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Thrombolytic Utilization in Ischemic Stroke Is Significantly Higher in US Hospitals with Neurology Residency Program (S02.006)
CONCLUSIONS: Stroke care at NR hospitals is associated with an increased thrombolytic utilization rate. The increased tPA utilization at NR between 2002-2006 may be related to the rapid increase in Primary Stroke Centers across the country.Disclosure: Dr. Moradiya has nothing to disclose. Dr. Grant has nothing to disclose. Dr. Valsamis has nothing to disclose. Dr. Levine has received personal compensation in an editorical capacity for MEDLINK.
Source: Neurology - February 14, 2013 Category: Neurology Authors: Moradiya, Y., Grant, J., Valsamis, H., Levine, S. Tags: S02 Acute Stroke Therapy Source Type: research

Alpha 1-Antitrypsin Therapy Mitigated Ischemic Stroke Damage in Rats
Our objective is to develop a new therapy for the treatment of stroke. Currently, the only effective therapy for acute ischemic stroke is the thrombolytic agent recombinant tissue plasminogen activator. α1-Antitrypsin (AAT), a serine proteinase inhibitor with potent anti-inflammatory, anti-apoptotic, antimicrobial, and cytoprotective activities, could be beneficial in stroke. The goal of this study is to test whether AAT can improve ischemic stroke outcome in an established rat model. Middle cerebral artery occlusion was induced in male rats via intracranial (i.c.) microinjection of endothelin-1. Five to 10 minutes after...
Source: Journal of Stroke and Cerebrovascular Diseases - March 3, 2014 Category: Neurology Authors: Huong L. Moldthan, Aaron C. Hirko, Jeffrey S. Thinschmidt, Maria B. Grant, Zhimin Li, Joanna Peris, Yuanqing Lu, Ahmed S. Elshikha, Michael A. King, Jeffrey A. Hughes, Sihong Song Tags: Original Articles Source Type: research

Intravenous Thrombolysis in Posterior Circulation Stroke
Conclusions: Up to date, no data about PCIS and IVT are available from RTCs. Based on limited results from retrospective clinical studies and case series, IVT is safer for use in PCIS than in ACIS. Patients with brainstem ischemia, vertebral artery occlusion, and absence of basilar or posterior cerebral artery occlusion could be considered for treatment with IVT even in borderline cases. Time to IVT in PCIS seems to be a less crucial factor than in ACIS. IVT for PCIS may be beneficial even after 4.5 h from symptom onset. Introduction History of Intravenous Thrombolysis—The Most Relevant Studies Intravenous...
Source: Frontiers in Neurology - April 25, 2019 Category: Neurology Source Type: research

Platelet Count Predicts Adverse Clinical Outcomes After Ischemic Stroke or TIA: Subgroup Analysis of CNSR II
Conclusion: In ischemic stroke or TIA patients with platelet count within normal range, platelet count may be a qualified predictor for long-term recurrent stroke, mortality, and poor functional outcome. Introduction Platelets exert a critical role in the pathogenesis of atherosclerotic complications of cardio-cerebrovascular disease, contributing to thrombus formation, and embolism (1, 2). Previous literature reported that platelets of various size and density are produced by megakaryocytes of different size and stages of maturation in different clinical conditions, suggesting various platelet patterns in differen...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

Frequency of Hemorrhage on Follow Up Imaging in Stroke Patients Treated With rt-PA Depending on Clinical Course
Conclusions: Frequency of hemorrhagic transformation in Routine follow-up brain imaging and consecutive changes in therapeutic management were different depending on clinical course measured by NHISS score. Introduction Brain imaging 24–36 h after systemic thrombolysis for acute ischemic stroke is recommended in American Stroke Association and European Stroke Organization guidelines (1, 2). Brain imaging is performed to detect secondary bleeding or hemorrhagic transformation in order to adapt medical stroke prevention if necessary. Guideline recommendations are based on the results of the first study on rt-PA...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Influence of Sex on Stroke Prognosis: A Demographic, Clinical, and Molecular Analysis
Conclusion Our data suggest that women who suffer from IS present with a poorer functional outcome than men at 3-months, regardless of other preclinical and clinical factors during the acute phase. These relationships seem to be mediated by atrial dysfunction and inflammation. The inflammatory response is slightly higher in women; however, there are no sex differences in their functional behavior. There is a probable relationship between the molecular marker of atrial dysfunction NT-proBNP and worse functional outcome in women, and the connection seems to be more important in cardioembolic stroke patients. In patients wi...
Source: Frontiers in Neurology - April 16, 2019 Category: Neurology Source Type: research

