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2. Global impact of the COVID-19 pandemic on subarachnoid haemorrhage hospitalisations, aneurysm treatment and in-hospital mortality: 1-year follow-up

Author

Nguyen, Tn, Qureshi, Mm, Klein, P, Yamagami, H, Mikulik, R, Etminan, N, Abdalkader, M, Mansour, Oy, Czlonkowska, A, Lo, H, Sathya, A, Demeestere, J, Tsivgoulis, G, Sakai, N, Sedova, P, Kristoffersen, Es, Mohammaden, M, Lereis, Vp, Scollo, Sd, Ma, A, Rahman, A, Bonnet, T, Cortier, J, De Raedt, S, Lemmens, R, Ligot, N, Hidalgo, Rct, Cuervo, Dlm, Neves, Ld, Rezende, Mts, Santiago, Ib, Sirakov, A, Sirakov, S, Cora, Ea, Kelly, Me, Lavoie, P, Peeling, L, Pikula, A, Rivera, R, Chen, Hs, Chen, Ym, Fang, Hl, Bedekovic, Mr, Budincevic, H, Strossmayer, Jj, Hrabanovska, E, Jurak, L, Cabal, M, Kadlckova, J, Karpowicz, I, Palouskova, H, Reiser, M, Klecka, L, Kovar, M, Neumann, J, Rekova, P, Sramek, M, Vitkova, E, Skorna, M, Zakova, L, Sobh, K, Alpay, K, Rautio, R, Strbian, D, Gentric, Jc, Magro, E, Naggara, O, Reiner, P, Abdulazim, A, Bohmann, Fo, Boskamp, S, Gerber, Jc, Kaiser, Dpo, Kestner, Ri, Mbroh, J, Neyazi, M, Rosenkranz, M, Sani, Af, Poli, S, Thomalla, G, Karapanayiotides, T, Kargiotis, O, Koutroulou, I, Palaiodimou, L, Guerra, Jdb, Huded, V, Nagendra, S, Prajapati, C, Krishna, A, Ghoreishi, A, Ilkhchi, Rb, Jalili, J, Sabetay, Si, Abu Raya, T, Acampa, M, Longoni, M, Bigliani, Cr, Castellan, L, Ornello, R, Renieri, L, Romoli, M, Sacco, S, Sangalli, D, Vigano, M, Zini, A, Tokimura, H, Sonoda, K, Todo, K, Fukuda, H, Fujita, K, Sakaguchi, M, Uno, M, Kan, I, Kosuke, M, Kono, R, Kimura, N, Yamamoto, N, Yamamoto, R, Doijiri, R, Shindo, S, Ohara, N, Imamura, H, Ogawa, T, Uwatoko, T, Kanamaru, T, Fujinaka, T, Takenobu, Y, Toyoda, K, Matsumaru, Y, Yazawa, Y, Sugiura, Y, Baek, Jh, Sunmonu, Ta, Kwon, Ys, Lee, Yh, Seo, Kd, Sohn, Si, Chan, Yc, Zaidi, Waw, Barrientos-Prieto, J, Gongora-Rivera, F, Martinez-Marino, M, Calderon-Vallejo, A, Groppa, S, Pavel, L, Coutinho, Jm, Dippel, D, Rinkel, L, Van Dam-Nolen, Dhk, Nwazor, Eo, Al Hashimi, Am, Ahmad, S, Rashid, U, Rodriguez-Kadota, L, Vences, Ma, Yalung, Pm, Jsh, Dy, Brola, W, Dorobek, M, Karlinski, Ma, Labuz-Roszak, Bm, Lasek-Bal, A, Sienkiewicz-Jarosz, H, Staszewski, J, Sobolewski, P, Zielinska-Turek, J, Araujo, Ap, Fonseca, L, Debiec, A, Silva, Ml, Castro, P, Rocha, M, Falup-Pecurariu, Rc, Venketasubramanian, N, Mako, Gkm, Ayo-Martin, O, Wiacek, M, Blasco, J, Cruz-Culebras, A, Hernandez-Fernandez, F, Fernandez, Cr, Lopez, Je, Rodriguez, A, Bolognese, M, Karwacki, Gm, Keller, E, Machi, P, Bernava, G, Boonyakarnkul, S, Churojana, A, Hammami, N, Bajrami, A, Senadim, S, Hussain, Si, John, S, Dow, G, Krishnan, K, Lenthall, R, Wong, K, Zhang, Lq, Altschul, D, Asif, Ks, Aziz-Sultan, Ma, Bach, I, Below, K, Biller, J, Cervantes-Arslanian, Am, Chaudhry, Sa, Chebl, A, Chen, M, Colasurdo, M, Czap, A, Dasenbrock, H, Bahiru, Z, de Havenon, Ah, Dharmadhikari, S, Dmytriw, Aa, Eskey, Cj, Etherton, M, Ezepue, C, Fink, L, Gasimova, U, Goyal, N, Grimmett, Kb, Hakemi, M, Hester, T, Inoa, V, Kan, Pt, Kasper, Em, Khandelwal, P, Khatri, R, Khoury, Nn, Kim, Bs, Kolikonda, M, Kuhn, Al, Linares, G, Linfante, I, Loochtan, Ai, Lukovits, Tg, Male, Ss, Khawaja, Am, Maali, L, Galecio-Castillo, Em, Min, Jy, Mohamed, Ga, Nalleballe, K, Ortega-Gutierrez, S, Radaideh, Y, Ramakrishnan, P, Masoud, He, Reddy, Ab, Ruland, S, Omran, Ss, Sheth, Sa, Puri, As, Rahangdale, Rh, Siegler, Je, Starosciak, Ak, Tarlov, Ne, Taylor, Ra, Tsai, J, Wang, Mj, Wong, Kh, Zaidat, Oo, Hv, Le, Phan, Ht, Ton, Md, Tran, Ad, Sirakova, K, Pham, Tn, Mohlenbruch, Ma, Nagel, S, Raymond, J, Nogueira, Rg, Neurology, ACS - Atherosclerosis & ischemic syndromes, and ANS - Neurovascular Disorders

Subjects
Psychiatry and Mental health, SDG 3 - Good Health and Well-being, COVID-19, SUBARACHNOID HAEMORRHAGE, CEREBROVASCULAR DISEASE, Surgery, Neurology (clinical)
Abstract

BackgroundPrior studies indicated a decrease in the incidences of aneurysmal subarachnoid haemorrhage (aSAH) during the early stages of the COVID-19 pandemic. We evaluated differences in the incidence, severity of aSAH presentation, and ruptured aneurysm treatment modality during the first year of the COVID-19 pandemic compared with the preceding year.MethodsWe conducted a cross-sectional study including 49 countries and 187 centres. We recorded volumes for COVID-19 hospitalisations, aSAH hospitalisations, Hunt-Hess grade, coiling, clipping and aSAH in-hospital mortality. Diagnoses were identified by International Classification of Diseases, 10th Revision, codes or stroke databases from January 2019 to May 2021.ResultsOver the study period, there were 16 247 aSAH admissions, 344 491 COVID-19 admissions, 8300 ruptured aneurysm coiling and 4240 ruptured aneurysm clipping procedures. Declines were observed in aSAH admissions (−6.4% (95% CI −7.0% to −5.8%), p=0.0001) during the first year of the pandemic compared with the prior year, most pronounced in high-volume SAH and high-volume COVID-19 hospitals. There was a trend towards a decline in mild and moderate presentations of subarachnoid haemorrhage (SAH) (mild: −5% (95% CI −5.9% to –4.3%), p=0.06; moderate: −8.3% (95% CI −10.2% to –6.7%), p=0.06) but no difference in higher SAH severity. The ruptured aneurysm clipping rate remained unchanged (30.7% vs 31.2%, p=0.58), whereas ruptured aneurysm coiling increased (53.97% vs 56.5%, p=0.009). There was no difference in aSAH in-hospital mortality rate (19.1% vs 20.1%, p=0.12).ConclusionDuring the first year of the pandemic, there was a decrease in aSAH admissions volume, driven by a decrease in mild to moderate presentation of aSAH. There was an increase in the ruptured aneurysm coiling rate but neither change in the ruptured aneurysm clipping rate nor change in aSAH in-hospital mortality.Trial registration numberNCT04934020.

