1
|
Ganesh A, Volny O, Kovacova I, Tomek A, Bar M, Pádr R, Cihlar F, Nevsimalova M, Jurak L, Havlicek R, Kovar M, Sevcik P, Rohan V, Fiksa J, Cerník D, Jura R, Vaclavik D, Hill MD, Mikulík R. Utilization, Workflow, and Outcomes of Endovascular Thrombectomy in Patients With vs Without Premorbid Disability in a National Registry. Neurol Clin Pract 2024; 14:e200341. [PMID: 39185095 PMCID: PMC11341008 DOI: 10.1212/cpj.0000000000200341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 04/17/2024] [Indexed: 08/27/2024]
Abstract
Background and Objectives Given the paucity of high-quality safety/efficacy data on acute stroke therapies in patients with premorbid disability, they risk being routinely excluded from such therapies. We examined utilization of endovascular thrombectomy (EVT), associated workflow, and poststroke outcomes among patients with vs without premorbid disability. Methods We used national registry data on thrombolysis/EVT for the Czech Republic from 1 January 2016 to 31 December 2020. Premorbid disability was defined as prestroke modified Rankin Scale score (mRS) ≥3. We compared proportions of patients with vs without premorbid disability who received EVT and examined workflow times. We compared ΔmRS-change in mRS from prestroke to 3 months-in patients with vs without premorbid disability, in addition to intracerebral hemorrhage (ICH), mortality, and discharge NIHSS (National Institutes of Health Stroke Scale score), adjusting for age, sex, baseline NIHSS, and comorbidities, and verified using propensity score weighting (PSW) and matching for differences in treatment assignment. We stratified by age group (<65, 65-74, 75-84, ≥85 years) to explore outcome heterogeneity with vs without premorbid disability. Results Among 22,405 patients with ischemic stroke who received thrombolysis/EVT/both, 1,712 (7.6%) had prestroke mRS ≥ 3. Patients with prestroke disability were less likely to receive EVT vs those without (10.1% vs 20.7%, aOR: 0.30, 95% CI 0.24-0.36). When treated, they had longer door-to-arterial puncture times (median: 75 minutes, IQR: 58-100 vs 54, IQR: 27-77, adjusted difference: 12.5, 95% CI 2.68-22.3). Patients with prestroke disability receiving thrombolysis/EVT/both had worse ΔmRS (adjusted rate ratio, aIRR on PSW: 1.57, 95% CI 1.43-1.72), rates of 3-month mRS 5-6, discharge NIHSS, and mortality (aOR-PSW [mortality]: 2.54, 95% CI 1.92-3.34), while ICH did not significantly differ. 32.1% of patients with prestroke disability receiving thrombolysis/EVT/both successfully returned to prestroke state, but this proportion ranged from 19.6% for those older than 85 years to 66.0% for those younger than 65 years. Regardless of premorbid disability, EVT was associated with better outcomes including lower ΔmRS (aIRR-PSW: 0.87, 95% CI 0.83-0.91) and mortality, with no interaction of treatment effect by premorbid disability status (e.g., mortality pinteraction = 0.73). EVT recipients with premorbid disability did not differ significantly for several outcomes including ΔmRS (aIRR: 0.99, 95% CI 0.84-1.17) but were more likely to have 3-month mRS 5-6 (70.1% vs 39.5% without premorbid disability, aOR: 1.85, 95% CI 1.12-3.04). Discussion Patients with premorbid disability were less likely to receive EVT, had slower treatment times, and had worse outcomes compared with patients without premorbid disability. However, regardless of premorbid disability, patients fared better with EVT vs medical management and one-third with prestroke disability returned to their prestroke status.
Collapse
Affiliation(s)
- Aravind Ganesh
- Calgary Stroke Program (AG, MDH), Departments of Clinical Neurosciences and Community Health Sciences, the Hotchkiss Brain Institute, and the O'Brien Institute for Public Health, University of Calgary Cumming School of Medicine, Canada; Department of Neurology (OV, MB), University Hospital Ostrava, Ostrava; International Clinical Research Centre (OV, IK, RM), Stroke Research Program, St. Anne's University Hospital, Brno; Faculty of Medicine (OV, MB), University Ostrava; Department of Neurology (OV), Charles University, 2nd Medical Faculty; Institute of Health Information and Statistics of the Czech Republic (AT), Prague; Department of Radiology (RP), 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital; Department of Radiology (FC), Masaryk Hospital, Usti nad Labem; Department of Neurology (MN), Hospital Ceske Budejovice; Neurocenter (LJ), Regional Hospital Liberec; Department of Neurology (RH), Military University Hospital; Department of Neurology (MK), Na Homolce Hospital, Prague; Department of Neurology (PS, VR), Faculty of Medicine in Pilsen, Charles University in Prague; Department of Neurology (JF), Charles University, First Faculty of Medicine and General University Hospital, Prague; Masaryk Hospital Usti nad Labem - KZ a.s. (DC), Department of Neurology-Comprehensive Stroke Center; Department of Neurology (RJ), University Hospital Brno and Faculty of Medicine Masaryk University, Brno; Department of Neurology (DV), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Departments of Radiology and Medicine (MDH), University of Calgary Cumming School of Medicine, Alberta, Canada; and Department of Neurology (RM), Tomas Bata Regional Hospital Zlin, Czech Republic
| | - Ondrej Volny
- Calgary Stroke Program (AG, MDH), Departments of Clinical Neurosciences and Community Health Sciences, the Hotchkiss Brain Institute, and the O'Brien Institute for Public Health, University of Calgary Cumming School of Medicine, Canada; Department of Neurology (OV, MB), University Hospital Ostrava, Ostrava; International Clinical Research Centre (OV, IK, RM), Stroke Research Program, St. Anne's University Hospital, Brno; Faculty of Medicine (OV, MB), University Ostrava; Department of Neurology (OV), Charles University, 2nd Medical Faculty; Institute of Health Information and Statistics of the Czech Republic (AT), Prague; Department of Radiology (RP), 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital; Department of Radiology (FC), Masaryk Hospital, Usti nad Labem; Department of Neurology (MN), Hospital Ceske Budejovice; Neurocenter (LJ), Regional Hospital Liberec; Department of Neurology (RH), Military University Hospital; Department of Neurology (MK), Na Homolce Hospital, Prague; Department of Neurology (PS, VR), Faculty of Medicine in Pilsen, Charles University in Prague; Department of Neurology (JF), Charles University, First Faculty of Medicine and General University Hospital, Prague; Masaryk Hospital Usti nad Labem - KZ a.s. (DC), Department of Neurology-Comprehensive Stroke Center; Department of Neurology (RJ), University Hospital Brno and Faculty of Medicine Masaryk University, Brno; Department of Neurology (DV), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Departments of Radiology and Medicine (MDH), University of Calgary Cumming School of Medicine, Alberta, Canada; and Department of Neurology (RM), Tomas Bata Regional Hospital Zlin, Czech Republic
| | - Ingrid Kovacova
- Calgary Stroke Program (AG, MDH), Departments of Clinical Neurosciences and Community Health Sciences, the Hotchkiss Brain Institute, and the O'Brien Institute for Public Health, University of Calgary Cumming School of Medicine, Canada; Department of Neurology (OV, MB), University Hospital Ostrava, Ostrava; International Clinical Research Centre (OV, IK, RM), Stroke Research Program, St. Anne's University Hospital, Brno; Faculty of Medicine (OV, MB), University Ostrava; Department of Neurology (OV), Charles University, 2nd Medical Faculty; Institute of Health Information and Statistics of the Czech Republic (AT), Prague; Department of Radiology (RP), 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital; Department of Radiology (FC), Masaryk Hospital, Usti nad Labem; Department of Neurology (MN), Hospital Ceske Budejovice; Neurocenter (LJ), Regional Hospital Liberec; Department of Neurology (RH), Military University Hospital; Department of Neurology (MK), Na Homolce Hospital, Prague; Department of Neurology (PS, VR), Faculty of Medicine in Pilsen, Charles University in Prague; Department of Neurology (JF), Charles University, First Faculty of Medicine and General University Hospital, Prague; Masaryk Hospital Usti nad Labem - KZ a.s. (DC), Department of Neurology-Comprehensive Stroke Center; Department of Neurology (RJ), University Hospital Brno and Faculty of Medicine Masaryk University, Brno; Department of Neurology (DV), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Departments of Radiology and Medicine (MDH), University of Calgary Cumming School of Medicine, Alberta, Canada; and Department of Neurology (RM), Tomas Bata Regional Hospital Zlin, Czech Republic
| | - Aleš Tomek
- Calgary Stroke Program (AG, MDH), Departments of Clinical Neurosciences and Community Health Sciences, the Hotchkiss Brain Institute, and the O'Brien Institute for Public Health, University of Calgary Cumming School of Medicine, Canada; Department of Neurology (OV, MB), University Hospital Ostrava, Ostrava; International Clinical Research Centre (OV, IK, RM), Stroke Research Program, St. Anne's University Hospital, Brno; Faculty of Medicine (OV, MB), University Ostrava; Department of Neurology (OV), Charles University, 2nd Medical Faculty; Institute of Health Information and Statistics of the Czech Republic (AT), Prague; Department of Radiology (RP), 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital; Department of Radiology (FC), Masaryk Hospital, Usti nad Labem; Department of Neurology (MN), Hospital Ceske Budejovice; Neurocenter (LJ), Regional Hospital Liberec; Department of Neurology (RH), Military University Hospital; Department of Neurology (MK), Na Homolce Hospital, Prague; Department of Neurology (PS, VR), Faculty of Medicine in Pilsen, Charles University in Prague; Department of Neurology (JF), Charles University, First Faculty of Medicine and General University Hospital, Prague; Masaryk Hospital Usti nad Labem - KZ a.s. (DC), Department of Neurology-Comprehensive Stroke Center; Department of Neurology (RJ), University Hospital Brno and Faculty of Medicine Masaryk University, Brno; Department of Neurology (DV), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Departments of Radiology and Medicine (MDH), University of Calgary Cumming School of Medicine, Alberta, Canada; and Department of Neurology (RM), Tomas Bata Regional Hospital Zlin, Czech Republic
| | - Michal Bar
- Calgary Stroke Program (AG, MDH), Departments of Clinical Neurosciences and Community Health Sciences, the Hotchkiss Brain Institute, and the O'Brien Institute for Public Health, University of Calgary Cumming School of Medicine, Canada; Department of Neurology (OV, MB), University Hospital Ostrava, Ostrava; International Clinical Research Centre (OV, IK, RM), Stroke Research Program, St. Anne's University Hospital, Brno; Faculty of Medicine (OV, MB), University Ostrava; Department of Neurology (OV), Charles University, 2nd Medical Faculty; Institute of Health Information and Statistics of the Czech Republic (AT), Prague; Department of Radiology (RP), 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital; Department of Radiology (FC), Masaryk Hospital, Usti nad Labem; Department of Neurology (MN), Hospital Ceske Budejovice; Neurocenter (LJ), Regional Hospital Liberec; Department of Neurology (RH), Military University Hospital; Department of Neurology (MK), Na Homolce Hospital, Prague; Department of Neurology (PS, VR), Faculty of Medicine in Pilsen, Charles University in Prague; Department of Neurology (JF), Charles University, First Faculty of Medicine and General University Hospital, Prague; Masaryk Hospital Usti nad Labem - KZ a.s. (DC), Department of Neurology-Comprehensive Stroke Center; Department of Neurology (RJ), University Hospital Brno and Faculty of Medicine Masaryk University, Brno; Department of Neurology (DV), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Departments of Radiology and Medicine (MDH), University of Calgary Cumming School of Medicine, Alberta, Canada; and Department of Neurology (RM), Tomas Bata Regional Hospital Zlin, Czech Republic
| | - Radek Pádr
- Calgary Stroke Program (AG, MDH), Departments of Clinical Neurosciences and Community Health Sciences, the Hotchkiss Brain Institute, and the O'Brien Institute for Public Health, University of Calgary Cumming School of Medicine, Canada; Department of Neurology (OV, MB), University Hospital Ostrava, Ostrava; International Clinical Research Centre (OV, IK, RM), Stroke Research Program, St. Anne's University Hospital, Brno; Faculty of Medicine (OV, MB), University Ostrava; Department of Neurology (OV), Charles University, 2nd Medical Faculty; Institute of Health Information and Statistics of the Czech Republic (AT), Prague; Department of Radiology (RP), 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital; Department of Radiology (FC), Masaryk Hospital, Usti nad Labem; Department of Neurology (MN), Hospital Ceske Budejovice; Neurocenter (LJ), Regional Hospital Liberec; Department of Neurology (RH), Military University Hospital; Department of Neurology (MK), Na Homolce Hospital, Prague; Department of Neurology (PS, VR), Faculty of Medicine in Pilsen, Charles University in Prague; Department of Neurology (JF), Charles University, First Faculty of Medicine and General University Hospital, Prague; Masaryk Hospital Usti nad Labem - KZ a.s. (DC), Department of Neurology-Comprehensive Stroke Center; Department of Neurology (RJ), University Hospital Brno and Faculty of Medicine Masaryk University, Brno; Department of Neurology (DV), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Departments of Radiology and Medicine (MDH), University of Calgary Cumming School of Medicine, Alberta, Canada; and Department of Neurology (RM), Tomas Bata Regional Hospital Zlin, Czech Republic
| | - Filip Cihlar
- Calgary Stroke Program (AG, MDH), Departments of Clinical Neurosciences and Community Health Sciences, the Hotchkiss Brain Institute, and the O'Brien Institute for Public Health, University of Calgary Cumming School of Medicine, Canada; Department of Neurology (OV, MB), University Hospital Ostrava, Ostrava; International Clinical Research Centre (OV, IK, RM), Stroke Research Program, St. Anne's University Hospital, Brno; Faculty of Medicine (OV, MB), University Ostrava; Department of Neurology (OV), Charles University, 2nd Medical Faculty; Institute of Health Information and Statistics of the Czech Republic (AT), Prague; Department of Radiology (RP), 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital; Department of Radiology (FC), Masaryk Hospital, Usti nad Labem; Department of Neurology (MN), Hospital Ceske Budejovice; Neurocenter (LJ), Regional Hospital Liberec; Department of Neurology (RH), Military University Hospital; Department of Neurology (MK), Na Homolce Hospital, Prague; Department of Neurology (PS, VR), Faculty of Medicine in Pilsen, Charles University in Prague; Department of Neurology (JF), Charles University, First Faculty of Medicine and General University Hospital, Prague; Masaryk Hospital Usti nad Labem - KZ a.s. (DC), Department of Neurology-Comprehensive Stroke Center; Department of Neurology (RJ), University Hospital Brno and Faculty of Medicine Masaryk University, Brno; Department of Neurology (DV), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Departments of Radiology and Medicine (MDH), University of Calgary Cumming School of Medicine, Alberta, Canada; and Department of Neurology (RM), Tomas Bata Regional Hospital Zlin, Czech Republic
| | - Miroslava Nevsimalova
- Calgary Stroke Program (AG, MDH), Departments of Clinical Neurosciences and Community Health Sciences, the Hotchkiss Brain Institute, and the O'Brien Institute for Public Health, University of Calgary Cumming School of Medicine, Canada; Department of Neurology (OV, MB), University Hospital Ostrava, Ostrava; International Clinical Research Centre (OV, IK, RM), Stroke Research Program, St. Anne's University Hospital, Brno; Faculty of Medicine (OV, MB), University Ostrava; Department of Neurology (OV), Charles University, 2nd Medical Faculty; Institute of Health Information and Statistics of the Czech Republic (AT), Prague; Department of Radiology (RP), 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital; Department of Radiology (FC), Masaryk Hospital, Usti nad Labem; Department of Neurology (MN), Hospital Ceske Budejovice; Neurocenter (LJ), Regional Hospital Liberec; Department of Neurology (RH), Military University Hospital; Department of Neurology (MK), Na Homolce Hospital, Prague; Department of Neurology (PS, VR), Faculty of Medicine in Pilsen, Charles University in Prague; Department of Neurology (JF), Charles University, First Faculty of Medicine and General University Hospital, Prague; Masaryk Hospital Usti nad Labem - KZ a.s. (DC), Department of Neurology-Comprehensive Stroke Center; Department of Neurology (RJ), University Hospital Brno and Faculty of Medicine Masaryk University, Brno; Department of Neurology (DV), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Departments of Radiology and Medicine (MDH), University of Calgary Cumming School of Medicine, Alberta, Canada; and Department of Neurology (RM), Tomas Bata Regional Hospital Zlin, Czech Republic
| | - Lubomir Jurak
- Calgary Stroke Program (AG, MDH), Departments of Clinical Neurosciences and Community Health Sciences, the Hotchkiss Brain Institute, and the O'Brien Institute for Public Health, University of Calgary Cumming School of Medicine, Canada; Department of Neurology (OV, MB), University Hospital Ostrava, Ostrava; International Clinical Research Centre (OV, IK, RM), Stroke Research Program, St. Anne's University Hospital, Brno; Faculty of Medicine (OV, MB), University Ostrava; Department of Neurology (OV), Charles University, 2nd Medical Faculty; Institute of Health Information and Statistics of the Czech Republic (AT), Prague; Department of Radiology (RP), 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital; Department of Radiology (FC), Masaryk Hospital, Usti nad Labem; Department of Neurology (MN), Hospital Ceske Budejovice; Neurocenter (LJ), Regional Hospital Liberec; Department of Neurology (RH), Military University Hospital; Department of Neurology (MK), Na Homolce Hospital, Prague; Department of Neurology (PS, VR), Faculty of Medicine in Pilsen, Charles University in Prague; Department of Neurology (JF), Charles University, First Faculty of Medicine and General University Hospital, Prague; Masaryk Hospital Usti nad Labem - KZ a.s. (DC), Department of Neurology-Comprehensive Stroke Center; Department of Neurology (RJ), University Hospital Brno and Faculty of Medicine Masaryk University, Brno; Department of Neurology (DV), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Departments of Radiology and Medicine (MDH), University of Calgary Cumming School of Medicine, Alberta, Canada; and Department of Neurology (RM), Tomas Bata Regional Hospital Zlin, Czech Republic
| | - Roman Havlicek
