54 results match your criteria: "Greece (A.H.K.); and Didymoteicho General Hospital[Affiliation]"
Tenecteplase vs Alteplase in Acute Ischemic Stroke Within 4.5 Hours: A Systematic Review and Meta-Analysis of Randomized Trials.
Neurology
November 2024
From the Second Department of Neurology (L.P., A.T., A. Safouris, G. Tsivgoulis), "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece; Department of Medicine (Neurology) (A.H.K.), McMaster University/Population Health Research Institute, Hamilton, Ontario, Canada; Department of Neurology (Guillaume Turc), GHU Paris Psychiatrie et Neurosciences; Université Paris Cité (G. Turc); INSERM U1266 (G. Turc); FHU NeuroVasc (G. Turc), Paris, France; Department of Primary Education (A.-G.A., D.M.), University of Ioannina, Greece; Department of Neurology and Neurogeriatrics (P.D.S.), Johannes Wesling Klinikum Minden, Ruhr-University Bochum, Germany; Department of Neurology (R.L.), University Hospitals Leuven; Division of Experimental Neurology (R.L.), Department of Neurosciences, KU Leuven-University of Leuven, Belgium; Department of Biotechnological and Applied Clinical Sciences (S.S.), University of L'Aquila, Italy; Stroke Unit (A. Safouris), Metropolitan Hospital, Piraeus, Greece; Department of Neurology (M.K., U.F.), University Hospital Basel, University of Basel, Switzerland; Department of Neurology (A. Sarraj), Case Western Reserve University, University Hospitals Cleveland Medical Center, OH; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland.
Article Synopsis
- The European Stroke Organisation recommends using tenecteplase (TNK) as an alternative to alteplase (TPA) for treating acute ischemic stroke within 4.5 hours, based on previous studies establishing its noninferiority.
- An updated systematic review and meta-analysis assessed the efficacy and safety of TNK compared to TPA, using data from 11 randomized controlled trials involving nearly 7,600 patients.
- Results showed that TNK was linked to better chances of achieving excellent functional outcomes and reduced disability at 3 months, while maintaining similar safety profiles for symptomatic intracranial hemorrhage when compared to TPA.
Blood Pressure Trajectories and Outcomes After Endovascular Thrombectomy for Acute Ischemic Stroke.
Hypertension
March 2024
Second Department of Neurology, Attikon University Hospital, School of Medicine (L.P., G.T.), National and Kapodistrian University of Athens, Greece.
Background: Data on systolic blood pressure (SBP) trajectories in the first 24 hours after endovascular thrombectomy (EVT) in acute ischemic stroke are limited. We sought to identify these trajectories and their relationship to outcomes.
Methods: We combined individual-level data from 5 studies of patients with acute ischemic stroke who underwent EVT and had individual blood pressure values after the end of the procedure.
An Introduction to Individual Participant Data Meta-analysis.
Neurology
June 2023
From the Knowledge Translation Program (A.A.V.), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto; Institute of Health Policy Management and Evaluation (A.A.V.), University of Toronto, Ontario, Canada; Department of Primary Education (G.S., D.M.), School of Education, University of Ioannina, Greece; Department of Neurology (G.T.), University of Tennessee Health Sciences Center, Memphis; Second Department of Neurology (G.T.), Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece; Division of Neurology (A.H.K.), McMaster University/Population Health Research Institute, Hamilton, Ontario, Canada; and Faculté de Médecine (D.M.), Université Paris Descartes, France.
Meta-analysis using individual participant data (IPD-MA) from randomized controlled trials (RCTs) can strengthen evidence used for decision making and is considered the "gold standard" approach. In this study, we present the importance, properties, and main approaches of conducting an IPD-MA. We exemplify the main approaches of conducting an IPD-MA and how these can be used to obtain subgroup effects through estimation of interaction terms.
View Article and Find Full Text PDFIV Thrombolysis Initiated Before Transfer for Endovascular Stroke Thrombectomy: A Systematic Review and Meta-analysis.
