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2. Endovascular therapy in patients with a large ischemic volume at presentation: An aggregate patient-level analysis

Author

Kerleroux, Basile, Hak, Jean François, Lapergue, Bertrand, Bricout, Nicolas, Zhu, François, Inoue, Manabu, Janot, Kevin, Dargazanli, Cyril, Kaesmacher, Johannes, Rouchaud, Aymeric, Forestier, Géraud, Gortais, Hugo, Benzakoun, Joseph, Yoshimoto, Takeshi, Consoli, Arturo, Ben Hassen, Wagih, Henon, Hilde, Naggara, Olivier, and Boulouis, Grégoire

Published
2024
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4. Safety and Outcomes of Intravenous Thrombolytic Therapy in Ischemic Stroke Patients with COVID-19: CASCADE Initiative

Author

Sasanejad, Payam, Afshar Hezarkhani, Leila, Arsang-Jang, Shahram, Tsivgoulis, Georgios, Ghoreishi, Abdoreza, Barlinn, Kristian, Rahmig, Jan, Farhoudi, Mehdi, Sadeghi Hokmabadi, Elyar, Borhani-Haghighi, Afshin, Sariaslani, Payam, Sharifi-Razavi, Athena, Ghandehari, Kavian, Khosravi, Alireza, Smith, Craig, Nilanont, Yongchai, Akbari, Yama, Nguyen, Thanh N, Bersano, Anna, Yassi, Nawaf, Yoshimoto, Takeshi, Lattanzi, Simona, Gupta, Animesh, Zand, Ramin, Rafie, Shahram, Pourandokht Mousavian, Seyede, Reza Shahsavaripour, Mohammad, Amini, Shahram, Kamenova, Saltanat U, Kondybayeva, Aida, Zhanuzakov, Murat, Macri, Elizabeth M, Nobleza, Christa O'Hana S, Ruland, Sean, Cervantes-Arslanian, Anna M, Desai, Masoom J, Ranta, Annemarei, Moghadam Ahmadi, Amir, Rostamihosseinkhani, Mahtab, Foroughi, Razieh, Hooshmandi, Etrat, Akhoundi, Fahimeh H, Shuaib, Ashfaq, Liebeskind, David S, Siegler, James, Romano, Jose G, Mayer, Stephan A, Bavarsad Shahripour, Reza, Zamani, Babak, Woolsey, Amadene, Fazli, Yasaman, Mojtaba, Khazaei, Isaac, Christian F, Biller, Jose, Di Napoli, Mario, and Azarpazhooh, M Reza

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Neurosciences, Stroke, Brain Disorders, Clinical Research, Good Health and Well Being, Aged, Aged, 80 and over, COVID-19, Disability Evaluation, Europe, Female, Fibrinolytic Agents, Hospital Mortality, Humans, Infusions, Intravenous, Intracranial Hemorrhages, Iran, Ischemic Stroke, Male, Middle Aged, Risk Assessment, Risk Factors, Thrombolytic Therapy, Time Factors, Treatment Outcome, COVID 19, Thrombolytic therapy, Longitudinal study, Safety, Outcomes, Disability, Stroke severity, death, Neurology & Neurosurgery, Clinical sciences
Abstract

BackgroundThere is little information regarding the safety of intravenous tissue plasminogen activator (IV-tPA) in patients with stroke and COVID-19.MethodsThis multicenter study included consecutive stroke patients with and without COVID-19 treated with IV-tPA between February 18, 2019, to December 31, 2020, at 9 centers participating in the CASCADE initiative. Clinical outcomes included modified Rankin Scale (mRS) at hospital discharge, in-hospital mortality, the rate of hemorrhagic transformation. Using Bayesian multiple regression and after adjusting for variables with significant value in univariable analysis, we reported the posterior adjusted odds ratio (OR, with 95% Credible Intervals [CrI]) of the main outcomes.ResultsA total of 545 stroke patients, including 101 patients with COVID-19 were evaluated. Patients with COVID-19 had a more severe stroke at admission. In the study cohort, 85 (15.9%) patients had a hemorrhagic transformation, and 72 (13.1%) died in the hospital. After adjustment for confounding variables, discharge mRS score ≥2 (OR: 0.73, 95% CrI: 0.16, 3.05), in-hospital mortality (OR: 2.06, 95% CrI: 0.76, 5.53), and hemorrhagic transformation (OR: 1.514, 95% CrI: 0.66, 3.31) were similar in COVID-19 and non COVID-19 patients. High-sensitivity C reactive protein level was a predictor of hemorrhagic transformation in all cases (OR:1.01, 95%CI: 1.0026, 1.018), including those with COVID-19 (OR:1.024, 95%CI:1.002, 1.054).ConclusionIV-tPA treatment in patients with acute ischemic stroke and COVID-19 was not associated with an increased risk of disability, mortality, and hemorrhagic transformation compared to those without COVID-19. IV-tPA should continue to be considered as the standard of care in patients with hyper acute stroke and COVID-19.

Published
2021

5. Association of thyroid peroxidase antibody with the RNF213 p.R4810K variant in ischemic stroke/transient ischemic attack

Author

Yoshimoto, Takeshi, Ishiyama, Hiroyuki, Hattori, Yorito, Nishimura, Kunihiro, Okada, Yoko, Watanabe, Hideaki, Ohyagi, Yasumasa, Akaiwa, Yasuhisa, Miyamoto, Tomoyuki, Kawamoto, Michi, Ichijo, Masahiko, Inoue, Hiroyasu, Matsukawa, Noriyuki, Mizuno, Toshiki, Matsuyama, Hirofumi, Tomimoto, Hidekazu, Kawakami, Daisuke, Toyoda, Kazunori, Koga, Masatoshi, and Ihara, Masafumi

Published
2023
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7. Stroke Care Trends During COVID-19 Pandemic in Zanjan Province, Iran. From the CASCADE Initiative: Statistical Analysis Plan and Preliminary Results

