Paolo Cerrato’s research while affiliated with Azienda Ospedaliera Città della Salute e della Scienza di Torino and other places

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Publications (111)


Outcomes of Mechanical Thrombectomy in Patients With Acute Basilar Artery Occlusion With Mild to Moderate Symptoms
  • Article

November 2024

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85 Reads

Neurology

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Background and objectives: The benefit of mechanical thrombectomy (MT) in patients with acute ischemic stroke (AIS) with basilar artery occlusion (BAO) and a baseline National Institute of Health Stroke Scale (NIHSS) score <10 is unclear because this subpopulation has been substantially excluded from large clinical trials. The aim of our study was to determine whether MT ± IV thrombolysis (IVT) improves functional outcomes compared with IVT alone in patients with BAO and a NIHSS score <10. Methods: We emulated a hypothetical trial including adult patients with BAO, a baseline NIHSS score <10, and prestroke modified Rankin scale (mRS) scores 0-2, comparing MT (±IVT) with IVT alone. We acquired data from patients receiving MT (±IVT) within 24 hours of onset from the Italian Registry of Endovascular Treatment in Acute Stroke and data from patients treated only with IVT within 9 hours of symptom onset from the SITS International Stroke Thrombolysis Register, from 2011 until 2021. We used inverse probability weighting (IPW) adjusted for prespecified covariates to weight each individual's contribution to the outcome. The primary outcome was 90-day mRS scores 0-2. Secondary outcomes included 90-day mRS scores 0-1, 90-day mRS scores 4-5, mortality at 90 days, in-hospital death, and symptomatic intracerebral hemorrhage. Results: Among the 764 patients recruited from the 2 databases (477 men [62.4%]; mean age [±SD] 67.88 [±13.9] years), 410 (53.7%) received MT±IVT and 354 (46.3%) only IVT. After applying IPW, our population was composed of 710 MT and 707 IVT patients. Of these, 454 MT-treated (63.9%) and 383 IVT-treated (54.2%) patients had a 90-day mRS score of 0-2 (adjusted odds ratio (aOR) 1.56 [95% CI 1.04-2.03]). MT was also associated with a higher rate of mRS scores 0-1 (aOR 2.01 [95% CI 1.37-2.95]) and a lower rate of in-hospital death (aOR 0.45 [95% CI 0.25-0.78]). Among the subgroups tested, MT had a larger effect on 90-day mRS scores 0-2 for patients with NIHSS scores 6-9 than for patients with a NIHSS score <6 (p for interaction 0.02). Discussion: In a large-scale target trial emulation on patients with stroke from BAO and a NIHSS score <10, MT was associated with better functional outcomes compared with IVT alone. Further research is needed to confirm the benefit of MT in patients with a NIHSS score <6. Classification of evidence: This study provides Class III evidence that MT ± intravenous thrombolysis is associated with better 90-day functional outcomes in patients with BAO and a NIHSS score < 10 compared with intravenous thrombolysis alone.


Stroke thrombectomy in the elderly: A propensity score matched study on a nationwide real-world registry

November 2024

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51 Reads

European Stroke Journal

Introduction Data on safety and efficacy of endovascular thrombectomy (EVT) for acute ischemic stroke in older patients are limited and controversial, and people aged 80 or older were under-represented in randomized trials. Our aim was to assess EVT effect for ischemic stroke patients aged ⩾80 at a nationwide level. Patients and methods The cohort included stroke patients undergoing EVT from the Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS). Patients were a priori divided into younger and older groups (<80 vs ⩾80). Primary outcome was good functional outcome (modified Rankin scale, mRS, 0–2 at 90 days). Secondary outcomes were symptomatic intracranial hemorrhage (sICH), successful reperfusion, EVT abortion. Propensity score matching (PSM) was performed between age groups for baseline features, functional status, stroke severity and neuroradiological features. Logistic regression was implemented to test the weight of age group on the predefined outcomes. Results Overall, 5872 individuals (1:1 matching, n = 2936 aged ⩾80 vs n = 2936 < 80) were matched from 13,922 records. In ⩾80 group 34.1% had good functional outcome, vs 51.2% in <80 group (absolute difference = −17.1%, p < 0.001), with a 4.4% excess in EVT abortion. Age ⩾80 was a negative independent predictor of good functional outcome (aOR = 0.4, 95% CI = 0.3–0.5), but had no impact on sICH. Discussion and conclusion Age ⩾80 years represents a consistent predictor of worse functional outcome, independently from successful reperfusion and sICH. Cost-effectiveness studies are needed for tailored and implement sustainable care, and research should focus on strategies to improve functional outcome in older age patient groups.


