54 results match your criteria: "Greece A.H.K.; and Didymoteicho General Hospital[Affiliation]"
Prolonged Cardiac Rhythm Monitoring and Secondary Stroke Prevention in Patients With Cryptogenic Cerebral Ischemia.
Stroke
August 2019
Department of Neurology, Alpert Medical School, Brown University, Providence, RI (B.M.G., B.A.R., S.C., K.F., S.Y.).
Background and Purpose- Although prolonged cardiac rhythm monitoring (PCM) can reveal a substantial proportion of ischemic stroke (IS) patients with atrial fibrillation not detected by conventional short-term monitoring, current guidelines indicate an uncertain clinical benefit for PCM. We evaluated the impact of PCM on secondary stroke prevention using data from available to date randomized clinical trials and observational studies. Methods- We performed a comprehensive literature search in MEDLINE, SCOPUS, CENTRAL (Cochrane Central Register of Controlled Trial), and conference proceedings to identify studies reporting stroke recurrence rates in patients with history of cryptogenic IS or transient ischemic attack (TIA) receiving PCM compared with patients receiving conventional (non-PCM) cardiac monitoring.
View Article and Find Full Text PDFOral anticoagulation in patients with chronic kidney disease: A systematic review and meta-analysis.
Neurology
May 2019
From the Department of Neurology (K.M.), Charleston Area Medical Center, West Virginia University, Charleston; Department of Neurology (M.F.I., N.G., A.W.A., A.V.A., G.T.), University of Tennessee Health Science Center, Memphis; Department of Neurology (A.H.K.), University of Ioannina School of Medicine; Department of Cardiology (J.P.), Heart Failure Unit, Attikon University Hospital, National and Kapodistrian University of Athens; and Second Department of Neurology (G.T.), National & Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece.
Objective: Data regarding the efficacy and safety of warfarin and non-vitamin K antagonist oral anticoagulant (NOAC) among patients with chronic kidney disease (CKD) remain scarce.
Methods: Systematic review and meta-analysis of studies involving patients with CKD treated with oral anticoagulants were conducted to evaluate the following outcomes: ischemic stroke, intracerebral hemorrhage (ICH), combined ischemic and hemorrhagic stroke (stroke), stroke or systemic embolism, mortality, and major bleeding events. CKD was defined based on creatinine clearance (CrCl) ranging from mild (CrCl: 60-89 mL/min), moderate (CrCl: 30-59 mL/min), to severe (CrCl: 15-29 mL/min).
Advanced Neuroimaging in Stroke Patient Selection for Mechanical Thrombectomy.
Stroke
December 2018
From the Second Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, Greece (G.T., A.H.K., L.P.).
Background and Purpose- There is clinical equipoise about the use of advanced imaging for selecting acute ischemic stroke patients eligible for mechanical thrombectomy (MT) during the first 6 hours from symptom onset. However, accumulating evidence indicates that advanced neuroimaging represents an invaluable and time-independent prognostic factor. Methods- We performed a systematic review and meta-analysis of available randomized clinical trials to evaluate the impact of patient selection with advanced neuroimaging on the 3-month: (1) functional independence (modified Rankin Scale score, 0-2), (2) favorable functional outcome (modified Rankin Scale scores, 0-1), (3) all-cause mortality, and (4) functional improvement (assessed with ordinal analysis of the modified Rankin Scale-scores).
View Article and Find Full Text PDFClinical Outcomes and Neuroimaging Profiles in Nondisabled Patients With Anticoagulant-Related Intracerebral Hemorrhage.
Stroke
October 2018
Department of Neurology, University of Tennessee Health Science Center, Memphis (N.G., A.P., A.K., A.V.A., G.T.).
Background and Purpose- The aim of this study was to prospectively validate our prior findings of smaller hematoma volume and lesser neurological deficit in nonvitamin K oral anticoagulant (NOAC) compared with Vitamin K antagonist (VKA)-related intracerebral hemorrhage (ICH). Methods- Prospective 12-month observational study in 15 tertiary stroke centers in the United States, Europe, and Asia. Consecutive patients with premorbid modified Rankin Scale score of <2 with acute nontraumatic anticoagulant-related ICH divided into 2 groups according to the type of anticoagulant: NOAC versus VKA.
