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| 1 | Chinese Stroke Association guidelines for clinical management of cerebrovascular disorders: executive summary and 2019 update of clinical management of ischaemic cerebrovascular diseases显示文摘Aim Stroke is the leading cause of disability and death in China.Ischaemic stroke accounts for about 60%-80%of all strokes.It is of considerable significance to carry out multidimensional management of ischaemic cerebrovascular diseases.This evidence-based guideline aims to provide the latest detailed and comprehensive recommendations on the diagnosis,treatment and secondary prevention of ischaemic cerebrovascular diseases.Methods We had performed comprehensive searches of MEDLINE(via PubMed)(before 30 June 2019),and integrated the relevant information into charts and distributed to the writing group.Writing group members discussed and determined the recommendations through teleconference.We used the level of evidence grading algorithm of Chinese Stroke Association to grade each recommendation.The draft was reviewed by the Guideline Writing Committee of Chinese Stroke Association Stroke and finalised.This guideline is fully updated every 3 years.results This evidence-based guideline is based on the treatment,care and prevention of ischaemic cerebrovascular diseases,which emphasises on pathogenesis evaluation,intravenous thrombolysis,endovascular therapy,antiplatelet therapy,prevention and treatment of complications,and risk factor management.Conclusions This updated guideline presents a framework for the management of ischaemic cerebrovascular diseases.Timely first-aid measures,professional care in the acute stage,and proactive secondary prevention will be helpful to patients. | Liping Liu Weiqi Chen Hongyu Zhou Wanying Duan Shujuan Li Xiaochuan Huo Weihai Xu Li'an Huang Huaguang Zheng Jingyi Liu Hui Liu Yufei Wei Jie Xu Yongjun Wang | 2020 | Stroke & Vascular Neurology2020，5，2： | 42 |
| 2 | Endovascular revascularisation of acute tandem vertebrobasilar artery occlusion:seven case series with literature reviews显示文摘background The outcome of acute ischaemic stroke due to tandem vertebrobasilar artery occlusion was poor.Endovascular revascularisation may be a positive approach for acute basilar artery occlusion combined with vertebral ostium stenosis or occlusion.We reported seven patients with acute vertebrobasilar tandem occlusion by using angioplasty or stenting for proximal lesion and thrombectomy for distal occlusion.Materials and methods Consecutive patients with acute tandem vertebrobasilar artery occlusion at two centres were included in this study.We retrospectively analysed the clinical,technical and functional outcomes of the patients.results From March 2016 to March 2017,seven patients were included.The mean age and National Institute of Health Stroke Scale score at admission was 57 years and 22,respectively.A reverse approach was used in five patients.The Thrombolysis in Cerebral Infarction score 2b-3 was acquired in all patients.There were no procedural complications.The modified Rankin Scale score was 1-2 for three patients and 4 for one patient at 3 months.Three patients died at 3 months of follow-up.Conclusions Endovascular revascularisation may be feasible for acute tandem vertebrobasilar artery occlusion,and more researches are needed. | Haihua Yang Ning Ma Shiyong Zhang Xiaochuan Huo Feng Gao Xuan Sun Dapeng Mo Zhongrong Miao | 2018 | Stroke & Vascular Neurology2018，3，1： | 10 |
| 3 | Endovascular therapy for Acute ischemic Stroke Trial (EAST): study protocol for a prospective, multicentre control trial in China显示文摘Background and purpose:5 recent trials have shown the benefit of endovascular treatment for acute ischaemic stroke(AIS)due to large vessel occlusion of the anterior circulation.This study aims to evaluate the safety and efficacy of Solitaire thrombectomy in patients with moderate-to-severe stroke in the Chinese population,which has a high prevalence of intracranial atherosclerosis.Methods and analysis:This multicentre prospective control study will involve 17 stroke centres in China,and plans to recruit 150 patients in the intervention group,and 150 patients in the medical group,in