Neurology
April 2023
From the Division of Neurology (A.H.K.), McMaster University and Population Health Research Institute, Hamilton, Ontario, Canada; Department of Neurology (A.S.), Case Western Reserve University, University Hospitals Cleveland Medical Center, OH; Cerebrovascular Program (M.F.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurology (J.P.), Heidelberg University Hospital, Germany; Department of Neurology (N.G., A.V.A., G. Tsivgoulis), University of Tennessee Health Science Center, Memphis; Departments of Neurosurgery and Neurology (R.W.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Second Department of Neurology (L.P., G. Tsivgoulis), Attikon University Hospital, National and Kapodistrian University of Athens, Greece; Advanced Neuroscience Network/Tenet South Florida (N.H.M.), Delray Beach; Department of Neurosciences (R.L.), Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND), KU Leuven - University of Leuven; Center for Brain & Disease Research (R.L.), Laboratory of Neurobiology, VIB; Department of Neurology (R.L.), University Hospitals Leuven, Belgium; Departments of Neurology and Neurogeriatrics (P.D.S.), Johannes Wesling Medical Center Minden, University Hospitals of the Ruhr-University of Bochum, Germany; Department of Biotechnological and Applied Clinical Sciences (S.S.), University of L'Aquila, Italy; Department of Neurology (G. Turc), GHU Paris Psychiatrie et Neurosciences, Université Paris Cité, INSERM U1266, FHU NeuroVasc, France.
Background And Objectives: The role of IV thrombolysis (IVT) in patients with large vessel occlusions (LVOs) administered before transfer from a primary stroke center (PSC) to a comprehensive stroke center (CSC) is questioned.
Methods: We included observational studies of patients with an LVO receiving IVT at a PSC before their endovascular thrombectomy (EVT) transfer compared with those receiving EVT alone. Efficacy outcomes included excellent or good functional outcomes (modified Rankin Scale [mRS] scores of 0-1 or 0-2, respectively) and reduced disability (mRS shift analysis) at 3 months.
Clinical, Neuroimaging, and Genetic Markers in Cerebral Amyloid Angiopathy-Related Inflammation: A Systematic Review and Meta-Analysis.
Stroke
January 2023
Second Department of Neurology (A.T., L.P., C.Z., G.P.P., G.T.), National & Kapodistrian University of Athens, "Attikon" University Hospital, Greece.
Background: There are limited data regarding the prevalence of distinct clinical, neuroimaging and genetic markers among patients diagnosed with cerebral amyloid angiopathy-related inflammation (CAA-ri). We sought to determine the prevalence of clinical, radiological, genetic and cerebrospinal fluid biomarker findings in patients with CAA-ri.
Methods: A systematic review and meta-analysis of published studies including patients with CAA-ri was conducted to determine the prevalence of clinical, neuroimaging, genetic and cerebrospinal fluid biomarker findings.
Prolonged Cardiac Monitoring and Stroke Recurrence: A Meta-analysis.
Neurology
May 2022
From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY.
Background And Objectives: Prolonged poststroke cardiac rhythm monitoring (PCM) reveals a substantial proportion of patients with ischemic stroke (IS) with atrial fibrillation (AF) not detected by conventional rhythm monitoring strategies. We evaluated the association between PCM and the institution of stroke preventive strategies and stroke recurrence.
Methods: We searched MEDLINE and SCOPUS databases to identify studies reporting stroke recurrence rates in patients with history of recent IS or TIA receiving PCM compared with patients receiving conventional cardiac rhythm monitoring.
Prevalence of Clinical and Neuroimaging Markers in Cerebral Amyloid Angiopathy: A Systematic Review and Meta-Analysis.
Stroke
June 2022
Second Department of Neurology (A.T., A.H.K., C.Z., G.P.P., G.T.), National and Kapodistrian University of Athens, "Attikon" University Hospital, Greece.
Background: Limited data exist regarding the prevalence of clinical and neuroimaging manifestations among patients diagnosed with cerebral amyloid angiopathy (CAA). We sought to determine the prevalence of clinical phenotypes and radiological markers in patients with CAA.
Methods: Systematic review and meta-analysis of studies including patients with CAA was conducted to primarily assess the prevalence of clinical phenotypes and neuroimaging markers as available in the included studies.
Blood Pressure After Endovascular Thrombectomy and Outcomes in Patients With Acute Ischemic Stroke: An Individual Patient Data Meta-analysis.
