scholarly journals Correlation between Clinical Outcomes and Baseline CT and CT Angiographic Findings in the SWIFT PRIME Trial

2017 ◽  
Vol 38 (12) ◽  
pp. 2270-2276 ◽  
Author(s):  
A.P. Jadhav ◽  
H.-C. Diener ◽  
A. Bonafe ◽  
V.M. Pereira ◽  
E.I. Levy ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Prime Trial ◽  
Angiographic Findings

Association of clot burden score with radiographic and clinical outcomes following Solitaire stent retriever thrombectomy: analysis of the SWIFT PRIME trial

2016 ◽  
Vol 9 (10) ◽  
pp. 929-932 ◽  
Author(s):  
Maxim Mokin ◽  
Elad I Levy ◽  
Adnan H Siddiqui ◽  
Mayank Goyal ◽  
Raul G Nogueira ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Stent Retriever ◽  
Study Cohort ◽  
Prime Trial ◽  
Good Clinical Outcome ◽  
Anterior Circulation ◽  
Clot Burden ◽  
Proximal Occlusion ◽  
The Relationship

BackgroundThe clot burden score (CBS) was developed as a tool to evaluate the extent of intracranial thrombus burden in patients with anterior circulation acute ischemic stroke. CBS is based on the presence or absence of contrast opacification on CT angiography (CTA). Its value in predicting radiographic and clinical outcomes in patients given endovascular stroke therapy remains unknown.ObjectiveTo evaluate the relationship between CBS and outcomes after stent retriever thrombectomy in the interventional arm of the SWIFT PRIME trial.MethodsCBS was calculated for the endovascular arm (IV tissue plasminogen activator plus Solitaire stent retriever) of SWIFT PRIME using baseline CTA. The cohort of 69 patients was divided into three groups according to their CBS values: CBS 0–5 (n=14), CBS 6–7 (n=23), and CBS 8–9 (n=32).ResultsThe mean age of the 69 patients who formed the study cohort was 63.2±13.1 years, mean National Institutes of Health Stroke Scale score was 16.8±4.5, and 55% of the patients were male. There was no difference in clinical characteristics among the three groups, except for the baseline Alberta Stroke Program Early CT Score (p=0.049). The site of proximal occlusion varied significantly among the three groups (p<0.001). Rates of successful recanalization (TICI 2b/3), complete recanalization (TICI 3 only) and of good clinical outcome at 3 months were similar among the three groups (p=0.24, p=0.35, and p=0.52, respectively).ConclusionsThe combination of IV thrombolysis and stent retriever thrombectomy with the Solitaire device is highly effective in achieving successful recanalization and a good clinical outcome throughout the entire range of CBS values.

scholarly journals Is There a Sex Gap in Surviving an Acute Coronary Syndrome or Subsequent Development of Heart Failure?

Circulation ◽  
2020 ◽  
Vol 142 (23) ◽  
pp. 2231-2239
Author(s):  
Justin A. Ezekowitz ◽  
Anamaria Savu ◽  
Robert C. Welsh ◽  
Finlay A. McAlister ◽  
Shaun G. Goodman ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Outcomes ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
St Segment Elevation ◽  
Vessel Disease ◽  
St Segment ◽  
First Time ◽  
Angiographic Findings ◽  
Over Time

Background: We hypothesized that disparities between sexes in the management of myocardial infarction (MI) may have changed over time, and thus altered the prognoses after MI, especially the risk for the development of heart failure. Methods: Using a large population-based cohort of patients with MI between April 1, 2002, and March 31, 2016, we examined the incidence, angiographic findings, treatment (including revascularization), and clinical outcomes of patients with a first-time MI. To elucidate the differences between sexes, a series of multivariable models were created to explore all MI and non–ST-segment–elevation MI (NSTEMI) versus ST-segment–elevation MI (STEMI) over time. Results: Between 2002 and 2016, 45 064 patients (13 878 [30.8%] women) were hospitalized with a primary diagnosis of first-time MI (54.9% NSTEMI and 45.1% STEMI). Women were older (median age, 72 versus 61 years), had more comorbidities, and had lower rates of diagnostic angiography than did men (women, 74%, versus men, 87%). When angiography was performed, women had a lower proportion of left main, 2-vessel disease with proximal left anterior descending or 3-vessel disease compared with men (33.4% versus 40.9%, P <0.0001), and a higher frequency of 1-vessel disease or nonobstructive coronary artery disease (39.6% versus 29.1%, P <0.0001). Women had a higher unadjusted rate of in-hospital mortality than did men in both patients with STEMI (women, 9.4%, versus men, 4.5%) and patients with NSTEMI (women, 4.7%, versus men, 2.9%). After adjustment, this difference remained significant in STEMI (adjusted odds ratio, 1.42 [95% CI, 1.24–1.64]) but not in NSTEMI (adjusted odds ratio, 0.97 [95% CI, 0.83–1.13]). After discharge, women developed heart failure after STEMI (women, 22.5%, versus men, 14.9%) as well as after NSTEMI (women, 23.2%, versus men, 15.7%). The adjusted relative risk for women versus men of developing the outcomes of mortality and heart failure remained similar across years, although the differences were nonsignificantly attenuated over 5 years of follow-up. Conclusions: Although some attenuation of differences in clinical outcomes over time has occurred, women remain at higher risk than men of dying or developing heart failure in the subsequent 5 years after STEMI or NSTEMI, even after accounting for differences in angiographic findings, revascularization, and other confounders.

scholarly journals TCT-21 Thrombolysis in Spontaneous Coronary Artery Dissection: Angiographic Findings and Clinical Outcomes