which patients meet enrolment criteria but refuse intervention.Patients with AIS due to large vessel occlusion indicated for treatment with Solitaire stent retriever within 12 hours of symptom onset,and who meet the inclusion and exclusion criteria,will be enrolled in this study.The primary efficacy endpoint is functional independence as defined by a modified Rankin Scale(mRS)score≤2 at 90 days or by functional improvement as defined by mRS,using shift analysis.The procedural efficacy endpoint is arterial recanalisation of the occluded target vessel measured by a modified Thrombolysis in Cerebral Infarction(mTICI)score equal or superior to 2b right following the use of the study device.The primary safety endpoint is symptomatic intracranial haemorrhage(sICH)within 24±3 hours postprocedure.Ethics and dissemination:The protocol was approved by the Ethics Committee at the coordinating centre and by the local Institutional Review Board of each participating centre.Trial registration number:NCT02350283. | Zhongrong Miao Xiaochuan Huo Feng Gao Xiaoling Liao Chunjuan Wang Ya Peng Yibin Cao Shengli Chen Meng Zhang Changchun Jiang Xiaoxiang Peng Cunfeng Song Liping Wei Qiyi Zhu Zaiyu Guo Li Liu Hang Lin Hua Yang Wei Wu Hui Liang Anding Xu Kangning Chen Xingquan Zhao Yuesong Pan Hao Li Liping Liu Yilong Wang Yongjun Wang EAST investigators | 2016 | Stroke & Vascular Neurology2016，1，2： | 8 |
| 4 | A comparison between acute large vessel occlusion in the posterior circulation and anterior circulation after endovascular treatment:the ANGEL-ACT registry experience显示文摘Background and purpose Endovascular treatment(EVT)has shown an overwhelming benefit for acute anterior circulation artery occlusion(ACO).Whether it can achieve the same outcomes in posterior circulation artery occlusion(PCO)has not been well explained.We aimed to evaluate the characteristics and prognosis of ACO and PCO after EVT in a nationwide registry.Method The present analysis was based on the prospective ANGEL-ACT Registry in China between November 2017 and March 2019.Demographic data,periprocedural times,recanalisation rate,intracranial haemorrhage(ICH)and 90-day functional outcomes were compared between the ACO and PCO groups.Results A total of 1793 patients were analysed including 397(22.1%)consecutive patients with PCO and 1396(77.9%)patients with ACO treated with EVT.A larger proportion of patients with PCO had intracranial atherosclerotic disease and received extra angioplasty during EVT.Successful recanalisation and 90-day favourable functional outcomes did not differ significantly between the two groups.Patients with PCO showed lower 24-hour ICH and symptomatic ICH rates.There was a trend towards higher mortality rate in the PCO group(22.09%vs 14.44%;adjusted OR 1.286(95%CI 0.820 to 2.017),p=0.2731),especially when the onset to puncture time was over 6 hours(30.77%vs 11.13%;adjusted OR 2.673(95%CI 1.280 to 5.583),p=0.0089,interactive p=0.0002).Conclusions In this large prospective multicentre registry,there was a significant difference in the characteristics and periprocedural features between patients with PCO and ACO.However,successful recanalisation and 90-day favourable functional outcomes in PCO were equivalent to those in ACO. | Xuan Sun Jingyu Zhang Xu Tong Baixue Jia Dapeng Mo Ning Ma Feng Gao Lian Liu Xiaochuan Huo Ligang Song Yiming Deng Zhongrong Miao | 2022 | Stroke & Vascular Neurology2022，7，4： | 4 |
| 5 | Acute Ischaemic Stroke Cooperation Group of Endovascular Treatment (ANGEL) registry: study protocol for a prospective, multicentre registry in China显示文摘Background and purpose Endovascular treatment could improve functional outcomes and reduce mortality in patients with intracranial large artery occlusion. This registry aims to evaluate the endovascular treatment delivery and to improve endovascular treatment algorithm in clinical practice for patients with stroke in China. Methods and analysis This multicentric, nationwide, prospective registry plans to include 20 stroke centres and recruit 900 consecutive AIS patients with large- artery occlusion under endovascular treatment. This registry will enrol acute large vessel occlusion patients suitable for endovascular treatment and