Neurology
January 2022
From the Division of Neurology (A.H.K., A. Shoamanesh, L.C.), McMaster University/Population Health Research Institute, Hamilton, Ontario, Canada; Second Department of Neurology (A.H.K., G.T.), "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece; Department of Neurology (K.M.), Allegheny Health Network, Pittsburgh, PA; Department of Neurology (N.A., M.M.), Karolinska University Hospital, and Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Primary Education (G.S., D.M., A.V.), University of Ioannina, Greece; Department of Neurology (E.A.M.), Vanderbilt University Medical Center, Nashville, TN; Paris Descartes University (D.M.), Sorbonne Paris Cité, Faculté de Médecine, France; Department of Neurology (J.-T.K.), Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea; Li Ka Shing Knowledge Institute (A.V.), St. Michael's Hospital, Unity Health Toronto, Ontario, Canada; Institute of Reproductive and Developmental Biology (A.V.), Department of Surgery and Cancer, Faculty of Medicine, Imperial College, London, UK; Department of Neurology (I.M.), University Medical Center Goettingen, Germany; Department of Neurology (P.K.), University of Cincinnati, OH; Departments of Neurology (M.A.) and Neurosurgery (M.A., A.M.S.), Medical University of South Carolina, Charleston; Departments of Neurology (N.G., A.V.A., G.T.) and Neurosurgery (N.G., A.S.A.), University of Tennessee Health Science Center, Memphis; Department of Neurology (A. Sarraj), UTHealth, Houston; Department of Neurology (S.Y.), NYU Langone Health, New York; Department of Hygiene, Epidemiology and Medical Statistics (M.K., T.P.), Medical School, National and Kapodistrian University of Athens, Greece; Diagnostic and Interventional Neuroradiology (A.R.), Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Sweden; Department of Neuroradiology (M.P.), Clinic for Radiology and Nuclear Medicine, University Hospital Basel, Switzerland; Division of Neurology, Neurosurgery, and Diagnostic Imaging (B.V.A.), Hamilton General Hospital, McMaster University, Ontario, Canada; Department of Neurology (E.C.S.), Stroke Unit, Oslo University Hospital; The Norwegian Air Ambulance Foundation (E.C.S.), Oslo, Norway; Department of Neurology (A.d.H.), Clinical Neurosciences Center, University of Utah, Salt Lake City; and Department of Neurology (N.H.P.), Yale University, New Haven, CT.
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.
Cerebral Venous Sinus Thrombosis and Thrombotic Events After Vector-Based COVID-19 Vaccines: A Systematic Review and Meta-analysis.
Neurology
November 2021
From the Second Department of Neurology (L.P., M.-I.S., A.H.K., S.G., K.I.V., G.T.), Second Department of Psychiatry (I.M.), and Fourth Department of Internal Medicine (S.T.), "Attikon" University Hospital, Department of Hygiene, Epidemiology and Medical Statistics (P.L., A.N.), School of Medicine, and Third Department of Critical Care Medicine, Evgenideio Hospital, Medical School (T.I.V.), and Third Department of Pediatrics (V.P.), National and Kapodistrian University of Athens, Greece; Division of Neurology (A.H.K.), McMaster University/Population Health Research Institute, Hamilton, Canada; Department of Neurosciences and Mental Health (D.A.d.S.), Hospital de Santa Maria, CHULN, University of Lisbon, Portugal; Department of Neurology (J.M.C.), Amsterdam UMC, University of Amsterdam, the Netherlands; Department of Epidemiology (P.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Neurology (K.V.), University Hospital of Alexandroupolis, Democritus University of Thrace; Hellenic Centre for Disease Control and Prevention (S.T.), Athens, Greece; and Department of Neurology (G.T.), University of Tennessee Health Science Center, Memphis.
Background And Objectives: There is accumulating evidence supporting an association between the thrombosis and thrombocytopenia syndrome (TTS) and adenovirus vector-based vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Yet TTS and TTS-associated cerebral venous sinus thrombosis (CVST) remain poorly characterized. We aim to systematically evaluate the proportion of CVST among TTS cases and assess its characteristics and outcomes.
View Article and Find Full Text PDFSonothrombolysis in Patients With Acute Ischemic Stroke With Large Vessel Occlusion: An Individual Patient Data Meta-Analysis.
