Searched for: in-biosketch:true
person:dehkhs01
Penumbral imaging and functional outcome in patients with anterior circulation ischaemic stroke treated with endovascular thrombectomy versus medical therapy: a meta-analysis of individual patient-level data
Campbell, Bruce C V; Majoie, Charles B L M; Albers, Gregory W; Menon, Bijoy K; Yassi, Nawaf; Sharma, Gagan; van Zwam, Wim H; van Oostenbrugge, Robert J; Demchuk, Andrew M; Guillemin, Francis; White, Philip; Dávalos, Antoni; van der Lugt, Aad; Butcher, Kenneth S; Cherifi, Aboubaker; Marquering, Henk A; Cloud, Geoffrey; Macho Fernández, Juan M; Madigan, Jeremy; Oppenheim, Catherine; Donnan, Geoffrey A; Roos, Yvo B W E M; Shankar, Jai; Lingsma, Hester; Bonafé, Alain; Raoult, Hélène; Hernández-Pérez, María; Bharatha, Aditya; Jahan, Reza; Jansen, Olav; Richard, Sébastien; Levy, Elad I; Berkhemer, Olvert A; Soudant, Marc; Aja, Lucia; Davis, Stephen M; Krings, Timo; Tisserand, Marie; San Román, Luis; Tomasello, Alejandro; Beumer, Debbie; Brown, Scott; Liebeskind, David S; Bracard, Serge; Muir, Keith W; Dippel, Diederik W J; Goyal, Mayank; Saver, Jeffrey L; Jovin, Tudor G; Hill, Michael D; Mitchell, Peter J; Berkhemer, Olvert A; Fransen, Puck Ss; Beumer, Debbie; van den Berg, Lucie A; Lingsma, Hester F; Yoo, Albert J; Schonewille, Wouter J; Vos, Jan Albert; Nederkoorn, Paul J; Wermer, Marieke Jh; van Walderveen, Marianne Aa; Staals, Julie; Hofmeijer, Jeannette; van Oostayen, Jacques A; Lycklama À Nijeholt, Geert J; Boiten, Jelis; Brouwer, Patrick A; Emmer, Bart J; de Bruijn, Sebastiaan F; van Dijk, Lukas C; Kappelle, Jaap; Lo, Rob H; van Dijk, Ewoud J; de Vries, Joost; de Kort, Paul L M; van Rooij, Willem Jan J; van den Berg, Jan S P; van Hasselt, Boudewijn A A M; Aerden, Leo A M; Dallinga, René J; Visser, Marieke C; Bot, Joseph C J; Vroomen, Patrick C; Eshghi, Omid; Schreuder, Tobien H C M L; Heijboer, Roel J J; Keizer, Koos; Tielbeek, Alexander V; den Hertog, Heleen M; Gerrits, Dick G; van den Berg-Vos, Renske M; Karas, Giorgos B; Steyerberg, Ewout W; Flach, Zwenneke; Marquering, Henk A; Sprengers, Marieke E S; Jenniskens, Sjoerd F M; Beenen, Ludo F M; van den Berg, René; Koudstaal, Peter J; van Zwam, Wim H; Roos, Yvo B W E M; van der Lugt, Aad; van Oostenbrugge, Robert J; Majoie, Charles B L M; Dippel, Diederik W J; Brown, Martin M; Liebig, Thomas; Stijnen, Theo; Andersson, Tommy; Mattle, Heinrich; Wahlgren, Nils; van der Heijden, Esther; Ghannouti, Naziha; Fleitour, Nadine; Hooijenga, Imke; Puppels, Corina; Pellikaan, Wilma; Geerling, Annet; Lindl-Velema, Annemieke; van Vemde, Gina; de Ridder, Ans; Greebe, Paut; de Bont-Stikkelbroeck, José; de Meris, Joke; Janssen, Kirsten; Struijk, Willy; Licher, Silvan; Boodt, Nikki; Ros, Adriaan; Venema, Esmee; Slokkers, Ilse; Ganpat, Raymie-Jayce; Mulder, Maxim; Saiedie, Nawid; Heshmatollah, Alis; Schipperen, Stefanie; Vinken, Stefan; van Boxtel, Tiemen; Koets, Jeroen; Boers, Merel; Santos, Emilie; Borst, Jordi; Jansen, Ivo; Kappelhof, Manon; Lucas, Marit; Geuskens, Ralph; Barros, Renan Sales; Dobbe, Roeland; Csizmadia, Marloes; Hill, M D; Goyal, M; Demchuk, A M; Menon, B K; Eesa, M; Ryckborst, K J; Wright, M R; Kamal, N R; Andersen, L; Randhawa, P A; Stewart, T; Patil, S; Minhas, P; Almekhlafi, M; Mishra, S; Clement, F; Sajobi, T; Shuaib, A; Montanera, W J; Roy, D; Silver, F L; Jovin, T G; Frei, D F; Sapkota, B; Rempel, J L; Thornton, J; Williams, D; Tampieri, D; Poppe, A Y; Dowlatshahi, D; Wong, J H; Mitha, A P; Subramaniam, S; Hull, G; Lowerison, M W; Sajobi, T; Salluzzi, M; Wright, M R; Maxwell, M; Lacusta, S; Drupals, E; Armitage, K; Barber, P A; Smith, E E; Morrish, W F; Coutts, S B; Derdeyn, C; Demaerschalk, B; Yavagal, D; Martin, R; Brant, R; Yu, Y; Willinsky, R A; Montanera, W J; Weill, A; Kenney, C; Aram, H; Stewart, T; Stys, P K; Watson, T W; Klein, G; Pearson, D; Couillard, P; Trivedi, A; Singh, D; Klourfeld, E; Imoukhuede, O; Nikneshan, D; Blayney, S; Reddy, R; Choi, P; Horton, M; Musuka, T; Dubuc, V; Field, T S; Desai, J; Adatia, S; Alseraya, A; Nambiar, V; van Dijk, R; Wong, J H; Mitha, A P; Morrish, W F; Eesa, M; Newcommon, N J; Shuaib, A; Schwindt, B; Butcher, K S; Jeerakathil, T; Buck, B; Khan, K; Naik, S S; Emery, D J; Owen, R J; Kotylak, T B; Ashforth, R A; Yeo, T A; McNally, D; Siddiqui, M; Saqqur, M; Hussain, D; Kalashyan, H; Manosalva, A; Kate, M; Gioia, L; Hasan, S; Mohammad, A; Muratoglu, M; Williams, D; Thornton, J; Cullen, A; Brennan, P; O'Hare, A; Looby, S; Hyland, D; Duff, S; McCusker, M; Hallinan, B; Lee, S; McCormack, J; Moore, A; O'Connor, M; Donegan, C; Brewer, L; Martin, A; Murphy, S; O'Rourke, K; Smyth, S; Kelly, P; Lynch, T; Daly, T; O'Brien, P; O'Driscoll, A; Martin, M; Daly, T; Collins, R; Coughlan, T; McCabe, D; Murphy, S; O'Neill, D; Mulroy, M; Lynch, O; Walsh, T; O'Donnell, M; Galvin, T; Harbison, J; McElwaine, P; Mulpeter, K; McLoughlin, C; Reardon, M; Harkin, E; Dolan, E; Watts, M; Cunningham, N; Fallon, C; Gallagher, S; Cotter, P; Crowe, M; Doyle, R; Noone, I; Lapierre, M; Coté, V A; Lanthier, S; Odier, C; Durocher, A; Raymond, J; Weill, A; Daneault, N; Deschaintre, Y; Jankowitz, B; Baxendell, L; Massaro, L; Jackson-Graves, C; Decesare, S; Porter, P; Armbruster, K; Adams, A; Billigan, J; Oakley, J; Ducruet, A; Jadhav, A; Giurgiutiu, D-V; Aghaebrahim, A; Reddy, V; Hammer, M; Starr, M; Totoraitis, V; Wechsler, L; Streib, S; Rangaraju, S; Campbell, D; Rocha, M; Gulati, D; Silver, F L; Krings, T; Kalman, L; Cayley, A; Williams, J; Stewart, T; Wiegner, R; Casaubon, L K; Jaigobin, C; Del Campo, J M; Elamin, E; Schaafsma, J D; Willinsky, R A; Agid, R; Farb, R; Ter Brugge, K; Sapkoda, B L; Baxter, B W; Barton, K; Knox, A; Porter, A; Sirelkhatim, A; Devlin, T; Dellinger, C; Pitiyanuvath, N; Patterson, J; Nichols, J; Quarfordt, S; Calvert, J; Hawk, H; Fanale, C; Frei, D F; Bitner, A; Novak, A; Huddle, D; Bellon, R; Loy, D; Wagner, J; Chang, I; Lampe, E; Spencer, B; Pratt, R; Bartt, R; Shine, S; Dooley, G; Nguyen, T; Whaley, M; McCarthy, K; Teitelbaum, J; Tampieri, D; Poon, W; Campbell, N; Cortes, M; Dowlatshahi, D; Lum, C; Shamloul, R; Robert, S; Stotts, G; Shamy, M; Steffenhagen, N; Blacquiere, D; Hogan, M; AlHazzaa, M; Basir, G; Lesiuk, H; Iancu, D; Santos, M; Choe, H; Weisman, D C; Jonczak, K; Blue-Schaller, A; Shah, Q; MacKenzie, L; Klein, B; Kulandaivel, K; Kozak, O; Gzesh, D J; Harris, L J; Khoury, J S; Mandzia, J; Pelz, D; Crann, S; Fleming, L; Hesser, K; Beauchamp, B; Amato-Marzialli, B; Boulton, M; Lopez-Ojeda, P; Sharma, M; Lownie, S; Chan, R; Swartz, R; Howard, P; Golob, D; Gladstone, D; Boyle, K; Boulos, M; Hopyan, J; Yang, V; Da Costa, L; Holmstedt, C A; Turk, A S; Navarro, R; Jauch, E; Ozark, S; Turner, R; Phillips, S; Shankar, J; Jarrett, J; Gubitz, G; Maloney, W; Vandorpe, R; Schmidt, M; Heidenreich, J; Hunter, G; Kelly, M; Whelan, R; Peeling, L; Burns, P A; Hunter, A; Wiggam, I; Kerr, E; Watt, M; Fulton, A; Gordon, P; Rennie, I; Flynn, P; Smyth, G; O'Leary, S; Gentile, N; Linares, G; McNelis, P; Erkmen, K; Katz, P; Azizi, A; Weaver, M; Jungreis, C; Faro, S; Shah, P; Reimer, H; Kalugdan, V; Saposnik, G; Bharatha, A; Li, Y; Kostyrko, P; Santos, M; Marotta, T; Montanera, W; Sarma, D; Selchen, D; Spears, J; Heo, J H; Jeong, K; Kim, D J; Kim, B M; Kim, Y D; Song, D; Lee, K-J; Yoo, J; Bang, O Y; Rho, S; Lee, J; Jeon, P; Kim, K H; Cha, J; Kim, S J; Ryoo, S; Lee, M J; Sohn, S-I; Kim, C-H; Ryu, H-G; Hong, J-H; Chang, H-W; Lee, C-Y; Rha, J; Davis, Stephen M; Donnan, Geoffrey A; Campbell, Bruce Cv; Mitchell, Peter J; Churilov, Leonid; Yan, Bernard; Dowling, Richard; Yassi, Nawaf; Oxley, Thomas J; Wu, Teddy Y; Silver, Gabriel; McDonald, Amy; McCoy, Rachael; Kleinig, Timothy J; Scroop, Rebecca; Dewey, Helen M; Simpson, Marion; Brooks, Mark; Coulton, Bronwyn; Krause, Martin; Harrington, Timothy J; Steinfort, Brendan; Faulder, Kenneth; Priglinger, Miriam; Day, Susan; Phan, Thanh; Chong, Winston; Holt, Michael; Chandra, Ronil V; Ma, Henry; Young, Dennis; Wong, Kitty; Wijeratne, Tissa; Tu, Hans; Mackay, Elizabeth; Celestino, Sherisse; Bladin, Christopher F; Loh, Poh Sien; Gilligan, Amanda; Ross, Zofia; Coote, Skye; Frost, Tanya; Parsons, Mark W; Miteff, Ferdinand; Levi, Christopher R; Ang, Timothy; Spratt, Neil; Kaauwai, Lara; Badve, Monica; Rice, Henry; de Villiers, Laetitia; Barber, P Alan; McGuinness, Ben; Hope, Ayton; Moriarty, Maurice; Bennett, Patricia; Wong, Andrew; Coulthard, Alan; Lee, Andrew; Jannes, Jim; Field, Deborah; Sharma, Gagan; Salinas, Simon; Cowley, Elise; Snow, Barry; Kolbe, John; Stark, Richard; King, John; Macdonnell, Richard; Attia, John; D'Este, Cate; Saver, Jeffrey L; Goyal, Mayank; Diener, Hans-Christoph; Levy, Elad I; Bonafé, Alain; Mendes Pereira, Vitor; Jahan, Reza; Albers, Gregory W; Cognard, Christophe; Cohen, David J; Hacke, Werner; Jansen, Olav; Jovin, Tudor G; Mattle, Heinrich P; Nogueira, Raul G; Siddiqui, Adnan H; Yavagal, Dileep R; von Kummer, Rüdiger; Smith, Wade; Turjman, Francis; Hamilton, Scott; Chiacchierini, Richard; Amar, Arun; Sanossian, Nerses; Loh, Yince; Devlin, T; Baxter, B; Hawk, H; Sapkota, B; Quarfordt, S; Sirelkhatim, A; Dellinger, C; Barton, K; Reddy, V K; Ducruet, A; Jadhav, A; Horev, A; Giurgiutiu, D-V; Totoraitis, V; Hammer, M; Jankowitz, B; Wechsler, L; Rocha, M; Gulati, D; Campbell, D; Star, M; Baxendell, L; Oakley, J; Siddiqui, A; Hopkins, L