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151. Surgical Decompression for Space-Occupying Hemispheric Infarction

Author

Reinink, Hendrik, primary, Jüttler, Eric, additional, Hacke, Werner, additional, Hofmeijer, Jeannette, additional, Vicaut, Eric, additional, Vahedi, Katayoun, additional, Slezins, Janis, additional, Su, Yingying, additional, Fan, Linlin, additional, Kumral, Emre, additional, Greving, Jacoba P., additional, Algra, Ale, additional, Kappelle, L. Jaap, additional, van der Worp, H. Bart, additional, and Neugebauer, Hermann, additional

Published
2021
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152. Importance of Occlusion Site for Thrombectomy Technique in Stroke

Author

Bernsen, Marie Louise E., primary, Goldhoorn, Robert-Jan B., additional, Lingsma, Hester F., additional, van Oostenbrugge, Robert J., additional, van Zwam, Wim H., additional, Uyttenboogaart, Maarten, additional, Roos, Yvo B.W.E.M., additional, Martens, Jasper M., additional, Hofmeijer, Jeannette, additional, Dippel, Diederik W.J., additional, van der Lugt, Aad, additional, Majoie, Charles B.L.M., additional, Boiten, Jelis, additional, Albert Vos, Jan, additional, Jansen, Ivo G.H., additional, Mulder, Maxim J.H.L., additional, Goldhoorn, Robert- Jan B., additional, Compagne, Kars C.J., additional, Kappelhof, Manon, additional, Brouwer, Josje, additional, den Hartog, Sanne J., additional, Hinsenveld, Wouter H., additional, Roozenbeek, Bob, additional, van Es, Adriaan C.G.M., additional, Emmer, Bart J., additional, Coutinho, Jonathan M., additional, Schonewille, Wouter J., additional, Wermer, Marieke J.H., additional, van Walderveen, Marianne A.A., additional, Staals, Julie, additional, Lycklama, Geert J., additional, Nijeholt, à, additional, de Bruijn, Sebastiaan F., additional, van Dijk, Lukas C., additional, van der Worp, H. Bart, additional, Lo, Rob H., additional, van Dijk, Ewoud J., additional, Boogaarts, Hieronymus D., additional, Vries, J. de, additional, de Kort, Paul L.M., additional, van Tuijl, Julia, additional, Peluso, Jo P., additional, Fransen, Puck, additional, van den Berg, Jan S.P., additional, van Hasselt, Boudewijn A.A.M., additional, Aerden, Leo A.M., additional, Dallinga, René J., additional, Eschgi, Omid, additional, Bokkers, Reinoud P.H., additional, Schreuder, Tobien H.C.M.L., additional, Heijboer, Roel J.J., additional, Keizer, Koos, additional, Yo, Lonneke S.F., additional, den Hertog, Heleen M., additional, Bulut, Tomas, additional, Brouwers, Paul J.A.M., additional, Sprengers, Marieke E.S., additional, Jenniskens, Sjoerd F.M., additional, van den Berg, René, additional, Yoo, Albert J., additional, Beenen, Ludo F.M., additional, Postma, Alida A., additional, Roosendaal, Stefan D., additional, der Kallen, Bas F.W. van, additional, van den Wijngaard, Ido R., additional, Bot, Joost, additional, van Doormaal, Pieter-Jan, additional, Meijer, Anton, additional, Ghariq, Elyas, additional, van Proosdij, Marc P., additional, Krietemeijer, G. Menno, additional, Lo, Rob, additional, Gerrits, Dick, additional, Dinkelaar, Wouter, additional, Appelman, Auke P.A., additional, Hammer, Bas, additional, Pegge, Sjoert, additional, van der Hoorn, Anouk, additional, Vinke, Saman, additional, Flach, H. Zwenneke, additional, el Ghannouti, Naziha, additional, Sterrenberg, Martin, additional, Pellikaan, Wilma, additional, Sprengers, Rita, additional, Elfrink, Marjan, additional, Simons, Michelle, additional, Vossers, Marjolein, additional, de Meris, Joke, additional, Vermeulen, Tamara, additional, Geerlings, Annet, additional, van Vemde, Gina, additional, Simons, Tiny, additional, Messchendorp, Gert, additional, Nicolaij, Nynke, additional, Bongenaar, Hester, additional, Bodde, Karin, additional, Kleijn, Sandra, additional, Lodico, Jasmijn, additional, Droste, Hanneke, additional, Wollaert, Maureen, additional, Verheesen, Sabrina, additional, Jeurrissen, D., additional, Bos, Erna, additional, Drabbe, Yvonne, additional, Sandiman, Michelle, additional, Aaldering, Nicoline, additional, Zweedijk, Berber, additional, Vervoort, Jocova, additional, Ponjee, Eva, additional, Romviel, Sharon, additional, Kanselaar, Karin, additional, Barning, Denn, additional, Venema, Esmee, additional, Chalos, Vicky, additional, Geuskens, Ralph R., additional, van Straaten, Tim, additional, Ergezen, Saliha, additional, Harmsma, Roger R.M., additional, Muijres, Daan, additional, de Jong, Anouk, additional, Berkhemer, Olvert A., additional, Boers, Anna M.M., additional, Huguet, J., additional, Groot, P.F.C., additional, Mens, Marieke A., additional, van Kranendonk, Katinka R., additional, Treurniet, Kilian M., additional, Tolhuisen, Manon L., additional, Alves, Heitor, additional, Weterings, Annick J., additional, Kirkels, Eleonora L.F., additional, Voogd, Eva J.H.F., additional, Schupp, Lieve M., additional, Collette, Sabine L., additional, Groot, Adrien E.D., additional, LeCouffe, Natalie E., additional, Konduri, Praneeta R., additional, Prasetya, Haryadi, additional, Arrarte-Terreros, Nerea, additional, and Ramos, Lucas A., additional

Published
2021
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157. Characteristics of Ischemic Brain Lesions After Stenting or Endarterectomy for Symptomatic Carotid Artery Stenosis: Results From the International Carotid Stenting Study–Magnetic Resonance Imaging Substudy

Author

Gensicke, Henrik, Zumbrunn, Thomas, Jongen, Lisa M., Nederkoorn, Paul J., Macdonald, Sumaira, Gaines, Peter A., Lyrer, Philippe A., Wetzel, Stephan G., van der Lugt, Aad, Mali, Willem P. Th. M., Brown, Martin M., van der Worp, H. Bart, Engelter, Stefan T., and Bonati, Leo H.

