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1. Mismatch Vs No Mismatch in Large Core—A Matter of Definition

Author

Yedavalli, Vivek, Salim, Hamza Adel, Lakhani, Dhairya A., Mei, Janet, Balar, Aneri, Musmar, Basel, Adeeb, Nimer, Hoseinyazdi, Meisam, Luna, Licia, Deng, Francis, Hyson, Nathan Z., Dmytriw, Adam A., Guenego, Adrien, Lu, Hanzhang, Urrutia, Victor C., Nael, Kambiz, Marsh, Elisabeth B., Llinas, Raf, Hillis, Argye E., Wintermark, Max, Faizy, Tobias D., Heit, Jeremy J., and Albers, Gregory W.

Published
2024
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3. Follow-up infarct volume on fluid attenuated inversion recovery (FLAIR) imaging in distal medium vessel occlusions: the role of cerebral blood volume index

Author

Salim, Hamza, Lakhani, Dhairya A., Balar, Aneri, Musmar, Basel, Adeeb, Nimer, Hoseinyazdi, Meisam, Luna, Licia, Deng, Francis, Hyson, Nathan Z., Mei, Janet, Dmytriw, Adam A., Guenego, Adrien, Faizy, Tobias D., Heit, Jeremy J., Albers, Gregory W., Urrutia, Victor C., Llinas, Raf, Marsh, Elisabeth B., Hillis, Argye E., Nael, Kambiz, and Yedavalli, Vivek

Published
2024
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4. Pretreatment parameters associated with hemorrhagic transformation among successfully recanalized medium vessel occlusions

Author

Koneru, Manisha, Hoseinyazdi, Meisam, Wang, Richard, Ozkara, Burak Berksu, Hyson, Nathan Z., Marsh, Elisabeth Breese, Llinas, Rafael H., Urrutia, Victor C., Leigh, Richard, Gonzalez, Luis Fernando, Xu, Risheng, Caplan, Justin M., Huang, Judy, Lu, Hanzhang, Luna, Licia, Wintermark, Max, Dmytriw, Adam A., Guenego, Adrien, Albers, Gregory W., Heit, Jeremy J., Nael, Kambiz, Hillis, Argye E., and Yedavalli, Vivek S.

Published
2024
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7. Evaluation of time-resolved whole brain flat panel detector perfusion imaging using RAPID ANGIO in patients with acute stroke: comparison with CT perfusion imaging

Author

Kurmann, Christoph C, Kaesmacher, Johannes, Cooke, Daniel L, Psychogios, Marios, Weber, Johannes, Lopes, Demetrius K, Albers, Gregory W, and Mordasini, Pasquale

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Neurosciences, Biomedical Imaging, Clinical Research, 4.2 Evaluation of markers and technologies, Detection, screening and diagnosis, Humans, Tomography, X-Ray Computed, Retrospective Studies, Stroke, Brain, Brain Ischemia, Perfusion Imaging, Thrombectomy, CT perfusion, Clinical sciences
Abstract

BackgroundIn contrast to conventional CT perfusion (CTP) imaging, flat panel detector CT perfusion (FD-CTP) imaging can be acquired directly in the angiosuite.ObjectiveTo evaluate time-resolved whole brain FD-CTP imaging and assess clinically important qualitative and quantitative perfusion parameters in correlation with previously acquired conventional CTP using the new RAPID for ANGIO software.MethodsWe included patients with internal carotid artery occlusions and M1 or M2 occlusions from six centers. All patients underwent mechanical thrombectomy (MT) with preinterventional conventional CTP and FD-CTP imaging. Quantitative performance was determined by comparing volumes of infarct core, penumbral tissue, and mismatch. Eligibility for MT according to the perfusion imaging criteria of DEFUSE 3 was determined for each case from both conventional CTP and FD-CTP imaging.ResultsA total of 20 patients were included in the final analysis. Conventional relative cerebral blood flow (rCBF) 6 s versus FD-CTP Tmax >6 s and CTP mismatch versus FD-CTP mismatch showed more variability (R2=0.57, and R2=0.33, respectively). Based on FD-CTP, 16/20 (80%) patients met the inclusion criteria for MT according to the DEFUSE 3 perfusion criteria, in contrast to 18/20 (90%) patients based on conventional CTP. The vessel occlusion could be correctly extrapolated from the hypoperfusion in 18/20 cases (90%).ConclusionsIn our multicenter study, time-resolved whole brain FD-CTP was technically feasible, and qualitative and quantitative perfusion results correlated with those obtained with conventional CTP.

Published
2023

8. USE-Evaluator: Performance Metrics for Medical Image Segmentation Models with Uncertain, Small or Empty Reference Annotations

Author

Ostmeier, Sophie, Axelrod, Brian, Bertels, Jeroen, Isensee, Fabian, Lansberg, Maarten G., Christensen, Soren, Albers, Gregory W., Li, Li-Jia, and Heit, Jeremy J.

Subjects
Electrical Engineering and Systems Science - Image and Video Processing, Computer Science - Computer Vision and Pattern Recognition, Computer Science - Machine Learning
Abstract

Performance metrics for medical image segmentation models are used to measure the agreement between the reference annotation and the predicted segmentation. Usually, overlap metrics, such as the Dice, are used as a metric to evaluate the performance of these models in order for results to be comparable. However, there is a mismatch between the distributions of cases and difficulty level of segmentation tasks in public data sets compared to clinical practice. Common metrics fail to measure the impact of this mismatch, especially for clinical data sets that include low signal pathologies, a difficult segmentation task, and uncertain, small, or empty reference annotations. This limitation may result in ineffective research of machine learning practitioners in designing and optimizing models. Dimensions of evaluating clinical value include consideration of the uncertainty of reference annotations, independence from reference annotation volume size, and evaluation of classification of empty reference annotations. We study how uncertain, small, and empty reference annotations influence the value of metrics for medical image segmentation on an in-house data set regardless of the model. We examine metrics behavior on the predictions of a standard deep learning framework in order to identify metrics with clinical value. We compare to a public benchmark data set (BraTS 2019) with a high-signal pathology and certain, larger, and no empty reference annotations. We may show machine learning practitioners, how uncertain, small, or empty reference annotations require a rethinking of the evaluation and optimizing procedures. The evaluation code was released to encourage further analysis of this topic. https://github.com/SophieOstmeier/UncertainSmallEmpty.git, Comment: 16 pages, 10 figures, Published in Medical Image Analysis

Published
2022
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12. Projections of Endovascular Therapy–Eligible Patients With Stroke for the US Population

Author

Mistry, Eva A., Khoury, Jane C., Kleindorfer, Dawn O., Kissela, Brett M., Alwell, Kathleen S., Jasne, Adam S., Ferioli, Simona, De Los Rios La Rosa, Felipe, Coleman, Elisheva, Demel, Stacie L., Walsh, Kyle B., Slavin, Sabreena J., Star, Michael, Haverbusch, Mary, Mackey, Jason, Woo, Daniel, Aziz, Yasmin N., Heldner, Mirjam R., Fischer, Urs, Jadhav, Ashutosh P., Jovin, Tudor G., Albers, Gregory W., Nogueira, Raul G., and Khatri, Pooja

Published
2024
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15. Acute Stroke Imaging Research Roadmap IV: Imaging Selection and Outcomes in Acute Stroke Clinical Trials and Practice.