Author

Ghoreishi, Abdoreza, Arsang-Jang, Shahram, Sabaa-Ayoun, Ziad, Yassi, Nawaf, Sylaja, PN, Akbari, Yama, Divani, Afshin A, Biller, Jose, Phan, Thanh, Steinwender, Sandy, Silver, Brian, Zand, Ramin, Bin Basri, Hamidon, Iqbal, Omer M, Ranta, Annemarei, Ruland, Sean, Macri, Elizabeth, Ma, Henry, Nguyen, Thanh N, Abootalebi, Shahram, Gupta, Animesh, Alet, Matias, Lattanzi, Simona, Desai, Masoom, Gagliardi, Rubens J, Girotra, Tarun, Inoue, Manabu, Yoshimoto, Takeshi, Isaac, Cristian Flavo, Mayer, Stephan A, Morovatdar, Negar, Nilanont, Yongchai, Nobleza, Christa O'Hana S, Saber, Hamidreza, Kamenova, Saltanat, Kondybayeva, Aida, Krupinski, Jerzy, Siegler, James E, Stranges, Saverio, Torbey, Michel T, Yorio, Diana, Zurrú, María Cristina, Rubinos, Clio Aracelli, Shahripour, Reza Bavarsad, Borhani-Haghighi, Afshin, Di Napoli, Mario, and Azarpazhooh, M Reza

Subjects
Stroke, Brain Disorders, Neurosciences, Patient Safety, Health and social care services research, 8.1 Organisation and delivery of services, Good Health and Well Being, Aged, Aged, 80 and over, Bayes Theorem, Brain Ischemia, COVID-19, Female, Hospital Mortality, Hospitalization, Humans, Interrupted Time Series Analysis, Intracranial Hemorrhages, Iran, Length of Stay, Male, Middle Aged, Outcome and Process Assessment, Health Care, Recovery of Function, Thrombolytic Therapy, Time Factors, Time-to-Treatment, Treatment Outcome, Epidemiology, Outcome, Mortality, Disability, Stroke care, Clinical Sciences, Neurology & Neurosurgery, Clinical sciences
Abstract

BackgroundThe emergence of the COVID-19 pandemic has significantly impacted global healthcare systems and this may affect stroke care and outcomes. This study examines the changes in stroke epidemiology and care during the COVID-19 pandemic in Zanjan Province, Iran.MethodsThis study is part of the CASCADE international initiative. From February 18, 2019, to July 18, 2020, we followed ischemic and hemorrhagic stroke hospitalization rates and outcomes in Valiasr Hospital, Zanjan, Iran. We used a Bayesian hierarchical model and an interrupted time series analysis (ITS) to identify changes in stroke hospitalization rate, baseline stroke severity [measured by the National Institutes of Health Stroke Scale (NIHSS)], disability [measured by the modified Rankin Scale (mRS)], presentation time (last seen normal to hospital presentation), thrombolytic therapy rate, median door-to-needle time, length of hospital stay, and in-hospital mortality. We compared in-hospital mortality between study periods using Cox-regression model.ResultsDuring the study period, 1,026 stroke patients were hospitalized. Stroke hospitalization rates per 100,000 population decreased from 68.09 before the pandemic to 44.50 during the pandemic, with a significant decline in both Bayesian [Beta: -1.034; Standard Error (SE): 0.22, 95% CrI: -1.48, -0.59] and ITS analysis (estimate: -1.03, SE = 0.24, p

Published
2020

8. Call to Action: SARS-CoV-2 and CerebrovAscular DisordErs (CASCADE).

Author

Abootalebi, Shahram, Aertker, Benjamin M, Andalibi, Mohammad Sobhan, Asdaghi, Negar, Aykac, Ozlem, Azarpazhooh, M Reza, Bahit, M Cecilia, Barlinn, Kristian, Basri, Hamidon, Shahripour, Reza Bavarsad, Bersano, Anna, Biller, Jose, Borhani-Haghighi, Afshin, Brown, Robert D, Campbell, Bruce Cv, Cruz-Flores, Salvador, De Silva, Deidre Anne, Di Napoli, Mario, Divani, Afshin A, Edgell, Randall C, Fifi, Johanna T, Ghoreishi, Abdoreza, Hirano, Teruyuki, Hong, Keun-Sik, Hsu, Chung Y, Huang, Josephine F, Inoue, Manabu, Jagolino, Amanda L, Kapral, Moira, Kee, Hoo Fan, Keser, Zafer, Khatri, Rakesh, Koga, Masatoshi, Krupinski, Jerzy, Liebeskind, David S, Liu, Liping, Ma, Henry, Maud, Alberto, McCullough, Louise D, Meyer, Dawn Matherne, Mifsud, Victoria, Morovatdar, Negar, Nilanont, Yongchai, Oxley, Thomas J, Özdemir, Atilla Özcan, Pandian, Jeyaraj, Pantoni, Leonardo, Papamitsakis, Nikolaos IH, Parry-Jones, Adrian, Phan, Thanh, Rodriguez, Gustavo, Romano, Jose G, Sabaa-Ayoun, Ziad, Saber, Hamidreza, Sasannezhad, Payam, Saver, Jeffrey L, Scharf, Eugene, Shuaib, Ashfaq, Silver, Brian, Singhal, Shaloo, Smith, Craig J, Stranges, Saverio, Sylaja, PN, Torbey, Michel, Toyoda, Kazunori, Tsivgoulis, Georgios, Wasay, Mohammad, Yassi, Nawaf, Yoshimoto, Takeshi, Zamani, Babak, and Zand, Ramin

Subjects
Humans, Pneumonia, Viral, Coronavirus Infections, Treatment Outcome, Hospitalization, Registries, Incidence, Hospital Mortality, Risk Factors, Retrospective Studies, Prospective Studies, Comorbidity, Time Factors, Stroke, Healthcare Disparities, Host-Pathogen Interactions, Pandemics, Interrupted Time Series Analysis, Practice Patterns, Physicians', Betacoronavirus, COVID-19, SARS-CoV-2, Health policy, Mortality, National crisis, Pandemic, Pneumonia, Viral, Practice Patterns, Physicians', Physicians, Neurology & Neurosurgery, Clinical Sciences, Neurosciences
Abstract

