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1. SPIRou: nIR velocimetry & spectropolarimetry at the CFHT

Author

Donati, J. -F., Kouach, D., Moutou, C., Doyon, R., Delfosse, X., Artigau, E., Baratchart, S., Lacombe, M., Barrick, G., Hebrard, G., Bouchy, F., Saddlemyer, L., Pares, L., Rabou, P., Micheau, Y., Dolon, F., Reshetov, V., Challita, Z., Carmona, A., Striebig, N., Thibault, S., Martioli, E., Cook, N., Fouque, P., Vermeulen, T., Wang, S. Y., Arnold, L., Pepe, F., Boisse, I., Figueira, P., Bouvier, J., Ray, T. P., Feugeade, C., Morin, J., Alencar, S., Hobson, M., Castilho, B., Udry, S., Santos, N. C., Hernandez, O., Benedict, T., Vallee, P., Gallou, G., Dupieux, M., Larrieu, M., Perruchot, S., Sottile, R., Moreau, F., Usher, C., Baril, M., Wildi, F., Chazelas, B., Malo, L., Bonfils, X., Loop, D., Kerley, D., Wevers, I., Dunn, J., Pazder, J., Macdonald, S., Dubois, B., Carrie, E., Valentin, H., Henault, F., Yan, C. H., and Steinmetz, T.

Subjects
Astrophysics - Instrumentation and Methods for Astrophysics, Astrophysics - Earth and Planetary Astrophysics, Astrophysics - Solar and Stellar Astrophysics
Abstract

This paper presents an overview of SPIRou, the new-generation near-infrared spectropolarimeter / precision velocimeter recently installed on the 3.6-m Canada-France-Hawaii Telescope (CFHT). Starting from the two main science goals, namely the quest for planetary systems around nearby M dwarfs and the study of magnetized star / planet formation, we outline the instrument concept that was designed to efficiently address these forefront topics, and detail the in-lab and on-sky instrument performances measured throughout the intensive testing phase that SPIRou was submitted to before passing the final acceptance review in early 2019 and initiating science observations. With a central position among the newly started programmes, the SPIRou Legacy Survey (SLS) Large Programme was allocated 300 CFHT nights until at least mid 2022. We also briefly describe a few of the first results obtained in the various science topics that SPIRou started investigating, focusing in particular on planetary systems of nearby M dwarfs, transiting exoplanets and their atmospheres, magnetic fields of young stars, but also on alternate science goals like the atmospheres of M dwarfs and the Earth's atmosphere. We finally conclude on the essential role that SPIRou and the CFHT can play in coordination with forthcoming major facilities like the JWST, the ELTs, PLATO and ARIEL over the decade., Comment: MNRAS, in press (20 pages, 18 figures, 1 table)

Published
2020
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5. Sympathetic activity is not a main cause of blood pressure reduction with exercise training in un-medicated middle-aged/older men

Author

Ehlers, Thomas Svare, Møller, Sophie, Hansen, Camilla Collin, Tamariz-Ellemann, Andrea Sofia, Vermeulen, T D, Shoemaker, J K, Gliemann, Lasse, Hellsten, Ylva, Ehlers, Thomas Svare, Møller, Sophie, Hansen, Camilla Collin, Tamariz-Ellemann, Andrea Sofia, Vermeulen, T D, Shoemaker, J K, Gliemann, Lasse, and Hellsten, Ylva

Abstract

Background: This study tested the hypothesis that training reduces resting sympathetic activity and improves baroreflex control in both hypertensive and normotensive men but reduces blood pressure only in hypertensive men.Methods: Middle-aged/older un-medicated stage-1 hypertensive males (mean age 55±3 yrs; n=13) and normotensive controls (mean age 60±5 yrs; n=12) participated in 8 weeks of supervised high-intensity interval spinning training. Before and after training, muscle sympathetic nerve activity (MSNA) and blood pressure were measured at rest and during a sympatho-excitatory cold pressor test (CPT). Based on the measurements, baroreceptor sensitivity and baroreceptor threshold were calculated.Results: Resting MSNA and baroreceptor sensitivity were similar for the hypertensive and the normotensive groups. Training lowered MSNA (p<0.05), expressed as burst frequency (burst/min), overall, and to a similar extent, in both groups (17 and 27%, respectively in hypertensive and normotensive group), whereas blood pressure was only significantly (p<0.05) lowered (by 4 mmHg in both systolic and diastolic pressure) in the hypertensive group. Training did not (p>0.05) alter the MSNA or blood pressure response to CPT or increase baroreceptor sensitivity but reduced (p<0.05) the baroreceptor threshold with a main effect for both groups. Training adherence and intensity was similar in both groups yet absolute maximal oxygen uptake increased by 15% in the normotensive group only.Conclusion: The dissociation between the training induced changes in resting MSNA, lack of change in baroreflex sensitivity and the change in blood pressure, suggests that MSNA is not a main cause of the blood pressure reduction with exercise training in un-medicated middle-aged/older men.

Published
2023

7. Onderzoek Opkopen vakantieparken. Omvang • Impacts • Instrumentarium

Author

Eijgelaar, Eke, de Haan, F., Hartman, S., Heslinga, J, Klijs, Jeroen, Kornet, A.J., Mosmans, H., Neelis, Ivar, Nijdam, R, Nijland, D., Peeters, Paul, van der Sterren, Jos, Vermeulen, T., Centre for Sustainability, Tourism and Transport (CSTT), Academy for Tourism, and Research group for Tourism Impacts on Society

Subjects
holiday park, jurisdiction, holiday home, impact, takeover, trailer
Published
2022

9. Radicaal duurzaam toerisme : een trend om mee te dealen

Author

van Adrichem, Cheryl, Buijtendijk, Harald, Eijgelaar, Eke, Duineveld, M, Koens, K, Fletcher, R, Koot, S, Huijbens, E.H., Vermeulen, T, Academy for Tourism, Centre for Sustainability, Tourism and Transport (CSTT), and Academy for Hotel & Facility

Subjects
radical change, aviation, degrowth, sustainable tourism, tourism policy
Abstract

Toerisme’s toenemende luchtvaartafhankelijkheid is een enorme barriere voor echte verduurzaming, terwijl aan dit laatste niet meer te ontkomen is. Dit essay presenteert daarom een radicaal alternatief voor planeetvriendelijk toerisme