- Calgary Stroke Program (AG, MDH), Departments of Clinical Neurosciences and Community Health Sciences, the Hotchkiss Brain Institute, and the O'Brien Institute for Public Health, University of Calgary Cumming School of Medicine, Canada; Department of Neurology (OV, MB), University Hospital Ostrava, Ostrava; International Clinical Research Centre (OV, IK, RM), Stroke Research Program, St. Anne's University Hospital, Brno; Faculty of Medicine (OV, MB), University Ostrava; Department of Neurology (OV), Charles University, 2nd Medical Faculty; Institute of Health Information and Statistics of the Czech Republic (AT), Prague; Department of Radiology (RP), 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital; Department of Radiology (FC), Masaryk Hospital, Usti nad Labem; Department of Neurology (MN), Hospital Ceske Budejovice; Neurocenter (LJ), Regional Hospital Liberec; Department of Neurology (RH), Military University Hospital; Department of Neurology (MK), Na Homolce Hospital, Prague; Department of Neurology (PS, VR), Faculty of Medicine in Pilsen, Charles University in Prague; Department of Neurology (JF), Charles University, First Faculty of Medicine and General University Hospital, Prague; Masaryk Hospital Usti nad Labem - KZ a.s. (DC), Department of Neurology-Comprehensive Stroke Center; Department of Neurology (RJ), University Hospital Brno and Faculty of Medicine Masaryk University, Brno; Department of Neurology (DV), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Departments of Radiology and Medicine (MDH), University of Calgary Cumming School of Medicine, Alberta, Canada; and Department of Neurology (RM), Tomas Bata Regional Hospital Zlin, Czech Republic
| | - Martin Kovar
- Calgary Stroke Program (AG, MDH), Departments of Clinical Neurosciences and Community Health Sciences, the Hotchkiss Brain Institute, and the O'Brien Institute for Public Health, University of Calgary Cumming School of Medicine, Canada; Department of Neurology (OV, MB), University Hospital Ostrava, Ostrava; International Clinical Research Centre (OV, IK, RM), Stroke Research Program, St. Anne's University Hospital, Brno; Faculty of Medicine (OV, MB), University Ostrava; Department of Neurology (OV), Charles University, 2nd Medical Faculty; Institute of Health Information and Statistics of the Czech Republic (AT), Prague; Department of Radiology (RP), 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital; Department of Radiology (FC), Masaryk Hospital, Usti nad Labem; Department of Neurology (MN), Hospital Ceske Budejovice; Neurocenter (LJ), Regional Hospital Liberec; Department of Neurology (RH), Military University Hospital; Department of Neurology (MK), Na Homolce Hospital, Prague; Department of Neurology (PS, VR), Faculty of Medicine in Pilsen, Charles University in Prague; Department of Neurology (JF), Charles University, First Faculty of Medicine and General University Hospital, Prague; Masaryk Hospital Usti nad Labem - KZ a.s. (DC), Department of Neurology-Comprehensive Stroke Center; Department of Neurology (RJ), University Hospital Brno and Faculty of Medicine Masaryk University, Brno; Department of Neurology (DV), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Departments of Radiology and Medicine (MDH), University of Calgary Cumming School of Medicine, Alberta, Canada; and Department of Neurology (RM), Tomas Bata Regional Hospital Zlin, Czech Republic
| | - Petr Sevcik
- Calgary Stroke Program (AG, MDH), Departments of Clinical Neurosciences and Community Health Sciences, the Hotchkiss Brain Institute, and the O'Brien Institute for Public Health, University of Calgary Cumming School of Medicine, Canada; Department of Neurology (OV, MB), University Hospital Ostrava, Ostrava; International Clinical Research Centre (OV, IK, RM), Stroke Research Program, St. Anne's University Hospital, Brno; Faculty of Medicine (OV, MB), University Ostrava; Department of Neurology (OV), Charles University, 2nd Medical Faculty; Institute of Health Information and Statistics of the Czech Republic (AT), Prague; Department of Radiology (RP), 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital; Department of Radiology (FC), Masaryk Hospital, Usti nad Labem; Department of Neurology (MN), Hospital Ceske Budejovice; Neurocenter (LJ), Regional Hospital Liberec; Department of Neurology (RH), Military University Hospital; Department of Neurology (MK), Na Homolce Hospital, Prague; Department of Neurology (PS, VR), Faculty of Medicine in Pilsen, Charles University in Prague; Department of Neurology (JF), Charles University, First Faculty of Medicine and General University Hospital, Prague; Masaryk Hospital Usti nad Labem - KZ a.s. (DC), Department of Neurology-Comprehensive Stroke Center; Department of Neurology (RJ), University Hospital Brno and Faculty of Medicine Masaryk University, Brno; Department of Neurology (DV), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Departments of Radiology and Medicine (MDH), University of Calgary Cumming School of Medicine, Alberta, Canada; and Department of Neurology (RM), Tomas Bata Regional Hospital Zlin, Czech Republic
| | - Vladimír Rohan
- Calgary Stroke Program (AG, MDH), Departments of Clinical Neurosciences and Community Health Sciences, the Hotchkiss Brain Institute, and the O'Brien Institute for Public Health, University of Calgary Cumming School of Medicine, Canada; Department of Neurology (OV, MB), University Hospital Ostrava, Ostrava; International Clinical Research Centre (OV, IK, RM), Stroke Research Program, St. Anne's University Hospital, Brno; Faculty of Medicine (OV, MB), University Ostrava; Department of Neurology (OV), Charles University, 2nd Medical Faculty; Institute of Health Information and Statistics of the Czech Republic (AT), Prague; Department of Radiology (RP), 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital; Department of Radiology (FC), Masaryk Hospital, Usti nad Labem; Department of Neurology (MN), Hospital Ceske Budejovice; Neurocenter (LJ), Regional Hospital Liberec; Department of Neurology (RH), Military University Hospital; Department of Neurology (MK), Na Homolce Hospital, Prague; Department of Neurology (PS, VR), Faculty of Medicine in Pilsen, Charles University in Prague; Department of Neurology (JF), Charles University, First Faculty of Medicine and General University Hospital, Prague; Masaryk Hospital Usti nad Labem - KZ a.s. (DC), Department of Neurology-Comprehensive Stroke Center; Department of Neurology (RJ), University Hospital Brno and Faculty of Medicine Masaryk University, Brno; Department of Neurology (DV), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Departments of Radiology and Medicine (MDH), University of Calgary Cumming School of Medicine, Alberta, Canada; and Department of Neurology (RM), Tomas Bata Regional Hospital Zlin, Czech Republic
| | - Jan Fiksa
- Calgary Stroke Program (AG, MDH), Departments of Clinical Neurosciences and Community Health Sciences, the Hotchkiss Brain Institute, and the O'Brien Institute for Public Health, University of Calgary Cumming School of Medicine, Canada; Department of Neurology (OV, MB), University Hospital Ostrava, Ostrava; International Clinical Research Centre (OV, IK, RM), Stroke Research Program, St. Anne's University Hospital, Brno; Faculty of Medicine (OV, MB), University Ostrava; Department of Neurology (OV), Charles University, 2nd Medical Faculty; Institute of Health Information and Statistics of the Czech Republic (AT), Prague; Department of Radiology (RP), 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital; Department of Radiology (FC), Masaryk Hospital, Usti nad Labem; Department of Neurology (MN), Hospital Ceske Budejovice; Neurocenter (LJ), Regional Hospital Liberec; Department of Neurology (RH), Military University Hospital; Department of Neurology (MK), Na Homolce Hospital, Prague; Department of Neurology (PS, VR), Faculty of Medicine in Pilsen, Charles University in Prague; Department of Neurology (JF), Charles University, First Faculty of Medicine and General University Hospital, Prague; Masaryk Hospital Usti nad Labem - KZ a.s. (DC), Department of Neurology-Comprehensive Stroke Center; Department of Neurology (RJ), University Hospital Brno and Faculty of Medicine Masaryk University, Brno; Department of Neurology (DV), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Departments of Radiology and Medicine (MDH), University of Calgary Cumming School of Medicine, Alberta, Canada; and Department of Neurology (RM), Tomas Bata Regional Hospital Zlin, Czech Republic
| | - David Cerník
- Calgary Stroke Program (AG, MDH), Departments of Clinical Neurosciences and Community Health Sciences, the Hotchkiss Brain Institute, and the O'Brien Institute for Public Health, University of Calgary Cumming School of Medicine, Canada; Department of Neurology (OV, MB), University Hospital Ostrava, Ostrava; International Clinical Research Centre (OV, IK, RM), Stroke Research Program, St. Anne's University Hospital, Brno; Faculty of Medicine (OV, MB), University Ostrava; Department of Neurology (OV), Charles University, 2nd Medical Faculty; Institute of Health Information and Statistics of the Czech Republic (AT), Prague; Department of Radiology (RP), 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital; Department of Radiology (FC), Masaryk Hospital, Usti nad Labem; Department of Neurology (MN), Hospital Ceske Budejovice; Neurocenter (LJ), Regional Hospital Liberec; Department of Neurology (RH), Military University Hospital; Department of Neurology (MK), Na Homolce Hospital, Prague; Department of Neurology (PS, VR), Faculty of Medicine in Pilsen, Charles University in Prague; Department of Neurology (JF), Charles University, First Faculty of Medicine and General University Hospital, Prague; Masaryk Hospital Usti nad Labem - KZ a.s. (DC), Department of Neurology-Comprehensive Stroke Center; Department of Neurology (RJ), University Hospital Brno and Faculty of Medicine Masaryk University, Brno; Department of Neurology (DV), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Departments of Radiology and Medicine (MDH), University of Calgary Cumming School of Medicine, Alberta, Canada; and Department of Neurology (RM), Tomas Bata Regional Hospital Zlin, Czech Republic
| | - Rene Jura
- Calgary Stroke Program (AG, MDH), Departments of Clinical Neurosciences and Community Health Sciences, the Hotchkiss Brain Institute, and the O'Brien Institute for Public Health, University of Calgary Cumming School of Medicine, Canada; Department of Neurology (OV, MB), University Hospital Ostrava, Ostrava; International Clinical Research Centre (OV, IK, RM), Stroke Research Program, St. Anne's University Hospital, Brno; Faculty of Medicine (OV, MB), University Ostrava; Department of Neurology (OV), Charles University, 2nd Medical Faculty; Institute of Health Information and Statistics of the Czech Republic (AT), Prague; Department of Radiology (RP), 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital; Department of Radiology (FC), Masaryk Hospital, Usti nad Labem; Department of Neurology (MN), Hospital Ceske Budejovice; Neurocenter (LJ), Regional Hospital Liberec; Department of Neurology (RH), Military University Hospital; Department of Neurology (MK), Na Homolce Hospital, Prague; Department of Neurology (PS, VR), Faculty of Medicine in Pilsen, Charles University in Prague; Department of Neurology (JF), Charles University, First Faculty of Medicine and General University Hospital, Prague; Masaryk Hospital Usti nad Labem - KZ a.s. (DC), Department of Neurology-Comprehensive Stroke Center; Department of Neurology (RJ), University Hospital Brno and Faculty of Medicine Masaryk University, Brno; Department of Neurology (DV), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Departments of Radiology and Medicine (MDH), University of Calgary Cumming School of Medicine, Alberta, Canada; and Department of Neurology (RM), Tomas Bata Regional Hospital Zlin, Czech Republic
| | - Daniel Vaclavik
- Calgary Stroke Program (AG, MDH), Departments of Clinical Neurosciences and Community Health Sciences, the Hotchkiss Brain Institute, and the O'Brien Institute for Public Health, University of Calgary Cumming School of Medicine, Canada; Department of Neurology (OV, MB), University Hospital Ostrava, Ostrava; International Clinical Research Centre (OV, IK, RM), Stroke Research Program, St. Anne's University Hospital, Brno; Faculty of Medicine (OV, MB), University Ostrava; Department of Neurology (OV), Charles University, 2nd Medical Faculty; Institute of Health Information and Statistics of the Czech Republic (AT), Prague; Department of Radiology (RP), 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital; Department of Radiology (FC), Masaryk Hospital, Usti nad Labem; Department of Neurology (MN), Hospital Ceske Budejovice; Neurocenter (LJ), Regional Hospital Liberec; Department of Neurology (RH), Military University Hospital; Department of Neurology (MK), Na Homolce Hospital, Prague; Department of Neurology (PS, VR), Faculty of Medicine in Pilsen, Charles University in Prague; Department of Neurology (JF), Charles University, First Faculty of Medicine and General University Hospital, Prague; Masaryk Hospital Usti nad Labem - KZ a.s. (DC), Department of Neurology-Comprehensive Stroke Center; Department of Neurology (RJ), University Hospital Brno and Faculty of Medicine Masaryk University, Brno; Department of Neurology (DV), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Departments of Radiology and Medicine (MDH), University of Calgary Cumming School of Medicine, Alberta, Canada; and Department of Neurology (RM), Tomas Bata Regional Hospital Zlin, Czech Republic
| | - Michael D Hill
- Calgary Stroke Program (AG, MDH), Departments of Clinical Neurosciences and Community Health Sciences, the Hotchkiss Brain Institute, and the O'Brien Institute for Public Health, University of Calgary Cumming School of Medicine, Canada; Department of Neurology (OV, MB), University Hospital Ostrava, Ostrava; International Clinical Research Centre (OV, IK, RM), Stroke Research Program, St. Anne's University Hospital, Brno; Faculty of Medicine (OV, MB), University Ostrava; Department of Neurology (OV), Charles University, 2nd Medical Faculty; Institute of Health Information and Statistics of the Czech Republic (AT), Prague; Department of Radiology (RP), 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital; Department of Radiology (FC), Masaryk Hospital, Usti nad Labem; Department of Neurology (MN), Hospital Ceske Budejovice; Neurocenter (LJ), Regional Hospital Liberec; Department of Neurology (RH), Military University Hospital; Department of Neurology (MK), Na Homolce Hospital, Prague; Department of Neurology (PS, VR), Faculty of Medicine in Pilsen, Charles University in Prague; Department of Neurology (JF), Charles University, First Faculty of Medicine and General University Hospital, Prague; Masaryk Hospital Usti nad Labem - KZ a.s. (DC), Department of Neurology-Comprehensive Stroke Center; Department of Neurology (RJ), University Hospital Brno and Faculty of Medicine Masaryk University, Brno; Department of Neurology (DV), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Departments of Radiology and Medicine (MDH), University of Calgary Cumming School of Medicine, Alberta, Canada; and Department of Neurology (RM), Tomas Bata Regional Hospital Zlin, Czech Republic
| | - Robert Mikulík
- Calgary Stroke Program (AG, MDH), Departments of Clinical Neurosciences and Community Health Sciences, the Hotchkiss Brain Institute, and the O'Brien Institute for Public Health, University of Calgary Cumming School of Medicine, Canada; Department of Neurology (OV, MB), University Hospital Ostrava, Ostrava; International Clinical Research Centre (OV, IK, RM), Stroke Research Program, St. Anne's University Hospital, Brno; Faculty of Medicine (OV, MB), University Ostrava; Department of Neurology (OV), Charles University, 2nd Medical Faculty; Institute of Health Information and Statistics of the Czech Republic (AT), Prague; Department of Radiology (RP), 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital; Department of Radiology (FC), Masaryk Hospital, Usti nad Labem; Department of Neurology (MN), Hospital Ceske Budejovice; Neurocenter (LJ), Regional Hospital Liberec; Department of Neurology (RH), Military University Hospital; Department of Neurology (MK), Na Homolce Hospital, Prague; Department of Neurology (PS, VR), Faculty of Medicine in Pilsen, Charles University in Prague; Department of Neurology (JF), Charles University, First Faculty of Medicine and General University Hospital, Prague; Masaryk Hospital Usti nad Labem - KZ a.s. (DC), Department of Neurology-Comprehensive Stroke Center; Department of Neurology (RJ), University Hospital Brno and Faculty of Medicine Masaryk University, Brno; Department of Neurology (DV), AGEL Research and Training Institute, Ostrava Vitkovice Hospital, Czech Republic; Departments of Radiology and Medicine (MDH), University of Calgary Cumming School of Medicine, Alberta, Canada; and Department of Neurology (RM), Tomas Bata Regional Hospital Zlin, Czech Republic
| |
Collapse
|
2
|
Enriquez BAB, Skattør TH, Laugesen NG, Truelsen T, Lund CG, Nome T, Beyer MK, Skjelland M, Aamodt AH. External validation of clinical risk prediction score for elderly treated with endovascular thrombectomy. J Neurol 2024; 271:5838-5845. [PMID: 38954035 PMCID: PMC11377628 DOI: 10.1007/s00415-024-12535-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 05/29/2024] [Accepted: 06/23/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND AND AIM The thrombectomy in the elderly prediction score (TERPS) for functional outcome after anterior circulation endovascular therapy (EVT) in patients ≥ 80 years was recently developed. The aim of this study was to assess predictors of functional outcome in the elderly and validate the prediction model. METHODS Consecutive patients treated with EVT from the Oslo Acute Reperfusion Stroke Study were evaluated for inclusion. Clinical and radiological parameters were used to calculate the TERPS, and functional outcome were assessed at 3-month follow-up. RESULTS Out of 1028 patients who underwent EVT for acute ischemic stroke from January 2017 to July 2022, 218 (21.2%) patients ≥ 80 years with anterior ischemic stroke were included. Fair outcome, defined as modified Rankin scale ≤ 3 (mRS), was achieved in 117 (53.7%). In bivariate analyses, male sex (p 0.035), age (p 0.025), baseline National Institute of Health Stroke Scale (NIHSS, p < 0.001), pre-stroke mRS (p 0.002) and Alberta Stroke Program Early Computed Tomography score (ASPECTS, p 0.001) were associated with fair outcome. Significant predictors for fair outcome in regression analyses were lower pre-stroke mRS, adjusted odd ratio, (aOR) 0.67 (95% CI 0.50-0.91, p 0.01), NIHSS, aOR 0.92 (95% CI 0.87-0.97, p 0.002), and higher ASPECTS, aOR 1.22 (95% CI 1.03-1.44, p 0.023). The area under the curve (AUC) using TERPS was 0.74 (95% CI 0.67-0.80). CONCLUSIONS The risk prediction score TERPS showed moderate performance in this external validation. Other variables may still be included to improve the model and validation using other cohorts is recommended. TRIAL REGISTRATION NCT06220981.