Thrombectomy in ischemic stroke patients with tandem occlusion in the posterior versus anterior circulation

June 2024

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65 Reads

Neurological Sciences

Mechanical thrombectomy (MT) was found to be beneficial in acute ischemic stroke patients with anterior tandem occlusion (a-TO). Instead, little is known about the effectiveness of MT in stroke patients with posterior tandem occlusion (p-TO). We aimed to compare MT within 24 h from last known well time in ischemic stroke patients with p-TO versus a-TO. We conducted a cohort study on prospectively collected data of patients registered in the Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS) who were treated with MT within 24 h from last known well time for acute ischemic stroke with p-TO (n = 275) or a-TO (n = 1853). After adjustment for unbalanced pre-procedure variables (year 2015–2021, age, sex, NIHSS score, ASPECTS, and time strata for puncture groin) and pre-stroke mRS score as pre-defined predictor, p-TO was significantly associated with lower probability of mRS score 0–2 (OR 0.415, 95% CI 0.268–0.644) and with higher risk of death (OR 2.813, 95% CI 2.080–3.805) at 3 months. After adjustment for unbalanced procedural and post-procedure variables (IVT, general anesthesia, TICI 3, and 24-h HT) and pre-stroke mRS score as pre-defined predictor, association between p-TO and lower probability of mRS score 0–2 (OR 0.444, 95% CI 0.304–0.649) and association between p-TO and with higher risk of death (OR 2.971, 95% CI 1.993–4.429) remained significant. MT within 24 h from last known well time in ischemic stroke patients with p-TO versus a-TO was associated with worse outcomes at 3 months.


Flowchart of included patients. IRETAS = Italian Registry of Endovascular Treatment in Acute Stroke
Association between procedural time and outcome in unsuccessful mechanical thrombectomy for acute ischemic stroke: analysis from the Italian Registry of Endovascular Treatment in Acute Stroke
  • Article
  • Publisher preview available

June 2024

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69 Reads

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1 Citation

Journal of Neurology

Background We aim to assess the association between procedural time and outcomes in patients in unsuccessful mechanical thrombectomy (MT) for anterior circulation acute stroke. Methods We conducted a cohort study on prospectively collected data from patients with M1 and/or M2 segment of middle cerebral artery occlusion with a thrombolysis in cerebral infarction 0–1 at the end of procedure. Primary outcome was 90-day poor outcome. Secondary outcomes were early neurological deterioration (END), symptomatic intracranial hemorrhage (sICH) according to ECASS II and sICH according to SITS-MOST. Results Among 852 patients, after comparing characteristics of favourable and poor outcome groups, logistic regression analysis showed age (OR: 1.04; 95%CI: 1.02–1.05; p < 0.001), previous TIA/stroke (OR: 0.23; 95%CI: 0.12–0.74; p = 0.009), M1 occlusion (OR: 1.69; 95%CI: 1.13–2.50; p = 0.01), baseline NIHSS (OR: 1.01; 95%CI: 1.06–1.13; p < 0.001) and procedural time (OR:1.00; 95% CI: 1.00–1.01; p = 0.003) as independent predictors poor outcome at 90 days. Concerning secondary outcomes, logistic regression analysis showed NIHSS (OR:0.96; 95%CI: 0.93–0.99; p = 0.008), general anaesthesia (OR:2.59; 95%CI: 1.52–4.40; p < 0.001), procedural time (OR: 1.00; 95% CI: 1.00–1.01; p = 0.002) and intraprocedural complications (OR: 1.89; 95%CI: 1.02–3.52; p = 0.04) as independent predictors of END. Bridging therapy (OR:2.93; 95%CI: 1.21–7.09; p = 0.017) was associated with sICH per SITS-MOST criteria whereas M1 occlusion (OR: 0.35; 95%CI: 0.18–0.69; p = 0.002), bridging therapy (OR: 2.02; 95%CI: 1.07–3.82; p = 0.03) and intraprocedural complications (OR: 5.55; 95%CI: 2.72–11.31; p < 0.001) were independently associated with sICH per ECASS II criteria. No significant association was found between the number of MT attempts and analyzed outcomes. Conclusions Regardless of the number of MT attempts and intraprocedural complications, procedural time was associated with poor outcome and END. We suggest a deeper consideration of procedural time when treating anterior circulation occlusions refractory to MT.