N; Snyder, K; Sawyer, R; Hall, S; Costalat, V; Riquelme, C; Machi, P; Omer, E; Arquizan, C; Mourand, I; Charif, M; Ayrignac, X; Menjot de Champfleur, N; Leboucq, N; Gascou, G; Moynier, M; du Mesnil de Rochemont, R; Singer, O; Berkefeld, J; Foerch, C; Lorenz, M; Pfeilschifer, W; Hattingen, E; Wagner, M; You, S J; Lescher, S; Braun, H; Dehkharghani, S; Belagaje, S R; Anderson, A; Lima, A; Obideen, M; Haussen, D; Dharia, R; Frankel, M; Patel, V; Owada, K; Saad, A; Amerson, L; Horn, C; Doppelheuer, S; Schindler, K; Lopes, D K; Chen, M; Moftakhar, R; Anton, C; Smreczak, M; Carpenter, J S; Boo, S; Rai, A; Roberts, T; Tarabishy, A; Gutmann, L; Brooks, C; Brick, J; Domico, J; Reimann, G; Hinrichs, K; Becker, M; Heiss, E; Selle, C; Witteler, A; Al-Boutros, S; Danch, M-J; Ranft, A; Rohde, S; Burg, K; Weimar, C; Zegarac, V; Hartmann, C; Schlamann, M; Göricke, S; Ringlestein, A; Wanke, I; Mönninghoff, C; Dietzold, M; Budzik, R; Davis, T; Eubank, G; Hicks, W J; Pema, P; Vora, N; Mejilla, J; Taylor, M; Clark, W; Rontal, A; Fields, J; Peterson, B; Nesbit, G; Lutsep, H; Bozorgchami, H; Priest, R; Ologuntoye, O; Barnwell, S; Dogan, A; Herrick, K; Takahasi, C; Beadell, N; Brown, B; Jamieson, S; Hussain, M S; Russman, A; Hui, F; Wisco, D; Uchino, K; Khawaja, Z; Katzan, I; Toth, G; Cheng-Ching, E; Bain, M; Man, S; Farrag, A; George, P; John, S; Shankar, L; Drofa, A; Dahlgren, R; Bauer, A; Itreat, A; Taqui, A; Cerejo, R; Richmond, A; Ringleb, P; Bendszus, M; Möhlenbruch, M; Reiff, T; Amiri, H; Purrucker, J; Herweh, C; Pham, M; Menn, O; Ludwig, I; Acosta, I; Villar, C; Morgan, W; Sombutmai, C; Hellinger, F; Allen, E; Bellew, M; Gandhi, R; Bonwit, E; Aly, J; Ecker, R D; Seder, D; Morris, J; Skaletsky, M; Belden, J; Baker, C; Connolly, L S; Papanagiotou, P; Roth, C; Kastrup, A; Politi, M; Brunner, F; Alexandrou, M; Merdivan, H; Ramsey, C; Given Ii, C; Renfrow, S; Deshmukh, V; Sasadeusz, K; Vincent, F; Thiesing, J T; Putnam, J; Bhatt, A; Kansara, A; Caceves, D; Lowenkopf, T; Yanase, L; Zurasky, J; Dancer, S; Freeman, B; Scheibe-Mirek, T; Robison, J; Rontal, A; Roll, J; Clark, D; Rodriguez, M; Fitzsimmons, B-Fm; Zaidat, O; Lynch, J R; Lazzaro, M; Larson, T; Padmore, L; Das, E; Farrow-Schmidt, A; Hassan, A; Tekle, W; Cate, C; Jansen, O; Cnyrim, C; Wodarg, F; Wiese, C; Binder, A; Riedel, C; Rohr, A; Lang, N; Laufs, H; Krieter, S; Remonda, L; Diepers, M; Añon, J; Nedeltchev, K; Kahles, T; Biethahn, S; Lindner, M; Chang, V; Gächter, C; Esperon, C; Guglielmetti, M; Arenillas Lara, J F; Martínez Galdámez, M; Calleja Sanz, A I; Cortijo Garcia, E; Garcia Bermejo, P; Perez, S; Mulero Carrillo, P; Crespo Vallejo, E; Ruiz Piñero, M; Lopez Mesonero, L; Reyes Muñoz, F J; Brekenfeld, C; Buhk, J-H; Krützelmann, A; Thomalla, G; Cheng, B; Beck, C; Hoppe, J; Goebell, E; Holst, B; Grzyska, U; Wortmann, G; Starkman, S; Duckwiler, G; Jahan, R; Rao, N; Sheth, S; Ng, K; Noorian, A; Szeder, V; Nour, M; McManus, M; Huang, J; Tarpley, J; Tateshima, S; Gonzalez, N; Ali, L; Liebeskind, D; Hinman, J; Calderon-Arnulphi, M; Liang, C; Guzy, J; Koch, S; DeSousa, K; Gordon-Perue, G; Haussen, D; Elhammady, M; Peterson, E; Pandey, V; Dharmadhikari, S; Khandelwal, P; Malik, A; Pafford, R; Gonzalez, P; Ramdas, K; Andersen, G; Damgaard, D; Von Weitzel-Mudersbach, P; Simonsen, C; Ruiz de Morales Ayudarte, N; Poulsen, M; Sørensen, L; Karabegovich, S; Hjørringgaard, M; Hjort, N; Harbo, T; Sørensen, K; Deshaies, E; Padalino, D; Swarnkar, A; Latorre, J G; Elnour, E; El-Zammar, Z; Villwock, M; Farid, H; Balgude, A; Cross, L; Hansen, K; Holtmannspötter, M; Kondziella, D; Hoejgaard, J; Taudorf, S; Soendergaard, H; Wagner, A; Cronquist, M; Stavngaard, T; Cortsen, M; Krarup, L H; Hyldal, T; Haring, H-P; Guggenberger, S; Hamberger, M; Trenkler, J; Sonnberger, M; Nussbaumer, K; Dominger, C; Bach, E; Jagadeesan, B D; Taylor, R; Kim, J; Shea, K; Tummala, R; Zacharatos, H; Sandhu, D; Ezzeddine, M; Grande, A; Hildebrandt, D; Miller, K; Scherber, J; Hendrickson, A; Jumaa, M; Zaidi, S; Hendrickson, T; Snyder, V; Killer-Oberpfalzer, M; Mutzenbach, J; Weymayr, F; Broussalis, E; Stadler, K; Jedlitschka, A; Malek, A; Mueller-Kronast, N; Beck, P; Martin, C; Summers, D; Day, J; Bettinger, I; Holloway, W; Olds, K; Arkin, S; Akhtar, N; Boutwell, C; Crandall, S; Schwartzman, M; Weinstein, C; Brion, B; Prothmann, S; Kleine, J; Kreiser, K; Boeckh-Behrens, T; Poppert, H; Wunderlich, S; Koch, M L; Biberacher, V; Huberle, A; Gora-Stahlberg, G; Knier, B; Meindl, T; Utpadel-Fischler, D; Zech, M; Kowarik, M; Seifert, C; Schwaiger, B; Puri, A; Hou, S; Wakhloo, A; Moonis, M; Henninger, N; Goddeau, R; Massari, F; Minaeian, A; Lozano, J D; Ramzan, M; Stout, C; Patel, A; Tunguturi, A; Onteddu, S; Carandang, R; Howk, M; Ribó, M; Sanjuan, E; Rubiera, M; Pagola, J; Flores, A; Muchada, M; Meler, P; Huerga, E; Gelabert, S; Coscojuela, P; Tomasello, A; Rodriguez, D; Santamarina, E; Maisterra, O; Boned, S; Seró, L; Rovira, A; Molina, C A; Millán, M; Muñoz, L; Pérez de la Ossa, N; Gomis, M; Dorado, L; López-Cancio, E; Palomeras, E; Munuera, J; García Bermejo, P; Remollo, S; Castaño, C; García-Sort, R; Cuadras, P; Puyalto, P; Hernández-Pérez, M; Jiménez, M; Martínez-Piñeiro, A; Lucente, G; Dávalos, A; Chamorro, A; Urra, X; Obach, V; Cervera, A; Amaro, S; Llull, L; Codas, J; Balasa, M; Navarro, J; Ariño, H; Aceituno, A; Rudilosso, S; Renu, A; Macho, J M; San Roman, L; Blasco, J; López, A; MacÃas, N; Cardona, P; Quesada, H; Rubio, F; Cano, L; Lara, B; de Miquel, M A; Aja, L; Serena, J; Cobo, E; Albers, Gregory W; Lees, Kennedy R; Arenillas, J; Roberts, R; Minhas, P; Al-Ajlan, F; Salluzzi, M; Zimmel, L; Patel, S; Eesa, M; MartÃ-Fà bregas, J; Jankowitz, B; Serena, J; Salvat-Plana, M; López-Cancio, E; Bracard, S; Ducrocq, Xavier; Anxionnat, René; Baillot, Pierre-Alexandre; Barbier, Charlotte; Derelle, Anne-Laure; Lacour, Jean-Christophe; Richard, Sébastien; Samson, Yves; Sourour, Nader; Baronnet-Chauvet, Flore; Clarencon, Frédéric; Crozier, Sophie; Deltour, Sandrine; Di Maria, Federico; Le Bouc, Raphael; Leger, Anne; Mutlu, Gurkan; Rosso, Charlotte; Szatmary, Zoltan; Yger, Marion; Zavanone, Chiara; Bakchine, Serge; Pierot, Laurent; Caucheteux, Nathalie; Estrade, Laurent; Kadziolka, Krzysztof; Leautaud, Alexandre; Renkes, Céline; Serre, Isabelle; Desal, Hubert; Guillon, Benoît; Boutoleau-Bretonniere, Claire; Daumas-Duport, Benjamin; De Gaalon, Solène; Derkinderen, Pascal; Evain, Sarah; Herisson, Fanny; Laplaud, David-Axel; Lebouvier, Thibaud; Lintia-Gaultier, Alina; Pouclet-Courtemanche, Hélène; Rouaud, Tiphaine; Rouaud Jaffrenou, Violaine; Schunck, Aurélia; Sevin-Allouet, Mathieu; Toulgoat, Frederique; Wiertlewski, Sandrine; Gauvrit, Jean-Yves; Ronziere, Thomas; Cahagne, Vincent; Ferre, Jean-Christophe; Pinel, Jean-François; Raoult, Hélène; Mas, Jean-Louis; Meder, Jean-François; Al Najjar-Carpentier, Amen-Adam; Birchenall, Julia; Bodiguel, Eric; Calvet, David; Domigo, Valérie; Godon-Hardy, Sylvie; Guiraud, Vincent; Lamy, Catherine; Majhadi, Loubna; Morin, Ludovic; Naggara, Olivier; Trystram, Denis; Turc, Guillaume; Berge, Jérôme; Sibon, Igor; Menegon, Patrice; Barreau, Xavier; Rouanet, François; Debruxelles, Sabrina; Kazadi, Annabelle; Renou, Pauline; Fleury, Olivier; Pasco-Papon, Anne; Dubas, Frédéric; Caroff, Jildaz; Godard Ducceschi, Sophie; Hamon, Marie-Aurélie; Lecluse, Alderic; Marc, Guillaume; Giroud, Maurice; Ricolfi, Frédéric; Bejot, Yannick; Chavent, Adrien; Gentil, Arnaud; Kazemi, Apolline; Osseby, Guy-Victor; Voguet, Charlotte; Mahagne, Marie-Hélène; Sedat, Jacques; Chau, Yves; Suissa, Laurent; Lachaud, Sylvain; Houdart, Emmanuel; Stapf, Christian; Buffon Porcher, Frédérique; Chabriat, Hugues; Guedin, Pierre; Herve, Dominique; Jouvent, Eric; Mawet, Jérôme; Saint-Maurice, Jean-Pierre; Schneble, Hans-Martin; Turjman, Francis; Nighoghossian, Norbert; Berhoune, Nadia-Nawel; Bouhour, Françoise; Cho, Tae-Hee; Derex, Laurent; Felix, Sandra; Gervais-Bernard, Hélène; Gory, Benjamin; Manera, Luis; Mechtouff, Laura; Ritzenthaler, Thomas; Riva, Roberto; Salaris Silvio, Fabrizio; Tilikete, Caroline; Blanc, Raphael; Obadia, Michaël; Bartolini, Mario Bruno; Gueguen, Antoine; Piotin, Michel; Pistocchi, Silvia; Redjem, Hocine; Drouineau, Jacques; Neau, Jean-Philippe; Godeneche, Gaelle; Lamy, Matthias; Marsac, Emilia; Velasco, Stephane; Clavelou, Pierre; Chabert, Emmanuel; Bourgois, Nathalie; Cornut-Chauvinc, Catherine; Ferrier, Anna; Gabrillargues, Jean; Jean, Betty; Marques, Anna-Raquel; Vitello, Nicolas; Detante, Olivier; Barbieux, Marianne; Boubagra, Kamel; Favre Wiki, Isabelle; Garambois, Katia; Tahon, Florence; Ashok, Vasdev; Voguet, Charlotte; Coskun, Oguzhan; Guedin, Pierre; Rodesch, Georges; Lapergue, Bertrand; Bourdain, Frédéric; Evrard, Serge; Graveleau, Philippe; Decroix, Jean Pierre; Wang, Adrien; Sellal, François; Ahle, Guido; Carelli, Gabriela; Dugay, Marie-Hélène; Gaultier, Claude; Lebedinsky, Ariel Pablo; Lita, Lavinia; Musacchio, Raul Mariano; Renglewicz-Destuynder, Catherine; Tournade, Alain; Vuillemet, Françis; Montoro, Francisco Macian; Mounayer, Charbel; Faugeras, Frederic; Gimenez, Laetitia; Labach, Catherine; Lautrette, Géraldine; Denier, Christian; Saliou, Guillaume; Chassin, Olivier; Dussaule, Claire; Melki, Elsa; Ozanne, Augustin; Puccinelli, Francesco; Sachet, Marina; Sarov, Mariana; Bonneville, Jean-François; Moulin, Thierry; Biondi, Alessandra; De