Author

Campbell, Bruce CV, Lansberg, Maarten G, Broderick, Joseph P, Derdeyn, Colin P, Khatri, Pooja, Sarraj, Amrou, Saver, Jeffrey L, Vagal, Achala, Albers, Gregory W, Adeoye, Opeolu, Ansari, Saeed, Boltze, Johannes, Buchan, Alastair, Chaisinanunkul, Napasri, Chen, Christopher, Davis, Thomas P, Ermakova, Tatiana, Fisher, Marc, Haddad, Walid, Hill, Michael D, Houser, Gary, Jadhav, Ashutosh P, Kimberly, W Taylor, Landen, Jaren W, Liebeskind, David S, Lyden, Patrick, Lynch, John, Mansi, Chris, Mocco, J, Nogueira, Raul G, Savitz, Sean I, Schwamm, Lee H, Sheth, Kevin N, Solberg, Yoram, Venkatasubramanian, Chitra, Warach, Steven, Wechsler, Lawrence R, Zhu, Bin, and Ziogas, Nikolaos K

Subjects
Neurosciences, Stroke, Clinical Research, Brain Disorders, Clinical Trials and Supportive Activities, Biomedical Imaging, Clinical Trials as Topic, Computed Tomography Angiography, Consensus Development Conferences as Topic, Endovascular Procedures, Humans, Magnetic Resonance Imaging, Tomography, X-Ray Computed, Treatment Outcome, angiography, clinical trials, ischemic stroke, perfusion imaging, tomography, STAIR XI Consortium, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Neurology & Neurosurgery
Abstract

Background and purposeThe Stroke Treatment Academic Industry Roundtable (STAIR) sponsored an imaging session and workshop during the Stroke Treatment Academic Industry Roundtable XI via webinar on October 1 to 2, 2020, to develop consensus recommendations, particularly regarding optimal imaging at primary stroke centers.MethodsThis forum brought together stroke neurologists, neuroradiologists, neuroimaging research scientists, members of the National Institute of Neurological Disorders and Stroke, industry representatives, and members of the US Food and Drug Administration to discuss imaging priorities in the light of developments in reperfusion therapies, particularly in an extended time window, and reinvigorated interest in brain cytoprotection trials.ResultsThe imaging session summarized and compared the imaging components of recent acute stroke trials and debated the optimal imaging strategy at primary stroke centers. The imaging workshop developed consensus recommendations for optimizing the acquisition, analysis, and interpretation of computed tomography and magnetic resonance acute stroke imaging, and also recommendations on imaging strategies for primary stroke centers.ConclusionsRecent positive acute stroke clinical trials have extended the treatment window for reperfusion therapies using imaging selection. Achieving rapid and high-quality stroke imaging is therefore critical at both primary and comprehensive stroke centers. Recommendations for enhancing stroke imaging research are provided.

Published
2021

19. The Utility of Domain-Specific End Points in Acute Stroke Trials

Author

Cramer, Steven C, Wolf, Steven L, Saver, Jeffrey L, Johnston, Karen C, Mocco, J, Lansberg, Maarten G, Savitz, Sean I, Liebeskind, David S, Smith, Wade, Wintermark, Max, Elm, Jordan J, Khatri, Pooja, Broderick, Joseph P, Janis, Scott, Chen, Daofen, Dromerick, Alexander, Dunning, Kari, Grande, Andrew W, Marshall, Randolph S, Meinzer, Caitlyn, Page, Stephen, Reiss, Aimee, Richards, Lorie, Wechsler, Lawrence, Winstein, Carolee, Bushnell, Cheryl, Edwards, Dorothy, Lo, Warren, Lee, Jin-Moo, Amlie-Lefond, Catherine M, Albers, Gregory W, Dempsey, Robert, Gropen, Toby I, Jauch, Edward C, Leira, Enrique C, Martin, Renee, Meyer, Brett C, Schindler, Kiva, Scott, Phillip, Singhal, Aneesh B, and Moy, Claudia S

Subjects
Biomedical and Clinical Sciences, Allied Health and Rehabilitation Science, Clinical Sciences, Health Sciences, Neurosciences, Endpoint Determination, Humans, Research Design, Stroke, Treatment Outcome, brain, infarction, neurons, outcome assessment, reperfusion, NIH StrokeNet Recovery and Rehabilitation Group and the Acute Stroke Group*, Cardiorespiratory Medicine and Haematology, Neurology & Neurosurgery, Clinical sciences, Allied health and rehabilitation science
Abstract

Domain-specific endpoints are assessments that correspond to the output of individual neural systems and are useful for capturing treatment effects on specific behaviors. By contrast, global endpoints combine several attributes into a single score and are useful for capturing broad treatment effects in a summary way. While global endpoints have become the de facto mechanism required to define benefit in stroke trials, they also have important limitations, some of which might be addressed by simultaneously measuring domain-specific endpoints. Substantial opportunity remains to identify quantifiable patient benefit that would otherwise not be captured by global endpoints. Potential advantages of incorporating domain-specific endpoints in acute stroke trials are discussed, such as increased granularity of measurement, improved understanding of how therapies affect the brain between acute treatment and day 90, and optimized therapeutic translation. Potential disadvantages are also considered, including time and cost of administering domain-specific endpoints, as well as statistical implications. Domain-specific endpoints and global endpoints are not mutually exclusive, and both capture clinical benefits to patients. Incorporating a broader set of outcome assessments in stroke trials, including both global and domain-specific endpoints, is warranted.

Published
2021

22. The charlotte large artery occlusion endovascular therapy outcome score compares favorably to the critical area perfusion score for prognostication before basilar thrombectomy

Author

Karamchandani, Rahul R., Satyanarayana, Sagar, Yang, Hongmei, Rhoten, Jeremy B., Strong, Dale, Singh, Sam, Clemente, Jonathan D., Defilipp, Gary, Hazim, Manuel, Patel, Nikhil M., Bernard, Joe, Stetler, William R., Parish, Jonathan M., Blackwell, Thomas A., Heit, Jeremy J., Albers, Gregory W., Saba, Kasser, Guzik, Amy K., Wolfe, Stacey Q., and Asimos, Andrew W.

