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1. Influence of vascular imaging acquisition at local stroke centers on workflows in the drip-n-ship model: a RACECAT post hoc analysis

Author

Flores, Alan, Garcia-Tornel, Alvaro, Seró, Laia, Ustrell, Xavier, Requena, Manuel, Pellisé, Anna, Rodriguez, Paula, Monterde, Angela, Lara, Lidia, Gonzalez-de-Echavarri, Jose María, Molina, Carlos A, Doncel-Moriano, Antonio, Dorado, Laura, Cardona, Pedro, Cánovas, David, Krupinski, Jerzy, Más, Natalia, Purroy, Francisco, Zaragoza-Brunet, Jose, Palomeras, Ernesto, Cocho, Dolores, Garcia, Jessica, Colom, Carla, Silva, Yolanda, Gomez-Cocho, Manuel, Jiménez, Xavier, Ros-Roig, Josep, Abilleira, Sonia, Pérez de la Ossa, Natalia, and Ribo, Marc

Abstract

BackgroundThe influence of vascular imaging acquisition on workflows at local stroke centers (LSCs) not capable of performing thrombectomy in patients with a suspected large vessel occlusion (LVO) stroke remains uncertain. We analyzed the impact of performing vascular imaging (VI+) or not (VI− at LSC arrival on variables related to workflows using data from the RACECAT Trial.ObjectiveTo compare workflows at the LSC among patients enrolled in the RACECAT Trial with or without VI acquisition.MethodsWe included patients with a diagnosis of ischemic stroke who were enrolled in the RACECAT Trial, a cluster-randomized trial that compared drip-n-ship versus mothership triage paradigms in patients with suspected acute LVO stroke allocated at the LSC. Outcome measures included time metrics related to workflows and the rate of interhospital transfers and thrombectomy among transferred patients.ResultsAmong 467 patients allocated to a LSC, vascular imaging was acquired in 277 patients (59%), of whom 198 (71%) had a LVO. As compared with patients without vascular imaging, patients in the VI+ group were transferred less frequently as thrombectomy candidates to a thrombectomy-capable center (58% vs 74%, P=0.004), without significant differences in door-indoor-out time at the LSC (median minutes, VI+ 78 (IQR 69–96) vs VI− 76 (IQR 59–98), P=0.6). Among transferred patients, the VI+ group had higher rate of thrombectomy (69% vs 55%, P=0.016) and shorter door to puncture time (median minutes, VI+ 41 (IQR 26–53) vs VI− 54 (IQR 40–70), P<0.001).ConclusionAmong patients with a suspected LVO stroke initially evaluated at a LSC, vascular imaging acquisition might improve workflow times at thrombectomy-capable centers and reduce the rate of futile interhospital transfers. These results deserve further evaluation and should be replicated in other settings and geographies.

Published
2024
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2. Association of Time of Day With Outcomes Among Patients Triaged for a Suspected Severe Stroke in Nonurban Catalonia.

Author

García-Tornel, Álvaro, Flores, Alan, Terceño, Mikel, Cardona, Pedro, Amaro, Sergi, Gomis, Meritxell, Zaragoza, Josep, Krupinski, Jerzy, Gómez-Choco, Manuel, Mas, Natalia, Cocho, Dolores, Catena, Esther, Purroy, Francesc, Deck, Matias, Rubiera, Marta, Pagola, Jorge, Rodriguez-Luna, David, Juega, Jesús, Rodríguez-Villatoro, Noelia, and Molina, Carlos A.

Published
2023
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3. Association of Time of Day With Outcomes Among Patients Triaged for a Suspected Severe Stroke in Nonurban Catalonia

