Publications by authors named "Beenen L"

Background: Cardiac computed tomography (CT) is increasingly used to search for cardioembolic sources of acute ischemic stroke (AIS). We assessed the association between high-risk cardioembolic sources on cardiac CT and AIS.

Methods: We performed a case-control study using data from a prospective cohort including consecutive adult patients with suspected stroke who underwent cardiac CT acquired during the initial stroke imaging protocol between 2018 and 2020.

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  • The study looked at whether a medical procedure called thrombectomy helps patients who have a large stroke as seen on a specific type of scan called a noncontrast CT within 24 hours of having the stroke.
  • It involved 300 patients from different hospitals who were split into two groups; one group received the thrombectomy treatment, while the other only received regular care.
  • The main goal was to see if those who had thrombectomy had better recovery after 90 days compared to those who didn’t, along with checking if there were any serious side effects.
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  • This study investigates the impact of left atrial appendage (LAA) slow-flow on ischemic stroke outcomes, finding that 16% of patients had slow-flow and shared characteristics with those having LAA thrombus.
  • While both slow-flow and thrombus were linked to a higher prevalence of atrial fibrillation, patients with thrombus experienced more severe strokes and worse functional outcomes than those with slow-flow.
  • Ultimately, slow-flow did not significantly affect functional outcomes or major cardiovascular events, but it was associated with an increased risk of stroke recurrence in patients with unknown causes of their strokes.
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The early management of transferred patients with a large vessel occlusion (LVO) stroke could be improved by identifying patients who are likely to recanalize early. We aim to predict early recanalization based on patient clinical and thrombus imaging characteristics. We included 81 transferred anterior-circulation LVO patients with an early recanalization, defined as the resolution of the LVO or the migration to a distal location not reachable with endovascular treatment upon repeated radiological imaging.

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Background: Cardiac computed tomography (CT) acquired during the initial acute stroke imaging protocol (acute cardiac CT) is increasingly used to screen for cardioembolism, but information on the long-term clinical implications of its findings is lacking.

Methods And Results: We performed a prospective, single-center cohort study in which consecutive patients with ischemic stroke underwent ECG-gated acute cardiac CT and were followed up for 2 years. The primary outcome was functional outcome assessed using the modified Rankin Scale.

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Introduction: Even when using the Advanced Trauma Life Support (ATLS) guidelines and other diagnostic protocols for the initial assessment of trauma patients, not all injuries will be diagnosed in this early stage of care. The aim of this study was to quantify how many, and assess which type of injuries were diagnosed with delay during the initial assessment of trauma patients including a total-body computed tomography (TBCT) scan in a Level 1 Trauma Center in the Netherlands.

Methods: We conducted a retrospective cohort study of 697 trauma patients who were assessed in the trauma bay of the Amsterdam University Medical Center (AUMC), using a TBCT.

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  • Multivessel occlusions (MVO) are rare (2.4% of patients) in large vessel occlusion stroke patients undergoing endovascular treatment (EVT) but lead to significantly worse outcomes.
  • Patients with MVO had higher baseline disability scores and poorer collateral blood flow compared to those without MVO.
  • After matching for confounding factors, MVO patients exhibited worse functional recovery at 90 days and higher mortality rates (46% vs 27%).
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Purpose: Cerebral arterial gas embolism (CAGE) occurs when air or medical gas enters the systemic circulation during invasive procedures and lodges in the cerebral vasculature. Non-contrast computer tomography (CT) may not always show intracerebral gas. CT perfusion (CTP) might be a useful adjunct for diagnosing CAGE in these patients.

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Objective: To explore the relationship between the volumetric bone mineral density (vBMD), the thickness of the condylar cortex (T) and the hemimandibular volumes (V) of symmetrical and asymmetrical mandibles of children.

Design: The data collection consisted of 92 archeological skeletal remains of children's mandibles between 1 and 12 years old. The mandibles were digitalized with a computed tomography (CT) scan, and three dimensional models were obtained.

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Background: Cardiac thrombi are an important cause of ischemic stroke but are infrequently detected on cardiac imaging. We hypothesized that this might be explained by early dissolution of these cardiac thrombi after stroke occurrence.

Methods: We performed a single-center observational pilot study between November 2019 and November 2020, embedded in the larger "Mind-the-Heart" study.

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Background: The recently published 4-level Pulmonary Embolism Clinical Probability Score (4PEPS) integrates different aspects from currently available diagnostic strategies to further reduce imaging testing in patients with clinically suspected pulmonary embolism (PE).

Aim: To externally validate the performance of 4PEPS in an independent cohort.

Methods: In this post-hoc analysis of the prospective diagnostic management YEARS study, the primary outcome measures were discrimination, calibration, efficiency (proportion of imaging tests potentially avoided), and failure rate (venous thromboembolism (VTE) diagnosis at baseline or follow-up in patients with a negative 4PEPS algorithm).

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Objectives: CT perfusion (CTP) has been suggested to increase the rate of large vessel occlusion (LVO) detection in patients suspected of acute ischemic stroke (AIS) if used in addition to a standard diagnostic imaging regime of CT angiography (CTA) and non-contrast CT (NCCT). The aim of this study was to estimate the costs and health effects of additional CTP for endovascular treatment (EVT)-eligible occlusion detection using model-based analyses.

Methods: In this Dutch, nationwide retrospective cohort study with model-based health economic evaluation, data from 701 EVT-treated patients with available CTP results were included (January 2018-March 2022; trialregister.