Published
2022

10. Dutch Grand Prix als vliegwiel voor integrale ontwikkeling Zandvoort

Author

Zegers, Kristel, Weppner, Jeroen, Klijs, Jeroen, Vermeulen, T, Placemaking and Events, Academy for Leisure & Events, Smart Cities and Logistics, Leisure and Tourism Experiences, Academy for Built Environment & Logistics, Academy for Tourism, and Research group for Tourism Impacts on Society

Published
2022

12. De carbon-footprint van Nederlandse toeristen

Author

Eijgelaar, Eke, Neelis, Ivar, Peeters, Paul, Vermeulen, T, Centre for Sustainability, Tourism and Transport (CSTT), and Academy for Tourism

Subjects
carbon footprint, climate change, tourism emissions, tourism transport, Netherlands
Published
2022

13. Onderzoek Opkopen Vakantieparken

Author

Vermeulen, T., Klijs, Jeroen, Academy for Tourism, and Research group for Tourism Impacts on Society

Subjects
opkopen vakantieparken
Published
2022

15. Beleving ontrafeld : een samenvatting van 5 jaar promotieonderzoek naar de rol van emoties in beleving

Author

Strijbosch, Wim, Bastiaansen, Marcel, Mitas, Ondrej, Gelissen, JPTM, Vermeulen, T, Leisure and Tourism Experiences, Academy for Leisure & Events, Storytelling, Research group for Tourism Impacts on Society, and Academy for Tourism

Abstract

Beleving is één van de belangrijkste concepten in de toerisme- en vrijetijdssector. Het maakt het verschil in of men voor het ene of het andere vrijetijdsproduct kiest (Mommaas, 2000) maar levert bijvoorbeeld ook een grote bijdrage aan geluk en welzijn (Nawijn & Strijbosch, 2021). Ergens weet iedereen wel wat beleving is. Dat is niet gek, want iedereen is een expert in het hebben van belevingen uit de eerste hand. Toch werd er tot voor kort weinig discussie gevoerd in de wetenschappelijke vrijetijd- en toerismeliteratuur over de definitie van het begrip beleving. Dat is vreemd voor een begrip waar zo’n belang aan wordt gehecht. In het Experience Lab op Breda University of Applied Sciences wordt daarom al enige tijd onderzoek gedaan naar de verschillende onderliggende processen van beleving en wordt gebruik gemaakt van de modernste technieken om die processen te kunnen meten

Published
2022

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

Author

Guglielmi, V., LeCouffe, N.E., Zinkstok, S.M., Compagne, K.C.J., Eker, R., Treurniet, K.M., Tolhuisen, M.L., Worp, H.B. van der, Jansen, I.G.H., Oostenbrugge, R.J. van, Marquering, H.A., Dippel, D.W.J., Emmer, B.J., Majoie, C.B.L.M., Roos, Y.B.W.E.M., Coutinho, J.M., Lugt, A. van der, Zwam, W.H. van, Boiten, J., Vos, J.A., Mulder, M.J.H.L., Goldhoorn, R.J.B., Kappelhof, M., Schonewille, W.J., Wermer, M.J.H., Walderveen, M.A.A. van, Staals, J., Hofmeijer, J., Martens, J.M., Nijeholt, G.J.L.A., Roozenbeek, B., Bruijn, S.F. de, Dijk, L.C. van, R.H. lo, Dijk, E.J. van, Boogaarts, H.D., Kort, P.L.M. de, Peluso, J.P., Berg, J.S.P. van den, Hasselt, B.A.A.M. van, Aerden, L.A.M., Dallinga, R.J., Uyttenboogaart, M., Eshghi, O., Schreuder, T.H.C.M.L., Heijboer, R.J.J., Keizer, K., Yo, L.S.F., Hertog, H.M. den, Sturm, E.J.C., Sprengers, M.E.S., Jenniskens, S.F.M., Berg, R. van den, Yoo, A.J., Beenen, L.F.M., Postma, A.A., Roosendaal, S.D., Kallen, B.F.W. van der, Wijngaard, I.R. van den, Es, A.C.G.M. van, Bot, J., Doormaal, P.J. van, Flach, H.Z., Lingsma, H.F., Ghannouti, N. el, Sterrenberg, M., Puppels, C., Pellikaan, W., Sprengers, R., Elfrink, M., Meris, J. de, Vermeulen, T., Geerlings, A., Vemde, G. van, Simons, T., Rijswijk, C. van, Messchendorp, G., Bongenaar, H., Bodde, K., Kleijn, S., Lodico, J., Droste, H., Wollaert, M., Jeurrissen, D., Bos, E., Drabbe, Y., Aaldering, N., Zweedijk, B., Khalilzada, M., Venema, E., Chalos, V., Geuskens, R.R., Straaten, T. van, Ergezen, S., Harmsma, R.R.M., Muijres, D., Jong, A. de, Hinsenveld, W., Berkhemer, O.A., Boers, A.M.M., Huguet, J., Groot, P.F.C., Mens, M.A., Kranendonk, K.R. van, Tolhuijsen, M.L., Alves, H., MR-CLEAN Registry Investigators, Neurology, Radiology and nuclear medicine, VU University medical center, Pediatric surgery, ACS - Atherosclerosis & ischemic syndromes, Radiology & Nuclear Medicine, ​Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Graduate School, ACS - Microcirculation, ACS - Pulmonary hypertension & thrombosis, ANS - Neurovascular Disorders, Radiology and Nuclear Medicine, AGEM - Re-generation and cancer of the digestive system, AGEM - Digestive immunity, CCA - Imaging and biomarkers, ARD - Amsterdam Reproduction and Development, MUMC+: MA Neurologie (3), Klinische Neurowetenschappen, RS: Carim - B05 Cerebral small vessel disease, RS: CARIM - R3.03 - Cerebral small vessel disease, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: Carim - B06 Imaging, RS: CARIM - R3.11 - Imaging, Promovendi CD, MUMC+: MA AIOS Neurologie (9), MUMC+: MA Med Staf Spec Neurologie (9), MUMC+: DA BV AIOS Nucleaire Geneeskunde (9), MUMC+: DA BV AIOS Radiologie (9), and MUMC+: MA Niet Med Staf Neurologie (9)

