, Hosp Universitari Vall d'Hebró n
, Hosp del Mar
, André s García-Pastor, Hosp Gregorio Marañ ó n, Hosp Universitari Germans Trias i Pujol
, Hosp Son Dureta
, Stroke Project of the Spanish Cerebrovascular Diseases Study Group Author Disclosures: W.J. Meurer: Research Grant
,
,
, Author Disclosures: I. Katzan: None. E. Novak: None. N. Obuchowski: None. M. Modic: Consultant/Advisory Board; Modest
,
, Pritzker Sch of Medicine
, There were no significant associations between ICH and any lipid profiles
,
,
,
, Florey Neuroscience Institutes
,
, Cntr of Functionally Integrative Neuroscience
,
, Stroke Unit, Joaquín Serena, Stroke Unit. Dept of Neurology
,
, Stroke Project of the Cerebrovascular Diseases Study Group
, None. Th P199 Positional Sleep Apnea In Patients With Acute Stroke Millene Camilo
, All AIS patients receive hydration via 1-2liter NS bolus and infusion of ?150cc/hr. Data collected included patient demographics, DM, HTN, chronic kidney disease (CKD), use of Metformin, ACE-I, ARB, and/or diuretics, baseline and highest Creatinine values in the following 5days. An increase of Creatinine ?25% from baseline was considered significant. Results: 91 patients (54% men) with mean age of 61?13.5years were included, of whom 31(34%) had cerebral angiograms with 109.3?42ml of additional contrast. DM and CKD were reported in 31(34%) patients and 69(75%) patients had HTN. Forty-five patients (49%) were on Metformin, ACE-I/ARB, and/or diuretics. The mean baseline Creatinine was 0.95?0.41. No patient had ?25% increase in Creatinine and no patient needed dialysis. There was no clinically or statistically significant difference in baseline vs
,
, We aimed to evaluate whether gender differences may also influence recanalization, early and long-term outcome and mortality in acute stroke patients treated with intraarterial (IA) reperfusion procedures. Methods: Consecutive stroke patients treated with IA procedures between, 2006.
, No differences were found in clinical improvement at discharge (W 47.1% vs M 49.1%, p?0.830), hemorrhagic transformation (34.6% vs 30.4%, p?0.637), 7% vs 71.7%, p?0.899) and occurred at a comparable symptoms-to-recanalization time (W 329.9min vs M 338.1min, p?0.778)
, Author Disclosures: O. Maisterra: None. M. Ribo: None. M. Quintana: None. J. Sargento: None
,
,
, We investigated the clinical impact of DE in patients treated with various methods of recanalization therapy. Methods: Ischemic stroke patients from 2005 to 2010, treated with either IV tPA alone or ERT with or without IV tPA, were identified in a prospectively maintained database. Post-treatment MR imaging for all patients was evaluated for changes consistent with DE. Catheter angiograms for ERT patients were evaluated for evidence of DE. Successful recanalization (SR) for ERT patients was defined as TICI 2b or 3, and recanalization for IV tPA patients was determined using post-treatment MRA. Variables analyzed included demographics, clinical history, laboratory and imaging findings, method of recanalization, initial NIHSS, and discharge modified Rankin Score (mRS). Results: Among 18 patients treated with IV tPA only, the mean age was 67.2 (range 41-97), 55.6% were female, and median initial NIHSS was 11.5. Among 50 ERT patients, mean age was 67.4 (range 29-95), 62% were female, and median initial NIHSS was 18.5. For ERT patients, p.1
, Therapies for ERT patients were Merci retriever alone in 50%, Merci retriever plus IV or IA tPA in 27%, IA tPA alone in 6%, and other in 17%. SR was achieved in 32% of ERT. Recanalization was seen on post-treatment MRA in 40% of those receiving IV tPA. SR was seen in 70% of ERT patients with final mRS 0-2, and 23% of those with final mRS 3-6 (P?0.012). DE was seen in 46% of ERT patients and 13% of IV tPA patients, pp.36-64
, For ERT patients who had both DE and SR, 60% had final mRS 0-2 and 7.5% had final mRS 3-6 (p?0.001). Conclusions: Distal embolization occurs in nearly half of patients treated with endovascular recanalization therapy. Good functional outcomes are associated with the presence of DE, likely because DE indicates recanalization of occluded vessels, ERT patients with non-disabled (mRS 0-2) than disabled outcomes, 80% vs 37.5% (P?0.04)
, Research Grant; Modest; NIH. Consultant/Advisory Board
, None. Th P211 Safety and Efficacy of Early Blood Pressure Reduction in Acute Ischemic Stroke: An Interim Analysis of VENTURE Trial Kyung-Ho Yu, Hallym Univ
, Asan Med Cntr
, Nowon Eulji Hosp
,
, Hallym Univ
,
, We assessed time from symptom onset to end of procedure as well as imaging parameters including: the extent of infarction, based on the Alberta Stroke Program Early CT Score (ASPECTS), site of angiographic occlusion, succesful recanalization (defined as a Thrombolysis in Myocardial Infarction score of ?2), and extent of intracranial collaterals. Collaterals were stratified according to a previously published classification system based on the most proximal reconstitution of the middle cerebral artery (MCA) segments. Hence, any reconstitution of the M1 segment was given a score of 1, any reconstitution upto the M2 segment was given a score of 2, etc. A score of 5 represented absent collaterals. Other parameters studies were recanalization with an ASPECTS score ? 8 and recanalization with a collateral score ?2 and ?3 respectively, We sought to determine which neuro-imaging parameters during intra-arterial (IA) thrombolysis can predict good functional recovery. Methods: With institutional approval from each center, 2006.
