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Browsing by Author "Field, T"

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  • Basilar Artery Occlusion Management: Specialist Perspectives From an International Survey
    Publication . Edwards, C; Drumm, B; Siegler, J; Schonewille, W; Klein, P; Huo, X; Chen, Y; Abdalkader, M; Qureshi, M; Strbian, D; Liu, X; Hu, W; Ji, X; Li, C; Fischer, U; Nagel, S; Puetz, V; Michel, P; Alemseged, F; Sacco, S; Yamagami, H; Yaghi, S; Strambo, D; Kristoffersen, E; Sandset, E; Mikulik, R; Tsivgoulis, G; Masoud, H; Aguiar de Sousa, D; Marto, JP; Lobotesis, K; Roi, D; Berberich, A; Demeestere, J; Meinel, T; Rivera, R; Poli, S; Ton, M; Zhu, Y; Li, F; Sang, H; Thomalla, G; Parsons, M; Campbell, B; Zaidat, O; Chen, HS; Field, T; Raymond, J; Kaesmacher, J; Nogueira, R; Jovin, T; Sun, D; Liu, R; Qureshi, A; Qiu, Z; Miao, Z; Banerjee, S; Nguyen, T
    Background and purpose: Two early basilar artery occlusion (BAO) randomized controlled trials did not establish the superiority of endovascular thrombectomy (EVT) over medical management. While many providers continue to recommend EVT for acute BAO, perceptions of equipoise in randomizing patients with BAO to EVT versus medical management may differ between clinician specialties. Methods: We conducted an international survey (January 18, 2022 to March 31, 2022) regarding management strategies in acute BAO prior to the announcement of two trials indicating the superiority of EVT, and compared responses between interventionalists (INTs) and non-interventionalists (nINTs). Selection practices for routine EVT and perceptions of equipoise regarding randomizing to medical management based on neuroimaging and clinical features were compared between the two groups using descriptive statistics. Results: Among the 1245 respondents (nINTs = 702), INTs more commonly believed that EVT was superior to medical management in acute BAO (98.5% vs. 95.1%, p < .01). A similar proportion of INTs and nINTs responded that they would not randomize a patient with BAO to EVT (29.4% vs. 26.7%), or that they would only under specific clinical circumstances (p = .45). Among respondents who would recommend EVT for BAO, there was no difference in the maximum prestroke disability, minimum stroke severity, or infarct burden on computed tomography between the two groups (p > .05), although nINTs more commonly preferred perfusion imaging (24.2% vs. 19.7%, p = .04). Among respondents who indicated they would randomize to medical management, INTs were more likely to randomize when the National Institutes of Health Stroke Scale was ≥10 (15.9% vs. 6.9%, p < .01). Conclusions: Following the publication of two neutral clinical trials in BAO EVT, most stroke providers believed EVT to be superior to medical management in carefully selected patients, with most indicating they would not randomize a BAO patient to medical treatment. There were small differences in preference for advanced neuroimaging for patient selection, although these preferences were unsupported by clinical trial data at the time of the survey.
    2023Journal article Open access Show more
  • Characteristics and Outcomes of Patients With Cerebral Venous Sinus Thrombosis in SARS-CoV-2 Vaccine–Induced Immune Thrombotic Thrombocytopenia