Background and purposeThe novel severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), now named coronavirus disease 2019 (COVID-19), may change the risk of stroke through an enhanced systemic inflammatory response, hypercoagulable state, and endothelial damage in the cerebrovascular system. Moreover, due to the current pandemic, some countries have prioritized health resources towards COVID-19 management, making it more challenging to appropriately care for other potentially disabling and fatal diseases such as stroke. The aim of this study is to identify and describe changes in stroke epidemiological trends before, during, and after the COVID-19 pandemic.MethodsThis is an international, multicenter, hospital-based study on stroke incidence and outcomes during the COVID-19 pandemic. We will describe patterns in stroke management, stroke hospitalization rate, and stroke severity, subtype (ischemic/hemorrhagic), and outcomes (including in-hospital mortality) in 2020 during COVID-19 pandemic, comparing them with the corresponding data from 2018 and 2019, and subsequently 2021. We will also use an interrupted time series (ITS) analysis to assess the change in stroke hospitalization rates before, during, and after COVID-19, in each participating center.ConclusionThe proposed study will potentially enable us to better understand the changes in stroke care protocols, differential hospitalization rate, and severity of stroke, as it pertains to the COVID-19 pandemic. Ultimately, this will help guide clinical-based policies surrounding COVID-19 and other similar global pandemics to ensure that management of cerebrovascular comorbidity is appropriately prioritized during the global crisis. It will also guide public health guidelines for at-risk populations to reduce risks of complications from such comorbidities.

Published
2020

10. Moyamoya disease: diagnosis and interventions

Author

Ihara, Masafumi, Yamamoto, Yumi, Hattori, Yorito, Liu, Wanyang, Kobayashi, Hatasu, Ishiyama, Hiroyuki, Yoshimoto, Takeshi, Miyawaki, Satoru, Clausen, Tim, Bang, Oh Young, Steinberg, Gary K, Tournier-Lasserve, Elisabeth, and Koizumi, Akio

Published
2022
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14. Abstract WMP2: A Randomized, Double-Blind, Placebo-Controlled, Phase II Trial in Acute Non-Cardioembolic Ischemic Stroke With Adrenomedullin

Author

Yoshimoto, Takeshi, primary, Saito, Satoshi, additional, Omae, Katsuhiro, additional, Kita, Toshihiro, additional, Kitamura, Kazuo, additional, Fukuma, Kazuki, additional, Washida, Kazuo, additional, Abe, Soichiro, additional, Ishiyama, Hiroyuki, additional, Yamaguchi, Eriko, additional, Yamagami, Hiroshi, additional, Nagatsuka, Kazuyuki, additional, Masahiro, Tsuji, additional, Minami, Manabu, additional, Yamamoto, Haruko, additional, Hattori, Yorito, additional, Tanaka, Tomotaka, additional, and Ihara, Masafumi, additional

Published
2024
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15. Abstract TMP87: Thrombus Age in Ischemic Stroke With Atrial Fibrillation

Author

Koge, Junpei, primary, Hatakeyama, Kinta, additional, Tanaka, Kanta, additional, Yoshimoto, Takeshi, additional, Shiozawa, Masayuki, additional, Naruhiko, Kamogawa, additional, Abe, Soichiro, additional, Ishiyama, Hiroyuki, additional, Yoshie, Tomohide, additional, Imamura, Hirotoshi, additional, Kataoka, Hiroharu, additional, Ihara, Masafumi, additional, Toyoda, Kazunori, additional, and Koga, Masatoshi, additional

Published
2024
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21. Using optical coherence tomography and optical coherence tomography angiography to delineate neurovascular homeostasis in migraine: a review

Author

Yoshimoto, Takeshi, Chaliha, Devahuti, Vaccarezza, Mauro, Charng, Jason, Chen, Fred K, Lim, Amy, Drummond, Peter, Takechi, Ryusuke, Lam, Virginie, Dhaliwal, Satvinder S, Mamo, John, Yoshimoto, Takeshi, Chaliha, Devahuti, Vaccarezza, Mauro, Charng, Jason, Chen, Fred K, Lim, Amy, Drummond, Peter, Takechi, Ryusuke, Lam, Virginie, Dhaliwal, Satvinder S, and Mamo, John

Abstract

Migraine is one of the world’s most debilitating disorders, and it has recently been shown that changes in the retina can be a potential biomarker for the disease. These changes can be detected by optical coherence tomography (OCT), which measures retinal thickness, and optical coherence tomography angiography (OCTA), which measures vessel density. We searched the databases Google Scholar, ProQuest, Scopus, and Web of Science for studies in English using OCT and OCTA in migraineurs, using the search terms “optical coherence tomography,” “OCT,” “optical coherence tomography angiography,” “OCTA” and “migraine.” We found 73 primary studies, 11 reviews, and 8 metaanalyses pertaining to OCT and OCTA findings in migraineurs. They showed that migraineurs had reduced retinal thickness (via OCT), retinal vessel density, and greater foveal avascular zone area (via OCTA) than controls. OCTA changes reflect a perfusion compromise occurring in migraineurs as opposed to in healthy controls. OCT and OCTA deficits were worse in migraine-with-aura and chronic migraine than in migraine-without-aura and episodic migraine. Certain areas of the eye, such as the fovea, may be more vulnerable to these perfusion changes than other parts. Direct comparison between study findings is difficult because of the heterogeneity between the studies in terms of both methodology and analysis. Moreover, as almost all case–control studies were cross-sectional, more longitudinal cohort studies are needed to determine cause and effect between migraine pathophysiology and OCT/OCTA findings. Current evidence suggests both OCT and OCTA may serve as retinal markers for migraineurs, and further research in this field will hopefully enable us to better understand the vascular changes associated with migraine, perhaps also providing a new diagnostic and therapeutic biomarker.

