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The Value of ADAMTS13 in Predicting Clinical Outcomes in Patients With Acute Ischemic Stroke Receiving Thrombolysis
Conclusion: In our cohort, blood ADAMTS13 antigen level before rt-PA therapy could not be used as an independent biomarker in predicting clinical outcomes of AIS patients at 90 days.
Source: Frontiers in Neurology - July 30, 2020 Category: Neurology Source Type: research

Hemodynamics and Hemorrhagic Transformation After Endovascular Therapy for Ischemic Stroke
Hemorrhagic transformation remains a potentially catastrophic complication of reperfusion therapies for the treatment of large-vessel occlusion ischemic stroke. Observational studies have found an increased risk of hemorrhagic transformation in patients with elevated blood pressure as well as a high degree of blood pressure variability, suggesting a link between hemodynamics and hemorrhagic transformation. Current society-endorsed guidelines recommend maintaining blood pressure below a fixed threshold of 180/105 mmHg regardless of thrombolytic or endovascular intervention. However, given the high recanalization rates with ...
Source: Frontiers in Neurology - July 16, 2020 Category: Neurology Source Type: research

Safety and Efficacy of Tirofiban in Rescue Treatment for Acute Intracranial Intraprocedural Stent Thrombosis
Conclusions: We observed a non-negligible rate of AIST during intracranial stenting procedures for ICAS. Intra-arterial bolus followed by intravenous tirofiban infusion seems to be efficacious and safe for AIST during stent placement for ICAS, without increasing the rate of hemorrhagic complications and death.
Source: Frontiers in Neurology - June 15, 2020 Category: Neurology Source Type: research

Prior Stroke in PFO Patients Is Associated With Both PFO-Related and -Unrelated Factors
Conclusion: In patients with CS and PFO, the likelihood of prior stroke is associated with both, PFO-related and PFO-unrelated factors.
Source: Frontiers in Neurology - June 3, 2020 Category: Neurology Source Type: research

Transcirculation Approach for Mechanical Thrombectomy in Acute Ischemic Stroke: A Multicenter Study and Review of the Literature
Conclusions: Transcirculation approaches may be used to access the target lesion when the parent artery cannot be crossed through conventional antegrade routes. These techniques are feasible but should be reserved as a bailout maneuver when anterograde MT is not possible. Newer endovascular devices have improved neurological and angiographic outcomes in transcirculation cases.
Source: Frontiers in Neurology - May 6, 2020 Category: Neurology Source Type: research

Effect of Balloon Guide Catheter Utilization on the Incidence of Sub-angiographic Peripheral Emboli on High-Resolution DWI After Thrombectomy: A Prospective Observational Study
Conclusions: BGC-aided MT reduces the number of peripheral emboli in successful but incomplete reperfusion (TICI 2b and 2c). The effectiveness of this strategy therefore goes above and beyond that which can be demonstrated by the TICI score alone.
Source: Frontiers in Neurology - May 6, 2020 Category: Neurology Source Type: research

Deep Vein Thrombosis and Pulmonary Embolism Among Patients With a Cryptogenic Stroke Linked to Patent Foramen Ovale —A Review of the Literature
Conclusion: VTE can be detected in patients with CS linked to PFO. While –based on the presented literature–routine screening for VTE in patients with CS linked to PFO does not appear justified, history taking, and clinical exam should consider concomitant VTE. Whenever clinically suspected, the threshold to trigger ancillary testing for VTE should be low. Among patients with an acute PE and PFO, vigilance for new neurologic deficits should be increased, with a low threshold for brain imaging.
Source: Frontiers in Neurology - May 4, 2020 Category: Neurology Source Type: research

Identifying Gaps and Missed Opportunities for Intravenous Thrombolytic Treatment of Inpatient Stroke
Conclusion: In our study, one in three ISC were true strokes. IVT treatment rates were low with a MTO of 1 in 6 IVT-eligible patients. The most common reason for not treating was NIHSS ≤4. Knowing predictors of true stroke and the common barriers to IVT treatment can help narrow this treatment gap.
Source: Frontiers in Neurology - February 25, 2020 Category: Neurology Source Type: research

A Case of Ischemic Stroke With Congenital Protein C Deficiency and Carotid Web Successfully Treated by Anticoagulant and Carotid Stenting
Conclusion: To our knowledge, this is the first report in which an immediate thrombus formation on the carotid web was observed in a patient with congenital protein C deficiency. In a case of acute ischemic stroke with carotid web, especially when congenital coagulopathy such as protein C deficiency is suspected, careful follow-up with ultrasound imaging should be performed.
Source: Frontiers in Neurology - February 17, 2020 Category: Neurology Source Type: research

Utility of Transthoracic Echocardiography in Diagnostic Evaluation of Ischemic Stroke
Conclusion: Our findings suggest that despite widespread use, the overall yield of TTE in AIS is low. Stratifying patients according to their likelihood of benefitting from it will be important toward better resource utilization.
Source: Frontiers in Neurology - February 17, 2020 Category: Neurology Source Type: research

Expression of Cytokines and Chemokines as Predictors of Stroke Outcomes in Acute Ischemic Stroke
Conclusions: Machine learning algorithms can be employed to develop prognostic predictive biomarkers for stroke outcomes in ischemic stroke patients, particularly in regard to identifying acute gene expression changes that occur during stroke.
Source: Frontiers in Neurology - January 14, 2020 Category: Neurology Source Type: research

Predicting Chronic Subdural Hematoma Recurrence and Stroke Outcomes While Withholding Antiplatelet and Anticoagulant Agents
Conclusion: ML modeling is feasible. However, large well-designed prospective multicenter studies are needed for accurate ML so that clinicians can balance the risks of recurrence with the risk of TEEs, especially for high-risk anticoagulated patients.
Source: Frontiers in Neurology - January 14, 2020 Category: Neurology Source Type: research

A Visual Task Management Application for Acute Ischemic Stroke Care
Conclusions: TCS is a novel approach that uses ICT to support information sharing in a parallel CS workflow in AIS care. It shortens the processing times of critical tasks and lessens the communication burden among team members.
Source: Frontiers in Neurology - October 29, 2019 Category: Neurology Source Type: research

MRI-Based Predictors of Hemorrhagic Transformation in Patients With Stroke Treated by Intravenous Thrombolysis
Clinical and biological risk factors for hemorrhagic transformation (HT) after intravenous thrombolysis (IT) have been well established in several registries. The added value of magnetic resonance imaging (MRI) variables has been studied in small samples, and is controversial. We aimed to assess the added value of MRI variables in HT, beyond that of clinical and biological factors. We enrolled 474 consecutive patients with brain infarction treated by IT alone at our primary stroke center between January 2011 and August 2017. Baseline demographic, clinical, biological, and imaging characteristics were collected. MRI variab...
Source: Frontiers in Neurology - August 26, 2019 Category: Neurology Source Type: research

Association Between Thrombus Density and Reperfusion Outcomes Using Different Thrombectomy Strategies: A Single-Center Study and Meta-Analysis
Conclusions: Although our meta-analysis did not show a significant association between thrombus density and successful reperfusion, subgroup analysis implicated that SR technique might be prone to retrieve high-density thrombus while the CA subgroup showed an opposite tendency. Further studies are needed to confirm these results and to investigate its role in the optimization of thrombectomy strategy.
Source: Frontiers in Neurology - August 15, 2019 Category: Neurology Source Type: research

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