Bustos Medeiros, Elisabeth; Vuillier, Fabrice; Courtheoux, Patrick; Viader, Fausto; Apoil-Brissard, Marion; Bataille, Mathieu; Bonnet, Anne-Laure; Cogez, Julien; Kazemi, Apolline; Touze, Emmanuel; Leclerc, Xavier; Leys, Didier; Aggour, Mohamed; Aguettaz, Pierre; Bodenant, Marie; Cordonnier, Charlotte; Deplanque, Dominique; Girot, Marie; Henon, Hilde; Kalsoum, Erwah; Lucas, Christian; Pruvo, Jean-Pierre; Zuniga, Paolo; Bonafé, Alain; Arquizan, Caroline; Costalat, Vincent; Machi, Paolo; Mourand, Isabelle; Riquelme, Carlos; Bounolleau, Pierre; Arteaga, Charles; Faivre, Anthony; Bintner, Marc; Tournebize, Patrice; Charlin, Cyril; Darcel, Françoise; Gauthier-Lasalarie, Pascale; Jeremenko, Marcia; Mouton, Servane; Zerlauth, Jean-Baptiste; Lamy, Chantal; Hervé, Deramond; Hassan, Hosseini; Gaston, André; Barral, Francis-Guy; Garnier, Pierre; Beaujeux, Rémy; Wolff, Valérie; Herbreteau, Denis; Debiais, Séverine; Murray, Alicia; Ford, Gary; Muir, Keith W; White, Philip; Clifton, Andy; Freeman, Janet; Ford, Ian; Markus, Hugh; Wardlaw, Joanna; Lees, Kennedy R; Molyneux, Andy; Robinson, Thompson; Lewis, Steff; Norrie, John; Robertson, Fergus; Perry, Richard; Dixit, Anand; Cloud, Geoffrey; Clifton, Andrew; Madigan, Jeremy; Roffe, Christine; Nayak, Sanjeev; Lobotesis, Kyriakos; Smith, Craig; Herwadkar, Amit; Kandasamy, Naga; Goddard, Tony; Bamford, John; Subramanian, Ganesh; Lenthall, Rob; Littleton, Edward; Lamin, Sal; Storey, Kelley; Ghatala, Rita; Banaras, Azra; Aeron-Thomas, John; Hazel, Bath; Maguire, Holly; Veraque, Emelda; Harrison, Louise; Keshvara, Rekha; Cunningham, James
BACKGROUND:CT perfusion (CTP) and diffusion or perfusion MRI might assist patient selection for endovascular thrombectomy. We aimed to establish whether imaging assessments of irreversibly injured ischaemic core and potentially salvageable penumbra volumes were associated with functional outcome and whether they interacted with the treatment effect of endovascular thrombectomy on functional outcome. METHODS:/s. Critically hypoperfused tissue was estimated as the volume of tissue with a CTP time to maximum longer than 6 s. Mismatch volume (ie, the estimated penumbral volume) was calculated as critically hypoperfused tissue volume minus ischaemic core volume. The association of ischaemic core and penumbral volumes with 90-day mRS score was analysed with multivariable logistic regression (functional independence, defined as mRS score 0-2) and ordinal logistic regression (functional improvement by at least one mRS category) in all patients and in a subset of those with more than 50% endovascular reperfusion, adjusted for baseline prognostic variables. The meta-analysis was prospectively designed by the HERMES executive committee, but not registered. FINDINGS:=0·94). Mismatch volume, examined only in the CTP group because of the small numbers of patients who had perfusion MRI, was not associated with either functional independence or functional improvement. In patients with CTP with more than 50% endovascular reperfusion (n=186), age, ischaemic core volume, and imaging-to-reperfusion time were independently associated with functional improvement. Risk of bias between studies was generally low. INTERPRETATION:Estimated ischaemic core volume was independently associated with functional independence and functional improvement but did not modify the treatment benefit of endovascular thrombectomy over standard medical therapy for improved functional outcome. Combining ischaemic core volume with age and expected imaging-to-reperfusion time will improve assessment of prognosis and might inform endovascular thrombectomy treatment decisions. FUNDING:Medtronic.
PMID: 30413385
ISSN: 1474-4465
CID: 5121972
A dual-tuned O-17/H-1 head array for direct brain oximetry at 3 Tesla
Lakshmanan, Karthik; Dehkharghani, Seena; Madelin, Guillaume; Brown, Ryan
ISI:000489237500001
ISSN: 0740-3194
CID: 4155922
Automated CT Perfusion Prediction of Large Vessel Acute Stroke from Intracranial Atherosclerotic Disease
Haussen, Diogo C; Bouslama, Mehdi; Dehkharghani, Seena; Grossberg, Jonathan A; Bianchi, Nicolas; Bowen, Meredith; Frankel, Michael R; Nogueira, Raul G
Background and Purpose/UNASSIGNED:We have observed that large vessel occlusion acute strokes (LVOS) due to intracranial atherosclerotic disease (ICAD) present with more benign CT perfusion (CTP) profiles, which we presume to potentially represent enhanced collateralization compared to embolic LVOS. We aim to determine if CTP profiles can predict ICAD in LVOS. Methods/UNASSIGNED:Retrospective review of a prospectively collected interventional stroke database from September 2010 to March 2015. Patients with intracranial ICA/MCA-M1/M2 occlusions and CTP were dichotomized into ICAD versus non-ICAD etiologies. Ischemic core (relative cerebral blood flow < 30%) and hypoperfusion volumes were estimated by automated CTP. Results/UNASSIGNED:= 0.01) were independently associated with ICAD. Conclusion/UNASSIGNED:An automated CTP Tmax > 4 s/Tmax > 6 s ratio ≥2 profile was found independently associated with underlying ICAD LVOS.
PMID: 30410510
ISSN: 1664-9737
CID: 3456282
Imaging features and safety and efficacy of endovascular stroke treatment: a meta-analysis of individual patient-level data
Román, Luis San; Menon, Bijoy K; Blasco, Jordi; Hernández-Pérez, María; Dávalos, Antoni; Majoie, Charles B L M; Campbell, Bruce C V; Guillemin, Francis; Lingsma, Hester; Anxionnat, René; Epstein, Jonathan; Saver, Jeffrey L; Marquering, Henk; Wong, John H; Lopes, Demetrius; Reimann, Gernot; Desal, Hubert; Dippel, Diederik W J; Coutts, Shelagh; du Mesnil de Rochemont, Richard; Yavagal, Dileep; Ferre, Jean Christophe; Roos, Yvo B W E M; Liebeskind, David S; Lenthall, Robert; Molina, Carlos; Al Ajlan, Fahad S; Reddy, Vivek; Dowlatshahi, Dar; Sourour, Nader-Antoine; Oppenheim, Catherine; Mitha, Alim P; Davis, Stephen M; Weimar, Christian; van Oostenbrugge, Robert J; Cobo, Erik; Kleinig, Timothy J; Donnan, Geoffrey A; van der Lugt, Aad; Demchuk, Andrew M; Berkhemer, Olvert A; Boers, Anna M M; Ford, Gary A; Muir, Keith W; Brown, B Scott; Jovin, Tudor; van Zwam, Wim H; Mitchell, Peter J; Hill, Michael D; White, Phil; Bracard, Serge; Goyal, Mayank; Berkhemer, Olvert A; Fransen, Puck Ss; Beumer, Debbie; van den Berg, Lucie A; Lingsma, Hester F; Yoo, Albert J; Schonewille, Wouter J; Vos, Jan Albert; Nederkoorn, Paul J; Wermer, Marieke Jh; van Walderveen, Marianne Aa; Staals, Julie; Hofmeijer, Jeannette; van Oostayen, Jacques A; Lycklama À Nijeholt, Geert J; Boiten, Jelis; Brouwer, Patrick A; Emmer, Bart J; de Bruijn, Sebastiaan F; van Dijk, Lukas C; Kappelle, Jaap; Lo, Rob H; van Dijk, Ewoud J; de Vries, Joost; de Kort, Paul L M; van Rooij, Willem Jan J; van den Berg, Jan S P; van Hasselt, Boudewijn A A M; Aerden, Leo A M; Dallinga, René J; Visser, Marieke C; Bot, Joseph C J; Vroomen, Patrick C; Eshghi, Omid; Schreuder, Tobien H C M L; Heijboer, Roel J J; Keizer, Koos; Tielbeek, Alexander V; den Hertog, Heleen M; Gerrits, Dick G; van den Berg-Vos, Renske M; Karas, Giorgos B; Steyerberg, Ewout W; Flach, Zwenneke; Marquering, Henk A; Sprengers, Marieke E S; Jenniskens, Sjoerd F M; Beenen, Ludo F M; van den Berg, René; Koudstaal, Peter J; van Zwam, Wim H; Roos, Yvo B W E M; van der Lugt, Aad; van Oostenbrugge, Robert J; Majoie, Charles B L M; Dippel, Diederik W J; Brown, Martin M; Liebig, Thomas; Stijnen, Theo; Andersson, Tommy; Mattle, Heinrich; Wahlgren, Nils; van der Heijden, Esther; Ghannouti, Naziha; Fleitour, Nadine; Hooijenga, Imke; Puppels, Corina; Pellikaan, Wilma; Geerling, Annet; Lindl-Velema, Annemieke; van Vemde, Gina; de Ridder, Ans; Greebe, Paut; de Bont-Stikkelbroeck, José; de Meris, Joke; Janssen, Kirsten; Struijk, Willy; Licher, Silvan; Boodt, Nikki; Ros, Adriaan; Venema, Esmee; Slokkers, Ilse; Ganpat, Raymie-Jayce; Mulder, Maxim; Saiedie, Nawid; Heshmatollah, Alis; Schipperen, Stefanie; Vinken, Stefan; van Boxtel, Tiemen; Koets, Jeroen; Boers, Merel; Santos, Emilie; Borst, Jordi; Jansen, Ivo; Kappelhof, Manon; Lucas, Marit; Geuskens, Ralph; Barros, Renan Sales; Dobbe, Roeland; Csizmadia, Marloes; Hill, M D; Goyal, M; Demchuk, A M; Menon, B K; Eesa, M; Ryckborst, K J; Wright, M R; Kamal, N R; Andersen, L; Randhawa, P A; Stewart, T; Patil, S; Minhas, P; Almekhlafi, M; Mishra, S; Clement, F; Sajobi, T; Shuaib, A; Montanera, W J; Roy, D; Silver, F L; Jovin, T G; Frei, D F; Sapkota, B; Rempel, J L; Thornton, J; Williams, D; Tampieri, D; Poppe, A Y; Dowlatshahi, D; Wong, J H; Mitha, A P; Subramaniam, S; Hull, G; Lowerison, M W; Sajobi, T; Salluzzi, M; Wright, M R; Maxwell, M; Lacusta, S; Drupals, E; Armitage, K; Barber, P A; Smith, E E; Morrish, W F; Coutts, S B; Derdeyn, C; Demaerschalk, B; Yavagal, D; Martin, R; Brant, R; Yu, Y; Willinsky, R A; Montanera, W J; Weill, A; Kenney, C; Aram, H; Stewart, T; Stys, P K; Watson, T W; Klein, G; Pearson, D; Couillard, P; Trivedi, A; Singh, D; Klourfeld, E; Imoukhuede, O; Nikneshan, D; Blayney, S; Reddy, R; Choi, P; Horton, M; Musuka, T; Dubuc, V; Field, T S; Desai, J; Adatia, S; Alseraya, A; Nambiar, V; van Dijk, R; Wong, J H; Mitha, A P; Morrish, W F; Eesa, M; Newcommon, N J; Shuaib, A; Schwindt, B; Butcher, K S; Jeerakathil, T; Buck, B; Khan, K; Naik, S