Author

García-Tornel, Álvaro, Flores, Alan, Terceño, Mikel, Cardona, Pedro, Amaro, Sergi, Gomis, Meritxell, Zaragoza, Josep, Krupinski, Jerzy, Gómez-Choco, Manuel, Mas, Natalia, Cocho, Dolores, Catena, Esther, Purroy, Francesc, Deck, Matias, Rubiera, Marta, Pagola, Jorge, Rodriguez-Luna, David, Juega, Jesús, Rodríguez-Villatoro, Noelia, Molina, Carlos A., Soro, Cristina, Jimenez, Xavier, Salvat-Plana, Mercè, Dávalos, Antoni, Jovin, Tudor G, Abilleira, Sonia, Pérez de la Ossa, Natalia, Ribó, Marc, Sanjuan, Estela, Santana, Katherine, Maisterra, Olga, Santamarina, Estevo, Muchada, Marian, Boned, Sandra, Franco, Antonio Palasi, Gadea, Marta Olivé, Deck, Matías, Requena, Manuel, Sala, Victoria, Muñoz, Lucía, Millán, Mónica, López-Cancio, Elena, Dorado, Laura, Hernández-Pérez, María, Ciurans, Jordi, Samaniego, Daniela, Canento, Tamara, Martin, Lorena, Planas, Anna, Broto, Joaquin, Sorrentino, Agustín, Paré, Martí, Zhu, Nuole, Garrido, Alicia, Grau, Laia, Crespo, Ane Miren, Presas, Silvia, Almendrote, Miriam, Ramos, Alba, Lucente, Giuseppe, Ispierto, Lourdes, Lozano, Manuel, Becerra, Juan Luis, Jiménez, Marta, Rolán, Dolores Vilas, Guanyabens, Nicolas, Sanchez-Ojanguren, Josep, Martínez-Piñeiro, Alicia, Forcén, Sara, Gea, Mireia, Álvarez, Marta, Ramos, Anna, Lizarbe, Manuel Domínguez, Guerra, Rubio, Bragado, Irene, Arbex, Andrea, Rodríguez, Luis, Bustamante, Alejandro, Portela, Pere Cardona, García, Helena Quesada, Rodríguez, Blanca Lara, Cayuela, Nuria, Miró, Julia, Marzal, Clara, Paipa, Andrés, Campoy, Sergio, Núñez, Ana, Arroyo, Pablo, Besora, Sarah, Adell, Vanessa, Campdelacreu, Jaume, Martí, Montse Alemany, González, Belén, Vila, Laura Bau, Crespo, Marta Fiter, Berbel, Anna, Urbaneja, Ma. Cristina Villaescusa, Guillen, Núria, Vidal, Nuria, Santamaria, Patricia Valentina Vérez, Navarro, Diego Herrero, Simó, Marta, Falip, Mercedes, Matas, Elisabeth, Ochoa, Neus Mongay, Gifreu, Ariadna, Muñoz, Albert, Romero, Lucía, Portell, Eduard, Perez, Guillermo Hernández, Esteve, F. Ruiz, Teixidor, Silvia, Talavera, Augusto Salazar, Gómez, Roser, Nuin, Xabier Urra, Vargas, Martha, Chamorro, Ángel, Llull, Laura, Renú, Arturo, Rudilosso, Salvatore, del Valle, Raquel Sánchez, Ariño, Helena, Solà, Nuria, la Puma, Delón, Gil, Francisco, Gómez, Juan Bernardo, Matos, Nuria, Falgàs, Neus, Borrego, Sergi, Sánchez, Almudena, Balasa, Mircea, Montejo, Carmen, Guasp, Mar, Reyes, David, Cervilla, Pablo Sánchez, Contador, Jose Miguel, Monge, Victor Augusto Vera, Ramos, Oscar, Rodríguez, Alejandro, Campello, Ana Rodríguez, Ballester, Gemma Romeral, Trujillano, Mireia Llop, Steinhauer, Eva Giralt, Godia, Elisa Cuadrado, Santiago, Angel Javier Ois, Conde, Jordi Jimenez, Fábregas, Joan Martí, Guisado, Daniel, Prats, Luís, Camps, Pol, Delgado, Raquel, Domeño, Alejandro Martínez, Marín, Rebeca, Cànovas, David, Estela, Jordi, Ros, Marta, Aranceta, Sonsoles, Espinosa, Jordi, Rubio, Marta, Lafuente, Cristina, Barrachina, Oriol, Anguita, Alicia, Reverter, Anna, García, Carmen, Sansa, Gemma, Hervas, Mariona, Crosas, Monica, Delgado, Tania, Folch, Dra Sonia Huertas, Gamito, Gemma Muñoz, Alvarez, Josep Trenado, Subirana, Teresa, Molina, Jessica, Besora, Sarah, Romero, Laura Comes, Valls, Gemma Guardia, Jover, Miriam, Sotova, Javier Joaquín, García Sánchez, Sonia Mª, Valenzuela, Sebastian, Mengual, Juan José, Font, M. Àngels, Gómez Ruiz, Mª Isabel, Zubizarreta, Irati, González, Susana Fernández, Gubieras, Laura, Cobos, Carmen E., Romo, Luis Mena, Caballol, Nuria, Cano, Luis, Leal, Joaquín Serena, Blas, Yolanda Silva, Trigo, Irene Bragado, Viturro, Saima Bashir, Albiñana, Laura Pardo, Garrido, Montserrat Reina, Cazcarra, Carla Marco, Uscamaita, Karol Enrique, Márquez, Fabian, Coll, Cristina, Villlas, Mar Irida Lloret, Vila, Berta Solano, Perna, Berta Alemany, Domínguezl, Daniel López, de Lera, Mercedes, Foraster, Anna Cots, Monge, Victor Augusto Vera, Bojaryn, Urszula, Benabdelhak, Ikram, Capdevila, Gerard Mauri, Montesinos, Jordi Sanahuja, Vázquez, Daniel, Hervás, José Vicente, González, Cristina, Quílez, Alejandro, Pascual, Mikel Vicente, Ruiz, María, Riba, Yolanda, Villar, M. Pilar Gil, García, Cristina, Roig, Xavier Ustrell, Mora, Mònica Baldrich, Guinjoan, Anna Pellisé, Borras, Judit, Martínez, Alba Mañé, Marés, Rafael, Viñas i Gaya, Jaume, Seró, Laia, Rodríguez, Paula, Castilho, Gislaine, Ortega, Angela Monterde, Reverté, Silvia, Baiges, Joan Josep, Ozaeta, Gisela Martín, Escalante, Sonia, Belloch, Patricia Esteve, Payo, Iago, Salvado, Júlia Saura, Soler Insa, Josep M, Vilamala, Ester Tio, Navarro, Josep Abos, Tabuenca, Héctor Cruz, Sánchez, Tamara Canento, Ros, Marta, Matos, Nuria, Roldán, Elisabet, Rubiol, Elsa Puiggrós, Franquet, Elisabet, Fuentes, Lidia, Donaire, Javier, Martí, Elena, Giménez, Laura, Vázquez, Junior Gil, Ambrós, Eloisa Nieto Clara Gris, Rodríguez, Puri, Oletta, José Félix, Mellado, Pilar Pons, Gómez, Bárbara, Raileau, Vergilin, Pardina, Oscar, Mercadal, Jordi, López-Diéguez, María, Pérez, Pilar, Gabarró, Lourdes, Orriols, María, Molina, José Carlos, Canet, Joan Josep, Roca, Mireia, Álvaro, Muriel, Boneu, Francesc, Giménez, Georgina, Albà, Jaume, Gibert, Francesc, Garcia, Jéssica, Barragan, Patricia, Jurado, Gustavo, Pascual_Medicina Interna, Vanesa, Ortega, Josep Sabaté, Solano, Joan Amaurys Martínez, Fernández, Víctor, Torres, Mónica, Alvaredo, Ana Belén Montero, Parejo, Laura Redondo, Aragonés, Josep Maria, Bullón, Anna, Loste, Cora, González, Paula, Bejarano, Neker, Sanchez, Francisco, Lucchetti, Gianni, Pla, Xavier, Gimeno, Dr Javier, Reynaga, Esteban, Barcons, Montse, Celedón, Gabriel, Ortiz, Juan, Anastasovski, Dr Goran, Mascaró, Dr Oscar, de los Ríos, Dr Javier Diez, Feliu, Meritxell, Ribera, Anna, Ruiz, Cristhian, Corominas, Gerard, Nunes, Dra Daniella, Roca, Claudia, Latorre, Nadina, Yataco, Lizbeth, Cruz, Maricelys, Blanco, Nerea, Castejón, Santiago, Sunyer, Claustre Pont, Garcia, Jordi Espinosa, Martin, Rodrigo Paz, de Luis Sanchez, Albert, Vivas, Dolores Espinosa, Molina, Juan Valencia, Palome, Planels, Chaume, Laia Tomas, Vilella, Ares Villagrasa, Bustamante, Marco, Boltes, Anunciación, Rodríguez, Fernando, Arrieta, Itziar, Molist, Jordi Ciurans, Andreu, Barnés, Soler, Ernest Palomeras, Buscà, Nicolau Guanyabens, López, Manuel Daza, Farreres, Jordi Bigas, Ruiz, Virginia Casado, Batiste, Desiree Muriana, Sanz Cartagena, Mª Pilar, de Vega, Eulalia Cabot, Real, Josep Bassa, Roman, Hector Pelaez, Socolich, César, Alonso Camp, Josep Mª, Orgaz, Antonio Tomás Cano, Fossas Felip, Mª Pilar, Morón, Nicolás, Bacca, Sandra, Molina, Mauricio, Casarramona, Francesc, Elias, Lorena, Bukaei, Muhammad Zidane, Gutierrez, Jose Antonio Martos, Escuin, Judith Lopez, Olaizola, Cristina, Vargas, Yolexis López, Oyonarte, Juan Jiménez, Soultana, Rashida, Golpe, Eduardo Sanjurjo, Salvador, Esther, Vila, Guillem, Serrano, Marcos, Claverol, Matilde Nuria López, Lamolla, Marian, Amate, Miquel, Rodriguez, Adriana, Romero, Ruth, del Carpio, Montgomery, Hernandez, Ana Isabel, Martín, Julián, Rosas, M Carmen, Nogueroles, Antonio, Encarnación, Sorilandy, Robles, Augusto, Herrera, Jose Antonio, Gavilán, Roger, Mameghani, Toghrol, Araujo, Gastón, Morales, M.Angeles Garrido, Segui, Enric Ramon Albert, Climent, Eva Fernandez, Pujol, Francesc Paris, Seira, Mireia Judit Garrofé, Pía, Lucía Gómez, Nuñez, Fernando Salleres, Peñalver, Cristina Aguar, Lopes, Cristina Vaz, Tasa, Elisenda Ribera, Vilchez, Carmen Repullo, Zambrana, Modesto Sánchez, Ribas, Beatriu Suescun, Panés, Inés Vilà, Planavila, Montserrat Vila, Lorenzo, Alicia Vaqueiro, Guixes, Meritxell Sabartés, Medina, Jorge, Sambrano, David, Zamarreño, Javi, Pirela, Carmen, Vélez, Paola, Cajamarca, Luis, Pérez, Honey, Martínez, Yarles, Gonçalves, Jesus Alexander, Regordosa, Carles, Mormeneo, Claudia, Griu, Laura, Colina, Maria Francia, Farik, Enric, Duch, Dolors Carrión, Badenas, Carles, Bernal, Oscar, Agramunt, Núria, Morales, Shyrlei, Reynoso, Victoria, Guerrero, Miguel, Cid, Primitivo Romera, Folqué, Mònica, Pedroza, Claudia, Hachem, Adnan, Martínez, Íñigo Soteras, García, Xavier Verdera, Amorós, Mercè López, Subirós, Xavier Costa, Benet, Marta Cufí, Van Eendenburg, Cecile, Osuna, Teresa, Santos, Dra Gina, Pallisera, Dra Mireia, Oliva, Dr Lluís Gonzalo, Sanchez, Dra Gemma, Basurto, Dr Xavier, Vivoda, Dr Ludgi, Van der Kleyn, Dr Richard, Robles, Dra Laura, Barranco, Ana Cabanelas, Almendros, Mª Cruz, Oliveras, Marc Pérez, Álvarez, Amelia Fernández, Rybyeva, Maria, Viñas, Antoni, Barcons, Maria, Tavera, Joaquim Danès Alberto, Burbano, Pablo, López, Cintie, Cruz, David, Bisbe, Paula, Fernández, Nora, Palacio, Juan Carlos, Fraiz, Eduardo, Aguiló, Oriol, Amorodjo, Rollmy, Velázquez, John, Sánchez, Elena, Español, Jaume, Perez de Celis, Judit, Coll, Anna, Díaz, Glòria, Vergés i Sala, Margarida, Casas Capdevila, Mª Ángels, Ferrini, Yosmairy Yoselin, Gorriz, Aitor, Navarro, Diego-Javier Cucurell, Velásquez, Dulce, Pla Soler, Jaume, González, Josep, Higuera, Julian David, Cuellar, Lina, Miniello, Liza Margarita, Pujol, Lluis, Cracan, Sorin, Vives, Mora, Angela, M, Lopez, Lopez, Molist, Montse