Published
2023
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23. Effect of atherosclerosis on 5-year risk of major vascular events in patients with transient ischaemic attack or minor ischaemic stroke: an international prospective cohort study

Author

Lavallée, Philippa C, Charles, Hugo, Albers, Gregory W, Caplan, Louis R, Donnan, Geoffrey A, Ferro, José M, Hennerici, Michael G, Labreuche, Julien, Molina, Carlos, Rothwell, Peter M, Steg, Philippe Gabriel, Touboul, Pierre-Jean, Uchiyama, Shinichiro, Vicaut, Éric, Wong, Lawrence K S, and Amarenco, Pierre

Published
2023
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25. Priorities for Advancements in Neuroimaging in the Diagnostic Workup of Acute Stroke

Author

Samaniego, Edgar A., Boltze, Johannes, Lyden, Patrick D., Hill, Michael D., Campbell, Bruce C.V., Silva, Gisele Sampaio, Sheth, Kevin N., Fisher, Marc, Hillis, Argye E., Nguyen, Thanh N., Carone, Davide, Favilla, Christopher G., Deljkich, Emir, Albers, Gregory W., Heit, Jeremy J., Lansberg, Maarten G., Aksoy, Didem, Broderick, Joe, Castonguay, Alicia C., Ghosh, Supurna, Grotta, James C., Harston, George, Houser, Gary R., Kuchenbecker, Kristopher, Latour, Lawrence L., Liebeskind, David S., Kylan Lynch, John, Maier, Carolina, Mistry, Eva, Mocco, J., Nogueira, Raul G., Saver, Jeffrey L., van Vlimmeren, Marijke, Wakhloo, Ajay K., and Wechsler, Lawrence

Published
2023
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29. Contralateral Hemispheric Cerebral Blood Flow Measured With Arterial Spin Labeling Can Predict Outcome in Acute Stroke

Author

Thamm, Thoralf, Guo, Jia, Rosenberg, Jarrett, Liang, Tie, Marks, Michael P, Christensen, Soren, Do, Huy M, Kemp, Stephanie M, Adair, Emma, Eyngorn, Irina, Mlynash, Michael, Jovin, Tudor G, Keogh, Bart P, Chen, Hui J, Lansberg, Maarten G, Albers, Gregory W, and Zaharchuk, Greg

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Neurosciences, Brain Disorders, Stroke, Biomedical Imaging, Detection, screening and diagnosis, 4.2 Evaluation of markers and technologies, Aged, Brain, Brain Ischemia, Cerebrovascular Circulation, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Neuroimaging, Prospective Studies, Treatment Outcome, cerebrovascular circulation, magnetic resonance imaging, perfusion imaging, prognosis, prospective studies, stroke, Cardiorespiratory Medicine and Haematology, Neurology & Neurosurgery, Clinical sciences, Allied health and rehabilitation science
Abstract

Background and Purpose- Imaging is frequently used to select acute stroke patients for intra-arterial therapy. Quantitative cerebral blood flow can be measured noninvasively with arterial spin labeling magnetic resonance imaging. Cerebral blood flow levels in the contralateral (unaffected) hemisphere may affect capacity for collateral flow and patient outcome. The goal of this study was to determine whether higher contralateral cerebral blood flow (cCBF) in acute stroke identifies patients with better 90-day functional outcome. Methods- Patients were part of the prospective, multicenter iCAS study (Imaging Collaterals in Acute Stroke) between 2013 and 2017. Consecutive patients were enrolled after being diagnosed with anterior circulation acute ischemic stroke. Inclusion criteria were ischemic anterior circulation stroke, baseline National Institutes of Health Stroke Scale score ≥1, prestroke modified Rankin Scale score ≤2, onset-to-imaging time

Published
2019

31. Risk of subsequent disabling or fatal stroke in patients with transient ischaemic attack or minor ischaemic stroke: an international, prospective cohort study

Author

Hobeanu, Cristina, Lavallée, Philippa C, Charles, Hugo, Labreuche, Julien, Albers, Gregory W, Caplan, Louis R, Donnan, Geoffrey A, Ferro, Jose M, Hennerici, Michael G, Molina, Carlos A, Rothwell, Peter M, Steg, Philippe Gabriel, Touboul, Pierre-Jean, Uchiyama, Shinichiro, Vicaut, Eric, Wong, K S Lawrence, and Amarenco, Pierre

Published
2022
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33. Infarct Core Growth During Interhospital Transfer For Thrombectomy Is Faster At Night

Author

Seners, Pierre, Mlynash, Michael, Sreekrishnan, Anirudh, Ter Schiphorst, Adrien, Arquizan, Caroline, Costalat, Vincent, Henon, Hilde, Bretzner, Martin, Heit, Jeremy J., Olivot, Jean-Marc, Lansberg, Maarten G., Albers, Gregory W., Schmitt, Perrine, Sablot, Denis, Lalu, Thibault, Bricout, Nicolas, Albucher, Jean-François, Cognard, Christophe, Cordonnier, Charlotte, Christensen, Soren, and Scheldeman, Lauranne

Published
2023
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34. Consensus Recommendations for Standardized Data Elements, Scales, and Time Segmentations in Studies of Human Circadian/Diurnal Biology and Stroke

Author

Saver, Jeffrey L., Klerman, Elizabeth B., Buchan, Alastair M., Calleja, Patricia, Lizasoain, Ignacio, Bahr-Hosseini, Mersedeh, Lee, Sarah, Liebeskind, David S., Mergenthaler, Philipp, Mun, Katherine T., Ning, MingMing, Pelz, David, Ray, David, Rothwell, Peter M., Seners, Pierre, Sreekrishnan, Anirudh, Sung, Eleanor Mina, Tiedt, Steffen, Webb, Alastair J.S., Wölfer, Teresa A., and Albers, Gregory W.

Published
2023
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35. Intravenous glibenclamide for cerebral oedema after large hemispheric stroke (CHARM): a phase 3, double-blind, placebo-controlled, randomised trial.

