, K, Thapa, L, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tulloch-Reid, M, Useche, J, Vanacker, P, Vassilopoulou, S, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wojtyniak, B, Wolfe, C, Yacouba, M, Yang, J, Yifru, Y, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Zagozdzon, P, Feigin V. L., Owolabi M. O., Abd-Allah F., Akinyemi R. O., Bhattacharjee N. V., Brainin M., Cao J., Caso V., Dalton B., Davis A., Dempsey R., Duprey J., Feng W., Ford G. A., Gall S., Gandhi D., Good D. C., Hachinski V., Hacke W., Hankey G. J., Ishida M., Johnson W., Kim J., Lavados P., Lindsay P., Mahal A., Martins S., Murray C., Nguyen T. P., Norrving B., Olaiya M. T., Olalusi O. V., Pandian J., Phan H., Platz T., Ranta A., Rehman S., Roth G., Sebastian I. A., Smith A. E., Suwanwela N. C., Sylaja P. N., Thapa R., Thrift A. G., Uvere E., Vollset S. E., Yavagal D., Yaria J., Abera S. F., Akinyemi R., Dempsey R. J., Ibrahim N. M., Liu L., Ovbiagele B., Piradov M., Suwanwela N., Abanto C., Addissie A., Adeleye A. O., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar de Sousa D., Akhmetzhanova Z., Akpalu A., El Alaoui-Faris M., Ameriso S. F., Andonova S., Arsovska A., Awoniyi F. E., Bakhiet M., Barboza M. A., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bohara M., Bovet P., Budincevic H., Cadilhac D. A., Cerimagic D., Charway-Felli A., Chen C., Chin J. H., Christensen H., Chwojnicki K., Conforto A. B., Correia M., Mora Cuervo D. L., Czlonkowska A., D'Amelio M., Danielyan K. E., Davis S., Demarin V., Demchuk A. M., Dichgans M., Dokova K., Donnan G., Duran J. C., Ekeng G., Elkind M. S., Endres M., Fischer U., Flomin Y., Gankpe F., Gavidia M., Gaye Saavedra A., Gebreyohanns M., George M., Gierlotka M., Giroud M., Gnedovskaya E. V., Goncalves I. P., Gongora-Rivera F., Gunaratne P. S., Hamadeh R. R., Hamzat T. -H. K., Heldner M. R., Ibrahim E., Ihle-Hansen H., Jee S., Jiann-Shing J., Johnston S. C., Jovanovic D., Jurjans K., Kalani R., Kalkonde Y., Kamenova S., Karaszewski B., Kelly P., Kiechl S., Kondybayeva A., Korv J., Kozera G., Kravchenko M., Krespi Y., Krishnamurthi R., Kruja J., Kutluk K., Langhorne P., Law Z. K., Lebedynets D., Lee T. -H., Leung T. W., Liebeskind D. S., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion M. J., Maia L. F., Malojcic B., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Miglane E., Mihejeva I., Mikulik R., Mirrakhimov E., Mohl S., Munakomi S., Murphy S., Musa K. I., Nasreldein A., Nogueira R. G., Nolte C. H., Noubiap J. J., Novarro-Escudero N., Ocampo C., O'Donnell M., Ogun Y., Ogunniyi A., Oraby M. I., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Pereira T., Peeters A., Potpara T., Proios H., Rathore F. A., Sacco R. L., Sahathevan R., Sandset E. S., Renato Santos I., Saposnik G., Sarfo F. S., Sargento-Freitas J., Sharma M., Shaw L., Sheth K. N., Shin Y. -I., Shobhana A., Silva S. N., Tedim Cruz V., Thakur K., Thapa L. J., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wojtyniak B., Wolfe C., Yacouba M. N., Yang J., Yifru Y. M., Yock-Corrales A., Yonemoto N., Yperzeele L., Zagozdzon P., Feigin, V, Owolabi, M, Abd-Allah, F, Akinyemi, R, Bhattacharjee, N, Brainin, M, Cao, J, Caso, V, Dalton, B, Davis, A, Dempsey, R, Duprey, J, Feng, W, Ford, G, Gall, S, Gandhi, D, Good, D, Hachinski, V, Hacke, W, Hankey, G, Ishida, M, Johnson, W, Kim, J, Lavados, P, Lindsay, P, Mahal, A, Martins, S, Murray, C, Nguyen, T, Norrving, B, Olaiya, M, Olalusi, O, Pandian, J, Phan, H, Platz, T, Ranta, A, Rehman, S, Roth, G, Sebastian, I, Smith, A, Suwanwela, N, Sylaja, P, Thapa, R, Thrift, A, Uvere, E, Vollset, S, Yavagal, D, Yaria, J, Abera, S, Ibrahim, N, Liu, L, Ovbiagele, B, Piradov, M, Abanto, C, Addissie, A, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar de Sousa, D, Akhmetzhanova, Z, Akpalu, A, El Alaoui-Faris, M, Ameriso, S, Andonova, S, Arsovska, A, Awoniyi, F, Bakhiet, M, Barboza, M, Basri, H, Bath, P, Bereczki, D, Beretta, S, Berkowitz, A, Bernhardt, J, Berzina, G, Bhavsar, B, Bisharyan, M, Bohara, M, Bovet, P, Budincevic, H, Cadilhac, D, Cerimagic, D, Charway-Felli, A, Chen, C, Chin, J, Christensen, H, Chwojnicki, K, Conforto, A, Correia, M, Mora Cuervo, D, Czlonkowska, A, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Demchuk, A, Dichgans, M, Dokova, K, Donnan, G, Duran, J, Ekeng, G, Elkind, M, Endres, M, Fischer, U, Flomin, Y, Gankpe, F, Gavidia, M, Gaye Saavedra, A, Gebreyohanns, M, George, M, Gierlotka, M, Giroud, M, Gnedovskaya, E, Goncalves, I, Gongora-Rivera, F, Gunaratne, P, Hamadeh, R, Hamzat, T, Heldner, M, Ibrahim, E, Ihle-Hansen, H, Jee, S, Jiann-Shing, J, Johnston, S, Jovanovic, D, Jurjans, K, Kalani, R, Kalkonde, Y, Kamenova, S, Karaszewski, B, Kelly, P, Kiechl, S, Kondybayeva, A, Korv, J, Kozera, G, Kravchenko, M, Krespi, Y, Krishnamurthi, R, Kruja, J, Kutluk, K, Langhorne, P, Law, Z, Lebedynets, D, Lee, T, Leung, T, Liebeskind, D, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, M, Maia, L, Malojcic, B, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Miglane, E, Mihejeva, I, Mikulik, R, Mirrakhimov, E, Mohl, S, Munakomi, S, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, Ocampo, C, O'Donnell, M, Ogun, Y, Ogunniyi, A, Oraby, M, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Pereira, T, Peeters, A, Potpara, T, Proios, H, Rathore, F, Sacco, R, Sahathevan, R, Sandset, E, Renato Santos, I, Saposnik, G, Sarfo, F, Sargento-Freitas, J, Sharma, M, Shaw, L, Sheth, K, Shin, Y, Shobhana, A, Silva, S, Tedim Cruz, V, Thakur, K, Thapa, L, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tulloch-Reid, M, Useche, J, Vanacker, P, Vassilopoulou, S, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wojtyniak, B, Wolfe, C, Yacouba, M, Yang, J, Yifru, Y, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Zagozdzon, P, Feigin V. L., Owolabi M. O., Abd-Allah F., Akinyemi R. O., Bhattacharjee N. V., Brainin M., Cao J., Caso V., Dalton B., Davis A., Dempsey R., Duprey J., Feng W., Ford G. A., Gall S., Gandhi D., Good D. C., Hachinski V., Hacke W., Hankey G. J., Ishida M., Johnson W., Kim J., Lavados P., Lindsay P., Mahal A., Martins S., Murray C., Nguyen T. P., Norrving B., Olaiya M. T., Olalusi O. V., Pandian J., Phan H., Platz T., Ranta A., Rehman S., Roth G., Sebastian I. A., Smith A. E., Suwanwela N. C., Sylaja P. N., Thapa R., Thrift A. G., Uvere E., Vollset S. E., Yavagal D., Yaria J., Abera S. F., Akinyemi R., Dempsey R. J., Ibrahim N. M., Liu L., Ovbiagele B., Piradov M., Suwanwela N., Abanto C., Addissie A., Adeleye A. O., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar de Sousa D., Akhmetzhanova Z., Akpalu A., El Alaoui-Faris M., Ameriso S. F., Andonova S., Arsovska A., Awoniyi F. E., Bakhiet M., Barboza M. A., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bohara M., Bovet P., Budincevic H., Cadilhac D. A., Cerimagic D., Charway-Felli A., Chen C., Chin J. H., Christensen H., Chwojnicki K., Conforto A. B., Correia M., Mora Cuervo D. L., Czlonkowska A., D'Amelio M., Danielyan K. E., Davis S., Demarin V., Demchuk A. M., Dichgans M., Dokova K., Donnan G., Duran J. C., Ekeng G., Elkind M. S., Endres M., Fischer U., Flomin Y., Gankpe F., Gavidia M., Gaye Saavedra A., Gebreyohanns M., George M., Gierlotka M., Giroud M., Gnedovskaya E. V., Goncalves I. P., Gongora-Rivera F., Gunaratne P. S., Hamadeh R. R., Hamzat T. -H. K., Heldner M. R., Ibrahim E., Ihle-Hansen H., Jee S., Jiann-Shing J., Johnston S. C., Jovanovic D., Jurjans K., Kalani R., Kalkonde Y., Kamenova S., Karaszewski B., Kelly P., Kiechl S., Kondybayeva A., Korv J., Kozera G., Kravchenko M., Krespi Y., Krishnamurthi R., Kruja J., Kutluk K., Langhorne P., Law Z. K., Lebedynets D., Lee T. -H., Leung T. W., Liebeskind D. S., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion M. J., Maia L. F., Malojcic B., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Miglane E., Mihejeva I., Mikulik R., Mirrakhimov E., Mohl S., Munakomi S., Murphy S., Musa K. I., Nasreldein A., Nogueira R. G., Nolte C. H., Noubiap J. J., Novarro-Escudero N., Ocampo C., O'Donnell M., Ogun Y., Ogunniyi A., Oraby M. I., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Pereira T., Peeters A., Potpara T., Proios H., Rathore F. A., Sacco R. L., Sahathevan R., Sandset E. S., Renato Santos I., Saposnik G., Sarfo F. S., Sargento-Freitas J., Sharma M., Shaw L., Sheth K. N., Shin Y. -I., Shobhana A., Silva S. N., Tedim Cruz V., Thakur K., Thapa L. J., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wojtyniak B., Wolfe C., Yacouba M. N., Yang J., Yifru Y. M., Yock-Corrales A., Yonemoto N., Yperzeele L., and Zagozdzon P.