Published
2024

28. Detrimental effect of anemia after mechanical thrombectomy on functional outcome in patients with ischemic stroke

Author

Inui, Ryoma, primary, Koge, Junpei, additional, Tanaka, Kanta, additional, Yoshimoto, Takeshi, additional, Shiozawa, Masayuki, additional, Abe, Soichiro, additional, Ishiyama, Hiroyuki, additional, Imamura, Hirotoshi, additional, Nakahara, Jin, additional, Kataoka, Hiroharu, additional, Ihara, Masafumi, additional, Toyoda, Kazunori, additional, and Koga, Masatoshi, additional

Published
2023
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32. RNF213 p.R4810K Variant Increases the Risk of Vasospastic Angina

Author

Ishiyama, Hiroyuki, primary, Tanaka, Tomotaka, additional, Yoshimoto, Takeshi, additional, Takahashi, Atsushi, additional, Ogata, Soshiro, additional, Nishimura, Kunihiro, additional, Asano, Yoshihiro, additional, Koizumi, Akio, additional, Noguchi, Teruo, additional, and Ihara, Masafumi, additional

Published
2023
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33. Oral Carriage of Streptococcus mutans Harboring the cnm Gene Relates to an Increased Incidence of Cerebral Microbleeds

Author

Hosoki, Satoshi, Saito, Satoshi, Tonomura, Shuichi, Ishiyama, Hiroyuki, Yoshimoto, Takeshi, Ikeda, Shuhei, Ikenouchi, Hajime, Yamamoto, Yumi, Hattori, Yorito, Miwa, Kaori, Friedland, Robert P., Carare, Roxana O., Nakahara, Jin, Suzuki, Norihiro, Koga, Masatoshi, Toyoda, Kazunori, Nomura, Ryota, Nakano, Kazuhiko, Takegami, Misa, and Ihara, Masafumi

Published
2020
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36. Tmax Mismatch Ratio to Identify Intracranial Atherosclerotic Stenosis‐Related Large‐Vessel Occlusion Before Endovascular Therapy

Author

Yoshimoto, Takeshi, primary, Inoue, Manabu, additional, Tanaka, Kanta, additional, Koge, Junpei, additional, Shiozawa, Masayuki, additional, Kamogawa, Naruhiko, additional, Ishiyama, Hiroyuki, additional, Abe, Soichiro, additional, Imamura, Hirotoshi, additional, Kataoka, Hiroharu, additional, Koga, Masatoshi, additional, Ihara, Masafumi, additional, and Toyoda, Kazunori, additional

Published
2023
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37. Early versus Later Anticoagulation for Stroke with Atrial Fibrillation

Author

Fischer, Urs, primary, Koga, Masatoshi, additional, Strbian, Daniel, additional, Branca, Mattia, additional, Abend, Stefanie, additional, Trelle, Sven, additional, Paciaroni, Maurizio, additional, Thomalla, Götz, additional, Michel, Patrik, additional, Nedeltchev, Krassen, additional, Bonati, Leo H., additional, Ntaios, George, additional, Gattringer, Thomas, additional, Sandset, Else-Charlotte, additional, Kelly, Peter, additional, Lemmens, Robin, additional, Sylaja, P.N., additional, Aguiar de Sousa, Diana, additional, Bornstein, Natan M., additional, Gdovinova, Zuzana, additional, Yoshimoto, Takeshi, additional, Tiainen, Marjaana, additional, Thomas, Helen, additional, Krishnan, Manju, additional, Shim, Gek C., additional, Gumbinger, Christoph, additional, Vehoff, Jochen, additional, Zhang, Liqun, additional, Matsuzono, Kosuke, additional, Kristoffersen, Espen, additional, Desfontaines, Philippe, additional, Vanacker, Peter, additional, Alonso, Angelika, additional, Yakushiji, Yusuke, additional, Kulyk, Caterina, additional, Hemelsoet, Dimitri, additional, Poli, Sven, additional, Paiva Nunes, Ana, additional, Caracciolo, Nicoletta, additional, Slade, Peter, additional, Demeestere, Jelle, additional, Salerno, Alexander, additional, Kneihsl, Markus, additional, Kahles, Timo, additional, Giudici, Daria, additional, Tanaka, Kanta, additional, Räty, Silja, additional, Hidalgo, Rea, additional, Werring, David J., additional, Göldlin, Martina, additional, Arnold, Marcel, additional, Ferrari, Cecilia, additional, Beyeler, Seraina, additional, Fung, Christian, additional, Weder, Bruno J., additional, Tatlisumak, Turgut, additional, Fenzl, Sabine, additional, Rezny-Kasprzak, Beata, additional, Hakim, Arsany, additional, Salanti, Georgia, additional, Bassetti, Claudio, additional, Gralla, Jan, additional, Seiffge, David J., additional, Horvath, Thomas, additional, and Dawson, Jesse, additional

Published
2023
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40. Early Initiation of Direct Oral Anticoagulants After Onset of Stroke and Short- and Long-Term Outcomes of Patients With Nonvalvular Atrial Fibrillation

Author

Mizoguchi, Tadataka, Tanaka, Kanta, Toyoda, Kazunori, Yoshimura, Sohei, Itabashi, Ryo, Takagi, Masahito, Todo, Kenichi, Shiozawa, Masayuki, Yagita, Yoshiki, Yoshimoto, Takeshi, Terasaki, Tadashi, Yamagami, Hiroshi, Takizawa, Shunya, Inoue, Manabu, Kamiyama, Kenji, Ihara, Masafumi, Okada, Yasushi, Kitazono, Takanari, and Koga, Masatoshi

Published
2020
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44. Abstract 3: Cerebral Small Vessel Disease Burden For Bleeding Risk During Antithrombotic Therapy -BAT2-

Author

Tanaka, Kanta, primary, Miwa, Kaori, additional, Yoshimura, Sohei, additional, Kamiyama, Kenji, additional, Yagita, Yoshiki, additional, Nagakane, Yoshinari, additional, Hoshino, Haruhiko, additional, Terasaki, Tadashi, additional, Okada, Yasushi, additional, Yakushiji, Yusuke, additional, Takahashi, Shinichi, additional, Ueda, Toshihiro, additional, Hasegawa, Yasuhiro, additional, Shiozawa, Masayuki, additional, Sasaki, Makoto, additional, Kudo, Kohsuke, additional, Tanaka, Jun, additional, Nishihara, Masashi, additional, Yamaguchi, Yoshitaka, additional, Fujita, Kyohei, additional, Honda, Yuko, additional, Kawano, Hiroyuki, additional, Ide, Toshihiro, additional, Yoshimoto, Takeshi, additional, Ihara, Masafumi, additional, Koga, Masatoshi, additional, Hirano, Teruyuki, additional, and Toyoda, Kazunori, additional