Author

Sheth, Kevin N, Albers, Gregory W, Saver, Jeffrey L, Campbell, Bruce C V, Molyneaux, Bradley J, Hinson, H E, Cordonnier, Charlotte, Steiner, Thorsten, Toyoda, Kazunori, Wintermark, Max, Littauer, Ross, Collins, Jessica, Lucas, Nisha, Nogueira, Raul G, Simard, J Marc, Wald, Michael, Dawson, Kate, and Kimberly, W Taylor

Subjects
*STRUCTURED treatment interruption, *CEREBRAL edema, *ISCHEMIC stroke, *DIFFUSION magnetic resonance imaging, *STROKE
Abstract

No treatment is available to prevent brain oedema, which can occur after a large hemispheric infarction. Glibenclamide has previously been shown to improve functional outcome and reduce neurological or oedema-related death in patients younger than 70 years who were at risk of brain oedema after an acute ischaemic stroke. We aimed to assess whether intravenous glibenclamide could improve functional outcome at 90 days in patients with large hemispheric infarction. CHARM was a phase 3, double-blind, placebo-controlled, randomised trial conducted across 143 acute stroke centres in 21 countries. We included patients aged 18–85 years with a large stroke, defined either by an Alberta Stroke Program Early CT Score (ASPECTS) of 1–5 or by an ischaemic core lesion volume of 80–300 mL on CT perfusion or MRI diffusion-weighted imaging. Patients were randomly assigned in a 1:1 ratio to either intravenous glibenclamide (8·6 mg over 72 h) or placebo. The study drug was started within 10 h of stroke onset. The primary efficacy outcome was the shift in the distribution of scores on the modified Rankin Scale at day 90, as a measure of functional outcome. The primary efficacy outcome was analysed in a modified intention-to-treat population, which included all randomly assigned patients aged 18–70 years. The safety population comprised all randomly assigned patients who received a dose. This trial is registered with ClinicalTrials.gov (NCT02864953). The trial was stopped early by the sponsor for strategic and operational reasons (slow enrolment because of COVID-19), before any unblinding or knowledge of the trial results. Between Aug 29, 2018, and May 23, 2023, 535 patients were enrolled and randomly assigned, of whom 518 received a dose (safety population) and 431 were aged 18–70 years and comprised the modified intention-to-treat population (217 were assigned glibenclamide and 214 placebo). The mean age of patients was 58·7 (SD 9·0) years in the placebo group and 58·0 (9·5) years in the glibenclamide group; the median US National Institutes of Health Stroke Scale (NIHSS) score was 19 (IQR 16–23) in the placebo group and 19 (IQR 16–22) in the glibenclamide group; and the mean time from stroke onset to study drug start was 8·9 h (SD 2·1) in the placebo group and 9·2 h (2·1) in the glibenclamide group. Intravenous glibenclamide was not associated with a favourable shift in the modified Rankin scale at 90 days (common odds ratio [OR] 1·17 [95% CI 0·80–1·71], p=0·42). 90-day mortality was 29% (61 of 214) in the placebo group and 32% (70 of 217) in the glibenclamide group (hazard ratio 1·20 [0·85–1·70]; p=0·30). Serious adverse events in the prespecified safety population were consistent with the known safety profile of glibenclamide and included hypoglycaemia in 15 (6%) of 259 patients in the glibenclamide group and in four (2%) of 259 patients in the placebo group, leading to dose interruption or reduction in seven (3%) patients in the glibenclamide group and in one (<1%) in the placebo group. Intravenous glibenclamide did not improve functional outcome in patients aged 18–70 years after large hemispheric infarction, although the trial was underpowered to make definitive conclusions because it was stopped early. Future prospective evaluation could be warranted to identify a possible benefit of intravenous glibenclamide in specific subgroups. Biogen. [ABSTRACT FROM AUTHOR]

Published
2024
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36. Predictors of futile recanalization in ischemic stroke patients with low baseline NIHSS.

Author

Heitkamp, Christian, Heitkamp, Alexander, Winkelmeier, Laurens, Thaler, Christian, Flottmann, Fabian, Schell, Maximilian, Kniep, Helge C, Broocks, Gabriel, Heit, Jeremy J, Albers, Gregory W, Thomalla, Götz, Fiehler, Jens, and Faizy, Tobias D

Subjects
STROKE patients, CEREBRAL infarction, INTRACRANIAL hemorrhage, LOGISTIC regression analysis, ISCHEMIC stroke
Abstract

Background: There is yet no randomized controlled evidence that mechanical thrombectomy (MT) is superior to best medical treatment in patients with large vessel occlusion but minor stroke symptoms (National Institutes of Health Stroke Scale (NIHSS) <6). Prior studies of patients with admission NIHSS scores ≥ 6 observed unfavorable functional outcomes despite successful recanalization, commonly termed as futile recanalization (FR), in up to 50% of cases. Aim: The aim of this study is to determine the prevalence of FR in patients with minor stroke and identify associated patient-specific risk factors. Methods: Our multicenter cohort study screened all patients prospectively enrolled in the German Stroke Registry Endovascular Treatment from 2015 to 2021 (n = 13,082). Included were patients who underwent MT for anterior circulation vessel occlusion with a baseline NIHSS score of <6 and successful recanalization (modified Thrombolysis in Cerebral Infarction (mTICI) scores of 2b–3). FR was defined by modified Rankin Scale (mRS) scores of 2–6 at 90 days. Multivariable logistic regression analysis was conducted to explore factors associated with FR. Results: A total of 674 patients met the inclusion criteria. FR occurred in 268 (40%) patients. Multivariable logistic regression analysis indicates that higher age (adjusted odds ratio (aOR) = 1.04 (95% confidence interval (CI) = 1.02–1.06)), pre-stroke mRS 1 (aOR = 2.70 (95% CI = 1.51–4.84)), transfer from admission hospital to comprehensive stroke center (aOR = 1.67 (95% CI = 1.08–2.56)), longer time from symptom onset/last seen well to admission (aOR = 1.02 (95% CI = 1.00–1.04)), MT under general anesthesia (aOR = 1.78 (95% CI = 1.13–2.82)), higher NIHSS after 24 h (aOR = 1.09 (95% CI = 1.05–1.14)), and symptomatic intracranial hemorrhage (aOR = 16.88 (95% CI = 2.03–140.14)) increased the odds of FR. There was no significant difference in primary outcome between achieving mTICI score of 2b or 3. Conclusions: Unfavorable functional outcomes despite successful vessel recanalization were frequent in acute ischemic stroke patients with low NIHSS scores on admission. We provide patient-specific risk factors that indicate an increased risk of FR and should be considered when treating patients with minor stroke. Data accessibility statement: The data that support the findings of our study are available on reasonable request after approval of the German Stroke Registry (GSR) steering committee. [ABSTRACT FROM AUTHOR]

Published
2024
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38. Utility of automated CT perfusion software in acute ischemic stroke with large and medium vessel occlusion.

