Search

Your search keyword '"Alexandrov AV"' showing total 546 results
Start Over Author "Alexandrov AV"
546 results on '"Alexandrov AV"'

2. Neuroimaging and clinical outcomes of oral anticoagulant-associated intracerebral hemorrhage

Author

Tsivgoulis, G, Wilson, D, Katsanos, AH, Sargento-Freitas, J, Marques-Matos, C, Azevedo, E, Adachi, T, von der Brelie, C, Aizawa, Y, Abe, H, Tomita, H, Okumura, K, Hagii, J, Seiffge, DJ, Lioutas, V-A, Traenka, C, Varelas, P, Basir, G, Krogias, C, Purrucker, JC, Sharma, VK, Rizos, T, Mikulik, R, Sobowale, OA, Barlinn, K, Sallinen, H, Goyal, N, Yeh, S-J, Karapanayiotides, T, Wu, TY, Vadikolias, K, Ferrigno, M, Hadjigeorgiou, G, Houben, R, Giannopoulos, S, Schreuder, FHBM, Chang, JJ, Perry, LA, Mehdorn, M, Marto, J-P, Pinho, J, Tanaka, J, Boulanger, M, Salman, RA-S, Jaeger, HR, Shakeshaft, C, Yakushiji, Y, Choi, PMC, Staals, J, Cordonnier, C, Jeng, J-S, Veltkamp, R, Dowlatshahi, D, Engelter, ST, Parry-Jones, AR, Meretoja, A, Mitsias, PD, Alexandrov, AV, Ambler, G, Werring, DJ, Tsivgoulis, G, Wilson, D, Katsanos, AH, Sargento-Freitas, J, Marques-Matos, C, Azevedo, E, Adachi, T, von der Brelie, C, Aizawa, Y, Abe, H, Tomita, H, Okumura, K, Hagii, J, Seiffge, DJ, Lioutas, V-A, Traenka, C, Varelas, P, Basir, G, Krogias, C, Purrucker, JC, Sharma, VK, Rizos, T, Mikulik, R, Sobowale, OA, Barlinn, K, Sallinen, H, Goyal, N, Yeh, S-J, Karapanayiotides, T, Wu, TY, Vadikolias, K, Ferrigno, M, Hadjigeorgiou, G, Houben, R, Giannopoulos, S, Schreuder, FHBM, Chang, JJ, Perry, LA, Mehdorn, M, Marto, J-P, Pinho, J, Tanaka, J, Boulanger, M, Salman, RA-S, Jaeger, HR, Shakeshaft, C, Yakushiji, Y, Choi, PMC, Staals, J, Cordonnier, C, Jeng, J-S, Veltkamp, R, Dowlatshahi, D, Engelter, ST, Parry-Jones, AR, Meretoja, A, Mitsias, PD, Alexandrov, AV, Ambler, G, and Werring, DJ

Abstract

OBJECTIVE: Whether intracerebral hemorrhage (ICH) associated with non-vitamin K antagonist oral anticoagulants (NOAC-ICH) has a better outcome compared to ICH associated with vitamin K antagonists (VKA-ICH) is uncertain. METHODS: We performed a systematic review and individual patient data meta-analysis of cohort studies comparing clinical and radiological outcomes between NOAC-ICH and VKA-ICH patients. The primary outcome measure was 30-day all-cause mortality. All outcomes were assessed in multivariate regression analyses adjusted for age, sex, ICH location, and intraventricular hemorrhage extension. RESULTS: We included 7 eligible studies comprising 219 NOAC-ICH and 831 VKA-ICH patients (mean age = 77 years, 52.5% females). The 30-day mortality was similar between NOAC-ICH and VKA-ICH (24.3% vs 26.5%; hazard ratio = 0.94, 95% confidence interval [CI] = 0.67-1.31). However, in multivariate analyses adjusting for potential confounders, NOAC-ICH was associated with lower admission National Institutes of Health Stroke Scale (NIHSS) score (linear regression coefficient = -2.83, 95% CI = -5.28 to -0.38), lower likelihood of severe stroke (NIHSS > 10 points) on admission (odds ratio [OR] = 0.50, 95% CI = 0.30-0.84), and smaller baseline hematoma volume (linear regression coefficient = -0.24, 95% CI = -0.47 to -0.16). The two groups did not differ in the likelihood of baseline hematoma volume < 30cm3 (OR = 1.14, 95% CI = 0.81-1.62), hematoma expansion (OR = 0.97, 95% CI = 0.63-1.48), in-hospital mortality (OR = 0.73, 95% CI = 0.49-1.11), functional status at discharge (common OR = 0.78, 95% CI = 0.57-1.07), or functional status at 3 months (common OR = 1.03, 95% CI = 0.75-1.43). INTERPRETATION: Although functional outcome at discharge, 1 month, or 3 months was comparable after NOAC-ICH and VKA-ICH, patients with NOAC-ICH had smaller baseline hematoma volumes and less severe acute stroke syndromes. Ann Neurol 2018;84:702-712.

