The clinical relevance of the transient intraluminal filament model of middle cerebral artery occlusion (tMCAO) has been questioned due to distinct cerebral blood flow profiles upon reperfusion between tMCAO (abrupt reperfusion) and alteplase treatment (gradual reperfusion), resulting in differing pathophysiologies. Positive results from recent endovascular thrombectomy trials, where the occluding clot is mechanically removed, could revolutionize stroke treatment. The rapid cerebral blood flow restoration in both tMCAO and endovascular thrombectomy provides clinical relevance for this pre-clinical model. Any future clinical trials of neuroprotective agents as adjuncts to endovascular thrombectomy should consider tMCAO as the model of choice to determine pre-clinical efficacy.
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http://dx.doi.org/10.1177/0271678X15606722 | DOI Listing |
Orv Hetil
December 2024
1 Debreceni Egyetem, Általános Orvostudományi Kar, Aneszteziológiai és Intenzív Terápiás Klinika Debrecen, Nagyerdei krt. 98., 4032 Magyarország.
Am J Hypertens
December 2024
Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Background: Systolic blood pressure (BP) is a key factor in the outcomes of patients with acute ischemic stroke (AIS) receiving endovascular thrombectomy (EVT). However, the factors that mediate the association between BP and clinical outcome are unclear.
Methods: Consecutive patients with AIS in the anterior circulation underwent continuous blood pressure monitoring for 24 hours.
Stroke
January 2025
Berry Consultants LLC, Austin, TX (E.L., A.M.C., S.M.B., R.J.L.).
Clinical trials of treatments for stroke have generally utilized 2-arm, randomized designs to evaluate a single intervention against a control. Running separate clinical trials, with each addressing a single therapeutic question, is resource intensive and slows evidence generation, especially in a field with rapidly expanding treatment options and evolving practices. Platform trials-randomized clinical trials designed to evaluate multiple interventions that may enter and exit the ongoing platform based on a master protocol-accelerate the investigation of multiple therapeutic options within a single infrastructure.
View Article and Find Full Text PDFClin Neuroradiol
December 2024
Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, 100070, Fengtai District, Beijing, China.
Background: The Hyperdense Middle Cerebral Artery Sign (HMCAS) is an early marker of acute MCA occlusion on non-contrast CT (NCCT), which has been linked with stroke type and thrombus composition.
Aims: To assess the prognostic value of HMCAS in M1 occlusion patients treated with endovascular thrombectomy and explore its predictive value across different patients.
Methods: Patients with M1 occlusion were selected from the ANGEL-ACT registry, which comprised 1793 individuals.
Ther Adv Neurol Disord
December 2024
Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing 210000, Jiangsu Province, China.
Background: Time elapsed from stroke onset and baseline infarct volume is influential on endovascular thrombectomy (EVT) outcomes.
Objectives: This study aimed to explore the utility of early infarct growth rate (EIGR) measured by apparent diffusion coefficient (ADC) in predicting symptomatic intracranial hemorrhage (sICH) of ischemic stroke patients after EVT.
Methods: We retrospectively analyzed patients from the prospectively maintained stroke registry admitted between January 2019 and March 2023, presenting with large vessel occlusive stroke in the anterior circulation.
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