Published
2013
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164. Combined Effect of Age and Baseline Alberta Stroke Program Early Computed Tomography Score on Post-Thrombectomy Clinical Outcomes in the MR CLEAN Registry

Author

Ospel, Johanna, primary, Kappelhof, Manon, additional, Groot, Adrien E., additional, LeCouffe, Natalie E., additional, Coutinho, Jonathan M., additional, Yoo, Albert J., additional, Yo, Lonneke S.F., additional, Beenen, Ludo F.M., additional, van Zwam, Wim H., additional, van der Lugt, Aad, additional, Postma, Alida A., additional, Roos, Yvo B.W.E.M., additional, Goyal, Mayank, additional, Majoie, Charles B.L.M., additional, Dippel, Diederik W.J., additional, van Oostenbrugge, Robert J., additional, Boiten, Jelis, additional, Albert Vos, Jan, additional, Jansen, Ivo G.H., additional, Mulder, Maxim J.H.L., additional, Goldhoorn, Robert- Jan B., additional, Compagne, Kars C.J., additional, Brouwer, Josje, additional, den Hartog, Sanne J., additional, Hinsenveld, Wouter H., additional, Roozenbeek, Bob, additional, van Es, Adriaan C.G.M., additional, Emmer, Bart J., additional, Schonewille, Wouter J., additional, Wermer, Marieke J.H., additional, van Walderveen, Marianne A.A., additional, Staals, Julie, additional, Hofmeijer, Jeannette, additional, Martens, Jasper M., additional, Lycklama à Nijeholt, Geert J., additional, de Bruijn, Sebastiaan F., additional, van Dijk, Lukas C., additional, van der Worp, H. Bart, additional, Lo, Rob H., additional, van Dijk, Ewoud J., additional, Boogaarts, Hieronymus D., additional, de Vries, J., additional, de Kort, Paul L.M., additional, van Tuijl, Julia, additional, Peluso, Jo P., additional, Fransen, Puck, additional, van den Berg, Jan S.P., additional, van Hasselt, Boudewijn A.A.M., additional, Aerden, Leo A.M., additional, Dallinga, René J., additional, Uyttenboogaart, Maarten, additional, Eschgi, Omid, additional, Bokkers, Reinoud P.H., additional, Schreuder, Tobien H.C.M.L., additional, Heijboer, Roel J.J., additional, Keizer, Koos, additional, den Hertog, Heleen M., additional, Sturm, Emiel J.C., additional, Brouwers, Paul J.A.M., additional, Sprengers, Marieke E.S., additional, Jenniskens, Sjoerd F.M., additional, van den Berg, René, additional, Roosendaal, Stefan D., additional, van der Kallen, Bas F.W., additional, van den Wijngaard, Ido R., additional, Bot, Joost, additional, van Doormaal, Pieter-Jan, additional, Meijer, Anton, additional, Ghariq, Elyas, additional, van Proosdij, Marc P., additional, Krietemeijer, G. Menno, additional, Lo, Rob, additional, Gerrits, Dick, additional, Dinkelaar, Wouter, additional, Appelman, Auke P.A., additional, Hammer, Bas, additional, Pegge, Sjoert, additional, van der Hoorn, Anouk, additional, Vinke, Saman, additional, Flach, H. Zwenneke, additional, Lingsma, Hester F., additional, Ghannouti, Naziha el, additional, Sterrenberg, Martin, additional, Pellikaan, Wilma, additional, Sprengers, Rita, additional, Elfrink, Marjan, additional, Simons, Michelle, additional, Vossers, Marjolein, additional, de Meris, Joke, additional, Vermeulen, Tamara, additional, Geerlings, Annet, additional, van Vemde, Gina, additional, Simons, Tiny, additional, Messchendorp, Gert, additional, Nicolaij, Nynke, additional, Bongenaar, Hester, additional, Bodde, Karin, additional, Kleijn, Sandra, additional, Lodico, Jasmijn, additional, Droste, Hanneke, additional, Wollaert, Maureen, additional, Verheesen, Sabrina, additional, Jeurrissen, D., additional, Bos, Erna, additional, Drabbe, Yvonne, additional, Sandiman, Michelle, additional, Aaldering, Nicoline, additional, Zweedijk, Berber, additional, Vervoort, Jocova, additional, Ponjee, Eva, additional, Romviel, Sharon, additional, Kanselaar, Karin, additional, Barning, Denn, additional, Venema, Esmee, additional, Chalos, Vicky, additional, Geuskens, Ralph R., additional, van Straaten, Tim, additional, Ergezen, Saliha, additional, Harmsma, Roger R.M., additional, Muijres, Daan, additional, de Jong, Anouk, additional, Berkhemer, Olvert A., additional, Boers, Anna M.M., additional, Huguet, J., additional, Groot, P.F.C., additional, Mens, Marieke A., additional, van Kranendonk, Katinka R., additional, Treurniet, Kilian M., additional, Tolhuisen, Manon L., additional, Alves, Heitor, additional, Weterings, Annick J., additional, Kirkels, Eleonora L.F., additional, Schupp, Lieve M., additional, Voogd, Eva J.H.F., additional, Collette, Sabine, additional, Konduri, Praneeta R., additional, Prasetya, Haryadi, additional, Arrarte-Terreros, Nerea, additional, and Ramos, Lucas A., additional

Published
2020
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165. Peripheral Artery Disease in Acute Ischemic Stroke Patients Treated With Endovascular Thrombectomy; Results From the MR CLEAN Registry

Author

Pirson, France A. V., primary, Hinsenveld, Wouter H., additional, Staals, Julie, additional, de Ridder, Inger R., additional, van Zwam, Wim H., additional, Schreuder, Tobien H. C. M. L., additional, Roos, Yvo B. W. E. M., additional, Majoie, Charles B. L. M., additional, van der Worp, H. Bart, additional, Uyttenboogaart, Maarten, additional, Lycklama à Nijeholt, Geert J., additional, Schonewille, Wouter J., additional, and van Oostenbrugge, Robert J., additional

Published
2020
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166. Path From Clinical Research to Implementation