Published
2018

3. Systemic thrombolysis in patients with acute ischemic stroke and InternalCarotid ARtery Occlusion: the ICARO study

Author

Paciaroni, Maurizio, Balucani, C, Agnelli, Giancarlo, Caso, Valeria, Silvestrelli, G, Grotta, Jc, Demchuk, Am, Sohn, Si, Orlandi, G, Leys, D, Pezzini, A, Alexandrov, Av, Silvestrini, M, Fofi, L, Barlinn, K, Inzitari, D, Ferrarese, C, Tassi, R, Tsivgoulis, G, Consoli, D, Baldi, A, Bovi, P, Luda, E, Galletti, G, Invernizzi, P, Delodovici, Ml, Corea, F, Del Sette, M, Monaco, S, Marcheselli, S, Alberti, A, Venti, M, Acciarresi, M, D'Amore, C, Macellari, F, Lanari, A, Previdi, P, Gonzales, Nr, Pandurengan, Rk, Vahidy, Fs, Sline, M, Bal, Ss, Chiti, A, Gialdini, G, Dumont, F, Cordonnier, C, Debette, S, Padovani, A, Cerqua, R, Bodechtel, U, Kepplinger, J, Nesi, M, Nencini, P, Beretta, S, Trentini, C, Martini, G, Piperidou, C, Heliopoulos, I, D'Anna, S, Cappellari, M, Donati, E, Bono, G, Traverso, E, and Toni, D.

Published
2012

4. Pre- and in-hospital intersection of stroke care

Author

DelZoppo, GJ, Alexandrov, AV, Meretoja, A, Kaste, M, DelZoppo, GJ, Alexandrov, AV, Meretoja, A, and Kaste, M

Abstract

Acute ischemic stroke is a time-critical emergency for which thrombolytic therapy is the only medical treatment. Many patients who would benefit from this treatment are deprived of it due to delays. Failure to call for help rapidly is the main obstacle, but even when the call is made in time, the prehospital evaluation, transportation, and emergency department (ED) diagnostics often take too long to treat the patient with thrombolysis. Interventions to reduce pre- and in-hospital delays have been described; although no single intervention is likely to make a major difference, a whole set of interventions needs to be implemented. The intersection of the pre- and in-hospital care is of special importance. With successful protocols and good communication between the emergency medical service and ED, delays can be significantly reduced. On the basis of our experience, 94% of patients can be treated within 60 min of arrival, based largely on using the prehospital time effectively.

Published
2012

6. Real-time validation of transcranial Doppler criteria in assessing recanalization during intra-arterial procedures for acute ischemic stroke: an international, multicenter study.

Author

Tsivgoulis G, Ribo M, Rubiera M, Vasdekis SN, Barlinn K, Athanasiadis D, Bavarsad Shahripour R, Giannopoulos S, Stamboulis E, Harrigan MR, Molina CA, Alexandrov AV, Tsivgoulis, Georgios, Ribo, Marc, Rubiera, Marta, Vasdekis, Spyros N, Barlinn, Kristian, Athanasiadis, Dimitrios, Bavarsad Shahripour, Reza, and Giannopoulos, Sotirios

Published
2013
Full Text
View/download PDF

20. Acute stroke imaging research roadmap.

Author

Wintermark M, Albers GW, Alexandrov AV, Alger JR, Bammer R, Baron JC, Davis S, Demaerschalk BM, Derdeyn CP, Donnan GA, Eastwood JD, Fiebach JB, Fisher M, Furie KL, Goldmakher GV, Hacke W, Kidwell CS, Kloska SP, Köhrmann M, and Koroshetz W

Published
2008
Full Text
View/download PDF

24. Highlights of the guidelines for screening of extracranial carotid artery disease: a statement for healthcare professionals from the Multidisciplinary Practice Guidelines Committee of the American Society of Neuroimaging; cosponsored by the Society of Vascular and Interventional Neurology.