Stroke
December 2021
Department of Neurology, University of Tennessee Health Sciences Center, Memphis (G.T., A.W.A., A.V.A.).
Article Synopsis
- The study aimed to assess the safety and effectiveness of sonothrombolysis (ultrasound-enhanced thrombolysis) in patients experiencing acute ischemic stroke (AIS) caused by large vessel occlusion, using data from randomized controlled trials.
- Out of 7 trials involving 1102 patients, those receiving sonothrombolysis showed a significantly higher rate of complete recanalization (40.3%) compared to those treated with standard intravenous thrombolysis (22.4%).
- The risk of symptomatic intracranial hemorrhage was not significantly different between the two groups, and there were no notable differences in other outcomes like asymptomatic hemorrhage or functional independence at three months.
Changes in Stroke Hospital Care During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis.
Stroke
November 2021
Second Department of Neurology, "Attikon" Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece (A.H.K., L.P., G. Tsivgoulis.).
[Figure: see text].
View Article and Find Full Text PDFPrevalence, Characteristics, and Outcomes of Undetermined Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis.
Stroke
November 2021
Second Department of Neurology (C.Z., A.T., A.H.K., K.V., G.T.), National and Kapodistrian University of Athens, "Attikon" University Hospital, Greece.
Background And Purpose: There are scarce data regarding the prevalence, characteristics and outcomes of intracerebral hemorrhage (ICH) of undetermined (unknown or cryptogenic) etiology. We sought to determine the prevalence, radiological characteristics, and clinical outcomes of undetermined ICH.
Methods: Systematic review and meta-analysis of studies involving patients with spontaneous ICH was conducted to primarily assess the prevalence and clinical-radiological characteristics of undetermined ICH.
Utility of Intravenous Alteplase Prior to Endovascular Stroke Treatment: A Systematic Review and Meta-analysis of RCTs.
Neurology
August 2021
From the Division of Neurology (A.H.K., A.S.), McMaster University/Population Health Research Institute, Hamilton, Ontario, Canada; Department of Neurology (G. Turc), GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne; Université de Paris (G. Turc); INSERM U1266 (G. Turc); FHU Neurovasc (G. Turc), Paris, France; Department of Neuroradiology (M.P.), Clinic for Radiology and Nuclear Medicine, University Hospital Basel; Department of Diagnostic and Interventional Neuroradiology and Department of Diagnostic, Interventional and Pediatric Radiology (J.K., J.G.), Inselspital University Hospital Bern, Switzerland; Second Department of Neurology (L.P., M.I.S., G. Tsivgoulis), Attikon Hospital, School of Medicine, National and Kapodistrian University of Athens; Stroke Unit (G.M.), Metropolitan Hospital, Piraeus; Department of Neurosurgery (M.T.), Pediatric Hospital of Athens, Agia Sophia, Greece; Neuroscience Section (S.S.), Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Italy; Department of Diagnostic and Interventional Neuroradiology (J.F.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Neurological Research Unit (D.S.), Department of Neurology, Neurocenter, Helsinki University Hospital, Finland; Department of Neurology (A.V.A., G. Tsivgoulis), University of Tennessee Health Science Center, Memphis; and Department of Neurology (U.F.), University Hospital Bern, Inselspital, University of Bern, Switzerland.
Objective: To provide a critical appraisal on the evidence from randomized controlled clinical trials (RCTs) on the utility of direct endovascular treatment (dEVT) compared to the combination of endovascular treatment preceded by IV thrombolysis (bridging therapy [BT]) for patients with acute large vessel occlusion (LVO).
Methods: Eligible RCTs were identified by searching Medline and Scopus. We calculated the corresponding odds ratios (ORs) and 95% confidence intervals (CIs) and pooled estimates using random-effects models.
SARS-CoV-2 and Stroke Characteristics: A Report From the Multinational COVID-19 Stroke Study Group.
Stroke
May 2021
Neurology Department, Neuroscience Institute, Geisinger Health System, PA (S. Shahjouei, A. Mowla, D.C., C.J.G., R.Z.).
[Figure: see text].
View Article and Find Full Text PDFRisk Factors for Intracerebral Hemorrhage in Patients With Atrial Fibrillation on Non-Vitamin K Antagonist Oral Anticoagulants for Stroke Prevention.
