Deep Pujara

[European Stroke Org @ESOstroke]

ATLAS meta-analysis of 6 trials on EVT for large core infarcts confirms large treatment effect of EVT, reducing disability and mortality, with a NNT of 4,2.

Treatment benefit was consistent over clinical and most imaging subgroups.

@ESOstroke #VoiceOfStroke #Stroke #ESOC2026

[The Lancet @TheLancet]

Presenting at #ESOC2026, the ATLAS study found endovascular thrombectomy was associated with improved functional outcomes & reduced mortality vs medical management in patients with large-core ischaemic stroke presenting within 24h of onset.

https://t.co/vLVUi01Nbz @ESOstroke

[Amrou Sarraj @amrsarrajMD]

On behalf of the large core trials principal investigators, immensely proud and honored to present primary results of the ATLAS IPD meta-analysis @ESOstroke with simultaneous publication in

@TheLancet -https://t.co/uY3DlB6KPJ

EVT not only improved outcomes compared to medical care, but functional independence and independent ambulation were also achieved in a meaningful proportion of patients. Additionally, EVT was life-saving, as one of the few reperfusion therapies to achieve it. With the exception of patients with very large core (volume ≥150 ml) in the late time window, where evidence is limited because of wide confidence intervals but benefit could not be excluded, EVT demonstrated consistent benefit regardless of ASPECTS and ischaemic core strata.

Our deepest gratitude to the patients, their families, and all investigators and coordinators at the trial sites. A mammoth collective effort over 3 years from 6 trials with practice changing results that improve care for 20% LVOs! #stroke #EVT #largecore #NoLVOleftbehind @XiaochuanHuo @VCostalat @oozaidat @VYogendrakumar @deeppujara @dliebesk @ARazzakMD @NguyenThanhMD @samialkasab @AmeerEHassan @Michael3Abraham @FelixSun1230 @HiroshiYamagam2 @SunilAShethMD @Fie0815 @RaulNogueiraMD @rgrandhi @PascalJabbourMD @shazamhussain @dr_mchen @mihill68 @lapergue6 @TudorGJovin @AlbertJYoo

[Deep Pujara @deeppujara]

@draravindganesh @MicieliA_MD @mayank_G0 @DCNSNeuro @StrokeAHA_ASA Very interesting thought experiment. That is why results from multiple trials across diverse settings (single payer vs multiple payer systems, systems of care establishment, resource allocations, provider experience) probably are the best bets for widely generalizable results.

[Stroke AHA/ASA @StrokeAHA_ASA]

Women Benefit Equally From Endovascular Thrombectomy for Large Core Ischemic Stroke in a Subanalysis of SELECT2

In this #BloggingStroke post, @drchloemutimer discusses #Stroke article by @JPTsaiMD et al. #AHAJournals #GoRedForWomen

https://t.co/uzXXexw67m

[Amrou Sarraj @amrsarrajMD]

Congratulations to @JPTsaiMD on leading the analysis on sex-based differences in EVT outcomes for large strokes from @SELECT2Trial, published in @StrokeAHA_ASA's #GoRedforWomen collection. No significant heterogeneity in EVT benefits across sexes. Age and ischemic core size remained prognostic in both males and females.@NguyenThanhMD @deeppujara @johannatfifi @Michael3Abraham @dr_mchen @shazamhussain @CerebrovascLab @aopaskar @marcriboj @AmeerEHassan @StavTjoumakaris @mihill68 @natperezossa @anjailibrahim @fournier_lauren @NeuroFaris

[NeuroNews @NN_publishing]

.@UHhospitals has been awarded US$7 million in research funding by @PCORI to evaluate endovascular #Thrombectomy in patients presenting more than 24 hours from time last known well via the global SELECT LATE clinical trial
@amrsarrajMD @SELECT2Trial
https://t.co/IPobwZKCsO

[Amrou Sarraj @amrsarrajMD]

Honored and grateful for the opportunity to assess the role of Endovascular Thrombectomy beyond 24 hours of last known well through SELECT LATE international, multicenter pragmatic clinical trial - https://t.co/KVlRMz0HRK funded by @PCORI @UHhospitals

Excited to collaborate with my Co-Investigators Bruce Campbell @UniMelb, Jeff Saver @UCLANeurology, Jim Grotta @memorialhermann, @NguyenThanhMD @The_BMC, @StavTjoumakaris @TJUHNeurosurg, Steve Messe @PennNeurology, Leonid Churilov @UniMelb and Clark Sitton @McGovernMed for the successful conduct of the trial.

Grateful to our stakeholders @MitchElkind, @AmeerEHassan, @dr_mchen, Erin Supan, Eric Hess, Daniel Ellenberger and patients’ advocates Christina Globuski, Matthew and Laura Antenucci, James and Jessica Sulecki and Kelly Montgomery for their guidance on how to make our study more pragmatic and patient-centered.

