480 results on '"Hofmeijer J"'
Search Results
2. Resting state EEG relates to short- and long-term cognitive functioning after cardiac arrest
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Glimmerveen, A.B., Verhulst, M.M.L.H., de Kruijf, N.L.M., van Gils, P., Delnoij, T., Bonnes, J., van Heugten, C.M., Van Putten, M.J.A.M., and Hofmeijer, J.
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- 2024
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3. Early Intubation in Endovascular Therapy for Basilar Artery Occlusion: A Post Hoc Analysis of the BASICS Trial
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Barlinn, Kristian, Langezaal, Lucianne C.M., Dippel, Diederik W.J., van Zwam, Wim H., Roessler, Martin, Roos, Yvo B.W.E.M., Emmer, Bart J., van Oostenbrugge, Robert J., Gerber, Johannes C., Yoo, Albert J., Pontes-Neto, Octavio M., Mazighi, Mikael, Audebert, Heinrich J., Michel, Patrik, Schonewille, Wouter J., Puetz, Volker, Schonewille, W.J., Vos, J.A., van der Hoeven, E.J.R.J., van Leersum, M., van den Heuvel, D.A.F., van Strijen, M.J.L., Teunissen, L.L., van der Lugt, A., van Es, A. C.G.M., van Doormaal, P.J., Kappelle, L.J., Lo, T.H., van der Worp, H.B., Boiten, J., Lycklama à Nijeholt, G.J., Nederkoorn, P.J., Majoie, C.B.L.M., Coutinho, J., Staals, J., Hofmeijer, J., Martens, J., Bernsen, M.L., Wermer, M.J.H., van Walderveen, M.A.A., Remmers, M.J.M., de Laat, K.F., de Kort, P.L.M., Mont’Alverne, F.J., Carvalho, J.J.F., de Araújo Rocha, F., de Almeida Bandeira, D., Freitas de Lucena, A., Coelho Silva, H., Martins, S.O, Dias, F.A., Abud, D.G., Cerantola, R., Camilo, M., Alves, F. A., Martins, R.K., Nakiri, G., Castro-Afonso, L.H., Pallesen, L.P., Barlinn, J., Siepmann, T., Nolte, C.H., Erdur, H., Scheitz, J.F., Szabo, K., Schneider, H., Berlis, A., Maurer, C., Ertl, M., Zickler, P., Schneider, C., Rueckert, C., Piotin, M., Ben Maacha, M., Blanc, R., Desilles, J.P., Redjem, H., Escalard, S., Smajda, S., Ciccio, G., Maier, B., Devoye, F., Herbert, S., Zini, A., Vallone, S., Bigliardi, G., Dell’Acqua, M.L., Rosafio, F., Verganti, L., Zelent, G., Maffei, S., Meyer, I., and Herzig, R.
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- 2023
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4. Dynamic functional connectivity of the EEG in relation to outcome of postanoxic coma
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Keijzer, H.M., Tjepkema-Cloostermans, M.C., Klijn, C.J.M., Blans, M., van Putten, M.J.A.M., and Hofmeijer, J.
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- 2021
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5. Brain imaging in comatose survivors of cardiac arrest: Pathophysiological correlates and prognostic properties
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Keijzer, H.M., Hoedemaekers, C.W.E., Meijer, F.J.A., Tonino, B.A.R., Klijn, C.J.M., and Hofmeijer, J.
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- 2018
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6. Anakinra in cerebral haemorrhage to target secondary injury resulting from neuroinflammation (ACTION): Study protocol of a phase II randomised clinical trial.
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Cliteur, MP, van der Kolk, AG, Hannink, G, Hofmeijer, J, Jolink, WMT, Klijn, CJM, and Schreuder, FHBM
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- 2024
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7. Anakinra in cerebral haemorrhage to target secondary injury resulting from neuroinflammation (ACTION): Study protocol of a phase II randomised clinical trial
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Cliteur, MP, primary, van der Kolk, AG, additional, Hannink, G, additional, Hofmeijer, J, additional, Jolink, WMT, additional, Klijn, CJM, additional, and Schreuder, FHBM, additional
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- 2023
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8. Cerebrospinal fluid volume improves prediction of malignant edema after endovascular treatment of stroke
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Kauw, F., Bernsen, M.L.E., Dankbaar, J.W., Jong, H.W.A.M. de, Kappelle, L.J., Velthuis, B.K., Worp, H.B. van der, Lugt, A. van der, Roos, Y.B.W.E.M., Yo, L.S.F., Walderveen, M.A.A. van, Hofmeijer, J., Bennink, E., MR CLEAN Registry Investigators, TechMed Centre, Clinical Neurophysiology, Radiology & Nuclear Medicine, Neurology, ACS - Atherosclerosis & ischemic syndromes, and Amsterdam Neuroscience - Neurovascular Disorders
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Ischemic stroke ,Neurology ,thrombectomy ,malignant edema ,computed tomography ,cerebrospinal fluid - Abstract
Background: The ratio of intracranial cerebrospinal fluid (CSF) volume to intracranial volume (ICV) has been identified as a potential predictor of malignant edema formation in patients with acute ischemic stroke. Aims: We aimed to evaluate the added value of the CSF/ICV ratio in a model to predict malignant edema formation in patients who underwent endovascular treatment. Methods: We included patients from the MR CLEAN Registry, a prospective national multicenter registry of patients who were treated with endovascular treatment between 2014 and 2017 because of acute ischemic stroke caused by large vessel occlusion. The CSF/ICV ratio was automatically measured on baseline thin-slice noncontrast CT. The primary outcome was the occurrence of malignant edema based on clinical and imaging features. The basic model included the following predictors: age, National Institutes of Health Stroke Scale, Alberta Stroke Program Early CT score, occlusion of the internal carotid artery, collateral score, time between symptom onset and groin puncture, and unsuccessful reperfusion. The extended model included the basic model and the CSF/ICV ratio. The performance of the basic and the extended model was compared with the likelihood ratio test. Results: Malignant edema occurred in 40 (6%) of 683 patients. In the extended model, a lower CSF/ICV ratio was associated with the occurrence of malignant edema (odds ratio (OR) per percentage point, 1.2; 95% confidence interval (CI) 1.1–1.3, p Conclusions: Adding the CSF/ICV ratio improves a multimodal prediction model for the occurrence of malignant edema after endovascular treatment.
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- 2023
9. Risk factors for atherosclerotic and medial arterial calcification of the intracranial internal carotid artery
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Majoie, C.B., Roos, Y.B., Duijm, L.E., Keizer, K., van der Lugt, A., Dippel, D.W., Droogh-de Greve, K.E., Bienfait, H.P., van Walderveen, M.A., Wermer, M.J.H., Lycklama à Nijeholt, G.J., Boiten, J., Duyndam, D., Kwa, V.I., Meijer, F.J., van Dijk, E.J., Kesselring, F.O., Hofmeijer, J., Vos, J.A., Schonewille, W.J., van Rooij, W.J., de Kort, P.L., Pleiter, C.C., Bakker, S.L., Bot, J., Visser, M.C., Velthuis, B.K., van der Schaaf, I.C., Dankbaar, J.W., Mali, W.P., van Seeters, T., Horsch, A.D., Niesten, J.M., Biessels, G.J., Kappelle, L.J., Luitse, M.J., van der Graaf, Y., Vos, Annelotte, Kockelkoren, Remko, de Vis, Jill B., van der Schouw, Yvonne T., van der Schaaf, Irene C., Velthuis, Birgitta K., Mali, Willem P.T.M., and de Jong, Pim A.
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- 2018
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10. EEG in a four-electrode frontotemporal montage reliably predicts outcome after cardiac arrest
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Admiraal, Marjolein M., primary, van Merkerk, Myrthe, additional, Horn, Janneke, additional, Koelman, J.H.T.M., additional, Hofmeijer, J., additional, Hoedemaekers, C.W., additional, and van Rootselaar, Anne-Fleur, additional
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- 2023
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11. Synaptic damage underlies EEG abnormalities in postanoxic encephalopathy: A computational study
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Ruijter, B.J., Hofmeijer, J., Meijer, H.G.E., and van Putten, M.J.A.M.
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- 2017
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12. Management of extracranial carotid artery stenosis during endovascular treatment for acute ischaemic stroke:results from the MR CLEAN Registry
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Collette, S.L., Rodgers, M.P., Walderveen, M.A.A. van, Compagne, K.C.J., Nederkoorn, P.J., Hofmeijer, J., Martens, J.M., Borst, G.J. de, Luijckx, G.J.R., Majoie, C.B.L.M., Lugt, A. van der, Bokkers, R.P.H., Uyttenboogaart, M., and MR CLEAN Registry Investigators
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Stroke ,Stents ,Carotid Stenosis ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,Atherosclerosis ,Thrombectomy - Abstract
BackgroundThe optimal management of ipsilateral extracranial internal carotid artery (ICA) stenosis during endovascular treatment (EVT) is unclear. We compared the outcomes of two different strategies: EVT with vs without carotid artery stenting (CAS).MethodsIn this observational study, we included patients who had an acute ischaemic stroke undergoing EVT and a concomitant ipsilateral extracranial ICA stenosis of ≥50% or occlusion of presumed atherosclerotic origin, from the Dutch Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) Registry (2014–2017). The primary endpoint was a good functional outcome at 90 days, defined as a modified Rankin Scale score ≤2. Secondary endpoints were successful intracranial reperfusion, new clot in a different vascular territory, symptomatic intracranial haemorrhage, recurrent ischaemic stroke and any serious adverse event.ResultsOf the 433 included patients, 169 (39%) underwent EVT with CAS. In 123/168 (73%) patients, CAS was performed before intracranial thrombectomy. In 42/224 (19%) patients who underwent EVT without CAS, a deferred carotid endarterectomy or CAS was performed. EVT with and without CAS were associated with similar proportions of good functional outcome (47% vs 42%, respectively; adjusted OR (aOR), 0.90; 95% CI, 0.50 to 1.62). There were no major differences between the groups in any of the secondary endpoints, except for the increased odds of a new clot in a different vascular territory in the EVT with CAS group (aOR, 2.96; 95% CI, 1.07 to 8.21).ConclusionsFunctional outcomes were comparable after EVT with and without CAS. CAS during EVT might be a feasible option to treat the extracranial ICA stenosis but randomised studies are warranted to prove non-inferiority or superiority.
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- 2023
13. Free water corrected diffusion tensor imaging discriminates between good and poor outcomes of comatose patients after cardiac arrest.
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Keijzer, H.M., Duering, M., Pasternak, O., Meijer, F.J.A., Verhulst, M.M.L.H., Tonino, B.A.R., Blans, M.J., Hoedemaekers, C.W.E., Klijn, C.J.M., Hofmeijer, J., Keijzer, H.M., Duering, M., Pasternak, O., Meijer, F.J.A., Verhulst, M.M.L.H., Tonino, B.A.R., Blans, M.J., Hoedemaekers, C.W.E., Klijn, C.J.M., and Hofmeijer, J.
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Item does not contain fulltext, OBJECTIVES: Approximately 50% of comatose patients after cardiac arrest never regain consciousness. Cerebral ischaemia may lead to cytotoxic and/or vasogenic oedema, which can be detected by diffusion tensor imaging (DTI). Here, we evaluate the potential value of free water corrected mean diffusivity (MD) and fractional anisotropy (FA) based on DTI, for the prediction of neurological recovery of comatose patients after cardiac arrest. METHODS: A total of 50 patients after cardiac arrest were included in this prospective cohort study in two Dutch hospitals. DTI was obtained 2-4 days after cardiac arrest. Outcome was assessed at 6 months, dichotomised as poor (cerebral performance category 3-5; n = 20) or good (n = 30) neurological outcome. We calculated the whole brain mean MD and FA and compared between patients with good and poor outcomes. In addition, we compared a preliminary prediction model based on clinical parameters with or without the addition of MD and FA. RESULTS: We found significant differences between patients with good and poor outcome of mean MD (good: 726 [702-740] × 10(-6) mm(2)/s vs. poor: 663 [575-736] × 10(-6) mm(2)/s; p = 0.01) and mean FA (0.30 ± 0.03 vs. 0.28 ± 0.03; p = 0.03). An exploratory prediction model combining clinical parameters, MD and FA increased the sensitivity for reliable prediction of poor outcome from 60 to 85%, compared to the model containing clinical parameters only, but confidence intervals are overlapping. CONCLUSIONS: Free water-corrected MD and FA discriminate between patients with good and poor outcomes after cardiac arrest and hold the potential to add to multimodal outcome prediction. KEY POINTS: • Whole brain mean MD and FA differ between patients with good and poor outcome after cardiac arrest. • Free water-corrected MD can better discriminate between patients with good and poor outcome than uncorrected MD. • A combination of free water-corrected MD (sensitive to grey matter abnormalities) and FA (sensitive to wh
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- 2023
14. MRI factors associated with cognitive functioning after acute onset brain injury: Systematic review and meta-analysis.
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Verhulst, M.M.L.H., Glimmerveen, A.B., Heugten, C.M. van, Helmich, R.C.G., Hofmeijer, J., Verhulst, M.M.L.H., Glimmerveen, A.B., Heugten, C.M. van, Helmich, R.C.G., and Hofmeijer, J.
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Item does not contain fulltext, Impairments of memory, attention, and executive functioning are frequently reported after acute onset brain injury. MRI markers hold potential to contribute to identification of patients at risk for cognitive impairments and clarification of mechanisms. The aim of this systematic review was to summarize and value the evidence on MRI markers of memory, attention, and executive functioning after acute onset brain injury. We included ninety-eight studies, on six classes of MRI factors (location and severity of damage (n = 15), volume/atrophy (n = 36), signs of small vessel disease (n = 15), diffusion-weighted imaging measures (n = 36), resting-state functional MRI measures (n = 13), and arterial spin labeling measures (n = 1)). Three measures showed consistent results regarding their association with cognition. Smaller hippocampal volume was associated with worse memory in fourteen studies (pooled correlation 0.58 [95% CI: 0.46-0.68] for whole, 0.11 [95% CI: 0.04-0.19] for left, and 0.34 [95% CI: 0.17-0.49] for right hippocampus). Lower fractional anisotropy in cingulum and fornix was associated with worse memory in six and five studies (pooled correlation 0.20 [95% CI: 0.08-0.32] and 0.29 [95% CI: 0.20-0.37], respectively). Lower functional connectivity within the default-mode network was associated with worse cognition in four studies. In conclusion, hippocampal volume, fractional anisotropy in cingulum and fornix, and functional connectivity within the default-mode network showed consistent associations with cognitive performance in all types of acute onset brain injury. External validation and cut off values for predicting cognitive impairments are needed for clinical implementation.
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- 2023
15. EEG in a four-electrode frontotemporal montage reliably predicts outcome after cardiac arrest.
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Admiraal, M.M., Merkerk, M. van, Horn, J., Koelman, J.H.T.M., Hofmeijer, J., Hoedemaekers, C.W., Rootselaar, A.F. van, Admiraal, M.M., Merkerk, M. van, Horn, J., Koelman, J.H.T.M., Hofmeijer, J., Hoedemaekers, C.W., and Rootselaar, A.F. van
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01 juli 2023, Item does not contain fulltext, AIM: To increase efficiency of continuous EEG monitoring for prognostication of neurological outcome in patients after cardiac arrest, we investigated the reliability of EEG in a four-electrode frontotemporal (4-FT) montage, compared to our standard nine-electrode (9-EL) montage. METHODS: EEG recorded with Ag/AgCl cup-electrodes at 12 and/or 24 h after cardiac arrest of 153 patients was available from a previous study. 220 EEG epochs of 5 minutes were reexamined in a 4-FT montage according to the ACNS criteria. Background classification was compared to the available 9-EL classification using Cohens kappa. Reliability for prognostication was assessed in 151 EEG epochs at 24 h after CA using sensitivity and specificity for prediction of poor (cerebral performance categories (CPC) 3-5) and good (CPC 1-2) neurological outcome. RESULTS: Agreement for EEG background classification between the two montages was substantial with a kappa of 0.85 (95%-CI 0.81-0.90). Specificity for prediction of poor outcome was 100% (95%-CI 95-100) for both montages, sensitivity was 31% (95%-CI 21-43) for the 4-FT montage and 35% (95%-CI 24-47) for the 9-EL montage. Good outcome was predicted with 65% specificity (95%-CI 53-76) and 81% sensitivity (95%-CI 71-89) for the 4-FT montage, similar to the 9-EL montage. CONCLUSION: In this cohort, EEG background patterns determined in a four-electrode frontotemporal montage predict both poor and good outcome after CA with similar reliability. Our results may contribute to decreasing the workload of EEG monitoring in patients after CA without compromising reliability of outcome prediction. However, validation in a larger cohort is necessary, as is a multimodal approach.
