Endovascular thrombectomy with or without systemic thrombolysis?

Journal article

Georgios Tsivgoulis, Aristeidis H Katsanos, Dimitris Mavridis, Anne Alexandrov, Georgios Magoufis, Adam Arthur, Valeria Caso, Peter D. Schellinger and Andrei V. Alexandrov. (2017). Endovascular thrombectomy with or without systemic thrombolysis? Therapeutic Advances in Neurological Disorders. 10(3), pp. 151-160. https://doi.org/10.1177/1756285616680549
AuthorsGeorgios Tsivgoulis, Aristeidis H Katsanos, Dimitris Mavridis, Anne Alexandrov, Georgios Magoufis, Adam Arthur, Valeria Caso, Peter D. Schellinger and Andrei V. Alexandrov
Abstract

Objectives:
Current recommendations advocate that pretreatment with intravenous thrombolysis (IVT) should first be offered to all eligible patients with emergent large vessel occlusion (ELVO) before an endovascular thrombectomy (ET) procedure. However, there are observational data that question the safety and efficacy of IVT pretreatment in patients with ELVO.

Methods:
We performed a meta-analysis of the included subgroups from ET randomized controlled trials (RCTs) to evaluate the comparative efficacy between direct ET without IVT pretreatment and bridging therapy (IVT and ET) in patients with ELVO.

Results:
We included a total of seven RCTs, including 1764 patients with ELVO (52.8% men). Patients receiving bridging therapy (IVT followed by ET) had lower rates (p = 0.041) of 90-day death/severe dependency (modified Rankin Scale-score of 5–6; 19.0%, 95% CI: 14.1–25.1%) compared with patients receiving only ET (31.0%, 95% CI: 21.2–42.9%). Moreover, patients receiving IVT and ET had a nonsignificant (p = 0.389) trend towards higher 90-day functional independence rates (51.4%, 95% CI: 42.5–60.1%) compared with patients undergoing only ET (41.7%, 95% CI: 24.1–61.7%). Finally, shift-analysis uncovered a nonsignificant trend towards functional improvement at 90 days for bridging therapy over ET (cOR = 1.28, 95% CI: 0.91–1.89; p = 0.155). It should be noted that patients included in the present meta-analysis were not randomized to receive IVT, and thus the two groups (bridging therapy versus ET monotherapy) may differ in terms of baseline characteristics and, in particular, in terms of onset to groin puncture time and thus the risk of confounding bias cannot be ruled out.

Conclusion:
Despite the limitations and the risk of confounding bias, our findings contradict the recent notion regarding potential equality between ET and bridging therapy in ELVO patients and suggest that IVT and ET are complementary therapies that should be pursued in a parallel and noncompeting fashion.

Keywordsacute ischemic stroke; emergent large vessel occlusion; intravenous thrombolysis; mechanical thrombectomy; meta-analysis
Year2017
JournalTherapeutic Advances in Neurological Disorders
Journal citation10 (3), pp. 151-160
PublisherSage Publications Ltd.
ISSN1756-2856
Digital Object Identifier (DOI)https://doi.org/10.1177/1756285616680549
Scopus EID2-s2.0-85015003307
Publisher's version
File Access Level
Controlled
Publication process dates
Deposited14 May 2021
Permalink -

https://acuresearchbank.acu.edu.au/item/8w0y5/endovascular-thrombectomy-with-or-without-systemic-thrombolysis

Log in to edit

Restricted files

Publisher's version

  • 108
    total views
  • 0
    total downloads
  • 8
    views this month
  • 0
    downloads this month
These values are for the period from 19th October 2020, when this repository was created.