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Background: The administration of contrast medium is associated with acute kidney injury; however, the effect of exposure of a deceased organ donor to contrast medium on kidney transplant outcomes has been poorly studied.

Methods: A retrospective analysis of all deceased kidney donors between 2011 and 2021 and their corresponding recipients in the Netherlands was conducted. Multivariable analyses were performed to assess the associations between contrast medium exposure and delayed graft function (DGF)/graft survival.

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Whether the fascia iliaca compartment block (FICB) involves the obturator nerve (ON) remains controversial. Involvement may require that the injectate spreads deep in the cranial direction, and might thus depend on the site of injection. Therefore, the effect of suprainguinal needle insertion with five centimeters of hydrodissection-mediated needle advancement (S-FICB-H) on ON involvement and cranial injectate spread was studied in this radiological cadaveric study.

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Introduction: Low and high volume mid-thigh (ie, distal femoral triangle) and distal adductor canal block approaches are frequently applied for knee surgical procedures. Although these techniques aim to contain the injectate within the adductor canal, spillage into the popliteal fossa has been reported. While in theory this could improve analgesia, it might also result in motor blockade due to coverage of motor branches of the sciatic nerve.

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Computed tomography perfusion (CTP) is frequently used in the triage of ischemic stroke patients for endovascular thrombectomy (EVT). We aimed to quantify the volumetric and spatial agreement of the CTP ischemic core estimated with different thresholds and follow-up MRI infarct volume on diffusion-weighted imaging (DWI). Patients treated with EVT between November 2017 and September 2020 with available baseline CTP and follow-up DWI were included.

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Background: Cardiac CT acquired during the acute stroke imaging protocol is an emerging alternative to transthoracic echocardiography (TTE) to screen for sources of cardioembolism. Currently, its diagnostic accuracy to detect patent foramen ovale (PFO) is unclear.

Methods: This was a substudy of Mind the Heart, a prospective cohort in which consecutive adult patients with acute ischemic stroke underwent prospective ECG-gated cardiac CT during the initial stroke imaging protocol.

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Article Synopsis
  • Cardiac thrombi, found in about 8% of patients with acute ischemic stroke, are often located in the left atrial appendage and are linked to more severe strokes and poor outcomes.
  • In a study of 452 patients, those with cardiac thrombi had higher NIHSS scores (indicating more severe symptoms) and more complications like multiple vascular occlusions compared to those without.
  • Although thrombi were associated with worse functional outcomes, the rate of stroke recurrence at 90 days was not significantly different between the two groups.
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Subcutaneous emphysema, pneumothorax and pneumomediastinum are well-known complications of invasive ventilation in patients with acute hypoxemic respiratory failure. We determined the incidences of air leaks that were visible on available chest images in a cohort of critically ill patients with acute hypoxemic respiratory failure due to coronavirus disease of 2019 (COVID-19) in a single-center cohort in the Netherlands. A total of 712 chest images from 154 patients were re-evaluated by a multidisciplinary team of independent assessors; there was a median of three (2-5) chest radiographs and a median of one (1-2) chest CT scans per patient.

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Objective: To explore the normal variation of asymmetry in mandibles of children in the age group of 1 to 12 years.

Materials And Methods: The study group consisted of 92 cadaveric mandibles of children with a dental age of 1 to 12 years old in possession of ACTA (Academic Centre for Dentistry Amsterdam), Faculty of Dentistry, the Netherlands. 3D models of the mandibles were obtained from CT-scans and hemimandibular volumes of all mandibles were calculated.

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Background: Computed tomography perfusion (CTP) is frequently performed during the diagnostic workup of acute ischemic stroke patients. Yet, ischemic core estimates vary widely between different commercially available software packages. We assessed the volumetric and spatial agreement of the ischemic core on CTP with the follow-up infarct on diffusion-weighted imaging (DWI) using an automated software.

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Background: Patients with COVID-19-related acute respiratory distress syndrome (ARDS) require respiratory support with invasive mechanical ventilation and show varying responses to recruitment manoeuvres. In patients with ARDS not related to COVID-19, two pulmonary subphenotypes that differed in recruitability were identified using latent class analysis (LCA) of imaging and clinical respiratory parameters. We aimed to evaluate if similar subphenotypes are present in patients with COVID-19-related ARDS.

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Background: Intracranial hemorrhage (ICH) is a frequent complication after endovascular stroke treatment.

Objective: To assess the association of the occurrence and type of ICH after endovascular treatment (EVT) with functional outcome.

Methods: We analyzed data from the MR CLEAN-NO IV and MR CLEAN-MED trials.

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Article Synopsis
  • The study evaluates an extended Tan collateral score to improve the assessment of intracranial collateral capacity in patients with acute large vessel occlusion.
  • The new 6-scale manual score showed better interobserver agreement compared to the conventional 4-point score, suggesting it could be more reliable.
  • Additionally, the extended score demonstrated strong correlation with a quantitative scoring method, indicating its potential for enhancing prognosis in clinical settings.
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Background: Quantitative radiological scores for the extent and severity of pulmonary infiltrates based on chest radiography (CXR) and computed tomography (CT) scan are increasingly used in critically ill invasively ventilated patients. This study aimed to determine and compare the prognostic capacity of the Radiographic Assessment of Lung Edema (RALE) score and the chest CT Severity Score (CTSS) in a cohort of invasively ventilated patients with acute respiratory distress syndrome (ARDS) due to COVID-19.

Methods: Two-center retrospective observational study, including consecutive invasively ventilated COVID-19 patients.

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