Pub Date : 2025-01-01Epub Date: 2025-01-31DOI: 10.5853/jos.2024.02544
Rena Seeger, Ubong Udoh, Brian Dewar, Stuart Nicholls, Mark Fedyk, Sophia Gocan, Victoria Shepherd, Dar Dowlatshahi, Michel Shamy
{"title":"Developing a Model of Advance Consent for Participation in Acute Stroke Trials.","authors":"Rena Seeger, Ubong Udoh, Brian Dewar, Stuart Nicholls, Mark Fedyk, Sophia Gocan, Victoria Shepherd, Dar Dowlatshahi, Michel Shamy","doi":"10.5853/jos.2024.02544","DOIUrl":"10.5853/jos.2024.02544","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 1","pages":"133-135"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-01-31DOI: 10.5853/jos.2024.03062
Anwer Zohaib Siddiqi, Katrina Ignacio, Chitapa Kaveeta, Fouzi Bala, Ayoola Ademola, Aleksander Tkach, Brian H Buck, Luciana Catanese, Gary Hunter, Dar Dowlatshahi, Michel Shamy, Atif Zafar, Thalia S Field, Ramana Appireddy, Ankur Wadhwa, Tolulope Sajobi, Rick Swartz, Mohammed Almekhlafi, Andrew Demchuk, Bijoy Menon, Nishita Singh
{"title":"Thrombolysis in Patients With Versus Without Visible Occlusion: A Secondary Analysis From the AcT Trial.","authors":"Anwer Zohaib Siddiqi, Katrina Ignacio, Chitapa Kaveeta, Fouzi Bala, Ayoola Ademola, Aleksander Tkach, Brian H Buck, Luciana Catanese, Gary Hunter, Dar Dowlatshahi, Michel Shamy, Atif Zafar, Thalia S Field, Ramana Appireddy, Ankur Wadhwa, Tolulope Sajobi, Rick Swartz, Mohammed Almekhlafi, Andrew Demchuk, Bijoy Menon, Nishita Singh","doi":"10.5853/jos.2024.03062","DOIUrl":"10.5853/jos.2024.03062","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 1","pages":"113-117"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-01-31DOI: 10.5853/jos.2024.03188
Jin Ok Yang, Seul Hee Lee, Hong Jun Kim, Chul-Hoo Kang, Joong-Goo Kim, Jay Chol Choi
{"title":"Prevalence of Genetic Variants Causing Mendelian Stroke Among 15,548 Koreans Without Neurological Disorders.","authors":"Jin Ok Yang, Seul Hee Lee, Hong Jun Kim, Chul-Hoo Kang, Joong-Goo Kim, Jay Chol Choi","doi":"10.5853/jos.2024.03188","DOIUrl":"10.5853/jos.2024.03188","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 1","pages":"136-139"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-01-31DOI: 10.5853/jos.2024.03923
Linxin Li, Vasileios-Arsenios Lioutas, Ralph K Akyea, Stefan Gerner, Kui Kai Lau, Emily Ramage, Aristeidis H Katsanos, George Howard, Philip M Bath
Randomized clinical trials are important in both clinical and academic stroke communities with increasing numbers of new design concepts emerging. One of the "less traditional" designs that have gained increasing interest in the last decade is non-inferiority trials. Whilst the concept might appear straightforward, the design and interpretation of non-inferiority trials can be challenging. In this review, we will use exemplars from clinical trials in the stroke field to provide an overview of the advantages and limitations of non-inferiority trials and how they should be interpreted in stroke research.