Export as

Related outputs

Safety and efficacy of sonothrombolysis for acute ischaemic stroke : A multicentre, double-blind, phase 3, randomised controlled trial
Alexandrov, Andrei V., Köhrmann, Martin, Soinne, Lauri, Tsivgoulis, Georgios, Barreto, Andrew D., Demchuk, Andrew M., Sharma, Vijay K., Mikulik, Robert, Muir, Keith W., Brandt, Gordon, Alleman, John, Grotta, James C., Levi, Christopher R., Molina, Carlos A., Saqqur, Maher, Mavridis, Dimitris, Psaltopoulou, Theodora, Vosko, Milan, Fiebach, Jochen B., ... Schellinger, Peter D.. (2019). Safety and efficacy of sonothrombolysis for acute ischaemic stroke : A multicentre, double-blind, phase 3, randomised controlled trial. The Lancet Neurology. 18(4), pp. 338-347. https://doi.org/10.1016/S1474-4422(19)30026-2
Does the addition of non-approved inclusion and exclusion criteria for rtPA impact treatment rates? Findings in Australia, the UK, and the USA
Craig, Louise E., Middleton, Sandy, Hamilton, Helen, Cudlip, Fern, Swatzell, Victoria, Alexandrov, Andrei V., Lightbody, Elizabeth, Watkins, Caroline, Philip, Sheeba, Cadihac, Dominique A., McInnes, Elizabeth, Dale, Simeon and Alexandrov, Anne W.. (2019). Does the addition of non-approved inclusion and exclusion criteria for rtPA impact treatment rates? Findings in Australia, the UK, and the USA. Interventional Neurology. 8(1), pp. 1-12. https://doi.org/10.1159/000493020
Admission hyperglycemia and outcomes in large vessel occlusion strokes treated with mechanical thrombectomy
Goyal, Nitin, Tsivgoulis, Georgios, Pandhi, Abhi, Dillard, Kira, Katsanos, Aristeidis H., Magoufis, Georgios, Chang, Jason J., Zand, Ramin, Hoit, Daniel, Safouris, Apostolos, Choudhri, Asim, Alexandrov, Anne W., Alexandrov, Andrei V., Arthur, Adam S. and Elijovich, Lucas. (2018). Admission hyperglycemia and outcomes in large vessel occlusion strokes treated with mechanical thrombectomy. Journal of NeuroInterventional Surgery. 10(2), pp. 112-117. https://doi.org/10.1136/neurintsurg-2017-012993
A multicenter study of the safety and effectiveness of mechanical thrombectomy for patients with acute ischemic stroke not meeting top-tier evidence criteria
Nitin Goyal, Georgios Tsivgoulis, Donald Frei, Aquilla Turk, Blaise Baxter, Michael T Froehler, J Mocco, Jay Vachhani, Daniel A. Hoit, L Elijovich, David Loy, Raymond D Turner, Justin Mascitelli, Kiersten Espaillat, Andrei V. Alexandrov, Anne Alexandrov and A Arthur. (2018). A multicenter study of the safety and effectiveness of mechanical thrombectomy for patients with acute ischemic stroke not meeting top-tier evidence criteria. Journal of NeuroInterventional Surgery. 10(1), pp. 10-16. https://doi.org/10.1136/neurintsurg-2016-012905
Back to basics : Adherence with guidelines for glucose and temperature control in an American comprehensive stroke center sample
Alexandrov, Anne W., Palazzo, Paola, Biby, Sharon, Doerr, Abbigayle, Dusenbury, Wendy, Young, Rhonda, Lindstrom, Anne, Grove, Mary, Tsivgoulis, Georgios, Middleton, Sandy and Alexandrov, Andrei V.. (2018). Back to basics : Adherence with guidelines for glucose and temperature control in an American comprehensive stroke center sample. Journal of Neuroscience Nursing. 50(3), pp. 131-137. https://doi.org/10.1097/JNN.0000000000000358
Hemicraniectomy for malignant middle cerebral artery syndrome: A review of functional outcomes in two high-volume stroke centers
