Publications by authors named "Panagiotis Papanagiotou"
Long-term outcomes after first-ever posterior circulation stroke and the prognostic significance of the New England Medical Center Posterior Circulation Registry stroke classification: A prospective study from the Athens Stroke Registry.
Eur Stroke J
December 2024
Article Synopsis
Article Synopsis
- * Common causes of IS during ECMO include thromboembolic events and reduced blood flow to the brain, which can be hard to diagnose due to patients' severe conditions and sedation.
- * Diagnosis involves immediate brain imaging, such as CT and CT angiography, while treatment typically requires mechanical thrombectomy instead of thrombolytic therapy due to ongoing anticoagulation, necessitating close collaboration between radiologists and the ECMO team.
Background: Emerging evidence suggests that endovascular thrombectomy is beneficial for treatment of childhood stroke, but the safety and effectiveness of endovascular thrombectomy has not been compared with best medical treatment. We aimed to prospectively analyse functional outcomes of endovascular thrombectomy versus best medical treatment in children with intracranial arterial occlusion stroke.
Methods: In this prospective registry study, 45 centres in 12 countries across Asia and Australia, Europe, North America, and South America reported functional outcomes for children aged between 28 days and 18 years presenting with arterial ischaemic stroke caused by a large-vessel or medium-vessel occlusion who received either endovascular thrombectomy plus best medical practice or best medical treatment alone.
Article Synopsis
- - The TENSION trial evaluated the long-term safety and effectiveness of endovascular thrombectomy for patients with ischemic stroke and large infarcts, demonstrating favorable outcomes at 90 days, with a follow-up extending to 12 months.
- - Conducted across various hospitals in Europe and Canada, the trial involved patients aged 18 and older with acute ischemic strokes caused by large vessel occlusions, comparing results between those receiving thrombectomy plus medical care versus medical care alone.
- - Out of 253 enrolled patients, results indicated significant insights into functional outcomes, quality of life, and mental health aspects like anxiety and depression, although the trial concluded early due to promising efficacy in the treatment group.
Article Synopsis
- The Alberta Stroke Program Early CT Score (ASPECTS) and penumbral imaging through computed tomography perfusion (CTP) are used to help determine who is eligible for mechanical thrombectomy (MT) in stroke patients.
- The study hypothesized that the effectiveness of recanalization in patients with large ischemic cores (volume > 50 mL) but high ASPECTS scores (≥6) would be comparable to those with smaller core volumes, and that there could be a tendency to overestimate the core size.
- Results showed that recanalization did not significantly differ between the two patient groups, and both recanalization and larger core volumes were associated with the overestimation of the ischemic core
Article Synopsis
- Cerebral vasospasm is a serious condition that can happen after bleeding in the brain, and if not treated quickly, it can be deadly.
- Doctors have made good progress in finding ways to treat and diagnose this problem, but there's still not enough information on which treatments are best.
- This review will talk about what is currently known about cerebral vasospasm and the new methods doctors are using to treat it.
Article Synopsis
- Giant intracranial aneurysms are very dangerous and can make people really sick if not treated.
- They can show different symptoms and have different characteristics, which makes it hard to choose the best way to treat them.
- Although doctors have made improvements in surgery and using special techniques to treat these aneurysms, we're still not sure if one method is the best for everyone.
Cardiovascular disease is a major cause of morbidity and mortality worldwide. In the last few years, the role of inflammation and inflammatory modulatory medications is investigated for the optimal treatment of coronary artery disease. It can be hypothesized that since inflammation is also involved in carotid artery stenosis development and progression, the same class of medication could be useful.
View Article and Find Full Text PDFBackground: Extracranial internal carotid aneurysms consist a rare pathology with an overall incidence less than 1% in the general population, and warrant treatment due to their association with cerebrovascular events and neurological complications. The incidence is even lower in the pediatric population.
Case Report: A 14-month infant presented in our clinic with neck swelling of unknown origin, with subsequent MR imaging revealing an extracranial internal carotid aneurysm.
Background: Recent evidence suggests a beneficial effect of endovascular thrombectomy in acute ischaemic stroke with large infarct; however, previous trials have relied on multimodal brain imaging, whereas non-contrast CT is mostly used in clinical practice.
Methods: In a prospective multicentre, open-label, randomised trial, patients with acute ischaemic stroke due to large vessel occlusion in the anterior circulation and a large established infarct indicated by an Alberta Stroke Program Early Computed Tomographic Score (ASPECTS) of 3-5 were randomly assigned using a central, web-based system (using a 1:1 ratio) to receive either endovascular thrombectomy with medical treatment or medical treatment (ie, standard of care) alone up to 12 h from stroke onset. The study was conducted in 40 hospitals in Europe and one site in Canada.
