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1. Effect of the Factor XIa Inhibitor Asundexian According to Baseline Infarct Pattern and on MRI Covert Infarct Outcomes

Author: Smith, Eric E., Shoamanesh, Ashkan, Xu, Lizhen, Heenan, Laura, Saad, Feryal, Colorado, Pablo, Chen, Chih-Hao, Lemmens, Robin, De Marchis, Gian Marco, Caso, Valeria, Masjuan, Jaime, Hirano, Teruyuki, Milanov, Ivan, Campbell, Bruce C.V., Mas, Jean-Louis, Connolly, Stuart J., Mundl, Hardi, Hart, Robert G., Bailey, P., Kleinig, T., Cordato, D., Choi, P., Garcia-Esperon, C., Chew, A., Cloud, G., Stanislaus, V., Krause, M., Priglinger, M., Grimley, R., Ghia, D., Sahathevan, R., Brown, H., Kwan, C., Devlin, M., Greisenegger, S., Bonelli-Nauer, S., Rath, J., Langer, A., Marko, M., Ferrari, J., Bernegger, A., Baumgartinger, M., Vigl, M., Krebs, S., Lang, W., Knoflach, M., Dejakum, B., Kiechl, S., Töll, T., Domig, L., Mutzenbach, J.S., Ganser, B., Hecker, C., Rösler, C., Bubel, N., Pikija, S., Zellner, T., Leitner, U., Berger, O., Surböck, B., Beirer, S., Staykov, D., Schrammel, D., Halilovic, A., Frattner, M., Barmherzigen, D., Lampl, C., Höfer, C., Nagl, S., Bocksrucker, C., Demeestere, J., Desfontaines, P., Ciobanu, C., De Pauw, A., Terwecoren, A., Hasenbroekx, M.C., Clement, F., De Klippel, N., Soors, P., Hermans, S., De Raedt, S., Vandervorst, F., Seynaeve, L., Fockaert, N., Smet, S., Rutgers, M., Del Gaudio, N., Paindeville, P., Staikov, I., Simeonova, A., Stoyanova, I., Cholakova, M., Mihnev, N., Petrova, T., Koralova, A., Dimov, D., Kuzev, Y., Danovska, M., Marinova, D., Marinova-Trifonova, D., Ovcharova, E., Mladenovski, I., Yanakieva, M., Stoev, P., Dimitrova, M., Todorova-Georgieva, S., Haralanov, L., Milkov, B., Solakov, D., Petkova, N., Ignatova-Valkova, V., Karabinov, V., Marinova, V., Miteva, Y., Andonova, V., Kasabova, D., Kostadinova, E., Shopova-Vrabcheva, Y., Gatev, D., Semova, D., Halil, E., Kaprelyan, A., Ivanov, B., Panov, G., Grudkova, M., Syuleyman, N., Kalpachki, R., Alexiev, F., Ivanova, I., Kancheva, K., Sakelarova, T., Maslarov, D., Drenska, D., Georgiev, V., Petrova, K., Petrova, N., Ivanova, I., Semerdjieva, N., Zhelyazkov, P., Spasova-Markova, S., Dong, X., Wang, D., Wang, S., Huang, W., Zhao, H., Wang, C., Jie, L., Xinyang, Y., Ping, Z., Dong, Q., Wang, Y., Fuling, Y., Yue, W., Liu, R., Yang, Y., Stetkarova, I., Mikulenka, P., Vasko, P., Peisker, T., Bar, M., Roubec, M., Mikulik, R., Cabukova, M., Vinklarek, J., Kovar, M., Pansky, M., Mencl, P., Skoda, O., Carek, M., Pernicka, M., Skodova, M., Geier, P., Cepkova, J., Drlik, J., Prax, T., Herzig, R., Krajickova, D., Vitkova, E., Haluskova, S., Vaclavik, D., Martinkova, J., Blejcharova, K., Tkacova, M., Pavlik, O., Nevšímalová, M., Rosol, J., Nevsimalova, M., Hruby, R., Iversen, H., Andersen, A.V., Rahimi, D., Christensen, H., Grundtvig, J., Hjort, N., Andersen, G., Sandal, B., Stilund, M., Modrau, B., Strade, A., Porobic, M., Andersen, S.D., Kruuse, C., Ölmestig, J., Kolmos, M., Parvez, A., Christensen, T., Stokholm, J., Jensen, H.B., Putaala, J., Strbian, D., Sibolt, G., Tiainen, M., Martinez-Majander, N., Curtze, S., Raty, S., Kraemer, Y., Roine, R., Aivo, J., Ruuskanen, J., Ylikotila, P., Roine, S., Hallikainen, M., Jakala, P., Kurl, S., Julkunen, V., Sibon, I., Olindo, S., Richard, S., Larrue, V., Gollion, C., Catala, H., Henon, H., Lucie, D.S., Nelly, D., Calvet, D., Malbranque, A., Mazé, B., Barbieux-Ghitu, C., Rosso, C., Samson, Y., Vannier, S., Moulin, T., Bonnet, L., Reiner, P., Buffon, F., Denier, C., Amri, K., Legris, N., Chassin, O., Selli, N., Mariana, S., Berrouschot, J., Stoll, A., Klunk, D., Keilitz, J., Neustadt, M., Zerrenner, S., Veltkamp, R., Hajjar, K., Heeger, A., Winezki, E., Apel, L., Pompsch, M., Mueller, P., Rappard, P., Auer, R., Ringleb, P.A., Berberich, A., Heyse, M., Mundiyanapurath, S., Reiff, T., Poli, S., Gomez-Exposito, A., Mengel, A., Tünnerhoff, J., Adeyemi, K., Poli, K., Kusch, V., Pelz, J., Michalski, D., Wartenberg, K., Althaus, K., Tavares, F., Mueller, S., Soda, H., Rascher, A., Hiermann, E., Weinhardt, R., Weissenborn, K., Leotescu, A., Grosse, G., Worthmann, H., Ernst, J., Gabriel, M., Schuppner, R., Schäfer, J.H., Charisse, D., Gruber, K., Kurka, N., Reitz, S.C., Pfeilschifter, W., Lee, J.I., Gliem, M., Moll, M., Steiner, T., Segura, L., Szegedi, N., Barandi, D., Uhrinakova, L., Czencz, M., Pasztor, M., Gyuker, N., Bartha, N.E., May, Z., Simony, Z., Szasz, G., Kakuk, I., Pető, N., Panczel, G.F., Olah, A., Racz, O., Balla, T., Horvath, B., Tuba, K., Czinderi, V., Klivenyi, P., Annus, A., Hertelendy, P., Szapary, L., Bosnyak, E., Kalmar, P., Karadi, Z., Cziba, L., Olah, L., Berki, A., Hudak, L., Kozák, M., Babel, S., Nemeth, L., Molnár, B., Simon, Z., Roveri, L., Cerri, F., Giacalone, G., Zini, A., Mauro, G., Asioli, G.M., Forlivesi, S., Arnone, G., Fiaccadori, A., Maria Fontana Francesca, E., Allegra, G., Mosconi, M.G., Longoni, M., Terlizzi, R., Paolucci, M., Tassi, R., Franci, B., Lucani, B., Domenichelli, C., Paoletti, D., Acampa, M., Zedde, M.L., Pezzella, F.R., Mangiardi, M., Galizia, P., Anticoli, S., Scalise, S., Lattanzi, S., Norata, D., Cannuccia, M., Cavallini, A., Federica, F., Denaro, M.F., Tosi, P., Sonoda, K., Kawajiri, M., Kusano, Y., Haraguchi, K., Kawano, H., Terasaki, T., Kaneko, C., Murase, S., Kumagai, M., Murai, N., Miyazaki, Y., Mori, T., Hatano, T., Kawanishi, M., Ochiai, J., Ishihara, S., Uehara, T., Yasaka, M., Nakagawa, H., Makino, M., Yonehara, T., Fukushima, Y., Hirotsune, N., Sakai, N., Yamasaki, M., Coutinho, J., Wouters, A., den Hertog, H., Zwartbol, R., Beumer, D., Kerklaan, J., Hilkens, P., Schreuder, T., Propper, D., Slowik, A., Wlodarczyk, E., Wrona, P., Pulyk, R., Lasek-Bal, A., Kosarz-Lanczek, K., Puz, P., Bilik, M., Magielska, A., Zamiela – Żółciak, A., Ochocinska, L., Bahdasaryan, S., Stępień, A., Dębiec, A., Joanna, K., Pawel, M., Jacek, S., Daniel, P., Marta, S., Rejdak, K., Wojczal, J., Luchowski, P., Fryze, W., Wisniewska, A., Krzyzanowska, M., Skowron, P., Wolosz, A., Galan, A., Grzymala, K., Krajewska, M., Nowak, R., Kłos, M., Cruz, V., Castro, P., Ferro, J., Canhão, P., Gouveia, R., Inácio, N., Rodrigues, M., Rachão, A., Ionel, C., Pereira, L., Viana-Baptista, M., Machado, C., Fernandes, C., Sargento, J., Inácio, N., Timchenko, L., Mironova, J., Zhadan, O., Torgashova, A., Bazhenova, O., Barashenkova, M., Kireeva, M., Romadina, N., Stepanova, I., Lenskaya, L., Lukinykh, L., Vorontsova, T., Agafina, A., Fedorova, A., Yashina, A., Alasheev, A., Smolkin, A., Prazdnichkova, E., Lutskovich, O., Gonysheva, Y., Mordvintseva, E., Nechaev, A., Martynova, E., Fedoraeva, N., Vishnyakova, T., Popov, D., Merzliakova, A., Margarita, K., Rechkalova, L., Ilyina, A., Kurenkova, N., Barbarash, O., Bazdyrev, E., Zvereva, T., Hromova, A., Morkvenas, A., Postnikova, E., Kovalenko, G., Taran, I., Pavlov, L., Ott, M., Chernitsova, N., Vodopyanova, N., Drozdova, E., Korebo, E., Lobanova, M., Lazareva, N., Snegova, N., Nikolaeva, O., Kolesnikov, Y., Kosheleva, Y., Krastev, G., Tomasova, K., Danis, M., Mako, M., Jankovicova, Z., Stevkova, Z., Kovacik, M., Kubikova, T., Jarosova, A., Serdahely, V., Cilingova, I., Pribulova, I., Sedlak, J., Slebodova, K., Paldaufova, M., Risnovsky, R., Berndtova, B., Urbanova, I., Junas, R., Karapetian, S., Gurcik, L., Vantrobova, A., Verbovsky, F., Vanacka, K., Ferenc, M., Galik, P., Bucakova, S., Ferencova, M., Kubalova, P., Boksanska, Z., Zacharova, E., Mahundi, E., Judita, H., Bachnak, M., Turcani, P., Kvasnicova Kamenska, A., Jurik, M., Vestenicka, V., Kycina, M., Sagatova, E., Dvorak, M., Hlubekova, A., Kucera, C., Gernath, L., Ferenc, M., Frimmelova, P., Slebodnikova, J., Aksteinerova, N., Horny, V., Gregova, Z., Segura, T., Romero, C., Ayo, O., Masjuan Vallejo, J., Cruz, A., De felipe, A, Matute, M.C., Garcia, S., Tembl Ferrairo, J., Vielba, I., Morales Caba, L., Molina, C., Garcia-Tornel García-Camba, Á., Requena Ruiz, M., Noelia, R., Rodriguez-Yañez, M., Rodriguez Castro, E., Lopez, I., Santamaria, M., Arias, S., Purroy García, F., Vázquez Justes, D., Mauri Capdevila, G., Vicente Pascual, M., Martí Fabregas, J., Camps Renom, P., Rodríguez Campello, A., Giralt, E., Krupinski, J., Molina, J., Trillo Senin, C. Ramos Martin, S., De La Fuente Sanz, E., Moniche, F., Manuel, M.R., Pardo, B., Martínez, I., Hernández Pérez, M., Arenillas Lara, J.F., De Lera, M., Egido, J.A., Gomez Escalonilla, C., Guillan, M., Martinez, J., Lindgren, A., Andsberg, G., Wictor, L., Leonidou, M., Stenman, M., Dalberg, N., Laska, A.C., Grünfeldt, A., Lundström, A., Nadzjafov, E., Rooth, E., Dalenbring, I., Sandén, P., Johansson, E., Thomas, G., Zietz, A.V., Rudin, S., Dittrich, T.D., Lilian, K., Kägi, G., Vehoff, J., Arnold, M., Scutelnic, A., Clénin, L., Beyeler, M., Madlaine, M., Maamari, B., Siepen, B., Vynckier, J., Tarnutzer, A., Bertschi, D., Luciani, M., Cereda, C., Maulucci, F., Bianco, G., Shairin, S., Pihan, H.A., Salmen, S., Quinn, T., McAlpine, C., Wright, F., Kalladka, D., Taylor, E., Sohaa, J., Brown, Z., Dawson, J., Cameron, A., Muir, S., Dima, S., Khan, U., Zhang, L., Warburton, E., Chatterjee, K., Nallasivan, A., Curran, D., Haider, S., Ghani, U., Kenton, A., Dallol, B., Mirza, M., Menezes, B., Davies, R., Robinson, T.G., Manning, L., Sztriha, L., Phinney, T., Sethi, P., Altafullah, I., Sharaf, A., Ostrander, M., Renati, S., Burgin, W.S., Olds, K., Delio, P., Malek, A., Dissin, J., Khatri, P., Flaherty, M., Demel, S., and Dofitas, S.
Published: 2024
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2. Andexanet for Factor Xa Inhibitor-Associated Acute Intracerebral Hemorrhage.

Author: Connolly, S.J., Sharma, Mukul, Cohen, A.T., Demchuk, A.M., Członkowska, A., Lindgren, A.G., Molina, C.A., Bereczki, D., Toni, D., Seiffge, D.J., Tanne, D., Sandset, E.C., Tsivgoulis, G., Christensen, H., Beyer-Westendorf, J., Coutinho, J.M., Crowther, M., Verhamme, P., Amarenco, P., Roine, R.O., Mikulik, R., Lemmens, R., Veltkamp, R., Middeldorp, S., Robinson, T.G., Milling TJ, J.r., Tedim-Cruz, V., Lang, W., Himmelmann, A., Ladenvall, P., Knutsson, M., Ekholm, E., Law, A., Taylor, A., Karyakina, T., Xu, L., Tsiplova, K., Poli, S., Kallmünzer, B., Gumbinger, C., Shoamanesh, A., Connolly, S.J., Sharma, Mukul, Cohen, A.T., Demchuk, A.M., Członkowska, A., Lindgren, A.G., Molina, C.A., Bereczki, D., Toni, D., Seiffge, D.J., Tanne, D., Sandset, E.C., Tsivgoulis, G., Christensen, H., Beyer-Westendorf, J., Coutinho, J.M., Crowther, M., Verhamme, P., Amarenco, P., Roine, R.O., Mikulik, R., Lemmens, R., Veltkamp, R., Middeldorp, S., Robinson, T.G., Milling TJ, J.r., Tedim-Cruz, V., Lang, W., Himmelmann, A., Ladenvall, P., Knutsson, M., Ekholm, E., Law, A., Taylor, A., Karyakina, T., Xu, L., Tsiplova, K., Poli, S., Kallmünzer, B., Gumbinger, C., and Shoamanesh, A.
Abstract: Contains fulltext : 306378.pdf (Publisher’s version ) (Closed access), BACKGROUND: Patients with acute intracerebral hemorrhage who are receiving factor Xa inhibitors have a risk of hematoma expansion. The effect of andexanet alfa, an agent that reverses the effects of factor Xa inhibitors, on hematoma volume expansion has not been well studied. METHODS: We randomly assigned, in a 1:1 ratio, patients who had taken factor Xa inhibitors within 15 hours before having an acute intracerebral hemorrhage to receive andexanet or usual care. The primary end point was hemostatic efficacy, defined by expansion of the hematoma volume by 35% or less at 12 hours after baseline, an increase in the score on the National Institutes of Health Stroke Scale of less than 7 points (scores range from 0 to 42, with higher scores indicating worse neurologic deficit) at 12 hours, and no receipt of rescue therapy between 3 hours and 12 hours. Safety end points were thrombotic events and death. RESULTS: A total of 263 patients were assigned to receive andexanet, and 267 to receive usual care. Efficacy was assessed in an interim analysis that included 452 patients, and safety was analyzed in all 530 enrolled patients. Atrial fibrillation was the most common indication for factor Xa inhibitors. Of the patients receiving usual care, 85.5% received prothrombin complex concentrate. Hemostatic efficacy was achieved in 150 of 224 patients (67.0%) receiving andexanet and in 121 of 228 (53.1%) receiving usual care (adjusted difference, 13.4 percentage points; 95% confidence interval [CI], 4.6 to 22.2; P = 0.003). The median reduction from baseline to the 1-to-2-hour nadir in anti-factor Xa activity was 94.5% with andexanet and 26.9% with usual care (P<0.001). Thrombotic events occurred in 27 of 263 patients (10.3%) receiving andexanet and in 15 of 267 (5.6%) receiving usual care (difference, 4.6 percentage points; 95% CI, 0.1 to 9.2; P = 0.048); ischemic stroke occurred in 17 patients (6.5%) and 4 patients (1.5%), respectively. There were no appreciable differences betwee
Published: 2024