{"title":"Non-Inferiority Trials in Stroke Research: What Are They, and How Should We Interpret Them?","authors":"Linxin Li, Vasileios-Arsenios Lioutas, Ralph K Akyea, Stefan Gerner, Kui Kai Lau, Emily Ramage, Aristeidis H Katsanos, George Howard, Philip M Bath","doi":"10.5853/jos.2024.03923","DOIUrl":"10.5853/jos.2024.03923","url":null,"abstract":"<p><p>Randomized clinical trials are important in both clinical and academic stroke communities with increasing numbers of new design concepts emerging. One of the \"less traditional\" designs that have gained increasing interest in the last decade is non-inferiority trials. Whilst the concept might appear straightforward, the design and interpretation of non-inferiority trials can be challenging. In this review, we will use exemplars from clinical trials in the stroke field to provide an overview of the advantages and limitations of non-inferiority trials and how they should be interpreted in stroke research.</p>","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 1","pages":"41-51"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-01-31DOI: 10.5853/jos.2024.04077
João Pedro Marto, Davide Strambo, George Ntaios, Thanh N Nguyen, Pawel Wrona, Simon Escalard, Simona Marcheselli, Ossama Yassin Mansour, Blanca Fuentes, Malgorzata Dorobek, Marta Nowakowska-Kotas, Elena Oana Terecoasa, Jonathan M Coutinho, Mariana Carvalho-Dias, Patricia Calleja, João Sargento-Freitas, Ana Paiva-Nunes, Martin Šrámek, Priyank Khandelwal, Torcato Meira, Mohamad Abdalkader, Pascal Jabbour, Martin Kovář, Oscar Ayo-Martin, Patrik Michel, Roman Herzig, Anna Członkowksa, Jelle Demeestere, Raul G Nogueira, Alexander Salerno, Susanne Wegener, Philipp Baumgartner, Carlo W Cereda, Giovanni Bianco, Morin Beyeler, Marcel Arnold, Emmanuel Carrera, Paolo Machi, Valerian Altersberger, Leo Bonati, Henrik Gensicke, Manuel Bolognese, Nils Peters, Stephan Wetzel, Marta Magriço, João Nuno Ramos, Rita Machado, Carolina Maia, Egídio Machado, Patrícia Ferreira, Teresa Pinho-E-Melo, André Paula, Manuel Alberto Correia, Pedro Castro, Elsa Azevedo, Luís Albuquerque, José Nuno-Alves, Joana Ferreira-Pinto, Liliana Pereira, Miguel Rodrigues, André Araújo, Marta Rodrigues, Mariana Rocha, Ângelo Pereira-Fonseca, Luís Ribeiro, Ricardo Varela, Sofia Malheiro, Manuel Cappellari, Cecilia Zivelonghi, Giulia Sajeva, Andrea Zini, Mauro Gentile, Stefano Forlivesi, Ludovica Migliaccio, Maria Sessa, Sara La Gioia, Alessandro Pezzini, Davide Sangalli, Marialuisa Zedde, Rosario Pascarella, Carlo Ferrarese, Simone Beretta, Susanna Diamanti, Ghil Schwarz, Giovanni Frisullo, Pierre Seners, Candice Sabben, Michel Piotin, Benjamin Maier, Guillaume Charbonnier, Fabrice Vuillier, Loic Legris, Pauline Cuisenier, Francesca R Vodret, Gaultier Marnat, Jean-Sebastien Liegey, Igor Sibon, Fabian Flottmann, Gabriel Broocks, Nils-Ole Gloyer, Ferdinand O Bohmann, Jan Hendrik Schaefer, Christian H Nolte, Heinrich Audebert, Eberhard Siebert, Marek Sykora, Wilfried Lang, Julia Ferrari, Lukas Mayer-Suess, Michael Knoflach, Elke-Ruth Gizewski, Jeffrey Stolp, Lotte J Stolze, Paul J Nederkoorn, Ido van-den-Wijngaard, Joke de Meris, Robin Lemmen, Sylvie De Raedt, Fenne Vandervorst, Matthieu Pierre Rutgers, Antoine Guilmot, Anne Dusart, Flavio Bellante, Fernando Ostos, Guillermo Gonzalez-Ortega, Paloma Martín-Jiménez, Sebastian García-Madrona, Antonio Cruz-Culebras, Rocio Vera, Maria-Consuelo Matute, María Alonso-de-Leciñana, Ricardo