Luís San Román
A5005513572- Acute Ischemic Stroke Management
- Cerebrovascular and Carotid Artery Diseases
- Intracranial Aneurysms: Treatment and Complications
- Venous Thromboembolism Diagnosis and Management
- Stroke Rehabilitation and Recovery
- Vascular Malformations Diagnosis and Treatment
- Traumatic Brain Injury and Neurovascular Disturbances
- Neurotransmitter Receptor Influence on Behavior
- Essential Oils and Antimicrobial Activity
- Receptor Mechanisms and Signaling
- Neuroscience and Neuropharmacology Research
- Nitric Oxide and Endothelin Effects
- Intracerebral and Subarachnoid Hemorrhage Research
- Pain Mechanisms and Treatments
- Neurosurgical Procedures and Complications
- Sesquiterpenes and Asteraceae Studies
- Heart Rate Variability and Autonomic Control
- Spine and Intervertebral Disc Pathology
- Peripheral Artery Disease Management
- Natural product bioactivities and synthesis
- Eicosanoids and Hypertension Pharmacology
- Phytochemistry and Biological Activities
- Advanced MRI Techniques and Applications
- Inflammatory mediators and NSAID effects
- Spinal Fractures and Fixation Techniques
Hospital Clínic de Barcelona
2016-2025
Consorci Institut D'Investigacions Biomediques August Pi I Sunyer
2015-2024
Health and Education Research Management and Epidemiologic Services (United States)
2021-2023
University Health Care System
2022
Hospital de Sant Pau
2002-2022
Hermes Arzneimittel (Germany)
2021
Universitat de Barcelona
2013-2021
Universitat Autònoma de Barcelona
2016-2021
Hospital Universitari Germans Trias i Pujol
2015-2021
Barrow Neurological Institute
2020
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...
Revascularization after endovascular therapy for acute ischemic stroke is measured by the Thrombolysis In Cerebral Infarction (TICI) scale, yet variability exists in scale definitions. We examined degree of reperfusion with expanded TICI (eTICI) and association outcomes HERMES collaboration recent trials.The Imaging Core, blind to all other data, evaluated angiography HERMES. A battery scores (mTICI, TICI, TICI2C) was used define initial target occlusion defined non-invasive imaging...
<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,...
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...
Abstract Uncertainty regarding the benefits of vertebroplasty (VP) for treatment acute osteoporotic vertebral fractures has recently arisen. A prospective, controlled, randomized single-center trial (ClinicalTrials.gov registration number NCT00994032) was designed to compare effects VP versus conservative on quality life and pain in patients with painful fractures, new secondary adverse were also analyzed during a 12-month follow-up period. total 125 randomly assigned receive or VP. The...
Background and Purpose— A progressive decline in the odds of favorable outcome as time to reperfusion increases is well known. However, impact specific workflow intervals not clear. Methods— We studied mechanical thrombectomy group (n=103) prospective, randomized REVASCAT (Randomized Trial Revascularization With Solitaire FR Device Versus Best Medical Therapy Treatment Acute Stroke due Anterior Circulation Large Vessel Occlusion Presenting Within Eight Hours Symptom Onset) trial. defined 3...
REVASCAT is a prospective, multicenter, randomized trial seeking to establish whether subjects meeting following main inclusion criteria: age 18-80, baseline National Institutes of Health Stroke Scale ≥6, evidence intracranial internal carotid artery or proximal (M1 segment) middle cerebral occlusion, Alberta Program Early Computed Tomography score >7 on non-contrast CT >6 diffusion-weighted magnetic resonance imaging , ineligible for with persistent occlusion after intravenous alteplase and...
Computed tomographic (CT) high attenuation (HA) areas after endovascular therapy for acute ischemic stroke are a common finding indicative of blood-brain barrier disruption. Dual-energy CT allows an accurate differentiation between HA related to contrast staining (CS) or brain hemorrhage (BH). We sought evaluate the prognostic significance presence CS and BH therapy.A prospective cohort 132 patients treated with was analyzed. According dual-energy findings, were classified into 3 groups: no...
Background Follow-up infarct volume (FIV) has been recommended as an early indicator of treatment efficacy in patients with acute ischemic stroke. Questions remain about the optimal imaging approach for FIV measurement. Objective To examine association 90-day modified Rankin Scale (mRS) score and investigate its dependency on acquisition time modality. Methods Data seven trials were pooled. was assessed follow-up (12 hours to 2 weeks) CT or MRI. Infarct location defined laterality...
The positive treatment effect of endovascular therapy (EVT) is assumed to be caused by the preservation brain tissue. It remains unclear what extent treatment-related reduction in follow-up infarct volume (FIV) explains improved functional outcome after EVT patients with acute ischemic stroke.To study whether FIV mediates relationship between and stroke.Patient data from 7 randomized multicenter trials were pooled. These conducted December 2010 April 2015 included 1764 randomly assigned...
Rationale Optimal pre-hospital delivery pathways for acute stroke patients suspected to harbor a large vessel occlusion have not been assessed in randomized trials. Aim To establish whether subjects with rapid arterial evaluation scale based suspicion of evaluated by emergency medical services the field higher rates favorable outcome when transferred directly an endovascular center (endovascular treatment center), as compared standard transfer closest local (local-SC). Design Multicenter,...
Although previous trials have established the efficacy and safety of endovascular thrombectomy (EVT) in large ischemic core strokes, most them excluded patients with extracranial internal carotid artery (e-ICA) occlusion. We aimed to compare outcomes e-ICA occlusion infarcts treated EVT vs medical management (MM). This was a secondary analysis SELECT2 trial, randomized controlled trial conducted at 31 international sites. Adult proximal intracranial anterior circulation defined as Alberta...
Whether intravenous thrombolysis adds a further benefit when given before endovascular thrombectomy (EVT) is unknown. Furthermore, delays time to groin puncture, mainly among drip and ship patients.Using region-wide registry data, we selected cases that received direct EVT or combined thrombolysis+EVT for anterior circulation strokes between January 2011 October 2015. Treatment effect was estimated by stratification on propensity score. The average odds ratios the association of treatment...
Background and Purpose— Less than half of acute ischemic stroke patients treated with mechanical thrombectomy obtain permanent clinical benefits. Consequently, there is an urgent need to identify mechanisms implicated in the limited efficacy early reperfusion. We evaluated predictors prognostic significance vessel wall permeability impairment its association blood–cerebrospinal fluid barrier (BCSFB) disruption after thrombectomy. Methods— A prospective cohort stent retrievers was analyzed....
Background Numerous neuroprotective drugs have failed to show benefit in the treatment of acute ischemic stroke, making search for new treatments imperative. Uric acid is an endogenous antioxidant it a drug candidate improve stroke outcomes. Aim To report effects uric therapy patients receiving intravenous thrombolysis and mechanical thrombectomy. Methods Forty-five with proximal vessel occlusions enrolled URICO-ICTUS trial received recombinant tissue plasminogen activator within 4.5 h after...