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- 2023
16. Endovascular treatment versus no endovascular treatment after 6-24 h in patients with ischaemic stroke and collateral flow on CT angiography (MR CLEAN-LATE) in the Netherlands: a multicentre, open-label, blinded-endpoint, randomised, controlled, phase 3 trial.
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Olthuis, S.G.H., Pirson, F.A.V., Pinckaers, F.M.E., Hinsenveld, W.H., Nieboer, D., Ceulemans, A., Knapen, R.R.M.M., Robbe, M.M.Q., Berkhemer, O.A., Walderveen, Marianne A.A. van, Lycklama a Nijeholt, G.J., Uyttenboogaart, M., Schonewille, W.J., Sluijs, P.M. van der, Wolff, L., Voorst, H. van, Postma, A.A., Roosendaal, S.D., Hoorn, A. van der, Emmer, B.J., Krietemeijer, M.G.M., Doormaal, P.J. van, Roozenbeek, B., Goldhoorn, R.B., Staals, J., Ridder, I.R. de, Leij, C. van der, Coutinho, J.M., Worp, H.B. van der, Lo, R.T., Bokkers, R.P., Dijk, E.J. van, Boogaarts, H.D., Wermer, M.J., Es, A.C. van, Tuijl, J.H. van, Kortman, H.G., Gons, R.A., Yo, L.S., Vos, J.A., Laat, K.F. de, Dijk, L.C. van, Wijngaard, I.R. van den, Hofmeijer, J., Martens, J.M., Brouwers, P.J., Bulut, T., Remmers, M.J., Jong, T.E.A.M. de, Hertog, H.M. den, Hasselt, B.A. van, Rozeman, A.D., Elgersma, O.E.H., Veen, B. van der, Sudiono, D.R., Lingsma, H.F., Roos, Y.B.W.E.M., Majoie, C.B.L.M., Lugt, A. van der, Dippel, D.W., Zwam, W.H. van, Oostenbrugge, R.J. van, Olthuis, S.G.H., Pirson, F.A.V., Pinckaers, F.M.E., Hinsenveld, W.H., Nieboer, D., Ceulemans, A., Knapen, R.R.M.M., Robbe, M.M.Q., Berkhemer, O.A., Walderveen, Marianne A.A. van, Lycklama a Nijeholt, G.J., Uyttenboogaart, M., Schonewille, W.J., Sluijs, P.M. van der, Wolff, L., Voorst, H. van, Postma, A.A., Roosendaal, S.D., Hoorn, A. van der, Emmer, B.J., Krietemeijer, M.G.M., Doormaal, P.J. van, Roozenbeek, B., Goldhoorn, R.B., Staals, J., Ridder, I.R. de, Leij, C. van der, Coutinho, J.M., Worp, H.B. van der, Lo, R.T., Bokkers, R.P., Dijk, E.J. van, Boogaarts, H.D., Wermer, M.J., Es, A.C. van, Tuijl, J.H. van, Kortman, H.G., Gons, R.A., Yo, L.S., Vos, J.A., Laat, K.F. de, Dijk, L.C. van, Wijngaard, I.R. van den, Hofmeijer, J., Martens, J.M., Brouwers, P.J., Bulut, T., Remmers, M.J., Jong, T.E.A.M. de, Hertog, H.M. den, Hasselt, B.A. van, Rozeman, A.D., Elgersma, O.E.H., Veen, B. van der, Sudiono, D.R., Lingsma, H.F., Roos, Y.B.W.E.M., Majoie, C.B.L.M., Lugt, A. van der, Dippel, D.W., Zwam, W.H. van, and Oostenbrugge, R.J. van
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Item does not contain fulltext, BACKGROUND: Endovascular treatment for anterior circulation ischaemic stroke is effective and safe within a 6 h window. MR CLEAN-LATE aimed to assess efficacy and safety of endovascular treatment for patients treated in the late window (6-24 h from symptom onset or last seen well) selected on the basis of the presence of collateral flow on CT angiography (CTA). METHODS: MR CLEAN-LATE was a multicentre, open-label, blinded-endpoint, randomised, controlled, phase 3 trial done in 18 stroke intervention centres in the Netherlands. Patients aged 18 years or older with ischaemic stroke, presenting in the late window with an anterior circulation large-vessel occlusion and collateral flow on CTA, and a neurological deficit score of at least 2 on the National Institutes of Health Stroke Scale were included. Patients who were eligible for late-window endovascular treatment were treated according to national guidelines (based on clinical and perfusion imaging criteria derived from the DAWN and DEFUSE-3 trials) and excluded from MR CLEAN-LATE enrolment. Patients were randomly assigned (1:1) to receive endovascular treatment or no endovascular treatment (control), in addition to best medical treatment. Randomisation was web based, with block sizes ranging from eight to 20, and stratified by centre. The primary outcome was the modified Rankin Scale (mRS) score at 90 days after randomisation. Safety outcomes included all-cause mortality at 90 days after randomisation and symptomatic intracranial haemorrhage. All randomly assigned patients who provided deferred consent or died before consent could be obtained comprised the modified intention-to-treat population, in which the primary and safety outcomes were assessed. Analyses were adjusted for predefined confounders. Treatment effect was estimated with ordinal logistic regression and reported as an adjusted common odds ratio (OR) with a 95% CI. This trial was registered with the ISRCTN, ISRCTN19922220. FINDINGS: Between Feb 2, 2018
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- 2023
17. Myoclonus in comatose patients with electrographic status epilepticus after cardiac arrest: Corresponding EEG patterns, effects of treatment and outcomes.
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Nutma, S., Ruijter, B.J., Beishuizen, A., Tromp, S.C., Scholten, E., Horn, J., Bergh, W.M. van den, Kranen-Mastenbroek, V.H. van, Thomeer, E.C., Moudrous, W., Aries, M., Hoedemaekers, A., Doorduin, J., Putten, M.J.A. van, Hofmeijer, J., Nutma, S., Ruijter, B.J., Beishuizen, A., Tromp, S.C., Scholten, E., Horn, J., Bergh, W.M. van den, Kranen-Mastenbroek, V.H. van, Thomeer, E.C., Moudrous, W., Aries, M., Hoedemaekers, A., Doorduin, J., Putten, M.J.A. van, and Hofmeijer, J.
- Abstract
Item does not contain fulltext, OBJECTIVE: To clarify the significance of any form of myoclonus in comatose patients after cardiac arrest with rhythmic and periodic EEG patterns (RPPs) by analyzing associations between myoclonus and EEG pattern, response to anti-seizure medication and neurological outcome. DESIGN: Post hoc analysis of the prospective randomized Treatment of ELectroencephalographic STatus Epilepticus After Cardiopulmonary Resuscitation (TELSTAR) trial. SETTING: Eleven ICUs in the Netherlands and Belgium. PATIENTS: One hundred and fifty-seven adult comatose post-cardiac arrest patients with RPPs on continuous EEG monitoring. INTERVENTIONS: Anti-seizure medication vs no anti-seizure medication in addition to standard care. MEASUREMENTS AND MAIN RESULTS: Of 157 patients, 98 (63%) had myoclonus at inclusion. Myoclonus was not associated with one specific RPP type. However, myoclonus was associated with a smaller probability of a continuous EEG background pattern (48% in patients with vs 75% without myoclonus, odds ratio (OR) 0.31; 95% confidence interval (CI) 0.16-0.64) and earlier onset of RPPs (24% vs 9% within 24 hours after cardiac arrest, OR 3.86;95% CI 1.64-9.11). Myoclonus was associated with poor outcome at three months, but not invariably so (poor neurological outcome in 96% vs 82%, p = 0.004). Anti-seizure medication did not improve outcome, regardless of myoclonus presence (6% good outcome in the intervention group vs 2% in the control group, OR 0.33; 95% CI 0.03-3.32). CONCLUSIONS: Myoclonus in comatose patients after cardiac arrest with RPPs is associated with poor outcome and discontinuous or suppressed EEG. However, presence of myoclonus does not interact with the effects of anti-seizure medication and cannot predict a poor outcome without false positives.
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- 2023
18. Anakinra in cerebral haemorrhage to target secondary injury resulting from neuroinflammation (ACTION): Study protocol of a phase II randomised clinical trial
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Cliteur, M.P., Kolk, A.G. van der, Hannink, G.J., Hofmeijer, J., Jolink, W.M.T., Klijn, C.J.M., Schreuder, F.H.B.M., Cliteur, M.P., Kolk, A.G. van der, Hannink, G.J., Hofmeijer, J., Jolink, W.M.T., Klijn, C.J.M., and Schreuder, F.H.B.M.
- Abstract
Item does not contain fulltext
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- 2023
19. Effects of oral anticoagulation in people with atrial fibrillation after spontaneous intracranial haemorrhage (COCROACH): prospective, individual participant data meta-analysis of randomised trials.
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Al-Shahi Salman, R., Stephen, J., Tierney, J.F., Lewis, Steff C., Newby, D.E., Parry-Jones, A.R., White, P.M., Connolly, S.J., Benavente, O.R., Dowlatshahi, D., Cordonnier, C., Viscoli, C.M., Sheth, K.N., Kamel, H., Veltkamp, R., Larsen, K.T., Hofmeijer, J., Kerkhoff, H., Schreuder, F.H.B.M., Shoamanesh, A., Klijn, C.J.M., Worp, H.B. van der, Al-Shahi Salman, R., Stephen, J., Tierney, J.F., Lewis, Steff C., Newby, D.E., Parry-Jones, A.R., White, P.M., Connolly, S.J., Benavente, O.R., Dowlatshahi, D., Cordonnier, C., Viscoli, C.M., Sheth, K.N., Kamel, H., Veltkamp, R., Larsen, K.T., Hofmeijer, J., Kerkhoff, H., Schreuder, F.H.B.M., Shoamanesh, A., Klijn, C.J.M., and Worp, H.B. van der
- Abstract
Contains fulltext : 300023.pdf (Publisher’s version ) (Open Access), BACKGROUND: The safety and efficacy of oral anticoagulation for prevention of major adverse cardiovascular events in people with atrial fibrillation and spontaneous intracranial haemorrhage are uncertain. We planned to estimate the effects of starting versus avoiding oral anticoagulation in people with spontaneous intracranial haemorrhage and atrial fibrillation. METHODS: In this prospective meta-analysis, we searched bibliographic databases and trial registries using the strategies of a Cochrane systematic review (CD012144) on June 23, 2023. We included clinical trials if they were registered, randomised, and included participants with spontaneous intracranial haemorrhage and atrial fibrillation who were assigned to either start long-term use of any oral anticoagulant agent or avoid oral anticoagulation (ie, placebo, open control, another antithrombotic agent, or another intervention for the prevention of major adverse cardiovascular events). We assessed eligible trials using the Cochrane Risk of Bias tool. We sought data for individual participants who had not opted out of data sharing from chief investigators of completed trials, pending completion of ongoing trials in 2028. The primary outcome was any stroke or cardiovascular death. We used individual participant data to construct a Cox regression model of the time to the first occurrence of outcome events during follow-up in the intention-to-treat dataset supplied by each trial, followed by meta-analysis using a fixed-effect inverse-variance model to generate a pooled estimate of the hazard ratio (HR) with 95% CI. This study is registered with PROSPERO, CRD42021246133. FINDINGS: We identified four eligible trials; three were restricted to participants with atrial fibrillation and intracranial haemorrhage (SoSTART [NCT03153150], with 203 participants) or intracerebral haemorrhage (APACHE-AF [NCT02565693], with 101 participants, and NASPAF-ICH [NCT02998905], with 30 participants), and one included a subgroup of p, 01 december 2023
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- 2023
20. Value of EEG in outcome prediction of hypoxic-ischemic brain injury in the ICU: A narrative review.
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Hoedemaekers, C.W.E., Hofmeijer, J., Horn, J., Hoedemaekers, C.W.E., Hofmeijer, J., and Horn, J.
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Contains fulltext : 300204.pdf (Publisher’s version ) (Open Access), Prognostication of comatose patients after cardiac arrest aims to identify patients with a large probability of favourable or unfavouble outcome, usually within the first week after the event. Electroencephalography (EEG) is a technique that is increasingly used for this purpose and has many advantages, such as its non-invasive nature and the possibility to monitor the evolution of brain function over time. At the same time, use of EEG in a critical care environment faces a number of challenges. This narrative review describes the current role and future applications of EEG for outcome prediction of comatose patients with postanoxic encephalopathy., 01 augustus 2023
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- 2023
21. EEG in postanoxic coma: Prognostic and diagnostic value
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Hofmeijer, J. and van Putten, M.J.A.M.
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- 2016
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22. Role of intravenous alteplase on late lesion growth and clinical outcome after stroke treatment
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Konduri, P., Cavalcante, F., van Voorst, H., Rinkel, L., Kappelhof, M., van Kranendonk, K., Treurniet, K., Emmer, B., Coutinho, J., Wolff, L., Hofmeijer, J., Uyttenboogaart, M., van Zwam, W., Roos, Y., Majoie, C., Marquering, H., Radiology & Nuclear Medicine, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: Carim - B05 Cerebral small vessel disease, and RS: Carim - B06 Imaging
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intracranial ,acute stroke ,neurovascular coupling ,ENDOVASCULAR THERAPY ,Brain edema ,INFARCT GROWTH ,VOLUME ,TPA ,RECANALIZATION ,REPERFUSION ,intracerebral hemorrhage ,FINAL INFARCT - Abstract
Several acute ischemic stroke mechanisms that cause lesion growth continue after treatment which is detrimental to long-term clinical outcome. The potential role of intravenous alteplase treatment (IVT), a standard in stroke care, in cessing the physiological processes causing post-treatment lesion development is understudied. We analyzed patients from the MR CLEAN-NO IV trial with good quality 24-hour and 1-week follow-up Non-Contrast CT scans. We delineated hypo- and hyper-dense regions on the scans as lesion. We performed univariable logistic and linear regression to estimate the influence of IVT on the presence (growth > 0 ml) and extent of late lesion growth. The association between late lesion growth and mRS was assessed using ordinal logistic regression. Interaction analysis was performed to evaluate the influence of IVT on this association. Of the 63/116 were randomized to included patients, IVT. Median growth was 8.4(-0.88-26) ml. IVT was not significantly associated with the presence (OR: 1.24 (0.57-2.74, p = 0.59) or extent (beta = 5.1(-8.8-19), p = 0.47) of growth. Late lesion growth was associated with worse clinical outcome (aOR: 0.85(0.76-0.95), p < 0.01; per 10 ml). IVT did not influence this association (p = 0.18). We did not find evidence that IVT influences late lesion growth or the relationship between growth and worse clinical outcome. Therapies to reduce lesion development are necessary.
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- 2023
23. Endovascular Therapy for Stroke Due to Basilar-Artery Occlusion
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Langezaal, L.C.M., Hoeven, E.J.R.J. van der, Mont'Alverne, F.J.A., Carvalho, J.J.F. de, Lima, F.O., Dippel, D.W.J., Lugt, A. van der, R.T.H. lo, Boiten, J., Nijeholt, G.J.L.A., Staals, J., Zwam, W.H. van, Nederkoorn, P.J., Majoie, C.B.L.M., Gerber, J.C., Mazighi, M., Piotin, M., Zini, A., Vallone, S., Hofmeijer, J., Martins, S.O., Nolte, C.H., Szabo, K., Dias, F.A., Abud, D.G., Wermer, M.J.H., Remmers, M.J.M., Schneider, H., Rueckert, C.M., Laat, K.F. de, Yoo, A.J., Doormaal, P.J. van, Es, A.C.G.M. van, Emmer, B.J., Michel, P., Puetz, V., Audebert, H.J., Pontes-Neto, O.M., Vos, J.A., Kappelle, L.J., Algra, A., Schonewille, W.J., BASICS Study Grp, Klinische Neurowetenschappen, MUMC+: MA Med Staf Spec Neurologie (9), RS: Carim - B05 Cerebral small vessel disease, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: Carim - B06 Imaging, TechMed Centre, Clinical Neurophysiology, Neurology, ACS - Atherosclerosis & ischemic syndromes, ANS - Neurovascular Disorders, Radiology and Nuclear Medicine, ACS - Microcirculation, and Radiology & Nuclear Medicine
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medicine.medical_specialty ,Endovascular therapy ,law.invention ,Randomized controlled trial ,law ,Internal medicine ,Severity of illness ,Occlusion ,medicine ,In patient ,ddc:610 ,cardiovascular diseases ,Stroke ,Intention-to-treat analysis ,business.industry ,Basilar artery occlusion ,General Medicine ,THROMBECTOMY ,medicine.disease ,ISCHEMIC-STROKE ,RESULTADO DE TRATAMENTO ,cardiovascular system ,Cardiology ,INTRAARTERIAL ,TRIAL ,business - Abstract
Background The effectiveness of endovascular therapy in patients with stroke caused by basilar-artery occlusion has not been well studied.Methods We randomly assigned patients within 6 hours after the estimated time of onset of a stroke due to basilar-artery occlusion, in a 1:1 ratio, to receive endovascular therapy or standard medical care. The primary outcome was a favorable functional outcome, defined as a score of 0 to 3 on the modified Rankin scale (range, 0 to 6, with 0 indicating no disability, 3 indicating moderate disability, and 6 indicating death) at 90 days. The primary safety outcomes were symptomatic intracranial hemorrhage within 3 days after the initiation of treatment and mortality at 90 days.Results A total of 300 patients were enrolled (154 in the endovascular therapy group and 146 in the medical care group). Intravenous thrombolysis was used in 78.6% of the patients in the endovascular group and in 79.5% of those in the medical group. Endovascular treatment was initiated at a median of 4.4 hours after stroke onset. A favorable functional outcome occurred in 68 of 154 patients (44.2%) in the endovascular group and 55 of 146 patients (37.7%) in the medical care group (risk ratio, 1.18; 95% confidence interval [CI], 0.92 to 1.50). Symptomatic intracranial hemorrhage occurred in 4.5% of the patients after endovascular therapy and in 0.7% of those after medical therapy (risk ratio, 6.9; 95% CI, 0.9 to 53.0); mortality at 90 days was 38.3% and 43.2%, respectively (risk ratio, 0.87; 95% CI, 0.68 to 1.12).Conclusions Among patients with stroke from basilar-artery occlusion, endovascular therapy and medical therapy did not differ significantly with respect to a favorable functional outcome, but, as reflected by the wide confidence interval for the primary outcome, the results of this trial may not exclude a substantial benefit of endovascular therapy. Larger trials are needed to determine the efficacy and safety of endovascular therapy for basilar-artery occlusion. (Funded by the Dutch Heart Foundation and others; BASICS ClinicalTrials.gov number, NCT01717755; Netherlands Trial Register number, NL2500.)Endovascular Therapy for Basilar-Artery Stroke In a randomized trial involving 300 patients with basilar-artery stroke, endovascular thrombectomy was not significantly different from medical therapy with respect to a favorable functional outcome (modified Rankin scale score of 0 to 3) at 90 days, but a clinically significant benefit could not be excluded.
