Aggressive Medical Treatment With or Without Stenting in High-Risk Patients With Intracranial Artery Stenosis (Sammpris): The Final Results of a Randomised Trial
Colin P. Derdeyn,Marc I. Chimowitz,Michael J. Lynn,David Fiorella,Tanya N. Turan,L. Scott Janis,Jean Montgomery,Azhar Nizam,Bethany F Lane,Helmi L. Lutsep,Stanley L. Barnwell,Michael F. Waters,Brian L. Hoh,J. Maurice Hourihane,Elad I. Levy,Andrei V. Alexandrov,Mark R. Harrigan,David Chiu,Richard P. Klucznik,Joni Clark,Cameron G. McDougall,Mark D. Johnson,G. Lee Pride,John R. Lynch,Osama O. Zaidat,Zoran Rumboldt,Harry J. Cloft +26 more
TLDR
The findings lend support to the use of aggressive medical management rather than PTAS with the Wingspan system in high-risk patients with atherosclerotic intracranial arterial stenosis.About:
This article is published in The Lancet.The article was published on 2014-01-25 and is currently open access. It has received 614 citations till now. The article focuses on the topics: Angioplasty & Stroke.read more
Citations
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Guidelines for the Early Management of Patients With Acute Ischemic Stroke A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
William J. Powers,Alejandro A. Rabinstein,Teri Ackerson,Opeolu Adeoye,Nicholas C. Bambakidis,Kyra J. Becker,José Biller,Michael D. Brown,Bart M. Demaerschalk,Brian L. Hoh,Edward C. Jauch,Chelsea S. Kidwell,Thabele M Leslie-Mazwi,Bruce Ovbiagele,Phillip A. Scott,Kevin N. Sheth,Andrew M. Southerland,Deborah V. Summers,David L. Tirschwell +18 more
TL;DR: These guidelines supersede the prior 2007 guidelines and 2009 updates and support the overarching concept of stroke systems of care and detail aspects of stroke care from patient recognition; emergency medical services activation, transport, and triage; through the initial hours in the emergency department and stroke unit.
Journal ArticleDOI
Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.
William J. Powers,Alejandro A. Rabinstein,Teri Ackerson,Opeolu Adeoye,Nicholas C. Bambakidis,Kyra J. Becker,José Biller,Michael D. Brown,Bart M. Demaerschalk,Brian L. Hoh,Edward C. Jauch,Chelsea S. Kidwell,Thabele M Leslie-Mazwi,Bruce Ovbiagele,Phillip A. Scott,Kevin N. Sheth,Andrew M. Southerland,Deborah V. Summers,David L. Tirschwell +18 more
TL;DR: These guidelines detail prehospital care, urgent and emergency evaluation and treatment with intravenous and intra-arterial therapies, and in-hospital management, including secondary prevention measures that are appropriately instituted within the first 2 weeks.
Journal ArticleDOI
Clopidogrel with Aspirin in Acute Minor Stroke or Transient Ischemic Attack
Yongjun Wang,Yilong Wang,Xingquan Zhao,Liping Liu,David Wang,Chunxue Wang,Chen Wang,Hao Li,Xia Meng,Liying Cui,Jianping Jia,Qiang Dong,Anding Xu,Jinsheng Zeng,Yansheng Li,Zhimin Wang,Haiqin Xia,S. Claiborne Johnston +17 more
TL;DR: Among patients with TIA or minor stroke who can be treated within 24 hours after the onset of symptoms, the combination of clopidogrel and aspirin is superior to aspirin alone for reducing the risk of stroke in the first 90 days and does not increase the riskof hemorrhage.
Journal ArticleDOI
Stroke Risk Factors, Genetics, and Prevention
TL;DR: Research into risk factors and genetics of stroke has not only identified those at risk for stroke but also identified ways to target at-risk populations for stroke prevention.
Journal ArticleDOI
2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
William J. Powers,Alejandro A. Rabinstein,Teri Ackerson,O.M. Adevoe,Nicholas C. Bambakidis,Kyra J. Becker +5 more
TL;DR: I alteplase treatment should be administered within 3 hours of acute ischemic stroke in appropriate patients and should not be delayed while waiting for hematologic or coagulation testing if there is no reason to suspect an abnormal test.
References
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Journal ArticleDOI
Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis
Marc I. Chimowitz,Michael J. Lynn,Harriet Howlett-Smith,Barney J. Stern,Vicki S. Hertzberg,Michael Frankel,Steven R. Levine,Seemant Chaturvedi,Scott E. Kasner,Curtis G. Benesch,Cathy A. Sila,Tudor G Jovin,Jose G. Romano +12 more
TL;DR: Warfarin was associated with significantly higher rates of adverse events and provided no benefit over aspirin in this trial, and aspirin should be used in preference to warfarin for patients with intracranial arterial stenosis.
Journal ArticleDOI
Analysis of pooled data from the randomised controlled trials of endarterectomy for symptomatic carotid stenosis.
Peter M. Rothwell,Michael Eliasziw,Sergei A. Gutnikov,Allan J. Fox,D W Taylor,Mayberg,Charles Warlow,H. J. M. Barnett +7 more
TL;DR: Re-analysis of the trials with the same measurements and definitions yielded highly consistent results, indicating that surgery is of some benefit for patients with 50-69% symptomatic stenosis, and highly beneficial for those with 70% symptome stenosis or greater but without near-occlusion.
Journal ArticleDOI
Stenting versus Aggressive Medical Therapy for Intracranial Arterial Stenosis
Marc I. Chimowitz,Michael J. Lynn,Colin P. Derdeyn,Tanya N. Turan,David Fiorella,Bethany F Lane,L. Scott Janis,Helmi L. Lutsep,Stanley L. Barnwell,Michael F. Waters,Brian L. Hoh,J. Maurice Hourihane,Elad I. Levy,Andrei V. Alexandrov,Mark R. Harrigan,David Chiu,Richard P. Klucznik,Joni Clark,Cameron G. McDougall,Mark D. Johnson,G. Lee Pride,Michel T. Torbey,Osama O. Zaidat,Zoran Rumboldt,Harry J. Cloft +24 more
TL;DR: In patients with intracranial arterial stenosis, aggressive medical management was superior to PTAS with the use of the Wingspan stent system, both because the risk of early stroke after PTAS was high and because therisk of stroke with aggressive medical therapy alone was lower than expected.
Journal ArticleDOI
Clopidogrel with Aspirin in Acute Minor Stroke or Transient Ischemic Attack
Yongjun Wang,Yilong Wang,Xingquan Zhao,Liping Liu,David Wang,Chunxue Wang,Chen Wang,Hao Li,Xia Meng,Liying Cui,Jianping Jia,Qiang Dong,Anding Xu,Jinsheng Zeng,Yansheng Li,Zhimin Wang,Haiqin Xia,S. Claiborne Johnston +17 more
TL;DR: Among patients with TIA or minor stroke who can be treated within 24 hours after the onset of symptoms, the combination of clopidogrel and aspirin is superior to aspirin alone for reducing the risk of stroke in the first 90 days and does not increase the riskof hemorrhage.
Journal Article
A Standardized Method for Measuring Intracranial Arterial Stenosis
TL;DR: This method shows good interobserver and intraobserver agreements for the measurement of intracranial stenosis of a major artery and may serve as a standard for this measurement.
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