A5078260458- Acute Ischemic Stroke Management
- Cerebrovascular and Carotid Artery Diseases
- Venous Thromboembolism Diagnosis and Management
- Stroke Rehabilitation and Recovery
- Traumatic Brain Injury and Neurovascular Disturbances
- Peripheral Artery Disease Management
- Intracranial Aneurysms: Treatment and Complications
- Intracerebral and Subarachnoid Hemorrhage Research
- Atrial Fibrillation Management and Outcomes
- Cardiovascular Health and Disease Prevention
- Blood Coagulation and Thrombosis Mechanisms
- S100 Proteins and Annexins
- Protease and Inhibitor Mechanisms
- Cardiac Imaging and Diagnostics
- Neurological Disorders and Treatments
- Long-Term Effects of COVID-19
- Neurosurgical Procedures and Complications
- Neurological Disease Mechanisms and Treatments
- Antiplatelet Therapy and Cardiovascular Diseases
- Lipoproteins and Cardiovascular Health
- Advanced MRI Techniques and Applications
- Advanced X-ray and CT Imaging
- COVID-19 Clinical Research Studies
- Cerebral Venous Sinus Thrombosis
- Genetic Associations and Epidemiology
Vall d'Hebron Hospital Universitari
2016-2025
Vall d'Hebron Institut de Recerca
2016-2025
Universitat Autònoma de Barcelona
2016-2025
Klinikum Ludwigshafen
2024
Boston University
2022-2024
Boston Medical Center
2022-2024
University of Pittsburgh Medical Center
2016-2024
Hebron University
2010-2024
Hôpital Purpan
2024
Gdańsk Medical University
2024
The effect of endovascular thrombectomy that is performed more than 6 hours after the onset ischemic stroke uncertain. Patients with a clinical deficit disproportionately severe relative to infarct volume may benefit from late thrombectomy.
We aimed to assess the safety and efficacy of thrombectomy for treatment stroke in a trial embedded within population-based reperfusion registry.During 2-year period at four centers Catalonia, Spain, we randomly assigned 206 patients who could be treated 8 hours after onset symptoms acute ischemic receive either medical therapy (including intravenous alteplase when eligible) endovascular with Solitaire stent retriever (thrombectomy group) or alone (control group). All had confirmed proximal...
Trials of the efficacy and safety endovascular thrombectomy in patients with large ischemic strokes have been carried out limited populations. Download a PDF Research Summary. We performed prospective, randomized, open-label, adaptive, international trial involving stroke due to occlusion internal carotid artery or first segment middle cerebral assess within 24 hours after onset. Patients had ischemic-core volume, defined as an Alberta Stroke Program Early Computed Tomography Score 3 5...
Background— Matrix metalloproteinase (MMP) expression is related to blood brain barrier disruption after cerebral ischemia. Moreover, MMP inhibitors reduce hemorrhagic transformation (HT) embolic ischemia in tissue plasminogen activator (t-PA)–treated animals. We aimed correlate plasmatic levels with the appearance of intracranial bleeding complications stroke patients treated t-PA. Methods and Results— Serial MMP-2 MMP-9 determinations were performed (ELISA, ng/mL) 41 strokes involving...
Background and Purpose— We sought to evaluate the effects of administration microbubbles (MBs) on beginning, speed, degree middle cerebral artery (MCA) recanalization during systemic thrombolysis continuous 2-MHz pulsed-wave transcranial Doppler (TCD) monitoring. Methods— evaluated 111 patients with acute stroke attributable MCA occlusion treated intravenous tissue plasminogen activator (tPA). Thirty-eight were tPA plus 2-hour TCD monitoring 3 doses 2.5 g (400 mg/mL) galactose-based MBs...
The effects and risks of endovascular thrombectomy 6 to 24 hours after stroke onset due basilar-artery occlusion have not been extensively studied.
Abnormal expression of some matrix metalloproteinases (MMP) has shown to play a deleterious role in brain injury experimental models cerebral ischemia. We aimed investigate MMP-2 (gelatinase A) and MMP-9 B) parenchyma both ischemic hemorrhagic strokes.Postmortem fresh tissue from 6 8 stroke patients was obtained within the first hours after death. Finally, 78 samples different areas (infarct, peri-infarct, perihematoma contralateral hemisphere) were studied. To quantify gelatinase content we...
Background and Purpose— Although tandem internal carotid artery/middle cerebral artery (MCA; TIM) occlusion has been associated with low recanalization rate after IV tissue plasminogen activator (tPA), its independent contribution on stroke outcome remains unknown. Moreover, whether the relative resistance to thrombolysis in lesions varies depending location of MCA clot uncertain. Methods— Two hundred twenty-one consecutive patients an acute treated tPA were studied. Emergent ultrasound...