Author

Wiegers, Eveline J.A., primary, Compagne, Kars C.J., additional, Janssen, Paula M., additional, Venema, Esmee, additional, Deckers, Jaap W., additional, Schonewille, Wouter J., additional, Albert Vos, Jan, additional, Lycklama à Nijeholt, Geert J., additional, Roozenbeek, Bob, additional, Martens, Jasper M., additional, Hofmeijer, Jeannette, additional, van Oostenbrugge, Robert-Jan, additional, van Zwam, Wim H., additional, Majoie, Charles B.L.M., additional, van der Lugt, Aad, additional, Lingsma, H.F., additional, Roos, Yvo B.W.E.M., additional, Dippel, Diederik W.J., additional, Boiten, Jelis, additional, Brouwer, Josje, additional, den Hartog, Sanne J., additional, Hinsenveld, Wouter H., additional, Kappelhof, Manon, additional, Goldhoorn, Robert-Jan B., additional, Mulder, Maxim J.H.L., additional, Jansen, Ivo G.H., additional, van Es, Adriaan C.G.M., additional, Emmer, Bart J., additional, Coutinho, Jonathan M., additional, Wermer, Marieke J.H., additional, van Walderveen, Marianne A.A., additional, Staals, Julie, additional, de Bruijn, Sebastiaan F., additional, van Dijk, Lukas C., additional, van der Worp, H. Bart, additional, Lo, Rob H., additional, van Dijk, Ewoud J., additional, Boogaarts, Hieronymus D., additional, Vries, J. de, additional, de Kort, Paul L.M., additional, van Tuijl, Julia, additional, Peluso, Jo Jo P., additional, Fransen, Puck, additional, van den Berg, Jan S.P., additional, van Hasselt, Boudewijn A.A.M., additional, Aerden, Leo A.M., additional, Dallinga, René J., additional, Uyttenboogaart, Maarten, additional, Eschgi, Omid, additional, Bokkers, Reinoud P.H., additional, Schreuder, Tobien H.C.M.L., additional, Heijboer, Roel J.J., additional, Keizer, Koos, additional, Yo, Lonneke S.F., additional, den Hertog, Heleen M., additional, Sturm, Emiel J.C., additional, Brouwers, Paul, additional, Sprengers, Marieke E.S., additional, Jenniskens, Sjoerd F.M., additional, van den Berg, René, additional, Yoo, Albert J., additional, Beenen, Ludo F.M., additional, Postma, Alida A., additional, Roosendaal, Stefan D., additional, van der Kallen, Bas F.W., additional, van den Wijngaard, Ido R., additional, Bot, Joost, additional, van Doormaal, Pieter-Jan, additional, Meijer, Anton, additional, Ghariq, Elyas, additional, van Proosdij, Marc P., additional, Krietemeijer, G. Menno, additional, Peluso, Jo P., additional, Lo, Rob, additional, Gerrits, Dick, additional, Dinkelaar, Wouter, additional, Appelman, Auke P.A., additional, Hammer, Bas, additional, Pegge, Sjoert, additional, van der Hoorn, Anouk, additional, Vinke, Saman, additional, Flach, H. Zwenneke, additional, Ghannouti, Naziha el, additional, Sterrenberg, Martin, additional, Puppels, Corina, additional, Pellikaan, Wilma, additional, Sprengers, Rita, additional, Elfrink, Marjan, additional, Simons, Michelle, additional, Vossers, Marjolein, additional, de Meris, Joke, additional, Vermeulen, Tamara, additional, Geerlings, Annet, additional, van Vemde, Gina, additional, Simons, Tiny, additional, van Rijswijk, Cathelijn, additional, Messchendorp, Gert, additional, Nicolaij, Nynke, additional, Bongenaar, Hester, additional, Bodde, Karin, additional, Kleijn, Sandra, additional, Lodico, Jasmijn, additional, Droste, Hanneke, additional, Wollaert, Maureen, additional, Verheesen, Sabrina, additional, Jeurrissen, D., additional, Bos, Erna, additional, Drabbe, Yvonne, additional, Sandiman, Michelle, additional, Aaldering, Nicoline, additional, Zweedijk, Berber, additional, Khalilzada, Mostafa, additional, Vervoort, Jocova, additional, Ponjee, Eva, additional, Romviel, Sharon, additional, Kanselaar, Karin, additional, Barning, Denn, additional, Chalos, Vicky, additional, Geuskens, Ralph R., additional, van Straaten, Tim, additional, Ergezen, Saliha, additional, Harmsma, Roger R.M., additional, Muijres, Daan, additional, de Jong, Anouk, additional, Berkhemer, Olvert A., additional, Boers, Anna M.M., additional, Huguet, J., additional, Groot, P.F.C., additional, Mens, Marieke A., additional, van Kranendonk, Katinka R., additional, Treurniet, Kilian M., additional, Tolhuisen, Manon L., additional, Alves, Heitor, additional, Weterings, Annick J., additional, Kirkels, Eleonora L.F., additional, Voogd, Eva J.H.F., additional, Schupp, Lieve M., additional, Collette, Sabine, additional, Groot, Adrien E.D., additional, LeCouffe, Natalie E., additional, Konduri, Praneeta R., additional, Prasetya, Haryadi, additional, Arrarte-Terreros, Nerea, additional, and Ramos, Lucas A., additional

Published
2020
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167. Clinical and Imaging Determinants of Collateral Status in Patients With Acute Ischemic Stroke in MR CLEAN Trial and Registry

Author

Wiegers, Eveline J.A., primary, Mulder, Maxim J.H.L., additional, Jansen, Ivo G.H., additional, Venema, Esmee, additional, Compagne, Kars C.J., additional, Berkhemer, Olvert A., additional, Emmer, Bart J., additional, Marquering, Henk A., additional, van Es, Adriaan C.G.M., additional, Sprengers, Marieke E., additional, van Zwam, Wim H., additional, van Oostenbrugge, Robert J., additional, Roos, Yvo B.W.E.M., additional, Majoie, Charles B.L.M., additional, Roozenbeek, Bob, additional, Lingsma, Hester F., additional, Dippel, Diederik W.J., additional, van der Lugt, Aad, additional, Boiten, Jelis, additional, Vos, Jan Albert, additional, Brouwer, Josje, additional, den Hartog, Sanne J., additional, Hinsenveld, Wouter H., additional, Kappelhof, Manon, additional, Goldhoorn, Robert-Jan B., additional, Coutinho, Jonathan M., additional, Schonewille, Wouter J., additional, Wermer, Marieke J.H., additional, van Walderveen, Marianne A.A., additional, Staals, Julie, additional, Hofmeijer, Jeannette, additional, Martens, Jasper M., additional, Lycklama à Nijeholt, Geert J., additional, de Bruijn, Sebastiaan F., additional, van Dijk, Lukas C., additional, van der Worp, H. Bart, additional, Lo, Rob H., additional, van Dijk, Ewoud J., additional, Boogaarts, Hieronymus D., additional, de Vries, J., additional, de Kort, Paul L.M., additional, van Tuijl, Julia, additional, Peluso, Jo Jo P., additional, Fransen, Puck, additional, van den Berg, Jan S.P., additional, van Hasselt, Boudewijn A.A.M., additional, Aerden, Leo A.M., additional, Dallinga, René J., additional, Uyttenboogaart, Maarten, additional, Eschgi, Omid, additional, Bokkers, Reinoud P.H., additional, Schreuder, Tobien H.C.M.L., additional, Heijboer, Roel J.J., additional, Keizer, Koos, additional, Yo, Lonneke S.F., additional, den Hertog, Heleen M., additional, Sturm, Emiel J.C., additional, Brouwers, Paul, additional, Jenniskens, Sjoerd F.M., additional, van den Berg, René, additional, Yoo, Albert J., additional, Beenen, Ludo F.M., additional, Postma, Alida A., additional, Roosendaal, Stefan D., additional, van der Kallen, Bas F.W., additional, van den Wijngaard, Ido R., additional, Bot, Joost, additional, van Doormaal, Pieter-Jan, additional, Meijer, Anton, additional, Ghariq, Elyas, additional, van Proosdij, Marc P., additional, Krietemeijer, G. Menno, additional, Peluso, Jo P., additional, Lo, Rob, additional, Gerrits, Dick, additional, Dinkelaar, Wouter, additional, Appelman, Auke P.A., additional, Hammer, Bas, additional, Pegge, Sjoert, additional, van der Hoorn, Anouk, additional, Vinke, Saman, additional, Flach, H. Zwenneke, additional, el Ghannouti, Naziha, additional, Sterrenberg, Martin, additional, Puppels, Corina, additional, Pellikaan, Wilma, additional, Sprengers, Rita, additional, Elfrink, Marjan, additional, Simons, Michelle, additional, Vossers, Marjolein, additional, de Meris, Joke, additional, Vermeulen, Tamara, additional, Geerlings, Annet, additional, van Vemde, Gina, additional, Simons, Tiny, additional, van Rijswijk, Cathelijn, additional, Messchendorp, Gert, additional, Nicolaij, Nynke, additional, Bongenaar, Hester, additional, Bodde, Karin, additional, Kleijn, Sandra, additional, Lodico, Jasmijn, additional, Droste, Hanneke, additional, Wollaert, Maureen, additional, Verheesen, Sabrina, additional, Jeurrissen, D., additional, Bos, Erna, additional, Drabbe, Yvonne, additional, Sandiman, Michelle, additional, Aaldering, Nicoline, additional, Zweedijk, Berber, additional, Khalilzada, Mostafa, additional, Vervoort, Jocova, additional, Ponjee, Eva, additional, Romviel, Sharon, additional, Kanselaar, Karin, additional, Barning, Denn, additional, Chalos, Vicky, additional, Geuskens, Ralph R., additional, van Straaten, Tim, additional, Ergezen, Saliha, additional, Harmsma, Roger R.M., additional, Muijres, Daan, additional, de Jong, Anouk, additional, Boers, Anna M.M., additional, Huguet, J., additional, Groot, P.F.C., additional, Mens, Marieke A., additional, van Kranendonk, Katinka R., additional, Treurniet, Kilian M., additional, Tolhuisen, Manon L., additional, Alves, Heitor, additional, Weterings, Annick J., additional, Kirkels, Eleonora L.F., additional, Voogd, Eva J.H.F., additional, Schupp, Lieve M., additional, Collette, Sabine, additional, Groot, Adrien E.D., additional, LeCouffe, Natalie E., additional, Konduri, Praneeta R., additional, Prasetya, Haryadi, additional, Arrarte-Terreros, Nerea, additional, and Ramos, Lucas A., additional

