Publications by authors named "Schiphorst A"

Purpose: To investigate retinal microvascular changes in ischemic stroke patients using optical coherence tomography angiography (OCT-A) and assess these alterations based on stroke etiology.

Methods: Case-control study conducted at Montpellier University Hospital from May 2021 to March 2022 (IRB: 202000607). Retinal vascular features were compared between strokes patients and age- and sex- matched controls.

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  • The study investigated the clinical and radiological factors affecting the outcomes of acute ischemic stroke patients with isolated posterior cerebral artery (PCA) occlusion treated only with medical management.
  • A total of 585 patients were analyzed, revealing that 56% experienced poor functional outcomes, which were linked to older age, higher NIHSS scores, larger infarct volumes, and not receiving intravenous thrombolysis (IVT).
  • The research highlighted that factors like age, NIHSS score, infarct volume, and IVT status significantly influenced outcomes, while finding that complete recanalization after 24 hours improved recovery chances.
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Background: In patients with an acute ischemic stroke, the penumbra is defined as ischemic tissue that remains salvageable when reperfusion occurs. However, the expected clinical recovery congruent with penumbral salvage is not always observed.

Aims: We aimed to determine whether the magnetic resonance imaging (MRI)-defined penumbra includes irreversible neuronal loss that impedes expected clinical recovery after reperfusion.

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Carbon-13 isotopomics of triacylglycerol (TAG) fatty acids or free fatty acids in biological matrices holds considerable potential in food authentication, forensic investigations, metabolic studies, and medical research. However, challenges arise in the isotopic analysis of short- and medium-chain (C4 to C10) fatty acid methyl esters (SMCFAMEs) through gas chromatography-combustion-isotope ratio mass spectrometry (GC-C-IRMS). The high volatility of these esters results in losses during their preparation, leading to isotopic fractionation.

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  • * Data from 670 patients revealed that while IVT may improve some outcomes, such as higher chances of achieving a modified Rankin Scale score of 0-2 in univariable analysis, this benefit was not consistently observed in more rigorous multivariable analyses.
  • * Overall, the findings suggest that adjunctive IVT may not significantly enhance clinical outcomes or safety compared to MT alone for this patient population.
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  • Mechanical thrombectomy is the standard treatment for large vessel occlusions, but there's limited evidence for its effectiveness in treating distal and medium vessel occlusions, particularly for patients with low stroke scale scores (≤6).
  • A study analyzed data from 41 academic centers, comparing outcomes of low versus higher stroke scale score patients who underwent thrombectomy, revealing high successful reperfusion rates in both groups.
  • Results showed that patients with lower stroke scale scores experienced better functional outcomes and lower mortality rates, but the treatment's effectiveness compared to intravenous thrombolysis (IVT) is still uncertain.
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Background: Patients with acute ischemic stroke harboring a large vessel occlusion admitted to nonendovascular-capable centers often require interhospital transfer for thrombectomy. We evaluated the incidence and predictors of arterial recanalization during transfer, as well as the relationship between interhospital recanalization and clinical outcomes.

Methods: We analyzed data from 2 cohorts of patients with an anterior circulation large vessel occlusion transferred for consideration of thrombectomy to a comprehensive center, with arterial imaging at the referring hospital and on comprehensive stroke center arrival.

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Background: Optimal anesthetic strategy for the endovascular treatment of stroke is still under debate. Despite scarce data concerning anesthetic management for medium and distal vessel occlusions (MeVOs) some centers empirically support a general anesthesia (GA) strategy in these patients.

Methods: We conducted an international retrospective study of MeVO cases.

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  • Patients with acute ischemic stroke and large vessel occlusion often require transfers to specialized centers for thrombectomy, leading to potential clinical changes during transit.
  • A study analyzed data from 504 patients transferred for thrombectomy, revealing that 22% improved, 14% deteriorated, and 64% remained stable in their condition.
  • Factors influencing outcomes included thrombolysis use and occlusion severity, with better 3-month outcomes seen in those who improved during transfer compared to stable patients.*
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Background: Performing endovascular treatment (EVT) in patients with acute ischemic stroke (AIS) allows a port of entry for intracranial biological sampling.

Objective: To test the hypothesis that specific immune players are molecular contributors to disease, outcome biomarkers, and potential targets for modifying AIS .

Methods: We examined 75 subjects presenting with large vessel occlusion of the anterior circulation and undergoing EVT.

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Background: Mechanical thrombectomy (MT) has revolutionized the treatment of acute ischemic stroke (AIS) due to large vessel occlusion (LVO), but its efficacy and safety in medium vessel occlusion (MeVO) remain less explored. This multicenter, retrospective study aims to investigate the incidence and clinical outcomes of vessel perforations (confirmed by extravasation during an angiographic series) during MT for AIS caused by MeVO.

Methods: Data were collected from 37 academic centers across North America, Asia, and Europe between September 2017 and July 2021.