Author

Ashayeri Ahmadabad, Rezan, Tran, Kim H., Zhang, Yiran, Kate, Mahesh P., Mishra, Sachin, Buck, Brian H., Khan, Khurshid A., Rempel, Jeremy, Albers, Gregory W., and Shuaib, Ashfaq

Subjects
STROKE patients, ISCHEMIC stroke, ARTERIAL occlusions, IMAGE processing software, ENDOVASCULAR surgery
Abstract

Background: Early diagnosis of large vessel occlusion (LVO) in acute stroke often requires CT angiography (CTA). Automated CT perfusion (CTP) software, which identifies blood flow abnormalities, enhances LVO diagnosis and patient selection for endovascular thrombectomy (EVT). This study evaluates the sensitivity of automated CTP images in detecting perfusion abnormalities in patients with acute ischemic stroke (AIS) and LVO or medium vessel occlusion (MeVO), compared to CTA. Methods: We screened acute ischemic stroke patients presenting within 24 h who underwent CT, CTA, and CTP as per institutional protocol. RAPID AI software processed CTP images, while neuroradiologists reviewed CTA for intracranial arterial occlusions. Sensitivity, specificity, and accuracy of automated CTP maps in detecting occlusions were assessed. Results: Of 790 screened patients, 31 were excluded due to lack of RAPID CTP data or poor‐quality scans, leaving 759 for analysis. The median age was 71 years (IQR: 61–81), with 47% female. Among them, 678 had AIS, and 81 had AIS ruled out. CTA identified arterial occlusion in 562 patients (74%), with corresponding CTP abnormalities in 537 patients (Tmax > 6 sec). In the 197 without occlusion, CTP was negative in 161. Automated CTP maps had a sensitivity of 95.55% (CI 95: 93.50–97.10%), specificity of 81.73% (CI 95: 75.61–86.86%), negative predictive value of 98.22% (CI 95: 97.39–98.79%), positive predictive value of 63.54% (CI 95: 56.46–70.09%), and overall accuracy of 85.18% (CI 95: 82.45–87.64%). Conclusions: Automated CTP maps demonstrated high sensitivity and negative predictive value for LVOs and MeVOs, suggesting their usefulness as a rapid diagnostic tool, especially in settings without expert neuroradiologists. [ABSTRACT FROM AUTHOR]

Published
2024
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40. CT perfusion to measure venous outflow in acute ischemic stroke in patients with a large vessel occlusion.

Author

Adusumilli, Gautam, Christensen, Soren, Yuen, Nicole, Mlynash, Michael, Faizy, Tobias D., Albers, Gregory W., Lansberg, Maarten G., Fiehler, Jens, and Heit, Jeremy J.

Subjects
CAROTID artery radiography, GRAPHICAL user interfaces, RESEARCH funding, CEREBRAL veins, BLOOD vessels, COMPUTED tomography, CRANIAL sinuses, MANN Whitney U Test, DESCRIPTIVE statistics, PERFUSION imaging, ISCHEMIC stroke, THROMBECTOMY, PERFUSION, AUTOMATION, CEREBRAL circulation, DATA analysis software, NEURORADIOLOGY, NONPARAMETRIC statistics
Abstract

Background Robust venous outflow (VO) profiles, measured by degree of venous opacification on pre-thrombectomy CT angiography (CTA) studies, are strongly correlated with favorable outcomes in patients with large vessel occlusion acute ischemic stroke treated by thrombectomy. However, VO measurements are laborious and require neuroimaging expertise. Objective To develop a semi-automated method to measure VO using CTA and CT perfusion imaging studies. Methods We developed a graphical interface using The Visualization Toolkit, allowing for voxel selection at the confluence and bilateral internal cerebral veins on CTA along with arterial input functions (AlFs) from both internal carotid arteries. We extracted concentration-time curves from the CT perfusion study at the corresponding locations associated with AIF and venous output function (VOF). Outcome analyses were primarily conducted by the Mann-Whitney U and Jonckheere-Terpstra tests. Results Segmentation at the pre-selected AIF and VOF locations was performed on a sample of 97 patients. 65 patients had favorable VO (VO+) and 32 patients had unfavorable VO (VO-). VO+ patients were found to have a significantly shorter VOF time to peak (8.26; 95% CI 7.07 to 10.34) than VO- patients (9.44; 95% CI 8.61 to 10.91), P=0.007. No significant difference was found in VOF curve width and the difference in time between AIF and VOF peaks. Conclusions Time to peak of VOF at the confluence of sinuses was significantly associated with manually scored venous outflow. Further studies should aim to understand better the association between arterial inflow and venous outflow, and capture quantitative metrics of venous outflow at other locations. [ABSTRACT FROM AUTHOR]

Published
2024
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41. Thrombectomy for anterior circulation stroke beyond 6 h from time last known well (AURORA): a systematic review and individual patient data meta-analysis

Author

Jovin, Tudor G, Nogueira, Raul G, Lansberg, Maarten G, Demchuk, Andrew M, Martins, Sheila O, Mocco, J, Ribo, Marc, Jadhav, Ashutosh P, Ortega-Gutierrez, Santiago, Hill, Michael D, Lima, Fabricio O, Haussen, Diogo C, Brown, Scott, Goyal, Mayank, Siddiqui, Adnan H, Heit, Jeremy J, Menon, Bijoy K, Kemp, Stephanie, Budzik, Ron, Urra, Xabier, Marks, Michael P, Costalat, Vincent, Liebeskind, David S, and Albers, Gregory W

Published
2022
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45. Endovascular Therapy or Medical Management Alone for Isolated Posterior Cerebral Artery Occlusion: A Multicenter Study

Author

Sabben, Candice, Charbonneau, Frédérique, Delvoye, François, Strambo, Davide, Heldner, Mirjam R., Ong, Elodie, Ter Schiphorst, Adrien, Henon, Hilde, Ben Hassen, Wagih, Agasse-Lafont, Thomas, Legris, Loïc, Sibon, Igor, Wolff, Valérie, Sablot, Denis, Elhorany, Mahmoud, Preterre, Cécile, Nehme, Nour, Soize, Sébastien, Weisenburger-Lile, David, Triquenot-Bagan, Aude, Mione, Gioia, Aignatoaie, Andreea, Papassin, Jérémie, Poll, Roxana, Béjot, Yannick, Carrera, Emmanuel, Garnier, Pierre, Michel, Patrik, Saliou, Guillaume, Mordasini, Pasquale, Berthezene, Yves, Costalat, Vincent, Bricout, Nicolas, Albers, Gregory W., Mazighi, Mikael, Turc, Guillaume, Seners, Pierre, Antonenko, Kateryna, Arquizan, Caroline, Benammar, Lynda, Boutet, Claire, Clarençon, Frédéric, Comby, Pierre-Olivier, Desal, Hubert, Detante, Olivier, Eugene, François, Gerardin, Emmanuel, Gory, Benjamin, Kremer, Stéphane, Ledure, Sylvain, Krug, Mathieu, Lapergue, Bertrand, Niclot, Philippe, Magni, Christophe, Obadia, Michael, Ozsancak, Canan, Pico, Fernando, Pilgram-Pastor, Sara, Pop, Raoul, Richard, Sébastien, Rosso, Charlotte, Savatovsky, Julien, Moulin, Solène, Tracol, Clément, and Zbinden, Martin

