Piers Klein
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View article: Prevalence and Radiological Manifestations of Internal Jugular Venous Stenosis in Patients with Pulsatile Tinnitus: A Case-Control Study
Prevalence and Radiological Manifestations of Internal Jugular Venous Stenosis in Patients with Pulsatile Tinnitus: A Case-Control Study Open
IIH = idiopathic intracranial hypertension; IJVS = internal jugular venous stenosis; LP = lumbar puncture; PT = pulsatile tinnitus; SSWA = sigmoid sinus wall abnormalities; TSS = transverse sinus stenosis.
View article: Hypoperfusion intensity ratio is associated with follow-up infarct volume in medium vessel occlusions: A multicenter multinational study
Hypoperfusion intensity ratio is associated with follow-up infarct volume in medium vessel occlusions: A multicenter multinational study Open
Medium vessel occlusion (MeVO) contributes significantly to acute ischemic stroke (AIS). The hypoperfusion intensity ratio (HIR), reflecting collateral circulation via the ratio of Tmax >10s to Tmax >6s volumes, predicts infarct progressio…
View article: The impact of inflammatory markers on clinical outcomes in acute ischemic stroke patients following mechanical thrombectomy: A multicentre study
The impact of inflammatory markers on clinical outcomes in acute ischemic stroke patients following mechanical thrombectomy: A multicentre study Open
View article: Intravenous thrombolysis versus endovascular thrombectomy in acute basilar artery occlusion—A multicenter cohort study
Intravenous thrombolysis versus endovascular thrombectomy in acute basilar artery occlusion—A multicenter cohort study Open
Background: Randomized controlled trials have demonstrated an improved outcome of basilar artery occlusion (BAO) with endovascular thrombectomy (EVT) compared to best medical treatment. However, a minority of the patients recruited up to 1…
View article: Comparison of thrombectomy alone versus bridging thrombolysis in a US population using regression discontinuity analysis
Comparison of thrombectomy alone versus bridging thrombolysis in a US population using regression discontinuity analysis Open
The role of intravenous thrombolysis (IVT) in combination with endovascular thrombectomy (EVT) for the treatment of large vessel occlusion acute ischemic stroke has been evaluated exclusively outside the US, in randomized clinical trials w…
View article: Endovascular treatment of sigmoid Sinus diverticulum in patients with pulsatile tinnitus
Endovascular treatment of sigmoid Sinus diverticulum in patients with pulsatile tinnitus Open
Background Sigmoid sinus diverticula (SSD) are increasingly recognized among the most common causes of pulsatile tinnitus (PT). However, questions remain regarding their etiopathogenesis and optimal management. This study aims to review an…
View article: A multicenter, propensity score-matched analysis of functional outcomes and recanalization success with or without Trevo for Medium and distal vessel occlusion
A multicenter, propensity score-matched analysis of functional outcomes and recanalization success with or without Trevo for Medium and distal vessel occlusion Open
Background Endovascular therapy (EVT) for stroke due to distal or medium vessel occlusion (DMVO) is safe. Due to the distinct anatomical characteristics of DMVOs, further evaluation of EVT is crucial to determine which devices may yield be…
View article: Age‐Specific Differences in Inflammatory Biomarkers and Their Impact on Futile Recanalization After Mechanical Thrombectomy: An Inverse Probability Weighting Analysis
Age‐Specific Differences in Inflammatory Biomarkers and Their Impact on Futile Recanalization After Mechanical Thrombectomy: An Inverse Probability Weighting Analysis Open
Background Mechanical thrombectomy (MT) is the standard treatment for large vessel occlusion (LVO) stroke. However, a substantial proportion of patients experience poor functional outcomes despite successful reperfusion, namely futile reca…
View article: C-reactive protein elevation and subsequent atrial fibrillation detection after ischemic stroke treated with mechanical thrombectomy: An inverse probability weighting analysis
C-reactive protein elevation and subsequent atrial fibrillation detection after ischemic stroke treated with mechanical thrombectomy: An inverse probability weighting analysis Open
Background and aims: Mechanical thrombectomy (MT) is an effective treatment for acute ischemic stroke due to large vessel occlusion (LVO). Atrial fibrillation (AF) can be known before the stroke (or prevalent AF) or be newly detected after…
View article: Efficacy and safety of mechanical thrombectomy in distal medium middle cerebral artery occlusion ischemic stroke patients on low-dose aspirin
Efficacy and safety of mechanical thrombectomy in distal medium middle cerebral artery occlusion ischemic stroke patients on low-dose aspirin Open
Background: Acute ischemic stroke (AIS) from distal medium vessel occlusion (DMVO) presents unique treatment challenges. Mechanical thrombectomy (MT) is emerging as a viable option for these patients, yet the role of pre-stroke aspirin tre…