Gorchs, Anna, Delofeu, Muñoz, Silvia Solà, Yolanda, Ferreres, Pujalte, Carol, Marín, Elisabeth Téllez, Casas, Yolanda Font, Luque, Sara Hernández, Sendra, Joaquim Mejias, Valero, Francesca Mellado, Escala, Campos, De Lacanal, Galup, Diaz, Lopez, Paramio, Castillo, Estopà, Català, Moreda, Español, Majo, Calafell, Almeida, Carballo, Naval, Castro, Elena, M, Ruiz, Cregut, Lluis, Pere, Font, Deulofeu, Sanjuan, Fabregat, Pere, Joan, Gorchs, Fontquerni, Bellés, Forés, Antoni, Joan, Herrera, Gomez, Carlos, Juan, Prades, Hijazo, Torvisco, Itzaina, Rovira, Marti, Gonzalez, Obiols, Cavero, Olive, Gil, Querol, Soledad, M, Rodriguez, Rico, Sambernardo, Rios, Molina, Ropero, Ramon, Jose, Valero, Sanchez, Arevalo, Santos, Jose, Maria, Garcia, Soto, Angeles, Maria, Escribano, Tebar, Garcia, Torres, José, Pedro, Carrion, Verdes, Isabel, M, Lopez, Verge, Jose, Juan, Canela, Lopez, Angeles, M, Guarque, Lucas, Alvarez, Morales, Arnulfo, Jorge, Fornieles, Morell, Gomez, Subirats, Teresa, Maria, Masa, Torello, Miquel, Lopez, Val, Mercedes, Maria, Reyes, Palmero, Manuel, Juan, Forne, Rodriguez, Turiel, Ruana, Gonzalez, Sanchez, Gornals, Sebastia, Rico, Abrio, Falip, Albert Gual, Oliveros, Aznar, Perotti, Brugues, Molinero, Calvet, Franco, Catells, Medina, Corrales, Miro, Daroca, Marquez, Duran, Pradas, Feliu, Casanova, Figueras, Tortajada, Garcia, Gallego, Grajera, del Mar, Azahara, Arroyo, Las, de Jesus, Dulcenombre, Sanz, Laserreta, Vidal, Llambrich, Corral, Monllao, de la Cruz, Morales, Blanco, Moreno, Orgaz, Orejuela, Suazo, Piñana, Minguillon, Pons, Gómez, Rodríguez, Carlos, José, Pereira, Rodriguez, Porcel, Sedo, Anna, Villar, Sevil, Lopez, Sierra, Romero, Torres, Calveres, Trepat, Anna, Arnella, Ventura, Gil, Acera, Teresa, M, Vico, Biesot, Galea, Castro, Maria, Rosa, Chafer, Escorcia, Antonio, Juan, Moreda, Español, Faure, Gil, Luque, Hernandez, Delgado, Jimenez, Gay, Mallafre, Angel, M., Sanzo, Olivares, Fondevila, Pubill, Fort, Sabate, Agámez, Segovia, Carlos, Antonio, Longaretti, Turata, Hernandez, Valle, Guixens, Trayner, Valor, Aguilar, Alvarez, Aguirre, Naval, Alastrue, Baquero, Alferez, Marne, Alonso, Orozco, Aloy, Colino, Alvarez, Peñuela, Alvarez, Cirilo, Ameller, Vanessa, Maria, Guerrero, Andujar, Remedios, Estefania, Sillero, Auladell, Sorbet, Azcarate, Genesca, Basany, Barduena, Benavent, Tudela, Benito, Pardo, Blanch, Pla, Boluda, Gonzalez, Bonilla, Serramalera, Bru, Andreu, Burnat, Calvo-Rayo, Caballero, Casellas, Calvo, Mombiela, Camps, Bresme, Cano, Fernandez, Carcelen, Solà, Caro, Matavacas, Casasas, Bolado, Castanedo, Cortina, Cerdeña, Jane, Abella, Borrego, Laia Collado, Orri, Colom, Vilanova, Comellas, Sole, Conillera, Torres, Cots, Estepa, Cuchi, de Sostoa Graell, Marc, del Rio Lopez, Laura, Compte, Delgado, Bueno, Diaz, Maneiro, Diaz, Lucia, Andrea, Palau, Domenech, Carme, M., Carasso, Duran, Javier, Pablo, Marquez, Duran, Abidi, El, Martin, Escoda, Casanovas, Esteve, Perez, Fernandez, Quintero, Ferre, Escobar, Flores, Abad, Fontcuberta, del Valle, Fortes, del Valle, Fortes, Luisa, Mª, Quesada, Franco, Maria, Sara, Romero, Franco, Teresa, Maria, Francisco, Gallego, Gala, Gamiz, Castañeda, Garcia, Rodriguez, Garcia, Gemma, Casajuana, Arroyo, Gomez, Girbau, Gomez, Fernandez, Gonzalez, Gonzalez, Gonzalez, Gonzalez, Gonzalez, Lopez, Gonzalez, Obeso, Gual, Blanco, Guerrero, Roca, Guillemas, Eudaldo, Guillermo, Hernandez, Sebastia, Covas, Homar, Alvarez, Hostench, Royo, Huerta, Barcelo, Ibañez, Cruz, Izquiero, Etxetxikia, Jaione Urdangarin, Gimenez, Juárez, Alami, Khlifi, Gasco, Laparra, Moreales, Lara, Arroyo, Las, de Jesus, Dulcenombre, Medina, Lasaosa, Lourdes, Maria, Cava, Lazaro, Berrar, Leon, Maturana, López, Ramirez, Lopez, Romero, López, Marco, Lorente, Martin, Lorenzo, Casals, Lozano, Nicola, Lujan, Diaz, Madrid, Antonio, Jose, Morales, Maria Teresa Peris, Clemente, Marti, Castaño, Martinez, Natanael, David, Gamez, Martinez, Gonzalez, Martinez, Quesada, Martinez, de la Cabeza, Maria, Fusté, Marzà, Lasheras, Melendo, Mestre, Miralles, Pastalle, Montserrat Puig, Vidal, Montserrate, Mellado, Mora, Ponce, Morales, Fornieles, Morell, Cabre, Morera, Vivet, Morera, Souza, Mundi, Quiles, Muñoz, Rosa, Navea, Iglesias, Neira, Asuncion, M, Manrique, Nuñez, Pilar, Mª, Martinez, Obiols, Reig, Pallares, Torres, Partegas, Berengueras, Pascual, Gamez, Perez, Oset, Perez, Restrepo, Perez, Alejandra, Maria, Yeste, Planas, Mangado, Planells, Minguillon, Pons, Carbonell, Puertas, Blanco, Quinteiro, Benavente, Rebollar, Fernandez, Recasens, Gomez, Reyes, del Carmen, Maria, Pou, Roca, Ferrer, Rodriguez, Franco, Rodriguez, Fuertes, Rodriguez, Muñoz, Rodriguez, Navarro, Rodriguez, Iniesta, Roig, Gracia, Romero, Brunet, Rovira, de Eugenio, Rovira, Baena, Rubio, Llorens, Ruiz, Llamazares, Sala, Alaez, San Juan, Segura, Sanchez, Soldevilla, Santasusana, Salmeron, Sanz, Perez, Segura, Balcells, Serra, Dumitras, Sorina, Montoya, Teixidor, Vicente, Tena, Salinas, Tierno, Ines, Ester, Testa, Toledo, Figueras, Tomàs, Ruperez, Tomas, Garcia-Penche, Torrano, Esparza, Torres, Blanco, Vazquez, De la Paz, Vazquez, Gil, Vazquez, Gonzalez, Vazquez, Meler, Vidal, Cots, Vilalta, Jimenez, Vilches, Jose, Maria, Fernandez, Visser, Gavin, Viu, Vives, Vives, Jimenez, Carmona, Jose, Francisco, Vilches, Galobardes, Gomez, Gonzalez, Manzanera, Jodar, Cortes, Marimon, Orive, Marrodan, Bosch, Martin, Jose, Maria, Lopez, Martorell, Roca, Millares, Jesus, M, Guri, Miralles, Hernandez, Muliterno, Oliva, Muñoz, Pujol, Pons, Conde, Postius, Arruñada, Prieto, Antonio, Jose, Mathé, Quintana, Mata, Rosell, Alvarez, Aguirre, Alvarez, Alvarin, Flores, Arrufat, Pago, Bañuelos, Andreu, Burnat, Vilar, Campo, Hidalgo, Cardus, Gil, Castello, Gloria, Maria, Montsesinos, Castrillo, Estopà, Català, Garces, Clave, Sanroma, Comes, Sequi, Descalzo, Ricol, Errando, Campillo, Escudero, del Mar, Maria, Alvarez, Fernandez, Gomez, Fernandez, Perez, Fernandez, Espinosa, Franch, Graells, Freixes, Plaza, Garcia, Gallego, Garcia-Marron, Simancas, Hernandez, Covas, Homar, Royo, Huerta, Armas, Jaraba, Ramos, Jimenez, Canela, Lopez, Angeles, M, Lopez, Lopez, Oganissian, Lopez, Romero, Madrona, Rosa, M, Millan, Martinez, Morón, Martínez, Encinas, Merchan, Fornieles, Morell, Jimenez, Moreno, Rico, Muñoz, Rodriguez, Navarro, Ibañez, Nogales, Maria, Rita, Viera, Novillo, Torrabadella, Parella, Alba, Mari, Villar, Pera, Montserrat, Carla, Carbonell, Puertas, Miralles, Rabella, Trilles, Ramis, Ortiz, Ribera, Fuertes, Rodriguez, Gonzalez, Sanchez, Perez, Sastre, Perez, Segura, Borrega, Soro, Garcia, Soto, Angeles, Maria, Fores, Tapia, Bernad, Tellez, Alvarez, Trenado, Moreda, Español, Martin, Felix, Perez, Herrero, Manzanera, Jodar, Fuster, Lanau, Gomariz, Lopez, Orive, Marrodan, Bosch, Martin, Jose, Maria, Guri, Miralles, Oliva, Muñoz, Lozano, Pardo, Pujol, Pons, Altimiras, Quintana, Lopez, Ventosa, Damian, Almodovar, Colino, Alvarez, Monterroso, Alvarez, Comas, Arambudo, Garzon, Boullon, Capella, Burgos, Garcia, Campuzano, Del Mar, Maria, Olivas, Capdevila, Fernandez, Carcelen, Solà, Caro, Marti, Carre, Isabel, Clara, Bacaicoa, Carretero, Gil, Castello, Gloria, Maria, Montsesinos, Castrillo, Calderon, Cazorla, Osuna, Chacon, Planas, Cortes, Olio, Cortit, Estany, Delhomme, Carasso, Duran, Javier, Pablo, Campillo, Escudero, del Mar, Maria, Martinez, Fructuos, Lopez, Garcia, Luis, Pascual, Plaza, Garcia, Vallve, Genis Amill, Arroyo, Gomez, Girbau, Gomez, Muñoz, Gonzalez, Ventura, Hernaez, Covas, Homar, Gimenez, Lavernia, Rojo, Martin, Medina, Martínez, Millan, Martinez, Barrera, Mayol, Pi, Mercader, Dalmau, Merino, Campodarbe, Miguel, Pastalle, Montserrat Puig, de la Cruz, Morales, Fornieles, Morell, Sanchez, Moreno, Javier, Francisco, Reig, Pallares, Torrabadella, Parella, Alba, Mari, Barrameda, Penela, Ajenjo, Prieto, Benavente, Rebollar, Pareja, Rodriguez, Piñar, Rodríguez, Javier, Francisco, Tello, Rodriguez, Pereda, Romero, Saborido, Sainz, Martin, Santacana, Martinez, Santos, Chavez, Sierra, Testa, Toledo, Figueras, Tomàs, Garcia, Torres, José, Pedro, Torres, Turbau, Domenech, Vicente, Esteo, Villena, Pertegaz, Vives, Gonzalez, Baena, Pont, Bagaria, Sanchez, Beltran, Alarcon, Bonet, Ballescà, Borch, Clanchet, Buhils, Garcia, Closa, Carril, Colomina, Sanchez, Cristina Fernandez, Toledo, Edurne Judith Fernandez, Rodriguez, Espases, Resa, Espert, Xavier, F, Sol, Fernández, Lugo, Gonzalez, Llesera, Gracia, Lendinez, Herrada, Liesa, Juliench, Alicia, Sandra, Ortega, Lopez, Yuste, Lopez, Villanueva, Lozano, Soto, Lucia Sola, Castellano, Madrid, Cano, Megias, Jesus, Daniel, Ponce, Montasell, Sospedra, Montesinos, Martinez, Moya, Herrera, Muñoz, Isabel, M, Fernandez, Ocaña, Jose, Maria, Bernal, Palau, Sole, Perez, Carbonell, Ramon, Lop, Ribas, López, Rubio, Lopez, Rueda, Castaño, Sabat, Lara, Sabata, Ramírez, Salmerón, Gornals, Sebastia, Creus, Serra, Dalmau, Serrano, Mainero, Sumasi, Gabriel, Gonzalo, Masa, Torello, Primo, Valencia, Muñoz, Ana Maria Viñuales, Roig, Josep, and Hidalgo, Verònica