View Article and Find Full Text PDFDual antiplatelet therapy pretreatment in IV thrombolysis for acute ischemic stroke.
Neurology
September 2018
From the Department of Neurology (G.T., N.G., A.K., R.K., A.P., P.D., A.D., R.B.S., T.B., K.N., B.C., J.C., R.Z., A.W.A., A.V.A.), University of Tennessee Health Science Center, Memphis; Second Department of Neurology (G.T., A.H.K.), Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece; Department of Neurology (K.M.), West Virginia University-Charleston Division; Department of Critical Care Medicine (J.C.), MedStar Washington Hospital Center, Washington, DC; and Department of Neurology (R.Z.), Geisinger Health System, Danville, PA.
Objective: We sought to determine the safety and efficacy of IV thrombolysis (IVT) in acute ischemic stroke (AIS) patients with a history of dual antiplatelet therapy pretreatment (DAPP) in a prospective multicenter study.
Methods: We compared the following outcomes between DAPP+ and DAPP- IVT-treated patients before and after propensity score matching (PSM): symptomatic intracranial hemorrhage (sICH), asymptomatic intracranial hemorrhage, favorable functional outcome (modified Rankin Scale score 0-1), and 3-month mortality.
Results: Among 790 IVT patients, 58 (7%) were on DAPP before stroke (mean age 68 ± 13 years; 57% men; median NIH Stroke Scale score 8).
Statin Pretreatment and Microembolic Signals in Large Artery Atherosclerosis.
Stroke
August 2018
From the Second Department of Neurology (A.S., A.H.K., G.T.).
Background and Purpose- Scarce data indicate that statin pretreatment (SP) in patients with acute cerebral ischemia because of large artery atherosclerosis may be related to lower risk of recurrent stroke because of a decreased incidence of microembolic signals (MES) during transcranial Doppler monitoring. Methods- We performed a systematic review and meta-analysis of available observational studies reporting MES presence/absence or MES burden, categorized according to SP status, in patients with acute cerebral ischemia because of symptomatic (≥50%) large artery atherosclerosis. In studies with partially-published data, authors were contacted for previously unpublished information.
View Article and Find Full Text PDFUltraearly Intravenous Thrombolysis for Acute Ischemic Stroke in Mobile Stroke Unit and Hospital Settings.
Stroke
August 2018
Department of Neurology, Charité-Universitätsmedizin Berlin, Germany (F.G., A.K., M.R., H.J.A.).
Background and Purpose- Mobile stroke units (MSUs) are known to increase the proportion of acute ischemic stroke (AIS) patients treated with intravenous thrombolysis (IVT) in the first golden hour (GH) after onset compared with hospital settings (HS). However, because of the low number of AIS patients treated with intravenous thrombolysis within this ultraearly time window in conventional care, characteristics, and outcome of this subgroup of AIS patients have not been compared between MSU and HS. Methods- MSU-GH patients were selected from the Berlin-based MSU (STEMO [Stroke Emergency Mobile]), whereas HS-GH patients were selected from the SITS-EAST (Safe Implementation of Treatments in Stroke-East) registry.
View Article and Find Full Text PDFPercutaneous patent foramen ovale closure for secondary stroke prevention: Network meta-analysis.
Neurology
July 2018
From the Second Department of Neurology (G.T., A.H.K., L.P., A. Filippatou) and Second Department of Cardiology (A. Frogoudaki, A.-R.V., I.I., J.P., S.D.), Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.W.A., A.V.A.), University of Tennessee Health Science Center, Memphis; Departments of Neurology (A.H.K.) and Hygiene and Epidemiology (D.M.), School of Medicine, and Department of Primary Education (D.M.), University of Ioannina; Second Department of Neurology (T.K.), Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece; Department of Neurology (F.P.), University Hospital of Geneva, Switzerland; Department of Neurology (G.H.), University of Thessaly, Larissa; and Department of Neurology (P.D.M.), School of Medicine, University of Crete, Heraklion, Greece.