Author

Qureshi AI, Alexandrov AV, Tegeler CH, Hobson RW 2nd, Baker JD, Hopkins LN, American Society of Neuroimaging. Multidisciplinary Practice Guidelines Committee, Qureshi, Adnan I, Alexandrov, Andrei V, Tegeler, Charles H, Hobson, Robert W 2nd, Baker, J Dennis, Hopkins, L Nelson, Multidisciplinary Practice Guidelines Committee of the American Society of Neuroimaging, and Society of Vascular and Interventional Neurology

Published
2007
Full Text
View/download PDF

32. Ultrasound-enhanced systemic thrombolysis for acute ischemic stroke.

Author

Alexandrov AV, Molina CA, Grotta JC, Garami Z, Ford SR, Alvarez-Sabin J, Montaner J, Saqqur M, Demchuk AM, Moyé LA, Hill MD, Wojner AW, CLOTBUST (Combined Lysis of Thrombus in Brain Ischemia Using Transcranial Ultrasound and Systemic t-PA) Investigators, Alexandrov, Andrei V, Molina, Carlos A, Grotta, James C, Garami, Zsolt, Ford, Shiela R, Alvarez-Sabin, Jose, and Montaner, Joan

Abstract

Background: Transcranial Doppler ultrasonography that is aimed at residual obstructive intracranial blood flow may help expose thrombi to tissue plasminogen activator (t-PA). Our objective was to determine whether ultrasonography can safely enhance the thrombolytic activity of t-PA. Methods: We treated all patients who had acute ischemic stroke due to occlusion of the middle cerebral artery with intravenous t-PA within three hours after the onset of symptoms. The patients were randomly assigned to receive continuous 2-MHz transcranial Doppler ultrasonography (the target group) or placebo (the control group). The primary combined end point was complete recanalization as assessed by transcranial Doppler ultrasonography or dramatic clinical recovery. Secondary end points included recovery at 24 hours, a favorable outcome at three months, and death at three months. Results: A total of 126 patients were randomly assigned to receive continuous ultrasonography (63 patients) or placebo (63 patients). Symptomatic intracerebral hemorrhage occurred in three patients in the target group and in three in the control group. Complete recanalization or dramatic clinical recovery within two hours after the administration of a t-PA bolus occurred in 31 patients in the target group (49 percent), as compared with 19 patients in the control group (30 percent; P=0.03). Twenty-four hours after treatment of the patients eligible for follow-up, 24 in the target group (44 percent) and 21 in the control group (40 percent) had dramatic clinical recovery (P=0.7). At three months, 22 of 53 patients in the target group who were eligible for follow-up analysis (42 percent) and 14 of 49 in the control group (29 percent) had favorable outcomes (as indicated by a score of 0 to 1 on the modified Rankin scale) (P=0.20). Conclusions: In patients with acute ischemic stroke, continuous transcranial Doppler augments t-PA-induced arterial recanalization, with a nonsignificant trend toward an increased rate of recovery from stroke, as compared with placebo. [ABSTRACT FROM AUTHOR]