3. Pragmatic solutions to reduce the global burden of stroke: a World Stroke Organization–Lancet Neurology Commission

Author: Feigin, V, Owolabi, M, Abd-Allah, F, Akinyemi, R, Bhattacharjee, N, Brainin, M, Cao, J, Caso, V, Dalton, B, Davis, A, Dempsey, R, Duprey, J, Feng, W, Ford, G, Gall, S, Gandhi, D, Good, D, Hachinski, V, Hacke, W, Hankey, G, Ishida, M, Johnson, W, Kim, J, Lavados, P, Lindsay, P, Mahal, A, Martins, S, Murray, C, Nguyen, T, Norrving, B, Olaiya, M, Olalusi, O, Pandian, J, Phan, H, Platz, T, Ranta, A, Rehman, S, Roth, G, Sebastian, I, Smith, A, Suwanwela, N, Sylaja, P, Thapa, R, Thrift, A, Uvere, E, Vollset, S, Yavagal, D, Yaria, J, Abera, S, Ibrahim, N, Liu, L, Ovbiagele, B, Piradov, M, Abanto, C, Addissie, A, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar de Sousa, D, Akhmetzhanova, Z, Akpalu, A, El Alaoui-Faris, M, Ameriso, S, Andonova, S, Arsovska, A, Awoniyi, F, Bakhiet, M, Barboza, M, Basri, H, Bath, P, Bereczki, D, Beretta, S, Berkowitz, A, Bernhardt, J, Berzina, G, Bhavsar, B, Bisharyan, M, Bohara, M, Bovet, P, Budincevic, H, Cadilhac, D, Cerimagic, D, Charway-Felli, A, Chen, C, Chin, J, Christensen, H, Chwojnicki, K, Conforto, A, Correia, M, Mora Cuervo, D, Czlonkowska, A, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Demchuk, A, Dichgans, M, Dokova, K, Donnan, G, Duran, J, Ekeng, G, Elkind, M, Endres, M, Fischer, U, Flomin, Y, Gankpe, F, Gavidia, M, Gaye Saavedra, A, Gebreyohanns, M, George, M, Gierlotka, M, Giroud, M, Gnedovskaya, E, Goncalves, I, Gongora-Rivera, F, Gunaratne, P, Hamadeh, R, Hamzat, T, Heldner, M, Ibrahim, E, Ihle-Hansen, H, Jee, S, Jiann-Shing, J, Johnston, S, Jovanovic, D, Jurjans, K, Kalani, R, Kalkonde, Y, Kamenova, S, Karaszewski, B, Kelly, P, Kiechl, S, Kondybayeva, A, Korv, J, Kozera, G, Kravchenko, M, Krespi, Y, Krishnamurthi, R, Kruja, J, Kutluk, K, Langhorne, P, Law, Z, Lebedynets, D, Lee, T, Leung, T, Liebeskind, D, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, M, Maia, L, Malojcic, B, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Miglane, E, Mihejeva, I, Mikulik, R, Mirrakhimov, E, Mohl, S, Munakomi, S, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, Ocampo, C, O'Donnell, M, Ogun, Y, Ogunniyi, A, Oraby, M, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Pereira, T, Peeters, A, Potpara, T, Proios, H, Rathore, F, Sacco, R, Sahathevan, R, Sandset, E, Renato Santos, I, Saposnik, G, Sarfo, F, Sargento-Freitas, J, Sharma, M, Shaw, L, Sheth, K, Shin, Y, Shobhana, A, Silva, S, Tedim Cruz, V, Thakur, K, Thapa, L, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tulloch-Reid, M, Useche, J, Vanacker, P, Vassilopoulou, S, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wojtyniak, B, Wolfe, C, Yacouba, M, Yang, J, Yifru, Y, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Zagozdzon, P, Feigin V. L., Owolabi M. O., Abd-Allah F., Akinyemi R. O., Bhattacharjee N. V., Brainin M., Cao J., Caso V., Dalton B., Davis A., Dempsey R., Duprey J., Feng W., Ford G. A., Gall S., Gandhi D., Good D. C., Hachinski V., Hacke W., Hankey G. J., Ishida M., Johnson W., Kim J., Lavados P., Lindsay P., Mahal A., Martins S., Murray C., Nguyen T. P., Norrving B., Olaiya M. T., Olalusi O. V., Pandian J., Phan H., Platz T., Ranta A., Rehman S., Roth G., Sebastian I. A., Smith A. E., Suwanwela N. C., Sylaja P. N., Thapa R., Thrift A. G., Uvere E., Vollset S. E., Yavagal D., Yaria J., Abera S. F., Akinyemi R., Dempsey R. J., Ibrahim N. M., Liu L., Ovbiagele B., Piradov M., Suwanwela N., Abanto C., Addissie A., Adeleye A. O., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar de Sousa D., Akhmetzhanova Z., Akpalu A., El Alaoui-Faris M., Ameriso S. F., Andonova S., Arsovska A., Awoniyi F. E., Bakhiet M., Barboza M. A., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bohara M., Bovet P., Budincevic H., Cadilhac D. A., Cerimagic D., Charway-Felli A., Chen C., Chin J. H., Christensen H., Chwojnicki K., Conforto A. B., Correia M., Mora Cuervo D. L., Czlonkowska A., D'Amelio M., Danielyan K. E., Davis S., Demarin V., Demchuk A. M., Dichgans M., Dokova K., Donnan G., Duran J. C., Ekeng G., Elkind M. S., Endres M., Fischer U., Flomin Y., Gankpe F., Gavidia M., Gaye Saavedra A., Gebreyohanns M., George M., Gierlotka M., Giroud M., Gnedovskaya E. V., Goncalves I. P., Gongora-Rivera F., Gunaratne P. S., Hamadeh R. R., Hamzat T. -H. K., Heldner M. R., Ibrahim E., Ihle-Hansen H., Jee S., Jiann-Shing J., Johnston S. C., Jovanovic D., Jurjans K., Kalani R., Kalkonde Y., Kamenova S., Karaszewski B., Kelly P., Kiechl S., Kondybayeva A., Korv J., Kozera G., Kravchenko M., Krespi Y., Krishnamurthi R., Kruja J., Kutluk K., Langhorne P., Law Z. K., Lebedynets D., Lee T. -H., Leung T. W., Liebeskind D. S., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion M. J., Maia L. F., Malojcic B., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Miglane E., Mihejeva I., Mikulik R., Mirrakhimov E., Mohl S., Munakomi S., Murphy S., Musa K. I., Nasreldein A., Nogueira R. G., Nolte C. H., Noubiap J. J., Novarro-Escudero N., Ocampo C., O'Donnell M., Ogun Y., Ogunniyi A., Oraby M. I., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Pereira T., Peeters A., Potpara T., Proios H., Rathore F. A., Sacco R. L., Sahathevan R., Sandset E. S., Renato Santos I., Saposnik G., Sarfo F. S., Sargento-Freitas J., Sharma M., Shaw L., Sheth K. N., Shin Y. -I., Shobhana A., Silva S. N., Tedim Cruz V., Thakur K., Thapa L. J., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wojtyniak B., Wolfe C., Yacouba M. N., Yang J., Yifru Y. M., Yock-Corrales A., Yonemoto N., Yperzeele L., Zagozdzon P., Feigin, V, Owolabi, M, Abd-Allah, F, Akinyemi, R, Bhattacharjee, N, Brainin, M, Cao, J, Caso, V, Dalton, B, Davis, A, Dempsey, R, Duprey, J, Feng, W, Ford, G, Gall, S, Gandhi, D, Good, D, Hachinski, V, Hacke, W, Hankey, G, Ishida, M, Johnson, W, Kim, J, Lavados, P, Lindsay, P, Mahal, A, Martins, S, Murray, C, Nguyen, T, Norrving, B, Olaiya, M, Olalusi, O, Pandian, J, Phan, H, Platz, T, Ranta, A, Rehman, S, Roth, G, Sebastian, I, Smith, A, Suwanwela, N, Sylaja, P, Thapa, R, Thrift, A, Uvere, E, Vollset, S, Yavagal, D, Yaria, J, Abera, S, Ibrahim, N, Liu, L, Ovbiagele, B, Piradov, M, Abanto, C, Addissie, A, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar de Sousa, D, Akhmetzhanova, Z, Akpalu, A, El Alaoui-Faris, M, Ameriso, S, Andonova, S, Arsovska, A, Awoniyi, F, Bakhiet, M, Barboza, M, Basri, H, Bath, P, Bereczki, D, Beretta, S, Berkowitz, A, Bernhardt, J, Berzina, G, Bhavsar, B, Bisharyan, M, Bohara, M, Bovet, P, Budincevic, H, Cadilhac, D, Cerimagic, D, Charway-Felli, A, Chen, C, Chin, J, Christensen, H, Chwojnicki, K, Conforto, A, Correia, M, Mora Cuervo, D, Czlonkowska, A, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Demchuk, A, Dichgans, M, Dokova, K, Donnan, G, Duran, J, Ekeng, G, Elkind, M, Endres, M, Fischer, U, Flomin, Y, Gankpe, F, Gavidia, M, Gaye Saavedra, A, Gebreyohanns, M, George, M, Gierlotka, M, Giroud, M, Gnedovskaya, E, Goncalves, I, Gongora-Rivera, F, Gunaratne, P, Hamadeh, R, Hamzat, T, Heldner, M, Ibrahim, E, Ihle-Hansen, H, Jee, S, Jiann-Shing, J, Johnston, S, Jovanovic, D, Jurjans, K, Kalani, R, Kalkonde, Y, Kamenova, S, Karaszewski, B, Kelly, P, Kiechl, S, Kondybayeva, A, Korv, J, Kozera, G, Kravchenko, M, Krespi, Y, Krishnamurthi, R, Kruja, J, Kutluk, K, Langhorne, P, Law, Z, Lebedynets, D, Lee, T, Leung, T, Liebeskind, D, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, M, Maia, L, Malojcic, B, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Miglane, E, Mihejeva, I, Mikulik, R, Mirrakhimov, E, Mohl, S, Munakomi, S, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, Ocampo, C, O'Donnell, M, Ogun, Y, Ogunniyi, A, Oraby, M, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Pereira, T, Peeters, A, Potpara, T, Proios, H, Rathore, F, Sacco, R, Sahathevan, R, Sandset, E, Renato Santos, I, Saposnik, G, Sarfo, F, Sargento-Freitas, J, Sharma, M, Shaw, L, Sheth, K, Shin, Y, Shobhana, A, Silva, S, Tedim Cruz, V, Thakur, K, Thapa, L, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tulloch-Reid, M, Useche, J, Vanacker, P, Vassilopoulou, S, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wojtyniak, B, Wolfe, C, Yacouba, M, Yang, J, Yifru, Y, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Zagozdzon, P, Feigin V. L., Owolabi M. O., Abd-Allah F., Akinyemi R. O., Bhattacharjee N. V., Brainin M., Cao J., Caso V., Dalton B., Davis A., Dempsey R., Duprey J., Feng W., Ford G. A., Gall S., Gandhi D., Good D. C., Hachinski V., Hacke W., Hankey G. J., Ishida M., Johnson W., Kim J., Lavados P., Lindsay P., Mahal A., Martins S., Murray C., Nguyen T. P., Norrving B., Olaiya M. T., Olalusi O. V., Pandian J., Phan H., Platz T., Ranta A., Rehman S., Roth G., Sebastian I. A., Smith A. E., Suwanwela N. C., Sylaja P. N., Thapa R., Thrift A. G., Uvere E., Vollset S. E., Yavagal D., Yaria J., Abera S. F., Akinyemi R., Dempsey R. J., Ibrahim N. M., Liu L., Ovbiagele B., Piradov M., Suwanwela N., Abanto C., Addissie A., Adeleye A. O., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar de Sousa D., Akhmetzhanova Z., Akpalu A., El Alaoui-Faris M., Ameriso S. F., Andonova S., Arsovska A., Awoniyi F. E., Bakhiet M., Barboza M. A., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bohara M., Bovet P., Budincevic H., Cadilhac D. A., Cerimagic D., Charway-Felli A., Chen C., Chin J. H., Christensen H., Chwojnicki K., Conforto A. B., Correia M., Mora Cuervo D. L., Czlonkowska A., D'Amelio M., Danielyan K. E., Davis S., Demarin V., Demchuk A. M., Dichgans M., Dokova K., Donnan G., Duran J. C., Ekeng G., Elkind M. S., Endres M., Fischer U., Flomin Y., Gankpe F., Gavidia M., Gaye Saavedra A., Gebreyohanns M., George M., Gierlotka M., Giroud M., Gnedovskaya E. V., Goncalves I. P., Gongora-Rivera F., Gunaratne P. S., Hamadeh R. R., Hamzat T. -H. K., Heldner M. R., Ibrahim E., Ihle-Hansen H., Jee S., Jiann-Shing J., Johnston S. C., Jovanovic D., Jurjans K., Kalani R., Kalkonde Y., Kamenova S., Karaszewski B., Kelly P., Kiechl S., Kondybayeva A., Korv J., Kozera G., Kravchenko M., Krespi Y., Krishnamurthi R., Kruja J., Kutluk K., Langhorne P., Law Z. K., Lebedynets D., Lee T. -H., Leung T. W., Liebeskind D. S., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion M. J., Maia L. F., Malojcic B., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Miglane E., Mihejeva I., Mikulik R., Mirrakhimov E., Mohl S., Munakomi S., Murphy S., Musa K. I., Nasreldein A., Nogueira R. G., Nolte C. H., Noubiap J. J., Novarro-Escudero N., Ocampo C., O'Donnell M., Ogun Y., Ogunniyi A., Oraby M. I., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Pereira T., Peeters A., Potpara T., Proios H., Rathore F. A., Sacco R. L., Sahathevan R., Sandset E. S., Renato Santos I., Saposnik G., Sarfo F. S., Sargento-Freitas J., Sharma M., Shaw L., Sheth K. N., Shin Y. -I., Shobhana A., Silva S. N., Tedim Cruz V., Thakur K., Thapa L. J., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wojtyniak B., Wolfe C., Yacouba M. N., Yang J., Yifru Y. M., Yock-Corrales A., Yonemoto N., Yperzeele L., and Zagozdzon P.
Published: 2023

4. Safety and Outcome of Revascularization Treatment in Patients With Acute Ischemic Stroke and COVID-19

Author: Marto, J, Strambo, D, Ntaios, G, Nguyen, T, Herzig, R, Czlonkowska, A, Demeestere, J, Mansour, O, Salerno, A, Wegener, S, Baumgartner, P, Cereda, C, Bianco, G, Beyeler, M, Arnold, M, Carrera, E, Machi, P, Altersberger, V, Bonati, L, Gensicke, H, Bolognese, M, Peters, N, Wetzel, S, Magrico, M, Ramos, J, Sargento-Freitas, J, Machado, R, Maia, C, Machado, E, Nunes, A, Ferreira, P, Pinho E Melo, T, Dias, M, Paula, A, Correia, M, Castro, P, Azevedo, E, Albuquerque, L, Alves, J, Ferreira-Pinto, J, Meira, T, Pereira, L, Rodrigues, M, Araujo, A, Rocha, M, Pereira-Fonseca, A, Ribeiro, L, Varela, R, Malheiro, S, Cappellari, M, Zivelonghi, C, Sajeva, G, Zini, A, Gentile, M, Forlivesi, S, Migliaccio, L, Sessa, M, La Gioia, S, Pezzini, A, Sangalli, D, Zedde, M, Pascarella, R, Ferrarese, C, Beretta, S, Diamanti, S, Schwarz, G, Frisullo, G, Marcheselli, S, Seners, P, Sabben, C, Escalard, S, Piotin, M, Maier, B, Charbonnier, G, Vuillier, F, Legris, L, Cuisenier, P, Vodret, F, Marnat, G, Liegey, J, Sibon, I, Flottmann, F, Broocks, G, Gloyer, N, Bohmann, F, Schaefer, J, Nolte, C, Audebert, H, Siebert, E, Sykora, M, Lang, W, Ferrari, J, Mayer-Suess, L, Knoflach, M, Gizewski, E, Stolp, J, Stolze, L, Coutinho, J, Nederkoorn, P, Van Den Wijngaard, I, De Meris, J, Lemmens, R, De Raedt, S, Vandervorst, F, Rutgers, M, Guilmot, A, Dusart, A, Bellante, F, Calleja-Castano, P, Ostos, F, Gonzalez-Ortega, G, Martin-Jimenez, P, Garcia-Madrona, S, Cruz-Culebras, A, Vera, R, Matute, M, Fuentes, B, Alonso-De-Lecinana, M, Rigual, R, Diez-Tejedor, E, Perez-Sanchez, S, Montaner, J, Diaz-Otero, F, Perez-De-La-Ossa, N, Flores-Pina, B, Munoz-Narbona, L, Chamorro, A, Rodriguez-Vazquez, A, Renu, A, Ayo-Martin, O, Hernandez-Fernandez, F, Segura, T, Tejada-Meza, H, Sagarra-Mur, D, Serrano-Ponz, M, Hlaing, T, See, I, Simister, R, Werring, D, Kristoffersen, E, Nordanstig, A, Jood, K, Rentzos, A, Simunek, L, Krajickova, D, Krajina, A, Mikulik, R, Cvikova, M, Vinklarek, J, Skoloudik, D, Roubec, M, Hurtikova, E, Hruby, R, Ostry, S, Skoda, O, Pernicka, M, Jurak, L, Eichlova, Z, Jira, M, Kovar, M, Pansky, M, Mencl, P, Palouskova, H, Tomek, A, Jansky, P, Olserova, A, Sramek, M, Havlicek, R, Maly, P, Trakal, L, Fiksa, J, Slovak, M, Karlinski, M, Nowak, M, Sienkiewicz-Jarosz, H, Bochynska, A, Wrona, P, Homa, T, Sawczynska, K, Slowik, A, Wlodarczyk, E, Wiacek, M, Tomaszewska-Lampart, I, Sieczkowski, B, Bartosik-Psujek, H, Bilik, M, Bandzarewicz, A, Dorobek, M, Zielinska-Turek, J, Nowakowska-Kotas, M, Obara, K, Urbanowski, P, Budrewicz, S, Guzinski, M, Switonska, M, Rutkowska, I, Sobieszak-Skura, P, Labuz-Roszak, B, Debiec, A, Staszewski, J, Stepien, A, Zwiernik, J, Wasilewski, G, Tiu, C, Terecoasa, E, Radu, R, Negrila, A, Dorobat, B, Panea, C, Tiu, V, Petrescu, S, Ozdemir, A, Mahmoud, M, El-Samahy, H, Abdelkhalek, H, Al-Hashel, J, Ismail, I, Salmeen, A, Ghoreishi, A, Sabetay, S, Gross, H, Klein, P, Abdalkader, M, Jabbour, P, El Naamani, K, Tjoumakaris, S, Abbas, R, Mohamed, G, Chebl, A, Min, J, Hovingh, M, Tsai, J, Khan, M, Nalleballe, K, Onteddu, S, Masoud, H, Michael, M, Kaur, N, Maali, L, Abraham, M, Khandelwal, P, Bach, I, Ong, M, Babici, D, Khawaja, A, Hakemi, M, Rajamani, K, Cano-Nigenda, V, Arauz, A, Amaya, P, Llanos, N, Arango, A, Vences, M, Barrientos Guerra, J, Caetano, R, Martins, R, Scollo, S, Yalung, P, Nagendra, S, Gaikwad, A, Seo, K, Georgiopoulos, G, Nogueira, R, Michel, P, Marto J. P., Strambo D., Ntaios G., Nguyen T. N., Herzig R., Czlonkowska A., Demeestere J., Mansour O. Y., Salerno A., Wegener S., Baumgartner P., Cereda C. W., Bianco G., Beyeler M., Arnold M., Carrera E., Machi P., Altersberger V., Bonati L., Gensicke H., Bolognese M., Peters N., Wetzel S., Magrico M., Ramos J. N., Sargento-Freitas J., Machado R., Maia C., Machado E., Nunes A. P., Ferreira P., Pinho E Melo T., Dias M. C., Paula A., Correia M. A., Castro P., Azevedo E., Albuquerque L., Alves J. N., Ferreira-Pinto J., Meira T., Pereira L., Rodrigues M., Araujo A. P., Rocha M., Pereira-Fonseca A., Ribeiro L., Varela R., Malheiro S., Cappellari M., Zivelonghi C., Sajeva G., Zini A., Gentile M., Forlivesi S., Migliaccio L., Sessa M., La Gioia S., Pezzini A., Sangalli D., Zedde M., Pascarella R., Ferrarese C., Beretta S., Diamanti S., Schwarz G., Frisullo G., Marcheselli S., Seners P., Sabben C., Escalard S., Piotin M., Maier B., Charbonnier G., Vuillier F., Legris L., Cuisenier P., Vodret F. R., Marnat G., Liegey J. -S., Sibon I., Flottmann F., Broocks G., Gloyer N. -O., Bohmann F. O., Schaefer J. H., Nolte C., Audebert H. J., Siebert E., Sykora M., Lang W., Ferrari J., Mayer-Suess L., Knoflach M., Gizewski E. R., Stolp J., Stolze L. J., Coutinho J. M., Nederkoorn P., Van Den Wijngaard I., De Meris J., Lemmens R., De Raedt S., Vandervorst F., Rutgers M. P., Guilmot A., Dusart A., Bellante F., Calleja-Castano P., Ostos F., Gonzalez-Ortega G., Martin-Jimenez P., Garcia-Madrona S., Cruz-Culebras A., Vera R., Matute M. C., Fuentes B., Alonso-De-Lecinana M., Rigual R., Diez-Tejedor E., Perez-Sanchez S., Montaner J., Diaz-Otero F., Perez-De-La-Ossa N., Flores-Pina B., Munoz-Narbona L., Chamorro A., Rodriguez-Vazquez A., Renu A., Ayo-Martin O., Hernandez-Fernandez F., Segura T., Tejada-Meza H., Sagarra-Mur D., Serrano-Ponz M., Hlaing T., See I., Simister R., Werring D., Kristoffersen E. S., Nordanstig A., Jood K., Rentzos A., Simunek L., Krajickova D., Krajina A., Mikulik R., Cvikova M., Vinklarek J., Skoloudik D., Roubec M., Hurtikova E., Hruby R., Ostry S., Skoda O., Pernicka M., Jurak L., Eichlova Z., Jira M., Kovar M., Pansky M., Mencl P., Palouskova H., Tomek A., Jansky P., Olserova A., Sramek M., Havlicek R., Maly P., Trakal L., Fiksa J., Slovak M., Karlinski M. A., Nowak M., Sienkiewicz-Jarosz H., Bochynska A., Wrona P., Homa T., Sawczynska K., Slowik A., Wlodarczyk E., Wiacek M., Tomaszewska-Lampart I., Sieczkowski B., Bartosik-Psujek H., Bilik M., Bandzarewicz A., Dorobek M., Zielinska-Turek J., Nowakowska-Kotas M., Obara K., Urbanowski P., Budrewicz S., Guzinski M., Switonska M., Rutkowska I., Sobieszak-Skura P., Labuz-Roszak B. M., Debiec A., Staszewski J., Stepien A., Zwiernik J., Wasilewski G., Tiu C., Terecoasa E. O., Radu R. A., Negrila A., Dorobat B., Panea C., Tiu V., Petrescu S., Ozdemir A., Mahmoud M., El-Samahy H., Abdelkhalek H., Al-Hashel J., Ismail I. I., Salmeen A., Ghoreishi A., Sabetay S. I., Gross H., Klein P., Abdalkader M., Jabbour P., El Naamani K., Tjoumakaris S., Abbas R., Mohamed G. A., Chebl A., Min J., Hovingh M., Tsai J. P., Khan M., Nalleballe K., Onteddu S., Masoud H., Michael M., Kaur N., Maali L., Abraham M. G., Khandelwal P., Bach I., Ong M., Babici D., Khawaja A. M., Hakemi M., Rajamani K., Cano-Nigenda V., Arauz A., Amaya P., Llanos N., Arango A., Vences M. A., Barrientos Guerra J. D., Caetano R., Martins R. T., Scollo S. D., Yalung P. M., Nagendra S., Gaikwad A., Seo K. -D., Georgiopoulos G., Nogueira R. G., Michel P., Marto, J, Strambo, D, Ntaios, G, Nguyen, T, Herzig, R, Czlonkowska, A, Demeestere, J, Mansour, O, Salerno, A, Wegener, S, Baumgartner, P, Cereda, C, Bianco, G, Beyeler, M, Arnold, M, Carrera, E, Machi, P, Altersberger, V, Bonati, L, Gensicke, H, Bolognese, M, Peters, N, Wetzel, S, Magrico, M, Ramos, J, Sargento-Freitas, J, Machado, R, Maia, C, Machado, E, Nunes, A, Ferreira, P, Pinho E Melo, T, Dias, M, Paula, A, Correia, M, Castro, P, Azevedo, E, Albuquerque, L, Alves, J, Ferreira-Pinto, J, Meira, T, Pereira, L, Rodrigues, M, Araujo, A, Rocha, M, Pereira-Fonseca, A, Ribeiro, L, Varela, R, Malheiro, S, Cappellari, M, Zivelonghi, C, Sajeva, G, Zini, A, Gentile, M, Forlivesi, S, Migliaccio, L, Sessa, M, La Gioia, S, Pezzini, A, Sangalli, D, Zedde, M, Pascarella, R, Ferrarese, C, Beretta, S, Diamanti, S, Schwarz, G, Frisullo, G, Marcheselli, S, Seners, P, Sabben, C, Escalard, S, Piotin, M, Maier, B, Charbonnier, G, Vuillier, F, Legris, L, Cuisenier, P, Vodret, F, Marnat, G, Liegey, J, Sibon, I, Flottmann, F, Broocks, G, Gloyer, N, Bohmann, F, Schaefer, J, Nolte, C, Audebert, H, Siebert, E, Sykora, M, Lang, W, Ferrari, J, Mayer-Suess, L, Knoflach, M, Gizewski, E, Stolp, J, Stolze, L, Coutinho, J, Nederkoorn, P, Van Den Wijngaard, I, De Meris, J, Lemmens, R, De Raedt, S, Vandervorst, F, Rutgers, M, Guilmot, A, Dusart, A, Bellante, F, Calleja-Castano, P, Ostos, F, Gonzalez-Ortega, G, Martin-Jimenez, P, Garcia-Madrona, S, Cruz-Culebras, A, Vera, R, Matute, M, Fuentes, B, Alonso-De-Lecinana, M, Rigual, R, Diez-Tejedor, E, Perez-Sanchez, S, Montaner, J, Diaz-Otero, F, Perez-De-La-Ossa, N, Flores-Pina, B, Munoz-Narbona, L, Chamorro, A, Rodriguez-Vazquez, A, Renu, A, Ayo-Martin, O, Hernandez-Fernandez, F, Segura, T, Tejada-Meza, H, Sagarra-Mur, D, Serrano-Ponz, M, Hlaing, T, See, I, Simister, R, Werring, D, Kristoffersen, E, Nordanstig, A, Jood, K, Rentzos, A, Simunek, L, Krajickova, D, Krajina, A, Mikulik, R, Cvikova, M, Vinklarek, J, Skoloudik, D, Roubec, M, Hurtikova, E, Hruby, R, Ostry, S, Skoda, O, Pernicka, M, Jurak, L, Eichlova, Z, Jira, M, Kovar, M, Pansky, M, Mencl, P, Palouskova, H, Tomek, A, Jansky, P, Olserova, A, Sramek, M, Havlicek, R, Maly, P, Trakal, L, Fiksa, J, Slovak, M, Karlinski, M, Nowak, M, Sienkiewicz-Jarosz, H, Bochynska, A, Wrona, P, Homa, T, Sawczynska, K, Slowik, A, Wlodarczyk, E, Wiacek, M, Tomaszewska-Lampart, I, Sieczkowski, B, Bartosik-Psujek, H, Bilik, M, Bandzarewicz, A, Dorobek, M, Zielinska-Turek, J, Nowakowska-Kotas, M, Obara, K, Urbanowski, P, Budrewicz, S, Guzinski, M, Switonska, M, Rutkowska, I, Sobieszak-Skura, P, Labuz-Roszak, B, Debiec, A, Staszewski, J, Stepien, A, Zwiernik, J, Wasilewski, G, Tiu, C, Terecoasa, E, Radu, R, Negrila, A, Dorobat, B, Panea, C, Tiu, V, Petrescu, S, Ozdemir, A, Mahmoud, M, El-Samahy, H, Abdelkhalek, H, Al-Hashel, J, Ismail, I, Salmeen, A, Ghoreishi, A, Sabetay, S, Gross, H, Klein, P, Abdalkader, M, Jabbour, P, El Naamani, K, Tjoumakaris, S, Abbas, R, Mohamed, G, Chebl, A, Min, J, Hovingh, M, Tsai, J, Khan, M, Nalleballe, K, Onteddu, S, Masoud, H, Michael, M, Kaur, N, Maali, L, Abraham, M, Khandelwal, P, Bach, I, Ong, M, Babici, D, Khawaja, A, Hakemi, M, Rajamani, K, Cano-Nigenda, V, Arauz, A, Amaya, P, Llanos, N, Arango, A, Vences, M, Barrientos Guerra, J, Caetano, R, Martins, R, Scollo, S, Yalung, P, Nagendra, S, Gaikwad, A, Seo, K, Georgiopoulos, G, Nogueira, R, Michel, P, Marto J. P., Strambo D., Ntaios G., Nguyen T. N., Herzig R., Czlonkowska A., Demeestere J., Mansour O. Y., Salerno A., Wegener S., Baumgartner P., Cereda C. W., Bianco G., Beyeler M., Arnold M., Carrera E., Machi P., Altersberger V., Bonati L., Gensicke H., Bolognese M., Peters N., Wetzel S., Magrico M., Ramos J. N., Sargento-Freitas J., Machado R., Maia C., Machado E., Nunes A. P., Ferreira P., Pinho E Melo T., Dias M. C., Paula A., Correia M. A., Castro P., Azevedo E., Albuquerque L., Alves J. N., Ferreira-Pinto J., Meira T., Pereira L., Rodrigues M., Araujo A. P., Rocha M., Pereira-Fonseca A., Ribeiro L., Varela R., Malheiro S., Cappellari M., Zivelonghi C., Sajeva G., Zini A., Gentile M., Forlivesi S., Migliaccio L., Sessa M., La Gioia S., Pezzini A., Sangalli D., Zedde M., Pascarella R., Ferrarese C., Beretta S., Diamanti S., Schwarz G., Frisullo G., Marcheselli S., Seners P., Sabben C., Escalard S., Piotin M., Maier B., Charbonnier G., Vuillier F., Legris L., Cuisenier P., Vodret F. R., Marnat G., Liegey J. -S., Sibon I., Flottmann F., Broocks G., Gloyer N. -O., Bohmann F. O., Schaefer J. H., Nolte C., Audebert H. J., Siebert E., Sykora M., Lang W., Ferrari J., Mayer-Suess L., Knoflach M., Gizewski E. R., Stolp J., Stolze L. J., Coutinho J. M., Nederkoorn P., Van Den Wijngaard I., De Meris J., Lemmens R., De Raedt S., Vandervorst F., Rutgers M. P., Guilmot A., Dusart A., Bellante F., Calleja-Castano P., Ostos F., Gonzalez-Ortega G., Martin-Jimenez P., Garcia-Madrona S., Cruz-Culebras A., Vera R., Matute M. C., Fuentes B., Alonso-De-Lecinana M., Rigual R., Diez-Tejedor E., Perez-Sanchez S., Montaner J., Diaz-Otero F., Perez-De-La-Ossa N., Flores-Pina B., Munoz-Narbona L., Chamorro A., Rodriguez-Vazquez A., Renu A., Ayo-Martin O., Hernandez-Fernandez F., Segura T., Tejada-Meza H., Sagarra-Mur D., Serrano-Ponz M., Hlaing T., See I., Simister R., Werring D., Kristoffersen E. S., Nordanstig A., Jood K., Rentzos A., Simunek L., Krajickova D., Krajina A., Mikulik R., Cvikova M., Vinklarek J., Skoloudik D., Roubec M., Hurtikova E., Hruby R., Ostry S., Skoda O., Pernicka M., Jurak L., Eichlova Z., Jira M., Kovar M., Pansky M., Mencl P., Palouskova H., Tomek A., Jansky P., Olserova A., Sramek M., Havlicek R., Maly P., Trakal L., Fiksa J., Slovak M., Karlinski M. A., Nowak M., Sienkiewicz-Jarosz H., Bochynska A., Wrona P., Homa T., Sawczynska K., Slowik A., Wlodarczyk E., Wiacek M., Tomaszewska-Lampart I., Sieczkowski B., Bartosik-Psujek H., Bilik M., Bandzarewicz A., Dorobek M., Zielinska-Turek J., Nowakowska-Kotas M., Obara K., Urbanowski P., Budrewicz S., Guzinski M., Switonska M., Rutkowska I., Sobieszak-Skura P., Labuz-Roszak B. M., Debiec A., Staszewski J., Stepien A., Zwiernik J., Wasilewski G., Tiu C., Terecoasa E. O., Radu R. A., Negrila A., Dorobat B., Panea C., Tiu V., Petrescu S., Ozdemir A., Mahmoud M., El-Samahy H., Abdelkhalek H., Al-Hashel J., Ismail I. I., Salmeen A., Ghoreishi A., Sabetay S. I., Gross H., Klein P., Abdalkader M., Jabbour P., El Naamani K., Tjoumakaris S., Abbas R., Mohamed G. A., Chebl A., Min J., Hovingh M., Tsai J. P., Khan M., Nalleballe K., Onteddu S., Masoud H., Michael M., Kaur N., Maali L., Abraham M. G., Khandelwal P., Bach I., Ong M., Babici D., Khawaja A. M., Hakemi M., Rajamani K., Cano-Nigenda V., Arauz A., Amaya P., Llanos N., Arango A., Vences M. A., Barrientos Guerra J. D., Caetano R., Martins R. T., Scollo S. D., Yalung P. M., Nagendra S., Gaikwad A., Seo K. -D., Georgiopoulos G., Nogueira R. G., and Michel P.
Abstract: Background and Objectives COVID-19–related inflammation, endothelial dysfunction, and coagulopathy may increase the bleeding risk and lower the efficacy of revascularization treatments in patients with acute ischemic stroke (AIS). We aimed to evaluate the safety and outcomes of revascularization treatments in patients with AIS and COVID-19. Methods This was a retrospective multicenter cohort study of consecutive patients with AIS receiving intravenous thrombolysis (IVT) and/or endovascular treatment (EVT) between March 2020 and June 2021 tested for severe acute respiratory syndrome coronavirus 2 infection. With a doubly robust model combining propensity score weighting and multivariate regression, we studied the association of COVID-19 with intracranial bleeding complications and clinical outcomes. Subgroup analyses were performed according to treatment groups (IVT-only and EVT). Results Of a total of 15,128 included patients from 105 centers, 853 (5.6%) were diagnosed with COVID-19; of those, 5,848 (38.7%) patients received IVT-only and 9,280 (61.3%) EVT (with or without IVT). Patients with COVID-19 had a higher rate of symptomatic intracerebral hemorrhage (SICH) (adjusted OR 1.53; 95% CI 1.16–2.01), symptomatic subarachnoid hemorrhage (SSAH) (OR 1.80; 95% CI 1.20–2.69), SICH and/or SSAH combined (OR 1.56; 95% CI 1.23–1.99), 24-hour mortality (OR 2.47; 95% CI 1.58–3.86), and 3-month mortality (OR 1.88; 95% CI 1.52–2.33). Patients with COVID-19 also had an unfavorable shift in the distribution of the modified Rankin score at 3 months (OR 1.42; 95% CI 1.26–1.60). Discussion Patients with AIS and COVID-19 showed higher rates of intracranial bleeding complications and worse clinical outcomes after revascularization treatments than contemporaneous non–COVID-19 patients receiving treatment. Current available data do not allow direct conclusions to be drawn on the effectiveness of revascularization treatments in patients with COVID-19 or to establish different treatment r
Published: 2023

5. Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial

Author: Abdelhamid, N, Abdul Rahman, D, Abdul-Saheb, M, Abreu, P, Abroskina, M, Abu Ahmad, F, Accassat, S, Acciaresi, M, Adami, A, Ahmad, N, Ahmed, F, Alberto Hawkes, M, Alemseged, F, Ali, A, Altavilla, R, Alwis, L, Amarenco, P, Amaro, S, Amaya Sanchez, LE, Amelia Pinto, A, Ameriso, SF, Amin, H, Amino, T, Amjad, AK, Anagnostou, E, Andersen, G, Anderson, C, Anderson, DC, Andrea Falco, M, Andres Mackinnon, F, Andreu, D, Androulakis, M, Angel Gamero, M, Angel Saredo, G, Angeles Diaz, R, Angels Font, M, Anticoli, S, Arauz, A, Arauz Gongora, AA, Araya, P, Arenillas Lara, JF, Arias Rivas, S, Arnold, M, Augustin, S, Avelar, W, Azevedo, E, Babikian, V, Bacellar, A, Badalyan, K, Bae, HJ, Baez Martinez, EM, Bagelmann, H, Bailey, P, Bak, Z, Baker, M, Balazs, A, Baldaranov, D, Balogun, I, Balueva, T, Bankuti, Z, Bar, M, Baranowska, A, Bardutzky, J, Barker Trejo, S, Barlinn, J, Baronnet, F, Barroso, C, Barteys, M, Bartolottiova, T, Barulin, A, Bas, M, Bashir, S, Basile, V, Bathe-Peters, R, Bathula, R, Batista, C, Batur Caglayan, H, Baumgartner, P, Bazan, R, Bazhenova, O, Beaudry, M, Beer, J, Behnam, Y, Beilei, C, Beinlich, A, Bejot, Y, Belkin, A, Benavente, OR, Benjamin, A, Berardi, V, Bereczki, D, Berkowitz, SD, Berlingieri, J, Berrios, W, Berrouschot, J, Bhandari, M, Bhargavah, M, Bicker, H, Bicsak, T, Bilik, M, Bindila, D, Birchenall, J, Birnbaum, L, Black, T, Blacker, D, Blacquiere, D, Blanc-Labarre, C, Blank, C, Blazejewska-Hyzorek, B, Bloch, S, Bodiguel, E, Bogdanov, E, Boos, L, Borcsik, L, Bornstein, N, Bouly, S, Braga, G, Bragado, I, Bravi, MC, Brokalaki, C, Brola, W, Brouns, R, Bruce, D, Brzoska-Mizgalska, J, Buck, B, Buksinska-Lisik, M, Burke, J, Burn, M, Bustamante, G, Cabrejo, L, Cai, K, Cajaraville, S, Calejo, M, Calvet, D, Campillo, J, Campos Costa, E, Camps, P, Can Alaydin, H, Candeloro, E, Canepa, C, Cantu Brito, CG, Cappellari, M, Carcel, C, Cardona Portela, P, Cardoso, F, Carek, M, Carletti, M, Carlos Portilla, J, Caruso, P, Casado-Naranjo, I, Castellini, P, Castro, D, Castro Meira, F, Cavallini, A, Cayuela Caudevilla, N, Cenciarelli, S, Cereda, C, Cerrone, P, Chakrabarti, A, Chaloulos-Iakovidis, P, Chamorro, A, Chandrasena, D, Chang, DI, Che, C, Chembala, J, Chen, J, Chen, Z, Chen, T, Chen, H, Chen, X, Chen, G, Chen, L, Chen, S, Cheripelli, B, Chin, M, Chiquete Anaya, E, Chorazy, M, Christensen, H, Christensen, T, Christian, L, Chu, F, Chung, CS, Clark, W, Clarke, R, Claverie, S, Clemente Agostoni, E, Clissold, B, Coelho, J, Cohen, D, Colakoglu, S, Collas, D, Condurso, R, Connolly, SJ, Consoli, D, Constantin, C, Constantino Silva, AB, Contardo, L, Corlobe, A, Correia, M, Correia, C, Cortijo Garcia, E, Coull, B, Coutts, S, Coveney, S, Cras, P, Crols, R, Crozier, S, Csanyi, A, Csiba, L, Csontos, K, Csuha, R, Cui, L, Cunha, L, Curtze, S, Czerska, M, Czlonkowska, A, Czurko, M, Czuryszkiewicz, M, Dagnino, M, Dai, C, Daineko, A, Dalek, G, Damgaard, D, Danese, A, Dani, K, Danku, V, Dario Toledo, W, Dávalos, A, De Havenon, A, De Keyser, J, De Klippel, N, De La Torre, J, De Pauw, A, De Smedt, A, De Torres, R, De Vries Basson, MM, Dearborn, J, Deganutto, R, Degeorgia, M, Deguchi, I, Del Giudice, A, Delcourt, C, Delgado-Mederos, R, Della Marca, G, Delpont, B, Deltour, S, Demets, DL, Dennis, M, Desai, J, Devine, J, Dhollander, I, Di Mascio, MT, Diaconu, M, Diaz Otero, F, Dietzel, J, Diez-Tejedor, E, Ding, N, Ding, J, Diomedi, M, Dioszeghy, P, Distefano, M, Domigo, V, Dorodnicov, E, Dossi, D, Doubal, F, Druzenko, I, Du, P, Du, J, Duman, T, Duodu, Y, Dutta, D, Dylewicz, L, Eckstein, J, Ehrensperger, E, Ehrlich, S, Einer Allende, G, Elena Halac, B, Elyas, S, Endres, M, Engelbrecht, JM, Engelter, S, Epinat, M, Eren, F, Esbjornsson, M, Escribano, B, Escudero, I, Esisi, B, Essa, B, Esterbauer, M, Evans, N, Eveson, D, Fabio, S, Fang, L, Fanta, S, Fares, M, Fatar, M, Faust, K, Favate, A, Fazekas, F, Federica Denaro, M, Fedin, A, Felipe Amaya, P, Feng, J, Ferencova, K, Fernanda Gilli, M, Fernandez, MD, Fernandez Pirrone, PN, Fernandez 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Published: 2018
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6. Primary stroke prevention worldwide: translating evidence into action

Author: Owolabi, M, Thrift, A, Mahal, A, Ishida, M, Martins, S, Johnson, W, Pandian, J, Abd-Allah, F, Yaria, J, Phan, H, Roth, G, Gall, S, Beare, R, Phan, T, Mikulik, R, Akinyemi, R, Norrving, B, Brainin, M, Feigin, V, Abanto, C, Abera, S, Addissie, A, Adebayo, O, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar de Sousa, D, Ajagbe, T, Akhmetzhanova, Z, Akpalu, A, Alvarez Ahlgren, J, Ameriso, S, Andonova, S, Awoniyi, F, Bakhiet, M, Barboza, M, Basri, H, Bath, P, Bello, O, Bereczki, D, Beretta, S, Berkowitz, A, Bernabe-Ortiz, A, Bernhardt, J, Berzina, G, Bisharyan, M, Bovet, P, Budincevic, H, Cadilhac, D, Caso, V, Chen, C, Chin, J, Chwojnicki, K, Conforto, A, Cruz, V, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Dempsey, R, Dichgans, M, Dokova, K, Donnan, G, Elkind, M, Endres, M, Fischer, U, Gankpe, F, Gaye Saavedra, A, Gil, A, Giroud, M, Gnedovskaya, E, Hachinski, V, Hafdi, M, Hamadeh, R, Hamzat, T, Hankey, G, Heldner, M, Ibrahim, E, Ibrahim, N, Inoue, M, Jee, S, Jeng, J, Kalkonde, Y, Kamenova, S, Karaszewski, B, Kelly, P, Khan, T, Kiechl, S, Kondybayeva, A, Korv, J, Kravchenko, M, Krishnamurthi, R, Kruja, J, Lakkhanaloet, M, Langhorne, P, Lavados, P, Law, Z, Lawal, A, Lazo-Porras, M, Lebedynets, D, Lee, T, Leung, T, Liebeskind, D, Lindsay, P, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, J, Makanjuola, A, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Merkin, A, Mirrakhimov, E, Mohl, S, Moscoso-Porras, M, Muller-Stierlin, A, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, Ogun, Y, Oguntoye, R, Oraby, M, Osundina, M, Ovbiagele, B, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Phromjai, J, Piradov, P, Platz, T, Potpara, T, Ranta, A, Rathore, F, Richard, E, Sacco, R, Sahathevan, R, Santos Carquin, I, Saposnik, G, Sarfo, F, Sharma, M, Sheth, K, Shobhana, A, Suwanwela, N, Svyato, I, Sylaja, P, Tao, X, Thakur, K, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tulloch-Reid, M, Useche, N, Vanacker, P, Vassilopoulou, S, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wolfe, C, Yifru, Y, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Zhang, P, Owolabi M. O., Thrift A. G., Mahal A., Ishida M., Martins S., Johnson W. D., Pandian J., Abd-Allah F., Yaria J., Phan H. T., Roth G., Gall S. L., Beare R., Phan T. G., Mikulik R., Akinyemi R. O., Norrving B., Brainin M., Feigin V. L., Abanto C., Abera S. F., Addissie A., Adebayo O., Adeleye A. O., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar de Sousa D., Ajagbe T., Akhmetzhanova Z., Akpalu A., Alvarez Ahlgren J., Ameriso S., Andonova S., Awoniyi F. E., Bakhiet M., Barboza M., Basri H., Bath P., Bello O., Bereczki D., Beretta S., Berkowitz A., Bernabe-Ortiz A., Bernhardt J., Berzina G., Bisharyan M., Bovet P., Budincevic H., Cadilhac D., Caso V., Chen C., Chin J., Chwojnicki K., Conforto A., Cruz V. T., D'Amelio M., Danielyan K., Davis S., Demarin V., Dempsey R., Dichgans M., Dokova K., Donnan G., Elkind M. S., Endres M., Fischer U., Gankpe F., Gaye Saavedra A., Gil A., Giroud M., Gnedovskaya E., Hachinski V., Hafdi M., Hamadeh R., Hamzat T. K., Hankey G., Heldner M., Ibrahim E. A., Ibrahim N. M., Inoue M., Jee S., Jeng J. -S., Kalkonde Y., Kamenova S., Karaszewski B., Kelly P., Khan T., Kiechl S., Kondybayeva A., Korv J., Kravchenko M., Krishnamurthi R. V., Kruja J., Lakkhanaloet M., Langhorne P., Lavados P. M., Law Z. K., Lawal A., Lazo-Porras M., Lebedynets D., Lee T. -H., Leung T., Liebeskind D. S., Lindsay P., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion J., Makanjuola A., Markus H. S., Marquez-Romero J. M., Medina M., Medukhanova S., Mehndiratta M. M., Merkin A., Mirrakhimov E., Mohl S., Moscoso-Porras M., Muller-Stierlin A., Murphy S., Musa K. I., Nasreldein A., Nogueira R. G., Nolte C., Noubiap J. J., Novarro-Escudero N., Ogun Y., Oguntoye R. A., Oraby M. I., Osundina M., Ovbiagele B., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Phromjai J., Piradov P., Platz T., Potpara T., Ranta A., Rathore F., Richard E., Sacco R. L., Sahathevan R., Santos Carquin I., Saposnik G., Sarfo F. S., Sharma M., Sheth K., Shobhana A., Suwanwela N., Svyato I., Sylaja P. N., Tao X., Thakur K. T., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T. C., Tsiskaridze A., Tulloch-Reid M., Useche N., Vanacker P., Vassilopoulou S., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wolfe C., Yifru Y. M., Yock-Corrales A., Yonemoto N., Yperzeele L., Zhang P., Owolabi, M, Thrift, A, Mahal, A, Ishida, M, Martins, S, Johnson, W, Pandian, J, Abd-Allah, F, Yaria, J, Phan, H, Roth, G, Gall, S, Beare, R, Phan, T, Mikulik, R, Akinyemi, R, Norrving, B, Brainin, M, Feigin, V, Abanto, C, Abera, S, Addissie, A, Adebayo, O, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar de Sousa, D, Ajagbe, T, Akhmetzhanova, Z, Akpalu, A, Alvarez Ahlgren, J, Ameriso, S, Andonova, S, Awoniyi, F, Bakhiet, M, Barboza, M, Basri, H, Bath, P, Bello, O, Bereczki, D, Beretta, S, Berkowitz, A, Bernabe-Ortiz, A, Bernhardt, J, Berzina, G, Bisharyan, M, Bovet, P, Budincevic, H, Cadilhac, D, Caso, V, Chen, C, Chin, J, Chwojnicki, K, Conforto, A, Cruz, V, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Dempsey, R, Dichgans, M, Dokova, K, Donnan, G, Elkind, M, Endres, M, Fischer, U, Gankpe, F, Gaye Saavedra, A, Gil, A, Giroud, M, Gnedovskaya, E, Hachinski, V, Hafdi, M, Hamadeh, R, Hamzat, T, Hankey, G, Heldner, M, Ibrahim, E, Ibrahim, N, Inoue, M, Jee, S, Jeng, J, Kalkonde, Y, Kamenova, S, Karaszewski, B, Kelly, P, Khan, T, Kiechl, S, Kondybayeva, A, Korv, J, Kravchenko, M, Krishnamurthi, R, Kruja, J, Lakkhanaloet, M, Langhorne, P, Lavados, P, Law, Z, Lawal, A, Lazo-Porras, M, Lebedynets, D, Lee, T, Leung, T, Liebeskind, D, Lindsay, P, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, J, Makanjuola, A, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Merkin, A, Mirrakhimov, E, Mohl, S, Moscoso-Porras, M, Muller-Stierlin, A, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, Ogun, Y, Oguntoye, R, Oraby, M, Osundina, M, Ovbiagele, B, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Phromjai, J, Piradov, P, Platz, T, Potpara, T, Ranta, A, Rathore, F, Richard, E, Sacco, R, Sahathevan, R, Santos Carquin, I, Saposnik, G, Sarfo, F, Sharma, M, Sheth, K, Shobhana, A, Suwanwela, N, Svyato, I, Sylaja, P, Tao, X, Thakur, K, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tulloch-Reid, M, Useche, N, Vanacker, P, Vassilopoulou, S, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wolfe, C, Yifru, Y, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Zhang, P, Owolabi M. O., Thrift A. G., Mahal A., Ishida M., Martins S., Johnson W. D., Pandian J., Abd-Allah F., Yaria J., Phan H. T., Roth G., Gall S. L., Beare R., Phan T. G., Mikulik R., Akinyemi R. O., Norrving B., Brainin M., Feigin V. L., Abanto C., Abera S. F., Addissie A., Adebayo O., Adeleye A. O., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar de Sousa D., Ajagbe T., Akhmetzhanova Z., Akpalu A., Alvarez Ahlgren J., Ameriso S., Andonova S., Awoniyi F. E., Bakhiet M., Barboza M., Basri H., Bath P., Bello O., Bereczki D., Beretta S., Berkowitz A., Bernabe-Ortiz A., Bernhardt J., Berzina G., Bisharyan M., Bovet P., Budincevic H., Cadilhac D., Caso V., Chen C., Chin J., Chwojnicki K., Conforto A., Cruz V. T., D'Amelio M., Danielyan K., Davis S., Demarin V., Dempsey R., Dichgans M., Dokova K., Donnan G., Elkind M. S., Endres M., Fischer U., Gankpe F., Gaye Saavedra A., Gil A., Giroud M., Gnedovskaya E., Hachinski V., Hafdi M., Hamadeh R., Hamzat T. K., Hankey G., Heldner M., Ibrahim E. A., Ibrahim N. M., Inoue M., Jee S., Jeng J. -S., Kalkonde Y., Kamenova S., Karaszewski B., Kelly P., Khan T., Kiechl S., Kondybayeva A., Korv J., Kravchenko M., Krishnamurthi R. V., Kruja J., Lakkhanaloet M., Langhorne P., Lavados P. M., Law Z. K., Lawal A., Lazo-Porras M., Lebedynets D., Lee T. -H., Leung T., Liebeskind D. S., Lindsay P., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion J., Makanjuola A., Markus H. S., Marquez-Romero J. M., Medina M., Medukhanova S., Mehndiratta M. M., Merkin A., Mirrakhimov E., Mohl S., Moscoso-Porras M., Muller-Stierlin A., Murphy S., Musa K. I., Nasreldein A., Nogueira R. G., Nolte C., Noubiap J. J., Novarro-Escudero N., Ogun Y., Oguntoye R. A., Oraby M. I., Osundina M., Ovbiagele B., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Phromjai J., Piradov P., Platz T., Potpara T., Ranta A., Rathore F., Richard E., Sacco R. L., Sahathevan R., Santos Carquin I., Saposnik G., Sarfo F. S., Sharma M., Sheth K., Shobhana A., Suwanwela N., Svyato I., Sylaja P. N., Tao X., Thakur K. T., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T. C., Tsiskaridze A., Tulloch-Reid M., Useche N., Vanacker P., Vassilopoulou S., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wolfe C., Yifru Y. M., Yock-Corrales A., Yonemoto N., Yperzeele L., and Zhang P.
Abstract: Stroke is the second leading cause of death and the third leading cause of disability worldwide and its burden is increasing rapidly in low-income and middle-income countries, many of which are unable to face the challenges it imposes. In this Health Policy paper on primary stroke prevention, we provide an overview of the current situation regarding primary prevention services, estimate the cost of stroke and stroke prevention, and identify deficiencies in existing guidelines and gaps in primary prevention. We also offer a set of pragmatic solutions for implementation of primary stroke prevention, with an emphasis on the role of governments and population-wide strategies, including task-shifting and sharing and health system re-engineering. Implementation of primary stroke prevention involves patients, health professionals, funders, policy makers, implementation partners, and the entire population along the life course.
Published: 2022