Pandhi, Abhi, Tsivgoulis, Georgios, Goyal, Nitin, Ishfaq, Muhammad Fawad, Male, Shailesh, Boviatsis, Efstathios, Chang, Jason J., Zand, Ramin, Voumvourakis, Konstantinos, Elijovich, Lucas, Alexandrov, Anne W., Malkoff, Marc D., Hoit, Daniel A., Arthur, Adam S. and Alexandrov, Andrei V.. (2018). Hemicraniectomy for malignant middle cerebral artery syndrome: A review of functional outcomes in two high-volume stroke centers. Journal of Stroke and Cerebrovascular Diseases. 27(9), pp. 2405 - 2410. https://doi.org/10.1016/j.jstrokecerebrovasdis.2018.04.031
Higher low-density lipoprotein cholesterol levels are associated with decreased mortality in patients with intracerebral hemorrhage
Chang, Jason J., Katsanos, Aristeidis, Khorchid, Yasser, Dillard, Kira, Kerro, Ali, Burgess, Lucia Goodwin, Goyal, Nitin, Alexandrov, Anne W., Alexandrov, Andrei V. and Tsivgoulis, Georgios. (2018). Higher low-density lipoprotein cholesterol levels are associated with decreased mortality in patients with intracerebral hemorrhage. Atherosclerosis. 269(February, 2018), pp. 14 - 20. https://doi.org/10.1016/j.atherosclerosis.2017.12.008
Implications of limiting mechanical thrombectomy to patients with emergent large vessel occlusion meeting top tier evidence criteria
Bhole, Rohini, Goyal, Nitin, Nearing, Katherine, Belayev, Andrey, Doss, Vinodh T., Elijovich, Lucas, Hoit, Daniel A., Tsivgoulis, Georgios, Alexandrov, Andrei V., Arthur, Adam S. and Alexandrov, Anne W.. (2017). Implications of limiting mechanical thrombectomy to patients with emergent large vessel occlusion meeting top tier evidence criteria. Journal of NeuroInterventional Surgery. 9(3), pp. 225-228. https://doi.org/10.1136/neurintsurg-2015-012206
Screening for aspiration risk associated with dysphagia in acute stroke (Protocol)
Boaden, Elizabeth, Doran, Dawn, Burnell, Jane, Clegg, Andrew, Dey, Paola, Hurley, Margaret, Alexandrov, Anne, McInnes, Elizabeth and Watkins, Caroline L.. (2017). Screening for aspiration risk associated with dysphagia in acute stroke (Protocol). Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD012679
Direct oral anticoagulant-vs vitamin k antagonist-related nontraumatic intracerebral hemorrhage
Tsivgoulis, Georgios, Lioutas, Vasileios-Arsenios, Varelas, Panayiotis, Katsanos, Aristeidis H., Goyal, Nitin, Mikulik, Robert, Barlinn, Kristian, Krogias, C., Sharma, Vijay K., Vadikolias, Konstantinos, Dardiotis, E., Karapanayiotides, Theodoros, Pappa, Alexandra, Zompola, Christina, Triantafyllou, Sokratis, Kargiotis, Odysseas, Ioakeimidis, Michael, Giannopoulos, Sotirios, Kerro, Ali, ... Alexandrov, Andrei V.. (2017). Direct oral anticoagulant-vs vitamin k antagonist-related nontraumatic intracerebral hemorrhage. Neurology. 89(11), pp. 1142 - 1151. https://doi.org/10.1212/WNL.0000000000004362
Sulfonylurea pretreatment and in-hospital use does not impact acute ischemic strokes (AIS) outcomes following intravenous thrombolysis
Tsivgoulis, Georgios, Goyal, Nitin, Iftikhar, Sulaiman, Zand, Ramin, Chang, Jason J., Elijovich, Lucas, Alexandrov, Anne W., Malkoff, Marc D. and Alexandrov, Andrei V.. (2017). Sulfonylurea pretreatment and in-hospital use does not impact acute ischemic strokes (AIS) outcomes following intravenous thrombolysis. Journal of Stroke and Cerebrovascular Diseases. 26(4), pp. 795 - 800. https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.10.019
Elevated pulse pressure levels are associated with increased in-hospital mortality in acute spontaneous intracerebral hemorrhage
