A5063324090- Acute Ischemic Stroke Management
- Cerebrovascular and Carotid Artery Diseases
- Stroke Rehabilitation and Recovery
- Traumatic Brain Injury and Neurovascular Disturbances
- Venous Thromboembolism Diagnosis and Management
- Intracranial Aneurysms: Treatment and Complications
- Peripheral Artery Disease Management
- Neurological Disorders and Treatments
- Intracerebral and Subarachnoid Hemorrhage Research
- Muscle activation and electromyography studies
- Aortic Disease and Treatment Approaches
- Tracheal and airway disorders
- Antiplatelet Therapy and Cardiovascular Diseases
- Autoimmune Neurological Disorders and Treatments
- Neurological disorders and treatments
- Genetic Neurodegenerative Diseases
- Vascular Malformations Diagnosis and Treatment
- Oral and Craniofacial Lesions
- Neurological Disease Mechanisms and Treatments
- Dysphagia Assessment and Management
- Tendon Structure and Treatment
- Acute Myocardial Infarction Research
- Parkinson's Disease Mechanisms and Treatments
- Cardiovascular and Diving-Related Complications
- Myasthenia Gravis and Thymoma
John Hunter Hospital
2017-2025
University of Alberta
2020
Fundación Pablo García
2017-2020
Hamad Medical Corporation
2017-2019
Hamad General Hospital
2016-2019
Universidad de Alcalá
2019
Neuroscience Institute
2018
Hospital Clínico Universitario de Valladolid
2011-2017
Hunter Medical Research Institute
2017
University of Newcastle Australia
2017
We aimed to evaluate how predefined candidate cerebral perfusion parameters correlate with collateral circulation status and assess their capacity predict infarct growth in patients acute ischemic stroke (AIS) eligible for endovascular therapy. Patients enrolled the SWIFT PRIME trial baseline computed tomography (CTP) scans were included. RAPID software was used calculate mean relative blood volume (rCBV) hypoperfused regions, hypoperfusion index ratio (HIR). Blind assessments of collaterals...
To compare the accuracy of Alberta Stroke Program Early Computed Tomography Score (ASPECTS) and CT perfusion to detect established infarction in acute anterior circulation stroke.We performed an observational study 59 ischemic stroke patients who underwent brain noncontrast CT, perfusion, MRI within 100 minutes from imaging. ASPECTS scores were calculated by 4 blinded vascular neurologists. The core volume diffusion lesion ≥70 mL was evaluated using receiver operating characteristics...
Background and purpose Perfusion‐computed tomography‐source images ( PCT ‐ SI ) may allow a dynamic assessment of leptomeningeal collateral arteries LMC filling emptying in middle cerebral artery MCA ischaemic stroke. We described regional scale on hypothesized that higher score would predict better response to intravenous (iv) thrombolysis. Methods studied consecutive stroke patients with an acute occlusion documented by transcranial Doppler/transcranial color‐coded duplex, treated iv...
We sought to assess outcomes after endovascular treatment/therapy of acute ischemic stroke, overall and by subgroups, looked for predictors outcome.We used data from a mandatory, population-based registry that includes external monitoring completeness, which assesses reperfusion therapies consecutive patients with stroke since 2011. described subgroups (age ≤ or >80 years; onset-to-groin puncture >6 hours; anterior posterior strokes; previous IV recombinant tissue-type plasminogen activator...
Background Patients with M2 middle cerebral artery (MCA) occlusions are not always considered for endovascular treatment. Objective To study outcomes in patients occlusion treated procedures the era of stentrievers. Methods We studied prospectively included SONIIA registry (years 2011–2012)—a mandatory, externally audited that monitors quality reperfusion therapies Catalonia routine practice. Good recanalization was defined as postprocedure Thrombolysis Cerebral Infarction (TICI) score 2b–3;...
To determine the association of ultraearly hematoma growth (uHG) with CT angiography (CTA) spot sign, expansion, and clinical outcomes in patients acute intracerebral hemorrhage (ICH).We analyzed data from 231 enrolled multicenter Predicting Haematoma Growth Outcome Intracerebral Haemorrhage Using Contrast Bolus study. uHG was defined as baseline ICH volume/onset-to-CT time (mL/h). The sign used marker active hemorrhage. parameters included significant expansion (>33% or >6 mL, primary...
OBJECTIVE Insulin resistance (IR) may not only increase stroke risk, but could also contribute to aggravate prognosis. Mainly through a derangement in endogenous fibrinolysis, IR affect the response intravenous thrombolysis, currently therapy proved be efficacious for acute ischemic stroke. We hypothesized that high is associated with more persistent arterial occlusions and poorer long-term outcome after thrombolysis. RESEARCH DESIGN AND METHODS performed prospective, observational,...
Implantable loop recorders (ILR) may allow detection of occult paroxysmal atrial fibrillation (PAF) in patients with cryptogenic ischemic stroke. However, optimal selection algorithm and ideal duration monitoring remain unclear. AIM. To determine the incidence time-profile PAF stroke studied Reveal XT ILR, who were selected based on a high suspicion cerebral embolism.absence etiology after complete study including vascular imaging, transesophageal echocardiography at least 24 hours cardiac...