Published
2020
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177. Malignant infarction after endovascular treatment: Incidence and prediction.

Author

Bernsen, Marie Louise E, Kauw, Frans, Martens, Jasper M, van der Lugt, Aad, Yo, Lonneke SF, van Walderveen, Marianne AA, Roos, Yvo BWEM, van der Worp, H Bart, Dankbaar, Jan W, and Hofmeijer, Jeannette

Subjects
INFARCTION, ENDOVASCULAR surgery, MOYAMOYA disease, RECEIVER operating characteristic curves, INTERNAL carotid artery
Abstract

Background: Early prediction of malignant infarction may guide treatment decisions. For patients who received endovascular treatment, the risk of malignant infarction is unknown and risk factors are unrevealed. Aims: The objective of this study is to estimate the incidence of malignant infarction after endovascular treatment in patients with an occlusion of the anterior circulation, to identify independent risk factors, and to establish a model for prediction. Methods: We analyzed patients who received endovascular treatment for a large vessel occlusion in the anterior circulation within 6.5 h after symptom onset, included in the Dutch MR CLEAN Registry between March 2014 and June 2016. We compared patients with and without malignant infarction. Candidate predictors were incorporated in a multivariable binary logistic regression model. The final prediction model was established using backward elimination. Discrimination and calibration were evaluated with the area under the receiver operating characteristic curve (AUROC) and the Hosmer-Lemeshow test. Results: Of 1445 patients, 82 (6%) developed malignant infarction. Independent predictors were lower age, higher National Institutes of Health Stroke Scale (NIHSS), lower alberta stroke program early CT score (ASPECTS), internal carotid artery occlusion, lower collateral score, longer times from onset to groin puncture, and unsuccessful reperfusion. The AUROC of a prediction model combining these features was 0.83 (95% confidence interval (CI): 0.79–0.88) and the Hosmer-Lemeshow test indicated appropriate calibration (P = 0.937). Conclusion: The risk of malignant infarction after endovascular treatment started within 6.5 h of stroke onset is approximately 6%. Successful reperfusion decreases the risk. A prediction model combining easily retrievable measures of age, ASPECTS, collateral status, and reperfusion shows good discrimination between patients who will develop malignant infarction and those who will not. [ABSTRACT FROM AUTHOR]

Published
2022
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180. General Interest Sessions

Author

Harshfield, Eric, Markus, Hugh, Compter, Annette, Küker, Wilhelm, Kappelle, L Jaap, Clifton, Andrew, Van Der Worp, H Bart, Rothwell, Peter, Algra, Ale, Harshfield, Eric [0000-0001-8767-0928], Markus, Hugh [0000-0002-9794-5996], and Apollo - University of Cambridge Repository

Subjects
3201 Cardiovascular Medicine and Haematology, 4206 Public Health, 4202 Epidemiology, 42 Health Sciences, 32 Biomedical and Clinical Sciences
Abstract

Background and Aims: Symptomatic vertebral artery stenosis has been associated with high risk of recurrent stroke, particularly in the first few weeks after symptoms, with higher risks for intracranial (IC) than extracranial (EC) stenosis. Vertebral artery stenosis can be treated with stenting with good technical results, but a higher periprocedural risk has been reported for IC than EC stenosis. We performed an individual patient pooled analysis of RCTs comparing vertebral stenting with medical treatment for symptomatic vertebral stenosis. Methods: Data were included from VIST (N = 179, EC 148, IC 31), VAST (N = 115, EC 96, IC 19) and SAMMPRIS (IC 60, no EC). Cox regression was performed stratified by trial. The primary outcome was any fatal or nonfatal stroke during follow-up. A further analysis was performed for patients randomised within 14 days of last symptoms. Results: The hazard ratio (HR) for any stroke in the stenting arm compared with the medical arm was 0.81 (95% CI 0.45-1.44). For EC alone it was 0.63 (0.27-1.46), and for IC alone 1.06 (0.46-2.42). For patients randomised within 14 days of last stroke/TIA the HRs were: all 0.65 (0.31-1.39), EC only 0.56 (0.17-1.87), IC only 0.72 (0.27-1.90). Conclusions: This pooled analysis of available data from completed vertebral artery stenting trials did not show a statistically significant benefit for either medical or interventional therapy. There was no evidence of even a trend of benefit of either strategy for IC stenosis. Stenting for EC stenosis might be beneficial, but further larger trials are required to determine whether there is benefit in this subgroup. Trial registration numbers: SAMMPRIS:NCT00576693; VAST:ISRCTN29597900; VIST:ISRCTN95212240.

Published
2019
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181. Consensus statements and recommendations from the ESO-Karolinska Stroke Update Conference, Stockholm 11-13 November 2018

Author

Ahmed, Niaz Audebert, Heinrich Turc, Guillaume Cordonnier, Charlotte Christensen, Hanne Sacco, Simona Sandset, Else Charlotte Ntaios, George Charidimou, Andreas Toni, Danilo and Pristipino, Christian Koehrmann, Martin Kuramatsu, Joji B. and Thomalla, Geotz Mikulik, Robert Ford, Gary A. and Marti-Fabregas, Joan Fischer, Urs Thoren, Magnus Lundstrom, Erik Rinkel, Gabriel J. E. van der Worp, H. Bart and Matusevicius, Marius Tsivgoulis, Georgios Milionis, Haralampos and Rubiera, Marta Hart, Robert Moreira, Tiago Lantz, Maria and Sjostrand, Christina Andersen, Grethe Schellinger, Peter and Kostulas, Konstantinos Sunnerhagen, Katharina Stibrant Keselman, Boris Korompoki, Eleni Purrucker, Jan Khatri, Pooja and Whiteley, William Berge, Eivind Mazya, Michael Dippel, Diederik W. J. Mustanoja, Satu Rasmussen, Mads Soderqvist, Asa Kuntze Escudero-Martinez, Irene Steiner, Thorsten