View article: Venous Sinus Stenting Using a Ledge‐Reducing Catheter, 0.088‐in. Catheter‐Extender With an External Single Point of Control: Technique and Multicenter Clinical Experience
Venous Sinus Stenting Using a Ledge‐Reducing Catheter, 0.088‐in. Catheter‐Extender With an External Single Point of Control: Technique and Multicenter Clinical Experience Open
Background Venous sinus stenting (VSS) is increasingly performed for managing venous sinus stenosis associated with refractory idiopathic intracranial hypertension and/or pulsatile tinnitus. The Monopoint System (MS; Route 92 Medical, San …
View article: Clinical outcomes of patients with unsuccessful mechanical thrombectomy versus best medical management of medium vessel occlusion stroke in the middle cerebral artery territory
Clinical outcomes of patients with unsuccessful mechanical thrombectomy versus best medical management of medium vessel occlusion stroke in the middle cerebral artery territory Open
Background Current randomized controlled trials are investigating the efficacy and safety of mechanical thrombectomy (MT) in patients with medium vessel occlusion (MeVO) stroke. Whether best medical management (MM) is more efficient than u…
View article: Rescue therapy after failed thrombectomy in medium/distal vessel occlusions: A retrospective analysis of an international, multi-center registry
Rescue therapy after failed thrombectomy in medium/distal vessel occlusions: A retrospective analysis of an international, multi-center registry Open
Background: There are limited therapeutic options in cases of failed reperfusion (modified thrombolysis in cerebral infarction [mTICI] score < 2b) after stent-retriever and/or aspiration based endovascular treatment (EVT) for acute ischemi…
View article: Sex-based differences in inflammatory predictors of outcomes in patients undergoing mechanical thrombectomy: an inverse probability weighting analysis
Sex-based differences in inflammatory predictors of outcomes in patients undergoing mechanical thrombectomy: an inverse probability weighting analysis Open
Background: Inflammatory biomarkers, key predictors of ischemic stroke prognosis, may exhibit sex-specific predictive patterns. Objectives: This study investigates sex-based differences in inflammatory biomarkers as predictors of 90-day cl…
View article: Platelet inhibition strategies in rescue stenting after failed thrombectomy: a large retrospective multicenter registry
Platelet inhibition strategies in rescue stenting after failed thrombectomy: a large retrospective multicenter registry Open
Background: Rescue stenting (RS) is a bailout strategy for failed thrombectomy. Optimal platelet inhibition strategy after RS remains unclear. Objectives: We aimed to describe and compare different platelet inhibition strategies during/aft…
View article: Outcomes of Adjunct Emergent Stenting Versus Mechanical Thrombectomy Alone: The RESCUE-ICAS Registry
Outcomes of Adjunct Emergent Stenting Versus Mechanical Thrombectomy Alone: The RESCUE-ICAS Registry Open
BACKGROUND: Underlying intracranial stenosis is the most common cause of failed mechanical thrombectomy in patients with acute ischemic stroke with large vessel occlusion. Adjunct emergent stenting is sometimes performed to improve or main…
View article: Lead-In Parenteral Anticoagulation Prior to Direct Oral Anticoagulation for Cerebral Venous Thrombosis
Lead-In Parenteral Anticoagulation Prior to Direct Oral Anticoagulation for Cerebral Venous Thrombosis Open
Background: Growing evidence suggests that direct oral anticoagulants (DOACs) may be suitable for cerebral venous thrombosis (CVT). The optimal strategy regarding lead-in parenteral anticoagulation (PA) prior to DOAC is unknown. Methods: I…
View article: Predictors and Outcomes of Excellent Recanalization Versus Successful Recanalization After Thrombectomy in Proximal and Distal Medium Vessel Occlusion Strokes: A Multinational Study
Predictors and Outcomes of Excellent Recanalization Versus Successful Recanalization After Thrombectomy in Proximal and Distal Medium Vessel Occlusion Strokes: A Multinational Study Open
Background Acute ischemic stroke arising from medium vessel occlusions (MeVO) poses substantial challenges in treatment and management. This study aims to elucidate the outcomes and factors contributing to achieving excellent recanalizatio…
View article: Endovascular therapy versus medical management in isolated posterior cerebral artery acute ischemic stroke: A multinational multicenter propensity score-weighted study
Endovascular therapy versus medical management in isolated posterior cerebral artery acute ischemic stroke: A multinational multicenter propensity score-weighted study Open
Background: Despite the proven effectiveness of endovascular therapy (EVT) in acute ischemic strokes (AIS) involving anterior circulation large vessel occlusions, isolated posterior cerebral artery (PCA) occlusions (iPCAo) remain underexpl…
View article: Venous sinus diverticulum in patients with pulsatile tinnitus: An acquired lesion
Venous sinus diverticulum in patients with pulsatile tinnitus: An acquired lesion Open
Background The etiopathogenesis of venous sinus diverticulum is controversial. Conflicting evidence has been published suggesting that venous sinus diverticulum is either a congenital or acquired lesion. Methods This is a case report of a …
