John Thornton
A5012120918- Acute Ischemic Stroke Management
- Cerebrovascular and Carotid Artery Diseases
- Venous Thromboembolism Diagnosis and Management
- Intracranial Aneurysms: Treatment and Complications
- Traumatic Brain Injury and Neurovascular Disturbances
- Stroke Rehabilitation and Recovery
- Vascular Malformations Diagnosis and Treatment
- Peripheral Artery Disease Management
- Neurosurgical Procedures and Complications
- Clinical practice guidelines implementation
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Intracerebral and Subarachnoid Hemorrhage Research
- Long-Term Effects of COVID-19
- COVID-19 and healthcare impacts
- Moyamoya disease diagnosis and treatment
- Auditing, Earnings Management, Governance
- Cerebrospinal fluid and hydrocephalus
- Radiation Dose and Imaging
- Antiplatelet Therapy and Cardiovascular Diseases
- Advanced MRI Techniques and Applications
- Spine and Intervertebral Disc Pathology
- Medical Imaging and Analysis
- Musculoskeletal pain and rehabilitation
- Respiratory and Cough-Related Research
- Legal and Constitutional Studies
Beaumont Hospital
2016-2025
Royal College of Surgeons in Ireland
2016-2025
United Nations Economic and Social Commission for Asia and the Pacific
2021-2024
University of Calgary
2016-2024
Hamilton Health Sciences
2024
McMaster University
2024
Population Health Research Institute
2024
Health and Education Research Management and Epidemiologic Services (United States)
2021-2023
Chelsea and Westminster Hospital NHS Foundation Trust
2023
Hermes Arzneimittel (Germany)
2021
Among patients with a proximal vessel occlusion in the anterior circulation, 60 to 80% of die within 90 days after stroke onset or do not regain functional independence despite alteplase treatment. We evaluated rapid endovascular treatment addition standard care acute ischemic small infarct core, intracranial arterial occlusion, and moderate-to-good collateral circulation.We randomly assigned participants receive (control group) plus use available thrombectomy devices (intervention group)....
Background— The Endovascular Treatment for Small Core and Proximal Occlusion Ischemic Stroke (ESCAPE) trial used innovative imaging aggressive target time metrics to demonstrate the benefit of endovascular treatment in patients with acute ischemic stroke. We analyze impact on clinical outcome effect patient, hospital, health system characteristics workflow within trial. Methods Results— Relationship between (modified Rankin Scale) interval times was modeled by using logistic regression....
The COVID-19 pandemic led to profound changes in the organization of health care systems worldwide.We sought measure global impact on volumes for mechanical thrombectomy, stroke, and intracranial hemorrhage hospitalizations over a three-month period at height (1 March-31 May 2020) compared with two control periods (immediately preceding one year prior).Retrospective, observational, international study, across 6 continents, 40 countries, 187 comprehensive stroke centers. diagnoses were...
ESCAPE is a prospective, multicenter, randomized clinical trial that will enroll subjects with the following main inclusion criteria: less than 12 h from symptom onset, age > 18, baseline NIHSS >5, ASPECTS score of >5 and CTA evidence carotid T/L or M1 segment MCA occlusion, at least moderate collaterals by CTA. The determine if endovascular treatment result in higher rates favorable outcome compared standard medical therapy alone. Patient populations are eligible include those...
Background Translational research on clot composition may be advanced by the use of analogs for preclinical evaluation mechanical thrombectomy devices. This work describes a novel set to represent diverse range fibrin and red blood cell (RBC) compositions in acute ischemic stroke (AIS) occlusion models. Method Fresh whole obtained from ovine species was used create seven different analog types. Five replicates were formed each type. Varying amounts constituents mixed with thrombotic factors...
Background Tandem occlusions of the extracranial carotid and intracranial or middle cerebral artery have a particularly poor prognosis without treatment. Several management strategies been used with no clear consensus recommendations. We examined subjects tandem enrolled in ESCAPE trial their outcomes. Methods Data are from trial. Additional data were sought on interventions for each subject. Results There 54 (17%) occlusions. Patients endovascular treatment arm (n=30) more likely to be...
Initial studies investigating correlations between stroke etiology and clot composition are conflicting do not account for size as determined by area. Radiological have shown that cardioembolic strokes associated with shorter lengths lower burden than non-cardioembolic clots.To report the relationship etiology, extracted area, histological at each procedural pass.As part of multi-institutional RESTORE Registry, Martius Scarlett Blue stained area 612 per-pass clots retrieved from 441 patients...
Background and Purpose— The goal of reperfusion therapy in acute ischemic stroke is to limit brain infarction. objective this study was investigate whether the beneficial effect endovascular treatment on functional outcome could be explained by a reduction post-treatment infarct volume. Methods— Endovascular Treatment for Small Core Anterior Circulation Proximal Occlusion With Emphasis Minimizing CT Recanalization Times (ESCAPE) trial multicenter randomized open-label with blinded...
Rationale: Targeted lung denervation (TLD) is a bronchoscopic radiofrequency ablation therapy for chronic obstructive pulmonary disease (COPD), which durably disrupts parasympathetic nerves to decrease airway resistance and mucus hypersecretion.Objectives: To determine the safety impact of TLD on respiratory adverse events.Methods: We conducted multicenter, randomized, sham bronchoscopy-controlled, double-blind trial in patients with symptomatic (modified Medical Research Council dyspnea...
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 ruptured aneurysm coiling interventions demonstrated similar declines.We conducted a cross-sectional, retrospective, observational study across 6 continents, 37 countries 140 comprehensive centres. Patients with diagnosis SAH, aneurysmal identified by prospective databases or International...
Background and Purpose— Infarct in a new previously unaffected territory (INT) is potential complication of endovascular treatment. We applied recently proposed methodology to identify classify INTs the ESCAPE randomized controlled trial (Endovascular Treatment for Small Core Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT Recanalization Times). Methods— The core laboratory identified 24-hour follow-up imaging, blinded treatment allocation, after assessing all baseline...
Mechanical thrombectomy is the standard of care for acute ischemic strokes with proximal intracranial occlusion. Arterial access commonly achieved femoral artery puncture, although this not always possible. In case series, we describe 11 cases anterior circulation stroke where direct carotid puncture was used to obtain vascular access.A review a prospectively maintained database over 2-year period (August 2016 - August 2018) undertaken identify performed. CT and angiographic imaging were...
Platelets and von Willebrand factor (vWF) are key factors in thrombosis thus likely components of acute ischemic stroke (AIS) emboli. We aimed to characterize platelet vWF levels AIS emboli assess associations between their expression clinical procedural information.Histopathological immunohistochemical analysis collected as part the multi-institutional RESTORE registry was performed. The composition quantified using Orbit Image Analysis machine learning software. Correlations clot...
Introduction In ischaemic stroke care, fast reperfusion is essential for disability free survival. It unknown if bypassing thrombolysis centres in favour of endovascular thrombectomy (mothership) outweighs transport to the nearest centre alteplase and then transfer (drip-and-ship). We use conditional probability modelling determine impact treatment times on decision-making acute stroke. Materials methods Probability good outcome was modelled using a previously published framework, data from...
Abstract Both intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) are evidence-based treatments for acute ischemic stroke (AIS) in selected cases. Recanalization may occur following IVT without the necessity of further interventions or requiring a subsequent MT procedure. prior to (bridging-therapy) be associated with benefits hazards. We studied retrieved clot area degree recanalization patients undergoing bridging-therapy whom it was possible collect thrombus material....