Rigual, Exuperio Díez-Tejedor, Soledad Pérez-Sánchez, Joan Montaner, Fernando Díaz-Otero, Natalia Perez-de-la-Ossa, Belén Flores-Pina, Lucia Muñoz-Narbona, Angel Chamorro, Alejandro Rodríguez-Vázquez, Arturo Renú, Francisco Hernandez-Fernandez, Tomas Segura, Herbert Tejada-Meza, Daniel Sagarra-Mur, Marta Serrano-Ponz, Thant Hlaing, Isaiah See, Robert Simister, David J Werring, Espen Saxhaug Kristoffersen, Annika Nordanstig, Katarina Jood, Alexandros Rentzos, Libor Šimu Ne, Dagmar Krajíčková, Antonín Krajina, Robert Mikulík, Martina Cviková, Jan Vinklárek, David Školoudík, Martin Roubec, Eva Hurtikova, Rostislav Hrubý, Svatopluk Ostry, Ondrej Skoda, Marek Pernicka, Lubomír Kočí, Zuzana Eichlová, Martin Jíra, Michal Panský, Pavel Mencl, Hana Paloušková, Aleš Tomek, Petr Janský, Anna Olšerová, Roman Havlíček, Petr Malý, Lukáš Trakal, Jan Fiksa, Matěj Slovák, Michał Karlińsk, Maciej Nowak, Halina Sienkiewicz-Jarosz, Anna Bochynska, Tomasz Homa, Katarzyna Sawczynska, Agnieszka Slowik, Ewa Wlodarczyk, Marcin Wiącek, Izabella Tomaszewska-Lampart, Bartosz Sieczkowski, Halina Bartosik-Psujek, Marta Bilik, Anna Bandzarewicz, Justyna Zielińska-Turek, Krystian Obara, Paweł Urbanowski, Sławomir Budrewicz, Maciej Guziński, Milena Świtońska, Iwona Rutkowska, Paulina Sobieszak-Skura, Beata Łabuz-Roszak, Aleksander Dębiec, Jacek Staszewski, Adam Stępień, Jacek Zwiernik, Grzegorz Wasilewski, Cristina Tiu, Razvan-Alexandru Radu, Anca Negrila, Bogdan Dorobat, Cristina Panea, Vlad Tiu, Simona Petrescu, Atilla Özcan-Özdemir, Mostafa Mahmoud, Hussam El-Samahy, Hazem Abdelkhalek, Jasem Al-Hashel, Ismail Ibrahim Ismail, Athari Salmeen, Abdoreza Ghoreishi, Sergiu Sabetay, Hana Gross, Piers Klein, Kareem El Naamani, Stavropoula Tjoumakaris, Rawad Abbas, Ghada-A Mohamed, Alex Chebl, Jiangyong Min, Majesta Hovingh, Jenney-P Tsai, Muhib-A Khan, Krishna Nalleballe, Sanjeeva Onteddu, Hesham-E Masoud, Mina Michael, Navreet Kaur, Laith Maali, Michael Abraham, Ivo Bach, Melody Ong, Denis Babici, Ayaz-M Khawaja, Maryam Hakemi, Kumar Rajamani, Vanessa Cano-Nigenda, Antonio Arauz, Pablo Amaya, Natalia Llanos, Akemi Arango, Miguel A Vences, José-Domingo Barrientos, Rayllene Caetano, Rodrigo Targa, Sergio Scollo, Patrick Yalung, Shashank Nagendra, Abhijit Gaikwad, Kwon-Duk Seo
{"title":"Recanalization Outcomes and Procedural Complications in Patients With Acute Ischemic Stroke and COVID-19 Receiving Endovascular Treatment.","authors":"João Pedro Marto, Davide Strambo, George Ntaios, Thanh N Nguyen, Pawel Wrona, Simon Escalard, Simona Marcheselli, Ossama Yassin Mansour, Blanca Fuentes, Malgorzata Dorobek, Marta Nowakowska-Kotas, Elena Oana Terecoasa, Jonathan M Coutinho, Mariana Carvalho-Dias, Patricia Calleja, João Sargento-Freitas, Ana Paiva-Nunes, Martin Šrámek, Priyank Khandelwal, Torcato Meira, Mohamad Abdalkader, Pascal Jabbour, Martin Kovář, Oscar Ayo-Martin, Patrik Michel, Roman Herzig, Anna Członkowksa, Jelle Demeestere, Raul G Nogueira, Alexander Salerno, Susanne Wegener, Philipp Baumgartner, Carlo W Cereda, Giovanni Bianco, Morin Beyeler, Marcel Arnold, Emmanuel Carrera, Paolo Machi, Valerian Altersberger, Leo Bonati, Henrik Gensicke, Manuel Bolognese, Nils Peters, Stephan Wetzel, Marta Magriço, João Nuno Ramos, Rita Machado, Carolina Maia, Egídio Machado, Patrícia Ferreira, Teresa Pinho-E-Melo, André Paula, Manuel Alberto Correia, Pedro Castro, Elsa Azevedo, Luís Albuquerque, José Nuno-Alves, Joana Ferreira-Pinto, Liliana Pereira, Miguel