Abstract

The purpose of the European Stroke Organisation-Karolinska Stroke Update Conference is to provide updates on recent stroke therapy research and to give an opportunity for the participants to discuss how these results may be implemented into clinical routine. The meeting started 22 years ago as Karolinska Stroke Update, but since 2014 it is a joint conference with European Stroke Organisation. Importantly, it provides a platform for discussion on the European Stroke Organisation guidelines process and on recommendations to the European Stroke Organisation guidelines committee on specific topics. By this, it adds a direct influence from stroke professionals otherwise not involved in committees and work groups on the guideline procedure. The discussions at the conference may also inspire new guidelines when motivated. The topics raised at the meeting are selected by the scientific programme committee mainly based on recent important scientific publications. This year's European Stroke Organisation-Karolinska Stroke Update Meeting was held in Stockholm on 11-13 November 2018. There were 11 scientific sessions discussed in the meeting including two short sessions. Each session except the short sessions produced a consensus statement (Full version with background, issues, conclusions and references are published as web-material and at and ) and recommendations which were prepared by a writing committee consisting of session chair(s), scientific secretary and speakers. These statements were presented to the 250 participants of the meeting. In the open meeting, general participants commented on the consensus statement and recommendations and the final document were adjusted based on the discussion from the general participants Recommendations (grade of evidence) were graded according to the 1998 Karolinska Stroke Update meeting with regard to the strength of evidence. Grade A Evidence: Strong support from randomised controlled trials and statistical reviews (at least one randomised controlled trial plus one statistical review). Grade B Evidence: Support from randomised controlled trials and statistical reviews (one randomised controlled trial or one statistical review). Grade C Evidence: No reasonable support from randomised controlled trials, recommendations based on small randomised and/or non-randomised controlled trials evidence.

Published
2019

186. Consensus statements and recommendations from the ESO-Karolinska Stroke Update Conference, Stockholm 11-13 November 2018.

Author

Ahmed, Niaz, Audebert, Heinrich, Turc, Guillaume, Cordonnier, Charlotte, Christensen, Hanne, Sacco, Simona, Sandset, Else Charlotte, Ntaios, George, Charidimou, Andreas, Toni, Danilo, Pristipino, Christian, Köhrmann, Martin, Kuramatsu, Joji B, Thomalla, Götz, Mikulik, Robert, Ford, Gary A, Martí-Fàbregas, Joan, Fischer, Urs, Thoren, Magnus, Lundström, Erik, Rinkel, Gabriel Je, van der Worp, H Bart, Matusevicius, Marius, Tsivgoulis, Georgios, Milionis, Haralampos, Rubiera, Marta, Hart, Robert, Moreira, Tiago, Lantz, Maria, Sjöstrand, Christina, Andersen, Grethe, Schellinger, Peter, Kostulas, Konstantinos, Sunnerhagen, Katharina Stibrant, Keselman, Boris, Korompoki, Eleni, Purrucker, Jan, Khatri, Pooja, Whiteley, William, Berge, Eivind, Mazya, Michael, Dippel, Diederik Wj, Mustanoja, Satu, Rasmussen, Mads, Söderqvist, Åsa Kuntze, Escudero-Martínez, Irene, Steiner, Thorsten, Ahmed, Niaz, Audebert, Heinrich, Turc, Guillaume, Cordonnier, Charlotte, Christensen, Hanne, Sacco, Simona, Sandset, Else Charlotte, Ntaios, George, Charidimou, Andreas, Toni, Danilo, Pristipino, Christian, Köhrmann, Martin, Kuramatsu, Joji B, Thomalla, Götz, Mikulik, Robert, Ford, Gary A, Martí-Fàbregas, Joan, Fischer, Urs, Thoren, Magnus, Lundström, Erik, Rinkel, Gabriel Je, van der Worp, H Bart, Matusevicius, Marius, Tsivgoulis, Georgios, Milionis, Haralampos, Rubiera, Marta, Hart, Robert, Moreira, Tiago, Lantz, Maria, Sjöstrand, Christina, Andersen, Grethe, Schellinger, Peter, Kostulas, Konstantinos, Sunnerhagen, Katharina Stibrant, Keselman, Boris, Korompoki, Eleni, Purrucker, Jan, Khatri, Pooja, Whiteley, William, Berge, Eivind, Mazya, Michael, Dippel, Diederik Wj, Mustanoja, Satu, Rasmussen, Mads, Söderqvist, Åsa Kuntze, Escudero-Martínez, Irene, and Steiner, Thorsten

Abstract

The purpose of the European Stroke Organisation-Karolinska Stroke Update Conference is to provide updates on recent stroke therapy research and to give an opportunity for the participants to discuss how these results may be implemented into clinical routine. The meeting started 22 years ago as Karolinska Stroke Update, but since 2014 it is a joint conference with European Stroke Organisation. Importantly, it provides a platform for discussion on the European Stroke Organisation guidelines process and on recommendations to the European Stroke Organisation guidelines committee on specific topics. By this, it adds a direct influence from stroke professionals otherwise not involved in committees and work groups on the guideline procedure. The discussions at the conference may also inspire new guidelines when motivated. The topics raised at the meeting are selected by the scientific programme committee mainly based on recent important scientific publications. This year's European Stroke Organisation-Karolinska Stroke Update Meeting was held in Stockholm on 11-13 November 2018. There were 11 scientific sessions discussed in the meeting including two short sessions. Each session except the short sessions produced a consensus statement (Full version with background, issues, conclusions and references are published as web-material and at www.eso-karolinska.org and http://eso-stroke.org) and recommendations which were prepared by a writing committee consisting of session chair(s), scientific secretary and speakers. These statements were presented to the 250 participants of the meeting. In the open meeting, general participants commented on the consensus statement and recommendations and the final document were adjusted based on the discussion from the general participants Recommendations (grade of evidence) were graded according to the 1998 Karolinska Stroke Update meeting with regard to the strength of evidence. Grade A Evidence: Strong support from randomised controlled tri

Published
2019
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189. Silent Intracerebral Hemorrhage in Patients Randomized to Stenting or Endarterectomy for Symptomatic Carotid Stenosis

Author

Müller, Mandy D, Jongen, Lisa M, Altinbas, Aysun, Blackham, Kristine A, Nederkoorn, Paul J, Macdonald, Sumaira, Jäger, Rolf, Wolff, Thomas, Lyrer, Philippe A, Kappelle, L Jaap, Wetzel, Stephan G, Richards, Toby, Hendrikse, Jeroen, de Borst, Gert J, van der Worp, H Bart, Engelter, Stefan T, Werring, David J, Brown, Martin M, Bonati, Leo H, Müller, Mandy D, Jongen, Lisa M, Altinbas, Aysun, Blackham, Kristine A, Nederkoorn, Paul J, Macdonald, Sumaira, Jäger, Rolf, Wolff, Thomas, Lyrer, Philippe A, Kappelle, L Jaap, Wetzel, Stephan G, Richards, Toby, Hendrikse, Jeroen, de Borst, Gert J, van der Worp, H Bart, Engelter, Stefan T, Werring, David J, Brown, Martin M, and Bonati, Leo H

Published
2019

190. Collateral Circulation and Outcome in Atherosclerotic Versus Cardioembolic Cerebral Large Vessel Occlusion

Author

Guglielmi, Valeria, LeCouffe, Natalie E., Zinkstok, Sanne M., Compagne, Kars C.J., Eker, Reyhan, Treurniet, Kilian M., Tolhuisen, Manon L., van der Worp, H. Bart, Jansen, Ivo G.H., van Oostenbrugge, Robert J., Marquering, Henk A., Dippel, Diederik W.J., Emmer, Bart J., Majoie, Charles B.L.M., Roos, Yvo B.W.E.M., Coutinho, Jonathan M., MR CLEAN Registry Investigators, Guglielmi, Valeria, LeCouffe, Natalie E., Zinkstok, Sanne M., Compagne, Kars C.J., Eker, Reyhan, Treurniet, Kilian M., Tolhuisen, Manon L., van der Worp, H. Bart, Jansen, Ivo G.H., van Oostenbrugge, Robert J., Marquering, Henk A., Dippel, Diederik W.J., Emmer, Bart J., Majoie, Charles B.L.M., Roos, Yvo B.W.E.M., Coutinho, Jonathan M., and MR CLEAN Registry Investigators

