Publications by authors named "J Gralla"
Noninferiority trials aim to prove that the efficacy, defined in terms of a key clinical outcome, of a new treatment is not meaningfully worse than that of an established active control. Noninferiority trials are important when other aspects of care can be improved, such as convenience, toxicity, costs, and safety (nonefficacy benefits). While the motivation for a noninferiority trial is straightforward, the design, execution, and interpretation of these trials is not a trivial task.
View Article and Find Full Text PDFBackground And Aim: Explicit diagnostic criteria for transient ischemic attack (TIA) (EDCT) have been recently proposed based on the assumption, that a migraine aura-like symptom is not typical for a TIA. However, migraine-like symptoms have been unexpectedly frequent in patients with confirmed ischemic stroke. This cross-sectional study aimed to field-test the EDCT to distinguish transient neurological symptoms caused by cerebral infarction from those caused by migraine aura.
View Article and Find Full Text PDFBackground: A third of endovascularly treated stroke patients experience incomplete reperfusion (expanded Thrombolysis in Cerebral Infarction, eTICI<3) and the natural evolution of this incomplete reperfusion remains unknown. We systematically reviewed literature and performed a meta-analysis on the natural evolution of incomplete reperfusion after endovascular therapy.
Methods: A systematic review of MEDLINE, Embase and PubMed up until March 1, 2024 using a predefined strategy.
Background: Distal occlusions associated with incomplete reperfusion (expanded Thrombolysis in Cerebral Infarction,
Methods: Retrospective registry analysis of patients undergoing endovascular therapy between July 2020 and December 2022, with available immediate post-interventional FPDCT and 24 hours follow-up perfusion imaging.
Article Synopsis
- The study evaluated the effectiveness and safety of endovascular thrombectomy (EVT) in acute ischemic stroke patients treated within early (<6 hours) and extended (6-24 hours) time windows after symptom onset.
- It compared outcomes like good functional recovery, intracranial hemorrhage, and mortality rates between the two groups, finding that while early treatment showed slightly better recovery rates, both time frames had similar safety outcomes.
- Overall, the findings suggest that EVT remains a viable option for patients up to 24 hours after stroke symptoms, aligning with real-world clinical practices.