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  • Online Resource  (6)
  • Cho, Yong-Jin  (6)
  • Jang, Min Uk  (6)
  • Kim, Dae-Hyun  (6)
  • Kim, Dong-Eog  (6)
  • Ko, Youngchai  (6)
  • Lee, Kyung Bok  (6)
  • Yu, Kyung-Ho  (6)
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  • Online Resource  (6)
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  • 1
    Online Resource
    Online Resource
    Mapping the Supratentorial Cerebral Arterial Territories Using 1160 Large Artery Infarcts
    American Medical Association (AMA) ; 2019
    In:  JAMA Neurology Vol. 76, No. 1 ( 2019-01-01), p. 72-
    Details
    In: JAMA Neurology, American Medical Association (AMA), Vol. 76, No. 1 ( 2019-01-01), p. 72-
    Type of Medium: Online Resource
    ISSN: 2168-6149
    URL: Article
    DOI: 10.1001/jamaneurol.2018.2808
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 2019
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Grading and Interpretation of White Matter Hyperintensities Using Statistical Maps
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Stroke Vol. 45, No. 12 ( 2014-12), p. 3567-3575
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 45, No. 12 ( 2014-12), p. 3567-3575
    Abstract: We aimed to generate rigorous graphical and statistical reference data based on volumetric measurements for assessing the relative severity of white matter hyperintensities (WMHs) in patients with stroke. Methods— We prospectively mapped WMHs from 2699 patients with first-ever ischemic stroke (mean age=66.8±13.0 years) enrolled consecutively from 11 nationwide stroke centers, from patient (fluid-attenuated-inversion-recovery) MRIs onto a standard brain template set. Using multivariable analyses, we assessed the impact of major (age/hypertension) and minor risk factors on WMH variability. Results— We have produced a large reference data library showing the location and quantity of WMHs as topographical frequency-volume maps. This easy-to-use graphical reference data set allows the quantitative estimation of the severity of WMH as a percentile rank score. For all patients (median age=69 years), multivariable analysis showed that age, hypertension, atrial fibrillation, and left ventricular hypertrophy were independently associated with increasing WMH (0–9.4%, median=0.6%, of the measured brain volume). For younger (≤69) hypertensives (n=819), age and left ventricular hypertrophy were positively associated with WMH. For older (≥70) hypertensives (n=944), age and cholesterol had positive relationships with WMH, whereas diabetes mellitus, hyperlipidemia, and atrial fibrillation had negative relationships with WMH. For younger nonhypertensives (n=578), age and diabetes mellitus were positively related to WMH. For older nonhypertensives (n=328), only age was positively associated with WMH. Conclusions— We have generated a novel graphical WMH grading (Kim statistical WMH scoring) system, correlated to risk factors and adjusted for age/hypertension. Further studies are required to confirm whether the combined data set allows grading of WMH burden in individual patients and a tailored patient-specific interpretation in ischemic stroke-related clinical practice.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.114.006662
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1467823-8
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    Online Resource
  • 3
    Online Resource
    Online Resource
    Stroke outcomes are worse with larger leukoaraiosis volumes
    Oxford University Press (OUP) ; 2017
    In:  Brain Vol. 140, No. 1 ( 2017-01), p. 158-170
    Details
    In: Brain, Oxford University Press (OUP), Vol. 140, No. 1 ( 2017-01), p. 158-170
    Type of Medium: Online Resource
    ISSN: 0006-8950 , 1460-2156
    URL: Article
    DOI: 10.1093/brain/aww259
    RVK:
    XA 10000
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2017
    detail.hit.zdb_id: 1474117-9
    SSG: 12
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  • 4
    Online Resource
    Online Resource
    Preceding Intravenous Thrombolysis in Patients Receiving Endovascular Therapy
    S. Karger AG ; 2017
    In:  Cerebrovascular Diseases Vol. 44, No. 1-2 ( 2017), p. 51-58
    Details
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 44, No. 1-2 ( 2017), p. 51-58
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 The beneficial effects of endovascular therapy (EVT) in acute ischemic stroke have been demonstrated in recent clinical trials using new-generation thrombectomy devices. However, the comparative effectiveness and safety of preceding intravenous thrombolysis (IVT) in this population has rarely been evaluated. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 From a prospective multicenter stroke registry database in Korea, we identified patients with acute ischemic stroke who were treated with EVT within 8 h of onset and admitted to 14 participating centers during 2008-2013. The primary outcome was a modified Rankin Scale (mRS) score at 3 months. Major secondary outcomes were successful recanalization defined as a modified Treatment in Cerebral Ischemia score of 2b-3, functional independence (mRS score 0-2), mortality at 3 months, and symptomatic hemorrhagic transformation (SHT) during hospitalization. Multivariable logistic regression analyses using generalized linear mixed models were performed to estimate the adjusted odds ratios (ORs) of preceding IVT. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Of the 639 patients (male, 61%; age 69 ± 12; National Institutes of Health Stroke Scale score of 15 [11-19]) who met the eligibility criteria, 458 received preceding IVT. These patients showed lower mRS scores (adjusted common OR, 1.38 [95% CI 0.98-1.96] ). Preceding IVT was associated with successful recanalization (1.96 [1.23-3.11]) and reduced 3-month mortality (0.58 [0.35-0.97] ) but not with SHT (0.96 [0.48-1.93]). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 In patients treated with EVT within 8 of acute ischemic stroke onset, preceding IVT may enhance survival and successful recanalization without additional risk of SHT, and mitigate disability at 3 months.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    URL: Article
