Explanipedia

Association of Minimal Clinically Important Difference With Infarct Volume in Clinical Poststroke Outcomes Open

Umberto Pensato, Johanna M. Ospel, Jianhai Zhang, Kazbek Barakhanov, Kõji Tanaka , et al. · 2025

Background Infarct volume is an imaging biomarker of ischemic tissue injury strongly correlated with poststroke outcomes and reperfusion benefit. We aimed to evaluate the follow‐up infarct volume (FIV) difference corresponding to a 1%, 5%,…

Brain Frailty and Functional Outcomes After Thrombolysis for Acute Ischemic Stroke Open

Spencer P. Loewen, Nishita Singh, Ibrahim Alhabli, Fouzi Bala, Brian Buck , et al. · 2025

Importance The cumulative burden of chronic vascular and neurodegenerative changes contributes to brain frailty, which may reduce the brain’s capacity to recover from acute ischemic stroke (AIS). The association between brain frailty marke…

Benefits of First Pass Recanalization by Initial Infarct Burden for Basilar Artery Strokes Open

Maria Fahmy, Vincent Brissette, Danielle Carole Roy, Joyce Beshara, Cyril Dargazanli , et al. · 2025

Background and aims: Achieving a first pass recanalization (FPR) improves clinical outcomes in patients with basilar artery strokes, but its association with initial infarct burden is unknown. We aimed to study the benefits of FPR for basi…

Spontaneous recanalization of extracranial internal carotid occlusion: A systematic scoping review Open

Sarah Y. Zhang, Hee Sahng Chung, Brian Dewar, Robert Fahed, Michel Shamy , et al. · 2025

Introduction The spontaneous recanalization of an occluded extracranial internal carotid artery (ICA) is thought to be an uncommon etiology of ischemic stroke. However, a growing number of reports describe this phenomenon. We sought to per…

P.020 Transcranial doppler for risk assessment of subarachnoid hemorrhage Open

L Poirier, V Brissette, Sanaz G. Biglou, Shane English, Célina Ducroux , et al. · 2025

Background: Vasospasm is an important complication of subarachnoid hemorrhage (SAH). Attempts to identify patients at highest risk of vasospasm have not led to practice change. We sought to identify patients at lowest risk of vasospasm by …

P.045 Prevalence of right-to-left shunting in stroke occurrence of patients with active cancer Open

SG Biglou, Ronda Lun, Tim Ramsay, Michel Shamy, Markus Schwerzmann , et al. · 2025

Background: Presence of right-to-left shunt has been proposed as a mechanism of paradoxical embolism in patients with active cancer. Our study thus aims to investigate the role of shunting in stroke occurrence among cancer patients. Method…

Stroke Hospitalization Administration & Monitoring: Routine or COVID-19 Care (SHAMROCC) Open

Timothé Langlois‐Thérien, Michel Shamy, Brian Dewar, Tim Ramsay, Ronda Lun , et al. · 2025

Background Monitoring stroke patients in critical-care units for 24 h after thrombolysis or endovascular thrombectomy is considered standard of care in current guidelines but is not evidence-based. Due to the COVID-19 pandemic, our center …

Malignancy Workup in Cryptogenic Stroke Open

Luc Poirier, Deborah Siegal, Dominick Bossé, Jamie Brehaut, Brian Dewar , et al. · 2025

This survey of stroke and thrombosis experts found heterogeneity in testing for cancer screening in patients with cryptogenic stroke, with the majority either not screening at all or deferring tests to primary care providers. Our survey hi…

Feasibility of telephone and computerized cognitive testing as a secondary outcome in an acute stroke clinical trial: A mixed methods sub-study of the AcT Trial Open

Sajeevan Sujanthan, Pugaliya Puveendrakumaran, Katie N. Dainty, Morgan D. Barense, Krista L. Lanctôt , et al. · 2025

Introduction: Post-stroke cognitive impairment is associated with impaired quality of life. Remote testing provides a potential avenue to measure cognitive outcomes efficiently. Patients and Methods: Prospective cognitive outcomes were col…

Thrombolysis in Patients With Versus Without Visible Occlusion: A Secondary Analysis From the AcT Trial Open

A. Zohaib Siddiqi, Katrina Hannah D. Ignacio, Chitapa Kaveeta, Fouzi Bala, Ayoola Ademola , et al. · 2025

Developing a Model of Advance Consent for Participation in Acute Stroke Trials Open