Subjects
Carotid Artery Diseases, Male, endovascular treatment, Original Contributions, FEATURES, EMBOLIC STROKES, Brain Ischemia, Modified Rankin Scale, Occlusion, Medicine, Advanced and Specialised Nursing, Registries, collateral circulation, ACUTE ISCHEMIC-STROKE, Stroke, HYPOPERFUSION, Aged, 80 and over, education.field_of_study, Brain, Atrial fibrillation, Middle Aged, THROMBECTOMY, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Collateral circulation, ETIOLOGY, Intracranial Embolism, Cardiology, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Female, Internal carotid artery, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, atherothrombotic stroke, Population, Clinical Sciences, Clinical Neurology, UNDETERMINED SOURCE, CLASSIFICATION, All institutes and research themes of the Radboud University Medical Center, medicine.artery, Internal medicine, ischemic stroke, Humans, cardiovascular diseases, education, cardiac emboli, Aged, Advanced and Specialized Nursing, business.industry, Other Research Radboud Institute for Health Sciences [Radboudumc 0], medicine.disease, CT ANGIOGRAPHY, Stenosis, ATRIAL-FIBRILLATION, Neurology (clinical), business
Abstract

Supplemental Digital Content is available in the text., Background and Purpose— Due to chronic hypoperfusion, cervical atherosclerosis may promote cerebral collateral circulation. We hypothesized that patients with ischemic stroke due to cervical carotid atherosclerosis have a more extensive collateral circulation and better outcomes than patients with cardioembolism. We tested this hypothesis in a population of patients who underwent endovascular treatment for large vessel occlusion. Methods— From the MR-CLEAN Registry (Multicenter Randomized Controlled Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands), we selected consecutive adult endovascular treatment patients (March 2014 to June 2016) with acute ischemic stroke due to anterior circulation large vessel occlusion and compared patients with cervical carotid artery stenosis >50% to those with cardioembolic etiology. The primary outcome was collateral score, graded on a 4-point scale. Secondary outcomes included the modified Rankin Scale (mRS) score and mortality at 90 days. We performed multivariable regression analyses and adjusted for potential confounders. Results— Of 1627 patients in the Registry, 190 patients with cervical carotid atherosclerosis and 476 with cardioembolism were included. Patients with cervical carotid atherosclerosis were younger (median 69 versus 76 years, P

Published
2019
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19. Urban agriculture and plant diseases

Author

Veen, E.J., Jansma, J.E., Vermeulen, T., and van de Vlasakker, Paulien

Subjects
OT Team Agriculture & Society, Life Science, Rurale Sociologie, OT Team Landbouw & Samenleving, Rural Sociology
Published
2021

25. Meten van dagbezoek : van vergeten onderwerp naar urgentie

Author

Klijs, Jeroen, Atai, Jalal, Bijl, J., Korteweg Maris, D, Weppner, Jeroen, Vermeulen, T, Bijl, J, Rooijackers, M, Heslinga, J, Politiek, M, Heerschap, N, Schreven, L, van Wijk, K, Academy for Tourism, Academy for Built Environment & Logistics, and Research group for Tourism Impacts on Society

Subjects
meten, big data, Trendrapport, dagbezoek
Published
2020

26. Stadslandbouw en plantenziekten

Author

Veen, E.J., Jansma, J.E., Vermeulen, T., and van de Vlasakker, Paulien

Subjects
OT Team Agriculture & Society, Life Science, Rurale Sociologie, OT Team Landbouw & Samenleving, Rural Sociology
Published
2020

29. Cultuur is zeg maar niet mijn ding: Cultuurbeleving van jongvolwassenen die zelden of nooit cultuur bezoeken

Author

van Bendegom, Coen, Mitas, Ondrej, Boode, Wilco, de Rooij, Pieter, Bastiaansen, Marcel, Vermeulen, T, Bijl, J, Korteweg Maris, D, Rooijackers, M, Heslinga, J, Politiek, M, Heerschap, N, Schreven, L, van Wijk, K, Cognitive Neuropsychology, Academy for Leisure & Events, Academy for Tourism, Academy for Games & Media, Leisure and Tourism Experiences, and Research group for Tourism Impacts on Society

Published
2020

30. Hopen op een vakantie: De coronacrisis en geplande vakanties

Author

van Bendegom, Coen, Mitas, Ondrej, Hogenelst, K, Vermeer, T, Vermeulen, T, Bijl, J, Korteweg Maris, D, Rooijackers, M, Heslinga, J, Politiek, M, Heerschap, N, Schreven, L, van Wijk, K, Academy for Leisure & Events, Academy for Tourism, Leisure and Tourism Experiences, Digitisation in Tourism, and Sustainable Tourism and Transport

Published
2020

33. Conjunctival stromal tumor: Report of 2 new cases and review of the literature

Author

Lam, J., Ang, A., Vermeulen, T., Ardakani, N.M., Lam, J., Ang, A., Vermeulen, T., and Ardakani, N.M.

Abstract

Conjunctival stromal tumor (COST) is an emerging entity with only a limited number of cases reported in the literature. In this report, we describe 2 additional cases, review the accumulative clinical and histopathological features and expand on the immunophenotypic property of this entity. COST appears to have a sporadic presentation, affecting both sexes and patients of variable ethnicity and age group and predominantly occurring on the bulbar conjunctiva as a slow-growing asymptomatic or slightly tender mass-like lesion. Histopathologically, COST is characterized by singly dispersed spindle to round cells, often with some degree of degenerative nuclear atypia, within a myxomatous to collagenous stroma. Lesional cells are characteristically positive for CD34 and vimentin, negative for S100, SOX10 and STAT6 and show a normal pattern of staining with RB1 by immunohistochemistry. The reported cases to date have shown an indolent biological behavior, reliably treated by a complete surgical excision.

Published
2020

35. SPIRou: NIR velocimetry and spectropolarimetry at the CFHT

Author

Donati, J-F, primary, Kouach, D, additional, Moutou, C, additional, Doyon, R, additional, Delfosse, X, additional, Artigau, E, additional, Baratchart, S, additional, Lacombe, M, additional, Barrick, G, additional, Hébrard, G, additional, Bouchy, F, additional, Saddlemyer, L, additional, Parès, L, additional, Rabou, P, additional, Micheau, Y, additional, Dolon, F, additional, Reshetov, V, additional, Challita, Z, additional, Carmona, A, additional, Striebig, N, additional, Thibault, S, additional, Martioli, E, additional, Cook, N, additional, Fouqué, P, additional, Vermeulen, T, additional, Wang, S Y, additional, Arnold, L, additional, Pepe, F, additional, Boisse, I, additional, Figueira, P, additional, Bouvier, J, additional, Ray, T P, additional, Feugeade, C, additional, Morin, J, additional, Alencar, S, additional, Hobson, M, additional, Castilho, B, additional, Udry, S, additional, Santos, N C, additional, Hernandez, O, additional, Benedict, T, additional, Vallée, P, additional, Gallou, G, additional, Dupieux, M, additional, Larrieu, M, additional, Perruchot, S, additional, Sottile, R, additional, Moreau, F, additional, Usher, C, additional, Baril, M, additional, Wildi, F, additional, Chazelas, B, additional, Malo, L, additional, Bonfils, X, additional, Loop, D, additional, Kerley, D, additional, Wevers, I, additional, Dunn, J, additional, Pazder, J, additional, Macdonald, S, additional, Dubois, B, additional, Carrié, E, additional, Valentin, H, additional, Henault, F, additional, Yan, C H, additional, and Steinmetz, T, additional