the inclusion and exclusion criteria. In this study, 90 days functional independence (modified Rankin Scale score ≤2) is the primary efficacy endpoint. The procedural efficacy endpoint of this registry is target artery recanalisation defined by modified Thrombolysis in Cerebral Infarction score 2b or 3 after endovascular therapy. Symptomatic intracranial haemorrhage with 24±3 hours after the procedure is the primary safety endpoint of this registry. Ethics and dissemination Beijing Tiantan Hospital’s Ethics committee and all other participating centres approved the protocol and data collection of Acute Ischaemic Stroke Cooperation Group of Endovascular Treatment registry. Each participant or representative had a written informed consent. | Xiaochuan Huo Ning Ma Dapeng Mo Feng Gao Ming Yang Yilong Wang Yongjun Wang Zhongrong Miao ANGEL investigators | 2019 | Stroke & Vascular Neurology2019，4，1： | 2 |
| 6 | PTEN and AKT/GSK-3β/CRMP-2 signaling pathway are involved in neuronal apoptosis and axonal injury in early brain injury after SAH in rats显示文摘In early brain injury(EBI)after subarachnoid hemorrhage(SAH),white matter(WM)axonal injury plays a key role in the prognosis of the disease.The purpose of this study was to investigate the effects of phosphatase and tensin homolog deleted on chromosome ten(PTEN)on axonal injury and neuronal apoptosis post-SAH in rats and to find its underlying mechanism.Adeno-associated virus was injected into the lateral ventricle to suppress or promote PTEN.Neural function post-SAH in animals was determined by the modified Garcia score,beam balance,and Rotarod test,and the blood–brain barrier disruption was assessed by the brain water content.Axonal injury post-SAH was observed by TEM and determined by IF,and neuron apoptosis was measured by TUNEL staining.The mechanism was analyzed by Western blot to detect p-PTEN/PTEN,p-AKT/AKT,p-GSK-3β/GSK-3β,p-CRMP-2/CRMP-2,axonal injury markerβ-APP and pro-and anti-apoptosis proteins,including Bax and Bcl-2,expression.We found 1.After knocking down PTEN,neuronal apoptosis and axonal injury were alleviated,and nerve function and blood–brain barrier were protected;accordingly,after overexpression of PTEN,neuronal apoptosis and axon damage were aggravated,and nerve function damage and blood–brain barrier damage were increased.2.PTEN and AKT/GSK-3β/CRMP-2 pathway were jointly involved in regulating neuronal apoptosis and WM axon injury after SAH.According to our research,PTEN was a negative factor of EBI,and together with the AKT/GSK-3β/CRMP-2 signaling pathway aggravates neuronal apoptosis and WM axon damage after SAH.Inhibition of PTEN expression may become a new target for SAH treatment. | Hong Chen Chao Zhou Jianfeng Zheng Zhaosi Zhang Yongbing Deng Chongjie Cheng Zongduo Guo Gang Huo Cheng Yin Xiaochuan Sun | 2022 | Genes & Diseases2022，9，1： | 1 |
| 7 | Performance of automated CT ASPECTS in comparison to physicians at different levels on evaluating acute ischemic stroke at a single institution in China显示文摘Background:Our aim was to evaluate the sensitivity and specificity of the automated computer-based Alberta Stroke Program Early CT Score(e-ASPECTS)for acute stroke patients and compare the result with physicians at different levels.Methods:In our center,e-ASPECTS and 9 physicians at different levels retrospectively and blindly assessed baseline computed tomography(CT)images of 55 patients.Sensitivity,specificity,receiver-operating characteristic curves,Bland–Altman plots with mean score error,and Matthews correlation coefficients were calculated.Comparisons were made between the scores by physicians and e-ASPECTS with diffusion-weighted imaging(DWI)being the ground truth.Two methods for clustered data were used to estimate sensitivity and specificity in the region-based analysis.Results:In total,1100(55 patients×20 regions per patient)ASPECTS regions were scored.In the region-based analysis,sensitivity of e-ASPECTS was better than junior doctors and residents(0.576 vs 0.165 and 0.111,p<0.05)but inferior to senior doctors(0.576 vs 0.617).Specificity was lower than junior doctors and residents(0.883 vs 0.971 and 0.914)but higher than senior doctors(0.883 vs 0.809,p<0.05).E-ASPECTS had the best Matthews correlation coefficient of 0.529,compared to senior doctors,junior doctors,and residents(0.463,0.251,and 0.087,respectively).Conclusions:e-ASPECTS showed a similar performance to that of senior physicians in the assessment of brain CT of acute ischemic stroke patients with the Alberta Stroke Program Early CT score method. | Xiaochuan Huo Raynald Hailan Jin Yin Yin Guangming Yang Zhongrong Miao | 2021 | Chinese Neurosurgical Journal2021，7，4： | 1 |
