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  1. Article: Absence of susceptibility vessel sign and hyperdense vessel sign in patients with cancer-related stroke.

    Beyeler, Morin / Grunder, Lorenz / Göcmen, Jayan / Steinauer, Fabienne / Belachew, Nebiyat F / Kielkopf, Moritz / Clénin, Leander / Mueller, Madlaine / Silimon, Norbert / Kurmann, Christoph / Meinel, Thomas / Bücke, Philipp / Seiffge, David / Dobrocky, Tomas / Piechowiak, Eike I / Pilgram-Pastor, Sara / Mattle, Heinrich P / Navi, Babak B / Arnold, Marcel /
    Fischer, Urs / Pabst, Thomas / Gralla, Jan / Berger, Martin D / Jung, Simon / Kaesmacher, Johannes

    Frontiers in neurology

    2023  Volume 14, Page(s) 1148152

    Abstract: Background and aim: Identification of paraneoplastic hypercoagulability in stroke patients helps to guide investigations and prevent stroke recurrence. A previous study demonstrated an association between the absence of the susceptibility vessel sign ( ... ...

    Abstract Background and aim: Identification of paraneoplastic hypercoagulability in stroke patients helps to guide investigations and prevent stroke recurrence. A previous study demonstrated an association between the absence of the susceptibility vessel sign (SVS) on brain MRI and active cancer in patients treated with mechanical thrombectomy. The present study aimed to confirm this finding and assess an association between the absence of the hyperdense vessel sign (HVS) on head CT and active cancer in all stroke patients.
    Methods: SVS and HVS status on baseline imaging were retrospectively assessed in all consecutive stroke patients treated at a comprehensive stroke center between 2015 and 2020. Active cancer, known at the time of stroke or diagnosed within 1 year after stroke (occult cancer), was identified. Adjusted odds ratios (aOR) and their 95% confidence interval (CI) for the association between the thrombus imaging characteristics and cancer were calculated using multivariable logistic regression.
    Results: Of the 2,256 patients with thrombus imaging characteristics available at baseline, 161 had an active cancer (7.1%), of which 36 were occult at the time of index stroke (1.6% of the total). The absence of SVS was associated with active cancer (aOR 3.14, 95% CI 1.45-6.80). No significance was reached for the subgroup of occult cancer (aOR 3.20, 95% CI 0.73-13.94). No association was found between the absence of HVS and active cancer (aOR 1.07, 95% CI 0.54-2.11).
    Conclusion: The absence of SVS but not HVS could help to identify paraneoplastic hypercoagulability in stroke patients with active cancer and guide patient care.
    Language English
    Publishing date 2023-03-20
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2564214-5
    ISSN 1664-2295
    ISSN 1664-2295
    DOI 10.3389/fneur.2023.1148152
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  2. Article ; Online: Yield of Echocardiography in Ischemic Stroke and Patients With Transient Ischemic Attack With Established Indications for Long-Term Direct Oral Anticoagulant Therapy: A Cross-Sectional Diagnostic Cohort Study.

    Meinel, Thomas R / Brignoli, Kristina / Kielkopf, Moritz / Clenin, Leander / Beyeler, Morin / Scutelnic, Adrian / Siepen, Bernhard / Mueller, Madlaine / Goeldlin, Martina / Seiffge, David / Kaesmacher, Johannes / Mujanovic, Adnan / Belachew, Nebiyat F / Fischer, Urs / Arnold, Marcel / Gräni, Christoph / Seiler, Christian / Buffle, Eric / Jung, Simon

    Journal of the American Heart Association

    2022  Volume 11, Issue 9, Page(s) e024989

    Abstract: Background We aimed to determine the diagnostic yield of transthoracic (TTE) and transesophageal echocardiography (TEE) in patients with ischemic stroke and transient ischemic attack with established indications for direct oral anticoagulants before the ... ...

