scholarly journals Consensus Recommendations for Transcranial Color-Coded Duplex Sonography for the Assessment of Intracranial Arteries in Clinical Trials on Acute Stroke

Stroke ◽  
2009 ◽  
Vol 40 (10) ◽  
pp. 3238-3244 ◽  
Author(s):  
Max Nedelmann ◽  
Erwin Stolz ◽  
Tibo Gerriets ◽  
Ralf W. Baumgartner ◽  
Giovanni Malferrari ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Acute Stroke ◽  
Duplex Sonography ◽  
Consensus Recommendations ◽  
Intracranial Arteries ◽  
Color Coded Duplex Sonography

scholarly journals Acute Stroke Imaging Research Roadmap IV: Imaging Selection and Outcomes in Acute Stroke Clinical Trials and Practice

Stroke ◽  
2021 ◽  
Author(s):  
Bruce C.V. Campbell ◽  
Maarten G. Lansberg ◽  
Joseph P. Broderick ◽  
Colin P. Derdeyn ◽  
Pooja Khatri ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Acute Stroke ◽  
Time Window ◽  
Stroke Treatment ◽  
Consensus Recommendations ◽  
Stroke Imaging ◽  
The Us ◽  
Imaging Research ◽  
Optimal Imaging ◽  
Acute Stroke Imaging

Background and Purpose: The Stroke Treatment Academic Industry Roundtable (STAIR) sponsored an imaging session and workshop during the Stroke Treatment Academic Industry Roundtable XI via webinar on October 1 to 2, 2020, to develop consensus recommendations, particularly regarding optimal imaging at primary stroke centers. Methods: This forum brought together stroke neurologists, neuroradiologists, neuroimaging research scientists, members of the National Institute of Neurological Disorders and Stroke, industry representatives, and members of the US Food and Drug Administration to discuss imaging priorities in the light of developments in reperfusion therapies, particularly in an extended time window, and reinvigorated interest in brain cytoprotection trials. Results: The imaging session summarized and compared the imaging components of recent acute stroke trials and debated the optimal imaging strategy at primary stroke centers. The imaging workshop developed consensus recommendations for optimizing the acquisition, analysis, and interpretation of computed tomography and magnetic resonance acute stroke imaging, and also recommendations on imaging strategies for primary stroke centers. Conclusions: Recent positive acute stroke clinical trials have extended the treatment window for reperfusion therapies using imaging selection. Achieving rapid and high-quality stroke imaging is therefore critical at both primary and comprehensive stroke centers. Recommendations for enhancing stroke imaging research are provided.

scholarly journals Diagnostic Impact and Prognostic Relevance of Early Contrast-Enhanced Transcranial Color-Coded Duplex Sonography in Acute Stroke

Stroke ◽  
1998 ◽  
Vol 29 (5) ◽  
pp. 955-962 ◽  
Author(s):  
Michael Goertler ◽  
Regina Kross ◽  
Matthias Baeumer ◽  
Stefan Jost ◽  
Reinhard Grote ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Duplex Sonography ◽  
Diagnostic Impact ◽  
Prognostic Relevance ◽  
Contrast Enhanced ◽  
Color Coded Duplex Sonography

scholarly journals Review of major trials of acute blood pressure management in stroke

2021 ◽  
pp. 0271678X2110043
Author(s):  
Thompson G Robinson ◽  
Jatinder S Minhas ◽  
Joseph Miller
Keyword(s):  
Blood Pressure ◽  
Clinical Trials ◽  
Acute Stroke ◽  
Trial Design ◽  
Haemorrhagic Stroke ◽  
Pressure Management ◽  
Blood Pressure Management ◽  
Multiple Trials ◽  
Hypertensive Crises ◽  
Improve Patient

Over the last two decades, there have been a number of major landmark clinical trials, classified as “major” as they sought to address clear clinical practice driven questions, in a pragmatic yet robust trial design, using a large powered sample size (n > 1000), in order to help improve patient outcome through informing guidelines. A commonality across all stroke sub-types included in these trials is the tendency to acute hypertensive crises within the acute stroke period. This phenomenon is associated with greater stroke complications and worsened overall prognosis. Multiple trials have attempted to address the issue of acute blood pressure management during the acute stroke period, with consideration for timing, magnitude of lowering, agent and relationship to other interventions. This review will consider the major clinical trials performed in ischaemic and haemorrhagic stroke that test the hypothesis that acute BP reduction improves clinical outcomes.