Collapse
Affiliation(s)
- Brian Anthony B Enriquez
- Department of Neurology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Thor Håkon Skattør
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Thomas Truelsen
- Department of Neurology, Stroke Center Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, The University of Copenhagen, Copenhagen, Denmark
| | | | - Terje Nome
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Mona K Beyer
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Mona Skjelland
- Department of Neurology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anne Hege Aamodt
- Department of Neurology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
- Department of Neuromedicine and Movement Science, The Norwegian University of Science and Technology, Trondheim, Norway.
| |
Collapse
|
3
|
Siegler JE, Koneru M, Qureshi MM, Doheim M, Nogueira RG, Martinez‐Majander N, Nagel S, Penckofer M, Demeestere J, Puetz V, Ribo M, Abdalkader M, Marto JP, Al‐Bayati AR, Yamagami H, Haussen DC, Olive‐Gadea M, Winzer S, Mohammaden MH, Lemmens R, Tanaka K, Virtanen P, Dusart A, Bellante F, Kaiser DPO, Caparros F, Henon H, Ramos JN, Ortega‐Gutierrez S, Sheth SA, Nannoni S, Vandewalle L, Kaesmacher J, Salazar‐Marioni S, Tomppo L, Ventura R, Zaidi SF, Jumaa M, Castonguay AC, Galecio‐Castillo M, Puri AS, Mujanovic A, Klein P, Shu L, Farzin B, Moomey H, Masoud HE, Jesser J, Möhlenbruch MA, Ringleb PA, Strbian D, Zaidat OO, Yaghi S, Strambo D, Michel P, Roy D, Yoshimura S, Uchida K, Raymond J, Nguyen TN. 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. J Am Heart Assoc 2024; 13:e034948. [PMID: 38979812 PMCID: PMC11292751 DOI: 10.1161/jaha.124.034948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 06/07/2024] [Indexed: 07/10/2024]
Abstract
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 medical management. METHODS AND RESULTS A multinational observational cohort of patients from the CLEAR (Computed Tomography for Late Endovascular Reperfusion) study with proximal intracranial occlusion (2014-2022) was queried (n=58 sites). Logistic regression analyses were used to derive a 9-point score for predicting good functional outcome (modified Rankin Scale score 0-2 or return to premorbid modified Rankin Scale score) at 90 days, with sensitivity analyses for prespecified subgroups conducted using bootstrapped random forest regressions. Secondary outcomes included 90-day functional independence (modified Rankin Scale score 0-2), poor outcome (modified Rankin Scale score 5-6), and 90-day survival. The score was externally validated with a single-center cohort (2014-2023). Of the 3231 included patients (n=2499 EVT), a 9-point score included age, early computed tomography ischemic changes, and stroke severity, with higher points indicating a higher probability of a good functional outcome. The areas under the curve for the primary outcome among EVT and best medical management subgroups were 0.72 (95% CI, 0.70-0.74) and 0.87 (95% CI, 0.84-0.90), respectively, with similar performance in the external validation cohort (area under the curve, 0.71 [95% CI, 0.66-0.76]). There was a significant interaction between the score and EVT for good functional outcome, functional independence, and poor outcome (all Pinteraction<0.001), with greater benefit favoring patients with lower and midrange scores. CONCLUSIONS This score is a pragmatic tool that can estimate the probability of a good outcome with EVT in the late window. REGISTRATION URL: https://www.Clinicaltrials.gov; Unique identifier: NCT04096248.
Collapse
|
4
|
Maestrini I, Rocchi L, Diana F, Requena Ruiz M, Elosua-Bayes I, Ribo M, Abdalkader M, Klein P, Gabrieli JD, Alexandre AM, Pedicelli A, Lacidogna G, Ciullo I, Marnat G, Cester G, Broccolini A, Nguyen TN, Tomasello A, Garaci F, Diomedi M, Da Ros V. 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. J Neurointerv Surg 2024:jnis-2024-021634. [PMID: 38811146 DOI: 10.1136/jnis-2024-021634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 04/13/2024] [Indexed: 05/31/2024]
Abstract
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 treatment (EVT) in patients with AIS with moderate pre-stroke disability (mRS score 3) in an extended time frame (ie, 6-24 hours from the last time known well). METHODS Data were collected from five centers in Europe and the USA from January 2018 to January 2023 and included 180 patients who underwent EVT in an extended time frame. Patients were divided into two groups of 90 each (Group 1: pre-mRS 0-2; Group 2: pre-mRS 3; 71% women, mean age 80.3±11.9 years). Primary outcomes were: (1) 3-month good clinical outcome (Group 1: mRS 0-2, Group 2: mRS 0-3) and ΔmRS; (2) any hemorrhagic transformation (HT); and (3) symptomatic HT. Secondary outcomes were successful and complete recanalization after EVT and 3-month mortality. RESULTS No between-group differences were found in the 3-month good clinical outcome (26.6% vs 25.5%, P=0.974), any HT (26.6% vs 22%, P=0.733), and symptomatic HT (8.9 vs 4.4%, P=0.232). Unexpectedly, ΔmRS was significantly smaller in Group 2 compared with Group 1 (1.64±1.61 vs 2.97±1.69, P<0.001). No between-group differences were found in secondary outcomes. CONCLUSION Patients with pre-stroke mRS 3 are likely to have similar outcomes after EVT in the extended time frame to those with pre-stroke mRS 0-2, with no difference in safety.
Collapse
Affiliation(s)
- Ilaria Maestrini
- Stroke Center, Department of Systems Medicine, University Hospital of Rome Tor Vergata, Rome, Italy
| | - Lorenzo Rocchi
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Francesco Diana
- Interventional Neuroradiology, Vall d'Hebron University Hospital, Barcelona, Spain
- Stroke Research group, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Manuel Requena Ruiz
- Stroke Research group, Vall d'Hebron Research Institute, Barcelona, Spain
- Stroke Unit, Department of Neurology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Iker Elosua-Bayes
- Stroke Research group, Vall d'Hebron Research Institute, Barcelona, Spain
- Stroke Unit, Department of Neurology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Marc Ribo
- Stroke Research group, Vall d'Hebron Research Institute, Barcelona, Spain
- Stroke Unit, Department of Neurology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Mohamad Abdalkader
- Diagnostic and Interventional Neuroradiology, Boston Medical Center, Boston, Massachusetts, USA
| | - Piers Klein
- Diagnostic and Interventional Neuroradiology, Boston Medical Center, Boston, Massachusetts, USA
| | - Joseph D Gabrieli
- Department of Neuroradiology, University Hospital of Padova, Padua, Italy
| | - Andrea M Alexandre
- UOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
| | - Alessandro Pedicelli
- UOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
- Catholic University School of Medicine, Institute of Bio-Imaging, Rome, Italy
| | - Giordano Lacidogna
- Stroke Center, Department of Systems Medicine, University Hospital of Rome Tor Vergata, Rome, Italy
| | - Ilaria Ciullo
- Stroke Center, Department of Systems Medicine, University Hospital of Rome Tor Vergata, Rome, Italy
| | - Gaultier Marnat
- Interventional and Diagnostic Neuroradiology, Bordeaux University Hospital, Bordeaux, France
| | - Giacomo Cester
- Department of Neuroradiology, University Hospital of Padova, Padua, Italy
| | - Aldobrando Broccolini
- Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Thanh N Nguyen
- Diagnostic and Interventional Neuroradiology, Boston Medical Center, Boston, Massachusetts, USA
| | - Alejandro Tomasello
- Interventional Neuroradiology, Vall d'Hebron University Hospital, Barcelona, Spain
- Stroke Research group, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Marina Diomedi
- Stroke Center, Department of Systems Medicine, University Hospital of Rome Tor Vergata, Rome, Italy
| | - Valerio Da Ros
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| |
Collapse
|
5
|
Nguyen TN, Nogueira RG, Qureshi MM, Nagel S, Raymond J, Abdalkader M, Demeestere J, Marto JP, Sheth SA, Puetz V, Dusart A, Michel P, Ribo M, Zaidat OO, Siegler JE, Haussen DC, Strbian D, Henon H, Mohammaden MH, Möhlenbruch MA, Olive-Gadea M, Puri AS, Winzer S, Kaesmacher J, Klein P, Tomppo L, Caparros F, Ramos JN, Jumaa MA, Zaidi SF, Martinez-Majander N, Nannoni S, Vandewalle L, Bellante F, Farooqui M, Salazar-Marioni S, Virtanen P, Kaiser DPO, Wouters A, Ventura R, Jesser J, Mujanovic A, Shu L, Castonguay AC, Mansoor Z, Qiu Z, Masoud HE, Requena M, Peltola E, Hu W, Lin E, Tanaka K, Cordonnier C, Roy D, Yaghi S, Strambo D, Yamagami H, Fischer U, Jovin TG, Lemmens R, Ringleb PA, Ortega-Gutierrez S. Noncontrast CT Selected Thrombectomy vs Medical Management for Late-Window Anterior Large Vessel Occlusion. Neurology 2024; 102:e209324. [PMID: 38709999 PMCID: PMC11177588 DOI: 10.1212/wnl.0000000000209324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 02/07/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND AND OBJECTIVES There is uncertainty whether patients with large vessel occlusion (LVO) presenting in the late 6-hour to 24-hour time window can be selected for endovascular therapy (EVT) by noncontrast CT (NCCT) and CT angiography (CTA) for LVO detection. We evaluated the clinical outcomes of patients selected for EVT by NCCT compared with those medically managed in the extended time window. METHODS This multinational cohort study was conducted at 66 sites across 10 countries. Consecutive patients with proximal anterior LVO stroke selected for EVT by NCCT or medically managed and presenting within 6-24 hours of time last seen well (TSLW) from January 2014 to May 2022 were included. The primary end point was the 90-day ordinal shift in the modified Rankin Scale (mRS) score. Inverse probability treatment weighting (IPTW) and multivariable methods were used. RESULTS Of 5,098 patients screened, 839 patients were included, with a median (interquartile range) age of 75 (64-83) years; 455 (54.2%) were women. There were 616 patients selected to undergo EVT by NCCT (73.4%) and 223 (26.6%) who were medically managed. In IPTW analyses, there was a more favorable 90-day ordinal mRS shift in patients selected by NCCT to EVT vs those who were medically managed (odds ratio [OR] 1.99, 95% CI 1.53-2.59; p < 0.001). There were higher rates of 90-day functional independence (mRS 0-2) in the EVT group (40.1% vs 18.4%, OR 3.31, 95% CI 2.11-5.20; p < 0.001). sICH was nonsignificantly higher in the EVT group (8.5% vs 1.4%, OR 3.77, 95% CI 0.72-19.7, p = 0.12). Mortality at 90 days was lower in the EVT vs MM group (23.9% vs 32.3%, OR 0.61, 95% CI 0.45-0.83, p = 0.002). DISCUSSION In patients with proximal anterior LVO in the extended time window, there was a lower rate of disability and mortality in patients selected with NCCT and CTA to EVT compared with those who were medically managed. These findings support the use of NCCT as a simpler and more inclusive approach to patient selection in the extended window. TRIAL REGISTRATION INFORMATION This study was registered at ClinicalTrials.gov under NCT04096248. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that for patients with proximal anterior circulation occlusion presenting with ischemic stroke from 6 to 24 hours, compared with medical management, those undergoing thrombectomy based on NCCT have reduced disability and mortality at 90 days.