    Abstract Background We aimed to determine the diagnostic yield of transthoracic (TTE) and transesophageal echocardiography (TEE) in patients with ischemic stroke and transient ischemic attack with established indications for direct oral anticoagulants before the index event. Methods and Results This was a retrospective cohort study of consecutive patients with preceding established indications for long-term therapeutic direct oral anticoagulants presenting to a single comprehensive stroke center with ischemic stroke or transient ischemic attack. Choice of echocardiography modality was based on expert recommendations. The primary outcome was a composite of prespecified management-relevant high-risk findings adjudicated by an expert panel, based on TTE and TEE reports according to evidence-based recommendations. Explorative analyses were performed to identify biomarkers associated with the primary outcome. Of 424 patients included (median [interquartile range] age, 78 [70-84] years; 175 [41%] women; National Institutes of Health Stroke Scale, 4 [1-12]; 67% atrial fibrillation), 292 (69%) underwent echocardiography, while 132 (31%) did not. Modality was TTE in 191 (45%) and TEE in 101 (24%). Median time from index event to echocardiography was 2 (1-3) days. TTE identified 26 of 191 (14%) patients with 35 management-relevant pathologies. TEE identified 16 of 101(16%) patients with 20 management-relevant pathologies. Most management-relevant findings represented indicated coronary artery disease and valvular pathologies. In a further 3 of 191 (2%) patients with TTE and 4 of 101 (4%) patients with TEE, other relevant findings were identified. Variables associated with management-relevant high-risk pathologies included more severe stroke, diabetes, and laboratory biomarkers (NT-proBNP [N-terminal pro-B-type natriuretic peptide], C-reactive protein, d-dimer, and troponin levels). Conclusions In patients with established indications for long-term direct oral anticoagulant therapy and stroke who received echocardiography, both TTE and TEE identified a relevant and similar proportion of management-relevant high-risk pathologies and predictive biomarkers could help to guide diagnostic workup in such patients.
    MeSH term(s) Aged ; Anticoagulants/therapeutic use ; Cohort Studies ; Cross-Sectional Studies ; Echocardiography/methods ; Echocardiography, Transesophageal ; Female ; Humans ; Ischemic Attack, Transient/diagnosis ; Ischemic Attack, Transient/drug therapy ; Ischemic Attack, Transient/etiology ; Ischemic Stroke/diagnostic imaging ; Ischemic Stroke/drug therapy ; Male ; Retrospective Studies ; Stroke/diagnostic imaging ; Stroke/drug therapy
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2022-04-27
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2653953-6
    ISSN 2047-9980 ; 2047-9980
    ISSN (online) 2047-9980
    ISSN 2047-9980
    DOI 10.1161/JAHA.121.024989
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Correction to: Casper Versus Precise Stent for the Treatment of Patients with Idiopathic Intracranial Hypertension.

    Belachew, Nebiyat F / Baschung, Severin / Almiri, William / Encinas, Ruben / Kaesmacher, Johannes / Dobrocky, Tomas / Schankin, Christoph J / Abegg, Mathias / Piechowiak, Eike I / Raabe, Andreas / Gralla, Jan / Mordasini, Pasquale

    Clinical neuroradiology

    2021  Volume 31, Issue 3, Page(s) 863–864

    Language English
    Publishing date 2021-07-13
    Publishing country Germany
    Document type Published Erratum
    ZDB-ID 2234662-4
    ISSN 1869-1447 ; 0939-7116 ; 1869-1439
    ISSN (online) 1869-1447
    ISSN 0939-7116 ; 1869-1439
    DOI 10.1007/s00062-021-01055-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 3413: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
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  4. Article ; Online: Stent-Based Retrieval Techniques in Acute Ischemic Stroke Patients with and Without Susceptibility Vessel Sign.

    Belachew, Nebiyat F / Piechowiak, Eike I / Dobrocky, Tomas / Meinel, Thomas R / Hakim, Arsany / Barvulsky, Enrique A / Vynckier, Jan / Arnold, Marcel / Seiffge, David J / Wiest, Roland / Fischer, Urs / Gralla, Jan / Kaesmacher, Johannes / Mordasini, Pasquale

    Clinical neuroradiology

    2021  Volume 32, Issue 2, Page(s) 407–418

    Abstract: Background and purpose: Randomized controlled trials have challenged the assumption that reperfusion success after mechanical thrombectomy varies depending on the retrieval techniques applied; however, recent analyses have suggested that acute ischemic ... ...