Published
2022

3. Oral anticoagulants in the oldest old with recent stroke and atrial fibrillation

Author

Polymeris, A. A., Macha, K., Paciaroni, M., Wilson, D., Koga, M., Cappellari, M., Schaedelin, S., Zietz, A., Peters, N., Seiffge, D. J., Haupenthal, D., Gassmann, L., De Marchis, G. M., Wang, R., Gensicke, H., Stoll, S., Thilemann, S., Avramiotis, N. S., Bonetti, B., Tsivgoulis, G., Ambler, G., Alberti, A., Yoshimura, S., Brown, M. M., Shiozawa, M., Lip, G. Y. H., Venti, M., Acciarresi, M., Tanaka, K., Mosconi, M. G., Takagi, M., Jager, R. H., Muir, K., Inoue, M., Schwab, S., Bonati, L. H., Lyrer, P. A., Toyoda, K., Caso, V., Werring, D. J., Kallmunzer, B., Engelter, S. T., Traenka, C., Hert, L., Wagner, B., Schaub, F., Meya, L., Fladt, J., Dittrich, T., Fisch, U., Volbers, B., Siedler, G., Bovi, P., Tomelleri, G., Micheletti, N., Zivelonghi, C., Emiliani, A., Parry-Jones, A., Patterson, C., Price, C., Elmarimi, A., Parry, A., Nallasivam, A., Nor, A. M., Esis, B., Bruce, D., Bhaskaran, B., Roffe, C., Cullen, C., Holmes, C., Cohen, D., Hargroves, D., Mangion, D., Chadha, D., Vahidassr, D., Manawadu, D., Giallombardo, E., Warburton, E., Flossman, E., Gunathilagan, G., Proschel, H., Emsley, H., Anwar, I., Burger, I., Okwera, J., Putterill, J., O'Connell, J., Bamford, J., Corrigan, J., Scott, J., Birns, J., Kee, K., Saastamoinen, K., Pasco, K., Dani, K., Sekaran, L., Choy, L., Iveson, L., Mamun, M., Sajid, M., Cooper, M., Burn, M., Smith, M., Power, M., Davis, M., Smyth, N., Veltkamp, R., Sharma, P., Guyler, P., O'Mahony, P., Wilkinson, P., Datta, P., Aghoram, P., Marsh, R., Luder, R., Meenakishundaram, S., Subramonian, S., Leach, S., Ispoglou, S., Andole, S., England, T., Manoj, A., Harrington, F., Rehman, H., Sword, J., Staals, J., Mahawish, K., Harkness, K., Shaw, L., Mccormich, M., Sprigg, N., Mansoor, S., Krishnamurthy, V., Giustozzi, M., Agnelli, G., Becattini, C., D'Amore, C., Cimini, L. A., Bandini, F., Liantinioti, C., Chondrogianni, M., Yaghi, S., Furie, K. L., Tadi, P., Zedde, M., Abdul-Rahim, A. H., Lees, K. R., Carletti, M., Rigatelli, A., Putaala, J., Tomppo, L., Tatlisumak, T., Marcheselli, S., Pezzini, A., Poli, L., Padovani, A., Vannucchi, V., Masotti, L., Sohn, S. -I., Lorenzini, G., Tassi, R., Guideri, F., Acampa, M., Martini, G., Ntaios, G., Athanasakis, G., Makaritsis, K., Karagkiozi, E., Vadikolias, K., Mumoli, N., Galati, F., Sacco, S., Tiseo, C., Corea, F., Ageno, W., Bellesini, M., Colombo, G., Silvestrelli, G., Ciccone, A., Lanari, A., Scoditti, U., Denti, L., Mancuso, M., Maccarrone, M., Ulivi, L., Orlandi, G., Giannini, N., Tassinari, T., De Lodovici, M. L., Rueckert, C., Baldi, A., Toni, D., Letteri, F., Pieroni, A., Giuntini, M., Lotti, E. M., Flomin, Y., Kargiotis, O., Karapanayiotides, T., Monaco, S., Baronello, M. M., Csiba, L., Szabo, L., Chiti, A., Giorli, E., Del Sette, M., Imberti, D., Zabzuni, D., Doronin, B., Volodina, V., Michel, P., Vanacker, P., Barlinn, K., Pallesen, L. -P., Barlinn, J., Deleu, D., Melikyan, G., Ibrahim, F., Akhtar, N., Gourbali, V., Todo, K., Kimura, K., Shibazaki, K., Yagita, Y., Furui, E., Itabashi, R., Terasaki, T., Shiokawa, Y., Hirano, T., Suzuki, R., Kamiyama, K., Nakagawara, J., Takizawa, S., Homma, K., Okuda, S., Okada, Y., Maeda, K., Kameda, T., Kario, K., Nagakane, Y., Hasegawa, Y., Akiyama, H., Shibuya, S., Mochizuki, H., Ito, Y., Nakashima, T., Matsuoka, H., Takamatsu, K., Nishiyama, K., Endo, K., Miyagi, T., Osaki, M., Kobayashi, J., Okata, T., Tanaka, E., Sakamoto, Y., Tokunaga, K., Takizawa, H., Takasugi, J., Matsubara, S., Higashida, K., Matsuki, T., Kinoshita, N., Ide, T., Yoshimoto, T., Ando, D., Fujita, K., Kumamoto, M., Kamimura, T., Kikuno, M., Mizoguchi, T., and Sato, T.

Subjects
Male, medicine.medical_specialty, Vitamin K, medicine.drug_class, 610 Medicine & health, Aged, 80 and over, Atrial Fibrillation, Factor Xa Inhibitors, Female, Humans, Stroke, Continuous variable, Internal medicine, 80 and over, medicine, Aged, Proportional hazards model, business.industry, Anticoagulant, Confounding, Atrial fibrillation, Patient data, medicine.disease, Oldest old, Neurology, Neurology (clinical), 610 Medizin und Gesundheit, business
Abstract

Objective: To investigate the safety and effectiveness of direct oral anticoagulants (DOAC) versus vitamin K antagonists (VKA) after recent stroke in patients with atrial fibrillation (AF) aged ≥85 years. Methods: Individual patient data analysis from seven prospective stroke cohorts. We compared DOAC versus VKA treatment among patients with AF and recent stroke (≥85y = 0.65, 95%-CI [0.52, 0.81]) and < 85 years (HR = 0.79, 95%-CI [0.66, 0.95]) in simple (p interaction = 0.129), adjusted (p interaction = 0.094) or weighted (p interaction = 0.512) models. Analyses on recurrent stroke, ICH and death separately were consistent with the primary analysis, as were sensitivity analyses using age dichotomized at 90 years and as a continuous variable. DOAC had a similar net clinical benefit in patients aged ≥85 (+1.73 to +2.66) and < 85 years (+1.90 to +3.36 events/100 patient-years for ICH-weights 1.5 to 3.1). Interpretation: The favorable profile of DOAC over VKA in patients with AF and recent stroke was maintained in the oldest old. ANN NEUROL 2021.

Published
2022
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4. Oral Anticoagulants in the Oldest Old with Recent Stroke and Atrial Fibrillation

Author

Polymeris, A.A. Macha, K. Paciaroni, M. Wilson, D. Koga, M. Cappellari, M. Schaedelin, S. Zietz, A. Peters, N. Seiffge, D.J. Haupenthal, D. Gassmann, L. De Marchis, G.M. Wang, R. Gensicke, H. Stoll, S. Thilemann, S. Avramiotis, N.S. Bonetti, B. Tsivgoulis, G. Ambler, G. Alberti, A. Yoshimura, S. Brown, M.M. Shiozawa, M. Lip, G.Y.H. Venti, M. Acciarresi, M. Tanaka, K. Mosconi, M.G. Takagi, M. Jäger, R.H. Muir, K. Inoue, M. Schwab, S. Bonati, L.H. Lyrer, P.A. Toyoda, K. Caso, V. Werring, D.J. Kallmünzer, B. Engelter, S.T. Engelter, S.T. Lyrer, P.A. Bonati, L.H. Seiffge, D.J. Traenka, C. Polymeris, A.A. Zietz, A. Peters, N. De Marchis, G.M. Thilemann, S. Avramiotis, N.S. Gensicke, H. Hert, L. Wagner, B. Schaub, F. Meya, L. Fladt, J. Dittrich, T. Fisch, U. Macha, K. Haupenthal, D. Gassmann, L. Wang, R. Stoll, S. Schwab, S. Volbers, B. Siedler, G. Kallmünzer, B. Cappellari, M. Bonetti, B. Bovi, P. Tomelleri, G. Micheletti, N. Zivelonghi, C. Emiliani, A. Parry-Jones, A. Patterson, C. Price, C. Elmarimi, A. Parry, A. Nallasivam, A. Nor, A.M. Esis, B. Bruce, D. Bhaskaran, B. Roffe, C. Cullen, C. Holmes, C. Cohen, D. Hargroves, D. Mangion, D. Chadha, D. Vahidassr, D. Manawadu, D. Giallombardo, E. Warburton, E. Flossman, E. Gunathilagan, G. Proschel, H. Emsley, H. Anwar, I. Burger, I. Okwera, J. Putterill, J. O’Connell, J. Bamford, J. Corrigan, J. Scott, J. Birns, J. Kee, K. Saastamoinen, K. Pasco, K. Dani, K. Sekaran, L. Choy, L. Iveson, L. Mamun, M. Sajid, M. Cooper, M. Burn, M. Smith, M. Power, M. Davis, M. Smyth, N. Veltkamp, R. Sharma, P. Guyler, P. O’Mahony, P. Wilkinson, P. Datta, P. Aghoram, P. Marsh, R. Luder, R. Meenakishundaram, S. Subramonian, S. Leach, S. Ispoglou, S. Andole, S. England, T. Manoj, A. Harrington, F. Rehman, H. Sword, J. Staals, J. Mahawish, K. Harkness, K. Shaw, L. McCormich, M. Sprigg, N. Mansoor, S. Krishnamurthy, V. Giustozzi, M. Acciarresi, M. Agnelli, G. Becattini, C. Alberti, A. D’Amore, C. Cimini, L.A. Bandini, F. Tsivgoulis, G. Liantinioti, C. Chondrogianni, M. Yaghi, S. Furie, K.L. Tadi, P. Zedde, M. Abdul-Rahim, A.H. Lees, K.R. Bovi, P. Carletti, M. Rigatelli, A. Cappellari, M. Putaala, J. Tomppo, L. Tatlisumak, T. Marcheselli, S. Pezzini, A. Poli, L. Padovani, A. Vannucchi, V. Masotti, L. Sohn, S.-I. Lorenzini, G. Tassi, R. Guideri, F. Acampa, M. Martini, G. Ntaios, G. Athanasakis, G. Makaritsis, K. Karagkiozi, E. Vadikolias, K. Mumoli, N. Galati, F. Sacco, S. Tiseo, C. Corea, F. Ageno, W. Bellesini, M. Colombo, G. Silvestrelli, G. Ciccone, A. Lanari, A. Scoditti, U. Denti, L. Mancuso, M. Maccarrone, M. Ulivi, L. Orlandi, G. Giannini, N. Tassinari, T. De Lodovici, M.L. Rueckert, C. Baldi, A. Toni, D. Letteri, F. Pieroni, A. Giuntini, M. Lotti, E.M. Flomin, Y. Kargiotis, O. Karapanayiotides, T. Monaco, S. Baronello, M.M. Csiba, L. Szabó, L. Chiti, A. Giorli, E. Del Sette, M. Imberti, D. Zabzuni, D. Doronin, B. Volodina, V. Michel, P. Vanacker, P. Barlinn, K. Pallesen, L.-P. Barlinn, J. Deleu, D. Melikyan, G. Ibrahim, F. Akhtar, N. Gourbali, V. Todo, K. Kimura, K. Shibazaki, K. Yagita, Y. Furui, E. Itabashi, R. Terasaki, T. Shiokawa, Y. Hirano, T. Suzuki, R. Kamiyama, K. Nakagawara, J. Takizawa, S. Homma, K. Okuda, S. Okada, Y. Maeda, K. Kameda, T. Kario, K. Nagakane, Y. Hasegawa, Y. Akiyama, H. Shibuya, S. Mochizuki, H. Ito, Y. Nakashima, T. Matsuoka, H. Takamatsu, K. Nishiyama, K. Tanaka, K. Endo, K. Miyagi, T. Osaki, M. Kobayashi, J. Okata, T. Tanaka, E. Sakamoto, Y. Tokunaga, K. Takizawa, H. Takasugi, J. Matsubara, S. Higashida, K. Matsuki, T. Kinoshita, N. Shiozawa, M. Ide, T. Yoshimoto, T. Ando, D. Fujita, K. Kumamoto, M. Kamimura, T. Kikuno, M. Mizoguchi, T. Sato, T. NOACISP-LONGTERM, Erlangen Registry, CROMIS-2, RAF, RAF-DOAC, SAMURAI-NVAF Verona Registry Collaborators