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IV thrombolysis plus thrombectomy versus IV thrombolysis alone for minor stroke with anterior circulation large vessel occlusion from the IRETAS and Italian SITS-ISTR cohorts

July 2023

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108 Reads

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2 Citations

Neurological Sciences

Introduction: The aim of this study was to compare the outcomes of patients treated with intravenous thrombolysis (IVT) <4.5 h after symptom onset plus mechanical thrombectomy (MT) <6 h with those treated with IVT alone <4.5 h for minor stroke (NIHSS ≤5) with large vessel occlusion (LVO) in the anterior circulation. Patients and methods: Patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS) and in the Italian centers included in the SITS-ISTR were analyzed. Results: Among the patients with complete data on 24-h ICH type, 236 received IVT plus MT and 382 received IVT alone. IVT plus MT was significantly associated with unfavorable shift on 24-h ICH types (from no ICH to PH-2) (OR, 2.130; 95% CI, 1.173-3.868; p=0.013) and higher rate of PH (OR, 4.363; 95% CI, 1.579-12.055; p=0.005), sICH per ECASS II definition (OR, 5.527; 95% CI, 1.378-22.167; p=0.016), and sICH per NINDS definition (OR, 3.805; 95% CI, 1.310-11.046; p=0.014). Among the patients with complete data on 3-month mRS score, 226 received IVT plus MT and 262 received IVT alone. No significant difference was reported between IVT plus MT and IVT alone on mRS score 0-1 (72.1% versus 69.1%), mRS score 0-2 (79.6% versus 79%), and death (6.2% versus 6.1%). Conclusions: Compared with IVT alone, IVT plus MT was associated with unfavorable shift on 24-h ICH types and higher rate of 24-h PH and sICH in patients with minor stroke and LVO in the anterior circulation. However, no difference was reported between the groups on 3-month functional outcome measures.



Predictors for hemorrhagic transformation and cerebral edema in stroke patients with first-pass complete recanalization

June 2023

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83 Reads

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5 Citations

International Journal of Stroke

Unlabelled: ABSTRACTBackground: Predictors of radiological complications attributable to reperfusion injury remain unknown when baseline setting is optimal for endovascular treatment and procedural setting is the best in stroke patients with large vessel occlusion (LVO). Aims: To identify clinical and radiological/procedural predictors for hemorrhagic transformation (HT) and cerebral edema (CED) at 24 hours in patients obtaining complete recanalization in one pass of thrombectomy for ischemic stroke ≤6 hours from symptoms onset with intra-cranial anterior circulation LVO and ASPECTS ≥6. Methods: We conducted a cohort study on prospectively collected data from 1400 patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke. Results: HT was reported in 248 (18%) patients and early CED was reported in 260 (19.2%) patients. In the logistic regression model including predictors from a first model with clinical variables and from a second model with radiological/procedural variables, diabetes mellitus (OR 1.832, 95% CI 1.201-2.795), higher NIHSS (OR 1.076, 95% CI 1.044-1.110), lower ASPECTS (OR 0.815, 95% CI 0.694-0.957), and longer onset-to-groin time (OR 1.005, 95% CI 1.002-1.007) were predictors of HT, whereas general anesthesia was inversely associated with HT (OR 0.540, 95% CI 0.355-0.820). Higher NIHSS (OR 1.049, 95% CI 1.021-1.077), lower ASPECTS (OR 0.700, 95% CI 0.613-0.801), intravenous thrombolysis (OR 1.464, 95% CI 1.061-2.020), longer onset-to-groin time (OR 1.002, 95% CI 1.001-1.005), and longer procedure time (OR 1.009, 95% CI 1.004-1.015) were predictors of early CED. After repeating a fourth logistic regression model including also good collaterals, the same variables remained predictors for HT and/or early CED, except diabetes mellitus and thrombolysis, while good collaterals were inversely associated with early CED (OR 0.385, 95% CI 0.248-0.599). Conclusions: Higher NIHSS, lower ASPECTS, and longer onset-to-groin time were predictors for both HT and early CED. General anesthesia and good collaterals were inversely associated with HT and early CED, respectively. Longer procedure time was predictor of early CED.


