المؤلفون: van Meenen, Laura C. C., Terreros, Nerea Arrarte, Groot, Adrien E., Kappelhof, Manon, Beenen, Ludo F. M., Marquering, Henk A., Emmer, Bart J., Roos, Yvo B. W. E. M., Majoie, Charles B. L. M., Coutinho, Jonathan M.

المصدر: Journal of NeuroInterventional Surgery; Jan2022, Vol. 14 Issue 1, p84-88, 9p

مصطلحات موضوعية: STROKE treatment, EVALUATION of diagnostic imaging, TREATMENT effectiveness, COMPARATIVE studies, STROKE patients, ENDOVASCULAR surgery, NEURORADIOLOGY

مستخلص: Background Patients with a stroke who are transferred to a comprehensive stroke center for endovascular treatment (EVT) often undergo repeated neuroimaging prior to EVT. Objective To evaluate the yield of repeating imaging and its effect on treatment times. Methods We included adult patients with a large vessel occlusion (LVO) stroke who were referred to our hospital for EVT by primary stroke centers (2016-2019). We excluded patients who underwent repeated imaging because primary imaging was unavailable, incomplete, or of insufficient quality. Outcomes included treatment times and repeated imaging findings. Results Of 677 transferred LVO stroke, 551 were included. Imaging was repeated in 165/551 patients (30%), mostly because of clinical improvement (86/165 (52%)) or deterioration (40/165 (24%)). Patients who underwent repeated imaging had higher door-to-groin-times than patients without repeated imaging (median 43 vs 27 min, adjusted time difference: 20 min, 95% CI 15 to 25). Among patients who underwent repeated imaging because of clinical improvement, the LVO had resolved in 50/86 (58%). In patients with clinical deterioration, repeated imaging led to refrainment from EVT in 3/40 (8%). No symptomatic intracranial hemorrhages (sICH) were identified. Ultimately, 75/165 (45%) of patients with repeated imaging underwent EVT compared with 326/386 (84%) of patients without repeated imaging (p<0.01). Conclusions Neuroimaging was repeated in 30% of patients with an LVO stroke and resulted in a median treatment delay of 20 minutes. In patients with clinical deterioration, no sICH were detected and repeated imaging rarely changed the indication for EVT. However, in more than half of patients with clinical improvement, the LVO had resolved, resulting in refrainment from EVT. [ABSTRACT FROM AUTHOR]

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المؤلفون: Campbell, Bruce C. V., Majoie, Charles B. L. M., Albers, Gregory W., Menon, Bijoy K., Yassi, Nawaf, Sharma, Gagan, van Zwam, Wim H., van Oostenbrugge, Robert J., Demchuk, Andrew M., Guillemin, Francis, White, Philip, Dávalos, Antoni, van der Lugt, Aad, Butcher, Kenneth S., Cherifi, Aboubaker, Marquering, Henk A., Cloud, Geoffrey, Macho Fernández, Juan M., Madigan, Jeremy, Oppenheim, Catherine, Donnan, Geoffrey A., Roos, Yvo B. W. E. M., Shankar, Jai, Lingsma, Hester, Bonafé, Alain, Raoult, H. lène, Hernández-Pérez, María, Bharatha, Aditya, Jahan, Reza, Jansen, Olav, Richard, S. bastien, Levy, Elad I., Berkhemer, Olvert A., Soudant, Marc, Aja, Lucia, Davis, Stephen M., Krings, Timo, Tisserand, Marie, San Román, Luis, Tomasello, Alejandro, Beumer, Debbie, Vos, Jan Albert, Emmer, Bart J., van Dijk, Ewoud J., Visser, Marieke C., Bot, Joseph C. J., Sprengers, Marieke E. S., Beenen, Ludo F. M., van den Berg, René, Khan, K., Brown, S., Jovin, Tudor G., Hill, Michael D., Mitchell, Peter J.

المصدر: Campbell , B C V , Majoie , C B L M , HERMES collaborators , Albers , G W , Menon , B K , Yassi , N , Sharma , G , van Zwam , W H , van Oostenbrugge , R J , Demchuk , A M , Guillemin , F , White , P , Dávalos , A , van der Lugt , A , Butcher , K S , Cherifi , A , Marquering , H A , Cloud , G , Macho Fernández , J M , Madigan , J , Oppenheim , ....