E-013 unchanged utilization of endovascular treatment in acute ischemic stroke patients in the post ims-iii era
ConclusionContrary to expectations, there has been no reduction in the utilization of endovascular treatment among acute ischemic stroke patients after IMS-III, MR RESCUE and SYNTHESIS EXPANSION results were published.Abstract E-013 Table 1Pre and Post IMS III Pre-IMS III Post-IMS III P-value Patients with ischemic stroke (%)6765 (50.5)6643 (49.5)Mechanical thrombectomy155 (2.3)161 (2.4)0.6IV tPA483 (7.1)520 (7.8)0.1Discharge dispositionHome or self care3135 (46.6)3079 (46.3)Skilled nursing facility1529 (22.6)1486 (22.4)Expired268 (4.0)253 (3.8)0.3Length of stay in hospital3.8 ± 4.13.6 ± 3.50.02Hospital c...
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Hassan, A., Bezzina, C., Malik, A., Sanchez, C., Tekle, W., Qureshi, A. Tags: SNIS 12th Annual Meeting Electronic Poster Abstracts Source Type: research

Predictors of Percutaneous Endoscopic Gastrostomy Tube Placement in Middle Cerebral Artery Acute Ischemic Stroke and Stroke Laterality (P02.018)
CONCLUSIONS: Our study indicates that high NIHSS on admission, aspiration pneumonia and inability to undergo first swallow evaluation are independent predictors of PEG placement in patients with acute MCA strokes. This knowledge can be used for early identification of patients that require PEG tube placement to provide prompt nutritional support.Supported by: Hartford Hospital Research Center grant.Disclosure: Dr. San Luis has nothing to disclose. Dr. McCullough has received personal compensation for activities with Genentech, Inc. Dr. Ollenschleger has nothing to disclose. Dr. Staff has nothing to disclose. Dr. Fortunato ...
Source: Neurology - February 14, 2013 Category: Neurology Authors: San Luis, C., McCullough, L., Ollenschleger, M., Staff, I., Fortunato, G. Tags: P02 Cerebrovascular Disease II Source Type: research

Long-term Risk of Complications after Percutaneous Transcatheter Closure of Patent Foramen Ovale (S51.003)
Conclusions:Approximately 1 in 6 patients who undergo percutaneous transcatheter closure of PFO after stroke or transient ischemic attack experience a serious complication or death within 5 years.Study Supported by:Dr. Gialdini is supported by the Feil Family Foundation.Dr. Navi is supported by NIH grant K23NS091395 and the Florence Gould Endowment for Discovery in Stroke.Dr. Iadecola is supported by NIH grants R37NS089323-02, R01NS034179-21, R01NS037853-19, and R01 NS073666-04.Dr. Kamel is supported by NIH grants K23NS082367 and R01NS097443 as well as the Michael Goldberg Research Fund.Disclosure: Dr. Merkler has nothing ...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Merkler, A., Gialdini, G., Yaghi, S., Okin, P., Iadecola, C., Navi, B., Kamel, H. Tags: Cerebrovascular Disease and Interventional Neurology: Stroke Prevention and Translation Source Type: research