Associations of Vascular Risk Factors with the Group of Patients with sCeAD, non-CeAD IS, and Stroke-Free Subjects Based on Multinomial Logistic Regression (Generalized Logit) Model
Association of Vascular Risk Factors with Specific Subgroups of Patients With sCeAD
Risk Profile of Patients with Spontaneous Cervical Artery Dissection

June 2023

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135 Reads

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9 Citations

Annals of Neurology

Objective: Epidemiological data to characterize the individual risk profile of patients with spontaneous cervical artery dissection (sCeAD) are rather inconsistent. Methods and results: In the setting of the Italian Project on Stroke in Young Adults Cervical Artery Dissection (IPSYS CeAD), we compared the characteristics of 1,468 patients with sCeAD (mean age, 47.3±11.3; males, 56.7%) prospectively recruited at 39 Italian centres with those of 2 control groups, composed of 1) patients whose ischemic stroke was caused by mechanisms other than dissection (non-CeAD IS) selected from the prospective IPSYS registry and Brescia Stroke Registry and 2) stroke-free individuals selected from the staff members of participating hospitals, matched 1:1:1 by sex, age, and race. Compared to stroke-free subjects, sCeAD patients were more likely to be hypertensive (OR,1.65; 95%CI,1.37-1.98), to have personal history of migraine with aura (OR,2.45; 95%CI,1.74-3.34), without aura (OR,2.67; 95%CI,2.15-3.32) and family history of vascular disease in first-degree relatives (OR,1.69; 95%CI,1.39-2.05), and less likely to be diabetic (OR,0.65; 95%CI,0.47-0.91), hypercholesterolemic (OR,0.75; 95%CI,0.62-0.91), and obese (OR,0.41; 95%CI,0.31-0.54). Migraine without aura was also associated with sCeAD (OR,1.81; 95%CI,1.47-2.22) in comparison with patients with non-CeAD IS. In the subgroup of patients with migraine, sCeAD patients had higher frequency of migraine attacks and were less likely to take anti-migraine preventive medications, especially beta-blockers, compared with the other groups. Interpretation: The risk of sCeAD is influenced by migraine, especially migraine without aura, more than by other factors, increases with increasing frequency of attacks, and seems to be reduced by migraine preventive medications, namely beta-blockers. This article is protected by copyright. All rights reserved.


PREVALENCE AND DISEASE SPECTRUM OF FIBROMUSCULAR DYSPLASIA IN PATIENTS WITH SPONTANEOUS CEREBROVASCULAR ARTERY DISSECTION

June 2023

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15 Reads

Journal of Hypertension

Objective Spontaneous cervical artery dissection (sCeAD) is the most frequent cause of ischemic stroke in young adults and has been associated to various arteriopathies, such as fibromuscular dysplasia (FMD). The aim of this study was to assess the prevalence of both cervical and extra-cervical FMD in patients with a diagnosis of CeAD. Design and method All patients discharged from the Stroke Unit of A.O.U. Città della Salute e della Scienza of Turin from 2016 to 2020 with a diagnosis of CeAD underwent a contrast-enhanced CTA from chest to pelvis to look for FMD-related lesions (multifocal stenosis, aneurysms, dissections, arterial tortuosity). FMD diagnosis was assessed in the presence of at least a multifocal stenosis in one of the vascular beds explored. Results Among 56 patients with spontaneous CeAD, 72.7% were male of middle age (52±8.5 y.o.). According to radiological findings, 43.2% of patients showed extra-cervical arterial lesions, with a prevalence of overall FMD (defined as the presence of at least a multifocal stenosis) reaching 47.3% of the studied sample and affecting carotid (36.4%), renal (18.9%), visceral (16.2%), iliac (22.2%) and coronary arteries (2.7%) respectively. Renal involvement included multifocal renal stenosis (13.5%) and arterial aneurysms (5.4%). Visceral involvement included multifocal stenosis (13.5%), visceral aneurysms (2.7%) and silent mesenteric artery dissection (5.4%). Iliac involvement included multifocal stenosis (2.7%), silent artery dissection (2.7%) and tortuosity (16.7%). Furthermore, two spontaneous dissections, one of the left external iliac artery and the other of the coeliac trunk, clinically asymptomatic, were reported in two males with no multifocal stenosis. Two women suffered also from SCAD. Multivascular extra-cervical involvement was observed in almost one third of the patients (27.0%) with sever lesions (multifocal high degree stenosis and/or arterial dissections) affecting 13.5% of the population. Conclusions According to our results, we demonstrated that FMD is frequently associated to CeAD and that silent FMD-related lesions, even severe as arterial dissections, may coexist in such patients. Therefore, FMD should always be taken in consideration in the differential diagnosis of spontaneous arterial dissection, especially in young subjects without major cardiovascular risk factors.