Published
2023
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4. Clinical improvement within 24 hours from mechanical thrombectomy as a predictor of long-term functional outcome in a multicenter population-based cohort of patients with ischemic stroke

Author

Rudilosso, Salvatore, Laredo, Carlos, Amaro, Sergio, Renú, Arturo, Llull, Laura, Obach, Víctor, Moreno, Javier, Ribó, Marc, Abilleira, Sònia, Cardona, Pedro, Martí-Fàbregas, Joan, Pérez de la Ossa, Natalia, Ramos, Anna, Roquer, Jaume, Serena, Joaquín, Purroy, Francisco, Urra, Xabier, and Chamorro, Ángel

Abstract

BackgroundSingle-center studies have suggested that the early clinical course after mechanical thrombectomy (MT) in patients with ischemic stroke is a clinical predictor of long-term outcome.ObjectiveTo analyze the prognostic value of clinical improvement within 24 hours in a population-based multicenter cohort.MethodsFrom a total of 3792 patients with acute ischemic stroke in Catalonia (CICAT registry), 1951 patients were treated with MT. The National Institutes of Health Stroke Scale (NIHSS) score within 24 hours, and follow-up was available in 1666 patients. Percentage variation in the NIHSS score was calculated in relation to a baseline assessment. Good outcome was defined as a modified Rankin Scale score ≤2 at 90 days. Predictive values of clinical improvement and adjusted OR to predict good outcomes were assessed in the whole cohort and the subgroup of patients with posterior circulation stroke (n=166).ResultsGood outcome was achieved in 656/1666 patients (39%) overall. Percentage improvements both at the end of MT and at 24 hours predicted good outcome, with higher predictive capacity at 24 hours (C-statistic, 0.85 vs 0.73, p<0.001). Positive and negative predictive values were 70% and 74% for the >30% cut-off point at the end of MT, and 69% and 84% for the >50% cut-off point at 24 hours, respectively. The adjusted OR for good outcome was 5.8 (95% CI 4.2 to 8.1) and 12.9 (95% CI 9.7 to 17.1), respectively. In patients with posterior circulation stroke, the predictive value of the improvement at 24 hours was similar (C-statistic 0.90).ConclusionClinical improvement of patients within 24 hours of MT is a reliable and robust predictor of long-term prognosis, including patients with posterior circulation occlusions.

Published
2021
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5. Characterization of epidermal growth factor receptor (EGFR) P848L, an unusual EGFR variant present in lung cancer patients, in a murine Ba/F3 model.

Author

Sarcar, Bhaswati, Gimbrone, Nicholas T., Wright, Gabriela, Remsing Rix, Lily L., Gordian, Edna R., Rix, Uwe, Chiappori, Alberto A., Reuther, Gary W., Santiago‐Cardona, Pedro G., Muñoz‐Antonia, Teresita, and Cress, William Douglas

Subjects
EPIDERMAL growth factor receptors, LUNG cancer, CANCER patients, PROTEIN-tyrosine kinases, OTOLITHS, KINASE inhibitors
Abstract

Lung cancer patients with mutations in epidermal growth factor receptor (EGFR) benefit from treatments targeting tyrosine kinase inhibitors (TKIs). However, both intrinsic and acquired resistance of tumors to TKIs are common, and EGFR variants have been identified that are resistant to multiple TKIs. In the present study, we characterized selected EGFR variants previously observed in lung cancer patients and expressed in a murine bone marrow pro‐B Ba/F3 cell model. Among these EGFR variants, we report that an exon 20 deletion/insertion mutation S768insVGH is resistant to erlotinib (a first‐generation TKI), but sensitive to osimertinib (a third‐generation TKI). We also characterized a rare exon 21 germline variant, EGFR P848L, which transformed Ba/F3 cells and conferred resistance to multiple EGFR‐targeting TKIs. Our analysis revealed that P848L (a) does not bind erlotinib; (b) is turned over less rapidly than L858R (a common tumor‐derived EGFR mutation); (c) is not autophosphorylated at Tyr 1045 [the major docking site for Cbl proto‐oncogene (c‐Cbl) binding]; and (d) does not bind c‐Cbl. Using viability assays including 300 clinically relevant targeted compounds, we observed that Ba/F3 cells transduced with EGFR P848L, S768insVGH, or L858R have very different drug‐sensitivity profiles. In particular, EGFR P848L, but not L858R or S768insVGH, was sensitive to multiple Janus kinase 1/2 inhibitors. In contrast, cells driven by L858R, but not by P848L, were sensitive to multikinase MAPK/extracellular‐signal‐regulated kinase (ERK) kinase and ERK inhibitors including EGFR‐specific TKIs. These observations suggest that continued investigation of rare TKI‐resistant EGFR variants is warranted to identify optimal treatments for cancer. [ABSTRACT FROM AUTHOR]

Published
2019
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6. An injectable implant to stimulate the sphenopalatine ganglion for treatment of acute ischaemic stroke up to 24 h from onset (ImpACT-24B): an international, randomised, double-blind, sham-controlled, pivotal trial

Author

Bornstein, Natan M, Saver, Jeffrey L, Diener, Hans Christoph, Gorelick, Philip B, Shuaib, Ashfaq, Solberg, Yoram, Thackeray, Lisa, Savic, Milan, Janelidze, Tamar, Zarqua, Natia, Yarnitsky, David, Molina, Carlos A, Shuaib, Ashfaq, Hill, Michael, Vaclavik, Daniel, Skoloudik, David, Fiksa, Jan, Andersen, Grethe, Jakala, Pekka, Tatlisumak, Turgut, Kuzmanovski, Igor, Guillon, Benoit, Chabriat, Hugues, Mahagne, Marie Helene, Timsit, Serge, Ronziere, Thomas, Ingorokva, Gocha, Beridze, Maya, Beridze, Mzia, Zarqua, Natia, Kharaishvili, Nino, Kakabadze, Nodar, Janelidze, Tamar, Griewing, Bernd, Hobohm, Carsten, Schneider, Dietmar, Weimar, Christian, Poppert, Holger, Kimmig, Hubert, Berrouschot, Joerg, Ringleb, Peter, Schwab, Stefan, Kohrmann, Martin, Kallmunzer, Bernd, Kollmar, Rainer, Endres, Matthias, Hausler, Karl-Georg, Cheung, Raymond, Wai Hong Leung, Thomas, Dorodnicov, Elena, Halevi, Hen, Auriel, Eitan, Streifler, Jonathan, Leker, Ronen, Schwammenthal, Yvonne, Toni, Danilo, Agnelli, Giancarlo, Caso, Valeria, Słowik, Agnieszka, Czlonkowska, Anna, Lubinski, Ignacy, Kochanowicz, Jan, Sobolewski, Piotr, Brola, Waldemar, Salgado, Antonio Vasco, Correia, Carlos, Azevedo, Elsa, Roriz, Jose, Zarkov, Marija, Savic, Milan, Petrovic, Zarko, Krastev, Georgi, Dvorak, Miloslav, Rodriguez Campello, Ana, Nunez, Antonio Gil, Molina, Carlos, Purroy, Francisco, Marti-Fabregas, Joan, Arenillas, Juan, Alonso, Maria, Cardona, Pedro, Blanco Gonzalez, Miguel, Tur, Silvia, Segura Martin, Tomas, Anzhelika, Payenok, Shownkeen, Harish, Concha, Mauricio, Sethi, Pramod, Sen, Souvik, Zaidi, Syed, Zaidi, Syed, and Devlin, Thomas

Abstract

Sphenopalatine ganglion stimulation increased cerebral collateral blood flow, stabilised the blood–brain barrier, and reduced infarct size, in preclinical models of acute ischaemic stroke, and showed potential benefit in a pilot randomised trial in humans. The pivotal ImpACT-24B trial aimed to determine whether sphenopalatine ganglion stimulation 8–24 h after acute ischaemic stroke improved functional outcome.