Published
2019

191. Collateral Circulation and Outcome in Atherosclerotic Versus Cardioembolic Cerebral Large Vessel Occlusion

Author

ZL Cerebrovasculaire Ziekten Medisch, Brain, Circulatory Health, Guglielmi, Valeria, LeCouffe, Natalie E., Zinkstok, Sanne M., Compagne, Kars C.J., Eker, Reyhan, Treurniet, Kilian M., Tolhuisen, Manon L., van der Worp, H. Bart, Jansen, Ivo G.H., van Oostenbrugge, Robert J., Marquering, Henk A., Dippel, Diederik W.J., Emmer, Bart J., Majoie, Charles B.L.M., Roos, Yvo B.W.E.M., Coutinho, Jonathan M., MR CLEAN Registry Investigators, ZL Cerebrovasculaire Ziekten Medisch, Brain, Circulatory Health, Guglielmi, Valeria, LeCouffe, Natalie E., Zinkstok, Sanne M., Compagne, Kars C.J., Eker, Reyhan, Treurniet, Kilian M., Tolhuisen, Manon L., van der Worp, H. Bart, Jansen, Ivo G.H., van Oostenbrugge, Robert J., Marquering, Henk A., Dippel, Diederik W.J., Emmer, Bart J., Majoie, Charles B.L.M., Roos, Yvo B.W.E.M., Coutinho, Jonathan M., and MR CLEAN Registry Investigators

Published
2019

192. Timing of Repetitive Transcranial Magnetic Stimulation Onset for Upper Limb Function After Stroke: A Systematic Review and Meta-Analysis

Author

In Vivo NMR ISI, Brain, ZL Cerebrovasculaire Ziekten Medisch, Circulatory Health, RF&S Team 1 Medisch, Revalidatie/Sportgeneeskunde Medisch, van Lieshout, Eline C.C., van der Worp, H. Bart, Visser-Meily, Johanna M.A., Dijkhuizen, Rick M., In Vivo NMR ISI, Brain, ZL Cerebrovasculaire Ziekten Medisch, Circulatory Health, RF&S Team 1 Medisch, Revalidatie/Sportgeneeskunde Medisch, van Lieshout, Eline C.C., van der Worp, H. Bart, Visser-Meily, Johanna M.A., and Dijkhuizen, Rick M.

Published
2019

193. Stenting for symptomatic vertebral artery stenosis: a preplanned pooled individual patient data analysis

Author

ZL Cerebrovasculaire Ziekten Medisch, Brain, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Markus, Hugh S., Harshfield, Eric L., Compter, Annette, Kuker, Wilhelm, Kappelle, L. Jaap, Clifton, Andrew, van der Worp, H. Bart, Rothwell, Peter, Algra, Ale, ZL Cerebrovasculaire Ziekten Medisch, Brain, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Markus, Hugh S., Harshfield, Eric L., Compter, Annette, Kuker, Wilhelm, Kappelle, L. Jaap, Clifton, Andrew, van der Worp, H. Bart, Rothwell, Peter, and Algra, Ale

Published
2019

194. Silent Intracerebral Hemorrhage in Patients Randomized to Stenting or Endarterectomy for Symptomatic Carotid Stenosis

Author

ZL Cerebrovasculaire Ziekten Medisch, Brain, Circulatory Health, MS Radiologie, Researchgr. Neuroradiologie, Zorgeenheid Vaatchirurgie Medisch, Regenerative Medicine and Stem Cells, Müller, Mandy D, Jongen, Lisa M, Altinbas, Aysun, Blackham, Kristine A, Nederkoorn, Paul J, Macdonald, Sumaira, Jäger, Rolf, Wolff, Thomas, Lyrer, Philippe A, Kappelle, L Jaap, Wetzel, Stephan G, Richards, Toby, Hendrikse, Jeroen, de Borst, Gert J, van der Worp, H Bart, Engelter, Stefan T, Werring, David J, Brown, Martin M, Bonati, Leo H, ZL Cerebrovasculaire Ziekten Medisch, Brain, Circulatory Health, MS Radiologie, Researchgr. Neuroradiologie, Zorgeenheid Vaatchirurgie Medisch, Regenerative Medicine and Stem Cells, Müller, Mandy D, Jongen, Lisa M, Altinbas, Aysun, Blackham, Kristine A, Nederkoorn, Paul J, Macdonald, Sumaira, Jäger, Rolf, Wolff, Thomas, Lyrer, Philippe A, Kappelle, L Jaap, Wetzel, Stephan G, Richards, Toby, Hendrikse, Jeroen, de Borst, Gert J, van der Worp, H Bart, Engelter, Stefan T, Werring, David J, Brown, Martin M, and Bonati, Leo H

Published
2019

195. Safety and Outcome of Endovascular Treatment for Minor Ischemic Stroke: Results From the Multicenter Clinical Registry of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands

Author

Goldhoorn, Robert-Jan B., Mulder, Maxim J. H. L., Jansen, Ivo G. H., van Zwam, Wim H., Staals, Julie, van der Lugt, Aad, Dippel, Diederik W. J., Lingsma, Hester F., Vos, Jan Albert, Boiten, Jelis, van den Wijngaard, Ido R., Majoie, Charles B. L. M., Roos, Yvo B. W. E. M., van Oostenbrugge, Robert J., Schonewille, Wouter J., Coutinho, Jonathan M., Wermer, Marieke J. H., van Walderveen, Marianne A. A., Hofmeijer, Jeannette, Martens, Jasper M., Nijeholt, Geert J. Lycklama A., Roozenbeek, Bob, Emmer, Bart J., de Bruijn, Sebastiaan F., van Dijk, Lukas C., van der Worp, H. Bart, Lo, Rob H., van Dijk, Ewoud J., Boogaarts, Hieronymus D., de Kort, Paul L. M., Peluso, Jo J. P., van den Berg, Jan S. P., van Hasselt, Boudewijn A. A. M., Aerden, Leo A. M., Dallinga, Rene J., Uyttenboogaart, Maarten, Eshghi, Omid, Schreuder, Tobien H. C. M. L., Heijboer, Roel J. J., Keizer, Koos, Yo, Lonneke S. F., den Hertog, Heleen M., Sturm, Emiel J. C., Sprengers, Marieke E. S., Jenniskens, Sjoerd F. M., Postma, Alida, Hinsenveld, Wouter, Groot, P. F. C., MR CLEAN Registry Investigators, Goldhoorn, Robert-Jan B., Mulder, Maxim J. H. L., Jansen, Ivo G. H., van Zwam, Wim H., Staals, Julie, van der Lugt, Aad, Dippel, Diederik W. J., Lingsma, Hester F., Vos, Jan Albert, Boiten, Jelis, van den Wijngaard, Ido R., Majoie, Charles B. L. M., Roos, Yvo B. W. E. M., van Oostenbrugge, Robert J., Schonewille, Wouter J., Coutinho, Jonathan M., Wermer, Marieke J. H., van Walderveen, Marianne A. A., Hofmeijer, Jeannette, Martens, Jasper M., Nijeholt, Geert J. Lycklama A., Roozenbeek, Bob, Emmer, Bart J., de Bruijn, Sebastiaan F., van Dijk, Lukas C., van der Worp, H. Bart, Lo, Rob H., van Dijk, Ewoud J., Boogaarts, Hieronymus D., de Kort, Paul L. M., Peluso, Jo J. P., van den Berg, Jan S. P., van Hasselt, Boudewijn A. A. M., Aerden, Leo A. M., Dallinga, Rene J., Uyttenboogaart, Maarten, Eshghi, Omid, Schreuder, Tobien H. C. M. L., Heijboer, Roel J. J., Keizer, Koos, Yo, Lonneke S. F., den Hertog, Heleen M., Sturm, Emiel J. C., Sprengers, Marieke E. S., Jenniskens, Sjoerd F. M., Postma, Alida, Hinsenveld, Wouter, Groot, P. F. C., and MR CLEAN Registry Investigators