Published
2023

3. Outcomes after reperfusion therapies in patients with ACA stroke: A multicenter cohort study from the EVATRISP collaboration

Author

Filioglo, A, Simaan, N, Honig, A, Heldner, M R, von Rennenberg, R, Pezzini, A, Padjen, V, Rentzos, A, Altersberger, V L, Baumgartner, P, Zini, A, Grisendi, I, Aladdin, S, Gomori, J M, Pilgram-Pastor, S M, Scheitz, J F, Magoni, M, Berisavac, I, Nordanstig, A, Psychogios, M, Luft, A, Gentile, M, Assenza, F, Arnold, M, Nolte, C H, Gamba, M, Ercegovac, M, Jood, K, Engelter, S T, Wegener, S, Forlivesi, S, Zedde, M, Gensicke, H, Tatlisumak, T, Cohen, J E, and Leker, R R

Subjects
Endovascular Procedures, eye diseases, Brain Ischemia, Cohort Studies, Stroke, stomatognathic diseases, Treatment Outcome, Neurology, Fibrinolytic Agents, Reperfusion, Humans, Thrombolytic Therapy, Neurology (clinical), 610 Medicine & health, Thrombectomy
Abstract

BACKGROUND Patients with stroke secondary to occlusions of the anterior cerebral artery (ACA) often have poor outcomes. The optimal acute therapeutic intervention for these patients remains unknown. METHODS Patients with isolated ACA-stroke were identified from 10 centers participating in the EndoVascular treatment And ThRombolysis in Ischemic Stroke Patients (EVATRISP) prospective registry. Patients treated with endovascular thrombectomy (EVT) were compared to those treated with intravenous thrombolysis (IVT). Odds ratios with 95% confidence intervals (OR; 95%CI) were calculated using multivariate regression analysis. RESULTS Included were 92 patients with ACA-stroke. Of the 92 ACA patients, 55 (60%) were treated with IVT only and 37 (40%) with EVT (��bridging IVT). ACA patients treated with EVT had more often wake-up stroke (24% vs. 6%, p��=��0.044) and proximal ACA occlusions (43% vs. 24%, p��=��0.047) and tended to have higher stroke severity on admission [NIHSS: 10.0 vs 7.0, p��=��0.054). However, odds for favorable outcome, mortality or symptomatic intracranial hemorrhage did not differ significantly between both groups. Exploration of the effect of clot location inside the ACA showed that in patients with A1 or A2/A3 ACA occlusions the chances of favorable outcome were not influenced by treatment allocation to IVT or EVT. DISCUSSION Treatment with either IVT or EVT could be safe with similar effect in patients with ACA-strokes and these effects may be independent of clot location within the occluded ACA.