Rodrigues, André Araújo, Marta Rodrigues, Mariana Rocha, Ângelo Pereira-Fonseca, Luís Ribeiro, Ricardo Varela, Sofia Malheiro, Manuel Cappellari, Cecilia Zivelonghi, Giulia Sajeva, Andrea Zini, Mauro Gentile, Stefano Forlivesi, Ludovica Migliaccio, Maria Sessa, Sara La Gioia, Alessandro Pezzini, Davide Sangalli, Marialuisa Zedde, Rosario Pascarella, Carlo Ferrarese, Simone Beretta, Susanna Diamanti, Ghil Schwarz, Giovanni Frisullo, Pierre Seners, Candice Sabben, Michel Piotin, Benjamin Maier, Guillaume Charbonnier, Fabrice Vuillier, Loic Legris, Pauline Cuisenier, Francesca R Vodret, Gaultier Marnat, Jean-Sebastien Liegey, Igor Sibon, Fabian Flottmann, Gabriel Broocks, Nils-Ole Gloyer, Ferdinand O Bohmann, Jan Hendrik Schaefer, Christian H Nolte, Heinrich Audebert, Eberhard Siebert, Marek Sykora, Wilfried Lang, Julia Ferrari, Lukas Mayer-Suess, Michael Knoflach, Elke-Ruth Gizewski, Jeffrey Stolp, Lotte J Stolze, Paul J Nederkoorn, Ido van-den-Wijngaard, Joke de Meris, Robin Lemmen, Sylvie De Raedt, Fenne Vandervorst, Matthieu Pierre Rutgers, Antoine Guilmot, Anne Dusart, Flavio Bellante, Fernando Ostos, Guillermo Gonzalez-Ortega, Paloma Martín-Jiménez, Sebastian García-Madrona, Antonio Cruz-Culebras, Rocio Vera, Maria-Consuelo Matute, María Alonso-de-Leciñana, Ricardo Rigual, Exuperio Díez-Tejedor, Soledad Pérez-Sánchez, Joan Montaner, Fernando Díaz-Otero, Natalia Perez-de-la-Ossa, Belén Flores-Pina, Lucia Muñoz-Narbona, Angel Chamorro, Alejandro Rodríguez-Vázquez, Arturo Renú, Francisco Hernandez-Fernandez, Tomas Segura, Herbert Tejada-Meza, Daniel Sagarra-Mur, Marta Serrano-Ponz, Thant Hlaing, Isaiah See, Robert Simister, David J Werring, Espen Saxhaug Kristoffersen, Annika Nordanstig, Katarina Jood, Alexandros Rentzos, Libor Šimu Ne, Dagmar Krajíčková, Antonín Krajina, Robert Mikulík, Martina Cviková, Jan Vinklárek, David Školoudík, Martin Roubec, Eva Hurtikova, Rostislav Hrubý, Svatopluk Ostry, Ondrej Skoda, Marek Pernicka, Lubomír Kočí, Zuzana Eichlová, Martin Jíra, Michal Panský, Pavel Mencl, Hana Paloušková, Aleš Tomek, Petr Janský, Anna Olšerová, Roman Havlíček, Petr Malý, Lukáš Trakal, Jan Fiksa, Matěj Slovák, Michał Karlińsk, Maciej Nowak, Halina Sienkiewicz-Jarosz, Anna Bochynska, Tomasz Homa, Katarzyna Sawczynska, Agnieszka Slowik, Ewa Wlodarczyk, Marcin Wiącek, Izabella Tomaszewska-Lampart, Bartosz Sieczkowski, Halina Bartosik-Psujek, Marta Bilik, Anna Bandzarewicz, Justyna Zielińska-Turek, Krystian Obara, Paweł Urbanowski, Sławomir Budrewicz, Maciej Guziński, Milena Świtońska, Iwona Rutkowska, Paulina Sobieszak-Skura, Beata Łabuz-Roszak, Aleksander Dębiec, Jacek Staszewski, Adam Stępień, Jacek Zwiernik, Grzegorz Wasilewski, Cristina Tiu, Razvan-Alexandru Radu, Anca Negrila, Bogdan Dorobat, Cristina Panea, Vlad Tiu, Simona Petrescu, Atilla Özcan-Özdemir, Mostafa Mahmoud, Hussam El-Samahy, Hazem Abdelkhalek, Jasem Al-Hashel, Ismail Ibrahim Ismail, Athari Salmeen, Abdoreza Ghoreishi, Sergiu Sabetay, Hana Gross, Piers Klein, Kareem El Naamani, Stavropoula Tjoumakaris, Rawad Abbas, Ghada-A Mohamed, Alex Chebl, Jiangyong Min, Majesta Hovingh, Jenney-P Tsai, Muhib-A Khan, Krishna Nalleballe, Sanjeeva Onteddu, Hesham-E Masoud, Mina Michael, Navreet Kaur, Laith Maali, Michael Abraham, Ivo Bach, Melody Ong, Denis Babici, Ayaz-M Khawaja, Maryam Hakemi, Kumar Rajamani, Vanessa Cano-Nigenda, Antonio Arauz, Pablo Amaya, Natalia Llanos, Akemi Arango, Miguel A Vences, José-Domingo Barrientos, Rayllene Caetano, Rodrigo Targa, Sergio Scollo, Patrick Yalung, Shashank Nagendra, Abhijit Gaikwad, Kwon-Duk Seo","doi":"10.5853/jos.2024.04077","DOIUrl":"10.5853/jos.2024.04077","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 1","pages":"128-132"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-01-31DOI: 10.5853/jos.2024.02586