Collapse
Affiliation(s)
- Thanh N Nguyen
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Raul G Nogueira
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Muhammad M Qureshi
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Simon Nagel
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Jean Raymond
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Mohamad Abdalkader
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Jelle Demeestere
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - João Pedro Marto
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Sunil A Sheth
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Volker Puetz
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Anne Dusart
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Patrik Michel
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Marc Ribo
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Osama O Zaidat
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - James E Siegler
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Diogo C Haussen
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Daniel Strbian
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Hilde Henon
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Mahmoud H Mohammaden
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Markus A Möhlenbruch
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Marta Olive-Gadea
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Ajit S Puri
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Simon Winzer
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Johannes Kaesmacher
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Piers Klein
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Liisa Tomppo
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Francois Caparros
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - João Nuno Ramos
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Mouhammad A Jumaa
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Syed F Zaidi
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Nicolas Martinez-Majander
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Stefania Nannoni
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Lieselotte Vandewalle
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Flavio Bellante
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Mudassir Farooqui
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Sergio Salazar-Marioni
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Pekka Virtanen
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Daniel P O Kaiser
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Anke Wouters
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Rita Ventura
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Jessica Jesser
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Adnan Mujanovic
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Liqi Shu
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Alicia C Castonguay
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Zain Mansoor
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Zhongming Qiu
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Hesham E Masoud
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Manuel Requena
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Erno Peltola
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Wei Hu
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Eugene Lin
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Kanta Tanaka
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Charlotte Cordonnier
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Daniel Roy
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Shadi Yaghi
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Davide Strambo
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Hiroshi Yamagami
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Urs Fischer
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Tudor G Jovin
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Robin Lemmens
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Peter A Ringleb
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| | - Santiago Ortega-Gutierrez
- From the Department of Neurology (T.N.N., P.K., Z.M.), and Department of Radiology (T.N.N., M.M.Q., M.A., P.K., Z.M.), Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), Neurosurgery, University of Pittsburgh Medical Center, PA; Department of Radiation Oncology (M.M.Q.), Boston Medical Center, MA; Department of Neurology (S. Nagel), Klinikum Ludwigshafen, Ludwigshafen, Germany; Department of Neurology (S. Nagel, P.A.R.), Heidelberg University Hospital, Germany; Interventional Neuroradiology Laboratory (J.R., D.R.), Department of Radiology, Centre Hospitalier de l'Universite de Montreal, Quebec, Canada; Department of Neurology (J.D., L.V., A.W., R.L.), UZ Leuven; Laboratory for Neurobiology (J.D., L.V., A.W., R.L.), KU Leuven, Belgium; Department of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (V.P., S.W.), and Dresden Neurovascular Center (V.P., S.W., D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (A.D., F.B.), Hôpital Civil Marie Curie, Charleroi, Belgium; Department of Neurology (P.M., D. Strambo), Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology (M. Ribo, M.O.-G., M. Requena), Hospital Vall d'Hebron, Barcelona, Spain; Neuroscience and Stroke Program (O.O.Z., E.L.), Bon Secours Mercy Health St. Vincent Hospital, Toledo, OH; Department of Neurology (J.E.S.), University of Chicago, IL; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Atlanta, GA; Department of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neurology (H.H., F.C., C.C.), Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; Department of Radiology (M.A.M., J.J.), Heidelberg University Hospital, Germany; Division of Interventional Neuroradiology (A.S.P.), University of Massachusetts Memorial Medical Center, Worcester; Department of Diagnostic and Interventional Neuroradiology (J.K., A.M.), University Hospital Bern, Switzerland; Department of Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (M.A.J., S.F.Z., A.C.C.), University of Toledo, OH; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; Department of Neurology (M.F., S.O.-G.), University of Iowa, Iowa City; Department of Radiology (P.V., E.P.), Helsinki University Hospital, University of Helsinki, Finland; Institute of Neuroradiology (D.P.O.K.), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Department of Neurology (L.S., S.Y.), Rhode Island Hospital, Providence; Department of Neurology (Z.Q.), 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Neurology (H.E.M.), State University of New York, Syracuse; Department of Neurology (W.H.), The First Affiliated Hospital of USTC, China; Department of Cerebrovascular Medicine (K.T.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurology (U.F.), University Hospital Basel, Switzerland; Department of Neurology (U.F.), University Hospital Bern, Switzerland; and Department of Neurology (T.G.J.), Cooper University Hospital, Camden, NJ
| |
Collapse
|
6
|
Nozoe M, Inoue T, Ogino T, Okuda K, Yamamoto K. The added value of frailty assessment as the premorbid stroke status on activities of daily living in patients with acute stroke, stratified by stroke severity. J Nutr Health Aging 2024; 28:100201. [PMID: 38460317 DOI: 10.1016/j.jnha.2024.100201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/10/2024] [Accepted: 02/11/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND The modified Rankin scale (mRS) is extensively used for premorbid evaluation in patients with stroke; however, its limited capacity to assess functional status highlights the need for additional indicators such as frailty. AIMS This study aimed to assess the impact of the premorbid mRS score and frailty on daily living (ADL) activities at hospital discharge, focusing on varying stroke severities. METHODS This single-centre, prospective cohort study included patients with acute stroke aged ≥60 years. Key metrics included the frailty index for frailty assessment or mRS for functional status premorbid and the functional independence measure of the motor domain (FIM-M) at discharge for ADL outcomes. The patients were categorized into mild (0-4), moderate (5-15), and severe (16-42) groups based on the National Institute of Health Stroke Scale. Multiple hierarchical linear regression analyses were performed for each group to evaluate the influence of mRS and frailty on FIM-M scores. RESULTS In the mild stroke group, significant associations were observed with premorbid mRS3 (β = -0.183, p = 0.004), mRS4 (β = -0.234, p < 0.001), and frailty status (β = -0.227, p = 0.005) and FIM-M scores. Premorbid frailty did not show a significant association with the FIM-M scores in the moderate or severe stroke group. Frailty status notably contributed to changes in R², particularly in the mild stroke group (R² change = 0.031, p = 0.002). However, such changes were not evident in the other stroke severity groups. CONCLUSION This study emphasizes the importance of incorporating frailty assessments into premorbid evaluations, particularly when considering ADL outcomes in patients with mild stroke. Conversely, the significance of frailty in moderate-to-severe stroke was less evident.
Collapse
Affiliation(s)
- Masafumi Nozoe
- Department of Physical Therapy, Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan.
| | - Tatsuro Inoue
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Tomoyuki Ogino
- Department of Physical Therapy,Faculty of Rehabilitation, Hyogo Medical University, Kobe, Japan
| | - Kazuki Okuda
- Department of Rehabilitation, Konan Medical Center, Kobe, Japan
| | - Kenta Yamamoto
- Department of Rehabilitation, Konan Medical Center, Kobe, Japan
| |
Collapse
|
7
|
Hahn M, Gröschel S, Othman A, Brockstedt L, Civelek A, Brockmann MA, Gröschel K, Uphaus T. Real world data in mechanical thrombectomy: who are we losing to follow-up? J Neurointerv Surg 2024; 16:471-477. [PMID: 37460214 PMCID: PMC11041564 DOI: 10.1136/jnis-2023-020435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/07/2023] [Indexed: 04/25/2024]
Abstract
BACKGROUND Missing outcome data (MOD) is a common problem in clinical trials and registries, and a potential bias when drawing conclusions from these data. Identifying factors associated with MOD may help to increase follow-up rates and assess the need for imputation strategies. We investigated MOD in a multicenter, prospective registry study of mechanical thrombectomy (MT) in large vessel occlusion ischemic stroke. METHODS 13 082 patients enrolled in the German Stroke Registry-Endovascular Treatment from May 2015 to December 2021 were analyzed with regard to MOD (90 day modified Rankin Scale, mRS). Univariate logistic regression analyses identified factors unbalanced between patients with and without MOD. Subgroup analyses were performed to identify patients for whom increased efforts to perform clinical follow-up after hospital discharge are needed. RESULTS We identified 19.7% (2580/13 082) of patients with MOD at the 90 day follow-up. MOD was more common with higher pre-stroke disability (mRS 3-5, 32.2% vs mRS 0-2, 13.7%; P<0.001), absence of bridging intravenous thrombolysis, longer time to treatment, and in patients with high post-stroke disability at discharge (mRS 3-5 vs 0-2: OR 1.234 (95% CI 1.107 to 1.375); P<0.001). In contrast, MOD was less common with futile recanalization (thrombolysis in cerebral infarction (TICI) score of 0-2a, 12.4% vs TICI 2b-3, 15.0%; P=0.001). In patients discharged alive with well documented baseline characteristics, shorter hospital stay (OR 0.992 (95% CI 0.985 to 0.998); P=0.010) and discharge to institutional care or hospital (OR 1.754 (95% CI 1.558 to 1.976); P<0.001) were associated with MOD. CONCLUSION MOD in routine care MT registry data was not random. Increased efforts to perform clinical follow-up are needed, especially in the case of higher pre-stroke and post-stroke disability and discharge to hospital or institutional care. TRIAL REGISTRATION NCT03356392.
Collapse
Affiliation(s)
- Marianne Hahn
- Department of Neurology and Focus Program Translational Neuroscience (FTN), Rhine main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sonja Gröschel
- Department of Neurology and Focus Program Translational Neuroscience (FTN), Rhine main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Ahmed Othman
- Department of Neuroradiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Lavinia Brockstedt
- Department of Neuroradiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Arda Civelek
- Department of Neurology and Focus Program Translational Neuroscience (FTN), Rhine main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Marc A Brockmann
- Department of Neuroradiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Klaus Gröschel
- Department of Neurology and Focus Program Translational Neuroscience (FTN), Rhine main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Timo Uphaus
- Department of Neurology and Focus Program Translational Neuroscience (FTN), Rhine main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| |
Collapse
|
8
|
Abdalkader M, Ning S, Qureshi MM, Haussen DC, Strbian D, Nagel S, Demeestere J, Puetz V, Mohammaden MH, Olive Gadea M, Winzer S, Yamagami H, Tanaka K, Marto JP, Tomppo L, Henon H, Sheth SA, Ortega-Gutierrez S, Martinez-Majander N, Caparros F, Lemmens R, Dusart A, Bellante F, Zaidi SF, Siegler JE, Nannoni S, Kaesmacher J, Dobrocky T, Farooqui M, Salazar-Marioni S, Virtanen P, Vandewalle L, Wouters A, Jesser J, Ventura R, Castonguay AC, Uchida K, Puri AS, Masoud HE, Klein P, Mansoor Z, Bui J, Kang M, Mujanovic A, Rizzo F, Kokkonen T, Ramos JN, Strambo D, Michel P, Möhlenbruch MA, Lin E, Kaiser DPO, Yoshimura S, Sakai N, Cordonnier C, Ringleb PA, Roy D, Zaidat OO, Fischer U, Ribo M, Raymond J, Nogueira RG, Nguyen TN. Sex Differences in Outcomes of Late-Window Endovascular Stroke Therapy. Stroke 2024; 55:278-287. [PMID: 38252759 DOI: 10.1161/strokeaha.123.045015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 12/15/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND The association between sex and outcome after endovascular thrombectomy of acute ischemic stroke is unclear. The aim of this study was to compare the clinical and safety outcomes between men and women treated with endovascular thrombectomy in the late 6-to-24-hour window period. METHODS This multicenter, retrospective observational cohort study included consecutive patients who underwent endovascular thrombectomy of anterior circulation stroke in the late window from 66 clinical sites in 10 countries from January 2014 to May 2022. The primary outcome was the 90-day ordinal modified Rankin Scale score. Secondary outcomes included 90-day functional independence (FI), return of Rankin (RoR) to prestroke baseline, FI or RoR, symptomatic intracranial hemorrhage, and mortality. Multivariable and inverse probability of treatment weighting methods were used. We explored the interaction of sex with baseline characteristics on the outcomes ordinal modified Rankin Scale and FI or RoR. RESULTS Of 1932 patients, 1055 were women and 877 were men. Women were older (77 versus 69 years), had higher rates of atrial fibrillation, hypertension, and greater prestroke disability, but there was no difference in baseline National Institutes of Health Stroke Scale score. Inverse probability of treatment weighting analysis showed no difference between women and men in ordinal modified Rankin Scale (odds ratio, 0.98 [95% CI, 0.79-1.21]), FI or RoR (odds ratio, 0.98 [95% CI, 0.78-1.22]), severe disability or mortality (odds ratio, 0.99 [95% CI, 0.80-1.23]). The multivariable analysis of the above end points was concordant. There were no interactions between baseline characteristics and sex on the outcomes of ordinal modified Rankin Scale and FI or RoR. CONCLUSIONS In late presenting patients with anterior circulation stroke treated with endovascular thrombectomy in the 6 to 24-hour window, there was no difference in clinical or safety outcomes between men and women.
Collapse
Affiliation(s)
- Mohamad Abdalkader
- Departments of Radiology (M.A., S. Ning, M.M.Q., P.K., Z.M., J.B., M.K., T.N.N.), Boston Medical Center
| | - Shen Ning
- Departments of Radiology (M.A., S. Ning, M.M.Q., P.K., Z.M., J.B., M.K., T.N.N.), Boston Medical Center
| | - Muhammad M Qureshi
- Departments of Radiology (M.A., S. Ning, M.M.Q., P.K., Z.M., J.B., M.K., T.N.N.), Boston Medical Center
- Radiation Oncology (M.M.Q.), Boston Medical Center
| | - Diogo C Haussen
- Departments of Neurology, Grady Memorial Hospital (D.C.H., M.H.M., R.G.N.)
| | - Daniel Strbian
- Departments of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, Finland
| | - Simon Nagel
- Department of Neurology, Klinikum Ludwigshafen, Germany (S. Nagel)
- Departments of Neurology (S. Nagel, P.A.R.). Heidelberg University Hospital, Germany
| | - Jelle Demeestere
- Laboratory for Neurobiology, KU Leuven, Belgium (J.D., R.L., L.V., A.W.)
- Department of Neurology, UZ Leuven, Belgium (J.D., R.L., L.V., A.W.)
| | - Volker Puetz
- Department of Neurology (V.P., S.W.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany
- Dresden Neurovascular Center, Germany (V.P., S.W., D.P.O.K.)
| | | | - Marta Olive Gadea
- Department of Neurology, Hospital Vall d'Hebron, Spain (M.O.G., F.R., M.R.)
| | - Simon Winzer
- Department of Neurology (V.P., S.W.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany
- Dresden Neurovascular Center, Germany (V.P., S.W., D.P.O.K.)
| | - Hiroshi Yamagami
- Department of Stroke Neurology, NHO Osaka National Hospital, Japan (H.Y.)
| | - Kanta Tanaka
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan (K.T.)
| | - João Pedro Marto
- Departments of Radiology (M.A., S. Ning, M.M.Q., P.K., Z.M., J.B., M.K., T.N.N.), Boston Medical Center
| | - Liisa Tomppo
- Departments of Neurology (D. Strbian, L.T., N.M.-M.), Helsinki University Hospital, Finland
| | - Hilde Henon
- Department of Neurology, University of Lille, CHU Lille, Inserm, France (H.H., F.C., C.C.)
| | - Sunil A Sheth
- Department of Neurology, UTHealth McGovern Medical School, Houston (S.A.S., S.S.-M.)
| | | | | | - Francois Caparros
- Department of Neurology, University of Lille, CHU Lille, Inserm, France (H.H., F.C., C.C.)
| | - Robin Lemmens
- Laboratory for Neurobiology, KU Leuven, Belgium (J.D., R.L., L.V., A.W.)
- Department of Neurology, UZ Leuven, Belgium (J.D., R.L., L.V., A.W.)
| | - Anne Dusart
- Department of Neurology, Hôpital Civil Marie Curie, Charleroi, Belgium (A.D., F.B.)
| | - Flavio Bellante
- Department of Neurology, Hôpital Civil Marie Curie, Charleroi, Belgium (A.D., F.B.)
| | - Syed F Zaidi
- Department of Neurology, University of Toledo, Toledo (S.F.Z., A.C.C.)
| | | | - Stefania Nannoni
- Clinical Neurosciences, University of Cambridge, United Kingdom (S. Nannoni)
| | - Johannes Kaesmacher
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Switzerland (J.K., T.D., A.M.)
| | - Tomas Dobrocky
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Switzerland (J.K., T.D., A.M.)
| | | | | | - Pekka Virtanen
- Radiology (P.V., T.K.), Helsinki University Hospital, Finland
| | - Lieselotte Vandewalle
- Laboratory for Neurobiology, KU Leuven, Belgium (J.D., R.L., L.V., A.W.)
- Department of Neurology, UZ Leuven, Belgium (J.D., R.L., L.V., A.W.)
| | - Anke Wouters
- Laboratory for Neurobiology, KU Leuven, Belgium (J.D., R.L., L.V., A.W.)