Published
2021

4. The state of stroke services across the globe: Report of World Stroke Organization–World Health Organization surveys

Author

Thrift A. G., Martins S., Johnson W., Pandian J., Abd-Allah F., Varghese C., Mahal A., Yaria J., Phan H. T., Roth G., Gall S. L., Beare R., Phan T. G., Mikulik R., Norrving B., Feigin V. Abera S. F., Addissie A., Adeleye A., Adilbekov Y., Adilbekova B., Adoukonou T. A. Aguiar de Sousa D., Akhmetzhanova Z., Akinyemi R. O., Akpalu A. MB. ChB, Ameriso S. F., Andonova S., Abanto C., Awoniyi F. E., Bakhiet M., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bovet P., Brainin M., Budincevic H., Cabral N. L., Cadilhac D A. , Caso V., Chen C., Chin J. H., Christensen H, Chwojnicki K., Conforto A. B., Cruz V. T., D'Amelio M., Danielyan K. E., Davis S., Demarin V, Dempsey R. J., Dichgans M., Dokova Donnan, G. Duran, Elizondo M. A. B., Elkind M. S., Endres M., Etedal I., Faris M. E., Fischer U., Gankpe F., Gavidia M., GayeSaavedra A., Giroud M., Gongora-Rivera F., Hachinski V., Hacke W., Hamadeh R. R., Hamzat T. K., Hankey G. J., Heldner M. R., Ibrahim N. M., Inoue M., Jee S., Jiann-Shing J., Johnston S. C., Kalkonde Y., Kamenova S., Kelly P., Khan T., Kiechl S., Kondybayeva A., Kõrv J., Kravchenko M., Krishnamurthi R., Langhorne P., Kang Z. L., Kruja J., Lavados P. M., Lebedynets D., Leung T. W., Liebeskind D. S., Lindsay P., Liu L., López-Jaramillo P., Lotufo P. A., Machline-Carrion J. M., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Mirrakhimov E., Mohl S., Murphy S., Musa K. I., Nasreldein A, Nogueira R., Nolte C. H., Noubiap J. J., Novarro-Escudero N., O'Donnell M., Ogun Y., Oraby M. I., Ovbiagele B., Ōrken D. N., Ōzdemir A. O., Ozturk S., Paccot M., Peters A., Piradov M., Platz T., Potpara T., Ranta A., Rathore F. A., Sacco R. L., Sahathevan R., Santos I. C., Saposnik G., Sarfo F. S., Sharma M., Sheth K. N., Shobhana A., Silva S. N., Suwanwela N. C., Sylaja P. N., Thakur K., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tsong-Hai L., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Venketasubramanian N., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wolfe C, Yifru M. Y., YockCorrales A., Yonemoto N., Yperzeele L., Owolabi, MO, Thrift, AG, Martins, S, Johnson, W, Pandian, J, Abd-Allah, F, Varghese, C, Mahal, A, Yaria, J, Phan, HT, Roth, G, Gall, SL, Beare, R, Phan, TG, D'Amelio M, Mikulik, R, Norrving, B, Feigin, VL, and Thrift A. G., Martins S., Johnson W., Pandian J., Abd-Allah F., Varghese C., Mahal A., Yaria J., Phan H. T., Roth G., Gall S. L., Beare R., Phan T. G., Mikulik R., Norrving B., Feigin V. Abera S.F., Addissie A., Adeleye A., Adilbekov Y., Adilbekova B., Adoukonou T.A. Aguiar de Sousa D., Akhmetzhanova Z., Akinyemi R.O., Akpalu A. MB. ChB , Ameriso S.F. , Andonova S., Abanto C., Awoniyi F.E., Bakhiet M., Basri H., Bath, P.M., Bereczki D., Beretta S., Berkowitz A.L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M.S., Bovet P., Brainin, M., Budincevic H., Cabral N.L., , Cadilhac D A. , Caso V., , Chen C., Chin J.H. , Christensen H, , Di, Chwojnicki K., Conforto A.B., Cruz V.T., D'Amelio M., Danielyan K.E., Davis, S., Demarin V, Dempsey R.J., Dichgans M., Dokova, Donnan, G., Duran, J., Elizondo M.A.B., Elkind M.S., Endres M., Etedal I., Faris M.E., Fischer U., Gankpe F., Gavidia M., GayeSaavedra A., Giroud M., Gongora-Rivera F., Hachinski V. , Hacke, W., Hamadeh R.R., Hamzat T.K., Hankey G.J., Heldner M.R., Ibrahim, N.M., Inoue M., Jee S., Jiann-Shing J., Johnston S. C., Kalkonde Y., Kamenova S., Kelly P., Khan T., Kiechl S., Kondybayeva A., Kõrv J., Kravchenko M., Krishnamurthi R., Langhorne, P., Kang Z.L., Kruja, J., Lavados P.M., Lebedynets D., Leung T.W., Liebeskind D.S., Lindsay P., Liu, L., López-Jaramillo P., Lotufo P.A., Machline-Carrion J.M., Markus, H.S., Marquez-Romero J.M., Medina M.T., Medukhanova S., Mehndiratta M.M., Mirrakhimov E., Mohl S., Murphy S., Musa K.I., Nasreldein A, Nogueira R., Nolte C.H., Norrving B., Noubiap J.J., Novarro-Escudero N., O'Donnell M., Ogun Y., Oraby M.I., Ovbiagele B., Ōrken D.N., Ōzdemir A.O., Ozturk S., Paccot M., Peters A., Piradov, M., Platz T., Potpara T., Ranta A., Rathore F.A., Roth G., Sacco R.L., Sahathevan R., Santos I.C., Saposnik G., Sarfo F.S., Sharma M., Sheth K.N., Shobhana A., Silva, S.N., Suwanwela N. C., Sylaja P.N., Thakur K., Toni D., Topcuoglu M.A., Torales J., Towfighi A., Truelsen, T., Tsiskaridze A., Tsong-Hai L., Tulloch-Reid M., Useche J.N., Vanacker P., Vassilopoulou S., Venketasubramanian N., Vukorepa G., Vuletic V., Wahab K.W., Wang W., Wijeratne T., Wolfe C, Yifru M.Y., YockCorrales A., Yonemoto N., Yperzeele L.