Published
2019
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7. Revalidation of the RACE scale after its regional implementation in Catalonia: a triage tool for large vessel occlusion

Author

Carrera, David, Gorchs, Montse, Querol, Marisol, Abilleira, Sònia, Ribó, Marc, Millán, Mònica, Ramos, Anna, Cardona, Pedro, Urra, Xabier, Rodríguez-Campello, Ana, Prats-Sánchez, Luis, Purroy, Francisco, Serena, Joaquín, Cánovas, David, Zaragoza-Brunet, Josep, Krupinski, Jerzy A, Ustrell, Xavier, Saura, Júlia, García, Sonia, Mora, Maria Àngela, Jiménez, Xavier, Dávalos, Antoni, and Pérez de la Ossa, Natalia

Abstract

Background and purposeOur aim was to revalidate the RACE scale, a prehospital tool that aims to identify patients with large vessel occlusion (LVO), after its region-wide implementation in Catalonia, and to analyze geographical differences in access to endovascular treatment (EVT).MethodsWe used data from the prospective CICAT registry (Stroke Code Catalan registry) that includes all stroke code activations. The RACE score evaluated by emergency medical services, time metrics, final diagnosis, presence of LVO, and type of revascularization treatment were registered. Sensitivity, specificity, and area under the curve (AUC) for the RACE cut-off value ≥5 for identification of both LVO and eligibility for EVT were calculated. We compared the rate of EVT and time to EVT of patients transferred from referral centers compared with those directly presenting to comprehensive stroke centers (CSC).ResultsThe RACE scale was evaluated in the field in 1822 patients, showing a strong correlation with the subsequent in-hospital evaluation of the National Institute of Health Stroke Scale evaluated at hospital (r=0.74, P<0.001). A RACE score ≥5 detected LVO with a sensitivity 0.84 and specificity 0.60 (AUC 0.77). Patients with RACE ≥5 harbored a LVO and received EVT more frequently than RACE <5 patients (LVO 35% vs 6%; EVT 20% vs 6%; all P<0.001). Direct admission at a CSC was independently associated with higher odds of receiving EVT compared with admission at a referral center (OR 2.40; 95% CI 1.66 to 3.46), and symtoms onset to groin puncture was 133 min shorter.ConclusionsThis large validation study confirms RACE accuracy to identify stroke patients eligible for EVT, and provides evidence of geographical imbalances in the access to EVT to the detriment of patients located in remote areas.

Published
2019
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8. Blood Biomarkers for the Early Diagnosis of Stroke: The Stroke-Chip Study.

Author

Bustamante, Alejandro, López-Cancio, Elena, Pich, Sara, Penalba, Anna, Giralt, Dolors, García-Berrocoso, Teresa, Ferrer-Costa, Carles, Gasull, Teresa, Hernández-Pérez, María, Millan, Mónica, Rubiera, Marta, Cardona, Pedro, Cano, Luis, Quesada, Helena, Terceño, Mikel, Silva, Yolanda, Castellanos, Mar, Garces, Moisés, Reverté, Silvia, and Ustrell, Xavier

Published
2017
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9. Vessel Patency at 24 Hours and Its Relationship With Clinical Outcomes and Infarct Volume in REVASCAT Trial (Randomized Trial of Revascularization With Solitaire FR Device Versus Best Medical Therapy in the Treatment of Acute Stroke Due to Anterior...

Author

Millán, Mònica, Remollo, Sebastià, Quesada, Helena, Renú, Arturo, Tomasello, Alejandro, Minhas, Priyanka, de la Ossa, Natalia Pérez, Rubiera, Marta, Llull, Laura, Cardona, Pedro, Al-Ajlan, Fahad, Hernández, María, Assis, Zarina, Demchuk, Andrew M., Jovin, Tudor, Dávalos, Antoni, REVASCAT Trial Investigators, and Pérez de la Ossa, Natalia

Published
2017
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10. Outcomes After Direct Thrombectomy or Combined Intravenous and Endovascular Treatment Are Not Different.

Author

Abilleira, Sònia, Ribera, Aida, Cardona, Pedro, Rubiera, Marta, López-Cancio, Elena, Amaro, Sergi, Rodríguez-Campello, Ana, Cánovas, David, de Miquel, Maria Angels, Tomasello, Alejandro, Remollo, Sebastian, López-Rueda, Antonio, Vivas, Elio, Perendreu, Joan, Gallofré, Miquel, Camps-Renom, Pol, and Catalan Stroke Code and Reperfusion Consortium

Published
2017
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11. Somatic Mutations and Ancestry Markers in Hispanic Lung Cancer Patients

Author

Gimbrone, Nicholas T., Sarcar, Bhaswati, Gordian, Edna R., Rivera, Jason I., Lopez, Christian, Yoder, Sean J., Teer, Jamie K., Welsh, Eric A., Chiappori, Alberto A., Schabath, Matthew B., Reuther, Gary W., Dutil, Julie, Garcia, Miosotis, Ventosilla-Villanueva, Ronald, Vera-Valdivia, Luis, Yabar-Berrocal, Alejandro, Motta-Guerrero, Rodrigo, Santiago-Cardona, Pedro G., Muñoz-Antonia, Teresita, and Cress, W. Douglas

Abstract

To address the lack of genomic data from Hispanic/Latino (H/L) patients with lung cancer, the Latino Lung Cancer Registry was established to collect patient data and biospecimens from H/L patients.

Published
2017
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12. Blood Biomarkers for the Early Diagnosis of Stroke

Author

Bustamante, Alejandro, López-Cancio, Elena, Pich, Sara, Penalba, Anna, Giralt, Dolors, García-Berrocoso, Teresa, Ferrer-Costa, Carles, Gasull, Teresa, Hernández-Pérez, María, Millan, Mónica, Rubiera, Marta, Cardona, Pedro, Cano, Luis, Quesada, Helena, Terceño, Mikel, Silva, Yolanda, Castellanos, Mar, Garces, Moisés, Reverté, Silvia, Ustrell, Xavier, Marés, Rafael, Baiges, Joan Josep, Serena, Joaquín, Rubio, Francisco, Salas, Eduardo, Dávalos, Antoni, and Montaner, Joan

Abstract

Supplemental Digital Content is available in the text.

Published
2017
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13. Cross-situational word learning in aphasia

Author

Peñaloza, Claudia, Mirman, Daniel, Cardona, Pedro, Juncadella, Montserrat, Martin, Nadine, Laine, Matti, and Rodríguez-Fornells, Antoni

Abstract

Human learners can resolve referential ambiguity and discover the relationships between words and meanings through a cross-situational learning (CSL) strategy. Some people with aphasia (PWA) can learn word-referent pairings under referential uncertainty supported by online feedback. However, it remains unknown whether PWA can learn new words cross-situationally and if such learning ability is supported by statistical learning (SL) mechanisms. The present study examined whether PWA can learn novel word-referent mappings in a CSL task without feedback. We also studied whether CSL is related to SL in PWA and neurologically healthy individuals. We further examined whether aphasia severity, phonological processing and verbal short-term memory (STM) predict CSL in aphasia, and also whether individual differences in verbal STM modulate CSL in healthy older adults. Sixteen people with chronic aphasia underwent a CSL task that involved exposure to a series of individually ambiguous learning trials and a SL task that taps speech segmentation. Their learning ability was compared to 18 older controls and 39 young adults recruited for task validation. CSL in the aphasia group was below the older controls and young adults and took place at a slower rate. Importantly, we found a strong association between SL and CSL performance in all three groups. CSL was modulated by aphasia severity in the aphasia group, and by verbal STM capacity in the older controls. Our findings indicate that some PWA can preserve the ability to learn new word-referent associations cross-situationally. We suggest that both PWA and neurologically intact individuals may rely on SL mechanisms to achieve CSL and that verbal STM also influences CSL. These findings contribute to the ongoing debate on the cognitive mechanisms underlying this learning ability.

Published
2017
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14. Vessel Patency at 24 Hours and Its Relationship With Clinical Outcomes and Infarct Volume in REVASCAT Trial (Randomized Trial of Revascularization With Solitaire FR Device Versus Best Medical Therapy in the Treatment of Acute Stroke Due to Anterior Circulation Large Vessel Occlusion Presenting Within Eight Hours of Symptom Onset)

Author

Millán, Mònica, Remollo, Sebastià, Quesada, Helena, Renú, Arturo, Tomasello, Alejandro, Minhas, Priyanka, Pérez de la Ossa, Natalia, Rubiera, Marta, Llull, Laura, Cardona, Pedro, Al-Ajlan, Fahad, Hernández, María, Assis, Zarina, Demchuk, Andrew M., Jovin, Tudor, and Dávalos, Antoni

Published
2017
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15. Outcomes After Direct Thrombectomy or Combined Intravenous and Endovascular Treatment Are Not Different

Author

Abilleira, Sònia, Ribera, Aida, Cardona, Pedro, Rubiera, Marta, López-Cancio, Elena, Amaro, Sergi, Rodríguez-Campello, Ana, Camps-Renom, Pol, Cánovas, David, de Miquel, Maria Angels, Tomasello, Alejandro, Remollo, Sebastian, López-Rueda, Antonio, Vivas, Elio, Perendreu, Joan, Gallofré, Miquel, Martí-Fàbregas, J., Delgado-Mederos, R., Martínez-Domeño, A., Marín, R., Roquer, J., Ois, Á., Jiménez-Conde, J., Guimaraens, L., Chamorro, Á., Obach, V., Urra, X., Macho, J.M., Blasco, J., San Roman, L., Martínez-Yélamos, A., Quesada, H., Lara, B, Cayuela, N., Aja, L., Mora, P., Molina, C., Ribó, M., Pagola, J., Rodríguez-Luna, D., Muchada, M., Coscojuela, P., Dávalos, A., Millán, M., Pérez de la Ossa, N., Gomis, M., Dorado, L., Castaño, C., Garcia, M.C., Estela, J., Krupinski, J., Huertas-Folch, S., Nicolás-Herrerias, M.C., Gómez-Choco, M., García, S., Martínez, R., Sanahuja, J., Purroy, F., Serena, J., Castellanos, M., Silva, Y., Marés, R., Pellisé, A., Ustrell, X., Baiges, J.J., Garcés, M., Saura, J., Soler-Insa, J.M., Aragonés, J.M., Cocho, D., and Palomeras, E.

