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1. Basilar artery occlusion management: An international survey of middle versus high-income countries.

Author

Drumm, Brian, Herning, Ana, Klein, Piers, Raymond, Jean, Abdalkader, Mohamad, Huo, Xiaochuan, Chen, Yimin, Siegler, James E., Peacock, Meabh, Schonewille, Wouter J., Liu, Xinfeng, Hu, Wei, Ji, Xunming, Li, Chuanhui, Alemseged, Fana, Liu, Liping, Nagel, Simon, Strbian, Daniel, Rebello, Leticia C., and Yaghi, Shadi

Subjects
BASILAR artery, HIGH-income countries, ENDOVASCULAR surgery, ARTERIAL occlusions, MIDDLE-income countries
Abstract

Background and Purpose: Two early basilar artery occlusion (BAO) randomized controlled trials (RCTs) did not establish the superiority of endovascular thrombectomy (EVT) over medical management. Yet many providers continued to recommend EVT. The goal of the present article is to compare physicians' diagnostic and management strategies of BAO among middle-income and high-income countries (MICs and HICs, respectively). Methods: We conducted an international survey from January to March 2022 regarding management strategies in acute BAO, to examine clinical and imaging parameters influencing clinician management of patients with BAO. We compared responses between physicians from HIC and MIC. Results: Among the 1245 respondents from 73 countries, 799 (64.2%) were from HIC, with the remaining 393 (31.6%) from MIC. Most respondents perceived that EVT was superior to medical management for acute BAO, but more so in respondents from HIC (98.0% vs. 94.2%, p < 0.01). MIC respondents were more likely to believe further RCTs were warranted (91.6% vs. 74.0%, p < 0.01) and were more likely to find it acceptable to enroll any patient who met a trial's criteria in the standard medical treatment arm (58.8% vs. 38.5%, p < 0.01). Conclusions: In an area where clinical equipoise was called into question despite the lack of RCT evidence, we found that respondents from MIC were more likely to express willingness to enroll patients with BAO in an RCT than their HIC counterparts. [ABSTRACT FROM AUTHOR]

Published
2024
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2. Site Experience and Outcomes in the Trevo Acute Ischemic Stroke (TRACK) Multicenter Registry: Higher Volumes Translate in Better Outcomes

Author

Nogueira, Raul G., Haussen, Diogo C., Castonguay, Alicia, Rebello, Leticia C., Abraham, Michael, Puri, Ajit, Alshekhlee, Amer, Majjhoo, Aniel, Farid, Hamed, Finch, Ira, English, Joey, Mokin, Maxim, Froehler, Michael T., Kabbani, Mo, Taqi, Muhammad A., Vora, Nirav, Khoury, Ramy El, Edgell, Randall C., Novakovic, Roberta, Nguyen, Thanh, Janardhan, Vallabh, Veznedaroglu, Enrol, Prabhakaran, Shyam, Budzik, Ron, Frankel, Michael R., Nordhaus, Brittany L., and Zaidat, Osama O.

Published
2019
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4. Global Impact of the COVID-19 Pandemic on Stroke Volumes and Cerebrovascular Events: A 1-Year Follow-up