S; Emery, D J; Owen, R J; Kotylak, T B; Ashforth, R A; Yeo, T A; McNally, D; Siddiqui, M; Saqqur, M; Hussain, D; Kalashyan, H; Manosalva, A; Kate, M; Gioia, L; Hasan, S; Mohammad, A; Muratoglu, M; Williams, D; Thornton, J; Cullen, A; Brennan, P; O'Hare, A; Looby, S; Hyland, D; Duff, S; McCusker, M; Hallinan, B; Lee, S; McCormack, J; Moore, A; O'Connor, M; Donegan, C; Brewer, L; Martin, A; Murphy, S; O'Rourke, K; Smyth, S; Kelly, P; Lynch, T; Daly, T; O'Brien, P; O'Driscoll, A; Martin, M; Daly, T; Collins, R; Coughlan, T; McCabe, D; Murphy, S; O'Neill, D; Mulroy, M; Lynch, O; Walsh, T; O'Donnell, M; Galvin, T; Harbison, J; McElwaine, P; Mulpeter, K; McLoughlin, C; Reardon, M; Harkin, E; Dolan, E; Watts, M; Cunningham, N; Fallon, C; Gallagher, S; Cotter, P; Crowe, M; Doyle, R; Noone, I; Lapierre, M; Coté, V A; Lanthier, S; Odier, C; Durocher, A; Raymond, J; Weill, A; Daneault, N; Deschaintre, Y; Jankowitz, B; Baxendell, L; Massaro, L; Jackson-Graves, C; Decesare, S; Porter, P; Armbruster, K; Adams, A; Billigan, J; Oakley, J; Ducruet, A; Jadhav, A; Giurgiutiu, D-V; Aghaebrahim, A; Reddy, V; Hammer, M; Starr, M; Totoraitis, V; Wechsler, L; Streib, S; Rangaraju, S; Campbell, D; Rocha, M; Gulati, D; Silver, F L; Krings, T; Kalman, L; Cayley, A; Williams, J; Stewart, T; Wiegner, R; Casaubon, L K; Jaigobin, C; Del Campo, J M; Elamin, E; Schaafsma, J D; Willinsky, R A; Agid, R; Farb, R; Ter Brugge, K; Sapkoda, B L; Baxter, B W; Barton, K; Knox, A; Porter, A; Sirelkhatim, A; Devlin, T; Dellinger, C; Pitiyanuvath, N; Patterson, J; Nichols, J; Quarfordt, S; Calvert, J; Hawk, H; Fanale, C; Frei, D F; Bitner, A; Novak, A; Huddle, D; Bellon, R; Loy, D; Wagner, J; Chang, I; Lampe, E; Spencer, B; Pratt, R; Bartt, R; Shine, S; Dooley, G; Nguyen, T; Whaley, M; McCarthy, K; Teitelbaum, J; Tampieri, D; Poon, W; Campbell, N; Cortes, M; Dowlatshahi, D; Lum, C; Shamloul, R; Robert, S; Stotts, G; Shamy, M; Steffenhagen, N; Blacquiere, D; Hogan, M; AlHazzaa, M; Basir, G; Lesiuk, H; Iancu, D; Santos, M; Choe, H; Weisman, D C; Jonczak, K; Blue-Schaller, A; Shah, Q; MacKenzie, L; Klein, B; Kulandaivel, K; Kozak, O; Gzesh, D J; Harris, L J; Khoury, J S; Mandzia, J; Pelz, D; Crann, S; Fleming, L; Hesser, K; Beauchamp, B; Amato-Marzialli, B; Boulton, M; Lopez-Ojeda, P; Sharma, M; Lownie, S; Chan, R; Swartz, R; Howard, P; Golob, D; Gladstone, D; Boyle, K; Boulos, M; Hopyan, J; Yang, V; Da Costa, L; Holmstedt, C A; Turk, A S; Navarro, R; Jauch, E; Ozark, S; Turner, R; Phillips, S; Shankar, J; Jarrett, J; Gubitz, G; Maloney, W; Vandorpe, R; Schmidt, M; Heidenreich, J; Hunter, G; Kelly, M; Whelan, R; Peeling, L; Burns, P A; Hunter, A; Wiggam, I; Kerr, E; Watt, M; Fulton, A; Gordon, P; Rennie, I; Flynn, P; Smyth, G; O'Leary, S; Gentile, N; Linares, G; McNelis, P; Erkmen, K; Katz, P; Azizi, A; Weaver, M; Jungreis, C; Faro, S; Shah, P; Reimer, H; Kalugdan, V; Saposnik, G; Bharatha, A; Li, Y; Kostyrko, P; Santos, M; Marotta, T; Montanera, W; Sarma, D; Selchen, D; Spears, J; Heo, J H; Jeong, K; Kim, D J; Kim, B M; Kim, Y D; Song, D; Lee, K-J; Yoo, J; Bang, O Y; Rho, S; Lee, J; Jeon, P; Kim, K H; Cha, J; Kim, S J; Ryoo, S; Lee, M J; Sohn, S-I; Kim, C-H; Ryu, H-G; Hong, J-H; Chang, H-W; Lee, C-Y; Rha, J; Davis, Stephen M; Donnan, Geoffrey A; Campbell, Bruce Cv; Mitchell, Peter J; Churilov, Leonid; Yan, Bernard; Dowling, Richard; Yassi, Nawaf; Oxley, Thomas J; Wu, Teddy Y; Silver, Gabriel; McDonald, Amy; McCoy, Rachael; Kleinig, Timothy J; Scroop, Rebecca; Dewey, Helen M; Simpson, Marion; Brooks, Mark; Coulton, Bronwyn; Krause, Martin; Harrington, Timothy J; Steinfort, Brendan; Faulder, Kenneth; Priglinger, Miriam; Day, Susan; Phan, Thanh; Chong, Winston; Holt, Michael; Chandra, Ronil V; Ma, Henry; Young, Dennis; Wong, Kitty; Wijeratne, Tissa; Tu, Hans; Mackay, Elizabeth; Celestino, Sherisse; Bladin, Christopher F; Loh, Poh Sien; Gilligan, Amanda; Ross, Zofia; Coote, Skye; Frost, Tanya; Parsons, Mark W; Miteff, Ferdinand; Levi, Christopher R; Ang, Timothy; Spratt, Neil; Kaauwai, Lara; Badve, Monica; Rice, Henry; de Villiers, Laetitia; Barber, P Alan; McGuinness, Ben; Hope, Ayton; Moriarty, Maurice; Bennett, Patricia; Wong, Andrew; Coulthard, Alan; Lee, Andrew; Jannes, Jim; Field, Deborah; Sharma, Gagan; Salinas, Simon; Cowley, Elise; Snow, Barry; Kolbe, John; Stark, Richard; King, John; Macdonnell, Richard; Attia, John; D'Este, Cate; Saver, Jeffrey L; Goyal, Mayank; Diener, Hans-Christoph; Levy, Elad I; Bonafé, Alain; Mendes Pereira, Vitor; Jahan, Reza; Albers, Gregory W; Cognard, Christophe; Cohen, David J; Hacke, Werner; Jansen, Olav; Jovin, Tudor G; Mattle, Heinrich P; Nogueira, Raul G; Siddiqui, Adnan H; Yavagal, Dileep R; von Kummer, Rüdiger; Smith, Wade; Turjman, Francis; Hamilton, Scott; Chiacchierini, Richard; Amar, Arun; Sanossian, Nerses; Loh, Yince; Devlin, T; Baxter, B; Hawk, H; Sapkota, B; Quarfordt, S; Sirelkhatim, A; Dellinger, C; Barton, K; Reddy, V K; Ducruet, A; Jadhav, A; Horev, A; Giurgiutiu, D-V; Totoraitis, V; Hammer, M; Jankowitz, B; Wechsler, L; Rocha, M; Gulati, D; Campbell, D; Star, M; Baxendell, L; Oakley, J; Siddiqui, A; Hopkins, L N; Snyder, K; Sawyer, R; Hall, S; Costalat, V; Riquelme, C; Machi, P; Omer, E; Arquizan, C; Mourand, I; Charif, M; Ayrignac, X; Menjot de Champfleur, N; Leboucq, N; Gascou, G; Moynier, M; du Mesnil de Rochemont, R; Singer, O; Berkefeld, J; Foerch, C; Lorenz, M; Pfeilschifer, W; Hattingen, E; Wagner, M; You, S J; Lescher, S; Braun, H; Dehkharghani, S; Belagaje, S R; Anderson, A; Lima, A; Obideen, M; Haussen, D; Dharia, R; Frankel, M; Patel, V; Owada, K; Saad, A; Amerson, L; Horn, C; Doppelheuer, S; Schindler, K; Lopes, D K; Chen, M; Moftakhar, R; Anton, C; Smreczak, M; Carpenter, J S; Boo, S; Rai, A; Roberts, T; Tarabishy, A; Gutmann, L; Brooks, C; Brick, J; Domico, J; Reimann, G; Hinrichs, K; Becker, M; Heiss, E; Selle, C; Witteler, A; Al-Boutros, S; Danch, M-J; Ranft, A; Rohde, S; Burg, K; Weimar, C; Zegarac, V; Hartmann, C; Schlamann, M; Göricke, S; Ringlestein, A; Wanke, I; Mönninghoff, C; Dietzold, M; Budzik, R; Davis, T; Eubank, G; Hicks, W J; Pema, P; Vora, N; Mejilla, J; Taylor, M; Clark, W; Rontal, A; Fields, J; Peterson, B; Nesbit, G; Lutsep, H; Bozorgchami, H; Priest, R; Ologuntoye, O; Barnwell, S; Dogan, A; Herrick, K; Takahasi, C; Beadell, N; Brown, B; Jamieson, S; Hussain, M S; Russman, A; Hui, F; Wisco, D; Uchino, K; Khawaja, Z; Katzan, I; Toth, G; Cheng-Ching, E; Bain, M; Man, S; Farrag, A; George, P; John, S; Shankar, L; Drofa, A; Dahlgren, R; Bauer, A; Itreat, A; Taqui, A; Cerejo, R; Richmond, A; Ringleb, P; Bendszus, M; Möhlenbruch, M; Reiff, T; Amiri, H; Purrucker, J; Herweh, C; Pham, M; Menn, O; Ludwig, I; Acosta, I; Villar, C; Morgan, W; Sombutmai, C; Hellinger, F; Allen, E; Bellew, M; Gandhi, R; Bonwit, E; Aly, J; Ecker, R D; Seder, D; Morris, J; Skaletsky, M; Belden, J; Baker, C; Connolly, L S; Papanagiotou, P; Roth, C; Kastrup, A; Politi, M; Brunner, F; Alexandrou, M; Merdivan, H; Ramsey, C; Given Ii, C; Renfrow, S; Deshmukh, V; Sasadeusz, K; Vincent, F; Thiesing, J T; Putnam, J; Bhatt, A; Kansara, A; Caceves, D; Lowenkopf, T; Yanase, L; Zurasky, J; Dancer, S; Freeman, B; Scheibe-Mirek, T; Robison, J; Rontal, A; Roll, J; Clark, D; Rodriguez, M; Fitzsimmons, B-Fm; Zaidat, O; Lynch, J R; Lazzaro, M; Larson, T; Padmore, L; Das, E; Farrow-Schmidt, A; Hassan, A; Tekle, W; Cate, C; Jansen, O; Cnyrim, C; Wodarg, F; Wiese, C; Binder, A; Riedel, C; Rohr, A; Lang, N; Laufs, H; Krieter, S; Remonda, L; Diepers, M; Añon, J; Nedeltchev, K; Kahles, T; Biethahn, S; Lindner, M; Chang, V; Gächter, C; Esperon, C; Guglielmetti, M; Arenillas Lara, J F; Martínez Galdámez, M; Calleja Sanz, A I; Cortijo Garcia, E; Garcia Bermejo, P; Perez, S; Mulero Carrillo, P; Crespo Vallejo, E; Ruiz Piñero, M; Lopez Mesonero, L; Reyes Muñoz, F J; Brekenfeld, C; Buhk, J-H; Krützelmann, A; Thomalla, G; Cheng, B; Beck, C; Hoppe, J; Goebell, E; Holst, B; Grzyska, U; Wortmann, G; Starkman, S; Duckwiler, G; Jahan, R; Rao, N; Sheth, S; Ng, K; Noorian, A; Szeder, V; Nour, M; McManus, M; Huang, J; Tarpley, J; Tateshima, S; Gonzalez, N; Ali, L; Liebeskind, D; Hinman, J; Calderon-Arnulphi, M; Liang, C; Guzy, J; Koch, S; DeSousa, K; Gordon-Perue, G; Haussen, D; Elhammady, M; Peterson, E; Pandey, V; Dharmadhikari, S; Khandelwal, P; Malik, A; Pafford, R; Gonzalez, P; Ramdas, K; Andersen, G; Damgaard, D; Von Weitzel-Mudersbach, P; Simonsen, C; Ruiz de Morales Ayudarte, N; Poulsen, M; Sørensen, L; Karabegovich, S; Hjørringgaard, M; Hjort, N; Harbo, T; Sørensen, K; Deshaies, E; Padalino, D; Swarnkar, A; Latorre, J G; Elnour, E; El-Zammar, Z; Villwock, M; Farid, H; Balgude, A; Cross, L; Hansen, K; Holtmannspötter, M; Kondziella, D; Hoejgaard, J; Taudorf, S; Soendergaard, H; Wagner, A; Cronquist, M; Stavngaard, T; Cortsen, M; Krarup, L H; Hyldal, T; Haring, H-P; Guggenberger, S; Hamberger, M; Trenkler, J; Sonnberger, M; Nussbaumer, K; Dominger, C; Bach, E; Jagadeesan, B D; Taylor, R; Kim, J; Shea, K; Tummala, R; Zacharatos, H; Sandhu, D; Ezzeddine, M; Grande, A; Hildebrandt, D; Miller, K; Scherber, J; Hendrickson, A; Jumaa, M; Zaidi, S; Hendrickson, T; Snyder, V; Killer-Oberpfalzer, M; Mutzenbach, J; Weymayr, F; Broussalis, E; Stadler, K; Jedlitschka, A; Malek, A; Mueller-Kronast, N; Beck, P; Martin, C; Summers, D; Day, J; Bettinger, I; Holloway, W; Olds, K; Arkin, S; Akhtar, N; Boutwell, C; Crandall, S; Schwartzman, M; Weinstein, C; Brion, B; Prothmann, S; Kleine, J; Kreiser, K; Boeckh-Behrens, T; Poppert, H; Wunderlich, S; Koch, M