Published
2023
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45. Abstract 1: The Very Core Limit Of Endovascular Therapy For Acute Stroke With A Large Ischemic Region

Author

Inoue, Manabu, primary, Yoshimoto, Takeshi, additional, Toyoda, Kazunori, additional, Sakai, Nobuyuki, additional, Yamagami, Hiroshi, additional, Matsumaru, Yuji, additional, Matsumoto, Yasushi, additional, Kimura, Kazumi, additional, Ishikura, Reiichi, additional, Uchida, Kazutaka, additional, Beppu, Mikiya, additional, Sakakibara, Fumihiro, additional, Morimoto, Takeshi, additional, and Yoshimura, Shinichi, additional

Published
2023
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47. Global Impact of the COVID-19 Pandemic on Stroke Volumes and Cerebrovascular Events: A 1-Year Follow-up

Author

Society of Vascular and Interventional Neurology (US), Nguyen, Thanh N., Qureshi, Muhammad M., Klein, Piers, Yamagami, Hiroshi, Mikulik, Robert, Czlonkowska, Anna, Abdalkader, Mohamad, Sedova, Petra, Sathya, Anvitha, Lo, Hannah C., Mansour, Ossama Yassin, Vanguru, Husitha Reddy, Lesaine, Emilie, Tsivgoulis, Georgios, Loochtan, Aaron I., Demeestere, Jelle, Uchino, Ken, Inoa, Violiza, Goyal, Nitin, Charidimou, Andreas, Siegler, James E., Yaghi, Shadi, Aguiar de Sousa, Diana, Mohammaden, Mahmoud H., Haussen, Diogo C., Kristoffersen, Espen Saxhaug, Lereis, Virginia Pujol, Scollo, Sergio Daniel, Campbell, Bruce C. V., Ma, Alice, Thomas, James Orton, Parsons, Mark W., Singhal, Shaloo, Slater, Lee-Anne, Tomazini Martins, Rodrigo, Enzinger, Chris, Gattringer, Thomas, Rahman, Aminur, Bonnet, Thomas, Ligot, Noemie, De Raedt, Sylvie, Lemmens, Robin, Vanacker, Peter, Vandervorst, Fenne, Conforto, Adriana Bastos, Hidalgo, Raquel C. T., Neves, Luciana de Oliveira, Martins, Rodrigo Targa, Mora Cuervo, Daissy Liliana, Rebello, Leticia C., Santiago, Igor Bessa, Silva, Isabelle Lameirinhas da, Sakelarova, Teodora, Kalpachki, Rosen, Alexiev, Filip, Catanese, Luciana, Cora, Elena Adela, Goyal, Mayank, Hill, Michael D., Kelly, Michael E., Khosravani, Houman, Lavoie, Pascale, Peeling, Lissa, Pikula, Aleksandra, Rivera, Rodrigo, Chen, Hui-Sheng, Chen, Yimin, Huo, Xiaochuan, Miao, Zhongrong, Yang, Shuiquan, Bedekovic, Marina Roje, Bralic, Marina, Budincevic, Hrvoje, Corredor-Quintero, Ángel Basilio, Lara-Sarabia, Osvaldo E., Cabal, Martin, Tenora, Dusan, Fibrich, Petr, Herzig, Roman, Hlaváčová, Helena, Hrabanovska, Emanuela, Hlinovsky, David, Jurak, Lubomir, Kadlcikova, Jana, Karpowicz, Igor, Klecka, Lukas, Kovar, Martin, Lauer, David, Neumann, Jiri, Palouskova, Hana, Reiser, Martin, Rekova, Petra, Rohan, Vladimir, Skoda, Ondrej, Škorňa, Miroslav, Sobotková, Lenka, Sramek, Martin, Zakova, Lenka, Christensen, Hanne, Drenck, Nicolas, Iversen, Helle Klingenberg, Truelsen, Thomas Clement, Wienecke, Troels, Sobh, Khalid, Ylikotila, Pauli, Alpay, Kemal, Strbian, Daniel, Bernady, Patricia, Casenave, Philippe, Dan, Maria, Faucheux, Jean-Marc, Gentric, Jean-Christophe, Magro, Elsa, Sabben, Candice, Reiner, Peggy, Rouanet, Francois, Bohmann, Ferdinand O., Boskamp, Stefan, Mbroh, Joshua, Nagel, Simon, Nolte, Christian H, Ringleb, Peter A., Rosenkranz, Michael, Poli, Sven, Thomalla, Götz, Karapanayiotides, Theodoros, Koutroulou, Ioanna, Kargiotis, Odysseas, Palaiodimou, Lina, Barrientos Guerra, José Domingo, Huded, Vikram, Menon, Bindu, Nagendra, Shashank, Prajapati, Chintan, Sylaja, P. N., Krishna Pramana, Nyoman Angga, Sani, Achmad Firdaus, Ghoreishi, Abdoreza, Farhoudi, Mehdi, Hokmabadi, Elyar Sadeghi, Raya, Tariq Abu, Kalmanovich, Shani Avnery, Ronen, Levite, Sabetay, Sergiu Ionut, Acampa, Maurizio, Adami, Alessandro, Castellan, Lucio, Longoni, Marco, Ornello, Raffaele, Renieri, Leonardo, Bigliani, Claudia Rolla, Romoli, Michele, Sacco, Simona, Salmaggi, Andrea, Sangalli, Davide, Zini, Andrea, Doijiri, Ryosuke, Fukuda, Hiroki, Fujinaka, Toshiyuki, Fujita, Kyohei, Imamura, Hirotoshi, Sakai, Nobuyuki, Kanamaru, Takuya, Kimura, Naoto, Kono, Ryuhei, Miyake, Kosuke, Sakaguchi, Manabu, Sakai, Kenichiro, Sonoda, Kazutaka, Todo, Kenichi, Miyashita, Fumio, Tokuda, Naoki, Matsumaru, Yuji, Matsumoto, Shoji, Ohara, Nobuyuki, Shindo, Seigo, Takenobu, Yohei, Yoshimoto, Takeshi, Toyoda, Kazunori, Uwatoko, Takeshi, Yagita, Yoshiki, Yamada, Takehiro, Yamamoto, Nobuaki, Yamamoto, Ryoo, Yazawa, Yukako, Sugiura, Yuri, Waweru, Peter Kuria, Baek, Jang-Hyun, Lee, Si Baek, Seo, Kwon-Duk, Sohn, Sung-Il, Arsovska, Anita Ante, Chan, Yong Chieh, Wan Zaidi, Wan Asyraf, Jaafar, Ainul Syahrilfazli, Gongora-Rivera, Fernando, Martinez-Marino, Manuel, Infante-Valenzuela, Adrian, Groppa, Stanislav, Leahu, Pavel, Coutinho, Jonathan M, Rinkel, Leon A., Dippel, Diederik W. J., Dam-Nolen, Dianne H. K. van, Ranta, Annemarei, Wu, Teddy Y., Adebayo, Tajudeen Temitayo, Bello, Abiodun H., Nwazor, Ernest Okwundu, Sunmonu, Taofiki Ajao, Wahab, Kolawole Wasiu, Ronning, Ole Morten, Sandset, Else Charlotte, Al Hashmi, Amal M., Ahmad, Saima, Rashid, Umair, Rodriguez-Kadota, Liliana, Vences, Miguel