Mechanical thrombectomy in patients with heart failure: the Italian registry of Endovascular Treatment in Acute Stroke

May 2023

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137 Reads

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3 Citations

Neurological Sciences

Background: Heart failure (HF) is the second most important cardiac risk factor for stroke after atrial fibrillation (AF). Few data are available on mechanical thrombectomy (MT) in acute ischemic stroke (AIS) patients with HF. Methods: The source of data is the multicentre Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS). All AIS patients ≥ 18 years receiving MT were categorised in two groups: HF and no-HF. Baseline clinical and neuroradiological findings on admission were analysed. Results: Of 8924 patients, 642 (7.2%) had HF. Compared to the no-HF group, HF patients had higher prevalence of cardiovascular risk factors. Rate of complete recanalisation (TICI 2b-3) was 76.9% in HF vs 78.1% in no-HF group (p = 0.481). Rate of symptomatic intracerebral haemorrhage at 24-h non-contrast computed tomography (NCCT) was 7.6% in HF vs 8.3% in no-HF patients (p = 0.520). At 3 months, 36.4% of HF patients and 48.2% of no-HF patients (p < 0.001) had mRS 0-2, and mortality was, respectively, 30.7% and 18.5% (p < 0.001). In multivariate logistic regression, HF was independently associated with mortality at 3 months (OR 1.53, 1.24-1.88 95% CI, p < 0.001). In multivariate ordinal regression, HF patients had a probability of transitioning to a higher mRS level of 1.23 (1.05-1.44 95% CI, p = 0.012). The propensity score analysis of two groups matched for age, sex, and NIHSS at admission yielded the same results. Conclusion: MT is safe and effective in HF patients with AIS. Patients with HF and AIS suffered from higher 3-month mortality and unfavourable outcome regardless of acute treatments.


Citations (73)


... However, several recent cohort studies have presented varying results on this subject. Yedavalli et al. [16] showed that EVT improved clinical outcomes, while Cappellari et al. [17] found that combining EVT with intravenous thrombolysis did not yield better outcomes compared to thrombolysis alone. Given these discrepancies, we propose a meta-analysis to offer updated insights on the use of EVT for these patients. ...

Reference:

Is Thrombectomy Effective for Large Vessel Occlusion Stroke Patients with Mild Symptoms? Meta-Analysis and Trial Sequential Analysis
IV thrombolysis plus thrombectomy versus IV thrombolysis alone for minor stroke with anterior circulation large vessel occlusion from the IRETAS and Italian SITS-ISTR cohorts
  • Citing Article
  • July 2023

Neurological Sciences

... One of the key findings of our study is the substantial reduction in cerebral edema associated with metformin administration. Cerebral edema, a common outcome of stroke, contributes to increased intracranial pressure and tissue damage [20,21]. By attenuating cerebral edema, metformin demonstrates its ability to preserve tissue integrity and potentially improve neurological outcomes following ischemic events. ...

Predictors for hemorrhagic transformation and cerebral edema in stroke patients with first-pass complete recanalization
  • Citing Article
  • June 2023

International Journal of Stroke

... Einstak lingar í rannsókninni voru ólíklegri en samanburðarhópurinn til að hafa sykursýki og blóðfituröskun. 18 Aðrar rannsóknir benda einnig til þess að ekki sé munur á tíðni háþrýstings, sykursýki, reykinga og blóðfituröskunar milli heilbrigðra og þeirra sem fengið hafa hálsaeðaflysjun. 19 Einungis einn einstaklingur í þýðinu hafði þekkta sögu um fyrri flysjun (0,9%) og fimm einstaklingar fengu endurtekna flysjun á eftirfylgdartímabilinu (4,6%). ...

Risk Profile of Patients with Spontaneous Cervical Artery Dissection

Annals of Neurology

... 98,99 At the same time, HF is associated with well-known stroke risk factors, such as hypertension, AF, coronary artery disease, obesity, and (Table 5). Previous studies reported that the presence of HF was associated with unfavorable functional outcomes [101][102][103] or higher in-hospital mortality after MT. 101,103 In the study by Tan et al, the presence of HF was associated with a worse outcome even in patients who obtained successful reperfusion. 103 A possible explanation for these findings is that HF might contribute to a decrease of the global cerebral blood flow, collateral flow, and cerebral vasomotor reactivity and predisposes to hypoperfusion during MT. ...