Rena Seeger, Ubong Udoh, Brian Dewar, Stuart G. Nicholls, Mark Fedyk , et al. · 2025

Brain Frailty and Functional Outcomes after Thrombolysis for Acute Ischaemic Stroke: Insights from the Act Trial Open

Shaun K. Loewen, Nishita Singh, Ibrahim Alhabli, Fouzi Bala, Brian Buck , et al. · 2025

Safety and Efficacy of Intravenous Thrombolysis by Infarct Type in Patients with No Visible Occlusion: A Secondary Analysis of the AcT Trial Open

A. Zohaib Siddiqi, Katrina Hannah D. Ignacio, Chitapa Kaveeta, Fouzi Bala, Ayoola Ademola , et al. · 2024

Background About 25% of patients with acute ischemic stroke have lacunar infarct on follow‐up imaging. In this secondary analysis from the AcT (Alteplase Compared With Tenecteplase) trial, we assessed if there is variation in safety or eff…

Automatic Matching Algorithms to Identify Eligible Participants for Stroke Trials: A Proof-of-Concept Study Open

Pattarawut Charatpangoon, Nishita Singh, Brian Buck, Federico Carpani, Luciana Catanese , et al. · 2024

Background: Clinical trials often struggle to recruit enough participants, with only 10% of eligible patients enrolling. This is concerning for conditions like stroke, where timely decision-making is crucial. Frontline clinicians typically…

The humanities in palliative medicine training: perspectives of academic palliative medicine physicians and trainees Open

Rayan Delbani, Christopher J. Barnes, Michel Shamy · 2024

Consent-Related Outcomes in the Alteplase Compared to Tenecteplase Trial Open

Michel Shamy, Brian Dewar, Yan Deschaintre, Nishita Singh, Carol Kenney , et al. · 2024

Deferral of consent was broadly acceptable to participants in the AcT trial as demonstrated by low rates of withdrawal and by survey results. Door-to-randomization times using deferral of consent in AcT were short, although a system of pro…

Advance Consent for Participation in Acute Stroke Trials: A Focus Group Study with People with Lived Experience of Stroke Open

Ubong Udoh, Rena Seeger, Emma Cummings, Brian Dewar, Stuart G. Nicholls , et al. · 2024

Advance consent could address many of the limitations traditional consenting methods pose to participation in acute stroke trials. We conducted a series of five focus groups with people with lived experience of stroke. Using an inductive t…

Endovascular treatment versus medical management for basilar artery occlusion with low-to-moderate symptoms (National Institutes of Health Stroke Scale < 10) Open

Cyril Dargazanli, Isabelle Mourand, Mehdi Mahmoudi, Luc Poirier, Julien Labreuche , et al. · 2024

Background: Patients with acute basilar artery occlusion (BAO) and low-to-moderate symptoms (National Institutes of Health Stroke Scale [NIHSS] < 10) are poorly represented in thrombectomy trials. Our objective is to compare thrombectomy a…

Advance Consent for participation in Acute Stroke Trials (ACTION): protocol for a feasibility study Open

Ubong Udoh, Rena Seeger, Brian Dewar, Emma Cummings, Sophia Gocan , et al. · 2024

Introduction Obtaining informed consent for research from patients in medical emergencies remains a challenge, particularly in acute stroke care as treatment must be administered quickly and patients often arrive in the hospital in a state…

Predicting intracerebral hemorrhage after endovascular therapy for anterior circulation strokes using CT-ASPECT, CTP-ASPECT and DWI-ASPECT: Protocol for a systematic review Open

Vincent Brissette, Chirayu Bhatt, Brian Dewar, Risa Shorr, Jordi Pardo Pardo , et al. · 2024

Introduction Over the last decade, there have been significant advances in treatments for anterior ischemic stroke, most notably endovascular thrombectomy (EVT). Despite the success of EVT on overall outcomes, intracerebral hemorrhage (ICH…

The prevalence of non-contrast CT imaging abnormalities in reversible cerebral vasoconstriction syndrome: A systematic review and meta-analysis Open

Ryan Gotesman, Naomi Niznick, Brian Dewar, Dean Fergusson, Ranjeeta Mallick , et al. · 2024