View article: Predictive value of follow-up infarct volume on functional outcomes in middle cerebral artery M2 segment vessel occlusion stroke treated with mechanical thrombectomy
Predictive value of follow-up infarct volume on functional outcomes in middle cerebral artery M2 segment vessel occlusion stroke treated with mechanical thrombectomy Open
Background: Medium vessel occlusion (MeVO) strokes, particularly affecting the M2 segment of the middle cerebral artery, represent a critical proportion of acute ischemic strokes, posing significant challenges in management and outcome pre…
View article: Control-matched octo/nonagenarian outcomes in acute basilar artery occlusions treated with mechanical thrombectomy—analysis of the PC-SEARCH thrombectomy registry
Control-matched octo/nonagenarian outcomes in acute basilar artery occlusions treated with mechanical thrombectomy—analysis of the PC-SEARCH thrombectomy registry Open
Introduction Age is often used as a predictor in determining outcomes in large vessel occlusions treated with mechanical thrombectomy. However, limited data exist for octo/nonagenarian outcomes compared to younger individuals in acute basi…
View article: Endovascular Treatment for Basilar Artery Occlusion
Endovascular Treatment for Basilar Artery Occlusion Open
Basilar artery occlusion (BAO) is a neurological emergency associated with a high risk for adverse outcomes. This review provides evidence on the therapeutic efficacy of intravenous thrombolysis (IVT) and endovascular therapy (EVT) in the …
View article: CLEAR Thrombectomy Score: An Index to Estimate the Probability of Good Functional Outcome With or Without Endovascular Treatment in the Late Window for Anterior Circulation Occlusion
CLEAR Thrombectomy Score: An Index to Estimate the Probability of Good Functional Outcome With or Without Endovascular Treatment in the Late Window for Anterior Circulation Occlusion Open
Background With the expanding eligibility for endovascular therapy (EVT) of patients presenting in the late window (6–24 hours after last known well), we aimed to derive a score to predict favorable outcomes associated with EVT versus best…
View article: Endovascular Thrombectomy Versus Intravenous Thrombolysis of Posterior Cerebral Artery Occlusion Stroke
Endovascular Thrombectomy Versus Intravenous Thrombolysis of Posterior Cerebral Artery Occlusion Stroke Open
Background and Purpose Posterior cerebral artery occlusion (PCAo) can cause long-term disability, yet randomized controlled trials to guide optimal reperfusion strategy are lacking. We compared the outcomes of PCAo patients treated with en…
View article: Prevalence and Associations of Dural Arteriovenous Fistulae in Cerebral Venous Thrombosis: Analysis of ACTION-CVT
Prevalence and Associations of Dural Arteriovenous Fistulae in Cerebral Venous Thrombosis: Analysis of ACTION-CVT Open
Dural arteriovenous fistulae (DAVFs) represent approximately 10% of all intracranial vascular malformations 1 with an incidence of 0.16-1.04per 100,000 person-years. 2,3Prior studies identified an association between cerebral venous thromb…
View article: Endovascular Therapy in the Extended Time Window for Large Vessel Occlusion in Patients With Pre-Stroke Disability
Endovascular Therapy in the Extended Time Window for Large Vessel Occlusion in Patients With Pre-Stroke Disability Open
Background and Purpose We compared the outcomes of endovascular therapy (EVT) in an extended time window in patients with large-vessel occlusion (LVO) between patients with and without pre-stroke disability.Methods In this prespecified ana…
View article: Outcomes and safety of endovascular treatment from 6 to 24 hours in patients with a pre-stroke moderate disability (mRS 3): a multicenter retrospective study
Outcomes and safety of endovascular treatment from 6 to 24 hours in patients with a pre-stroke moderate disability (mRS 3): a multicenter retrospective study Open
Background Approximately 30% of patients presenting with acute ischemic stroke (AIS) due to large vessel occlusion have pre-stroke modified Rankin Scale (mRS) scores ≥2. We aimed to investigate the safety and outcomes of endovascular treat…
View article: Safety and clinical outcomes of endovascular therapy versus medical management in late presentation of large ischemic stroke
Safety and clinical outcomes of endovascular therapy versus medical management in late presentation of large ischemic stroke Open
Introduction: The benefit of endovascular therapy (EVT) among stroke patients with large ischemic core (ASPECTS 0–5) in the extended time window outside of trial settings remains unclear. We analyzed the effect of EVT among these stroke pa…
View article: Endovascular Versus Medical Therapy in Posterior Cerebral Artery Stroke: Role of Baseline NIHSS Score and Occlusion Site
Endovascular Versus Medical Therapy in Posterior Cerebral Artery Stroke: Role of Baseline NIHSS Score and Occlusion Site Open
BACKGROUND: Acute ischemic stroke with isolated posterior cerebral artery occlusion (iPCAO) lacks management evidence from randomized trials. We aimed to evaluate whether the association between endovascular treatment (EVT) and outcomes in…