Marc Fadel, Grace Sembajwe, Jian Li, Annette Leclerc, Fernando Pico, Alexis Schnitzler, Eric Richard Fadel, Yves Roquelaure, Alexis Descatha
{"title":"Direct and Indirect Effects of Prolonged Exposure to Long Working Hours on Risk Stroke Subtypes in the CONSTANCES Cohort.","authors":"Marc Fadel, Grace Sembajwe, Jian Li, Annette Leclerc, Fernando Pico, Alexis Schnitzler, Eric Richard Fadel, Yves Roquelaure, Alexis Descatha","doi":"10.5853/jos.2024.02586","DOIUrl":"10.5853/jos.2024.02586","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 1","pages":"154-157"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-01-31DOI: 10.5853/jos.2024.03139
Mayank Goyal, Bijoy K Menon, Johanna Ospel, Mohammed Almekhlafi, Charlotte Zerna, Raul Nogueira, Ryan McTaggart, Andrew M Demchuk, Alexandre Y Poppe, Brian Buck, Kathy Heard, Manish Joshi, Diogo Haussen, Shawna Cutting, Shelagh B Coutts, Daniel Roy, Jeremy L Rempel, Thalia S Field, Dar Dowlatshahi, Brian van Adel, Richard Swartz, Ruchir Shah, Eric Sauvageau, Volker Puetz, Frank L Silver, Bruce Campbell, René Chapot, Michael Tymianski, Michael D Hill
Background and purpose: In the ESCAPE-NA1 (Efficacy and Safety of Nerinetide for the Treatment of Acute Ischaemic Stroke) trial, treatment with nerinetide was associated with improved outcomes in patients who did not receive intravenous alteplase. We compared the effect of nerinetide on clinical outcomes in patients without concurrent intravenous alteplase treatment within different patient subgroups.
Methods: ESCAPE-NA1 was a multicenter randomized trial in which acute stroke patients with baseline Alberta Stroke Program Early CT Score (ASPECTS) >4 undergoing endovascular treatment (EVT) were randomized to intravenous nerinetide or placebo. The primary outcome was independence (modified Rankin Scale [mRS] score 0-2) at 90 days. We assessed baseline, clinical, and imaging variables as predictors of outcome and for evidence of treatment effect modification. We constructed two multivariable models using variables known prior to randomization and variables known immediately post-EVT procedure to provide adjusted estimates of effect. We assessed for evidence of treatment effect modification using multiplicative interaction terms within each model.
Results: Four hundred forty-six patients were included in the analysis. Clinical outcomes were better in patients randomized to the nerinetide arm (mRS 0-2: 59.4% vs. 49.8%). There was possible treatment effect modification by ASPECTS score; patients with ASPECTS 8-10 showed a larger treatment effect compared to those with lower ASPECTS score. Younger age, lower NIHSS score, lower baseline serum glucose, absence of atrial fibrillation at baseline, higher ASPECTS score, middle cerebral artery (vs. internal carotid artery) occlusion, use of conscious or no sedation (vs. general anesthesia), and faster treatment were all predictors of favorable outcome.
Conclusion: Patients in the nerinetide arm who were not treated with concurrent alteplase showed improved clinical outcomes and the treatment effect was larger among patients with favorable ASPECTS profiles.
