scholarly journals COVID-19-associated Large Vessel Stroke in a 28-year-old Patient

2021 ◽  
Author(s):  
Tobias Boeckh-Behrens ◽  
Daniel Golkowski ◽  
Benno Ikenberg ◽  
Jürgen Schlegel ◽  
Ulrike Protzer ◽  
...  
Keyword(s):  
Large Vessel ◽  
Large Vessel Stroke

Abstract TMP50: A Polymorphism in HDAC9 was Associated with Large Vessel Stroke in the Vienna and German Stroke Studies

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
May M Luke ◽  
Carmen H Tong ◽  
Joseph J Catanese ◽  
James J Devlin ◽  
Christine Mannhalter ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Ischemic Stroke ◽  
Genome Wide Association Study ◽  
Multinomial Logistic Regression ◽  
Large Vessel ◽  
Stroke Subtype ◽  
German Study ◽  
Genome Wide ◽  
Increased Risk ◽  
Large Vessel Stroke

Introduction The International Stroke Genetics Consortium (ISGC) and the Wellcome Trust Case Control Consortium 2 (WTCCC2) performed a large genome wide association study of ischemic stroke and its subtypes (large vessel stroke (LVD), small vessel stroke (SVD), cardioembolic stroke (CE)), and identified a polymorphism in HDAC9 (rs11984041) associated with the LVD subtype of ischemic stroke. Hypothesis We assessed the hypothesis that rs11984041 is associated with LVD in two additional studies. Methods The genotype of rs11984041 was determined for participants of the Vienna Study (815 controls, 122 LVD, 165 SVD, 202 CE) and of the German Study (1040 controls, 495 LVD, 230 SVD, 462 CE). The association of rs11984041 with LVD was assessed by logistic regression. Heterogeneity of the effect of rs11984041 on LVD, CE or SVD was assessed by testing the equality of the corresponding regression coefficients from a multinomial logistic regression model. Results Carriers of the minor (T) allele of rs11984041 (23.3% of LVD cases and 17.4% of controls), compared with noncarriers, had increased risk for LVD: the odds ratios (OR) were 1.92 (95%CI 1.25-2.96) for the Vienna Study and 1.33 (95%CI 1.02-1.74) for the German Study. Adjusting for covariates including sex, age, diabetes, and hypertension did not materially change the ORs. Heterogeneity of the effects of rs11984041 on LVD vs CE was significant in the Vienna Study (p = 0.009) and in the German Study (p = 0.005). Heterogeneity of the effects of rs11984041 on LVD vs SVD trended toward significance in the Vienna Study (p = 0.088) and was significant in the German Study (p = 0.047). Adjusting for covariates did not materially change the heterogeneity test p values. Conclusions The HDAC9 polymorphism rs11984041 was associated with the LVD stroke subtype in the Vienna Study and the German Study. These results replicated the ISGC/WTCCC2 findings.

Abstract W MP6: SAVER I: Superselective Administration of VErapamil during Recanalization in Acute Ischemic Stroke. A Phase I Feasibility Study

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Justin F Fraser ◽  
Michael E Maniskas ◽  
Abdulnasser Alhajeri ◽  
Gregory J Bix
Keyword(s):  
Ischemic Stroke ◽  
Phase I ◽  
Large Vessel ◽  
Direct Result ◽  
Dose Selection ◽  
Grading Scale ◽  
Symptomatic Intracranial Hemorrhage ◽  
Drug Studies ◽  
Acute Stroke Therapy ◽  
Large Vessel Stroke

Large vessel occlusive ischemic stroke results in high rates of morbidity and mortality. While intravenous t-PA and intra-arterial (IA) thrombectomy are mainstays in acute stroke therapy, clinical outcomes lag significantly behind improving rates of acute revascularization. Thus, there is a critical need for a novel adjunctive therapy to reduce stroke burden and to improve outcome. Previous neuroprotective drug studies failed due to long intervals between symptom onset and drug administration, lack of concordant thrombolytic revascularization, and lack of targeted administration to the affected vessel. Through a retro-engineered mouse model of large vessel stroke allowing concomitant recanalization and selective intra-arterial (IA) administration we previously evaluated verapamil, a calcium channel blocker (CCB) that is already safely injected intra-arterially (IA) for vasospasm. In this clinically relevant model, verapamil was highly neuroprotective when combined with vessel recanalization. Based on this data, we conducted a single-institution Phase I study to evaluate the feasibility and safety of superselective IA verapamil (10mg) administration immediately following mechanical thrombectomy. We collected information about demographics, location of the occlusion, last known normal time, time to and recanalization. Evaluation of CTA collateralization was performed using a previously a published grading scale (Souza et al. AJNR. 2012). The primary endpoint was symptomatic intracranial hemorrhage (ICH) within 24 hours post-procedure as defined by the Interventional Management Stroke (IMS) III Trial (Broderick et al. NEJM. 2013). Patients were monitored and graded at 3 months with the modified Rankin Score (mRS). Of the enrolled patients, none had a significant ICH, and none died as a direct result of the procedure. Clinical outcome results for patients were encouraging, and warrant further study. These results will be used to support a Phase II dose selection study.