- Department of Neurology, UZ Leuven, Belgium (J.D., R.L., L.V., A.W.)
| | - Jessica Jesser
- Radiology (J.J., M.A.M.). Heidelberg University Hospital, Germany
| | - Rita Ventura
- Departments of Neurology (J.P.M., R.V.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Occidental, Portugal
| | | | - Kazutaka Uchida
- Department of Neurosurgery, Hyogo Medical University, Japan (K.U., S.Y.)
| | - Ajit S Puri
- Interventional Neuroradiology, University of Massachusetts Memorial Medical Center (A.S.P.)
| | - Hesham E Masoud
- Department of Neurology, State University of New York (H.E.M.)
| | - Piers Klein
- Departments of Radiology (M.A., S. Ning, M.M.Q., P.K., Z.M., J.B., M.K., T.N.N.), Boston Medical Center
| | - Zain Mansoor
- Departments of Radiology (M.A., S. Ning, M.M.Q., P.K., Z.M., J.B., M.K., T.N.N.), Boston Medical Center
| | - Jenny Bui
- Departments of Radiology (M.A., S. Ning, M.M.Q., P.K., Z.M., J.B., M.K., T.N.N.), Boston Medical Center
| | - Matthew Kang
- Departments of Radiology (M.A., S. Ning, M.M.Q., P.K., Z.M., J.B., M.K., T.N.N.), Boston Medical Center
| | - Adnan Mujanovic
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Switzerland (J.K., T.D., A.M.)
| | - Federica Rizzo
- Department of Neurology, Hospital Vall d'Hebron, Spain (M.O.G., F.R., M.R.)
| | - Tatu Kokkonen
- Radiology (P.V., T.K.), Helsinki University Hospital, Finland
| | - João Nuno Ramos
- Radiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Occidental, Portugal
| | - Davide Strambo
- Department of Neurology, Lausanne University Hospital, Switzerland (D. Strambo, P.M.)
| | - Patrik Michel
- Department of Neurology, Lausanne University Hospital, Switzerland (D. Strambo, P.M.)
| | | | - Eugene Lin
- Neuroscience and Stroke Program, Mercy Health St. Vincent Hospital, Toledo (E.L., O.O.Z.)
| | - Daniel P O Kaiser
- Institute of Neuroradiology (D.P.O.K.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany
- Dresden Neurovascular Center, Germany (V.P., S.W., D.P.O.K.)
| | - Shinichi Yoshimura
- Department of Neurosurgery, Hyogo Medical University, Japan (K.U., S.Y.)
| | - Nobuyuki Sakai
- Neurovascular Research, Kobe City Medical Center General Hospital, Japan (N.S.)
| | - Charlotte Cordonnier
- Department of Neurology, University of Lille, CHU Lille, Inserm, France (H.H., F.C., C.C.)
| | - Peter A Ringleb
- Departments of Neurology (S. Nagel, P.A.R.). Heidelberg University Hospital, Germany
| | - Daniel Roy
- Interventional Neuroradiology, CHU Montreal, Canada (D.R., J.R.)
| | - Osama O Zaidat
- Neuroscience and Stroke Program, Mercy Health St. Vincent Hospital, Toledo (E.L., O.O.Z.)
| | - Urs Fischer
- Department of Neurology, University Hospital Basel, Switzerland (U.F.)
| | - Marc Ribo
- Department of Neurology, Hospital Vall d'Hebron, Spain (M.O.G., F.R., M.R.)
| | - Jean Raymond
- Interventional Neuroradiology, CHU Montreal, Canada (D.R., J.R.)
| | - Raul G Nogueira
- Departments of Neurology, Grady Memorial Hospital (D.C.H., M.H.M., R.G.N.)
- Department of Neurology, University of Pittsburgh Medical Center (R.G.N.)
| | - Thanh N Nguyen
- Departments of Radiology (M.A., S. Ning, M.M.Q., P.K., Z.M., J.B., M.K., T.N.N.), Boston Medical Center
- Neurology (T.N.N.), Boston Medical Center
| |
Collapse
|
9
|
Bala F, Beland B, Mistry E, Almekhlafi MA, Goyal M, Ganesh A. Endovascular treatment of acute ischemic stroke in patients with pre-morbid disability: a meta-analysis. J Neurointerv Surg 2023; 15:343-349. [PMID: 35292569 DOI: 10.1136/neurintsurg-2021-018573] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/06/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND Trials of endovascular thrombectomy (EVT) for acute stroke have excluded patients with pre-morbid disability. Observational studies may help inform consideration of EVT in this population. We aimed to assess the effectiveness and safety of EVT in patients with pre-morbid disability. METHODS According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched MEDLINE and Embase for studies describing outcomes in patients with pre-morbid disability (modified Rankin Scale (mRS) 2-5), treated with EVT or medical management (MM). Random-effects meta-analysis was used to pool outcomes including 90-day return to baseline mRS, symptomatic intracerebral hemorrhage (sICH), and 90-day mortality. RESULTS We analyzed 14 studies of patients with pre-morbid disability (mRS 2-5, 1373 EVT and 253 MM). The rate of return to baseline mRS was 30.0% (95% CI 25.3% to 34.7%) in patients treated with EVT. Compared with medical therapy, EVT was associated with a higher likelihood of return to baseline mRS (OR 2.37, 95% CI 1.39 to 4.04) and a trend towards lower mortality (OR 0.68, 95% CI 0.46 to 1.02), with similar odds of sICH (OR 1.01, 95% CI 0.49 to 2.08). In studies comparing patients with versus without pre-morbid disability treated with EVT, similar results were found except that pre-morbid disability, when defined more strictly as mRS 3-5, was associated with mortality (OR 3.49, p<0.001). CONCLUSION In eligible patients with pre-morbid disability, observational studies suggest that EVT carries a higher chance of return to baseline mRS compared with patients treated with MM or without pre-morbid disability, although with higher mortality than patients without pre-morbid disability. These findings argue against the routine exclusion of such patients from EVT and merit validation with randomized trials.
Collapse
Affiliation(s)
- Fouzi Bala
- Calgary Stroke Program, Departments of Clinical Neurosciences, Community Health Sciences, and Radiology, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Benjamin Beland
- Calgary Stroke Program, Departments of Clinical Neurosciences, Community Health Sciences, and Radiology, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Eva Mistry
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Mohammed A Almekhlafi
- Calgary Stroke Program, Departments of Clinical Neurosciences, Community Health Sciences, and Radiology, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Mayank Goyal
- Calgary Stroke Program, Departments of Clinical Neurosciences, Community Health Sciences, and Radiology, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Aravind Ganesh
- Calgary Stroke Program, Departments of Clinical Neurosciences, Community Health Sciences, and Radiology, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada .,Hotchkiss Brain Institute, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| |
Collapse
|
10
|
Siegler JE, Nagel S, Nguyen TN. Author Response: Endovascular vs Medical Management for Late Anterior Large Vessel Occlusion With Prestroke Disability: Analysis of CLEAR and RESCUE-Japan. Neurology 2023; 100:642. [PMID: 36973071 PMCID: PMC10065217 DOI: 10.1212/wnl.0000000000207198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
|
11
|
Iezzi Z, Patel P, Wolfe J, Tiongson J, Vigilante N, Kamen S, Penckofer M, Khalife J, Siegler JE. Outcomes following thrombectomy for acute large vessel occlusion beyond 24 hours or with unknown time of onset. J Stroke Cerebrovasc Dis 2023; 32:106952. [PMID: 36669375 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/21/2022] [Accepted: 12/18/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Endovascular thrombectomy (EVT) is recommended in medically eligible patients with large vessel occlusions (LVO) within 24 hours of symptom onset. While there is evidence that EVT ≥24h after last known well (LKW) is associated with favorable outcomes in patients who meet DAWN/DEFUSE-3 criteria, it is unknown if more liberal criteria can be applied. METHODS A single center, prospective observational cohort of consecutive adult stroke patients was queried for symptomatic occlusions of the internal carotid (ICA) or proximal middle cerebral (M1) arteries (October 2019-January 2022), with a National Institutes of Health Stroke Scale (NIHSS) ≥6, pre-stroke modified Rankin Scale (mRS) 0-2, and Alberta Stroke Program Early Computed Tomography Scale score 3-10. These inclusion criteria were extrapolated from recently published data indicating a benefit with EVT with more liberal patient selection. Patients who underwent EVT ≥24h after LKW were compared against those treated medically. The primary outcome was a good functional outcome (90-day mRS 0-2), which was evaluated using multivariable logistic regression. RESULTS Of the 27 included patients, the median age was 65y (IQR 49-76) with a median NIHSS of 15 (IQR 8-26), and 17 (63.0%) underwent EVT (median LKW-to-puncture 35.5h (IQR 26.9-65.8h). The primary outcome was no different with EVT in unadjusted regression (OR 1.17, 95%CI 0.17-8.09), and there remained no association across all multivariable models tested. Age, pre-stroke disability, and M1 occlusions were non-significantly associated with the primary outcome (p>0.05). There was a non-significant trend indicating a favorable shift in 90-day mRS with EVT (proportional OR 2.04, 95%CI 0.44-9.48). CONCLUSIONS Using more liberal inclusion criteria for EVT in the ultra-extended window, there was no statistically significant difference in the rate of good functional outcome with EVT. Larger studies are called upon to evaluate outcomes when more liberal criteria are used to assess thrombectomy eligibility.
Collapse
Affiliation(s)
- Zachary Iezzi
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Pratit Patel
- Cooper Neurological Institute, Cooper University Hospital, Camden, NJ, USA; Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Jared Wolfe
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | | | | | - Scott Kamen
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Mary Penckofer
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Jane Khalife
- Cooper Neurological Institute, Cooper University Hospital, Camden, NJ, USA; Cooper Medical School of Rowan University, Camden, NJ, USA
| | - James E Siegler
- Cooper Neurological Institute, Cooper University Hospital, Camden, NJ, USA; Cooper Medical School of Rowan University, Camden, NJ, USA.
| |
Collapse
|
12
|
Siegler JE, Qureshi MM, Nogueira RG, Tanaka K, Nagel S, Michel P, Vigilante N, Ribo M, Yamagami H, Yoshimura S, Abdalkader M, Haussen DC, Mohammaden MH, Nannoni S, Möhlenbruch MA, Henon H, Sheth SA, Ortega-Gutierrez S, Olive-Gadea M, Caparros F, Seker F, Zaidi S, Castonguay AC, Uchida K, Sakai N, Puri AS, Farooqui M, Toyoda K, Salazar-Marioni S, Takeuchi M, Farzin B, Masoud HE, Kuhn AL, Rana A, Morimoto M, Shibata M, Nonaka T, Klein P, Sathya A, Kiley NL, Cordonnier C, Strambo D, Demeestere J, Ringleb PA, Roy D, Zaidat OO, Jovin TG, Kaesmacher J, Fischer U, Raymond J, Nguyen TN. Endovascular vs Medical Management for Late Anterior Large Vessel Occlusion With Prestroke Disability: Analysis of CLEAR and RESCUE-Japan. Neurology 2023; 100:e751-e763. [PMID: 36332983 PMCID: PMC9969918 DOI: 10.1212/wnl.0000000000201543] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Current guidelines do not address recommendations for mechanical thrombectomy (MT) in the extended time window (>6 hours after time last seen well [TLSW]) for large vessel occlusion (LVO) patients with preexisting modified Rankin Scale (mRS) > 1. In this study, we evaluated the outcomes of MT vs medical management in patients with prestroke disability presenting in the 6- to 24-hour time window with acute LVO. METHODS We analyzed a multinational cohort (61 sites, 6 countries from 2014 to 2020) of patients with prestroke (or baseline) mRS 2 to 4 and anterior circulation LVO treated 6-24 hours from TLSW. Patients treated in the extended time window with MT vs medical management were compared using multivariable logistic regression and inverse probability of treatment weighting (IPTW). The primary outcome was the return of Rankin (ROR, return to prestroke mRS by 90 days). RESULTS Of 554 included patients (448 who underwent MT), the median age was 82 years (interquartile range [IQR] 72-87) and the National Institutes of Health Stroke Scale (NIHSS) was 18 (IQR 13-22). In both MV logistic regression and IPTW analysis, MT was associated with higher odds of ROR (adjusted OR [aOR] 3.96, 95% CI 1.78-8.79 and OR 3.10, 95% CI 1.20-7.98, respectively). Among other factors, premorbid mRS 4 was associated with higher odds of ROR (aOR, 3.68, 95% CI 1.97-6.87), while increasing NIHSS (aOR 0.90, 95% CI 0.86-0.94) and decreasing Alberta Stroke Program Early Computed Tomography Scale score (aOR per point 0.86, 95% CI 0.75-0.99) were associated with lower odds of ROR. Age, intravenous thrombolysis, and occlusion location were not associated with ROR. DISCUSSION In patients with preexisting disability presenting in the 6- to 24-hour time window, MT is associated with a higher probability of returning to baseline function compared with medical management. CLASSIFICATION OF EVIDENCE This investigation's results provide Class III evidence that in patients with preexisting disability presenting 6-24 hours from the TLSW and acute anterior LVO stroke, there may be a benefit of MT over medical management in returning to baseline function.
Collapse
Affiliation(s)
- James E Siegler
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Muhammad M Qureshi
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Raul G Nogueira
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Kanta Tanaka
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Simon Nagel
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Patrik Michel
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Nicholas Vigilante
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Marc Ribo
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Hiroshi Yamagami
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Shinichi Yoshimura
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Mohamad Abdalkader
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Diogo C Haussen
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Mahmoud H Mohammaden
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Stefania Nannoni
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Markus A Möhlenbruch
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Hilde Henon
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Sunil A Sheth
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Santiago Ortega-Gutierrez
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Marta Olive-Gadea
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Francois Caparros
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Fatih Seker
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Syed Zaidi
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Alicia C Castonguay
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Kazutaka Uchida
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Nobuyuki Sakai
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Ajit S Puri
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Mudassir Farooqui
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Kazunori Toyoda
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Sergio Salazar-Marioni
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Masataka Takeuchi
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Behzad Farzin
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Hesham E Masoud
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Anna Luisa Kuhn
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Ameena Rana
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Masafumi Morimoto
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Masunari Shibata
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Tadashi Nonaka
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Piers Klein
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Anvitha Sathya
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Nicole L Kiley
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Charlotte Cordonnier
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Davide Strambo
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Jelle Demeestere
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Peter A Ringleb
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Daniel Roy
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Osama O Zaidat
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Tudor G Jovin
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Johannes Kaesmacher
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Urs Fischer
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Jean Raymond
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| | - Thanh N Nguyen
- From the Cooper Neurological Institute (J.E.S., A.R., T.G.J.), Cooper University Hospital, Camden, NJ; Department of Radiology (M.M.Q., M.A., P.K., A.S., N.L.K., T.N.N.), Boston Medical Center, Boston University School of Medicine, MA; Departments of Radiation Oncology (M.M.Q.) and Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Department of Neurology (R.G.N.), University of Pittsburgh Medical Center, PA; Division of Stroke Care Unit (Kanta Tanaka, Kazunori Toyoda), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology (S. Nagel), Klinikum Ludwigshafen; Departments of Neurology (S. Nagel, P.A.R.) and Neuroradiology (M.A.M., F.S.), Heidelberg University Hospital, Germany; Department of Neurology (P.M., D.S.), Lausanne University Hospital, University of Lausanne, Switzerland; Cooper Medical School of Rowan University (N.V.), Camden, NJ; Stroke Unit (M.R., M.O.-G.), Neurology, Hospital Vall D'Hebron, Barcelona, Spain; Department of Stroke Neurology (H.Y.), NHO Osaka National Hospital, Japan; Department of Neurosurgery (S.Y.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurology (D.C.H., M.H.M.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA; Department of Clinical Neurosciences (S. Nannoni), University of Cambridge, United Kingdom; University of Lille (H.H., F.C., C.C.), Inserm, Centre Hospitalier Universitaire de Lille, U1172, LilNCog-Lille Neuroscience & Cognition, France; Department of Neurology (S.A.S., S.S.-M.), UTHealth McGovern Medical School, Houston, TX; Department of Neurology (S.O.G., M.F.), University of Iowa Hospitals and Clinics, Iowa City,; Department of Neurology (S.Z., A.C.), University of Toledo, OH; Department of Neurosurgery (K.U.), Hyogo College of Medicine, Nishinomiya, Japan; Department of Neurovascular Research (N.S.), Kobe City Medical Center General Hospital, Japan; Division of Neurointerventional Radiology (A.S.P., A.L.K.), University of Massachusetts Memorial Medical Center, Worcester; Department of Neurosurgery (M.T.), Seisho Hospital, Odawara, Japan; Department of Radiology (B.F., D.R., J.R.), Centre Hospitalier de L'Université de Montréal, Canada; Department of Neurology (H.E.M.), State University of New York, Upstate Medical University, Syracuse, NY; Department of Neurosurgery (M. Morimoto), Yokohama Shintoshi Neurosurgical Hospital; Department of Neurology (M.S.), Ise Red Cross Hospital; Department of Neurosurgery (T.N.), Sapporo Shiroishi Memorial Hospital, Japan; Neurology Department (J.D.), Leuven University Hospital, Belgium; Department of Neurology (P.A.R.), Heidelberg University Hospital, Germany; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; Institute of Diagnostic and Interventional Neuroradiology (J.K.), University of Bern, Inselspital; Institute of Diagnostic (J.K.), Interventional and Pediatric Radiology, University Hospital Bern, Inselspital; Department of Neurology (U.F.), University Hospital Basel, University of Basel; and Department of Neurology (U.F.), University Hospital Bern, University of Bern, Switzerland
| |
Collapse
|
13
|
Successful thrombectomy is beneficial in patients with pre-stroke disability: Results from an international multicenter cohort study. J Neuroradiol 2023; 50:59-64. [PMID: 35341899 DOI: 10.1016/j.neurad.2022.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 03/18/2022] [Accepted: 03/19/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Patients with pre-stroke disability, defined as a modified Rankin Scale (mRS) ≥3, were excluded from most trials of endovascular thrombectomy (EVT) for acute stroke. We sought to evaluate the prognostic factors associated with favorable outcome in stroke patients with known disability undergoing EVT, and the impact of successful reperfusion. METHODS Consecutive acute stroke patients with pre-stroke disability, undergoing EVT, were retrospectively collected between 2016 to 2019 from a Canadian cohort and a multicenter French cohort (Endovascular Treatment in Ischemic Stroke registry-ETIS). Favorable outcome was defined as an mRS equal to pre-stroke mRS. Patients achieving successful reperfusion (defined as a modified Thrombolysis in Cerebral Infarction score of 2b/3) were compared with patients without successful reperfusion to determine if successful EVT was associated with better functional outcomes. RESULTS Among 6220 patients treated with EVT, 280 (4.5%) patients with a pre-stroke mRS ≥3 were included. Sixty-one patients (21.8%) had a favorable outcome and 146 (52.1%) died at 3 months. Patients with successful reperfusion had a higher proportion of favorable 90-day mRS (27.6% versus 19.6%, p = 0.025) and a lower mortality (48.3% versus 69.6%, p = 0.008) than patients without successful reperfusion. After adjusting for baseline prognostic factors, successful reperfusion defined by TICI ≥2b was associated with favorable functional outcome (OR 3.16 CI95% [1.11-11.5]; p 0.048). CONCLUSION In patients with pre-stroke disability, successful reperfusion is associated with a greater proportion of favorable outcome and lower mortality.