Computed Tomography Perfusion Imaging in the Selection of Acute Stroke Patients to Undergo Emergent Carotid Endarterectomy
Severe acute stroke patients with critical carotid stenosis or occlusion without intracranial thrombus typically do not undergo emergent carotid thromboendarterectomy (CEA) because of the risk of reperfusion-related intracranial hemorrhage. Past studies have not consistently demonstrated benefit of early operative intervention. Cerebral computed tomography (CT), cervical and cerebral CT angiography (CTA), and cerebral CT perfusion (CTP) imaging may identify a subset of acute stroke patients without intracranial thrombus who may benefit from emergent CEA.
Source: Annals of Vascular Surgery - September 3, 2014 Category: Surgery Authors: Thomas G. Devlin, Sachin V. Phade, Rodney K. Hutson, Mark W. Fugate, Grant R. Major, Gregory W. Albers, Abdelazim A. Sirelkhatim, Biggya L. Sapkota, Steven D. Quartfordt, Blaise W. Baxter Tags: Case Report Source Type: research

E-077 Laboratory analogs of challenging thromboemboli in acute ischemic stroke
Conclusion Thrombus analogs with mechanical characteristics similar to those of challenging clinical thrombi were successfully developed. The calcium apatite thrombus analog was found to be stiffer than the fibrin-rich thrombus analog. References . Saver JL et al: Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. N Engl J Med 2015, 372(24):2285–2295. . Dorn F et al: Endovascular treatment of acute intracerebral artery occlusions with the solitaire stent: single-centre experience with 108 recanalization procedures. Cerebrovasc Dis 2012, 34(1):70–77. Disclosures: J. Chueh: None. J....
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Chueh, J., Litchman, J., Arslanian, R., Carniato, S., Rex, D., Howk, M., Gounis, M., Puri, A. Tags: Electronic Poster Abstracts Source Type: research

Asymptomatic Carotid Stenosis Is Associated With Circadian and Other Variability in Embolus Detection
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this t...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Associations of Anemia With Outcomes in Patients With Spontaneous Intracerebral Hemorrhage: A Meta-Analysis
Conclusions: Anemia on admission was associated with higher mortality and an increased risk of poor outcome in patients with ICH. However, the results were limited by the high heterogeneity of included studies. Prospective, multi-center or population-based, large sample cohort studies are needed in the future. Introduction Intracerebral hemorrhage (ICH) is the second most common cause of stroke and a highly lethal disease (1), which still lacks effective therapeutic interventions (2, 3). Although age, baseline ICH volume and neurological status on admission are well-known predictors of outcome of ICH (4), none of t...
Source: Frontiers in Neurology - April 24, 2019 Category: Neurology Source Type: research

E-105 Analysis of clinical associations of serum SCFAs taken at the time of thrombectomy in AIS patients
ConclusionsThe evaluation of SCFAs in the serum at the time of stroke provides novel insight into the potential role of SCFAs during stroke in human patients. Age remains a significant factor to SCFA concentrations in stroke patients. The length of time following stroke also contributes to the levels of SCFAs. Previous studies have shown that increased levels of SCFAs is associated with decreased severity of stroke, however our data did not detect any such effect. This observation may be due to the acute time of the blood collection following stroke and analyzing serum instead of fecal samples. Furthermore, acquiring infor...
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Henry, N., Frank, J., Fraser, J., Trout, A., Morris, A., Chen, J., Stowe, A., McLouth, C., Pennypacker, K. Tags: Electronic poster abstracts Source Type: research

New Data From Two Large Studies Reinforce Effectiveness of Dual Pathway Inhibition (DPI) with XARELTO ® (rivaroxaban) Plus Aspirin in Patients with Coronary Artery Disease (CAD) and/or Peripheral Artery Disease (PAD)
RARITAN, N.J., May 23, 2022 – Findings from the XARELTO® (rivaroxaban) Phase 3 COMPASS Long-Term Open Label Extension (LTOLE) study and the XARELTO® in Combination with Acetylsalicylic Acid (XATOA) registry have been published in the European Society of Cardiology’s (ESC) European Heart Journal, Cardiovascular Pharmacotherapy. Additionally, the XATOA registry was presented at the American Congress of Cardiology’s 71st Annual Scientific Session (ACC.22). These studies provide further evidence supporting the role of dual pathway inhibition (DPI) with the XARELTO® vascular dose (2.5 mg twice daily plus aspirin 100 mg...
Source: Johnson and Johnson - May 23, 2022 Category: Pharmaceuticals Source Type: news

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