    Publication . Sánchez van Kammen, M; Aguiar de Sousa, D; Poli, S; Cordonnier, C; Heldner, M; van de Munckhof, A; Krzywicka, K; van Haaps, T; Ciccone, A; Middeldorp, S; Levi, M; Kremer Hovinga, J; Silvis, S; Hiltunen, S; Mansour, M; Arauz, A; Barboza, M; Field, T; Tsivgoulis, G; Nagel, S; Lindgren, E; Tatlisumak, T; Jood, K; Putaala, J; Ferro, J; Arnold, M; Coutinho, J; Sharma, A; Elkady, A; Negro, A; Günther, A; Gutschalk, A; Schönenberger, S; Buture, A; Murphy, S; Paiva Nunes, A; Tiede, A; Puthuppallil Philip, A; Mengel, A; Medina, A; Hellström Vogel, Å; Tawa, A; Aujayeb, A; Casolla, B; Buck, B; Zanferrari, C; Garcia-Esperon, C; Vayne, C; Legault, C; Pfrepper, C; Tracol, C; Soriano, C; Guisado-Alonso, D; Bougon, D; Zimatore, D; Michalski, D; Blacquiere, D; Johansson, E; Cuadrado-Godia, E; De Maistre, E; Carrera, E; Vuillier, F; Bonneville, F; Giammello, F; Bode, F; Zimmerman, J; d’Onofrio, F; Grillo, F; Cotton, F; Caparros, F; Puy, L; Maier, F; Gulli, G; Frisullo, G; Polkinghorne, G; Franchineau, G; Cangür, H; Katzberg, H; Sibon, I; Baharoglu, I; Brar, J; Payen, JF; Burrow, J; Fernandes, J; Schouten, J; Althaus, K; Garambois, K; Derex, L; Humbertjean, L; Lebrato Hernandez, L; Kellermair, L; Morin Martin, M; Petruzzellis, M; Cotelli, M; Dubois, MC; Carvalho, M; Wittstock, M; Miranda, M; Skjelland, M; Bandettini di Poggio, M; Scholz, M; Raposo, N; Kahnis, R; Kruyt, N; Huet, O; Sharma, P; Candelaresi, P; Reiner, P; Vieira, R; Acampora, R; Kern, R; Leker, R; Coutts, S; Bal, S; Sharma, S; Susen, S; Cox, T; Geeraerts, T; Gattringer, T; Bartsch, T; Kleinig, T; Dizonno, V; Arslan, Y
    Importance: Thrombosis with thrombocytopenia syndrome (TTS) has been reported after vaccination with the SARS-CoV-2 vaccines ChAdOx1 nCov-19 (Oxford-AstraZeneca) and Ad26.COV2.S (Janssen/Johnson & Johnson). Objective: To describe the clinical characteristics and outcome of patients with cerebral venous sinus thrombosis (CVST) after SARS-CoV-2 vaccination with and without TTS. Design, setting, and participants: This cohort study used data from an international registry of consecutive patients with CVST within 28 days of SARS-CoV-2 vaccination included between March 29 and June 18, 2021, from 81 hospitals in 19 countries. For reference, data from patients with CVST between 2015 and 2018 were derived from an existing international registry. Clinical characteristics and mortality rate were described for adults with (1) CVST in the setting of SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia, (2) CVST after SARS-CoV-2 vaccination not fulling criteria for TTS, and (3) CVST unrelated to SARS-CoV-2 vaccination. Exposures: Patients were classified as having TTS if they had new-onset thrombocytopenia without recent exposure to heparin, in accordance with the Brighton Collaboration interim criteria. Main outcomes and measures: Clinical characteristics and mortality rate. Results: Of 116 patients with postvaccination CVST, 78 (67.2%) had TTS, of whom 76 had been vaccinated with ChAdOx1 nCov-19; 38 (32.8%) had no indication of TTS. The control group included 207 patients with CVST before the COVID-19 pandemic. A total of 63 of 78 (81%), 30 of 38 (79%), and 145 of 207 (70.0%) patients, respectively, were female, and the mean (SD) age was 45 (14), 55 (20), and 42 (16) years, respectively. Concomitant thromboembolism occurred in 25 of 70 patients (36%) in the TTS group, 2 of 35 (6%) in the no TTS group, and 10 of 206 (4.9%) in the control group, and in-hospital mortality rates were 47% (36 of 76; 95% CI, 37-58), 5% (2 of 37; 95% CI, 1-18), and 3.9% (8 of 207; 95% CI, 2.0-7.4), respectively. The mortality rate was 61% (14 of 23) among patients in the TTS group diagnosed before the condition garnered attention in the scientific community and 42% (22 of 53) among patients diagnosed later. Conclusions and relevance: In this cohort study of patients with CVST, a distinct clinical profile and high mortality rate was observed in patients meeting criteria for TTS after SARS-CoV-2 vaccination.