Collapse
|
14
|
Ospel JM, Kunz WG, McDonough RV, van Zwam W, Pinckaers F, Saver JL, Hill MD, Demchuk AM, Jovin TG, Mitchell P, Campbell BCV, White P, Muir K, Achit H, Bracard S, Brown S, Goyal M. Cost-Effectiveness of Endovascular Treatment in Large Vessel Occlusion Stroke With Mild Prestroke Disability: Results From the HERMES Collaboration. Stroke 2023; 54:226-233. [PMID: 36472199 DOI: 10.1161/strokeaha.121.038407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The clinical and economic benefit of endovascular treatment (EVT) in addition to best medical management in patients with stroke with mild preexisting symptoms/disability is not well studied. We aimed to investigate cost-effectiveness of EVT in patients with large vessel occlusion and mild prestroke symptoms/disability, defined as a modified Rankin Scale score of 1 or 2. METHODS Data are from the HERMES collaboration (Highly Effective Reperfusion Evaluated in Multiple Endovascular Stroke Trials), which pooled patient-level data from 7 large, randomized EVT trials. We used a decision model consisting of a short-run model to analyze costs and functional outcomes within 90 days after the index stroke and a long-run Markov state transition model (cycle length of 12 months) to estimate expected lifetime costs and outcomes from a health care and a societal perspective. Incremental cost-effectiveness ratio and net monetary benefits were calculated, and a probabilistic sensitivity analysis was performed. RESULTS EVT in addition to best medical management resulted in lifetime cost savings of $2821 (health care perspective) or $5378 (societal perspective) and an increment of 1.27 quality-adjusted life years compared with best medical management alone, indicating dominance of additional EVT as a treatment strategy. The net monetary benefits were higher for EVT in addition to best medical management compared with best medical management alone both at the higher (100 000$/quality-adjusted life years) and lower (50 000$/quality-adjusted life years) willingness to pay thresholds. Probabilistic sensitivity analysis showed decreased costs and an increase in quality-adjusted life years for additional EVT compared with best medical management only. CONCLUSIONS From a health-economic standpoint, EVT in addition to best medical management should be the preferred strategy in patients with acute ischemic stroke with large vessel occlusion and mild prestroke symptoms/disability.
Collapse
Affiliation(s)
- Johanna M Ospel
- Department of Neuroradiology, University Hospital Basel, Switzerland (J.M.O.).,Department of Clinical Neurosciences (J.M.O., R.V.M., M.D.H., A.M.D., M.G.), University of Calgary, Canada.,Department of Diagnostic Imaging (J.M.O., R.V.M., M.D.H., A.M.D., M.G.), University of Calgary, Canada
| | - Wolfgang G Kunz
- Department of Radiology, University Hospital, LMU Munich, Germany (W.G.K.)
| | - Rosalie V McDonough
- Department of Clinical Neurosciences (J.M.O., R.V.M., M.D.H., A.M.D., M.G.), University of Calgary, Canada.,Department of Diagnostic Imaging (J.M.O., R.V.M., M.D.H., A.M.D., M.G.), University of Calgary, Canada
| | - Wim van Zwam
- Department of Radiology, Maastricht University Medical Center, the Netherlands (W.v.Z.)
| | | | - Jeffrey L Saver
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles (J.L.S.)
| | - Michael D Hill
- Department of Clinical Neurosciences (J.M.O., R.V.M., M.D.H., A.M.D., M.G.), University of Calgary, Canada.,Department of Diagnostic Imaging (J.M.O., R.V.M., M.D.H., A.M.D., M.G.), University of Calgary, Canada
| | - Andrew M Demchuk
- Department of Clinical Neurosciences (J.M.O., R.V.M., M.D.H., A.M.D., M.G.), University of Calgary, Canada.,Department of Diagnostic Imaging (J.M.O., R.V.M., M.D.H., A.M.D., M.G.), University of Calgary, Canada
| | - Tudor G Jovin
- Department of Neurology, Cooper University Health Care, Camden (T.G.J.)
| | - Peter Mitchell
- Department of Radiology (P.M.), Royal Melbourne Hospital, University of Melbourne, Australia
| | - Bruce C V Campbell
- Department of Neurology (B.C.V.C.), Royal Melbourne Hospital, University of Melbourne, Australia
| | - Phil White
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.)
| | - Keith Muir
- Department of Neurology, University of Glasgow, Scotland (K.M.)
| | - Hamza Achit
- Department of Medicine (H.A.), Nancy University Hospital, France
| | - Serge Bracard
- Department of Neuroradiology (S.B.), Nancy University Hospital, France
| | - Scott Brown
- Altair Biostatistics, St Louis Park' MN (S.B.)
| | - Mayank Goyal
- Department of Clinical Neurosciences (J.M.O., R.V.M., M.D.H., A.M.D., M.G.), University of Calgary, Canada.,Department of Diagnostic Imaging (J.M.O., R.V.M., M.D.H., A.M.D., M.G.), University of Calgary, Canada
| | | |
Collapse
|
15
|
Zhao H, Bai X, Li W, Tian Q, Wang W, Guo X, Feng Y, Duan L, Dmytriw AA, Patel AB, Yi T, Cao W, Min X, Chen W, Jiao L. Influence of pre-stroke dependency on safety and efficacy of endovascular therapy: A systematic review and meta-analysis. Front Neurol 2022; 13:956958. [PMID: 36212663 PMCID: PMC9532553 DOI: 10.3389/fneur.2022.956958] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/29/2022] [Indexed: 11/27/2022] Open
Abstract
Background and purpose In the landmark trials studying endovascular thrombectomy (EVT), pre-stroke dependent (PSD) patients were generally excluded. This systematic review and meta-analysis aimed to compare the safety and efficacy of EVT between PSD and pre-stroke independent (PSI) patients. Methods We searched CENTRAL, Embase, and Ovid MEDLINE up to 11 November 2021 for studies assessing PSD and PSI patients, which were separately defined as pre-stroke mRS score >2 or >1, and ≤2 or ≤1 accordingly. Two authors extracted data and assessed the risk of bias. A meta-analysis was carried out using the random-effects model. Adjusted OR and 95% CI were used to estimate adjusted pool effects. The main outcomes included favorable outcomes, successful recanalization, symptomatic intracranial hemorrhage, and 90-day mortality. Results A total of 8,004 records met the initial search strategy, and ten studies were included in the final decision. Compared with PSImRS≤2, PSDmRS>2 had a lower favorable outcome (OR 0.51; 95% CI, 0.33-0.79) and higher 90-day mortality (OR 3.32; 95% CI, 2.77-3.98). No significant difference was found in successful recanalization and sICH. After adjustment, only 90-day mortality (aOR 1.99; 95% CI, 1.58-2.49) remained significantly higher in PSDmRS>2. Compared with PSImRS≤1, PSDmRS>1 had lower 90-day mortality (OR, 3.10; 95% CI, 1.84-5.24). No significant difference was found regarding the favorable outcome, successful recanalization, and sICH. After adjustment, no significant difference was found in a favorable outcome, but a higher rate of 90-day mortality (aOR, 2.13; 95% CI, 1.66-2.72) remained in PSDmRS>1. Conclusions PSD does not innately influence the EVT outcomes regarding sICH and favorable outcomes but may increase the risk of 90-day mortality. Until further evidence is available, it is reasonable to suggest EVT for patients with PSD.
Collapse
Affiliation(s)
- Hengxiao Zhao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
| | - Xuesong Bai
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
| | - Wei Li
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- Department of Neurosurgery, Liaocheng Brain Hospital, Liaocheng, China
| | - Qiuyue Tian
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Wenjiao Wang
- Department of Library, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xiaofan Guo
- Department of Neurology, Loma Linda University Health, Loma Linda, CA, United States
| | - Yao Feng
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
| | - Linyan Duan
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Adam A. Dmytriw
- Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Aman B. Patel
- Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Tingyu Yi
- Department of Neurology, Zhangzhou Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Wenbo Cao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
| | - Xiaoli Min
- Department of Cerebrovascular Diseases, The Second Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Wenhuo Chen
- Department of Neurology, Zhangzhou Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Liqun Jiao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
- Department of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
16
|
Yang JC, Bao QJ, Guo Y, Chen SJ, Zhang JT, Zhang Q, Zhou P, Yang MF. Endovascular thrombectomy in acute ischemic stroke patients with prestroke disability (mRS ≥2): A systematic review and meta-analysis. Front Neurol 2022; 13:971399. [PMID: 36188370 PMCID: PMC9520304 DOI: 10.3389/fneur.2022.971399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/19/2022] [Indexed: 11/29/2022] Open
Abstract
Objective The effect of endovascular thrombectomy (EVT) in acute ischemic stroke patients with prestroke disability (modified Rankin Scale score, mRS) ≥2) has not been well-studied. This study aimed to assess the safety and benefit of EVT in patients with prestroke disability. Methods According to PRISMA guidelines, literature searching was performed using PubMed, Embase, and Cochrane databases, for a series of acute ischemic stroke patients with prestroke mRS ≥2 treated by EVT. Random-effects meta-analysis was used to pool the rate of return to prestroke mRS and mortality at 3-month follow-up. Results In total, 13 observational studies, with 2,625 patients, were analyzed. The rates of return to prestroke mRS in patients with prestroke mRS of 2–4 were 20% (120/588), 27% (218/827), and 31% (34/108), respectively. Patients with prestroke disability treated by EVT had a higher likelihood of return to prestroke mRS (relative risk, RR, 1.86; 95% CI 1.28–2.70) and a lower likelihood of mortality (RR 0.75; 95%CI 0.58–0.97) compared with patients with standard medical treatment. Successful recanalization (Thrombolysis in Cerebral Infarction grade 2b-3) after EVT gave a higher likelihood of return to prestroke mRS (RR 2.04; 95% CI 1.17–3.55) and lower mortality (RR 0.72; 95% CI 0.62–0.84) compared with unsuccessful reperfusion. Conclusions Acute ischemic stroke patients with prestroke disability may benefit from EVT. Withholding EVT on the sole ground of prestroke disabilities may not be justified. Systematic Review Registration:https://www.crd.york.ac.uk/prospero/.
Collapse
Affiliation(s)
- Jin-Cai Yang
- Graduate School, Qinghai University, Xining, China
| | - Qiang-Ji Bao
- Graduate School, Qinghai University, Xining, China
| | - Yu Guo
- Graduate School, Qinghai University, Xining, China
| | - Shu-Jun Chen
- Graduate School, Qinghai University, Xining, China
| | | | - Qiang Zhang
- Department of Neurosurgery, Qinghai Provincial People's Hospital, Xining, China
| | - Ping Zhou
- Department of Neurosurgery, Qinghai Provincial People's Hospital, Xining, China
| | - Ming-Fei Yang
- Department of Neurosurgery, Qinghai Provincial People's Hospital, Xining, China
- *Correspondence: Ming-Fei Yang
| |
Collapse
|
17
|
Meinel TR, Lerch C, Fischer U, Beyeler M, Mujanovic A, Kurmann C, Siepen B, Scutelnic A, Müller M, Goeldlin M, Belachew NF, Dobrocky T, Gralla J, Seiffge D, Jung S, Arnold M, Wiest R, Meier R, Kaesmacher J. Multivariable Prediction Model for Futile Recanalization Therapies in Patients With Acute Ischemic Stroke. Neurology 2022; 99:e1009-e1018. [PMID: 35803722 PMCID: PMC9519255 DOI: 10.1212/wnl.0000000000200815] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 04/19/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Very poor outcome despite IV thrombolysis (IVT) and mechanical thrombectomy (MT) occurs in approximately 1 of 4 patients with ischemic stroke and is associated with a high logistic and economic burden. We aimed to develop and validate a multivariable prognostic model to identify futile recanalization therapies (FRTs) in patients undergoing those therapies. METHODS Patients from a prospectively collected observational registry of a single academic stroke center treated with MT and/or IVT were included. The data set was split into a training (N = 1,808, 80%) and internal validation (N = 453, 20%) cohort. We used gradient boosted decision tree machine learning models after k-nearest neighbor imputation of 32 variables available at admission to predict FRT defined as modified Rankin scale 5-6 at 3 months. We report feature importance, ability for discrimination, calibration, and decision curve analysis. RESULTS A total of 2,261 patients with a median (interquartile range) age of 75 years (64-83 years), 46% female, median NIH Stroke Scale 9 (4-17), 34% IVT alone, 41% MT alone, and 25% bridging were included. Overall, 539 (24%) had FRT, more often in MT alone (34%) as compared with IVT alone (11%). Feature importance identified clinical variables (stroke severity, age, active cancer, prestroke disability), laboratory values (glucose, C-reactive protein, creatinine), imaging biomarkers (white matter hyperintensities), and onset-to-admission time as the most important predictors. The final model was discriminatory for predicting 3-month FRT (area under the curve 0.87, 95% CI 0.87-0.88) and had good calibration (Brier 0.12, 0.11-0.12). Overall performance was moderate (F1-score 0.63 ± 0.004), and decision curve analyses suggested higher mean net benefit at lower thresholds of treatment (up to 0.8). CONCLUSIONS This FRT prediction model can help inform shared decision making and identify the most relevant features in the emergency setting. Although it might be particularly useful in low resource healthcare settings, incorporation of further multifaceted variables is necessary to further increase the predictive performance.
