Publications by authors named "Joon Tae Kim"
Background: This study aimed to explore the association between admission HbA1c and the risk of 1-year vascular outcomes stratified by age group in patients with acute ischemic stroke (AIS) and diabetes mellitus (DM).
Methods: This study analyzed prospective multicenter data from patients with AIS and DM. Admission HbA1C were categorized as:≤6.
Article Synopsis
- Researchers aimed to create and validate a prediction score for futile recanalization (FR) in patients with low Alberta Stroke Program Early Computed Tomography Scores (ASPECTS) who underwent endovascular thrombectomy (EVT) for large vessel occlusions (LVO).
- The study analyzed data from 219 patients with anterior circulation LVO and identified key predictors of FR, resulting in the development of the SNAP score, which considers factors like the site of occlusion and patient age.
- The SNAP score successfully predicted FR with an area under the curve of 0.79 in both training and validation cohorts, indicating its potential usefulness for guiding expectations in patients undergoing EVT for severe strokes.
Background: Endovascular therapy (EVT) is the treatment of choice for acute ischemic stroke (AIS) with large vessel occlusion. However, in many patients, successful EVT recanalization does not correspond to a clinical improvement, called futile recanalization (FR). We aimed to identify stroke risk factors and patient characteristics associated with FR in AIS with large core infarct (LCI).
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- This study examined how non-traditional lipid profiles, specifically the LDL/HDL ratio, affect the risk of vascular events within a year in stroke patients already on statins and with low LDL-C levels.
- The analysis included 7028 patients with acute ischemic strokes and found a significant association between higher LDL/HDL ratios and increased risk of recurrent stroke, heart attack, or death after adjusting for other variables.
- The results suggest that even with low LDL-C levels due to statin use, monitoring the LDL/HDL ratio is important to assess residual risk after a stroke.
Article Synopsis
- A multi-center MRI study investigated how white matter hyperintensity (WMH) affects recovery after stroke, focusing on different severity levels of ischemic stroke.
- Higher WMH levels were linked to worse outcomes three months later, but the impact varied based on initial stroke severity: mild strokes showed a dose-dependent effect while moderate-to-severe strokes had a threshold effect.
- The study found that WMH impacted 3-month recovery more significantly in those with mild strokes, suggesting that increased WMH burden worsens recovery, but its effect is less pronounced in more severe strokes.
Background: A higher number of recanalization attempts reduces the efficacy of endovascular thrombectomy (EVT) for acute ischemic stroke secondary to large vessel occlusion (LVO). We assessed the impact of switching EVT techniques after a failed first pass on procedural and clinical outcomes.
Methods: This multicenter international study, conducted between January 2013 and December 2022, included patients undergoing EVT for anterior circulation LVO (internal carotid artery or M1 segments) with failed first pass recanalization.
Background: To evaluate the stand-alone efficacy and improvements in diagnostic accuracy of early-career physicians of the artificial intelligence (AI) software to detect large vessel occlusion (LVO) in CT angiography (CTA).
Methods: This multicenter study included 595 ischemic stroke patients from January 2021 to September 2023. Standard references and LVO locations were determined by consensus among three experts.
Background And Objectives: This study aimed to compare outcomes of low Alberta Stroke Program Early Computed Tomography Score (ASPECTS) patients with stroke who underwent mechanical thrombectomy (MT) within 6 hours or 6 to 24 hours after stroke onset.
Methods: A retrospective cohort study was conducted using data from a large multicenter international registry from 2013 to 2023. Patients with low ASPECTS (2-5) who underwent MT for anterior circulation intracranial large vessel occlusion were included.
Background: The benefit of intravenous thrombolysis (IVT) is well established. We aim to study the benefits of IVT in acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) who underwent unsuccessful mechanical thrombectomy (MT).
Methods: We included AIS patients who underwent MT for anterior circulation LVO with failed recanalization (modified treatment in cerebral ischemia [mTICI] score ≤ 2A).
Contemporary Statistics of Acute Ischemic Stroke and Transient Ischemic Attack in 2021: Insights From the CRCS-K-NIH Registry.
J Korean Med Sci
September 2024
Article Synopsis
- The report offers updated statistics on stroke patients in South Korea from a nationwide registry, revealing a male-to-female ratio of 1.5, with average ages of 67 for men and 73 for women.
- Hypertension is the leading risk factor (67%), with notable rates of diabetes (35%) and smoking (21%), while atrial fibrillation is less common (19%) than in Western populations, indicating effective preventive measures.
- There has been a decline in intravenous thrombolysis use, unchanged timing for treatment, and despite favorable outcomes at 3 months, there is a pressing need for improvements in acute stroke care.
Comparison of combined intravenous and intra-arterial thrombolysis with intravenous thrombolysis alone in stroke patients undergoing mechanical thrombectomy: a propensity-matched analysis.
J Neurointerv Surg
August 2024
Background: A combination of intravenous (IVT) or intra-arterial (IAT) thrombolysis with mechanical thrombectomy (MT) for acute ischemic stroke due to large vessel occlusion (AIS-LVO) has been investigated. However, there is limited data on patients who receive both IVT and IAT compared with IVT alone before MT.
Methods: STAR data from 2013 to 2023 was utilized.
Background: Whereas mechanical thrombectomy (MT) has become standard-of-care treatment for patients with salvageable brain tissue after acute stroke caused by large-vessel occlusions, the results of MT in patients with medium-vessel occlusions (MEVOs), particularly in the posterior cerebral artery (PCA), are not well known.
