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Article ; Online: Advances in Acute Ischemic Stroke Treatment: Current Status and Future Directions.

Bathla, G / Ajmera, P / Mehta, P M / Benson, J C / Derdeyn, C P / Lanzino, G / Agarwal, A / Brinjikji, W

AJNR. American journal of neuroradiology

2023 Volume 44, Issue 7, Page(s) 750–758

Abstract: The management of acute ischemic stroke has undergone a paradigm shift in the past decade. This has been spearheaded by the emergence of endovascular thrombectomy, along with advances in medical therapy, imaging, and other facets of stroke care. Herein, ... ...

Abstract	The management of acute ischemic stroke has undergone a paradigm shift in the past decade. This has been spearheaded by the emergence of endovascular thrombectomy, along with advances in medical therapy, imaging, and other facets of stroke care. Herein, we present an updated review of the various stroke trials that have impacted and continue to transform stroke management. It is critical for the radiologist to stay abreast of the ongoing developments to provide meaningful input and remain a useful part of the stroke team.
MeSH term(s)	Humans ; Ischemic Stroke ; Brain Ischemia/diagnostic imaging ; Brain Ischemia/therapy ; Stroke/diagnostic imaging ; Stroke/therapy ; Thrombectomy/methods ; Endovascular Procedures/methods ; Treatment Outcome
Language	English
Publishing date	2023-05-18
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	603808-6
ISSN	1936-959X ; 0195-6108
ISSN (online)	1936-959X
ISSN	0195-6108
DOI	10.3174/ajnr.A7872
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Article: A review of technological innovations leading to modern endovascular brain aneurysm treatment.

Lauzier, David C / Huguenard, Anna L / Srienc, Anja I / Cler, Samuel J / Osbun, Joshua W / Chatterjee, Arindam R / Vellimana, Ananth K / Kansagra, Akash P / Derdeyn, Colin P / Cross, Dewitte T / Moran, Christopher J

Frontiers in neurology

2023 Volume 14, Page(s) 1156887

Abstract: Tools and techniques utilized in endovascular brain aneurysm treatment have undergone rapid evolution in recent decades. These technique and device-level innovations have allowed for treatment of highly complex intracranial aneurysms and improved patient ...

Abstract	Tools and techniques utilized in endovascular brain aneurysm treatment have undergone rapid evolution in recent decades. These technique and device-level innovations have allowed for treatment of highly complex intracranial aneurysms and improved patient outcomes. We review the major innovations within neurointervention that have led to the current state of brain aneurysm treatment.
Language	English
Publishing date	2023-04-11
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2023.1156887
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Article ; Online: In-hospital imaging utilization after elective endovascular brain aneurysm treatment: a surrogate metric for the value of hospitalization.

Lauzier, David C / Cler, Samuel J / Chatterjee, Arindam R / Osbun, Joshua W / Vellimana, Ananth K / Derdeyn, Colin P / Cross, Dewitte T / Moran, Christopher J / Kansagra, Akash P

Journal of neurosurgery

2023 Volume 140, Issue 2, Page(s) 430–435

Abstract: ... positively associated with larger aneurysm size (p < 0.05) and negatively associated with underlying ... cardiovascular disease (p < 0.05).: Conclusions: More than 1 in 8 patients who underwent elective endovascular ...

Abstract	Objective: Despite the adoption of same-day outpatient surgical procedures in some specialties, it remains common practice to admit patients for monitoring after elective endovascular treatment of brain aneurysms to monitor for complications. The necessity of such monitoring has not been fully characterized. Here, the authors reviewed the utilization of imaging during posttreatment hospitalization, a surrogate measure for workup of suspected complications requiring hospital resources, to infer the value of inpatient monitoring after endovascular aneurysm treatment. Methods: Clinical and angiographic data from eligible patients were retrospectively assessed for demographic characteristics, imaging indications, timing of imaging, and imaging findings. Patients were included if they underwent elective endovascular brain aneurysm treatment, and patients were excluded if significant intraprocedural complications occurred. The recorded imaging modalities included CT, MRI, catheter-based imaging, and ultrasound; plain radiographs were excluded. Multivariable logistic regression analysis was performed to identify predictors of the need for posttreatment imaging. Results: In total, 1229 elective endovascular procedures for brain aneurysm treatment were included. Patients underwent imaging before discharge in 13.4% (165/1229) of cases, with significant findings in 5.0% (61/1229) of cases. The median (interquartile range) time to first posttreatment imaging was 13.2 (4.2-22.8) hours. The need for imaging during posttreatment hospitalization was positively associated with larger aneurysm size (p < 0.05) and negatively associated with underlying cardiovascular disease (p < 0.05). Conclusions: More than 1 in 8 patients who underwent elective endovascular brain aneurysm treatment required imaging during posttreatment hospitalization, most within the first 24 hours, and 1 in 20 had significant findings. These results suggest the importance of short-term hospitalization after elective endovascular aneurysm treatment.
MeSH term(s)	Humans ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/surgery ; Aortic Aneurysm, Abdominal/etiology ; Aortic Aneurysm, Abdominal/surgery ; Retrospective Studies ; Endovascular Procedures/methods ; Treatment Outcome ; Blood Vessel Prosthesis Implantation/methods ; Hospitalization ; Hospitals ; Elective Surgical Procedures ; Risk Factors
Language	English
Publishing date	2023-07-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	3089-2
ISSN	1933-0693 ; 0022-3085
ISSN (online)	1933-0693
ISSN	0022-3085
DOI	10.3171/2023.5.JNS23656
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Article ; Online: Evolution of Elective Intracranial Aneurysm Treatment.