Abstract

Objective: To investigate the safety and effectiveness of direct oral anticoagulants (DOAC) versus vitamin K antagonists (VKA) after recent stroke in patients with atrial fibrillation (AF) aged ≥85 years. Methods: Individual patient data analysis from seven prospective stroke cohorts. We compared DOAC versus VKA treatment among patients with AF and recent stroke (

Published
2022

7. Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID-19 pandemic

Author

Nguyen, T.N. Haussen, D.C. Qureshi, M.M. Yamagami, H. Fujinaka, T. Mansour, O.Y. Abdalkader, M. Frankel, M. Qiu, Z. Taylor, A. Lylyk, P. Eker, O.F. Mechtouff, L. Piotin, M. Lima, F.O. Mont'Alverne, F. Izzath, W. Sakai, N. Mohammaden, M. Al-Bayati, A.R. Renieri, L. Mangiafico, S. Ozretic, D. Chalumeau, V. Ahmad, S. Rashid, U. Hussain, S.I. John, S. Griffin, E. Thornton, J. Fiorot, J.A. Rivera, R. Hammami, N. Cervantes-Arslanian, A.M. Dasenbrock, H.H. Vu, H.L. Nguyen, V.Q. Hetts, S. Bourcier, R. Guile, R. Walker, M. Sharma, M. Frei, D. Jabbour, P. Herial, N. Al-Mufti, F. Ozdemir, A.O. Aykac, O. Gandhi, D. Chugh, C. Matouk, C. Lavoie, P. Edgell, R. Beer-Furlan, A. Chen, M. Killer-Oberpfalzer, M. Pereira, V.M. Nicholson, P. Huded, V. Ohara, N. Watanabe, D. Shin, D.H. Magalhaes, P.S.C. Kikano, R. Ortega-Gutierrez, S. Farooqui, M. Abou-Hamden, A. Amano, T. Yamamoto, R. Weeks, A. Cora, E.A. Sivan-Hoffmann, R. Crosa, R. Möhlenbruch, M. Nagel, S. Al-Jehani, H. Sheth, S.A. Rivera, V.S.L. Siegler, J.E. Sani, A.F. Puri, A.S. Kuhn, A.L. Bernava, G. Machi, P. Abud, D.G. Pontes-Neto, O.M. Wakhloo, A.K. Voetsch, B. Raz, E. Yaghi, S. Mehta, B.P. Kimura, N. Murakami, M. Lee, J.S. Hong, J.M. Fahed, R. Walker, G. Hagashi, E. Cordina, S.M. Roh, H.G. Wong, K. Arenillas, J.F. Martinez-Galdamez, M. Blasco, J. Vasquez, A.R. Fonseca, L. Silva, M.L. Wu, T.Y. John, S. Brehm, A. Psychogios, M. Mack, W.J. Tenser, M. Todaka, T. Fujimura, M. Novakovic, R. Deguchi, J. Sugiura, Y. Tokimura, H. Khatri, R. Kelly, M. Peeling, L. Murayama, Y. Winters, H.S. Wong, J. Teleb, M. Payne, J. Fukuda, H. Miyake, K. Shimbo, J. Sugimura, Y. Uno, M. Takenobu, Y. Matsumaru, Y. Yamada, S. Kono, R. Kanamaru, T. Morimoto, M. Iida, J. Saini, V. Yavagal, D. Bushnaq, S. Huang, W. Linfante, I. Kirmani, J. Liebeskind, D.S. Szeder, V. Shah, R. Devlin, T.G. Birnbaum, L. Luo, J. Churojana, A. Masoud, H.E. Lopez, C.Y. Steinfort, B. Ma, A. Hassan, A.E. Al Hashmi, A. McDermott, M. Mokin, M. Chebl, A. Kargiotis, O. Tsivgoulis, G. Morris, J.G. Eskey, C.J. Thon, J. Rebello, L. Altschul, D. Cornett, O. Singh, V. Pandian, J. Kulkarni, A. Lavados, P.M. Olavarria, V.V. Todo, K. Yamamoto, Y. Silva, G.S. Geyik, S. Johann, J. Multani, S. Kaliaev, A. Sonoda, K. Hashimoto, H. Alhazzani, A. Chung, D.Y. Mayer, S.A. Fifi, J.T. Hill, M.D. Zhang, H. Yuan, Z. Shang, X. Castonguay, A.C. Gupta, R. Jovin, T.G. Raymond, J. Zaidat, O.O. Nogueira, R.G.

Subjects
cardiovascular diseases, nervous system diseases
Abstract

Background During the COVID-19 pandemic, decreased volumes of stroke admissions and mechanical thrombectomy were reported. The study's objective was to examine whether subarachnoid haemorrhage (SAH) hospitalisations and ruptured aneurysm coiling interventions demonstrated similar declines. Methods We conducted a cross-sectional, retrospective, observational study across 6 continents, 37 countries and 140 comprehensive stroke centres. Patients with the diagnosis of SAH, aneurysmal SAH, ruptured aneurysm coiling interventions and COVID-19 were identified by prospective aneurysm databases or by International Classification of Diseases, 10th Revision, codes. The 3-month cumulative volume, monthly volumes for SAH hospitalisations and ruptured aneurysm coiling procedures were compared for the period before (1 year and immediately before) and during the pandemic, defined as 1 March-31 May 2020. The prior 1-year control period (1 March-31 May 2019) was obtained to account for seasonal variation. Findings There was a significant decline in SAH hospitalisations, with 2044 admissions in the 3 months immediately before and 1585 admissions during the pandemic, representing a relative decline of 22.5% (95% CI -24.3% to -20.7%, p