L; Biberacher, V; Huberle, A; Gora-Stahlberg, G; Knier, B; Meindl, T; Utpadel-Fischler, D; Zech, M; Kowarik, M; Seifert, C; Schwaiger, B; Puri, A; Hou, S; Wakhloo, A; Moonis, M; Henniger, N; Goddeau, R; Massari, F; Minaeian, A; Lozano, J D; Ramzan, M; Stout, C; Patel, A; Tunguturi, A; Onteddu, S; Carandang, R; Howk, M; Ribó, M; Sanjuan, E; Rubiera, M; Pagola, J; Flores, A; Muchada, M; Meler, P; Huerga, E; Gelabert, S; Coscojuela, P; Tomasello, A; Rodriguez, D; Santamarina, E; Maisterra, O; Boned, S; Seró, L; Rovira, A; Molina, C A; Millán, M; Muñoz, L; Pérez de la Ossa, N; Gomis, M; Dorado, L; López-Cancio, E; Palomeras, E; Munuera, J; García Bermejo, P; Remollo, S; Castaño, C; García-Sort, R; Cuadras, P; Puyalto, P; Hernández-Pérez, M; Jiménez, M; Martínez-Piñeiro, A; Lucente, G; Dávalos, A; Chamorro, A; Urra, X; Obach, V; Cervera, A; Amaro, S; Llull, L; Codas, J; Balasa, M; Navarro, J; Ariño, H; Aceituno, A; Rudilosso, S; Renu, A; Macho, J M; San Roman, L; Blasco, J; López, A; MacÃas, N; Cardona, P; Quesada, H; Rubio, F; Cano, L; Lara, B; de Miquel, M A; Aja, L; Serena, J; Cobo, E; Albers, Gregory W; Lees, Kennedy R; Arenillas, J; Roberts, R; Minhas, P; Al-Ajlan, F; Salluzzi, M; Zimmel, L; Patel, S; Eesa, M; MartÃ-Fà bregas, J; Jankowitz, B; Serena, J; Salvat-Plana, M; López-Cancio, E; Bracard, S; Ducrocq, Xavier; Anxionnat, René; Baillot, Pierre-Alexandre; Barbier, Charlotte; Derelle, Anne-Laure; Lacour, Jean-Christophe; Richard, Sébastien; Samson, Yves; Sourour, Nader; Baronnet-Chauvet, Flore; Clarencon, Frédéric; Crozier, Sophie; Deltour, Sandrine; Di Maria, Federico; Le Bouc, Raphael; Leger, Anne; Mutlu, Gurkan; Rosso, Charlotte; Szatmary, Zoltan; Yger, Marion; Zavanone, Chiara; Bakchine, Serge; Pierot, Laurent; Caucheteux, Nathalie; Estrade, Laurent; Kadziolka, Krzysztof; Leautaud, Alexandre; Renkes, Céline; Serre, Isabelle; Desal, Hubert; Guillon, Benoît; Boutoleau-Bretonniere, Claire; Daumas-Duport, Benjamin; De Gaalon, Solène; Derkinderen, Pascal; Evain, Sarah; Herisson, Fanny; Laplaud, David-Axel; Lebouvier, Thibaud; Lintia-Gaultier, Alina; Pouclet-Courtemanche, Hélène; Rouaud, Tiphaine; Rouaud Jaffrenou, Violaine; Schunck, Aurélia; Sevin-Allouet, Mathieu; Toulgoat, Frederique; Wiertlewski, Sandrine; Gauvrit, Jean-Yves; Ronziere, Thomas; Cahagne, Vincent; Ferre, Jean-Christophe; Pinel, Jean-François; Raoult, Hélène; Mas, Jean-Louis; Meder, Jean-François; Al Najjar-Carpentier, Amen-Adam; Birchenall, Julia; Bodiguel, Eric; Calvet, David; Domigo, Valérie; Godon-Hardy, Sylvie; Guiraud, Vincent; Lamy, Catherine; Majhadi, Loubna; Morin, Ludovic; Naggara, Olivier; Trystram, Denis; Turc, Guillaume; Berge, Jérôme; Sibon, Igor; Menegon, Patrice; Barreau, Xavier; Rouanet, François; Debruxelles, Sabrina; Kazadi, Annabelle; Renou, Pauline; Fleury, Olivier; Pasco-Papon, Anne; Dubas, Frédéric; Caroff, Jildaz; Godard Ducceschi, Sophie; Hamon, Marie-Aurélie; Lecluse, Alderic; Marc, Guillaume; Giroud, Maurice; Ricolfi, Frédéric; Bejot, Yannick; Chavent, Adrien; Gentil, Arnaud; Kazemi, Apolline; Osseby, Guy-Victor; Voguet, Charlotte; Mahagne, Marie-Hélène; Sedat, Jacques; Chau, Yves; Suissa, Laurent; Lachaud, Sylvain; Houdart, Emmanuel; Stapf, Christian; Buffon Porcher, Frédérique; Chabriat, Hugues; Guedin, Pierre; Herve, Dominique; Jouvent, Eric; Mawet, Jérôme; Saint-Maurice, Jean-Pierre; Schneble, Hans-Martin; Turjman, Francis; Nighoghossian, Norbert; Berhoune, Nadia-Nawel; Bouhour, Françoise; Cho, Tae-Hee; Derex, Laurent; Felix, Sandra; Gervais-Bernard, Hélène; Gory, Benjamin; Manera, Luis; Mechtouff, Laura; Ritzenthaler, Thomas; Riva, Roberto; Salaris Silvio, Fabrizio; Tilikete, Caroline; Blanc, Raphael; Obadia, Michaël; Bartolini, Mario Bruno; Gueguen, Antoine; Piotin, Michel; Pistocchi, Silvia; Redjem, Hocine; Drouineau, Jacques; Neau, Jean-Philippe; Godeneche, Gaelle; Lamy, Matthias; Marsac, Emilia; Velasco, Stephane; Clavelou, Pierre; Chabert, Emmanuel; Bourgois, Nathalie; Cornut-Chauvinc, Catherine; Ferrier, Anna; Gabrillargues, Jean; Jean, Betty; Marques, Anna-Raquel; Vitello, Nicolas; Detante, Olivier; Barbieux, Marianne; Boubagra, Kamel; Favre Wiki, Isabelle; Garambois, Katia; Tahon, Florence; Ashok, Vasdev; Voguet, Charlotte; Coskun, Oguzhan; Guedin, Pierre; Rodesch, Georges; Lapergue, Bertrand; Bourdain, Frédéric; Evrard, Serge; Graveleau, Philippe; Decroix, Jean Pierre; Wang, Adrien; Sellal, François; Ahle, Guido; Carelli, Gabriela; Dugay, Marie-Hélène; Gaultier, Claude; Lebedinsky, Ariel Pablo; Lita, Lavinia; Musacchio, Raul Mariano; Renglewicz-Destuynder, Catherine; Tournade, Alain; Vuillemet, Françis; Montoro, Francisco Macian; Mounayer, Charbel; Faugeras, Frederic; Gimenez, Laetitia; Labach, Catherine; Lautrette, Géraldine; Denier, Christian; Saliou, Guillaume; Chassin, Olivier; Dussaule, Claire; Melki, Elsa; Ozanne, Augustin; Puccinelli, Francesco; Sachet, Marina; Sarov, Mariana; Bonneville, Jean-François; Moulin, Thierry; Biondi, Alessandra; De Bustos Medeiros, Elisabeth; Vuillier, Fabrice; Courtheoux, Patrick; Viader, Fausto; Apoil-Brissard, Marion; Bataille, Mathieu; Bonnet, Anne-Laure; Cogez, Julien; Kazemi, Apolline; Touze, Emmanuel; Leclerc, Xavier; Leys, Didier; Aggour, Mohamed; Aguettaz, Pierre; Bodenant, Marie; Cordonnier, Charlotte; Deplanque, Dominique; Girot, Marie; Henon, Hilde; Kalsoum, Erwah; Lucas, Christian; Pruvo, Jean-Pierre; Zuniga, Paolo; Bonafé, Alain; Arquizan, Caroline; Costalat, Vincent; Machi, Paolo; Mourand, Isabelle; Riquelme, Carlos; Bounolleau, Pierre; Arteaga, Charles; Faivre, Anthony; Bintner, Marc; Tournebize, Patrice; Charlin, Cyril; Darcel, Françoise; Gauthier-Lasalarie, Pascale; Jeremenko, Marcia; Mouton, Servane; Zerlauth, Jean-Baptiste; Lamy, Chantal; Hervé, Deramond; Hassan, Hosseini; Gaston, André; Barral, Francis-Guy; Garnier, Pierre; Beaujeux, Rémy; Wolff, Valérie; Herbreteau, Denis; Debiais, Séverine; Murray, Alicia; Ford, Gary; Muir, Keith W; White, Philip; Brown, Martin M; Clifton, Andy; Freeman, Janet; Ford, Ian; Markus, Hugh; Wardlaw, Joanna; Lees, Kennedy R; Molyneux, Andy; Robinson, Thompson; Lewis, Steff; Norrie, John; Robertson, Fergus; Perry, Richard; Dixit, Anand; Cloud, Geoffrey; Clifton, Andrew; Madigan, Jeremy; Roffe, Christine; Nayak, Sanjeev; Lobotesis, Kyriakos; Smith, Craig; Herwadkar, Amit; Kandasamy, Naga; Goddard, Tony; Bamford, John; Subramanian, Ganesh; Lenthall, Rob; Littleton, Edward; Lamin, Sal; Storey, Kelley; Ghatala, Rita; Banaras, Azra; Aeron-Thomas, John; Hazel, Bath; Maguire, Holly; Veraque, Emelda; Harrison, Louise; Keshvara, Rekha; Cunningham, James
BACKGROUND:Evidence regarding whether imaging can be used effectively to select patients for endovascular thrombectomy (EVT) is scarce. We aimed to investigate the association between baseline imaging features and safety and efficacy of EVT in acute ischaemic stroke caused by anterior large-vessel occlusion. METHODS:In this meta-analysis of individual patient-level data, the HERMES collaboration identified in PubMed seven randomised trials in endovascular stroke that compared EVT with standard medical therapy, published between Jan 1, 2010, and Oct 31, 2017. Only trials that required vessel imaging to identify patients with proximal anterior circulation ischaemic stroke and that used predominantly stent retrievers or second-generation neurothrombectomy devices in the EVT group were included. Risk of bias was assessed with the Cochrane handbook methodology. Central investigators, masked to clinical information other than stroke side, categorised baseline imaging features of ischaemic change with the Alberta Stroke Program Early CT Score (ASPECTS) or according to involvement of more than 33% of middle cerebral artery territory, and by thrombus volume, hyperdensity, and collateral status. The primary endpoint was neurological functional disability scored on the modified Rankin Scale (mRS) score at 90 days after randomisation. Safety outcomes included symptomatic intracranial haemorrhage, parenchymal haematoma type 2 within 5 days of randomisation, and mortality within 90 days. For the primary analysis, we used mixed-methods ordinal logistic regression adjusted for age, sex, National Institutes of Health Stroke Scale score at admission, intravenous alteplase, and time from onset to randomisation, and we used interaction terms to test whether imaging categorisation at baseline modifies the association between treatment and outcome. This meta-analysis was prospectively designed by the HERMES executive committee but has not been registered. FINDINGS:=0·012). INTERPRETATION:EVT achieves better outcomes at 90 days than standard medical therapy across a broad range of baseline imaging categories, including infarcts affecting more than 33% of middle cerebral artery territory or ASPECTS less than 6, although in these patients the risk of symptomatic intracranial haemorrhage was higher in the EVT group than the control group. This analysis provides preliminary evidence for potential use of EVT in patients with large infarcts at baseline. FUNDING:Medtronic.