| 8 | Mechanical thrombectomy with combined stent retriever and contact aspiration versus stent retriever alone for acute large vessel occlusion:data from ANGEL-ACT registry显示文摘Background and purpose An analysis of the ASTER 2 trial revealed similar final recanalisation levels and clinical outcomes in acute large vessel occlusion(LVO)stroke between stent retrieval(SR)alone as a first-line mechanical thrombectomy(MT)technique(SR alone first-line)and concomitant use of contact aspiration(CA)plus SR as a first-line MT technique(SR+CA first-line).The purpose of the present study was to compare the safety and efficacy of SR+CA first-line with those of SR alone first-line for patients with LVO in China.Methods We conducted the present study by using the data from the ANGEL-ACT registry.We divided the selected patients into SR+CA first-line and SR alone first-line groups.We performed logistic regression and generalised linear models with adjustments to compare the angiographic and clinical outcomes,including successful/complete recanalisation after the first technique alone and all procedures,first-pass successful/complete recanalisation,number of passes,90-day modified Rankin Scale,procedure duration,rescue treatment and intracranial haemorrhage within 24 hours.Results Of the 1233 enrolled patients,1069(86.7%)received SR alone first-line,and 164(13.3%)received SR+CA first-line.SR+CA first-line was associated with more thrombectomy passes(3(2-4)vs 2(1-2);β=1.77,95%CI=1.55 to 1.99,p<0.001),and longer procedure duration(86(60-129)min vs 80(50-122)min;β=10.76,95%CI=1.08 to 20.43,p=0.029)than SR alone first-line group.Other outcomes were comparable(all p>0.05)between the two groups.Conclusions Patients undergoing SR+CA first-line had more thrombectomy passes and longer procedure duration than patients undergoing SR alone first-line.Additionally,we suggested that SR+CA first-line was not superior to SR alone first-line in final recanalisation level,first-pass recanalisation level and 90-day clinical outcomes in the Chinese population. | Xiaochuan Huo Dapeng Sun Mingkai Hu Raynald Baixue Jia Xu Tong Gaoting Ma Anxin Wang Ning Ma Feng Gao Dapeng Mo Zhongrong Miao the ANGEL-ACT Study group | 2023 | Stroke & Vascular Neurology2023，8，4： | 1 |
| 9 | Endovascular treatment for acute ischaemic stroke due to medium vessel occlusion:data from ANGEL-ACT registry显示文摘Objectives To investigate the safety and efficacy of endovascular treatment(EVT)for acute medium vessel occlusion(MeVO)in the anterior circulation and to explore the independent predictors of the 90-day good outcome for such patients.Methods Data from ANGEL-ACT Registry were analysed in our study.The outcomes,such as the modified Rankin Scale(mRS)at 90 days,successful recanalisation rate and symptomatic intracranial haemorrhage(SICH)rate,were compared between MeVO and acute large vessel occlusions(LVO).Then,the independent predictors of the good outcome at 90 days in MeVO patients were determined by the logistic regression analyses.Results We included 1032 subjects in the analysis,of which,147 were MeVO and 885 were LVO.mRS at 90 days distribution(3(0-4)vs 3(0-5),common odds ratio(OR)=1.00,95%confidence interval(CI)0.73 to 1.38,p=0.994),SICH rate(4.8%vs 8.9%;OR=0.59,95%CI 0.26 to 1.34,p=0.205)and successful recanalisation rate(89.8%vs 89.7%;OR=1.0095%CI 0.51 to 1.93,p=0.992)were similar between the MeVO and LVO groups after adjusting for the confounders.We identified that baseline neutrophil-to lymphocyte ratio≤4.1(OR=2.13,95%CI 1.14 to 3.99,p=0.019),baseline National Institutes of Health Stroke Scale≤14(OR=1.96,95%CI 1.02 to 3.80,p=0.045)and mechanical thrombectomy passes≤1(OR=2.16,95%CI 1.14 to 4.11,p=0.021)were independent predictors of the 90-day good outcome in MeVO patients undergoing EVT.Conclusions Patients with MeVO achieved similar 90-day mRS,SICH rate and successful recanalisation rate after EVT compared with patients with LVO.Several independent predictors of 90-day good outcome in MeVO patients undergoing EVT were determined,which should be highly considered in MeVO stroke management. | Dapeng Sun Raynald Xiaochuan Huo Baixue Jia Xu Tong Anxin Wang Gaoting Ma Ning Ma Feng Gao Dapeng Mo Zhongrong Miao 无 | 2023 | Stroke & Vascular Neurology2023，8，1： | 0 |