الوصف: Background: CT perfusion (CTP) and diffusion or perfusion MRI might assist patient selection for endovascular thrombectomy. We aimed to establish whether imaging assessments of irreversibly injured ischaemic core and potentially salvageable penumbra volumes were associated with functional outcome and whether they interacted with the treatment effect of endovascular thrombectomy on functional outcome. Methods: In this systematic review and meta-analysis, the HERMES collaboration pooled patient-level data from all randomised controlled trials that compared endovascular thrombectomy (predominantly using stent retrievers) with standard medical therapy in patients with anterior circulation ischaemic stroke, published in PubMed from Jan 1, 2010, to May 31, 2017. The primary endpoint was functional outcome, assessed by the modified Rankin Scale (mRS) at 90 days after stroke. Ischaemic core was estimated, before treatment with either endovascular thrombectomy or standard medical therapy, by CTP as relative cerebral blood flow less than 30% of normal brain blood flow or by MRI as an apparent diffusion coefficient less than 620 μm 2 /s. Critically hypoperfused tissue was estimated as the volume of tissue with a CTP time to maximum longer than 6 s. Mismatch volume (ie, the estimated penumbral volume) was calculated as critically hypoperfused tissue volume minus ischaemic core volume. The association of ischaemic core and penumbral volumes with 90-day mRS score was analysed with multivariable logistic regression (functional independence, defined as mRS score 0–2) and ordinal logistic regression (functional improvement by at least one mRS category) in all patients and in a subset of those with more than 50% endovascular reperfusion, adjusted for baseline prognostic variables. The meta-analysis was prospectively designed by the HERMES executive committee, but not registered. Findings: We identified seven studies with 1764 patients, all of which were included in the meta-analysis. CTP was available and assessable for 591 (34%) ...

العلاقة: https://research.vumc.nl/en/publications/39fa1c7d-a25b-4de4-8f1a-ceaeeb306a3eTest

الإتاحة: https://doi.org/10.1016/S1474-4422Test(18)30314-4
https://research.vumc.nl/en/publications/39fa1c7d-a25b-4de4-8f1a-ceaeeb306a3eTest
https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85058897467&origin=inwardTest
https://www.ncbi.nlm.nih.gov/pubmed/30413385Test

المؤلفون: Boers, Anna M. M., Jansen, Ivo G. H., Brown, Scott, Lingsma, Hester F., Beenen, Ludo F. M., Devlin, Thomas G., Román, Luis San, Heo, Ji-Hoe, Ribó, Marc, Almekhlafi, Mohammed A., Liebeskind, David S., Teitelbaum, Jeanne, Cuadras, Patricia, du Mesnil de Rochemont, Richard, Beaumont, Marine, Brown, Martin M., Yoo, Albert J., Donnan, Geoffrey A., Mas, Jean Louis, Oppenheim, Catherine, Dowling, Richard J., Moulin, Thierry, Agrinier, Nelly, Lopes, Demetrius K., Aja Rodríguez, Lucía, Compagne, Kars C. J., Al-Ajlan, Fahad S., Madigan, Jeremy, Albers, Gregory W., Soize, Sebastien, Blasco, Jordi, Davis, Stephen M., Nogueira, Raul G., Dávalos, Antoni, Menon, Bijoy K., van der Lugt, Aad, Muir, Keith W., Roos, Yvo B. W. E. M., White, Phil, Mitchell, Peter J., Demchuk, Andrew M., van Zwam, Wim H., Jovin, Tudor G., van Oostenbrugge, Robert J., Dippel, Diederik W. J., Campbell, Bruce C. V., Guillemin, Francis, Bracard, Serge, Hill, Michael D., Goyal, Mayank, Marquering, Henk A., Majoie, Charles B. L. M.

الوصف: Importance: The positive treatment effect of endovascular therapy (EVT) is assumed to be caused by the preservation of brain tissue. It remains unclear to what extent the treatment-related reduction in follow-up infarct volume (FIV) explains the improved functional outcome after EVT in patients with acute ischemic stroke. Objective: To study whether FIV mediates the relationship between EVT and functional outcome in patients with acute ischemic stroke. Design, Setting, and Participants: Patient data from 7 randomized multicenter trials were pooled. These trials were conducted between December 2010 and April 2015 and included 1764 patients randomly assigned to receive either EVT or standard care (control). Follow-up infarct volume was assessed on computed tomography or magnetic resonance imaging after stroke onset. Mediation analysis was performed to examine the potential causal chain in which FIV may mediate the relationship between EVT and functional outcome. A total of 1690 patients met the inclusion criteria. Twenty-five additional patients were excluded, resulting in a total of 1665 patients, including 821 (49.3%) in the EVT group and 844 (50.7%) in the control group. Data were analyzed from January to June 2017. Main Outcome and Measure: The 90-day functional outcome via the modified Rankin Scale (mRS). Results: Among 1665 patients, the median (interquartile range [IQR]) age was 68 (57-76) years, and 781 (46.9%) were female. The median (IQR) time to FIV measurement was 30 (24-237) hours. The median (IQR) FIV was 41 (14-120) mL. Patients in the EVT group had significantly smaller FIVs compared with patients in the control group (median [IQR] FIV, 33 [11-99] vs 51 [18-134] mL; P = .007) and lower mRS scores at 90 days (median [IQR] score, 3 [1-4] vs 4 [2-5]). Follow-up infarct volume was a predictor of functional outcome (adjusted common odds ratio, 0.46; 95% CI, 0.39-0.54; P < .001). Follow-up infarct volume partially mediated the relationship between treatment type with mRS score, as EVT was still ...