Published
2020
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39. Workflow Intervals of Endovascular Acute Stroke Therapy During On- Versus Off-Hours The MR CLEAN Registry

Author

Hinsenveld, W.H., Ridder, I.R. de, Oostenbrugge, R.J. van, Vos, J.A., Groot, A.E., Coutinho, J.M., Nijeholt, G.J.L.A., Boiten, J., Schonewille, W.J., Dippel, D.W.J., Lugt, A. van der, Majoie, C.B.L.M., Roos, Y.B.W.E.M., Zwam, W.H. van, Jansen, I.G.H., Mulder, M.J.H.L., Goldhoorn, R.J.B., Compagne, K.C.J., Kappelhof, M., Wermer, M.J.H., Walderveen, M.A.A. van, Staals, J., Hofmeijer, J., Martens, J.M., Roozenbeek, B., Emmer, B.J., Bruijn, S.F. de, Dijk, L.C. van, Worp, H.B. van der, R.H. lo, Dijk, E.J. van, Boogaarts, H.D., Kort, P.L.M. de, Peluso, J.J.P., Berg, J.S.P. van den, Hasselt, B.A.A.M. van, Aerden, L.A.M., Dallinga, R.J., Uyttenboogaart, M., Eshghi, O., Schreuder, T.H.C.M.L., Heijboer, R.J.J., Keizer, K., Yo, L.S.F., Hertog, H.M. den, Sturm, E.J.C., Sprengers, M.E.S., Jenniskens, S.F.M., Berg, R. van den, Yoo, A.J., Beenen, L.F.M., Postma, A.A., Roosendaal, S.D., Kallen, B.F.W. van der, Wijngaard, I.R. van den, Es, A.C.G.M. van, Bot, J., Doormaal, P.J. van, Flach, H.Z., Lingsma, H.F., Ghannouti, N. el, Sterrenberg, M., Puppels, C., Pellikaan, W., Sprengers, R., Elfrink, M., Meris, J. de, Vermeulen, T., Geerlings, A., Vemde, G. van, Simons, T., Rijswijk, C. van, Messchendorp, G., Bongenaar, H., Bodde, K., Kleijn, S., Lodico, J., Droste, H., Wollaert, M., Jeurrissen, D., Bos, E., Drabbe, Y., Aaldering, N., Zweedijk, B., Khalilzada, M., Venema, E., Chalos, V., Geuskens, R.R., Straaten, T. van, Ergezen, S., Harmsma, R.R.M., Muijres, D., Jong, A. de, Hinsenveld, W., Berkhemer, O.A., Boersc, A.M.M., Huguet, J., Groot, P.F.C., Mens, M.A., Kranendonk, K.R. van, Treurniet, K.M., Tolhuijsen, M.L., Alves, H., MR CLEAN Registry Investigators, RS: Carim - B05 Cerebral small vessel disease, RS: CARIM - R3.03 - Cerebral small vessel disease, MUMC+: MA Niet Med Staf Neurologie (9), Promovendi CD, MUMC+: MA Med Staf Spec Neurologie (9), MUMC+: MA Neurologie (3), Klinische Neurowetenschappen, RS: Carim - B06 Imaging, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: CARIM - R3.11 - Imaging, MUMC+: MA AIOS Neurologie (9), MUMC+: DA BV AIOS Nucleaire Geneeskunde (9), MUMC+: DA BV AIOS Radiologie (9), Psychiatrie & Neuropsychologie, Radiology and nuclear medicine, VU University medical center, Pediatric surgery, ACS - Atherosclerosis & ischemic syndromes, ​Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Graduate School, Neurology, ANS - Neurovascular Disorders, Radiology and Nuclear Medicine, ACS - Microcirculation, ACS - Pulmonary hypertension & thrombosis, AGEM - Digestive immunity, AGEM - Re-generation and cancer of the digestive system, ARD - Amsterdam Reproduction and Development, Radiology & Nuclear Medicine, and Public Health

Subjects
Male, medicine.medical_specialty, Time Factors, workflow, medicine.medical_treatment, DOOR, endovascular procedures, DELAYS, Time-to-Treatment, All institutes and research themes of the Radboud University Medical Center, Modified Rankin Scale, medicine, Clinical endpoint, Humans, QUALITY, Registries, Lead (electronics), Stroke, Aged, Retrospective Studies, Aged, 80 and over, Advanced and Specialized Nursing, OUTCOMES, Groin, business.industry, delivery of health care, holidays, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Odds ratio, Middle Aged, THROMBECTOMY, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], medicine.disease, ADMISSION, stroke, Surgery, TIME, Observational Studies as Topic, medicine.anatomical_structure, ISCHEMIC-STROKE, Intravenous therapy, Female, Neurology (clinical), Cardiology and Cardiovascular Medicine, Complication, business
Abstract

Background and Purpose— Endovascular treatment (EVT) of patients with acute ischemic stroke because of large vessel occlusion involves complicated logistics, which may cause a delay in treatment initiation during off-hours. This might lead to a worse functional outcome. We compared workflow intervals between endovascular treatment–treated patients presenting during off- and on-hours. Methods— We retrospectively analyzed data from the MR CLEAN Registry, a prospective, multicenter, observational study in the Netherlands and included patients with an anterior circulation large vessel occlusion who presented between March 2014 and June 2016. Off-hours were defined as presentation on Monday to Friday between 17:00 and 08:00 hours, weekends (Friday 17:00 to Monday 8:00) and national holidays. Primary end point was first door to groin time. Secondary end points were functional outcome at 90 days (modified Rankin Scale) and workflow time intervals. We stratified for transfer status, adjusted for prognostic factors, and used linear and ordinal regression models. Results— We included 1488 patients of which 936 (62.9%) presented during off-hours. Median first door to groin time was 140 minutes (95% CI, 110–182) during off-hours and 121 minutes (95% CI, 85–157) during on-hours. Adjusted first door to groin time was 14.6 minutes (95% CI, 9.3–20.0) longer during off-hours. Door to needle times for intravenous therapy were slightly longer (3.5 minutes, 95% CI, 0.7–6.3) during off-hours. Groin puncture to reperfusion times did not differ between groups. For transferred patients, the delay within the intervention center was 5.0 minutes (95% CI, 0.5–9.6) longer. There was no significant difference in functional outcome between patients presenting during off- and on-hours (adjusted odds ratio, 0.92; 95% CI, 0.74–1.14). Reperfusion rates and complication rates were similar. Conclusions— Presentation during off-hours is associated with a slight delay in start of endovascular treatment in patients with acute ischemic stroke. This treatment delay did not translate into worse functional outcome or increased complication rates.

