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Mashup Score: 2Article Commentary: “Automated Large Vessel Occlusion Detection Software and Thrombectomy Treatment Times” - 7 day(s) ago
The authors designed a cluster randomized stepped-wedge observational study using four comprehensive stroke centers in Houston to determine the impact of AI-enabled automated LVO detection in AIS and workflow enhancements acute stroke treatment. Each Comprehensive Stroke Center (CSC) was denoted as a cluster and allocation was determined by cluster. Patients with LVO AIS presenting to the emergency departments of 4 CSCs were included in the trial and underwent imaging with CT head and angiogram. One CSC
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Mashup Score: 12Article Commentary: “Follow-up Imaging After Thrombolysis: FIAT, A Randomized Trial” - 10 day(s) ago
The use of a stability non-contrast CT brain scan 24 hours after intravenous thrombolysis treatment for acute ischemic stroke dates back to the initial NINDs protocol to evaluate for hemorrhagic conversion. However, several recent studies have questioned the use of stability CT in patients with symptomatic improvement. Retrospective studies by Dharmasaroja and Schurig showed stability CT scans in patients who received thrombolysis with resolved symptoms at 24 to 36 hours offered no changes in management.
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Mashup Score: 11
Recent evidence from three randomized clinical trials (RESCUE-Japan LIMIT, SELECT2, and ANGEL-ASPECT) and a meta-analysis has suggested that endovascular thrombectomy (EVT) improves functional outcomes in ischemic stroke patients with large core infarcts. Although these results are very encouraging, the trials relied heavily on advanced imaging (either CT perfusion or MRI) to determine whether patients had large core infarcts. Such advanced imaging techniques, however, are not available at many clinical
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Mashup Score: 19To Anticoagulate or Not to Anticoagulate - 15 day(s) ago
In patients with atrial fibrillation (AF), anticoagulation is recommended as level A evidence with either non-vitamin K antagonist oral inhibitor (NOACs) or warfarin for secondary stroke prevention. Prolonged cardiac monitoring with implantable devices can detect AF with rates as high as 22.6 % than conventional monitoring. In a similar context, atrial high rates episodes (AHREs) can be detected with an implanted device. Since AHREs are rare and brief, there is no clinical consensus whether anticoagulation
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Mashup Score: 2Closing in on Pharmaceutical Therapy to Target Lipoprotein(a) for Cardiovascular Disease and Stroke - 24 day(s) ago
Recent research has confirmed an association of elevated lipoprotein(a) (Lp(a)) levels with subsequent major cardiovascular events and stroke. 1 Several pharmaceutical approaches to reduce the predominantly genetically determined Lp(a) levels are in the pipeline, but no drug has yet been approved by authorities. Recent scientific advances in RNA interference have brought a novel approach on therapies which degrade apolipoprotein(a) mRNA prior to translation. Two approaches (antisense oligonucleotides and
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Mashup Score: 13Management of Inherited CNS Small Vessel Diseases: The CADASIL Example: A Scientific Statement From the American Heart Association - 1 month(s) ago
Lacunar infarcts and vascular dementia are important phenotypic characteristics of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, the most common inherite
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Mashup Score: 9
An interview with Dr. Geert-Jan Geersing, PhD, MD, Associate Professor, Department of General Practice and Nursing Science, University Medical Center Utrecht, Utrecht, Netherlands. Interviewed by Dr. Braydon Dymm, MD, Neurologist, Department of Neurology, Charleston Area Medical Center, Charleston, WV. Dr. Dymm: Thank you, Dr. Geersing, for agreeing to this interview. This is the first major pragmatic, randomized controlled trial looking at switching frail older atrial fibrillation (AF) patients from
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INTERVIEW: #BloggingStroke contributor @BraydonDymm interviews Dr. Geert-Jan Geersing on @CircAHA article "“Safety of Switching from a Vitamin K Antagonist to a Non-Vitamin K Antagonist Oral Anticoagulant in Frail Older Patients with Atrial Fibrillation.” https://t.co/todCvPAn5R https://t.co/JgLjDnn3lJ
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Mashup Score: 1
Endovascular therapy (EVT) has been established as the gold standard for large-vessel occlusion (LVO) stroke with National Institutes of Health Stroke Scale (NIHSS) scores > 6 by randomized clinical trials over the past decade. However, nearly 50 percent of all LVO patients are found to have mild stroke (NIHSS < 6). Some go on to have disabling neurologic deficits with nearly one-third remaining functionally dependent at 90 days if not treated with EVT. As we await the completion of clinical trials for
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Mashup Score: 36LVO Recanalization With Tenecteplase vs Alteplase - 4 month(s) ago
Intravenous thrombolysis (IVT) with tenecteplase or alteplase is recommended for large vessel occlusion (LVO) acute ischemic stroke (AIS) before mechanical thrombectomy (MT), with the goal of IVT providing early vessel recanalization (ER). There are divergent data on whether ER rates differ between tenecteplase and alteplase. 1,2 Checkouri et al. aimed to compare ER before MT in patients with LVO treated with tenecteplase versus alteplase, and to investigate differences in treatment effect stratified by
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LVO Recanalization With Tenecteplase vs Alteplase https://t.co/gyf2AiG8R2 In this #BloggingStroke post, @wechsler_paul discusses Stroke article "Early Recanalization Among Pts Undergoing Bridging Therapy With Tenecteplase or Alteplase" by Checkouri & Gerschenfeld et al. @jildazz https://t.co/DxVqJkPCka
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Mashup Score: 36Article Commentary: “Dual Antiplatelet Therapy vs Alteplase for Patients With Minor Nondisabling Acute Ischemic Stroke” - 5 month(s) ago
One of the most challenging clinical dilemmas in vascular neurology is patients with “mild” stroke symptoms that are candidates for intravenous thrombolytics and/or endovascular thrombectomy. Part of the ch allenge is that this patient population is understudied, either by exclusion from large clinical trials (such as in the 2015 anterior circulation core thrombectomy trials) or by incomplete studies (such as the PRISMS study in 2018 that stopped recruitment early). Another part of the challenge to
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Article Commentary: "Automated Large Vessel Occlusion Detection Software and Thrombectomy Treatment Times" https://t.co/Bj8XbtEeZ2 In this #BloggingStroke post, Sucharita Ray discusses @JAMANeuro article by @JCMartinezMD et al. @LD_McCullough @SunilAShethMD