Objective: Current guidelines report no benefit for patent foramen ovale (PFO) closure compared to medical treatment in patients with cryptogenic ischemic stroke (IS) or TIA. Two recent randomized controlled clinical trials have challenged these recommendations.
Methods: We performed a systematic review and network meta-analysis of randomized controlled trials to estimate the safety and efficacy of closure compared to medical treatment, and to compare available devices.
Comparative safety and efficacy of combined IVT and MT with direct MT in large vessel occlusion.
Neurology
April 2018
From the Department of Neurology (N.G., G.T., A.P., R.Z., L.E., A.W.A., A.V.A.), University of Tennessee Health Science Center, Memphis; Second Department of Neurology (G.T., A.H.K.), "Attikon University Hospital," School of Medicine, University of Athens, Greece; International Clinical Research Center (G.T.), St. Anne's Hospital, Brno, Czech Republic; Department of Interventional Neuroradiology (D.F., D.L.), Radiology Imaging Associates, Englewood, CO; Department of Neurosurgery (A.T., R.D.T.), Medical University of South Carolina, Charleston; Department of Interventional Neuroradiology (B.B.), Erlanger Hospital, Chattanooga; Cerebrovascular Program (M.T.F., K.E.), Vanderbilt University, Nashville, TN; Department of Neurosurgery (J. Mocco, J. Mascitelli), Mount Sinai Medical Center, New York, NY; Charleston Area Medical Center (K.M.), West Virginia University; and Department of Neurosurgery (D.H., L.E., A.S.A.), University of Tennessee Health Science Center and Semmes-Murphey Clinic, Memphis.
Objective: In this multicenter study, we sought to evaluate comparative safety and efficacy of combined IV thrombolysis (IVT) and mechanical thrombectomy (MT) vs direct MT in emergent large vessel occlusion (ELVO) patients.
Methods: Consecutive ELVO patients treated with MT at 6 high-volume endovascular centers were evaluated. Standard safety and efficacy outcomes (successful reperfusion [modified Thrombolysis in Cerebral Infarction IIb/III], functional independence [FI] [modified Rankin Scale (mRS) score of 0-2 at 3 months], favorable functional outcome [mRS of 0-1 at 3 months], functional improvement [mRS shift by 1-point decrease in mRS score]) were compared between patients who underwent combined IVT and MT vs MT alone.
Cerebrovascular Outcomes With Proton Pump Inhibitors and Thienopyridines: A Systematic Review and Meta-Analysis.
Stroke
February 2018
From the Department of Neurology, West Virginia University-Charleston Division (K.M.); Second Department of Neurology, National and Kapodistrian University of Athens, "Attikon" University Hospital, Greece (A.H.K., G.T.); Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Department of Gastroenterology & Hepatology, University of Texas Medical Branch, Galveston (M.B.); and Department of Neurology, University of Tennessee Health Science Center, Memphis (M.F.I., N.G., G.T.).
Background And Purpose: Pharmacokinetic and prior studies on thienopyridine and proton pump inhibitors (PPI) coadministration provide conflicting data for cardiovascular outcomes, whereas there is no established evidence on the association of concomitant use of PPI and thienopyridines with adverse cerebrovascular outcomes.
Methods: We conducted a systematic review and meta-analysis of randomized controlled trials and cohort studies from inception to July 2017, reporting following outcomes among patients treated with thienopyridine and PPI versus thienopyridine alone (1) ischemic stroke, (2) combined ischemic or hemorrhagic stroke, (3) composite outcome of stroke, myocardial infarction (MI), and cardiovascular death, (4) MI, (5) all-cause mortality, and (6) major or minor bleeding events. After the unadjusted analyses of risk ratios, we performed additional analyses of studies reporting hazard ratios adjusted for potential confounders.
Stroke Incidence and Outcomes in Northeastern Greece: The Evros Stroke Registry.