Abstract

Supplemental Digital Content is available in the text.

Published
2017
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16. Abstract WP4: Intravenous Thrombolysis And Outcomes In Patients With Large-vessel Stroke Directly Admitted Or Transferred To A Thrombectomy-capable Center

Author

Garcia-Tornel Garcia-Camba, Alvaro, Lozano, Prudencio, Requena, Manuel, Rodriguez-Luna, David, Rodriguez-Villatoro, Noelia, Rubiera, Marta, Muchada, Marian, Olive-Gadea, Marta, Rizzo, Federica, boned, sandra, Ribo, Marc, Molina, Carlos A, Pagola, Jorge, Juega, Jesús, Dorado, Laura, Jimenez-Fabrega, Xavier, Cardona, Pedro, Urra, Xabier, Purroy, Francisco, Terceño, Mikel, Flores, Alan F, Chamorro, Angel, Silva, Yolanda, Ustrell, Xavier, Zaragoza, Jose, Roquer, Jaime, Krupinski, Jerzy, Cocho, Dolores, Palomeras, Ernest, Gomez-Choco, Manuel J, Canovas, David, Martí-Fàbregas, Joan, Mas, Natalia, Fagundez, Olga, Abilleira, Sonia, Molina, Carlos A, and Perez de la Ossa, Natalia

Abstract

Objective:To assess whether the effect of intravenous thrombolysis in patients with large-vessel occlusion differed between patients directly admitted to thrombectomy-capable centers and patients transferred from local stroke centers without thrombectomy capabilities.Methods:We included 3206 patients with an acute ischemic large-vessel stroke with first imaging within 7 hours after onset that were directly admitted to thrombectomy-capable centers and treated with thrombectomy, or transferred from local stroke centers for thrombectomy evaluation, between 2017 and 2021 in Catalonia, Spain. Primary outcome was the degree of disability at 90 days, as evaluated by the shift analysis on the mRs score. Secondary outcomes included mortality at 90 days and the rate of parenchymal hemorrhage and successful reperfusion. Inverse-probability weighting clustered at the type of stroke center was used to estimate the effects.Results:The analysis included 2268 patients (975[49%] treated with thrombolysis) directly admitted to thrombectomy-capable centers and 938 patients (580[66%] treated with thrombolysis and 616[67%] treated with thrombectomy) transferred from local stroke centers (mean age 72±13 years, median NIHSS score 17[IQR 12-21], 1363 female[48%]). Patients treated with intravenous thrombolysis were younger, had shorter time from onset to first image acquisition, and higher rates of wake-up stroke, atrial fibrillation and anticoagulation intake. The effect of intravenous thrombolysis on the primary outcome was similar in patients directly admitted to thrombectomy-capable centers (acOR 1.50, 95% CI 1.24-1.81) and patients transferred from local stroke centers (acOR 1.44, 95% CI 1.04 to 2.01)(pinteraction=0.68). Patients treated with intravenous thrombolysis had lower mortality rate, higher rate of parenchymal hematoma and similar rate of successful reperfusion, with no difference according to type of center (pinteraction>0.1).Conclusion:Administration of intravenous thrombolysis in patients with a large-vessel stroke with intention to thrombectomy was associated with higher odds of good functional outcome and higher rates of parenchymal hematoma, independently of the type of stroke center were it was administered.

Published
2023
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17. Abstract 95: High Proportion Of Granulocytes Form Intracranial Thrombus Is Associated With Increased Stiffness And Resistance To Endovascular Recanalization

Author

Juega, Jesus, Li, Jiahui, Palacio, Carlos, Rodriguez, Maite, Tiberi, Ricardo, Pinana Plaza, Carlos, Rodriguez-Luna, David, Requena, Manuel, Garcia-Tornel Garcia, Alvaro, Rodriguez-Villatoro, Noelia, Rubiera, Marta, Muchada, Marian, Olive-Gadea, Marta, Rizzo, Federica, Hernandez Morales, David, de Dios Lascuevas, Marta, Lozano, Prudencio, boned, sandra, Hernandez-Perez, Maria, Dorado, Laura, Quesada, Helena, Cardona, Pedro, de la Torre, Carolina, Gallur, LAura, Camacho, Jessica, Ramon y Cajal, Santiago, Tomasello, Alejandro, Ribo, Marc, Molina, Carlos A, and Pagola, Jorge

Abstract

Hypothesis:We aim to identify a profile of intracranial thrombus resistant to recanalization by standard mechanical thrombectomy (MT) in acute stroke treatment.Methods:First extracted clot of each MT were analyzed by Flow Cytometry obtaining composition of main leukocyte populations: granulocytes, monocytes and lymphocytes. Demographics, reperfusion treatment and grade of recanalization were registered. MT Failure ( MTF) was defined as final Thrombolysis in Cerebral Infarction score IIa or lower and/ or need of permanent intracranial stenting as a rescue therapy after standard MT. In other cohort of cases, unconfined compression tests were performed to explore stiffness of retrieved clots . We looked for correlation between mechanical characterization tests and clot composition.Results:Among 225 patients, there were 13 % of MTF that were significantly associated to atherosclerosis etiology ( 33.3% vs. 15.9% ; p 0.021) , more passes ( 3 vs. 2; p <0.001), higher proportion of clot granulocytes ( 82.46% vs. 68.90% ; p <0.001) and lower proportion of clot monocytes ( 9.18% vs.17.34% ; p<0.001). The proportion of clot granulocytes (aOR 1.07; 95% CI 1.01-1.14) remained as an independent marker of MTF. Among Thirty eight clots tested by unconfined compression median clot stiffness was 30.2 (IQR, 18.9-42.7) kPa. There was a positive correlation between granulocyte proportion and thrombi stiffness (Pearson’s r=0.35, p=0.032).Conclusions:There is a positive correlation between granulocyte proportion and thrombi stiffness that may explain endovascular resistance to recanalization. Influence of granulocytes within thrombus may be a target for future reperfusion treatments.

Published
2023
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18. Novel word acquisition in aphasia: Facing the word-referent ambiguity of natural language learning contexts

Author

Peñaloza, Claudia, Mirman, Daniel, Tuomiranta, Leena, Benetello, Annalisa, Heikius, Ida-Maria, Järvinen, Sonja, Majos, Maria C., Cardona, Pedro, Juncadella, Montserrat, Laine, Matti, Martin, Nadine, and Rodríguez-Fornells, Antoni

Abstract

Recent research suggests that some people with aphasia preserve some ability to learn novel words and to retain them in the long-term. However, this novel word learning ability has been studied only in the context of single word-picture pairings. We examined the ability of people with chronic aphasia to learn novel words using a paradigm that presents new word forms together with a limited set of different possible visual referents and requires the identification of the correct word-object associations on the basis of online feedback. We also studied the relationship between word learning ability and aphasia severity, word processing abilities, and verbal short-term memory (STM). We further examined the influence of gross lesion location on new word learning. The word learning task was first validated with a group of forty-five young adults. Fourteen participants with chronic aphasia were administered the task and underwent tests of immediate and long-term recognition memory at 1 week. Their performance was compared to that of a group of fourteen matched controls using growth curve analysis. The learning curve and recognition performance of the aphasia group was significantly below the matched control group, although above-chance recognition performance and case-by-case analyses indicated that some participants with aphasia had learned the correct word-referent mappings. Verbal STM but not word processing abilities predicted word learning ability after controlling for aphasia severity. Importantly, participants with lesions in the left frontal cortex performed significantly worse than participants with lesions that spared the left frontal region both during word learning and on the recognition tests. Our findings indicate that some people with aphasia can preserve the ability to learn a small novel lexicon in an ambiguous word-referent context. This learning and recognition memory ability was associated with verbal STM capacity, aphasia severity and the integrity of the left inferior frontal region.

Published
2016
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19. Oscillating transcranial Doppler patterns of brain death associated with therapeutic maneuvers.