Subjects
Gerontology, medicine.medical_specialty, medicine.medical_treatment, media_common.quotation_subject, Globe, Commission, stroke quadrangle, Global Health, World Health Organization, World health, Article, Stroke service, rehabilitation, low and middle-income countrie, 03 medical and health sciences, 0302 clinical medicine, State (polity), prevention, Acute care, Surveys and Questionnaires, medicine, Humans, 030212 general & internal medicine, high-income countrie, Stroke, Developing Countries, media_common, Stroke services, Rehabilitation, business.industry, Stroke Rehabilitation, medicine.disease, 3. Good health, medicine.anatomical_structure, Neurology, low- and middle-income countrie, Settore MED/26 - Neurologia, acute care, business, 030217 neurology & neurosurgery
Abstract

Background Improving stroke services is critical for reducing the global stroke burden. The World Stroke Organization–World Health Organization– Lancet Neurology Commission on Stroke conducted a survey of the status of stroke services in low and middle-income countries (LMICs) compared to high-income countries. Methods Using a validated World Stroke Organization comprehensive questionnaire, we collected and compared data on stroke services along four pillars of the stroke quadrangle (surveillance, prevention, acute stroke, and rehabilitation) in 84 countries across World Health Organization regions and economic strata. The World Health Organization also conducted a survey of non-communicable diseases in 194 countries in 2019. Results Fewer surveillance activities (including presence of registries, presence of recent risk factors surveys, and participation in research) were reported in low-income countries than high-income countries. The overall global score for prevention was 40.2%. Stroke units were present in 91% of high-income countries in contrast to 18% of low-income countries (p Conclusions There is an urgent need to improve access to stroke units and services globally especially in LMICs. Countries with less stroke services can adapt strategies from those with better services. This could include establishment of a framework for regular monitoring of stroke burden and services, implementation of integrated prevention activities and essential acute stroke care services, and provision of interdisciplinary care for stroke rehabilitation.

Published
2021

8. The state of stroke services across the globe: Report of World Stroke Organization–World Health Organization surveys

Author

Owolabi, M, Thrift, A, Martins, S, Johnson, W, Pandian, J, Abd-Allah, F, Varghese, C, Mahal, A, Yaria, J, Phan, H, Roth, G, Gall, S, Beare, R, Phan, T, Mikulik, R, Norrving, B, Feigin, V, on behalf of the Stroke Experts Collaboration, G, Abera, S, Addissie, A, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar, D, Akhmetzhanova, Z, Akinyemi, R, Akpalu, A, Ameriso, S, Andonova, S, Abanto, C, Awoniyi, F, Bakhiet, M, Basri, H, Bath, P, Bereczki, D, Beretta, S, Berkowitz, A, Bernhardt, J, Berzina, G, Bhavsar, B, Bisharyan, M, Bovet, P, Brainin, M, Budincevic, H, Cabral, N, Cadilhac, D, Caso, V, Chen, C, Chin, J, Christensen, H, Chwojnicki, K, Conforto, A, Cruz, V, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Dempsey, R, Dichgans, M, Dokova, Donnan, G, Duran, J, Elizondo, M, Elkind, M, Endres, M, Etedal, I, Faris, M, Fischer, U, Gankpe, F, Gavidia, M, Gaye-Saavedra, A, Giroud, M, Gongora-Rivera, F, Hachinski, V, Hacke, W, Hamadeh, R, Hamzat, T, Hankey, G, Heldner, M, Ibrahim, N, Inoue, M, Jee, S, Jiann-Shing, J, Johnston, S, Kalkonde, Y, Kamenova, S, Kelly, P, Khan, T, Kiechl, S, Kondybayeva, A, Korv, J, Kravchenko, M, Krishnamurthi, R, Langhorne, P, Kang, Z, Kruja, J, Lavados, P, Lebedynets, D, Leung, T, Liebeskind, D, Lindsay, P, Liu, L, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, J, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Mirrakhimov, E, Mohl, S, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, O'Donnell, M, Ogun, V, Oraby, M, Ovbiagele, B, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Peters, A, Piradov, M, Platz, T, Potpara, T, Ranta, A, Rathore, F, Sacco, R, Sahathevan, R, Santos, I, Saposnik, G, Sarfo, F, Sharma, M, Sheth, K, Shobhana, A, Silva, S, Suwanwela, N, Sylaja, P, Thakur, K, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tsong-Hai, L, Tulloch-Reid, M, Useche, J, Vanacker, P, Vassilopoulou, S, Venketasubramanian, N, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wolfe, C, Yifru, M, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Owolabi M. O., Thrift A. G., Martins S., Johnson W., Pandian J., Abd-Allah F., Varghese C., Mahal A., Yaria J., Phan H. T., Roth G., Gall S. L., Beare R., Phan T. G., Mikulik R., Norrving B., Feigin V. L., on behalf of the Stroke Experts Collaboration Group, Abera S. F., Addissie A., Adeleye A., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar D. S. D., Akhmetzhanova Z., Akinyemi R. O., Akpalu A., Ameriso S. F., Andonova S., Abanto C., Awoniyi F. E., Bakhiet M., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bovet P., Brainin M., Budincevic H., Cabral N. L., Cadilhac D. A., Caso V., Chen C., Chin J. H., Christensen H., Chwojnicki K., Conforto A. B., Cruz V. T., D'Amelio M., Danielyan K. E., Davis S., Demarin V., Dempsey R. J., Dichgans M., Donnan G., Duran J., Elizondo M. A. B., Elkind M. S., Endres M., Etedal I., Faris M. E., Fischer U., Gankpe F., Gavidia M., Gaye-Saavedra A., Giroud M., Gongora-Rivera F., Hachinski V., Hacke W., Hamadeh R. R., Hamzat T. K., Hankey G. J., Heldner M. R., Ibrahim N. M., Inoue M., Jee S., Jiann-Shing J., Johnston S., Kalkonde Y., Kamenova S., Kelly P., Khan T., Kiechl S., Kondybayeva A., Korv J., Kravchenko M., Krishnamurthi R., Langhorne P., Kang Z. L., Kruja J., Lavados P. M., Lebedynets D., Leung T. W., Liebeskind D. S., Lindsay P., Liu L., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion J. M., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Mirrakhimov E., Mohl S., Murphy S., Musa K. I., Nasreldein A., Nogueira R., Nolte C. H., Noubiap J. J., Novarro-Escudero N., O'Donnell M., Ogun V., Oraby M. I., Ovbiagele B., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Peters A., Piradov M., Platz T., Potpara T., Ranta A., Rathore F. A., Sacco R. L., Sahathevan R., Santos I. C., Saposnik G., Sarfo F. S., Sharma M., Sheth K. N., Shobhana A., Silva S. N., Suwanwela N., Sylaja P. N., Thakur K., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tsong-Hai L., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Venketasubramanian N., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wolfe C., Yifru M. Y., Yock-Corrales A., Yonemoto N., Yperzeele L., Owolabi, M, Thrift, A, Martins, S, Johnson, W, Pandian, J, Abd-Allah, F, Varghese, C, Mahal, A, Yaria, J, Phan, H, Roth, G, Gall, S, Beare, R, Phan, T, Mikulik, R, Norrving, B, Feigin, V, on behalf of the Stroke Experts Collaboration, G, Abera, S, Addissie, A, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar, D, Akhmetzhanova, Z, Akinyemi, R, Akpalu, A, Ameriso, S, Andonova, S, Abanto, C, Awoniyi, F, Bakhiet, M, Basri, H, Bath, P, Bereczki, D, Beretta, S, Berkowitz, A, Bernhardt, J, Berzina, G, Bhavsar, B, Bisharyan, M, Bovet, P, Brainin, M, Budincevic, H, Cabral, N, Cadilhac, D, Caso, V, Chen, C, Chin, J, Christensen, H, Chwojnicki, K, Conforto, A, Cruz, V, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Dempsey, R, Dichgans, M, Dokova, Donnan, G, Duran, J, Elizondo, M, Elkind, M, Endres, M, Etedal, I, Faris, M, Fischer, U, Gankpe, F, Gavidia, M, Gaye-Saavedra, A, Giroud, M, Gongora-Rivera, F, Hachinski, V, Hacke, W, Hamadeh, R, Hamzat, T, Hankey, G, Heldner, M, Ibrahim, N, Inoue, M, Jee, S, Jiann-Shing, J, Johnston, S, Kalkonde, Y, Kamenova, S, Kelly, P, Khan, T, Kiechl, S, Kondybayeva, A, Korv, J, Kravchenko, M, Krishnamurthi, R, Langhorne, P, Kang, Z, Kruja, J, Lavados, P, Lebedynets, D, Leung, T, Liebeskind, D, Lindsay, P, Liu, L, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, J, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Mirrakhimov, E, Mohl, S, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, O'Donnell, M, Ogun, V, Oraby, M, Ovbiagele, B, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Peters, A, Piradov, M, Platz, T, Potpara, T, Ranta, A, Rathore, F, Sacco, R, Sahathevan, R, Santos, I, Saposnik, G, Sarfo, F, Sharma, M, Sheth, K, Shobhana, A, Silva, S, Suwanwela, N, Sylaja, P, Thakur, K, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tsong-Hai, L, Tulloch-Reid, M, Useche, J, Vanacker, P, Vassilopoulou, S, Venketasubramanian, N, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wolfe, C, Yifru, M, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Owolabi M. O., Thrift A. G., Martins S., Johnson W., Pandian J., Abd-Allah F., Varghese C., Mahal A., Yaria J., Phan H. T., Roth G., Gall S. L., Beare R., Phan T. G., Mikulik R., Norrving B., Feigin V. L., on behalf of the Stroke Experts Collaboration Group, Abera S. F., Addissie A., Adeleye A., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar D. S. D., Akhmetzhanova Z., Akinyemi R. O., Akpalu A., Ameriso S. F., Andonova S., Abanto C., Awoniyi F. E., Bakhiet M., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bovet P., Brainin M., Budincevic H., Cabral N. L., Cadilhac D. A., Caso V., Chen C., Chin J. H., Christensen H., Chwojnicki K., Conforto A. B., Cruz V. T., D'Amelio M., Danielyan K. E., Davis S., Demarin V., Dempsey R. J., Dichgans M., Donnan G., Duran J., Elizondo M. A. B., Elkind M. S., Endres M., Etedal I., Faris M. E., Fischer U., Gankpe F., Gavidia M., Gaye-Saavedra A., Giroud M., Gongora-Rivera F., Hachinski V., Hacke W., Hamadeh R. R., Hamzat T. K., Hankey G. J., Heldner M. R., Ibrahim N. M., Inoue M., Jee S., Jiann-Shing J., Johnston S., Kalkonde Y., Kamenova S., Kelly P., Khan T., Kiechl S., Kondybayeva A., Korv J., Kravchenko M., Krishnamurthi R., Langhorne P., Kang Z. L., Kruja J., Lavados P. M., Lebedynets D., Leung T. W., Liebeskind D. S., Lindsay P., Liu L., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion J. M., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Mirrakhimov E., Mohl S., Murphy S., Musa K. I., Nasreldein A., Nogueira R., Nolte C. H., Noubiap J. J., Novarro-Escudero N., O'Donnell M., Ogun V., Oraby M. I., Ovbiagele B., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Peters A., Piradov M., Platz T., Potpara T., Ranta A., Rathore F. A., Sacco R. L., Sahathevan R., Santos I. C., Saposnik G., Sarfo F. S., Sharma M., Sheth K. N., Shobhana A., Silva S. N., Suwanwela N., Sylaja P. N., Thakur K., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tsong-Hai L., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Venketasubramanian N., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wolfe C., Yifru M. Y., Yock-Corrales A., Yonemoto N., and Yperzeele L.