[Amrou Sarraj @amrsarrajMD]

Congratulations @AmeerEHassan @Michael3Abraham on leading analyses on effect of procedure characteristics and reperfusion success on EVT outcomes for patients with large strokes from @SELECT2Trial https://t.co/IJnkwfrTBH @ANA_journals ~80% procedural success that improved clinical outcomes and reduced infarct growth. eTICI 2c-3 improved outcomes compared to those with eTICI 2b. Prolonged procedures were associated with worse outcomes. Consistent results across aspiration first vs stent retriever approaches.

@shazamhussain, @CerebrovascLab, @dr_mchen, @deeppujara, @NabeelHerial, @JPTsaiMD, @DrPatchiz, @drricardohanel, @almuftifawaz, @AndrewKCheung, @jordiblascoa, @LUISANROMA, @NiravAVora, @DanSahlein, @LElijovich, @ArenillasJF, @Teddyyhwu, @PCardonaP, @natperezossa, @JoannaSchaafsma, @BJHicksMD, @NaviSSangha, @warach_steven, @TimothyKleinig, @Faris_Shaker, @FreqFrequentist, @wondeasa, @mark_dannenbaum, @GaborTothMD, @AmuluruKrishna, @JanKarlBurkhar1, @ARazzakMD,  @HarisKamalMD, @vitorpereiracan, @NguyenThanhMD, @Johannatfifi, @esamaniego, @AdamArthurMD, @StavTjoumakaris, @PascalJabbourMD, @jimgrotta, @mihill68, @marcriboj

[Amrou Sarraj @amrsarrajMD]

Our comprehensive review @ANA_journals on current neuroimaging evidence for reperfusion therapies, shifting treatment paradigms and utility of different imaging modalities in acute ischemic stroke. @DrBruceCampbell @deeppujara

https://t.co/4W75wPtPOE

[Amrou Sarraj @amrsarrajMD]

Honored to receive the 2024 Clinical Research Forum top 10 award on behalf of @SELECT2Trial investigators.Inspiring & motivational to see exciting progress on many healthcare fronts by elite clinician scientists.This recognition motivates us to keep pushing boundaries @CRForumUS

[JNIS @JNIS_BMJ]

🎯 Major Findings in Stroke 🌟

Hopeful twist in recovery! Despite 75% patients experience intracranial hemorrhage post-EVT, functional outcomes remain unaffected. 🧠💪 SELECT2 trial shows hemorrhages are not the end of the road! 🚀
Read the full study 👉 https://t.co/ppyu1myLaI

[Deep Pujara @deeppujara]

@ESOstroke Can you please provide further evidence to support the claim?

[Deep Pujara @deeppujara]

@ResusMed @SaveToBookmarks

[Deep Pujara @deeppujara]

@TudorGJovin @Fie0815 @GeoffreyDonnan @dliebesk @ESOstroke @rosevmcd @RaulNogueiraMD @oozaidat @CSI_Lab @VladoKZg @DoctorGaldamez Follow up infarct volume does not take into account baseline infarct before reperfusion that is not salvageable. Cerebral edema also affects outcomes. See our analysis that explained ~90% effect from SELECT and EXTEND IA. https://t.co/EaTJO3jfER

[Deep Pujara @deeppujara]

@Stata Stata 17, healthcare research

[Amrou Sarraj @amrsarrajMD]

Proud and honored to present @SELECT2Trial results at #ISC2023 EVT is safe and efficacious in large core! We’re a step closer to improving more patients lives. https://t.co/EACbka6fEK

[Deep Pujara @deeppujara]

@Stata I see table1 command already mentioned. An iteration of it is table1_mc, which is my personal favorite for formatting options in addition to all the usability of table1.

resource - a command that allows for running R scripts through stata console.

[Amrou Sarraj @amrsarrajMD]

Our latest @JAMANeuro “SELECT Late” international cohort study; EVT was associated with increased odds of functional independence in selected patients treated beyond 24 hours of last known well #NoLVOleftbehind #stroke #neurology https://t.co/33Rvb1mkkt

[Deep Pujara @deeppujara]

@francisdeng @AshleshaUdare @BFlanksteak There are nuances to multimodal neuroimaging in acute phase stroke management and the aim should not be to find one imaging that we trust blindly but to review all imaging modalities, understand the context and interpret accordingly.

[Deep Pujara @deeppujara]

@francisdeng @AshleshaUdare @BFlanksteak All imaging modalities have their strengths and pitfalls and you would want to interpret them within those limitations, just like CTs (delay in appearance of hypodensities and poor inter rater agreement) or DWI( potential reversibility in hyper acute phase).