Published
2004

34. Paramedic and emergency department care of stroke: baseline data from a citywide performance improvement study.

Author

Wojner AW, Morgenstern L, Alexandrov AV, Rodriguez D, Persse D, and Grotta JC

Abstract

BACKGROUND: Rapid diagnosis and transport by paramedics and efficient, effective emergency management are essential to improving care of acute stroke patients. OBJECTIVES: To measure the performance of paramedics and emergency departments providing care for patients with suspected acute stroke. METHODS: Two stroke centers and 4 other hospitals where most patients with acute stroke in Houston, Tex, are admitted participated. Hospital and paramedic performance data were collected prospectively on 446 patients with suspected acute stroke transported by paramedics between September 1999 and February 2000. RESULTS: Paramedics had a sensitivity of 66%, specificity of 98%, and overall accuracy of 72% in diagnosing stroke. For patients with suspected stroke, 58.5% arrived in the emergency department within 120 minutes of symptom onset; in confirmed cases, that percentage was 67%. Mean total transport time was 42.2 minutes and was significantly longer (P < .001) to inner-city hospitals (44 minutes) than to suburban, community-based centers (39 minutes). Door to computed tomography times were significantly (P < .001) shorter for the 2 stroke centers than the other hospitals. Overall thrombolysis treatment rate among patients with confirmed ischemic stroke was 7.4% (range, 0-19.4%); treatment rates at the 2 stroke centers were 5.9% and 19.4%. CONCLUSIONS: More than half of patients with suspected stroke arrive at hospitals while thrombolytic treatment is still feasible. Although the current rate for thrombolytic treatment in Houston exceeds the national rate, performance of paramedics and hospitals in treating acute stroke can be improved by increasing efficiency and standardizing medical practices. [ABSTRACT FROM AUTHOR]

Published
2003
Full Text
View/download PDF

49. Endovascular equipoise shift in a phase III randomized clinical trial of sonothrombolysis for acute ischemic stroke

Author

[Alexandrov AV] Department of Neurology, University of Tennessee Health Science Center, Memphis, USA. [Tsivgoulis G] ] Department of Neurology, University of Tennessee Health Science Center, Memphis, USA. Second Department of Neurology, ‘Attikon’ University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. [Köhrmann M] Department of Neurology, Universitaetsklinikum Erlangen, Erlangen, Germany. Department of Neurology, University Duisburg-Essen, Essen, Germany. [Katsanos AH] Second Department of Neurology, ‘Attikon’ University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. Department of Neurology, St Josef Hospital, Ruhr University Bochum, Bochum, Germany. [Soinne L] Department of Neurology, Helsinki University Hospital and Clinical Neurosciences, Neurology, University of Helsinki, Helsinki, Finland. [Barreto AD] Department of Neurology, University of Texas Health Science Center at Houston, Houston, USA. [Molina CA] Servei de Neurologia, Hospital Universitari Vall d’Hebron, Barcelona, Spain. Recerca en Ictus, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain. Universitat Autònoma de Barcelona, Barcelona, Spain. and Hospital Universitari Vall d'Hebron

Subjects
Vasos sanguinis - Cirurgia, Surgical Procedures, Operative::Surgical Procedures, Operative::Minimally Invasive Surgical Procedures::Endovascular Procedures [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Procedimientos Quirúrgicos Operativos::Procedimientos Quirúrgicos Operativos::Procedimientos Quirúrgicos Mínimamente Invasivos::Procedimientos Endovasculares [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Health Care Quality, Access, and Evaluation::Ethics::Health Care Quality, Access, and Evaluation::Ethics::Ethics, Research::Therapeutic Equipoise [HEALTH CARE], Therapeutics::Drug Therapy::Thrombolytic Therapy [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Teràpia trombolítica, Terapéutica::Quimioterapia::Terapia Trombolítica [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], calidad, acceso y evaluación de la atención sanitaria::ética::calidad, acceso y evaluación de la atención sanitaria::ética::ética en investigación::equiponderación terapéutica [ATENCIÓN DE SALUD]
Published
2021