Published
2019
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40. Impact of single phase CT angiography collateral status on functional outcome over time: results from the MR CLEAN Registry

Author

Jansen, I.G.H., Mulder, M.J.H.L., Goldhoorn, R.J.B., Boers, A.M.M., Es, A.C.G.M. van, Yo, L.S.F., Hofmeijer, J., Martens, J.M., Walderveen, M.A.A. van, Kallen, B.F.W. van der, Jenniskens, S.F.M., Treurniet, K.M., Marqueriny, H.A., Sprengers, M.E.S., Schonewille, W.J., Bot, J.C.J., Nijeholt, G.J.L.A., Lingsma, H.F., Liebeskind, D.S., Boiten, J., Vos, J.A., Roos, Y.B.W.E.M., Oostenbrugge, R.J. van, Lugt, A. van der, Zwam, W.H. van, Dippel, D.W.J., Wijngaard, I.R. van den, Majoie, C.B.L.M., Coutinho, J.M., Wermern, M.J.H., Staals, J., Roozenbeek, B., Emmer, B.J., Bruijn, S.F. de, Dijk, L.C. van, Worp, H.B. van der, R.H. lo, Dijk, E.J. van, Boogaarts, H.D., Kort, P.L.M. de, Peluso, J.J.P., Berg, J.S.P. van den, Hasselt, B.A.A.M. van, Aerden, L.A.M., Dallinga, R.J., Uyttenboogaart, M., Eshghi, O., Schreuder, T.H.C.M.L., Heijboer, R.J.J., Keizer, K., Hertog, H.M. den, Sturm, E.J.C., Berg, R. van den, Yoo, A.J., Beenen, L.F.M., Roosendaal, S.D., Es, A. van, Emmer, B., Bot, J., Doormaal, P.J. van, Flach, H.Z., Ghannouti, N. el, Sterrenberg, M., Puppels, C., Pellikaan, W., Sprengers, R., Elfrink, M., Meris, J. de, Vermeulen, T., Geerlings, A., Vemde, G. van, Simons, T., Rijswijk, C. van, Messchendorp, G., Bongenaar, H., Bodde, K., Kleijn, S., Lodico, J., Droste, H., Wollaert, M., Jeurrissen, D., Bos, E., Drabbe, Y., Zweedijk, B., Khalilzada, M., Venema, E., Chalos, V., Compagne, K.J., Geuskens, R.R., Straaten, T. van, Ergezen, S., Harmsma, R.R.M., Muijres, D., Jong, A. de, Hinseveld, W., Berkhemer, O.A., Huguet, J., Groot, P.F.C., Mens, M.A., Kranendonk, K.R. van, Kappelhof, M., Tolhuijsen, M.L., Alves, H., MR CLEAN Registry Investigators, ​Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Clinical Neurophysiology, Neurology, Radiology & Nuclear Medicine, Public Health, MUMC+: MA AIOS Neurologie (9), Klinische Neurowetenschappen, RS: Carim - B05 Cerebral small vessel disease, RS: CARIM - R3.03 - Cerebral small vessel disease, Promovendi CD, MUMC+: MA Neurologie (3), RS: Carim - B06 Imaging, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: CARIM - R3.11 - Imaging, MUMC+: MA Med Staf Spec Neurologie (9), Radiology and nuclear medicine, Amsterdam Neuroscience - Neurovascular Disorders, ACS - Atherosclerosis & ischemic syndromes, ANS - Neurovascular Disorders, ACS - Microcirculation, Graduate School, and Radiology and Nuclear Medicine

Subjects
Male, PREDICTOR, Computed Tomography Angiography, THERAPY, 030218 nuclear medicine & medical imaging, law.invention, Brain Ischemia, 0302 clinical medicine, Randomized controlled trial, Modified Rankin Scale, Time windows, law, ct angiography, REPERFUSION, Prospective Studies, Registries, Single phase, Stroke, intervention, Netherlands, Aged, 80 and over, medicine.diagnostic_test, Endovascular Procedures, General Medicine, Middle Aged, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Treatment Outcome, Cardiology, Female, LEPTOMENINGEAL COLLATERALS, STROKE, Adult, medicine.medical_specialty, Adolescent, Time to treatment, Collateral Circulation, 03 medical and health sciences, Young Adult, Internal medicine, SCORE, medicine, MANAGEMENT, Humans, Endovascular treatment, Aged, business.industry, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Recovery of Function, medicine.disease, n/a OA procedure, ENDOVASCULAR TREATMENT, Angiography, Surgery, Neurology (clinical), business, COMPUTED TOMOGRAPHIC ANGIOGRAPHY, 030217 neurology & neurosurgery
Abstract

BackgroundCollateral status modified the effect of endovascular treatment (EVT) for stroke in several randomized trials. We assessed the association between collaterals and functional outcome in EVT treated patients and investigated if this association is time dependent.MethodsWe included consecutive patients from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in The Netherlands (MR CLEAN) Registry (March 2014–June 2016) with an anterior circulation large vessel occlusion undergoing EVT. Functional outcome was measured on the modified Rankin Scale (mRS) at 90 days. We investigated the association between collaterals and mRS in the MR CLEAN Registry with ordinal logistic regression and if this association was time dependent with an interaction term. Additionally, we determined modification of EVT effect by collaterals compared with MR CLEAN controls, and also investigated if this was time dependent with multiplicative interaction terms.Results1412 patients were analyzed. Functional independence (mRS score of 0–2) was achieved in 13% of patients with grade 0 collaterals, in 27% with grade 1, in 46% with grade 2, and in 53% with grade 3. Collaterals were significantly associated with mRS (adjusted common OR 1.5 (95% CI 1.4 to 1.7)) and significantly modified EVT benefit (P=0.04). None of the effects were time dependent. Better collaterals corresponded to lower mortality (PConclusionIn routine clinical practice, better collateral status is associated with better functional outcome and greater treatment benefit in EVT treated acute ischemic stroke patients, independent of time to treatment. Within the 6 hour time window, a substantial proportion of patients with absent and poor collaterals can still achieve functional independence.