Chang, Jason J., Khorchid, Yasser, Dillard, Kira, Kerro, Ali, Burgess, Lucia Goodwin, Cherkassky, Georgy, Goyal, Nitin, Chapple, Kristina, Alexandrov, Anne W., Buechner, David, Alexandrov, Andrei V. and Tsivgoulis, Georgios. (2017). Elevated pulse pressure levels are associated with increased in-hospital mortality in acute spontaneous intracerebral hemorrhage. American Journal of Hypertension. 30(7), pp. 719 - 727. https://doi.org/10.1093/ajh/hpx025
Blood pressure reduction and secondary stroke prevention
Katsanos, Aristeidis H., Filippatou, Angeliki, Manios, Efstathios, Deftereos, Spyridon, Parissis, John T., Frogoudaki, Alexandra, Vrettou, Agathi-Rosa, Ikonomidis, Ignatios, Pikilidou, Maria, Kargiotis, Odysseas, Voumvourakis, Konstantinos, Alexandrov, Anne W., Alexandrov, Andrei V. and Tsivgoulis, Georgios. (2017). Blood pressure reduction and secondary stroke prevention. Hypertension. 69(1), pp. 171 - 179. https://doi.org/10.1161/HYPERTENSIONAHA.116.08485
Sulfonylurea drug pretreatment and functional outcome in diabetic patients with acute intracerebral hemorrhage
Chang, Jason J., Khorchid, Yasser, Kerro, Ali, Goodwin Burgess, L., Goyal, Nitin, Alexandrov, Anne W., Alexandrov, Andrei V. and Tsivgoulis, Georgios. (2017). Sulfonylurea drug pretreatment and functional outcome in diabetic patients with acute intracerebral hemorrhage. Journal of the Neurological Sciences. 381, pp. 182-187. https://doi.org/10.1016/j.jns.2017.08.3252
Antiplatelet pretreatment and outcomes in intravenous thrombolysis for stroke: A systematic review and meta-analysis
Tsivgoulis, Georgios, Katsanos, Aristeidis H., Zand, Ramin, Sharma, Vijay K., Köhrmann, Martin, Giannopoulos, Sotirios, Dardiotis, Efthymios, Alexandrov, Anne W., Mitsias, Panayiotis D., Schellinger, Peter D. and Alexandrov, Andrei V.. (2017). Antiplatelet pretreatment and outcomes in intravenous thrombolysis for stroke: A systematic review and meta-analysis. Journal of Neurology. 264(6), pp. 1227 - 1235. https://doi.org/10.1007/s00415-017-8520-1
Statin pretreatment is associated with better outcomes in large artery atherosclerotic stroke
Tsivgoulis, Georgios, Katsanos, Aristeidis H., Sharma, Vijay K., Krogias, Christos, Mikulik, Robert, Vadikolias, Konstantinos, Mijajlovic, Milija, Safouris, Apostolos, Zompola, Christina, Faissner, Simon, Weiss, Viktor, Giannopoulos, Sotirios, Vasdekis, Spyros, Boviatsis, Efstathios, Alexandrov, Anne W., Voumvourakis, Konstantinos and Alexandrov, Andrei V.. (2016). Statin pretreatment is associated with better outcomes in large artery atherosclerotic stroke. Neurology. 86(12), pp. 1103-1111. https://doi.org/10.1212/WNL.0000000000002493
Percutaneous transluminal angioplasty and stenting for symptomatic intracranial arterial stenosis : A systematic review and meta-analysis
Tsivgoulis, Georgios, Katsanos, Aristeidis H., Magoufis, Georgios, Kargiotis, Odysseas, Papadimitropoulos, Georgios, Vadikolias, Konstantinos, Karapanayiotides, Theodoros, Ellul, John, Alexandrov, Anne W., Mitsias, Panayiotis D. and Alexandrov, Andrei V.. (2016). Percutaneous transluminal angioplasty and stenting for symptomatic intracranial arterial stenosis : A systematic review and meta-analysis. Therapeutic Advances in Neurological Disorders. 9(5), pp. 351-358. https://doi.org/10.1177/1756285616650357