Author

Society of Vascular and Interventional Neurology (US), Nguyen, Thanh N., Qureshi, Muhammad M., Klein, Piers, Yamagami, Hiroshi, Mikulik, Robert, Czlonkowska, Anna, Abdalkader, Mohamad, Sedova, Petra, Sathya, Anvitha, Lo, Hannah C., Mansour, Ossama Yassin, Vanguru, Husitha Reddy, Lesaine, Emilie, Tsivgoulis, Georgios, Loochtan, Aaron I., Demeestere, Jelle, Uchino, Ken, Inoa, Violiza, Goyal, Nitin, Charidimou, Andreas, Siegler, James E., Yaghi, Shadi, Aguiar de Sousa, Diana, Mohammaden, Mahmoud H., Haussen, Diogo C., Kristoffersen, Espen Saxhaug, Lereis, Virginia Pujol, Scollo, Sergio Daniel, Campbell, Bruce C. V., Ma, Alice, Thomas, James Orton, Parsons, Mark W., Singhal, Shaloo, Slater, Lee-Anne, Tomazini Martins, Rodrigo, Enzinger, Chris, Gattringer, Thomas, Rahman, Aminur, Bonnet, Thomas, Ligot, Noemie, De Raedt, Sylvie, Lemmens, Robin, Vanacker, Peter, Vandervorst, Fenne, Conforto, Adriana Bastos, Hidalgo, Raquel C. T., Neves, Luciana de Oliveira, Martins, Rodrigo Targa, Mora Cuervo, Daissy Liliana, Rebello, Leticia C., Santiago, Igor Bessa, Silva, Isabelle Lameirinhas da, Sakelarova, Teodora, Kalpachki, Rosen, Alexiev, Filip, Catanese, Luciana, Cora, Elena Adela, Goyal, Mayank, Hill, Michael D., Kelly, Michael E., Khosravani, Houman, Lavoie, Pascale, Peeling, Lissa, Pikula, Aleksandra, Rivera, Rodrigo, Chen, Hui-Sheng, Chen, Yimin, Huo, Xiaochuan, Miao, Zhongrong, Yang, Shuiquan, Bedekovic, Marina Roje, Bralic, Marina, Budincevic, Hrvoje, Corredor-Quintero, Ángel Basilio, Lara-Sarabia, Osvaldo E., Cabal, Martin, Tenora, Dusan, Fibrich, Petr, Herzig, Roman, Hlaváčová, Helena, Hrabanovska, Emanuela, Hlinovsky, David, Jurak, Lubomir, Kadlcikova, Jana, Karpowicz, Igor, Klecka, Lukas, Kovar, Martin, Lauer, David, Neumann, Jiri, Palouskova, Hana, Reiser, Martin, Rekova, Petra, Rohan, Vladimir, Skoda, Ondrej, Škorňa, Miroslav, Sobotková, Lenka, Sramek, Martin, Zakova, Lenka, Christensen, Hanne, Drenck, Nicolas, Iversen, Helle Klingenberg, Truelsen, Thomas Clement, Wienecke, Troels, Sobh, Khalid, Ylikotila, Pauli, Alpay, Kemal, Strbian, Daniel, Bernady, Patricia, Casenave, Philippe, Dan, Maria, Faucheux, Jean-Marc, Gentric, Jean-Christophe, Magro, Elsa, Sabben, Candice, Reiner, Peggy, Rouanet, Francois, Bohmann, Ferdinand O., Boskamp, Stefan, Mbroh, Joshua, Nagel, Simon, Nolte, Christian H, Ringleb, Peter A., Rosenkranz, Michael, Poli, Sven, Thomalla, Götz, Karapanayiotides, Theodoros, Koutroulou, Ioanna, Kargiotis, Odysseas, Palaiodimou, Lina, Barrientos Guerra, José Domingo, Huded, Vikram, Menon, Bindu, Nagendra, Shashank, Prajapati, Chintan, Sylaja, P. N., Krishna Pramana, Nyoman Angga, Sani, Achmad Firdaus, Ghoreishi, Abdoreza, Farhoudi, Mehdi, Hokmabadi, Elyar Sadeghi, Raya, Tariq Abu, Kalmanovich, Shani Avnery, Ronen, Levite, Sabetay, Sergiu Ionut, Acampa, Maurizio, Adami, Alessandro, Castellan, Lucio, Longoni, Marco, Ornello, Raffaele, Renieri, Leonardo, Bigliani, Claudia Rolla, Romoli, Michele, Sacco, Simona, Salmaggi, Andrea, Sangalli, Davide, Zini, Andrea, Doijiri, Ryosuke, Fukuda, Hiroki, Fujinaka, Toshiyuki, Fujita, Kyohei, Imamura, Hirotoshi, Sakai, Nobuyuki, Kanamaru, Takuya, Kimura, Naoto, Kono, Ryuhei, Miyake, Kosuke, Sakaguchi, Manabu, Sakai, Kenichiro, Sonoda, Kazutaka, Todo, Kenichi, Miyashita, Fumio, Tokuda, Naoki, Matsumaru, Yuji, Matsumoto, Shoji, Ohara, Nobuyuki, Shindo, Seigo, Takenobu, Yohei, Yoshimoto, Takeshi, Toyoda, Kazunori, Uwatoko, Takeshi, Yagita, Yoshiki, Yamada, Takehiro, Yamamoto, Nobuaki, Yamamoto, Ryoo, Yazawa, Yukako, Sugiura, Yuri, Waweru, Peter Kuria, Baek, Jang-Hyun, Lee, Si Baek, Seo, Kwon-Duk, Sohn, Sung-Il, Arsovska, Anita Ante, Chan, Yong Chieh, Wan Zaidi, Wan Asyraf, Jaafar, Ainul Syahrilfazli, Gongora-Rivera, Fernando, Martinez-Marino, Manuel, Infante-Valenzuela, Adrian, Groppa, Stanislav, Leahu, Pavel, Coutinho, Jonathan M, Rinkel, Leon A., Dippel, Diederik W. J., Dam-Nolen, Dianne H. K. van, Ranta, Annemarei, Wu, Teddy Y., Adebayo, Tajudeen Temitayo, Bello, Abiodun H., Nwazor, Ernest Okwundu, Sunmonu, Taofiki Ajao, Wahab, Kolawole Wasiu, Ronning, Ole Morten, Sandset, Else Charlotte, Al Hashmi, Amal M., Ahmad, Saima, Rashid, Umair, Rodriguez-Kadota, Liliana, Vences, Miguel Ángel, Yalung, Patrick Matic, Hao Dy, Jon Stewart, Pineda-Franks, Maria Carissa, Co, Christian Oliver, Brola, Waldemar, Debiec, Aleksander, Dorobek, Malgorzata, Karlinski, Michal Adam, Labuz-Roszak, Beata M., Lasek-Bal, Anetta, Sienkiewicz-Jarosz, Halina, Staszewski, Jacek, Sobolewski, Piotr, Wiacek, Marcin, Zielinska-Turek, Justyna, Araujo, Andre Pinho, Rocha, Mariana, Castro, Pedro, Cruz, Vitor Tedim, Ferreira, Paulo Venancio, Ferreira, Patricia, Nunes, Ana Paiva, Fonseca, Luisa, Marto, João Pedro, Pinho E Melo, Teresa, Rodrigues, Miguel, Silva, M. Luis, Dimitriade, Adela, Falup-Pecurariu, Cristian, Hamid, May Adel, Venketasubramanian, Narayanaswamy, Krastev, Georgi, Mako, Miroslav, Ayo-Martin, Oscar, Hernández-Fernández, Francisco, Blasco, Jordi, Rodríguez-Vázquez, Alejandro, Cruz-Culebras, Antonio, Moniche, Francisco, Montaner, Joan, Pérez-Sánchez, Soledad, García Sánchez, María Jesús, Guillán Rodríguez, Marta, Jood, Katarina, Nordanstig, Annika, Mazya, Michael V., Moreira, Tiago T. P., Bernava, Gianmarco, Beyeler, Morin, Bolognese, Manuel, Carrera, Emmanuel, Dobrocky, Tomas, Karwacki, Grzegorz Marek, Keller, Emanuela, Hsieh, Chang Yang, Boonyakarnkul, Surawan, Churojana, Anchalee, Aykac, Ozlem, Ozdemir, Atilla Ã-Zcan, Bajrami, Arsida, Senadim, Songul, Hussain, Syed Irteza, John, Seby, Banerjee, Soma, Kwan, Joseph, Krishnan, Kailash, Lenthall, Robert, Matthews, Ashok, Wong, Ken, Zhang, Liqun, Altschul, Dorothea, Asif, Kaiz S., Bahiru, Zeelalem, Below, Kristine, Biller, José, Ruland, Sean, Chaudry, Saqib A., Chen, Michael, Chebl, Alex, Cibulka, Jackie, Cistrunk, Leon, Clark, Judith, Colasurdo, Marco, Czap, Alexandra, de Havenon, Adam, D'Amato, Salvatore, Dharmadhikari, Sushrut, Grimmett, Kasey B., Dmytriw, Adam A., Etherton, Mark R., Ezepue, Chizoba, Farooqui, Mudassir, Feske, Steven K., Fink, Lauren, Gasimova, Ulviyya, Guzik, Amy K., Hakemi, Maryam, Hovingh, Majesta, Khan, Muhib, Jillela, Dinesh, Kan, Peter T., Khatri, Rakesh, Khawaja, Ayaz M., Khoury, Naim N., Kiley, Nicole L., Kim, Benny S., Kolikonda, Murali K., Kuhn, Anna Luisa, Lara, Stephanie, Linares, Guillermo, Linfante, Italo, Lukovits, Timothy G., Lycan, Sarah, Male, Shailesh S., Maali, Laith, Mancin, John, Masoud, Hesham, Mohamed, Ghada A., Monteiro, Andre, Nahab, Fadi, Nalleballe, Krishna, Ortega-Gutiérrez, Santiago, Puri, Ajit S, Radaideh, Yazan, Rahangdale, Rahul H., Rai, Ansaar, Ramakrishnan, Pankajavalli, Reddy, Aravind B., Rojas-Soto, Diana M., Romero, José Rafael, Rost, Natalia S., Rothstein, Aaron, Omran, Setareh Salehi, Sheth, Sunil A., Siddiqui, Adnan H., Starosciak, Amy K., Tarlov, Nicholas E., Taylor, Robert A., Wang, Michael J., Wolfe, Jared, Wong, Ka-Ho, Le, Huynh Vu, Nguyen, Quy Viet, Pham, Thong Nhu, Nguyen, Trung Thanh, Phan, Hoang Thi, Ton, Mai Duy, Fischer, Urs, Michel, Patrik, Strambo, Davide, Martins, Sheila O., Zaidat, Osama O., Nogueira, Raul