Published
2019
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41. Periprocedural Intravenous Heparin During Endovascular Treatment for Ischemic Stroke: Results From the MR CLEAN Registry

Author

Graaf, R.A. van de, Chalos, V., Es, A.C.G.M. van, Emmer, B.J., Nijeholt, G.J.L.A., Worp, H.B. van der, Schonewille, W.J., Lugt, A. van der, Dippel, D.W.J., Lingsma, H.F., Roozenbeek, B., Dippel, D., Majoie, C., Roos, Y., Oostenbrugge, R. van, Zwam, W. van, Boiten, J., Vos, J.A., Jansen, I., Mulder, M., Goldhoorn, R.J., Compagne, K., Kappelhof, M., Schonewille, W., Coutinho, J., Wermer, M., Walderveen, M. van, Staals, J., Hofmeijer, J., Martens, J.M., Nijeholt, G.L.A., Emmer, B., Bruijn, S. de, Dijk, L. van, R. lo, Dijk, E. van, Boogaarts, H., Kort, P. de, Peluso, J., Berg, J. van den, Hasselt, B. van, Aerden, L., Dallinga, R., Uyttenboogaart, M., Eshghi, O., Schreuder, T., Heijboer, R., Keizer, K., Yo, L., Hertog, H. den, Sturm, E., Sprengers, M., Jenniskens, S., Berg, R. van den, Yoo, A., Beenen, L., Postma, A., Roosendaal, S., Kallen, B. van der, Wijngaard, I. van den, Es, A. van, Martens, J., Bot, J., Doormaal, P.J. van, Worp, B. van der, Flach, Z., Lingsma, H., Ghannouti, N. el, Sterrenberg, M., Puppels, C., Pellikaan, W., Sprengers, R., Elfrink, M., Meris, J. de, Vermeulen, T., Geerlings, A., Vemde, G. van, Simons, T., Rijswijk, C. van, Messchendorp, G., Bongenaar, H., Bodde, K., Kleijn, S., Lodico, J., Droste, H., Wollaert, M., Jeurrissen, D., Bos, E., Drabbe, Y., Aaldering, N., Zweedijk, B., Khalilzada, M., Venema, E., Geuskens, R., Straaten, T. van, Ergezen, S., Harmsma, R., Muijres, D., Jong, A. de, Hinseveld, W., Berkhemer, O., Boers, A., Huguet, J., Groot, P., Mens, M., Kranendonk, K. van, Treurniet, K., Tolhuijsen, M., Alves, H., MR CLEAN Registry Investigators, Radiology and nuclear medicine, VU University medical center, Pediatric surgery, ACS - Atherosclerosis & ischemic syndromes, ​Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Neurology, Radiology & Nuclear Medicine, Public Health, Radiology and Nuclear Medicine, ANS - Neurovascular Disorders, MUMC+: MA Neurologie (3), Klinische Neurowetenschappen, RS: Carim - B05 Cerebral small vessel disease, RS: CARIM - R3.03 - Cerebral small vessel disease, RS: Carim - B06 Imaging, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: CARIM - R3.11 - Imaging, MUMC+: MA AIOS Neurologie (9), Promovendi CD, MUMC+: MA Med Staf Spec Neurologie (9), MUMC+: DA BV AIOS Nucleaire Geneeskunde (9), RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, and MUMC+: DA BV AIOS Radiologie (9)

Subjects
Male, Original Contributions, medicine.medical_treatment, heparin, GUIDELINES, Brain Ischemia, law.invention, Randomized controlled trial, Modified Rankin Scale, law, Recombinant Proteins/therapeutic use, 80 and over, REPERFUSION, PROUROKINASE, Heparin/administration & dosage, Stroke, Aged, 80 and over, Anticoagulants/administration & dosage, Cerebral infarction, Endovascular Procedures, Heparin, Thrombolysis, Middle Aged, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], cerebral infarction, stroke, Recombinant Proteins, Treatment Outcome, thrombectomy, FOCAL CEREBRAL-ISCHEMIA, Anesthesia, Combination, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Drug Therapy, Combination, Female, Cardiology and Cardiovascular Medicine, Stroke/drug therapy, medicine.drug, Clinical Sciences, PROACT, All institutes and research themes of the Radboud University Medical Center, Fibrinolytic Agents, Drug Therapy, medicine, Humans, Urokinase-Type Plasminogen Activator/therapeutic use, Aged, Advanced and Specialized Nursing, business.industry, Fibrinolytic Agents/therapeutic use, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Anticoagulants, Brain Ischemia/drug therapy, Odds ratio, medicine.disease, Urokinase-Type Plasminogen Activator, Endovascular Procedures/methods, Ischemic stroke, Neurology (clinical), business
Abstract

Supplemental Digital Content is available in the text., Background and Purpose— Intravenous administration of heparin during endovascular treatment for ischemic stroke may improve outcomes. However, risks and benefits of this adjunctive therapy remain uncertain. We aimed to evaluate periprocedural intravenous heparin use in Dutch stroke intervention centers and to assess its efficacy and safety. Methods— Patients registered between March 2014 and June 2016 in the MR CLEAN Registry (Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke), including all patients treated with endovascular treatment in the Netherlands, were analyzed. The primary outcome was functional outcome (modified Rankin Scale) at 90 days. Secondary outcomes were successful recanalization (extended Thrombolysis in Cerebral Infarction ≥2B), symptomatic intracranial hemorrhage, and mortality at 90 days. We used multilevel regression analysis to evaluate the association of periprocedural intravenous heparin on outcomes, adjusted for center effects and prognostic factors. To account for possible unobserved confounding by indication, we analyzed the effect of center preference to administer intravenous heparin, defined as percentage of patients treated with intravenous heparin in a center, on functional outcome. Results— One thousand four hundred eighty-eight patients from 16 centers were analyzed, of whom 398 (27%) received intravenous heparin (median dose 5000 international units). There was substantial between-center variability in the proportion of patients treated with intravenous heparin (range, 0%–94%). There was no significant difference in functional outcome between patients treated with intravenous heparin and those without (adjusted common odds ratio, 1.17; 95% CI, 0.87–1.56), successful recanalization (adjusted odds ratio, 1.24; 95% CI, 0.89–1.71), symptomatic intracranial hemorrhage (adjusted odds ratio, 1.13; 95% CI, 0.65–1.99), or mortality (adjusted odds ratio, 0.95; 95% CI, 0.66–1.38). Analysis at center level showed that functional outcomes were better in centers with higher percentages of heparin administration (adjusted common odds ratio, 1.07 per 10% more heparin, 95% CI, 1.01–1.13). Conclusions— Substantial between-center variability exists in periprocedural intravenous heparin use during endovascular treatment, but the treatment is safe. Centers using heparin more often had better outcomes. A randomized trial is needed to further study these effects.

