Stroke; a journal of cerebral circulation
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Randomized Controlled Trial Multicenter Study
Vagus Nerve Stimulation Paired With Upper Limb Rehabilitation After Chronic Stroke.
Background and Purpose- We assessed safety, feasibility, and potential effects of vagus nerve stimulation (VNS) paired with rehabilitation for improving arm function after chronic stroke. Methods- We performed a randomized, multisite, double-blinded, sham-controlled pilot study. All participants were implanted with a VNS device and received 6-week in-clinic rehabilitation followed by a home exercise program. ⋯ A pivotal study of this therapy is justified. Clinical Trial Registration- URL: https://www.clinicaltrials.gov. Unique identifier: NCT02243020.
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Randomized Controlled Trial Multicenter Study Observational Study
Safety and Outcome of Endovascular Treatment in Prestroke-Dependent Patients.
Background and Purpose- Prestroke dependence is an exclusion criterion in most trials of endovascular treatment (EVT) for acute ischemic stroke. Little is known about outcomes after EVT in these patients. We compared outcome and safety of EVT between prestroke-dependent and prestroke-independent patients. ⋯ The occurrence of symptomatic intracranial hemorrhage and ischemic stroke progression was similar in both groups. Conclusions- A substantial proportion of prestroke-dependent patients will reach prestroke modified Rankin Scale scores after EVT, and complication rates are comparable with prestroke-independent patients. Therefore, prestroke-dependent patients should not be routinely excluded from EVT.
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Randomized Controlled Trial
Efficacy and Safety of Ticagrelor in Relation to Aspirin Use Within the Week Before Randomization in the SOCRATES Trial.
SOCRATES (Acute Stroke or Transient Ischemic Attack Treated With Aspirin or Ticagrelor and Patient Outcomes), comparing ticagrelor with aspirin in patients with acute cerebral ischemia, found a nonsignificant 11% relative risk reduction for stroke, myocardial infarction, or death (P=0.07). Aspirin intake before randomization could enhance the effect of ticagrelor by conferring dual antiplatelet effect during a high-risk period for subsequent stroke. Therefore, we explored the efficacy and safety of ticagrelor versus aspirin in the patients who received any aspirin the week before randomization. ⋯ URL: https://www.clinicaltrials.gov. Unique identifier: NCT01994720.
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Randomized Controlled Trial
Similar Outcomes for Contact Aspiration and Stent Retriever Use According to the Admission Clot Burden Score in ASTER.
The clot burden score (CBS) at admission reliably evaluates the thrombus burden in acute ischemic stroke patients with anterior circulation large vessel occlusion. Mechanical thrombectomy has been diversified, especially with contact aspiration technique, and its efficiency with respect to the thrombus burden is not known. We compared reperfusion, adverse events, neurological recovery, and 90-day functional outcome of stent retriever use versus contact aspiration according to the admission CBS. ⋯ First-line mechanical thrombectomy with contact aspiration compared with stent retriever did not result in an increased successful reperfusion rate in acute ischemic stroke patients with large vessel occlusion of the anterior circulation according to the admission CBS. The latter, however, seems to be a reliable prognostic indicator of angiographic and clinical outcome.
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Randomized Controlled Trial
Long-Term Outcomes in Patients Aged ≤70 Years With Intravenous Glyburide From the Phase II GAMES-RP Study of Large Hemispheric Infarction: An Exploratory Analysis.
We aimed to determine whether subjects aged ≤70 years who were treated with intravenous glyburide (RP-1127; BIIB093; glibenclamide) would have better long-term outcomes than those who received placebo. ⋯ URL: https://www.clinicaltrials.gov. Unique identifier: NCT01794182.