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4 results on '"Maria Pia Prontera"'

1. Longitudinal Study on Low-Dose Aspirin versus Placebo Administration in Silent Brain Infarcts: The Silence Study

Author

Ilaria Maestrini, Marta Altieri, Laura Di Clemente, Edoardo Vicenzini, Patrizia Pantano, Eytan Raz, Mauro Silvestrini, Leandro Provinciali, Isabella Paolino, Carmine Marini, Matteo Di Giuseppe, Tommasina Russo, Francesco Federico, Cristiana Coppola, Maria Pia Prontera, Domenico Maria Mezzapesa, Vincenzo Lucivero, Lucilla Parnetti, Paola Sarchielli, Maria Peducci, Domenico Inzitari, Giovanna Carlucci, Carlo Serrati, Carla Zat, Anna Cavallini, Alessandra Persico, Giuseppe Micieli, Stefano Bastianello, and Vittorio Di Piero

Subjects
Neurology. Diseases of the nervous system, RC346-429
Abstract

Background. We investigated low-dose aspirin (ASA) efficacy and safety in subjects with silent brain infarcts (SBIs) in preventing new cerebrovascular (CVD) events as well as cognitive impairment. Methods. We included subjects aged ≥45 years, with at least one SBI and no previous CVD. Subjects were followed up to 4 years assessing CVD and SBI incidence as primary endpoint and as secondary endpoints: (a) cardiovascular and adverse events and (b) cognitive impairment. Results. Thirty-six subjects received ASA while 47 were untreated. Primary endpoint occurred in 9 controls (19.1%) versus 2 (5.6%) in the ASA group (p=0.10). Secondary endpoints did not differ in the two groups. Only baseline leukoaraiosis predicts primary [OR 5.4 (95%CI 1.3-22.9, p=0.022)] and secondary endpoint-a [3.2 (95%CI 1.1-9.6, p=0.040)] occurrence. Conclusions. These data show an increase of new CVD events in the untreated group. Despite the study limitations, SBI seems to be a negative prognostic factor and ASA preventive treatment might improve SBI prognosis. EU Clinical trial is registered with EudraCT Number: 2005-000996-16; Sponsor Protocol Number: 694/30.06.04.

Published
2018
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2. Direct thrombectomy for stroke in the presence of absolute exclusion criteria for thrombolysis

Author

Paolo Invernizzi, Roberto Menozzi, Federico Carimati, Cristina Dell’Aera, Maria Ruggiero, Mauro Gentile, Bruno Bonetti, Giuseppe Ganci, Stefano Barbero, Patrizia Nencini, Rossana Tassi, Marina Mannino, Simona Sacco, Umberto Scoditti, Ilaria Casetta, Davide Castellano, Luigi Simonetti, Maria Pia Prontera, Luigi Chiumarulo, Lucio Castellan, Stefano Forlivesi, Mauro Magoni, Valentina Saia, Francesco Causin, Alfredo Petrone, Giovanni Orlandi, Nicola Limbucci, Sandra Bracco, Alfonsina Casalena, Ettore Nicolini, Elisa Francesca Maria Ciceri, Nicola Cavasin, Manuel Corato, Guido Squassina, Manuel Cappellari, Annalisa Sugo, Cinzia Finocchi, Federica Schirru, Sergio Vinci, Fabrizio Sallustio, Nunzio Paolo Nuzzi, Wiliam Auteri, Roberto Gasparotti, Valerio Da Ros, Marco Petruzzelli, Pietro Amistà, Pietro Filauri, Guido Bigliardi, Mauro Bergui, Domenico Inzitari, Giuseppe Carità, Alessandro Sgreccia, Cristiano Azzini, Andrea Naldi, Edoardo Puglielli, Giuseppe Craparo, Stefano Vallone, Nicola Burdi, Giulio Guidetti, G Lazzarotti, R. Cavallo, Samuele Cioni, Sara Biguzzi, Salvatore Mangiafico, Federica Viaro, Danilo Toni, Adriana Critelli, Giovanni Pracucci, Maria Federica Denaro, Andrea Zini, and Carlo Pellegrino

Subjects
medicine.medical_specialty, medicine.medical_treatment, Brain Ischemia/drug therapy, Brain Ischemia, NO, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Hematoma, Fibrinolytic Agents, Outcome, Stroke, Thrombectomy, Thrombolysis, Humans, Thrombolytic Therapy, Treatment Outcome, Modified Rankin Scale, Internal medicine, Occlusion, Medicine, 030212 general & internal medicine, Neuroradiology, Intracerebral hemorrhage, business.industry, medicine.disease, Neurology, Cohort, Cardiology, Neurology (clinical), business, 030217 neurology & neurosurgery, Cohort study
Abstract