PMID: 30264728
ISSN: 1474-4465
CID: 5121962
Is there added value in obtaining cervical spine MRI in the assessment of nontraumatic angiographically negative subarachnoid hemorrhage? A retrospective study and meta-analysis of the literature
Sadigh, Gelareh; Holder, Chad A; Switchenko, Jeffrey M; Dehkharghani, Seena; Allen, Jason W
OBJECTIVE Diagnostic algorithms for nontraumatic angiographically negative subarachnoid hemorrhage (AN-SAH) vary, and the optimal method remains subject to debate. This study assessed the added value of cervical spine MRI in identifying a cause for nontraumatic AN-SAH. METHODS Consecutive patients 18 years of age or older who presented with nontraumatic SAH between February 1, 2009, and October 31, 2014, with negative cerebrovascular catheter angiography and subsequent cervical MRI were studied. Patients with intraparenchymal, subdural, or epidural hemorrhage; recent trauma; or known vascular malformations were excluded. All cervical MR images were reviewed by two blinded neuroradiologists. The diagnostic yield of cervical MRI was calculated. A literature review was conducted to identify studies reporting the diagnostic yield of cervical MRI in patients with AN-SAH. The weighted pooled estimate of diagnostic yield of cervical MRI was calculated. RESULTS For all 240 patients (mean age 53 years, 48% male), catheter angiography was performed within 4 days after admission (median 12 hours, interquartile range [IQR] 10 hours). Cervical MRI was performed within 19 days of admission (median 24 hours, IQR 10 hours). In a single patient, cervical MRI identified a source for SAH (cervical vascular malformation). Meta-analysis of 7 studies comprising 538 patients with AN-SAH produced a pooled estimate of 1.3% (95% confidence interval 0.5%-2.5%) for diagnostic yield of cervical MRI. No statistically significant between-study heterogeneity or publication bias was identified. CONCLUSIONS Cervical MRI following AN-SAH, in the absence of findings to suggest spinal etiology, has a very low diagnostic yield and is not routinely necessary.
PMCID:5899067
PMID: 29027857
ISSN: 1933-0693
CID: 2732092
Effect of general anaesthesia on functional outcome in patients with anterior circulation ischaemic stroke having endovascular thrombectomy versus standard care: a meta-analysis of individual patient data
Campbell, Bruce C V; van Zwam, Wim H; Goyal, Mayank; Menon, Bijoy K; Dippel, Diederik W J; Demchuk, Andrew M; Bracard, Serge; White, Philip; Dávalos, Antoni; Majoie, Charles B L M; van der Lugt, Aad; Ford, Gary A; de la Ossa, Natalia Pérez; Kelly, Michael; Bourcier, Romain; Donnan, Geoffrey A; Roos, Yvo B W E M; Bang, Oh Young; Nogueira, Raul G; Devlin, Thomas G; van den Berg, Lucie A; Clarençon, Frédéric; Burns, Paul; Carpenter, Jeffrey; Berkhemer, Olvert A; Yavagal, Dileep R; Pereira, Vitor Mendes; Ducrocq, Xavier; Dixit, Anand; Quesada, Helena; Epstein, Jonathan; Davis, Stephen M; Jansen, Olav; Rubiera, Marta; Urra, Xabier; Micard, Emilien; Lingsma, Hester F; Naggara, Olivier; Brown, Scott; Guillemin, Francis; Muir, Keith W; van Oostenbrugge, Robert J; Saver, Jeffrey L; Jovin, Tudor G; Hill, Michael D; Mitchell, Peter J; Berkhemer, Olvert A; Fransen, Puck Ss; Beumer, Debbie; van den Berg, Lucie A; Lingsma, Hester F; Yoo, Albert J; Schonewille, Wouter J; Vos, Jan Albert; Nederkoorn, Paul J; Wermer, Marieke Jh; van Walderveen, Marianne Aa; Staals, Julie; Hofmeijer, Jeannette; van Oostayen, Jacques A; Lycklama À Nijeholt, Geert J; Boiten, Jelis; Brouwer, Patrick A; Emmer, Bart J; de Bruijn, Sebastiaan F; van Dijk, Lukas C; Kappelle, Jaap; Lo, Rob H; van Dijk, Ewoud J; de Vries, Joost; de Kort, Paul L M; van Rooij, Willem Jan J; van den Berg, Jan S P; van Hasselt, Boudewijn A A M; Aerden, Leo A M; Dallinga, René J; Visser, Marieke C; Bot, Joseph C J; Vroomen, Patrick C; Eshghi, Omid; Schreuder, Tobien H C M L; Heijboer, Roel J J; Keizer, Koos; Tielbeek, Alexander V; den Hertog, Heleen M; Gerrits, Dick G; van den Berg-Vos, Renske M; Karas, Giorgos B; Steyerberg, Ewout W; Flach, Zwenneke; Marquering, Henk A; Sprengers, Marieke E S; Jenniskens, Sjoerd F M; Beenen, Ludo F M; van den Berg, René; Koudstaal, Peter J; van Zwam, Wim H; Roos, Yvo B W E M; van der Lugt, Aad; van Oostenbrugge, Robert J; Majoie, Charles B L M; Dippel, Diederik W J; Brown, Martin M; Liebig, Thomas; Stijnen, Theo; Andersson, Tommy; Mattle, Heinrich; Wahlgren, Nils; van der Heijden, Esther; Ghannouti, Naziha; Fleitour, Nadine; Hooijenga, Imke; Puppels, Corina; Pellikaan, Wilma; Geerling, Annet; Lindl-Velema, Annemieke; van Vemde, Gina; de Ridder, Ans; Greebe, Paut; de Bont-Stikkelbroeck, José; de Meris, Joke; Janssen, Kirsten; Struijk, Willy; Licher, Silvan; Boodt, Nikki; Ros, Adriaan; Venema, Esmee; Slokkers, Ilse; Ganpat, Raymie-Jayce; Mulder, Maxim; Saiedie, Nawid; Heshmatollah, Alis; Schipperen, Stefanie; Vinken, Stefan; van Boxtel, Tiemen; Koets, Jeroen; Boers, Merel; Santos, Emilie; Borst, Jordi; Jansen, Ivo; Kappelhof, Manon; Lucas, Marit; Geuskens, Ralph; Barros, Renan Sales; Dobbe, Roeland; Csizmadia, Marloes; Hill, M D; Goyal, M; Demchuk, A M; Menon, B K; Eesa, M; Ryckborst, K J; Wright, M R; Kamal, N R; Andersen, L; Randhawa, P A; Stewart, T; Patil, S; Minhas, P; Almekhlafi, M; Mishra, S; Clement, F; Sajobi, T; Shuaib, A; Montanera, W J; Roy, D; Silver, F L; Jovin, T G; Frei, D F; Sapkota, B; Rempel, J L; Thornton, J; Williams, D; Tampieri, D; Poppe, A Y; Dowlatshahi, D; Wong, J H; Mitha, A P; Subramaniam, S; Hull, G; Lowerison, M W; Sajobi, T; Salluzzi, M; Wright, M R; Maxwell, M; Lacusta, S; Drupals, E; Armitage, K; Barber, P A; Smith, E E; Morrish, W F; Coutts, S B; Derdeyn, C; Demaerschalk, B; Yavagal, D; Martin, R; Brant, R; Yu, Y; Willinsky, R A; Montanera, W J; Weill, A; Kenney, C; Aram, H; Stewart, T; Stys, P K; Watson, T W; Klein, G; Pearson, D; Couillard, P; Trivedi, A; Singh, D; Klourfeld, E; Imoukhuede, O; Nikneshan, D; Blayney, S; Reddy, R; Choi, P; Horton, M; Musuka, T; Dubuc, V; Field, T S; Desai, J; Adatia, S; Alseraya, A; Nambiar, V; van Dijk, R; Wong, J H; Mitha, A P; Morrish, W F; Eesa, M; Newcommon, N J; Shuaib, A; Schwindt, B; Butcher, K S; Jeerakathil, T; Buck, B; Khan, K; Naik, S S; Emery, D J; Owen, R J; Kotylak, T B; Ashforth, R A; Yeo, T A; McNally, D; Siddiqui, M; Saqqur, M; Hussain, D; Kalashyan, H; Manosalva, A; Kate, M; Gioia, L; Hasan, S; Mohammad, A; Muratoglu, M; Williams, D; Thornton, J; Cullen, A; Brennan, P; O'Hare, A; Looby, S; Hyland, D; Duff, S; McCusker, M; Hallinan, B; Lee, S; McCormack, J; Moore, A; O'Connor, M; Donegan, C; Brewer, L; Martin, A; Murphy, S; O'Rourke, K; Smyth, S; Kelly, P; Lynch, T; Daly, T; O'Brien, P; O'Driscoll, A; Martin, M; Daly, T; Collins, R; Coughlan, T; McCabe, D; Murphy, S; O'Neill, D; Mulroy, M; Lynch, O; Walsh, T; O'Donnell, M; Galvin, T; Harbison, J; McElwaine, P; Mulpeter, K; McLoughlin, C; Reardon, M; Harkin, E; Dolan, E; Watts, M; Cunningham, N; Fallon, C; Gallagher, S; Cotter, P; Crowe, M; Doyle, R; Noone, I; Lapierre, M; Coté, V A; Lanthier, S; Odier, C; Durocher, A; Raymond, J; Weill, A; Daneault, N; Deschaintre, Y; Jankowitz, B; Baxendell, L; Massaro, L; Jackson-Graves, C; Decesare, S; Porter, P; Armbruster, K; Adams, A; Billigan, J; Oakley, J; Ducruet, A; Jadhav, A; Giurgiutiu, D-V; Aghaebrahim, A; Reddy, V; Hammer, M; Starr, M; Totoraitis, V; Wechsler, L; Streib, S; Rangaraju, S; Campbell, D; Rocha, M; Gulati, D; Silver, F L; Krings, T; Kalman, L; Cayley, A; Williams, J; Stewart, T; Wiegner, R; Casaubon, L K; Jaigobin, C; Del Campo, J M; Elamin, E; Schaafsma, J D; Willinsky, R A; Agid, R; Farb, R; Ter Brugge, K; Sapkoda, B L; Baxter, B W; Barton, K; Knox, A; Porter, A; Sirelkhatim, A; Devlin, T; Dellinger, C; Pitiyanuvath, N; Patterson, J; Nichols, J; Quarfordt, S; Calvert, J; Hawk, H; Fanale, C; Frei, D F; Bitner, A; Novak, A; Huddle, D; Bellon, R; Loy, D; Wagner, J; Chang, I; Lampe, E; Spencer, B; Pratt, R; Bartt, R; Shine, S; Dooley, G; Nguyen, T; Whaley, M; McCarthy, K; Teitelbaum, J; Tampieri, D; Poon, W; Campbell, N; Cortes, M; Dowlatshahi, D; Lum, C; Shamloul, R; Robert, S; Stotts, G; Shamy, M; Steffenhagen, N; Blacquiere, D; Hogan, M; AlHazzaa, M; Basir, G; Lesiuk, H; Iancu, D; Santos, M; Choe, H; Weisman, D C; Jonczak, K; Blue-Schaller, A; Shah, Q; MacKenzie, L; Klein, B; Kulandaivel, K; Kozak, O; Gzesh, D J; Harris, L J; Khoury, J S; Mandzia, J; Pelz, D; Crann, S; Fleming, L; Hesser, K; Beauchamp, B; Amato-Marzialli, B; Boulton, M; Lopez-Ojeda, P; Sharma, M; Lownie, S; Chan, R; Swartz, R; Howard, P; Golob, D; Gladstone, D; Boyle, K; Boulos, M; Hopyan, J; Yang, V; Da Costa, L; Holmstedt, C A; Turk, A S; Navarro, R; Jauch, E; Ozark, S; Turner, R; Phillips, S; Shankar, J; Jarrett, J; Gubitz, G; Maloney, W; Vandorpe, R; Schmidt, M; Heidenreich, J; Hunter, G; Kelly, M; Whelan, R; Peeling, L; Burns, P A; Hunter, A; Wiggam, I; Kerr, E; Watt, M; Fulton, A; Gordon, P; Rennie, I; Flynn, P; Smyth, G; O'Leary, S; Gentile, N; Linares, G; McNelis, P; Erkmen, K; Katz, P; Azizi, A; Weaver, M; Jungreis, C; Faro, S; Shah, P; Reimer, H; Kalugdan, V; Saposnik, G; Bharatha, A; Li, Y; Kostyrko, P; Santos, M; Marotta, T; Montanera, W; Sarma, D; Selchen, D; Spears, J; Heo, J H; Jeong, K; Kim, D J; Kim, B M; Kim, Y D; Song, D; Lee, K-J; Yoo, J; Bang, O Y; Rho, S; Lee, J; Jeon, P; Kim, K H; Cha, J; Kim, S J; Ryoo, S; Lee, M J; Sohn, S-I; Kim, C-H; Ryu, H-G; Hong, J-H; Chang, H-W; Lee, C-Y; Rha, J; Davis, Stephen M; Donnan, Geoffrey A; Campbell, Bruce Cv; Mitchell, Peter J; Churilov, Leonid; Yan, Bernard; Dowling, Richard; Yassi, Nawaf; Oxley, Thomas J; Wu, Teddy Y; Silver, Gabriel; McDonald, Amy; McCoy, Rachael; Kleinig, Timothy J; Scroop, Rebecca; Dewey, Helen M; Simpson, Marion; Brooks, Mark; Coulton, Bronwyn; Krause, Martin; Harrington, Timothy J; Steinfort, Brendan; Faulder, Kenneth; Priglinger, Miriam; Day, Susan; Phan, Thanh; Chong, Winston; Holt, Michael; Chandra, Ronil V; Ma, Henry; Young, Dennis; Wong, Kitty; Wijeratne, Tissa; Tu, Hans; Mackay, Elizabeth; Celestino, Sherisse; Bladin, Christopher F; Loh, Poh Sien; Gilligan, Amanda; Ross, Zofia; Coote, Skye; Frost, Tanya; Parsons, Mark W; Miteff, Ferdinand; Levi, Christopher R; Ang, Timothy; Spratt, Neil; Kaauwai, Lara; Badve, Monica; Rice, Henry; de Villiers, Laetitia; Barber, P Alan; McGuinness, Ben; Hope, Ayton; Moriarty, Maurice; Bennett, Patricia; Wong, Andrew; Coulthard, Alan; Lee, Andrew; Jannes, Jim; Field, Deborah; Sharma, Gagan; Salinas, Simon; Cowley, Elise; Snow, Barry; Kolbe, John; Stark, Richard; King, John; Macdonnell, Richard; Attia, John; D'Este, Cate; Saver, Jeffrey