7/7 Practice Implications:
ASM choice is a modifiable risk factor in anticoagulated patients:
Avoid assuming levetiracetam is completely interaction-neutral with DOACs
1/7 Which antiseizure medication (ASM) is safest for patients on DOACs?
A new target trial emulation published in JAMA Neurology (Schubert et al.) analyzes 9,500+ adults with epilepsy on DOACs to evaluate risks of thromboembolism, bleeding, and mortality https://t.co/m9QHUC2oml…
#NeuroTwitter #CardioTwitter #Stroke #Epilepsy #JAMANeurol @JAMANeuro
https://t.co/iWXDaedCFw
6/7 counterfactual modeling showed that switching eligible patients to lamotrigine or lacosamide could theoretically prevent ~28% of all thromboembolic events in this population
8/8 Practice Implications:
ASM choice is a modifiable risk factor in anticoagulated patients:
Avoid assuming levetiracetam is completely interaction-neutral with DOACs.
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
Thrilled to share that I’ve officially matched into Vascular Neurology at the University of Pittsburgh—one of the premier stroke institutions! Excited for this next chapter with such an incredible team.
#Match2026#UPMC@PittStroke@Matt_StarrMD@AlAlBayati1@RaulNogueiraMD
#BANANA2026 Course is hitting the nail on the head by grounding neuroanatomy in embryology. It’s the difference between memorizing a map and actually understanding the terrain
If you don't know where it started, you can't fully know where it's going! 🧠
@eytanraz@neuroangio1
Spot on. Checking the flow on the first and second delays of a multiphase CTA can help. Seeing delayed contrast opacification in the ICA on later phases can reveal that it's a pseudo-occlusion rather than a true tandem lesion
“The hidden truth inside the Trojan horse”
- A carotid terminus clot blocks the flow → ICA looks occluded proximally on CTA but vessel is actually open.
- 15-20% of presumed ‘tandem lesions’ = pseudo-occlusion from stagnant column
Retrieve distal clot → ICA flows again 🔄
🧠 A less invasive approach to #SDH at #SVIN25 The MMAe and transvascular drainage of non-acute SDH is shown to be feasible and leads to rapid radiographic/clinical improvement. Less invasive, better outcomes! Huge congrats @SavastanoLuisMD and the team! @svinsociety@AshuPJadhav
CREST-2 Trial #SVIN25: 4-year data🧠
Adding CAS to IMM significantly reduced stroke/death risk vs. IMM alone in (Absolute Risk Difference 3.2%, P=0.016). No significant difference was observed for CEA+ IMM vs. IMM alone (P=0.24). @JamesMeschia@svinsociety@esamaniego