Selection of best responders to reperfusion therapies could be aided by predicting the duration tissue-at-risk viability, which may dependant on collateral circulation status. We aimed identify predictor good among perfusion computed tomography (PCT) parameters in middle cerebral artery (MCA) ischemic stroke and analyze how early MCA response intravenous thrombolysis PCT-derived markers collaterals interact determine outcome.We prospectively studied patients with acute treated who underwent...
Background and purpose We investigated the effectiveness of intravenous thrombolysis (IVT) in acute ischaemic stroke (AIS) patients with large vessel or distal occlusions mild neurological deficits, defined as National Institutes Health Stroke Scale scores < 6 points. Methods The primary efficacy outcome was 3‐month functional independence (FI) [modified Rankin (mRS) 0–2] that compared between without IVT treatment. Other outcomes interest included favorable (mRS 0–1) mRS score...
<b><i>Background:</i></b> Extending the therapeutic window of intravenous thrombolysis for acute ischemic stroke beyond established 4.5-hour limit is critical importance in order to increase proportion thrombolysed patients. In this setting, capacity MRI select patients reperfusion therapies delayed time windows has been and being tested clinical trials. However, whether more available cost-effective perfusion computed tomography (PCT) may be useful candidates remains...
Background Etiology of a large vessel occlusion is relevant in the management acute ischemic stroke patients and often difficult to determine phase. Aims We aim investigate whether angiographic appearance related its etiology outcome. Materials Methods Patients without cervical carotid occlusions who underwent mechanical thrombectomy our center from April 2015 September 2018 were studied. Demographics, clinical radiological variables outcome measures, including etiological classification...
Background Acute ischemic stroke patients with unclear onset time presenting >4.5 h from last-seen-normal (LSN) are considered late and excluded i.v. thrombolysis. We aimed to evaluate whether this subgroup of is different a witnessed onset, in terms eligibility response computed tomography perfusion (CTP)-guided Methods prospectively studied consecutive acute non-lacunar middle cerebral artery (MCA) LSN. All underwent multimodal CT were eligible for thrombolysis according CTP criteria. Two...
Clinical experience with the Pipeline Embolization Device (PED) has been widely described in literature since it obtained its European CE and FDA approvals 2008 2011, respectively. The new generation of PED, Flex Device, received mark approval March 2014. While implant composition not changed, delivery system some differences. One main changes from previous is a that makes device resheathable until deployed over 90% length. We present our preliminary using this device.Between May June 2014,...
The use of retrievable stents for endovascular clot retrieval has dramatically improved successful revascularization and clinical outcome in selected patients with acute stroke.To describe the rate consequences unwanted spontaneous detachment these devices during mechanical thrombectomy.We studied 262 consecutive treated stent, Solitaire, ischemic stroke between November 2008 April 2015. Clinical, procedural, variables were compared without unexpected this device. Detachment was classified...
Background and Purpose: Telestroke aims to increase access endovascular clot retrieval (ECR) for rural areas. There is limited information on transfer workflow ECR in settings. We sought describe the metrics a telestroke network with respect decision making. Methods: A retrospective cohort study was employed consecutive patients transferred comprehensive stroke center (CSC) hub-and-spoke between April 2013 October 2019, by road or air. Key time-based were analyzed. Results: Sixty-two...
Background: Metabolic syndrome and insulin resistance may hamper the beneficial effect of intravenous thrombolysis in acute ischemic stroke.We investigated temporal profile prognostic value 11 circulating biomarkers stroke patients treated with thrombolysis.Methods: We performed a prospective study middle cerebral artery (MCA) occlusion who received tissue plasminogen activator (tPA).Measurement C-Peptide, Ghrelin, Gastricinhibitory-polypeptide (GIP), Glucagon-like-peptide-1 (GLP-1),...
Currently, treatment options for patients with strokes unknown time of onset (UKO) remain limited. With the advance neuroimaging and endovascular (EVT), selected might have a chance therapeutic option. We sought to compare clinical outcome after EVT in known stroke (KO) those UKO.We prospectively registered consecutive acute large artery occlusion anterior territory who underwent EVT. Multimodal MR or Alberta Stroke Program early CT score (ASPECTS) transcranial color-coded Duplex sonography...
Cocaine is a widespread recreational drug that has the potential to induce neurological vascular diseases, including ischaemic and haemorrhagic stroke. Although arterial vasospasm been suggested as pathogenic factor in development of neurovascular complications, it remains unclear whether cocaine users carry an increased risk suffer iatrogenic during endovascular procedures. We report case two patients with history abuse, who developed unusual severe vasospasms different interventional The...
Background: Admission outside normal business hours has been associated with prolonged door-to-treatment times and poorer patient outcomes, the so called "weekend effect". This is first examination of weekend effect in a telestroke service that uses multi-modal computed tomography. Aims: To examine differences workflow triage between in-hours out-of-hours calls to service. Methods: All patients assessed using Northern New South Wales (N-NSW) from April 2013 January 2019 were eligible for...