, Hosp Universitari Vall d'Hebró n
, Hosp del Mar-IMIM
, Dá valos A. Soft Hyperdense Areas on CT Scan after Endovascular Treatment in Acute Ischemic Stroke of the Anterior Territory: a Sign of Successful Recanalization and Good Outcome. Hyperdense lesions (HDL) on CT scan 24h after endovasand HDL were classified according to location, Hosp Universitari Vall d'Hebró n
, Age, gender, risk factors, prior antithrombotic therapy, vital signs, site of arterial occlusion, early CT signs of ischemia and bridging therapy with iv tPA were not different between groups, but admission serum glucose levels were higher in all HDL groups compared with the non-HDL group (p?0.02). Good outcome at 3 months was achieve in 40% of non-HDL, 64% of soft, 0% of bright and 25% of subarachnoid HDL patients (p?0.004), Results: 35/109 (32.1%) patients showed HDL: soft HDL in 12 (11%), bright in 15 (13.8%) and subarachnoid in 8 (7.3%)
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,
, Abstracts and presentations are embargoed for release at date and time of presentation or time of AHA/ASA news event. Information may not be released before then. Failure to honor embargo policies will result in the abstract being withdrawn and barred from presentation
, Author Disclosures
, Consultant/Advisory Board; Modest; ev3 Neurovascular, Jovin: Ownership Interest; Modest
, Results: Among the 1,348 AIS patients who presented to our hospital within the study period, 118 subjects (8.7%) met criteria for LTB (mean age 66?14.8 years; 40% women; 93% Caucasian). Of those LTB, 62 (52%) underwent IAT. There was a significant increase in rates of IAT after protocol implementation, Consultant/Advisory Board
, Compared with those who were not treated, patients selected for IAT were older
, Following multivariable adjustment, only age (OR 0p?0.6). Conclusions: Most AIS patients did not meet our criteria for LTB, and only 52% of those defined as LTB overall received IAT. Adoption of the protocol increased use of IAT over time, across all stroke staff members, 3?15 years, P?0.03), received IV tPA prior to IAT more often (58.6% vs. 41.4%, P?0.02), had shorter median LKW to arrival time (2.7 vs. 3.5 hours, P?0.02), and were less often diabetic (11.3% vs. 26.8%, P?0.03)
, Nogueira: Consultant/Advisory Board; Modest; ev3 Neurovascular, Inc; CoAxia Inc; Rapid Medical, Inc. Consultant/Advisory Board; Significant; Concentric Medical, Inc. A.J. Yoo: Other Research Support
, Ownership Interest; Modest
, Consultant/Advisory Board; Modest; Intratech Medical. L.H. Schwamm: Consultant/Advisory Board
,
, Mean age was 85.8 ? 4.6 years (range 80-103), 13.6% had pre-stroke dementia, 31.2% were men, 88.3% were white, and 98% were ambulatory prior to admission. Median NIHSS score on admission was 16 (IQR 11-20). Ten patients (6.5%) had sICH, of whom 3 (30%) had pre-stroke dementia, 6 (60%) received IV tPA alone, 2 (20%) received IAT alone, and 2 (20%) received both. Good outcome occurred in 84/154 (54.5%) patients, of whom 64 (59%) received IV tPA, 22 (41%) received IAT, and 3 (3.5%) received both. In-hospital mortality rate was 35% (57% in IV tPA, We retrospectively identified all AIS patients age ? 80 yr who received IV or intra-arterial thrombolysis (IAT) in our Get With the Guidelines Stroke, vol.80, p.95
, NIHSS (OR 0.89 per point, 95%CI 0.84-0.95) as well as with sICH, p.95
, IAT, and pre-stroke dementia
, Author Disclosures: K. Busl: None. R.G. Nogueira: Consultant/Advisory Board; Modest, p.3
, Other Research Support; Significant; Penumbra, Inc. J.A. Hirsch: Ownership Interest; Modest; Intratech Medical. Consultant/Advisory Board; Modest
, Intratech Medical. L.H. Schwamm: Consultant/Advisory Board; Modest