    2021-11Journal article Open access Show more
  • Decompressive Surgery in Cerebral Venous Sinus Thrombosis Due to Vaccine‐Induced Immune Thrombotic Thrombocytopenia
    Publication . Krzywicka, K; Aguiar de Sousa, D; Cordonnier, C; Bode, F; Field, T; Michalski, D; Pelz, J; Skjelland, M; Wiedmann, M; Zimmermann, J; Wittstock, M; Zanotti, B; Ciccone, A; Bandettini di Poggio, M; Borhani‐Haghighi, A; Chatterton, S; Aujayeb, A; Devroye, A; Dizonno, V; Geeraerts, T; Giammello, F; Günther, A; Ichaporia, N; Kleinig, T; Kristoffersen, E; Lemmens, R; De Maistre, E; Mirzaasgari, Z; Payen, JF; Putaala, J; Petruzzellis, M; Raposo, N; Sadeghi‐Hokmabadi, E; Schoenenberger, S; Umaiorubahan, M; Sylaja, P; van de Munckhof, A; Sánchez van Kammen, M; Lindgren, E; Jood, K; Scutelnic, A; Heldner, M; Poli, S; Kruip, M; Arauz, A; Conforto, A; Aaron, S; Middeldorp, S; Tatlisumak, T; Arnold, M; Coutinho, J; Ferro, J
    Background and purpose: Cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) is an adverse drug reaction occurring after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. CVST-VITT patients often present with large intracerebral haemorrhages and a high proportion undergoes decompressive surgery. Clinical characteristics, therapeutic management and outcomes of CVST-VITT patients who underwent decompressive surgery are described and predictors of in-hospital mortality in these patients are explored. Methods: Data from an ongoing international registry of patients who developed CVST within 28 days of SARS-CoV-2 vaccination, reported between 29 March 2021 and 10 May 2022, were used. Definite, probable and possible VITT cases, as defined by Pavord et al. (N Engl J Med 2021; 385: 1680-1689), were included. Results: Decompressive surgery was performed in 34/128 (27%) patients with CVST-VITT. In-hospital mortality was 22/34 (65%) in the surgical and 27/94 (29%) in the non-surgical group (p < 0.001). In all surgical cases, the cause of death was brain herniation. The highest mortality rates were found amongst patients with preoperative coma (17/18, 94% vs. 4/14, 29% in the non-comatose; p < 0.001) and bilaterally absent pupillary reflexes (7/7, 100% vs. 6/9, 67% with unilaterally reactive pupil, and 4/11, 36% with bilaterally reactive pupils; p = 0.023). Postoperative imaging revealed worsening of index haemorrhagic lesion in 19 (70%) patients and new haemorrhagic lesions in 16 (59%) patients. At a median follow-up of 6 months, 8/10 of surgical CVST-VITT who survived admission were functionally independent. Conclusions: Almost two-thirds of surgical CVST-VITT patients died during hospital admission. Preoperative coma and bilateral absence of pupillary responses were associated with higher mortality rates. Survivors often achieved functional independence.
    2023-05Journal article Open access Show more
  • Global Impact of COVID-19 on Stroke Care and IV Thrombolysis
    Publication . Nogueira, RG; Qureshi, MM; Abdalkader, M; Martins, SO; Yamagami, H; Qiu, Z; Mansour, OY; Sathya, A; Czlonkowska, A; Tsivgoulis, G; Aguiar de Sousa, D; Demeestere, J; Mikulik, R; Vanacker, P; Siegler, JE; Kõrv, J; Biller, J; Liang, CW; Sangha, NS; Zha, AM.; Czap, AL; Holmstedt, CA; Turan, TN; Ntaios, G; Malhotra, K; Tayal, A; Loochtan, A; Ranta, A; Mistry, EA; Alexandrov, AW; Huang, DY; Yaghi, S; Raz, E; Sheth, SA; Mohammaden, MH; Frankel, M; Bila