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Background And Purpose: The best management of patients with persistent distal occlusion after mechanical thrombectomy with or without IV thrombolysis remains unknown. We sought to evaluate the variability and agreement in decision-making for persistent distal occlusions.

Materials And Methods: A portfolio of 60 cases was sent to clinicians with varying backgrounds and experience.

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  • The study aimed to evaluate the effectiveness and safety of the pRESET LITE stent retriever for treating medium vessel occlusions in acute ischemic stroke patients.
  • A retrospective analysis included 227 patients from 37 institutions, distinguishing between proximal and distal occlusions, revealing successful reperfusion rates of 85% and 97%, respectively.
  • Despite a 7% complication rate and a significant percentage of patients experiencing hemorrhagic transformations, the procedure showed a favorable outcome in 58% of cases after three months.
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  • * Past surgeries didn't really help these patients, but some doctors are looking into a new way called endovascular treatment to fix the blood flow to the brain.
  • * While some studies show that this new treatment is successful and safe, more research is needed to make sure it’s effective and can be used regularly.
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Introduction: Patent foramen ovale (PFO) is present in a significant proportion of young patients with stroke of undetermined etiology, but is not always causal. Therefore, classifications (RoPE, PASCAL) have been developed to determine the probability that PFO is the stroke cause. However, the presence of an initial arterial occlusion as a prediction factor was not studied when these classifications were built.

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Introduction: Physical activity (PA) is associated with higher quality of life and probably better prognosis among colorectal cancer (CRC) patients. This study focuses on determinants of PA among CRC patients from diagnosis until 5 yr postdiagnosis.

Methods: Sociodemographic and disease-related factors of participants of two large CRC cohort studies were combined.

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  • The study investigates the first pass effect (FPE) in endovascular treatment (EVT) for medium vessel occlusion strokes, focusing on its predictors and impact on patient outcomes.
  • The analysis included 836 patients, revealing that FPE occurred in 36.1% and was linked to better functional outcomes as well as lower rates of mortality and intracranial hemorrhage.
  • FPE was significantly associated with favorable outcomes at 90 days, suggesting its importance in improving recovery and reducing complications in stroke patients.
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The reported incidence of persistent hypoperfusion despite complete recanalization as surrogate for impaired microvascular reperfusion (IMR) has varied widely among clinical studies, possibly due to differences in i) definition of complete recanalization, with only recent Thrombolysis in Cerebral Infarction (TICI) grading schemes allowing distinction between complete (TICI3) and partial recanalization with distal occlusions (TICI2c); ii) operational definition of IMR; and iii) consideration of potential alternative causes for hypoperfusion, notably carotid stenosis, re-occlusion and post-thrombectomy hemorrhage. We performed a systematic review to identify clinical studies that carried out brain perfusion imaging within 72 hrs post-thrombectomy for anterior circulation stroke and reported hypoperfusion rates separately for TICI3 and TICI2c grades. Authors were contacted if this data was missing.

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Purpose: Inguinal-related groin pain (IRGP) in athletes is a multifactorial condition, posing a therapeutic challenge. If conservative treatment fails, totally extraperitoneal (TEP) repair is effective in pain relief. Because there are only few long-term follow-up results available, this study was designed to evaluate effectiveness of TEP repair in IRGP-patients years after the initial procedure.

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Background: Preclinical stroke models have recently reported faster infarct growth (IG) when ischemia was induced during daytime. Considering the inverse rest-activity cycles of rodents and humans, faster IG during the nighttime has been hypothesized in humans.

Methods: We retrospectively evaluated acute ischemic stroke patients with a large vessel occlusion transferred from a primary to 1 of 3 French comprehensive stroke center, with magnetic resonance imaging obtained at both centers before thrombectomy.

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Purpose: This study aims to evaluate quality of life trajectory during the first year after surgical treatment in patients with resectable primary colon cancer.

Methods: Patients with resectable primary colon cancer diagnosed between 2013 and 2019 who received surgical treatment and adjuvant chemotherapy if indicated were selected from the Prospective Dutch ColoRectal Cancer cohort study (PLCRC). Health-related quality of life (HR-QoL) was assessed using EORTC-QLQ-C30 questionnaire before surgery, and three and twelve months after surgery.

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Introduction: We evaluated the effect of the inclusion of a geriatrician in the multidisciplinary cancer team (MDT) on decision-making for chemotherapy with curative intent in older patients with colorectal cancer.

Materials And Methods: We audited all patients aged 70 years and older with colorectal cancer discussed at MDT meetings between January 2010 and July 2018; selection was limited to those patients for whom guidelines recommended chemotherapy with curative intent as part of the primary treatment. We assessed how treatment decisions came about, and what the course of treatment was in the period before (2010-2013) and after (2014-2018) the geriatrician joined the MDT meetings.

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