Publications by authors named "Arba F"

Introduction: Recent evidence suggests a possible role of non-stenotic carotid atherosclerotic plaques in the aetiology of embolic stroke of undetermined source (ESUS).

Methods: We conducted a systematic review and meta-analysis of prevalence and characteristics of non-stenotic carotid plaques (NSP) with high-risk features (complicated NSP) in internal carotid artery in unilateral ESUS in the anterior circulation. We searched Medline and Ovid-Embase databases.

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Introduction: The latest research in ischaemic stroke pathogenesis is directed to unveil what is inside embolic stroke of undetermined source (ESUS). Whether vulnerable non stenotic carotid plaques (NSTEPS), i.e.

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Background And Purpose: Mechanical thrombectomy (MT) along with emergent carotid stent placement (eCAS) has been suggested to have a greater benefit in patients with tandem lesions (TL), compared with other strategies of treatment. Nonetheless, there is no agreement on whether the intracranial occlusion should be treated before the cervical ICA lesion, or vice versa. In this retrospective multicenter study, we sought to compare clinical and procedural outcomes of the 2 different treatment approaches in patients with TL.

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Background: Collaterals are a strong determinant of clinical outcome in acute ischemic stroke (AIS) patients undergoing Endovascular Treatment (EVT). Careggi Collateral Score (CCS) is an angiographic score that demonstrated to be superior to the widely suggested ASITN/SIR score. Multi-phase CT-Angiography (mCTA) could be alternatively adopted for collateral assessment.

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We investigated relations between cerebral small vessel disease (cSVD) markers and evolution of the ischemic tissue from ischemic core to final infarct in people with acute ischemic stroke treated with intravenous thrombolysis. Data from the Stroke Imaging Repository (STIR) and Virtual International Stroke Trials Archive (VISTA) were used. Any pre-existing lacunar infarcts and white matter hyperintensities (WMH) were assessed on magnetic resonance (MR) before thrombolytic therapy.

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Introduction: Lacunar stroke represents around a quarter of all ischemic strokes; however, their identification with computed tomography in the hyperacute setting is challenging. We aimed to validate a clinical score to identify lacunar stroke in the acute setting, independently, with data from the WAKE-UP trial using magnetic resonance imaging.

Methods: We analyzed data from the WAKE-UP trial and extracted Oxfordshire Community Stroke Project (OCSP) classification.

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Background: Recent randomized trials have shown the benefit of mechanical thrombectomy (MT) also in patients with an established large ischemic core.

Aims: The purpose of this study was to define baseline predictors of clinical outcome in patients with large vessel occlusion (LVO) in the anterior circulation and an Alberta Stroke Program Early CT score (ASPECTS) ⩽ 5, undergoing MT.

Material And Methods: The databases of 16 comprehensive stroke centers were retrospectively screened for patients with LVO and ASPECTS ⩽5 that received MT.

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Article Synopsis
  • The study examines how general anesthesia (GA) compares to conscious sedation/local anesthesia (CS/LA) in patients with minor strokes undergoing immediate mechanical thrombectomy (iMT).
  • The research involved analyzing data from 16 stroke centers, focusing on patients with isolated M2 occlusions and mild stroke severity, utilizing propensity score matching for a fair comparison.
  • Results showed no significant difference in patient outcomes or complications between those receiving GA or CS/LA, indicating that the choice of anesthesia does not impact recovery or procedural safety in these cases.
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Background: The aim of our study was to find predictors of parenchymal hematoma (PH) and clinical outcome after mechanical thrombectomy (MT) in patients with large vessel occlusion (LVO) and baseline large infarct.

Methods: The databases of 16 stroke centers were retrospectively screened for patients with anterior circulation LVO and baseline Alberta Stroke Program Early CT Score (ASPECTS) ≤5 that received MT. Procedural parameters, including the number of passes during first and second technique of MT, were recorded.

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Article Synopsis
  • - Researchers studied patients with brain injuries in the lower brain area to find out what factors could lead to a worsening condition called hematoma expansion (HE), which is when bleeding in the brain gets worse.
  • - They looked at 175 patients and found that 21.7% had HE, and those with HE were more likely to have certain signs on their brain scans and higher chances of dying within 90 days.
  • - The study concluded that if patients showed specific signs and came to the hospital quickly, it could help predict the risk of HE and the chances of survival after brain bleeding events.
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Background And Objectives: Hematoma expansion (HE) is a major determinant of neurologic deterioration and poor outcome in intracerebral hemorrhage (ICH) and represents an appealing therapeutic target. We analyzed the prognostic effect of different degrees of HE.

Methods: This was a retrospective analysis of patients with ICH admitted at 8 academic institutions in Italy, Germany, Canada, China, and the United States.

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Article Synopsis
  • Cerebral collateral circulation is important in determining outcomes for acute ischemic stroke patients, particularly in relation to infarct size and effectiveness of treatment.
  • A study involved 520 patients to explore how factors such as age, sex, and stroke severity impact the development of collaterals, using CT angiography for assessment.
  • Results showed that good collateral circulation was linked to lower stroke severity and more frequent left hemisphere involvement, whereas previous strokes/TIAs were associated with poorer collateral formation.
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Background: Patients with minor stroke and M2 occlusion undergoing best medical management (BMM) may face early neurological deterioration (END) that can lead to poor long-term outcome. In case of END, rescue mechanical thrombectomy (rMT) seems beneficial. Our study aimed to define factors relevant to clinical outcome in patients undergoing BMM with the possibility of rMT on END, and find predictors of END.