    Abstract Background and purpose: Randomized controlled trials have challenged the assumption that reperfusion success after mechanical thrombectomy varies depending on the retrieval techniques applied; however, recent analyses have suggested that acute ischemic stroke (AIS) patients showing susceptibility vessel sign (SVS) may respond differently. We aimed to compare different stent retriever (SR)-based thrombectomy techniques with respect to interventional outcome parameters depending on SVS status.
    Methods: We retrospectively reviewed 497 patients treated with SR-based thrombectomy for anterior circulation AIS. Imaging was conducted using a 1.5 T or 3 T magnetic resonance imaging (MRI) scanner. Logistic regression analyses were performed to test for the interaction of SVS status and first-line retrieval technique. Results are shown as percentages, total values or adjusted odds ratio (aOR) with 95% confidence intervals (CI).
    Results: An SVS was present in 87.9% (n = 437) of patients. First-line SR thrombectomy was used to treat 293 patients, whereas 204 patients were treated with a combined approach (COA) of SR and distal aspiration. An additional balloon-guide catheter (BGC) was used in 273 SR-treated (93.2%) and 89 COA-treated (43.6%) patients. On logistic regression analysis, the interaction variable of SVS status and first-line retrieval technique was not associated with first-pass reperfusion (aOR 1.736, 95% CI 0.491-6.136; p = 0.392), overall reperfusion (aOR 3.173, 95% CI 0.752-13.387; p = 0.116), periinterventional complications, embolization into new territories, or symptomatic intracerebral hemorrhage. The use of BGC did not affect the results.
    Conclusion: While previous analyses indicated that first-line SR thrombectomy may promise higher rates of reperfusion than contact aspiration in AIS patients with SVS, our data show no superiority of any particular SR-based retrieval technique regardless of SVS status.
    MeSH term(s) Brain Ischemia/complications ; Brain Ischemia/diagnostic imaging ; Brain Ischemia/surgery ; Coenzyme A ; Humans ; Ischemic Stroke/complications ; Ischemic Stroke/diagnostic imaging ; Ischemic Stroke/surgery ; Retrospective Studies ; Stents ; Thrombectomy/methods ; Treatment Outcome
    Chemical Substances Coenzyme A (SAA04E81UX)
    Language English
    Publishing date 2021-08-31
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2234662-4
    ISSN 1869-1447 ; 0939-7116 ; 1869-1439
    ISSN (online) 1869-1447
    ISSN 0939-7116 ; 1869-1439
    DOI 10.1007/s00062-021-01079-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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  5. Article ; Online: Casper Versus Precise Stent for the Treatment of Patients with Idiopathic Intracranial Hypertension.

    Belachew, Nebiyat F / Baschung, Severin / Almiri, William / Encinas, Ruben / Kaesmacher, Johannes / Dobrocky, Tomas / Schankin, Christoph J / Abegg, Mathias / Piechowiak, Eike I / Raabe, Andreas / Gralla, Jan / Mordasini, Pasquale

    Clinical neuroradiology

    2021  Volume 31, Issue 3, Page(s) 853–862

    Abstract: Purpose: We hypothesized that due to its specific characteristics, the Casper: Methods: A total of 15 patients with IIH (median age 28.7 years) were reviewed retrospectively. Technical aspects as well as peri- and postinterventional complication ... ...