Novel oral anticoagulants for the secondary prevention of cerebral ischemia : A network meta-analysis
Katsanos, Aristeidis H., Mavridis, Dimitris, Parissis, John, Deftereos, Spyridon, Frogoudaki, Alexandra, Vrettou, Agathi-Rosa, Ikonomidis, Ignatios, Chondrogianni, Maria, Safouris, Apostolos, Filippatou, Angeliki, Voumvourakis, Konstantinos, Triantafyllou, Nikos, Ellul, John, Karapanayiotides, Theodore, Giannopoulos, Sotirios, Alexandrov, Anne W., Alexandrov, Andrei V. and Tsivgoulis, Georgios. (2016). Novel oral anticoagulants for the secondary prevention of cerebral ischemia : A network meta-analysis. Therapeutic Advances in Neurological Disorders. 9(5), pp. 359-368. https://doi.org/10.1177/1756285616659411
Direct stroke unit admission of intravenous tissue plasminogen activator : Safety, clinical outcome, and hospital cost savings
Alexandrov, Anne W., Coleman, Kisha C., Palazzo, Paola, Shahripour, Reza Bavarsad and Alexandrov, Andrei V.. (2016). Direct stroke unit admission of intravenous tissue plasminogen activator : Safety, clinical outcome, and hospital cost savings. Therapeutic Advances in Neurological Disorders. 9(4), pp. 304-309. https://doi.org/10.1177/1756285616648061
Transcranial Doppler versus transthoracic echocardiography for the detection of patent foramen ovale in patients with cryptogenic cerebral ischemia: A systematic review and diagnostic test accuracy meta-analysis
Katsanos, Aristeidis H., Psaltopoulou, Theodora, Sergentanis, Theodoros N., Frogoudaki, Alexandra, Vrettou, Agathi Rosa, Ikonomidis, Ignatios, Paraskevaidis, Ioannis, Parissis, John T., Bogiatzi, Chrysa, Zompola, Christina, Ellul, John, Triantafyllou, Nikos, Voumvourakis, Konstantinos, Kyritsis, Athanassios P., Giannopoulos, Sotirios, Alexandrov, Anne, Alexandrov, Andrei V. and Tsivgoulis, Georgios. (2016). Transcranial Doppler versus transthoracic echocardiography for the detection of patent foramen ovale in patients with cryptogenic cerebral ischemia: A systematic review and diagnostic test accuracy meta-analysis. Annals of Neurology. https://doi.org/10.1002/ana.24609
Risk of symptomatic intracerebral hemorrhage after intravenous thrombolysis in patients with acute ischemic stroke and high cerebral microbleed burden ameta-analysis
Tsivgoulis, Georgios, Zand, Ramin, Katsanos, Aristeidis H., Turc, Guillaume, Nolte, Christian H., Jung, Simon, Cordonnier, Charlotte, Fiebach, Jochen B., Scheitz, Jan F., Klinger-Gratz, Pascal P., Oppenheim, Catherine, Goyal, Nitin, Safouris, Apostolos, Mattle, Heinrich P., Alexandrov, Anne W., Schellinger, Peter D. and Alexandrov, Andrei V.. (2016). Risk of symptomatic intracerebral hemorrhage after intravenous thrombolysis in patients with acute ischemic stroke and high cerebral microbleed burden ameta-analysis. JAMA Neurology. 73(6), pp. 675 - 683. https://doi.org/10.1001/jamaneurol.2016.0292
Do billing codes accurately capture intravenous tissue plasminogen activator treatment rates? Justified concern for clinical performance measures based on billing code assignment
Palazzo, Paola, Alexandrov, Andrei V. and Alexandrov, Anne. (2015). Do billing codes accurately capture intravenous tissue plasminogen activator treatment rates? Justified concern for clinical performance measures based on billing code assignment. Journal of Stroke and Cerebrovascular Diseases. 24(2), pp. 327 - 329. https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.08.024