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- 2021
24. ESICM LIVES 2016: part three: Milan, Italy. 1–5 October 2016
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Velasquez, T., Mackey, G., Lusk, J., Kyle, U. G., Fontenot, T., Marshall, P., Shekerdemian, L. S., Coss-Bu, J. A., Nishigaki, A., Yatabe, T., Tamura, T., Yamashita, K., Yokoyama, M., Ruiz-Rodriguez, J. C., Encina, B., Belmonte, R., Troncoso, I., Tormos, P., Riveiro, M., Baena, J., Sanchez, A., Bañeras, J., Cordón, J., Duran, N., Ruiz, A., Caballero, J., Nuvials, X., Riera, J., Serra, J., Rutten, A. M. F., van Ieperen, S. N. M., Der Kinderen, E. P. H. M., Van Logten, T., Kovacikova, L., Skrak, P., Zahorec, M., Kyle, U. G., Akcan-Arikan, A., Silva, J. C., Mackey, G., Lusk, J., Goldsworthy, M., Shekerdemian, L. S., Coss-Bu, J. A., Wood, D., Harrison, D., Parslow, R., Davis, P., Pappachan, J., Goodwin, S., Ramnarayan, P., Chernyshuk, S., Yemets, H., Zhovnir, V., Pulitano’, S. M., De Rosa, S., Mancino, A., Villa, G., Tosi, F., Franchi, P., Conti, G., Patel, B., Khine, H., Shah, A., Sung, D., Singer, L., Haghbin, S., Inaloo, S., Serati, Z., Idei, M., Nomura, T., Yamamoto, N., Sakai, Y., Yoshida, T., Matsuda, Y., Yamaguchi, Y., Takaki, S., Yamaguchi, O., Goto, T., Longani, N., Medar, S., Abdel-Aal, I. R., El Adawy, A. S., Mohammed, H. M. E. H., Mohamed, A. N., Parry, S. M., Knight, L. D., Denehy, L., De Morton, N., Baldwin, C. E., Sani, D., Kayambu, G., da Silva, V. Z. M., Phongpagdi, P., Puthucheary, Z. A., Granger, C. L., Rydingsward, J. E., Horkan, C. M., Christopher, K. B., McWilliams, D., Jones, C., Reeves, E., Atkins, G., Snelson, C., Aitken, L. M., Rattray, J., Kenardy, J., Hull, A. M., Ullman, A., Le Brocque, R., Mitchell, M., Davis, C., Macfarlane, B., Azevedo, J. C., Rocha, L. L., De Freitas, F. F. M., Cavalheiro, A. M., Lucinio, N. M., Lobato, M. S., Ebeling, G., Kraegpoeth, A., Laerkner, E., De Brito-Ashurst, I., White, C., Gregory, S., Forni, L. G., Flowers, E., Curtis, A., Wood, C. A., Siu, K., Venkatesan, K., Muhammad, J. B. H., Ng, L., Seet, E., Baptista, N., Escoval, A., Tomas, E., Agrawal, R., Mathew, R., Varma, A., Dima, E., Charitidou, E., Perivolioti, E., Pratikaki, M., Vrettou, C., Giannopoulos, A., Zakynthinos, S., Routsi, C., Atchade, E., Houzé, S., Jean-Baptiste, S., Thabut, G., Genève, C., Tanaka, S., Lortat-Jacob, B., Augustin, P., Desmard, M., Montravers, P., de Molina, F. J. González, Barbadillo, S., Alejandro, R., Álvarez-Lerma, F., Vallés, J., Catalán, R. M., Palencia, E., Jareño, A., Granada, R. M., Ignacio, M. L., Cui, N., Liu, D., Wang, H., Su, L., Qiu, H., Li, R., Jaffal, K., Rouzé, A., Poissy, J., Sendid, B., Nseir, S., Paramythiotou, E., Rizos, M., Frantzeskaki, F., Antoniadou, A., Vourli, S., Zerva, L., Armaganidis, A., Riera, J., Gottlieb, J., Greer, M., Wiesner, O., Martínez, M., Acuña, M., Rello, J., Welte, T., Atchade, E., Mignot, T., Houzé, S., Jean-Baptiste, S., Thabut, G., Lortat-Jacob, B., Tanaka, S., Augustin, P., Desmard, M., Montravers, P., Soussi, S., Dudoignon, E., Ferry, A., Chaussard, M., Benyamina, M., Alanio, A., Touratier, S., Chaouat, M., Lafaurie, M., Mimoun, M., Mebazaa, A., Legrand, M., Sheils, M. A., Patel, C., Mohankumar, L., Akhtar, N., Noriega, S. K. Pacheco, Aldana, N. Navarrete, León, J. L. Ávila, Baquero, J. Durand, Bernal, F. Fernández, Ahmadnia, E., Hadley, J. S., Millar, M., Hall, D., Hewitt, H., Yasuda, H., Sanui, M., Komuro, T., Kawano, S., Andoh, K., Yamamoto, H., Noda, E., Hatakeyama, J., Saitou, N., Okamoto, H., Kobayashi, A., Takei, T., Matsukubo, S., Rotzel, H. B., Lázaro, A. Serrano, Prada, D. Aguillón, Gimillo, M. Rodriguez, Barinas, O. Diaz, Cortes, M. L. Blasco, Franco, J. Ferreres, Roca, J. M. Segura, Carratalá, A., Gonçalves, B., Turon, R., Mendes, A., Miranda, F., Mata, P. J., Cavalcanti, D., Melo, N., Lacerda, P., Kurtz, P., Righy, C., Rosario, L. E. de la Cruz, Lesmes, S. P. Gómez, Romero, J. C. García, Herrera, A. N. García, Pertuz, E. D. Díaz, Sánchez, M. J. Gómez, Sanz, E. Regidor, Hualde, J. Barado, Hernández, A. Ansotegui, Irazabal, J. M. Guergué, Spatenkova, V., Bradac, O., Suchomel, P., Urli, T., Lazzeri, E. Heusch, Aspide, R., Zanello, M., Perez-Borrero, L., Garcia-Alvarez, J. M., Arias-Verdu, M. D., Aguilar-Alonso, E., Rivera-Fernandez, R., Mora-Ordoñez, J., De La Fuente-Martos, C., Castillo-Lorente, E., Guerrero-Lopez, F., Lesmes, S. P. Gómez, Rosario, L. E. De la Cruz, Pertuz, E. D. Díaz, Hernández, A. Ansotegui, Romero, J. C. García, Sánchez, M. J. Gómez, Herrera, A. N. García, Ramírez, J. Roldán, Sanz, E. Regidor, Hualde, J. Barado, León, J. P. Tirapu, Navarro-Guillamón, L., Cordovilla-Guardia, S., Iglesias-Santiago, A., Guerrero-López, F., Fernández-Mondéjar, E., Vidal, A., Perez, M., Juez, A., Arias, N., Colino, L., Perez, J. L., Pérez, H., Calpe, P., Alcala, M. A., Robaglia, D., Perez, C., Lan, S. K., Cunha, M. M., Moreira, T., Santos, F., Lafuente, E., Fernandes, M. J., Silva, J. G., Rosario, L. E. de la Cruz, Lesmes, S. P. Gómez, Herrera, A. N. García, Romero, J. C. García, Pertuz, E. D. Díaz, Sánchez, M. J. Gómez, Sanz, E. Regidor, Echeverría, J. G. Armando, Hernández, A. Ansotegui, Hualde, J. Barado, Podlepich, V., Sokolova, E., Alexandrova, E., Lapteva, K., Kurtz, P., Shuinotsuka, C., Rabello, L., Vianna, G., Reis, A., Cairus, C., Salluh, J., Bozza, F., Torres, J. C. Barrios, Araujo, N. J. Fernández, García-Olivares, P., Keough, E., Dalorzo, M., Tang, L. K., De Sousa, I., Díaz, M., Marcos-Zambrano, L. J., Guerrero, J. E., Gomez, S. E. Zamora, Lopez, G. D. Hernandez, Cuellar, A. I. Vazquez, Nieto, O. R. Perez, Gonzalez, J. A. Castanon, Bhasin, D., Rai, S., Singh, H., Gupta, O., Bhattal, M. K., Sampley, S., Sekhri, K., Nandha, R., Aliaga, F. A., Olivares, F., Appiani, F., Farias, P., Alberto, F., Hernández, A., Pons, S., Sonneville, R., Bouadma, L., Neuville, M., Mariotte, E., Radjou, A., Lebut, J., Chemam, S., Voiriot, G., Dilly, M. P., Mourvillier, B., Dorent, R., Nataf, P., Wolff, M., Timsit, J. F., Ediboglu, O., Ataman, S., Ozkarakas, H., Kirakli, C., Vakalos, A., Avramidis, V., Obukhova, O., Kurmukov, I. A., Kashiya, S., Golovnya, E., Baikova, V. N., Ageeva, T., Haritydi, T., Kulaga, E. V., Rios-Toro, J. J., Perez-Borrero, L., Aguilar-Alonso, E., Arias-Verdu, M. D., Garcia-Alvarez, J. M., Lopez-Caler, C., De La Fuente-Martos, C., Rodriguez-Fernandez, S., Sanchez-Orézzoli, M. Gomez, Martin-Gallardo, F., Nikhilesh, J., Joshi, V., Villarreal, E., Ruiz, J., Gordon, M., Quinza, A., Gimenez, J., Piñol, M., Castellanos, A., Ramirez, P., Jeon, Y. D., Jeong, W. Y., Kim, M. H., Jeong, I. Y., Ahn, M. Y., Ahn, J. Y., Han, S. H., Choi, J. Y., Song, Y. G., Kim, J. M., Ku, N. S., Shah, H., Kellner, F., Rezai, F., Mistry, N., Yodice, P., Ovnanian, V., Fless, K., Handler, E., Alejos, R. Martínez, Romeu, J. D. Martí, Antón, D. González, Quinart, A., Martí, A. Torres, Llaurado-Serra, M., Lobo-Civico, A., Ventura-Rosado, A., Piñol-Tena, A., Pi-Guerrero, M., Paños-Espinosa, C., Peralvo-Bernat, M., Marine-Vidal, J., Gonzalez-Engroba, R., Montesinos-Cerro, N., Treso-Geira, M., Valeiras-Valero, A., Martinez-Reyes, L., Sandiumenge, A., Jimenez-Herrera, M. F., Helyar, S., Riozzi, P., Noon, A., Hallows, G., Cotton, H., Keep, J., Hopkins, P. A., Taggu, A., Renuka, S., Sampath, S., Rood, P. J. T., Frenzel, T., Verhage, R., Bonn, M., Pickkers, P., van der Hoeven, J. G., van den Boogaard, M., Corradi, F., Melnyk, L., Moggia, F., Pienovi, R., Adriano, G., Brusasco, C., Mariotti, L., Lattuada, M., Bloomer, M. J., Coombs, M., Ranse, K., Endacott, R., Maertens, B., Blot, K., Blot, S., Amerongen, M. P. van Nieuw, van der Heiden, E. S., Twisk, J. W. R., Girbes, A. R. J., Spijkstra, J. J., Riozzi, P., Helyar, S., Cotton, H., Hallows, G., Noon, A., Bell, C., Peters, K., Feehan, A., Keep, J., Hopkins, P. A., Churchill, K., Hawkins, K., Brook, R., Paver, N., Endacott, R., Maistry, N., van Wijk, A., Rouw, N., van Galen, T., Evelein-Brugman, S., Taggu, A., Krishna, B., Sampath, S., Putzu, A., Fang, M., Berto, M. Boscolo, Belletti, A., Cassina, T., Cabrini, L., Mistry, M., Alhamdi, Y., Welters, I., Abrams, S. T., Toh, C. H., Han, H. S., Gil, E. M., Lee, D. S., Park, C. M., Winder-Rhodes, S., Lotay, R., Doyle, J., Ke, M. W., Huang, W. C., Chiang, C. H., Hung, W. T., Cheng, C. C., Lin, K. C., Lin, S. C., Chiou, K. R., Wann, S. R., Shu, C. W., Kang, P. L., Mar, G. Y., Liu, C. P., Dubó, S., Aquevedo, A., Jibaja, M., Berrutti, D., Labra, C., Lagos, R., García, M. F., Ramirez, V., Tobar, M., Picoita, F., Peláez, C., Carpio, D., Alegría, L., Hidalgo, C., Godoy, K., Bakker, J., Hernández, G., Sadamoto, Y., Katabami, K., Wada, T., Ono, Y., Maekawa, K., Hayakawa, M., Sawamura, A., Gando, S., Marin-Mateos, H., Perez-Vela, J. L., Garcia-Gigorro, R., Peiretti, M. A. Corres, Lopez-Gude, M. J., Chacon-Alves, S., Renes-Carreño, E., Montejo-González, J. C., Parlevliet, K. L., Touw, H. R. W., Beerepoot, M., Boer, C., Elbers, P. W. G., Tuinman, P. R., Abdelmonem, S. A., Helmy, T. A., El Sayed, I., Ghazal, S., Akhlagh, S. H., Masjedi, M., Hozhabri, K., Kamali, E., Zýková, I., Paldusová, B., Sedlák, P., Morman, D., Youn, A. M., Ohta, Y., Sakuma, M., Bates, D., Morimoto, T., Su, P. L., Chang, W. Y., Lin, W. C., Chen, C. W., Facchin, F., Zarantonello, F., Panciera, G., De Cassai, A., Venrdramin, A., Ballin, A., Tonetti, T., Persona, P., Ori, C., Del Sorbo, L., Rossi, S., Vergani, G., Cressoni, M., Chiumello, D., Chiurazzi, C., Brioni, M., Algieri, I., Tonetti, T., Guanziroli, M., Colombo, A., Tomic, I., Colombo, A., Crimella, F., Carlesso, E., Gasparovic, V., Gattinoni, L., Neto, A. Serpa, Schmidt, M., Pham, T., Combes, A., de Abreu, M. Gama, Pelosi, P., Schultz, M. J., Katira, B. H., Engelberts, D., Giesinger, R. E., Ackerley, C., Yoshida, T., Zabini, D., Otulakowski, G., Post, M., Kuebler, W. M., McNamara, P. J., Kavanagh, B. P., Pirracchio, R., Rigon, M. Resche, Carone, M., Chevret, S., Annane, D., Eladawy, S., El-Hamamsy, M., Bazan, N., Elgendy, M., De Pascale, G., Vallecoccia, M. S., Cutuli, S. L., Di Gravio, V., Pennisi, M. A., Conti, G., Antonelli, M., Andreis, D. T., Khaliq, W., Singer, M., Hartmann, J., Harm, S., Carmona, S. Alcantara, Almudevar, P. Matia, Abellán, A. Naharro, Ramos, J. Veganzones, Pérez, L. Pérez, Valbuena, B. Lobo, Sanz, N. Martínez, Simón, I. Fernández, Arrigo, M., Feliot, E., Deye, N., Cariou, A., Guidet, B., Jaber, S., Leone, M., Resche-Rigon, M., Baron, A. Vieillard, Legrand, M., Gayat, E., Mebazaa, A., Balik, M., Kolnikova, I., Maly, M., Waldauf, P., Tavazzi, G., Kristof, J., Herpain, A., Su, F., Post, E., Taccone, F., Vincent, J. L., Creteur, J., Lee, C., Hatib, F., Jian, Z., Buddi, S., Cannesson, M., Fileković, S., Turel, M., Knafelj, R., Gorjup, V., Stanić, R., Gradišek, P., Cerović, O., Mirković, T., Noč, M., Tirkkonen, J., Hellevuo, H., Olkkola, K. T., Hoppu, S., Lin, K. C., Hung, W. T., Chiang, C. C., Huang, W. C., Juan, W. C., Lin, S. C., Cheng, C. C., Lin, P. H., Fong, K. Y., Hou, D. S., Kang, P. L., Wann, S. R., Chen, Y. S., Mar, G. Y., Liu, C. P., Paul, M., Bougouin, W., Geri, G., Dumas, F., Champigneulle, B., Legriel, S., Charpentier, J., Mira, J. P., Sandroni, C., Cariou, A., Zimmerman, J., Sullivan, E., Noursadeghi, M., Fox, B., Sampson, D., McHugh, L., Yager, T., Cermelli, S., Seldon, T., Bhide, S., Brandon, R. A., Brandon, R. B., Zwaag, J., Beunders, R., Pickkers, P., Kox, M., Gul, F., Arslantas, M. K., Genc, D., Zibandah, N., Topcu, L., Akkoc, T., Cinel, I., Greco, E., Lauretta, M. P., Andreis, D. T., Singer, M., Garcia, I. Palacios, Cordero, M., Martin, A. Diaz, Pallás, T. Aldabó, Montero, J. 