Carotid artery stenting and follow-up: Value of 64-MSCT angiography as complementary imaging method to color-coded duplex sonography

2012 ◽  
Vol 81 (1) ◽  
pp. 89-94 ◽  
Author(s):  
Richard Nolz ◽  
Andreas Wibmer ◽  
Dietrich Beitzke ◽  
Stephan Gentzsch ◽  
Andrea Willfort-Ehringer ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Duplex Sonography ◽  
Imaging Method ◽  
Color Coded Duplex Sonography ◽  
Msct Angiography

Abstract 3769: Barriers to Obtaining Informed Consent in Acute Stroke Clinical Trials

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Sacha R Masuca ◽  
Devsmita S Das ◽  
Deji Delano ◽  
Malcom Irani ◽  
Renga Pandurengan ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Informed Consent ◽  
Acute Stroke ◽  
Single Center ◽  
Severe Stroke ◽  
Single Center Study ◽  
Investigational Therapies ◽  
Clinical Trial Enrollment ◽  
Barriers To Enrollment ◽  
Clinical Research Trials

Background Identification of barriers to enrollment in acute stroke clinical trials may identify ways to improve enrollment and expedite completion of clinical research trials. In this exploratory analysis we sought to evaluate the differences in presenting characteristics between patients who are able to provide informed consent (IC) compared with those who were enrolled by the legal authorized representative (LAR). Methods From our single center, prospectively collected registry, we identified consecutive patients with acute ischemic stroke (AIS) who presented to our emergency department and were enrolled into acute (<8hrs from symptom onset) prospective clinical treatment trials. Data collected included arrival time, thrombolysis time, IC time, source of IC (LAR or patient), aphasia or neglect and method of arrival. For analysis, the patients who were consented by a LAR were compared with patients who provided their own IC. Results From 2003 - 2011, we identified 124 patients who met inclusion criteria. There were no differences in age, sex, presentation or door to needle times (Table 1). Patients who were able to provide IC presented with less severe stroke (p<0.0001). Aphasia and neglect were significantly more common when a LAR provided IC (p<0.0001). LAR consent required a significantly longer amount of time (90 vs. 71 min., p=0.04). Conclusions In our single center study, we found that patients with milder stroke are able to provide IC and the presence of aphasia or neglect can hinder enrollment in the absence of a LAR. In addition, when patients are able to provide IC, they do so almost on average 20 minutes faster than the LAR. Additional evaluation is necessary to determine the reasons for delay. Since good outcomes with investigational therapies for AIS treatment are likely to be time dependent, further efforts should target improvement of the IC process to minimize delay in clinical trial enrollment.

scholarly journals Transcranial Color Coded Duplex Sonography Findings in Stroke Patients Undergoing Rehabilitation: An Observational Study

2022 ◽  
Author(s):  
Srikant Venkatakrishnan ◽  
Meeka Khanna ◽  
Anupam Gupta
Keyword(s):  
Clinical Outcome ◽  
Duplex Sonography ◽  
Modified Rankin Scale ◽  
Mean Flow ◽  
Stroke Patients ◽  
Symmetric Flow ◽  
Rehabilitation Outcomes ◽  
Outcome Scores ◽  
Color Coded Duplex Sonography ◽  
Flow Velocities

Abstract Background Transcranial color-coded duplex sonography (TCCD) provides information on intracranial blood flow status in stroke patients and can predict rehabilitation outcomes. Objective This study aimed to assess middle cerebral artery (MCA) parameters using TCCD in MCA territory stroke patients admitted for rehabilitation and correlate with clinical outcome measures. Material and Methods Patients aged 18 to 65 years with a first MCA territory stroke, within 6 months of onset were recruited. The clinical outcome scales and TCCD parameters were assessed at both admission and discharge. The scales used were the Scandinavian stroke scale (SSS), Barthel Index (BI), modified Rankin Scale (mRS), Fugl–Meyer upper extremity scale (FMA-UE), modified motor assessment scale (mMAS) scores. TCCD parameters measured were MCA peak systolic, end diastolic, mean flow velocities (MFV), and index of symmetry (SI) and were correlated with clinical scores. Results Fourteen patients were recruited with median age of 56.5 years, median duration of stroke was 42.5 days. Mean flow velocities of affected and unaffected MCA were 46.2 and 50.7 cm/s, respectively. Flow velocities and SI did not change between the two assessments. There was significant improvement in clinical outcome scores at discharge. Significant correlation was observed for patient group with SI > 0.9 at admission with FMA-UE, SSS, and BI scores at discharge (p < 0.05). Conclusion Flow velocity parameters did not change during in-patient rehabilitation. Patients with symmetric flow at admission had improved clinical outcomes measure scores at discharge. Thus SI can predict rehabilitation outcomes in stroke survivors.

scholarly journals Transcranial color coded duplex sonography in the intensive care unit

2011 ◽  
Vol 3 (1) ◽  
pp. 47-49
Author(s):  
Juan Antonio Llompart-Pou ◽  
Josep María Abadal ◽  
Miguel Rodríguez-Yago ◽  
Mireia Ferreruela
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Duplex Sonography ◽  
Color Coded Duplex Sonography
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