Collapse
Affiliation(s)
- Thomas Raphael Meinel
- From the Department of Neurology (T.M., C.L., M.B., B.S., A.S., M.M., M.G., D.S., S.J., M.A.), University Hospital Bern, Inselspital, University of Bern; Department of Neurology and Stroke Center (U.F.), University Hospital Basel and University of Basel; University Institute of Diagnostic and Interventional Neuroradiology (A.M., C.K., N.F.B., T.D., J.G., R.W., R.M., J.K.), Support Center for Advanced Neuroimaging (R.W., R.M., J.K.), and Department of Diagnostic, Paediatric and Interventional Radiology (J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland.
| | - Christine Lerch
- From the Department of Neurology (T.M., C.L., M.B., B.S., A.S., M.M., M.G., D.S., S.J., M.A.), University Hospital Bern, Inselspital, University of Bern; Department of Neurology and Stroke Center (U.F.), University Hospital Basel and University of Basel; University Institute of Diagnostic and Interventional Neuroradiology (A.M., C.K., N.F.B., T.D., J.G., R.W., R.M., J.K.), Support Center for Advanced Neuroimaging (R.W., R.M., J.K.), and Department of Diagnostic, Paediatric and Interventional Radiology (J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland
| | - Urs Fischer
- From the Department of Neurology (T.M., C.L., M.B., B.S., A.S., M.M., M.G., D.S., S.J., M.A.), University Hospital Bern, Inselspital, University of Bern; Department of Neurology and Stroke Center (U.F.), University Hospital Basel and University of Basel; University Institute of Diagnostic and Interventional Neuroradiology (A.M., C.K., N.F.B., T.D., J.G., R.W., R.M., J.K.), Support Center for Advanced Neuroimaging (R.W., R.M., J.K.), and Department of Diagnostic, Paediatric and Interventional Radiology (J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland
| | - Morin Beyeler
- From the Department of Neurology (T.M., C.L., M.B., B.S., A.S., M.M., M.G., D.S., S.J., M.A.), University Hospital Bern, Inselspital, University of Bern; Department of Neurology and Stroke Center (U.F.), University Hospital Basel and University of Basel; University Institute of Diagnostic and Interventional Neuroradiology (A.M., C.K., N.F.B., T.D., J.G., R.W., R.M., J.K.), Support Center for Advanced Neuroimaging (R.W., R.M., J.K.), and Department of Diagnostic, Paediatric and Interventional Radiology (J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland
| | - Adnan Mujanovic
- From the Department of Neurology (T.M., C.L., M.B., B.S., A.S., M.M., M.G., D.S., S.J., M.A.), University Hospital Bern, Inselspital, University of Bern; Department of Neurology and Stroke Center (U.F.), University Hospital Basel and University of Basel; University Institute of Diagnostic and Interventional Neuroradiology (A.M., C.K., N.F.B., T.D., J.G., R.W., R.M., J.K.), Support Center for Advanced Neuroimaging (R.W., R.M., J.K.), and Department of Diagnostic, Paediatric and Interventional Radiology (J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland
| | - Christoph Kurmann
- From the Department of Neurology (T.M., C.L., M.B., B.S., A.S., M.M., M.G., D.S., S.J., M.A.), University Hospital Bern, Inselspital, University of Bern; Department of Neurology and Stroke Center (U.F.), University Hospital Basel and University of Basel; University Institute of Diagnostic and Interventional Neuroradiology (A.M., C.K., N.F.B., T.D., J.G., R.W., R.M., J.K.), Support Center for Advanced Neuroimaging (R.W., R.M., J.K.), and Department of Diagnostic, Paediatric and Interventional Radiology (J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland
| | - Bernhard Siepen
- From the Department of Neurology (T.M., C.L., M.B., B.S., A.S., M.M., M.G., D.S., S.J., M.A.), University Hospital Bern, Inselspital, University of Bern; Department of Neurology and Stroke Center (U.F.), University Hospital Basel and University of Basel; University Institute of Diagnostic and Interventional Neuroradiology (A.M., C.K., N.F.B., T.D., J.G., R.W., R.M., J.K.), Support Center for Advanced Neuroimaging (R.W., R.M., J.K.), and Department of Diagnostic, Paediatric and Interventional Radiology (J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland
| | - Adrian Scutelnic
- From the Department of Neurology (T.M., C.L., M.B., B.S., A.S., M.M., M.G., D.S., S.J., M.A.), University Hospital Bern, Inselspital, University of Bern; Department of Neurology and Stroke Center (U.F.), University Hospital Basel and University of Basel; University Institute of Diagnostic and Interventional Neuroradiology (A.M., C.K., N.F.B., T.D., J.G., R.W., R.M., J.K.), Support Center for Advanced Neuroimaging (R.W., R.M., J.K.), and Department of Diagnostic, Paediatric and Interventional Radiology (J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland
| | - Madlaine Müller
- From the Department of Neurology (T.M., C.L., M.B., B.S., A.S., M.M., M.G., D.S., S.J., M.A.), University Hospital Bern, Inselspital, University of Bern; Department of Neurology and Stroke Center (U.F.), University Hospital Basel and University of Basel; University Institute of Diagnostic and Interventional Neuroradiology (A.M., C.K., N.F.B., T.D., J.G., R.W., R.M., J.K.), Support Center for Advanced Neuroimaging (R.W., R.M., J.K.), and Department of Diagnostic, Paediatric and Interventional Radiology (J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland
| | - Martina Goeldlin
- From the Department of Neurology (T.M., C.L., M.B., B.S., A.S., M.M., M.G., D.S., S.J., M.A.), University Hospital Bern, Inselspital, University of Bern; Department of Neurology and Stroke Center (U.F.), University Hospital Basel and University of Basel; University Institute of Diagnostic and Interventional Neuroradiology (A.M., C.K., N.F.B., T.D., J.G., R.W., R.M., J.K.), Support Center for Advanced Neuroimaging (R.W., R.M., J.K.), and Department of Diagnostic, Paediatric and Interventional Radiology (J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland
| | - Nebiyat Filate Belachew
- From the Department of Neurology (T.M., C.L., M.B., B.S., A.S., M.M., M.G., D.S., S.J., M.A.), University Hospital Bern, Inselspital, University of Bern; Department of Neurology and Stroke Center (U.F.), University Hospital Basel and University of Basel; University Institute of Diagnostic and Interventional Neuroradiology (A.M., C.K., N.F.B., T.D., J.G., R.W., R.M., J.K.), Support Center for Advanced Neuroimaging (R.W., R.M., J.K.), and Department of Diagnostic, Paediatric and Interventional Radiology (J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland
| | - Tomas Dobrocky
- From the Department of Neurology (T.M., C.L., M.B., B.S., A.S., M.M., M.G., D.S., S.J., M.A.), University Hospital Bern, Inselspital, University of Bern; Department of Neurology and Stroke Center (U.F.), University Hospital Basel and University of Basel; University Institute of Diagnostic and Interventional Neuroradiology (A.M., C.K., N.F.B., T.D., J.G., R.W., R.M., J.K.), Support Center for Advanced Neuroimaging (R.W., R.M., J.K.), and Department of Diagnostic, Paediatric and Interventional Radiology (J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland
| | - Jan Gralla
- From the Department of Neurology (T.M., C.L., M.B., B.S., A.S., M.M., M.G., D.S., S.J., M.A.), University Hospital Bern, Inselspital, University of Bern; Department of Neurology and Stroke Center (U.F.), University Hospital Basel and University of Basel; University Institute of Diagnostic and Interventional Neuroradiology (A.M., C.K., N.F.B., T.D., J.G., R.W., R.M., J.K.), Support Center for Advanced Neuroimaging (R.W., R.M., J.K.), and Department of Diagnostic, Paediatric and Interventional Radiology (J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland
| | - David Seiffge
- From the Department of Neurology (T.M., C.L., M.B., B.S., A.S., M.M., M.G., D.S., S.J., M.A.), University Hospital Bern, Inselspital, University of Bern; Department of Neurology and Stroke Center (U.F.), University Hospital Basel and University of Basel; University Institute of Diagnostic and Interventional Neuroradiology (A.M., C.K., N.F.B., T.D., J.G., R.W., R.M., J.K.), Support Center for Advanced Neuroimaging (R.W., R.M., J.K.), and Department of Diagnostic, Paediatric and Interventional Radiology (J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland
| | - Simon Jung
- From the Department of Neurology (T.M., C.L., M.B., B.S., A.S., M.M., M.G., D.S., S.J., M.A.), University Hospital Bern, Inselspital, University of Bern; Department of Neurology and Stroke Center (U.F.), University Hospital Basel and University of Basel; University Institute of Diagnostic and Interventional Neuroradiology (A.M., C.K., N.F.B., T.D., J.G., R.W., R.M., J.K.), Support Center for Advanced Neuroimaging (R.W., R.M., J.K.), and Department of Diagnostic, Paediatric and Interventional Radiology (J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland
| | - Marcel Arnold
- From the Department of Neurology (T.M., C.L., M.B., B.S., A.S., M.M., M.G., D.S., S.J., M.A.), University Hospital Bern, Inselspital, University of Bern; Department of Neurology and Stroke Center (U.F.), University Hospital Basel and University of Basel; University Institute of Diagnostic and Interventional Neuroradiology (A.M., C.K., N.F.B., T.D., J.G., R.W., R.M., J.K.), Support Center for Advanced Neuroimaging (R.W., R.M., J.K.), and Department of Diagnostic, Paediatric and Interventional Radiology (J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland
| | - Roland Wiest
- From the Department of Neurology (T.M., C.L., M.B., B.S., A.S., M.M., M.G., D.S., S.J., M.A.), University Hospital Bern, Inselspital, University of Bern; Department of Neurology and Stroke Center (U.F.), University Hospital Basel and University of Basel; University Institute of Diagnostic and Interventional Neuroradiology (A.M., C.K., N.F.B., T.D., J.G., R.W., R.M., J.K.), Support Center for Advanced Neuroimaging (R.W., R.M., J.K.), and Department of Diagnostic, Paediatric and Interventional Radiology (J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland
| | - Raphael Meier
- From the Department of Neurology (T.M., C.L., M.B., B.S., A.S., M.M., M.G., D.S., S.J., M.A.), University Hospital Bern, Inselspital, University of Bern; Department of Neurology and Stroke Center (U.F.), University Hospital Basel and University of Basel; University Institute of Diagnostic and Interventional Neuroradiology (A.M., C.K., N.F.B., T.D., J.G., R.W., R.M., J.K.), Support Center for Advanced Neuroimaging (R.W., R.M., J.K.), and Department of Diagnostic, Paediatric and Interventional Radiology (J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland
| | - Johannes Kaesmacher
- From the Department of Neurology (T.M., C.L., M.B., B.S., A.S., M.M., M.G., D.S., S.J., M.A.), University Hospital Bern, Inselspital, University of Bern; Department of Neurology and Stroke Center (U.F.), University Hospital Basel and University of Basel; University Institute of Diagnostic and Interventional Neuroradiology (A.M., C.K., N.F.B., T.D., J.G., R.W., R.M., J.K.), Support Center for Advanced Neuroimaging (R.W., R.M., J.K.), and Department of Diagnostic, Paediatric and Interventional Radiology (J.K.), University Hospital Bern, Inselspital, University of Bern, Switzerland
| |
Collapse
|
18
|
Sprügel MI, Sembill JA, Kremer S, Gerner ST, Knott M, Hock S, Engelhorn T, Dörfler A, Huttner HB, Schwab S. Evaluation of Functional Recovery Following Thrombectomy in Patients With Large Vessel Occlusion and Prestroke Disability. JAMA Netw Open 2022; 5:e2227139. [PMID: 35972737 PMCID: PMC9382438 DOI: 10.1001/jamanetworkopen.2022.27139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE It is uncertain whether thrombectomy is associated with benefits in patients with prestroke disability. OBJECTIVE To evaluate the use of thrombectomy for patients with large vessel occlusion and prestroke disability. DESIGN, SETTING, AND PARTICIPANTS This cohort study included patients with large vessel occlusion stroke and prestroke disability (modified Rankin Scale score, 3 or 4) admitted to a single tertiary care center between January 1, 2006, and June 30, 2019 (controls: 2006-2015; thrombectomy: 2015-2019). Follow-up was conducted at 90 days. Data analysis was performed from November 1 to December 31, 2021. EXPOSURES Use of thrombectomy vs no thrombectomy. MAIN OUTCOMES AND MEASURES The primary outcome was functional recovery at 90 days defined as clinical recovery to the functional status before stroke onset. Secondary outcomes included functional dependency, mortality, early neurologic improvement, and recanalization. RESULTS Among 205 patients (149 women [72.7%]; median age, 82 years [IQR, 75-87 years]), 102 individuals (49.8%) received thrombectomy and 103 (50.2%) were controls. Thrombectomy was significantly associated with functional recovery (thrombectomy, 20 [19.6%]; controls, 8 [7.8%]; adjusted difference, 9.4%; 95% CI, 2.2% to 16.7%; P = .005). Secondary outcomes showed differences in mortality, early neurologic improvement, and recanalization in favor of thrombectomy treatment. The rate of functional dependency did not differ significantly between the 2 groups (adjusted difference, 8.9%; 95% CI, -2.5% to 20.2%; P = .13). The rate of functional recovery after thrombectomy was 44.0% for patients with early neurologic improvement, 29.4% for patients with small infarct volume (<50 mL), and 7.0% for patients with neither of these parameters. CONCLUSIONS AND RELEVANCE Findings of this study suggest that selected patients with prestroke disability may benefit from thrombectomy. However, the thrombectomy-associated increase in functional recovery was small. Therefore, routine use of thrombectomy may not be beneficial among patients with a large ischemic core and infarct volumes less than 50 mL may be necessary to obtain functional recovery. Patients with higher chances of functional recovery are also at an increased risk of survival with substantial disability, indicating potential harms from the intervention; further studies are needed.
Collapse
Affiliation(s)
- Maximilian I. Sprügel
- Department of Neurology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Jochen A. Sembill
- Department of Neurology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Svenja Kremer
- Department of Neurology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Stefan T. Gerner
- Department of Neurology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Knott
- Department of Neuroradiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Stefan Hock
- Department of Neuroradiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Tobias Engelhorn
- Department of Neuroradiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Arnd Dörfler
- Department of Neuroradiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Hagen B. Huttner
- Department of Neurology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Stefan Schwab
- Department of Neurology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| |
Collapse
|
19
|
Nguyen TN, Raymond J, Nogueira RG, Fischer U, Siegler JE. The Problem of Restrictive Thrombectomy Trial Eligibility Criteria. Stroke 2022; 53:2988-2990. [DOI: 10.1161/strokeaha.122.040006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Since 2015, a series of endovascular trials transformed the management of patients with large vessel occlusion stroke. Most thrombectomy trials used restrictive eligibility criteria to optimize the chances of showing that thrombectomy could work. The problem arises when generalizing trial results into evidence-based recommendations. Many organizations, oblivious of this problem, translated verbatim restrictive trial eligibility criteria into authoritative guidelines, which limit the use of thrombectomy to highly selected patients. The clinical problem becomes as follows: what to do for all other stroke patients equally in need of care? The cycle of restrictive trial eligibility criteria, corresponding restrictive guidelines, observational studies of unvalidated practices showing other patients benefit, a new trial is needed, has been repeated often. Thrombectomy trials ought to have included all patients that could potentially benefit. If the signal that was looked for by restricting eligibility is at risk of being lost in the noise generated by the heterogeneity of patients, D. Sackett proposed a solution: to use the same criteria, not to select some patients and exclude others but to prespecify the subgroup of patients most likely to benefit. In this commentary, we propose a tiered approach, where the boundaries of treatment beneficiaries can be more rigorously tested and confirmed. Identification of these patients before the development of guidelines, which would have otherwise neglected these individuals, may open innumerable treatment opportunities to those who will instead be denied of them.
Collapse
Affiliation(s)
- Thanh N. Nguyen
- Department of Neurology and Radiology, Boston Medical Center, Boston University School of Medicine, MA (T.N.N.)
| | - Jean Raymond
- Department of Radiology, Service of Neuroradiology, Centre Hospitalier de l’Université de Montreal, Canada (J.R.)
| | - Raul G. Nogueira
- Department of Neurology and Neurosurgery, University of Pittsburgh Medical Center, PA (R.G.N.)
| | - Urs Fischer
- Department of Neurology, University Hospital Basel, University of Basel, Switzerland (U.F.)