Abstract

Goal: Insufficient data is available about safety and efficacy of endovascular treatment (EVT) in patients with minor stroke symptoms because these patients were excluded from most randomized trials. We aimed to compare characteristics, functional outcome, and complications in patients with minor ischemic stroke National Institutes of Health Stroke Scale score = 6) due to intracranial proximal artery occlusion of the anterior circulation who underwent EVT. Materials and Methods: We report patients with an anterior circulation occlusion who were included between March 2014 and June 2016 in the multicenter randomized clinical trial of EVT of acute ischemic stroke in the Netherlands Registry, a prospective, multicenter, observational study for stroke centers that perform EVT in the Netherlands. Minor ischemic stroke was defined as baseline NIHSS score of 5 or less. Primary outcome is the modified Rankin Scale (mRS) score at 90 days. Secondary outcomes include symptomatic intracranial hemorrhage (sICH) and mortality. Findings: Seventy-one (5.5%) patients had a NIHSS score of 5 or less. Functional independence (mRS 0-2 at 90 days) was reached in 75% of these patients, compared to 40% of patients with NIHSS score of 6 or more. sICH occurred in 4% of patients, of which 1% occurred peri-interventionally. Death occurred in 6% of patients. Conclusions: Patients with minor ischemic stroke with an intracranial proximal arterial occlusion of the anterior circulation who underwent EVT have a high chance of favorable outcome and appear to have low occurrence of treatment-related sICH. Therefore, our results encourage the use of EVT for minor ischemic stroke in the absence of effect estimates from controlled studies.

Published
2019

196. Which patients with acute stroke due to proximal occlusion should not be treated with endovascular thrombectomy?

Author

Goyal, Mayank, Almekhlafi, Mohammed A., Cognard, Christoph, McTaggart, Ryan, Blackham, Kristine, Biondi, Alessandra, van der Lugt, Aad, Majoie, Charles B. L. M., van Zwam, Wim H., van der Worp, H. Bart, Hill, Michael D., Goyal, Mayank, Almekhlafi, Mohammed A., Cognard, Christoph, McTaggart, Ryan, Blackham, Kristine, Biondi, Alessandra, van der Lugt, Aad, Majoie, Charles B. L. M., van Zwam, Wim H., van der Worp, H. Bart, and Hill, Michael D.

Published
2019

197. Impact of single phase CT angiography collateral status on functional outcome over time: results from the MR CLEAN Registry

Author

Jansen, Ivo G. H., Mulder, Maxim J. H. L., Goldhoorn, Robert-Jan B., Boers, Anna M. M., van Es, Adriaan C. G. M., Yo, Lonneke S. F., Hofmeijer, Jeannette, Martens, Jasper M., van Walderveen, Marianne A. A., van der Kallen, Bas F. W., Jenniskens, Sjoerd F. M., Treurniet, Kilian M., Marqueriny, Henk A., Sprengers, Marieke E. S., Schonewille, Wouter J., Bot, Joost, Lycklama A Nijeholt, Geert J., Lingsma, Hester F., Liebeskind, David S., Boiten, Jelis, Vos, Jan-Albert, Roos, Yvo B. W. E. M., van Oostenbrugge, Robert J., van der Lugt, Aad, van Zwam, Wim H., Dippel, Diederik W. J., van den Wijngaard, Ido R., Majoie, Charles B. L. M., Coutinho, Jonathan M., Wermern, Marieke J. H., Staals, Julie, Roozenbeek, Bob, Emmer, Bart J., de Bruijn, Sebastiaan F., van Dijk, Lukas C., van der Worp, H. Bart, Lo, Rob H., van Dijk, Ewoud J., Boogaarts, Hieronymus D., de Kort, Paul L. M., Peluso, Jo J. P., van den Berg, Jan S. P., van Hasselt, Boudewijn A. A. M., Aerden, Leo A. M., Dallinga, Rene J., Uyttenboogaart, Maarten, Eshghi, Omid, Schreuder, Tobien H. C. M. L., Heijboer, Roel J. J., Groot, P. F. C., MR CLEAN Registry Investigators, Jansen, Ivo G. H., Mulder, Maxim J. H. L., Goldhoorn, Robert-Jan B., Boers, Anna M. M., van Es, Adriaan C. G. M., Yo, Lonneke S. F., Hofmeijer, Jeannette, Martens, Jasper M., van Walderveen, Marianne A. A., van der Kallen, Bas F. W., Jenniskens, Sjoerd F. M., Treurniet, Kilian M., Marqueriny, Henk A., Sprengers, Marieke E. S., Schonewille, Wouter J., Bot, Joost, Lycklama A Nijeholt, Geert J., Lingsma, Hester F., Liebeskind, David S., Boiten, Jelis, Vos, Jan-Albert, Roos, Yvo B. W. E. M., van Oostenbrugge, Robert J., van der Lugt, Aad, van Zwam, Wim H., Dippel, Diederik W. J., van den Wijngaard, Ido R., Majoie, Charles B. L. M., Coutinho, Jonathan M., Wermern, Marieke J. H., Staals, Julie, Roozenbeek, Bob, Emmer, Bart J., de Bruijn, Sebastiaan F., van Dijk, Lukas C., van der Worp, H. Bart, Lo, Rob H., van Dijk, Ewoud J., Boogaarts, Hieronymus D., de Kort, Paul L. M., Peluso, Jo J. P., van den Berg, Jan S. P., van Hasselt, Boudewijn A. A. M., Aerden, Leo A. M., Dallinga, Rene J., Uyttenboogaart, Maarten, Eshghi, Omid, Schreuder, Tobien H. C. M. L., Heijboer, Roel J. J., Groot, P. F. C., and MR CLEAN Registry Investigators

Abstract

Background Collateral status modified the effect of endovascular treatment (EVT) for stroke in several randomized trials. We assessed the association between collaterals and functional outcome in EVT treated patients and investigated if this association is time dependent.Methods We included consecutive patients from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in The Netherlands (MR CLEAN) Registry (March 2014-June 2016) with an anterior circulation large vessel occlusion undergoing EVT. Functional outcome was measured on the modified Rankin Scale (mRS) at 90 days. We investigated the association between collaterals and mRS in the MR CLEAN Registry with ordinal logistic regression and if this association was time dependent with an interaction term. Additionally, we determined modification of EVT effect by collaterals compared with MR CLEAN controls, and also investigated if this was time dependent with multiplicative interaction terms.Results 1412 patients were analyzed. Functional independence (mRS score of 0-2) was achieved in 13% of patients with grade 0 collaterals, in 27% with grade 1, in 46% with grade 2, and in 53% with grade 3. Collaterals were significantly associated with mRS (adjusted common OR 1.5 (95% CI 1.4 to 1.7)) and significantly modified EVT benefit (P=0.04). None of the effects were time dependent. Better collaterals corresponded to lower mortality (PConclusion In routine clinical practice, better collateral status is associated with better functional outcome and greater treatment benefit in EVT treated acute ischemic stroke patients, independent of time to treatment. Within the 6 hour time window, a substantial proportion of patients with absent and poor collaterals can still achieve functional independence.