    DOI: 10.1159/000471492
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2017
    detail.hit.zdb_id: 1482069-9
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  • 5
    Online Resource
    Online Resource
    Abstract WP18: Futility and Predicted Therapeutic Gain of Endovascular Treatment According to the Baseline Stroke Severity in Acute Ischemic Stroke
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Stroke Vol. 47, No. suppl_1 ( 2016-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 47, No. suppl_1 ( 2016-02)
    Abstract: Introduction: To describe the distribution of futile recanalization, defined by 3-month modified Rankin scale (mRS) 3 to 6 despite of successful recanalization (Thrombolysis in Cerebral Infarction grade 2b-3), and therapeutic gain of endovascular treatment (EVT) across the whole range of initial National Institutes of Health Stroke Scale (NIHSS) in patients with acute ischemic stroke attributable to major cerebral artery occlusion. Methods: Using a prospective multicenter stroke registry database, acute ischemic stroke patients, who were confirmed anterior circulation large artery occlusion and were treated with EVT within 12h of onset between November 2009 and July 2014, were identified. Futile recanalization rates were described across the whole range of NIHSS score, categorized as ≤ 5, 6∼10, 11∼20 and 〉 20. To estimate therapeutic gain, defined as a difference in the proportions of mRS 3-6 between those recanalized completely with EVT and those not treated, a proportion of mRS 3-6 in those not treated was obtained through age-specific direct standardization using a population who were hospitalized within 12 h due to acute ischemic stroke, had major anterior circulation large artery occlusion and were not treated with recanalization therapy. Results: Among 21,591 patients with acute ischemic stroke, 4.5% (n=972) received EVT within 12 h of onset. Of those 972 patients, 54.8% (n=533) were successfully recanalized. Of those 533, 440 with anterior circulation larger artery occlusion were enrolled for study (male 58%, age 67.3±12.3 years, onset to EVT starting time 4.19±1.96 hours). Seventy percent of patients were treated with intravenous alteplase prior to EVT. Futile recanalization was observed in 51.4% (n=226). Futile recanalization increased with the increase of stroke severity; 20.9% in NIHSS≤ 5; 34.6% in 6∼10; 58.9% in 11∼20; 63.8% in 〉 20 (p for trends 〈 0.001). Therapeutic gain of EVT significantly differed by initial stroke severity (p for interaction 〈 0.001); -1.9% in NIHSS≤ 5; 14.3% in 6∼10; 27.7% in 11∼20; 34.3% in 〉 20. Conclusions: This study emphasized the impact of initial stroke severity on futile recanalization and therapeutic gain in patients receiving EVT for acute ischemic stroke caused by anterior circulation large artery occlusion.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.47.suppl_1.wp18
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 1467823-8
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  • 6
    Online Resource
    Online Resource
    Abstract 72: Comparative Effectiveness of Intravenous Thrombolysis in patients with Mild Ischemic Stroke
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Stroke Vol. 45, No. suppl_1 ( 2014-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 45, No. suppl_1 ( 2014-02)
    Abstract: Background: One third of patients with initially mild strokes have unfavorable outcome, and the efficacy of intravenous thrombolysis (IVT) in those patients has not proven. This study aimed to evaluate the comparative effectiveness of IVT over no thrombolysis in patients with mild ischemic stroke presenting within 4.5 hours of onset. Methods: From a multicenter prospective stroke registry database, we identified acute ischemic stroke patients (1) who were aged 18 years or more, (2) whose neuroimaging confirmed relevant acute ischemic lesions, (3) who were presented within 4.5 hours of onset, and (4) whose initial NIHSS scores were 5 points or less. Matching and inverse probability of treatment weighting (IPTW) by propensity score (PS) were used to remove baseline imbalance between the IVT and no treatment groups. Further adjustments for potential confounders were made in the IPTW analysis. The adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) of IVT compared to no treatment were calculated for 3-month modified Rankin Scale (mRS) 0-1 (primary efficacy outcome), the full distribution of mRS scores (sedoncary efficacy outcome, by an ordinal logistic regression analysis), and symptomatic hemorrhagic transformation (sHT, safety outcome). Results: Between April 2008 and May 2012, 13,117 stroke patients were hospitalized to the 12 participating centers. Among them, 1,386 subjects met the eligibility criteria, and 194 (14.0%) were treated with IVT. The proportions of 3-month mRS 0-1 were not different between the IVT and no treatment groups (71% vs. 75%, p=0.18), but those of sHT were different (4.1% vs. 0.5%, p 〈 0.001). The adjusted ORs (95% CIs, p values) were 1.46 (0.95-2.25, 0.08) by PS-matching and 1.47 (0.77-2.82, 0.24) by IPTW for 3-month mRS 0-1; 1.05 (0.73-1.49, 0.80) by PS-matching and 1.09 (0.65-1.81, 0.75) for an increment of 3-month mRS score; and 7.47 (1.52-36.64, 0.01) by PS-matching and 3.85 (0.82-18.06, 0.09) by IPTW for sHT. Conclusion: This comparative effectiveness analysis based on the large multicenter stroke registry database failed to prove the superiority of intravenous thrombolysis over no treatment in patients with mild ischemic stroke.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.45.suppl_1.72
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1467823-8
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