Background and Purpose— Because there is no biologic marker offering precise information about stroke etiology, many patients receive a diagnosis of undetermined even after all available diagnostic tests are done, precluding correct treatment. Methods— To examine the value panel biochemical markers to differentiate etiologies, consecutive acute were prospectively evaluated. Brain computed tomography, ultrasonography, cardiac evaluations, other done identify an etiologic according TOAST...
<h3>Importance</h3> It is estimated that only 27% of patients with acute ischemic stroke and large vessel occlusion who undergo successful reperfusion after mechanical thrombectomy are disability free at 90 days. An incomplete microcirculatory might contribute to these suboptimal clinical benefits. <h3>Objective</h3> To investigate whether treatment adjunct intra-arterial alteplase improves outcomes following reperfusion. <h3>Design, Setting, Participants</h3> Phase 2b randomized,...
Advanced imaging for patient selection in mechanical thrombectomy is not widely available.To compare the clinical outcomes of patients selected by noncontrast computed tomography (CT) vs those perfusion (CTP) or magnetic resonance (MRI) extended time window.This multinational cohort study included consecutive with proximal anterior circulation occlusion stroke presenting within 6 to 24 hours last seen well from January 2014 December 2020. This was conducted at 15 sites across 5 countries...
On 11 March 2020, World Health Organization (WHO) declared the COVID-19 infection a pandemic. The risk of ischemic stroke may be higher in patients with similar to those other respiratory tract infections. We present comprehensive set practice implications single document for clinicians caring adult acute confirmed or suspected infection.The were prepared after review data reach consensus among experts from 18 countries. writers used systematic literature reviews, reference previously...
Rationale Efficacy of mechanical thrombectomy for acute stroke due to large vessel occlusion initiated beyond 6 h time last seen well has not been demonstrated in randomized trials. Aim To establish whether subjects considered have substantial areas salvageable brain based on age-adjusted clinical core mismatch who can undergo endovascular treatment within 6–24 from (TLSW) better outcomes at three months compared treated with standard medical therapy alone. Age-adjusted is defined by age...
Background Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has been associated with a significant risk of thrombotic events in critically ill patients. Aim To summarize the findings multinational observational cohort patients SARS-CoV-2 and cerebrovascular disease. Methods Retrospective consecutive adults evaluated emergency department and/or admitted coronavirus disease 2019 (COVID-19) across 31 hospitals four countries (1 February 2020–16 June 2020). The primary outcome was...
Importance In nonurban areas with limited access to thrombectomy-capable centers, optimal prehospital transport strategies in patients suspected large-vessel occlusion stroke are unknown. Objective To determine whether, areas, direct a center is beneficial compared the closest local center. Design, Setting, and Participants Multicenter, population-based, cluster-randomized trial including 1401 acute attended by emergency medical services where was not capable of performing thrombectomy...
Reperfusion without functional independence (RFI) is an undesired outcome following thrombectomy in acute ischemic stroke. The primary objective was to evaluate, patients presenting with proximal anterior circulation occlusion stroke the extended time window, whether selection computed tomography (CT) perfusion or magnetic resonance imaging associated RFI, mortality, symptomatic intracranial hemorrhage (sICH) compared noncontrast CT selected patients.The CLEAR study (CT for Late Endovascular...
BACKGROUND: The optimal management of patients with isolated posterior cerebral artery occlusion is uncertain. We compared clinical outcomes for endovascular therapy (EVT) versus medical (MM) in occlusion. METHODS: This multinational case-control study conducted at 27 sites Europe and North America included consecutive presenting within 24 hours time last well from January 2015 to August 2022. Patients treated EVT or MM were multivariable logistic regression inverse probability treatment...
Importance Whether endovascular thrombectomy (EVT) efficacy for patients with acute ischemic stroke and large cores varies depending on the extent of injury is uncertain. Objective To describe relationship between imaging estimates irreversibly injured brain (core) at-risk regions (mismatch) clinical outcomes EVT treatment effect. Design, Setting, Participants An exploratory analysis SELECT2 trial, which randomized 352 adults (18-85 years) due to occlusion internal carotid or middle cerebral...
Approximately 10% to 20% of large vessel occlusion (LVO) strokes involve tandem lesions (TLs), defined as concomitant intracranial LVO and stenosis or the cervical internal carotid artery. Mechanical thrombectomy (MT) may benefit patients with TLs; however, optimal management procedural strategy lesion remain unclear.
BACKGROUND: Transfemoral access is predominantly used for mechanical thrombectomy in patients with stroke a large vessel occlusion. Following the interventional cardiology guidelines, routine transradial has been proposed as an alternative, although its safety and efficacy remain controversial. We aim to explore noninferiority of radial terms final recanalization. METHODS: The study was investigator-initiated, single-center, evaluator-blinded, randomized clinical trial. Patients undergoing...