Background Reversible cerebral vasoconstriction syndrome (RCVS) is a syndrome of recurrent thunderclap headaches and reversible vasoconstriction of the cerebral arteries on neuroimaging within 3 months of onset. Initial non-contrast comput…

Network meta‐analysis can inform the ethical evaluation of trials that randomise away from standard of care: The case of symptomatic carotid stenosis Open

Ronda Lun, Gabriele Zitikyte, Vignan Yogendrakumar, Olena Bereznyakova, Brian Dewar , et al. · 2023

Objective Little guidance exists on the conduct of randomised clinical trials (RCT) that seek to randomise patients away from standard of care. We sought to test the technique of network meta‐analysis (NMA) to ascertain best available evid…

Ethical evaluation in acute stroke decision‐making Open

Michel Shamy, Brian Dewar, Mark Fedyk · 2023

Rationale The evidentiary standards and epistemic models of clinical care, especially those of evidence‐based medicine, are dissimilar to those used in philosophy and examination of how the two systems intersect may help clinicians make mo…

Resource allocation decisions under pandemic conditions: A cross-sectional survey of Ontario physicians Open

Raiza S. Rivera, Joanna E. Anderson, Brian Dewar, Edmund Kwok, Tim Ramsay , et al. · 2023

The COVID-19 pandemic has forced physicians to confront difficult choices regarding the allocation of scarce resources, such as ventilators and critical care beds. Developing policies to guide the allocation of such resources has proven ch…

Safety and efficacy of tenecteplase versus alteplase in stroke patients with carotid tandem lesions: Results from the AcT trial Open

Fouzi Bala, Mohammed Almekhlafi, Nishita Singh, Ibrahim Alhabli, Ayoola Ademola , et al. · 2023

Background: Carotid tandem lesions ((TL) ⩾70% stenosis or occlusion) account for 15–20% of acute stroke with large vessel occlusion. Aims: We investigated the safety and efficacy of intravenous tenecteplase (0.25 mg/kg) versus intravenous …

Recurrence of cervical artery dissection: A systematic review and meta-analysis Open

Elizabeth Lounsbury, Naomi Niznick, Ranjeeta Mallick, Brian Dewar, Alexandra Davis , et al. · 2023

Background and Purpose: Cervical artery dissection (CAD) involving the carotid or vertebral arteries is an important cause of stroke in younger patients. The purpose of this systematic review is to assess the risk of recurrent CAD. Methods…

Advance Consent in Acute Stroke Trials: Survey of Canadian Research Ethics Board Chairs Open

Rena Seeger, Ubong Udoh, Brian Dewar, Stuart G. Nicholls, Mark Fedyk , et al. · 2023

Advance consent could allow individuals at high risk of stroke to provide consent before they might become eligible for enrollment in acute stroke trials. This survey explores the acceptability of this novel technique to Canadian Research …

Safety and Efficacy of Tenecteplase Compared With Alteplase in Patients With Large Vessel Occlusion Stroke Open

Fouzi Bala, Nishita Singh, Brian Buck, Ayoola Ademola, Shelagh B. Coutts , et al. · 2023

Importance It is unknown whether intravenous thrombolysis using tenecteplase is noninferior or preferable compared with alteplase for patients with acute ischemic stroke. Objective To examine the safety and efficacy of tenecteplase compare…

P.065 Comparison in outcomes by sex in acute ischemic stroke patients treated with alteplase versus tenecteplase: a subgroup analysis of AcT Open

Kim Dj, Nishita Singh, Luciana Catanese, BH Buck, Yan Deschaintre , et al. · 2023

Background: Sex differences in treatment response to intravenous thrombolysis (IVT) are poorly characterized. We compared sex-disaggregated outcomes in patients receiving IVT for acute ischemic stroke in the Alteplase compared to Tenectepl…

Stroke Hospitalization Administration & Monitoring: Routine Or Covid-19 Care (SHAMROCC) Open

Timothé Langlois‐Thérien, Michel Shamy, Brian Dewar, Tim Ramsay, Ronda Lun , et al. · 2023

BACKGROUND Monitoring stroke patients in critical-care units for 24 hours after thrombolysis or endovascular thrombectomy is considered standard of care but is not evidence-based. Due to the Covid-19 pandemic, our center modified its proto…

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