Lauzier, David C / Cler, Samuel J / Vellimana, Ananth K / Osbun, Joshua W / Chatterjee, Arindam R / Derdeyn, Colin P / Cross, Dewitte T / Moran, Christopher J / Kansagra, Akash P

World neurosurgery

2022 Volume 168, Page(s) 309–310

Language	English
Publishing date	2022-08-30
Publishing country	United States
Document type	Letter
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2022.08.133
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Article ; Online: Recruitment in Acute Stroke Trials: Challenges and Potential Solutions.

Broderick, Joseph P / Aziz, Yasmin N / Adeoye, Opeolu M / Grotta, James C / Naidech, Andrew M / Barreto, Andrew D / Derdeyn, Colin P / Sucharew, Heidi J / Elm, Jordan J / Khatri, Pooja

Stroke

2022 Volume 54, Issue 2, Page(s) 632–638

Abstract: Randomized clinical trials of acute stroke have led to major advances in acute stroke therapy over the past decade. Despite these successes, recruitment in acute trials is often difficult. We outline challenges in recruitment for acute stroke trials and ... ...

Abstract	Randomized clinical trials of acute stroke have led to major advances in acute stroke therapy over the past decade. Despite these successes, recruitment in acute trials is often difficult. We outline challenges in recruitment for acute stroke trials and present potential solutions, which can increase the speed and decrease the cost of identifying new treatments for acute stroke. One of the largest opportunities to increase the speed of enrollment and make trials more generalizable is expansion of inclusion criteria whose impact on expected recruitment can be assessed by epidemiologic and registry databases. Another barrier to recruitment besides the number of eligible patients is availability of study investigators limited to business hours, which may be helped by financial support for after-hours call. The wider use of telemedicine has accelerated quicker stroke treatment at many hospitals and has the potential to accelerate research enrollment but requires training of clinical investigators who are often inexperienced with this approach. Other potential solutions to enhance recruitment include rapid prehospital notification of clinical investigators of potential patients, use of mobile stroke units, advances in the process of emergency informed consent, storage of study medication in the emergency department, simplification of study treatments and data collection, education of physicians to improve equipoise and enthusiasm for randomization of patients within a trial, and clear recruitment plans, and even potentially coenrollment, when there are competing trials at sites. Without successful recruitment, scientific advances and clinical benefit for acute stroke patients will lag.
MeSH term(s)	Humans ; Stroke/therapy ; Hospitals ; Informed Consent
Language	English
Publishing date	2022-12-19
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/STROKEAHA.122.040071
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Article ; Online: Reply

Nagpal, P / Policeni, B A / Kwofie, M / Bathla, G / Derdeyn, C P / Skeete, D

AJNR. American journal of neuroradiology

2018 Volume 39, Issue 9, Page(s) E104

MeSH term(s)	Mass Screening ; Research
Language	English
Publishing date	2018-08-09
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	603808-6
ISSN	1936-959X ; 0195-6108
ISSN (online)	1936-959X
ISSN	0195-6108
DOI	10.3174/ajnr.A5758
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Article ; Online: Differential Risk Factors and Outcomes of Ischemic Stroke due to Cervical Artery Dissection in Young Adults.

Garg, Aayushi / Bathla, Girish / Molian, Vaelan / Limaye, Kaustubh / Hasan, David / Leira, Enrique C / Derdeyn, Colin P / Adams, Harold P / Shaban, Amir

Cerebrovascular diseases (Basel, Switzerland)

2020 Volume 49, Issue 5, Page(s) 509–515

Abstract: Introduction: Cervical artery dissection (CeAD) is a major cause of ischemic stroke in young adults. Our understanding of the specific risk factors and clinical course of CeAD is still evolving. In this study, we evaluated the differential risk factors ... ...

