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Keywords: aphasia, depression, PHQ-9, post-stroke suicidality, prediction models, primary care, standardized assessment, stroke survivors
Published in DiRROS: 01.07.2026; Views: 90; Downloads: 62
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Keywords: Intravenous thrombolysis, ischemic stroke, posterior circulation
Published in DiRROS: 12.06.2026; Views: 153; Downloads: 511
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Abstract: Fabry disease (FD) leads to significant morbidity and mortality, which may indicate accelerated ageing. However, it is still unclear whether there is a relationship between telomere length (TL), a marker of biological ageing, and disease outcome. We aimed to examine the relationship between leukocyte TL (LTL) dynamics and the presence of advanced disease stages and/or late complications of FD, including hypertrophic cardiomyopathy, nephropathy and stroke, both cross-sectionally and longitudinally. DNA was extracted from peripheral blood leukocytes and quantitative PCR was utilized to determine relative LTL in 99 Fabry patients. In the longitudinal analysis, we included 50 patients in whom at least three measurements were performed over a period of 5–10 years. The results showed a significant inverse correlation between LTL and age (ρ = −0.20, p = 0.05). No significant differences in LTL were found between females and males (p = 0.79) or between patients receiving disease-specific therapy and those without (p = 0.34). In a cross-sectional analysis, no association was found between the presence (p = 0.15) or number (p = 0.28) of advanced stages of the disease and/or late complications and LTL. Similarly, in a longitudinal analysis, no difference in LTL dynamics was found regarding the presence (p = 0.16) of advanced stage organ involvement and/or late complications or their number. These findings indicate that LTL dynamics in adulthood may not be a reliable indicator of disease outcomes in Fabry patients. Therefore, LTL may more accurately reflect the disease burden in early life, when TL is primarily determined.
Keywords: Fabry disease, telomere length, hyperthropic cardiomyopathy, nephropathy, stroke
Published in DiRROS: 04.06.2026; Views: 119; Downloads: 96
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Abstract: Background/Objectives: Acute carotid tandem lesions (TLs), defined by concurrent cervical internal carotid artery (ICA) stenosis or occlusion and intracranial large vessel occlusion, occur in 10–20% of patients undergoing mechanical thrombectomy (MT) for acute ischemic stroke (AIS). Optimal periprocedural antiplatelet management during emergent carotid artery stenting (eCAS) remains uncertain, particularly regarding the balance between preventing stent thrombosis and avoiding hemorrhagic complications. Methods: A narrative review was conducted using PubMed and Scopus (until 6 March 2026) to identify English-language studies evaluating antiplatelet therapies during eCAS for TLs. We included seven real-world studies and registry analyses. Data on study design, patient characteristics, procedural strategies, angiographic results, functional outcomes, and safety metrics were extracted. Results: No randomized controlled trials (RCTs) were identified. The available evidence is derived exclusively from observational studies. Across these cohorts, glycoprotein IIb/IIIa inhibitors (GPIs), particularly tirofiban, were generally associated with lower rates of in-stent thrombosis and higher reperfusion success, with symptomatic intracranial hemorrhage (sICH) rates that appeared comparable to or lower than those reported with acetylsalicylic acid (ASA). Cangrelor, an intravenous (IV) P2Y12 inhibitor, was associated with improved stent patency and increased likelihood of complete reperfusion, although reported effects on clinical outcomes were inconsistent when compared with GPIs or ASA. Aside from abciximab, potent IV antiplatelet agents did not consistently show an increased sICH signal. Oral dual antiplatelet therapy was also associated with improved technical outcomes without a clear excess in bleeding complications. Conclusions: Current real-world observational data suggest that rapid-acting IV antiplatelet agents—particularly GPIs and, increasingly, cangrelor—may represent feasible periprocedural options during eCAS for TLs, with potential benefits for technical success and no consistent evidence of increased hemorrhagic risk. However, interpretation is limited by study heterogeneity and non-randomized designs. The absence of RCTs highlights the need for prospective comparative studies and standardized periprocedural antiplatelet protocols.
Keywords: acute carotid tandem lesions, acute ischemic stroke, antiplatelet therapy, cangrelor, glycoprotein IIb/IIIa inhibitors
Published in DiRROS: 23.04.2026; Views: 228; Downloads: 146
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Abstract: Purpose: This study aimed to evaluate the predictive value of automatically assessed collateral circulation (CC) and infarct core for functional outcome in acute ischemic stroke (AIS) patients treated with endovascular thrombectomy (EVT). Methods: We conducted a retrospective cohort study of 208 patients with anterior large vessel occlusion treated with EVT. Two AI-powered software were used to automatically assess CC and infarct core. Comparative analyses included patient demographics, clinical and imaging data, and functional outcome. Univariate and multivariable logistic regression analyses were conducted to predict the 90-day functional outcome. A favorable outcome was defined as a modified Rankin scale (mRS) score ≤ 2. Results: Among the 208 patients, 114 (54.8%) were women and 94 were men, with a mean age of 71.4 ± 13.3 years. Patients with higher collateral score (CS) exhibited lower infarct core volumes (p < 0.001) and better mRS score at 90 days (p = 0.008). Among patients with a favorable outcome, the mean infarct core volume was lower compared to those with poor outcomes (5 mL vs. 8.6 mL, p = 0.003). In univariate logistic regression, both infarct core (OR 0.94, p = 0.005) and CS (OR 1.84, p = 0.014) were predictors of favorable outcome. However, in multivariable models, only infarct core remained a significant independent predictor [AORs of 0.95 (p = 0.021) and 0.96 (p = 0.039)]. Conclusion: Automatically assessed infarct core is a robust predictor of functional outcome in AIS patients post-EVT, while CS's predictive value diminishes when adjusted for infarct core. These findings support the integration of AI-powered evaluations in clinical settings to improve prognosis and treatment strategies for AIS.
Keywords: acute ischemic stroke, CT angiography, CT perfusion, collorectal circulation, infarct core
Published in DiRROS: 16.04.2026; Views: 236; Downloads: 233
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