Ángel, Yalung, Patrick Matic, Hao Dy, Jon Stewart, Pineda-Franks, Maria Carissa, Co, Christian Oliver, Brola, Waldemar, Debiec, Aleksander, Dorobek, Malgorzata, Karlinski, Michal Adam, Labuz-Roszak, Beata M., Lasek-Bal, Anetta, Sienkiewicz-Jarosz, Halina, Staszewski, Jacek, Sobolewski, Piotr, Wiacek, Marcin, Zielinska-Turek, Justyna, Araujo, Andre Pinho, Rocha, Mariana, Castro, Pedro, Cruz, Vitor Tedim, Ferreira, Paulo Venancio, Ferreira, Patricia, Nunes, Ana Paiva, Fonseca, Luisa, Marto, João Pedro, Pinho E Melo, Teresa, Rodrigues, Miguel, Silva, M. Luis, Dimitriade, Adela, Falup-Pecurariu, Cristian, Hamid, May Adel, Venketasubramanian, Narayanaswamy, Krastev, Georgi, Mako, Miroslav, Ayo-Martin, Oscar, Hernández-Fernández, Francisco, Blasco, Jordi, Rodríguez-Vázquez, Alejandro, Cruz-Culebras, Antonio, Moniche, Francisco, Montaner, Joan, Pérez-Sánchez, Soledad, García Sánchez, María Jesús, Guillán Rodríguez, Marta, Jood, Katarina, Nordanstig, Annika, Mazya, Michael V., Moreira, Tiago T. P., Bernava, Gianmarco, Beyeler, Morin, Bolognese, Manuel, Carrera, Emmanuel, Dobrocky, Tomas, Karwacki, Grzegorz Marek, Keller, Emanuela, Hsieh, Chang Yang, Boonyakarnkul, Surawan, Churojana, Anchalee, Aykac, Ozlem, Ozdemir, Atilla Ã-Zcan, Bajrami, Arsida, Senadim, Songul, Hussain, Syed Irteza, John, Seby, Banerjee, Soma, Kwan, Joseph, Krishnan, Kailash, Lenthall, Robert, Matthews, Ashok, Wong, Ken, Zhang, Liqun, Altschul, Dorothea, Asif, Kaiz S., Bahiru, Zeelalem, Below, Kristine, Biller, José, Ruland, Sean, Chaudry, Saqib A., Chen, Michael, Chebl, Alex, Cibulka, Jackie, Cistrunk, Leon, Clark, Judith, Colasurdo, Marco, Czap, Alexandra, de Havenon, Adam, D'Amato, Salvatore, Dharmadhikari, Sushrut, Grimmett, Kasey B., Dmytriw, Adam A., Etherton, Mark R., Ezepue, Chizoba, Farooqui, Mudassir, Feske, Steven K., Fink, Lauren, Gasimova, Ulviyya, Guzik, Amy K., Hakemi, Maryam, Hovingh, Majesta, Khan, Muhib, Jillela, Dinesh, Kan, Peter T., Khatri, Rakesh, Khawaja, Ayaz M., Khoury, Naim N., Kiley, Nicole L., Kim, Benny S., Kolikonda, Murali K., Kuhn, Anna Luisa, Lara, Stephanie, Linares, Guillermo, Linfante, Italo, Lukovits, Timothy G., Lycan, Sarah, Male, Shailesh S., Maali, Laith, Mancin, John, Masoud, Hesham, Mohamed, Ghada A., Monteiro, Andre, Nahab, Fadi, Nalleballe, Krishna, Ortega-Gutiérrez, Santiago, Puri, Ajit S, Radaideh, Yazan, Rahangdale, Rahul H., Rai, Ansaar, Ramakrishnan, Pankajavalli, Reddy, Aravind B., Rojas-Soto, Diana M., Romero, José Rafael, Rost, Natalia S., Rothstein, Aaron, Omran, Setareh Salehi, Sheth, Sunil A., Siddiqui, Adnan H., Starosciak, Amy K., Tarlov, Nicholas E., Taylor, Robert A., Wang, Michael J., Wolfe, Jared, Wong, Ka-Ho, Le, Huynh Vu, Nguyen, Quy Viet, Pham, Thong Nhu, Nguyen, Trung Thanh, Phan, Hoang Thi, Ton, Mai Duy, Fischer, Urs, Michel, Patrik, Strambo, Davide, Martins, Sheila O., Zaidat, Osama O., Nogueira, Raul G., Society of Vascular and Interventional Neurology (US), Nguyen, Thanh N., Qureshi, Muhammad M., Klein, Piers, Yamagami, Hiroshi, Mikulik, Robert, Czlonkowska, Anna, Abdalkader, Mohamad, Sedova, Petra, Sathya, Anvitha, Lo, Hannah C., Mansour, Ossama Yassin, Vanguru, Husitha Reddy, Lesaine, Emilie, Tsivgoulis, Georgios, Loochtan, Aaron I., Demeestere, Jelle, Uchino, Ken, Inoa, Violiza, Goyal, Nitin, Charidimou, Andreas, Siegler, James E., Yaghi, Shadi, Aguiar de Sousa, Diana, Mohammaden, Mahmoud H., Haussen, Diogo C., Kristoffersen, Espen Saxhaug, Lereis, Virginia Pujol, Scollo, Sergio Daniel, Campbell, Bruce C. V., Ma, Alice, Thomas, James Orton, Parsons, Mark W., Singhal, Shaloo, Slater, Lee-Anne, Tomazini Martins, Rodrigo, Enzinger, Chris, Gattringer, Thomas, Rahman, Aminur, Bonnet, Thomas, Ligot, Noemie, De Raedt, Sylvie, Lemmens, Robin, Vanacker, Peter, Vandervorst, Fenne, Conforto, Adriana Bastos, Hidalgo, Raquel C. T., Neves, Luciana de Oliveira, Martins, Rodrigo Targa, Mora Cuervo, Daissy Liliana, Rebello, Leticia C., Santiago, Igor Bessa, Silva, Isabelle Lameirinhas da, Sakelarova, Teodora, Kalpachki, Rosen, Alexiev, Filip, Catanese, Luciana, Cora, Elena Adela, Goyal, Mayank, Hill, Michael D., Kelly, Michael E., Khosravani, Houman, Lavoie, Pascale, Peeling, Lissa, Pikula, Aleksandra, Rivera, Rodrigo, Chen, Hui-Sheng, Chen, Yimin, Huo, Xiaochuan, Miao, Zhongrong, Yang, Shuiquan, Bedekovic, Marina Roje, Bralic, Marina, Budincevic, Hrvoje, Corredor-Quintero, Ángel Basilio, Lara-Sarabia, Osvaldo E., Cabal, Martin, Tenora, Dusan, Fibrich, Petr, Herzig, Roman, Hlaváčová, Helena, Hrabanovska, Emanuela, Hlinovsky, David, Jurak, Lubomir, Kadlcikova, Jana, Karpowicz, Igor, Klecka, Lukas, Kovar, Martin, Lauer, David, Neumann, Jiri, Palouskova, Hana, Reiser, Martin, Rekova, Petra, Rohan, Vladimir, Skoda, Ondrej, Škorňa, Miroslav, Sobotková, Lenka, Sramek, Martin, Zakova, Lenka, Christensen, Hanne, Drenck, Nicolas, Iversen, Helle Klingenberg, Truelsen, Thomas