7. Basilar artery occlusion management: Specialist perspectives from an international survey

Author: Edwards, C, Drumm, B, Siegler, JE, Schonewille, WJ, Klein, P, Huo, X, Chen, Y, Abdalkader, M, Qureshi, MM, Strbian, D, Liu, X, Hu, W, Ji, X, Li, C, Fischer, U, Nagel, S, Puetz, V, Michel, P, Alemseged, F, Sacco, S, Yamagami, H, Yaghi, S, Strambo, D, Kristoffersen, ES, Sandset, EC, Mikulik, R, Tsivgoulis, G, Masoud, HE, de Sousa, DA, Marto, JP, Lobotesis, K, Roi, D, Berberich, A, Demeestere, J, Meinel, TR, Rivera, R, Poli, S, Ton, MD, Zhu, Y, Li, F, Sang, H, Thomalla, G, Parsons, M, Campbell, BCV, Zaidat, OO, Chen, H-S, Field, TS, Raymond, J, Kaesmacher, J, Nogueira, RG, Jovin, TG, Sun, D, Liu, R, Qureshi, AI, Qiu, Z, Miao, Z, Banerjee, S, Nguyen, TN, Edwards, C, Drumm, B, Siegler, JE, Schonewille, WJ, Klein, P, Huo, X, Chen, Y, Abdalkader, M, Qureshi, MM, Strbian, D, Liu, X, Hu, W, Ji, X, Li, C, Fischer, U, Nagel, S, Puetz, V, Michel, P, Alemseged, F, Sacco, S, Yamagami, H, Yaghi, S, Strambo, D, Kristoffersen, ES, Sandset, EC, Mikulik, R, Tsivgoulis, G, Masoud, HE, de Sousa, DA, Marto, JP, Lobotesis, K, Roi, D, Berberich, A, Demeestere, J, Meinel, TR, Rivera, R, Poli, S, Ton, MD, Zhu, Y, Li, F, Sang, H, Thomalla, G, Parsons, M, Campbell, BCV, Zaidat, OO, Chen, H-S, Field, TS, Raymond, J, Kaesmacher, J, Nogueira, RG, Jovin, TG, Sun, D, Liu, R, Qureshi, AI, Qiu, Z, Miao, Z, Banerjee, S, and Nguyen, TN
Abstract: BACKGROUND AND PURPOSE: Two early basilar artery occlusion (BAO) randomized controlled trials did not establish the superiority of endovascular thrombectomy (EVT) over medical management. While many providers continue to recommend EVT for acute BAO, perceptions of equipoise in randomizing patients with BAO to EVT versus medical management may differ between clinician specialties. METHODS: We conducted an international survey (January 18, 2022 to March 31, 2022) regarding management strategies in acute BAO prior to the announcement of two trials indicating the superiority of EVT, and compared responses between interventionalists (INTs) and non-interventionalists (nINTs). Selection practices for routine EVT and perceptions of equipoise regarding randomizing to medical management based on neuroimaging and clinical features were compared between the two groups using descriptive statistics. RESULTS: Among the 1245 respondents (nINTs = 702), INTs more commonly believed that EVT was superior to medical management in acute BAO (98.5% vs. 95.1%, p < .01). A similar proportion of INTs and nINTs responded that they would not randomize a patient with BAO to EVT (29.4% vs. 26.7%), or that they would only under specific clinical circumstances (p = .45). Among respondents who would recommend EVT for BAO, there was no difference in the maximum prestroke disability, minimum stroke severity, or infarct burden on computed tomography between the two groups (p > .05), although nINTs more commonly preferred perfusion imaging (24.2% vs. 19.7%, p = .04). Among respondents who indicated they would randomize to medical management, INTs were more likely to randomize when the National Institutes of Health Stroke Scale was ≥10 (15.9% vs. 6.9%, p < .01). CONCLUSIONS: Following the publication of two neutral clinical trials in BAO EVT, most stroke providers believed EVT to be superior to medical management in carefully selected patients, with most indicating they would not randomize a BAO patient
Published: 2023

8. Health Status and Self-Perception of Health in Czech Roma Community

Author: Volevach, E, primary, Ely, M, additional, Maršálková, H, additional, Gulová, L, additional, and Mikulik, R, additional
Published: 2022
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9. The state of stroke services across the globe: Report of World Stroke Organization–World Health Organization surveys

Author: Owolabi, M, Thrift, A, Martins, S, Johnson, W, Pandian, J, Abd-Allah, F, Varghese, C, Mahal, A, Yaria, J, Phan, H, Roth, G, Gall, S, Beare, R, Phan, T, Mikulik, R, Norrving, B, Feigin, V, on behalf of the Stroke Experts Collaboration, G, Abera, S, Addissie, A, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar, D, Akhmetzhanova, Z, Akinyemi, R, Akpalu, A, Ameriso, S, Andonova, S, Abanto, C, Awoniyi, F, Bakhiet, M, Basri, H, Bath, P, Bereczki, D, Beretta, S, Berkowitz, A, Bernhardt, J, Berzina, G, Bhavsar, B, Bisharyan, M, Bovet, P, Brainin, M, Budincevic, H, Cabral, N, Cadilhac, D, Caso, V, Chen, C, Chin, J, Christensen, H, Chwojnicki, K, Conforto, A, Cruz, V, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Dempsey, R, Dichgans, M, Dokova, Donnan, G, Duran, J, Elizondo, M, Elkind, M, Endres, M, Etedal, I, Faris, M, Fischer, U, Gankpe, F, Gavidia, M, Gaye-Saavedra, A, Giroud, M, Gongora-Rivera, F, Hachinski, V, Hacke, W, Hamadeh, R, Hamzat, T, Hankey, G, Heldner, M, Ibrahim, N, Inoue, M, Jee, S, Jiann-Shing, J, Johnston, S, Kalkonde, Y, Kamenova, S, Kelly, P, Khan, T, Kiechl, S, Kondybayeva, A, Korv, J, Kravchenko, M, Krishnamurthi, R, Langhorne, P, Kang, Z, Kruja, J, Lavados, P, Lebedynets, D, Leung, T, Liebeskind, D, Lindsay, P, Liu, L, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, J, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Mirrakhimov, E, Mohl, S, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, O'Donnell, M, Ogun, V, Oraby, M, Ovbiagele, B, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Peters, A, Piradov, M, Platz, T, Potpara, T, Ranta, A, Rathore, F, Sacco, R, Sahathevan, R, Santos, I, Saposnik, G, Sarfo, F, Sharma, M, Sheth, K, Shobhana, A, Silva, S, Suwanwela, N, Sylaja, P, Thakur, K, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tsong-Hai, L, Tulloch-Reid, M, Useche, J, Vanacker, P, Vassilopoulou, S, Venketasubramanian, N, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wolfe, C, Yifru, M, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Owolabi M. O., Thrift A. G., Martins S., Johnson W., Pandian J., Abd-Allah F., Varghese C., Mahal A., Yaria J., Phan H. T., Roth G., Gall S. L., Beare R., Phan T. G., Mikulik R., Norrving B., Feigin V. L., on behalf of the Stroke Experts Collaboration Group, Abera S. F., Addissie A., Adeleye A., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar D. S. D., Akhmetzhanova Z., Akinyemi R. O., Akpalu A., Ameriso S. F., Andonova S., Abanto C., Awoniyi F. E., Bakhiet M., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bovet P., Brainin M., Budincevic H., Cabral N. L., Cadilhac D. A., Caso V., Chen C., Chin J. H., Christensen H., Chwojnicki K., Conforto A. B., Cruz V. T., D'Amelio M., Danielyan K. E., Davis S., Demarin V., Dempsey R. J., Dichgans M., Donnan G., Duran J., Elizondo M. A. B., Elkind M. S., Endres M., Etedal I., Faris M. E., Fischer U., Gankpe F., Gavidia M., Gaye-Saavedra A., Giroud M., Gongora-Rivera F., Hachinski V., Hacke W., Hamadeh R. R., Hamzat T. K., Hankey G. J., Heldner M. R., Ibrahim N. M., Inoue M., Jee S., Jiann-Shing J., Johnston S., Kalkonde Y., Kamenova S., Kelly P., Khan T., Kiechl S., Kondybayeva A., Korv J., Kravchenko M., Krishnamurthi R., Langhorne P., Kang Z. L., Kruja J., Lavados P. M., Lebedynets D., Leung T. W., Liebeskind D. S., Lindsay P., Liu L., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion J. M., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Mirrakhimov E., Mohl S., Murphy S., Musa K. I., Nasreldein A., Nogueira R., Nolte C. H., Noubiap J. J., Novarro-Escudero N., O'Donnell M., Ogun V., Oraby M. I., Ovbiagele B., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Peters A., Piradov M., Platz T., Potpara T., Ranta A., Rathore F. A., Sacco R. L., Sahathevan R., Santos I. C., Saposnik G., Sarfo F. S., Sharma M., Sheth K. N., Shobhana A., Silva S. N., Suwanwela N., Sylaja P. N., Thakur K., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tsong-Hai L., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Venketasubramanian N., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wolfe C., Yifru M. Y., Yock-Corrales A., Yonemoto N., Yperzeele L., Owolabi, M, Thrift, A, Martins, S, Johnson, W, Pandian, J, Abd-Allah, F, Varghese, C, Mahal, A, Yaria, J, Phan, H, Roth, G, Gall, S, Beare, R, Phan, T, Mikulik, R, Norrving, B, Feigin, V, on behalf of the Stroke Experts Collaboration, G, Abera, S, Addissie, A, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar, D, Akhmetzhanova, Z, Akinyemi, R, Akpalu, A, Ameriso, S, Andonova, S, Abanto, C, Awoniyi, F, Bakhiet, M, Basri, H, Bath, P, Bereczki, D, Beretta, S, Berkowitz, A, Bernhardt, J, Berzina, G, Bhavsar, B, Bisharyan, M, Bovet, P, Brainin, M, Budincevic, H, Cabral, N, Cadilhac, D, Caso, V, Chen, C, Chin, J, Christensen, H, Chwojnicki, K, Conforto, A, Cruz, V, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Dempsey, R, Dichgans, M, Dokova, Donnan, G, Duran, J, Elizondo, M, Elkind, M, Endres, M, Etedal, I, Faris, M, Fischer, U, Gankpe, F, Gavidia, M, Gaye-Saavedra, A, Giroud, M, Gongora-Rivera, F, Hachinski, V, Hacke, W, Hamadeh, R, Hamzat, T, Hankey, G, Heldner, M, Ibrahim, N, Inoue, M, Jee, S, Jiann-Shing, J, Johnston, S, Kalkonde, Y, Kamenova, S, Kelly, P, Khan, T, Kiechl, S, Kondybayeva, A, Korv, J, Kravchenko, M, Krishnamurthi, R, Langhorne, P, Kang, Z, Kruja, J, Lavados, P, Lebedynets, D, Leung, T, Liebeskind, D, Lindsay, P, Liu, L, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, J, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Mirrakhimov, E, Mohl, S, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, O'Donnell, M, Ogun, V, Oraby, M, Ovbiagele, B, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Peters, A, Piradov, M, Platz, T, Potpara, T, Ranta, A, Rathore, F, Sacco, R, Sahathevan, R, Santos, I, Saposnik, G, Sarfo, F, Sharma, M, Sheth, K, Shobhana, A, Silva, S, Suwanwela, N, Sylaja, P, Thakur, K, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tsong-Hai, L, Tulloch-Reid, M, Useche, J, Vanacker, P, Vassilopoulou, S, Venketasubramanian, N, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wolfe, C, Yifru, M, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Owolabi M. O., Thrift A. G., Martins S., Johnson W., Pandian J., Abd-Allah F., Varghese C., Mahal A., Yaria J., Phan H. T., Roth G., Gall S. L., Beare R., Phan T. G., Mikulik R., Norrving B., Feigin V. L., on behalf of the Stroke Experts Collaboration Group, Abera S. F., Addissie A., Adeleye A., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar D. S. D., Akhmetzhanova Z., Akinyemi R. O., Akpalu A., Ameriso S. F., Andonova S., Abanto C., Awoniyi F. E., Bakhiet M., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bovet P., Brainin M., Budincevic H., Cabral N. L., Cadilhac D. A., Caso V., Chen C., Chin J. H., Christensen H., Chwojnicki K., Conforto A. B., Cruz V. T., D'Amelio M., Danielyan K. E., Davis S., Demarin V., Dempsey R. J., Dichgans M., Donnan G., Duran J., Elizondo M. A. B., Elkind M. S., Endres M., Etedal I., Faris M. E., Fischer U., Gankpe F., Gavidia M., Gaye-Saavedra A., Giroud M., Gongora-Rivera F., Hachinski V., Hacke W., Hamadeh R. R., Hamzat T. K., Hankey G. J., Heldner M. R., Ibrahim N. M., Inoue M., Jee S., Jiann-Shing J., Johnston S., Kalkonde Y., Kamenova S., Kelly P., Khan T., Kiechl S., Kondybayeva A., Korv J., Kravchenko M., Krishnamurthi R., Langhorne P., Kang Z. L., Kruja J., Lavados P. M., Lebedynets D., Leung T. W., Liebeskind D. S., Lindsay P., Liu L., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion J. M., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Mirrakhimov E., Mohl S., Murphy S., Musa K. I., Nasreldein A., Nogueira R., Nolte C. H., Noubiap J. J., Novarro-Escudero N., O'Donnell M., Ogun V., Oraby M. I., Ovbiagele B., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Peters A., Piradov M., Platz T., Potpara T., Ranta A., Rathore F. A., Sacco R. L., Sahathevan R., Santos I. C., Saposnik G., Sarfo F. S., Sharma M., Sheth K. N., Shobhana A., Silva S. N., Suwanwela N., Sylaja P. N., Thakur K., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tsong-Hai L., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Venketasubramanian N., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wolfe C., Yifru M. Y., Yock-Corrales A., Yonemoto N., and Yperzeele L.
Abstract: Background: Improving stroke services is critical for reducing the global stroke burden. The World Stroke Organization–World Health Organization–Lancet Neurology Commission on Stroke conducted a survey of the status of stroke services in low and middle-income countries (LMICs) compared to high-income countries. Methods: Using a validated World Stroke Organization comprehensive questionnaire, we collected and compared data on stroke services along four pillars of the stroke quadrangle (surveillance, prevention, acute stroke, and rehabilitation) in 84 countries across World Health Organization regions and economic strata. The World Health Organization also conducted a survey of non-communicable diseases in 194 countries in 2019. Results: Fewer surveillance activities (including presence of registries, presence of recent risk factors surveys, and participation in research) were reported in low-income countries than high-income countries. The overall global score for prevention was 40.2%. Stroke units were present in 91% of high-income countries in contrast to 18% of low-income countries (p < 0.001). Acute stroke treatments were offered in ∼ 60% of high-income countries compared to 26% of low-income countries (p = 0.009). Compared to high-income countries, LMICs provided less rehabilitation services including in-patient rehabilitation, home assessment, community rehabilitation, education, early hospital discharge program, and presence of rehabilitation protocol. Conclusions: There is an urgent need to improve access to stroke units and services globally especially in LMICs. Countries with less stroke services can adapt strategies from those with better services. This could include establishment of a framework for regular monitoring of stroke burden and services, implementation of integrated prevention activities and essential acute stroke care services, and provision of interdisciplinary care for stroke rehabilitation.
Published: 2021

10. Clinical outcome of cardioembolic stroke treated by intravenous thrombolysis

Author: Vaclavik, D., Vilionskis, A., Jatuzis, D., Karlinski, M. A., Gdovinova, Z., Kõrv, J., Tsivgoulis, G., and Mikulik, R.
Published: 2018
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11. The state of stroke services across the globe: Report of World Stroke Organization–World Health Organization surveys

Author: Thrift A. G., Martins S., Johnson W., Pandian J., Abd-Allah F., Varghese C., Mahal A., Yaria J., Phan H. T., Roth G., Gall S. L., Beare R., Phan T. G., Mikulik R., Norrving B., Feigin V. Abera S. F., Addissie A., Adeleye A., Adilbekov Y., Adilbekova B., Adoukonou T. A. Aguiar de Sousa D., Akhmetzhanova Z., Akinyemi R. O., Akpalu A. MB. ChB, Ameriso S. F., Andonova S., Abanto C., Awoniyi F. E., Bakhiet M., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bovet P., Brainin M., Budincevic H., Cabral N. L., Cadilhac D A. , Caso V., Chen C., Chin J. H., Christensen H, Chwojnicki K., Conforto A. B., Cruz V. T., D'Amelio M., Danielyan K. E., Davis S., Demarin V, Dempsey R. J., Dichgans M., Dokova Donnan, G. Duran, Elizondo M. A. B., Elkind M. S., Endres M., Etedal I., Faris M. E., Fischer U., Gankpe F., Gavidia M., GayeSaavedra A., Giroud M., Gongora-Rivera F., Hachinski V., Hacke W., Hamadeh R. R., Hamzat T. K., Hankey G. J., Heldner M. R., Ibrahim N. M., Inoue M., Jee S., Jiann-Shing J., Johnston S. C., Kalkonde Y., Kamenova S., Kelly P., Khan T., Kiechl S., Kondybayeva A., Kõrv J., Kravchenko M., Krishnamurthi R., Langhorne P., Kang Z. L., Kruja J., Lavados P. M., Lebedynets D., Leung T. W., Liebeskind D. S., Lindsay P., Liu L., López-Jaramillo P., Lotufo P. A., Machline-Carrion J. M., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Mirrakhimov E., Mohl S., Murphy S., Musa K. I., Nasreldein A, Nogueira R., Nolte C. H., Noubiap J. J., Novarro-Escudero N., O'Donnell M., Ogun Y., Oraby M. I., Ovbiagele B., Ōrken D. N., Ōzdemir A. O., Ozturk S., Paccot M., Peters A., Piradov M., Platz T., Potpara T., Ranta A., Rathore F. A., Sacco R. L., Sahathevan R., Santos I. C., Saposnik G., Sarfo F. S., Sharma M., Sheth K. N., Shobhana A., Silva S. N., Suwanwela N. C., Sylaja P. N., Thakur K., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tsong-Hai L., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Venketasubramanian N., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wolfe C, Yifru M. Y., YockCorrales A., Yonemoto N., Yperzeele L., Owolabi, MO, Thrift, AG, Martins, S, Johnson, W, Pandian, J, Abd-Allah, F, Varghese, C, Mahal, A, Yaria, J, Phan, HT, Roth, G, Gall, SL, Beare, R, Phan, TG, D'Amelio M, Mikulik, R, Norrving, B, Feigin, VL, and Thrift A. G., Martins S., Johnson W., Pandian J., Abd-Allah F., Varghese C., Mahal A., Yaria J., Phan H. T., Roth G., Gall S. L., Beare R., Phan T. G., Mikulik R., Norrving B., Feigin V. Abera S.F., Addissie A., Adeleye A., Adilbekov Y., Adilbekova B., Adoukonou T.A. Aguiar de Sousa D., Akhmetzhanova Z., Akinyemi R.O., Akpalu A. MB. ChB , Ameriso S.F. , Andonova S., Abanto C., Awoniyi F.E., Bakhiet M., Basri H., Bath, P.M., Bereczki D., Beretta S., Berkowitz A.L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M.S., Bovet P., Brainin, M., Budincevic H., Cabral N.L., , Cadilhac D A. , Caso V., , Chen C., Chin J.H. , Christensen H, , Di, Chwojnicki K., Conforto A.B., Cruz V.T., D'Amelio M., Danielyan K.E., Davis, S., Demarin V, Dempsey R.J., Dichgans M., Dokova, Donnan, G., Duran, J., Elizondo M.A.B., Elkind M.S., Endres M., Etedal I., Faris M.E., Fischer U., Gankpe F., Gavidia M., GayeSaavedra A., Giroud M., Gongora-Rivera F., Hachinski V. , Hacke, W., Hamadeh R.R., Hamzat T.K., Hankey G.J., Heldner M.R., Ibrahim, N.M., Inoue M., Jee S., Jiann-Shing J., Johnston S. C., Kalkonde Y., Kamenova S., Kelly P., Khan T., Kiechl S., Kondybayeva A., Kõrv J., Kravchenko M., Krishnamurthi R., Langhorne, P., Kang Z.L., Kruja, J., Lavados P.M., Lebedynets D., Leung T.W., Liebeskind D.S., Lindsay P., Liu, L., López-Jaramillo P., Lotufo P.A., Machline-Carrion J.M., Markus, H.S., Marquez-Romero J.M., Medina M.T., Medukhanova S., Mehndiratta M.M., Mirrakhimov E., Mohl S., Murphy S., Musa K.I., Nasreldein A, Nogueira R., Nolte C.H., Norrving B., Noubiap J.J., Novarro-Escudero N., O'Donnell M., Ogun Y., Oraby M.I., Ovbiagele B., Ōrken D.N., Ōzdemir A.O., Ozturk S., Paccot M., Peters A., Piradov, M., Platz T., Potpara T., Ranta A., Rathore F.A., Roth G., Sacco R.L., Sahathevan R., Santos I.C., Saposnik G., Sarfo F.S., Sharma M., Sheth K.N., Shobhana A., Silva, S.N., Suwanwela N. C., Sylaja P.N., Thakur K., Toni D., Topcuoglu M.A., Torales J., Towfighi A., Truelsen, T., Tsiskaridze A., Tsong-Hai L., Tulloch-Reid M., Useche J.N., Vanacker P., Vassilopoulou S., Venketasubramanian N., Vukorepa G., Vuletic V., Wahab K.W., Wang W., Wijeratne T., Wolfe C, Yifru M.Y., YockCorrales A., Yonemoto N., Yperzeele L.
Subjects: Gerontology, medicine.medical_specialty, medicine.medical_treatment, media_common.quotation_subject, Globe, Commission, stroke quadrangle, Global Health, World Health Organization, World health, Article, Stroke service, rehabilitation, low and middle-income countrie, 03 medical and health sciences, 0302 clinical medicine, State (polity), prevention, Acute care, Surveys and Questionnaires, medicine, Humans, 030212 general & internal medicine, high-income countrie, Stroke, Developing Countries, media_common, Stroke services, Rehabilitation, business.industry, Stroke Rehabilitation, medicine.disease, 3. Good health, medicine.anatomical_structure, Neurology, low- and middle-income countrie, Settore MED/26 - Neurologia, acute care, business, 030217 neurology & neurosurgery
Abstract: Background Improving stroke services is critical for reducing the global stroke burden. The World Stroke Organization–World Health Organization– Lancet Neurology Commission on Stroke conducted a survey of the status of stroke services in low and middle-income countries (LMICs) compared to high-income countries. Methods Using a validated World Stroke Organization comprehensive questionnaire, we collected and compared data on stroke services along four pillars of the stroke quadrangle (surveillance, prevention, acute stroke, and rehabilitation) in 84 countries across World Health Organization regions and economic strata. The World Health Organization also conducted a survey of non-communicable diseases in 194 countries in 2019. Results Fewer surveillance activities (including presence of registries, presence of recent risk factors surveys, and participation in research) were reported in low-income countries than high-income countries. The overall global score for prevention was 40.2%. Stroke units were present in 91% of high-income countries in contrast to 18% of low-income countries (p Conclusions There is an urgent need to improve access to stroke units and services globally especially in LMICs. Countries with less stroke services can adapt strategies from those with better services. This could include establishment of a framework for regular monitoring of stroke burden and services, implementation of integrated prevention activities and essential acute stroke care services, and provision of interdisciplinary care for stroke rehabilitation.
Published: 2021