Author

Cardona, Pedro, Quesada, Helena, Cano, Luis, Campelacreu, Jaume, Escrig, Anna, Mora, Paloma, and Rubio, Francisco

Subjects
TRANSCRANIAL Doppler ultrasonography, BRAIN death, INTRACRANIAL pressure, CEREBRAL circulation, DISEASE progression, CEREBRAL hemorrhage
Abstract

Summary: Background: Transcranial Doppler (TCD) is a specific test for brain death diagnosis. Several Doppler patterns could change slightly during an increase of intracranial pressure related to mass effect. Methods: We present two patients with a clinical diagnosis of brain death after massive brain hemorrhage. A Doppler pattern of reverse flow with small diastolic positive flow in both middle cerebral arteries and basilar arteries was observed in both cases. Results: TCD was repeated 6h later, showing an increase of systolic and diastolic flow associated with high intracranial pressure (ICP) in the first patient and a decrease of ICP in the second patient associated with polyuria. Transient improvements of blood cerebral flow could be related to the use of adrenergic drugs or the use of osmotic drugs to decrease ICP. Finally the patients showed a pattern of low spikes that led to the diagnosis of cerebrovascular arrest and brain death. Conclusions: Therapeutics drugs to decrease ICP and several physiological processes can change several patterns of TCD associated with progression of brain death. [ABSTRACT FROM AUTHOR]

Published
2012
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20. The Role of Vascular Imaging atReferral Centers in the Drip and Ship Paradigm.

Author

Flores, Alan, Seró, Laia, Gomez-Choco, Manuel, Ustrell, Xavier, Pellisé, Anna, Viñas, Jaume, Rodriguez, Paula, Monterde, Angela, Castilho, Gislaine, Rubiera, Marta, Amaro, Sergi, Padrós, Maria Angels Font, Cardona, Pedro, Marti-Fabregas, Joan, Molina, Carlos A., Serena, Joaquín, Jimenez-Fábrega, Francesc Xavier, Purroy, Francisco, Zaragoza-Brunet, José, and Cocho, Dolores

Abstract

Background: In drip-and-ship protocols, non-invasive vascular imaging (NIVI) at Referral Centers (RC), although recommended, is not consistently performed and its value is uncertain. We evaluated the role of NIVI at RC, comparing patients with (VI+) and without (VI-) vascular imaging in several outcomes.Methods: Observational, multicenter study from a prospective government-mandated population-based registry of code stroke patients. We selected acute ischemic stroke patients, initially assessed at RC from January-2016 to June-2020. We compared and analyzed the rates of patients transferred to a Comprehensive Stroke Center (CSC) for Endovascular Treatment (EVT), rates of EVT and workflow times between VI+ and VI- patients.Results: From 5128 ischemic code stroke patients admitted at RC; 3067 (59.8%) were VI+, 1822 (35.5%) were secondarily transferred to a CSC and 600 (11.7%) received EVT. Among all patients with severe stroke (NIHSS ≥16) at RC, a multivariate analysis showed that lower age, thrombolytic treatment, and VI+ (OR:1.479, CI95%: 1.117-1.960, p=0.006) were independent factors associated to EVT. The rate of secondary transfer to a CSC was lower in VI+ group (24.6% vs. 51.6%, p<0.001). Among transferred patients, EVT was more frequent in VI+ than VI- (48.6% vs. 21.7%, p<0.001). Interval times as door-in door-out (median-minutes 83.5 vs. 82, p= 0.13) and RC-Door to puncture (median-minutes 189 vs. 178, p= 0.47) did not show differences between both groups.Conclusion: In the present study, NIVI at RC improves selection for EVT, and is associated with receiving EVT in severe stroke patients. Time-metrics related to drip-and-ship model were not affected by NIVI. [ABSTRACT FROM AUTHOR]

Published
2022
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21. Abstract 138: Thrombus Composition Is Associated With First Pass Recanalization

Author

Juega, Jesus, Palacio, Carlos, Piñana, Carlos, Rodriguez, Maite, deck, matias, Moline, Teresa, Camacho, Jessica, Cardona, Pedro, QUESADA, HELENA, Hernandez-Perez, Maria, Dorado, Laura, Requena, Manuel, Alvaro, Garcia-Tornel, Rodriguez-villatoro, Noelia, Olive, Marta, boned, sandra, Muchada, Marian, Lozano, Prudencio, Li, Jiahui, Rubiera, Marta, tomasello, alejandro, Hernandez, David, DE Dios, Marta, Ramon y Cajal, Santiago, Ribo, Marc, Sabin, Jose A, Molina, Carlos A, and PAGOLA, JORGE

Abstract

Introduction:Our objective is to identify thrombus composition associated with first pass recanalization (FPR) in mechanical thrombectomy (MT).Methods:Intracranial thrombi obtained in MT were divided in two equal parts. One part was analyzed with anatomopathological studies to quantify fibrin, red-blood cell( Hematoxilin & Eosin) and platelets( cd61 Immunohistochemical staining) , the other part was analyzed by flow cytometry to quantify leukocyte populations (granulocytes, lymphocytes and monocytes) and their relative proportions . FPR were defined as ≥ mTICI 2b after first pass in MT. Thrombi composition, baseline variables (demographics, previos use of antiplatelets or anticoagulants, blood pressure and blood glucose at hospital arrival ) etiology, intravenous fibrinolysis, ASPECTS score and first attempt thrombectomy devices: direct aspiration, stent retriever or combinations were compared between FPR and Non-FPR groups.Results:Fifty percent (38/76) of the cases analyzed obtained FPR. There were no differences in baseline variables , etiology, Aspects score, previous use of fibrinolysis or type of device used for MT. The thrombi obtained with FPR presented higher proportion of red blood cells (33.64% vs 18.16% p = 0.048) and lymphocytes (10.07% vs 4.43% p = 0.042) and lower proportion of platelets (61, 48% vs 67.26% p = 0.042) in comparison to non-FPR group. The proportion of platelets was an independent marker of FPR (OR 0.97; CI 0.95-0.99). There was an inverse correlation between the proportion of platelets and lymphocytes (rho -0.44, p <0.001).Conclusion:Platelets proportion in intracranial thrombus is an independent marker of first pass recanalization. Inverse relationship between lymphocytes and platelets may be a target for future reperfusion treatments

Published
2022
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22. Abstract TP255: Lymphocytes And Platelets In Extracted Thrombus May Indicate The Etiology Of The Thrombus. Results From The Itacat Multicentric Registry.

Author

Pagola, Jorge, Juega, Jesus, Camacho, Jessica, Dorado, Laura, Rodriguez, Maite, Hernandez-Perez, Maria, Quesada Garcia, Helena, Cardona, Pedro, de la Torre, Carolina, Deck, Matias, Garcia-Tornel, Alvaro, Requena, Manuel, Rubiera, Marta, Boned, Sandra, Muchada, Marian, Olive, Marta, Ribo, Marc, Piñana, Carlos, Hernandez, David, Rodriguez-luna, David, Rodriguez Villatoro, Noelia, SANJUAN, Estela, tomasello, alejandro, Alvarez Sabin, Jose, Ramon y Cajal, Santiago, and Molina, Carlos A

Abstract

Aim:We performed a histological and immune analysis of the clot in acute stroke patients to detect surrogates of stroke etiology.Methods:We conducted a prospective observational study of consecutive patients with acute stroke who underwent thrombectomy that obtained extracted thrombus (ITACAT study). Several staining were performed to evaluate red blood cells/fibrin (hematoxylin/eosin), platelets (CD61) and leucocytes (CD4, CD8 and CD20). All patients received CT angio to detect extra/intracranial vascular stenosis and 30-day cardiac monitoring to diagnose AF. According to TOAST classification the thrombi were classified in cardioembolic etiology CE (T-CE), due to symptomatic atherosclerosis (T-AT) and without any cause (T-CRYP). We excluded strokes due to double cause or incomplete workup.Results:Of the 117 patients: 30 were T-AT, 55 were T-CE and 32 were T-CRYP. T-AT patients were younger: T-AT 68 years (60-77) Vs. T-CE 75 years (68-80) Vs. T-CRYP 72 years (55-81) (p=0.034). T-AT group had higher percentage of CD4: T-AT 6.52% (4-13) Vs. T-CE (3.31% (12.9) Vs .T-CRYP 3.72% (1.5-12) (p=0.015) and lower percentage of CD61: T-AT 51.18% (34-68) Vs. CE 64.70% (19.56) Vs. CRYP 70.3% (19) (p=0.001). There were no correlation between CD4 and platelets. Both CD4 OR 1.05 (1-1.10) (p=0.020) and CD61 (OR 0.96 (0.94-0.98) (p=0.01) independently predicted T-AT from the age. Final analysis (n=400 cases) will be ended in September 2021.Conclusions:Patients with high percentage of CD4 and low percentage of CD61 are related to atherosclerosis etiology.

Published
2022
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23. Lipopolysaccharides induce intestinal serum amyloid A expression in the sea cucumber Holothuria glaberrima

Author

Santiago-Cardona, Pedro G., Berrı´os, Ce´sar A., Ramı´rez, Francisco, and Garcı´a-Arrara´s, Jose´ E.

Abstract

We have previously characterized the first invertebrate homolog of serum amyloid A (SAA) proteins in the sea cucumber Holothuria glaberrima , where its expression is associated with intestinal regeneration, suggesting a possible involvement of SAA proteins in intestinal morphogenesis. Here we show that bacterial lipopolysaccharides (LPS) trigger a coelomocyte-mediated immune response in H. glaberrima , inducing an approximately threefold increase in coelomocyte phagocytic activity. Furthermore, LPS induces an approximately fourfold increase in SAA mRNA levels in non-regenerating intestines. These results show that in H. glaberrima , LPS act as an immune activator and that SAA expression can be modulated by immune-associated processes.

Published
2002
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24. Transcranial and cervical duplex: A feasible approach to the diagnosis of pulsatile tinnitus.

