A5079955678- Acute Ischemic Stroke Management
- Cerebrovascular and Carotid Artery Diseases
- Stroke Rehabilitation and Recovery
- Venous Thromboembolism Diagnosis and Management
- Traumatic Brain Injury and Neurovascular Disturbances
- Intracerebral and Subarachnoid Hemorrhage Research
- Peripheral Artery Disease Management
- Intracranial Aneurysms: Treatment and Complications
- Cardiovascular Health and Risk Factors
- Neurological Disorders and Treatments
- Cardiac Imaging and Diagnostics
- Antiplatelet Therapy and Cardiovascular Diseases
- Health Systems, Economic Evaluations, Quality of Life
- Neurological Disease Mechanisms and Treatments
- Trauma and Emergency Care Studies
- Blood Coagulation and Thrombosis Mechanisms
- Atrial Fibrillation Management and Outcomes
- Botulinum Toxin and Related Neurological Disorders
- Cardiovascular Health and Disease Prevention
- Healthcare Systems and Practices
- Advanced MRI Techniques and Applications
- COVID-19 and healthcare impacts
- Blood Pressure and Hypertension Studies
- S100 Proteins and Annexins
- Meta-analysis and systematic reviews
University of Cincinnati
2016-2025
The University of Texas Health Science Center at Houston
2025
McMaster University
2021-2025
Population Health Research Institute
2021-2025
University of Cincinnati Medical Center
2015-2024
Cincinnati Children's Hospital Medical Center
2010-2024
Brown University
2015-2024
The Royal Melbourne Hospital
2015-2024
The University of Melbourne
2015-2024
National Health and Medical Research Council
2024
Background and Purpose— The authors present an overview of the current evidence management recommendations for evaluation treatment adults with acute ischemic stroke. intended audiences are prehospital care providers, physicians, allied health professionals, hospital administrators responsible stroke patients within first 48 hours from onset. These guidelines supersede prior 2007 2009 updates. Methods— Members writing committee were appointed by American Stroke Association Council’s...
Endovascular therapy is increasingly used after the administration of intravenous tissue plasminogen activator (t-PA) for patients with moderate-to-severe acute ischemic stroke, but whether a combined approach more effective than t-PA alone uncertain.
We describe temporal trends in stroke incidence stratified by age from our population-based epidemiology study. hypothesized that younger adults (age 20-54) increased over time, most notably between 1999 and 2005.
<b>Background:</b> Trials of IV recombinant tissue plasminogen activator (rt-PA) have demonstrated that longer times from ischemic stroke symptom onset to initiation treatment are associated with progressively lower likelihoods clinical benefit, and likely no benefit beyond 4.5 hours. How the timing rt-PA relates restoration blood flow has been unclear. An understanding relationship between angiographic reperfusion outcome is needed establish time parameters for intraarterial (IA) therapies....
Background and Purpose— Recombinant tissue-type plasminogen activator (rtPA) is the only approved therapy for acute ischemic stroke (AIS). In 2004, 1.8% to 2.1% of AIS patients in United States received rtPA. Given incentives from regulatory agencies payors increase rtPA use, we hypothesized that use would 2005 2009. Methods— cases were defined by exclusion hemorrhagic transient attack International Classification Diseases 9 th revision codes (430, 431, 432, 435) diagnosis-related groups 14,...
Mechanical thrombectomy (MT) has become the cornerstone of acute ischaemic stroke management in patients with large vessel occlusion (LVO). The aim this guideline document is to assist physicians their clinical decisions regard MT.These Guidelines were developed based on standard operating procedure European Stroke Organisation and followed Grading Recommendations, Assessment, Development, Evaluation (GRADE) approach. An interdisciplinary working group identified 15 relevant questions,...
Background Mechanical thrombectomy (MT) has become the cornerstone of acute ischemic stroke management in patients with large vessel occlusion (LVO). The aim this guideline document is to assist physicians their clinical decisions regard MT. Methods These guidelines were developed based on standard operating procedure European Stroke Organisation, and followed Grading Recommendations, Assessment, Development, Evaluation (GRADE) approach. An interdisciplinary working group identified 15...