12. Intravenous thrombolysis for patients with in‐hospital stroke onset: propensity‐matched analysis from the Safe Implementation of Treatments in Stroke‐East registry

Author: Tsivgoulis, G., Katsanos, A. H., Kadlecová, P., Czlonkowska, A., Kobayashi, A., Brozman, M., Švigelj, V., Csiba, L., Fekete, K., Kõrv, J., Demarin, V., Vilionskis, A., Jatuzis, D., Krespi, Y., Karapanayiotides, T., Giannopoulos, S., and Mikulik, R.
Published: 2017
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13. Global impact of the COVID-19 pandemic on subarachnoid haemorrhage hospitalisations, aneurysm treatment and in-hospital mortality: 1-year follow-up

Author: Nguyen, Tn, Qureshi, Mm, Klein, P, Yamagami, H, Mikulik, R, Etminan, N, Abdalkader, M, Mansour, Oy, Czlonkowska, A, Lo, H, Sathya, A, Demeestere, J, Tsivgoulis, G, Sakai, N, Sedova, P, Kristoffersen, Es, Mohammaden, M, Lereis, Vp, Scollo, Sd, Ma, A, Rahman, A, Bonnet, T, Cortier, J, De Raedt, S, Lemmens, R, Ligot, N, Hidalgo, Rct, Cuervo, Dlm, Neves, Ld, Rezende, Mts, Santiago, Ib, Sirakov, A, Sirakov, S, Cora, Ea, Kelly, Me, Lavoie, P, Peeling, L, Pikula, A, Rivera, R, Chen, Hs, Chen, Ym, Fang, Hl, Bedekovic, Mr, Budincevic, H, Strossmayer, Jj, Hrabanovska, E, Jurak, L, Cabal, M, Kadlckova, J, Karpowicz, I, Palouskova, H, Reiser, M, Klecka, L, Kovar, M, Neumann, J, Rekova, P, Sramek, M, Vitkova, E, Skorna, M, Zakova, L, Sobh, K, Alpay, K, Rautio, R, Strbian, D, Gentric, Jc, Magro, E, Naggara, O, Reiner, P, Abdulazim, A, Bohmann, Fo, Boskamp, S, Gerber, Jc, Kaiser, Dpo, Kestner, Ri, Mbroh, J, Neyazi, M, Rosenkranz, M, Sani, Af, Poli, S, Thomalla, G, Karapanayiotides, T, Kargiotis, O, Koutroulou, I, Palaiodimou, L, Guerra, Jdb, Huded, V, Nagendra, S, Prajapati, C, Krishna, A, Ghoreishi, A, Ilkhchi, Rb, Jalili, J, Sabetay, Si, Abu Raya, T, Acampa, M, Longoni, M, Bigliani, Cr, Castellan, L, Ornello, R, Renieri, L, Romoli, M, Sacco, S, Sangalli, D, Vigano, M, Zini, A, Tokimura, H, Sonoda, K, Todo, K, Fukuda, H, Fujita, K, Sakaguchi, M, Uno, M, Kan, I, Kosuke, M, Kono, R, Kimura, N, Yamamoto, N, Yamamoto, R, Doijiri, R, Shindo, S, Ohara, N, Imamura, H, Ogawa, T, Uwatoko, T, Kanamaru, T, Fujinaka, T, Takenobu, Y, Toyoda, K, Matsumaru, Y, Yazawa, Y, Sugiura, Y, Baek, Jh, Sunmonu, Ta, Kwon, Ys, Lee, Yh, Seo, Kd, Sohn, Si, Chan, Yc, Zaidi, Waw, Barrientos-Prieto, J, Gongora-Rivera, F, Martinez-Marino, M, Calderon-Vallejo, A, Groppa, S, Pavel, L, Coutinho, Jm, Dippel, D, Rinkel, L, Van Dam-Nolen, Dhk, Nwazor, Eo, Al Hashimi, Am, Ahmad, S, Rashid, U, Rodriguez-Kadota, L, Vences, Ma, Yalung, Pm, Jsh, Dy, Brola, W, Dorobek, M, Karlinski, Ma, Labuz-Roszak, Bm, Lasek-Bal, A, Sienkiewicz-Jarosz, H, Staszewski, J, Sobolewski, P, Zielinska-Turek, J, Araujo, Ap, Fonseca, L, Debiec, A, Silva, Ml, Castro, P, Rocha, M, Falup-Pecurariu, Rc, Venketasubramanian, N, Mako, Gkm, Ayo-Martin, O, Wiacek, M, Blasco, J, Cruz-Culebras, A, Hernandez-Fernandez, F, Fernandez, Cr, Lopez, Je, Rodriguez, A, Bolognese, M, Karwacki, Gm, Keller, E, Machi, P, Bernava, G, Boonyakarnkul, S, Churojana, A, Hammami, N, Bajrami, A, Senadim, S, Hussain, Si, John, S, Dow, G, Krishnan, K, Lenthall, R, Wong, K, Zhang, Lq, Altschul, D, Asif, Ks, Aziz-Sultan, Ma, Bach, I, Below, K, Biller, J, Cervantes-Arslanian, Am, Chaudhry, Sa, Chebl, A, Chen, M, Colasurdo, M, Czap, A, Dasenbrock, H, Bahiru, Z, de Havenon, Ah, Dharmadhikari, S, Dmytriw, Aa, Eskey, Cj, Etherton, M, Ezepue, C, Fink, L, Gasimova, U, Goyal, N, Grimmett, Kb, Hakemi, M, Hester, T, Inoa, V, Kan, Pt, Kasper, Em, Khandelwal, P, Khatri, R, Khoury, Nn, Kim, Bs, Kolikonda, M, Kuhn, Al, Linares, G, Linfante, I, Loochtan, Ai, Lukovits, Tg, Male, Ss, Khawaja, Am, Maali, L, Galecio-Castillo, Em, Min, Jy, Mohamed, Ga, Nalleballe, K, Ortega-Gutierrez, S, Radaideh, Y, Ramakrishnan, P, Masoud, He, Reddy, Ab, Ruland, S, Omran, Ss, Sheth, Sa, Puri, As, Rahangdale, Rh, Siegler, Je, Starosciak, Ak, Tarlov, Ne, Taylor, Ra, Tsai, J, Wang, Mj, Wong, Kh, Zaidat, Oo, Hv, Le, Phan, Ht, Ton, Md, Tran, Ad, Sirakova, K, Pham, Tn, Mohlenbruch, Ma, Nagel, S, Raymond, J, Nogueira, Rg, Neurology, ACS - Atherosclerosis & ischemic syndromes, and ANS - Neurovascular Disorders
Subjects: Psychiatry and Mental health, SDG 3 - Good Health and Well-being, COVID-19, SUBARACHNOID HAEMORRHAGE, CEREBROVASCULAR DISEASE, Surgery, Neurology (clinical)
Abstract: BackgroundPrior studies indicated a decrease in the incidences of aneurysmal subarachnoid haemorrhage (aSAH) during the early stages of the COVID-19 pandemic. We evaluated differences in the incidence, severity of aSAH presentation, and ruptured aneurysm treatment modality during the first year of the COVID-19 pandemic compared with the preceding year.MethodsWe conducted a cross-sectional study including 49 countries and 187 centres. We recorded volumes for COVID-19 hospitalisations, aSAH hospitalisations, Hunt-Hess grade, coiling, clipping and aSAH in-hospital mortality. Diagnoses were identified by International Classification of Diseases, 10th Revision, codes or stroke databases from January 2019 to May 2021.ResultsOver the study period, there were 16 247 aSAH admissions, 344 491 COVID-19 admissions, 8300 ruptured aneurysm coiling and 4240 ruptured aneurysm clipping procedures. Declines were observed in aSAH admissions (−6.4% (95% CI −7.0% to −5.8%), p=0.0001) during the first year of the pandemic compared with the prior year, most pronounced in high-volume SAH and high-volume COVID-19 hospitals. There was a trend towards a decline in mild and moderate presentations of subarachnoid haemorrhage (SAH) (mild: −5% (95% CI −5.9% to –4.3%), p=0.06; moderate: −8.3% (95% CI −10.2% to –6.7%), p=0.06) but no difference in higher SAH severity. The ruptured aneurysm clipping rate remained unchanged (30.7% vs 31.2%, p=0.58), whereas ruptured aneurysm coiling increased (53.97% vs 56.5%, p=0.009). There was no difference in aSAH in-hospital mortality rate (19.1% vs 20.1%, p=0.12).ConclusionDuring the first year of the pandemic, there was a decrease in aSAH admissions volume, driven by a decrease in mild to moderate presentation of aSAH. There was an increase in the ruptured aneurysm coiling rate but neither change in the ruptured aneurysm clipping rate nor change in aSAH in-hospital mortality.Trial registration numberNCT04934020.
Published: 2022

14. Primary stroke prevention worldwide: translating evidence into action.

Author: Owolabi M.O., Thrift A.G., Mahal A., Ishida M., Martins S., Johnson W.D., Pandian J., Abd-Allah F., Yaria J., Phan H.T., Roth G., Gall S.L., Beare R., Phan T.G., Mikulik R., Akinyemi R.O., Norrving B., Brainin M., Feigin V.L., Abanto C., Abera S.F., Addissie A., Adebayo O., Adeleye A.O., Adilbekov Y., Adilbekova B., Adoukonou T.A., Aguiar de Sousa D., Ajagbe T., Akhmetzhanova Z., Akpalu A., Alvarez Ahlgren J., Ameriso S., Andonova S., Awoniyi F.E., Bakhiet M., Barboza M., Basri H., Bath P., Bello O., Bereczki D., Beretta S., Berkowitz A., Bernabe-Ortiz A., Bernhardt J., Berzina G., Bisharyan M., Bovet P., Budincevic H., Cadilhac D., Caso V., Chen C., Chin J., Chwojnicki K., Conforto A., Cruz V.T., D'Amelio M., Danielyan K., Davis S., Demarin V., Dempsey R., Dichgans M., Dokova K., Donnan G., Elkind M.S., Endres M., Fischer U., Gankpe F., Gaye Saavedra A., Gil A., Giroud M., Gnedovskaya E., Hachinski V., Hafdi M., Hamadeh R., Hamzat T.K., Hankey G., Heldner M., Ibrahim E.A., Ibrahim N.M., Inoue M., Jee S., Jeng J.-S., Kalkonde Y., Kamenova S., Karaszewski B., Kelly P., Khan T., Kiechl S., Kondybayeva A., Korv J., Kravchenko M., Krishnamurthi R.V., Kruja J., Lakkhanaloet M., Langhorne P., Lavados P.M., Law Z.K., Lawal A., Lazo-Porras M., Lebedynets D., Lee T.-H., Leung T., Liebeskind D.S., Lindsay P., Lopez-Jaramillo P., Lotufo P.A., Machline-Carrion J., Makanjuola A., Markus H.S., Marquez-Romero J.M., Medina M., Medukhanova S., Mehndiratta M.M., Merkin A., Mirrakhimov E., Mohl S., Moscoso-Porras M., Muller-Stierlin A., Murphy S., Musa K.I., Nasreldein A., Nogueira R.G., Nolte C., Noubiap J.J., Novarro-Escudero N., Ogun Y., Oguntoye R.A., Oraby M.I., Osundina M., Ovbiagele B., Orken D.N., Ozdemir A.O., Ozturk S., Paccot M., Phromjai J., Piradov P., Platz T., Potpara T., Ranta A., Rathore F., Richard E., Sacco R.L., Sahathevan R., Santos Carquin I., Saposnik G., Sarfo F.S., Sharma M., Sheth K., Shobhana A., Suwanwela N., Svyato I., Sylaja P.N., Tao X., Thakur K.T., Toni D., Topcuoglu M.A., Torales J., Towfighi A., Truelsen T.C., Tsiskaridze A., Tulloch-Reid M., Useche N., Vanacker P., Vassilopoulou S., Vukorepa G., Vuletic V., Wahab K.W., Wang W., Wijeratne T., Wolfe C., Yifru Y.M., Yock-Corrales A., Yonemoto N., Yperzeele L., Zhang P., Owolabi M.O., Thrift A.G., Mahal A., Ishida M., Martins S., Johnson W.D., Pandian J., Abd-Allah F., Yaria J., Phan H.T., Roth G., Gall S.L., Beare R., Phan T.G., Mikulik R., Akinyemi R.O., Norrving B., Brainin M., Feigin V.L., Abanto C., Abera S.F., Addissie A., Adebayo O., Adeleye A.O., Adilbekov Y., Adilbekova B., Adoukonou T.A., Aguiar de Sousa D., Ajagbe T., Akhmetzhanova Z., Akpalu A., Alvarez Ahlgren J., Ameriso S., Andonova S., Awoniyi F.E., Bakhiet M., Barboza M., Basri H., Bath P., Bello O., Bereczki D., Beretta S., Berkowitz A., Bernabe-Ortiz A., Bernhardt J., Berzina G., Bisharyan M., Bovet P., Budincevic H., Cadilhac D., Caso V., Chen C., Chin J., Chwojnicki K., Conforto A., Cruz V.T., D'Amelio M., Danielyan K., Davis S., Demarin V., Dempsey R., Dichgans M., Dokova K., Donnan G., Elkind M.S., Endres M., Fischer U., Gankpe F., Gaye Saavedra A., Gil A., Giroud M., Gnedovskaya E., Hachinski V., Hafdi M., Hamadeh R., Hamzat T.K., Hankey G., Heldner M., Ibrahim E.A., Ibrahim N.M., Inoue M., Jee S., Jeng J.-S., Kalkonde Y., Kamenova S., Karaszewski B., Kelly P., Khan T., Kiechl S., Kondybayeva A., Korv J., Kravchenko M., Krishnamurthi R.V., Kruja J., Lakkhanaloet M., Langhorne P., Lavados P.M., Law Z.K., Lawal A., Lazo-Porras M., Lebedynets D., Lee T.-H., Leung T., Liebeskind D.S., Lindsay P., Lopez-Jaramillo P., Lotufo P.A., Machline-Carrion J., Makanjuola A., Markus H.S., Marquez-Romero J.M., Medina M., Medukhanova S., Mehndiratta M.M., Merkin A., Mirrakhimov E., Mohl S., Moscoso-Porras M., Muller-Stierlin A., Murphy S., Musa K.I., Nasreldein A., Nogueira R.G., Nolte C., Noubiap J.J., Novarro-Escudero N., Ogun Y., Oguntoye R.A., Oraby M.I., Osundina M., Ovbiagele B., Orken D.N., Ozdemir A.O., Ozturk S., Paccot M., Phromjai J., Piradov P., Platz T., Potpara T., Ranta A., Rathore F., Richard E., Sacco R.L., Sahathevan R., Santos Carquin I., Saposnik G., Sarfo F.S., Sharma M., Sheth K., Shobhana A., Suwanwela N., Svyato I., Sylaja P.N., Tao X., Thakur K.T., Toni D., Topcuoglu M.A., Torales J., Towfighi A., Truelsen T.C., Tsiskaridze A., Tulloch-Reid M., Useche N., Vanacker P., Vassilopoulou S., Vukorepa G., Vuletic V., Wahab K.W., Wang W., Wijeratne T., Wolfe C., Yifru Y.M., Yock-Corrales A., Yonemoto N., Yperzeele L., and Zhang P.
Abstract: Stroke is the second leading cause of death and the third leading cause of disability worldwide and its burden is increasing rapidly in low-income and middle-income countries, many of which are unable to face the challenges it imposes. In this Health Policy paper on primary stroke prevention, we provide an overview of the current situation regarding primary prevention services, estimate the cost of stroke and stroke prevention, and identify deficiencies in existing guidelines and gaps in primary prevention. We also offer a set of pragmatic solutions for implementation of primary stroke prevention, with an emphasis on the role of governments and population-wide strategies, including task-shifting and sharing and health system re-engineering. Implementation of primary stroke prevention involves patients, health professionals, funders, policy makers, implementation partners, and the entire population along the life course.Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Published: 2022

15. Large scale implementation of nurse-initiated protocols for fever, hyperglycaemia and swallowing management: The results of the Qasc Europe project.

Author: Middleton S., Dale S., Mcelduff B., Coughlan K., Mcinnes E., Fischer T., Van De Merwe J., Halvalda R., Grecu A., Mikulik R., Cadilhac D., D'Este C., Levi C., Grimshaw J.M., Quinn C., Cheung N.W., Pfeilschifter W., Middleton S., Dale S., Mcelduff B., Coughlan K., Mcinnes E., Fischer T., Van De Merwe J., Halvalda R., Grecu A., Mikulik R., Cadilhac D., D'Este C., Levi C., Grimshaw J.M., Quinn C., Cheung N.W., and Pfeilschifter W.
Abstract: Introduction: Facilitated implementation of nurse-initiated protocols to manage fever, hyperglycaemia (sugar) and swallowing (FeSS) following stroke significantly reduces 90-day death and disability. We present results on FeSS protocol uptake in multiple European countries, including low-and-middle income countries, following implementation facilitation arising from our international collaboration with the European Stroke Organisation, Angels Initiative, and Registry of Stroke Care Quality. Method(s): Our multi-country, multi-centre, pre-test/post-test study was conducted between 2017- 2021. Data were provided at baseline and three months after FeSS protocol implementation. Nursing clinical champions, with support from the Project team (European Liaison Officer, Angels Consultants, Country Coordinators and the Nursing Research Institute) conducted multidisciplinary workshops to examine baseline results, identify barriers and facilitators to protocol implementation, and held education sessions. Outcomes were adjusted for clustering by country and hospital controlling for age/ sex/NIHSS. Result(s): Data from 76 hospitals (18 countries) were received for 3999 patients at baseline, and from 64 hospitals (17 countries) for 3257 patients post-implementation (Total n=7256). Significantly increased proportion of patients received care from pre to post according to the: fever protocol (Pre: 16%, Post: 51%, p<0.0001): hyperglycaemic protocol (Pre: 16%, Post: 52%, p<0.0001): swallow protocol (Pre: 41%, Post: 67%, p<0.0001); and the FeSS Protocols overall (Pre: 3.2%, Post: 35%, p<0.0001). Significant improvements were also found in low-and-middle income countries. Conclusion(s): Facilitated implementation of nurse-initiated FeSS protocols demonstrated successful large-scale translation of evidence into countries with different health care systems, many of which with no access to reperfusion therapies-a European first. This will reduce death and disability post-stroke.
Published: 2022

16. Exploring stroke care differences between high and middle income European countries for fever, sugar and swallow management (the QASC Europe project).