Intravenous thrombolysis (IVT)-ineligible patients undergoing direct thrombectomy tended to have poorer functional outcome as compared with IVT-eligible patients undergoing bridging therapy. We aimed to assess radiological and functional outcomes in large vessel occlusion-related stroke patients receiving direct thrombectomy in the presence of absolute exclusion criteria for IVT vs relative exclusion criteria for IVT and vs non-exclusion criteria for IVT. A cohort study on prospectively collected data from 2282 patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke cohort for treatment with direct thrombectomy (n = 486, absolute exclusion criteria for IVT alone; n = 384, absolute in combination with relative exclusion criteria for IVT; n = 777, relative exclusion criteria for IVT alone; n = 635, non-exclusion criteria for IVT). After adjustment for unbalanced variables (model 1), ORs for 3-month death was higher in the presence of absolute exclusion criteria for IVT alone (vs relative exclusion criteria for IVT alone) (1.595, 95% CI 1.042–2.440) and in the presence of absolute exclusion criteria for IVT alone (vs non-exclusion criteria for IVT) (1.235, 95% CI 1.014–1.504). After adjustment for predefined variables (model 2: age, sex, pre-stroke mRS ≤ 1, NIHSS, occlusion in the anterior circulation, onset-to-groin time, and procedure time), ORs for 3-month death was higher in the presence of absolute exclusion criteria for IVT alone (vs relative exclusion criteria for IVT alone) (1.235, 95% CI 1.014–1.504) and in the presence of absolute exclusion criteria for IVT alone (vs non-exclusion criteria for IVT) (1.246, 95% CI 1.039–1.495). No significant difference was found between the groups as regards any type of intracerebral hemorrhage and parenchymal hematoma within 24 h, successful and complete recanalization after procedure, and modified Rankin Scale score 0–2 at 3 months. After adjustment for predefined variables of model 2, ORs for death were higher in the presence of recent administration of IV heparin (OR: 2.077), platelet count

Published
2020
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3. Comparison Between Three Commonly Used Large-Bore Aspiration Catheters in Terms of Successful Recanalization and First-Passage Effect

Author

Alessandra Briatico, Vittorio Semeraro, Francesco D'Argento, Maria Porzia Ganimede, Iacopo Valente, Sofia Vidali, Carmine Di Stasi, Fabrizio Sallustio, Andrea Romi, Maria Pia Prontera, Pietro Trombatore, Alfredo Berardelli, Emilio Lozupone, Alessandro Pedicelli, Giovanni Boero, Nicola Burdi, Marina Diomedi, Andrea Alexandre, and Roberto Gandini

Subjects
Male, medicine.medical_specialty, Logistic regression, Settore MED/26, First-passage effect, 03 medical and health sciences, 0302 clinical medicine, Stroke—Aspiration catheters—First-passage effect—Mechanical thrombectomy, Settore MED/36, Medicine, Aspiration catheters, Humans, Middle cerebral artery occlusion, Stroke, Aged, Ischemic Stroke, Retrospective Studies, Thrombectomy, Aged, 80 and over, business.industry, Rehabilitation, Endovascular Procedures, Infarction, Middle Cerebral Artery, Equipment Design, Middle Aged, medicine.disease, Surgery, Mechanical thrombectomy, Catheter, Treatment Outcome, Multicenter study, Italy, Population study, Observational study, Female, Neurology (clinical), Cardiology and Cardiovascular Medicine, business, 030217 neurology & neurosurgery, Vascular Access Devices
Abstract

To compare three commonly used large-bore aspiration catheters in terms of final successful recanalization rate and first-passage successful and complete recanalization rates (the so called "first-passage effect").it is an observational retrospective multicenter study conducted in three Italian high-volume tertiary stroke centers between January 2017 and May 2019. The study population included all consecutive patients with an ischemic stroke due to middle cerebral artery occlusion (M1 segment only) that underwent intra-arterial mechanical thrombectomy with contact aspiration as first-line strategy within 24 hours from symptoms onset.Three hundred twenty-one patients were included in the study. Multivariable logistic regression analysis comparing the three catheters revealed no differences in terms of successful recanalization. Sofia 6 Plus catheter was associated with better first-passage successful recanalization [OR, 9.09; 95% CI, 2.66-31.03] (p0.001) and first-passage complete recanalization [OR: 3.73; 95% CI: 1.43-9.72] (p=0.007) whereas rt-PA was associated with worse first-passage recanalization [OR: 0.52; 95% CI: 0.29-0.93] (p=0.028).No differences between the three catheters were reported in terms of successful recanalization. Sofia 6 Plus has proven to be superior in achieving both successful and complete first-passage recanalization. Conversely, rt-PA was found to be a negative predicting factor of first-passage effect.