Published
2021

8. Global impact of COVID-19 on stroke care

Author

Nogueira, R.G. Abdalkader, M. Qureshi, M.M. Frankel, M.R. Mansour, O.Y. Yamagami, H. Qiu, Z. Farhoudi, M. Siegler, J.E. Yaghi, S. Raz, E. Sakai, N. Ohara, N. Piotin, M. Mechtouff, L. Eker, O. Chalumeau, V. Kleinig, T.J. Pop, R. Liu, J. Winters, H.S. Shang, X. Vasquez, A.R. Blasco, J. Arenillas, J.F. Martinez-Galdamez, M. Brehm, A. Psychogios, M.-N. Lylyk, P. Haussen, D.C. Al-Bayati, A.R. Mohammaden, M.H. Fonseca, L. Luís Silva, M. Montalverne, F. Renieri, L. Mangiafico, S. Fischer, U. Gralla, J. Frei, D. Chugh, C. Mehta, B.P. Nagel, S. Mohlenbruch, M. Ortega-Gutierrez, S. Farooqui, M. Hassan, A.E. Taylor, A. Lapergue, B. Consoli, A. Campbell, B.C.V. Sharma, M. Walker, M. Van Horn, N. Fiehler, J. Nguyen, H.T. Nguyen, Q.T. Watanabe, D. Zhang, H. Le, H.V. Nguyen, V.Q. Shah, R. Devlin, T. Khandelwal, P. Linfante, I. Izzath, W. Lavados, P.M. Olavarría, V.V. Sampaio Silva, G. de Carvalho Sousa, A.V. Kirmani, J. Bendszus, M. Amano, T. Yamamoto, R. Doijiri, R. Tokuda, N. Yamada, T. Terasaki, T. Yazawa, Y. Morris, J.G. Griffin, E. Thornton, J. Lavoie, P. Matouk, C. Hill, M.D. Demchuk, A.M. Killer-Oberpfalzer, M. Nahab, F. Altschul, D. Ramos-Pachón, A. Pérez de la Ossa, N. Kikano, R. Boisseau, W. Walker, G. Cordina, S.M. Puri, A. Luisa Kuhn, A. Gandhi, D. Ramakrishnan, P. Novakovic-White, R. Chebl, A. Kargiotis, O. Czap, A. Zha, A. Masoud, H.E. Lopez, C. Ozretic, D. Al-Mufti, F. Zie, W. Duan, Z. Yuan, Z. Huang, W. Hao, Y. Luo, J. Kalousek, V. Bourcier, R. Guile, R. Hetts, S. Al-Jehani, H.M. AlHazzani, A. Sadeghi-Hokmabadi, E. Teleb, M. Payne, J. Lee, J.S. Hong, J.M. Sohn, S.-I. Hwang, Y.-H. Shin, D.H. Roh, H.G. Edgell, R. Khatri, R. Smith, A. Malik, A. Liebeskind, D. Herial, N. Jabbour, P. Magalhaes, P. Ozdemir, A.O. Aykac, O. Uwatoko, T. Dembo, T. Shimizu, H. Sugiura, Y. Miyashita, F. Fukuda, H. Miyake, K. Shimbo, J. Sugimura, Y. Beer-Furlan, A. Joshi, K. Catanese, L. Abud, D.G. Neto, O.G. Mehrpour, M. Al Hashmi, A. Saqqur, M. Mostafa, A. Fifi, J.T. Hussain, S. John, S. Gupta, R. Sivan-Hoffmann, R. Reznik, A. Sani, A.F. Geyik, S. Akıl, E. Churojana, A. Ghoreishi, A. Saadatnia, M. Sharifipour, E. Ma, A. Faulder, K. Wu, T. Leung, L. Malek, A. Voetsch, B. Wakhloo, A. Rivera, R. Barrientos Iman, D.M. Pikula, A. Lioutas, V.-A. Thomalla, G. Birnbaum, L. Machi, P. Bernava, G. McDermott, M. Kleindorfer, D. Wong, K. Patterson, M.S. Fiorot, J.A., Jr. Huded, V. Mack, W. Tenser, M. Eskey, C. Multani, S. Kelly, M. Janardhan, V. Cornett, O. Singh, V. Murayama, Y. Mokin, M. Yang, P. Zhang, X. Yin, C. Han, H. Peng, Y. Chen, W. Crosa, R. Frudit, M.E. Pandian, J.D. Kulkarni, A. Yagita, Y. Takenobu, Y. Matsumaru, Y. Yamada, S. Kono, R. Kanamaru, T. Yamazaki, H. Sakaguchi, M. Todo, K. Yamamoto, N. Sonoda, K. Yoshida, T. Hashimoto, H. Nakahara, I. Cora, E. Volders, D. Ducroux, C. Shoamanesh, A. Ospel, J. Kaliaev, A. Ahmed, S. Rashid, U. Rebello, L.C. Pereira, V.M. Fahed, R. Chen, M. Sheth, S.A. Palaiodimou, L. Tsivgoulis, G. Chandra, R. Koyfman, F. Leung, T. Khosravani, H. Dharmadhikari, S. Frisullo, G. Calabresi, P. Tsiskaridze, A. Lobjanidze, N. Grigoryan, M. Czlonkowska, A. de Sousa, D.A. Demeestere, J. Liang, C. Sangha, N. Lutsep, H.L. Ayo-Martín, Ó. Cruz-Culebras, A. Tran, A.D. Young, C.Y. Cordonnier, C. Caparros, F. De Lecinana, M.A. Fuentes, B. Yavagal, D. Jovin, T. Spelle, L. Moret, J. Khatri, P. Zaidat, O. Raymond, J. Martins, S. Nguyen, T.

Abstract

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. © 2021 World Stroke Organization.

Published
2021

9. Global Impact of COVID-19 on Stroke Care and IV Thrombolysis

Author

Nogueira, R.G. Qureshi, M.M. Abdalkader, M. Martins, S.O. Yamagami, H. Qiu, Z. Mansour, O.Y. Sathya, A. Czlonkowska, A. Tsivgoulis, G. Aguiar de Sousa, D. Demeestere, J. Mikulik, R. Vanacker, P. Siegler, J.E. Kõrv, J. Biller, J. Liang, C.W. Sangha, N.S. Zha, A.M. Czap, A.L. Holmstedt, C.A. Turan, T.N. Ntaios, G. Malhotra, K. Tayal, A. Loochtan, A. Ranta, A. Mistry, E.A. Alexandrov, A.W. Huang, D.Y. Yaghi, S. Raz, E. Sheth, S.A. Mohammaden, M.H. Frankel, M. Bila Lamou, E.G. Aref, H.M. Elbassiouny, A. Hassan, F. Menecie, T. Mustafa, W. Shokri, H.M. Roushdy, T. Sarfo, F.S. Alabi, T.O. Arabambi, B. Nwazor, E.O. Sunmonu, T.A. Wahab, K. Yaria, J. Mohammed, H.H. Adebayo, P.B. Riahi, A.D. Sassi, S.B. Gwaunza, L. Ngwende, G.W. Sahakyan, D. Rahman, A. Ai, Z. Bai, F. Duan, Z. Hao, Y. Huang, W. Li, G. Li, W. Liu, G. Luo, J. Shang, X. Sui, Y. Tian, L. Wen, H. Wu, B. Yan, Y. Yuan, Z. Zhang, H. Zhang, J. Zhao, W. Zi, W. Leung, T.W. Chugh, C. Huded, V. Menon, B. Pandian, J.D. Sylaja, P.N. Usman, F.S. Farhoudi, M. Hokmabadi, E.S. Horev, A. Reznik, A. Sivan Hoffmann, R. Ohara, N. Sakai, N. Watanabe, D. Yamamoto, R. Doijiri, R. Tokuda, N. Yamada, T. Terasaki, T. Yazawa, Y. Uwatoko, T. Dembo, T. Shimizu, H. Sugiura, Y. Miyashita, F. Fukuda, H. Miyake, K. Shimbo, J. Sugimura, Y. Yagita, Y. Takenobu, Y. Matsumaru, Y. Yamada, S. Kono, R. Kanamaru, T. Yamazaki, H. Sakaguchi, M. Todo, K. Yamamoto, N. Sonoda, K. Yoshida, T. Hashimoto, H. Nakahara, I. Kondybayeva, A. Faizullina, K. Kamenova, S. Zhanuzakov, M. Baek, J.-H. Hwang, Y. Lee, J.S. Lee, S.B. Moon, J. Park, H. Seo, J.H. Seo, K.-D. Sohn, S.I. Young, C.J. Ahdab, R. Wan Zaidi, W.A. Aziz, Z.A. Basri, H.B. Chung, L.W. Ibrahim, A.B. Ibrahim, K.A. Looi, I. Tan, W.Y. Yahya, N.W. Groppa, S. Leahu, P. Al Hashmi, A.M. Imam, Y.Z. Akhtar, N. Pineda-Franks, M.C. Co, C.O. Kandyba, D. Alhazzani, A. Al-Jehani, H. Tham, C.H. Mamauag, M.J. Venketasubramanian, N. Chen, C.-H. Tang, S.-C. Churojana, A. Akil, E. Aykaç, Ö. Ozdemir, A.O. Giray, S. Hussain, S.I. John, S. Le Vu, H. Tran, A.D. Nguyen, H.H. Nhu Pham, T. Nguyen, T.H. Nguyen, T.Q. Gattringer, T. Enzinger, C. Killer-Oberpfalzer, M. Bellante, F. De Blauwe, S. Vanhooren, G. De Raedt, S. Dusart, A. Lemmens, R. Ligot, N. Pierre Rutgers, M. Yperzeele, L. Alexiev, F. Sakelarova, T. Bedeković, M.R. Budincevic, H. Cindric, I. Hucika, Z. Ozretic, D. Saric, M.S. Pfeifer, F. Karpowic, I. Cernik, D. Sramek, M. Skoda, M. Hlavacova, H. Klecka, L. Koutny, M. Vaclavik, D. Skoda, O. Fiksa, J. Hanelova, K. Nevsimalova, M. Rezek, R. Prochazka, P. Krejstova, G. Neumann, J. Vachova, M. Brzezanski, H. Hlinovsky, D. Tenora, D. Jura, R. Jurák, L. Novak, J. Novak, A. Topinka, Z. Fibrich, P. Sobolova, H. Volny, O. Krarup Christensen, H. Drenck, N. Klingenberg Iversen, H. Simonsen, C.Z. Truelsen, T.C. Wienecke, T. Vibo, R. Gross-Paju, K. Toomsoo, T. Antsov, K. Caparros, F. Cordonnier, C. Dan, M. Faucheux, J.-M. Mechtouff, L. Eker, O. Lesaine, E. Ondze, B. Peres, R. Pico, F. Piotin, M. Pop, R. Rouanet, F. Gubeladze, T. Khinikadze, M. Lobjanidze, N. Tsiskaridze, A. Nagel, S. Ringleb, P.A. Rosenkranz, M. Schmidt, H. Sedghi, A. Siepmann, T. Szabo, K. Thomalla, G. Palaiodimou, L. Sagris, D. Kargiotis, O. Klivenyi, P. Szapary, L. Tarkanyi, G. Adami, A. Bandini, F. Calabresi, P. Frisullo, G. Renieri, L. Sangalli, D. Pirson, A. Uyttenboogaart, M. van den Wijngaard, I. Kristoffersen, E.S. Brola, W. Fudala, M. Horoch-Lyszczarek, E. Karlinski, M. Kazmierski, R. Kram, P. Rogoziewicz, M. Kaczorowski, R. Luchowski, P. Sienkiewicz-Jarosz, H. Sobolewski, P. Fryze, W. Wisniewska, A. Wiszniewska, M. Ferreira, P. Ferreira, P. Fonseca, L. Marto, J.P. Pinho E Melo, T. Nunes, A.P. Rodrigues, M. Tedim Cruz, V. Falup-Pecurariu, C. Krastev, G. Mako, M. de Leciñana, M.A. Arenillas, J.F. Ayo-Martin, O. Cruz Culebras, A. Tejedor, E.D. Montaner, J. Pérez-Sánchez, S. Tola Arribas, M.A. Rodriguez Vasquez, A. Mayza, M. Bernava, G. Brehm, A. Machi, P. Fischer, U. Gralla, J. Michel, P.L. Psychogios, M.-N. Strambo, D. Banerjee, S. Krishnan, K. Kwan, J. Butt, A. Catanese, L. Demchuk, A.M. Field, T. Haynes, J. Hill, M.D. Khosravani, H. Mackey, A. Pikula, A. Saposnik, G. Scott, C.A. Shoamanesh, A. Shuaib, A. Yip, S. Barboza, M.A. Barrientos, J.D. Portillo Rivera, L.I. Gongora-Rivera, F. Novarro-Escudero, N. Blanco, A. Abraham, M. Alsbrook, D. Altschul, D. Alvarado-Ortiz, A.J. Bach, I. Badruddin, A. Barazangi, N. Brereton, C. Castonguay, A. Chaturvedi, S. Chaudry, S.A. Choe, H. Choi, J.H. Dharmadhikari, S. Desai, K. Devlin, T.G. Doss, V.T. Edgell, R. Etherton, M. Farooqui, M. Frei, D. Gandhi, D. Grigoryan, M. Gupta, R. Hassan, A.E. Helenius, J. Kaliaev, A. Kaushal, R. Khandelwal, P. Khawaja, A.M. Khoury, N.N. Kim, B.S. Kleindorfer, D.O. Koyfman, F. Lee, V.H. Leung, L.Y. Linares, G. Linfante, I. Lutsep, H.L. Macdougall, L. Male, S. Malik, A.M. Masoud, H. McDermott, M. Mehta, B.P. Min, J. Mittal, M. Morris, J.G. Multani, S.S. Nahab, F. Nalleballe, K. Nguyen, C.B. Novakovic-White, R. Ortega-Gutierrez, S. Rahangdale, R.H. Ramakrishnan, P. Romero, J.R. Rost, N. Rothstein, A. Ruland, S. Shah, R. Sharma, M. Silver, B. Simmons, M. Singh, A. Starosciak, A.K. Strasser, S.L. Szeder, V. Teleb, M. Tsai, J.P. Voetsch, B. Balaguera, O. Pujol Lereis, V.A. Luraschi, A. Almeida, M.S. Cardoso, F.B. Conforto, A. De Deus Silva, L. Varrone Giacomini, L. Oliveira Lima, F. Longo, A.L. Magalhães, P.S.C. Martins, R.T. Mont'alverne, F. Mora Cuervo, D.L. Costa Rebello, L. Valler, L. Zetola, V.F. Lavados, P.M. Navia, V. Olavarría, V.V. Almeida Toro, J.M. Amaya, P.F.R. Bayona, H. Corredor, A. Rivera Ordonez, C.E. Mantilla Barbosa, D.K. Lara, O. Patiño, M.R. Diaz Escobar, L.F. Dejesus Melgarejo Fariña, D.E. Cardozo Villamayor, A. Zelaya Zarza, A.J. Barrientos Iman, D.M. Rodriguez Kadota, L. Campbell, B. Hankey, G.J. Hair, C. Kleinig, T. Ma, A. Tomazini Martins, R. Sahathevan, R. Thijs, V. Salazar, D. Yuan-Hao Wu, T. Haussen, D.C. Liebeskind, D. Yavagal, D.R. Jovin, T.G. Zaidat, O.O. Nguyen, T.N. SVIN COVID-19 Global Stroke Registry SVIN COVID-19 Global Stroke Registry