背景和目的:在ESCAPE-NA1(奈利肽治疗急性缺血性卒中的有效性和安全性)试验中,奈利肽治疗与未静脉注射阿替普酶的患者预后改善相关。我们比较了在不同的患者亚组中,在没有同时静脉注射阿替普酶治疗的患者中,奈奈肽对临床结果的影响。ESCAPE-NA1是一项多中心随机试验,在该试验中,接受血管内治疗(EVT)的基线阿尔伯塔卒中计划早期CT评分(ASPECTS) bbbb4的急性卒中患者被随机分配到静脉注射奈奈肽或安慰剂组。90天的主要终点是独立性(修正Rankin量表[mRS]评分0-2)。我们评估了基线、临床和影像学变量作为预后的预测因子和治疗效果改变的证据。我们构建了两个多变量模型,使用随机化之前已知的变量和evt过程后立即已知的变量来提供调整后的效果估计。我们在每个模型中使用乘法相互作用项来评估治疗效果改变的证据。结果:446例患者纳入分析。随机分配到nerinetide组的患者临床结果更好(mRS 0-2: 59.4% vs 49.8%)。通过ASPECTS评分有可能改变治疗效果;8 ~ 10分的患者治疗效果较低。年龄较小、NIHSS评分较低、基线血糖较低、基线无房颤、ASPECTS评分较高、大脑中动脉(与颈内动脉相比)闭塞、使用有意识镇静或不使用镇静(与全身麻醉相比)以及更快的治疗都是有利结果的预测因素。结论:未同时使用阿替普酶治疗的奈利肽组患者临床预后较好,且在具有良好方面概况的患者中治疗效果更大。
{"title":"Factors Influencing Nerinetide Effect on Clinical Outcome in Patients Without Alteplase Treatment in the ESCAPE-NA1 Trial.","authors":"Mayank Goyal, Bijoy K Menon, Johanna Ospel, Mohammed Almekhlafi, Charlotte Zerna, Raul Nogueira, Ryan McTaggart, Andrew M Demchuk, Alexandre Y Poppe, Brian Buck, Kathy Heard, Manish Joshi, Diogo Haussen, Shawna Cutting, Shelagh B Coutts, Daniel Roy, Jeremy L Rempel, Thalia S Field, Dar Dowlatshahi, Brian van Adel, Richard Swartz, Ruchir Shah, Eric Sauvageau, Volker Puetz, Frank L Silver, Bruce Campbell, René Chapot, Michael Tymianski, Michael D Hill","doi":"10.5853/jos.2024.03139","DOIUrl":"10.5853/jos.2024.03139","url":null,"abstract":"<p><strong>Background and purpose: </strong>In the ESCAPE-NA1 (Efficacy and Safety of Nerinetide for the Treatment of Acute Ischaemic Stroke) trial, treatment with nerinetide was associated with improved outcomes in patients who did not receive intravenous alteplase. We compared the effect of nerinetide on clinical outcomes in patients without concurrent intravenous alteplase treatment within different patient subgroups.</p><p><strong>Methods: </strong>ESCAPE-NA1 was a multicenter randomized trial in which acute stroke patients with baseline Alberta Stroke Program Early CT Score (ASPECTS) >4 undergoing endovascular treatment (EVT) were randomized to intravenous nerinetide or placebo. The primary outcome was independence (modified Rankin Scale [mRS] score 0-2) at 90 days. We assessed baseline, clinical, and imaging variables as predictors of outcome and for evidence of treatment effect modification. We constructed two multivariable models using variables known prior to randomization and variables known immediately post-EVT procedure to provide adjusted estimates of effect. We assessed for evidence of treatment effect modification using multiplicative interaction terms within each model.</p><p><strong>Results: </strong>Four hundred forty-six patients were included in the analysis. Clinical outcomes were better in patients randomized to the nerinetide arm (mRS 0-2: 59.4% vs. 49.8%). There was possible treatment effect modification by ASPECTS score; patients with ASPECTS 8-10 showed a larger treatment effect compared to those with lower ASPECTS score. Younger age, lower NIHSS score, lower baseline serum glucose, absence of atrial fibrillation at baseline, higher ASPECTS score, middle cerebral artery (vs. internal carotid artery) occlusion, use of conscious or no sedation (vs. general anesthesia), and faster treatment were all predictors of favorable outcome.</p><p><strong>Conclusion: </strong>Patients in the nerinetide arm who were not treated with concurrent alteplase showed improved clinical outcomes and the treatment effect was larger among patients with favorable ASPECTS profiles.</p>","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 1","pages":"95-101"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-01-31DOI: 10.5853/jos.2024.01655
Radosław Rzepliński, Sylwia Tarka, Michał Tomaszewski, Michał Kucewicz, Albert Acewicz, Jerzy Małachowski, Bogdan Ciszek
Background and purpose: The pathogenesis of neurovascular diseases and various types of dementia is tightly connected to cerebral circulation. An area that requires further exploration is the system of deep cerebral perforating arteries-arteries branching directly from high-pressure intracranial arteries, supplying vital neural structures such as the internal capsule, and characterized by a diameter of well below 1 mm, which makes them difficult to visualize with standard radiological examinations. This study aimed to analyze the morphology of the perforator origins, which constitute connection points between high-pressure intracranial arteries and microcirculation.