Author

Cardona, Pedro, Quesada, Helena, Cano, Luis, Campdelacreu, Jaume, Escrig, Anna, Mora, Paloma, and Rubio, Francisco

Subjects
TRANSCRANIAL Doppler ultrasonography, DUPLEX ultrasonography, TINNITUS, CAROTID artery surgery, HEMODYNAMICS, ETIOLOGY of diseases, SYSTOLIC blood pressure, DIAGNOSIS
Abstract

Summary: Pulsatile tinnitus is an uncommon form of tinnitus. Several vascular causes, such as carotid dissection and arteriovenous fistulae, have been associated to pulsatile tinnitus. Methods: We present two patients who complained of pulsatile tinnitus and headache in the last 2weeks. Results: Transcranial Doppler demonstrated disturbances in systolic blood flow consisting of turbulences in the middle cerebral artery in one patient and disturbances in a vertebral artery in the other. MR and CT angiography confirmed the diagnosis of vertebrobasilar arteriovenous fistula. Daily compression maneuvers reduced the flow and bruit of both fistulas. Conclusions: Hemodynamic changes in cerebral flow through a non-invasive and feasible test such as TCD or duplex can be very useful for the etiological diagnosis of pulsatile tinnitus. [ABSTRACT FROM AUTHOR]

Published
2012
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25. Abstract 18: The Role of Vascular Imaging at Primary Stroke Centers in the Drip and Ship Paradigm

Author

Flores, Alan, Seró, Laia, Ustrell, Xavier, Pellisé, Anna, Gomez Choco, Manuel, Viñas, Jaume, Palomeras, Ernest, Krupinski, Jurek, Más, Natalia, Cocho, Dolores, Purroy, Francisco, Zaragoza-brunet, Jose, Cardona, Pedro, Serena, Joaquin, Ribó, Marc, Obach, Victor, Rubiera, Marta, and Perez de la Ossa, Natalia

Abstract

Background:In drip-and-ship protocols, vascular imaging at Primary Stroke Centers (PSC), although recommended, is not usually performed in many PSC, and its value is uncertain. Our aim was to evaluate the role of performing vascular imaging at PSC, comparing patients with vascular imaging at PSC (VI+) Vs. those without vascular imaging (VI-) in several outcomes.Methods:Observational, multicenter study from a prospective, government-mandated, population-based registry of ischemic stroke code patients firstly evaluated at a PSC from January-2016 to June-2020. We determined and compared rates of Mechanical Thrombectomy (MT) candidates transferred to CSC from all ischemic stroke codes at PSC, MT treated at CSC patients from all MT candidates transferred, and metrics related to drip-and-ship paradigm between VI + and VI- groups. A multivariate analysis to determine PSC related factors associated with receiving EVT at CSC was performed.Results:From 5792 ischemic stroke code patients at PSC, 3384 (58.4%) received a vascular imaging at PSC (VI+). Among all, 32.6% were transferred to CSC as MT candidates, and finally, 10.6% were treated with MT at CSC. The rate of transferred MT candidates was lower in the VI+ than VI- group (n: 783, 23.1% Vs. n: 1109, 46 %, p< 0.001). Among the transferred MT candidates, MT treatment at CSC was more common in the VI+ than VI- (n: 377, 48.1% Vs: n: 239, 21.5%, p<0.001). In patients transferred with baseline mild strokes (NIHSS <6), the rate of MT treated patients was higher in VI+ than VI- (n: 31, 29% Vs. n: 20, 7% p<0.001). Interval times as DIDO (median minutes 84 Vs. 81) and DTP time (188 Vs. 182) did not show differences between VI+ and VI-. In multivariate analysis adjusted by age, the independent factors associated to receiving MT at CSC were VI+ (OR: 2,128, CI95%:1,549-2,922, p<0.001), baseline NIHSS, and RACE scale.Conclusion:In the present study, performing vascular imaging at PSC diminishes unnecessary transfers to CSC and is associated with a higher probability of receiving MT at CSC in transferred patients. In mild strokes, performing a vascular imaging at PSC increases the probability of receiving MT at CSC. Metrics related to drip-and-ship model were not affected by performing a vascular imaging at PSC.

Published
2021
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26. Abstract P94: Stroke Etiologies in Patients With Covid-19: The Svin Covid-19 Multinational Registry

Author

Ramos-Araque, Maria Esther, Siegler, James E, Ribo, Marc, Requena, Manuel, López, Cristina, de Lera, Mercedes, Arenillas, Juan F, Pérez-Hernández, Isabel, Beatriz, Gómez-Vicente, Talavera, Blanca, Cardona, Pedro, Guillén, Ana, Urra, Xabier, Lull, Laura, Renu, Arturo, Nguyen, Thanh, Jillella, Dinesh, Nahab, Fadi B, Nogueira, Raul G, Haussen, Diogo C, Then, Ryna, Thon, Jesse M, Rodriguez Esparragoza, Luis, Hernández-Pérez, Maria, Bustamante, Alejandro, Mansour, Ossama, Mohammed, Megahed, Hassan, Tamer, Liebeskind, David S, Hassan, Ameer E, Bushnaq, Saif, Osman, Mohamed, and Rodriguez Vazquez, Alejandro

Abstract

Background and purpose:Coronavirus disease 2019 (COVID-19) is associated with a small but clinically significant risk of stroke, the cause of which is frequently cryptogenic. In a large multinational cohort of consecutive COVID-19 patients with stroke, we evaluated clinical predictors of cryptogenic stroke, short-term functional outcomes and in-hospital mortality among patients according to stroke etiology.Methods:We explored clinical characteristics and short-term outcomes of consecutively evaluated patients 18 years of age or older with acute ischemic stroke (AIS) and laboratory-confirmed COVID-19 from 31 hospitals in 4 countries (3/1/20-6/16/20).Results:Of the 14.483 laboratory-confirmed patients with COVID-19, 156 (1.1%) were diagnosed with AIS. Sixty-one (39.4%) were female, 84 (67.2%) white, and 88 (61.5%) were between 60-79 years of age. The most frequently reported etiology of AIS was cryptogenic (55/129, 42.6%), which was associated with significantly higher white blood cell count, c-reactive protein, and D-dimer levels than non-cryptogenic AIS patients (p

Published
2021
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27. Abstract P779: Monocyte to Lymphocyte Ratio in Clot Analysis is a Marker of Cardioembolic Stroke Etiology

Author

Juega, Jesus, Pagola, Jorge, Palacio, Carlos, deck, matias, Rodriguez, maria teresa, Requena, Manuel, Garcia-Tornel, Alvaro, Olivé, MArta, Rodriguez-villatoro, Noelia, Rodriguez-luna, David, Rubiera, Marta, Muchada, Marian, boned, sandra, Ribo, Marc, Sanjuan, Estela, Pancorbo, Olalla, carlos, pinana, Hernandez, David, Coscojuela, Pilar, Hernandez, MAria, Dorado, Laura, carolina.delatorre@gmail.com, Carolina, Cardona, Pedro, QUESADA, HELENA, Camacho, Jessica, Ramon y Cajal, Santiago, Alvarez-Sabin, Jose, and MOLINA, Carlos A

Abstract

Methods:We analyzed data from 190 patients in a prospective unicentric study. Thrombi obtained in emergent endovascular treatment ( EVT) were analyzed by MFC order to calculate the percentage of granulocytes , monocytes and lymphocytes, over total leukocyte population as well as monocyte-to-lymphocyte ratio ( MLR) Clinical and interventional parameters were recorded for each patient. Stroke subtypes were defined by the Trial of ORG 10172 in Acute Stroke Treatment classification. We tested MFC predictors of high risk cardioembolic strokes (HR CE) in patients with undetermined stroke etiology . MFC predictor was obtained by comparison of clots due to Large Arterial Atherosclerosis compared with clots due to HR CE.Results:Among 190 clots retrieved, 163 cases were properly analized. 91 cases with known stroke etiology after EVT and 72 cases of Undetermined stroke. In a demographic (age, gender) and EVT matched (time, tpa, number of passes) case -control study of 56 patients: HR CE strokes (28 cases) and LAA strokes (28 cases), the proportion of monocytes ( OR 1.06 , 95% CI 1.01- 1.11) and MLR ( OR 1.83 , 95% CI 1.12- 2.98) independently predicted HR CE detection. A cut-off point of 1.77% in a receiver operating characteristic curve predicted cardiomebolic etiology with sensitivity of 71% and specificity of 82%. Among Undetermined Strokes (n=72) the percentage of HR CE detection was higher in patients with high MLR (n=40 ; 74%) compared with low MLR (n=6; 33%) ( p< 0.001). Patients with high MLR were older than low MLR cases, although MLR > 1.77 independently predicted HR CE detection among Undetermined strokes (OR, 4.50 ,95% CI 1.35-15.04) in a multivariate model adjusted for age.Conclusion:Measurement of monocyte to lymphocyte ratio in clots by multiparametric flow cytometry detected patients at high risk of hidden cardioembolic origin among undetermined stroke population.

Published
2021
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30. Abstract W MP18.

Author

Cardona, Pedro, Quesada, Helena, Cano, Luis, Lara, Blanca, Mora, Paloma, Aixut, Sonia, Aja, Lucia, Escrig, Ana, De Miquel, Maria Angeles, and Rubio, Francisco

Published
2014

31. Abstract TP10.

Author

Cardona, Pedro, Quesada, Helena, Cano, Luis, Aja, Lucia, Ma., De Miquel, Ana, Escrig, and Francisco, Rubio

Published
2013

32. Abstract 3035.

Author

Cardona, Pedro, Quesada, Helena, De Miquel, Maria Angeles, Aja, Lucia, Mora, Paloma, Cano, Luis, and Rubio, Francisco

Published
2012

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