Methods: Using data from the international Stroke Thrombectomy and Aneurysm Registry (STAR), we assessed presenting characteristics and clinical outcomes for patients who underwent MT for primary occlusions in the P2 PCA segment. As a subanalysis, we compared the PCA MeVO outcomes with STAR's anterior circulation MeVO outcomes, namely middle cerebral artery (MCA) M2 and M3 segments.
Introduction: We developed and externally validated a fully automated algorithm using deep learning to detect large vessel occlusion (LVO) in computed tomography angiography (CTA).
Method: A total of 2,045 patients with acute ischemic stroke who underwent CTA were included in the development of our model. We validated the algorithm using two separate external datasets: one with 64 patients (external 1) and another with 313 patients (external 2), with ischemic stroke.
Article Synopsis
- A study was conducted to develop deep learning algorithms for the automatic segmentation of white matter hyperintensity (WMH) lesions in patients with cerebral infarction, involving a large dataset of 8,421 patients from multiple hospitals in Korea.
- Two models, 2D UNet and SE-Unet, were trained and validated using FLAIR MRI images, with performance measured against a human-segmented gold standard using various statistical metrics.
- Results showed that while both models had good performance, the SE-Unet outperformed the UNet with higher average Dice Similarity Coefficients (DSCs) in both internal and external validations, indicating it was more reliable for WMH segmentation.
Background: The definitive impact of onset to arterial puncture time (OPT) on 90-day mortality after endovascular thrombectomy (EVT) in patients with acute ischemic stroke (AIS) caused by anterior circulation large vessel occlusion (LVO) remains unknown. The present study aimed to evaluate the influence of OPT on 90-day mortality in anterior circulation AIS-LVO patients who underwent EVT.
Methods: Data from 33 international centers were retrospectively analyzed.
Article Synopsis
- The study investigates the outcomes of endovascular thrombectomy (EVT) for medium vessel occlusions (MeVOs) in different brain areas by analyzing data from an international registry.
- Researchers analyzed 1,744 cases of isolated MeVOs treated between 2013 and 2022, observing different success rates for occlusions in specific vascular territories.
- Results showed that A2/A3 occlusions had significantly poorer outcomes in terms of the 90-day modified Rankin score compared to M2 occlusions, while P2/P3 occlusions had lower rates of successful recanalization and increased early neurological deterioration.
Article Synopsis
- Accurate classification of ischemic stroke subtypes is crucial for effective prevention strategies, and a deep learning algorithm was developed using diffusion-weighted imaging (DWI) and atrial fibrillation (AF) data for this purpose.
- The study involved training models on a dataset of 2,988 stroke patients using two algorithms: one based solely on DWI and another incorporating AF as a factor.
- Results showed that the DWI+AF algorithm achieved higher agreement rates with expert opinions compared to the DWI-only method, indicating its effectiveness in accurately classifying stroke subtypes.
Background: Early identification of large vessel occlusion (LVO) in patients with ischemic stroke is crucial for timely interventions. We propose a machine learning-based algorithm (JLK-CTL) that uses handcrafted features from noncontrast computed tomography to predict LVO.
Methods: We included patients with ischemic stroke who underwent concurrent noncontrast computed tomography and computed tomography angiography in seven hospitals.
Article Synopsis
- - The study reviews how dual antiplatelet therapy (DAPT-AC) with aspirin and clopidogrel has been increasingly used among stroke patients who didn't qualify for major clinical trials, particularly after the CHANCE trial results became available in 2013.
- - Analysis of data from over 32,000 patients from 2008 to 2022 showed that the usage of DAPT-AC rose significantly from 33% in 2008 to 78% in 2022, while the use of other antiplatelet medications decreased.
- - Despite this increase in DAPT-AC usage, clinical outcomes, including stroke rates and mortality, improved only slightly, indicating ongoing efforts are needed to enhance recovery
Background: Late hospital arrival keeps patients with stroke from receiving recanalization therapy and is associated with poor outcomes. This study used a nationwide acute stroke registry to investigate the trends and regional disparities in prehospital delay and analyze the significant factors associated with late arrivals.
Methods: Patients with acute ischemic stroke or transient ischemic attack between January 2012 and December 2021 were included.
Background And Purpose: WHO grade 3 meningiomas are rare and poorly understood and have a higher propensity for recurrence, metastasis, and worsened clinical outcomes compared with lower-grade meningiomas. The purpose of our study was to prospectively evaluate the molecular profile, PET characteristics, and outcomes of patients with World Health Organization grade 3 meningiomas who were imaged with gallium 68 (Ga) DOTATATE PET/MR imaging.
Materials And Methods: Patients with World Health Organization grade 3 meningiomas enrolled in our prospective observational cohort evaluating the utility of (Ga) DOTATATE PET/MR imaging in somatostatin receptor positive brain tumors were included.
Background: Our purpose was to determine the utility of [68Ga]-DOTATATE PET/MRI in meningioma response assessment following radiosurgery.
Methods: Patients with meningioma prospectively underwent postoperative DOTATATE PET/MRI. Co-registered PET and gadolinium-enhanced T1-weighted MRI were employed for radiosurgery planning.
Background And Objectives: First pass effect (FPE) is a metric increasingly used to determine the success of mechanical thrombectomy (MT) procedures. However, few studies have investigated whether the duration of the procedure can modify the clinical benefit of FPE. We sought to determine whether FPE after MT for anterior circulation large vessel occlusion acute ischemic stroke is modified by procedural time (PT).
View Article and Find Full Text PDFDual antiplatelet therapy (DAPT) with the combination of clopidogrel and aspirin is recommended for preventing secondary ischemic events in patients with acute coronary syndrome (ACS) or acute ischemic stroke (AIS). Proton pump inhibitors (PPIs) are suggested as preventive treatment for these patients. Due to clopidogrel-PPI interactions, separating their administration might be considered.
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