Tenecteplase vs Alteplase Before Endovascular Therapy in Basilar Artery Occlusion.

Aged Aged, 80 and over Cerebral Angiography Endovascular Procedures / methods Female Fibrin / drug effects Fibrinolytic Agents / pharmacokinetics Half-Life Humans Intracranial Hemorrhages / chemically induced Ischemic Stroke / drug therapy Male Middle Aged Reperfusion Retrospective Studies Tenecteplase / pharmacokinetics Tissue Plasminogen Activator / pharmacokinetics Treatment Outcome Vertebrobasilar Insufficiency / drug therapy

Journal

Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060

Informations de publication

Date de publication:
02 03 2021
Historique:
received: 02 06 2020
accepted: 02 11 2020
pubmed: 8 1 2021
medline: 16 3 2021
entrez: 7 1 2021
Statut: ppublish

Résumé

To investigate the efficacy of tenecteplase (TNK), a genetically modified variant of alteplase with greater fibrin specificity and longer half-life than alteplase, prior to endovascular thrombectomy (EVT) in patients with basilar artery occlusion (BAO). To determine whether TNK is associated with better reperfusion rates than alteplase prior to EVT in BAO, clinical and procedural data of consecutive patients with BAO from the Basilar Artery Treatment and Management (BATMAN) registry and the Tenecteplase vs Alteplase before Endovascular Therapy for Ischemic Stroke (EXTEND-IA TNK) trial were retrospectively analyzed. Reperfusion >50% or absence of retrievable thrombus at the time of the initial angiogram was evaluated. We included 110 patients with BAO treated with IV thrombolysis prior to EVT (mean age 69 [SD 14] years; median NIH Stroke Scale score 16 [interquartile range (IQR) 7-32]). Nineteen patients were thrombolysed with TNK (0.25 mg/kg or 0.40 mg/kg) and 91 with alteplase (0.9 mg/kg). Reperfusion >50% occurred in 26% (n = 5/19) of patients thrombolysed with TNK vs 7% (n = 6/91) thrombolysed with alteplase (risk ratio 4.0, 95% confidence interval 1.3-12; TNK may be associated with an increased rate of reperfusion in comparison with alteplase before EVT in BAO. Randomized controlled trials to compare TNK with alteplase in patients with BAO are warranted. NCT02388061 and NCT03340493. This study provides Class III evidence that TNK leads to higher reperfusion rates in comparison with alteplase prior to EVT in patients with BAO.

Identifiants

DOI: 10.1212/WNL.0000000000011520 PMID: 33408145
pubmed: 33408145
pii: WNL.0000000000011520
doi: 10.1212/WNL.0000000000011520
doi:

Substances chimiques

Fibrinolytic Agents 0
Fibrin 9001-31-4
Tissue Plasminogen Activator EC 3.4.21.68
Tenecteplase WGD229O42W

Banques de données

ClinicalTrials.gov
['NCT02388061', 'NCT03340493']

Types de publication

Clinical Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e1272-e1277

Commentaires et corrections

Type : CommentIn

Informations de copyright

© 2021 American Academy of Neurology.

Auteurs

Fana Alemseged (F)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia. fana.alemseged@mh.org.au.

Felix C Ng (FC)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.

Cameron Williams (C)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.

Volker Puetz (V)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.

Gregoire Boulouis (G)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.
ORCID: 0000-0001-8422-9205

Timothy John Kleinig (TJ)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.

Alessandro Rocco (A)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.

Teddy Y Wu (TY)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.
ORCID: 0000-0003-1845-1769

Darshan Shah (D)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.

Francesco Arba (F)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.
ORCID: 0000-0003-3941-7383

Daniel Kaiser (D)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.
ORCID: 0000-0001-5258-0025

Francesca Di Giuliano (F)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.
ORCID: 0000-0002-6067-183X

Andrea Morotti (A)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.
ORCID: 0000-0002-6558-1155

Fabrizio Sallustio (F)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.

Helen M Dewey (HM)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.
ORCID: 0000-0001-9484-2070

Peter Bailey (P)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.

Billy O'Brien (B)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.

Gagan Sharma (G)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.

Steven Bush (S)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.

Richard Dowling (R)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.

Marina Diomedi (M)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.

Leonid Churilov (L)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.

Bernard Yan (B)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.

Mark William Parsons (MW)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.

Stephen M Davis (SM)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.

Peter J Mitchell (PJ)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.

Nawaf Yassi (N)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.

Bruce C V Campbell (BCV)

From the Department of Medicine and Neurology (F. Alemseged, G.S., L.C., B.Y., M.W.P., S.M.D., P.J.M., N.Y. B.C.V.C.), University of Melbourne, and Department of Radiology (C.W., S.B., R.D.), Royal Melbourne Hospital, Parkville, Australia; Stroke Unit (F. Alemseged, A.R., F.S., M.D.) and Department of Biomedicine and Prevention (F.D.), University Hospital of Tor Vergata, Rome, Italy; Department of Neurology (F.C.N.), Austin Health, Melbourne, Australia; Department of Neurology (V.P.), Institute of Neuroradiology (D.K.), and Dresden Neurovascular Center (V.P., D.K.), University of Technology Dresden, Germany; Department of Interventional Neuroradiology (G.B.), Sainte-Anne-Hospital, Paris, France; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Department of Neurology (T.Y.W.), Christchurch Hospital, New Zealand; Division of Medicine (D.S.), Princess Alexandra Hospital, Brisbane, Australia; NEUROFARBA Department (F. Arba), Careggi University Hospital, Florence; ASST Valcamonica (A.M.), Department of Neurology, Esine, Italy; Department of Neurosciences (H.M.D.), Eastern Health, Melbourne; Department of Neurology (P.B.), Gold Coast University Hospital, Queensland; Department of Neurology (B.O.), Gosford Hospital, New South Wales; and Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.
ORCID: 0000-0003-3632-9433

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