Abstract

OBJECTIVE: To measure the global impact of COVID-19 pandemic on volumes of IV thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with 2 control 4-month periods. METHODS: We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. RESULTS: There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95% confidence interval [CI] -11.7 to -11.3, p < 0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95% CI -13.8 to -12.7, p < 0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95% CI -13.7 to -10.3, p = 0.001). Recovery of stroke hospitalization volume (9.5%, 95% CI 9.2-9.8, p < 0.0001) was noted over the 2 later (May, June) vs the 2 earlier (March, April) pandemic months. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was noted in 3.3% (1,722/52,026) of all stroke admissions. CONCLUSIONS: The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID-19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months. © 2021 American Academy of Neurology.

Published
2021

10. Global impact of COVID-19 on stroke care

Author

Nogueira, RG, Abdalkader, M, Qureshi, MM, Frankel, MR, Mansour, OY, Yamagami, H, Qiu, Z, Farhoudi, M, Siegler, JE, Yaghi, S, Raz, E, Sakai, N, Ohara, N, Piotin, M, Mechtouff, L, Eker, O, Chalumeau, V, Kleinig, TJ, Pop, R, Liu, J, Winters, HS, Shang, X, Rodriguez Vasquez, A, Blasco, J, Arenillas, JF, Martinez-Galdamez, M, Brehm, A, Psychogios, M-N, Lylyk, P, Haussen, DC, Al-Bayati, AR, Mohammaden, MH, Fonseca, L, Luis Silva, M, Montalverne, F, Renieri, L, Mangiafico, S, Fischer, U, Gralla, J, Frei, D, Chugh, C, Mehta, BP, Nagel, S, Mohlenbruch, M, Ortega-Gutierrez, S, Farooqui, M, Hassan, AE, Taylor, A, Lapergue, B, Consoli, A, Campbell, BCV, Sharma, M, Walker, M, Van Horn, N, Fiehler, J, Huy, TN, Nguyen, QT, Watanabe, D, Zhang, H, Le, HV, Nguyen, VQ, Shah, R, Devlin, T, Khandelwal, P, Linfante, I, Izzath, W, Lavados, PM, Olavarria, VV, Silva, GS, de Carvalho Sousa, AV, Kirmani, J, Bendszus, M, Amano, T, Yamamoto, R, Doijiri, R, Tokuda, N, Yamada, T, Terasaki, T, Yazawa, Y, Morris, JG, Griffin, E, Thornton, J, Lavoie, P, Matouk, C, Hill, MD, Demchuk, AM, Killer-Oberpfalzer, M, Nahab, F, Altschul, D, Ramos-Pachon, A, Perez de la Ossa, N, Kikano, R, Boisseau, W, Walker, G, Cordina, SM, Puri, A, Kuhn, AL, Gandhi, D, Ramakrishnan, P, Novakovic-White, R, Chebl, A, Kargiotis, O, Czap, A, Zha, A, Masoud, HE, Lopez, C, Ozretic, D, Al-Mufti, F, Zie, W, Duan, Z, Yuan, Z, Huang, W, Hao, Y, Luo, J, Kalousek, V, Bourcier, R, Guile, R, Hetts, S, Al-Jehani, HM, AlHazzani, A, Sadeghi-Hokmabadi, E, Teleb, M, Payne, J, Lee, JS, Hong, JM, Sohn, S-I, Hwang, Y-H, Shin, DH, Roh, HG, Edgell, R, Khatri, R, Smith, A, Malik, A, Liebeskind, D, Herial, N, Jabbour, P, Magalhaes, P, Ozdemir, AO, Aykac, O, Uwatoko, T, Dembo, T, Shimizu, H, Sugiura, Y, Miyashita, F, Fukuda, H, Miyake, K, Shimbo, J, Sugimura, Y, Beer-Furlan, A, Joshi, K, Catanese, L, Abud, DG, Pontes Neto, O, Mehrpour, M, Al Hashmi, A, Saqqur, M, Mostafa, A, Fifi, JT, Hussain, S, John, S, Gupta, R, Sivan-Hoffmann, R, Reznik, A, Sani, AF, Geyik, S, Akil, ECR, Churojana, A, Ghoreishi, A, Saadatnia, M, Sharifipour, E, Ma, A, Faulder, K, Wu, T, Leung, L, Malek, A, Voetsch, B, Wakhloo, A, Rivera, R, Barrientos Iman, DM, Pikula, A, Lioutas, V-A, Thomalla, G, Birnbaum, L, Machi, P, Bernava, G, McDermott, M, Kleindorfer, D, Wong, K, Patterson, MS, Fiorot, JA, Huded, V, Mack, W, Tenser, M, Eskey, C, Multani, S, Kelly, M, Janardhan, V, Cornett, O, Singh, V, Murayama, Y, Mokin, M, Yang, P, Zhang, X, Yin, C, Han, H, Peng, Y, Chen, W, Crosa, R, Frudit, ME, Pandian, JD, Kulkarni, A, Yagita, Y, Takenobu, Y, Matsumaru, Y, Yamada, S, Kono, R, Kanamaru, T, Yamazaki, H, Sakaguchi, M, Todo, K, Yamamoto, N, Sonoda, K, Yoshida, T, Hashimoto, H, Nakahara, I, Cora, E, Volders, D, Ducroux, C, Shoamanesh, A, Ospel, J, Kaliaev, A, Ahmed, S, Rashid, U, Rebello, LC, Pereira, VM, Fahed, R, Chen, M, Sheth, SA, Palaiodimou, L, Tsivgoulis, G, Chandra, R, Koyfman, F, Leung, T, Khosravani, H, Dharmadhikari, S, Frisullo, G, Calabresi, P, Tsiskaridze, A, Lobjanidze, N, Grigoryan, M, Czlonkowska, A, de Sousa, DA, Demeestere, J, Liang, C, Sangha, N, Lutsep, HL, Ayo-Martin, O, Cruz-Culebras, A, Tran, AD, Young, CY, Cordonnier, C, Caparros, F, Alonso De Lecinana, M, Fuentes, B, Yavagal, D, Jovin, T, Spelle, L, Moret, J, Khatri, P, Zaidat, O, Raymond, J, Martins, S, Thanh, N, Nogueira, RG, Abdalkader, M, Qureshi, MM, Frankel, MR, Mansour, OY, Yamagami, H, Qiu, Z, Farhoudi, M, Siegler, JE, Yaghi, S, Raz, E, Sakai, N, Ohara, N, Piotin, M, Mechtouff, L, Eker, O, Chalumeau, V, Kleinig, TJ, Pop, R, Liu, J, Winters, HS, Shang, X, Rodriguez Vasquez, A, Blasco, J, Arenillas, JF, Martinez-Galdamez, M, Brehm, A, Psychogios, M-N, Lylyk, P, Haussen, DC, Al-Bayati, AR, Mohammaden, MH, Fonseca, L, Luis Silva, M, Montalverne, F, Renieri, L, Mangiafico, S, Fischer, U, Gralla, J, Frei, D, Chugh, C, Mehta, BP, Nagel, S, Mohlenbruch, M, Ortega-Gutierrez, S, Farooqui, M, Hassan, AE, Taylor, A, Lapergue, B, Consoli, A, Campbell, BCV, Sharma, M, Walker, M, Van Horn, N, Fiehler, J, Huy, TN, Nguyen, QT, Watanabe, D, Zhang, H, Le, HV, Nguyen, VQ, Shah, R, Devlin, T, Khandelwal, P, Linfante, I, Izzath, W, Lavados, PM, Olavarria, VV, Silva, GS, de Carvalho Sousa, AV, Kirmani, J, Bendszus, M, Amano, T, Yamamoto, R, Doijiri, R, Tokuda, N, Yamada, T, Terasaki, T, Yazawa, Y, Morris, JG, Griffin, E, Thornton, J, Lavoie, P, Matouk, C, Hill, MD, Demchuk, AM, Killer-Oberpfalzer, M, Nahab, F, Altschul, D, Ramos-Pachon, A, Perez de la