| 10 | Endovascular therapy in acute anterior circulation large vessel occlusive patients with a large infarct core(ANGEL-ASPECT):protocol of a multicentre randomised trial显示文摘Background The benefit of stroke thrombectomy for large infarct core still lacks robust randomised controlled studies.Aim To demonstrate the design of a clinical trial on endovascular therapy for acute anterior circulation large vessel occlusion(LVO)patients with large infarct core volume.Design ANGEL-ASPECT is a multicentre,prospective,randomised,open-label,blinded End-point trial to evaluate whether best medical management(BMM)combined with endovascular therapy improves neurological functional outcomes as compared with BMM alone in acute LVO patients with Alberta Stroke Program Early CT Score(ASPECTS)of 3-5 on non-contrast CT or infarct core volume range of 70-100 mL(defined as rCBF<30%on CT perfusion or ADC<620 on MRI)up to 24 hours from symptom onset or last seen well.Study outcomes The primary efficacy outcome is 90(±7)days modified Rankin Scale.Symptomatic intracranial haemorrhage within 48 hours from randomisation is the primary safety outcome.Discussion The ANGEL-ASPECT trial will screen patients with large infarct core(ASPECTS 3-5 or 70-100 mL)through image evaluation criteria within 24 hours and explore the efficacy and safety of endovascular therapy compared with BMM. | Xiaochuan Huo Gaoting Ma Xuelei Zhang Yuesong Pan Xu Tong Dapeng Sun Liping Liu Yilong Wang David S Liebeskind Yongjun Wang Vitor Mendes Pereira Zeguang Ren Zhongrong Miao | 2023 | Stroke & Vascular Neurology2023，8，2： | 0 |
| 11 | Natural boundary of the random power series显示文摘We investigate convergence properties of random Taylor series whose coefficients are ψ-mixing random variables. In particular, we give sufficient conditions such that the circle of convergence of the series forms almost surely a natural boundary. | Yingying Huo Daochun Sun Xiaochuan Yang Lulu Fang | 2022 | Science China Mathematics2022，65，5： | 0 |
| 12 | Safety and efficacy of oral antiplatelet for patients who had acute ischaemic stroke undergoing endovascular therapy显示文摘Background and purpose To investigate the safety and efficacy of oral antiplatelet therapy(APT)for patients who had acute ischaemic stroke(AIS),receiving endovascular therapy(EVT).Methods Patients were divided into non-APT group and APT(single APT or dual APT(DAPT)group.The safety and efficacy endpoints at 3-month follow-up were symptomatic intracranial haemorrhage(sICH),recanalisation rate,clinical outcome and mortality.Results Among 915 patients who had AIS,those in APT group(n=199)showed shorter puncture-to recanalisation time,lower frequency of intravenous thrombolysis and more use of tirofiban compared with those in non-antiplatelet group(n=716)(p<0.05 for all).Oral APT was found to be associated with superior clinical outcome compared with non-APT(APT(44.2%)versus non-APT(41.1%)),adjusted OR=2.605,95% CI 1.244 to 5.455,p=0.011).DAPT showed superior clinical outcome compared with non-APT(DAPT(56.5%)versus non-APT(41.1%),adjusted OR=5.405,95% CI 1.614 to 18.102,p=0.006)and lower risk of mortality at 3-month follow-up(DAPT(4.8%)versus non-DAPT(17.7%),adjusted OR=0.008,95%CI 0.000 to 0.441,p=0.019).There was no significant difference in sICH between the two groups.Conclusions Oral APT prior to undergoing EVT is safe and may accompany with superior clinical outcomes.DAPT may associate with superior clinical outcomes and lower risk of mortality. | Xiaochuan Huo Raynald Jing Jing Anxin Wang Dapeng Mo Feng Gao Ning Ma Yilong Wang Yongjun Wang Zhongrong Miao | 2021 | Stroke & Vascular Neurology2021，6，2： | 0 |
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