Publications by authors named "Roberto Javier Crosa"
Background: The elderly population (≥80 years) were underrepresented in recent trials of endovascular thrombectomy (EVT) for anterior circulation large vessel occlusion acute ischemic stroke (LVO-AIS) with low Alberta Stroke Program Early CT Score (ASPECTS) (≤5).
Methods: This study analyzed data from a prospectively maintained database of 37 thrombectomy centers. The primary cohort of the study comprised patients with LVO-AIS aged ≥80 who underwent EVT with ASPECTS≤5 from 2013 to 2023.
Background: A higher number of recanalization attempts reduces the efficacy of endovascular thrombectomy (EVT) for acute ischemic stroke secondary to large vessel occlusion (LVO). We assessed the impact of switching EVT techniques after a failed first pass on procedural and clinical outcomes.
Methods: This multicenter international study, conducted between January 2013 and December 2022, included patients undergoing EVT for anterior circulation LVO (internal carotid artery or M1 segments) with failed first pass recanalization.
Comparison of combined intravenous and intra-arterial thrombolysis with intravenous thrombolysis alone in stroke patients undergoing mechanical thrombectomy: a propensity-matched analysis.
J Neurointerv Surg
January 2025
Background: A combination of intravenous (IVT) or intra-arterial (IAT) thrombolysis with mechanical thrombectomy (MT) for acute ischemic stroke due to large vessel occlusion (AIS-LVO) has been investigated. However, there is limited data on patients who receive both IVT and IAT compared with IVT alone before MT.
Methods: STAR data from 2013 to 2023 was utilized.
Background: The role for the transradial approach for mechanical thrombectomy is controversial. We sought to compare transradial and transfemoral mechanical thrombectomy in a large multicenter database of acute ischemic stroke.
Methods: The prospectively maintained Stroke Thrombectomy and Aneurysm Registry (STAR) was reviewed for patients who underwent mechanical thrombectomy for an internal carotid artery (ICA) or middle cerebral artery M1 occlusion.
Background: Recent clinical trials have demonstrated that patients with large vessel occlusion (LVO) and large infarction core may still benefit from mechanical thrombectomy (MT). In this study, we evaluate outcomes of MT in LVO patients presenting with extremely large infarction core Alberta Stroke Program Early CT Score (ASPECTS 0-2).
Methods: Data from the Stroke Thrombectomy and Aneurysm Registry (STAR) was interrogated.
Background: The safety and efficacy of mechanical thrombectomy (MT) for the treatment of acute anterior cerebral artery (ACA) occlusions have not clearly been delineated. Outcomes may be impacted based on whether the occlusion is isolated to the ACA (primary ACA occlusion) or occurs in conjunction with other cerebral arteries (secondary).
Methods: We performed a retrospective review of the multicenter Stroke Thrombectomy and Aneurysm (STAR) database.
Background: Several studies have established the safety and efficacy of balloon guide catheters (BGCs) for large vessel occlusions. However, the utility of BGCs remains largely unexplored for distal medium vessel occlusions (DMVOs). In this study, we aim to compare the outcomes of BGC vs.
View Article and Find Full Text PDFObjective: To evaluate the effect of procedure time on thrombectomy outcomes in different subpopulations of patients undergoing endovascular thrombectomy (EVT), given the recently expanded indications for EVT.
Methods: This multicenter study included patients undergoing EVT for acute ischemic stroke at 35 centers globally. Procedure time was defined as time from groin puncture to successful recanalization (Thrombolysis in Cerebral Infarction score ≥2b) or abortion of procedure.
Background: Reducing intracranial hemorrhage (ICH) can improve patient outcome in acute ischemic stroke (AIS) intervention. We sought to identify ICH risk factors after AIS thrombectomy.
Methods: This is a retrospective review of the Stroke Thrombectomy and Aneurysm Registry (STAR) database.
Background: Recent clinical trials have shown that mechanical thrombectomy is superior to medical management for large vessel occlusion for up to 24 hours from onset. Our objective is to examine the safety and efficacy of thrombectomy beyond the standard of care window.
Methods: A retrospective review was undertaken of the multicenter Stroke Thrombectomy and Aneurysm Registry (STAR).
Background: Endovascular thrombectomy (EVT) is the standard-of-care for proximal large vessel occlusion (LVO) stroke. Data on technical and clinical outcomes in distal vessel occlusions (DVOs) remain limited.
Methods: This was a retrospective study of patients undergoing EVT for stroke at 32 international centers.
Article Synopsis
- Atrial fibrillation (AF) in stroke patients negatively impacts functional recovery and increases the risk of hemorrhagic complications when treated with intravenous thrombolysis (IVT), but does not show the same issues with mechanical thrombectomy (MT).
- In a study of 6461 patients, those with AF who received bridging therapy (IVT followed by MT) experienced higher rates of hemorrhagic complications without any improvement in their recovery outcomes compared to non-AF patients, who benefitted from bridging therapy.
- The findings suggest that AF patients may be better suited for direct MT, raising the need for future clinical trials to explore this treatment approach at specialized stroke centers.
Article Synopsis
- This study investigates the clinical outcomes of stroke patients treated with mechanical thrombectomy (MT) and whether complete reperfusion (mTICI 3) offers any significant benefits over near-complete reperfusion (mTICI 2c).
- Researchers analyzed data from 33 centers, finding no significant differences in primary and secondary outcomes between patients achieving mTICI 2c versus mTICI 3, suggesting both reperfusion grades yield similar results.
- While outcomes were generally comparable, patients with baseline modified Rankin Scale (mRS) scores of ≥2 and a history of stroke showed improved odds of a favorable outcome with mTICI 3.
Background: Atrial fibrillation (AF) associated ischemic stroke has worse functional outcomes, less effective recanalization, and increased rates of hemorrhagic complications after intravenous thrombolysis (IVT). Limited data exist about the effect of AF on procedural and clinical outcomes after mechanical thrombectomy (MT).
Objective: To determine whether recanalization efficacy, procedural speed, and clinical outcomes differ in AF associated stroke treated with MT.
Background: In response to the COVID-19 pandemic, many centers altered stroke triage protocols for the protection of their providers. However, the effect of workflow changes on stroke patients receiving mechanical thrombectomy (MT) has not been systematically studied.
Methods: A prospective international study was launched at the initiation of the COVID-19 pandemic.