Pediatric spinal tumors are rare and manifest frequently with unspecific symptoms, frequently resulting in delayed diagnosis. Many spinal tumor entities in children and adults are similar, but the lesions demonstrate a different prevalence and sometimes a different molecular genetic profile in children. For radiological evaluation of spinal tumor lesions, it is helpful to define the affected anatomical compartment.
View Article and Find Full Text PDFFlow Diversion for the Management of Posterior Circulation's Intracranial Aneurysms.
CNS Neurol Disord Drug Targets
September 2024
The endovascular treatment of posterior circulation aneurysms, although challenging, has been well-established due to various factors that limit the surgical approach in most cases. Flow diversion has also been utilized in the treatment of such aneurysms, although its effectiveness and safety still require evaluation. Numerous studies have examined the outcomes and complication rates in patients treated with FD, resulting in varying findings.
View Article and Find Full Text PDFBackground And Purpose: This study aimed to investigate the effect of endovascular treatment (EVT, with or without intravenous thrombolysis [IVT]) versus IVT alone on outcomes in patients with acute ischemic stroke (AIS) and intracranial large vessel occlusion (LVO) attributable to cervical artery dissection (CeAD).
Methods: This multinational cohort study was conducted based on prospectively collected data from the EVA-TRISP (EndoVAscular treatment and ThRombolysis for Ischemic Stroke Patients) collaboration. Consecutive patients (2015-2019) with AIS-LVO attributable to CeAD treated with EVT and/or IVT were included.
Background: Numerous questions regarding procedural details of distal stroke thrombectomy remain unanswered. This study assesses the effect of anesthetic strategies on procedural, clinical and safety outcomes following thrombectomy for distal medium vessel occlusions (DMVOs).
Methods: Patients with isolated DMVO stroke from the TOPMOST registry were analyzed with regard to anesthetic strategies (ie, conscious sedation (CS), local (LA) or general anesthesia (GA)).
Background Evidence supporting a potential benefit of thrombectomy for distal medium vessel occlusions (DMVOs) of the anterior cerebral artery (ACA) is, to the knowledge of the authors, unknown. Purpose To compare the clinical and safety outcomes between mechanical thrombectomy (MT) and best medical treatment (BMT) with or without intravenous thrombolysis for primary isolated ACA DMVOs. Materials and Methods Treatment for Primary Medium Vessel Occlusion Stroke, or TOPMOST, is an international, retrospective, multicenter, observational registry of patients treated for DMVO in daily practice.
View Article and Find Full Text PDFBackground: Patients with stroke secondary to isolated anterior cerebral artery (ACA) occlusions have poor outcomes. Whether tandem occlusions (TO) of the extracranial internal carotid (ICA) and the ACA carry even worse outcomes that remain unknown.
Methods: Patients with TO involving ICA and ACA occlusions were identified from 14 participating centers from the EndoVascular treatment And ThRombolysis in Ischemic Stroke Patients (EVATRISP) project which is a multicenter, observational, cohort study with prospective accrual of data followed by retrospective data analysis.
Background: Recent advances in machine learning have enabled development of the automated Alberta Stroke Program Early CT Score (ASPECTS) prediction algorithms using non-contrast enhanced computed tomography (NCCT) scans. The applicability of automated ASPECTS in daily clinical practice is yet to be established. The objective of this meta-analysis was to directly compare the performance of automated and manual ASPECTS predictions in recognizing early stroke changes on NCCT.
View Article and Find Full Text PDFArticle Synopsis
- The study aimed to determine if early cardiac rhythm control benefits patients with acute ischemic stroke and paroxysmal atrial fibrillation (PAF) compared to those with sustained atrial fibrillation (AF).
- Researchers followed 297 patients who had their first stroke and confirmed PAF to analyze outcomes like mortality, stroke recurrence, and major adverse cardiovascular events (MACE) over a median period of 28 months.
- The results indicated that patients with self-terminating PAF had significantly lower risks of death, stroke recurrence, and MACE compared to those with sustained AF, suggesting that early rhythm control may have benefits.
Purpose: To estimate the prevalence of the sphenoidal emissary foramina (SEF), and the effect of possible moderators on it.
Methods: A systematic online literature search was conducted. The pooled prevalence with 95% confidence intervals was estimated.