Evaluation of sex differences in acid/base and electrolyte concentrations in acute large vessel stroke

2020 ◽  
Vol 323 ◽  
pp. 113078
Author(s):  
Sarah R. Martha ◽  
Lisa A. Collier ◽  
Stephanie M. Davis ◽  
Akin Erol ◽  
Doug Lukins ◽  
...  
Keyword(s):  
Sex Differences ◽  
Large Vessel ◽  
Acid Base ◽  
Large Vessel Stroke

scholarly journals Impact of the Thrombectomy Trials on the Management and Outcome of Large Vessel Stroke: Data From the Lyon Stroke Center

2018 ◽  
Vol 9 ◽  
Author(s):  
Louis Viannay ◽  
Julie Haesebaert ◽  
Fannie Florin ◽  
Roberto Riva ◽  
Laura Mechtouff ◽  
...  
Keyword(s):  
Large Vessel ◽  
Stroke Center ◽  
Large Vessel Stroke

scholarly journals Leptomeningeal Collateral Flow Modifies Endovascular Treatment Efficacy on Large-Vessel Occlusion Strokes

Stroke ◽  
2021 ◽  
Vol 52 (1) ◽  
pp. 299-303
Author(s):  
Álvaro García-Tornel ◽  
Ludovico Ciolli ◽  
Marta Rubiera ◽  
Manuel Requena ◽  
Marian Muchada ◽  
...  
Keyword(s):  
Ct Angiography ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Multivariable Analysis ◽  
Large Vessel ◽  
Collateral Flow ◽  
Vessel Occlusion ◽  
Shift Analysis ◽  
Final Degree ◽  
Large Vessel Stroke

Background and Purpose: We aim to evaluate if good collateral flow (CF) modifies endovascular therapy (EVT) efficacy on large-vessel stroke. To do that, we used final degree of reperfusion and number of device-passes performed, factors previously associated with better functional outcome, as main outcome measures. Methods: Single-center retrospective study including consecutive stroke patients receiving EVT for anterior circulation large-vessel stroke. CF degree was assessed on CT angiography before EVT using a previously validated 4-grade score. Final degree of reperfusion, using modified Thrombolysis in Cerebral Ischemia (mTICI), and number of device-passes performed were prospectively collected. Multivariable analysis was performed to evaluate the influence of collateral flow degree on final degree of reperfusion and number of device-passes performed. Results: Six hundred twenty-six patients were included in the study; 369 patients (59%) presented good collateral flow on CT angiography. Five hundred twenty-two patients (84%) achieved successful reperfusion (mTICI 2B-3) after EVT, 304 (48%) of them with a final mTICI 2C-3. Median number of device-passes was 2 (interquartile range, 1–3). Good CF was independently associated with better final degree of reperfusion (shift analysis for mTICI0-2A/2B/2C-3%, poor CF 19/38/43 versus good CF 15/32/53, adjusted odds ratio, 1.51 [95% CI, 1.08–2.11]). Poor CF was independently associated with higher number of device-passes performed to achieve successful reperfusion (mTICI2B-3; shift analysis for 1/2/3/4+ device-passes, adjusted odds ratio, 1.59, [95% CI, 1.09–2.31]) and complete reperfusion (mTICI2C-3; shift analysis for 1/2/3/4+ device-passes, adjusted odds ratio, 1.70 [95% CI, 1.04–2.90]). Conclusions: Patients with good CF treated with EVT experience higher rates of successful reperfusion with lower number of device-passes. CF may facilitate thrombus retrieval and prevent distal embolization of clot fragments, improving device-passes efficacy.

Sign in / Sign up

Export Citation Format

Share Document