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Browsing by Author "Kargiotis, O"

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  • Endovascular Treatment for Anterior Circulation Large-Vessel Occlusion Ischemic Stroke with Low ASPECTS: a Systematic Review and Meta-Analysis
    Publication . Safouris, A; Palaiodimou, L; Szikora, I; Kargiotis, O; Magoufis, G; Psychogios, K; Paraskevas, G; Spiliopoulos, S; Brountzos, E; Nardai, S; Goyal, N; Aguiar de Sousa, D; Strbian, D; Caso, V; Alexandrov, A; Tsivgoulis, G
    Background: Endovascular treatment (EVT) for acute ischemic stroke (AIS) patients presenting with Alberta Stroke Program Early CT Score (ASPECTS) 0-5 has not yet proven safe and effective by clinical trials. Objectives: The aim of the study was to assess whether EVT in AIS patients presenting with low ASPECTS is beneficial. Design: Systematic review and meta-analysis of available studies in accordance with the PRISMA statement. Data sources and methods: We have searched MEDLINE, the Cochrane Central Register of Controlled Trials, and reference lists of articles published until 28 May 2022 with the aim to calculate (1) modified Rankin scale (mRS) score 0-3 at 3 months, (2) mRS score 0-2 at 3 months, (3) symptomatic intracranial hemorrhage (sICH), and (3) mortality at 3 months. Results: Overall, 24 eligible studies were included in the meta-analysis, comprising a total of 2539 AIS patients with ASPECTS 0-5 treated with EVT. The pooled proportion of EVT-treated patients achieving mRS 0-3 at 3 months was calculated at 38.4%. The pooled proportion of EVT-treated patients achieving mRS 0-2 at 3 months was 25.7%. Regarding safety outcomes, sICH occurred in 12.8% of patients. The 3-month pooled mortality was 30%. In pairwise meta-analysis, patients treated with EVT had a higher likelihood of achieving mRS 0-3 at 3 months compared with patients treated with best medical therapy (BMT, OR: 2.41). sICH occurred more frequently in EVT-treated patients compared with the BMT-treated patients (OR: 2.30). Mortality at 3 months was not different between the two treatment groups (OR: 0.71). Conclusion: EVT may be beneficial for AIS patients with low baseline ASPECTS despite an increased risk for sICH. Further data from randomized-controlled clinical trials are needed to elucidate the role of EVT in this subgroup of AIS patients. Registration: The protocol has been registered in the International Prospective Register of Ongoing Systematic Reviews PROSPERO; Registration Number: CRD42022334417.
    2022-11Journal 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