العلاقة: Boers, A. M. M. et al. (2019) Mediation of the relationship between endovascular therapy and functional outcome by follow-up infarct volume in patients with acute ischemic stroke. JAMA Neurology , 76(2), pp. 194-202. (doi:10.1001/jamaneurol.2018.3661 ) (PMID:30615038)

الإتاحة: https://doi.org/10.1001/jamaneurol.2018.3661Test
http://eprints.gla.ac.uk/178229Test/

المؤلفون: Smit, Marry R., Beenen, Ludo F. M., Valk, Christel M. A., de Boer, Milou M., Scheerder, Maeke J., Annema, Jouke T., Paulus, Frederique, Horn, Janneke, Vlaar, Alexander P. J., Kooij, Fabian O., Hollmann, Markus W., Schultz, Marcus J., Bos, Lieuwe D. J.

المصدر: Journal of Thoracic Imaging; Sep2021, Vol. 36 Issue 5, p286-293, 8p

المؤلفون: van der Steen, Wouter, van de Graaf, Rob A, Chalos, Vicky, Lingsma, Hester F, van Doormaal, Pieter Jan, Coutinho, Jonathan M, Emmer, Bart J, de Ridder, Inger, van Zwam, Wim, van der Worp, H Bart, van der Schaaf, Irene, Gons, Rob A R, Yo, Lonneke S F, Boiten, Jelis, van den Wijngaard, Ido, Hofmeijer, Jeannette, Martens, Jasper, Schonewille, Wouter, Vos, Jan Albert, Tuladhar, Anil Man, de Laat, Karlijn F, van Hasselt, Boudewijn, Remmers, Michel, Vos, Douwe, Rozeman, Anouk, Elgersma, Otto, Uyttenboogaart, Maarten, Bokkers, Reinoud P H, van Tuijl, Julia, Boukrab, Issam, van den Berg, René, Beenen, Ludo F M, Roosendaal, Stefan D, Postma, Alida Annechien, Krietemeijer, Menno, Lycklama, Geert, Meijer, Frederick J A, Hammer, Sebastiaan, van der Hoorn, Anouk, Yoo, Albert J, Gerrits, Dick, Truijman, Martine T B, Zinkstok, Sanne, Koudstaal, Peter J, Manschot, Sanne, Kerkhoff, Henk, Nieboer, Daan, Berkhemer, Olvert, Wolff, Lennard, van der Sluijs, P Matthijs, van Voorst, Henk, Tolhuisen, Manon, Roos, Yvo B W E M, Majoie, Charles B L M, Staals, Julie, van Oostenbrugge, Robert J, Jenniskens, Sjoerd F M, van Dijk, Lukas C, den Hertog, Heleen M, van Es, Adriaan C G M, van der Lugt, Aad, Dippel, Diederik W J, Roozenbeek, Bob

المصدر: The Lancet; March 2022, Vol. 399 Issue: 10329 p1059-1069, 11p

مستخلص: Aspirin and unfractionated heparin are often used during endovascular stroke treatment to improve reperfusion and outcomes. However, the effects and risks of anti-thrombotics for this indication are unknown. We therefore aimed to assess the safety and efficacy of intravenous aspirin, unfractionated heparin, both, or neither started during endovascular treatment in patients with ischaemic stroke.

المؤلفون: Korevaar, Daniël A., Kootte, Ruud S., Smits, Loek P., van den Aardweg, Joost G., Bonta, Peter I., Schinkel, Janke, Vigeveno, René M., van den Berk, Inge A. H., Scheerder, Maeke J., Lemkes, Bregtje A., Goorhuis, Abraham, Beenen, Ludo F. M., Annema, Jouke T., Study group members AMC, Hovius, Joppe W. R., Harris, Vanessa C.