50. Endovascular equipoise shift in a phase III randomized clinical trial of sonothrombolysis for acute ischemic stroke

Author

Alexandrov, Andrei V., Tsivgoulis, Georgios, Köhrmann, Martin, Katsanos, Aristeidis H., Soinne, Lauri, Barreto, Andrew D., Rothlisberger, Travis, Sharma, Vijay K., Mikulik, Robert, Muir, Keith W., Levi, Christopher R., Molina, Carlos A., Saqqur, Maher, Mavridis, Dimitris, Psaltopoulou, Theodora, Vosko, Milan R., Fiebach, Jochen B., Mandava, Pitchaiah, Kent, Thomas A., Alexandrov, Andrei V, Schellinger, Peter D., Universitat Autònoma de Barcelona, [Alexandrov AV] Department of Neurology, University of Tennessee Health Science Center, Memphis, USA. [Tsivgoulis G] ] Department of Neurology, University of Tennessee Health Science Center, Memphis, USA. Second Department of Neurology, ‘Attikon’ University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. [Köhrmann M] Department of Neurology, Universitaetsklinikum Erlangen, Erlangen, Germany. Department of Neurology, University Duisburg-Essen, Essen, Germany. [Katsanos AH] Second Department of Neurology, ‘Attikon’ University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. Department of Neurology, St Josef Hospital, Ruhr University Bochum, Bochum, Germany. [Soinne L] Department of Neurology, Helsinki University Hospital and Clinical Neurosciences, Neurology, University of Helsinki, Helsinki, Finland. [Barreto AD] Department of Neurology, University of Texas Health Science Center at Houston, Houston, USA. [Molina CA] Servei de Neurologia, Hospital Universitari Vall d’Hebron, Barcelona, Spain. Recerca en Ictus, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain. Universitat Autònoma de Barcelona, Barcelona, Spain., Vall d'Hebron Barcelona Hospital Campus, Clinicum, HUS Neurocenter, University Management, Department of Neurosciences, and Neurologian yksikkö

Subjects
medicine.medical_treatment, Medizin, Health Care Quality, Access, and Evaluation::Ethics::Health Care Quality, Access, and Evaluation::Ethics::Ethics, Research::Therapeutic Equipoise [HEALTH CARE], Intracranial hemorrhage, 030204 cardiovascular system & hematology, recanalization, lcsh:RC346-429, 3124 Neurology and psychiatry, law.invention, 0302 clinical medicine, Vasos sanguinis - Cirurgia, Randomized controlled trial, law, Medicine, Acute ischemic stroke, Stroke, ULTRASOUND, Original Research, Outcome, Endovascular, Ultrasound, Thrombolysis, Recanalization, THROMBECTOMY, stroke, equipoise shift, terapéutica::farmacoterapia::tratamiento trombolítico [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Neurology, SAFETY, Cardiology, outcome, endovascular, Equipoise shift, calidad, acceso y evaluación de la atención sanitaria::ética::calidad, acceso y evaluación de la atención sanitaria::ética::ética en investigación::equiponderación terapéutica [ATENCIÓN DE SALUD], medicine.medical_specialty, 03 medical and health sciences, mechanical thrombectomy, Internal medicine, MANAGEMENT, Therapeutics::Drug Therapy::Thrombolytic Therapy [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], cardiovascular diseases, ddc:610, lcsh:Neurology. Diseases of the nervous system, Pharmacology, business.industry, 3112 Neurosciences, CARE, Ultrasound-enhanced thrombolysis, medicine.disease, EFFICACY, intervenciones quirúrgicas::intervenciones quirúrgicas::procedimientos quirúrgicos mínimamente invasivos::procedimientos endovasculares [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Sonothrombolysis, Mechanical thrombectomy, ultrasound-enhanced thrombolysis, sonothrombolysis, Surgical Procedures, Operative::Surgical Procedures, Operative::Minimally Invasive Surgical Procedures::Endovascular Procedures [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Neurology (clinical), Teràpia trombolítica, business, 030217 neurology & neurosurgery, intracranial hemorrhage, High frequency ultrasound
Abstract

Background: Results of our recently published phase III randomized clinical trial of ultrasound-enhanced thrombolysis (sonothrombolysis) using an operator-independent, high frequency ultrasound device revealed heterogeneity of patient recruitment among centers. Methods: We performed a post hoc analysis after excluding subjects that were recruited at centers reporting a decline in the balance of randomization between sonothrombolysis and concurrent endovascular trials. Results: From a total of 676 participants randomized in the CLOTBUST-ER trial we identified 52 patients from 7 centers with perceived equipoise shift in favor of endovascular treatment. Post hoc sensitivity analysis in the intention-to-treat population adjusted for age, National Institutes of Health Scale score at baseline, time from stroke onset to tPA bolus and baseline serum glucose showed a significant (p Conclusion: Our experience in CLOTBUST-ER indicates that increasing implementation of endovascular therapies across major academic stroke centers raises significant challenges for clinical trials aiming to test noninterventional or adjuvant reperfusion strategies.

Published
2019

Catalog

Books, media, physical & digital resources
See catalog results