Published
2020

4. Complications of mechanical thrombectomy for acute ischemic stroke: Incidence, risk factors, and clinical relevance in the Italian Registry of Endovascular Treatment in acute stroke

Author

Nicola Cavasin, Delfina Ferrandi, Danilo Toni, Monia Russo, Simona Sacco, Salvatore Mangiafico, William Auteri, Nunzio Paolo Nuzzi, Mirco Cosottini, Luca Di Maggio, Monica Bandettini di Poggio, Paolo Invernizzi, Valentina Saia, Edoardo Puglielli, Marco Mauri, Lilia Latte, Maria Porzia Ganimede, Anne Falcou, Andrea Grazioli, Francesco Causin, Mauro Magoni, Pietro Amistà, Roberto Menozzi, Alessio Comai, Giacomo Della Marca, Valeria Piras, Andrea Naldi, Enrica Franchini, Tiziana Tassinari, Salvatore Isceri, Alfonsina Casalena, Roberto Gasparotti, Stefano Vallone, Isabella Francalanza, Marco Petruzzellis, Andrea Zini, Francesco Cordici, Christian Commodaro, Andrea Wlderk, Francesco Pintus, Stefano Forlivesi, Nicola Mavilio, Giuseppe Carità, Antonio Baule, Mariano Velo, Giuseppina Sanfilippo, Manuel Corato, Nicola Limbucci, Lucio Castellan, Marina Mannino, Gianpaolo Toscano, Maria Pia Prontera, Laura Malfatto, Giancarlo Salsano, Paolo Cerrato, Critelli Adriana, Giorgianni Andrea, Alfredo Petrone, Andrea Alexandre, Gianluca Deiana, Giuseppe Ganci, Giovanni Pracucci, Rossana Tassi, Giovanni Dui, Cristiano Azzini, Guido Squassina, Guido Bigliardi, Mauro Bergui, Claudio Baracchini, Giuseppe Craparo, Michelangelo Mancuso, Carlo Cirelli, Simona Corraine, Patrizia Nencini, Luigi Chiumarulo, Paola Gennari, Ivan Gallesio, and Fabrizio Sallustio

Subjects
medicine.medical_specialty, acute ischemic stroke, thrombolysis, Complications, Italy, cerebral infarction, endovascular stroke therapy, mechanical thrombectomy, risk factors, stroke incidence, medicine.medical_treatment, 030204 cardiovascular system & hematology, Brain Ischemia, 03 medical and health sciences, 0302 clinical medicine, Humans, Incidence, Registries, Risk Factors, Thrombectomy, Treatment Outcome, Endovascular Procedures, Ischemic Stroke, Stroke, Internal medicine, medicine, Clinical significance, Cumulative incidence, Endovascular treatment, Acute ischemic stroke, Cerebral infarction, business.industry, Incidence (epidemiology), Thrombolysis, medicine.disease, Brain Ischemia/epidemiology *Ischemic Stroke Italy/epidemiology Registries Risk Factors *Stroke/epidemiology/therapy Thrombectomy/*adverse effects Treatment Outcome Complications Italy acute ischemic stroke cerebral infarction endovascular stroke therapy mechanical thrombectomy stroke incidence thrombolysis, Mechanical thrombectomy, Neurology, Cardiology, business, 030217 neurology & neurosurgery
Abstract

Background There are limited data concerning procedure-related complications of endovascular thrombectomy for large vessel occlusion strokes. Aims We evaluated the cumulative incidence, the clinical relevance in terms of increased disability and mortality, and risk factors for complications. Methods From January 2011 to December 2017, 4799 patients were enrolled by 36 centers in the Italian Registry of Endovascular Stroke Treatment. Data on demographic and procedural characteristics, complications, and clinical outcome at three months were prospectively collected. Results The complications cumulative incidence was 201 per 1000 patients undergoing endovascular thrombectomy. Ongoing antiplatelet therapy (p Conclusions Complications globally considered are not uncommon and may result in poor clinical outcome. Early recognition of risk factors might help to prevent complications and manage them appropriately in order to maximize endovascular thrombectomy benefits.

Published
2020

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