Published
2023
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46. Efficacy and Safety of Ticagrelor in Relation to Aspirin Use Within the Week Before Randomization in the SOCRATES Trial

Author

Wong, KS Lawrence, Amarenco, Pierre, Albers, Gregory W, Denison, Hans, Easton, J Donald, Evans, Scott R, Held, Peter, Himmelmann, Anders, Kasner, Scott E, Knutsson, Mikael, Ladenvall, Per, Minematsu, Kazuo, Molina, Carlos A, Wang, Yongjun, and Johnston, S Claiborne

Subjects
Health Services and Systems, Health Sciences, Neurosciences, Heart Disease, Patient Safety, Heart Disease - Coronary Heart Disease, Brain Disorders, Stroke, Cardiovascular, Clinical Research, Evaluation of treatments and therapeutic interventions, 6.1 Pharmaceuticals, Aged, Aged, 80 and over, Aspirin, Brain Ischemia, Drug Interactions, Female, Hemorrhage, Humans, Ischemic Attack, Transient, Male, Middle Aged, Myocardial Infarction, Platelet Aggregation Inhibitors, Ticagrelor, Treatment Outcome, aspirin, platelet aggregation inhibitors, stroke, ticagrelor, transient ischemic attack, SOCRATES Steering Committee and Investigators, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Neurology & Neurosurgery, Clinical sciences, Allied health and rehabilitation science
Abstract

Background and purposeSOCRATES (Acute Stroke or Transient Ischemic Attack Treated With Aspirin or Ticagrelor and Patient Outcomes), comparing ticagrelor with aspirin in patients with acute cerebral ischemia, found a nonsignificant 11% relative risk reduction for stroke, myocardial infarction, or death (P=0.07). Aspirin intake before randomization could enhance the effect of ticagrelor by conferring dual antiplatelet effect during a high-risk period for subsequent stroke. Therefore, we explored the efficacy and safety of ticagrelor versus aspirin in the patients who received any aspirin the week before randomization.MethodsA prespecified subgroup analysis in SOCRATES (n=13 199), randomizing patients with acute ischemic stroke (National Institutes of Health Stroke Scale score of ≤5) or transient ischemic attack (ABCD2 score of ≥4) to 90-day treatment with ticagrelor or aspirin. Patients in the prior-aspirin group had received any aspirin within the week before randomization. Primary end point was time to stroke, myocardial infarction, or death. Safety end point was PLATO (Study of Platelet Inhibition and Patient Outcomes) major bleeding.ResultsThe 4232 patients in the prior-aspirin group were older, had more vascular risk factors, and vascular disease than the other patients. In the prior-aspirin group, the primary end point occurred in 138/2130 (6.5%) of patients on ticagrelor and in 177/2102 (8.3%) on aspirin (hazard ratio, 0.76; 95% confidence interval, 0.61-0.95; P=0.02); in patients with no prior-aspirin usage an event occurred in 304/4459 (6.9%) and 320/4508 (7.1%) on ticagrelor and aspirin, respectively (hazard ratio, 0.96; 95% confidence interval, 0.82-1.12; P=0.59). The treatment-by-prior-aspirin interaction was not statistically significant (P=0.10). In the prior-aspirin group, major bleeding occurred in 0.7% and 0.4% of patients on ticagrelor and aspirin, respectively (hazard ratio, 1.58; 95% confidence interval, 0.68-3.65; P=0.28).ConclusionsIn this secondary analysis from SOCRATES, fewer primary end points occurred on ticagrelor treatment than on aspirin in patients receiving aspirin before randomization, but there was no significant treatment-by-prior-aspirin interaction. A new study will investigate the benefit-risk of combining ticagrelor and aspirin in patients with acute cerebral ischemia (URL: https://www.clinicaltrials.gov. Unique identifier: NCT03354429).Clinical trial registrationURL: https://www.clinicaltrials.gov. Unique identifier: NCT01994720.

Published
2018

47. Lower admission stroke severity is associated with good collateral status in distal medium vessel occlusion stroke

Author

Mei, Janet, primary, Salim, Hamza A., additional, Lakhani, Dhairya A., additional, Balar, Aneri, additional, Musmar, Basel, additional, Adeeb, Nimer, additional, Hoseinyazdi, Meisam, additional, Luna, Licia, additional, Deng, Francis, additional, Hyson, Nathan Z., additional, Dmytriw, Adam A., additional, Guenego, Adrien, additional, Faizy, Tobias D., additional, Heit, Jeremy J., additional, Albers, Gregory W., additional, Urrutia, Victor C., additional, Llinas, Raf, additional, Marsh, Elisabeth B., additional, Hillis, Argye E., additional, Nael, Kambiz, additional, and Yedavalli, Vivek S., additional

Published
2024
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48. Penumbral imaging and functional outcome in patients with anterior circulation ischaemic stroke treated with endovascular thrombectomy versus medical therapy: a meta-analysis of individual patient-level data