Triage, treatment and transfer : Evidence-based clinical practice recommendations and models of nursing care for the first 72 hours of admission to hospital for acute stroke
Middleton, Sandy, Grimley, Rohan and Alexandrov, Anne W.. (2015). Triage, treatment and transfer : Evidence-based clinical practice recommendations and models of nursing care for the first 72 hours of admission to hospital for acute stroke. Stroke. 46(2), pp. e18-e25. https://doi.org/10.1161/STROKEAHA.114.006139
Investigating the utility of previously developed prediction scores in acute ischemic stroke patients in the stroke belt
Boehme, Amelia K., Rawal, Pawan V., Lyerly, Michael J., Albright, Karen C., Shahripour, Reza Bavarsad, Palazzo, Paola, Kapoor, Niren, Alvi, Muhammad Yasin, Houston, J. Thomas, Harrigan, Mark R., Cava, Luis, Sisson, April, Alexandrov, Anne W. and Alexandrov, Andrei V.. (2014). Investigating the utility of previously developed prediction scores in acute ischemic stroke patients in the stroke belt. Journal of Stroke and Cerebrovascular Diseases. 23(8), pp. 2001 - 2006. https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.02.003
Race, regionality and pre-diabetes in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study
Lee, Loretta T., Alexandrov, Anne W. and Howard, Virginia J.. (2014). Race, regionality and pre-diabetes in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. Preventive Medicine. 63(June), pp. 43 - 47. https://doi.org/10.1016/j.ypmed.2014.02.013
A Systematic Review of Probiotics as a Potential Intervention to Restore Gut Health in HIV Infection
Wilson, Natalie, Moneyham, Linda and Alexandrov, Anne. (2013). A Systematic Review of Probiotics as a Potential Intervention to Restore Gut Health in HIV Infection. Journal of the Association of Nurses in AIDS Care. https://doi.org/10.1016/j.jana.2012.04.004
Slim Stroke scales for assessing patients with acute stroke : Ease of use or loss of valuable assessment data?
Nye, Brandon, Hyde, Christina, Tsivgoulis, Georgios, Albright, Karen, Alexandrov, Andrei and Alexandrov, Anne. (2012). Slim Stroke scales for assessing patients with acute stroke : Ease of use or loss of valuable assessment data? American Journal of Critical Care. 21(6), pp. 442 - 448. https://doi.org/10.4037/ajcc2012633
The Effect of Facilitated Peer Support Sessions on Burnout and Grief Management among Health Care Providers in Pediatric Intensive Care Units : A Pilot Study
Eagle, Samantha, Creel, Amy and Alexandrov, Anne. (2012). The Effect of Facilitated Peer Support Sessions on Burnout and Grief Management among Health Care Providers in Pediatric Intensive Care Units : A Pilot Study. Journal of Palliative Medicine. 15(11), pp. 1178 - 1180. https://doi.org/10.1089/jpm.2012.0231
Utility of Cocaine Drug Screens to Predict Safe Delivery of General Anesthesia for ElectiveSurgical Patients
Baxter, Joshua and Alexandrov, Anne. (2012). Utility of Cocaine Drug Screens to Predict Safe Delivery of General Anesthesia for ElectiveSurgical Patients. American Association of Nurse Anesthetists Journal. 80(4 Suppl), pp. S33 - S36.
Low-power 2-MHz pulsed-wave transcranial ultrasound reduces ischemic brain damage in rats
Alexandrov, Andrei V., Barlinn, Kristian, Strong, Roger, Alexandrov, Anne W. and Aronowski, Jaroslaw. (2011). Low-power 2-MHz pulsed-wave transcranial ultrasound reduces ischemic brain damage in rats. Translational Stroke Research. 2(3), pp. 376 - 381. https://doi.org/10.1007/s12975-011-0080-6