Lamou, EG; Aref, HM; Elbassiouny, A; Hassan, F; Menecie, T; Mustafa, W; Shokri, HM; Roushdy, T; Sarfo, FS; Alabi, TO; Arabambi, B; Nwazor, EO; Sunmonu, TA; Wahab, K; Yaria, J; Mohammed, HH; Adebayo, PB; Riahi, AD; Sassi, SB; Gwaunza, L; Ngwende, GW; Sahakyan, D; Rahman, A; Ai, Z; Bai, F; Duan, Z; Hao, Y; Huang, W; Li, G; Li, W; Liu, G; Luo, J; Shang, X; Sui, Y; Tian, L; Wen, H; Wu, B; Yan, Y; Yuan, Z; Zhang, H; Zhang, J; Zhao, W; Zi, W; Leung, TW; Chugh, C; Huded, V; Menon, B; Pandian, JD; Sylaja, PN; Usman, FS; Farhoudi, M; Hokmabadi, ES; Horev, A; Reznik, A; Sivan Hoffmann, R; Ohara, N; Sakai, N; Watanabe, D; Yamamoto, R; Doijiri, R; Tokuda, N; Yamada, T; Terasaki, T; Yazawa, Y; Uwatoko, T; Dembo, T; Shimizu, H; Sugiura, Y; Miyashita, F; Fukuda, H; Miyake, K; Shimbo, J; Sugimura, Y; Yagita, Y; Takenobu, Y; Matsumaru, Y; Yamada, S; Kono, R; Kanamaru, T; Yamazaki, H; Sakaguchi, M; Todo, K; Yamamoto, N; Sonoda, K; Yoshida, T; Hashimoto, H; Nakahara, I; Kondybayeva, A; Faizullina, K; Kamenova, S; Zhanuzakov, M; Baek, JH; Hwang, Y; Lee, JS; Lee, SB; Moon, J; Park, H; Seo, JH; Seo, KD; Sohn, SI; Young, CJ; Ahdab, R; Wan Zaidi, WA; Aziz, ZA; Basri, HB; Chung, LW; Ibrahim, AB; Ibrahim, KA; Looi, I; Tan, WY; Yahya, NW; Groppa, S; Leahu, P; Al Hashmi, AM; Imam, YZ; Akhtar, N; Pineda-Franks, MC; Co, CO; Kandyba, D; Alhazzani, A; Al-Jehani, H; Tham, CH; Mamauag, MJ; Venketasubramanian, N; Chen, CH; Tang, SC; Churojana, A; Akil, E; aykaç, O; Ozdemir, AO; Giray, S; Hussain, SI; John, S; Le Vu, H; Tran, AD; Nguyen, HH; Nhu Pham, T; Nguyen, TH; Nguyen, TQ; Gattringer, T; Enzinger, C; Killer-Oberpfalzer, M; Bellante, F; De Blauwe, S; Vanhooren, G; De Raedt, S; Dusart, A; Lemmens, R; Ligot, N; Pierre Rutgers, M; Yperzeele, L; Alexiev, F; Sakelarova, T; Bedeković, MR; Budincevic, H; Cindric, I; Hucika, Z; Ozretic, D; Saric, MS; Pfeifer, F; Karpowic, I; Cernik, D; Sramek, M; Skoda, M; Hlavacova, H; Klecka, L; Koutny, M; Vaclavik, D; Skoda, O; Fiksa, J; Hanelova, K; Nevsimalova, M; Rezek, R; Prochazka, P; Krejstova, G; Neumann, J; Vachova, M; Brzezanski, H; Hlinovsky, D; Tenora, D; Jura, R; Jurák, L; Novak, J; Novak, A; Topinka, Z; Fibrich, P; Sobolova, H; Volny, O; Krarup Christensen, H; Drenck, N; Klingenberg Iversen, H; Simonsen, CZ; Truelsen, TC; Wienecke, T; Vibo, R; Gross-Paju, K; Toomsoo, T; Antsov, K; Caparros, F; Cordonnier, C; Dan, M; Faucheux, JM; Mechtouff, L; Eker, O; Lesaine, E; Ondze, B; Peres, R; Pico, F; Piotin, M; Pop, R; Rouanet, F; Gubeladze, T; Khinikadze, M; Lobjanidze, N; Tsiskaridze, A; Nagel, S; Ringleb, PA; Rosenkranz, M; Schmidt, H; Sedghi, A; Siepmann, T; Szabo, K; Thomalla, G; Palaiodimou, L; Sagris, D; Kargiotis, O; Klivenyi, P; Szapary, L; Tarkanyi, G; Adami, A; Bandini, P; Calabresi, P; Frisullo, G; Renieri, L; Sangalli, D; Pirson, A; Uyttenboogaart, M; van den Wijngaard, I; Kristoffersen, ES; Brola, W; Fudala, M; Horoch-Lyszczarek, E; Karlinski, M; Kazmierski, R; Kram, P; Rogoziewicz, M; Kaczorowski, R; Luchowski, P; Sienkiewicz-Jarosz, H; Sobolewski, P; Fryze, W; Wisniewska, A; Wiszniewska, M; Ferreira, P; Ferreira, P; Fonseca, L; Marto, JP; Pinho e Melo, T; Nunes, AP; Rodrigues, M; Tedim Cruz, V; Falup-Pecurariu, C; Krastev, G; Mako, M; de Leciñana, MA; Arenillas, JF; Ayo-Martin, O; Cruz Culebras, A; Tejedor, ED; Montaner, J; Pérez-Sánchez, S; Tola Arribas, MA; Rodriguez Vasquez, A; Mayza, M; Bernava, G; Brehm, A; Machi, P; Fischer, U; Gralla, J; Michel, PL; Psychogios, MN; Strambo, D; Banerjee, S; Krishnan, K; Kwan, J; Butt, A; Catanese, L; Demchuk, AM; Field, T; Haynes, J; Hill, MD.; Khosravani, H; Mackey, A; Pikula, A; Saposnik, G; Scott, CA; Shoamanesh, A; Shuaib, A; Yip, S; Barboza, MA; Barrientos, JD; Portillo