Ossa, N, Kikano, R, Boisseau, W, Walker, G, Cordina, SM, Puri, A, Kuhn, AL, Gandhi, D, Ramakrishnan, P, Novakovic-White, R, Chebl, A, Kargiotis, O, Czap, A, Zha, A, Masoud, HE, Lopez, C, Ozretic, D, Al-Mufti, F, Zie, W, Duan, Z, Yuan, Z, Huang, W, Hao, Y, Luo, J, Kalousek, V, Bourcier, R, Guile, R, Hetts, S, Al-Jehani, HM, AlHazzani, A, Sadeghi-Hokmabadi, E, Teleb, M, Payne, J, Lee, JS, Hong, JM, Sohn, S-I, Hwang, Y-H, Shin, DH, Roh, HG, Edgell, R, Khatri, R, Smith, A, Malik, A, Liebeskind, D, Herial, N, Jabbour, P, Magalhaes, P, Ozdemir, AO, Aykac, O, Uwatoko, T, Dembo, T, Shimizu, H, Sugiura, Y, Miyashita, F, Fukuda, H, Miyake, K, Shimbo, J, Sugimura, Y, Beer-Furlan, A, Joshi, K, Catanese, L, Abud, DG, Pontes Neto, O, Mehrpour, M, Al Hashmi, A, Saqqur, M, Mostafa, A, Fifi, JT, Hussain, S, John, S, Gupta, R, Sivan-Hoffmann, R, Reznik, A, Sani, AF, Geyik, S, Akil, ECR, Churojana, A, Ghoreishi, A, Saadatnia, M, Sharifipour, E, Ma, A, Faulder, K, Wu, T, Leung, L, Malek, A, Voetsch, B, Wakhloo, A, Rivera, R, Barrientos Iman, DM, Pikula, A, Lioutas, V-A, Thomalla, G, Birnbaum, L, Machi, P, Bernava, G, McDermott, M, Kleindorfer, D, Wong, K, Patterson, MS, Fiorot, JA, Huded, V, Mack, W, Tenser, M, Eskey, C, Multani, S, Kelly, M, Janardhan, V, Cornett, O, Singh, V, Murayama, Y, Mokin, M, Yang, P, Zhang, X, Yin, C, Han, H, Peng, Y, Chen, W, Crosa, R, Frudit, ME, Pandian, JD, Kulkarni, A, Yagita, Y, Takenobu, Y, Matsumaru, Y, Yamada, S, Kono, R, Kanamaru, T, Yamazaki, H, Sakaguchi, M, Todo, K, Yamamoto, N, Sonoda, K, Yoshida, T, Hashimoto, H, Nakahara, I, Cora, E, Volders, D, Ducroux, C, Shoamanesh, A, Ospel, J, Kaliaev, A, Ahmed, S, Rashid, U, Rebello, LC, Pereira, VM, Fahed, R, Chen, M, Sheth, SA, Palaiodimou, L, Tsivgoulis, G, Chandra, R, Koyfman, F, Leung, T, Khosravani, H, Dharmadhikari, S, Frisullo, G, Calabresi, P, Tsiskaridze, A, Lobjanidze, N, Grigoryan, M, Czlonkowska, A, de Sousa, DA, Demeestere, J, Liang, C, Sangha, N, Lutsep, HL, Ayo-Martin, O, Cruz-Culebras, A, Tran, AD, Young, CY, Cordonnier, C, Caparros, F, Alonso De Lecinana, M, Fuentes, B, Yavagal, D, Jovin, T, Spelle, L, Moret, J, Khatri, P, Zaidat, O, Raymond, J, Martins, S, and Thanh, N

Abstract

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

11. A multicenter study of transient global amnesia for the better detection of magnetic resonance imaging abnormalities

Author

Higashida, K., primary, Okazaki, S., additional, Todo, K., additional, Sasaki, T., additional, Ohara, N., additional, Kohara, N., additional, Yamamoto, S., additional, Yamagami, H., additional, Hashikawa, K., additional, Yoshimoto, T., additional, Ihara, M., additional, Koga, M., additional, Szabo, K., additional, and Mochizuki, H., additional

Published
2020
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13. A Case of Prosthetic Valve Dysfunction Early after Surgery Using a Mosaic Bioprosthesis

Author

Hiroshi Yasunaga, Todo K, Naofumi Enomoto, Yukio Hosokawa, Takeshi Oda, Hideki Sakashita, and Takahiro Shojima

Subjects
medicine.medical_specialty, business.industry, medicine, Prosthetic Valve Dysfunction, business, Surgery
Abstract

症例は81歳，男性．2005年9月に先天性二尖弁に伴う大動脈弁狭窄症に対し大動脈弁置換術が施行された．術後急性期より大動脈弁位人工弁流速は軽度高値を示したが，全身状態は良好であったため外来にて経過観察されていた．その後経胸壁心エコーにて徐々に流速の上昇を認め，2007年11月より労作時の前胸部不快感が出現し，拡張期雑音も聴取されるようになった．生体弁機能不全と診断し再手術を行った．術中所見では左冠尖に相当する弁葉に2カ所の亀裂を認め，生体弁流入側は多量のpannusが形成されており，流入側は狭小化していた．摘出された生体弁所見は右・無冠尖交連部ステントポストが9度外倒し，残り二対のステントポストが接近することで左冠尖が圧迫されていた．その結果人工弁流速の上昇および血液の乱流が発生し，多量のpannus増生を招き，早期に弁葉が破綻したと推察された．

Published
2010
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16. Clinical characteristics and prognosis of ischemic stroke/transient ischemic attack patients with non-valvular atrial fibrillation not eligible for large trials of direct oral anticoagulants: SAMURAI-NVAF study

Author

Kumamoto, M., primary, Sato, S., additional, Koga, M., additional, Todo, K., additional, Terasaki, T., additional, Kamiyama, K., additional, Kimura, K., additional, Yagita, Y., additional, Fujita, K., additional, Ando, D., additional, Kamimura, T., additional, Yashimoto, T., additional, Ide, T., additional, Matsubara, S., additional, Shiozawa, M., additional, Yamaguchi, Y., additional, Yamagami, H., additional, Yoshimura, S., additional, Arihiro, S., additional, and Toyoda, K., additional

Published
2017
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19. Remarkable effect of a phosphodiesterase type 3 inhibitor, milrinone in a reversible cerebral vasoconstriction syndrome patient with ischemic stroke: A case report

Author

Oyama, N., primary, Sakaguchi, M., additional, Higashida, K., additional, Murase, S., additional, Gon, Y., additional, Watanabe, A., additional, Terasaki, Y., additional, Todo, K., additional, Sasaki, T., additional, Yamamoto, J., additional, Saito, S., additional, Toda, K., additional, Sawa, Y., additional, and Mochizuki, H., additional

Published
2017
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20. Extended Endocardial Repair of Postinfarction Ventricular Septal Rupture: New Operative Technique?Modification of the Komeda-David Operation

Author

Todo K, Hiroshi Yasunaga, Takemi Kawara, Tadashi Tashiro, Ryuichi Shibano, and Haruta Y

Subjects
Male, Pulmonary and Respiratory Medicine, Cardiac Catheterization, medicine.medical_specialty, Heart Ventricles, Severity of Illness Index, Ventriculotomy, Ventricular Septal Rupture, Internal medicine, medicine, Humans, Pericardium, Hospital Mortality, cardiovascular diseases, Myocardial infarction, Aged, Heart Rupture, Post-Infarction, Aged, 80 and over, Surgical repair, Ventricular function, business.industry, Suture Techniques, Ventricular wall, Hemodynamics, Gated Blood-Pool Imaging, Middle Aged, medicine.disease, Surgery, Survival Rate, Treatment Outcome, medicine.anatomical_structure, cardiovascular system, Left ventricular cavity, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract

