Nils Mueller‐Kronast
A5003759615- Acute Ischemic Stroke Management
- Cerebrovascular and Carotid Artery Diseases
- Stroke Rehabilitation and Recovery
- Venous Thromboembolism Diagnosis and Management
- Peripheral Artery Disease Management
- Intracranial Aneurysms: Treatment and Complications
- Traumatic Brain Injury and Neurovascular Disturbances
- Trauma and Emergency Care Studies
- Healthcare Systems and Public Health
- Antiplatelet Therapy and Cardiovascular Diseases
- Health, Environment, Cognitive Aging
- Intracerebral and Subarachnoid Hemorrhage Research
- Vascular Malformations Diagnosis and Treatment
- MRI in cancer diagnosis
- Renal and Vascular Pathologies
- Alcohol Consumption and Health Effects
- Renal function and acid-base balance
- Tracheal and airway disorders
- Hemispheric Asymmetry in Neuroscience
- Advanced MRI Techniques and Applications
- Myasthenia Gravis and Thymoma
- Cardiac Imaging and Diagnostics
- Infective Endocarditis Diagnosis and Management
- Advanced X-ray and CT Imaging
- Cardiac Valve Diseases and Treatments
Collaborative Neuroscience Network
2017-2024
Delray Medical Center
2014-2024
Health and Education Research Management and Epidemiologic Services (United States)
2023
John Wiley & Sons (United States)
2023
Hudson Institute
2023
Liechtenstein Institute
2023
Heidelberg University
2022
University Hospital Heidelberg
2022
University of Tennessee Health Science Center
2022
Case Western Reserve University
2022
Background and Purpose— In acute ischemic stroke, fast complete recanalization of the occluded vessel is associated with improved outcomes. We describe a novel measure for newer generation devices: first pass effect (FPE). FPE defined as achieving single thrombectomy device pass. Methods— The North American Solitaire Acute Stroke Registry database was used to identify subgroup. Their baseline features clinical outcomes were compared non-FPE patients. Clinical outcome measures included...
Background: Endovascular treatment with mechanical thrombectomy (MT) is beneficial for patients acute stroke suffering a large-vessel occlusion, although efficacy highly time-dependent. We hypothesized that interhospital transfer to endovascular-capable centers would result in delays and worse clinical outcomes compared direct presentation. Methods: STRATIS (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices Acute Ischemic Stroke) was prospective, multicenter,...
Efficient and timely recanalization is an important goal in acute stroke endovascular therapy. Several studies demonstrated improved clinical outcomes with the stent retriever devices compared Merci device. The of this study was to evaluate role balloon guide catheter (BGC) success a substudy North American Solitaire Acute Stroke (NASA) registry.The investigator-initiated NASA registry recruited 24 sites within America submit demographic, clinical, site-adjudicated angiographic, outcome data...
Mechanical thrombectomy with stent retrievers has become standard of care for treatment acute ischemic stroke patients because large vessel occlusion. The STRATIS registry (Systematic Evaluation Patients Treated With Neurothrombectomy Devices Acute Ischemic Stroke) aimed to assess whether similar process timelines, technical, and functional outcomes could be achieved in a real world cohort as the randomized trials.STRATIS was designed prospectively enroll treated United States Solitaire...
Background Limited post-marketing data exist on the use of Solitaire FR device in clinical practice. The North American Stent Retriever Acute Stroke (NASA) registry aimed to assess real world performance contrast with results from SWIFT (Solitaire Intention for Thrombectomy) and TREVO 2 (Trevo versus Merci retrievers thrombectomy revascularization large vessel occlusions acute ischemic stroke) trials. Methods investigator initiated NASA recruited sites submit retrospective angiographic...
Mechanical thrombectomy with stent-retrievers results in higher recanalization rates compared previous devices. Despite successful (Thrombolysis Cerebral Infarction (TICI) score ≥2b) of 70-83%, good outcomes by 90-day modified Rankin Scale (mRS) ≤2 are achieved only 40-55% patients. We evaluated predictors poor (mRS >2) despite (TICI the North American Solitaire Stent Retriever Acute Stroke (NASA) registry.Logistic regression was used to evaluate baseline characteristics and for association...
Background and Purpose— Previous work that predated the availability of safer stent-retriever devices has suggested general anesthesia (GA) may have a negative impact on outcomes in patients with acute ischemic stroke undergoing endovascular therapy. Methods— We reviewed demographic, clinical, procedural (GA versus local [LA], etc), site-adjudicated angiographic clinical data from consecutive treated Solitaire FR device investigator-initiated North American SOLITAIRE Stent-Retriever Acute...
Background and Purpose— Mechanical thrombectomy has been shown to improve clinical outcomes in patients with acute ischemic stroke. However, the impact of balloon guide catheter (BGC) use is not well established. Methods— STRATIS (Systematic Evaluation Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) was a prospective, multicenter study large vessel occlusion treated Solitaire stent retriever as first-line therapy. In this study, an independent core laboratory,...
Background and Purpose— The Solitaire With the Intention for Thrombectomy (SWIFT) thrombectomy revascularization of large vessel occlusions in acute ischemic stroke (TREVO 2) trial results demonstrated improved recanalization rates with mechanical thrombectomy; however, outcomes elderly population remain poorly understood. Here, we report effect age on clinical angiographic outcome within North American Solitaire-FR Stent-Retriever Acute Stroke (NASA) Registry. Methods— NASA Registry...
