Publications by authors named "Liqi Shu"
Background: Although intravenous thrombolysis (IVT) is safe and effective in populations with general stroke, its impact on cervical artery dissection-related acute ischemic stroke (CeAD-AIS) remains unclear. This retrospective study used the National Inpatient Sample to compare outcomes in patients with CeAD-AIS treated with and without IVT.
Methods: We included adult patients with concurrent CeAD and AIS diagnoses ( [], codes) hospitalized from 2016 to 2019.
The optimal endovascular management of cervical carotid dissection causing tandem occlusion remains uncertain. We investigated the impact of emergent carotid stenting during endovascular treatment (EVT) for acute ischemic stroke (AIS) in patients with tandem occlusion secondary to cervical carotid artery dissection. This was a secondary analysis of patients treated with EVT for AIS due to occlusive carotid artery dissection and tandem occlusion included in the retrospective international Antithrombotic Treatment for Stroke Prevention in Cervical Artery Dissection (STOP-CAD) study.
View Article and Find Full Text PDFBackground: Mechanical thrombectomy (MT) significantly improves outcomes in patients with acute ischemic stroke due to large vessel occlusion. There is limited understanding of how the site of hospital readmission after MT influences patient outcomes. Addressing this gap may be important for optimizing post-MT care and improving long-term outcomes for stroke patients.
View Article and Find Full Text PDFObjectives: Nearly 25% of those with a small vessel stroke will develop early neurological deterioration (END). The objectives of this study were to identify clinical risk factors for small vessel stroke-related END and its associated impact on functional outcomes in an ethnically diverse data set.
Methods: We performed a post hoc analysis of the "Secondary Prevention of Small Subcortical Strokes" trial.
Introduction: Cervical artery dissection (CAD) involves the carotid or vertebral artery. However, limited studies have compared their clinical features and outcomes.
Methods: We examined non-traumatic CAD patients from the National Inpatient Sample (2005-2019).
Background: Growing evidence suggests that direct oral anticoagulants (DOACs) may be suitable for cerebral venous thrombosis (CVT). The optimal strategy regarding lead-in parenteral anticoagulation (PA) prior to DOAC is unknown.
Methods: In this post hoc analysis of the retrospective ACTION-CVT study, we compared patients treated with DOACs as part of routine care: those given "very early" DOAC (no PA), "early" (<5 days PA) and "delayed" (5-21 days PA).
Article Synopsis
- Left ventricular diastolic dysfunction (LVDD) and elevated left ventricular filling pressure (LVFP) may be linked to clinical outcomes in stroke patients, but their specific role in embolic stroke of undetermined source (ESUS) needs further exploration.
- A study was conducted on adults with acute ischemic stroke to evaluate the relationship between LVDD, elevated LVFP, and stroke types, specifically comparing ESUS and non-cardioembolic stroke (NCE). Patients with cardioembolic strokes were excluded.
- Findings suggest that while LVDD alone isn't significantly related to ESUS or atrial fibrillation (AF), having LVDD with elevated LVFP shows a borderline association with ESUS and a significant association
Article Synopsis
- A significant portion of patients (1 in 10) experience epilepsy after having cerebral venous thrombosis (CVT), but it's challenging to predict who will be affected.* -
- Researchers created the DIAS3 prognostic score using clinical data from over 1,100 patients to assess the likelihood of developing post-CVT epilepsy based on six clinical variables.* -
- The study found a range of predicted risks for post-CVT epilepsy within one and three years, with successful validation of the score confirming its effectiveness in estimating individual risk.*
Background And Objectives: Cerebral venous thrombosis (CVT) is a rare cause of stroke. While the standard treatment is anticoagulation, the type and duration of anticoagulation depends on the underlying etiology. This study aims to identify prevalence, risk factors, and recurrent venous thromboembolism (VTE) rates among patients with idiopathic (cryptogenic) CVT and CVT provoked by transient (peripartum, hormonal treatment, infection, trauma) and persistent (cancer, thrombophilia) factors.
View Article and Find Full Text PDFArticle Synopsis
- Cervical artery dissection (CeAD) is a leading cause of ischemic strokes in young adults, and this study explored the effects of intravenous thrombolysis (IVT) on patients with CeAD and stroke symptoms.
- Analyzed data from the STOP-CAD study, it found that IVT significantly improved functional independence after 90 days in patients without increasing the risk of symptomatic intracranial hemorrhage.
- The results suggest that IVT is a beneficial treatment for eligible patients with CeAD, aligning with current medical guidelines on its use.
RDguru: A Conversational Intelligent Agent for Rare Diseases.
IEEE J Biomed Health Inform
September 2024
Article Synopsis
- Large language models (LLMs) show promise for clinical use, but issues with errors and harmful outputs limit their application, especially in rare diseases (RDs).
- The study presents RDguru, an AI agent built on the LangChain framework using GPT-3.5-turbo, which provides advanced medical consultations, knowledge Q&A, and a unique diagnostic model for improved accuracy.
- RDguru outperforms ChatGPT and current top methods by effectively integrating multiple diagnostic strategies and enhancing clinical decision-making in rare disease cases.
In-hospital recurrent stroke in ipsilateral carotid web patients undergoing thrombectomy.
