Abstract 22: Late Functional Improvement in Acute Ischemic Stroke Patients: Pooled Analysis of Three Multicenter Clinical Trials

Stroke ◽  
2018 ◽  
Vol 49 (Suppl_1) ◽  
Author(s):  
Adnan I Qureshi ◽  
Sher Afghan ◽  
Ahmed A Malik ◽  
Omar Saeed ◽  
Nazli A Janjua
Keyword(s):  
Clinical Trials ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Pooled Analysis ◽  
Functional Improvement ◽  
Stroke Patients ◽  
Multicenter Clinical Trials

Clinical and radiological outcomes of acute ischemic stroke patients without angiographic occlusion on digital subtraction angiogram. A pooled analysis of case series

2008 ◽  
Vol 50 (11) ◽  
pp. 963-968 ◽  
Author(s):  
Qaisar A. Shah ◽  
Muhammad Zeeshan Memon ◽  
Gabriela Vazquez ◽  
M. Fareed K. Suri ◽  
Haitham M. Hussein ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Case Series ◽  
Pooled Analysis ◽  
Digital Subtraction ◽  
Stroke Patients ◽  
Digital Subtraction Angiogram

Abstract TP13: Procedural Time (Groin Puncture to Recanalization) Significantly Predicts Outcomes in Endovascular Treatment: A Pooled Analysis of SWIFT, STAR and SWIFT PRIME Trials

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Ameer E Hassan ◽  
Jeffrey L Saver ◽  
Mayank Goyal ◽  
David S Liebeskind ◽  
Reza Jahan ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Endovascular Treatment ◽  
Acute Ischemic Stroke ◽  
Clinical Outcomes ◽  
Pooled Analysis ◽  
Favorable Outcome ◽  
Stroke Patients ◽  
Nihss Score ◽  
Post Procedure ◽  
Procedural Time

Background: Recent single center studies have suggested that “procedural time” independent of “time to procedure” can affect outcomes of acute ischemic stroke patients undergoing endovascular treatment (ET). We performed a pooled analysis from three ET trials to determine the effect of procedural time on angiographic and clinical outcomes. Objective: To determine the relationship between procedural time and clinical outcomes among acute ischemic stroke patients undergoing successful recanalization with ET. Methods: We analyzed data from SWIFT, STAR and SWIFT PRIME trials. Baseline demographic and clinical characteristics, NIHSS score on admission, intracranial hemorrhage rates and mRS at 3 months post procedure were analyzed. TICI scale was used to grade post procedure angiographic recanalization. Procedural time was defined by the time interval between groin puncture and recanalization. We estimated the procedural time after which favorable clinical outcome was unlikely even after recanalization (futile) after age and NIHSS score adjustment. Results: We analyzed 301 patients who underwent ET and had near complete or complete recanalization (TICI 2b or 3). The procedural time (±SD) was significantly shorter in patients who achieved a favorable outcome (mRS 0-2) compared with those who did not achieve favorable outcome (44±25 vs 51±33 minutes, p=0.04). Table 1. In the multivariate analysis (including all baseline characteristics with a p value <0.05 as independent variables), shorter procedural time was a significant predictor of lower odds of unfavorable outcome (OR 0.49, 95% CI 0.28, 0.85, p=0.012). The rates of favorable outcomes were significantly higher when the procedural time was <60 minutes compared with ≥60 minutes (62% vs 45%, p=0.020). Conclusion: Procedural time in patients undergoing mechanical thrombectomy for acute ischemic stroke is an important determinant of favorable outcomes in those with near complete or complete recanalization.

Acute Kidney Injury in Acute Ischemic Stroke Patients in Clinical Trials

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Adnan I. Qureshi ◽  
Hunain Aslam ◽  
Werdah Zafar ◽  
Wei Huang ◽  
Iryna Lobanova ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Clinical Trials ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Kidney Injury ◽  
Stroke Patients

scholarly journals Delayed recanalization in acute ischemic stroke patients: Late is better than never?

2019 ◽  
Vol 39 (12) ◽  
pp. 2536-2538 ◽  
Author(s):  
Jinwei Pang ◽  
John H Zhang ◽  
Yong Jiang
Keyword(s):  
Clinical Trials ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Brain Tissue ◽  
Symptom Onset ◽  
Therapeutic Window ◽  
Stroke Patients ◽  
Narrow Therapeutic Window ◽  
Better Than

Successful recanalization of the occluded vessel as early as possible has been widely accepted as the key principle of acute ischemic stroke (AIS) treatment. Unfortunately, for many years, the vast majority of AIS patients were prevented from receiving effective recanalization therapy because of a narrow therapeutic window. Recently, a series of inspiring clinical trials have indicated that more patients may benefit from delayed recanalization during an expanded therapeutic window, even up to 24 h after symptom onset. However, could potentially salvageable brain tissue (penumbra) in patients who do not receive medication within 24 h still possible to be saved?