المساهمون: Pulmonology, Vascular Medicine, ACS - Diabetes & metabolism, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, AMS - Amsterdam Movement Sciences, ACS - Pulmonary hypertension & thrombosis, Medical Microbiology and Infection Prevention, AII - Infectious diseases, Graduate School, Radiology and Nuclear Medicine, APH - Methodology, APH - Personalized Medicine, Infectious diseases, ACS - Amsterdam Cardiovascular Sciences, APH - Aging & Later Life, APH - Global Health, ARD - Amsterdam Reproduction and Development, AII - Amsterdam institute for Infection and Immunity, APH - Health Behaviors & Chronic Diseases, Global Health, AMS - Sports, ACS - Atherosclerosis & ischemic syndromes, ACS - Microcirculation

المصدر: European respiratory journal, 56(2):01377. European Respiratory Society

مصطلحات موضوعية: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), medicine.diagnostic_test, business.industry, Radiography, Computed tomography, Retrospective cohort study, Emergency department, medicine.disease, 03 medical and health sciences, Pneumonia, 0302 clinical medicine, 030228 respiratory system, medicine, 030212 general & internal medicine, Tomography, Radiology, business, Indeterminate

الوصف: In a high-prevalence emergency department setting, chest CT showed a high probability of COVID-19 in 30% of patients with a negative or indeterminate initial RT-PCR result https://bit.ly/38hLDzRTest

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::eb4fd18e65f10ae3c0f631e9fbfa0c26Test
https://doi.org/10.1183/13993003.01377-2020Test

المؤلفون: van der Hulle, Tom, Cheung, Whitney Y, Kooij, Stephanie, Beenen, Ludo F M, van Bemmel, Thomas, van Es, Josien, Faber, Laura M, Hazelaar, Germa M, Heringhaus, Christian, Hofstee, Herman, Hovens, Marcel M C, Kaasjager, Karin A H, van Klink, Rick C J, Kruip, Marieke J H A, Loeffen, Rinske F, Mairuhu, Albert T A, Middeldorp, Saskia, Nijkeuter, Mathilde, van der Pol, Liselotte M, Schol-Gelok, Suzanne, ten Wolde, Marije, Klok, Frederikus A, Huisman, Menno V, Fogteloo, Anne J, Kroft, Lucia J M, Brekelmans, Marjolein P, Vermaire, René M J, Bastiaansen-Bergsma, Hanny, Biedermann, Jossi S, Klijn, Adinda, van der Voort, Sanne, Lieveld, Arthur W E, de Jong, Peter Y, Schaar, Cees G, del Sol, Antonio Iglesias

المصدر: The Lancet ; volume 390, issue 10091, page 289-297 ; ISSN 0140-6736

الإتاحة: https://doi.org/10.1016/s0140-6736Test(17)30885-1
https://api.elsevier.com/content/article/PII:S0140673617308851?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S0140673617308851?httpAccept=text/plainTest

المؤلفون: Schalekamp, Steven, Bleeker-Rovers, Chantal P., Beenen, Ludo F. M., van Ufford, Henriette M. E. Quarles, Gietema, Hester A., Stöger, J. Lauran, Harris, Vanessa, Reijers, Monique H. E., Rahamat-Langendoen, Janette, Korevaar, Daniel A., Smits, Loek P., Korteweg, Christine, Vellinga, Tjalco F.D. van Rees, Vermaat, Marieke, Stassen, Patricia M., Scheper, Henk, Wijnakker, Roos, Borm, Frank J., Dofferhoff, Anthonius S. M., Prokop, Mathias

المصدر: Radiology; February 2021, Vol. 298 Issue: 2 pE98-E106, 9p

مستخلص: Chest CT analysis using the coronavirus disease 2019 (COVID-19) Reporting and Data System is fast and achieves a high performance for diagnosing COVID-19, particularly when symptom duration is greater than 48 hours.