Stroke
April 2021
Second Department of Neurology, "Attikon" Hospital, National and Kapodistrian University of Athens, School of Medicine, Greece (L. Palaiodimou, G.T.).
[Figure: see text].
View Article and Find Full Text PDFLetter by Katsanos and Tsivgoulis Regarding Article, "Risk of Distal Embolization From tPA (Tissue-Type Plasminogen Activator) Administration Prior to Endovascular Stroke Treatment".
Stroke
January 2021
Second Department of Neurology, "Attikon" Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece (G.T.).
Intravenous Thrombolysis With Tenecteplase in Patients With Large Vessel Occlusions: Systematic Review and Meta-Analysis.
Stroke
January 2021
Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Greece (A. Safouris, G.T.).
Background And Purpose: Accumulating evidence from randomized controlled clinical trials suggests that tenecteplase may represent an effective treatment alternative to alteplase for acute ischemic stroke. In the present systematic review and meta-analysis, we sought to compare the efficacy and safety outcomes of intravenous tenecteplase to intravenous alteplase administration for acute ischemic stroke patients with large vessel occlusions (LVOs).
Methods: We searched MEDLINE (Medical Literature Analysis and Retrieval System Online) and Scopus for published randomized controlled clinical trials providing outcomes of acute ischemic stroke with confirmed LVO receiving intravenous thrombolysis with either tenecteplase at different doses or alteplase at a standard dose of 0.
Probabilistic Reasoning in Stroke: A Primer to Statistical Literacy.
Stroke
August 2020
Department of Primary Education, School of Education, University of Ioannina, Greece (G.S., D.M.).
Intravenous thrombolysis in patients with chronic kidney disease: A systematic review and meta-analysis.
Neurology
July 2020
From the Department of Neurology (K.M., A.T.), Allegheny Health Network, Pittsburgh, PA; Department of Neurology (A.H.K., A.W.A., A.V.A.), University of Ioannina School of Medicine, Greece; Department of Neurology (N.G., G.T.), University of Tennessee Health Science Center, Memphis; Department of Neurology and Stroke Center (H.G., G.M.D.M.), University Hospital Basel and University of Basel, Switzerland; Department of Neurology (P.D.M.), School of Medicine, University of Crete, Greece; Department of Cardiology (E.B.), Oslo University Hospital, Norway; and Second Department of Neurology (G.T.), National & Kapodistrian University of Athens, "Attikon" University Hospital, Greece.
Objective: To determine the association of chronic kidney disease (CKD) with the safety and efficacy of IV thrombolysis (IVT) among patients with acute ischemic stroke (AIS).
Methods: A systematic review and pairwise meta-analysis of studies involving patients with CKD undergoing IVT for AIS were conducted to evaluate the following outcomes: symptomatic intracranial hemorrhage (sICH), asymptomatic and any intracranial hemorrhage (ICH), in-hospital and 3-month mortality, 3-month favorable functional outcome (FFO; modified Rankin Scale [mRS] score 0-1), and 3-month functional independence (FI, mRS score 0-2). CKD was defined with estimated glomerular filtration rate (eGFR) ranging from mild (eGFR 60-89 mL/min) to moderate (eGFR 30-59 mL/min) to severe (eGFR 15-29 mL/min).
Ischemic Stroke Epidemiology During the COVID-19 Pandemic: Navigating Uncharted Waters With Changing Tides.
Stroke
July 2020
Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Italy (R.O., S.S.).
Safety and efficacy of dual antiplatelet pretreatment in patients with ischemic stroke treated with IV thrombolysis: A systematic review and meta-analysis.
Neurology
February 2020
From the Department of Neurology (K.M.), Allegheny Health Network, Pittsburgh, PA; Department of Neurology (A.H.K.), University of Ioannina School of Medicine, Greece; Department of Neurology (N.G., A.W.A., A.V.A, G.T.), University of Tennessee Health Science Center, Memphis; Department of Neurology (N.A.), Karolinska University Hospital; Department of Clinical Neuroscience (N.A.), Karolinska Institute, Stockholm, Sweden; Department of Neurology (D.S.), Helsinki University Central Hospital, Finland; Second Department of Neurology (A.H.K., L.P., G.T.), National and Kapodistrian University of Athens, "Attikon" University Hospital; Second Department of Neurology (T.K.), AHEPA University Hospital, Aristotle University of Thessaloniki, Greece; and Clinical Innovation and Research Institute (J.C.G.), Memorial Hermann Hospital-Texas Medical Center, Houston.