    Abstract Purpose: We hypothesized that due to its specific characteristics, the Casper
    Methods: A total of 15 patients with IIH (median age 28.7 years) were reviewed retrospectively. Technical aspects as well as peri- and postinterventional complication rates were examined in patients treated with CP (n = 10) and the PP (n = 5). Improvements in cerebrospinal fluid opening pressure (CSF OP), transstenotic pressure gradient (TSPG) and clinical symptoms were also assessed.
    Results: Stent delivery was easier and more successful with the CP than the PP (difficult/failed stent delivery 0.0% versus 57.1%) and consequently achieved with less attempts (≥ 2: 0.0% versus 40.0%). No severe peri- or postinterventional complications or instances of in-stent thrombosis and/or stenosis were observed during follow-up. Improvement of CSF OP and TSPG immediately after VSS as well as at 6‑month follow-up was comparable between the CP and PP group. Both groups showed substantial and similar decreases in intensity and frequency of headache. Almost all patients with other IIH-related symptoms showed either improvement or complete resolution of those symptoms after VSS. All patients who were available for interview (n = 12/15) reported a substantial improvement in quality of life.
    Conclusion: VSS using the CP seems to be safe and effective. The CP may reduce the risk of difficult or failed stent delivery in patients with challenging intracranial venous anatomy.
    MeSH term(s) Adult ; Cranial Sinuses ; Humans ; Pseudotumor Cerebri/diagnostic imaging ; Pseudotumor Cerebri/surgery ; Quality of Life ; Retrospective Studies ; Stents ; Treatment Outcome
    Language English
    Publishing date 2021-05-18
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2234662-4
    ISSN 1869-1447 ; 0939-7116 ; 1869-1439
    ISSN (online) 1869-1447
    ISSN 0939-7116 ; 1869-1439
    DOI 10.1007/s00062-021-01024-2
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    In stock of ZB MED Cologne/Königswinter

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    ab Jg. 2022: Lesesaal (EG)

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  6. Article: Lungenfunktion, Lung Clearance Index und bronchiale Entzündung bei Kindern und Jugendlichen mit Bronchiolitis obliterans

    Belachew, Nebiyat F. / Jerkic, Silvija / Michel, Felix / Schubert, Ralf / Zielen, Stefan / Rosewic, Martin

    Kinder- und Jugendmedizin

    2019  Volume 19, Issue 05, Page(s) 336–344

    Abstract: Einleitung: Die Bronchiolitis obliterans (BO) ist eine sehr seltene, chronische Lungenerkrankung, die vereinzelt nach schweren Atemwegsinfektionen oder als Folge von Stammzell- und Lungentransplantation auftritt. Ziel der Arbeit war es, die ... ...

    Abstract Einleitung: Die Bronchiolitis obliterans (BO) ist eine sehr seltene, chronische Lungenerkrankung, die vereinzelt nach schweren Atemwegsinfektionen oder als Folge von Stammzell- und Lungentransplantation auftritt. Ziel der Arbeit war es, die Lungenfunktion und die bronchiale Entzündung bei BO-Patienten im Jugend- und Kindesalter zu untersuchen. Zudem sollte das Potenzial des LCI in der Diagnostik dieser Patienten untersucht werden.
    Methoden: Es wurden 16 BO-Patienten (Alter:Median 16,7; 9,6–25,3 Jahre) und 17 gesunde Probanden (Alter: Median 16,6; 7,6–25,0 Jahre) untersucht. Neben der Untersuchung der Lungenfunktion (FVC, FEV 1, MEF 25, RV und RV/TLC) mittels Bodyplethysmografie erfolgte eine Reversibilitätstestung nach Gabe von 400 μg Salbutamol. Die Bestimmung des LCI erfolgte mittels Multiple Breath Washout (MBW)-Methode. Zusätzlich wurde die Zellverteilung und das Zytokinprofil (IL-1ß, IL-6, IL-8, TNF-α)mittels Cytometric Bead Array (CBA) im induzierten Sputum analysiert.
    Ergebnisse: FVC, FEV 1 und MEF 25 der BO-Patienten waren signifikant niedriger, das RV und die RV/TLC jedoch signifikant erhöht im Vergleich zur Kontrollgruppe. Eine bronchiale Reversibilität zeigte sich bei 3 Patienten. Der LCI war bei den BO-Patienten gegenüber der Kontrollgruppe signifikant erhöht (Median 10,24 vs. 7,1) und korrelierte signifikant mit dem MEF 25 (p < 0,0001). Im induzierten Sputum fand sich eine signifikante Erhöhung der Gesamtzellzahl, der neutrophilen Granulozyten sowie von IL-6 und IL-8 (p < 0,01).
    Schlussfolgerung: Die Lungenfunktion ist bei Kindern und Jugendlichen mit BO stark eingeschränkt. Zudem erwies sich der LCI als sensitiver und reproduzierbarer Marker zur Beurteilung der obstruktiven Beeinträchtigung der kleinen Atemwege. Im induzierten Sputum ist eine von Neutrophilen dominierte bronchiale Entzündung nachweisbar.
    Language German
    Publishing date 2019-10-01
    Publisher © Georg Thieme Verlag KG Stuttgart · New York
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 2223494-9
    ISSN 2567-577X ; 1617-0288
    ISSN (online) 2567-577X
    ISSN 1617-0288
    DOI 10.1055/a-1003-4684
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  7. Article: Absence of Susceptibility Vessel Sign in Patients With Malignancy-Related Acute Ischemic Stroke Treated With Mechanical Thrombectomy.