Author: Middleton S., Dale S., McElduff B., Coughlan K., McInnes E., Fischer T., Van Der Merwe J., Havalda R., Grecu A., Mikulik R., Cadilhac D.A., D'Este C., Levi C., Grimshaw J., Quinn C., Cheung N.W., Pfeilschifter W., Middleton S., Dale S., McElduff B., Coughlan K., McInnes E., Fischer T., Van Der Merwe J., Havalda R., Grecu A., Mikulik R., Cadilhac D.A., D'Este C., Levi C., Grimshaw J., Quinn C., Cheung N.W., and Pfeilschifter W.
Abstract: Background and aim: The QASC Europe project significantly improved nurse-initiated management of fever, hyperglycaemia (sugar) and swallowing (FeSS) in European stroke units with vastly different health care systems. We examined pre-post country management using the 2021-2022 World Bank income classifications. Method(s): This pan-European pre-test/post-test study (2018-2021) collected data at baseline and three months after FeSS protocol implementation. Clinical champions conducted multidisciplinary workshops to feedback baseline audit data, provided education, and identified barriers to protocol implementation. Outcomes were adjusted for age, sex, NIHSS and for clustering by site and country. The interaction between country classification (high income countries [HIC] vs middle income countries [MIC]) and time (pre/post) tested differences in proportions. Result(s): Pre-implementation data were analysed from 76 hospitals in 18 countries (eight HIC, ten MIC) (n=3999 patients); and post-implementation from 64 hospitals in 17 countries (seven HIC and the same ten MIC) (3257 patients). Significant pre-to-post improvements were made in both HIC and MIC (Adjusted difference in proportion HIC:(24% (16%,33%), MIC:(25% (15%,34%)). Post-implementation FeSS Protocol adherence were broadly similar between HIC and MIC. There was no difference in post-implementation overall FeSS Protocol adherence between HIC and MIC (p=0.8909). Conclusion(s): Our nurse-initiated intervention was highly effective in improving stroke management in all countries irrespective of their income level classification. The clinical significance of these improvements in MIC is noteworthy in that many of these hospitals have limited access to stroke care including acute reperfusion therapies. Upscaling of effective stroke interventions is essential to improving stroke care globally.
Published: 2022

17. Primary stroke prevention worldwide: translating evidence into action

Author: Owolabi, MO, Thrift, AG, Mahal, A, Ishida, M, Martins, S, Johnson, W, Pandian, J, Abd-Allah, F, Yaria, J, Phan, HT, Roth, G, Gall, SL, Beare, R, Phan, TG, Mikulik, R, Akinyemi, RO, Norrving, B, Brainin, M, Feigin, VL, Owolabi, MO, Thrift, AG, Mahal, A, Ishida, M, Martins, S, Johnson, W, Pandian, J, Abd-Allah, F, Yaria, J, Phan, HT, Roth, G, Gall, SL, Beare, R, Phan, TG, Mikulik, R, Akinyemi, RO, Norrving, B, Brainin, M, and Feigin, VL
Abstract: Stroke is the second leading cause of death and the third leading cause of disability worldwide and its burden is increasing rapidly in low-income and middle-income countries, many of which are unable to face the challenges it imposes. In this Health Policy paper on primary stroke prevention, we provide an overview of the current situation regarding primary prevention services, estimate the cost of stroke and stroke prevention, and identify deficiencies in existing guidelines and gaps in primary prevention. We also offer a set of pragmatic solutions for implementation of primary stroke prevention, with an emphasis on the role of governments and population-wide strategies, including task-shifting and sharing and health system re-engineering. Implementation of primary stroke prevention involves patients, health professionals, funders, policy makers, implementation partners, and the entire population along the life course.
Published: 2022

18. Current Opinions on Optimal Management of Basilar Artery Occlusion: After the BEST of BASICS Survey

Author: Drumm, B, Banerjee, S, Qureshi, MM, Schonewille, WJ, Klein, P, Huo, X, Chen, Y, Strbian, D, Fischer, U, Puetz, V, Hu, W, Ji, X, Li, C, Alemseged, F, Yamagami, H, Sacco, S, Saposnik, G, Michel, P, Kristoffersen, ES, Sedova, P, Mikulik, R, Siegler, JE, Meinel, TR, Aguiar de Sousa, D, Lobotesis, K, Roi, D, Demeestere, J, Asif, KS, Martins, SO, Abdalkader, M, Goyal, M, Nguyen, TH, Ton, MD, Zhu, Y, Liu, X, Qiu, Z, Miao, Z, Caroff, J, Romoli, M, Diana, F, Thomalla, G, Nagel, S, Sandset, EC, Campbell, BCV, Jovin, TG, Nogueira, RG, Raymond, J, Nguyen, TN, Drumm, B, Banerjee, S, Qureshi, MM, Schonewille, WJ, Klein, P, Huo, X, Chen, Y, Strbian, D, Fischer, U, Puetz, V, Hu, W, Ji, X, Li, C, Alemseged, F, Yamagami, H, Sacco, S, Saposnik, G, Michel, P, Kristoffersen, ES, Sedova, P, Mikulik, R, Siegler, JE, Meinel, TR, Aguiar de Sousa, D, Lobotesis, K, Roi, D, Demeestere, J, Asif, KS, Martins, SO, Abdalkader, M, Goyal, M, Nguyen, TH, Ton, MD, Zhu, Y, Liu, X, Qiu, Z, Miao, Z, Caroff, J, Romoli, M, Diana, F, Thomalla, G, Nagel, S, Sandset, EC, Campbell, BCV, Jovin, TG, Nogueira, RG, Raymond, J, and Nguyen, TN
Abstract: Background The best management of basilar artery occlusion (BAO) remains uncertain. The BASICS (Basilar Artery International Cooperation Study) and the BEST (Basilar Artery Occlusion Endovascular Intervention Versus Standard Medical Treatment) trials reported neutral results. We sought to understand physicians’ approaches to BAOs and whether further BAO randomized controlled trials were warranted. Methods We conducted an online international survey from January to March 2022 to stroke neurologists and neurointerventionalists. Survey questions were designed to examine clinical and imaging parameters under which clinicians would offer (or rescind) a patient with BAO to endovascular therapy (EVT) or best medical management versus enrollment into a randomized clinical trial. Results Of >3002 invited participants, 1245 responded (41.4% response rate) from 73 countries, including 54.7% stroke neurologists and 43.6% neurointerventionalists. More than 95% of respondents would offer EVT to patients with BAO, albeit in various clinical circumstances. There were 70.0% of respondents who indicated that the BASICS and BEST trials did not change their practice. Only 22.1% of respondents would perform EVT according to anterior circulation occlusion criteria. The selection of patients for BAO EVT by clinical severity, timing, and imaging modality differed according to geography, specialty, and country income level. Over 80% of respondents agreed that further randomized clinical trials for BAO were warranted. Moreover, 45.6% of respondents indicated they would find it acceptable to enroll all trial‐eligible patients into the medical arm of a BAO trial, whereas 26.3% would not enroll. Conclusion Most stroke physicians continue to believe in the efficacy of EVT in selected patients with BAO in spite of BEST and BASICS. There is no consensus on which selection criteria to use, and few clinicians would use anterior circulation occlusion criteria for BAOs. Further randomized clinical
Published: 2022

19. Association of statin pre-treatment with baseline stroke severity and outcome in patients with acute ischemic stroke and received reperfusion treatment: An observational study

Author: Escudero-Martínez I, Matusevicius M, Pavia-Nunes A, Sevcik P, Nevsimalova M, Rand VM, Kõrv J, Cappellari M, Mikulik R, Toni D, and Ahmed N
Subjects: Stroke, lipids, prevention, severity, neuroprotection, statins
Abstract: BACKGROUND: Statins have an important role in stroke prevention, especially in high-risk populations and may also affect the initial stroke severity and outcomes in patients taking them before an ischemic stroke. AIMS: Our aim was to evaluate the association of statin pre-treatment with the severity in acute ischemic stroke (AIS). METHODS: We analyzed AIS patients received intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT) and recorded in the SITS International Thrombolysis and Thrombectomy Registry from 2011 to 2017. We identified patients with statin information at baseline. The primary outcome was baseline National Institutes of Health Stroke Scale (NIHSS) score. Secondary outcomes were NIHSS score at 24 h, symptomatic intracerebral hemorrhage (SICH) and functional outcome at 90 days after acute intervention. Multivariable linear and logistic regression and propensity score matching (PSM) was used to quantify the effect of statin pre-treatment. RESULTS: Of 93,849 patients, 23,651 (25.2%) were treated with statins prior the AIS. Statin pre-treatment group was older and had higher comorbidity. Median NIHSS at baseline was similar between groups. In the adjusted and PSM analysis, statin pre-treatment was inversely associated with baseline NIHSS (odds ratio (OR) = 0.77, 95% confidence interval (CI) = 0.6-0.99 and OR for PSM 0.73, 95% CI = 0.54-0.99, p = 0.004) and independently associated with mild stroke defined as NIHSS ?8 in adjusted and PSM analysis (OR = 1.21, 95% CI = 1.1-1.34, p < 0.001 and OR for PSM 1.17, 95% CI = 1.05-1.31, p = 0.007). Regarding secondary outcomes, there were no differences in functional outcomes, death nor SICH rates between groups. CONCLUSION: Prior treatment with statins was associated with lower NIHSS at baseline. However, this association did not translate into any difference regarding functional outcome at 90 days. No association was found regarding SICH. These findings indicate the need of further studies to assess the effect on statin pre-treatment on initial stroke severity.
Published: 2022

20. Frequency and Patterns of Brain Infarction in Patients With Embolic Stroke of Undetermined Source: NAVIGATE ESUS Trial

Author: Sharma, Mukul, primary, Smith, Eric E., additional, Pearce, Lesly A., additional, Shoamanesh, Ashkan, additional, Perera, Kanjana S., additional, Coutts, Shelagh B., additional, Damgaard, Dorte, additional, Ameriso, Sebastian F., additional, Rha, Joung-Ho, additional, Modrau, Boris, additional, Yoon, Byung-Woo, additional, Romano, Marina, additional, Messé, Steven R., additional, Barlinn, Jessica, additional, Lambeck, Johann, additional, Saad, Feryal, additional, Berkowitz, Scott D., additional, Mundl, Hardi, additional, Connolly, Stuart J., additional, Hart, Robert G., additional, Field, T.S., additional, Stotts, G.J., additional, Gladstone, D.J., additional, Phillips, S.J., additional, Sharrief, A., additional, Holmstedt, C., additional, Vora, N., additional, Wilson, C., additional, Coull, B.M., additional, de Havenon, A., additional, Birnbaum, L.A., additional, Patel, N., additional, Hussain, M.S., additional, Greer, D., additional, Chen, S., additional, Kittner, S., additional, Mehta, D., additional, Lowenkopf, T., additional, Sawyer, R., additional, Babikian, V., additional, Zweifler, R., additional, Tirschwell, D.L., additional, Sila, C., additional, Zhang, C., additional, Hong, K-S., additional, Oh, K., additional, Heo, J.H., additional, Bae, H-J., additional, Park, M.S., additional, Kim, J.S., additional, Chung, C-S., additional, Lee, B-C., additional, Povedano, G.P., additional, Martin, J.J., additional, Bruera, G.M., additional, Jure, L.V., additional, Marti-Fabregas, J., additional, Naranjo, I.C., additional, Moreno, J.M.R., additional, Portela, P.C., additional, Gomis, M., additional, Serena, J., additional, Christensen, H., additional, Christensen, T., additional, Knecht, S., additional, Endres, M., additional, Berrouschot, J., additional, Schlachetzki, F., additional, Wunderlich, S., additional, Kraft, P., additional, Guyler, P., additional, Veltkamp, RC., additional, Burn, M., additional, Rashed, K., additional, Macleod, M.J., additional, Canepa, C., additional, Selvarajah, J., additional, Hargroves, D., additional, Behnam, Y., additional, Robinson, T.G., additional, Roveri, L., additional, Lembo, G., additional, Toni, D.S., additional, Monzani, V., additional, Cavallini, A., additional, Popov, D., additional, Friedrich, M., additional, Minelli, C., additional, Moro, C., additional, Gagliardi, R.J., additional, Bacellar, A., additional, Mikulik, R., additional, Eckstein, J., additional, Panczel, G., additional, Szegedi, N., additional, and O’Donnell, M.J., additional
Published: 2022
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21. Treatment of acute stroke: an update

Author: Mikulik, R. and Wahlgren, N.
Published: 2015
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22. Blood pressure excursions in acute ischemic stroke patients treatedwith intravenous thrombolysis

Author: Tsivgoulis, G. Katsanos, A.H. Mandava, P. Kohrmann, M. Soinne, L. Barreto, A.D. Sharma, V.K. Mikulik, R. Muir, K.W. Rothlisberger, T. Grotta, J.C. Levi, C.R. Molina, C.A. Saqqur, M. Mavridis, D. Psaltopoulou, T. Vosko, M.R. Fiebach, J.B. Sandset, E.C. Kent, T.A. Alexandrov, A.W. Schellinger, P.D. Alexandrov, A.V.
Abstract: Objective: To investigate the association of blood pressure BP excursions, defined as greater than 185 SBP or greater than 105 DBP, with the probability of intracranial hemorrhage (ICH) and worse functional outcomes in patients with acute ischemic stroke (AIS) treated with tissue plasminogen activator (tPA). Methods: We performed a post hoc analysis of the CLOTBUST-ER trial. Serial BP measurements were conducted using automated cuff recording according to the recommended BP protocol guidelines for tPA administration. The outcomes were prespecified efficacy and safety endpoints of CLOTBUST-ER. Results: The mean number of serial BP recordings per patient was 37. Of the 674 patients, 227 (34%) had at least one BP excursion (>185/105 mmHg) during the first 24 h following tPA-bolus. The majority of BP excursions (46%) occurred within the first 75min from tPA-bolus. Patients with at least one BP excursion in the first 24 h following tPA bolus had significantly lower rates of independent functional outcome at 90 days (31 vs. 40.1%, P=0.028). The total number of BP excursions was associated with decreased odds of 24-h clinical recovery (OR=0.88, 95% CI:0.80-0.96), 24-h neurological improvement (OR=0.87, 95% CI: 0.81-0.94), 7-day functional improvement (common OR=0.92, 95% CI: 0.87-0.97), 90-day functional improvement (common OR=0.94, 95% CI: 0.88-0.98) and 90-day independent functional outcome (OR=0.90, 95% CI: 0.82-0.98) in analyses adjusted for potential confounders. DBP excursions were independently associated with increased odds of any intracranial hemorrhage (OR=1.26, 95% CI: 1.04-1.53). Conclusion: BP excursions above guideline thresholds during the first 24 h following tPA administration for AIS are common and are independently associated with adverse clinical outcomes. © 2021 Lippincott Williams and Wilkins. All rights reserved.
Published: 2021

23. Safety and outcomes of routine endovascular thrombectomy in large artery occlusion recorded in the SITS Register: An observational study

Author: Ahmed, N. Mazya, M. Nunes, A.P. Moreira, T. Ollikainen, J.P. Escudero-Martinez, I. Bigliardi, G. Dorado, L. Dávalos, A. Egido, J.A. Tassi, R. Strbian, D. Zini, A. Nichelli, P. Herzig, R. Jurák, L. Hurtikova, E. Tsivgoulis, G. Peeters, A. Nevšímalová, M. Brozman, M. Cavallo, R. Lees, K.R. Mikulik, R. Toni, D. Holmin, S.
Abstract: Background and objective: We aimed to evaluate the safety and outcomes of thrombectomy in anterior circulation acute ischaemic stroke recorded in the SITS–International Stroke Thrombectomy Register (SITS-ISTR) and compare them with pooled randomized controlled trials (RCTs) and two national registry studies. Methods: We identified centres recording ≥10 consecutive patients in the SITS-ISTR with at least 70% of available modified Rankin Scale (mRS) at 3 months during 2014–2019. We defined large artery occlusion as intracranial internal carotid artery, first and second segment of middle cerebral artery and first segment of anterior cerebral artery. Outcome measures were functional independence (mRS score 0-2) and death at 3 months and symptomatic intracranial haemorrhage (SICH) per modified SITS-MOST. Results: Results are presented in the following order: SITS-ISTR, RCTs, MR CLEAN Registry and German Stroke Registry (GSR). Median age was 73, 68, 71 and 75 years; baseline NIHSS score was 16, 17, 16 and 15; prior intravenous thrombolysis was 62%, 83%, 78% and 56%; onset to reperfusion time was 289, 285, 267 and 249 min; successful recanalization (mTICI score 2b or 3) was 86%, 71%, 59% and 83%; functional independence at 3 months was 45.5% (95% CI: 44–47), 46.0% (42–50), 38% (35–41) and 37% (35–41), respectively; death was 19.2% (19–21), 15.3% (12.7–18.4), 29.2% (27–32) and 28.6% (27–31); and SICH was 3.6% (3–4), 4.4% (3.0–6.4), 5.8% (4.7–7.1) and not available. Conclusion: Thrombectomy in routine clinical use registered in the SITS-ISTR showed safety and outcomes comparable to RCTs, and better functional outcomes and lower mortality than previous national registry studies. © 2021 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine
Published: 2021

24. Global Impact of COVID-19 on Stroke Care and IV Thrombolysis

Author: Nogueira, R.G. Qureshi, M.M. Abdalkader, M. Martins, S.O. Yamagami, H. Qiu, Z. Mansour, O.Y. Sathya, A. Czlonkowska, A. Tsivgoulis, G. Aguiar de Sousa, D. Demeestere, J. Mikulik, R. Vanacker, P. Siegler, J.E. Kõrv, J. Biller, J. Liang, C.W. Sangha, N.S. Zha, A.M. Czap, A.L. Holmstedt, C.A. Turan, T.N. Ntaios, G. Malhotra, K. Tayal, A. Loochtan, A. Ranta, A. Mistry, E.A. Alexandrov, A.W. Huang, D.Y. Yaghi, S. Raz, E. Sheth, S.A. Mohammaden, M.H. Frankel, M. Bila Lamou, E.G. Aref, H.M. Elbassiouny, A. Hassan, F. Menecie, T. Mustafa, W. Shokri, H.M. Roushdy, T. Sarfo, F.S. Alabi, T.O. Arabambi, B. Nwazor, E.O. Sunmonu, T.A. Wahab, K. Yaria, J. Mohammed, H.H. Adebayo, P.B. Riahi, A.D. Sassi, S.B. Gwaunza, L. Ngwende, G.W. Sahakyan, D. Rahman, A. Ai, Z. Bai, F. Duan, Z. Hao, Y. Huang, W. Li, G. Li, W. Liu, G. Luo, J. Shang, X. Sui, Y. Tian, L. Wen, H. Wu, B. Yan, Y. Yuan, Z. Zhang, H. Zhang, J. Zhao, W. Zi, W. Leung, T.W. Chugh, C. Huded, V. Menon, B. Pandian, J.D. Sylaja, P.N. Usman, F.S. Farhoudi, M. Hokmabadi, E.S. Horev, A. Reznik, A. Sivan Hoffmann, R. Ohara, N. Sakai, N. Watanabe, D. Yamamoto, R. Doijiri, R. Tokuda, N. Yamada, T. Terasaki, T. Yazawa, Y. Uwatoko, T. Dembo, T. Shimizu, H. Sugiura, Y. Miyashita, F. Fukuda, H. Miyake, K. Shimbo, J. Sugimura, Y. Yagita, Y. Takenobu, Y. Matsumaru, Y. Yamada, S. Kono, R. Kanamaru, T. Yamazaki, H. Sakaguchi, M. Todo, K. Yamamoto, N. Sonoda, K. Yoshida, T. Hashimoto, H. Nakahara, I. Kondybayeva, A. Faizullina, K. Kamenova, S. Zhanuzakov, M. Baek, J.-H. Hwang, Y. Lee, J.S. Lee, S.B. Moon, J. Park, H. Seo, J.H. Seo, K.-D. Sohn, S.I. Young, C.J. Ahdab, R. Wan Zaidi, W.A. Aziz, Z.A. Basri, H.B. Chung, L.W. Ibrahim, A.B. Ibrahim, K.A. Looi, I. Tan, W.Y. Yahya, N.W. Groppa, S. Leahu, P. Al Hashmi, A.M. Imam, Y.Z. Akhtar, N. Pineda-Franks, M.C. Co, C.O. Kandyba, D. Alhazzani, A. Al-Jehani, H. Tham, C.H. Mamauag, M.J. Venketasubramanian, N. Chen, C.-H. Tang, S.-C. Churojana, A. Akil, E. Aykaç, Ö. Ozdemir, A.O. Giray, S. Hussain, S.I. John, S. Le Vu, H. Tran, A.D. Nguyen, H.H. Nhu Pham, T. Nguyen, T.H. Nguyen, T.Q. Gattringer, T. Enzinger, C. Killer-Oberpfalzer, M. Bellante, F. De Blauwe, S. Vanhooren, G. De Raedt, S. Dusart, A. Lemmens, R. Ligot, N. Pierre Rutgers, M. Yperzeele, L. Alexiev, F. Sakelarova, T. Bedeković, M.R. Budincevic, H. Cindric, I. Hucika, Z. Ozretic, D. Saric, M.S. Pfeifer, F. Karpowic, I. Cernik, D. Sramek, M. Skoda, M. Hlavacova, H. Klecka, L. Koutny, M. Vaclavik, D. Skoda, O. Fiksa, J. Hanelova, K. Nevsimalova, M. Rezek, R. Prochazka, P. Krejstova, G. Neumann, J. Vachova, M. Brzezanski, H. Hlinovsky, D. Tenora, D. Jura, R. Jurák, L. Novak, J. Novak, A. Topinka, Z. Fibrich, P. Sobolova, H. Volny, O. Krarup Christensen, H. Drenck, N. Klingenberg Iversen, H. Simonsen, C.Z. Truelsen, T.C. Wienecke, T. Vibo, R. Gross-Paju, K. Toomsoo, T. Antsov, K. Caparros, F. Cordonnier, C. Dan, M. Faucheux, J.-M. Mechtouff, L. Eker, O. Lesaine, E. Ondze, B. Peres, R. Pico, F. Piotin, M. Pop, R. Rouanet, F. Gubeladze, T. Khinikadze, M. Lobjanidze, N. Tsiskaridze, A. Nagel, S. Ringleb, P.A. Rosenkranz, M. Schmidt, H. Sedghi, A. Siepmann, T. Szabo, K. Thomalla, G. Palaiodimou, L. Sagris, D. Kargiotis, O. Klivenyi, P. Szapary, L. Tarkanyi, G. Adami, A. Bandini, F. Calabresi, P. Frisullo, G. Renieri, L. Sangalli, D. Pirson, A. Uyttenboogaart, M. van den Wijngaard, I. Kristoffersen, E.S. Brola, W. Fudala, M. Horoch-Lyszczarek, E. Karlinski, M. Kazmierski, R. Kram, P. Rogoziewicz, M. Kaczorowski, R. Luchowski, P. Sienkiewicz-Jarosz, H. Sobolewski, P. Fryze, W. Wisniewska, A. Wiszniewska, M. Ferreira, P. Ferreira, P. Fonseca, L. Marto, J.P. Pinho E Melo, T. Nunes, A.P. Rodrigues, M. Tedim Cruz, V. Falup-Pecurariu, C. Krastev, G. Mako, M. de Leciñana, M.A. Arenillas, J.F. Ayo-Martin, O. Cruz Culebras, A. Tejedor, E.D. Montaner, J. Pérez-Sánchez, S. Tola Arribas, M.A. Rodriguez Vasquez, A. Mayza, M. Bernava, G. Brehm, A. Machi, P. Fischer, U. Gralla, J. Michel, P.L. Psychogios, M.-N. Strambo, D. Banerjee, S. Krishnan, K. Kwan, J. Butt, A. Catanese, L. Demchuk, A.M. Field, T. Haynes, J. Hill, M.D. Khosravani, H. Mackey, A. Pikula, A. Saposnik, G. Scott, C.A. Shoamanesh, A. Shuaib, A. Yip, S. Barboza, M.A. Barrientos, J.D. Portillo Rivera, L.I. Gongora-Rivera, F. Novarro-Escudero, N. Blanco, A. Abraham, M. Alsbrook, D. Altschul, D. Alvarado-Ortiz, A.J. Bach, I. Badruddin, A. Barazangi, N. Brereton, C. Castonguay, A. Chaturvedi, S. Chaudry, S.A. Choe, H. Choi, J.H. Dharmadhikari, S. Desai, K. Devlin, T.G. Doss, V.T. Edgell, R. Etherton, M. Farooqui, M. Frei, D. Gandhi, D. Grigoryan, M. Gupta, R. Hassan, A.E. Helenius, J. Kaliaev, A. Kaushal, R. Khandelwal, P. Khawaja, A.M. Khoury, N.N. Kim, B.S. Kleindorfer, D.O. Koyfman, F. Lee, V.H. Leung, L.Y. Linares, G. Linfante, I. Lutsep, H.L. Macdougall, L. Male, S. Malik, A.M. Masoud, H. McDermott, M. Mehta, B.P. Min, J. Mittal, M. Morris, J.G. Multani, S.S. Nahab, F. Nalleballe, K. Nguyen, C.B. Novakovic-White, R. Ortega-Gutierrez, S. Rahangdale, R.H. Ramakrishnan, P. Romero, J.R. Rost, N. Rothstein, A. Ruland, S. Shah, R. Sharma, M. Silver, B. Simmons, M. Singh, A. Starosciak, A.K. Strasser, S.L. Szeder, V. Teleb, M. Tsai, J.P. Voetsch, B. Balaguera, O. Pujol Lereis, V.A. Luraschi, A. Almeida, M.S. Cardoso, F.B. Conforto, A. De Deus Silva, L. Varrone Giacomini, L. Oliveira Lima, F. Longo, A.L. Magalhães, P.S.C. Martins, R.T. Mont'alverne, F. Mora Cuervo, D.L. Costa Rebello, L. Valler, L. Zetola, V.F. Lavados, P.M. Navia, V. Olavarría, V.V. Almeida Toro, J.M. Amaya, P.F.R. Bayona, H. Corredor, A. Rivera Ordonez, C.E. Mantilla Barbosa, D.K. Lara, O. Patiño, M.R. Diaz Escobar, L.F. Dejesus Melgarejo Fariña, D.E. Cardozo Villamayor, A. Zelaya Zarza, A.J. Barrientos Iman, D.M. Rodriguez Kadota, L. Campbell, B. Hankey, G.J. Hair, C. Kleinig, T. Ma, A. Tomazini Martins, R. Sahathevan, R. Thijs, V. Salazar, D. Yuan-Hao Wu, T. Haussen, D.C. Liebeskind, D. Yavagal, D.R. Jovin, T.G. Zaidat, O.O. Nguyen, T.N. SVIN COVID-19 Global Stroke Registry SVIN COVID-19 Global Stroke Registry
Abstract: OBJECTIVE: To measure the global impact of COVID-19 pandemic on volumes of IV thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with 2 control 4-month periods. METHODS: We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. RESULTS: There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95% confidence interval [CI] -11.7 to -11.3, p < 0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95% CI -13.8 to -12.7, p < 0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95% CI -13.7 to -10.3, p = 0.001). Recovery of stroke hospitalization volume (9.5%, 95% CI 9.2-9.8, p < 0.0001) was noted over the 2 later (May, June) vs the 2 earlier (March, April) pandemic months. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was noted in 3.3% (1,722/52,026) of all stroke admissions. CONCLUSIONS: The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID-19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months. © 2021 American Academy of Neurology.
Published: 2021

25. The state of stroke services across the globe: Report of World Stroke Organization-World Health Organization surveys.