Mechanical thrombectomy in patients with heart failure: the Italian registry of Endovascular Treatment in Acute Stroke

Neurological Sciences

... A total of 4668 articles were initially identified as potentially relevant. Following the removal of duplicates and screening of titles and abstracts to exclude irrelevant studies, case reports, and reviews, 21 articles [3,4,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] met all inclusion criteria. The details of our literature search can be found in supplementary online Table S1 and Fig S1. ...

Carotid artery stenting during endovascular thrombectomy for acute ischemic stroke with tandem occlusion: the Italian Registry of Endovascular Treatment in Acute Stroke
  • Citing Article
  • September 2022

Acta neurologica Belgica

... In the Italian Project on Stroke in Young Adults-Cervical Artery Dissection (IPSYS CeAD), individuals with spontaneous sCeAD displayed elevated prevalence rates of HTN (OR: 1.65), migraine (OR: 2.45) and vascular disease family history in rst-degree relatives (OR: 1.69) relative to those without stroke [27]. These studies only focused on extracranial arterial dissection; there are no existing studies comparing potential risk factors between patients who have IAD and individuals without the condition who are healthy. ...

Antithrombotic therapy in the postacute phase of cervical artery dissection: The Italian Project on Stroke in Young Adults Cervical Artery Dissection
  • Citing Article
  • May 2022

Journal of Neurology, Neurosurgery, and Psychiatry

... CTA is used to determine collateral flow by many people, clinics, and centers because it is non-invasive, easy to use, and easily accessible and allows rapid evaluation, among other things [10,11,18]. Although many scoring systems (the Alberta Stroke Program Early CT Score (ASPECTS), Christoforidis collateral score, Miteff collateral score, Maas collateral score, Tan collateral score, Careggi collateral score, and Souza collateral score) have been used to evaluate the CTA collateral system, there is still no consensus on scoring [9,13,[18][19][20][21][22]. Patients with a malignant profile are less likely to benefit from revascularization treatment due to the risk of having a large infarct volume before treatment. ...

Association of the careggi collateral score with radiological outcomes after thrombectomy for stroke with an occlusion of the middle cerebral artery

Journal of Thrombosis and Thrombolysis

... In addition, the provision of EVT could result in a suboptimal outcome in stroke treatment for women when it is associated with other factors such as socioeconomics and accessibility [11][12][13]. Prior studies [39,[45][46][47][48][49] assessing sex differences in thrombectomy outcomes found no differences in the rates of reperfusion and time to reperfusion, nor significant differences in 90-day neurological outcomes between transportation to a local stroke center (drip-andship) and a thrombectomy-capable (mothership model) referral center [50,51]. According to the results, women with strokes from the area would be a target population with high-cost benefits associated with residual disability and the need for post-episode care. ...

Sex differences in outcome after thrombectomy for acute ischemic stroke. A propensity score-matched study
  • Citing Article
  • April 2022

European Stroke Journal

... All of the subsequent inclusion criteria had to be fulfilled before a study could be incorporated into this meta-analysis: (1) studies evaluating endovascular treatment for patients with an extended time window for stroke (> 24 h); (2) reported any of the outcomes of interest; and (3) was either a randomized control trial or a nonrandomized cohort. The exclusion criteria were: (1) studies not published in English; ...

Endovascular treatment beyond 24 hours from the onset of acute ischemic stroke: the Italian Registry of Endovascular Thrombectomy in Acute Stroke (IRETAS)
  • Citing Article
  • November 2021

Journal of Neurointerventional Surgery

... 14 Predisposing connective tissue diseases include Marfan disease, Ehlers-Danlos syndrome, autosomal dominant poly cystic kidney disease, alpha1-antitrypsin deficiency and hereditary hemochromatosis. 15 Other predisposing conditions have been identified, including fibromuscular dysplasia, 16,17 pregnancy and post-partum, 18 systemic inflammatory diseases and connectivitis (infection, lupus, Horton's disease, etc.). 19 We have described the case of a patient with concurrent dissection of the anterior inter-ventricular artery and the internal carotid artery. ...

Clinical Features of Patients With Cervical Artery Dissection and Fibromuscular Dysplasia
  • Citing Article
  • January 2021

Stroke