Safety and outcomes of intravenous thrombolysis in stroke mimics :A 6-year, single-care center study and a pooled analysis of reported series
Tsivgoulis, Georgios, Alexandrov, Andrei, Chang, Jason, Sharma, Vijay, Hoover, Steven, Lao, Annabelle, Liu, Wei, Stamboulis, Elefterios, Alexandrov, Anne, Malkoff, Marc, Frey, James and Frey, James. (2011). Safety and outcomes of intravenous thrombolysis in stroke mimics :A 6-year, single-care center study and a pooled analysis of reported series. Stroke: a journal of cerebral circulation. 42(6), pp. 1771 - 1774. https://doi.org/10.1161/STROKEAHA.110.609339
Reperfusion and outcomes in Penumbra vs. systemic tissue plasminogen activator clinical trials
Alexandrov, Andrei, Schellinger, Peter, Saqqur, Maher, Barreto, Andrew, Demchuk, Andrew, Ribo, Marc, Rubiera, Marta, Sharma, Vijay, Heliopoulos, Ioannis, Alexandrov, Anne, Molina, Carlos, Tsivgoulis, Georgios and Tsivgoulis, Georgios. (2011). Reperfusion and outcomes in Penumbra vs. systemic tissue plasminogen activator clinical trials. International Journal of Stroke. 6(2), pp. 118 - 122. https://doi.org/10.1111/j.1747-4949.2010.00559.x
Computed tomography perfusion prognostic maps do not predict reversible and irreversible neurological dysfunction following reperfusion therapies
Zhao, Limin, Barlinn, Kristian, Bag, Asim, Kesani, Maruthi, Cava, Luis, Balucani, Clotilde, Alexandrov, Anne, Horton, Joseph, Patterson, Damon and Harrigan, Mark. (2011). Computed tomography perfusion prognostic maps do not predict reversible and irreversible neurological dysfunction following reperfusion therapies. International Journal of Stroke. 6(6), pp. 544 - 546. https://doi.org/10.1111/j.1747-4949.2011.00681.x
Safety and tolerability of early noninvasive ventilatory correction using bilevel positive airway pressure in acute ischemic stroke
Tsivgoulis, Georgios, Zhang, Yi, Alexandrov, Anne, Harrigan, Mark, Sisson, April, Zhao, Limin, Brethour, Mary, Cava, Luis, Balucani, Clotilde, Barlinn, Kristian, Patterson, Damon, Giannopoulos, Sotirios, DeWolfe, Jennifer and Alexandrov, Andrei. (2011). Safety and tolerability of early noninvasive ventilatory correction using bilevel positive airway pressure in acute ischemic stroke. Stroke: a journal of cerebral circulation. 42(4), pp. 1030 - 1034. https://doi.org/10.1161/STROKEAHA.110.600221
End-diastolic velocity increase predicts recanalization and neurological improvement in patients with ischemic stroke with proximal arterial occlusions receiving reperfusion therapies
Alexandrov, Andrei, Tsivgoulis, Georgios, Rubiera, Marta, Vadikolias, Konstantinos, Stamboulis, Elefterios, Molina, Carlos and Alexandrov, Anne. (2010). End-diastolic velocity increase predicts recanalization and neurological improvement in patients with ischemic stroke with proximal arterial occlusions receiving reperfusion therapies. Stroke: a journal of cerebral circulation. 41(5), pp. 948 - 952. https://doi.org/10.1161/STROKEAHA.109.577502
What is a stroke?
Alexandrov, Anne W.. (2010). What is a stroke? In In J. Williams, L. Perry and C. Watkins (Ed.). Acute Stroke Nursing pp. 33 - 65
Acute stroke nursing management
Alexandrov, Anne W.. (2010). Acute stroke nursing management. In In J. Williams, L. Perry and C. Watkins (Ed.). Acute Stroke Nursing pp. 66 - 90 Blackwell Publishing.
Postgraduate fellowship education and training for nurses: The NET SMART Experience