Stroke
February 2018
From the Department of Neurology (G.T., A.P., A.T., A.K., C.P., K.V., I.H.), Department of Neurosurgery (T.B.), Department of Radiology (M.M.), Second Department of Internal Medicine (N.P., I.K., E.M.), and First Department of Internal Medicine (P.S.), University Hospital of Alexandroupolis, Democritus University of Thrace, School of Medicine, Greece; Second Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, School of Medicine, Greece (G.T., A.H.K.); 1st Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece (M.P., P.Z.); Department of Neurology, School of Medicine, University of Ioannina, Greece (A.H.K.); and Didymoteicho General Hospital, Greece (A.A.).
Background And Purpose: Data are scarce on both stroke incidence rates and outcomes in Greece and in rural areas in particular. We performed a prospective population-based study evaluating the incidence of first-ever stroke in the Evros prefecture, a region of a total 147 947 residents located in North Eastern Greece.
Methods: Adult patients with first-ever stroke were registered during a 24-month period (2010-2012) and followed up for 12 months.
Successful Reperfusion With Intravenous Thrombolysis Preceding Mechanical Thrombectomy in Large-Vessel Occlusions.
Stroke
January 2018
From the Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Greece (G.T., A.H.K.); Department of Neurology, University of Tennessee Health Science Center, Memphis (G.T., A.W.A., A.V.A.); Department of Neurology, University of Ioannina, Greece (A.H.K.); Department of Neurology (P.D.S.) and Department of Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology, Universitätsklinikum Essen, Germany (M.K.); Department of Neurology, Henry Ford Hospital, Detroit, MI (P.V.); Department of Interventional Neuroradiology, Metropolitan Hospital, Piraeus, Greece (G.M.); Stroke Unit and Division of Cardiovascular Medicine, University of Perugia, Italy (M.P., V.C.); and J.P. Kistler Stroke Research Center, Massachusetts General Hospital, Boston (E.G.).
Background And Purpose: Although current guidelines advocate pretreatment with intravenous thrombolysis (IVT) in all eligible patients with acute ischemic stroke with large-vessel occlusion before mechanical thrombectomy, there are observational data questioning the efficacy of this approach. One of the main arguments in favor of IVT pretreatment is the potential for tissue-type plasminogen activator-induced successful reperfusion (SR) before the onset of endovascular procedure.
Methods: We performed a systematic review and meta-analysis of randomized controlled clinical trials and observational cohorts providing rates of SR with IVT in patients with large-vessel occlusion before the initiation of mechanical thrombectomy.
Teaching Neuro: Interferon-induced psoriasis flare in a multiple sclerosis case remits with dimethyl fumarate.
Neurology
October 2017
From the Second Department of Neurology (G.T., G.N.P., C.Z., K.V.), National and Kapodistrian University of Athens, School of Medicine, "Attikon" University Hospital, Greece; Department of Neurology (G.T.), The University of Tennessee Health Science Center, Memphis; International Clinical Research Center, Department of Neurology (G.T.), St. Anne's University Hospital in Brno, Czech Republic; Department of Neurology (A.H.K.), University of Ioannina School of Medicine; and Stroke Unit (A.S., O.K.), Metropolitan Hospital, Piraeus, Greece.
Direct oral anticoagulant- vs vitamin K antagonist-related nontraumatic intracerebral hemorrhage.
Neurology
September 2017
From the Department of Neurology (G.T., N.G., A.K., J.C., A.W.A., A.V.A.), University of Tennessee Health Science Center, Memphis; Second Department of Neurology (G.T., A.H.K., C.Z., S.T., M.I., A.B.), "Attikon" Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece; Department of Neurology (V.-A.L., C.N.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Neurology (P.V., C.M., M.J., P.M.), Henry Ford Hospital, Detroit, MI; Department of Neurology (A.H.K., S.G.), University of Ioannina School of Medicine, Greece; International Clinical Research Center (R.M.), Neurology Department, St. Anne's Hospital and Masaryk University, Brno, Czech Republic; Department of Neurology (K.B.), Dresden University Stroke Center; Department of Neurology (C.K., C.S.), St. Josef-Hospital, Ruhr University of Bochum, Germany; Division of Neurology (V.K.S.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (K.V.), Democritus University of Thrace, Alexandroupolis, Greece; Department of Neurology (E.D., A.P.), University of Thessaly, Larissa; Second Department of Neurology (T.K.), AHEPA University Hospital, Aristotelian University of Thessaloniki; Acute Stroke Unit (O.K.), Metropolitan Hospital, Piraeus; Laboratory of Haematology and Blood Bank Unit (A.T.), "Attikon" Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece; Australian Catholic University (A.W.A.), School of Nursing, Sydney, Australia; and Department of Neurology (P.M.), University of Crete, Heraklion, Greece.