G., Society of Vascular and Interventional Neurology (US), Nguyen, Thanh N., Qureshi, Muhammad M., Klein, Piers, Yamagami, Hiroshi, Mikulik, Robert, Czlonkowska, Anna, Abdalkader, Mohamad, Sedova, Petra, Sathya, Anvitha, Lo, Hannah C., Mansour, Ossama Yassin, Vanguru, Husitha Reddy, Lesaine, Emilie, Tsivgoulis, Georgios, Loochtan, Aaron I., Demeestere, Jelle, Uchino, Ken, Inoa, Violiza, Goyal, Nitin, Charidimou, Andreas, Siegler, James E., Yaghi, Shadi, Aguiar de Sousa, Diana, Mohammaden, Mahmoud H., Haussen, Diogo C., Kristoffersen, Espen Saxhaug, Lereis, Virginia Pujol, Scollo, Sergio Daniel, Campbell, Bruce C. V., Ma, Alice, Thomas, James Orton, Parsons, Mark W., Singhal, Shaloo, Slater, Lee-Anne, Tomazini Martins, Rodrigo, Enzinger, Chris, Gattringer, Thomas, Rahman, Aminur, Bonnet, Thomas, Ligot, Noemie, De Raedt, Sylvie, Lemmens, Robin, Vanacker, Peter, Vandervorst, Fenne, Conforto, Adriana Bastos, Hidalgo, Raquel C. T., Neves, Luciana de Oliveira, Martins, Rodrigo Targa, Mora Cuervo, Daissy Liliana, Rebello, Leticia C., Santiago, Igor Bessa, Silva, Isabelle Lameirinhas da, Sakelarova, Teodora, Kalpachki, Rosen, Alexiev, Filip, Catanese, Luciana, Cora, Elena Adela, Goyal, Mayank, Hill, Michael D., Kelly, Michael E., Khosravani, Houman, Lavoie, Pascale, Peeling, Lissa, Pikula, Aleksandra, Rivera, Rodrigo, Chen, Hui-Sheng, Chen, Yimin, Huo, Xiaochuan, Miao, Zhongrong, Yang, Shuiquan, Bedekovic, Marina Roje, Bralic, Marina, Budincevic, Hrvoje, Corredor-Quintero, Ángel Basilio, Lara-Sarabia, Osvaldo E., Cabal, Martin, Tenora, Dusan, Fibrich, Petr, Herzig, Roman, Hlaváčová, Helena, Hrabanovska, Emanuela, Hlinovsky, David, Jurak, Lubomir, Kadlcikova, Jana, Karpowicz, Igor, Klecka, Lukas, Kovar, Martin, Lauer, David, Neumann, Jiri, Palouskova, Hana, Reiser, Martin, Rekova, Petra, Rohan, Vladimir, Skoda, Ondrej, Škorňa, Miroslav, Sobotková, Lenka, Sramek, Martin, Zakova, Lenka, Christensen, Hanne, Drenck, Nicolas, Iversen, Helle Klingenberg, Truelsen, Thomas Clement, Wienecke, Troels, Sobh, Khalid, Ylikotila, Pauli, Alpay, Kemal, Strbian, Daniel, Bernady, Patricia, Casenave, Philippe, Dan, Maria, Faucheux, Jean-Marc, Gentric, Jean-Christophe, Magro, Elsa, Sabben, Candice, Reiner, Peggy, Rouanet, Francois, Bohmann, Ferdinand O., Boskamp, Stefan, Mbroh, Joshua, Nagel, Simon, Nolte, Christian H, Ringleb, Peter A., Rosenkranz, Michael, Poli, Sven, Thomalla, Götz, Karapanayiotides, Theodoros, Koutroulou, Ioanna, Kargiotis, Odysseas, Palaiodimou, Lina, Barrientos Guerra, José Domingo, Huded, Vikram, Menon, Bindu, Nagendra, Shashank, Prajapati, Chintan, Sylaja, P. N., Krishna Pramana, Nyoman Angga, Sani, Achmad Firdaus, Ghoreishi, Abdoreza, Farhoudi, Mehdi, Hokmabadi, Elyar Sadeghi, Raya, Tariq Abu, Kalmanovich, Shani Avnery, Ronen, Levite, Sabetay, Sergiu Ionut, Acampa, Maurizio, Adami, Alessandro, Castellan, Lucio, Longoni, Marco, Ornello, Raffaele, Renieri, Leonardo, Bigliani, Claudia Rolla, Romoli, Michele, Sacco, Simona, Salmaggi, Andrea, Sangalli, Davide, Zini, Andrea, Doijiri, Ryosuke, Fukuda, Hiroki, Fujinaka, Toshiyuki, Fujita, Kyohei, Imamura, Hirotoshi, Sakai, Nobuyuki, Kanamaru, Takuya, Kimura, Naoto, Kono, Ryuhei, Miyake, Kosuke, Sakaguchi, Manabu, Sakai, Kenichiro, Sonoda, Kazutaka, Todo, Kenichi, Miyashita, Fumio, Tokuda, Naoki, Matsumaru, Yuji, Matsumoto, Shoji, Ohara, Nobuyuki, Shindo, Seigo, Takenobu, Yohei, Yoshimoto, Takeshi, Toyoda, Kazunori, Uwatoko, Takeshi, Yagita, Yoshiki, Yamada, Takehiro, Yamamoto, Nobuaki, Yamamoto, Ryoo, Yazawa, Yukako, Sugiura, Yuri, Waweru, Peter Kuria, Baek, Jang-Hyun, Lee, Si Baek, Seo, Kwon-Duk, Sohn, Sung-Il, Arsovska, Anita Ante, Chan, Yong Chieh, Wan Zaidi, Wan Asyraf, Jaafar, Ainul Syahrilfazli, Gongora-Rivera, Fernando, Martinez-Marino, Manuel, Infante-Valenzuela, Adrian, Groppa, Stanislav, Leahu, Pavel, Coutinho, Jonathan M, Rinkel, Leon A., Dippel, Diederik W. J., Dam-Nolen, Dianne H. K. van, Ranta, Annemarei, Wu, Teddy Y., Adebayo, Tajudeen Temitayo, Bello, Abiodun H., Nwazor, Ernest Okwundu, Sunmonu, Taofiki Ajao, Wahab, Kolawole Wasiu, Ronning, Ole Morten, Sandset, Else Charlotte, Al Hashmi, Amal M., Ahmad, Saima, Rashid, Umair, Rodriguez-Kadota, Liliana, Vences, Miguel Ángel, Yalung, Patrick Matic, Hao Dy, Jon Stewart, Pineda-Franks, Maria Carissa, Co, Christian Oliver, Brola, Waldemar, Debiec, Aleksander, Dorobek, Malgorzata, Karlinski, Michal Adam, Labuz-Roszak, Beata M., Lasek-Bal, Anetta, Sienkiewicz-Jarosz, Halina, Staszewski, Jacek, Sobolewski, Piotr, Wiacek, Marcin, Zielinska-Turek, Justyna, Araujo, Andre Pinho, Rocha, Mariana, Castro, Pedro, Cruz, Vitor Tedim, Ferreira, Paulo Venancio, Ferreira, Patricia, Nunes, Ana Paiva, Fonseca, Luisa, Marto, João Pedro, Pinho E Melo, Teresa, Rodrigues, Miguel, Silva, M. Luis, Dimitriade, Adela, Falup-Pecurariu, Cristian, Hamid, May Adel, Venketasubramanian, Narayanaswamy, Krastev, Georgi, Mako, Miroslav, Ayo-Martin, Oscar, Hernández-Fernández, Francisco, Blasco, Jordi, Rodríguez-Vázquez, Alejandro, Cruz-Culebras, Antonio, Moniche, Francisco, Montaner, Joan, Pérez-Sánchez, Soledad, García Sánchez, María Jesús, Guillán Rodríguez, Marta, Jood, Katarina, Nordanstig, Annika, Mazya, Michael V., Moreira, Tiago T. P., Bernava, Gianmarco, Beyeler, Morin, Bolognese, Manuel, Carrera, Emmanuel, Dobrocky, Tomas, Karwacki, Grzegorz Marek, Keller, Emanuela, Hsieh, Chang Yang, Boonyakarnkul, Surawan, Churojana, Anchalee, Aykac, Ozlem, Ozdemir, Atilla Ã-Zcan, Bajrami, Arsida, Senadim, Songul, Hussain, Syed Irteza, John, Seby, Banerjee, Soma, Kwan, Joseph, Krishnan, Kailash, Lenthall, Robert, Matthews, Ashok, Wong, Ken, Zhang, Liqun, Altschul, Dorothea, Asif, Kaiz S., Bahiru, Zeelalem, Below, Kristine, Biller, José, Ruland, Sean, Chaudry, Saqib A., Chen, Michael, Chebl, Alex, Cibulka, Jackie, Cistrunk, Leon, Clark, Judith, Colasurdo, Marco, Czap, Alexandra, de Havenon, Adam, D'Amato, Salvatore, Dharmadhikari, Sushrut, Grimmett, Kasey B., Dmytriw, Adam A., Etherton, Mark R., Ezepue, Chizoba, Farooqui, Mudassir, Feske, Steven K., Fink, Lauren, Gasimova, Ulviyya, Guzik, Amy K., Hakemi, Maryam, Hovingh, Majesta, Khan, Muhib, Jillela, Dinesh, Kan, Peter T., Khatri, Rakesh, Khawaja, Ayaz M., Khoury, Naim N., Kiley, Nicole L., Kim, Benny S., Kolikonda, Murali K., Kuhn, Anna Luisa, Lara, Stephanie, Linares, Guillermo, Linfante, Italo, Lukovits, Timothy G., Lycan, Sarah, Male, Shailesh S., Maali, Laith, Mancin, John, Masoud, Hesham, Mohamed, Ghada A., Monteiro, Andre, Nahab, Fadi, Nalleballe, Krishna, Ortega-Gutiérrez, Santiago, Puri, Ajit S, Radaideh, Yazan, Rahangdale, Rahul H., Rai, Ansaar, Ramakrishnan, Pankajavalli, Reddy, Aravind B., Rojas-Soto, Diana M., Romero, José Rafael, Rost, Natalia S., Rothstein, Aaron, Omran, Setareh Salehi, Sheth, Sunil A., Siddiqui, Adnan H., Starosciak, Amy K., Tarlov, Nicholas E., Taylor, Robert A., Wang, Michael J., Wolfe, Jared, Wong, Ka-Ho, Le, Huynh Vu, Nguyen, Quy Viet, Pham, Thong Nhu, Nguyen, Trung Thanh, Phan, Hoang Thi, Ton, Mai Duy, Fischer, Urs, Michel, Patrik, Strambo, Davide, Martins, Sheila O., Zaidat, Osama O., and Nogueira, Raul G.

