Is there diurnal variation in neuroprotective and thrombolytic therapy effect upon acute cerebral ischemia outcome?

Background: Preclinical studies have found marked diurnal/circadian variation in the effect of neuroprotective agents in acute ischemic stroke. However, the presence of diurnal variation in treatment outcomes after neuroprotective therapy has not been analyzed in human clinical trials and variation after thrombolytic therapy has been under-studied.

Methods: We analyzed patients with acute cerebral ischemia enrolled in the Field Administration of Stroke Therapy - Magnesium (FAST-MAG) randomized trial of magnesium sulfate started in the ambulance within two hours of stroke onset (last known well time).

Minimal clinical impact of embolization to new territory on outcomes in medium vessel occlusion strokes treated with mechanical thrombectomy: a retrospective multicenter study.

Background: Mechanical thrombectomy (MT) is established as an effective treatment for large vessel occlusion strokes, but its efficacy and safety for medium vessel occlusions (MeVOs) remain less clear. This study examines the impact of periprocedural embolization to a new vascular territory (ENT) on clinical outcomes in patients with MeVO stroke treated with MT.

Methods: A multicenter, retrospective analysis was conducted using the MAD-MT (Multicenter Analysis of primary Distal medium vessel occlusions: effect of Mechanical Thrombectomy) registry, including 2122 patients with MeVO stroke w-ho underwent MT between September 2017 and July 2023.

Susceptibility Vessel Sign and Intravenous Alteplase in Stroke Patients Treated with Thrombectomy : A Secondary Analysis of the SWIFT DIRECT Trial.

Background: The susceptibility vessel sign (SVS) on baseline MRI in acute ischemic stroke patients has been associated with better outcomes post-thrombectomy. This study aimed to investigate whether the presence of the SVS modifies the treatment effect of intravenous thrombolysis plus endovascular thrombectomy (IVT + EVT) versus thrombectomy alone (EVT alone).

Methods: In this secondary analysis of the SWIFT DIRECT trial, comparing IVT + EVT versus EVT alone, treatment effect and its heterogeneity were assessed with rates of pre-interventional reperfusion (eTICI 2a-3) and successful post-interventional reperfusion (eTICI of 2b-3) according to the SVS status using adjusted multivariable logistic regression.

Collaterals and outcomes after endovascular treatment in acute large vessel occlusion: Disparity by stroke etiologies.

Background: Collateral circulation provides compensatory flow to ischemic brain regions in acute large vessel occlusion (LVO), which had been associated with better outcomes after endovascular treatment (EVT).

Aims: We aimed to reveal the pre-EVT collateral status and its associations with outcomes after EVT, in patients with acute LVO with different etiologies.

Methods: Based on a prospective, multicenter registry, we analyzed patients with acute, intracranial anterior-circulation LVO due to large artery atherosclerosis (LAA) and cardioembolism (CE), who underwent EVT within 24 hours.