Objective: To compare the neuroimaging profile and clinical outcomes among patients with intracerebral hemorrhage (ICH) related to use of vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs) for nonvalvular atrial fibrillation (NVAF).
Methods: We evaluated consecutive patients with NVAF with nontraumatic, anticoagulant-related ICH admitted at 13 tertiary stroke care centers over a 12-month period. We also performed a systematic review and meta-analysis of eligible observational studies reporting baseline characteristics and outcomes among patients with VKA- or DOAC-related ICH.
Plasma Glial Fibrillary Acidic Protein in the Differential Diagnosis of Intracerebral Hemorrhage.
Stroke
September 2017
From the Second Department of Neurology (A.H.K., M.C., C.Z., K.V., G.T.), Second Department of Cardiology (I.R., J.P.), and Second Department of Internal Medicine (E.B.), Attikon University Hospital, National and Kapodistrian University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Clinical Biochemistry Department (K.M.) and Department of Internal Medicine (D.S., K.K., E.G., M.L.), KAT General Hospital, Athens, Greece; Department of Neurology, University Hospital of Larissa, Greece (E.D.); and Department of Neurology, University of Tennessee Health Science Center, Memphis (G.T.).
Background And Purpose: Plasma GFAP (glial fibrillary acidic protein) has recently emerged as a potential biomarker for the differentiation of acute intracerebral hemorrhage (ICH) from acute ischemic stroke (AIS). We prospectively assessed the diagnostic accuracy of GFAP in the differential diagnosis of ICH.
Methods: Consecutive patients presenting to the emergency department within 6 hours from symptom onset were evaluated.
Noninvasive Ventilatory Correction in Patients With Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.
Stroke
August 2017
From the Department of Neurology, University of Tennessee Health Science Center, Memphis (G.T., A.V.A., A.W.A.); Second Department of Neurology (G.T., A.H.K., A.B.) and Second Department of Internal Medicine (V.L.),"Attikon" University Hospital, National and Kapodistrian University of Athens, Greece; Department of Neurology, University of Ioannina, Greece (A.H.K.); Department of Neurology, Carl Gustav Carus Hospital Dresden, Germany (K.B.); and International Clinical Research Center, Neurology Department, St Anne's Hospital and Masaryk University, Brno, Czech Republic (R.M.).
Background And Purpose: Even though current guidelines suggest that noninvasive ventilatory correction (NIVC) could be considered for acute ischemic stroke patients with obstructive sleep apnea, available evidence is conflicting, with no adequately powered randomized clinical trial being available to date.
Methods: We conducted a systematic review and meta-analysis of all available literature data evaluating the effect of NIVC on neurological improvement (based on decrease in National Institutes of Health Stroke Scale score), vascular events (recurrent stroke, transient ischemic attack, myocardial infarction and unstable angina), and mortality during the follow-up period.
Results: We identified 4 randomized clinical trials and 1 prospectively matched observational cohort, comprising a total of 389 patients (59.
Statin Pretreatment and Microembolic Signals in Large Artery Atherosclerosis.