Abstract

Background: Improving stroke services is critical for reducing the global stroke burden. The World Stroke Organization–World Health Organization–Lancet Neurology Commission on Stroke conducted a survey of the status of stroke services in low and middle-income countries (LMICs) compared to high-income countries. Methods: Using a validated World Stroke Organization comprehensive questionnaire, we collected and compared data on stroke services along four pillars of the stroke quadrangle (surveillance, prevention, acute stroke, and rehabilitation) in 84 countries across World Health Organization regions and economic strata. The World Health Organization also conducted a survey of non-communicable diseases in 194 countries in 2019. Results: Fewer surveillance activities (including presence of registries, presence of recent risk factors surveys, and participation in research) were reported in low-income countries than high-income countries. The overall global score for prevention was 40.2%. Stroke units were present in 91% of high-income countries in contrast to 18% of low-income countries (p < 0.001). Acute stroke treatments were offered in ∼ 60% of high-income countries compared to 26% of low-income countries (p = 0.009). Compared to high-income countries, LMICs provided less rehabilitation services including in-patient rehabilitation, home assessment, community rehabilitation, education, early hospital discharge program, and presence of rehabilitation protocol. Conclusions: There is an urgent need to improve access to stroke units and services globally especially in LMICs. Countries with less stroke services can adapt strategies from those with better services. This could include establishment of a framework for regular monitoring of stroke burden and services, implementation of integrated prevention activities and essential acute stroke care services, and provision of interdisciplinary care for stroke rehabilitation.

Published
2021

12. Anaemia at admission is associated with poor clinical outcome in cerebral venous thrombosis.

Author

Silvis, S. M., Reinstra, E., Hiltunen, S., Lindgren, E., Heldner, M. R., Mansour, M., Ghiasian, M., Jood, K., Zuurbier, S. M., Groot, A. E., Arnold, M., Barboza, M. A., Arauz, A., Putaala, J., Tatlisumak, T., and Coutinho, J. M.