Author

Berkhemer, Olvert A, Fransen, Puck SS, Beumer, Debbie, van den Berg, Lucie A, Lingsma, Hester F, Yoo, Albert J, Schonewille, Wouter J, Vos, Jan Albert, Nederkoorn, Paul J, Wermer, Marieke JH, van Walderveen, Marianne AA, Staals, Julie, Hofmeijer, Jeannette, van Oostayen, Jacques A., Lycklama à Nijeholt, Geert J., Boiten, Jelis, Brouwer, Patrick A., Emmer, Bart J., de Bruijn, Sebastiaan F., van Dijk, Lukas C., Kappelle, Jaap, Lo, Rob H, van Dijk, Ewoud J., de Vries, Joost, de Kort, Paul L.M., van Rooij, Willem Jan J., van den Berg, Jan S.P., van Hasselt, Boudewijn A.A.M., Aerden, Leo A.M., Dallinga, René J., Visser, Marieke C., Bot, Joseph C.J., Vroomen, Patrick C., Eshghi, Omid, Schreuder, Tobien H.C.M.L., Heijboer, Roel J.J., Keizer, Koos, Tielbeek, Alexander V., den Hertog, Heleen M., Gerrits, Dick G., van den Berg-Vos, Renske M., Karas, Giorgos B., Steyerberg, Ewout W., Flach, Zwenneke, Marquering, Henk A., Sprengers, Marieke E.S., Jenniskens, Sjoerd F.M., Beenen, Ludo F.M., van den Berg, René, Koudstaal, Peter J., van Zwam, Wim H., Roos, Yvo B.W.E.M., van der Lugt, Aad, van Oostenbrugge, Robert J., Majoie, Charles B.L.M., Dippel, Diederik W.J., Brown, Martin M., Liebig, Thomas, Stijnen, Theo, Andersson, Tommy, Mattle, Heinrich, Wahlgren, Nils, van der Heijden, Esther, Ghannouti, Naziha, Fleitour, Nadine, Hooijenga, Imke, Puppels, Corina, Pellikaan, Wilma, Geerling, Annet, Lindl-Velema, Annemieke, van Vemde, Gina, de Ridder, Ans, Greebe, Paut, de Bont-Stikkelbroeck, José, de Meris, Joke, Janssen, Kirsten, Struijk, Willy, Licher, Silvan, Boodt, Nikki, Ros, Adriaan, Venema, Esmee, Slokkers, Ilse, Ganpat, Raymie-Jayce, Mulder, Maxim, Saiedie, Nawid, Heshmatollah, Alis, Schipperen, Stefanie, Vinken, Stefan, van Boxtel, Tiemen, Koets, Jeroen, Boers, Merel, Santos, Emilie, Borst, Jordi, Jansen, Ivo, Kappelhof, Manon, Lucas, Marit, Geuskens, Ralph, Barros, Renan Sales, Dobbe, Roeland, Csizmadia, Marloes, Hill, MD, Goyal, M, Demchuk, AM, Menon, BK, Eesa, M, Ryckborst, KJ, Wright, MR, Kamal, NR, Andersen, L, Randhawa, PA, Stewart, T, Patil, S, Minhas, P, Almekhlafi, M, Mishra, S, Clement, F, Sajobi, T, Shuaib, A, Montanera, WJ, Roy, D, Silver, FL, Jovin, TG, Frei, DF, Sapkota, B, Rempel, JL, Thornton, J, Williams, D, Tampieri, D, Poppe, AY, Dowlatshahi, D, Wong, JH, Mitha, AP, Subramaniam, S, Hull, G, Lowerison, MW, Salluzzi, M, Maxwell, M, Lacusta, S, Drupals, E, Armitage, K, Barber, PA, Smith, EE, Morrish, WF, Coutts, SB, Derdeyn, C, Demaerschalk, B, Yavagal, D, Martin, R, Brant, R, Yu, Y, Willinsky, RA, Weill, A, Kenney, C, Aram, H, Stys, PK, Watson, TW, Klein, G, Pearson, D, Couillard, P, Trivedi, A, Singh, D, Klourfeld, E, Imoukhuede, O, Nikneshan, D, Blayney, S, Reddy, R, Choi, P, Horton, M, Musuka, T, Dubuc, V, Field, TS, Desai, J, Adatia, S, Alseraya, A, Nambiar, V, van Dijk, R, Newcommon, NJ, Schwindt, B, Butcher, KS, Jeerakathil, T, Buck, B, Khan, K, Naik, SS, Emery, DJ, Owen, RJ, Kotylak, TB, Ashforth, RA, Yeo, TA, McNally, D, Siddiqui, M, Saqqur, M, Hussain, D, Kalashyan, H, Manosalva, A, Kate, M, Gioia, L, Hasan, S, Mohammad, A, Muratoglu, M, Cullen, A, Brennan, P, O'Hare, A, Looby, S, Hyland, D, Duff, S, McCusker, M, Hallinan, B, Lee, S, McCormack, J, Moore, A, O'Connor, M, Donegan, C, Brewer, L, Martin, A, Murphy, S, O'Rourke, K, Smyth, S, Kelly, P, Lynch, T, Daly, T, O'Brien, P, O'Driscoll, A, Martin, M, Collins, R, Coughlan, T, McCabe, D, O'Neill, D, Mulroy, M, Lynch, O, Walsh, T, O'Donnell, M, Galvin, T, Harbison, J, McElwaine, P, Mulpeter, K, McLoughlin, C, Reardon, M, Harkin, E, Dolan, E, Watts, M, Cunningham, N, Fallon, C, Gallagher, S, Cotter, P, Crowe, M, Doyle, R, Noone, I, Lapierre, M, Coté, VA, Lanthier, S, Odier, C, Durocher, A, Raymond, J, Daneault, N, Deschaintre, Y, Jankowitz, B, Baxendell, L, Massaro, L, Jackson-Graves, C, Decesare, S, Porter, P, Armbruster, K, Adams, A, Billigan, J, Oakley, J, Ducruet, A, Jadhav, A, Giurgiutiu, D-V, Aghaebrahim, A, Reddy, V, Hammer, M, Starr, M, Totoraitis, V, Wechsler, L, Streib, S, Rangaraju, S, Campbell, D, Rocha, M, Gulati, D, Krings, T, Kalman, L, Cayley, A, Williams, J, Wiegner, R, Casaubon, LK, Jaigobin, C, del Campo, JM, Elamin, E, Schaafsma, JD, Agid, R, Farb, R, ter Brugge, K, Sapkoda, BL, Baxter, BW, Barton, K, Knox, A, Porter, A, Sirelkhatim, A, Devlin, T, Dellinger, C, Pitiyanuvath, N, Patterson, J, Nichols, J, Quarfordt, S, Calvert, J, Hawk, H, Fanale, C, Bitner, A, Novak, A, Huddle, D, Bellon, R, Loy, D, Wagner, J, Chang, I, Lampe, E, Spencer, B, Pratt, R, Bartt, R, Shine, S, Dooley, G, Nguyen, T, Whaley, M, McCarthy, K, Teitelbaum, J, Poon, W, Campbell, N, Cortes, M, Lum, C, Shamloul, R, Robert, S, Stotts, G, Shamy, M, Steffenhagen, N, Blacquiere, D, Hogan, M, AlHazzaa, M, Basir, G, Lesiuk, H, Iancu, D, Santos, M, Choe, H, Weisman, DC, Jonczak, K, Blue-Schaller, A, Shah, Q, MacKenzie, L, Klein, B, Kulandaivel, K, Kozak, O, Gzesh, DJ, Harris, LJ, Khoury, JS, Mandzia, J, Pelz, D, Crann, S, Fleming, L, Hesser, K, Beauchamp, B, Amato-Marzialli, B, Boulton, M, Lopez- Ojeda, P, Sharma, M, Lownie, S, Chan, R, Swartz, R, Howard, P, Golob, D, Gladstone, D, Boyle, K, Boulos, M, Hopyan, J, Yang, V, Da