Arterioscler Thromb Vasc Biol
July 2017
From the Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece (A.S., A.H.K., A.R., C.Z., K.V., G.T.); Acute Stroke Unit, Metropolitan Hospital, Pireus, Greece (A.S., O.K.); Department of Neurology, St. Josef-Hospital, Ruhr University, Bochum, Germany (C.K., S.F., J.K.); Yong Loo Lin School of Medicine, National University of Singapore (V.K.S.); Division of Neurology, National University Hospital, Singapore (V.K.S.); Department of Neurology, University Hospital of Ioannina, School of Medicine, University of Ioannina, Greece (A.H.K.); Second Department of Cardiology, Attikon University Hospital, National and Kapodistrian University of Athens, Greece (S.D., G.G.); First Department of Neurology, University of Athens, School of Medicine, Eginition University Hospital, Greece (N.T.); and Department of Neurology, Alexandroupolis University Hospital, School of Medicine, Democritus University of Thrace, Greece (K.V.).
Objective: Although statin pretreatment (SP) is associated with better outcomes in patients with acute cerebral ischemia after an ischemic stroke/transient ischemic attack, data on the underlying mechanism of this beneficial effect are limited.
Approach And Results: We sought to evaluate the potential association between SP and microembolic signal (MES) burden in acute cerebral ischemia because of large artery atherosclerosis (LAA). We prospectively evaluated consecutive patients with first-ever acute cerebral ischemia because of LAA in 3 tertiary stroke centers over a 2-year period.
Blood Pressure Reduction and Secondary Stroke Prevention: A Systematic Review and Metaregression Analysis of Randomized Clinical Trials.
Hypertension
January 2017
From the Second Department of Neurology (A.H.K., A.F., K.V., G.T.) and Second Department of Cardiology (S.D., J.P., A.F., A.-R.V., I.I.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, University of Athens, Greece (E.M.); First Department of Internal Medicine, Hypertension Excellence Center, AHEPA University Hospital, Thessaloniki, Greece (M.P.); Acute Stroke Unit, Metropolitan Hospital, Piraeus, Greece (O.K.); Department of Neurology, University of Tennessee Health Science Center, Memphis (A.W.A., A.V.A., G.T.); Australian Catholic University, Sydney, Australia (A.W.A.); and International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic (G.T.).
Current recommendations do not specifically address the optimal blood pressure (BP) reduction for secondary stroke prevention in patients with previous cerebrovascular events. We conducted a systematic review and metaregression analysis on the association of BP reduction with recurrent stroke and cardiovascular events using data from randomized controlled clinical trials of secondary stroke prevention. For all reported events during each eligible study period, we calculated the corresponding risk ratios to express the comparison of event occurrence risk between patients randomized to antihypertensive treatment and those randomized to placebo.
View Article and Find Full Text PDFThe value of transesophageal echocardiography for embolic strokes of undetermined source.
Neurology
September 2016
From the Department of Neurology (A.H.K., S.G., A.P.K.) and Second Department of Cardiology (K.P.), University Hospital of Ioannina, School of Medicine, University of Ioannina; Second Department of Neurology (A.H.K., K.V., G.T.) and Second Department of Cardiology (A.F., A.-R.V., I.I., I.P., J.P.), Attikon University Hospital, School of Medicine, University of Athens, Greece; Department of Neurology (R.B., N.G., A.W.A., M.D.M., A.V.A., G.T.), University of Tennessee Health Science Center, Memphis; Australian Catholic University (A.W.A.), Sydney, Australia; First Department of Neurology (N.T.), Eginition University Hospital, School of Medicine, University of Athens, Greece; and International Clinical Research Center (G.T.), St. Anne's University Hospital in Brno, Czech Republic.
Objective: Our aim was to evaluate the diagnostic yield of transesophageal echocardiography (TEE) in consecutive patients with ischemic stroke (IS) fulfilling the diagnostic criteria of embolic strokes of undetermined source (ESUS).
Methods: We prospectively evaluated consecutive patients with acute IS satisfying ESUS criteria who underwent in-hospital TEE examination in 3 tertiary care stroke centers during a 12-month period. We also performed a systematic review and meta-analysis estimating the cumulative effect of TEE findings on therapeutic management for secondary stroke prevention among different IS subgroups.
Mechanical Thrombectomy Improves Functional Outcomes Independent of Pretreatment With Intravenous Thrombolysis.