Background and Purpose- The safety efficacy of mechanical thrombectomy in patients with acute ischemic stroke has been demonstrated. However, the impact stent retriever size on clinical angiographic outcomes is not well established. Methods- This was a retrospective ad hoc analysis data from STRATIS (Systematic Evaluation Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) registry-a prospective, multicenter study large vessel occlusion treated Solitaire retriever. An...
Background and Purpose- Mechanical thrombectomy (MT) devices have led to improved reperfusion clinical outcomes in acute ischemic stroke patients with emergent large vessel occlusions; however, less than one-third of achieve complete reperfusion. Use intraarterial thrombolysis the context MT may provide an opportunity enhance these results. Here, we evaluate use rtPA (recombinant tissue-type plasminogen activator) as rescue therapy (RT) after failed North American Solitaire Stent-Retriever...
This study investigates clinical outcomes after mechanical thrombectomy in adult patients with baseline Alberta Stroke Program Early CT Score (ASPECTS) of 0 to 5.We included data from the STRATIS Registry (Systematic Evaluation Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) who underwent within 8 hours symptom onset and had available ASPECTS adjudicated by an independent core laboratory. Angiographic were collected, including successful reperfusion (modified...
Background: The indications for mechanical thrombectomy in acute ischemic stroke continue to broaden, leading neurointerventionalists treat vessel occlusions at increasingly distal locations farther time from onset. Accessing these smaller vessels raises the concern of iatrogenic subarachnoid hemorrhage (SAH) owing increasing complexity device navigation and retrieval. This study aims determine prevalence SAH following thrombectomy, associated predictors, resulting functional outcomes using...
Racial-ethnic disparities in acute stroke care can contribute to inequality outcomes. We examined race-ethnic performance metrics a voluntary registry among Florida and Puerto Rico Get With the Guidelines-Stroke hospitals.Seventy-five sites Stroke Registry (66 9 Rico) recorded 58 864 ischemic cases (2010-2014). Logistic regression models racial-ethnic differences measures defect-free (intravenous tissue plasminogen activator treatment, in-hospital antithrombotic therapy, deep vein thrombosis...
Background The DEFUSE 3 and DAWN trials have shown the benefit of thrombectomy beyond 6 hours stroke symptom onset in carefully selected patients. Objective To evaluate real-world outcomes stent retriever using combined individual patient data from North American Solitaire Stent Retriever Acute Stroke (NASA) Trevo Stent-Retriever (TRACK) registries. Methods Pooled analysis all cases anterior circulation acute ischemic (AIS) NASA TRACK was performed to compare patients presenting within first...
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Background and Purpose: Achieving complete revascularization after a single pass of mechanical thrombectomy device (first effect [FPE]) is associated with good clinical outcomes in patients acute ischemic stroke due to large vessel occlusion. We assessed patient characteristics, outcomes, predictors FPE among real-world cohort (Systematic Evaluation Patients Treated Stroke Devices for Acute Ischemic registry). Methods: Demographics, procedural characteristics were analyzed whom (modified...
Background: The impact of time to treatment on outcomes endovascular thrombectomy (EVT) especially in patients presenting after 6 hours from symptom onset is not well characterized. We studied the differences characteristics and timelines EVT-treated participating Florida Stroke Registry aimed characterize extent which impacts EVT early late windows. Methods: Prospectively collected data Get With Guidelines–Stroke hospitals January 2010 April 2020 were reviewed. Participants with...
Background and Purpose— Failure to recanalize predicts mortality in acute ischemic stroke. In the North American Solitaire Acute Stroke registry, we investigated parameters associated with successfully recanalized patients. Methods— Logistic regression was used evaluate baseline characteristics recanalization for association 90-day mortality. A multivariable model developed based on backward selection retention criteria of P <0.05 from factors at least marginal significance ( ≤0.10), then...
The authors reviewed 42 consecutive cases of decompressive hemicraniectomy after hemispheric ischemic stroke to assess predictors outcome. On univariate analysis, advanced age and history hypertension were significantly associated with unfavorable outcome, whereas thrombolysis was protective. Side infarction, pupillary nonreactivity, degree preoperative midline shift, timing surgery did not predict multivariate older independently predicted poor recovery (odds ratio 2.9 per 10-year increase in age).
Background Routing patients directly to endovascular capable centers (ECCs) would decrease time mechanical thrombectomy (MT), but may delay intravenous thrombolysis (IVT). Objective To study the clinical outcomes of with a stroke transferred ECCs compared those from non-endovascular (nECCs). Methods Data STRATIS registry were analyzed evaluate process and under five routing policies: (1) transport nearest nECC; (2) ECC over any distance or (3) within 20 miles; (4) ideal (iECC), (5) miles....
Background Limited post-marketing data exist on the use of Solitaire FR device in clinical practice. The North American Stent Retriever Acute Stroke (NASA) registry aimed to assess real world performance contrast with results from SWIFT (Solitaire Intention for Thrombectomy) and TREVO 2 (Trevo versus Merci retrievers thrombectomy revascularization large vessel occlusions acute ischemic stroke) trials. Methods investigator initiated NASA recruited sites submit retrospective angiographic...
Background and Purpose— We aimed to evaluate the current practice patterns, safety outcomes of patients who receive endovascular therapy (EVT) having mild neurological symptoms. Methods— From Jan 2010 2018, 127,794 ischemic stroke were enrolled in Florida-Puerto Rico Stroke Registry. Patients presenting within 24 hours symptoms received EVT classified into (National Institutes Health Scale [NIHSS] ≤5) or moderate/severe (NIHSS>5) categories. Differences clinical characteristics evaluated...