Alexandrov, Anne W., Brethour, Mary K., Cudlip, Fern, Swatzell, Victoria, Biby, Sharon, Reiner, Dana, Kiernan, Terri-Ellen, Handler, Diane, Tocco, Susan and Yang, Joanna Jiehong. (2009). Postgraduate fellowship education and training for nurses: The NET SMART Experience. Critical Care Nursing Clinics of North America. 21(4), pp. 435 - 449. https://doi.org/10.1016/j.ccell.2009.09.001
Pre-tissue plasminogen activator blood pressure levels and risk of symptomatic intracerebral hemorrhage
Tsivgoulis, Georgios, Frey, James L., Flaster, Murray, Sharma, Vijay K., Lao, Annabelle Y., Hoover, Steven L., Liu, Wei, Stamboulis, Elefterios, Alexandrov, Anne W., Malkoff, Marc D. and Alexandrov, Andrei V.. (2009). Pre-tissue plasminogen activator blood pressure levels and risk of symptomatic intracerebral hemorrhage. Stroke: a journal of cerebral circulation. 40(11), pp. 3631 - 3634. https://doi.org/10.1161/STROKEAHA.109.564096
Prevalence and risk factors associated with reversed robin hood syndrome in acute ischemic stroke
Alexandrov, Andrei V., Nguyen, Huy Thang, Rubiera, Marta, Alexandrov, Anne W., Zhao, Limin, Heliopoulos, Ioannis, Robinson, Alice, DeWolfe, Jennifer and Tsivgoulis, Georgios. (2009). Prevalence and risk factors associated with reversed robin hood syndrome in acute ischemic stroke. Stroke: a journal of cerebral circulation. 40(8), pp. 2738 - 2742. https://doi.org/10.1161/STROKEAHA.109.547950
Methodologic challenges in the design and conduct of hyperacute stroke research
Alexandrov, Anne. (2008). Methodologic challenges in the design and conduct of hyperacute stroke research. AACN Advanced Critical Care. 19(2), pp. 186 - 201. https://doi.org/10.1097/01.AACN.0000318122.56759.55
Perfusion augmentation in acute stroke using mechanical counter-pulsation-phase iia: Effect of external counterpulsation on middle cerebral artery mean flow velocity in five healthy subjects
Alexandrov, Anne W., Ribo, Marc, Wong, Kay Sing, Sugg, Rebecca M., Garami, Zsolt, Jesurum, Jill T., Montgomery, Baxter and Alexandrov, Andrei V.. (2008). Perfusion augmentation in acute stroke using mechanical counter-pulsation-phase iia: Effect of external counterpulsation on middle cerebral artery mean flow velocity in five healthy subjects. Stroke: a journal of cerebral circulation. 39(10), pp. 2760 - 2764. https://doi.org/10.1161/STROKEAHA.107.512418
Preliminary findings of external counterpulsation for ischemic stroke patient with large artery occlusive disease
Han, Jing Hao, Leung, Thomas W., Lam, Wynnie W., Soo, Yannie O., Alexandrov, Anne W., Mok, Vincent, Leung, Yee-Fong V., Lo, Raymond and Wong, Ka Sing. (2008). Preliminary findings of external counterpulsation for ischemic stroke patient with large artery occlusive disease. Stroke: a journal of cerebral circulation. 39(4), pp. 1340 - 1343. https://doi.org/10.1161/STROKEAHA.107.500132
Quantification of microspheres appearance in brain vessels: Implications for residual flow velocity measurements, dose calculations, and potential drug delivery
Sharma, Vijay K., Tsivgoulis, Georgios, Lao, Annabelle Y., Malkoff, Marc D., Alexandrov, Anne W. and Alexandrov, Andrei V.. (2008). Quantification of microspheres appearance in brain vessels: Implications for residual flow velocity measurements, dose calculations, and potential drug delivery. Stroke: a journal of cerebral circulation. 39(5), pp. 1476 - 1481. https://doi.org/10.1161/STROKEAHA.107.501593