Costa, L, Holmstedt, CA, Turk, AS, Navarro, R, Jauch, E, Ozark, S, Turner, R, Phillips, S, Shankar, J, Jarrett, J, Gubitz, G, Maloney, W, Vandorpe, R, Schmidt, M, Heidenreich, J, Hunter, G, Kelly, M, Whelan, R, Peeling, L, Burns, PA, Hunter, A, Wiggam, I, Kerr, E, Watt, M, Fulton, A, Gordon, P, Rennie, I, Flynn, P, Smyth, G, O'Leary, S, Gentile, N, Linares, G, McNelis, P, Erkmen, K, Katz, P, Azizi, A, Weaver, M, Jungreis, C, Faro, S, Shah, P, Reimer, H, Kalugdan, V, Saposnik, G, Bharatha, A, Li, Y, Kostyrko, P, Marotta, T, Montanera, W, Sarma, D, Selchen, D, Spears, J, Heo, JH, Jeong, K, Kim, DJ, Kim, BM, Kim, YD, Song, D, Lee, K-J, Yoo, J, Bang, OY, Rho, S, Lee, J, Jeon, P, Kim, KH, Cha, J, Kim, SJ, Ryoo, S, Lee, MJ, Sohn, S-I, Kim, C-H, Ryu, H-G, Hong, J-H, Chang, H-W, Lee, C-Y, Rha, J, Davis, Stephen M, Donnan, Geoffrey A, Campbell, Bruce CV, Mitchell, Peter J, Churilov, Leonid, Yan, Bernard, Dowling, Richard, Yassi, Nawaf, Oxley, Thomas J, Wu, Teddy Y, Silver, Gabriel, McDonald, Amy, McCoy, Rachael, Kleinig, Timothy J, Scroop, Rebecca, Dewey, Helen M, Simpson, Marion, Brooks, Mark, Coulton, Bronwyn, Krause, Martin, Harrington, Timothy J, Steinfort, Brendan, Faulder, Kenneth, Priglinger, Miriam, Day, Susan, Phan, Thanh, Chong, Winston, Holt, Michael, Chandra, Ronil V, Ma, Henry, Young, Dennis, Wong, Kitty, Wijeratne, Tissa, Tu, Hans, Mackay, Elizabeth, Celestino, Sherisse, Bladin, Christopher F, Loh, Poh Sien, Gilligan, Amanda, Ross, Zofia, Coote, Skye, Frost, Tanya, Parsons, Mark W, Miteff, Ferdinand, Levi, Christopher R, Ang, Timothy, Spratt, Neil, Kaauwai, Lara, Badve, Monica, Rice, Henry, de Villiers, Laetitia, Barber, P. Alan, McGuinness, Ben, Hope, Ayton, Moriarty, Maurice, Bennett, Patricia, Wong, Andrew, Coulthard, Alan, Lee, Andrew, Jannes, Jim, Field, Deborah, Sharma, Gagan, Salinas, Simon, Cowley, Elise, Snow, Barry, Kolbe, John, Stark, Richard, King, John, Macdonnell, Richard, Attia, John, D'Este, Cate, Saver, Jeffrey L, Goyal, Mayank, Diener, Hans-Christoph, Levy, Elad I., Bonafé, Alain, Mendes Pereira, Vitor, Jahan, Reza, Albers, Gregory W., Cognard, Christophe, Cohen, David J., Hacke, Werner, Jansen, Olav, Jovin, Tudor G., Mattle, Heinrich P., Nogueira, Raul G., Siddiqui, Adnan H., Yavagal, Dileep R., von Kummer, Rüdiger, Smith, Wade, Turjman, Francis, Hamilton, Scott, Chiacchierini, Richard, Amar, Arun, Sanossian, Nerses, Loh, Yince, Baxter, B, Reddy, VK, Horev, A, Star, M, Siddiqui, A, Hopkins, LN, Snyder, K, Sawyer, R, Hall, S, Costalat, V, Riquelme, C, Machi, P, Omer, E, Arquizan, C, Mourand, I, Charif, M, Ayrignac, X, Menjot de Champfleur, N, Leboucq, N, Gascou, G, Moynier, M, du Mesnil de Rochemont, R, Singer, O, Berkefeld, J, Foerch, C, Lorenz, M, Pfeilschifer, W, Hattingen, E, Wagner, M, You, SJ, Lescher, S, Braun, H, Dehkharghani, S, Belagaje, SR, Anderson, A, Lima, A, Obideen, M, Haussen, D, Dharia, R, Frankel, M, Patel, V, Owada, K, Saad, A, Amerson, L, Horn, C, Doppelheuer, S, Schindler, K, Lopes, DK, Chen, M, Moftakhar, R, Anton, C, Smreczak, M, Carpenter, JS, Boo, S, Rai, A, Roberts, T, Tarabishy, A, Gutmann, L, Brooks, C, Brick, J, Domico, J, Reimann, G, Hinrichs, K, Becker, M, Heiss, E, Selle, C, Witteler, A, Al-Boutros, S, Danch, M-J, Ranft, A, Rohde, S, Burg, K, Weimar, C, Zegarac, V, Hartmann, C, Schlamann, M, Göricke, S, Ringlestein, A, Wanke, I, Mönninghoff, C, Dietzold, M, Budzik, R, Davis, T, Eubank, G, Hicks, WJ, Pema, P, Vora, N, Mejilla, J, Taylor, M, Clark, W, Rontal, A, Fields, J, Peterson, B, Nesbit, G, Lutsep, H, Bozorgchami, H, Priest, R, Ologuntoye, O, Barnwell, S, Dogan, A, Herrick, K, Takahasi, C, Beadell, N, Brown, B, Jamieson, S, Hussain, MS, Russman, A, Hui, F, Wisco, D, Uchino, K, Khawaja, Z, Katzan, I, Toth, G, Cheng-Ching, E, Bain, M, Man, S, Farrag, A, George, P, John, S, Shankar, L, Drofa, A, Dahlgren, R, Bauer, A, Itreat, A, Taqui, A, Cerejo, R, Richmond, A, Ringleb, P, Bendszus, M, Möhlenbruch, M, Reiff, T, Amiri, H, Purrucker, J, Herweh, C, Pham, M, Menn, O, Ludwig, I, Acosta, I, Villar, C, Morgan, W, Sombutmai, C, Hellinger, F, Allen, E, Bellew, M, Gandhi, R, Bonwit, E, Aly, J, Ecker, RD, Seder, D, Morris, J, Skaletsky, M, Belden, J, Baker, C, Connolly, LS, Papanagiotou, P, Roth, C, Kastrup, A, Politi, M, Brunner, F, Alexandrou, M, Merdivan, H, Ramsey, C, Given II, C, Renfrow, S, Deshmukh, V, Sasadeusz, K, Vincent, F, Thiesing, JT, Putnam, J, Bhatt, A, Kansara, A, Caceves, D, Lowenkopf, T, Yanase, L, Zurasky, J, Dancer, S, Freeman, B, Scheibe-Mirek, T, Robison, J, Roll, J, Clark, D, Rodriguez, M, Fitzsimmons, B-FM, Zaidat, O, Lynch, JR, Lazzaro, M, Larson, T, Padmore, L, Das, E, Farrow-Schmidt, A, 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2019
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