Author: Owolabi M.O., Thrift A.G., Martins S., Johnson W., Pandian J., Abd-Allah F., Varghese C., Mahal A., Yaria J., Phan H.T., Gall S.L., Beare R., Phan T.G., Mikulik R., Feigin V.L., on behalf of the Stroke Experts Collaboration Group, Abera S.F., Addissie A., Adeleye A., Adilbekov Y., Adilbekova B., Adoukonou T.A., Aguiar D.S.D., Akhmetzhanova Z., Akinyemi R.O., Akpalu A., Ameriso S.F., Andonova S., Abanto C., Awoniyi F.E., Bakhiet M., Basri H., Bath P.M., Bereczki D., Beretta S., Berkowitz A.L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M.S., Bovet P., Brainin M., Budincevic H., Cabral N.L., Cadilhac D.A., Caso V., Chen C., Chin J.H., Christensen H., Chwojnicki K., Conforto A.B., Cruz V.T., D'Amelio M., Danielyan K.E., Davis S., Demarin V., Dempsey R.J., Dichgans M., Dokova, Donnan G., Duran J., Elizondo M.A.B., Elkind M.S., Endres M., Etedal I., Faris M.E., Fischer U., Gankpe F., Gavidia M., Gaye-Saavedra A., Giroud M., Gongora-Rivera F., Hachinski V., Hacke W., Hamadeh R.R., Hamzat T.K., Hankey G.J., Heldner M.R., Ibrahim N.M., Inoue M., Jee S., Jiann-Shing J., Johnston S., Kalkonde Y., Kamenova S., Kelly P., Khan T., Kiechl S., Kondybayeva A., Korv J., Kravchenko M., Krishnamurthi R., Langhorne P., Kang Z.L., Kruja J., Lavados P.M., Lebedynets D., Leung T.W., Liebeskind D.S., Lindsay P., Liu L., Lopez-Jaramillo P., Lotufo P.A., Machline-Carrion J.M., Markus H.S., Marquez-Romero J.M., Medina M.T., Medukhanova S., Mehndiratta M.M., Mirrakhimov E., Mohl S., Murphy S., Musa K.I., Nasreldein A., Nogueira R., Nolte C.H., Norrving B., Noubiap J.J., Novarro-Escudero N., O'Donnell M., Ogun V., Oraby M.I., Ovbiagele B., Orken D.N., Ozdemir A.O., Ozturk S., Paccot M., Peters A., Piradov M., Platz T., Potpara T., Ranta A., Rathore F.A., Roth G., Sacco R.L., Sahathevan R., Santos I.C., Saposnik G., Sarfo F.S., Sharma M., Sheth K.N., Shobhana A., Silva S.N., Suwanwela N., Sylaja P.N., Thakur K., Toni D., Topcuoglu M.A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tsong-Hai L., Tulloch-Reid M., Useche J.N., Vanacker P., Vassilopoulou S., Venketasubramanian N., Vukorepa G., Vuletic V., Wahab K.W., Wang W., Wijeratne T., Wolfe C., Yifru M.Y., Yock-Corrales A., Yonemoto N., Yperzeele L., Owolabi M.O., Thrift A.G., Martins S., Johnson W., Pandian J., Abd-Allah F., Varghese C., Mahal A., Yaria J., Phan H.T., Gall S.L., Beare R., Phan T.G., Mikulik R., Feigin V.L., on behalf of the Stroke Experts Collaboration Group, Abera S.F., Addissie A., Adeleye A., Adilbekov Y., Adilbekova B., Adoukonou T.A., Aguiar D.S.D., Akhmetzhanova Z., Akinyemi R.O., Akpalu A., Ameriso S.F., Andonova S., Abanto C., Awoniyi F.E., Bakhiet M., Basri H., Bath P.M., Bereczki D., Beretta S., Berkowitz A.L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M.S., Bovet P., Brainin M., Budincevic H., Cabral N.L., Cadilhac D.A., Caso V., Chen C., Chin J.H., Christensen H., Chwojnicki K., Conforto A.B., Cruz V.T., D'Amelio M., Danielyan K.E., Davis S., Demarin V., Dempsey R.J., Dichgans M., Dokova, Donnan G., Duran J., Elizondo M.A.B., Elkind M.S., Endres M., Etedal I., Faris M.E., Fischer U., Gankpe F., Gavidia M., Gaye-Saavedra A., Giroud M., Gongora-Rivera F., Hachinski V., Hacke W., Hamadeh R.R., Hamzat T.K., Hankey G.J., Heldner M.R., Ibrahim N.M., Inoue M., Jee S., Jiann-Shing J., Johnston S., Kalkonde Y., Kamenova S., Kelly P., Khan T., Kiechl S., Kondybayeva A., Korv J., Kravchenko M., Krishnamurthi R., Langhorne P., Kang Z.L., Kruja J., Lavados P.M., Lebedynets D., Leung T.W., Liebeskind D.S., Lindsay P., Liu L., Lopez-Jaramillo P., Lotufo P.A., Machline-Carrion J.M., Markus H.S., Marquez-Romero J.M., Medina M.T., Medukhanova S., Mehndiratta M.M., Mirrakhimov E., Mohl S., Murphy S., Musa K.I., Nasreldein A., Nogueira R., Nolte C.H., Norrving B., Noubiap J.J., Novarro-Escudero N., O'Donnell M., Ogun V., Oraby M.I., Ovbiagele B., Orken D.N., Ozdemir A.O., Ozturk S., Paccot M., Peters A., Piradov M., Platz T., Potpara T., Ranta A., Rathore F.A., Roth G., Sacco R.L., Sahathevan R., Santos I.C., Saposnik G., Sarfo F.S., Sharma M., Sheth K.N., Shobhana A., Silva S.N., Suwanwela N., Sylaja P.N., Thakur K., Toni D., Topcuoglu M.A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tsong-Hai L., Tulloch-Reid M., Useche J.N., Vanacker P., Vassilopoulou S., Venketasubramanian N., Vukorepa G., Vuletic V., Wahab K.W., Wang W., Wijeratne T., Wolfe C., Yifru M.Y., Yock-Corrales A., Yonemoto N., and Yperzeele L.
Abstract: Background: Improving stroke services is critical for reducing the global stroke burden. The World Stroke Organization-World Health Organization-Lancet Neurology Commission on Stroke conducted a survey of the status of stroke services in low and middle-income countries (LMICs) compared to high-income countries. Method(s): Using a validated World Stroke Organization comprehensive questionnaire, we collected and compared data on stroke services along four pillars of the stroke quadrangle (surveillance, prevention, acute stroke, and rehabilitation) in 84 countries across World Health Organization regions and economic strata. The World Health Organization also conducted a survey of non-communicable diseases in 194 countries in 2019. Result(s): Fewer surveillance activities (including presence of registries, presence of recent risk factors surveys, and participation in research) were reported in low-income countries than high-income countries. The overall global score for prevention was 40.2%. Stroke units were present in 91% of high-income countries in contrast to 18% of low-income countries (p < 0.001). Acute stroke treatments were offered in ~ 60% of high-income countries compared to 26% of low-income countries (p = 0.009). Compared to high-income countries, LMICs provided less rehabilitation services including in-patient rehabilitation, home assessment, community rehabilitation, education, early hospital discharge program, and presence of rehabilitation protocol. Conclusion(s): There is an urgent need to improve access to stroke units and services globally especially in LMICs. Countries with less stroke services can adapt strategies from those with better services. This could include establishment of a framework for regular monitoring of stroke burden and services, implementation of integrated prevention activities and essential acute stroke care services, and provision of interdisciplinary care for stroke rehabilitation.Copyright © 2021 World Stroke Organization.
Published: 2021

26. Reducing inequity in stroke outcomes in low-and-middle-income countries. implementation of nurse-initiated protocols for fever, sugar and swallow management (Qasc Europe project).

Author: Middleton S., Dale S., Mcelduff B., Coughlan K., Mcinnes E., Fischer T., Van Der Merwe J., Halvalda R., Grecu A., Mikulik R., Cadilhac D., D'Este C., Levi C., Grimshaw J.M., Quinn C., Cheung N.W., Pfeilschifter W., Middleton S., Dale S., Mcelduff B., Coughlan K., Mcinnes E., Fischer T., Van Der Merwe J., Halvalda R., Grecu A., Mikulik R., Cadilhac D., D'Este C., Levi C., Grimshaw J.M., Quinn C., Cheung N.W., and Pfeilschifter W.
Abstract: Background and Aims: The QASC Europe project significantly improved nurse-initiated management of: fever, hyperglycaemia (sugar) and swallowing (FeSS) in European stroke units with varying health care systems. We examined pre-post management for low-and-middle-income-countries (LMIC). Method(s): Data from this multi-site, multi-country, pre-test/post-test study (2018-2021) were collected at baseline and three months after FeSS protocol implementation. Clinical champions conducted multidisciplinary workshops to feedback baseline audit data results, provided education, and identified barriers to protocol implementation. Outcomes were adjusted for age, sex, NIHSS, country and within clustering by site. Result(s): Data were received from 76 hospitals in 18 countries (n=4196 patients); and post-implementation, 64 hospitals in 17 countries (3348 patients). 13 hospitals (pre-implementation, n=648 patients) and 9 hospital (post-implementation, n=444 patients) from six LMIC Significant improvements were achieved from pre-to-post implementation in LMIC for: monitoring of temperature at least four times on day three (26% vs 62%, p=0.018); venous blood glucose level (BLG) on admission (86% vs 98%, p=0.0256); BGL monitored four times/day on day of admission to stroke unit (51% vs 84%, p=0.001); swallow screen/assessment performed before oral medication (73% vs 94%, p=0.039); and swallow screen/assessment before being given oral food or fluid (76% vs 93%, p=0.007). Results from LMIC were broadly consistent with those from high-income countries. Conclusion(s): Our nurse-initiated intervention was highly effective in improving stroke outcomes in LMIC. While LMIC are known to have reduced thrombolysis rates, that they are providing comparable evidenced-based care for fever, hyperglycaemia and swallowing is noteworthy. Upscaling of effective stroke interventions is essential to improving stroke outcomes globally.
Published: 2021

27. Safety and outcomes of routine endovascular thrombectomy in large artery occlusion recorded in the SITS Register: An observational study

Author: Ahmed, N, Mazya, M, Nunes, AP, Moreira, T, Ollikainen, JP, Escudero-Martinez, I, Bigliardi, G, Dorado, L, Dávalos, A, Egido, JA, Tassi, R, Strbian, D, Zini, A, Nichelli, P, Herzig, R, Jurák, L, Hurtikova, E, Tsivgoulis, G, Peeters, Anna, Nevšímalová, M, Brozman, M, Cavallo, R, Lees, KR, Mikulik, R, Toni, D, Holmin, S, Ahmed, N, Mazya, M, Nunes, AP, Moreira, T, Ollikainen, JP, Escudero-Martinez, I, Bigliardi, G, Dorado, L, Dávalos, A, Egido, JA, Tassi, R, Strbian, D, Zini, A, Nichelli, P, Herzig, R, Jurák, L, Hurtikova, E, Tsivgoulis, G, Peeters, Anna, Nevšímalová, M, Brozman, M, Cavallo, R, Lees, KR, Mikulik, R, Toni, D, and Holmin, S
Published: 2021

28. The state of stroke services across the globe: Report of World Stroke Organization-World Health Organization surveys

Author: Owolabi, MO, Thrift, AG, Martins, S, Johnson, W, Pandian, J, Abd-Allah, F, Varghese, C, Mahal, A, Yaria, J, Phan, HT, Roth, G, Gall, SL, Beare, R, Phan, TG, Mikulik, R, Norrving, B, Feigin, VL, Owolabi, MO, Thrift, AG, Martins, S, Johnson, W, Pandian, J, Abd-Allah, F, Varghese, C, Mahal, A, Yaria, J, Phan, HT, Roth, G, Gall, SL, Beare, R, Phan, TG, Mikulik, R, Norrving, B, and Feigin, VL
Abstract: BACKGROUND: Improving stroke services is critical for reducing the global stroke burden. The World Stroke Organization-World Health Organization-Lancet Neurology Commission on Stroke conducted a survey of the status of stroke services in low and middle-income countries (LMICs) compared to high-income countries. METHODS: Using a validated World Stroke Organization comprehensive questionnaire, we collected and compared data on stroke services along four pillars of the stroke quadrangle (surveillance, prevention, acute stroke, and rehabilitation) in 84 countries across World Health Organization regions and economic strata. The World Health Organization also conducted a survey of non-communicable diseases in 194 countries in 2019. RESULTS: Fewer surveillance activities (including presence of registries, presence of recent risk factors surveys, and participation in research) were reported in low-income countries than high-income countries. The overall global score for prevention was 40.2%. Stroke units were present in 91% of high-income countries in contrast to 18% of low-income countries (p < 0.001). Acute stroke treatments were offered in ∼ 60% of high-income countries compared to 26% of low-income countries (p = 0.009). Compared to high-income countries, LMICs provided less rehabilitation services including in-patient rehabilitation, home assessment, community rehabilitation, education, early hospital discharge program, and presence of rehabilitation protocol. CONCLUSIONS: There is an urgent need to improve access to stroke units and services globally especially in LMICs. Countries with less stroke services can adapt strategies from those with better services. This could include establishment of a framework for regular monitoring of stroke burden and services, implementation of integrated prevention activities and essential acute stroke care services, and provision of interdisciplinary care for stroke rehabilitation.
Published: 2021

29. Safety and outcomes of routine endovascular thrombectomy in large artery occlusion recorded in the SITS Register: An observational study

Author: Karolinska Institute, Stockholm County Council, Swedish Heart-Lung Foundation, Order of Saint John in Sweden, Friends of Karolinska Institute, Boehringer Ingelheim Fonds, European Commission, Biogen, Stryker, Covidien, Phenox, Ragnar Söderberg Foundation, Torsten Söderberg Foundation, The Erling-Persson Family Foundation, VINNOVA (Sweden), Junta de Andalucía, Ministry of Health of the Czech Republic, Charles University (Czech Republic), Ahmed, Niaz, Mazya, Michael, Paiva Nunes, Ana, Moreira, T., Ollikainen, J. P., Escudero-Martínez, Irene, Bigliardi, G., Dorado, L., Dávalos, Antonio, Egido, J.A., Tassi, R., Strbian, Daniel, Zini, A., Nichelli, P., Herzig, R., Jurák, L., Hurtikova, E., Tsivgoulis, Georgios, Peeters, André, Nevšímalová, M., Brozman, M., Cavallo, R., Lees, K. R., Mikulik, R., Toni, Danilo, Holmin, S., Karolinska Institute, Stockholm County Council, Swedish Heart-Lung Foundation, Order of Saint John in Sweden, Friends of Karolinska Institute, Boehringer Ingelheim Fonds, European Commission, Biogen, Stryker, Covidien, Phenox, Ragnar Söderberg Foundation, Torsten Söderberg Foundation, The Erling-Persson Family Foundation, VINNOVA (Sweden), Junta de Andalucía, Ministry of Health of the Czech Republic, Charles University (Czech Republic), Ahmed, Niaz, Mazya, Michael, Paiva Nunes, Ana, Moreira, T., Ollikainen, J. P., Escudero-Martínez, Irene, Bigliardi, G., Dorado, L., Dávalos, Antonio, Egido, J.A., Tassi, R., Strbian, Daniel, Zini, A., Nichelli, P., Herzig, R., Jurák, L., Hurtikova, E., Tsivgoulis, Georgios, Peeters, André, Nevšímalová, M., Brozman, M., Cavallo, R., Lees, K. R., Mikulik, R., Toni, Danilo, and Holmin, S.
Abstract: [Background and objective] We aimed to evaluate the safety and outcomes of thrombectomy in anterior circulation acute ischaemic stroke recorded in the SITS–International Stroke Thrombectomy Register (SITS-ISTR) and compare them with pooled randomized controlled trials (RCTs) and two national registry studies., [Methods] We identified centres recording ≥10 consecutive patients in the SITS-ISTR with at least 70% of available modified Rankin Scale (mRS) at 3 months during 2014–2019. We defined large artery occlusion as intracranial internal carotid artery, first and second segment of middle cerebral artery and first segment of anterior cerebral artery. Outcome measures were functional independence (mRS score 0-2) and death at 3 months and symptomatic intracranial haemorrhage (SICH) per modified SITS-MOST., [Results] Results are presented in the following order: SITS-ISTR, RCTs, MR CLEAN Registry and German Stroke Registry (GSR). Median age was 73, 68, 71 and 75 years; baseline NIHSS score was 16, 17, 16 and 15; prior intravenous thrombolysis was 62%, 83%, 78% and 56%; onset to reperfusion time was 289, 285, 267 and 249 min; successful recanalization (mTICI score 2b or 3) was 86%, 71%, 59% and 83%; functional independence at 3 months was 45.5% (95% CI: 44–47), 46.0% (42–50), 38% (35–41) and 37% (35–41), respectively; death was 19.2% (19–21), 15.3% (12.7–18.4), 29.2% (27–32) and 28.6% (27–31); and SICH was 3.6% (3–4), 4.4% (3.0–6.4), 5.8% (4.7–7.1) and not available., [Conclusion] Thrombectomy in routine clinical use registered in the SITS-ISTR showed safety and outcomes comparable to RCTs, and better functional outcomes and lower mortality than previous national registry studies.
Published: 2021

30. Safety of performing CT angiography in stroke patients treated with intravenous thrombolysis

Author: Aulicky, P., Mikulik, R., Goldemund, D., Reif, M., Dufek, M., and Kubelka, T.
Subjects: Stroke (Disease) -- Care and treatment, Stroke (Disease) -- Patient outcomes, Stroke (Disease) -- Diagnosis, Angiography -- Usage, Angiography -- Health aspects, Fibrinolysis -- Usage, Fibrinolysis -- Patient outcomes, Health, Psychology and mental health
Published: 2010

31. Safety of early endarterectomy in patients with symptomatic carotid artery stenosis: an international multicenter study

Author: Tsivgoulis, G., Krogias, C., Georgiadis, G. S., Mikulik, R., Safouris, A., Meves, S. H., Voumvourakis, K., Haršány, M., Staffa, R., Papageorgiou, S. G., Katsanos, A. H., Lazaris, A., Mumme, A., Lazarides, M., and Vasdekis, S. N.
Published: 2014
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32. Safety and outcomes of routine endovascular thrombectomy in large artery occlusion recorded in the SITS Register: An observational study

Author: Ahmed, N., primary, Mazya, M., additional, Nunes, A. P., additional, Moreira, T., additional, Ollikainen, J. P., additional, Escudero‐Martinez, I., additional, Bigliardi, G., additional, Dorado, L., additional, Dávalos, A., additional, Egido, J. A., additional, Tassi, R., additional, Strbian, D., additional, Zini, A., additional, Nichelli, P., additional, Herzig, R., additional, Jurák, L., additional, Hurtikova, E., additional, Tsivgoulis, G., additional, Peeters, A., additional, Nevšímalová, M., additional, Brozman, M., additional, Cavallo, R., additional, Lees, K. R, additional, Mikulik, R., additional, Toni, D., additional, and Holmin, S., additional
Published: 2021
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33. Frequency and Predictors of Major Bleeding in Patients With Embolic Strokes of Undetermined Source NAVIGATE-ESUS Trial