Between January 1992 and November 1992, four consecutive patients (ages 53 to 81 years) underwent early surgical repair of postinfarction ventricular septal ruptures using a new simple operative technique. The principles of the technique are longitudinal incision of the infarcted left anterior ventricular wall, placement of a saccular patch of single equine pericardium that covers the infarcted left ventricular wall, and large buttressed suture closure of the left ventriculotomy. The infarcted septum and infarcted left ventricular wall are completely separated from the left ventricular cavity. In this procedure, the infarcted myocardium is not resected, and left and right ventricular muscles are preserved. This technique is simple and safe for use in the acute phase of myocardial infarction, and it preserves ventricular function after surgery. (J Card Surg 1994;9:97–102)

Published
1994
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21. Left atrial myxoma mimicking papillary fibroelastoma

Author

Mau Amako, Koichi Higaki, Hiroshi Yasunaga, Hideki Tashiro, Takeshi Oda, Yoshinori Naito, Tohru Takaseya, Todo K, and Takemi Kawara

Subjects
medicine.medical_specialty, business.industry, Deep vein, Myxoma, General Medicine, medicine.disease, Thrombosis, Surgery, medicine.anatomical_structure, Papillary fibroelastoma, Left atrial, cardiovascular system, medicine, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, Radiology, Transthoracic echocardiogram, Left Atrial Myxoma, business, Histological examination
Abstract

A 67-year-old woman was referred to our hospital with a diagnosis of deep vein thrombosis due to surgery for left patellar fracture. Deep vein thrombosis resolved with thrombolytic therapy. Transthoracic echocardiogram revealed a mobile left atrial tumor. Transesophageal echocardiography showed a fragile tumor with multiple fronds, implying a papillary fibroelastoma. Because this patient had a history of cerebral embolism, urgent surgery was scheduled. The excised tumor showed a sea anemone-like appearance in saline, which was similar to that of a papillary fibroelastoma. However, histological examination revealed the features of a myxoma and not papillary fibroelastoma. Herein, we illustrate a very rare case of left atrial myxoma with papillary fibroelastoma-like features in terms of both echocardiographic and gross findings.

Published
2011

22. Anastomosis of left to right superior vena cava for repair of unroofed coronary sinus

Author

Hiroshi Yasunaga, Todo K, and Shingo Chihara

Subjects
Pulmonary and Respiratory Medicine, Heart Defects, Congenital, Male, medicine.medical_specialty, Vena Cava, Superior, Coronary Vessel Anomalies, Anastomosis, Internal medicine, medicine, Humans, cardiovascular diseases, Heart Atria, Vein, Child, Unroofed coronary sinus, Left superior vena cava, business.industry, Anastomosis, Surgical, Coronary Sinus, General Medicine, Right superior vena cava, Cardiac surgery, medicine.anatomical_structure, Cardiothoracic surgery, cardiovascular system, Complex cardiac anomalies, Cardiology, Surgery, Cardiology and Cardiovascular Medicine, business
Abstract

Left superior vena cava (LSVC) draining into the left atrium is a rare congenital cardiac complex. It may appear as an isolated anomaly or as part of more complex cardiac anomalies. Intraatrial rerouting techniques have been the most common approaches to correcting LSVC drainage into the left atrium in patients without a connecting vein. Although these techniques have proved reliable and successful, there are cases in which extracardiac methods for managing this form of anomalous systemic drainage may be preferable. In the present report, we describe an extracardiac approach to the correction of LSVC draining into the left atrium.

Published
2011

23. Sequential Internal Mammary Artery Grafts: Clinical and Angiographic Assessment

Author

Todo K, Hiroshi Yasunaga, Tadashi Tashiro, Haruta Y, and Tachikawa Y

Subjects
Male, medicine.medical_specialty, Myocardial Infarction, Anastomosis, Coronary Angiography, Angina, Postoperative Complications, String sign, medicine, Humans, Radiology, Nuclear Medicine and imaging, Severe stenosis, Internal Mammary-Coronary Artery Anastomosis, Aged, medicine.diagnostic_test, business.industry, Middle Aged, medicine.disease, Surgery, Survival Rate, Coronary arteries, medicine.anatomical_structure, Angiography, Exercise Test, Mammary artery, Female, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies, Artery
Abstract

Between January 1988 and August 1992, the internal mammary artery was used as a sequential graft to the left anterior descending artery and/or diagonal branch in 34 patients. One patient died in hospital. After surgery all survivors were free from angina for a follow-up of up to 4 years. Recatheterization was performed in 33 patients within 1 year of surgery. Postoperative angiography showed that 65 anastomoses (98%) were patent, but three patent grafts (5%) between the proximal and distal sequential anastomoses showed ‘string sign’. It is important to prevent ‘string sign’ in sequential grafting. It is considered that sequential internal mammary artery grafting should be limited to coronary arteries with severe stenosis that divides anastomosed coronary arteries into two.

Published
1993
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24. A child with influenza A (H1N1)-associated myocarditis rescued by extracorporeal membrane oxygenation

Author

Takeshi Oda, Hiroshi Yasunaga, Yasuyuki Zaima, Hiroshi Nishino, Todo K, Takahiro Shojima, Yoshimitsu Tsutsumi, and Shinichi Ito

Subjects
Male, medicine.medical_specialty, Cardiac output, medicine.medical_treatment, Pneumonia, Viral, Biomedical Engineering, Femoral vein, Medicine (miscellaneous), Femoral artery, Cardioversion, Biomaterials, Extracorporeal Membrane Oxygenation, Influenza A Virus, H1N1 Subtype, Jugular vein, medicine.artery, Influenza, Human, medicine, Extracorporeal membrane oxygenation, Humans, cardiovascular diseases, Child, business.industry, medicine.disease, Cardiac surgery, Surgery, Myocarditis, surgical procedures, operative, Ventricular fibrillation, cardiovascular system, Cardiology and Cardiovascular Medicine, business
Abstract

A 6-year-old boy had cold-like symptoms and was diagnosed with influenza A at a clinic. Administration of oseltamivir and azithromycin did not improve the symptoms. He was referred to our hospital and was diagnosed with H1N1 pneumonia. The patient required ventilator support. However, hypoxia and hypercapnia were uncontrollable. To oxygenate and reduce the carbon dioxide concentration, veno-venous extracorporeal membrane oxygenation (ECMO) was applied 24 h after admission. We established outflow via the right internal jugular vein and inflow via the right femoral vein. Six hours later, an electrical storm of ventricular fibrillation occurred, probably due to influenza myocarditis. Chest compression was started immediately. Both cardioversion and medication were ineffective in treating the electrical storm. Therefore, we decided to switch the veno-venous ECMO to veno-arterial ECMO to maintain systemic flow. During chest compression, a 6-mm graft was anastomosed to the left common femoral artery, and an outflow tube was connected to the graft. Consequently, veno-arterial ECMO was established via outflow through the left common femoral artery and inflow through both the right jugular vein and right femoral vein. Veno-arterial ECMO terminated the electrical storm, and cardiac output improved. Veno-arterial ECMO was provided for 107 h, and was then replaced by veno-venous ECMO. Forty-three hours later, veno-venous ECMO was discontinued. The patient was successfully weaned from the mechanical ventilator on the 9th day after admission. Unfortunately, spinal infarction appeared as a complication. The patient was discharged from the hospital on the 86th day, and has now returned to primary school.

Published
2010

25. Repair of left coronary artery ostial isolation caused by aortic valve leaflet

Author

Kenji Suda, Takeshi Oda, Hiroshi Yasunaga, and Todo K

Subjects
Pulmonary and Respiratory Medicine, Aortic valve, Heart Defects, Congenital, medicine.medical_specialty, Myocardial ischemia, Adolescent, Myocardial Ischemia, Postoperative recovery, Regurgitation (circulation), Coronary Artery Disease, Syncope, Angina Pectoris, Left coronary artery, Aortic valve repair, Internal medicine, medicine.artery, medicine, Cineangiography, Humans, Cardiac Surgical Procedures, Coronary sinus, business.industry, Myocardial Perfusion Imaging, medicine.anatomical_structure, Treatment Outcome, Aortic Valve, cardiovascular system, Cardiology, Exercise Test, Surgery, Female, Cardiology and Cardiovascular Medicine, business, Echocardiography, Transesophageal
Abstract

A 13-year-old girl had recurrent syncope episodes and chest oppression during exercise caused by myocardial ischemia that was confirmed by stress myocardial scintigraphy. Echocardiography revealed mild aortic regurgitation (AR). Cineangiography revealed persistent opacification of the left coronary sinus. Freeing of the adherent left coronary cusp from the aortic wall increased antegrade left coronary flow and commissural resuspension restored AR. Postoperative recovery was uneventful and myocardial ischemia did not develop after surgery. Hence, although left coronary artery ostial isolation by aortic valve leaflet is rare, it can be successfully treated by aortic valve repair.

