Publications by authors named "Rentzos A"
Background And Purpose: Patients with active cancer face an increased risk of ischemic stroke. Also, stroke may be an initial indicator of cancer. In patients with large vessel occlusion (LVO) stroke treated with thrombectomy, analysis of the clot composition may contribute new insights into the pathological connections between these two conditions.
View Article and Find Full Text PDFBackground: First pass reperfusion (FPR), defined as near complete reperfusion (extended Treatment in Cerebral Ischemia (eTICI) score 2c/3) in a single attempt without rescue therapy has been proposed as a quality metric. However, it remains unclear if the thrombectomy method influences clinical outcome and FPR rate. This study evaluates whether stent retriever and aspiration based thrombectomy differ in FPR rate, technical and clinical outcomes in FPR, and multiple pass reperfusion (MPR).
View Article and Find Full Text PDFThe need for biomarkers for acute ischemic stroke (AIS) to understand the mechanisms implicated in pathological clot formation is critical. The levels of the brain natriuretic peptides known as brain natriuretic peptide (BNP) and NT-proBNP have been shown to be increased in patients suffering from heart failure and other heart conditions. We measured their expression in AIS clots of cardioembolic (CE) and large artery atherosclerosis (LAA) etiology, evaluating their location inside the clots, aiming to uncover their possible role in thrombosis.
View Article and Find Full Text PDFBackground: Lymphocytes, macrophages, neutrophils, and neutrophil extracellular traps (NETs) associate with stroke risk factors and form a thrombus through different mechanisms. We investigated the total WBCs, WBC subtypes and NETs composition in acute ischemic stroke (AIS) clots to identify possible etiological differences that could help us further understand the process of thrombosis that leads to AIS.
Methods: AIS clots from 100 cases each of atherothrombotic (AT), cardioembolic (CE) and cryptogenic stroke etiology were collected per-pass as part of the CÚRAM RESTORE registry of AIS clots.
Article Synopsis
- Studies during the COVID-19 pandemic suggest a link between COVID-19 and an increased risk of acute ischemic stroke, particularly in cases of large vessel occlusion (LVO).
- The research involved analyzing blood clots from COVID-19 patients who underwent mechanical thrombectomy and comparing their characteristics with those of a control group.
- Results showed higher levels of C-reactive protein (CRP) and von Willebrand factor (vWF) in COVID-19-positive patients, indicating that systemic inflammation and endothelial injury may play significant roles in clot formation for these individuals.
Article Synopsis
- * Researchers used Magnetic Resonance Angiography (MRA) and logistic regression to analyze the incidence and contributing factors, discovering that sex was a significant variable, with men showing a lower odds of developing new aneurysms.
- * The findings emphasize the importance of longer-term imaging follow-ups for these patients, to improve monitoring and treatment strategies for any new aneurysm developments.
Background And Purpose: Successful reperfusion, defined as a modified treatment in cerebral ischemia (mTICI) score 2b or 3, is an important goal for endovascular treatment (EVT) of stroke. Recently, an extension of the mTICI score with an additional grade 2c indicating near-complete reperfusion (expanded TICI, eTICI) and a revised definition of success as eTICI 2c or 3 were proposed. We evaluate whether eTICI 2c translates into improved clinical outcome compared to eTICI 2b.
View Article and Find Full Text PDFBackground And Purpose: Post-thrombectomy intracranial hemorrhages (PTIH) are dangerous complications of acute ischemic stroke (AIS) following mechanical thrombectomy. We aimed to investigate if S100b levels in AIS clots removed by mechanical thrombectomy correlated to increased risk of PTIH.
Methods: We analyzed 122 thrombi from 80 AIS patients in the RESTORE Registry of AIS clots, selecting an equal number of patients having been pre-treated or not with rtPA (40 each group).
Background And Purpose: The risk of poststroke epilepsy (PSE) after endovascular treatment (EVT) is not well characterized. In this nationwide study, we assessed the risk of PSE after EVT and identified associated predictors.
Methods: We included all individuals (n = 3319) treated with EVT (±intravenous thrombolysis [IVT]) between 2015 and 2019 in the Swedish National Quality Register for EVT.
Background And Objectives: COVID-19-related inflammation, endothelial dysfunction, and coagulopathy may increase the bleeding risk and lower the efficacy of revascularization treatments in patients with acute ischemic stroke (AIS). We aimed to evaluate the safety and outcomes of revascularization treatments in patients with AIS and COVID-19.
Methods: This was a retrospective multicenter cohort study of consecutive patients with AIS receiving intravenous thrombolysis (IVT) and/or endovascular treatment (EVT) between March 2020 and June 2021 tested for severe acute respiratory syndrome coronavirus 2 infection.
Article Synopsis
- The relationship between stroke and cancer is increasingly significant, especially as the population ages and cancer survival rates improve, leading to more cases of patients experiencing both conditions simultaneously.
- Patients with concurrent cancer often show higher markers of clotting and have different stroke characteristics, such as more frequent multiple infarctions and denser clots compared to those without cancer.
- Clinicians can utilize new MRI techniques and a cancer probability score during stroke evaluations to guide cancer screenings, while treatment decisions, particularly for thrombolysis and thrombectomy, must be carefully considered based on the cancer's stage and patient's overall health.