Author: Mikulik, R, Eckstein, J, Pearce, LA, Mundl, H, Rudilosso, S, Olavarria, VV, Shoamanesh, A, Chamorro, A, Marti-Fabregas, J, Veltkamp, R, Ozturk, S, Tatlisumak, T, Peacock, WF, Berkowitz, SD, Connolly, SJ, and Hart, RG
Subjects: glomerular filtration rate, infarction, blood pressure, embolism, rivaroxaban
Abstract: Background and Purpose: Risks, sites, and predictors of major bleeding during antithrombotic therapies have not been well defined for patients with recent embolic stroke of undetermined source. Methods: Exploratory analysis of major bleeds defined by International Society of Thrombosis and Hemostasis criteria occurring among 7213 participants in international NAVIGATE (New Approach Rivaroxaban Inhibition of Factor Xa in a Global Trial) embolic stroke of undetermined source randomized trial comparing rivaroxaban 15 mg daily with aspirin 100 mg daily. Results: During a median follow-up of 11 months, 85 major bleeds occurred. The most frequent site was gastrointestinal (38%), followed by intracranial (29%). Assignment to rivaroxaban (hazard ratio [HR], 2.7 [95% CI, 1.7-4.3]), East Asia region (HR, 2.5 [95% CI, 1.6-3.9]), systolic blood pressure >= 160 mm Hg (HR, 2.2 [95% CI, 1.2-3.8]), and reduced estimated glomerular filtration rate (HR, 1.2 per 10 mL/min per 1.73 m(2)decrease, [95% CI, 1.0-1.3]) were independently associated with presence of major bleeds. Five (6%) were fatal. Among 15 patients with intracerebral hemorrhage, 2 (13%) were fatal. There was no evidence of an early high-risk period following initiation of rivaroxaban. The annualized rate of intracerebral hemorrhage was 6-fold higher among East Asian participants (0.67%) versus all other regions (0.11%; HR, 6.3 [95% CI, 2.2-18.0]). Distribution of bleeding sites was similar for rivaroxaban and aspirin. Conclusions: Among embolic stroke of undetermined source patients participating in an international randomized trial, independent predictors of major bleeding were assignment to rivaroxaban, East Asia region, increased systolic blood pressure, and impaired renal function. East Asia as a region was strongly associated with risk of intracerebral hemorrhage. Estimated glomerular filtration rate should be a consideration for stratifying bleeding risk. Registration: URL:. Unique identifier: NCT02313909.
Published: 2020

34. Pulse pressure variability is associated with unfavorable outcomes in acute ischaemic stroke patients treated with intravenous thrombolysis

Author: Katsanos, A.H. Alexandrov, A.V. Mandava, P. Köhrmann, M. Soinne, L. Barreto, A.D. Sharma, V.K. Mikulik, R. Muir, K.W. Rothlisberger, T. Grotta, J.C. Levi, C.R. Molina, C.A. Saqqur, M. Palaiodimou, L. Psaltopoulou, T. Vosko, M.R. Moreira, T. Fiebach, J.B. Rubiera, M. Sandset, E.C. de Havenon, A. Kent, T.A. Alexandrov, A.W. Schellinger, P.D. Tsivgoulis, G. for the CLOTBUST-ER Trial Investigators
Abstract: Background and purpose: Blood pressure (BP) variability has been associated with worse neurological outcomes in acute ischaemic stroke (AIS) patients receiving treatment with intravenous thrombolysis (IVT). However, no study to date has investigated whether pulse pressure (PP) variability may be a superior indicator of the total cardiovascular risk, as measured by clinical outcomes. Methods: Pulse pressure variability was calculated from 24-h PP measurements following tissue plasminogen activator bolus in AIS patients enrolled in the Combined Lysis of Thrombus using Ultrasound and Systemic Tissue Plasminogen Activator for Emergent Revascularization (CLOTBUST-ER) trial. The outcomes of interest were the pre-specified efficacy and safety end-points of CLOTBUST-ER. All associations were adjusted for potential confounders in multivariable regression models. Results: Data from 674 participants was analyzed. PP variability was identified as the BP parameter with the most parsimonious fit in multivariable models of all outcomes, and was independently associated (P
Published: 2020

35. Timing of recanalization and functional recovery in acute ischemic stroke

Author: Tsivgoulis, G. Saqqur, M. Sharma, V.K. Brunser, A. Eggers, J. Mikulik, R. Katsanos, A.H. Sergentanis, T.N. Vadikolias, K. Perren, F. Rubiera, M. Shahripour, R.B. Nguyen, H.T. Martínez-Sánchez, P. Safouris, A. Heliopoulos, I. Shuaib, A. Derksen, C. Voumvourakis, K. Psaltopoulou, T. Alexandrov, A.W. Alexandrov, A.V. CLOTBUST-PRO investigators
Abstract: Background and Purpose Although onset-to-treatment time is associated with early clinical recovery in acute ischemic stroke (AIS) patients treated with intravenous tissue plasminogen activator (tPA), the effect of the timing of tPA-induced recanalization on functional outcomes remains debatable. Methods We conducted a multicenter, prospective observational cohort study to determine whether early (within 1-hour from tPA-bolus) complete or partial recanalization assessed during 2-hour real-time transcranial Doppler monitoring is associated with improved outcomes in patients with proximal occlusions. Outcome events included dramatic clinical recovery (DCR) within 2 and 24-hours from tPA-bolus, 3-month mortality, favorable functional outcome (FFO) and functional independence (FI) defined as modified Rankin Scale (mRS) scores of 0–1 and 0–2 respectively. Results We enrolled 480 AIS patients (mean age 66±15 years, 60% men, baseline National Institutes of Health Stroke Scale score 15). Patients with early recanalization (53%) had significantly (P
Published: 2020

36. PLANNING A MULTI-CENTER EFFICACY TRIAL OF SONOTHROMBOLYSIS: O39

Author: Alexandrov, A. V., Brandt, G., Barreto, A., Schellinger, P. D., Kohrmann, M., Barlinn, K., Mikulik, R., Vosko, M. R., Tsivgoulis, G., Muir, K., Ford, G., and Molina, C. A.
Published: 2011

37. INTRAVENOUS ALTEPLASE IN ISCHAEMIC STROKE PATIENTS NOT FULLY ADHERING TO THE CURRENT DRUG LICENSE IN CENTRAL AND EASTERN EUROPE: 15

Author: Karlinski, M. A., Kobayashi, A., Mikulik, R., Sanak, D., Wahlgren, N., and Czlonkowska, A.
Published: 2011

38. PHYSICIANS DELAY THROMBOLYSIS IF THERE IS MORE TIME TO THE END OF THE THROMBOLYTIC WINDOW: 12

Author: Mikulik, R., Kadlecova, P., Czlonkowska, A., Kobayashi, A., Brozman, M., Švigelj, V., Csiba, L., Fekete, K., Kõrv, J., Damarin, V., Vilionskis, A., Jatuzis, D., Krespi, Y., and Ahmed, N.
Published: 2011

39. Knowledge about stroke in school children. Is it time to teach about stroke at school?: PO20186

Author: Mikulik, R and Pokorna, H
Published: 2010

40. Optimized tPA dosing in correlation with artery status - acute stroke study: preliminary results: PO10409

Author: Brichta, J, Goldemund, D, Kara, T, Bar, M, Reif, M, and Mikulik, R
Published: 2010

41. Calling 911 in response to stroke: no change following a four-year educational campaign: FC50002

Author: Mikulik, R, Goldemund, D, Reif, M, Brichta, J, Neumann, J, Dusek, L, and Kryza, J
Published: 2010

42. OUTCOME OF PATIENTS WITH NEGATIVE CT ANGIOGRAPHY TREATED WITH INTRAVENOUS THROMBOLYSIS: 2

Author: Mikulik, R., Goldemund, D., Reif, M., Bunt, L., Aulicky, P., and Krupa, P.
Published: 2008

43. Safety and efficacy of sonothrombolysis for acute ischaemic stroke: a multicentre, double-blind, phase 3, randomised controlled trial

Author: Alexandrov, A.V. Köhrmann, M. Soinne, L. Tsivgoulis, G. Barreto, A.D. Demchuk, A.M. Sharma, V.K. Mikulik, R. Muir, K.W. Brandt, G. Alleman, J. Grotta, J.C. Levi, C.R. Molina, C.A. Saqqur, M. Mavridis, D. Psaltopoulou, T. Vosko, M. Fiebach, J.B. Mandava, P. Kent, T.A. Alexandrov, A.W. Schellinger, P.D. CLOTBUST-ER Trial Investigators
Abstract: Background: Pulsed-wave ultrasound increases the exposure of an intracranial thrombus to alteplase (recombinant tissue plasminogen activator), potentially facilitating early reperfusion. We aimed to ascertain if a novel operator-independent transcranial ultrasound device delivering low-power high-frequency ultrasound could improve functional outcome in patients treated with alteplase after acute ischaemic stroke. Methods: We did a multicentre, double-blind, phase 3, randomised controlled trial (CLOTBUST-ER) at 76 medical centres in 14 countries. We included patients with acute ischaemic stroke (National Institutes of Health Stroke Scale score ≥10) who received intravenous thrombolysis (alteplase bolus) within 3 h of symptom onset in North America and within 4·5 h of symptom onset in all other countries. Participants were randomly allocated (1:1) via an interactive web response system to either active ultrasound (2 MHz pulsed-wave ultrasound for 120 min [sonothrombolysis]; intervention group) or sham ultrasound (control group). Ultrasound was delivered using an operator-independent device, which had to be activated within 30 min of the alteplase bolus. Participants, investigators, and those assessing outcomes were unaware of group assignments. The primary outcome was improvement in the modified Rankin Scale score at 90 days in patients enrolled within 3 h of symptom onset, assessed in the intention-to-treat population as a common odds ratio (cOR) using ordinal logistic regression shift analysis. This trial is registered with ClinicalTrials.gov, number NCT01098981. The trial was stopped early by the funder after the second interim analysis because of futility. Findings: Between August, 2013, and April, 2015, 335 patients were randomly allocated to the intervention group and 341 patients to the control group. Compared with the control group, the adjusted cOR for an improvement in modified Rankin Scale score at 90 days in the intervention group was 1·05 (95% CI 0·77–1·45; p=0·74). 51 (16%) of 317 patients in the intervention group and 44 (13%) of 329 patients in the control group died (unadjusted OR 1·24, 95% CI 0·80–1·92; p=0·37) and 83 (26%) and 79 (24%), respectively, had serious adverse events (1·12, 0·79–1·60; p=0·53). Interpretation: Sonothrombolysis delivered by an operator-independent device to patients treated with alteplase after acute ischaemic stroke was feasible and most likely safe, but no clinical benefit was seen at 90 days. Sonothrombolysis could be further investigated either in randomised trials undertaken in stroke centres that are dependent on patient transfer for endovascular reperfusion therapies or in countries where these treatments cannot yet be offered as the standard of care. Funding: Cerevast Therapeutics. © 2019 Elsevier Ltd
Published: 2019

44. Safety of urgent endarterectomy in acute non-disabling stroke patients with symptomatic carotid artery stenosis: an international multicenter study

Author: Roussopoulou, A. Tsivgoulis, G. Krogias, C. Lazaris, A. Moulakakis, K. Georgiadis, G.S. Mikulik, R. Kakisis, J.D. Zompola, C. Faissner, S. Chondrogianni, M. Liantinioti, C. Hummel, T. Safouris, A. Matsota, P. Voumvourakis, K. Lazarides, M. Geroulakos, G. Vasdekis, S.N.
Abstract: Background and purpose: International recommendations advocate that carotid endarterectomy (CEA) should be performed within 2 weeks from the index event in symptomatic carotid artery stenosis (sCAS) patients. However, there are controversial data regarding the safety of CEA performed during the first 2 days of ictus. The aim of this international, multicenter study was to prospectively evaluate the safety of urgent (0–2 days) in comparison to early (3–14 days) CEA in patients with sCAS. Methods: Consecutive patients with non-disabling (modified Rankin Scale scores ≤2) acute ischaemic stroke or transient ischaemic attack due to sCAS (≥70%) underwent urgent or early CEA at five tertiary-care stroke centers during a 6-year period. The primary outcome events included stroke, myocardial infarction or death during the 30-day follow-up period. Results: A total of 311 patients with sCAS underwent urgent (n = 63) or early (n = 248) CEA. The two groups did not differ in baseline characteristics with the exception of crescendo transient ischaemic attacks (21% in urgent vs. 7% in early CEA; P = 0.001). The 30-day rates of stroke did not differ (P = 0.333) between patients with urgent (7.9%; 95% confidence interval 3.1%–17.7%) and early (4.4%; 95% confidence interval 2.4%–7.9%) CEA. The mortality and myocardial infarction rates were similar between the two groups. The median length of hospitalization was shorter in urgent CEA [6 days (interquartile range 4–6) vs. 10 days (interquartile range 7–14); P
Published: 2019

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

Author: Alexandrov, A.V. Tsivgoulis, G. Köhrmann, M. Katsanos, A.H. Soinne, L. Barreto, A.D. Rothlisberger, T. Sharma, V.K. Mikulik, R. Muir, K.W. Levi, C.R. Molina, C.A. Saqqur, M. Mavridis, D. Psaltopoulou, T. Vosko, M.R. Fiebach, J.B. Mandava, P. Kent, T.A. Alexandrov, A.W. Schellinger, P.D. for the CLOTBUST-ER Trial Investigators
Abstract: Background: Results of our recently published phase III randomized clinical trial of ultrasound-enhanced thrombolysis (sonothrombolysis) using an operator-independent, high frequency ultrasound device revealed heterogeneity of patient recruitment among centers. Methods: We performed a post hoc analysis after excluding subjects that were recruited at centers reporting a decline in the balance of randomization between sonothrombolysis and concurrent endovascular trials. Results: From a total of 676 participants randomized in the CLOTBUST-ER trial we identified 52 patients from 7 centers with perceived equipoise shift in favor of endovascular treatment. Post hoc sensitivity analysis in the intention-to-treat population adjusted for age, National Institutes of Health Scale score at baseline, time from stroke onset to tPA bolus and baseline serum glucose showed a significant (p < 0.01) interaction of perceived endovascular equipoise shift on the association between sonothrombolysis and 3 month functional outcome [adjusted common odds ratio (cOR) in centers with perceived endovascular equipoise shift: 0.22, 95% CI 0.06–0.75; p = 0.02; adjusted cOR for centers without endovascular equipoise shift: 1.20, 95% CI 0.89–1.62; p = 0.24)]. After excluding centers with perceived endovascular equipoise shift, patients randomized to sonothrombolysis had higher odds of 3 month functional independence (mRS scores 0–2) compared with patients treated with tPA only (adjusted OR: 1.53; 95% CI 1.01–2.31; p = 0.04). Conclusion: Our experience in CLOTBUST-ER indicates that increasing implementation of endovascular therapies across major academic stroke centers raises significant challenges for clinical trials aiming to test noninterventional or adjuvant reperfusion strategies. © The Author(s), 2019.
Published: 2019

46. CLOTBUST-PRO: prospective multi-national CLOTBUST collaboration on reperfusion therapies for stroke: 019

Author: Saqqur, M, Tsivgoulis, G, Molina, C A, Garami, Zs, Barreto, A, Demchuk, A M, Spengos, K, Sharma, V K, and Mikulik, R
Published: 2007

47. Ultraearly intravenous thrombolysis for acute ischemic stroke in mobile stroke unit and hospital settings: A comparative analysis

Author: Tsivgoulis, G. Geisler, F. Katsanos, A.H. Kõrv, J. Kunz, A. Mikulik, R. Rozanski, M. Wendt, M. Audebert, H.J.
Abstract: Background and Purpose-Mobile stroke units (MSUs) are known to increase the proportion of acute ischemic stroke (AIS) patients treated with intravenous thrombolysis (IVT) in the first golden hour (GH) after onset compared with hospital settings (HS). However, because of the low number of AIS patients treated with intravenous thrombolysis within this ultraearly time window in conventional care, characteristics, and outcome of this subgroup of AIS patients have not been compared between MSU and HS. Methods-MSU-GH patients were selected from the Berlin-based MSU (STEMO [Stroke Emergency Mobile]), whereas HS-GH patients were selected from the SITS-EAST (Safe Implementation of Treatments in Stroke-East) registry. The outcome events of interest included the rates of favorable functional outcome (modified Rankin Scale scores of 0 or 1), distribution of the modified Rankin Scale scores, and mortality after 3 months between MSU-GH and HS-GH groups. Results-We identified 117 MSU-GH (38.4% of 305 MSU-treated patients) and 136 HS-GH (0.9% of 15 591 HS-treated patients) eligible patients without prestroke disability. No significant differences were documented in the rates of favorable functional outcome (51.3% versus 46.2%, P=0.487) and mortality (7.7% versus 9.9%, P=0.576) at 3 months, or in the distribution of 3-month modified Rankin Scale scores between the 2 groups (P=0.196). In multivariable logistic regression analyses, adjusting for potential confounders, MSU treatment was not associated with a significantly different likelihood of favorable functional outcome (odds ratio, 1.84 for MSU patients; 95% CI, 0.86-3.96) or mortality (odds ratio, 0.95; 95% CI, 0.28-3.20) at 3 months. Conclusions-There is no evidence that safety and efficacy of ultraearly intravenous thrombolysis for AIS differs when used in MSUs or in HS. © 2018 American Heart Association, Inc.
Published: 2018

48. Neuroimaging and clinical outcomes of oral anticoagulant–associated intracerebral hemorrhage

Author: Tsivgoulis, G. Wilson, D. Katsanos, A.H. Sargento-Freitas, J. Marques-Matos, C. Azevedo, E. Adachi, T. von der Brelie, C. Aizawa, Y. Abe, H. Tomita, H. Okumura, K. Hagii, J. Seiffge, D.J. Lioutas, V.-A. Traenka, C. Varelas, P. Basir, G. Krogias, C. Purrucker, J.C. Sharma, V.K. Rizos, T. Mikulik, R. Sobowale, O.A. Barlinn, K. Sallinen, H. Goyal, N. Yeh, S.-J. Karapanayiotides, T. Wu, T.Y. Vadikolias, K. Ferrigno, M. Hadjigeorgiou, G. Houben, R. Giannopoulos, S. Schreuder, F.H.B.M. Chang, J.J. Perry, L.A. Mehdorn, M. Marto, J.-P. Pinho, J. Tanaka, J. Boulanger, M. Salman, R.A.-S. Jäger, H.R. Shakeshaft, C. Yakushiji, Y. Choi, P.M.C. Staals, J. Cordonnier, C. Jeng, J.-S. Veltkamp, R. Dowlatshahi, D. Engelter, S.T. Parry-Jones, A.R. Meretoja, A. Mitsias, P.D. Alexandrov, A.V. Ambler, G. Werring, D.J.
Subjects: cardiovascular diseases, nervous system diseases
Abstract: Objective: Whether intracerebral hemorrhage (ICH) associated with non–vitamin K antagonist oral anticoagulants (NOAC-ICH) has a better outcome compared to ICH associated with vitamin K antagonists (VKA-ICH) is uncertain. Methods: We performed a systematic review and individual patient data meta-analysis of cohort studies comparing clinical and radiological outcomes between NOAC-ICH and VKA-ICH patients. The primary outcome measure was 30-day all-cause mortality. All outcomes were assessed in multivariate regression analyses adjusted for age, sex, ICH location, and intraventricular hemorrhage extension. Results: We included 7 eligible studies comprising 219 NOAC-ICH and 831 VKA-ICH patients (mean age = 77 years, 52.5% females). The 30-day mortality was similar between NOAC-ICH and VKA-ICH (24.3% vs 26.5%; hazard ratio = 0.94, 95% confidence interval [CI] = 0.67–1.31). However, in multivariate analyses adjusting for potential confounders, NOAC-ICH was associated with lower admission National Institutes of Health Stroke Scale (NIHSS) score (linear regression coefficient = −2.83, 95% CI = −5.28 to −0.38), lower likelihood of severe stroke (NIHSS > 10 points) on admission (odds ratio [OR] = 0.50, 95% CI = 0.30–0.84), and smaller baseline hematoma volume (linear regression coefficient = −0.24, 95% CI = −0.47 to −0.16). The two groups did not differ in the likelihood of baseline hematoma volume < 30cm3 (OR = 1.14, 95% CI = 0.81–1.62), hematoma expansion (OR = 0.97, 95% CI = 0.63–1.48), in-hospital mortality (OR = 0.73, 95% CI = 0.49–1.11), functional status at discharge (common OR = 0.78, 95% CI = 0.57–1.07), or functional status at 3 months (common OR = 1.03, 95% CI = 0.75–1.43). Interpretation: Although functional outcome at discharge, 1 month, or 3 months was comparable after NOAC-ICH and VKA-ICH, patients with NOAC-ICH had smaller baseline hematoma volumes and less severe acute stroke syndromes. Ann Neurol 2018;84:702–712. © 2018 American Neurological Association
Published: 2018

49. Rivaroxaban for Stroke Prevention after Embolic Stroke of Undetermined Source

Author: Hart, RG, Sharma, M, Mundl, H, Kasner, SE, Bangdiwala, SI, Berkowitz, SD, Swaminathan, B, Lavados, P, Wang, Y, Davalos, A, Shamalov, N, Mikulik, R, Cunha, L, Lindgren, A, Arauz, A, Lang, W, Czlonkowska, A, Eckstein, J, Gagliardi, RJ, Amarenco, P, Ameriso, SF, Tatlisumak, T, Veltkamp, R, Hankey, GJ, Toni, D, Bereczki, D, Uchiyama, S, Ntaios, G, Yoon, BW, Brouns, R, Endres, M, Muir, KW, Bornstein, N, Ozturk, S, O'Donnell, MJ, Basson, MMD, Pare, G, Pater, C, Kirsch, B, Sheridan, P, Peters, G, Weitz, JI, Peacock, WF, Shoamanesh, A, Benavente, OR, Joyner, C, Themeles, E, and Connolly, SJ
Abstract: BACKGROUND Embolic strokes of undetermined source represent 20% of ischemic strokes and are associated with a high rate of recurrence. Anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, may result in a lower risk of recurrent stroke than aspirin. METHODS We compared the efficacy and safety of rivaroxaban (at a daily dose of 15 mg) with aspirin (at a daily dose of 100 mg) for the prevention of recurrent stroke in patients with recent ischemic stroke that was presumed to be from cerebral embolism but without arterial stenosis, lacune, or an identified cardioembolic source. The primary efficacy outcome was the first recurrence of ischemic or hemorrhagic stroke or systemic embolism in a time-to-event analysis; the primary safety outcome was the rate of major bleeding. RESULTS A total of 7213 participants were enrolled at 459 sites; 3609 patients were randomly assigned to receive rivaroxaban and 3604 to receive aspirin. Patients had been followed for a median of 11 months when the trial was terminated early because of a lack of benefit with regard to stroke risk and because of bleeding associated with rivaroxaban. The primary efficacy outcome occurred in 172 patients in the rivaroxaban group (annualized rate, 5.1%) and in 160 in the aspirin group (annualized rate, 4.8%) (hazard ratio, 1.07; 95% confidence interval [CI], 0.87 to 1.33; P=0.52). Recurrent ischemic stroke occurred in 158 patients in the rivaroxaban group (annualized rate, 4.7%) and in 156 in the aspirin group (annualized rate, 4.7%). Major bleeding occurred in 62 patients in the rivaroxaban group (annualized rate, 1.8%) and in 23 in the aspirin group (annualized rate, 0.7%) (hazard ratio, 2.72; 95% CI, 1.68 to 4.39; P
Published: 2018

50. P1455Atrial fibrillation detection by integrated trans-telephonic ECG monitoring after cryptogenic stroke in the years 2016–2018 in the Czech and Slovak Republics

Author: Bulkova, V, primary, Sanak, D, additional, Tomek, A, additional, Brozman, M, additional, Gandalovicova, J, additional, Kovarikova, D, additional, Pelikanova, V, additional, Mikulik, R, additional, Nevsimalova, M, additional, Monhart, Z, additional, Palanova, A, additional, Taborsky, M, additional, Linhart, A, additional, and Fiala, M, additional
Published: 2019
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