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Y., Onodera, M., Nakataki, E., Oto, J., Imanaka, H., Nishimura, M., Khadjibaev, A., Sabirov, D., Rosstalnaya, A., Akalaev, R., Parpibaev, F., Antonucci, E., Rossini, P., Gandolfi, S., Montini, E., Orlando, S., van Nes, M., Karachi, F., Hanekom, S., Andrade, A. H., Pereira, U. V., Filho, C. A. C. Abreu, Costa, R. C., Parkin, M. S. W., Moore, M., Andrade, A. H., Costa, R. C., Carvalho, K. V. Silva, Filho, C. A. C. Abreu, Min, H. J., Kim, H. J., Lee, D. S., Choi, Y. Y., Lee, E. Y., Song, I., Kim, D. J., E, Y. Y., Kim, J. W., Park, J. S., Cho, Y. J., Lee, J. H., Suh, J. W., Jo, Y. H., Kim, K. S., Lee, Y. J., Ferrero-Calleja, J., Merino-Vega, D., González-Jiménez, A. I., Sigcha, M. Sigcha, Hernández-Tejedor, A., Martin-Vivas, A., Gabán-Díez, Á., Luna, R. Ruiz-de, De la Calle-Pedrosa, N., Temprano-Gómez, I., Afonso-Rivero, D., Pellin-Ariño, J. I., Algora-Weber, A., Fumis, R. R. L., Ferraz, A. B., Junior, J. M. Vieira, Kirca, H., Cakin, O., Unal, M., Mutlu, H., Ramazanoglu, A., Cengiz, M., Nicolini, E. A., Pelisson, F. G. F., Nunes, R. S., da Silva, S. L., Carreira, M. M., Bellissimo-Rodrigues, F., Ferez, M. A., Basile-Filho, A., Chao, H. C., Chen, C. M., Chen, L., Hravnak, M., Clermont, G., Pinsky, M., Dubrawski, A., Varas, J. Luján, Montero, R. Molina, Sánchez-Elvira, L. Alcázar, Díaz, P. Villa, Delgado, C. Pintado, Ruiz, B. Llorente, Guerrero, A. Pardo, Galache, J. A. Cambronero, Sherif, H., Hassanin, H., El Hossainy, R., Samy, W., Ly, H., David, H., Burtin, P., Charpentier, C., Barral, M., Courant, P., Fournel, E., Gaide-Chevronnay, L., Durand, M., Albaladejo, P., Payen, J. F., Chavanon, O., Ortiz, A. Blandino, Pozzebon, S., Lheureux, O., Brasseur, A., Vincent, J. L., Creteur, J., Taccone, F. S., Fumagalli, F., Scala, S., Affatato, R., De Maglie, M., Zani, D., Novelli, D., Marra, C., Luciani, A., De Zani, D., Luini, M., Letizia, T., Pravettoni, D., Staszewsky, L., Masson, S., Belloli, A., Di Giancamillo, M., Scanziani, E., Latini, R., Ristagno, G., Kye, Y. C., Suh, G. J., Kwon, W. Y., Kim, K. S., Yu, K. M., Babini, G., Ristagno, G., Grassi, L., Fumagalli, F., Bendel, S., De Maglie, M., Affatato, R., Masson, S., Latini, R., Scanziani, E., Reinikainen, M., Skrifvars, M., Kappler, F., Blobner, M., Schaller, S. J., Roasio, A., Costanzo, E., Cardellino, S., Iesu, E., Cavicchi, F. Zama, Fontana, V., Nobile, L., Vincent, J. L., Creteur, J., Taccone, F. S., Park, M., You, K. M., Suh, G. J., Kwon, W. Y., Ko, S. B., Kim, K. S., Xini, A., Marca, L., Lheureux, O., Brasseur, A., Vincent, J. L., Creteur, J., Taccone, F. S., Beane, A., Thilakasiri, M. C. K. T., De Silva, A. P., Stephens, T., Sigera, C. S., Athapattu, P., Jayasinghe, S., Padeniya, A., Haniffa, R., Santiago, A. Iglesias, Sáez, V. Chica, Ruiz-Ruano, R. de la Chica, González, A. Sánchez, Kunze-Szikszay, N., Wand, S., Klapsing, P., Wetz, A., Heyne, T., Schwerdtfeger, K., Troeltzsch, M., Bauer, M., Quintel, M., Moerer, O., Cook, D. J., Rutherford, W. B., Scales, D. C., Adhikari, N. K., Cuthbertson, B. H., Suzuki, T., Takei, T., Fushimi, K., Iwamoto, M., Nakagawa, S., Mendsaikhan, N., Begzjav, T., Lundeg, G., Dünser, M. W., Romero, D. González, Cabrera, J. L. Santana, Santana, J. D. Martín, Padilla, Y. Santana, Pérez, H. Rodríguez, Torrent, R. Lorenzo, Kleinpell, R., Chouris, I., Radu, V., Stougianni, M., Lavrentieva, A., Lagonidis, D., Price, R. D. T., Day, A., Arora, N., Henderson, M. A., Hickey, S., Costa, M. I. Almeida, Carvalho, J. P., Gomes, A. A., Mergulhão, P. J., Chan, K. K. C., Shum, H. P., Yan, W. W., Maghsoudi, B., Tabei, S. H., Masjedi, M., Sabetian, G., Tabatabaei, H. R., Akbarzadeh, A., Saigal, S., Pakhare, A., Joshi, R., Pattnaik, S. K., Ray, B., Rousseau, A. F., Michel, L., Bawin, M., Cavalier, E., Reginster, J. Y., Damas, P., Bruyere, O., Zhou, J. C., Cauwenberghs, H., De Backer, A., Neels, H., Deblier, I., Berghmans, J., Himpe, D., Barea-Mendoza, J. A., Portillo, I. Prieto, Fernández, M. Valiente, Gigorro, R. Garcia, Vela, J. L. Perez, Mateos, H. Marín, Alves, S. Chacón, Varas, G. Morales, Rodriguez-Biendicho, A., Carreño, E. Renes, González, J. C. Montejo, Yang, J. S., Chiang, C. H., Hung, W. T., Huang, W. C., Cheng, C. C., Lin, K. C., Lin, S. C., Chiou, K. R., Wann, S. R., Lin, K. L., Kang, P. L., Mar, G. Y., Liu, C. P., Zhou, J. C., Choi, Y. J., Yoon, S. Z., Gordillo-Brenes, A., Fernandez-Zamora, M. D., Perez-Borrero, L., Arias-Verdu, M. D., Aguilar-Alonso, E., Herruzo-Aviles, A., Garcia-Delgado, M., Hinojosa-Perez, R., Curiel-Balsera, E., Rivera-Fernandez, R., Lesmes, S. P. Gómez, Rosario, L. E. De la Cruz, Hernández, A. Ansotegui, Herrera, A. N. García, Sanz, E. Regidor, Sánchez, M. J. Gómez, Hualde, J. Barado, Pascual, O. 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J., Oto, J., Nakataki, E., Tsunano, Y., Izawa, M., Tane, N., Onodera, M., Nishimura, M., Ghosh, S., Gupta, A., De Gasperi, A., Mazza, E., Limuti, R., Prosperi, M., Bissenova, N., Yergaliyeva, A., Talan, L., Yılmaz, G., Güven, G., Yoruk, F., Altıntas, N. D., Mukherjee, D. N., Agarwal, L. K., Mandal, K., Palomar, M., Balsera, B., Vallverdu, M., Martinez, M., Garcia, M., Castellana, D., Lopez, R., Barcenilla, F., Kaminsky, G. E., Carreño, R., Escribá, A., Fuentes, M., Gálvez, V., Del Olmo, R., Nieto, B., Vaquerizo, C., Alvarez, J., De la Torre, M. A., Torres, E., Bogossian, E., Nouer, S. Aranha, Salgado, D. Ribeiro, Brugger, S. Carvalho, Jiménez, G. Jiménez, Torner, M. Miralbés, Vidal, M. Vallverdú, Garrido, B. Balsera, Casals, X. Nuvials, Gaite, F. Barcenilla, Cabello, J. Trujillano, Martínez, M. Palomar, Doganci, M., Izdes, S., Besevli, S. Guzeldag, Alkan, A., Kayaaslan, B., Ramírez, C. Sánchez, Balcázar, L. Caipe, Santana, M. Cabrera, Viera, M. A. Hernández, Escalada, S. Hípola, Vázquez, C. F. Lübbe, Penichet, S. M. Marrero, Campelo, F. Artiles, López, M. A. De La Cal, Santana, P. Saavedra, Santana, S. Ruíz, Repessé, X., Artiguenave, M., Paktoris-Papine, S., Espinasse, F., Dinh, A., El Sayed, F., Charron, C., Géri, G., Vieillard-Baron, A., Marmanidou, K., Oikonomou, M., Nouris, C., Dimitroulakis, K., Soilemezi, E., Matamis, D., Ferré, A., Guillot, M., Teboul, J. L., Lichtenstein, D., Mézière, G., Richard, C., Monnet, X., Pham, T., Beduneau, G., Schortgen, F., Piquilloud, L., Zogheib, E., Jonas, M., Grelon, F., Runge, I., Terzi, N., Grangé, S., Barberet, G., Guitard, P. G., Frat, J. P., Constan, A., Chrétien, J. M., Mancebo, J., Mercat, A., Richard, J. C. M., Brochard, L., Prīdāne, S., Sabeļņikovs, O., Mojoli, F., Orlando, A., Bianchi, I., Torriglia, F., Bianzina, S., Pozzi, M., Iotti, G. A., Braschi, A., Beduneau, G., Pham, T., Schortgen, F., Piquilloud, L., Zogheib, E., Jonas, M., Grelon, F., Runge, I., Terzi, N., Grangé, S., Barberet, G., Guitard, P. G., Frat, J. P., Constan, A., Chrétien, J. M., Mancebo, J., Mercat, A., Richard, J. C. M., Brochard, L., Kondili, E., Psarologakis, C., Kokkini, S., Amargianitakis, V., Babalis, D., Chytas, A., Chouvarda, I., Vaporidi, K., Georgopoulos, D., Trapp, O., Kalenka, A., Mojoli, F., Orlando, A., Bianchi, I., Torriglia, F., Bianzina, S., Pozzi, M., Iotti, G. A., Braschi, A., Lozano, J. A. Benítez, Sánchez, P. Carmona, Francioni, J. E. Barrueco, Ferrón, F. Ruiz, Simón, J. M. Serrano, Spadaro, S., Karbing, D. S., Gioia, A., Moro, F., Corte, F. Dalla, Mauri, T., Volta, C. A., Rees, S. E., Petrova, M. V., Mohan, R., Butrov, A. V., Beeharry, S. D., Vatsik, M. V., Sakieva, F. I., Gobert, F., Yonis, H., Tapponnier, R., Fernandez, R., Labaune, M. A., Burle, J. F., Barbier, J., Vincent, B., Cleyet, M., Richard, J. C., Guérin, C., Shinotsuka, C. Righy, Creteur, J., Taccone, F. S., Törnblom, S., Nisula, S., Vaara, S., Poukkanen, M., Andersson, S., Pettilä, V., Pesonen, E., Xie, Z., Liao, X., Kang, Y., Zhang, J., Kubota, K., Egi, M., Mizobuchi, S., Hegazy, S., El-Keraie, A., El Sayed, E., El Hamid, M. Abd, Rodrigues, N. J., Pereira, M., Godinho, I., Gameiro, J., Neves, M., Gouveia, J., e Silva, Z. Costa, Lopes, J. A., Mckinlay, J., Kostalas, M., Kooner, G., Dudas, G., Horton, A., Kerr, C., Karanjia, N., Creagh-Brown, B., Forni, L., Yamazaki, A., Ganuza, M. Sanz, Molina, J. A. Martinez, Martinez, F. Hidalgo, Freile, M. T. Chiquito, Fernandez, N. Garcia, Travieso, P. Medrano, Bandert, A., Frithiof, R., Lipcsey, M., Smekal, D., Schlaepfer, P., Durovray, J. D., Plouhinec, V., Chiappa, C., Bellomo, R., Schneider, A. G., Mitchell, S., Durrant, J., Street, H., Dunthorne, E., Shears, J., Caballero, C. Hernandez, Hutchison, R., Schwarze, S., Ghabina, S., Thompson, E., Prowle, J. R., Kirwan, C. J., Gonzalez, C. A., Pinto, J. L., Orozco, V., Patiño, J. A., Garcia, P. K., Contreras, K. M., Rodriguez, P., Echeverri, J. E., GETGAG Working Group, JSEPTIC (Japanese Society of Education for Physicians and Trainees in Intensive Care) Clinical Trial Group, CAPCRI Study, for the ReVA Research Network and the PROVE Network Investigators, from the FROG ICU Investigators, The WIND study group, Plug Working Group, GETGAG/SEMICYUC, AKI Research Group, St George’s University of London, IPREA Study Group, FINNRESUSCI Study Group, PICS- HCPA: Programa Intrahospitalar de Combate à Sepse do Hospital de Clínicas de Porto Alegre, ENVIN-HELICS Study Group, ARIAM registry of adult cardiac surgery, The Rapid Diagnosis of Infections in the Critically Ill Team, Tokyo Womens Medical University, PLUG working group, PLUG Working Group, On behalf of Okayama Research Investigation Organizing Network (ORION)investigators, PS-ICU Group, Japan Septic Disseminated Intravascular Coagulation (JSEPTIC DIC) study group, Student Research Committee - Shiraz University of Medical Sciences, ARIAM-ANDALUCIA, The WIND study group, PLUG Working Group, The WIND study group, PLUG Working Group, and Plug working group
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25. ESICM LIVES 2016: part two: Milan, Italy. 1–5 October 2016
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Sivakumar, S., Taccone, F. S., Desai, K. A., Lazaridis, C., Skarzynski, M., Sekhon, M., Henderson, W., Griesdale, D., Chapple, L., Deane, A., Williams, L., Strickland, R., Lange, K., Heyland, D., Chapman, M., Rowland, M. J., Garry, P., Westbrook, J., Corkill, R., Antoniades, C. A., Pattinson, K. T., Fatania, G., Strong, A. J., Myers, R. B., Lazaridis, C., Jermaine, C. M., Robertson, C. S., Rusin, C. G., Hofmeijer, J., Sondag, L., Tjepkema-Cloostermans, M. C., Beishuizen, A., Bosch, F. H., van Putten, M. J. A. M., Carteron, L., Patet, C., Solari, D., Oddo, M., Ali, M. A., Dias, C., Almeida, R., Vaz-Ferreira, A., Silva, J., Monteiro, E., Cerejo, A., Rocha, A. P., Elsayed, A. A., Abougabal, A. M., Beshey, B. N., Alzahaby, K. M., Pozzebon, S., Ortiz, A. Blandino, Cristallini, S., Lheureux, O., Brasseur, A., Vincent, J. L., Creteur, J., Taccone, F. S., Hravnak, M., Yousef, K., Chang, Y., Crago, E., Friedlander, R. M., Abdelmonem, S. A., Tahon, S. A., Helmy, T. A., Meligy, H. S., Puig, F., Dunn-Siegrist, I., Pugin, J., Gupta, S., Govil, D., Srinivasan, S., Patel, S. J., N, J. K., Gupta, A., Tomar, D. S., Shafi, M., Harne, R., Arora, D. P., Talwar, N., Mazumdar, S., Papakrivou, E. E., Makris, D., Manoulakas, E., Tsolaki, B., Karadodas, B., Zakynthinos, E., Garcia, I. Palacios, Martin, A. Diaz, Encinares, V. Sanchez, Ibañez, M. Pachón, Montero, J. Garnacho, Labrador, G., Cangueiro, T. Cebrero, Poulose, V., Koh, J., Kam, J. W., Yeter, H., Kara, A., Aktepe, O., Topeli, A., Tsolakoglou, I., Intas, G., Stergiannis, P., Kolaros, A. A., Chalari, E., Athanasiadou, E., Martika, A., Fildisis, G., Faivre, V., Mengelle, C., Favier, B., Payen, D., Poppe, A., Winkler, M. S., Mudersbach, E., Schreiber, J., Wruck, M. L., Schwedhelm, E., Kluge, S., Zöllner, C., Tavladaki, T., Spanaki, A. M., Dimitriou, H., Kondili, E., Choulaki, C., Meleti, E., Kafetzopoulos, D., Georgopoulos, D., Briassoulis, G., la Torre, A. García-de, de la Torre-Prados, M. V., Tsvetanova-Spasova, T., Nuevo-Ortega, P., Rueda-Molina, C., Fernández-Porcel, A., Camara-Sola, E., Salido-Díaz, L., García-Alcántara, A., Tavladaki, T., Spanaki, A. M., Dimitriou, H., Kondili, E., Choulaki, C., Meleti, D. E., Kafetzopoulos, D., Georgopoulos, D., Briassoulis, G., Suberviola, B., Riera, J., Rellan, L., Sanchez, M., Robles, J. C., Lopez, E., Vicente, R., Miñambres, E., Santibañez, M., Le Guen, M., Moore, J., Mason, N., Windpassinger, M., Plattner, O., Mascha, E., Sessler, D. I., Research, Outcomes, Melia, U., Fontanet, J., van den Berg, J. P., Struys, M. M. R. F., Vereecke, H. E. M., Jensen, E. W., Rood, P. J. T., van de Schoor, F., van Tertholen, K., Pickkers, P., van den Boogaard, M., Beardow, Z. J., Redhead, H., Paramasivam, K., Numan, T., van den Boogaard, M., Kamper, A. M., Rood, P., Peelen, L. M., Zeman, P. M., Slooter, A. J., van Ewijk, C. E., Jacobs, G. E., Girbes, A. R. J., Myatra, S. N., Harish, M. M., Prabu, N. R., Siddiqui, S., Kulkarni, A. 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C., Vieira, Jr, J. M., Azevedo, L. C. P., Nurses of the Central and General ICUs of Shiraz Namazi Hospital, Sedation an Delirium Group Hospital Universitari de Bellvitge, SPACeR group (Surrey Peri-operative, Anaesthesia and Critical Care Collaborative Research Group), for the PRoVENT investigators and the PROVE Network, SEMICYUC/GETGAG Working Group, TAVeM study group, POPC-CB investigators, DESIRE (DExmedetomidine for Sepsis in ICU Randomized Evaluation) Trial Investigators, GEMINI, Bioethics work group of SEMICYUC, The FINNAKI Study Group, Queen Square Neuroanaesthesia and Neurocritical Care Resreach Group, Renal Transplantation HUVR, GEMINI, EDISVAL Group, EDISVAL Group, PLUG Working group, TAVeM study Group, The FINNAKI Study Group, on behalf of Department of Professional Development, ESICM, Critical Care Research Group, SIRAKI group, and Grupo ESBAGA
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26. Systematic Review - Combining Neuroprotection With Reperfusion in Acute Ischemic Stroke
- Author
