The Massachusetts Emergency Medical Service Stroke Quality Improvement Collaborative, 2009–2012

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CDC: September 26, 2013 Introduction Quality improvement collaboratives are a popular model used to address gaps between evidence-based practice and patient care. Little is known about use of such collaboratives in emergency medical services, particularly for improving prehospital stroke care. To determine the feasibility of using this approach to improve prehospital stroke care, we conducted […]

Burden and Outcome of Prevalent Ischemic Brain Disease in a National Acute Stroke Registry

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STROKEAHA: September 24, 2013 Background and Purpose—Previous overt stroke and subclinical stroke are frequent in patients with stroke; yet, their clinical significance and effects on stroke outcome are not clear. We studied the burden and outcome after acute ischemic stroke by prevalent ischemic brain disease in a national registry of hospitalized patients with acute stroke. Methods—Patients […]

Systemization of advanced stroke care: the dollars and sense of comprehensive stroke centers

Ischemic Stroke

J NeuroIntervent Surg: September 23, 2013 Stroke center designation is an integral component of maintaining the systems of care for cerebrovascular diseases.1 Organization of hospitals into efficient vehicles of healthcare delivery helps improve clinical outcomes.2 The approval of IV tissue plasminogen activator (tPA) for acute ischemic stroke (AIS) highlighted the need for specialized stroke centers able to quickly […]

Prospective, Multicenter, Single-Arm Study of Mechanical Thrombectomy Using Solitaire Flow Restoration in Acute Ischemic Stroke

AHA Stroke: August 1, 2013 Background and Purpose—Mechanical thrombectomy using stent retriever devices have been advocated to increase revascularization in intracranial vessel occlusion. We present the results of a large prospective study on the use of the Solitaire Flow Restoration in patients with acute ischemic stroke. Methods—Solitaire Flow Restoration Thrombectomy for Acute Revascularization was an international, multicenter, […]

Serum Fatty Acids and Incidence of Ischemic Stroke Among Postmenopausal Women

AHA Stroke.: July 30, 2013 Background and Purpose—Although studies have linked types of fatty acids with coronary heart disease, data on individual fatty acids and risk of ischemic stroke are limited. We aimed to examine the associations between serum fatty acid concentrations and incidence of ischemic stroke and its subtypes. Methods—We conducted a prospective case–control study nested […]

Associations Between Hospital Thrombolysis Volume and Speed of Thrombolysis Administration in Acute Ischemic Stroke

STROKEAHA: September 19, 2013 Background and Purpose—There is evidence that high-volume hospitals may produce better patient outcomes. We aimed to identify whether there were any associations between hospital thrombolysis volume and speed of thrombolysis (tissue-type plasminogen activator [tPA]) administration in patients with ischemic stroke. Read more

Identifying delays to mechanical thrombectomy for acute stroke: onset to door and door to clot times

NeuroIntervent Surg:  9/19/13 Outcomes from endovascular therapy for acute stroke are time dependent. Delays in the administration of this therapy have not been extensively studied and no performance benchmarks have been established. There are limited data on the complex factors that can affect these delays. In this review, we discuss the existing literature on the […]

Association of Geographical Factors With Administration of Tissue Plasminogen Activator for Acute Ischemic Stroke

J Am Heart Assoc.: 9/17/13   Background Intravenous tissue plasminogen activator (tPA) is an effective treatment for acute ischemic stroke if administered within a few hours of stroke onset. Because of this time restriction, tPA administration remains infrequent. Ambulance use is an effective strategy for increasing tPA administration but may be influenced by geographical factors. The objectives […]

Temporal Trends in Patient Characteristics and Treatment With Intravenous Thrombolysis Among Acute Ischemic Stroke Patients at Get With the Guidelines–Stroke Hospitals

AHA: Cardiovascular Quality and Outcomes 9/1/13   Background—Substantial efforts over the past decade have increased rates of intravenous tissue plasminogen activator (tPA) use in the United States. We sought to determine changes in patient characteristics and rates of tPA use over time among hospitalized acute ischemic stroke (AIS) patients. Methods and Results—We analyzed all AIS patients […]

Early Dual versus Mono Antiplatelet Therapy for Acute Non-Cardioembolic Ischemic Stroke or Transient Ischemic Attack: An Updated Systematic Review and Meta-Analysis

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CIRCULATIONAHA: September 12, 2013 Background—Emerging studies suggest that early administration of dual antiplatelet therapy may be better than monotherapy for prevention of early recurrent stroke and cardiovascular outcomes in acute ischemic stroke (IS) and transient ischemic attack (TIA). We performed a meta-analysis of randomized controlled trials (RCTs) evaluating dual versus mono antiplatelet therapy for acute non-cardioembolic […]

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