L; Goyal, Mayank; Diener, Hans-Christoph; Levy, Elad I; Bonafé, Alain; Mendes Pereira, Vitor; Jahan, Reza; Albers, Gregory W; Cognard, Christophe; Cohen, David J; Hacke, Werner; Jansen, Olav; Jovin, Tudor G; Mattle, Heinrich P; Nogueira, Raul G; Siddiqui, Adnan H; Yavagal, Dileep R; von Kummer, Rüdiger; Smith, Wade; Turjman, Francis; Hamilton, Scott; Chiacchierini, Richard; Amar, Arun; Sanossian, Nerses; Loh, Yince; Devlin, T; Baxter, B; Hawk, H; Sapkota, B; Quarfordt, S; Sirelkhatim, A; Dellinger, C; Barton, K; Reddy, V K; Ducruet, A; Jadhav, A; Horev, A; Giurgiutiu, D-V; Totoraitis, V; Hammer, M; Jankowitz, B; Wechsler, L; Rocha, M; Gulati, D; Campbell, D; Star, M; Baxendell, L; Oakley, J; Siddiqui, A; Hopkins, L N; Snyder, K; Sawyer, R; Hall, S; Costalat, V; Riquelme, C; Machi, P; Omer, E; Arquizan, C; Mourand, I; Charif, M; Ayrignac, X; Menjot de Champfleur, N; Leboucq, N; Gascou, G; Moynier, M; du Mesnil de Rochemont, R; Singer, O; Berkefeld, J; Foerch, C; Lorenz, M; Pfeilschifer, W; Hattingen, E; Wagner, M; You, S J; Lescher, S; Braun, H; Dehkharghani, S; Belagaje, S R; Anderson, A; Lima, A; Obideen, M; Haussen, D; Dharia, R; Frankel, M; Patel, V; Owada, K; Saad, A; Amerson, L; Horn, C; Doppelheuer, S; Schindler, K; Lopes, D K; Chen, M; Moftakhar, R; Anton, C; Smreczak, M; Carpenter, J S; Boo, S; Rai, A; Roberts, T; Tarabishy, A; Gutmann, L; Brooks, C; Brick, J; Domico, J; Reimann, G; Hinrichs, K; Becker, M; Heiss, E; Selle, C; Witteler, A; Al-Boutros, S; Danch, M-J; Ranft, A; Rohde, S; Burg, K; Weimar, C; Zegarac, V; Hartmann, C; Schlamann, M; Göricke, S; Ringlestein, A; Wanke, I; Mönninghoff, C; Dietzold, M; Budzik, R; Davis, T; Eubank, G; Hicks, W J; Pema, P; Vora, N; Mejilla, J; Taylor, M; Clark, W; Rontal, A; Fields, J; Peterson, B; Nesbit, G; Lutsep, H; Bozorgchami, H; Priest, R; Ologuntoye, O; Barnwell, S; Dogan, A; Herrick, K; Takahasi, C; Beadell, N; Brown, B; Jamieson, S; Hussain, M S; Russman, A; Hui, F; Wisco, D; Uchino, K; Khawaja, Z; Katzan, I; Toth, G; Cheng-Ching, E; Bain, M; Man, S; Farrag, A; George, P; John, S; Shankar, L; Drofa, A; Dahlgren, R; Bauer, A; Itreat, A; Taqui, A; Cerejo, R; Richmond, A; Ringleb, P; Bendszus, M; Möhlenbruch, M; Reiff, T; Amiri, H; Purrucker, J; Herweh, C; Pham, M; Menn, O; Ludwig, I; Acosta, I; Villar, C; Morgan, W; Sombutmai, C; Hellinger, F; Allen, E; Bellew, M; Gandhi, R; Bonwit, E; Aly, J; Ecker, R D; Seder, D; Morris, J; Skaletsky, M; Belden, J; Baker, C; Connolly, L S; Papanagiotou, P; Roth, C; Kastrup, A; Politi, M; Brunner, F; Alexandrou, M; Merdivan, H; Ramsey, C; Given Ii, C; Renfrow, S; Deshmukh, V; Sasadeusz, K; Vincent, F; Thiesing, J T; Putnam, J; Bhatt, A; Kansara, A; Caceves, D; Lowenkopf, T; Yanase, L; Zurasky, J; Dancer, S; Freeman, B; Scheibe-Mirek, T; Robison, J; Rontal, A; Roll, J; Clark, D; Rodriguez, M; Fitzsimmons, B-Fm; Zaidat, O; Lynch, J R; Lazzaro, M; Larson, T; Padmore, L; Das, E; Farrow-Schmidt, A; Hassan, A; Tekle, W; Cate, C; Jansen, O; Cnyrim, C; Wodarg, F; Wiese, C; Binder, A; Riedel, C; Rohr, A; Lang, N; Laufs, H; Krieter, S; Remonda, L; Diepers, M; Añon, J; Nedeltchev, K; Kahles, T; Biethahn, S; Lindner, M; Chang, V; Gächter, C; Esperon, C; Guglielmetti, M; Arenillas Lara, J F; Martínez Galdámez, M; Calleja Sanz, A I; Cortijo Garcia, E; Garcia Bermejo, P; Perez, S; Mulero Carrillo, P; Crespo Vallejo, E; Ruiz Piñero, M; Lopez Mesonero, L; Reyes Muñoz, F J; Brekenfeld, C; Buhk, J-H; Krützelmann, A; Thomalla, G; Cheng, B; Beck, C; Hoppe, J; Goebell, E; Holst, B; Grzyska, U; Wortmann, G; Starkman, S; Duckwiler, G; Jahan, R; Rao, N; Sheth, S; Ng, K; Noorian, A; Szeder, V; Nour, M; McManus, M; Huang, J; Tarpley, J; Tateshima, S; Gonzalez, N; Ali, L; Liebeskind, D; Hinman, J; Calderon-Arnulphi, M; Liang, C; Guzy, J; Koch, S; DeSousa, K; Gordon-Perue, G; Haussen, D; Elhammady, M; Peterson, E; Pandey, V; Dharmadhikari, S; Khandelwal, P; Malik, A; Pafford, R; Gonzalez, P; Ramdas, K; Andersen, G; Damgaard, D; Von Weitzel-Mudersbach, P; Simonsen, C; Ruiz de Morales Ayudarte, N; Poulsen, M; Sørensen, L; Karabegovich, S; Hjørringgaard, M; Hjort, N; Harbo, T; Sørensen, K; Deshaies, E; Padalino, D; Swarnkar, A; Latorre, J G; Elnour, E; El-Zammar, Z; Villwock, M; Farid, H; Balgude, A; Cross, L; Hansen, K; Holtmannspötter, M; Kondziella, D; Hoejgaard, J; Taudorf, S; Soendergaard, H; Wagner, A; Cronquist, M; Stavngaard, T; Cortsen, M; Krarup, L H; Hyldal, T; Haring, H-P; Guggenberger, S; Hamberger, M; Trenkler, J; Sonnberger, M; Nussbaumer, K; Dominger, C; Bach, E; Jagadeesan, B D; Taylor, R; Kim, J; Shea, K; Tummala, R; Zacharatos, H; Sandhu, D; Ezzeddine, M; Grande, A; Hildebrandt, D; Miller, K; Scherber, J; Hendrickson, A; Jumaa, M; Zaidi, S; Hendrickson, T; Snyder, V; Killer-Oberpfalzer, M; Mutzenbach, J; Weymayr, F; Broussalis, E; Stadler, K; Jedlitschka, A; Malek, A; Mueller-Kronast, N; Beck, P; Martin, C; Summers, D; Day, J; Bettinger, I; Holloway, W; Olds, K; Arkin, S; Akhtar, N; Boutwell, C; Crandall, S; Schwartzman, M; Weinstein, C; Brion, B; Prothmann, S; Kleine, J; Kreiser, K; Boeckh-Behrens, T; Poppert, H; Wunderlich, S; Koch, M L; Biberacher, V; Huberle, A; Gora-Stahlberg, G; Knier, B; Meindl, T; Utpadel-Fischler, D; Zech, M; Kowarik, M; Seifert, C; Schwaiger, B; Puri, A; Hou, S; Wakhloo, A; Moonis, M; Henninger, N; Goddeau, R; Massari, F; Minaeian, A; Lozano, J D; Ramzan, M; Stout, C; Patel, A; Tunguturi, A; Onteddu, S; Carandang, R; Howk, M; Ribó, M; Sanjuan, E; Rubiera, M; Pagola, J; Flores, A; Muchada, M; Meler, P; Huerga, E; Gelabert, S; Coscojuela, P; Tomasello, A; Rodriguez, D; Santamarina, E; Maisterra, O; Boned, S; Seró, L; Rovira, A; Molina, C A; Millán, M; Muñoz, L; Pérez de la Ossa, N; Gomis, M; Dorado, L; López-Cancio, E; Palomeras, E; Munuera, J; García Bermejo, P; Remollo, S; Castaño, C; García-Sort, R; Cuadras, P; Puyalto, P; Hernández-Pérez, M; Jiménez, M; Martínez-Piñeiro, A; Lucente, G; Dávalos, A; Chamorro, A; Urra, X; Obach, V; Cervera, A; Amaro, S; Llull, L; Codas, J; Balasa, M; Navarro, J; Ariño, H; Aceituno, A; Rudilosso, S; Renu, A; Macho, J M; San Roman, L; Blasco, J; López, A; MacÃas, N; Cardona, P; Quesada, H; Rubio, F; Cano, L; Lara, B; de Miquel, M A; Aja, L; Serena, J; Cobo, E; Albers, Gregory W; Lees, Kennedy R; Arenillas, J; Roberts, R; Minhas, P; Al-Ajlan, F; Salluzzi, M; Zimmel, L; Patel, S; Eesa, M; MartÃ-Fà bregas, J; Jankowitz, B; Serena, J; Salvat-Plana, M; López-Cancio, E; Bracard, S; Ducrocq, Xavier; Anxionnat, René; Baillot, Pierre-Alexandre; Barbier, Charlotte; Derelle, Anne-Laure; Lacour, Jean-Christophe; Richard, Sébastien; Samson, Yves; Sourour, Nader; Baronnet-Chauvet, Flore; Clarencon, Frédéric; Crozier, Sophie; Deltour, Sandrine; Di Maria, Federico; Le Bouc, Raphael; Leger, Anne; Mutlu, Gurkan; Rosso, Charlotte; Szatmary, Zoltan; Yger, Marion; Zavanone, Chiara; Bakchine, Serge; Pierot, Laurent; Caucheteux, Nathalie; Estrade, Laurent; Kadziolka, Krzysztof; Leautaud, Alexandre; Renkes, Céline; Serre, Isabelle; Desal, Hubert; Guillon, Benoît; Boutoleau-Bretonniere, Claire; Daumas-Duport, Benjamin; De Gaalon, Solène; Derkinderen, Pascal; Evain, Sarah; Herisson, Fanny; Laplaud, David-Axel; Lebouvier, Thibaud; Lintia-Gaultier, Alina; Pouclet-Courtemanche, Hélène; Rouaud, Tiphaine; Rouaud Jaffrenou, Violaine; Schunck, Aurélia; Sevin-Allouet, Mathieu; Toulgoat, Frederique; Wiertlewski, Sandrine; Gauvrit, Jean-Yves; Ronziere, Thomas; Cahagne, Vincent; Ferre, Jean-Christophe; Pinel, Jean-François; Raoult, Hélène; Mas, Jean-Louis; Meder, Jean-François; Al Najjar-Carpentier, Amen-Adam; Birchenall, Julia; Bodiguel, Eric; Calvet, David; Domigo, Valérie; Godon-Hardy, Sylvie; Guiraud, Vincent; Lamy, Catherine; Majhadi, Loubna; Morin, Ludovic; Naggara, Olivier; Trystram, Denis; Turc, Guillaume; Berge, Jérôme; Sibon, Igor; Menegon, Patrice; Barreau, Xavier; Rouanet, François; Debruxelles, Sabrina; Kazadi, Annabelle; Renou, Pauline; Fleury, Olivier; Pasco-Papon, Anne; Dubas, Frédéric; Caroff, Jildaz; Godard Ducceschi, Sophie; Hamon, Marie-Aurélie; Lecluse, Alderic; Marc, Guillaume; Giroud, Maurice; Ricolfi, Frédéric; Bejot, Yannick; Chavent, Adrien; Gentil, Arnaud; Kazemi, Apolline; Osseby, Guy-Victor; Voguet, Charlotte; Mahagne, Marie-Hélène; Sedat, Jacques; Chau, Yves; Suissa, Laurent; Lachaud, Sylvain; Houdart, Emmanuel; Stapf, Christian; Buffon Porcher, Frédérique; Chabriat, Hugues; Guedin, Pierre; Herve, Dominique; Jouvent, Eric; Mawet, Jérôme; Saint-Maurice, Jean-Pierre; Schneble, Hans-Martin; Turjman, Francis; Nighoghossian, Norbert; Berhoune, Nadia-Nawel; Bouhour, Françoise; Cho, Tae-Hee; Derex, Laurent; Felix, Sandra; Gervais-Bernard, Hélène; Gory, Benjamin; Manera, Luis; Mechtouff, Laura; Ritzenthaler, Thomas; Riva, Roberto; Salaris Silvio, Fabrizio; Tilikete, Caroline; Blanc, Raphael; Obadia, Michaël; Bartolini, Mario Bruno; Gueguen, Antoine; Piotin, Michel; Pistocchi, Silvia; Redjem, Hocine; Drouineau, Jacques; Neau, Jean-Philippe; Godeneche, Gaelle; Lamy, Matthias; Marsac, Emilia; Velasco, Stephane; Clavelou, Pierre; Chabert, Emmanuel; Bourgois, Nathalie; Cornut-Chauvinc, Catherine; Ferrier, Anna; Gabrillargues, Jean; Jean, Betty; Marques, Anna-Raquel; Vitello, Nicolas; Detante, Olivier; Barbieux, Marianne; Boubagra, Kamel; Favre Wiki, Isabelle; Garambois, Katia; Tahon, Florence; Ashok, Vasdev; Voguet, Charlotte; Coskun, Oguzhan; Guedin, Pierre; Rodesch, Georges; Lapergue, Bertrand; Bourdain, Frédéric; Evrard, Serge; Graveleau, Philippe; Decroix, Jean Pierre; Wang, Adrien; Sellal, François; Ahle, Guido; Carelli, Gabriela; Dugay, Marie-Hélène; Gaultier, Claude; Lebedinsky, Ariel Pablo; Lita, Lavinia; Musacchio, Raul Mariano; Renglewicz-Destuynder, Catherine; Tournade, Alain; Vuillemet, Françis; Montoro, Francisco Macian; Mounayer, Charbel; Faugeras, Frederic; Gimenez, Laetitia; Labach, Catherine; Lautrette, Géraldine; Denier, Christian; Saliou, Guillaume; Chassin, Olivier; Dussaule, Claire; Melki, Elsa; Ozanne, Augustin; Puccinelli, Francesco; Sachet, Marina; Sarov, Mariana; Bonneville, Jean-François; Moulin, Thierry; Biondi, Alessandra; De Bustos Medeiros, Elisabeth; Vuillier, Fabrice; Courtheoux, Patrick; Viader, Fausto; Apoil-Brissard, Marion; Bataille, Mathieu; Bonnet, Anne-Laure; Cogez, Julien; Kazemi, Apolline; Touze, Emmanuel; Leclerc, Xavier; Leys, Didier; Aggour, Mohamed; Aguettaz, Pierre; Bodenant, Marie; Cordonnier, Charlotte; Deplanque, Dominique; Girot, Marie; Henon, Hilde; Kalsoum, Erwah; Lucas, Christian; Pruvo, Jean-Pierre; Zuniga, Paolo; Bonafé, Alain; Arquizan, Caroline; Costalat, Vincent; Machi, Paolo; Mourand, Isabelle; Riquelme, Carlos; Bounolleau, Pierre; Arteaga, Charles; Faivre, Anthony; Bintner, Marc; Tournebize, Patrice; Charlin, Cyril; Darcel, Françoise; Gauthier-Lasalarie, Pascale; Jeremenko, Marcia; Mouton, Servane; Zerlauth, Jean-Baptiste; Lamy, Chantal; Hervé, Deramond; Hassan, Hosseini; Gaston, André; Barral, Francis-Guy; Garnier, Pierre; Beaujeux, Rémy; Wolff, Valérie; Herbreteau, Denis; Debiais, Séverine; Murray, Alicia; Ford, Gary; Muir, Keith W; White, Philip; Brown, Martin M; Clifton, Andy; Freeman, Janet; Ford, Ian; Markus, Hugh; Wardlaw, Joanna; Lees, Kennedy R; Molyneux, Andy; Robinson, Thompson; Lewis, Steff; Norrie, John; Robertson, Fergus; Perry, Richard; Dixit, Anand; Cloud, Geoffrey; Clifton, Andrew; Madigan, Jeremy; Roffe, Christine; Nayak, Sanjeev; Lobotesis, Kyriakos; Smith, Craig; Herwadkar, Amit; Kandasamy, Naga; Goddard, Tony; Bamford, John; Subramanian, Ganesh; Lenthall, Rob; Littleton, Edward; Lamin, Sal; Storey, Kelley; Ghatala, Rita; Banaras, Azra; Aeron-Thomas, John; Hazel, Bath; Maguire, Holly; Veraque, Emelda; Harrison, Louise; Keshvara, Rekha; Cunningham, James