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Vos, E.M., Geraedts, V.J., Lugt, A. van der, Dippel, D.W.J., Wermer, M.J.H., Hofmeijer, J., Es, A.C.G.M. van, Roos, Y.B.W.E.M., Peeters-Scholte, C.M.P.C.D., Wijngaard, I.R. van den, Radiology & Nuclear Medicine, and Neurology
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Neurology ,reperfusion after ischemia ,thrombectomy ,neuroprotection ,intravenous thrombolysis ,Neurology (clinical) ,stroke - Abstract
BackgroundClinical trials of neuroprotection in acute ischemic stroke (AIS) have provided disappointing results. Reperfusion may be a necessary condition for positive effects of neuroprotective treatments. This systematic review provides an overview of efficacy of neuroprotective agents in combination with reperfusion therapy in AIS.MethodsA literature search was performed on the following databases, namely PubMed, Embase, Web of Science, Cochrane Library, Emcare. All databases were searched up to September 23rd 2021. All randomized controlled trials in which patients were treated with neuroprotective strategies within 12 h of stroke onset in combination with intravenous thrombolysis (IVT), endovascular therapy (EVT), or both were included.ResultsWe screened 1,764 titles/abstracts and included 30 full reports of unique studies with a total of 16,160 patients. In 15 studies neuroprotectants were tested for clinical efficacy, where all patients had to receive reperfusion therapies, either IVT and/or EVT. Heterogeneity in reported outcome measures was observed. Treatment was associated with improved clinical outcome for: 1) uric acid in patients treated with EVT and IVT, 2) nerinetide in patients who underwent EVT without IVT, 3) imatinib in stroke patients treated with IVT with or without EVT, 4) remote ischemic perconditioning and IVT, and 5) high-flow normobaric oxygen treatment after EVT, with or without IVT.ConclusionStudies specifically testing effects of neuroprotective agents in addition to IVT and/or EVT are scarce. Future neuroprotection studies should report standardized functional outcome measures and combine neuroprotective agents with reperfusion therapies in AIS or aim to include prespecified subgroup analyses for treatment with IVT and/or EVT.
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- 2022
27. Safety and efficacy of aspirin, unfractionated heparin, both, or neither during endovascular stroke treatment (MR CLEAN-MED):an open-label, multicentre, randomised controlled trial
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Steen, W. van der, Graaf, R.A.V. de, Chalos, V., Lingsma, H.F., Doormaal, P.J. van, Coutinho, J.M., Emmer, B.J., Ridder, I. de, Zwam, W. van, Worp, H.B. van der, Schaaf, I. van der, Gons, R.A.R., Yo, L.S.F., Boiten, J., Wijngaard, I. van den, Hofmeijer, J., Martens, J., Schonewille, W., Vos, J.A., Tuladhar, A.M., Laat, K.F. de, Hasselt, B. van, Remmers, M., Vos, D., Rozeman, A., Elgersma, O., Uyttenboogaart, M., Bokkers, R.P.H., Tuijl, J. van, Boukrab, I., Berg, R. van den, Beenen, L.F.M., Roosendaal, S.D., Postma, A.A., Krietemeijer, M., Lycklama, G., Meijer, F.J.A., Hammer, S., Hoorn, A. van der, Yoo, A.J., Gerrits, D., Truijman, M.T.B., Zinkstok, S., Koudstaal, P.J., Manschot, S., Kerkhoff, H., Nieboer, D., Berkhemer, O., Wolff, L., Sluijs, P.M. van der, Voorst, H. van, Tolhuisen, M., Roos, Y.B.W.E.M., Majoie, C.B.L.M., Staals, J., Oostenbrugge, R.J. van, Jenniskens, S.F.M., Dijk, L.C. van, Hertog, H.M. den, Es, A.C.G.M. van, Lugt, A. van der, Dippel, D.W.J., Roozenbeek, B., MR CLEAN-MED Investigators, Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Damage and Repair in Cancer Development and Cancer Treatment (DARE), Neurology, ACS - Atherosclerosis & ischemic syndromes, ANS - Neurovascular Disorders, Radiology and Nuclear Medicine, ACS - Microcirculation, ACS - Pulmonary hypertension & thrombosis, ANS - Cellular & Molecular Mechanisms, Biomedical Engineering and Physics, Graduate School, ANS - Brain Imaging, ANS - Compulsivity, Impulsivity & Attention, Radiology & Nuclear Medicine, Public Health, Pediatric surgery, Radiology and nuclear medicine, RS: Carim - B05 Cerebral small vessel disease, MUMC+: MA Med Staf Spec Neurologie (9), Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: Carim - B06 Imaging, MUMC+: DA BV AIOS Radiologie (9), MUMC+: DA BV AIOS Nucleaire Geneeskunde (9), MUMC+: MA AIOS Neurologie (9), Klinische Neurowetenschappen, and MUMC+: MA Neurologie (3)
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Stroke/etiology ,Adult ,Brain Ischemia/therapy ,Aspirin ,Heparin ,INTRAVENOUS ALTEPLASE ,Other Research Radboud Institute for Health Sciences [Radboudumc 0] ,Vascular damage Radboud Institute for Molecular Life Sciences [Radboudumc 16] ,General Medicine ,THROMBECTOMY ,Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] ,Magnetic Resonance Imaging ,TIME ,Brain Ischemia ,Stroke ,All institutes and research themes of the Radboud University Medical Center ,Treatment Outcome ,Aspirin/therapeutic use ,REPERFUSION ,Humans ,Heparin/adverse effects ,ACUTE ISCHEMIC-STROKE ,Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] - Abstract
BACKGROUND: Aspirin and unfractionated heparin are often used during endovascular stroke treatment to improve reperfusion and outcomes. However, the effects and risks of anti-thrombotics for this indication are unknown. We therefore aimed to assess the safety and efficacy of intravenous aspirin, unfractionated heparin, both, or neither started during endovascular treatment in patients with ischaemic stroke.METHODS: We did an open-label, multicentre, randomised controlled trial with a 2 × 3 factorial design in 15 centres in the Netherlands. We enrolled adult patients (ie, ≥18 years) with ischaemic stroke due to an intracranial large-vessel occlusion in the anterior circulation in whom endovascular treatment could be initiated within 6 h of symptom onset. Eligible patients had a score of 2 or more on the National Institutes of Health Stroke Scale, and a CT or MRI ruling out intracranial haemorrhage. Randomisation was done using a web-based procedure with permuted blocks and stratified by centre. Patients were randomly assigned (1:1) to receive either periprocedural intravenous aspirin (300 mg bolus) or no aspirin, and randomly assigned (1:1:1) to receive moderate-dose unfractionated heparin (5000 IU bolus followed by 1250 IU/h for 6 h), low-dose unfractionated heparin (5000 IU bolus followed by 500 IU/h for 6 h), or no unfractionated heparin. The primary outcome was the score on the modified Rankin Scale at 90 days. Symptomatic intracranial haemorrhage was the main safety outcome. Analyses were based on intention to treat, and treatment effects were expressed as odds ratios (ORs) or common ORs, with adjustment for baseline prognostic factors. This trial is registered with the International Standard Randomised Controlled Trial Number, ISRCTN76741621.FINDINGS: Between Jan 22, 2018, and Jan 27, 2021, we randomly assigned 663 patients; of whom, 628 (95%) provided deferred consent or died before consent could be asked and were included in the modified intention-to-treat population. On Feb 4, 2021, after unblinding and analysis of the data, the trial steering committee permanently stopped patient recruitment and the trial was stopped for safety concerns. The risk of symptomatic intracranial haemorrhage was higher in patients allocated to receive aspirin than in those not receiving aspirin (43 [14%] of 310 vs 23 [7%] of 318; adjusted OR 1·95 [95% CI 1·13-3·35]) as well as in patients allocated to receive unfractionated heparin than in those not receiving unfractionated heparin (44 [13%] of 332 vs 22 [7%] of 296; 1·98 [1·14-3·46]). Both aspirin (adjusted common OR 0·91 [95% CI 0·69-1·21]) and unfractionated heparin (0·81 [0·61-1·08]) led to a non-significant shift towards worse modified Rankin Scale scores.INTERPRETATION: Periprocedural intravenous aspirin and unfractionated heparin during endovascular stroke treatment are both associated with an increased risk of symptomatic intracranial haemorrhage without evidence for a beneficial effect on functional outcome.FUNDING: The Collaboration for New Treatments of Acute Stroke consortium, the Brain Foundation Netherlands, the Ministry of Economic Affairs, Stryker, Medtronic, Cerenovus, and the Dutch Heart Foundation.
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- 2022
28. Treating Rhythmic and Periodic EEG Patterns in Comatose Survivors of Cardiac Arrest
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Ruijter, B.J., Keijzer, H.M., Tjepkema-Cloostermans, M.C., Blans, M.J., Beishuizen, A., Tromp, S.C., Scholten, E., Horn, J., Rootselaar, A.F. van, Admiraal, M.M., Bergh, W.M. van den, Elting, J.W.J., Foudraine, N.A., Kornips, F.H.M., Kranen-Mastenbroek, V.H.J.M. van, Rouhl, R.P.W., Thomeer, E.C., Moudrous, W., Nijhuis, F.A.P., Booij, S.J., Hoedemaekers, C.W.E., Doorduin, J., Taccone, F.S., Palen, J. van der, Putten, M.J.A.M. van, Hofmeijer, J., TELSTAR Investigators, MUMC+: HZC Med Staf Spec Klinische Neurofys (9), RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, Klinische Neurowetenschappen, MUMC+: MA Med Staf Spec Neurologie (9), Clinical Neurophysiology, TechMed Centre, Neurology, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Intensive Care Medicine, ANS - Neuroinfection & -inflammation, ANS - Brain Imaging, and ANS - Neurodegeneration
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Male ,THERAPEUTIC HYPOTHERMIA ,EUROPEAN-RESUSCITATION-COUNCIL ,POSTANOXIC STATUS EPILEPTICUS ,SOCIETY ,Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0] ,Coma/etiology ,GUIDELINES ,Heart Arrest/complications ,Seizures ,Seizures/diagnosis ,MANAGEMENT ,Humans ,Glasgow Coma Scale ,22/1 OA procedure ,Coma ,PREDICTORS ,Aged ,DISCHARGES ,Anticonvulsants/adverse effects ,Other Research Radboud Institute for Health Sciences [Radboudumc 0] ,Electroencephalography ,ENCEPHALOPATHY ,General Medicine ,Middle Aged ,Heart Arrest ,PROGNOSTIC VALUE ,Treatment Outcome ,Anticonvulsants ,Female - Abstract
BACKGROUNDWhether the treatment of rhythmic and periodic electroencephalographic (EEG) patterns in comatose survivors of cardiac arrest improves outcomes is uncertain.METHODSWe conducted an open-label trial of suppressing rhythmic and periodic EEG patterns detected on continuous EEG monitoring in comatose survivors of cardiac arrest. Patients were randomly assigned in a 1:1 ratio to a stepwise strategy of antiseizure medications to suppress this activity for at least 48 consecutive hours plus standard care (antiseizure-treatment group) or to standard care alone (control group); standard care included targeted temperature management in both groups. The primary outcome was neurologic outcome according to the score on the Cerebral Performance Category (CPC) scale at 3 months, dichotomized as a good outcome (CPC score indicating no, mild, or moderate disability) or a poor outcome (CPC score indicating severe disability, coma, or death). Secondary outcomes were mortality, length of stay in the intensive care unit (ICU), and duration of mechanical ventilation.RESULTSWe enrolled 172 patients, with 88 assigned to the antiseizure-treatment group and 84 to the control group. Rhythmic or periodic EEG activity was detected a median of 35 hours after cardiac arrest; 98 of 157 patients (62%) with available data had myoclonus. Complete suppression of rhythmic and periodic EEG activity for 48 consecutive hours occurred in 49 of 88 patients (56%) in the antiseizure-treatment group and in 2 of 83 patients (2%) in the control group. At 3 months, 79 of 88 patients (90%) in the antiseizure-treatment group and 77 of 84 patients (92%) in the control group had a poor outcome (difference, 2 percentage points; 95% confidence interval, -7 to 11; P=0.68). Mortality at 3 months was 80% in the antiseizure-treatment group and 82% in the control group. The mean length of stay in the ICU and mean duration of mechanical ventilation were slightly longer in the antiseizure-treatment group than in the control group.CONCLUSIONSIn comatose survivors of cardiac arrest, the incidence of a poor neurologic outcome at 3 months did not differ significantly between a strategy of suppressing rhythmic and periodic EEG activity with the use of antiseizure medication for at least 48 hours plus standard care and standard care alone. (Funded by the Dutch Epilepsy Foundation; TELSTAR ClinicalTrials.gov number, TELSTAR ClinicalTrials.gov number, NCT02056236.)Treatment of Epileptiform Activity after Cardiac Arrest A trial involving comatose survivors of cardiac arrest tested whether aggressively treating rhythmic and periodic EEG activity would improve neurologic outcomes. Despite suppression of abnormal EEG activity, the incidence of a poor neurologic outcome did not differ significantly from that with standard care, and mortality was high.
