Felipe A. Montellano

PhD student @ikeb_wuerzburg | Neurology resident @Uniklinikum_WUE | Interested in 🧠↔️❤️interaction, stroke, prognosis, biomarkers, (neuro)critical care, POCUS

[ESC Council on Stroke Chairperson @ESCStrokeChair]

🚨 Mark your calendars!
Join us for the 1st Joint Conference of the #ESCStroke & @ESCWGThrombosis!

📅 15-16 November 2025
📍 Milan, Italy

Take part in this milestone event🌟
🔗https://t.co/8KVRrdyFCx

#ESCHeartAndStroke #Eurothrombosis2025

[Johanna Seiden, MD MPH @JohannaSeidenMD]

PRESTIGE-AF results, as presented by Roland Veltkamp
In ICH survivors with AF, DOAC use (2 weeks-1 year after ICH) prevents ischemic stroke (HR 0.05) but was not non-inferior in terms of recurrent ICH (HR 10.9)

Other ongoing Phase 3 RCTs: ENRICH-AF, ASPIRE
#ISC25 #AHA @StrokeAHA_ASA

[Felipe A. Montellano @famontellano]

@SeligChr @nervensystemck Es gibt einige statistische Probleme mit den Responder-Analysen, s. bspw. Senn.

https://t.co/4EK2dIozDn

[Peter Tulip @peter_tulip]

It seems timely to repost one of my favourite tables:
https://t.co/QpyjQouIIS

[Felipe A. Montellano @famontellano]

@ShadiYaghi2 Using AI in which way? Beyond the obvious problem of (likely) unsupervised peer-review, I find it quite problematic to feed an algorithm with the intellectual work of others.

[Eric Widera, MD @EWidera]

If you see an observational study where the drug works immediately for a disease that takes years to develop, throw the study out. Like this study claiming Ozempic reduces risks of Alzheimer’s in diabetics within 30 days of initiation. Junk science
https://t.co/tT5nsgSTwn

[Alex Nevard @AlexNevard]

We have a population that is changing, and we can't keep doing the same thing.

Bringing someone to the ED is an intervention that may not be in their best interests.

We need to get better for them and for us.

#eusem2024

[Casey Albin, MD @caseyalbin]

1/
A 34 yo M presents with worsening confusion and seizures. He is febrile.

He is intubated and transferred to the NeuroICU.

A #continuumcase about a cause that’s probably low (not) on your DDx.

[Felipe A. Montellano @famontellano]

@interneurona @J_Rosales_MD @juankalleja @pablofneuro @SposatoL @neuropuc @mariosurcouf Dificil pregunta sin mucha evidencia. De momento nosotros observamos, descartamos una oclusión de gran vaso si el deterioro es significativo. Habían datos de Heidelberg con doble antiagregación, definitivamente un tema a explorar.

[Felipe A. Montellano @famontellano]

@SimatsAlba @ArthurLiesz @CellCellPress Congrats for this fantastic work Alba! Very well deserved!

[Felipe A. Montellano @famontellano]

@Toaster_Pastry No procedure in the LAA will be able to reduce the stroke rate to 0 simply because not all ischaemic strokes are cardioembolic. To lump all ischaemic strokes in one group is not granular enough.

[Felipe A. Montellano @famontellano]

@apsmunro @statsepi Never been an Editor but I wonder if I would let this "peer-review" leave the editorial office with my signature beneath it.

[Felipe A. Montellano @famontellano]

@janpurrucker @stephanamayer @hoomankamel At the same time, and I quote Charles Warlow here, I think one should be able to "tolerate the genuine uncertainty of others" (Stroke. 2004;35:2211–2219). Interestingly, also talking about IVT.

[Felipe A. Montellano @famontellano]

@janpurrucker @stephanamayer @hoomankamel Do not get me wrong. I think this trial is great news, and I hope it shows no increased risk of sICH and it becomes standard of care. But I think we owe to our patients that this potentially risky interventions are overseen by an DSMB.

[Felipe A. Montellano @famontellano]

@DavidSeiffge @stephanamayer @hoomankamel Yes, and I explain why the data is even more confounded by indication.

[Felipe A. Montellano @famontellano]

@janpurrucker @stephanamayer @hoomankamel This comes from the COCROACH IPDMA.

[Felipe A. Montellano @famontellano]

@janpurrucker @stephanamayer @hoomankamel I always ask my students to compare these two graphics when in our seminar of interpreting real-world-data. This comes from Nielsen et al. Circulation. 2015;132(6):517-25

[Felipe A. Montellano @famontellano]

@DavidSeiffge @stephanamayer @hoomankamel For the pyhsician, therefore, the risk-benefit analysis looks different: "(at least theoretically) increased risk of bleeding -> I must be cautios and offer this therapy to a patients that will likely benefit from it". The available data reflects this heuristic. Not a liberal one

[Felipe A. Montellano @famontellano]

@DavidSeiffge @stephanamayer @hoomankamel The risk-benefit analysis is therefore: "not likely to bleed, more likely to benefit". Liberal adminstration policy. In the case of anticoagulants, I am not aware of an IVT trial that did not exclude patients on OAC; particularly on DOACs.