Abstract

Background and Objectives: Declines in stroke admission, IV thrombolysis (IVT), and mechanical thrombectomy volumes were reported during the first wave of the COVID-19 pandemic. There is a paucity of data on the longer-term effect of the pandemic on stroke volumes over the course of a year and through the second wave of the pandemic. We sought to measure the effect of the COVID-19 pandemic on the volumes of stroke admissions, intracranial hemorrhage (ICH), IVT, and mechanical thrombectomy over a 1-year period at the onset of the pandemic (March 1, 2020, to February 28, 2021) compared with the immediately preceding year (March 1, 2019, to February 29, 2020)., Methods: We conducted a longitudinal retrospective study across 6 continents, 56 countries, and 275 stroke centers. We collected volume data for COVID-19 admissions and 4 stroke metrics: ischemic stroke admissions, ICH admissions, IVT treatments, and mechanical thrombectomy procedures. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases., Results: There were 148,895 stroke admissions in the 1 year immediately before compared with 138,453 admissions during the 1-year pandemic, representing a 7% decline (95% CI [95% CI 7.1–6.9]; p < 0.0001). ICH volumes declined from 29,585 to 28,156 (4.8% [5.1–4.6]; p < 0.0001) and IVT volume from 24,584 to 23,077 (6.1% [6.4–5.8]; p < 0.0001). Larger declines were observed at high-volume compared with low-volume centers (all p < 0.0001). There was no significant change in mechanical thrombectomy volumes (0.7% [0.6–0.9]; p = 0.49). Stroke was diagnosed in 1.3% [1.31–1.38] of 406,792 COVID-19 hospitalizations. SARS-CoV-2 infection was present in 2.9% ([2.82–2.97], 5,656/195,539) of all stroke hospitalizations., Discussion: There was a global decline and shift to lower-volume centers of stroke admission volumes, ICH volumes, and IVT volumes during the 1st year of the COVID-19 pandemic compared with the prior year. Mechanical thrombectomy volumes were preserved. These results suggest preservation in the stroke care of higher severity of disease through the first pandemic year., Trial Registration Information: This study is registered under NCT04934020.

Published
2023

5. Global impact of the COVID-19 pandemic on stroke volumes and cerebrovascular events

Author

Nguyen, Thanh N., Qureshi, Muhammad M., Klein, Piers, Yamagami, Hiroshi, Mikulik, Robert, Czlonkowska, Anna, Abdalkader, Mohamad, Sedova, Petra, Sathya, Anvitha, Lo, Hannah C., Mansour, Ossama Yassin, Iversen, Helle Klingenberg, Truelsen, Thomas Clement, Wienecke, Troels, Sobh, Khalid, Ylikotila, Pauli, Alpay, Kemal, Strbian, Daniel, Bernady, Patricia, Casenave, Philippe, Dan, Maria, Vanguru, Husitha Reddy, Faucheux, Jean-Marc, Gentric, Jean-Christophe, Magro, Elsa, Sabben, Candice, Reiner, Peggy, Rouanet, Francois, Bohmann, Ferdinand O., Boskamp, Stefan, Mbroh, Joshua, Nagel, Simon, Lesaine, Emilie, Nolte, Christian H., Ringleb, Peter A., Rosenkranz, Michael, Poli, Sven, Thomalla, Götz, Karapanayiotides, Theodoros, Koutroulou, Ioanna, Kargiotis, Odysseas, Palaiodimou, Lina, Barrientos Guerra, Jose Dominguo, Tsivgoulis, Georgios, Huded, Vikram, Menon, Bindu, Nagendra, Shashank, Prajapati, Chintan, Sylaja, P.N., Krishna Pramana, Nyoman Angga, Sani, Achmad Firdaus, Ghoreishi, Abdoreza, Farhoudi, Mehdi, Hokmabadi, Elyar Sadeghi, Loochtan, Aaron I., Raya, Tariq Abu, Kalmanovich, Shani Avnery, Ronen, Levite, Sabetay, Sergiu Ionut, Acampa, Maurizio, Adami, Alessandro, Castellan, Lucio, Longoni, Marco, Ornello, Raffaele, Renieri, Leonardo, Demeestere, Jelle, Bigliani, Claudia Rolla, Romoli, Michele, Sacco, Simona, Salmaggi, Andrea, Sangalli, Davide, Zini, Andrea, Doijiri, Ryosuke, Fukuda, Hiroki, Fujinaka, Toshiyuki, Fujita, Kyohei, Uchino, Ken, Imamura, Hirotoshi, Sakai, Nobuyuki, Kanamaru, Takuya, Kimura, Naoto, Kono, Ryuhei, Miyake, Kosuke, Sakaguchi, Manabu, Sakai, Kenichiro, Sonoda, Kazutaka, Todo, Kenichi, Inoa, Violiza, Miyashita, Fumio, Tokuda, Naoki, Matsumaru, Yuji, Matsumoto, Shoji, Ohara, Nobuyuki, Shindo, Seigo, Takenobu, Yohei, Yoshimoto, Takeshi, Toyoda, Kazunori, Uwatoko, Takeshi, Goyal, Nitin, Yagita, Yoshiki, Yamada, Takehiro, Yamamoto, Nobuaki, Yamamoto, Ryoo, Yazawa, Yukako, Sugiura, Yuri, Waweru, Peter Kuria, Baek, Jang-Hyun, Lee, Si Baek, Seo, Kwon-Duk, Charidimou, Andreas, Sohn, Sung-Il, Arsovska, Anita Ante, Chan, Yong Chieh, Wan Zaidi, Wan Asyraf, Jaafar, Ainul Syahrilfazli, Gongora-Rivera, Fernando, Martinez-Marino, Manuel, Infante-Valenzuela, Adrian, Groppa, Stanislav, Leahu, Pavel, Siegler, James E., Coutinho, Jonathan M., Rinkel, Leon A., Dippel, Diederik W.J., van Dam-Nolen, Dianne H.K., Ranta, Annemarei, Wu, Teddy Y., Adebayo, Tajudeen Temitayo, Bello, Abiodun H., Nwazor, Ernest Okwundu, Sunmonu, Taofiki Ajao, Yaghi, Shadi, Wahab, Kolawole Wasiu, Ronning, Ole Morten, Sandset, Else Charlotte, Al Hashmi, Amal M., Ahmad, Saima, Rashid, Umair, Rodriguez-Kadota, Liliana, Vences, Miguel Ángel, Yalung, Patrick Matic, Hao Dy, Jon Stewart, de Sousa, Diana Aguiar, Pineda-Franks, Maria Carissa, Co, Christian Oliver, Brola, Waldemar, Debiec, Aleksander, Dorobek, Malgorzata, Karlinski, Michal Adam, Labuz-Roszak, Beata M., Lasek-Bal, Anetta, Sienkiewicz-Jarosz, Halina, Staszewski, Jacek, Mohammaden, Mahmoud H., Sobolewski, Piotr, Wiacek, Marcin, Zielinska-Turek, Justyna, Araujo, Andre Pinho, Rocha, Mariana, Castro, Pedro, Cruz, Vitor Tedim, Ferreira, Paulo Venancio, Ferreira, Patricia, Nunes, Ana Paiva, Haussen, Diogo C., Fonseca, Luisa, Marto, João Pedro, Melo, Teresa Pinho e, Rodrigues, Miguel, Silva, M. Luis, Dimitriade, Adela, Falup-Pecurariu, Cristian, Hamid, May Adel, Venketasubramanian, Narayanaswamy, Krastev, Georgi, Kristoffersen, Espen Saxhaug, Mako, Miroslav, Ayo-Martin, Oscar, Hernández-Fernández, Francisco, Blasco, Jordi, Rodríguez-Vázquez, Alejandro, Cruz-Culebras, Antonio, Moniche, Francisco, Montaner, Joan, Perez-Sanchez, Soledad, García Sánchez, María Jesús, Lereis, Virginia Pujol, Guillán Rodríguez, Marta, Jood, Katarina, Nordanstig, Annika, Mazya, Michael V., Moreira, Tiago T.P., Bernava, Gianmarco, Beyeler, Morin, Bolognese, Manuel, Carrera, Emmanuel, Dobrocky, Tomas, Scollo, Sergio Daniel, Karwacki, Grzegorz Marek, Keller, Emanuela, Hsieh, Chang Yang, Boonyakarnkul, Surawan, Churojana, Anchalee, Aykac, Ozlem, Ozdemir, Atilla Özcan, Bajrami, Arsida, Senadim, Songul, Hussain, Syed Irteza, Campbell, Bruce C. V., John, Seby, Banerjee, Soma, Kwan, Joseph, Krishnan, Kailash, Lenthall, Robert, Matthews, Ashok, Wong, Ken, Zhang, Liqun, Altschul, Dorothea, Asif, Kaiz S., Ma, Alice, Bahiru, Zeelalem, Below, Kristine, Biller, José, Ruland, Sean, Chaudry, Saqib A., Chen, Michael, Chebl, Alex, Cibulka, Jackie, Cistrunk, Leon, Clark, Judith, Thomas, James Orton, Colasurdo, Marco, Czap, Alexandra, de Havenon, Adam, D'Amato, Salvatore, Dharmadhikari, Sushrut, Grimmett, Kasey B., Dmytriw, Adam A., Etherton, Mark R., Ezepue, Chizoba, Farooqui, Mudassir, Parsons, Mark W., Feske, Steven K., Fink, Lauren, Gasimova, Ulviyya, Guzik, Amy K., Hakemi, Maryam, Hovingh, Majesta, Khan, Muhib, Jillela, Dinesh, Kan, Peter T., Khatri, Rakesh, Singhal, Shaloo, Khawaja, Ayaz M., Khoury, Naim N., Kiley, Nicole L., Kim, Benny S., Kolikonda, Murali K., Kuhn, Anna Luisa, Lara, Stephanie, Linares, Guillermo, Linfante, Italo, Lukovits, Timothy G., Slater, Lee-Anne, Lycan, Sarah, Male, Shailesh S., Maali, Laith, Mancin, John, Masoud, Hesham, Mohamed, Ghada A., Monteiro, Andre, Nahab, Fadi, Nalleballe, Krishna, Ortega-Gutierrez, Santiago, Tomazini Martins, Rodrigo, Puri, Ajit S., Radaideh, Yazan, Rahangdale, Rahul H., Rai, Ansaar, Ramakrishnan, Pankajavalli, Reddy, Aravind B., Rojas-Soto, Diana M., Romero, Jose Rafael, Rost, Natalia S., Rothstein, Aaron, Enzinger, Chris, Omran, Setareh Salehi, Sheth, Sunil A., Siddiqui, Adnan H., Starosciak, Amy K., Tarlov, Nicholas E., Taylor, Robert A., Wang, Michael J., Wolfe, Jared, Wong, Ka-Ho, Le, Huynh Vu, Gattringer, Thomas, Nguyen, Quy Viet, Pham, Thong Nhu, Nguyen, Trung Thanh, Phan, Hoang Thi, Ton, Mai Duy, Fischer, Urs, Michel, Patrik, Strambo, Davide, Martins, Sheila O., Zaidat, Osama O., Rahman, Aminur, Nogueira, Raul G., Bonnet, Thomas, Ligot, Noemie, De Raedt, Sylvie, Lemmens, Robin, Vanacker, Peter, Vandervorst, Fenne, Conforto, Adriana Bastos, Hidalgo, Raquel C.T., de Oliveira Neves, Luciana, Martins, Rodrigo Targa, Mora Cuervo, Daissy Liliana, Rebello, Leticia C., Santiago, Igor Bessa, Lameirinhas da Silva, Isabelle, Sakelarova, Teodora, Kalpachki, Rosen, Alexiev, Filip, Catanese, Luciana, Cora, Elena Adela, Goyal, Mayank, Hill, Michael D., Kelly, Michael E., Khosravani, Houman, Lavoie, Pascale, Peeling, Lissa, Pikula, Aleksandra, Rivera, Rodrigo, Chen, Hui-Sheng, Chen, Yimin, Huo, Xiaochuan, Miao, Zhongrong, Yang, Shuiquan, Bedekovic, Marina Roje, Bralic, Marina, Budincevic, Hrvoje, Corredor-Quintero, Angel Basilio, Lara-Sarabia, Osvaldo E., Cabal, Martin, Tenora, Dusan, Fibrich, Petr, Herzig, Roman, Hlaváčová, Helena, Hrabanovska, Emanuela, Hlinovsky, David, Jurak, Lubomir, Kadlcikova, Jana, Karpowicz, Igor, Klecka, Lukas, Kovar, Martin, Lauer, David, Neumann, Jiri, Palouskova, Hana, Reiser, Martin, Rekova, Petra, Rohan, Vladimir, Skoda, Ondrej, Škorňa, Miroslav, Sobotková, Lenka, Sramek, Martin, Zakova, Lenka, Christensen, Hanne, Drenck, Nicolas, and Repositório da Universidade de Lisboa