Subjects
CEREBRAL embolism & thrombosis, VENOUS thrombosis, ANEMIA, LOGISTIC regression analysis, SINUS thrombosis
Abstract

Background and purpose: Anaemia is associated with poor clinical outcome after ischaemic and haemorrhagic stroke. The association between anaemia and outcome in patients with cerebral venous thrombosis (CVT) was examined. Methods: Consecutive adult patients with CVT were included from seven centres. Anaemia at admission was scored according to World Health Organization definitions. Poor clinical outcome was defined as a modified Rankin Scale score 3–6 at last follow‐up. A multiple imputation procedure was applied for handling missing data in the multivariable analysis. Using binary logistic regression analysis, adjustments were made for age, sex, cancer and centre of recruitment (model 1). In a secondary analysis, adjustments were additionally made for coma, intracerebral haemorrhage, non‐haemorrhagic lesion and deep venous system thrombosis (model 2). In a sensitivity analysis, patients with cancer were excluded. Results: Data for 952 patients with CVT were included, 22% of whom had anaemia at admission. Patients with anaemia more often had a history of cancer (17% vs. 7%, P < 0.001) than patients without anaemia. Poor clinical outcome (21% vs. 11%, P < 0.001) and mortality (11% vs. 6%, P = 0.07) were more common amongst patients with anaemia. After adjustment, anaemia at admission increased the risk of poor outcome [adjusted odds ratio (aOR) 2.4, 95% confidence interval (CI) 1.5–3.7, model 1]. Model 2 revealed comparable results (aOR 1.9, 95% CI 1.2–3.2), as did the sensitivity analysis excluding patients with cancer (aOR 2.3, 95% CI 1.3–3.8, model 1). Conclusion: The risk of poor clinical outcome is doubled in CVT patients presenting with anaemia at admission. [ABSTRACT FROM AUTHOR]

Published
2020
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13. Impact of intravenous thrombolysis on recanalization rates in patients with stroke treated with bridging therapy

Author

Mueller, L., primary, Pult, F., additional, Meisterernst, J., additional, Heldner, M. R., additional, Mono, M.-L., additional, Kurmann, R., additional, Buehlmann, M., additional, Fischer, U., additional, Mattle, H. P., additional, Arnold, M., additional, Mordasini, P., additional, Gralla, J., additional, Schroth, G., additional, El-Koussy, M., additional, and Jung, S., additional

Published
2017
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14. Physical activity in secondary stroke prevention.

Author

Scutelnic, A., Arnold, M., Jung, S., and Heldner, M. R.

Subjects
PHYSICAL activity, STROKE, ACTIVITIES of daily living
Abstract

Copyright of SSEM-Journal is the property of Schwiez Zschr Sportmed Sporttraumatologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2019
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15. The role of physical activity in primary stroke prevention.

Author

Scutelnic, A., Arnold, M., Jung, S., and Heldner, M. R.

Subjects
PHYSICAL activity, SEDENTARY behavior, STROKE, ATRIAL fibrillation, SLEEP apnea syndromes
Abstract

Copyright of SSEM-Journal is the property of Schwiez Zschr Sportmed Sporttraumatologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2019

16. IV thrombolysis and renal function

Author

Gensicke, H., primary, Zinkstok, S. M., additional, Roos, Y. B., additional, Seiffge, D. J., additional, Ringleb, P., additional, Artto, V., additional, Putaala, J., additional, Haapaniemi, E., additional, Leys, D., additional, Bordet, R., additional, Michel, P., additional, Odier, C., additional, Berrouschot, J., additional, Arnold, M., additional, Heldner, M. R., additional, Zini, A., additional, Bigliardi, G., additional, Padjen, V., additional, Peters, N., additional, Pezzini, A., additional, Schindler, C., additional, Sarikaya, H., additional, Bonati, L. H., additional, Tatlisumak, T., additional, Lyrer, P. A., additional, Nederkoorn, P. J., additional, and Engelter, S. T., additional

Published
2013
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17. Management der Transienten Ischämischen Attacke (TIA) und des Akuten Hirnschlags.

Author

Heldner, M. R., Arnold, M., Gralla, J., and Fischer, U.

Subjects
*TRANSIENT ischemic attack treatment, *STROKE, *ACUTE diseases, *ETIOLOGY of diseases, *MAXIMUM likelihood statistics, *DISEASE relapse, *THROMBOLYTIC therapy, *ENDOVASCULAR surgery
Abstract

Patients with a transient ischemic attack and an acute stroke need urgent investigations and therapy in a stroke unit. Immediate investigation of the etiology and early secondary prevention measures reduce the likelihood of recurrent and other vascular events. In selected stroke patients intravenous thrombolysis and/or endovascular therapies lead to a significant reduction of long term disabilities. [ABSTRACT FROM AUTHOR]

Published
2012
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18. Correlation of Collateral Scores Derived from Whole-Brain Time-Resolved Flat Panel Detector Imaging in Acute Ischemic Stroke.

Author

Kurmann CC, Kaesmacher J, Pilgram-Pastor S, Piechowiak EI, Scutelnic A, Heldner MR, Dobrocky T, Gralla J, and Mordasini P

Subjects
Humans, Brain, Cerebral Angiography methods, Collateral Circulation, Computed Tomography Angiography methods, Reproducibility of Results, Retrospective Studies, Brain Ischemia diagnostic imaging, Brain Ischemia therapy, Ischemic Stroke, Stroke diagnostic imaging, Stroke therapy
Abstract

Background and Purpose: Flat panel detector CT imaging allows simultaneous acquisition of multiphase flat panel CTA and flat panel CTP imaging directly in the angio suite. We compared collateral assessment derived from multiphase flat panel CTA and flat panel CTP with collateral assessment derived from DSA as the gold-standard., Materials and Methods: We performed a retrospective analysis of patients with occlusion of the first or second segment of the MCA who underwent pre-interventional flat panel detector CT. The hypoperfusion intensity ratio as a correlate of collateral status was calculated from flat panel CTP (time-to-maximum > 10 seconds volume/time-to-maximum > 6 seconds volume). Intraclass correlation coefficients were calculated for interrater reliability for the Calgary/Menon score for multiphase flat panel CTA and for the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) score for DSA collateral scores. Correlations of the hypoperfusion intensity ratio, multiphase flat panel CTA score, and the ASITN/SIR score were calculated using the Spearman correlation., Results: From November 2019 to February 2020, thirty patients were included. Moderate interrater reliability was achieved for the ASITN/SIR DSA score (0.68; 95% CI, 0.50-0.82) as well as for the Calgary/Menon multiphase flat panel CTA score (0.53; 95% CI, 0.29-0.72). We found a strong correlation between the ASITN/SIR DSA and Calgary/Menon multiphase flat panel CTA score (ρ = 0.54, P = .002) and between the hypoperfusion intensity ratio and the Calgary/Menon multiphase flat panel CTA score (ρ = -0.57, P < .001). The correlation was moderate between the hypoperfusion intensity ratio and the ASITN/SIR DSA score (ρ = -0.49, P = .006). The infarct core volume correlated strongly with the Calgary/Menon multiphase flat panel CTA score (ρ = -0.66, P  < .001) and the hypoperfusion intensity ratio (ρ = 0.76, P  < .001) and correlated moderately with the ASITN/SIR DSA score (ρ = -0.46, P = .01)., Conclusions: The Calgary/Menon multiphase flat panel CTA score and the hypoperfusion intensity ratio correlated with each other and with the ASITN/SIR DSA score as the gold-standard. In our cohort, the collateral scoring derived from flat panel detector CT was clinically reliable., (© 2022 by American Journal of Neuroradiology.)