Methods: Twenty-three human basal ganglia specimens with the middle cerebral artery (MCA, including 172 perforating arteries) and ten brainstem specimens with the basilar artery (BA, including 162 perforating arteries) were prepared and scanned using microcomputed tomography. The geometry and structure of the perforating arteries were analyzed using radiological images and additional histological studies.
Results: The ostia of the perforating arteries were ellipsoidal in shape with median stenosis severity of 23% and 20% for MCA and BA perforators, respectively. The local narrowing structure was typical of neointimal hyperplasia. Statistical analysis revealed that the severity of stenosis may be related to age and cardiovascular health.
Conclusion: Origins of the deep cerebral perforators are locally narrowed by neointimal hyperplasia, which may be a protective mechanism to adjust high blood pressure to the microcirculation. The narrowings may lead to chronic hypoperfusion and play a role in the pathophysiology of cerebral small vessel disease.
{"title":"Narrowings of the Deep Cerebral Perforating Arteries Ostia: Geometry, Structure, and Clinical Implications.","authors":"Radosław Rzepliński, Sylwia Tarka, Michał Tomaszewski, Michał Kucewicz, Albert Acewicz, Jerzy Małachowski, Bogdan Ciszek","doi":"10.5853/jos.2024.01655","DOIUrl":"10.5853/jos.2024.01655","url":null,"abstract":"<p><strong>Background and purpose: </strong>The pathogenesis of neurovascular diseases and various types of dementia is tightly connected to cerebral circulation. An area that requires further exploration is the system of deep cerebral perforating arteries-arteries branching directly from high-pressure intracranial arteries, supplying vital neural structures such as the internal capsule, and characterized by a diameter of well below 1 mm, which makes them difficult to visualize with standard radiological examinations. This study aimed to analyze the morphology of the perforator origins, which constitute connection points between high-pressure intracranial arteries and microcirculation.</p><p><strong>Methods: </strong>Twenty-three human basal ganglia specimens with the middle cerebral artery (MCA, including 172 perforating arteries) and ten brainstem specimens with the basilar artery (BA, including 162 perforating arteries) were prepared and scanned using microcomputed tomography. The geometry and structure of the perforating arteries were analyzed using radiological images and additional histological studies.</p><p><strong>Results: </strong>The ostia of the perforating arteries were ellipsoidal in shape with median stenosis severity of 23% and 20% for MCA and BA perforators, respectively. The local narrowing structure was typical of neointimal hyperplasia. Statistical analysis revealed that the severity of stenosis may be related to age and cardiovascular health.</p><p><strong>Conclusion: </strong>Origins of the deep cerebral perforators are locally narrowed by neointimal hyperplasia, which may be a protective mechanism to adjust high blood pressure to the microcirculation. The narrowings may lead to chronic hypoperfusion and play a role in the pathophysiology of cerebral small vessel disease.</p>","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 1","pages":"52-64"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-01-31DOI: 10.5853/jos.2024.02005
James L Barker, Oshi Swarup, Yohanna Kusuma, Leonid Churilov, Geoffrey Donnan, Stephen M Davis, Peter J Mitchell, Bernard Yan
{"title":"Thrombectomy With Bridging Thrombolytic May Benefit Asian Patients More Than Non-Asian Patients: Insights From DIRECT-SAFE Sub-Analysis.","authors":"James L Barker, Oshi Swarup, Yohanna Kusuma, Leonid Churilov, Geoffrey Donnan, Stephen M Davis, Peter J Mitchell, Bernard Yan","doi":"10.5853/jos.2024.02005","DOIUrl":"10.5853/jos.2024.02005","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"27 1","pages":"118-121"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}