Clement, Wienecke, Troels, Sobh, Khalid, Ylikotila, Pauli, Alpay, Kemal, Strbian, Daniel, Bernady, Patricia, Casenave, Philippe, Dan, Maria, Faucheux, Jean-Marc, Gentric, Jean-Christophe, Magro, Elsa, Sabben, Candice, Reiner, Peggy, Rouanet, Francois, Bohmann, Ferdinand O., Boskamp, Stefan, Mbroh, Joshua, Nagel, Simon, Nolte, Christian H, Ringleb, Peter A., Rosenkranz, Michael, Poli, Sven, Thomalla, Götz, Karapanayiotides, Theodoros, Koutroulou, Ioanna, Kargiotis, Odysseas, Palaiodimou, Lina, Barrientos Guerra, José Domingo, Huded, Vikram, Menon, Bindu, Nagendra, Shashank, Prajapati, Chintan, Sylaja, P. N., Krishna Pramana, Nyoman Angga, Sani, Achmad Firdaus, Ghoreishi, Abdoreza, Farhoudi, Mehdi, Hokmabadi, Elyar Sadeghi, Raya, Tariq Abu, Kalmanovich, Shani Avnery, Ronen, Levite, Sabetay, Sergiu Ionut, Acampa, Maurizio, Adami, Alessandro, Castellan, Lucio, Longoni, Marco, Ornello, Raffaele, Renieri, Leonardo, Bigliani, Claudia Rolla, Romoli, Michele, Sacco, Simona, Salmaggi, Andrea, Sangalli, Davide, Zini, Andrea, Doijiri, Ryosuke, Fukuda, Hiroki, Fujinaka, Toshiyuki, Fujita, Kyohei, Imamura, Hirotoshi, Sakai, Nobuyuki, Kanamaru, Takuya, Kimura, Naoto, Kono, Ryuhei, Miyake, Kosuke, Sakaguchi, Manabu, Sakai, Kenichiro, Sonoda, Kazutaka, Todo, Kenichi, Miyashita, Fumio, Tokuda, Naoki, Matsumaru, Yuji, Matsumoto, Shoji, Ohara, Nobuyuki, Shindo, Seigo, Takenobu, Yohei, Yoshimoto, Takeshi, Toyoda, Kazunori, Uwatoko, Takeshi, Yagita, Yoshiki, Yamada, Takehiro, Yamamoto, Nobuaki, Yamamoto, Ryoo, Yazawa, Yukako, Sugiura, Yuri, Waweru, Peter Kuria, Baek, Jang-Hyun, Lee, Si Baek, Seo, Kwon-Duk, Sohn, Sung-Il, Arsovska, Anita Ante, Chan, Yong Chieh, Wan Zaidi, Wan Asyraf, Jaafar, Ainul Syahrilfazli, Gongora-Rivera, Fernando, Martinez-Marino, Manuel, Infante-Valenzuela, Adrian, Groppa, Stanislav, Leahu, Pavel, Coutinho, Jonathan M, Rinkel, Leon A., Dippel, Diederik W. J., Dam-Nolen, Dianne H. K. van, Ranta, Annemarei, Wu, Teddy Y., Adebayo, Tajudeen Temitayo, Bello, Abiodun H., Nwazor, Ernest Okwundu, Sunmonu, Taofiki Ajao, Wahab, Kolawole Wasiu, Ronning, Ole Morten, Sandset, Else Charlotte, Al Hashmi, Amal M., Ahmad, Saima, Rashid, Umair, Rodriguez-Kadota, Liliana, Vences, Miguel Ángel, Yalung, Patrick Matic, Hao Dy, Jon Stewart, Pineda-Franks, Maria Carissa, Co, Christian Oliver, Brola, Waldemar, Debiec, Aleksander, Dorobek, Malgorzata, Karlinski, Michal Adam, Labuz-Roszak, Beata M., Lasek-Bal, Anetta, Sienkiewicz-Jarosz, Halina, Staszewski, Jacek, Sobolewski, Piotr, Wiacek, Marcin, Zielinska-Turek, Justyna, Araujo, Andre Pinho, Rocha, Mariana, Castro, Pedro, Cruz, Vitor Tedim, Ferreira, Paulo Venancio, Ferreira, Patricia, Nunes, Ana Paiva, Fonseca, Luisa, Marto, João Pedro, Pinho E Melo, Teresa, Rodrigues, Miguel, Silva, M. Luis, Dimitriade, Adela, Falup-Pecurariu, Cristian, Hamid, May Adel, Venketasubramanian, Narayanaswamy, Krastev, Georgi, Mako, Miroslav, Ayo-Martin, Oscar, Hernández-Fernández, Francisco, Blasco, Jordi, Rodríguez-Vázquez, Alejandro, Cruz-Culebras, Antonio, Moniche, Francisco, Montaner, Joan, Pérez-Sánchez, Soledad, García Sánchez, María Jesús, Guillán Rodríguez, Marta, Jood, Katarina, Nordanstig, Annika, Mazya, Michael V., Moreira, Tiago T. P., Bernava, Gianmarco, Beyeler, Morin, Bolognese, Manuel, Carrera, Emmanuel, Dobrocky, Tomas, Karwacki, Grzegorz Marek, Keller, Emanuela, Hsieh, Chang Yang, Boonyakarnkul, Surawan, Churojana, Anchalee, Aykac, Ozlem, Ozdemir, Atilla Ã-Zcan, Bajrami, Arsida, Senadim, Songul, Hussain, Syed Irteza, John, Seby, Banerjee, Soma, Kwan, Joseph, Krishnan, Kailash, Lenthall, Robert, Matthews, Ashok, Wong, Ken, Zhang, Liqun, Altschul, Dorothea, Asif, Kaiz S., Bahiru, Zeelalem, Below, Kristine, Biller, José, Ruland, Sean, Chaudry, Saqib A., Chen, Michael, Chebl, Alex, Cibulka, Jackie, Cistrunk, Leon, Clark, Judith, Colasurdo, Marco, Czap, Alexandra, de Havenon, Adam, D'Amato, Salvatore, Dharmadhikari, Sushrut, Grimmett, Kasey B., Dmytriw, Adam A., Etherton, Mark R., Ezepue, Chizoba, Farooqui, Mudassir, Feske, Steven K., Fink, Lauren, Gasimova, Ulviyya, Guzik, Amy K., Hakemi, Maryam, Hovingh, Majesta, Khan, Muhib, Jillela, Dinesh, Kan, Peter T., Khatri, Rakesh, Khawaja, Ayaz M., Khoury, Naim N., Kiley, Nicole L., Kim, Benny S., Kolikonda, Murali K., Kuhn, Anna Luisa, Lara, Stephanie, Linares, Guillermo, Linfante, Italo, Lukovits, Timothy G., Lycan, Sarah, Male, Shailesh S., Maali, Laith, Mancin, John, Masoud, Hesham, Mohamed, Ghada A., Monteiro, Andre, Nahab, Fadi, Nalleballe, Krishna, Ortega-Gutiérrez, Santiago, Puri, Ajit S, Radaideh, Yazan, Rahangdale, Rahul H., Rai, Ansaar, Ramakrishnan, Pankajavalli, Reddy, Aravind B., Rojas-Soto, Diana M., Romero, José Rafael, Rost, Natalia S., Rothstein, Aaron, Omran, Setareh Salehi, Sheth, Sunil A., Siddiqui, Adnan H., Starosciak, Amy K., Tarlov, Nicholas E., Taylor, Robert A., Wang, Michael J., Wolfe, Jared, Wong, Ka-Ho, Le, Huynh Vu, Nguyen, Quy Viet, Pham, Thong Nhu, Nguyen, Trung Thanh, Phan, Hoang Thi, Ton, Mai Duy, Fischer, Urs, Michel, Patrik, Strambo, Davide, Martins, Sheila O., Zaidat, Osama O., and Nogueira, Raul G.