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- 2022
29. MRI markers of brain network integrity relate to neurological outcome in postanoxic coma
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Keijzer, H.M., Lange, P.A.M., Meijer, F.J.A., Tonino, B.A.R., Blans, Michiel J., Klijn, C.J.M., Hoedemaekers, C.W.E., Hofmeijer, J., Helmich, R.C.G., Keijzer, H.M., Lange, P.A.M., Meijer, F.J.A., Tonino, B.A.R., Blans, Michiel J., Klijn, C.J.M., Hoedemaekers, C.W.E., Hofmeijer, J., and Helmich, R.C.G.
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Contains fulltext : 283277.pdf (Publisher’s version ) (Open Access)
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- 2022
30. The Montreal Cognitive Assessment is a valid cognitive screening tool for cardiac arrest survivors
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Gils, P. van, Heugten, C.M. van, Hofmeijer, J., Keijzer, H.M., Nutma, S., Duits, A.A., Gils, P. van, Heugten, C.M. van, Hofmeijer, J., Keijzer, H.M., Nutma, S., and Duits, A.A.
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Item does not contain fulltext
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- 2022
31. Hospital Variation in Time to Endovascular Treatment for Ischemic Stroke: What Is the Optimal Target for Improvement?
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Hartog, S.J. den, Lingsma, H.F., Doormaal, P.J. van, Hofmeijer, J., Yo, L.S., Majoie, C., Dippel, D.W., Jenniskens, S.F.M., Lugt, A. van der, Roozenbeek, B., Hartog, S.J. den, Lingsma, H.F., Doormaal, P.J. van, Hofmeijer, J., Yo, L.S., Majoie, C., Dippel, D.W., Jenniskens, S.F.M., Lugt, A. van der, and Roozenbeek, B.
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Item does not contain fulltext, Background Time to reperfusion in patients with ischemic stroke is strongly associated with functional outcome and may differ between hospitals and between patients within hospitals. Improvement in time to reperfusion can be guided by between-hospital and within-hospital comparisons and requires insight in specific targets for improvement. We aimed to quantify the variation in door-to-reperfusion time between and within Dutch intervention hospitals and to assess the contribution of different time intervals to this variation. Methods and Results We used data from the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Registry. The door-to-reperfusion time was subdivided into time intervals, separately for direct patients (door-to-computed tomography, computed tomography-to-computed tomography angiography [CTA], CTA-to-groin, and groin-to-reperfusion times) and for transferred patients (door-to-groin and groin-to-reperfusion times). We used linear mixed models to distinguish the variation in door-to-reperfusion time between hospitals and between patients. The proportional change in variance was used to estimate the amount of variance explained by each time interval. We included 2855 patients of 17 hospitals providing endovascular treatment. Of these patients, 44% arrived directly at an endovascular treatment hospital. The between-hospital variation in door-to-reperfusion time was 9%, and the within-hospital variation was 91%. The contribution of case-mix variables on the variation in door-to-reperfusion time was marginal (2%-7%). Of the between-hospital variation, CTA-to-groin time explained 83%, whereas groin-to-reperfusion time explained 15%. Within-hospital variation was mostly explained by CTA-to-groin time (33%) and groin-to-reperfusion time (42%). Similar results were found for transferred patients. Conclusions Door-to-reperfusion time varies between, but even more within, hospitals providing e
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- 2022
32. Outcome Prediction of Postanoxic Coma: A Comparison of Automated Electroencephalography Analysis Methods
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Pham, S.D.T., Keijzer, H.M., Ruijter, B.J., Seeber, A.A., Scholten, E., Drost, G., Bergh, W.M. van den, Kornips, F.H.M., Foudraine, N.A., Beishuizen, A., Blans, M.J., Hofmeijer, J., Putten, M.J.A.M. van, Tjepkema-Cloostermans, M.C., Pham, S.D.T., Keijzer, H.M., Ruijter, B.J., Seeber, A.A., Scholten, E., Drost, G., Bergh, W.M. van den, Kornips, F.H.M., Foudraine, N.A., Beishuizen, A., Blans, M.J., Hofmeijer, J., Putten, M.J.A.M. van, and Tjepkema-Cloostermans, M.C.
- Abstract
Contains fulltext : 282535.pdf (Publisher’s version ) (Open Access), BACKGROUND: To compare three computer-assisted quantitative electroencephalography (EEG) prediction models for the outcome prediction of comatose patients after cardiac arrest regarding predictive performance and robustness to artifacts. METHODS: A total of 871 continuous EEGs recorded up to 3 days after cardiac arrest in intensive care units of five teaching hospitals in the Netherlands were retrospectively analyzed. Outcome at 6 months was dichotomized as "good" (Cerebral Performance Category 1-2) or "poor" (Cerebral Performance Category 3-5). Three prediction models were implemented: a logistic regression model using two quantitative features, a random forest model with nine features, and a deep learning model based on a convolutional neural network. Data from two centers were used for training and fivefold cross-validation (n = 663), and data from three other centers were used for external validation (n = 208). Model output was the probability of good outcome. Predictive performances were evaluated by using receiver operating characteristic analysis and the calculation of predictive values. Robustness to artifacts was evaluated by using an artifact rejection algorithm, manually added noise, and randomly flattened channels in the EEG. RESULTS: The deep learning network showed the best overall predictive performance. On the external test set, poor outcome could be predicted by the deep learning network at 24 h with a sensitivity of 54% (95% confidence interval [CI] 44-64%) at a false positive rate (FPR) of 0% (95% CI 0-2%), significantly higher than the logistic regression (sensitivity 33%, FPR 0%) and random forest models (sensitivity 13%, FPR, 0%) (p < 0.05). Good outcome at 12 h could be predicted by the deep learning network with a sensitivity of 78% (95% CI 52-100%) at a FPR of 12% (95% CI 0-24%) and by the logistic regression model with a sensitivity of 83% (95% CI 83-83%) at a FPR of 3% (95% CI 3-3%), both significantly higher than the random forest model (
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- 2022
33. Prehospital transdermal glyceryl trinitrate in patients with presumed acute stroke (MR ASAP): an ambulance-based, multicentre, randomised, open-label, blinded endpoint, phase 3 trial
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Berg, S.A. van den, Venema, S.M. Uniken, Reinink, H., Hofmeijer, J., Schonewille, W.J., Miedema, I., Fransen, P.S., Pruissen, D.M.O., Raaijmakers, T.W.M., Dijk, G.W. van, Leeuw, F.E. de, Vliet, Jorien A. van der, Kwa, V.I.H., Kerkhoff, H., Net, A. van 't, Boomars, R., Siegers, A., Lok, T., Caminada, K., Cuevas, L.M. Esteve, Visser, M.C, Zwetsloot, C.P., Boomsma, J.M.F., Schipper, M.H., Eijkelenburg, R.P.J. van, Berkhemer, O.A., Nieboer, D., Lingsma, H.F., Emmer, B.J., Oostenbrugge, R.J. van, Lugt, A. van der, Roos, Y., Majoie, C., Dippel, D.W., Nederkoorn, P.J., Worp, H.B. van der, Berg, S.A. van den, Venema, S.M. Uniken, Reinink, H., Hofmeijer, J., Schonewille, W.J., Miedema, I., Fransen, P.S., Pruissen, D.M.O., Raaijmakers, T.W.M., Dijk, G.W. van, Leeuw, F.E. de, Vliet, Jorien A. van der, Kwa, V.I.H., Kerkhoff, H., Net, A. van 't, Boomars, R., Siegers, A., Lok, T., Caminada, K., Cuevas, L.M. Esteve, Visser, M.C, Zwetsloot, C.P., Boomsma, J.M.F., Schipper, M.H., Eijkelenburg, R.P.J. van, Berkhemer, O.A., Nieboer, D., Lingsma, H.F., Emmer, B.J., Oostenbrugge, R.J. van, Lugt, A. van der, Roos, Y., Majoie, C., Dippel, D.W., Nederkoorn, P.J., and Worp, H.B. van der
- Abstract
Item does not contain fulltext, BACKGROUND: Pooled analyses of previous randomised studies have suggested that very early treatment with glyceryl trinitrate (also known as nitroglycerin) improves functional outcome in patients with acute ischaemic stroke or intracerebral haemorrhage, but this finding was not confirmed in a more recent trial (RIGHT-2). We aimed to assess whether patients with presumed acute stroke benefit from glyceryl tr initrate started within 3 h after symptom onset. METHODS: MR ASAP was a phase 3, randomised, open-label, blinded endpoint trial done at six ambulance services serving 18 hospitals in the Netherlands. Eligible participants (aged ≥18 years) had a probable diagnosis of acute stroke (as assessed by a paramedic), a face-arm-speech-time test score of 2 or 3, systolic blood pressure of at least 140 mm Hg, and could start treatment within 3 h of symptom onset. Participants were randomly assigned (1:1) by ambulance personnel, using a secure web-based electronic application with random block sizes stratified by ambulance service, to receive either transdermal glyceryl trinitrate 5 mg/day for 24 h plus standard care (glyceryl trinitrate group) or to standard care alone (control group) in the prehospital setting. Informed consent was deferred until after arrival at the hospital. The primary outcome was functional outcome assessed with the modified Rankin Scale (mRS) at 90 days. Safety outcomes included death within 7 days, death within 90 days, and serious adverse events. Analyses were based on modified intention to treat, and treatment effects were expressed as odds ratios (ORs) or common ORs, with adjustment for baseline prognostic factors. We separately analysed the total population and the target population (ie, patients with intracerebral haemorrhage, ischaemic stroke, or transient ischaemic attack). The target sample size was 1400 patients. The trial is registered as ISRCTN99503308. FINDINGS: On June 24, 2021, the MR ASAP trial was prematurely terminated on the advice o
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- 2022
34. Cracking coma: MRI and EEG markers of outcome after cardiac arrest
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Klijn, C.J.M., Hofmeijer, J., Hoedemaekers, C.W.E., Keijzer, H.M., Klijn, C.J.M., Hofmeijer, J., Hoedemaekers, C.W.E., and Keijzer, H.M.
- Abstract
Radboud University, 13 september 2022, Promotores : Klijn, C.J.M., Hofmeijer, J. Co-promotor : Hoedemaekers, C.W.E., Contains fulltext : 252874.pdf (Publisher’s version ) (Open Access)
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- 2022
35. Improvements in Endovascular Treatment for Acute Ischemic Stroke: A Longitudinal Study in the MR CLEAN Registry
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Compagne, K.C.J., Kappelhof, M., Hinsenveld, W.H., Brouwer, J., Goldhoorn, R.B., Uyttenboogaart, M., Bokkers, R.P., Schonewille, W.J., Martens, J.M., Hofmeijer, J., Worp, H.B. van der, Lo, R.T., Keizer, K., Yo, L.S., Nijeholt, G.J., Hertog, H.M. den, Sturm, E.J.C., Brouwers, P., Walderveen, Marianne A.A. van, Wermer, M.J., Bruijn, S.F. de, Dijk, L.C. van, Boogaarts, H.D., Dijk, E.J. van, Tuijl, J.H. van, Peluso, J.P.P., Kort, P.L. de, Hasselt, B. van, Fransen, P.S., Schreuder, T., Heijboer, R.J., Jenniskens, S.F.M., Sprengers, M.E., Ghariq, E., Wijngaard, I.R. van den, Roosendaal, S.D., Meijer, A., Beenen, L.F., Postma, A.A., Berg, R van den, Yoo, A.J., Doormaal, P.J. van, Proosdij, M.P. van, Krietemeijer, M.G.M., Gerrits, D.G., Hammer, S., Vos, Janet R., Boiten, J., Coutinho, J.M., Emmer, B.J., Es, A. van, Roozenbeek, B., Roos, Y., Zwam, W.H. van, Oostenbrugge, R.J. van, Majoie, C., Dippel, D.W., Lugt, A. van der, Compagne, K.C.J., Kappelhof, M., Hinsenveld, W.H., Brouwer, J., Goldhoorn, R.B., Uyttenboogaart, M., Bokkers, R.P., Schonewille, W.J., Martens, J.M., Hofmeijer, J., Worp, H.B. van der, Lo, R.T., Keizer, K., Yo, L.S., Nijeholt, G.J., Hertog, H.M. den, Sturm, E.J.C., Brouwers, P., Walderveen, Marianne A.A. van, Wermer, M.J., Bruijn, S.F. de, Dijk, L.C. van, Boogaarts, H.D., Dijk, E.J. van, Tuijl, J.H. van, Peluso, J.P.P., Kort, P.L. de, Hasselt, B. van, Fransen, P.S., Schreuder, T., Heijboer, R.J., Jenniskens, S.F.M., Sprengers, M.E., Ghariq, E., Wijngaard, I.R. van den, Roosendaal, S.D., Meijer, A., Beenen, L.F., Postma, A.A., Berg, R van den, Yoo, A.J., Doormaal, P.J. van, Proosdij, M.P. van, Krietemeijer, M.G.M., Gerrits, D.G., Hammer, S., Vos, Janet R., Boiten, J., Coutinho, J.M., Emmer, B.J., Es, A. van, Roozenbeek, B., Roos, Y., Zwam, W.H. van, Oostenbrugge, R.J. van, Majoie, C., Dippel, D.W., and Lugt, A. van der
- Abstract
Contains fulltext : 251533.pdf (Publisher’s version ) (Open Access), BACKGROUND: We evaluated data from all patients in the Netherlands who underwent endovascular treatment for acute ischemic stroke in the past 3.5 years, to identify nationwide trends in time to treatment and procedural success, and assess their effect on clinical outcomes. METHODS: We included patients with proximal occlusions of the anterior circulation from the second and first cohorts of the MR CLEAN (Multicenter Randomized Clinical trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Registry (March 2014 to June 2016; June 2016 to November 2017, respectively). We compared workflow times and rates of successful reperfusion (defined as an extended Thrombolysis in Cerebral Infarction score of 2B-3) between cohorts and chronological quartiles (all included patients stratified in chronological quartiles of intervention dates to create equally sized groups over the study period). Multivariable ordinal logistic regression was used to assess differences in the primary outcome (ordinal modified Rankin Scale at 90 days). RESULTS: Baseline characteristics were similar between cohorts (second cohort n=1692, first cohort n=1488) except for higher age, poorer collaterals, and less signs of early ischemia on computed tomography in the second cohort. Time from stroke onset to groin puncture and reperfusion were shorter in the second cohort (median 185 versus 210 minutes; P<0.001 and 236 versus 270 minutes; P<0.001, respectively). Successful reperfusion was achieved more often in the second than in the first cohort (72% versus 66%; P<0.001). Functional outcome significantly improved (adjusted common odds ratio 1.23 [95% CI, 1.07-1.40]). This effect was attenuated by adjustment for time from onset to reperfusion (adjusted common odds ratio, 1.12 [95% CI, 0.98-1.28]) and successful reperfusion (adjusted common odds ratio, 1.13 [95% CI, 0.99-1.30]). Outcomes were consistent in the analysis per chronological quartile. CONCLUSIONS: Clinical outcomes after end
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- 2022
36. Prognosis After Cardiac Arrest: The Additional Value of DWI and FLAIR to EEG
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Keijzer, H.M., Verhulst, M., Meijer, F.J.A., Tonino, B.A.R., Bosch, F.H., Klijn, C.J.M., Hoedemaekers, C.W.E., Hofmeijer, J., Keijzer, H.M., Verhulst, M., Meijer, F.J.A., Tonino, B.A.R., Bosch, F.H., Klijn, C.J.M., Hoedemaekers, C.W.E., and Hofmeijer, J.