Background And Aims: Besides the crucial role in the treatment of acute ischemic stroke (AIS), mechanical thrombectomy represents a unique opportunity for researchers to study the retrieved clots, with the possibility of unveiling biological patterns linked to stroke pathophysiology and etiology. We aimed to develop a shotgun proteomic approach to study and compare the proteome of formalin-fixed paraffin-embedded (FFPE) cardioembolic and large artery atherosclerotic (LAA) clots.
Methods: We used 16 cardioembolic and 15 LAA FFPE thrombi from 31 AIS patients.
Background: Patients with stroke secondary to occlusions of the anterior cerebral artery (ACA) often have poor outcomes. The optimal acute therapeutic intervention for these patients remains unknown.
Methods: Patients with isolated ACA-stroke were identified from 10 centers participating in the EndoVascular treatment And ThRombolysis in Ischemic Stroke Patients (EVATRISP) prospective registry.
Article Synopsis
- The study investigates the prevalence and characteristics of dural arteriovenous fistulas (dAVFs) in patients with cerebral venous thrombosis (CVT), finding that 2.4% of CVT patients had dAVFs.
- It highlights that patients with dAVFs tend to be older, predominantly male, and more likely to experience chronic CVT onset, with specific imaging findings.
- Despite these associations, the clinical outcomes for patients with and without dAVFs were similar, with most fistulas identified either at the time of CVT diagnosis or afterward.
Background And Objectives: To explore the association between blood pressure (BP) levels after endovascular thrombectomy (EVT) and the clinical outcomes of patients with acute ischemic stroke (AIS) patients with large vessel occlusion (LVO).
Methods: A study was eligible if it enrolled patients with AIS >18 years of age with an LVO treated with either successful or unsuccessful EVT and provided either individual or mean 24-hour systolic BP values after the end of the EVT procedure. Individual patient data from all studies were analyzed with a generalized linear mixed-effects model.
Introduction: We assessed the correlation between thrombus size before and after mechanical thrombectomy, measured as length by Computed Tomography Angiography/Non-Contrast Computed Tomography (CTA/NCCT) and Extracted Clot Area, ECA, respectively. We also assessed the influence of thrombus size on the number of passes required for clot removal and final recanalization outcome.
Materials And Methods: Acute ischaemic stroke (AIS) thrombi retrieved by mechanical thrombectomy from 500 patients and data of clot length by CTA/NCCT were collected from three hospitals in Europe.
Characterization of the 'White' Appearing Clots that Cause Acute Ischemic Stroke.
J Stroke Cerebrovasc Dis
December 2021
Objectives: Most clots retrieved from patients with acute ischemic stroke are 'red' in color. 'White' clots represent a less common entity and their histological composition is less known. Our aim was to investigate the composition, imaging and procedural characteristics of 'white' clots retrieved by mechanical thrombectomy.
View Article and Find Full Text PDFArticle Synopsis
- The study investigated the effects of bridging-therapy (IVT before mechanical thrombectomy) on clot characteristics in acute ischemic stroke patients.
- Clots from patients receiving IVT were found to be significantly smaller compared to those from patients who only underwent thrombectomy, despite no differences in histological composition (RBCs, fibrin, platelets).
- Bridging-therapy clots had lower amounts of RBCs, fibrin, and platelets per clot area than MT-only clots, suggesting IVT may influence clot size and composition.
Article Synopsis
- The Thrombolysis in Ischemic Stroke Patients (TRISP) collaboration was established in 2010 to study the effectiveness and safety of intravenous thrombolysis (IVT) and has now evolved to include endovascular treatment (EVT) in a new registry called EVA-TRISP.
- The collaboration involves 20 stroke centers committed to collecting detailed data on patients for better accuracy and investigating specific research questions regarding EVT and its outcomes.
- The initiative aims to fill crucial gaps in knowledge about EVT's safety and effectiveness in various patient groups that may not be addressed by randomized controlled trials (RCTs), thus supporting clinical decision-making for stroke physicians.
Objectives: Cerebral vasospasm is a known complication to aneurysmal subarachnoid haemorrhage, which can lead to severe morbidity. Intra-arterial vasodilation therapy is widely used as a last resort treatment in patients with symptomatic refractory cerebral vasospasm but there is limited data about the outcome. The purpose of this study is to evaluate the neurological and radiological outcome in patients treated with intra-arterial nimodipine in relation to cerebral infarction, procedure-related complications and clinical outcome.
View Article and Find Full Text PDFObjective: Long-term data on neurological and radiological outcome after aneurysmal subarachnoid hemorrhage (aSAH) are scarce. The aim of this study was to report neurological and radiological outcome >15 years after aSAH.
Methods: Patients with aSAH who were randomly assigned to endovascular treatment (EVT) or microsurgical treatment (MST) during 1997-2001 were included.
Stroke is a major public health problem that can cause a long-term disability or death due to brain damage. Serious stroke is frequently caused by a large vessel occlusion in the anterior circulation, which should be treated by endovascular embolectomy if possible. In this study, we investigated the use of the brain damage biomarkers tau, NFL, NSE, GFAp, and S100B to understand the progression of nervous tissue damage and their relationship to outcome in such stroke after endovascular treatment.
View Article and Find Full Text PDFBackground: Initial studies investigating correlations between stroke etiology and clot composition are conflicting and do not account for clot size as determined by area. Radiological studies have shown that cardioembolic strokes are associated with shorter clot lengths and lower clot burden than non-cardioembolic clots.
Objective: To report the relationship between stroke etiology, extracted clot area, and histological composition at each procedural pass.