, International Steering Committee/DIAS-4 ). Consultant/Advisory Board; Significant
, Research Grant; Significant
,
, Seiai Rehabilitation Hosp
, Statin group was also divided into early-statin group; statin being started before or within 14 days of admission to our institute (n?70), and late-statin group (n?14); ibid., after 14 days of admission. The effects of neurological improvement were assessed by Functional Independence Measure (FIM) and Barthel Index (BI). Results: Cholesterol data of 2 groups were not different (T-Chol 175, n?84) and non-statin group (age 72.7?12.9 years, n?219)
, Systolic and diastolic blood pressure was not different (118.8?1.9 and 68.8?10.5 mmHg as statin group, 119.1?15.9 and 69.1?10.6 mmHg as non-statin group), 5?3.1, LDL-Chol 109.8?27.0 mg/dl as non-statin group
, there might be no significant gains. Conclusion: Statin group showed much more improvement in cognitive FIM score during post-rehabilitation periods. Because this is a retrospective study, functional scores on the admission period were not even, namely e.g., early statin group had already higher scores on the stage of admission. However, even late timing of administration of statin may have a role to improve neurological function on ischemic stroke patients in convalescence stage, Although there were no differences on FIM gain (19.9?17.2 and 18.7?18.9) and BI gain (21.0?15.4 and 17.6?15.8). Late-statin group showed a higher improvement in cognitive FIM score gain as compared with that in early-statin group and non-statin group (5.4?5.7, 1.9?4.7 and 1.6?6.0, respectively, P?0.05) and BI gain (27.1?17.4, 21.2?15.9 and 17.1?16.4, respectively, P?0.05). Because early statin group had already better FIM scores in comparison to non-statin group (cognitive 26.3?7.7 and motor 52.1?17.9, as compared with cognitive 24.2?9.1 and motor 47.2?18.7, p?0.08 and p?0.058, respectively)
, Research Grant; Modest; This study was supported by the Korea Research Foundation Grant, pp.810-20080029
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, International Clinical Rsch Cntr
,
,
, Neurology department
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,
,
, Eulji General Hosp
, Seoul Med Cntr
,
,
, Ilsan Paik Hosp
,
,
, Republic of Grant; Modest, Clinical Research Center for Stroke. Y. Cho: Research Grant; Modest
,
, For both AUC-ROC and IDI analyses, two models were used. Patients' outcome (3-month mRS 3-6, 4-6, 5-6, or mortality) was used as a dependent variable in both models. As independent variables, model 1 (M1) included age, baseline NIHSS score, baseline glucose level, OTT, and presence of hyperdense artery sign or artery occlusion in any cerebral artery on baseline imaging. Model 2 (M2) included the same variables as M1 plus information on presence/lack of sICH (separately for each definition). Findings The frequency of sICH was 2, vol.9, 1995.
, Author Disclosures: D. Strbian: None. T. Sairanen: None. A. Meretoja: Honoraria; Modest
, Kaste: Speakers; Modest; Boehringer-Ingelheim. Honoraria; Modest; Steering Committee meetings of ECASS, None. O. Salonen: None. H. Silvennoinen: None. M
, Research Grant
, BrainsGate. Consultant/Advisory Board; Modest
,
, Outcomes were QOL, measured via the Stroke-Specific QOL Scale (SS-QOL) and reported as QOL domain means (standard deviation (SD)), and percent of recurrent TIA/stroke during follow-up. Results: Of the 83 patients identified in the database, 67 survived to hospital discharge and were sent surveys; there were 40 responses (response rate 60%), 11 of which represented interim deaths. Of the 29 surviving respondents, 31% were female, mean age was 59.8 (SD?13.1), and follow-up length was a median of 26.3 months (IQR 17.5, 41.2). Initial median NIHSS for all 83 patients was 15, vol.20, 2005.