Published
2022
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19. Diagnostic Accuracy of High-Resolution 3D T2-SPACE in Detecting Cerebral Venous Sinus Thrombosis.

Author

Hakim A, Kurmann C, Pospieszny K, Meinel TR, Shahin MA, Heldner MR, Umarova R, Jung S, Arnold M, and El-Koussy M

Subjects
Cranial Sinuses diagnostic imaging, Humans, Imaging, Three-Dimensional methods, Magnetic Resonance Imaging methods, Reproducibility of Results, Retrospective Studies, Contrast Media, Sinus Thrombosis, Intracranial diagnostic imaging
Abstract

Background and Purpose: Assessment of cerebral venous sinus thrombosis on MR imaging can be challenging. The aim of this study was to evaluate the diagnostic accuracy of high-resolution 3D T2 sampling perfection with application-optimized contrasts by using different flip angle evolution (SPACE) in patients with cerebral venous sinus thrombosis and to compare its performance with contrast-enhanced 3D T1-MPRAGE., Materials and Methods: We performed a blinded retrospective analysis of T2-SPACE and contrast-enhanced MPRAGE sequences from patients with cerebral venous sinus thrombosis and a control group. The results were compared with a reference standard, which was based on all available sequences and clinical history. Subanalyses were performed according to the venous segment involved and the clinical stage of the thrombus., Results: Sixty-three MR imaging examinations from 35 patients with cerebral venous sinus thrombosis and 51 examinations from 40 control subjects were included. The accuracy, sensitivity, and specificity calculated from the initial MR imaging examination for each patient were 100% each for T2-SPACE and 95%, 91%, and 98%, respectively, for contrast-enhanced MPRAGE. The interrater reliability was high for both sequences. In the subanalysis, the accuracy for each venous segment involved and if subdivided according to the clinical stage of thrombus was ≥95% and ≥85% for T2-SPACE and contrast-enhanced MPRAGE, respectively., Conclusions: Both T2-SPACE and contrast-enhanced MPRAGE offer high accuracy for the detection and exclusion of cerebral venous sinus thrombosis; however, T2-SPACE showed a better overall performance and thus could be a useful tool if included in a multiparametric MR imaging protocol for the diagnosis of cerebral venous sinus thrombosis, especially in scenarios where gadolinium administration is contraindicated., (© 2022 by American Journal of Neuroradiology.)

Published
2022
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20. Outcomes after reperfusion therapies in patients with ACA stroke: A multicenter cohort study from the EVATRISP collaboration.

Author

Filioglo A, Simaan N, Honig A, Heldner MR, von Rennenberg R, Pezzini A, Padjen V, Rentzos A, Altersberger VL, Baumgartner P, Zini A, Grisendi I, Aladdin S, Gomori JM, Pilgram-Pastor SM, Scheitz JF, Magoni M, Berisavac I, Nordanstig A, Psychogios M, Luft A, Gentile M, Assenza F, Arnold M, Nolte CH, Gamba M, Ercegovac M, Jood K, Engelter ST, Wegener S, Forlivesi S, Zedde M, Gensicke H, Tatlisumak T, Cohen JE, and Leker RR

Subjects
Cohort Studies, Fibrinolytic Agents therapeutic use, Humans, Reperfusion, Thrombectomy, Thrombolytic Therapy, Treatment Outcome, Brain Ischemia complications, Brain Ischemia drug therapy, Endovascular Procedures, Stroke drug therapy
Abstract

Background: Patients with stroke secondary to occlusions of the anterior cerebral artery (ACA) often have poor outcomes. The optimal acute therapeutic intervention for these patients remains unknown., Methods: Patients with isolated ACA-stroke were identified from 10 centers participating in the EndoVascular treatment And ThRombolysis in Ischemic Stroke Patients (EVATRISP) prospective registry. Patients treated with endovascular thrombectomy (EVT) were compared to those treated with intravenous thrombolysis (IVT). Odds ratios with 95% confidence intervals (OR; 95%CI) were calculated using multivariate regression analysis., Results: Included were 92 patients with ACA-stroke. Of the 92 ACA patients, 55 (60%) were treated with IVT only and 37 (40%) with EVT (±bridging IVT). ACA patients treated with EVT had more often wake-up stroke (24% vs. 6%, p = 0.044) and proximal ACA occlusions (43% vs. 24%, p = 0.047) and tended to have higher stroke severity on admission [NIHSS: 10.0 vs 7.0, p = 0.054). However, odds for favorable outcome, mortality or symptomatic intracranial hemorrhage did not differ significantly between both groups. Exploration of the effect of clot location inside the ACA showed that in patients with A1 or A2/A3 ACA occlusions the chances of favorable outcome were not influenced by treatment allocation to IVT or EVT., Discussion: Treatment with either IVT or EVT could be safe with similar effect in patients with ACA-strokes and these effects may be independent of clot location within the occluded ACA., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Published
2022
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21. Secondary Cerebrovascular Prevention in Light of the COVID-19 Pandemic.

Author

Padlina G, Bellwald S, Maurer A, and Heldner MR

Abstract

Background: The COVID-19 pandemic has affected healthcare systems, professionals and patients around the world. At the same time, the burden of cerebrovascular events is considerable. Worldwide, more than one million deaths per year are due to cerebrovascular events, which are the second most frequent cause of death and the main cause of long-term disability in Europe. To approach the challenges of the COVID-19 pandemic and secondary cerebrovascular prevention., Conclusion: We recommend:(1) As in normal times, during the COVID-19 pandemic wave, patients need to seek urgent medical attention in case of any acute cerebrovascular event. This will assure they receive needed rapid cerebrovascular secondary prevention in addition to acute intravenous and endovascular reperfusion strategies.(2) As in normal times, during the COVID-19 pandemic wave, it is of utmost importance that patients adhere to their individual recommendations for secondary prevention.(3) Optimal secondary but also primary cerebrovascular prevention might reduce the burden of COVID-19 now and during potential subsequent waves.(4) Patients with cerebrovascular disease should strictly adhere to advice concerning the pandemic provided by their governments and to pandemic-related recommendations for them as individuals expressed by their treating physicians., (© Springer Science+Business Media, LLC, part of Springer Nature 2020.)

Published
2020
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22. Availability of secondary prevention services after stroke in Europe: An ESO/SAFE survey of national scientific societies and stroke experts.

