Publications by authors named "N E LeCouffe"

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.

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(1) : For acute ischemic strokes caused by large vessel occlusion, manually assessed thrombus volume and perviousness have been associated with treatment outcomes. However, the manual assessment of these characteristics is time-consuming and subject to inter-observer bias. Alternatively, a recently introduced fully automated deep learning-based algorithm can be used to consistently estimate full thrombus characteristics.

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Article Synopsis
  • Multivessel occlusions (MVO) are rare (2.4% of patients) in large vessel occlusion stroke patients undergoing endovascular treatment (EVT) but lead to significantly worse outcomes.
  • Patients with MVO had higher baseline disability scores and poorer collateral blood flow compared to those without MVO.
  • After matching for confounding factors, MVO patients exhibited worse functional recovery at 90 days and higher mortality rates (46% vs 27%).
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Introduction: High systolic blood pressure (SBP) is associated with poor functional outcome. We analysed whether the association of SBP with outcomes after endovascular treatment (EVT) is modified by prior intravenous thrombolysis (IVT).

Patients And Methods: This was a post-hoc analysis of MR CLEAN-NO IV, a randomised trial of IVT with alteplase followed by EVT versus EVT alone, within 4.

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Article Synopsis
  • This text discusses a study evaluating whether endovascular treatment alone is as effective as using both intravenous thrombolysis and endovascular treatment in patients with acute ischemic stroke.
  • The study was conducted through a systematic review and meta-analysis of randomized controlled trials, focusing on patients' outcomes measured by their 90-day modified Rankin Scale scores.
  • A total of six studies, involving over 2300 participants, were analyzed to determine the non-inferiority of endovascular treatment alone compared to the combination of treatments.
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