Abstract

© 2022 American Academy of Neurology, Background and objectives: Declines in stroke admission, IV thrombolysis (IVT), and mechanical thrombectomy volumes were reported during the first wave of the COVID-19 pandemic. There is a paucity of data on the longer-term effect of the pandemic on stroke volumes over the course of a year and through the second wave of the pandemic. We sought to measure the effect of the COVID-19 pandemic on the volumes of stroke admissions, intracranial hemorrhage (ICH), IVT, and mechanical thrombectomy over a 1-year period at the onset of the pandemic (March 1, 2020, to February 28, 2021) compared with the immediately preceding year (March 1, 2019, to February 29, 2020). Methods: We conducted a longitudinal retrospective study across 6 continents, 56 countries, and 275 stroke centers. We collected volume data for COVID-19 admissions and 4 stroke metrics: ischemic stroke admissions, ICH admissions, IVT treatments, and mechanical thrombectomy procedures. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. Results: There were 148,895 stroke admissions in the 1 year immediately before compared with 138,453 admissions during the 1-year pandemic, representing a 7% decline (95% CI [95% CI 7.1-6.9]; p < 0.0001). ICH volumes declined from 29,585 to 28,156 (4.8% [5.1-4.6]; p < 0.0001) and IVT volume from 24,584 to 23,077 (6.1% [6.4-5.8]; p < 0.0001). Larger declines were observed at high-volume compared with low-volume centers (all p < 0.0001). There was no significant change in mechanical thrombectomy volumes (0.7% [0.6-0.9]; p = 0.49). Stroke was diagnosed in 1.3% [1.31-1.38] of 406,792 COVID-19 hospitalizations. SARS-CoV-2 infection was present in 2.9% ([2.82-2.97], 5,656/195,539) of all stroke hospitalizations. Discussion: There was a global decline and shift to lower-volume centers of stroke admission volumes, ICH volumes, and IVT volumes during the 1st year of the COVID-19 pandemic compared with the prior year. Mechanical thrombectomy volumes were preserved. These results suggest preservation in the stroke care of higher severity of disease through the first pandemic year.