2021 ◽  
Vol 78 (19) ◽  
pp. B10
Author(s):  
Cameron McAlister ◽  
Rohit Samuel ◽  
Mesfer Alfadhel ◽  
Thomas Nestelberger ◽  
Andrew Starovoytov ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Clinical Outcomes ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
Angiographic Findings

scholarly journals Manual aspiration thrombectomy using a Penumbra catheter in patients with acute migrated MCA occlusion

2017 ◽  
Vol 23 (2) ◽  
pp. 173-179 ◽  
Author(s):  
Sung Hyun Baik ◽  
Hyo Sung Kwak ◽  
Seung Bae Hwang ◽  
Gyung Ho Chung
Keyword(s):  
Clinical Outcomes ◽  
Cerebral Angiography ◽  
Medical Records ◽  
High Rate ◽  
Procedure Time ◽  
Aspiration Thrombectomy ◽  
Mca Occlusion ◽  
Distal Migration ◽  
The Difference ◽  
Angiographic Findings

Background We retrospectively assessed the efficacy and safety of manual aspiration thrombectomy (MAT) using a Penumbra catheter in patients with acute migrated middle cerebral artery (MCA) occlusion. Methods We conducted a retrospective review of patients who underwent MAT using Penumbra 4 or 5 MAX reperfusion catheters for the treatment of acute MCA occlusion between January 2012 and December 2015. A migrated thrombus was defined as distal migration greater than ≥1 cm on initial cerebral angiography compared with preprocedural angiographic findings. We evaluated immediate angiographic results and clinical outcomes through a review of electronic medical records and compared clinical outcomes between migrated and non-migrated MCA occlusions. Results During this period, 98 patients underwent MAT using Penumbra catheters for treatment of acute MCA occlusions. Of these, 19 (19.4%) had a migrated MCA thrombus on initial cerebral angiography compared with preprocedural angiographic findings. The overall rate of successful recanalization (TICI grade ≥ 2b) was 90.8%. The rate of successful recanalization in the migrated thrombus group was 94.7% (18/19). Overall procedure time for recanalization in the migrated thrombus group was significantly shorter than that in the non-migrated thrombus group ( p = 0.001). Although the difference was not significant, there was a trend toward more favorable clinical outcomes in the migrated thrombus group compared to the non-migrated thrombus groups (78.9% versus 60.8%, p = 0.231). Conclusion MAT appears to be safe and can achieve a high rate of successful recanalization and favorable clinical outcomes with short procedure time and without serious complications in patients with acute migrated MCA occlusion.

Selecting Skills To Teach Communication Partners: Where Do I Start?

2012 ◽  
Vol 21 (4) ◽  
pp. 127-135 ◽  
Author(s):  
Cathy Binger ◽  
Jennifer Kent-Walsh
Keyword(s):  
Clinical Outcomes ◽  
Intervention Program ◽  
Communication Partners ◽  
Multiple Challenges

Abstract Clinicians and researchers long have recognized that teaching communication partners how to provide AAC supports is essential to AAC success. One way to improve clinical outcomes is to select appropriate skills to teach communication partners. Although this sometimes seems like it should be a straightforward component of any intervention program, deciding which skills to teach partners can present multiple challenges. In this article, we will troubleshoot common issues and discuss how to select skills systematically, resulting in the desired effects for both communication partners and clients.

Linguistic Interactions: A Therapeutic Consideration for Adults With Aphasia

2008 ◽  
Vol 17 (3) ◽  
pp. 93-98
Author(s):  
Lynn E. Fox
Keyword(s):  
Clinical Outcomes ◽  
Social Contexts ◽  
Interaction Models ◽  
Social Communities ◽  
Wernicke's Aphasia ◽  
Communication Challenges ◽  
Therapeutic Consideration ◽  
Patterns Of Interaction ◽  
Structural Language

Abstract Linguistic interaction models suggest that interrelationships arise between structural language components and between structural and pragmatic components when language is used in social contexts. The linguist, David Crystal (1986, 1987), has proposed that these relationships are central, not peripheral, to achieving desired clinical outcomes. For individuals with severe communication challenges, erratic or unpredictable relationships between structural and pragmatic components can result in atypical patterns of interaction between them and members of their social communities, which may create a perception of disablement. This paper presents a case study of a woman with fluent, Wernicke's aphasia that illustrates how attention to patterns of linguistic interaction may enhance AAC intervention for adults with aphasia.

The Complexity of Health Disparities: More Than Just Black–White Differences

2021 ◽  
pp. 1-10
Author(s):  
Charles Ellis ◽  
Molly Jacobs
Keyword(s):  
Health Disparities ◽  
Clinical Outcomes ◽  
The United States ◽  
Careful Examination ◽  
White Americans ◽  
Speech Language Pathology ◽  
Death Rates ◽  
The Social ◽  
Health Related ◽  
Language Pathology

Health disparities have once again moved to the forefront of America's consciousness with the recent significant observation of dramatically higher death rates among African Americans with COVID-19 when compared to White Americans. Health disparities have a long history in the United States, yet little consideration has been given to their impact on the clinical outcomes in the rehabilitative health professions such as speech-language pathology/audiology (SLP/A). Consequently, it is unclear how the absence of a careful examination of health disparities in fields like SLP/A impacts the clinical outcomes desired or achieved. The purpose of this tutorial is to examine the issue of health disparities in relationship to SLP/A. This tutorial includes operational definitions related to health disparities and a review of the social determinants of health that are the underlying cause of such disparities. The tutorial concludes with a discussion of potential directions for the study of health disparities in SLP/A to identify strategies to close the disparity gap in health-related outcomes that currently exists.

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