Stroke
June 2016
From the Department of Neurology (G.T., A.V.A.) and Department of Neurosurgery, Semmes-Murphey Neurologic and Spine Institute (A.A.), University of Tennessee Health Science Center, Memphis; Second Department of Neurology, "Attikon" Hospital, School of Medicine, University of Athens, Athens, Greece (G.T., A.H.K.); Department of Neurology, International Clinical Research Center, St. Anne's University Hospital in Brno, Brno, Czech Republic (G.T.); and Department of Neurology, School of Medicine (A.H.K.), Department of Primary Education (D.M.), and Department of Hygiene and Epidemiology, School of Medicine (D.M.), University of Ioannina, Ioannina, Greece; Stroke Unit, Metropolitan Hospital, Piraeus, Greece (G.M.).
Background And Purpose: Endovascular intervention for emergent large-vessel occlusion (ELVO) has evolved rapidly during the past decade. The question of whether pretreatment with intravenous thrombolysis (IVT) has a significant impact on the functional outcome of patients with ELVO still remains unanswered.
Methods: We conducted a systematic review and meta-analysis of all available randomized controlled trials evaluating the efficacy of endovascular therapy (ET) for acute ischemic stroke.
Statin pretreatment is associated with better outcomes in large artery atherosclerotic stroke.
Neurology
March 2016
From the Department of Neurology (G.T., A.W.A., A.V.A.), University of Tennessee Health Science Center, Memphis; Second Department of Neurology (G.T., A.H.K., C.Z., K.Voumvourakis), Attikon University Hospital, School of Medicine, University of Athens, Greece; International Clinical Research Center (G.T., R.M., V.W.), St. Anne's University Hospital in Brno, Czech Republic; Department of Neurology (A.H.K., S.G.), University Hospital of Ioannina, School of Medicine, University of Ioannina, Greece; Division of Neurology (V.K.S.), Yong Loo Lin School of Medicine, National University of Singapore; Department of Neurology (C.K., S.F.), St. Josef-Hospital, Ruhr University, Bochum, Germany; Neurology Department (R.M., V.W.), St. Anne's Hospital and Masaryk University, Brno, Czech Republic; Department of Neurology (K.Vadikolias), University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece; Neurology Clinic (M.M.), Clinical Center of Serbia, School of Medicine, University of Belgrade, Serbia; Stroke Unit (A.S.), Department of Neurology, Brugmann University Hospital, Brussels, Belgium; Departments of Vascular Surgery (S.V.) and Neurosurgery (E.B.), Attikon University Hospital, University of Athens, Greece; and Australian Catholic University (A.W.A.), Sydney, Australia.
Objective: Even though statin pretreatment is associated with better functional outcomes and lower risk of mortality in acute ischemic stroke, there are limited data evaluating this association in acute ischemic stroke due to large artery atherosclerosis (LAA), which carries the highest risk of early stroke recurrence.
Methods: Consecutive patients with acute LAA were prospectively evaluated from 7 tertiary-care stroke centers during a 3-year period. Statin pretreatment, demographics, vascular risk factors, and admission and discharge stroke severity were recorded.
Diagnostic Accuracy of Transcranial Doppler for Brain Death Confirmation: Systematic Review and Meta-Analysis.
AJNR Am J Neuroradiol
March 2016
From the Department of Neurology (J.J.C., G.T., M.D.M., A.V.A.), University of Tennessee Health Science Center, Memphis, Tennessee.
Background And Purpose: Transcranial Doppler is a useful ancillary test for brain death confirmation because it is safe, noninvasive, and done at the bedside. Transcranial Doppler confirms brain death by evaluating cerebral circulatory arrest. Case series studies have generally reported good correlations between transcranial Doppler confirmation of cerebral circulatory arrest and clinical confirmation of brain death.
View Article and Find Full Text PDFSystemic thrombolysis in acute ischemic stroke patients with unruptured intracranial aneurysms.