Published
2023

15. Global impact of COVID-19 on stroke care

Author

Nogueira, Raul G., Abdalkader, Mohamad, Qureshi, Muhammed M., Frankel, Michael R., Mansour, Ossama Yassin, Yamagami, Hiroshi, Qiu, Zhongming, Farhoudi, Mehdi, Siegler, James E, Yaghi, Shadi, Raz, Eytan, Sakai, Nobuyuki, Ohara, Nobuyuki, Piotin, Michel, Mechtouff, Laura, Eker, Omer, Chalumeau, Vanessa, Kleinig, Timothy J., Pop, Raoul, Liu, Jianmin, Winters, Hugh S., Shang, Xianjin, Rodriguez Vasquez, Alejandro, Blasco, Jordi, Arenillas, Juan F, Martinez-Galdamez, Mario, Brehm, Alex, Psychogios, Marios-Nikos, Lylyk, Pedro, Haussen, Diogo C., Al-Bayati, Alhamza R., Mohammaden, Mahmoud H., Fonseca, Luísa, Luís Silva, M., Montalverne, Francisco, Renieri, Leonardo, Mangiafico, Salvatore, Fischer, Urs, Gralla, Jan, Frei, Donald, Chugh, Chandril, Mehta, Brijesh P., Nagel, Simon, Mohlenbruch, Markus, Ortega-Gutierrez, Santiago, Farooqui, Mudassir, Hassan, Ameer E, Taylor, Allan, Lapergue, Bertrand, Consoli, Arturo, Campbell, Bruce C.V., Sharma, Malveeka, Walker, Melanie, Van Horn, Noel, Fiehler, Jens, Nguyen, Huy Thang, Nguyen, Quoc T., Watanabe, Daisuke, Zhang, Hao, Le, Huynh V., Nguyen, Viet Q., Shah, Ruchir, Devlin, Thomas, Khandelwal, Priyank, Linfante, Italo, Izzath, Wazim, Lavados, Pablo M., Olavarría, Veronica V., Sampaio Silva, Gisele, de Carvalho Sousa, Anna Verena, Kirmani, Jawad, Bendszus, Martin, Amano, Tatsuo, Yamamoto, Ryoo, Doijiri, Ryosuke, Tokuda, Naoki, Yamada, Takehiro, Terasaki, Tadashi, Yazawa, Yukako, Morris, Jane G., Griffin, Emma, Thornton, John, Lavoie, Pascale, Matouk, Charles, Hill, M. D, Demchuk, Andrew M., Killer-Oberpfalzer, Monika, Nahab, Fadi, Altschul, Dorothea, Ramos-Pachón, Anna, Pérez de la Ossa, Natalia, Kikano, Raghid, Boisseau, William, Walker, Gregory, Cordina, Steve M., Puri, Ajit, Luisa Kuhn, Anna, Gandhi, Dheeraj, Ramakrishnan, Pankajavalli, Novakovic-White, Roberta, Chebl, Alex, Kargiotis, Odysseas, Czap, Alexandra L, Zha, Alicia M, Masoud, Hesham E., Lopez, Carlos, Ozretic, David, Al-Mufti, Fawaz, Zie, Wenjie, Duan, Zhenhui, Yuan, Zhengzhou, Huang, Wenguo, Hao, Yonggang, Luo, Jun, Kalousek, Vladimir, Bourcier, Romain, Guile, Romain, Hetts, Steven, Al-Jehani, Hosam M., AlHazzani, Adel, Sadeghi-Hokmabadi, Elyar, Teleb, Mohamed, Payne, Jeremy, Lee, Jin Soo, Hong, Ji Man, Sohn, Sung-Il, Hwang, Yang-Ha, Shin, Dong Hoon, Roh, Hong Gee, Edgell, Randy, Khatri, Rakesh, Smith, Ainsley, Malik, Amer, Liebeskind, David, Herial, Nabeel, Jabbour, Pascal, Magalhaes, Pedro, Ozdemir, Atilla Ozcan, Aykac, Ozlem, Uwatoko, Takeshi, Dembo, Tomohisa, Shimizu, Hisao, Sugiura, Yuri, Miyashita, Fumio, Fukuda, Hiroki, Miyake, Kosuke, Shimbo, Junsuke, Sugimura, Yusuke, Beer-Furlan, Andre, Joshi, Krishna, Catanese, Luciana, Abud, Daniel Giansante, Neto, Octavio Giansante, Mehrpour, Masoud, Al Hashmi, Amal, Saqqur, Mahar, Mostafa, Abdulrahman, Fifi, Johanna T., Hussain, Syed, John, Seby, Gupta, Rishi, Sivan-Hoffmann, Rotem, Reznik, Anna, Sani, Achmad Fidaus, Geyik, Serdar, Akıl, Eşref, Churojana, Anchalee, Ghoreishi, Abdoreza, Saadatnia, Mohammad, Sharifipour, Ehsan, Ma, Alice, Faulder, Ken, Wu, Teddy, Leung, Lester, Malek, Adel, Voetsch, Barbara, Wakhloo, Ajay, Rivera, Rodrigo, Barrientos Iman, Danny Moises, Pikula, Aleksandra, Lioutas, Vasileios-Arsenios, Thomalla, Gotz, Birnbaum, Lee, Machi, Paolo, Bernava, Gianmarco, McDermott, Mollie, Kleindorfer, Dawn, Wong, Ken, Patterson, Mary S., Fiorot, Jose Antonio, Huded, Vikram, Mack, William, Tenser, Matthew, Eskey, Clifford, Multani, Sumeet, Kelly, Michael, Janardhan, Vallabh, Cornett, Oriana, Singh, Varsha, Murayama, Yuichi, Mokin, Maxim, Yang, Pengfei, Zhang, Xiaoxi, Yin, Congguo, Han, Hongxing, Peng, Ya, Chen, Wenhuo, Crosa, Roberto, Frudit, Michel E., Pandian, Jeyaraj D., Kulkarni, Anirudh, Yagita, Yoshiki, Takenobu, Yohei, Matsumaru, Yuji, Yamada, Satoshi, Kono, Ryuhei, Kanamaru, Takuya, Yamazaki, Hidekazu, Sakaguchi, Manabu, Todo, Kenichi, Yamamoto, Nobuaki, Sonoda, Kazutaka, Yoshida, Tomoko, Hashimoto, Hiroyuki, Nakahara, Ichiro, Cora, Elena, Volders, David, Ducroux, Celina, Shoamanesh, Ashkan, Ospel, Johanna, Kaliaev, Artem, Ahmed, Saima, Rashid, Umair, Rebello, Leticia C., Pereira, Vitor Mendes, Fahed, Robert, Chen, Michael, Sheth, Sunil A., Palaiodimou, Lina, Tsivgoulis, Georgios, Chandra, Ronil, Koyfman, Feliks, Leung, Thomas, Khosravani, Houman, Dharmadhikari, Sushrut, Frisullo, Giovanni, Calabresi, Paolo, Tsiskaridze, Alexander, Lobjanidze, Nino, Grigoryan, Mikayel, Czlonkowska, Anna, de Sousa, Diana A., Demeestere, Jelle, Liang, Conrad, Sangha, Navdeep, Lutsep, Helmi L., Ayo-Martín, Óscar, Cruz-Culebras, Antonio, Tran, Anh D., Young, Chang Y., Cordonnier, Charlotte, Caparros, Francois, De Lecinana, Maria Alonso, Fuentes, Blanca, Yavagal, Dileep, Jovin, Tudor, Spelle, Laurent, Moret, Jacques, Khatri, Pooja, Zaidat, Osama, Raymond, Jean, Martins, Sheila, Nguyen, Thanh N, Universitat Autònoma de Barcelona, and UAM. Departamento de Medicina

Subjects
Gerontology, 2019-20 coronavirus outbreak, medicine.medical_specialty, acute ischemic stroke, Hospitals, Low-Volume, Time Factors, Coronavirus disease 2019 (COVID-19), Medicina, Clinical Neurology, Stroke care, stroke care, Global Health, mechanical thrombectomy, Pandemic, Epidemiology, Health care, Global health, Medicine, Humans, Registries, Stroke, Retrospective Studies, Thrombectomy, Science & Technology, business.industry, Research, COVID-19, medicine.disease, Hospitalization, Cross-Sectional Studies, Peripheral Vascular Disease, Neurology, Cardiovascular System & Cardiology, epidemiology, Neurosciences & Neurology, business, Life Sciences & Biomedicine, Intracranial Hemorrhages, Hospitals, High-Volume, intracranial hemorrhage
Abstract