Abstract W MP7: Predictors and Implications of Capacity to Provide Informed Consent for Acute Ischemic Stroke Treatment Trials

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Hari Kishan R Indupuru ◽  
Loren Shen ◽  
Amber N Jacobs ◽  
Chunyan Cai ◽  
James C Grotta ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Ischemic Stroke ◽  
Informed Consent ◽  
Acute Ischemic Stroke ◽  
Stroke Patients ◽  
Stroke Treatment ◽  
Capacity To Consent ◽  
Decision Making Capacity ◽  
The Right ◽  
Study Designs

Background and objectives: Enrollment into AIS trials has always been limited by the ability of the patient to give informed consent or the availability of a Legally Authorized Representative (LAR) in decision making capacity on behalf of the patient. In this analysis we try to identify the factors contributing to an acute ischemic stroke (AIS) patient’s inability to give informed consent. We hypothesized that clinical features and demographics would differ between those patients with and without capacity to consent. Methods: This analysis includes patients who enrolled into the coordinating center of the prospective, randomized ARTSS-2 clinical trial (Argatroban + TPA for acute ischemic stroke) and also screen failures due to inability to consent. Data is collected prospectively in the study screening log. The data collected included age, gender, race, NIHSS, lesion location, ER arrival time and mode of consent (self-consent, LAR-consent and unable to consent). Results: Between 12/11 and 06/13, a total of 33 acute ischemic stroke patients received IV-tPA and were eligible for the ARTSS-2 study. While 19 were enrolled, 14/33 (42.4%) were otherwise eligible, but not enrolled due to inability to self-consent and no LAR present. Patients not enrolled due to lack of capacity to consent and without LAR present tended to have higher median NIHSS scores and greater proportions of drowsiness and aphasia compared to the other groups (see table). Conclusion: Approximately 2 in 5 AIS patients are not eligible for AIS clinical trials based solely on their lack of capacity for informed consent. It is remains ethically imperative that current clinical trials as well as future study designs address this disregarded group of patients who deserve the right to be able to participate in research. Addressing this group of patients through exception from informed consent (EFIC) will both extend research to all stroke patients, but also greatly enhance AIS research.

scholarly journals Increasing Dose of Autologous Bone Marrow Mononuclear Cells Transplantation Is Related to Stroke Outcome: Results from a Pooled Analysis of Two Clinical Trials

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Francisco Moniche ◽  
Paulo Henrique Rosado-de-Castro ◽  
Irene Escudero ◽  
Elena Zapata ◽  
Francisco Javier de la Torre Laviana ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Ischemic Stroke ◽  
Mononuclear Cells ◽  
Autologous Bone Marrow ◽  
Pooled Analysis ◽  
Experimental Models ◽  
Stroke Patients ◽  
Good Outcome ◽  
Cell Dose ◽  
Number Of Cells

Background and Purpose.BM-MNC transplantation improves recovery in experimental models of ischemic stroke. Clinical trials are ongoing to test efficacy in stroke patients. However, whether cell dose is related to outcomes is not known.Methods. We performed a pooling data analysis of two pilot clinical trials with autologous BM-MNCs transplantation in ischemic stroke patients. Cell dose and route were analyzed to evaluate their relation to good outcome (m-Rankin scale [mRS] score 0–2) at 6 months.Results. Twenty-two patients were included. A median of 153 × 106(±121 × 106) BM-MNCs was injected. Intra-arterial route was used in 77.3% of cases. A higher number of cells injected were associated with better outcomes at 180 days (390 × 106[320–422] BM-MNCs injected in those patients with mRS of 0–2 at 6 months versus 130 × 106[89–210] in those patients with mRS 3–6,p=0.015). In the intra-arterially treated patients, a strong correlation between dose of cells and disability was found (r=-0.63,p=0.006). A cut point of 310 × 106injected cells predicted good outcome with 80% sensitivity and 88.2% specificity.Conclusions. Similar to preclinical studies, a higher dose of autologous BM-MNC was related to better outcome in stroke patients, especially when more than 310 × 106cells are injected. Further interventional studies are warranted to confirm these data.

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