Publications by authors named "L A Rinkel"
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.
Article Synopsis
- Most stroke researchers currently use frequentist statistics, but there is a growing trend towards using Bayesian statistics in stroke research.
- Bayesian statistics focus on updating the probability of parameters based on observed data and prior beliefs, allowing for more flexible interpretations of treatment effectiveness.
- This review discusses the fundamental concepts of Bayesian statistics in stroke trials, compares them to frequentist methods with examples, and explains how to conduct and interpret Bayesian analyses.
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.
Article Synopsis
- 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.
Background: The benefit of intravenous thrombolysis with alteplase before endovascular thrombectomy (EVT) for acute ischemic stroke due to large vessel occlusion remains debated. In this study, we analyzed the cost-effectiveness of EVT alone versus intravenous alteplase before EVT in patients directly admitted to EVT-capable stroke centers from the Dutch health care payer perspective.
Methods: A decision analysis was performed using a Markov model with 15-year simulated follow-up to estimate total costs, quality-adjusted life years, and an incremental cost-effectiveness ratio of intravenous alteplase before EVT compared with EVT alone.