    Beyeler, Morin / Belachew, Nebiyat F / Kielkopf, Moritz / Aleman, Enrique B / León Betancourt, Alejandro Xavier / Genceviciute, Kotryna / Kurmann, Christoph / Grunder, Lorenz / Birner, Barbara / Meinel, Thomas R / Scutelnic, Adrian / Bücke, Philipp / Seiffge, David J / Dobrocky, Tomas / Piechowiak, Eike I / Pilgram-Pastor, Sara / Mattle, Heinrich P / Mordasini, Pasquale / Arnold, Marcel /
    Fischer, Urs / Pabst, Thomas / Gralla, Jan / Berger, Martin D / Jung, Simon / Kaesmacher, Johannes

    Frontiers in neurology

    2022  Volume 13, Page(s) 930635

    Abstract: Background and purpose: Clots rich in platelets and fibrin retrieved from patients with acute ischemic stroke (AIS) have been shown to be independently associated with the absence of the susceptibility vessel sign (SVS) on MRI and active malignancy. ... ...

    Abstract Background and purpose: Clots rich in platelets and fibrin retrieved from patients with acute ischemic stroke (AIS) have been shown to be independently associated with the absence of the susceptibility vessel sign (SVS) on MRI and active malignancy. This study analyzed the association of SVS and the presence of active malignancy in patients with AIS who underwent mechanical thrombectomy (MT).
    Methods: This single-center, retrospective, and cross-sectional study included consecutive patients with AIS with admission MRI treated with MT between January 2010 and December 2018. SVS status was evaluated on susceptibility-weighted imaging. Adjusted odds ratios (aORs) were calculated to determine the association between absent SVS and the presence of active or occult malignancy. The performance of predictive models incorporating and excluding SVS status was compared using areas under the receiver operating characteristics curve (auROC).
    Results: Of 577 patients with AIS with assessable SVS status, 40 (6.9%) had a documented active malignancy and 72 (12.5%) showed no SVS. The absence of SVS was associated with active malignancy (aOR 4.85, 95% CI 1.94-12.11) or occult malignancy (aOR 11.42, 95% CI 2.36-55.20). The auROC of predictive models, including demographics and common malignancy biomarkers, was higher but not significant (0.85 vs. 0.81,
    Conclusion: Absence of SVS on admission MRI of patients with AIS undergoing MT is associated with malignancy, regardless of whether known or occult. Therefore, the SVS might be helpful in detecting paraneoplastic coagulation disorders and occult malignancy in patients with AIS.
    Language English
    Publishing date 2022-07-14
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2564214-5
    ISSN 1664-2295
    ISSN 1664-2295
    DOI 10.3389/fneur.2022.930635
    Database MEDical Literature Analysis and Retrieval System OnLINE

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