Published
2010

26. Coronary artery bypass grafting without cardiopulmonary bypass for high-risk patients

Author

Hiroshi Yasunaga, Todo K, Yutaka Tachikawa, Haruta Y, and Tadashi Tashiro

Subjects
Carotid Artery Diseases, Male, medicine.medical_specialty, medicine.medical_treatment, Left Main Coronary Artery Stenosis, Carotid endarterectomy, Endarterectomy, Anterior Descending Coronary Artery, Thoracic aortic aneurysm, medicine.artery, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Myocardial infarction, Coronary Artery Bypass, Aged, Aged, 80 and over, Cardiopulmonary Bypass, business.industry, Middle Aged, medicine.disease, Abdominal aortic aneurysm, Aortic Aneurysm, Treatment Outcome, Coronary occlusion, Right coronary artery, cardiovascular system, Cardiology, Heart Arrest, Induced, Surgery, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Between January 1991 and June 1993, coronary artery bypass grafting was performed without either cardiopulmonary bypass or cardiac arrest in 23 patients. Most patients had several surgical risk factors, including age ⩾ 70 years, poor left ventricular function, left main coronary artery stenosis, chronic renal failure, and aortic aneurysm. Distal anastomoses were made under temporary interruption of coronary flow. A total of 37 distal anastomoses to the left anterior descending coronary artery and/or right coronary artery (mean 1.6 per patient) were made, 24 of which were internal thoracic arteries. The coronary occlusion time ranged from 7–14 min (mean 9.8 min). Combined cardiac or vascular operations were carried out in six patients (abdominal aortic aneurysm repair, thoracic aortic aneurysm repair, carotid endarterectomy, and coronary endarterectomy). There was one hospital death. Postoperative angiography was performed in 22 patients and showed a patency rate of 89%. In summary, coronary artery bypass grafting without cardiopulmonary bypass may improve the postoperative outcome of high-risk patients.

Published
1996

27. IN22-TU-01 Current status of carotid artery stenting (CAS)

Author

Sakai, N., primary, Adachi, H., additional, Ueno, Y., additional, Kunieda, T., additional, Sakai, C., additional, Yamagami, H., additional, Imamura, H., additional, Koyanagi, M., additional, Todo, K., additional, Yamamoto, S., additional, Kuramoto, Y., additional, Kohara, N., additional, and Kikuchi, H., additional

Published
2009
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31. High early patency rate following free internal mammary artery grafting

Author

Tadashi Tashiro, Masanao Nakamura, Haruta Y, Ko Tanaka, Todo K, and Masahiko Nagat

Subjects
medicine.medical_specialty, Graft patency, medicine.diagnostic_test, business.industry, Anastomosis, Surgery, medicine.anatomical_structure, medicine.artery, Internal medicine, Ascending aorta, Operative death, Angiography, Mammary artery, medicine, Cardiology, Cardiology and Cardiovascular Medicine, business, Vein, Artery
Abstract

We performed 28 coronary artery bypass procedures using the free internal mammary artery (IMA) from 1988–1991. An average of 3.6 coronary artery bypass grafts per patient were constructed, with 1.5 distal anastomoses per patient with each free IMA graft. We constructed proximal anastomoses between the ascending aorta and the free IMA. There was one operative death (3.6%). Early graft patency, 42 days as assessed by angiography, was 97.3%. The clinical and patency results (97%) obtained in our series confirm that the free internal mammary artery can be successfully employed instead of the saphenous vein in situations where the in-situ internal mammary artery graft is too short.

Published
1992
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49. Optimal Endovascular Therapy Technique for Isolated Intracranial Atherothrombotic Stroke-Related Large-Vessel Occlusion in the Acute-to-Subacute Stage.

Author

Beppu M, Uchida K, Sakai N, Yamagami H, Toyoda K, Matsumaru Y, Matsumoto Y, Todo K, Hayakawa M, Shindo S, Ota S, Morimoto M, Takeuchi M, Imamura H, Ikeda H, Tanaka K, Ishihara H, Kakita H, Sano T, Araki H, Nomura T, Sakakibara F, Shirakawa M, and Yoshimura S

Subjects
Humans, Male, Female, Aged, Middle Aged, Treatment Outcome, Intracranial Arteriosclerosis diagnostic imaging, Intracranial Arteriosclerosis therapy, Intracranial Arteriosclerosis surgery, Intracranial Arteriosclerosis complications, Stroke diagnostic imaging, Stroke surgery, Aged, 80 and over, Intracranial Thrombosis diagnostic imaging, Intracranial Thrombosis surgery, Intracranial Thrombosis therapy, Registries, Stents, Endovascular Procedures methods, Endovascular Procedures instrumentation, Thrombectomy methods, Thrombectomy instrumentation
Abstract

Background and Purpose: Reocclusion after treatment is a concern in endovascular therapy for isolated intracranial atherothrombotic stroke-related large-vessel occlusion (AT-LVO). However, the optimal endovascular therapy technique for AT-LVO has not yet been investigated. This study evaluated the optimal endovascular therapy technique for AT-LVO in a real-world setting., Materials and Methods: We conducted a historical, multicenter registry study at 51 centers that enrolled patients with AT-LVO. We divided the patients into 3 groups based on the endovascular therapy technique: mechanical thrombectomy alone, percutaneous transluminal angioplasty (PTA), and stent deployment. Mechanical thrombectomy alone was classified into the mechanical thrombectomy-only group; PTA and mechanical thrombectomy-PTA, into the PTA group; and mechanical thrombectomy-stent deployment, mechanical thrombectomy-PTA-stent deployment, PTA-stent deployment, and stent deployment-only into the stent group. The primary outcome was incidence of reocclusion of the treated vessels within 90 days of endovascular therapy completion., Results: We enrolled 770 patients and analyzed 509 patients. The rates in the mechanical thrombectomy-only, PTA, and stent deployment groups were 40.7%, 44.4%, and 14.9%, respectively. Incidence rate of residual stenosis >70% of final angiography was significantly higher in the mechanical thrombectomy-only group than in the PTA and stent deployment groups (mechanical thrombectomy-only versus PTA versus stent deployment: 34.5% versus 26.3% versus 13.2%, P = .002). Reocclusion rate was significantly lower in the PTA group than in the mechanical thrombectomy-only group (adjusted hazard ratio, 0.48; 95% CI, 0.29-0.80). Of the patients, 83.5% experienced reocclusion within 10 days after endovascular therapy. Alarmingly, a substantial subset (approximately 62.0%) of patients experienced reocclusion within 2 days of endovascular therapy. Incidence of mRS scores of 0-2 ninety days after endovascular therapy was not significantly different among the 3 groups. Incidences of symptomatic intracranial hemorrhage, any other intracranial hemorrhage, and death were not significantly different., Conclusions: Incidence rate of reocclusion was significantly lower in the PTA group than in the mechanical thrombectomy-only group. We found no meaningful difference in reocclusion rates between the stent deployment and mechanical thrombectomy-only groups. In Japan, glycoprotein IIb/IIIa inhibitors are not reimbursed. Therefore, PTA might be the preferred choice for AT-LVOs due to the higher reocclusion risk with mechanical thrombectomy-only. Reocclusion was likely to occur within 10 days, particularly within 2 days post-endovascular therapy., (© 2024 by American Journal of Neuroradiology.)

Published
2024
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50. Relationship between initial B-type natriuretic peptide levels and detection of atrial fibrillation with an insertable cardiac monitor in cryptogenic stroke: CRYPTON-ICM registry.

Author

Moriyama T, Todo K, Yamagami H, Kimura Y, Yamamoto S, Nagano K, Doijiri R, Yamazaki H, Sonoda K, Koge J, Nakayama T, Iwata T, Ueno Y, Gon Y, Okazaki S, Sasaki T, and Mochizuki H

Abstract

High B-type natriuretic peptide (BNP) levels are associated with new atrial fibrillation (AF). This study investigated the distribution of AF detection rates according to BNP levels in patients with cryptogenic stroke (CS) using an insertable cardiac monitor (ICM). We enrolled consecutive patients with CS who underwent ICM implantation between October 2016 and September 2020 at eight stroke centers in Japan. Those with BNP levels were divided into three groups by tertiles. We evaluated the association of BNP levels with AF detection. Youden's index was calculated to identify the optimal cutoff for BNP. Of 417 patients, we analyzed 266 patients with BNP data. The tertile range of BNP level was 19.0 to 48.5 pg/mL. AF detection rate was 13.3%/year, 12.8%/year, and 53.7%/year in the low-BNP (≤19.0), mid-BNP (19.1-48.4), and high-BNP (≥48.5) groups, respectively (log-rank trend p  < 0.01). Compared with low-BNP group, the adjusted hazard ratios for AF detection in mid-and high-BNP groups were 0.91 [95% confidence interval (CI) 0.46-1.78] and 2.17 (95% CI 1.14-4.13), respectively. Receiver operating characteristic curve analysis showed the optimal cutoff value was 43.4 pg/mL. The area under curve using BNP to predict AF detection was 0.69. The BNP level was associated with AF detection in patients with CS. This relationship changed around the BNP levels of 40-50 pg/mL., Competing Interests: KT reports lecture fees from Pfizer, Bristol-Myers Squibb, Daiichi-Sankyo, Bayer, Stryker, Medtronic, AstraZeneca, Otsuka Pharmaceutical, Kyowa Kirin, Takeda Pharmaceutical and Amgen. HirY reports lecturer fees from Medtronic, Abbott, Daiichi Sankyo, Bristol-Myers Squibb, and Bayer, and grant support from Bristol-Myers Squibb. RD reports lecture fees from Medtronic, Abbott, Biotronic, Stryker, CERENOVUS, Daiichi Sankyo, Bristol-Myers Squibb, and Bayer. HidY reports lecture fees from Medtronic, Abbott, CERENOVUS, Daiichi Sankyo, Bristol-Myers Squibb, and Bayer. KS reports lecture fees from Medtronic, Stryker, Abbott, and Daiichi-Sankyo, and grants support from JSPS KAKENHI. JK reports lecture fees from Medtronic. TI reports lecture fees from Daiichi-Sankyo, Medtronic, Eisai, Takeda Pharmaceutical, and Nestle Health Sciences. YU reports OHARA Pharmaceutical’s lecture fees and Bristol-Myers Squibb’s research funds. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Moriyama, Todo, Yamagami, Kimura, Yamamoto, Nagano, Doijiri, Yamazaki, Sonoda, Koge, Nakayama, Iwata, Ueno, Gon, Okazaki, Sasaki and Mochizuki.)

Published
2024
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