المؤلفون: van der Hulle, Tom, Cheung, Whitney Y, Kooij, Stephanie, Beenen, Ludo F M, van Bemmel, Thomas, van Es, Josien, Faber, Laura M, Hazelaar, Germa M, Heringhaus, Christian, Hofstee, Herman, Hovens, Marcel M C, Kaasjager, Karin A H, van Klink, Rick C J, Kruip, Marieke J H A, Loeffen, Rinske F, Mairuhu, Albert T A, Middeldorp, Saskia, Nijkeuter, Mathilde, van der Pol, Liselotte M, Schol-Gelok, Suzanne, ten Wolde, Marije, Klok, Frederikus A, Huisman, Menno V, Fogteloo, Jaap A, Kroft, Lucia J M, Brekelmans, Marjolein P, Vermaire, René M J, Bastiaansen-Bergsma, Hanny, Biedermann, Jossi S, Klijn, Adinda, van der Voort, Sanne, Lieveld, Arthur W E, de Jong, Peter Y, Schaar, Cees G, del Sol, Antonio Iglesias

المصدر: The Lancet; 20240101, Issue: Preprints

مستخلص: Validated diagnostic algorithms in patients with suspected pulmonary embolism are often not used correctly or only benefit subgroups of patients, leading to overuse of computed tomography pulmonary angiography (CTPA). The YEARS clinical decision rule that incorporates differential D-dimer cutoff values at presentation, has been developed to be fast, to be compatible with clinical practice, and to reduce the number of CTPA investigations in all age groups. We aimed to prospectively evaluate this novel and simplified diagnostic algorithm for suspected acute pulmonary embolism.

المؤلفون: Yoo, Albert J., Berkhemer, Olvert A., Fransen, Puck S. S., van den Berg, Lucie A., Beumer, Debbie, Lingsma, Hester F., Schonewille, Wouter J., Sprengers, Marieke E. S., van den Berg, Rene, van Walderveen, Marianne A. A., Beenen, Ludo F. M., Wermer, Marieke J. H., Nijeholt, Geert J. Lycklama a, Boiten, Jelis, Jenniskens, Sjoerd F. M., Bot, Joseph C. J., Boers, Anna M. M., Marquering, Henk A., Roos, Yvo B. W. E. M., van Oostenbrugge, Robert J., Dippel, Diederik W. J., van der Lugt, Aad, van Zwam, Wim H., Majoie, Charles B. L. M.

المصدر: Yoo , A J , Berkhemer , O A , Fransen , P S S , van den Berg , L A , Beumer , D , Lingsma , H F , Schonewille , W J , Sprengers , M E S , van den Berg , R , van Walderveen , M A A , Beenen , L F M , Wermer , M J H , Nijeholt , G J L A , Boiten , J , Jenniskens , S F M , Bot , J C J , Boers , A M M , Marquering , ....

الوصف: Background Whether infarct size modifies intra-arterial treatment effect is not certain, particularly in patients with large infarcts. We examined the effect of the baseline Alberta Stroke Program Early CT Score (ASPECTS) on the safety and efficacy of intra-arterial treatment in a subgroup analysis of the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN). Methods MR CLEAN was a randomised, controlled, open-label, phase 3 trial of intra-arterial treatment in patients (aged >= 18 years from the Netherlands) with proximal arterial occlusion of the anterior circulation, given intraarterial treatment within 6 h of stroke onset. The primary outcome was 90 day modified Rankin Scale (mRS) score. We estimated the intra-arterial treatment effect for all patients in MR CLEAN who had ASPECTS graded by using multivariable ordinal logistic regression analysis (a proportional odds model) to calculate the adjusted common odds ratio for a shift towards a better functional outcome according to the mRS for intra-arterial treatment and usual care than for usual care alone. We entered an interaction term into the model to test for interaction with prespecified ASPECTS subgroups: 0-4 (large infarct) versus 5-7 (moderate infarct) versus 8-10 (small infarct). MR CLEAN is registered with the Netherlands Trial Registry, number NTR1804, and the ISRCTN Registry, number ISRCTN10888758. Findings 496 patients-232 (47%) in the intra-arterial treatment and usual care group and 264 (53%) in the usual care alone group were included in the analysis. We noted no significant difference in intra-arterial treatment effect between the ASPECTS subgroups according to 90 day ordinal mRS (adjusted common odds ratio interaction term relative to ASPECTS 8-10: ASPECTS 0-4: 0.79 [95% CI 0.20-3-19], p=0.740; and ASPECTS 5-7: 1.02 [0.44-2.35], p=0.966). Intra-arterial treatment did not cause a significant increase in the proportion of patients with at least one serious adverse event in any ...

العلاقة: https://cris.maastrichtuniversity.nl/en/publications/85ee7772-dc94-414b-bab1-5a2ce6835fb3Test

الإتاحة: https://doi.org/10.1016/S1474-4422Test(16)00124-1
https://cris.maastrichtuniversity.nl/en/publications/85ee7772-dc94-414b-bab1-5a2ce6835fb3Test