Abstract	Introduction: Cervical artery dissection (CeAD) is a major cause of ischemic stroke in young adults. Our understanding of the specific risk factors and clinical course of CeAD is still evolving. In this study, we evaluated the differential risk factors and outcomes of CeAD-related strokes among young adults. Methods: The study population consisted of young patients 15-45 years of age consecutively admitted with acute ischemic stroke to our comprehensive stroke center between January 1, 2010, and November 30, 2016. Diagnosis of CeAD was based on clinical and radiological findings. Univariate and multivariable logistic regression analyses were used to assess the risk factors and clinical outcomes associated with CeAD-related strokes. Results: Of the total 333 patients with acute ischemic stroke included in the study (mean ± SD age: 36.4 ± 7.1 years; women 50.8%), CeAD was identified in 79 (23.7%) patients. As compared to stroke due to other etiologies, patients with CeAD were younger in age, more likely to have history of migraine and recent neck manipulation and were less likely to have hypertension, diabetes, and previous history of stroke. Clinical outcomes of CeAD were comparable to strokes due to other etiologies. Within the CeAD group, higher initial stroke severity and history of tobacco use were associated with higher modified Rankin Scale score at follow-up. Conclusions: While history of migraine and neck manipulation are significantly associated with CeAD, most of the traditional vascular risk factors for stroke are less prevalent in this group when compared to strokes due to other etiologies. For CeAD-related strokes, higher initial stroke severity and history of tobacco use may be associated with higher stroke-related disability, but overall, patients with CeAD have similar outcomes as compared to strokes due to other etiologies.
MeSH term(s)	Adolescent ; Adult ; Age Factors ; Brain Ischemia/diagnostic imaging ; Brain Ischemia/etiology ; Carotid Artery, Internal, Dissection/diagnostic imaging ; Carotid Artery, Internal, Dissection/etiology ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Registries ; Risk Assessment ; Risk Factors ; Stroke/diagnostic imaging ; Stroke/etiology ; Vertebral Artery Dissection/diagnostic imaging ; Vertebral Artery Dissection/etiology ; Young Adult
Language	English
Publishing date	2020-09-25
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	1069462-6
ISSN	1421-9786 ; 1015-9770
ISSN (online)	1421-9786
ISSN	1015-9770
DOI	10.1159/000510437
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Article ; Online: Organizational update: American Heart Association Stroke Council.

Broderick, Joseph P / Jauch, Edward C / Derdeyn, Colin P

Stroke

2014 Volume 45, Issue 6, Page(s) e104–5

MeSH term(s)	American Heart Association/organization & administration ; Humans ; Stroke ; United States
Language	English
Publishing date	2014-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/STROKEAHA.114.004936
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Article ; Online: American Stroke Association Stroke Council update.

Broderick, Joseph P / Jauch, Edward C / Derdeyn, Colin P

Stroke

2014 Volume 45, Issue 1, Page(s) e5–7

MeSH term(s)	Association ; Foundations ; Health Planning ; Humans ; Research ; Stroke/mortality ; Stroke/therapy ; United States
Language	English
Publishing date	2014-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/STROKEAHA.113.001357
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Article ; Online: Preserving Access: A Review of Stroke Thrombectomy during the COVID-19 Pandemic.

Leslie-Mazwi, T M / Fargen, K M / Levitt, M / Derdeyn, C P / Feske, S K / Patel, A B / Hirsch, J A

AJNR. American journal of neuroradiology

2020 Volume 41, Issue 7, Page(s) 1136–1141

Abstract: Thrombectomy for large-vessel-occlusion stroke is a highly impactful treatment. The spread of coronavirus 19 (COVID-19) across the United States and the globe impacts access to this crucial intervention through widespread societal and institutional ... ...

Abstract	Thrombectomy for large-vessel-occlusion stroke is a highly impactful treatment. The spread of coronavirus 19 (COVID-19) across the United States and the globe impacts access to this crucial intervention through widespread societal and institutional changes. In this document, we review the implications of COVID-19 on the emergency care of large-vessel occlusion stroke, reviewing specific infection-control recommendations, available literature, existing resources, and expert consensus. As a population, patients with large-vessel occlusion stroke face unique challenges during pandemics. These are broad in scope. Responses to these challenges through adaptation of stroke systems of care and with imaging, thrombectomy, and postprocedural care are detailed. Preservation of access to thrombectomy must be prioritized for its public health impact. While the extent of required changes will vary by region, tiered planning for both escalation and de-escalation of measures must be a part of each practice. In addition, preparations described serve as templates in the event of future pandemics.
MeSH term(s)	Arterial Occlusive Diseases/surgery ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Humans ; Pandemics ; Pneumonia, Viral/epidemiology ; SARS-CoV-2 ; Stroke/surgery ; Thrombectomy/methods ; United States/epidemiology
Keywords	covid19
Language	English
Publishing date	2020-05-21
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	603808-6
ISSN	1936-959X ; 0195-6108
ISSN (online)	1936-959X
ISSN	0195-6108
DOI	10.3174/ajnr.A6606
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