Rivera, LI; Gongora-Rivera, F; Novarro-Escudero, N; Blanco, A; Abraham, M; Alsbrook, D; Altschul, D; Alvarado-Ortiz, AJ; Bach, I; Badruddin, A; Barazangi, N; Brereton, C; Castonguay, A; Chaturvedi, S; Chaudry, SA; Choe, H; Choi, JA; Dharmadhikari, S; Desai, K; Devlin, TG; Doss, VT; Edgell, R; Etherton, M; Farooqui, M; Frei, D; Gandhi, D; Grigoryan, M; Gupta, R; Hassan, AE; Helenius, J; Kaliaev, A; Kaushal, R; Khandelwal, P; Khawaja, AM; Khoury, NN; Kim, BS; Kleindorfer, DO; Koyfman, F; Lee, VH; Leung, LY; Linares, G; Linfante, I; Lutsep, HL; Macdougall, L; Male, S; Malik, AM; Masoud, H; McDermott, M; Mehta, BP; Min, J; Mittal, M; Morris, JG; Multani, SS; Nahab, F; Nalleballe, K; Nguyen, CB; Novakovic-White, R; Ortega-Gutierrez, S; Rahangdale, RH; Ramakrishnan, P; Romero, JR; Rost, N; Rothstein, A; Ruland, S; Shah, R; Sharma, M; Silver, B; Simmons, M; Singh, A; Starosciak, AK; Strasser, SL; Szeder, V; Teleb, M; Tsai, JP; Voetsch, B; Balaguera, O; Pujol Lereis, VA; Luraschi, A; Almeida, MS; Cardoso, FB; Conforto, A; De Deus Silva, L; Varrone Giacomini, L; Oliveira Lima, F; Longo, AL; Magalhães, PSC; Martins, RT; Mont'alverne, F; Mora Cuervo, DL; Costa Rebello, L; Valler, L; Zetola, VF; Lavados, PM; Navia, V; Olavarría, VV; Almeida Toro, JM; Amaya, PFR; Bayona, H; Corredor, A; Rivera Ordonez, CE; Mantilla Barbosa, DK; Lara, O; Patiño, MR; Diaz Escobar, LF; Dejesus Melgarejo Fariña, DE; Cardozo Villamayor, A; Zelaya Zarza, AJ; Barrientos Iman, DM; Rodriguez Kadota, L; Campbell, B; Hankey, GJ.; Hair, C; Kleinig, T; Ma, A; Tomazini Martins, R; Sahathevan, R; Thijs, V; Salazar, D; Yuan-Hao Wu, T; Haussen, DC; Liebeskind, D; Yavagal, DR; Jovin, TG; Zaidat, OO; Nguyen, TN
    Objective: To measure the global impact of COVID-19 pandemic on volumes of IV thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with 2 control 4-month periods. Methods: We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. Results: There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95% confidence interval [CI] -11.7 to -11.3, p < 0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95% CI -13.8 to -12.7, p < 0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95% CI -13.7 to -10.3, p = 0.001). Recovery of stroke hospitalization volume (9.5%, 95% CI 9.2-9.8, p < 0.0001) was noted over the 2 later (May, June) vs the 2 earlier (March, April) pandemic months. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was noted in 3.3% (1,722/52,026) of all stroke admissions. Conclusions: The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID-19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months.
    2021Journal article Open access Show more
  • Global Impact of the COVID-19 Pandemic on Cerebral Venous Thrombosis and Mortality
    Publication . Nguyen, T; Qureshi, M; Klein, P; Yamagami, H; Abdalkader, M; Mikulik, R; Sathya, A; Mansour, O; Czlonkowska, A; Lo, H; Field, T; Charidimou, A; Banerjee, S; Yaghi, S; Siegler, J; Sedova, P; Kwan, J; Aguiar de Sousa, D; Demeestere, J; Inoa, V; Omran, S; Zhang, L; Michel, P; Strambo, D; Marto, JP; Nogueira, R
    Background and purpose: Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. Methods: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). Results: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. Conclusions: During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.
    2022-05Journal article Open access Show more