Neurology
October 2015
From the Department of Neurology (N.G., G.T., R.Z., S.M., S.I., L.E., A.W.A., A.V.A.), The University of Tennessee Health Science Center, Memphis; Second Department of Neurology (G.T., A.H.K.), "Attikon" Hospital, School of Medicine, University of Athens, Greece; International Clinical Research Center (G.T.), Department of Neurology, St. Anne's University Hospital in Brno, Czech Republic; Department of Neurology (V.K.S.), National University Hospital, Singapore; Department of Neurology (K.B., U.B.), Carl Gustav Carus University Hospital, Dresden University Stroke Center, Germany; Department of Neurosurgery (A.A., L.E.), The University of Tennessee Health Science Center, Memphis; and Australian Catholic University (A.W.A.), School of Nursing, Sydney, Australia.
Objective: We sought to determine the safety of IV thrombolysis (IVT) in acute ischemic stroke (AIS) patients harboring unruptured intracranial aneurysm (UIA) in a multicenter study and a comprehensive meta-analysis of available case series.
Methods: We analyzed prospectively collected data from consecutive AIS patients treated with IVT during a 4-year period at 4 tertiary-care stroke centers. All patients routinely underwent CT or magnetic resonance angiography during hospitalization.
Safety of Statin Pretreatment in Intravenous Thrombolysis for Acute Ischemic Stroke.
Stroke
September 2015
From the Second Department of Neurology, "Attikon" Hospital, University of Athens, School of Medicine, Athens, Greece (G.T., A.H.K.); Department of Neurology, International Clinical Research Center, St. Anne's Hospital, Brno, Czech Republic (G.T., P.K., R.M.); Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland (A.K., A.C.); Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland (A.C.); Neurology Department, University Hospital Nitra, Nitra, Slovakia (M.B.); Department of Vascular Neurology and Neurological Intensive Care, University Medical Center Ljubljana and Zdravstveni Nasveti, Ljubljana, Slovenia (V.Š.); Department of Neurology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary (L.C.); Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia (J.K.); Department of Neurology, Sestre Milosrdnice University Hospital Centre, Zagreb, Croatia (V.D.); Department of Neurology and Neurosurgery, Vilnius University and Republican Vilnius University Hospital, Vilnius, Lithuania (A.V.); Department of Neurology and Neurosurgery, Vilnius University and Vilnius University Hospital Santariskiu Clinics, Vilnius, Lithuania (D.J.); Department of Neurology, "Papageorgiou Hospital", Thessaloniki, Greece (J.R.); and Neurology Department and Stroke Center, Istanbul Science University and Florence Nightingale Hospital, Istanbul, Turkey (Y.K.).
Background And Purpose: A recent meta-analysis investigating the association between statins and early outcomes in acute ischemic stroke (AIS) patients treated with intravenous thrombolysis (IVT) indicated that prestroke statin treatment was associated with increased risk of 90-day mortality and symptomatic intracranial hemorrhage. We investigated the potential association of statin pretreatment with early outcomes in a large, international registry of AIS patients treated with IVT.
Methods: We analyzed prospectively collected data from the Safe Implementation of Treatments in Stroke-East registry (SITS-EAST) registry on consecutive AIS patients treated with IVT during an 8-year period.
Safety of intravenous thrombolysis in stroke mimics: prospective 5-year study and comprehensive meta-analysis.
Stroke
May 2015
From the Department of Neurology, University of Tennessee Health Science Center, Memphis (G.T., R.Z., N.G., J.C., A.W.A., M.D.M., A.V.A.); Second Department of Neurology, "Attikon University Hospital," School of Medicine, University of Athens, Athens, Greece (G.T., A.H.K.); Department of Neurology, Cerebrovascular Center, Cleveland Clinic, OH (K.U.); Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece (E.D.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (J.P.); and College of Nursing, Australian Catholic University, Sydney, New South Wales, Australia (A.W.A.).
Background And Purpose: Shortening door-to-needle time may lead to inadvertent intravenous thrombolysis (IVT) administration in stroke mimics (SMs). We sought to determine the safety of IVT in SMs using prospective, single-center data and by conducting a comprehensive meta-analysis of reported case-series.
Methods: We prospectively analyzed consecutive IVT-treated patients during a 5-year period at a tertiary care stroke center.