- Abstract
Item does not contain fulltext, BACKGROUND: Despite application of the multimodal European Resuscitation Council and European Society of Intensive Care Medicine algorithm, neurological prognosis of patients who remain comatose after cardiac arrest remains uncertain in a large group of patients. In this study, we investigate the additional predictive value of visual and quantitative brain magnetic resonance imaging (MRI) to electroencephalography (EEG) for outcome estimation of comatose patients after cardiac arrest. METHODS: We performed a prospective multicenter cohort study in patients after cardiac arrest submitted in a comatose state to the intensive care unit of two Dutch hospitals. Continuous EEG was recorded during the first 3 days and MRI was performed at 3 ± 1 days after cardiac arrest. EEG at 24 h and ischemic damage in 21 predefined brain regions on diffusion weighted imaging and fluid-attenuated inversion recovery on a scale from 0 to 4 were related to outcome. Quantitative MRI analyses included mean apparent diffusion coefficient (ADC) and percentage of brain volume with ADC < 450 × 10(-6) mm(2)/s, < 550 × 10(-6) mm(2)/s, and < 650 × 10(-6) mm(2)/s. Poor outcome was defined as a Cerebral Performance Category score of 3-5 at 6 months. RESULTS: We included 50 patients, of whom 20 (40%) demonstrated poor outcome. Visual EEG assessment correctly identified 3 (15%) with poor outcome and 15 (50%) with good outcome. Visual grading of MRI identified 13 (65%) with poor outcome and 25 (89%) with good outcome. ADC analysis identified 11 (55%) with poor outcome and 3 (11%) with good outcome. EEG and MRI combined could predict poor outcome in 16 (80%) patients at 100% specificity, and good outcome in 24 (80%) at 63% specificity. Ischemic damage was most prominent in the cortical gray matter (75% vs. 7%) and deep gray nuclei (45% vs. 3%) in patients with poor versus good outcome. CONCLUSIONS: Magnetic resonance imaging is complementary with EEG for the prediction of poor and good outcome of patient
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- 2022
37. EEG monitoring after cardiac arrest
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Sandroni, Claudio, Cronberg, T., Hofmeijer, J., Sandroni C. (ORCID:0000-0002-8878-2611), Sandroni, Claudio, Cronberg, T., Hofmeijer, J., and Sandroni C. (ORCID:0000-0002-8878-2611)
- Abstract
Hypoxic-ischaemic brain injury (HIBI) is the main cause of death and disability in patients who are comatose after return of spontaneous circulation (ROSC) from cardiac arrest. The electroencephalogram (EEG) is a useful tool to assess the severity of HIBI and provide prognostic information. In addition, EEG can be used to diagnose epileptiform activity in patients with suspected seizures and monitor the effectiveness of antiepileptic treatment. The EEG signal is complex and the information from EEG experts may be difficult to interpret for the intensive care unit (ICU) physicians. However, continuous EEG (cEEG), facilitating the assessment of the evolution of brain activity over time, allows instantaneous detection of electrographic seizures. These innovative approaches may facilitate bedside EEG monitoring in the future.
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- 2022
38. Endovascular Thrombectomy in Young Patients With Stroke: A MR CLEAN Registry Study
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Brouwer, J., Smaal, J.A., Emmer, B.J., de Ridder, I.R., van den Wijngaard, I.R., de Leeuw, F.E., Hofmeijer, J., van Zwam, W.H., Martens, J.M., Roos, Y.B.W.E.M., Majoie, C.B., van Oostenbrugge, R.J., Coutinho, J.M., MR CLEAN Registry Investigators, Brouwer, J., Smaal, J.A., Emmer, B.J., de Ridder, I.R., van den Wijngaard, I.R., de Leeuw, F.E., Hofmeijer, J., van Zwam, W.H., Martens, J.M., Roos, Y.B.W.E.M., Majoie, C.B., van Oostenbrugge, R.J., Coutinho, J.M., and MR CLEAN Registry Investigators
- Abstract
Background and Purpose: Acute ischemic stroke due to large vessel occlusion is uncommon in young adults. We assessed stroke cause in young patients and compared their outcomes after endovascular thrombectomy with older patients. Methods: We used data (March 2014 until November 2017) of patients with an anterior circulation large vessel occlusion stroke from the MR CLEAN (Multicenter Randomized Controlled Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Registry, a nationwide, prospective study on endovascular thrombectomy in the Netherlands. We compared young patients (18-49 years) with older patients (>= 50 years). Outcomes included modified Rankin Scale score after 90 days (both shift and dichotomized analyses), expanded Thrombolysis in Cerebral Infarction score, and symptomatic intracranial hemorrhage. Analyses were adjusted for confounding. Results: We included 3256 patients, 310 (10%) were 18 to 49 years old. Young patients had lower median National Institutes of Health Stroke Scale scores (14 versus 16, P<0.001) and less cardiovascular comorbidities than older patients. Stroke etiologies in young patients included carotid dissection (16%), cardio-embolism (15%), large artery atherosclerosis (10%), and embolic stroke of undetermined source (31%). Clinical outcome was better in young than older patients (acOR for modified Rankin Scale shift: 1.8 [95% CI, 1.5-2.2]; functional independence [modified Rankin Scale score 0-2] 61 versus 39% [adjusted odds ratio, 2.1 [95% CI, 1.6-2.8]); mortality 7% versus 32%, adjusted odds ratio, 0.2 [95% CI, 0.1-0.3]). Symptomatic intracranial hemorrhage occurred less frequently in young patients (3% versus 6%, adjusted odds ratio, 0.5 [95% CI, 0.2-1.00]). Successful reperfusion (expanded Thrombolysis in Cerebral Infarction Score 2b-3) did not differ between groups. Onset to reperfusion time was shorter in young patients (253 versus 255 minutes, adjusted B in minutes 12.4 [95% CI, 2.4-22.5]). Concl
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- 2022
39. Systematic Review - Combining Neuroprotection With Reperfusion in Acute Ischemic Stroke
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Vos, E. M., Geraedts, V. J., van der Lugt, A., Dippel, D. W. J., Wermer, M. J. H., Hofmeijer, J., van Es, A. C. G. M., Roos, Y. B. W. E. M., Peeters-Scholte, C. M. P. C. D., van den Wijngaard, I. R., Vos, E. M., Geraedts, V. J., van der Lugt, A., Dippel, D. W. J., Wermer, M. J. H., Hofmeijer, J., van Es, A. C. G. M., Roos, Y. B. W. E. M., Peeters-Scholte, C. M. P. C. D., and van den Wijngaard, I. R.
- Abstract
Background: Clinical trials of neuroprotection in acute ischemic stroke (AIS) have provided disappointing results. Reperfusion may be a necessary condition for positive effects of neuroprotective treatments. This systematic review provides an overview of efficacy of neuroprotective agents in combination with reperfusion therapy in AIS. Methods: A literature search was performed on the following databases, namely PubMed, Embase, Web of Science, Cochrane Library, Emcare. All databases were searched up to September 23rd 2021. All randomized controlled trials in which patients were treated with neuroprotective strategies within 12 h of stroke onset in combination with intravenous thrombolysis (IVT), endovascular therapy (EVT), or both were included. Results: We screened 1,764 titles/abstracts and included 30 full reports of unique studies with a total of 16,160 patients. In 15 studies neuroprotectants were tested for clinical efficacy, where all patients had to receive reperfusion therapies, either IVT and/or EVT. Heterogeneity in reported outcome measures was observed. Treatment was associated with improved clinical outcome for: 1) uric acid in patients treated with EVT and IVT, 2) nerinetide in patients who underwent EVT without IVT, 3) imatinib in stroke patients treated with IVT with or without EVT, 4) remote ischemic perconditioning and IVT, and 5) high-flow normobaric oxygen treatment after EVT, with or without IVT. Conclusion: Studies specifically testing effects of neuroprotective agents in addition to IVT and/or EVT are scarce. Future neuroprotection studies should report standardized functional outcome measures and combine neuroprotective agents with reperfusion therapies in AIS or aim to include prespecified subgroup analyses for treatment with IVT and/or EVT.
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- 2022
40. Endovascular thrombectomy in young patients with stroke
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Brouwer, J., Smaal, J.A., Emmer, B.J., Ridder, I.R. de, Wijngaard, I.R. van den, Leeuw, F.E. de, Hofmeijer, J., Zwam, W.H. van, Martens, J.M., Roos, Y.B.W.E.M., Majoie, C.B., Oostenbrugge, R.J. van, Coutinho, J.M., MR CLEAN Registry Investigators, TechMed Centre, Clinical Neurophysiology, Graduate School, Neurology, Radiology and Nuclear Medicine, ANS - Neurovascular Disorders, ACS - Atherosclerosis & ischemic syndromes, ACS - Microcirculation, MUMC+: MA AIOS Neurologie (9), RS: Carim - B05 Cerebral small vessel disease, MUMC+: MA Med Staf Spec Neurologie (9), Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: Carim - B06 Imaging, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, Klinische Neurowetenschappen, MUMC+: MA Neurologie (3), and MUMC+: Hersen en Zenuw Centrum (3)
- Subjects
Male ,Brain Ischemia ,Cohort Studies ,All institutes and research themes of the Radboud University Medical Center ,1ST-EVER ISCHEMIC-STROKE ,Humans ,odds ratio ,cardiovascular diseases ,Prospective Studies ,Registries ,Aged ,Ischemic Stroke ,Netherlands ,Advanced and Specialized Nursing ,Aged, 80 and over ,22/3 OA procedure ,adult ,Endovascular Procedures ,ADULTS ,Middle Aged ,Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] ,AGED 15 ,ETIOLOGY ,reperfusion ,Treatment Outcome ,dissection ,thrombectomy ,RISK-FACTORS ,Female ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,LEPTOMENINGEAL COLLATERALS - Abstract
Background and Purpose: Acute ischemic stroke due to large vessel occlusion is uncommon in young adults. We assessed stroke cause in young patients and compared their outcomes after endovascular thrombectomy with older patients. Methods: We used data (March 2014 until November 2017) of patients with an anterior circulation large vessel occlusion stroke from the MR CLEAN (Multicenter Randomized Controlled Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Registry, a nationwide, prospective study on endovascular thrombectomy in the Netherlands. We compared young patients (18–49 years) with older patients (≥50 years). Outcomes included modified Rankin Scale score after 90 days (both shift and dichotomized analyses), expanded Thrombolysis in Cerebral Infarction score, and symptomatic intracranial hemorrhage. Analyses were adjusted for confounding. Results: We included 3256 patients, 310 (10%) were 18 to 49 years old. Young patients had lower median National Institutes of Health Stroke Scale scores (14 versus 16, P Conclusions: Ten percent of patients with acute ischemic stroke undergoing endovascular thrombectomy were younger than 50. Cardioembolism and carotid dissection were common underlying causes in young patients. In one-third of cases, no cause was identified, indicating the need for more research on stroke cause in young patients. Young patients had better prognosis and lower risk of symptomatic intracranial hemorrhage than older patients.
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- 2022
41. Recovery after cardiac arrest: the brain is the heart of the matter
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Hofmeijer, J. and Hemels, M. E. W.
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- 2018
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42. Clinical and Imaging Markers Associated With Hemorrhagic Transformation in Patients With Acute Ischemic Stroke
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Kranendonk, K.R. van, Treumiet, K.M., Boers, A.M.M., Berkhemer, O.A., Berg, L.A. van den, Chalos, V., Lingsma, H.F., Zwam, W.H. van, Lugt, A. van der, Oostenbrugge, R.J. van, Dippel, D.W.J., Roos, Y.B.W.E.M., Marquering, H.A., Majoie, C.B.L.M., Fransen, P.S.S., Beumer, D., Yoo, A.J., Schonewille, W.J., Vos, J.A., Nederkoorn, P.J., Wenner, M.J.H., Walderveen, M.A.A. van, Staals, J., Hofmeijer, J., Oostayen, J.A. van, Nijeholt, G.J.L.A., Boiten, J., Brouwer, P.A., Emmet, B.J., Bruijn, S.F. de, Dijk, L.C. van, Kappelle, L.J., R.H. lo, Dijk, E.J. van, Vries, J. de, Kort, P.L.M. de, Rooij, W.J.J. van, Berg, J.S.P. van den, Hassell, B.A.A.M. van, Aerden, L.A.M., Dallinga, R.J., Visser, M.C., Bot, J.C.J., Vroomen, P.C., Eshghi, O., Schreuder, T.H.C.M.L., Heijboer, R.J.J., Keizer, K., Tielbeek, A.V., Hertog, H.M. den, Gerrits, D.G., Berg-Vos, R.M. van den, Karas, G.B., Steyerberg, E.W., Flach, H.Z., Sprengers, M.E.S., Jenniskens, S.F.M., Beenen, L.F.M., Berg, R. van den, Koudstaal, P.J., MR CLEAN Investigators, RS: Carim - B05 Cerebral small vessel disease, RS: CARIM - R3.03 - Cerebral small vessel disease, RS: Carim - B06 Imaging, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: CARIM - R3.11 - Imaging, MUMC+: MA Neurologie (3), Klinische Neurowetenschappen, MUMC+: MA AIOS Neurologie (9), MUMC+: MA Med Staf Spec Neurologie (9), Graduate School, Radiology and Nuclear Medicine, ACS - Atherosclerosis & ischemic syndromes, ACS - Microcirculation, ANS - Neurovascular Disorders, Neurology, Radiology and nuclear medicine, VU University medical center, Amsterdam Neuroscience - Neurovascular Disorders, Radiology & Nuclear Medicine, Orthopedics and Sports Medicine, and Public Health
- Subjects
medicine.medical_specialty ,Population ,infarction ,intracranial hemorrhages ,Infarction ,BLOOD-PRESSURE ,Tissue plasminogen activator ,All institutes and research themes of the Radboud University Medical Center ,Hematoma ,Internal medicine ,medicine ,risk factors ,atrial fibrillation ,education ,Stroke ,TISSUE-PLASMINOGEN ACTIVATOR ,Advanced and Specialized Nursing ,HEALTH-CARE PROFESSIONALS ,education.field_of_study ,business.industry ,INTRAVENOUS ALTEPLASE ,Other Research Radboud Institute for Health Sciences [Radboudumc 0] ,blood pressure ,Atrial fibrillation ,SYMPTOMATIC INTRACRANIAL HEMORRHAGE ,Odds ratio ,Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] ,medicine.disease ,stroke ,n/a OA procedure ,reperfusion ,Blood pressure ,THROMBOLYTIC THERAPY ,ENDOVASCULAR TREATMENT ,Cardiology ,RISK-FACTORS ,TRIAL ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug ,INTRAARTERIAL TREATMENT - Abstract
Background and Purpose— Hemorrhagic transformation (HT) after acute ischemic stroke may cause severe neurological deterioration and affects functional outcome. Identifying patients most likely to suffer from this complication could potentially be used for future treatment selection. Reperfusion after endovascular therapy could be associated with different risk factors for HT than intravenous thrombolytics as these treatments largely differ. In this study, we aimed to identify clinical and imaging markers that are associated with HT subtypes in the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) population. Methods— In this post hoc analysis, all patients with follow-up imaging were included. HT was classified according to ECASS II (European Cooperative Acute Stroke Study). Variables with an association of P Results— Of the 478 out of 500 included patients in this subanalysis, 46% had HT (n=222). Of these, 66% had hemorrhagic infarction (n=147) and 34% PH (n=75). Symptomatic intracranial hemorrhage was observed in 7.3% (n=35) of all patients. Baseline National Institutes of Health Stroke Scale (odds ratio [OR], 1.05,95% CI, 1.01–1.09 per point) and absent/poor collaterals (OR, 1.90; 95% CI, 1.05–3.42) were significantly associated with hemorrhagic infarction. Increased systolic blood pressure (OR, 1.17; 95% CI, 1.05–1.31 per 10 mm Hg) and atrial fibrillation (OR, 1.94; 95% CI, 1.08–3.48) were associated with PH. Increased systolic blood pressure (OR, 1.28; 95% CI, 1.12–1.48) and antiplatelet use (OR, 2.6; 95% CI, 1.08–6.3) were associated with symptomatic intracranial hemorrhage. Conclusions— Clinical and imaging stroke severity parameters were associated with HT, both in hemorrhagic infarction and PH, whereas baseline patients characteristics like systolic blood pressure, atrial fibrillation, and antiplatelet use were only associated with PH or symptomatic intracranial hemorrhage. Clinical Trial Registration— URL: http://www.controlled-trials.com . Unique identifier: ISRCTN10888758.