, In-hospital mortality was 19%, overall mortality was 32.5%, and the percent of recurrent TIA/stroke during follow-up was 2.4%. The overall, aggregate SS-QOL score was
, survivors of ischemic stroke who have undergone intra-arterial therapy over a 5 year period report good QOL. The domains with the lowest perceived QOL are in energy levels and social roles; the highest are in vision and self care. Patient-centered outcomes, such as QOL, should be included in all acute stroke trials, Conclusions: : In this single center study
, None. Th P287 Stroke Care and Outcomes in Patients With Pre-existing Dementia
, Institute for Clinical Evaluative Sciences
, Using multivariate logistic regression, the data was analyzed for differences in post-stroke disposition among patients with UI. Results: Home vs. Other Level of Care: Of 3744 patients, a total of 3260 were included in the analysis. Approximately 1593 were discharged home, 1667 to another level of care, on behalf of the Investigators of the Registry ofthe Canadian Stroke Network, vol.65, 2004.
, None. E. Noser: None. J. Grotta: None
, Other Research Support; Modest
,
,
, Research Grant; Modest
, Kanter Health. Honoraria; Modest
, Consultant/Advisory Board; Modest, Victhom Human Bionics. Author Disclosures: D. Tong: Honoraria; Modest; Genentech. X. Zhao: None. D. Olson: Consultant/Advisory Board; Modest; Sanofi-Aventis. M. Reeves: None. G. Fonarow: Research Grant
, Ownership Interest; Modest; UCLA
, Advisory Board; Significant; Novartis. Other; Modest; GWTG steering committee. L. Schwamm: Consultant/Advisory Board; Modest; GWTG Chair (unpaid), Consultant/Advisory Board
, Massachusetts Department of Public Health. E. Smith: Consultant/Advisory Board; Modest; Genentech
,
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, Republic of Yongchai Nilanont, Siriraj Hosp
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, Brigham and Women hospital
,
,
,
, Stanford Sch of Medicine
, The Children's Hosp of Philadelphia
, 7% agreement. IVH score and manual IVH volume correlation was fair, R2?0.52. At a median of 10 months (1-28 months), 25 children had KOSCHI ?5. There were 2 deaths, both had ICH volume ?4% of TBV, IVH scores ?5, and herniation. Presence of hydrocephalus showed a trend for poorer outcome (p?0.09). Presence of IVH, high IVH score, or high IVH volume did not predict poor outcome or functional impairment in univariable or multivariable analyses. Conclusion: Only large ICH volume predicted poor outcome. Despite excellent agreement between raters, the IVH score and other measures of IVH did not predict outcome in this small pediatric sample. Hydrocephalus showed a trend toward poor outcome, and therefore may be important as a marker of clinically significant IVH, Children, full term to 17 years, with spontaneous ICH and/or IVH on CT or MRI were prospectively enrolled from 2007-9, p.93
, Critical Event Committee for an FDA-monitored device trial
,
,
, Seoul Med Cntr
,
,
, Republic of of the afterload, coiling has higher SVRI and MAP than clipping group (SVRI: coiling 2166 vs. clipping 1848, MAP coiling 108 mmHg vs. clipping 101 mmHg). Conclusions: We first show that systemic
, mmHg), less education (8.0 vs. 9.0 years), more history of minor stroke (6.8% vs. 1.7%), higher creatinine (61.9 vs.59.2 mol/L), and lower GFR (72.8 vs. 75.3 mL/min/1.73 m2). When possible confounders were entered into the multivariate logistic regression model (the forward stepwise method), the independent predictors of frontal lobe dysfunction were diastolic BP (odds ratio 1.023; 95% CI 1.001 to 1.045 per 1 mmHg), GFR (odds ratio 0.848; 95% CI 0.737 to 0.975 per 10 mL/min/1.73 m2), and number of lacune(s) (odds ratio 1.471; 95% CI 1.135 to 1.908). The score of Stroop test was compared according to the GFR category with ANCOVA adjusted for age and diastolic BP. The mean of logarithmic-transformed scores of Stroop test in the GFR?60 mL/min/1.73 m2 group was 1.376 (95%CI 1.301-1.451), which was significantly higher (worse) than 1.250 (95%CI 1.214-1.285) in the GFR 60-89 mL/min/1.73 m2 group (p?0.009). CKD was not related to global cognition defined by Mini-Mental State Examination. Conclusions: The present study showed that CKD, high blood pressure, and subclinical lacunar infarction might contribute to frontal lobe dysfunction. The intervention directed at treatment and prevention of CKD, Subclinical Lacunar Infarction And Chronic Kidney Disease Are Independently Associated With Frontal Lobe Dysfunction In Community-dwelling Elderly Subjects -The Sefuri Brain MRI Study Hiroshi Yao