Author

Webb A, Heldner MR, Aguiar de Sousa D, Sandset EC, Randall G, Bejot Y, van der Worp B, Caso V, and Fischer U

Abstract

Background: Recurrent stroke is associated with increased disability and cognitive impairment, but the availability of secondary prevention measures after transient ischaemic attack (TIA) or stroke in Europe is uncertain. This limits prioritisation of investment and development of national stroke strategies., Methods: National stroke representatives throughout Europe were surveyed. Consensus panels reported national data if available, or else expert opinion, estimating the availability of each intervention by quintiles of patients, dichotomised for analysis at 60%. Countries were classified into tertiles of gross domestic product per capita., Results: Of 50 countries, 46 responded; 14/45 (31%) had national stroke registries and 25/46 (54.3%) had national stroke strategies incorporating secondary prevention. Respondents reported that the majority of TIA patients were assessed by specialist services within 48 hours in 74.4% of countries, but in nine countries more than 20% of patients were seen after more than seven days and usually assessed by non-specialists (7/46 countries). Eighty percent of countries deferred blood pressure assessment to primary care, whilst lifestyle management programmes were commonly available in only 46% of countries. Although basic interventions were widely available, interventions frequently not available to more than 60% of patients included: ambulatory cardiac monitoring (40% countries); prescription (26%) and continuation (46%) of statins; blood pressure control at follow-up (44%); carotid endarterectomy within one month (15%); face-to-face follow-up in hospital (33%); direct oral anticoagulants (21%). Gross domestic product per capita and reimbursement of interventions were the commonest predictors of availability of interventions., Conclusions: Provision of secondary prevention varied, with gaps in care prevalent throughout Europe, particularly in lower income countries.

Published
2019
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23. Reasons for Reperfusion Failures in Stent-Retriever-Based Thrombectomy: Registry Analysis and Proposal of a Classification System.

Author

Kaesmacher J, Gralla J, Mosimann PJ, Zibold F, Heldner MR, Piechowiak E, Dobrocky T, Arnold M, Fischer U, and Mordasini P

Subjects
Aged, Cohort Studies, Female, Humans, Male, Middle Aged, Registries, Reperfusion, Stents, Thrombectomy instrumentation, Stroke surgery, Thrombectomy methods, Treatment Failure
Abstract

Background and Purpose: In 5%-10% of patients with acute ischemic stroke with an intention to treat with mechanical thrombectomy, no reperfusion can be achieved (Thrombolysis in Cerebral Infarction score = 0/1). Purpose of this analysis was a systematic assessment of underlying reasons for reperfusion failures., Materials and Methods: An intention-to-treat single-center cohort ( n = 592) was re-evaluated for all patients in whom no reperfusion could be achieved ( n = 63). Baseline characteristics of patients were compared between patients with and without reperfusion failures. After qualitative review of all cases with reperfusion failures, a classification system was proposed and relative frequencies were reported. In a second step, occurrence of delayed recanalization at 24 hours after reperfusion failure and dependency on IV-tPA were evaluated., Results: In 63/592 patients with an intention to perform stent-retriever thrombectomy, no reperfusion was achieved (TICI 0/1, 10.6%, 95% CI, 8.2%-13.1%). Older patients (adjusted OR per yr = 1.03; 95% CI, 1.01-1.05) and patients with M2 occlusion (adjusted OR = 3.36; 95% CI, 1.82-6.21) were at higher risk for reperfusion failure. In most cases, no reperfusion was a consequence of technical difficulties (56/63, 88.9%). In one-third of these cases, reperfusion failures were due to the inability to reach the target occlusion (20/63, 31.7%), while "stent-retriever failure" occurred in 39.7% (25/63) of patients. Delayed recanalization was very rare (18.2%), without dependence on IV-tPA pretreatment status., Conclusions: Reasons for reperfusion failure in stent-retriever thrombectomy are heterogeneous. The failure to establish intracranial or cervical access is almost as common as stent-retriever failure after establishing intracranial access. Systematic reporting standards of reasons may help to further estimate relative frequencies and thereby guide priorities for technical development and scientific effort., (© 2018 by American Journal of Neuroradiology.)

Published
2018
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24. Technical feasibility and application of mechanical thrombectomy with the Solitaire FR Revascularization Device in acute basilar artery occlusion.

Author

Mordasini P, Brekenfeld C, Byrne JV, Fischer U, Arnold M, Heldner MR, Lüdi R, Mattle HP, Schroth G, and Gralla J

Subjects
Aged, Aged, 80 and over, Equipment Design, Equipment Failure Analysis, Feasibility Studies, Female, Humans, Male, Middle Aged, Radiography, Treatment Outcome, Cerebral Revascularization instrumentation, Mechanical Thrombolysis instrumentation, Vertebrobasilar Insufficiency diagnostic imaging, Vertebrobasilar Insufficiency surgery
Abstract

Background and Purpose: Acute BAO is a devastating neurological condition associated with a poor clinical outcome and a high mortality rate. Recanalization has been identified as a major prognostic factor for good outcome in BAO. Mechanical thrombectomy using retrievable stents is an emerging treatment option for acute stroke. First clinical trials using stent retrievers have shown promising high recanalization rates. However, these studies mainly included large artery occlusions in the anterior circulation with only a few or single cases of BAO. Therefore, the purpose of this study was to evaluate technical feasibility, safety, and efficacy of mechanical thrombectomy using retrievable stent in the treatment of acute BAO., Materials and Methods: Fourteen consecutive patients with BAO undergoing endovascular therapy using retrievable stents (Solitaire FR Revascularization Device) were included. Additional multimodal treatment approaches included thromboaspiration, intravenous and/or intra-arterial thrombolysis, and PTA/ permanent stent placement. Recanalization rates after multimodal therapy and stent retrieval were determined. Clinical outcome and mortality were assessed 3 months after treatment., Results: Median patient age was 64.5 years (range 55-85). Median NIHSS score at presentation was 21 (range 5-36). Overall, successful recanalization (TICI 3 or 2b) was achieved in all patients (TICI 3 in 78.6%, 11/14). In 4 patients (28.6%), insufficient recanalization after stent retrieval was due to an underlying atherosclerotic stenosis. Additional deployment of a permanent intracranial stent was performed in 3 patients (21.4%) and PTA alone in 1 patient (7.1%), resulting in final TICI 3 in 1 patient and TICI 2b in 3 patients. Stent retrieval alone was performed in 4 patients (28.6%). Average number of device passes was 1.3 (range 1-3). Median procedure time to maximal recanalization was 47 minutes (range 10-252). No device-related complications or thromboembolic occlusion of a previously unaffected artery occurred. There was no symptomatic intracranial hemorrhage. At 3 months, good functional outcome (mRS 0-2) was observed in 28.6% (4/14); overall mortality was 35.7% (5/14)., Conclusions: A multimodal endovascular approach using retrievable stents in BAO has high recanalization rates, with very low complication rates. Underlying atherothrombotic stenotic lesions of the basilar artery may still necessitate additional permanent stent placement to achieve complete recanalization.

Published
2013
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