BACKGROUND:General anaesthesia (GA) during endovascular thrombectomy has been associated with worse patient outcomes in observational studies compared with patients treated without GA. We assessed functional outcome in ischaemic stroke patients with large vessel anterior circulation occlusion undergoing endovascular thrombectomy under GA, versus thrombectomy not under GA (with or without sedation) versus standard care (ie, no thrombectomy), stratified by the use of GA versus standard care. METHODS:For this meta-analysis, patient-level data were pooled from all patients included in randomised trials in PuMed published between Jan 1, 2010, and May 31, 2017, that compared endovascular thrombectomy predominantly done with stent retrievers with standard care in anterior circulation ischaemic stroke patients (HERMES Collaboration). The primary outcome was functional outcome assessed by ordinal analysis of the modified Rankin scale (mRS) at 90 days in the GA and non-GA subgroups of patients treated with endovascular therapy versus those patients treated with standard care, adjusted for baseline prognostic variables. To account for between-trial variance we used mixed-effects modelling with a random effect for trials incorporated in all models. Bias was assessed using the Cochrane method. The meta-analysis was prospectively designed, but not registered. FINDINGS:Seven trials were identified by our search; of 1764 patients included in these trials, 871 were allocated to endovascular thrombectomy and 893 were assigned standard care. After exclusion of 74 patients (72 did not undergo the procedure and two had missing data on anaesthetic strategy), 236 (30%) of 797 patients who had endovascular procedures were treated under GA. At baseline, patients receiving GA were younger and had a shorter delay between stroke onset and randomisation but they had similar pre-treatment clinical severity compared with patients who did not have GA. Endovascular thrombectomy improved functional outcome at 3 months both in patients who had GA (adjusted common odds ratio (cOR) 1·52, 95% CI 1·09-2·11, p=0·014) and in those who did not have GA (adjusted cOR 2·33, 95% CI 1·75-3·10, p<0·0001) versus standard care. However, outcomes were significantly better for patients who did not receive GA versus those who received GA (covariate-adjusted cOR 1·53, 95% CI 1·14-2·04, p=0·0044). The risk of bias and variability between studies was assessed to be low. INTERPRETATION:Worse outcomes after endovascular thrombectomy were associated with GA, after adjustment for baseline prognostic variables. These data support avoidance of GA whenever possible. The procedure did, however, remain effective versus standard care in patients treated under GA, indicating that treatment should not be withheld in those who require anaesthesia for medical reasons. FUNDING:Medtronic.
PMID: 29263006
ISSN: 1474-4465
CID: 5121942
The Brain Thermal Response as a Potential Neuroimaging Biomarker of Cerebrovascular Impairment
Fleischer, C C; Wu, J; Qiu, D; Park, S-E; Nahab, F; Dehkharghani, S
BACKGROUND AND PURPOSE: Brain temperature is critical for homeostasis, relating intimately to cerebral perfusion and metabolism. Cerebral thermometry is historically challenged by the cost and invasiveness of clinical and laboratory methodologies. We propose the use of noninvasive MR thermometry in patients with cerebrovascular disease, hypothesizing the presence of a measurable brain thermal response reflecting the tissue hemodynamic state. MATERIALS AND METHODS: Contemporaneous imaging and MR thermometry were performed in 10 patients (32-68 years of age) undergoing acetazolamide challenge for chronic, anterior circulation steno-occlusive disease. Cerebrovascular reactivity was calculated with blood oxygen level-dependent imaging and arterial spin-labeling methods. Brain temperature was calculated pre- and post-acetazolamide using previously established chemical shift thermometry. Mixed-effects models of the voxelwise relationships between the brain thermal response and cerebrovascular reactivity were computed, and the significance of model coefficients was determined with an F test (P < .05). RESULTS: We observed significant, voxelwise quadratic relationships between cerebrovascular reactivity from blood oxygen level-dependent imaging and the brain thermal response (x coefficient = 0.052, P < .001; x2coefficient = 0.0068, P < .001) and baseline brain temperatures (x coefficient = 0.59, P = .008; x2 coefficient = -0.13, P < .001). A significant linear relationship was observed for the brain thermal response with cerebrovascular reactivity from arterial spin-labeling (P = .001). CONCLUSIONS: The findings support the presence of a brain thermal response exhibiting complex but significant interactions with tissue hemodynamics, which we posit to reflect a relative balance of heat-producing versus heat-dissipating tissue states. The brain thermal response is a potential noninvasive biomarker for cerebrovascular impairment.
PMCID:5690840
PMID: 28935624
ISSN: 1936-959x
CID: 2768962
Utility of Repeat Cerebrovascular Imaging among Hospitalized Stroke Patients
Raza, Syed Ali; Javalkar, Vijay; Dehkharghani, Seena; Kudrimoti, Archana; Saindane, Amit; Mullins, Mark; Nahab, Fadi
BACKGROUND AND PURPOSE: The purpose of this study is to evaluate the frequency and clinical utility of repeat cerebrovascular imaging with computed tomography angiography (CTA) of the head after contrast-enhanced magnetic resonance angiography (CE-MRA) of the head in acute stroke patients. MATERIALS AND METHODS: All stroke patients admitted to 2 academic medical centers from January 1, 2012 through December 31, 2014 were identified as part of prospective radiology database if they underwent CE-MRA of the head followed by subsequent CTA of the head within 7 days. Two vascular neurologists blinded to CTA results retrospectively reviewed medical records including documented indications for imaging studies and clinical changes in patients to determine necessity of CTA. RESULTS: Of 1355 acute stroke patients who underwent CE-MRA of the head, 195 (14%) patients underwent subsequent CTA of the head within 7 days, including 33 patients with nondiagnostic CE-MRA because of motion artifact. Of the remaining 162 (12%) patients, 69 (43%) were considered to have an unnecessary CTA of the head. Multivariable logistic regression analysis identified (1) absence of new neurologic examination changes [OR 7.29; 95% CI 1.92-27.63] and (2) same documented indication for both studies [OR 6.47; 95% CI 3.04-13.78] as significant predictors of an unnecessary CTA. Changes in clinical management after CTA were significantly more common in necessary CTAs compared with studies determined to be unnecessary (42% versus 7%, P < .0001). CONCLUSION: The utility of repeat cerebrovascular imaging with CTA of the head following a diagnostic CE-MRA is low when there is no change in neurologic examination or when ordered for the same indication.
PMID: 28268151
ISSN: 1532-8511
CID: 2477032
Imaging Approaches to Stroke and Neurovascular Disease
Dehkharghani, Seena; Andre, Jalal
PMID: 28525926
ISSN: 1524-4040
CID: 2604842
CT Perfusion to Predict Response to Recanalization in Ischemic Stroke
Lansberg, Maarten G; Christensen, Soren; Kemp, Stephanie; Mlynash, Michael; Mishra, Nishant; Federau, Christian; Tsai, Jenny P; Kim, Sun; Nogueria, Raul G; Jovin, Tudor; Devlin, Thomas G; Akhtar, Naveed; Yavagal, Dileep R; Haussen, Diogo; Dehkharghani, Seena; Bammer, Roland; Straka, Matus; Zaharchuk, Greg; Marks, Michael P; Albers, Gregory W
OBJECTIVE: To assess the utility of CT perfusion for selection of patients for endovascular therapy up to 18 hours after symptom onset. METHODS: We conducted a multicenter cohort study of consecutive acute stroke patients scheduled to undergo endovascular therapy within 90 min after a baseline CTP. Patients were classified as 'target mismatch' if they had a small ischemic core and a large penumbra on their baseline CT perfusion. Reperfusion was defined as >50% reduction in critical hypoperfusion between the baseline CT perfusion and the 36-hour follow-up MRI. RESULTS: Of the 201 patients enrolled, 190 patients with an adequate baseline CT perfusion study who underwent angiography were included; mean age 66 years, median NIHSS 16, median time from symptom onset to endovascular therapy 5.2 hours. Rate of reperfusion was 89%. In patients with target mismatch (n=131), reperfusion was associated with higher odds of favorable clinical response, defined as an improvement of >/=8 points on the NIH Stroke Scale (83% vs 44%, p=0.002; adjusted OR=6.6; 95% CI 2.1-20.9). This association did not differ between patients treated within 6 hrs (OR = 6.4; 95% CI 1.5-27.8) and those treated beyond 6 hrs after symptom onset (OR = 13.7; 95% CI 1.4-140). INTERPRETATION: The robust association between endovascular reperfusion and good outcome among patients with the CT perfusion target mismatch profile treated up to 18 hours after symptom onset supports a randomized trial of endovascular therapy in this patient population
PMCID:5521988
PMID: 28486789
ISSN: 1531-8249
CID: 2560342