Ann Clin Transl Neurol
September 2024
Objective: Carotid artery web is a possible cause of ischemic stroke, especially in young patients who lack conventional risk factors. The immediate and long-term outcomes are not well studied. We aimed to determine the association between an ipsilateral carotid web and in-hospital stroke recurrence.
View Article and Find Full Text PDFArticle Synopsis
- Researchers developed a 9-point score to predict positive outcomes for patients undergoing endovascular therapy (EVT) in late-presenting strokes (6-24 hours after last known well), based on a multinational study involving over 3,200 patients.
- The score takes into account factors like age, early CT changes, and stroke severity, with higher scores indicating a better chance of functional recovery at 90 days compared to those receiving only medical management.
- Validation of the score showed it is a useful tool for estimating EVT outcomes, particularly benefiting patients with lower to midrange scores in terms of good functional results and independence.
Introduction: Patients with atrial fibrillation (AF) undergoing elective procedures are at risk for Major Adverse Cardiovascular Events (MACE) and symptomatic bleeding. We aimed to identify risk factors to guide perioperative risk stratification.
Methods: We conducted a post-hoc analysis of the "Bridging Anticoagulation in Patients who Require Temporary Interruption of Warfarin Therapy for an Elective Invasive Procedure or Surgery" randomized trial.
Background: It is uncertain whether antiplatelets or anticoagulants are more effective in preventing early recurrent stroke in patients with cervical artery dissection. Following the publication of the observational Antithrombotic for STOP-CAD (Stroke Prevention in Cervical Artery Dissection) study, which has more than doubled available data, we performed an updated systematic review and meta-analysis comparing antiplatelets versus anticoagulation in cervical artery dissection.
Methods: The systematic review was registered in PROSPERO (CRD42023468063).
Article Synopsis
- The study investigates the effectiveness of two anesthesia methods—general anesthesia (GA) and conscious sedation (non-GA)—for patients undergoing endovascular treatment for isolated posterior cerebral artery (PCA) occlusion stroke.
- Researchers analyzed data from the PLATO study focusing on patient outcomes such as the modified Rankin Scale scores after 90 days, as well as successful reperfusion rates and safety measures like intracranial hemorrhage.
- Results show that while both anesthesia methods had similar functional outcomes and safety profiles, GA was associated with significantly higher rates of successful reperfusion during treatment.
Article Synopsis
- Posterior cerebral artery occlusion (PCAo) can lead to long-term disabilities, and this study compares the effectiveness of endovascular thrombectomy (EVT), both with and without intravenous thrombolysis (IVT), against IVT alone for treating PCAo.
- The study analyzed data from 724 patients treated within 24 hours of PCAo onset, measuring outcomes like functional independence and early neurological improvement over a three-month period.
- Results indicated that EVT did not improve overall functional outcomes compared to IVT alone; however, it increased the likelihood of early improvement, but also raised risks of symptomatic intracranial hemorrhage and mortality.
Nearly one fifth of patients with venous thromboembolism (VTE) have cancer. When both of these conditions occur, especially in cases of cerebral vein thrombosis (CVT), patient management is often challenging. The aim of this study was to compare the characteristics and event courses in patients affected by CVT with and without cancer.
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- The study investigates the effectiveness of endovascular treatment (EVT) versus medical management (MM) in patients with isolated posterior cerebral artery occlusion (iPCAO) during acute ischemic strokes, lacking prior randomized trial evidence.
- Results show that EVT leads to better functional outcomes for patients with more severe stroke symptoms (NIHSS >6), but not for those with milder symptoms (NIHSS ≤6).
- Additionally, while EVT improves outcomes, it is also linked to a higher occurrence of symptomatic intracranial hemorrhages, regardless of initial stroke severity.
Background And Objectives: There is uncertainty whether patients with large vessel occlusion (LVO) presenting in the late 6-hour to 24-hour time window can be selected for endovascular therapy (EVT) by noncontrast CT (NCCT) and CT angiography (CTA) for LVO detection. We evaluated the clinical outcomes of patients selected for EVT by NCCT compared with those medically managed in the extended time window.
Methods: This multinational cohort study was conducted at 66 sites across 10 countries.
External validation of the SINCALC score for outcomes following cerebral venous thrombosis.
J Stroke Cerebrovasc Dis
June 2024
Article Synopsis
- The study aimed to validate the SINCALC score, which predicts poor outcomes and mortality in patients with cerebral venous thrombosis (CVT), using an international cohort from the ACTION-CVT study.
- The ACTION-CVT cohort showed differences from the original International CVT Consortium, being older, having fewer females, and milder symptoms, with a mortality rate of 2.5% at 30 days and 6% at one year.
- Results indicated the SINCALC score performed reasonably well in predicting outcomes, with AUC values suggesting its effectiveness, and further validation in diverse populations is recommended.
Article Synopsis
- This study focuses on a new type of lightweight, origami-based actuator and soft gripper that responds to hand gestures, utilizing machine learning for gesture recognition.
- The actuator requires 20% less pressure for bending compared to similar pneumatic actuators and shows a strong relationship between pressure, bending angle, and interaction force.
- Experiments with the soft gripper, which features three actuators, reveal its ability to grasp different object shapes effectively, highlighting its versatility in various applications while being controlled by signals from the user's muscles.