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Background And Purpose: Intracranial carotid artery calcifications (ICACs) are a common finding on noncontrast computed tomography (NCCT) and have been associated with an increased risk of ischemic stroke. However, no data are available about the association between ICAC patterns and stroke etiology. We investigated the association between ICAC patterns and etiological subtypes of ischemic stroke.

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Background: Noncontrast computed tomography hypodensities are a validated predictor of hematoma expansion (HE) in intracerebral hemorrhage and a possible alternative to the computed tomography angiography (CTA) spot sign but their added value to available prediction models remains unclear. We investigated whether the inclusion of hypodensities improves prediction of HE and compared their added value over the spot sign.

Methods: Retrospective analysis of patients admitted for primary spontaneous intracerebral hemorrhage at the following 8 university hospitals in Boston, US (1994-2015, prospective), Hamilton, Canada (2010-2016, retrospective), Berlin, Germany (2014-2019, retrospective), Chongqing, China (2011-2015, retrospective), Pavia, Italy (2017-2019, prospective), Ferrara, Italy (2010-2019, retrospective), Brescia, Italy (2020-2021, retrospective), and Bologna, Italy (2015-2019, retrospective).

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Metabolic perturbations and inflammatory mediators play a fundamental role in both early and late adverse post-acute ischemic stroke outcomes. Using data from the observational MAGIC (MArker bioloGici nell'Ictus Cerebrale) study, we evaluated the effect of 130 serum metabolic features, using a nuclear magnetic spectroscopy approach, on the following outcomes: hemorrhagic transformation at 24 h after stroke, non-response to intravenous thrombolytic treatment with the recombinant tissue plasminogen activator (rt-PA), and the 3 month functional outcome. Blood circulating metabolites, lipoproteins, and inflammatory markers were assessed at the baseline and 24 h after rt-PA treatment.

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Background: Hematoma expansion (HE) is an appealing therapeutic target in intracerebral hemorrhage (ICH) and non-contrast computed tomography (NCCT) features are promising predictors of HE.

Aims: We investigated whether onset-to-CT time influences the diagnostic performance of NCCT markers for HE.

Methods: Retrospective multicentre analysis of patients with primary ICH.

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Background: The purpose of this study was to evaluate the effectiveness of mechanical thrombectomy (MT) in patients with isolated M2 occlusion and minor symptoms and identify possible baseline predictors of clinical outcome.

Methods: The databases of 16 high-volume stroke centers were retrospectively screened for consecutive patients with isolated M2 occlusion and a baseline National Institutes of Health Stroke Scale (NIHSS) score ≤5 who received either early MT (eMT) or best medical management (BMM) with the possibility of rescue MT (rMT) on early neurological worsening. Because our patients were not randomized, we used propensity score matching (PSM) to estimate the treatment effect of eMT compared with the BMM/rMT.

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Introduction: Although stroke occurs frequently in patients with cancer, there is scarce evidence regarding the safety and efficacy of endovascular treatment (EVT) in patients with acute ischemic stroke and concurrent cancer. We performed a systematic review and meta-analysis to summarize the existing literature.

Methods: We searched for English written observational studies reporting data on safety and efficacy of EVT in patients with acute ischemic stroke and concurrent cancer.

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Article Synopsis
  • Hematoma expansion (HE) is prevalent in patients with intracerebral hemorrhage (ICH) who have unclear symptom onset, potentially leading to worse outcomes.
  • A study analyzed the relationship between certain markers observed in non-contrast computed tomography (NCCT) scans and the likelihood of HE in 646 ICH patients, with key findings indicating that markers like hypodensities, heterogeneous density, blend sign, and irregular shape are significantly linked to higher HE risk.
  • The research suggests that these NCCT markers could assist in stratifying the risk of HE in future studies of patients who present with unclear symptom onset, but further prospective research is needed to confirm these results.
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  • The study aimed to assess how effective time to maximum concentration (T)-based target mismatch on computed tomography perfusion (CTP) is in predicting outcomes for patients with acute ischemic stroke (AIS) who undergo endovascular treatment (EVT).
  • Researchers analyzed 393 AIS patients and found that certain T thresholds (specifically T > 16 seconds) were strong predictors of final infarct volume (FIV) and clinical outcomes after treatment.
  • Results indicated that a T > 16 seconds volume of 67ml or less enhanced the likelihood of achieving a favorable outcome, with high sensitivity and specificity metrics, highlighting its potential utility in clinical decision-making.
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  • The NIHSS may not accurately reflect the severity of posterior circulation strokes, leading to potential misclassification for treatment eligibility.
  • Researchers developed the Posterior NIHSS (POST-NIHSS) to better assess prognosis in these patients by incorporating specific clinical features.
  • The POST-NIHSS improved predictive accuracy compared to the standard NIHSS, demonstrating its potential as a more effective tool for evaluating patients with mild to moderate symptoms of posterior circulation strokes.
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