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- 2019
43. Collateral Circulation and Outcome in Atherosclerotic Versus Cardioembolic Cerebral Large Vessel Occlusion
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Guglielmi, V., LeCouffe, N.E., Zinkstok, S.M., Compagne, K.C.J., Eker, R., Treurniet, K.M., Tolhuisen, M.L., Worp, H.B. van der, Jansen, I.G.H., Oostenbrugge, R.J. van, Marquering, H.A., Dippel, D.W.J., Emmer, B.J., Majoie, C.B.L.M., Roos, Y.B.W.E.M., Coutinho, J.M., Lugt, A. van der, Zwam, W.H. van, Boiten, J., Vos, J.A., Mulder, M.J.H.L., Goldhoorn, R.J.B., Kappelhof, M., Schonewille, W.J., Wermer, M.J.H., Walderveen, M.A.A. van, Staals, J., Hofmeijer, J., Martens, J.M., Nijeholt, G.J.L.A., Roozenbeek, B., Bruijn, S.F. de, Dijk, L.C. van, R.H. lo, Dijk, E.J. van, Boogaarts, H.D., Kort, P.L.M. de, Peluso, J.P., Berg, J.S.P. van den, Hasselt, B.A.A.M. van, Aerden, L.A.M., Dallinga, R.J., Uyttenboogaart, M., Eshghi, O., Schreuder, T.H.C.M.L., Heijboer, R.J.J., Keizer, K., Yo, L.S.F., Hertog, H.M. den, Sturm, E.J.C., Sprengers, M.E.S., Jenniskens, S.F.M., Berg, R. van den, Yoo, A.J., Beenen, L.F.M., Postma, A.A., Roosendaal, S.D., Kallen, B.F.W. van der, Wijngaard, I.R. van den, Es, A.C.G.M. van, Bot, J., Doormaal, P.J. van, Flach, H.Z., Lingsma, H.F., Ghannouti, N. el, Sterrenberg, M., Puppels, C., Pellikaan, W., Sprengers, R., Elfrink, M., Meris, J. de, Vermeulen, T., Geerlings, A., Vemde, G. van, Simons, T., Rijswijk, C. van, Messchendorp, G., Bongenaar, H., Bodde, K., Kleijn, S., Lodico, J., Droste, H., Wollaert, M., Jeurrissen, D., Bos, E., Drabbe, Y., Aaldering, N., Zweedijk, B., Khalilzada, M., Venema, E., Chalos, V., Geuskens, R.R., Straaten, T. van, Ergezen, S., Harmsma, R.R.M., Muijres, D., Jong, A. de, Hinsenveld, W., Berkhemer, O.A., Boers, A.M.M., Huguet, J., Groot, P.F.C., Mens, M.A., Kranendonk, K.R. van, Tolhuijsen, M.L., Alves, H., MR-CLEAN Registry Investigators, Neurology, Radiology and nuclear medicine, VU University medical center, Pediatric surgery, ACS - Atherosclerosis & ischemic syndromes, Radiology & Nuclear Medicine, Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Graduate School, ACS - Microcirculation, ACS - Pulmonary hypertension & thrombosis, ANS - Neurovascular Disorders, Radiology and Nuclear Medicine, AGEM - Re-generation and cancer of the digestive system, AGEM - Digestive immunity, CCA - Imaging and biomarkers, ARD - Amsterdam Reproduction and Development, MUMC+: MA Neurologie (3), Klinische Neurowetenschappen, RS: Carim - B05 Cerebral small vessel disease, RS: CARIM - R3.03 - Cerebral small vessel disease, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: Carim - B06 Imaging, RS: CARIM - R3.11 - Imaging, Promovendi CD, MUMC+: MA AIOS Neurologie (9), MUMC+: MA Med Staf Spec Neurologie (9), MUMC+: DA BV AIOS Nucleaire Geneeskunde (9), MUMC+: DA BV AIOS Radiologie (9), and MUMC+: MA Niet Med Staf Neurologie (9)
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Carotid Artery Diseases ,Male ,endovascular treatment ,Original Contributions ,FEATURES ,EMBOLIC STROKES ,Brain Ischemia ,Modified Rankin Scale ,Occlusion ,Medicine ,Advanced and Specialised Nursing ,Registries ,collateral circulation ,ACUTE ISCHEMIC-STROKE ,Stroke ,HYPOPERFUSION ,Aged, 80 and over ,education.field_of_study ,Brain ,Atrial fibrillation ,Middle Aged ,THROMBECTOMY ,Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] ,Collateral circulation ,ETIOLOGY ,Intracranial Embolism ,Cardiology ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,Female ,Internal carotid artery ,Cardiology and Cardiovascular Medicine ,medicine.medical_specialty ,atherothrombotic stroke ,Population ,Clinical Sciences ,Clinical Neurology ,UNDETERMINED SOURCE ,CLASSIFICATION ,All institutes and research themes of the Radboud University Medical Center ,medicine.artery ,Internal medicine ,ischemic stroke ,Humans ,cardiovascular diseases ,education ,cardiac emboli ,Aged ,Advanced and Specialized Nursing ,business.industry ,Other Research Radboud Institute for Health Sciences [Radboudumc 0] ,medicine.disease ,CT ANGIOGRAPHY ,Stenosis ,ATRIAL-FIBRILLATION ,Neurology (clinical) ,business - Abstract
Supplemental Digital Content is available in the text., Background and Purpose— Due to chronic hypoperfusion, cervical atherosclerosis may promote cerebral collateral circulation. We hypothesized that patients with ischemic stroke due to cervical carotid atherosclerosis have a more extensive collateral circulation and better outcomes than patients with cardioembolism. We tested this hypothesis in a population of patients who underwent endovascular treatment for large vessel occlusion. Methods— From the MR-CLEAN Registry (Multicenter Randomized Controlled Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands), we selected consecutive adult endovascular treatment patients (March 2014 to June 2016) with acute ischemic stroke due to anterior circulation large vessel occlusion and compared patients with cervical carotid artery stenosis >50% to those with cardioembolic etiology. The primary outcome was collateral score, graded on a 4-point scale. Secondary outcomes included the modified Rankin Scale (mRS) score and mortality at 90 days. We performed multivariable regression analyses and adjusted for potential confounders. Results— Of 1627 patients in the Registry, 190 patients with cervical carotid atherosclerosis and 476 with cardioembolism were included. Patients with cervical carotid atherosclerosis were younger (median 69 versus 76 years, P
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- 2019
44. Residual High-Grade Stenosis After Recanalization of Extracranial Carotid Occlusion in Acute Ischemic Stroke
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Luitse, Merel J.A., Velthuis, Birgitta K., Dauwan, Meenakshi, Dankbaar, Jan Willem, Biessels, Geert Jan, Kappelle, L. Jaap, Majoie, C.B., Roos, Y.B., Duijm, L.E., Keizer, K., van der Lugt, A., Dippel, D.W., Droogh-de Greve, K.E., Bienfait, H.P., van Walderveen, M.A., Wermer, M.J., Lycklama à Nijeholt, G.J., Boiten, J., Duyndam, D.A., Kwa, V.I., Meijer, F.J., van Dijk, E.J., Kesselring, F.O., Hofmeijer, J., Vos, J.A., Schonewille, W.J., van Rooij, W.J., de Kort, P.L., Pleiter, C.C., Bakker, S.L., Bot, J.C., Visser, M.C., van der Schaaf, I.C., Mali, W.P., van Seeters, T., Horsch, A.D., Niesten, J.M., and van der Graaf, Y.
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- 2015
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45. Malignant infarction after endovascular treatment: Incidence and prediction
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Bernsen, M.L.E., Kauw, F., Martens, J.M., Lugt, A. van der, Yo, L.S.F., Walderveen, M.A.A. van, Roos, Y.B.W.E.M., Worp, H.B. van der, Dankbaar, J.W., Hofmeijer, J., MR CLEAN Registry Investigators, Neurology, ACS - Atherosclerosis & ischemic syndromes, ANS - Neurovascular Disorders, Clinical Neurophysiology, TechMed Centre, and Radiology & Nuclear Medicine
- Subjects
medicine.medical_specialty ,Arterial Occlusive Diseases ,Ischaemic stroke ,Medicine ,Humans ,Malignant infarction ,cardiovascular diseases ,Endovascular treatment ,Stroke ,intervention ,ischaemic stroke ,therapy ,treatment ,business.industry ,Incidence (epidemiology) ,Incidence ,Endovascular Procedures ,medicine.disease ,Treatment Outcome ,Neurology ,Infarction ,Emergency medicine ,Reperfusion ,Treatment decision making ,business - 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.
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- 2021
46. Apixaban versus no anticoagulation after anticoagulation-associated intracerebral haemorrhage in patients with atrial fibrillation in the Netherlands (APACHE-AF): a randomised, open-label, phase 2 trial
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Schreuder, F.H.B.M., Nieuwenhuizen, Koen M. van, Hofmeijer, J., Vermeer, S.E., Kerkhoff, Henk, Zock, E., Tuijl, Julia van, Dalen, J. van, Worp, H.B. van der, Klijn, C.J.M., Schreuder, F.H.B.M., Nieuwenhuizen, Koen M. van, Hofmeijer, J., Vermeer, S.E., Kerkhoff, Henk, Zock, E., Tuijl, Julia van, Dalen, J. van, Worp, H.B. van der, and Klijn, C.J.M.
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Item does not contain fulltext
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- 2021
47. Importance of Occlusion Site for Thrombectomy Technique in Stroke: Comparison Between Aspiration and Stent Retriever
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Bernsen, M.L.E., Goldhoorn, R.B., Lingsma, H.F., Oostenbrugge, R.J. van, Zwam, W.H. van, Uyttenboogaart, M., Roos, Y., Dijk, E.J. van, Boogaarts, H.D., Vinke, R.S., Jenniskens, S.F.M., Pegge, S.A.H., Meijer, A., Martens, J.M., Hofmeijer, J., Bernsen, M.L.E., Goldhoorn, R.B., Lingsma, H.F., Oostenbrugge, R.J. van, Zwam, W.H. van, Uyttenboogaart, M., Roos, Y., Dijk, E.J. van, Boogaarts, H.D., Vinke, R.S., Jenniskens, S.F.M., Pegge, S.A.H., Meijer, A., Martens, J.M., and Hofmeijer, J.
- Abstract
Item does not contain fulltext, BACKGROUND AND PURPOSE: Thrombectomy with stent retriever and direct aspiration are equally effective in the endovascular treatment of anterior circulation acute ischemic stroke. We report efficacy and safety of initial treatment technique per occlusion segment. METHODS: For this study, we analyzed data from the MR CLEAN Registry, a prospective, observational study in all centers that perform endovascular therapy in the Netherlands. We used ordinal logistic regression analysis to compare clinical and technical results of first line direct aspiration treatment with that of stent retriever thrombectomy stratified for occlusion segment. Primary outcome measure was functional outcome at 3 months. Secondary outcome measures included reperfusion grade expressed as the extended Thrombolysis in Cerebral Infarction score, periprocedural complication risk, time to reperfusion, and mortality. RESULTS: Of the 2282 included patients, 1658 (73%) were initially treated with stent retriever and 624 (27%) with aspiration. Four hundred sixty-two patients had an occlusion of the intracranial part of the carotid artery, 1349 of the proximal middle cerebral artery, and 471 of the distal parts of the middle cerebral artery. There was no difference in functional outcome between aspiration and stent retriever thrombectomy (odds ratio, 1.0 [95% CI, 0.9-1.2]) in any of the occlusion segments (P value for interaction=0.2). Reperfusion rate was higher in the aspiration group (odds ratio, 1.4 [95% CI, 1.1-1.6]) and did not differ between occlusion segments (P value for interaction=0.6). Procedure times were shorter in the aspiration group (minutes 50 versus 65 minutes; P<0.0001). There was no difference in periprocedural complications or mortality. CONCLUSIONS: In unselected patients with anterior circulation infarcts, we observed equal functional outcome of aspiration and stent retriever thrombectomy in all occlusion segments. When aspiration was the first line treatment modality, reperfusion
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- 2021
48. EEG functional connectivity contributes to outcome prediction of postanoxic coma
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Carrasco-Gomez, Martin, Keijzer, H.M., Ruijter, Barry J., Bruna, Ricardo, Tjepkema-Cloostermans, Marleen C., Hofmeijer, J., Putten, Michel J.A.M. van, Carrasco-Gomez, Martin, Keijzer, H.M., Ruijter, Barry J., Bruna, Ricardo, Tjepkema-Cloostermans, Marleen C., Hofmeijer, J., and Putten, Michel J.A.M. van
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Item does not contain fulltext
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- 2021
49. White Matter Lesions and Outcomes After Endovascular Treatment for Acute Ischemic Stroke: MR CLEAN Registry Results
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Venema, S.M. Uniken, Postma, A.A., Wijngaard, I.R. van den, Vos, J.A., Lingsma, H.F., Bokkers, R.P., Hofmeijer, J., Dippel, D.W., Dijk, E.J. van, Boogaarts, H.D., Jenniskens, S.F.M., Straaten, T. van, Majoie, C.B., Worp, H.B. van der, Venema, S.M. Uniken, Postma, A.A., Wijngaard, I.R. van den, Vos, J.A., Lingsma, H.F., Bokkers, R.P., Hofmeijer, J., Dippel, D.W., Dijk, E.J. van, Boogaarts, H.D., Jenniskens, S.F.M., Straaten, T. van, Majoie, C.B., and Worp, H.B. van der
- Abstract
Item does not contain fulltext, [Figure: see text].
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- 2021
50. A Randomized Trial of Intravenous Alteplase before Endovascular Treatment for Stroke
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LeCouffe, N.E., Kappelhof, M., Treurniet, K.M., Rinkel, L.A., Bruggeman, A.E., Berkhemer, O.A., Wolff, L., van Voorst, H., Tolhuisen, M.L., Dippel, D.W.J., van der Lugt, A., van Es, A.C.G.M., Boiten, J., Nijeholt, G.J.L.A., Keizer, K., Gons, R.A.R., Yo, L.S.F., van Oostenbrugge, R.J., van Zwam, W.H., Roozenbeek, B., van der Worp, H.B., Lo, R.T.H., van den Wijngaard, I.R., de Ridder, I.R., Costalat, V., Arquizan, C., Lemmens, R., Demeestere, J., Hofmeijer, J., Martens, J.M., Schonewille, W.J., Vos, J.A., Uyttenboogaart, M., Bokkers, R.P.H., van Tuijl, J.H., Kortman, H., Schreuder, F.H.B.M., Boogaarts, H.D., de Laat, K.F., van Dijk, L.C., den Hertog, H.M., van Hasselt, B.A.A.M., Brouwers, P.J.A.M., Bulut, T., Remmers, M.J.M., van Norden, A., Imani, F., Rozeman, A.D., Elgersma, O.E.H., Desfontaines, P., MR CLEAN-NO IV Investigators, LeCouffe, N.E., Kappelhof, M., Treurniet, K.M., Rinkel, L.A., Bruggeman, A.E., Berkhemer, O.A., Wolff, L., van Voorst, H., Tolhuisen, M.L., Dippel, D.W.J., van der Lugt, A., van Es, A.C.G.M., Boiten, J., Nijeholt, G.J.L.A., Keizer, K., Gons, R.A.R., Yo, L.S.F., van Oostenbrugge, R.J., van Zwam, W.H., Roozenbeek, B., van der Worp, H.B., Lo, R.T.H., van den Wijngaard, I.R., de Ridder, I.R., Costalat, V., Arquizan, C., Lemmens, R., Demeestere, J., Hofmeijer, J., Martens, J.M., Schonewille, W.J., Vos, J.A., Uyttenboogaart, M., Bokkers, R.P.H., van Tuijl, J.H., Kortman, H., Schreuder, F.H.B.M., Boogaarts, H.D., de Laat, K.F., van Dijk, L.C., den Hertog, H.M., van Hasselt, B.A.A.M., Brouwers, P.J.A.M., Bulut, T., Remmers, M.J.M., van Norden, A., Imani, F., Rozeman, A.D., Elgersma, O.E.H., Desfontaines, P., and MR CLEAN-NO IV Investigators
- Abstract
Alteplase with EVT versus EVT Alone for Stroke Trials involving Asian patients with acute stroke have suggested that endovascular treatment alone is not inferior to the usual practice of thrombolysis before endovascular treatment. This trial involving European patients did not show noninferiority or superiority of endovascular treatment alone.Background The value of administering intravenous alteplase before endovascular treatment (EVT) for acute ischemic stroke has not been studied extensively, particularly in non-Asian populations. Methods We performed an open-label, multicenter, randomized trial in Europe involving patients with stroke who presented directly to a hospital that was capable of providing EVT and who were eligible for intravenous alteplase and EVT. Patients were randomly assigned in a 1:1 ratio to receive EVT alone or intravenous alteplase followed by EVT (the standard of care). The primary end point was functional outcome on the modified Rankin scale (range, 0 [no disability] to 6 [death]) at 90 days. We assessed the superiority of EVT alone over alteplase plus EVT, as well as noninferiority by a margin of 0.8 for the lower boundary of the 95% confidence interval for the odds ratio of the two trial groups. Death from any cause and symptomatic intracerebral hemorrhage were the main safety end points. Results The analysis included 539 patients. The median score on the modified Rankin scale at 90 days was 3 (interquartile range, 2 to 5) with EVT alone and 2 (interquartile range, 2 to 5) with alteplase plus EVT. The adjusted common odds ratio was 0.84 (95% confidence interval [CI], 0.62 to 1.15; P=0.28), which showed neither superiority nor noninferiority of EVT alone. Mortality was 20.5% with EVT alone and 15.8% with alteplase plus EVT (adjusted odds ratio, 1.39; 95% CI, 0.84 to 2.30). Symptomatic intracerebral hemorrhage occurred in 5.9% and 5.3% of the patients in the respective groups (adjusted odds ratio, 1.30; 95% CI, 0.60 to 2.81). Conclusions In
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- 2021
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