Artículo escrito por un elevado número de autores, solo se referencian el que aparece en primer lugar, el nombre del grupo de colaboración, si le hubiere, y los autores pertenecientes a la UAM, Background: The COVID-19 pandemic led to profound changes in the organization of health care systems worldwide. Aims: We sought to measure the global impact of the COVID-19 pandemic on the volumes for mechanical thrombectomy, stroke, and intracranial hemorrhage hospitalizations over a three-month period at the height of the pandemic (1 March–31 May 2020) compared with two control three-month periods (immediately preceding and one year prior). Methods: Retrospective, observational, international study, across 6 continents, 40 countries, and 187 comprehensive stroke centers. The diagnoses were identified by their ICD-10 codes and/or classifications in stroke databases at participating centers. Results: The hospitalization volumes for any stroke, intracranial hemorrhage, and mechanical thrombectomy were 26,699, 4002, and 5191 in the three months immediately before versus 21,576, 3540, and 4533 during the first three pandemic months, representing declines of 19.2% (95%CI, −19.7 to −18.7), 11.5% (95%CI, −12.6 to −10.6), and 12.7% (95%CI, −13.6 to −11.8), respectively. The decreases were noted across centers with high, mid, and low COVID-19 hospitalization burden, and also across high, mid, and low volume stroke/mechanical thrombectomy centers. High-volume COVID-19 centers (−20.5%) had greater declines in mechanical thrombectomy volumes than mid- (−10.1%) and low-volume (−8.7%) centers (p < 0.0001). There was a 1.5% stroke rate across 54,366 COVID-19 hospitalizations. SARS-CoV-2 infection was noted in 3.9% (784/20,250) of all stroke admissions. Conclusion: The COVID-19 pandemic was associated with a global decline in the volume of overall stroke hospitalizations, mechanical thrombectomy procedures, and intracranial hemorrhage admission volumes. Despite geographic variations, these volume reductions were observed regardless of COVID-19 hospitalization burden and pre-pandemic stroke/mechanical thrombectomy volumes

Published
2021

16. Abstract 131: Feasibility and Efficacy of Central Blinded Video Rankin Scale Outcome Assessments in a Randomized Clinical Trial

Author

Oliveira-Filho, Jamary, primary, Bezerra, Daniel C, additional, Pontes Neto, Octavio M, additional, Abud, Daniel, additional, Lima, Fabricio O, additional, Silva, Gisele S, additional, Rebello, Leticia C, additional, MontAlverne, Francisco, additional, Frudit, Michel, additional, Farias, Mario B, additional, Cabral, Lucas, additional, Zetola, Viviane, additional, de Freitas, Gabriel R, additional, Liebeskind, David S, additional, Wagner, Mario B, additional, Molina, Carlos, additional, Nogueira, Raul G, additional, and Martins, Sheila O, additional

Published
2020
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17. Abstract 5: CT Perfusion is Not a Treatment Effect Modifier for Mechanical Thrombectomy in the 0-8-Hour-Window: A Pre-Planned Analysis of the RESILIENT Trial

Author

Rebello, Leticia C, primary, Parente, Bruno S, additional, Waihrich, Eduardo S, additional, Pontes-Neto, Octavio, additional, Abud, Daniel G, additional, Montalverne, Francisco Jose, additional, Lima, Fabricio O, additional, Silva, Gisele S, additional, Frudit, Michel, additional, Liebeskind, David S, additional, Molina, Carlos, additional, Freitas, Gabriel R, additional, Barbosa, Leandro A, additional, Wagner, Mario B, additional, Martins, Sheila C, additional, and Nogueira, Raul G, additional

Published
2020
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18. Assessment of Optimal Patient Selection for Endovascular Thrombectomy Beyond 6 Hours After Symptom Onset: A Pooled Analysis of the AURORA Database.

Author

Albers, Gregory W., Lansberg, Maarten G., Brown, Scott, Jadhav, Ashutosh P., Haussen, Diogo C., Martins, Sheila O., Rebello, Leticia C., Demchuk, Andrew M., Goyal, Mayank, Ribo, Marc, Turk, Aquilla S., Liebeskind, David S., Heit, Jeremy J., Marks, Michael P., Jovin, Tudor G., and Nogueira, Raul G.

Published
2021
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19. Endovascular management of acute large vessel occlusion stroke in pregnancy is safe and feasible

Author

Limaye, Kaustubh, primary, Van de Walle Jones, Ann, additional, Shaban, Amir, additional, Desai, Shashvat, additional, Al Kasab, Sami, additional, Almallouhi, Eyad, additional, Holmstedt, Christine A, additional, Ortega-Gutierrez, Santiago, additional, Haussen, Diogo C, additional, Nogueira, Raul, additional, Mont’Alverne, Francisco, additional, Ragiotto, Carlos, additional, Rebello, Leticia C, additional, Jovin, Tudor G, additional, Hasan, David, additional, and Jadhav, Ashutosh, additional

Published
2019
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20. Endovascular management of acute large vessel occlusion stroke in pregnancy is safe and feasible.

Author

Limaye, Kaustubh, Van de Walle Jones, Ann, Shaban, Amir, Desai, Shashvat, Al Kasab, Sami, Almallouhi, Eyad, Holmstedt, Christine A., Ortega-Gutierrez, Santiago, Haussen, Diogo C., Nogueira, Raul, Mont'Alverne, Francisco, Ragiotto, Carlos, Rebello, Leticia C., Jovin, Tudor G., Hasan, David, and Jadhav, Ashutosh

Subjects
ENDOVASCULAR surgery, CATHETERIZATION, CEREBRAL ischemia, DATABASES, LONGITUDINAL method, PURPURA (Pathology), SURGICAL stents, STROKE, THROMBOSIS, TISSUE plasminogen activator, VEIN surgery, INSTITUTIONAL review boards, TREATMENT effectiveness, RETROSPECTIVE studies, ACUTE diseases, MEDICAL suction, TERTIARY care, NIH Stroke Scale, PREGNANCY
Abstract

Introduction Stroke is a leading cause of adult death and disability. Although acute ischemic stroke (AIS) in pregnancy is rare, it has devastating consequences on the life of the mother and fetus. Pregnancy was an exclusion criterion in endovascular thrombectomy (EVT) trials and so there are no evidence-based treatment recommendations in this subgroup. The objective of this study was to evaluate the safety and feasibility of mechanical thrombectomy in large vessel occlusion (LVO) stroke in pregnancy. Methods Patients with AIS due to LVO treated with EVT during pregnancy between 2000 and 2019 were identified at seven tertiary care centers. After IRB approval, retrospective analysis of prospectively maintained stroke/endovascular databases was performed. Results A total of seven subjects were identified. The average age was 33.2 years (range 25-38 years) and the average initial National Institutes of Health Stroke Scale (NIHSS) score at presentation was 15 (range 9-28). Three patients received IV tissue plasminogen activator. Techniques of EVT included stent retriever thrombectomy, stent retriever-assisted continuous aspiration, direct contact aspiration, and multimodal techniques including a rescue balloon mounted coronary stent placement. While one patient was noted to have petechial hemorrhage, no individuals developed parenchymal hematoma. Mean discharge NIHSS score was 1.7 (range 0-5). Conclusion EVT is a safe and effective treatment for acute stroke secondary to LVO in this series of pregnant patients. While EVT for acute stroke is standard of care in select patient populations, our study suggests that treatment should be considered in the gravid population. [ABSTRACT FROM AUTHOR]

Published
2020
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22. Endovascular Therapy and Ethnic Disparities in Stroke Outcomes

Author

Bouslama, Mehdi, primary, Rebello, Leticia C., additional, Haussen, Diogo C., additional, Grossberg, Jonathan A., additional, Anderson, Aaron M., additional, Belagaje, Samir R., additional, Bianchi, Nicolas A., additional, Frankel, Michael R., additional, and Nogueira, Raul G., additional

Published
2018
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23. Clinical and Imaging Outcomes of Endovascular Therapy in Patients with Acute Large Vessel Occlusion Stroke and Mild Clinical Symptoms

Author

Bowen, Meredith T., primary, Rebello, Leticia C., additional, Bouslama, Mehdi, additional, Haussen, Diogo C., additional, Grossberg, Jonathan A., additional, Bianchi, Nicolas A., additional, Belagaje, Samir, additional, Anderson, Aaron, additional, Frankel, Michael R., additional, and Nogueira, Raul G., additional

Published
2017
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30. Abstract 129: Clinical-imaging Mismatch versus Perfusion Imaging Mismatch Selection for Stroke Patients Undergoing Mechanical Thrombectomy