Mechanical thrombectomy (MT) has become the cornerstone of acute ischemic stroke management in patients with large vessel occlusion (LVO).To assist physicians their clinical decisions regard toMT.These guidelines were developed based on standard operating procedure European Stroke Organisation and followed Grading Recommendations, Assessment, Development, Evaluation (GRADE) approach. An interdisciplinary working group identified 15 relevant questions, performed systematic reviews...
<b><i>Background:</i></b> Population-based studies have estimated that about 15% of ischemic strokes are caused by large-vessel cerebrovascular disease. We determined the types atherosclerosis responsible for in a population-based stroke study. <b><i>Methods:</i></b> Patients with first-ever or recurrent Greater Cincinnati area were identified during 2005 at all local hospitals. Study physicians assigned subtypes. Overall event rates and...
Our aim was to detail revascularization results, including impact on outcome and mortality, in the Interventional Management of Stroke (IMS) II trial.
Although other studies (in largely white populations) have found that stroke incidence declined during the 1990s, we previously reported in our population (18% of which was black) did not change decade and rates blacks were significantly higher than whites. We sought to update temporal trends by adding new data obtained from large, biracial 2005. The objective this study examine case-fatality within a large over time comparing 1993 1994, 1999,
Background and Purpose— Endovascular strategies provide unique opportunity to correlate angiographic measures of collateral circulation at the time endovascular therapy. We conducted systematic analyses collaterals conventional angiography on recanalization, reperfusion, clinical outcomes in treatment arm Interventional Management Stroke (IMS) III trial. Methods— Prospective evaluation was via central review subjects treated with therapy IMS (n=331). Collateral grade before assessed American...
<h3>Importance</h3> More than half of patients with acute ischemic stroke have minor neurologic deficits (National Institutes Health Stroke Scale [NIHSS] score 0-5) at presentation. Although prior major trials alteplase included low NIHSS scores, few without clearly disabling were enrolled. <h3>Objective</h3> To evaluate the efficacy and safety in scores 0 to 5 whose are not disabling. <h3>Design, Setting, Participants</h3> The PRISMS trial was designed as a 948-patient, phase 3b,...
Thrombectomy, primarily with stent retrievers or without adjunctive aspiration, provided clinical benefit across multiple prospective randomized trials. Whether this is exclusive to unclear.THERAPY (The Randomized, Concurrent Controlled Trial Assess the Penumbra System's Safety and Effectiveness in Treatment of Acute Stroke; NCT01429350) was an international, multicenter, prospective, (1:1), open label, blinded end point evaluation, concurrent controlled trial aspiration thrombectomy after...
T he rate of stroke among adults with atrial fibrilla- tion (AF) varies widely, ranging between 1% and 20% annually (mean 4.5% per year) depending on comorbidities a patient's history prior cerebrovascular events. 1 Stratification risk is important, because the major antithrombotic medications used to lower incidence AF-related bleeding.2][3] The advent several new agents offers alternatives warfarin may threshold for thromboembolic initiating therapy in patients AF.In this update American...
<h3>Objective:</h3> Previous studies have estimated that wake-up strokes comprise 8%to 28% of all ischemic strokes, but these were either small or not population-based. We sought to establish the proportion and event rate in a large population-based study compare patients who awoke with stroke symptoms those awake at time onset. <h3>Methods:</h3> First-time recurrent among residents Greater Cincinnati/Northern Kentucky region (population 1.3 million) 2005 identified using International...
Only 3% to 5% of patients with acute ischemic stroke receive intravenous recombinant tissue-type plasminogen activator (r-tPA) and <1% endovascular therapy. We describe access the US population all facilities that actually provide r-tPA or therapy for stroke.We used demographic data rates in 2011 Medicare Provider Analysis Review set. International Classification Diseases-Ninth Revision codes 433.xx, 434.xx 436 identified cases. code 99.10 defined treatment 39.74 estimated ambulance response...