- Department of Neurology, University Hospital Bern, University of Bern, Switzerland (U.F.)
| | | |
Collapse
|
20
|
Mohammaden MH, Haussen DC, Al-Bayati AR, Hassan A, Tekle W, Fifi J, Matsoukas S, Kuybu O, Gross BA, Lang MJ, Narayanan S, Cortez GM, Hanel RA, Aghaebrahim A, Sauvageau E, Farooqui M, Ortega-Gutierrez S, Zevallos C, Galecio-Castillo M, Sheth SA, Nahhas M, Salazar-Marioni S, Nguyen TN, Abdalkader M, Klein P, Hafeez M, Kan P, Tanweer O, Khaldi A, Li H, Jumaa M, Zaidi S, Oliver M, Salem MM, Burkhardt JK, Pukenas BA, Alaraj A, Peng S, Kumar R, Lai M, Siegler J, Nogueira RG. Stenting and Angioplasty in Neurothrombectomy: Matched Analysis of Rescue Intracranial Stenting Versus Failed Thrombectomy. Stroke 2022; 53:2779-2788. [DOI: 10.1161/strokeaha.121.038248] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND:
Successful reperfusion is one of the strongest predictors of functional outcomes after mechanical thrombectomy (MT). Despite continuous advancements in MT technology and techniques, reperfusion failure still occurs in ≈15% to 30% of patients with large vessel occlusion strokes undergoing MT. We aim to evaluate the safety and efficacy of rescue intracranial stenting for large vessel occlusion stroke after failed MT.
METHODS:
The SAINT (Stenting and Angioplasty in Neurothrombectomy) Study is a retrospective analysis of prospectively collected data from 14 comprehensive stroke centers through January 2015 to December 2020. Patients were included if they had anterior circulation large vessel occlusion stroke due to intracranial internal carotid artery and middle cerebral artery-M1/M2 segments and failed MT. The cohort was divided into 2 groups: rescue intracranial stenting and failed recanalization (modified Thrombolysis in Cerebral Ischemia score 0–1). Propensity score matching was used to balance the 2 groups. The primary outcome was the shift in the degree of disability as measured by the modified Rankin Scale at 90 days. Secondary outcomes included functional independence (90-day modified Rankin Scale score 0–2). Safety measures included symptomatic intracranial hemorrhage and 90-day mortality.
RESULTS:
A total of 499 patients were included in the analysis. Compared with the failed reperfusion group, rescue intracranial stenting had a favorable shift in the overall modified Rankin Scale score distribution (acOR, 2.31 [95% CI, 1.61–3.32];
P
<0.001), higher rates of functional independence (35.1% versus 7%; adjusted odds ratio [aOR], 6.33 [95% CI, 3.14–12.76];
P
<0.001), and lower mortality (28% versus 46.5%; aOR, 0.55 [95% CI, 0.31–0.96];
P
=0.04) at 90 days. Rates of symptomatic intracerebral hemorrhage were comparable across both groups (7.1% versus 10.2%; aOR, 0.99 [95% CI, 0.42–2.34];
P
=0.98). The matched cohort analysis demonstrated similar results. Specifically, rescue intracranial stenting (n=107) had a favorable shift in the overall modified Rankin Scale score distribution (acOR, 3.74 [95% CI, 2.16–6.57];
P
<0.001), higher rates of functional independence (34.6% versus 6.5%; aOR, 10.91 [95% CI, 4.11–28.92];
P
<0.001), and lower mortality (29.9% versus 43%; aOR, 0.49 [95% CI, 0.25–0.94];
P
=0.03) at 90 days with similar rates of symptomatic intracerebral hemorrhage (7.5% versus 11.2%; aOR, 0.87 [95% CI, 0.31–2.42];
P
=0.79) compared with patients who failed to reperfuse (n=107). There was no heterogeneity of treatment effect across the prespecified subgroups for improvement in functional outcomes.
CONCLUSIONS:
Acute intracranial stenting appears to be a safe and effective rescue strategy in patients with large vessel occlusion stroke who failed MT. Randomized multicenter trials are warranted.
Collapse
Affiliation(s)
- Mahmoud H. Mohammaden
- Department of Neurology, Marcus Stroke & Neuroscience Center, Grady Memorial Hospital, Emory University School of Medicine-Atlanta, GA (M.H.M., D.C.H.)
| | - Diogo C. Haussen
- Department of Neurology, Marcus Stroke & Neuroscience Center, Grady Memorial Hospital, Emory University School of Medicine-Atlanta, GA (M.H.M., D.C.H.)
| | - Alhamza R. Al-Bayati
- UPMC Stroke Institute, Departments of Neurology and Neurosurgery, University of Pittsburgh School of Medicine, PA (A.R.A.-B., O.K., B.A.G., M.J.L., S.N., R.G.N.)
| | - Ameer Hassan
- Department of Neurology, Valley Baptist Medical Center, Harlingen, TX (A.H., W.T.)
| | - Wondwossen Tekle
- Department of Neurology, Valley Baptist Medical Center, Harlingen, TX (A.H., W.T.)
| | - Johanna Fifi
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York (J.F., S.M.)
| | - Stavros Matsoukas
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York (J.F., S.M.)
| | - Okkes Kuybu
- UPMC Stroke Institute, Departments of Neurology and Neurosurgery, University of Pittsburgh School of Medicine, PA (A.R.A.-B., O.K., B.A.G., M.J.L., S.N., R.G.N.)
| | - Bradley A. Gross
- UPMC Stroke Institute, Departments of Neurology and Neurosurgery, University of Pittsburgh School of Medicine, PA (A.R.A.-B., O.K., B.A.G., M.J.L., S.N., R.G.N.)
| | - Michael J. Lang
- UPMC Stroke Institute, Departments of Neurology and Neurosurgery, University of Pittsburgh School of Medicine, PA (A.R.A.-B., O.K., B.A.G., M.J.L., S.N., R.G.N.)
| | - Sandra Narayanan
- UPMC Stroke Institute, Departments of Neurology and Neurosurgery, University of Pittsburgh School of Medicine, PA (A.R.A.-B., O.K., B.A.G., M.J.L., S.N., R.G.N.)
| | - Gustavo M. Cortez
- Lyerly Neurosurgery, Baptist Medical Center Downtown, Jacksonville, FL (G.M.C., R.A.H., A.A., E.S.)
| | - Ricardo A. Hanel
- Lyerly Neurosurgery, Baptist Medical Center Downtown, Jacksonville, FL (G.M.C., R.A.H., A.A., E.S.)
| | - Amin Aghaebrahim
- Lyerly Neurosurgery, Baptist Medical Center Downtown, Jacksonville, FL (G.M.C., R.A.H., A.A., E.S.)
| | - Eric Sauvageau
- Lyerly Neurosurgery, Baptist Medical Center Downtown, Jacksonville, FL (G.M.C., R.A.H., A.A., E.S.)
| | - Mudassir Farooqui
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City (M.F., S.O.-G., C.Z., M.G.-C.)
| | - Santiago Ortega-Gutierrez
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City (M.F., S.O.-G., C.Z., M.G.-C.)
| | - Cynthia Zevallos
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City (M.F., S.O.-G., C.Z., M.G.-C.)
| | - Milagros Galecio-Castillo
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City (M.F., S.O.-G., C.Z., M.G.-C.)
| | - Sunil A. Sheth
- Department of Neurology, University of Texas, Houston (S.A.S., M.N., S.S.-M.)
| | - Michael Nahhas
- Department of Neurology, University of Texas, Houston (S.A.S., M.N., S.S.-M.)
| | | | - Thanh N. Nguyen
- Department of Neurology, Radiology, Boston University School of Medicine, MA (T.N.N., M.A., P.K.)
| | - Mohamad Abdalkader
- Department of Neurology, Radiology, Boston University School of Medicine, MA (T.N.N., M.A., P.K.)
| | - Piers Klein
- Department of Neurology, Radiology, Boston University School of Medicine, MA (T.N.N., M.A., P.K.)
| | - Muhammad Hafeez
- Department of Neurosurgery, Baylor School of Medicine, Houston, TX (M.H., P.K., O.T.)
| | - Peter Kan
- Department of Neurosurgery, Baylor School of Medicine, Houston, TX (M.H., P.K., O.T.)
| | - Omar Tanweer
- Department of Neurosurgery, Baylor School of Medicine, Houston, TX (M.H., P.K., O.T.)
| | - Ahmad Khaldi
- Department of Neurosciences, WellStar Health System, Atlanta, GA (A.K., H.L.)
| | - Hanzhou Li
- Department of Neurosciences, WellStar Health System, Atlanta, GA (A.K., H.L.)
| | - Mouhammad Jumaa
- Department of Neurology, University of Toledo, OH (M.J., S.Z., M.O.)
| | - Syed Zaidi
- Department of Neurology, University of Toledo, OH (M.J., S.Z., M.O.)
| | - Marion Oliver
- Department of Neurology, University of Toledo, OH (M.J., S.Z., M.O.)
| | - Mohamed M. Salem
- Department of Neurosurgery, University of Pennsylvania, Philadelphia (M.M.S., J.-K.B., B.A.P.)
| | - Jan-Karl Burkhardt
- Department of Neurosurgery, University of Pennsylvania, Philadelphia (M.M.S., J.-K.B., B.A.P.)
| | - Bryan A. Pukenas
- Department of Neurosurgery, University of Pennsylvania, Philadelphia (M.M.S., J.-K.B., B.A.P.)
| | - Ali Alaraj
- Department of Neurosurgery, University of Illinois at Chicago (A.A., S.P.)
| | - Sophia Peng
- Department of Neurosurgery, University of Illinois at Chicago (A.A., S.P.)
| | - Rahul Kumar
- Department of Neurology, Cooper University Medical Center, Camden, NJ (R.K., M.L., J.S.)
| | - Michael Lai
- Department of Neurology, Cooper University Medical Center, Camden, NJ (R.K., M.L., J.S.)
| | - James Siegler
- Department of Neurology, Cooper University Medical Center, Camden, NJ (R.K., M.L., J.S.)
| | - Raul G. Nogueira
- UPMC Stroke Institute, Departments of Neurology and Neurosurgery, University of Pittsburgh School of Medicine, PA (A.R.A.-B., O.K., B.A.G., M.J.L., S.N., R.G.N.)
| |
Collapse
|
21
|
Beland B, Bala F, Ganesh A. Thrombolysis for Acute Ischemic Stroke in Patients With Premorbid Disability: A Meta-Analysis. Stroke 2022; 53:3055-3063. [PMID: 35686556 DOI: 10.1161/strokeaha.121.038374] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Randomized controlled trials for the use of alteplase in acute ischemic stroke have excluded or had little representation of patients with prestroke disability, and the benefit of alteplase in this population remains uncertain. We performed a systematic review and meta-analysis to examine the outcomes of thrombolysis in patients with premorbid disability. METHODS We performed a systematic review in accordance with the Meta-Analysis of Observational Studies in Epidemiology guidelines and retrieved studies reporting intravenous thrombolysis (IVT) in patients with prestroke disability (modified Rankin Scale score, 3-5) with acute ischemic stroke, either compared with untreated patients or treated patients without premorbid disability. The primary outcome was the return to premorbid disability at 90 days. Secondary outcomes included rate and odds ratio of favorable functional outcome at 90 days (modified Rankin Scale score 0-2 or return to premorbid modified Rankin Scale), symptomatic intracerebral hemorrhage (sICH), and 90-day mortality. RESULTS Eight articles were included involving 103 988 patients. Patients with disability treated with IVT had better odds of returning to baseline function compared with those who did not receive IVT (odds ratio, 7.26 [95% CI, 2.51-21.02]). Mortality and rates of sICH were not significantly different between patients with disability treated with IVT and those not treated, although there were numerically more sICHs in the IVT group. Return to baseline function was not significantly different between patients with and without prestroke disability (odds ratio, 1.46 [95% CI, 0.75-2.83]). The rates of sICH were not significantly different in patients with and without premorbid disability. However, mortality was 3× higher in patients with premorbid disability than in those without premorbid disability (38.2% versus 12.6%). CONCLUSIONS The use of IVT in patients with disability was associated with better outcomes compared with patients who did not receive IVT without statistically significant added risks of sICH or mortality. When compared with those without disability, there was no significant difference in the return to baseline function or sICH. High-quality data comparing treated versus untreated patients with premorbid disability are needed to clarify this issue. REGISTRATION URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifier: CRD42021240499.
Collapse
Affiliation(s)
- Benjamin Beland
- Department of Clinical Neurosciences, University of Calgary, Alberta, Canada
| | - Fouzi Bala
- Department of Clinical Neurosciences, University of Calgary, Alberta, Canada
| | - Aravind Ganesh
- Department of Clinical Neurosciences, University of Calgary, Alberta, Canada
| |
Collapse
|
22
|
Siegler JE, Vigilante N. Reader Response: Prestroke Disability and Outcome After Thrombectomy for Emergent Anterior Circulation Large Vessel Occlusion Stroke. Neurology 2022; 98:950. [PMID: 35636956 DOI: 10.1212/wnl.0000000000200727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
23
|
Feng Q, Zhou H, Zhao Z. Reader Response: Prestroke Disability and Outcome After Thrombectomy for Emergent Anterior Circulation Large Vessel Occlusion Stroke. Neurology 2022; 98:949-950. [PMID: 35636955 DOI: 10.1212/wnl.0000000000200726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
24
|
de Havenon A. Author Response: Prestroke Disability and Outcome After Thrombectomy for Emergent Anterior Circulation Large Vessel Occlusion Stroke. Neurology 2022; 98:951. [PMID: 35636958 DOI: 10.1212/wnl.0000000000200728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
25
|
Adamou A, Gkana A, Mavrovounis G, Beltsios ET, Kastrup A, Papanagiotou P. Outcome of Endovascular Thrombectomy in Pre-stroke Dependent Patients With Acute Ischemic Stroke: A Systematic Review and Meta-Analysis. Front Neurol 2022; 13:880046. [PMID: 35572918 PMCID: PMC9097509 DOI: 10.3389/fneur.2022.880046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 04/05/2022] [Indexed: 01/01/2023] Open
Abstract
Introduction Endovascular thrombectomy (EVT) is a well-established and effective therapeutic option for patients that meet certain criteria. However, this modality is not well studied in patients with pre-existing disability. The aim of the present study was to investigate the impact of mechanical thrombectomy in patients with acute onset ischemic stroke and pre-stroke dependency (PSD) in regard to their clinical outcome and mortality. Materials and Methods The MEDLINE, Scopus, and Cochrane Library databases were comprehensively searched with a cut-off date of December 11th, 2021. We performed meta-analysis to investigate the 90-day clinical outcome, the 90-day mortality, and the rate of symptomatic intracerebral hemorrhage (sICH) between the PSD (modified Rankin Scale score ≥ 3) and non-PSD (modified Rankin Scale score = 0-2) groups who underwent EVT for acute onset ischemic stroke. Results Six studies were included in the meta-analysis involving 4,543 cases with no PSD and 591 cases with PSD. The non-PSD group showed a statistically significant better clinical outcome at 90 days compared to the PSD group [RR (95% CI) = 1.44 (1.06, 1.85); p z = 0.02]. The non-PSD group demonstrated a statistically significant lower risk of death at 90 days in comparison to the PSD group [RR (95% CI) = 0.45 (0.41, 0.50); p z < 0.01]. Lastly, the rate of sICH was comparable between the two groups [RR (95% CI) = 0.89 (0.64, 1.24); p z = 0.48]. Discussion We report a higher rate of unfavorable clinical outcome and a higher mortality rate in patients with PSD undergoing EVT compared to those with no previous disability. However, there was a significant proportion of PSD cases who fared well post-procedurally, indicating that PSD patients should not be routinely excluded from mechanical thrombectomy. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021284181, identifier: CRD42021284181.
Collapse
Affiliation(s)
- Antonis Adamou
- Department of Radiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Androniki Gkana
- Department of Emergency Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Georgios Mavrovounis
- Department of Emergency Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Eleftherios T. Beltsios
- Department of Emergency Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Andreas Kastrup
- Department of Neurology, Hospital Bremen-Mitte, Bremen, Germany
| | - Panagiotis Papanagiotou
- Department of Diagnostic and Interventional Neuroradiology, Hospital Bremen-Mitte/Bremen-Ost, Bremen, Germany
- First Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Areteion Hospital, Athens, Greece
| |
Collapse
|