Author

Bouslama, Mehdi, primary, Bowen, Meredith, additional, Haussen, Diogo C, additional, Dehkharghani, Seena, additional, Grossberg, Jonathan A, additional, Rebello, Leticia C, additional, Rangaraju, Srikant, additional, Schindler, Kiva, additional, Frankel, Michael, additional, and Nogueira, Raul G, additional

Published
2017
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32. Abstract TP10: Clinical and Imaging Outcomes of Patients with Acute Ischemic Stroke and Mild Nihss Treated with Endovascular Therapy

Author

Rebello, Leticia C, primary, Bouslama, Mehdi, additional, Haussen, Diogo C, additional, Grossberg, Jonathan A, additional, Belagaje, Samir R, additional, Bianchi, Nicolas, additional, Rangaraju, Srikant, additional, Schindler, Kiva, additional, Anderson, Aaron, additional, Frankel, Michael, additional, and Nogueira, Raul G, additional

Published
2017
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33. Brazilian guidelines for endovascular treatment of patients with acute ischemic stroke

Author

Pontes-Neto, Octávio Marques, primary, Cougo, Pedro, additional, Martins, Sheila Cristina Ouriques, additional, Abud, Daniel G., additional, Nogueira, Raul G., additional, Miranda, Maramélia, additional, Castro-Afonso, Luiz Henrique de, additional, Rebello, Leticia C., additional, Caldas, José Guilherme M. Pereira, additional, Bazan, Rodrigo, additional, Bezerra, Daniel C, additional, Rezende, Marco Tulio, additional, Freitas, Gabriel R. de, additional, Longo, Alexandre, additional, Magalhães, Pedro, additional, Carvalho, João José Freitas de, additional, Montalverne, Francisco José, additional, Lima, Fabricio Oliveira, additional, Andrade, Gustavo H.V., additional, Massaro, Ayrton R., additional, Oliveira-Filho, Jamary, additional, Gagliardi, Rubens, additional, and Silva, Gisele Sampaio, additional

Published
2017
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39. Internal Carotid Artery S-Shaped Curve as a Marker of Fibromuscular Dysplasia in Dissection-Related Acute Ischemic Stroke

Author

Haussen, Diogo C., primary, Jadhav, Ashutosh, additional, Rebello, Leticia C., additional, Belagaje, Samir, additional, Anderson, Aaron, additional, Jovin, Tudor, additional, Aghaebrahim, Amin, additional, Gulati, Deepak, additional, Wells, Bryan, additional, Frankel, Michael, additional, and Nogueira, Raul G., additional

Published
2016
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42. Clinical and Imaging Outcomes of Endovascular Therapy in Patients with Acute Large Vessel Occlusion Stroke and Mild Clinical Symptoms

Author

Bowen, Meredith T., Rebello, Leticia C., Bouslama, Mehdi, Haussen, Diogo C., Grossberg, Jonathan A., Bianchi, Nicolas A., Belagaje, Samir, Anderson, Aaron, Frankel, Michael R., and Nogueira, Raul G.

Abstract

Background:The minimal stroke severity justifying endovascular intervention remains elusive. However, a significant proportion of patients presenting with large vessel occlusion stroke (LVOS) and mild symptoms go untreated and face poor outcomes. We aimed to evaluate the clinical outcomes of patients presenting with LVOS and low symptom scores (National Institutes of Health Stroke Scale [NIHSS] score ≤8) undergoing endovascular therapy (ET). Methods:We performed a retrospective analysis of a prospectively collected ET database between September 2010 and March 2016. Endovascularly treated patients with LVOS and a baseline NIHSS score ≤8 were included. Baseline patient characteristics, procedural details, and outcome parameters were collected. Efficacy outcomes were the rate of good outcome (90-day modified Rankin Scale score 0-2) and of successful reperfusion (modified Treatment in Cerebral Infarction [mTICI] score 2b-3). Safety was assessed by the rate of parenchymal hematoma (parenchymal hematoma type 1 [PH-1] and parenchymal hematoma type 2 [PH-2]) and 90-day mortality. Logistic regression was used to identify predictors of good clinical outcomes. Results:A total of 935 patients were considered; 72 patients with an NIHSS score ≤8 were included. Median [IQR] age was 61.5 years [56.2-73.0]; 39 patients (54%) were men. Mean (SD) baseline NIHSS score, computed tomography perfusion core volume, and ASPECTS were 6.3 (1.5), 7.5 mL (16.1), and 8.5 (1.3), respectively. Twenty-eight patients (39%) received intravenous tissue plasminogen activator. Occlusions locations were as follows: 29 (40%) proximal MCA-M1, 20 (28%) MCA-M2, 6 (8%) ICA terminus, and 9 (13%) vertebrobasilar. Tandem occlusion was documented in 7 patients (10%). Sixty-seven patients (93%) achieved successful reperfusion (mTICI score 2b-3); 52 (72%) had good 90-day outcomes. Mean final infarct volume was 32.2 ± 59.9 mL. Parenchymal hematoma occurred in 4 patients (6%). Ninety-day mortality was 10% (n= 7). Logistic regression showed that only successful reperfusion (OR 27.7, 95% CI 1.1-655.5, p= 0.04) was an independent predictor of good outcomes. Conclusion:Our findings demonstrate that ET is safe and feasible for LVOS patients presenting with mild clinical syndromes. Future controlled studies are warranted.

Published
2018
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43. Brazilian guidelines for endovascular treatment of patients with acute ischemic stroke.

Author

Marques Pontes-Neto, Octávio, Cougo, Pedro, Ouriques Martins, Sheila Cristina, Abud, Daniel G., Nogueira, Raul G., Miranda, Maramélia, de Castro-Afonso, Luiz Henrique, Rebello, Leticia C., Pereira Caldas, José Guilherme M., Bazan, Rodrigo, Bezerra, Daniel C., Rezende, Marco Tulio, de Freitas, Gabriel R., Longo, Alexandre, Magalhães, Pedro, Freitas de Carvalho, João José, Montalverne, Francisco José, Oliveira Lima, Fabricio, Andrade, Gustavo H. V., and Massaro, Ayrton R.

Abstract

Copyright of Arquivos de Neuro-Psiquiatria is the property of Thieme Medical Publishing Inc. 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
2017
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44. Repeated Mechanical Thrombectomy in Recurrent Large Vessel Occlusion Acute Ischemic Stroke

Author

Bouslama, Mehdi, Haussen, Diogo C., Rebello, Leticia C., Grossberg, Jonathan A., Frankel, Michael R., and Nogueira, Raul G.

Abstract

Background:Endovascular therapy has been proven effective for the treatment of large vessel occlusion strokes (LVOS). However, the feasibility and potential benefits of repeat thrombectomy for recurrent stroke is unclear. We aim to report our experience with repeat thrombectomy for recurrent LVOS. Methods:We reviewed our prospectively collected endovascular database for patients who underwent repeated mechanical thrombectomy. Baseline characteristics, procedural data and outcomes were evaluated. Patients with repeat thrombectomy were compared to patients with single thrombectomy. For patients with repeat thrombectomy, imaging and procedural variables were compared between first and last procedures. Results:Out of 697 patients treated within the study period, 15 patients (2%) had repeat thrombectomies (14 treated twice and one thrice). The mean age was 63 ± 15 years and 40% were males. The median time between the first and last procedure was 18 (1-278) days. Cardioembolism (66%) was the most common etiology, followed by intracranial atherosclerosis (13%) and large vessel atherosclerosis (6%). At 90 days after the last thrombectomy, 60% of patients achieved a modified Rankin Scale score of 0-2 and 20% were deceased. There were no statistically significant differences in demographics, stroke severity, time from last known normal to puncture, reperfusion rates, hemorrhagic complications, good clinical outcomes and mortality between patients who underwent repeat thrombectomy and those who had a single thrombectomy. Conclusion:In properly selected patients suffering recurrent LVOS, repeated mechanical thrombectomy appears to be feasible and safe. A previous thrombectomy should not discourage aggressive treatment as these patients may achieve similar rates of good clinical outcomes as those who undergo single thrombectomy.

Published
2017
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