Objective: Conflicting data exist on the safety and efficacy of IV thrombolysis (IVT) in patients with acute ischemic stroke (AIS) receiving dual antiplatelet pretreatment (DAPP). The aim of the present systematic review and meta-analysis is to assess the safety and outcome of DAPP history among patients with AIS treated with IVT.
Methods: We performed a comprehensive literature review to identify studies that investigated the safety and efficacy of DAPP among patients with AIS treated with IVT.
Association of Blood Pressure With Outcomes in Acute Stroke Thrombectomy.
Hypertension
March 2020
Department of Neurology, University of Tennessee, Memphis (N.G., A.V.A., G.T.).
Limited data exist evaluating the effect of blood pressure (BP) on clinical outcomes among patients with acute ischemic stroke with large vessel occlusion treated with mechanical thrombectomy (MT). We sought to evaluate the association of BP levels on clinical outcomes among patients with acute ischemic stroke with large vessel occlusion treated with MT. Studies were identified that reported the association of systolic BP (SBP) or diastolic BP levels before, during, or after MT on the outcomes of patients with acute ischemic stroke treated with MT.
View Article and Find Full Text PDFThrombolysis for acute ischemic stroke in the unwitnessed or extended therapeutic time window.
Neurology
March 2020
From the Second Department of Neurology (G.T., A.H.K.), "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Department of Neurology (A.H.K., C.K.), St. Josef Hospital, Ruhr University Bochum, Germany; Department of Neurology (K.M.), Allegheny Health Network, Pittsburgh, Pennsylvania; Department of Neurology (A.S., A.D.B.), University of Texas Health Science Center, Houston; Department of Neurology (M.K.), Universitaetsklinikum Essen, Germany; Department of Neurology (N.A.), Karolinska University Hospital; Department of Clinical Neuroscience (N.A.), Karolinska Institute, Stockholm, Sweden; Stroke Unit and Division of Cardiovascular Medicine (V.C.), University of Perugia, Italy; and Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany.
Objective: To assess the utility of IV thrombolysis (IVT) treatment in patients with acute ischemic stroke (AIS) with unclear symptom onset time or outside the 4.5-hour time window selected by advanced neuroimaging.
Methods: We performed random-effects meta-analyses on the unadjusted and adjusted for potential confounders associations of IVT (alteplase 0.
Age and Sex Differences in Ischemic Stroke Treatment in a Nationwide Analysis of 1.11 Million Hospitalized Cases.
Stroke
December 2019
Department of Neurology, University of Heidelberg, Germany (W.H.).
Background and Purpose- To date, there is still uncertainty about age and sex differences in access to stroke unit treatment and use of intravenous thrombolysis (IVT), while age and sex differences have not been investigated for the new treatment option of mechanical thrombectomy (MT). We, therefore, undertook a complete nationwide analysis of all hospitalized ischemic stroke patients in Germany from 2013 to 2017. Methods- We used the nationwide administrative database of the German Federal Statistical Office and investigated access to stroke unit treatment, IVT, MT, and in-hospital mortality.
View Article and Find Full Text PDFCauses and Risk Factors of Cerebral Ischemic Events in Patients With Atrial Fibrillation Treated With Non-Vitamin K Antagonist Oral Anticoagulants for Stroke Prevention.
Stroke
August 2019
Second Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, School of Medicine, Greece (C.L., L.P., G.T.).
Article Synopsis
- - This study investigates ischemic cerebrovascular events in patients with nonvalvular atrial fibrillation (AF) who are being treated with non-vitamin K antagonist oral anticoagulants (NOACs) to identify risk factors and understand the underlying mechanisms.
- - The research involved 713 patients who experienced ischemic strokes or transient ischemic attacks while on NOACs, and 700 who did not, revealing significant associations between these events and factors like low NOAC dosage, atrial enlargement, hyperlipidemia, and higher CHADS-VASc scores, which indicate greater stroke risk.
- - Findings suggest that while most strokes in this population were of cardioembolic origin, other factors such as being older,