Published
2019
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42. Endovascular Treatment With or Without Prior Intravenous Alteplase for Acute Ischemic Stroke

Author

Chalos, V., LeCouffe, N.E., Uyttenboogaart, M., Lingsma, H.F., Mulder, M.J.H.L., Venema, E., Treurniet, K.M., Eshghi, O., Worp, H.B. van der, Lugt, A. van der, Roos, Y.B.W.E.M., Majoie, C.B.L.M., Dippel, D.W.J., Roozenbeek, B., Coutinho, J.M., Oostenbrugge, R.J. van, Zwam, W.H. van, Boiten, J., Vos, J.A., Jansen, I.G.H., Goldhoorn, R.J.B., Schonewille, W.J., Wermer, M.J.H., Walderveen, M.A.A. van, Staals, J., Hofmeijer, J., Martens, J.M., Nijeholt, G.J.L.A., Emmer, B.J., Bruijn, S.F. de, Dijk, L.C. van, R.H. lo, Dijk, E.J. van, Boogaarts, H.D., Kort, P.L.M. de, Peluso, J.J.P., Berg, J.S.P. van den, Hasselt, B.A.A.M. van, Aerden, L.A.M., Dallinga, R.J., Schreuder, T.H.C.M.L., Heijboer, R.J.J., Keizer, K., Yo, L.S.F., Hertog, H.M. den, Sturm, E.J.C., Sprengers, M.E.S., Jenniskens, S.F.M., Berg, R. van den, Yoo, A.J., Beenen, L.F.M., Roosendaal, S.D., Kallen, B.F.W. van der, Wijngaard, I.R. van den, Es, A.C.G.M. van, Bot, J.C.J., Doormaal, P.J. van, Flach, H.Z., Ghannouti, N. el, Sterrenberg, M., Puppels, C., Pellikaan, W., Sprengers, R., Elfrink, M., Meris, J. de, Vermeulen, T., Geerlings, A., Vemde, G. van, Simons, T., Rijswijk, C. van, Messchendorp, G., Bongenaar, H., Bodde, K., Kleijn, S., Lodico, J., Droste, H., Wollaert, M., Jeurrissen, D., Bos, E., Drabbe, Y., Zweedijk, B., Khalilzada, M., Compagne, K.C.J., Geuskens, R.R., Straaten, T. van, Ergezen, S., Harmsma, R.R.M., Jong, A. de, Hinsenveld, W., Berkhemer, O.A., Boers, A.M.M., Groot, P.F.C., Mens, M.A., Kranendonk, K.R. van, Kappelhof, M., Tolhuijsen, M.L., Alves, H., MR CLEAN Registry Investigators, Neurology, Public Health, Radiology & Nuclear Medicine, ​Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Radiology and nuclear medicine, ACS - Atherosclerosis & ischemic syndromes, Graduate School, ACS - Microcirculation, ANS - Neurovascular Disorders, Radiology and Nuclear Medicine, MUMC+: MA Neurologie (3), Klinische Neurowetenschappen, RS: Carim - B05 Cerebral small vessel disease, RS: CARIM - R3.03 - Cerebral small vessel disease, RS: Carim - B06 Imaging, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: CARIM - R3.11 - Imaging, MUMC+: MA Niet Med Staf Neurologie (9), Promovendi CD, MUMC+: MA Med Staf Spec Neurologie (9), and Clinical Neurophysiology

Subjects
Male, endovascular treatment, Time Factors, medicine.medical_treatment, RECANALIZATION, ANTERIOR CIRCULATION STROKE, THERAPY, law.invention, Brain Ischemia, Workflow, Disability Evaluation, Randomized controlled trial, Modified Rankin Scale, law, Risk Factors, REPERFUSION, Thrombolytic Therapy, Prospective Studies, Registries, Stroke, DIRECT MECHANICAL THROMBECTOMY, Netherlands, Original Research, Aged, 80 and over, OUTCOMES, Confounding, Endovascular Procedures, Atrial fibrillation, Thrombolysis, Middle Aged, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Combined Modality Therapy, stroke, Treatment Outcome, thrombectomy, Tissue Plasminogen Activator, Cardiology, Female, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, thrombolysis, Cerebrovascular Procedures, All institutes and research themes of the Radboud University Medical Center, Fibrinolytic Agents, Internal medicine, large vessel occlusion, medicine, Humans, Aged, Ischemic Stroke, business.industry, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Odds ratio, Recovery of Function, medicine.disease, Cerebrovascular Disease/Stroke, Observational study, business
Abstract

Background It is unclear whether intravenous thrombolysis ( IVT ) with alteplase before endovascular treatment ( EVT ) is beneficial for patients with acute ischemic stroke caused by a large vessel occlusion. We compared clinical and procedural outcomes, safety, and workflow between patients treated with both IVT and EVT and those treated with EVT alone in routine clinical practice. Methods and Results Using multivariable regression, we evaluated the association of IVT + EVT with 90‐day functional outcome (modified Rankin Scale), mortality, reperfusion, first‐pass effect, and symptomatic intracranial hemorrhage in the MR CLEAN (Multicenter Randomised Controlled Trial of Endovascular Treatment for Acute Ischemic Stroke in The Netherlands) Registry. Of 1485 patients, 1161 (78%) were treated with IVT + EVT , and 324 (22%) with EVT alone. Patients treated with IVT + EVT had atrial fibrillation less often (16% versus 44%) and had better pre‐stroke modified Rankin Scale scores (pre‐stroke modified Rankin Scale 0: 73% versus 52%) than those treated with EVT alone. Procedure time was shorter in the IVT + EVT group (median 62 versus 68 minutes). Nontransferred IVT + EVT patients had longer door‐to‐groin‐puncture times (median 105 versus 94 minutes). IVT + EVT was associated with better functional outcome (adjusted common odds ratio 1.47; 95% CI : 1.10–1.96) and lower mortality (adjusted odds ratio 0.58; 95% CI : 0.40–0.82). Successful reperfusion, first‐pass effect, and symptomatic intracranial hemorrhage did not differ between groups. Conclusions In this observational study, patients treated with IVT + EVT had better clinical outcomes than patients who received EVT alone. This finding may demonstrate a true benefit of IVT before EVT , but its interpretation is hampered by the possibility of residual confounding and selection bias. Randomized trials are required to properly assess the effect of IVT before EVT .