Published
2019

198. Therapeutic hypothermia for acute ischaemic stroke:Results of a European multicentre, randomised, phase III clinical trial

Author

van der Worp, H Bart, Macleod, Malcolm R, Bath, Philip Mw, Bathula, Raj, Christensen, Hanne, Colam, Bridget, Cordonnier, Charlotte, Demotes-Mainard, Jacques, Durand-Zaleski, Isabelle, Gluud, Christian, Jakobsen, Janus Christian, Kallmünzer, Bernd, Kollmar, Rainer, Krieger, Derk W, Lees, Kennedy R, Michalski, Dominik, Molina, Carlos, Montaner, Joan, Roine, Risto O, Petersson, Jesper, Perry, Richard, Sprigg, Nikola, Staykov, Dimitre, Szabo, Istvan, Vanhooren, Geert, Wardlaw, Joanna M, Winkel, Per, Schwab, Stefan, van der Worp, H Bart, Macleod, Malcolm R, Bath, Philip Mw, Bathula, Raj, Christensen, Hanne, Colam, Bridget, Cordonnier, Charlotte, Demotes-Mainard, Jacques, Durand-Zaleski, Isabelle, Gluud, Christian, Jakobsen, Janus Christian, Kallmünzer, Bernd, Kollmar, Rainer, Krieger, Derk W, Lees, Kennedy R, Michalski, Dominik, Molina, Carlos, Montaner, Joan, Roine, Risto O, Petersson, Jesper, Perry, Richard, Sprigg, Nikola, Staykov, Dimitre, Szabo, Istvan, Vanhooren, Geert, Wardlaw, Joanna M, Winkel, Per, and Schwab, Stefan

Abstract

Introduction: We assessed whether modest systemic cooling started within 6 hours of symptom onset improves functional outcome at three months in awake patients with acute ischaemic stroke.Patients and methods: In this European randomised open-label clinical trial with blinded outcome assessment, adult patients with acute ischaemic stroke were randomised to cooling to a target body temperature of 34.0-35.0°C, started within 6 h after stroke onset and maintained for 12 or 24 h , versus standard treatment. The primary outcome was the score on the modified Rankin Scale at 91 days, as analysed with ordinal logistic regression.Results: The trial was stopped after inclusion of 98 of the originally intended 1500 patients because of slow recruitment and cessation of funding. Forty-nine patients were randomised to hypothermia versus 49 to standard treatment. Four patients were lost to follow-up. Of patients randomised to hypothermia, 15 (31%) achieved the predefined cooling targets. The primary outcome did not differ between the groups (odds ratio for good outcome, 1.01; 95% confidence interval, 0.48-2.13; p = 0.97). The number of patients with one or more serious adverse events did not differ between groups (relative risk, 1.22; 95% confidence interval, 0.65-1.94; p = 0.52).Discussion: In this trial, cooling to a target of 34.0-35.0°C and maintaining this for 12 or 24 h was not feasible in the majority of patients. The final sample was underpowered to detect clinically relevant differences in outcomes.Conclusion: Before new trials are launched, the feasibility of cooling needs to be improved.

Published
2019

199. INTEnsive ambulance-delivered blood pressure Reduction in hyper-ACute stroke Trial (INTERACT4): study protocol for a randomized controlled trial.

Author

Song, Lili, Chen, Chen, Chen, Xiaoying, Guo, Yijia, Liu, Feifeng, Lin, Yapeng, Billot, Laurent, Li, Qiang, Liu, Hueiming, Si, Lei, Ouyang, Menglu, Arima, Hisatomi, Bath, Philip M., Ford, Gary A., Robinson, Thompson, Sandset, Else Charlotte, Saver, Jeffrey L., Sprigg, Nikola, van der Worp, H. Bart, and Zhang, Chunfang

Subjects
RANDOMIZED controlled trials, RESEARCH protocols, BLOOD pressure, INTRACRANIAL hemorrhage, ISCHEMIC stroke, HYPERTENSION, REPERFUSION, SYSTOLIC blood pressure
Abstract

Background: Early pre-hospital initiation of blood pressure (BP) lowering could improve outcomes for patients with acute stroke, by reducing hematoma expansion in intracerebral hemorrhage (ICH), and time to reperfusion treatment and risk of intracranial hemorrhage in ischemic stroke (IS). We present the design of the fourth INTEnsive ambulance-delivered blood pressure Reduction in hyper-ACute stroke Trial (INTERACT4).Methods: A multi-center, ambulance-delivered, prospective, randomized, open-label, blinded endpoint (PROBE) assessed trial of pre-hospital BP lowering in 3116 hypertensive patients with suspected acute stroke at 50+ sites in China. Patients are randomized through a mobile phone digital system to intensive BP lowering to a target systolic BP of < 140 mmHg within 30 min, or guideline-recommended BP management according to local protocols. After the collection of in-hospital clinical and management data and 7-day outcomes, trained blinded assessors conduct telephone or face-to-face assessments of physical function and health-related quality of life in participants at 90 days. The primary outcome is the physical function on the modified Rankin scale at 90 days, analyzed as an ordinal outcome with 7 categories. The sample size was estimated to provide 90% power (α = 0.05) to detect a 22% reduction in the odds of a worse functional outcome using ordinal logistic regression.Discussion: INTERACT4 is a pragmatic clinical trial to provide reliable evidence on the effectiveness and safety of ambulance-delivered hyperacute BP lowering in patients with suspected acute stroke.Trial Registration: ClinicalTrials.gov NCT03790800. Registered on 2 January 2019; Chinese Trial Registry ChiCTR1900020534. Registered on 7 January 2019. All items can be found in this protocol paper. [ABSTRACT FROM AUTHOR]

Published
2021
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200. Blood Pressure in the First 6 Hours Following Endovascular Treatment for Ischemic Stroke Is Associated With Outcome.

Author

Samuels, Noor, van de Graaf, Rob A., van den Berg, Carlijn A.L., Uniken Venema, Simone M., Bala, Kujtesa, van Doormaal, Pieter Jan, van der Steen, Wouter, Witvoet, Elbert, Boiten, Jelis, den Hertog, Heleen, Schonewille, Wouter J., Hofmeijer, Jeannette, Schreuder, Floris, Schreuder, Tobien A.H.C.M.L., van der Worp, H. Bart, Roos, Yvo B.W.E.M., Majoie, Charles B.L.M., Burke, James F., van Es, Adriaan C.G.M., and van der Lugt, Aad

Published
2021
Full Text
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