Abstract

Background and Objectives: Declines in stroke admission, IV thrombolysis (IVT), and mechanical thrombectomy volumes were reported during the first wave of the COVID-19 pandemic. There is a paucity of data on the longer-term effect of the pandemic on stroke volumes over the course of a year and through the second wave of the pandemic. We sought to measure the effect of the COVID-19 pandemic on the volumes of stroke admissions, intracranial hemorrhage (ICH), IVT, and mechanical thrombectomy over a 1-year period at the onset of the pandemic (March 1, 2020, to February 28, 2021) compared with the immediately preceding year (March 1, 2019, to February 29, 2020)., Methods: We conducted a longitudinal retrospective study across 6 continents, 56 countries, and 275 stroke centers. We collected volume data for COVID-19 admissions and 4 stroke metrics: ischemic stroke admissions, ICH admissions, IVT treatments, and mechanical thrombectomy procedures. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases., Results: There were 148,895 stroke admissions in the 1 year immediately before compared with 138,453 admissions during the 1-year pandemic, representing a 7% decline (95% CI [95% CI 7.1–6.9]; p < 0.0001). ICH volumes declined from 29,585 to 28,156 (4.8% [5.1–4.6]; p < 0.0001) and IVT volume from 24,584 to 23,077 (6.1% [6.4–5.8]; p < 0.0001). Larger declines were observed at high-volume compared with low-volume centers (all p < 0.0001). There was no significant change in mechanical thrombectomy volumes (0.7% [0.6–0.9]; p = 0.49). Stroke was diagnosed in 1.3% [1.31–1.38] of 406,792 COVID-19 hospitalizations. SARS-CoV-2 infection was present in 2.9% ([2.82–2.97], 5,656/195,539) of all stroke hospitalizations., Discussion: There was a global decline and shift to lower-volume centers of stroke admission volumes, ICH volumes, and IVT volumes during the 1st year of the COVID-19 pandemic compared with the prior year. Mechanical thrombectomy volumes were preserved. These results suggest preservation in the stroke care of higher severity of disease through the first pandemic year., Trial Registration Information: This study is registered under NCT04934020.

Published
2023

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