Published
2019
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43. Safety and Outcome of Endovascular Treatment for Minor Ischemic Stroke: Results From the Multicenter Clinical Registry of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands

Author

Goldhoorn, R.B., Mulder, M.J.H.L., Jansen, I.G.H., Zwam, W.H. van, Staals, J., Lugt, A. van der, Dippel, D.W.J., Lingsma, H.F., Vos, J.A., Boiten, J., Wijngaard, I.R. van den, Majoie, C.B.L.M., Roos, Y.B.W.E.M., Oostenbrugge, R.J. van, Goldhoorn, R.J.B., Schonewille, W.J., Coutinho, J.M., Wermer, M.J.H., Walderveen, M.A.A. van, Hofmeijer, J., Martens, J.M., Nijeholt, G.J.L.A., Roozenbeek, B., Emmer, B.J., Bruijn, S.F. de, Dijk, L.C. van, Worp, H.B. van der, R.H. lo, Dijk, E.J. van, Boogaarts, H.D., Kort, P.L.M. de, Peluso, J.J.P., Berg, J.S.P. van den, Hasselt, B.A.A.M. van, Aerden, L.A.M., Dallinga, R.J., Uyttenboogaart, M., Eshghi, O., Schreuder, T.H.C.M.L., Heijboer, R.J.J., Keizer, K., Yo, L.S.F., Hertog, H.M. den, Sturm, E.J.C., Sprengers, M.E.S., Jenniskens, S.F.M., Berg, R. van den, Yoo, A.J., Beenen, L.F.M., Roosendaal, S.D., Kallen, B.F.W. van der, Es, A. van, Emmer, B., Bot, J., Doormaal, P.J. van, Postma, A., Flach, H.Z., Ghannouti, N. el, Sterrenberg, M., Puppels, C., Pellikaan, W., Sprengers, R., Elfrink, M., Meris, J. de, Vermeulen, T., Geerlings, A., Vemde, G. van, Simons, T., Rijswijk, C. van, Messchendorp, G., Bongenaar, H., Bodde, K., Kleijn, S., Lodico, J., Droste, H., Wollaert, M., Jeurrissen, D., Bos, E., Drabbe, Y., Zweedijk, B., Khalilzada, M., Venema, E., Chalos, V., Compagne, K.J., Geuskens, R.R., Straaten, T. van, Ergezen, S., Harmsma, R.R.M., Muijres, D., Jong, A. de, Hinsenveld, W., Berkhemer, O.A., Boers, A.M.M., Huguet, J., Groot, P.F.C., Mens, M.A., Kranendonk, K.R. van, Treurniet, K.M., Kappelhof, M., Tolhuijsen, M.L., Alves, H., MR CLEAN Registry Investigators, Neurology, Radiology & Nuclear Medicine, Public Health, Klinische Neurowetenschappen, RS: Carim - B05 Cerebral small vessel disease, RS: CARIM - R3.03 - Cerebral small vessel disease, MUMC+: MA Niet Med Staf Neurologie (9), Promovendi CD, RS: Carim - B06 Imaging, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: CARIM - R3.11 - Imaging, MUMC+: MA Med Staf Spec Neurologie (9), MUMC+: MA Neurologie (3), MUMC+: DA BV AIOS Nucleaire Geneeskunde (9), RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, MUMC+: DA BV AIOS Radiologie (9), Amsterdam Neuroscience - Neurovascular Disorders, ACS - Atherosclerosis & ischemic syndromes, ACS - Microcirculation, Radiology and Nuclear Medicine, ​Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), and Radiology and nuclear medicine

Subjects
Male, endovascular treatment, Time Factors, Severity of Illness Index, THERAPY, ANGIOGRAPHY, law.invention, Brain Ischemia, Disability Evaluation, 0302 clinical medicine, Randomized controlled trial, Modified Rankin Scale, law, Risk Factors, Occlusion, Prospective Studies, Registries, Stroke, Netherlands, Ischemic stroke, medicine.diagnostic_test, LARGE VESSEL OCCLUSION, Rehabilitation, Endovascular Procedures, minor symptoms, Middle Aged, THROMBECTOMY, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Treatment Outcome, Cerebrovascular Circulation, Cardiology, ANTERIOR CIRCULATION, Female, TRIAL, SCALE SCORE, Cardiology and Cardiovascular Medicine, Intracranial Hemorrhages, medicine.medical_specialty, Clinical Decision-Making, 03 medical and health sciences, large vessel oclusion, All institutes and research themes of the Radboud University Medical Center, Internal medicine, medicine, Humans, Artery occlusion, cardiovascular diseases, Aged, business.industry, Patient Selection, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Recovery of Function, MILD, medicine.disease, Arterial occlusion, Angiography, Surgery, Observational study, Neurology (clinical), business, 030217 neurology & neurosurgery, INTRAARTERIAL TREATMENT
Abstract

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

Published
2019
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45. Toerisme en duurzaamheid

Author

Eijgelaar, Eke, Peeters, Paul, Schreven, L, Vermeulen, T, Bijl, J, Rooijackers, M, Heslinga, J, Politiek, M, Heerschap, N, van Wijk, K, Academy for Tourism, and Sustainable Tourism and Transport

Published
2019

47. Overtoerisme : impacts, indicatoren en maatregelen

Author

Klijs, Jeroen, Eijgelaar, Eke, Hartman, S., Peeters, Paul, Vermeulen, T, Bijl, J, Rooijackers, M, Heslinga, J, Politiek, M, Heerschap, N, Schreven, L, van Wijk, K, Academy for Tourism, Sustainable Tourism and Transport, and Research group for Tourism Impacts on Society

Published
2019

49. Naar een inclusieve toeristische sector

Author

van der Duim, R, Smit, Bert, Ormond, M., Vermeulen, T, Bijl, J, Rooijackers, M, Heslinga, J, Politiek, M, Heerschap, N, Schreven, L, van Wijk, K, and Academy for Hotel & Facility

Published
2019

50. Attractiepuntensector

Author

Lukken, Goof, Vermeulen, T, Bijl, J, Rooijackers, M, Heslinga, J, Politiek, M, Heerschap, N, Schreven, L, van Wijk, K, and Academy for Tourism

Published
2019

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