International journal of activity and behavior computing Kitakyushu : Care XDX Center, Kyushu Institute of Technology, 2024 (2025), 2, Seite 1-16 Online-Ressource
von Athiththan Yogeswaran ; Paul M. Hassoun ; Khaled Saleh ; Meike Fünderich ; Aparna Balasubramanian ; Ziad Konswa ; David G. Kiely ; Allen Lawrie ; Thenappan Thenappan ; Christina Eichstaedt ; Ekkehard Grünig ; Martin R. Wilkins ; Luke Howard ; Horst Olschewski ; Gabor Kovacs ; Hector R. Cajigas ; Robert Frantz ; Hani Sabbour ; Andrew J. Sweatt ; Roham T. Zamanian ; Alexandra Arvanitaki ; George Giannakoulas ; Jean Elwing ; Arun Jose ; Stephan Beckmann ; Karen M. Olsson ; Stefan Stadler ; Matthias Held ; Michael Halank ; Ralf Ewert ; Jürgen Behr ; Katrin Milger-Kneidinger ; Christine Pausch ; David Pittrow ; Raphael W. Majeed ; Jochen Wilhelm ; Hossein Ardeschir Ghofrani ; Friedrich Grimminger ; Khodr Tello ; Marius M. Hoeper ; Werner Seeger ; Anne Hilgendorff
Pulmonary hypertension (PH) in interstitial lung disease (ILD) lacks approved therapies.The Pulmonary Vascular Research Institute GoDeep metaregistry collects real-world data of patients with PH from international PH referral centers.Patients with ILD-PH and relevant subgroups (idiopathic interstitial pneumonia [IIP], idiopathic pulmonary fibrosis [IPF]) were stratified by pulmonary vascular resistance (PVR). Kaplan-Meier survival analyses and adjusted Cox proportional hazards models were employed, additionally accounting for immortal time bias, sensitivity analyses, Heller explained relative risk statistics, and target trial emulation framework analysis.Among 34,482 patients, 940 with hemodynamically fully characterized incident ILD-PH (median age, 67 [IQR, 59-74] yr) were identified. A total of 62% had severe ILD-PH with PVR >5 Wood units (WU) and poor survival rates (29% and 18% at 3 and 5 yr), significantly worse than patients with ILD-PH with PVR ≤5 WU and patients with pulmonary arterial hypertension. Survival was poorest in severe IPF-PH. A total of 59% of all patients ILD-PH received PH-targeted therapy, predominantly phosphodiesterase-5 inhibitors (PDE5is). PDE5i treatment was consistently associated with significantly improved survival in patients with severe PH (hazard ratios of 0.537 [0.370-0.781], 0.461 [0.233-0.913], and 0.435 [0.215-0.8] for IIP-PH, IPF-PH, and IIP-PH with nintedanib/pirfenidone background therapy), but not in patients with less severe hemodynamic impairment, supported by sensitivity analyses, Heller statistics, and target trial emulation framework analysis. The survival statistics of patients with PDE5i-treated IIP-PH or IPF-PH were validated in the independent COMPERA registry. Combination therapy with PDE5is and inhaled prostacyclin analogues was superior to monotherapy using PDE5is (hazard ratio, 0.341; 0.205-0.566).Prognosis in ILD-PH was generally very poor and was related to PH severity. PDE5i treatment in severe IIP-PH and IPF-PH was associated with improved survival, which is to be further verified in controlled trials.
American journal of respiratory and critical care medicine New York, NY : American Thoracic Society, 1959 211(2025), 10, Seite 1855-1866 Online-Ressource
von Larissa Regina Topanotti ; Jasper M. Fuchs ; Matthias Albert ; Jan Schick ; Alice Penanhoat ; Carmen Alicia Rivera Pérez ; Estela Covre Foltran ; Scott Michael Appleby ; Benjamin Matthias Wildermuth ; Thalea Stuckenberg ; Likulunga Emmanuel Likulunga ; Jonas Glatthorn ; Andreas Schuldt ; Andrea Polle ; Niko Balkenhol ; Stefan Scheu ; Christian Ammer ; Carola Paul ; Nathaly Guerrero-Ramírez
von Regina Freiin von Rennenberg ; Christian H. Nolte ; Thomas Liman ; Simon Hellwig ; Christoph Paul Riegler ; Jan Friedrich Scheitz ; Marios K. Georgakis ; Rong Fang ; Felix J. Bode ; Gabor Petzold ; Peter Hermann ; Inga Zerr ; Michael Görtler ; Kathleen Bernkopf ; Silke Wunderlich ; Martin Dichgans ; Matthias Endres ; Oliver Speck
von Victor Schulze-Zachau ; Nikki Rommers ; Nikos Ntoulias ; Alex Brehm ; Nadja Krug ; Ioannis Tsogkas ; Matthias Anthony Mutke ; Thilo Rusche ; Amedeo Cervo ; Claudia Rollo ; Markus Alfred Möhlenbruch ; Jessica Jesser ; Kornelia Kreiser ; Katharina Althaus ; Manuel Requena ; Marc Rodrigo-Gisbert ; Tomas Dobrocky ; Bettina L. Serrallach ; Christian H. Nolte ; Christoph Paul Riegler ; Jawed Nawabi ; Errikos Maslias ; Patrik Michel ; Guillaume Saliou ; Nathan Manning ; Alexander McQuinn ; Alon Taylor ; Christoph J. Maurer ; Ansgar Berlis ; Daniel Kaiser ; Ani Cuberi ; Manuel Moreu ; Alfonso López-Frías ; Carlos Pérez-García ; Riitta Rautio ; Ylikotila Pauli ; Nicola Limbucci ; Leonardo Renieri ; Isabel Fragata ; Tania Rodriguez-Ares ; Jan Kirschke ; Julian Schwarting ; Sami Al Kasab ; Alejandro M. Spiotta ; Ahmad Abu Qdais ; Adam A. Dmytriw ; Robert W. Regenhardt ; Aman B. Patel ; Vitor Mendes Pereira ; Nicole M. Cancelliere ; Carsten Schmeel ; Franziska Dorn ; Malte Sauer ; Grzegorz Marek Karwacki ; Jane Khalife ; Ajith Thomas ; Hamza A. Shaikh ; Christian Commodaro ; Marco Pileggi ; Roland Schwab ; Flavio Bellante ; Anne Dusart ; Jeremy Hofmeister ; Paolo Machi ; Edgar A. Samaniego ; Diego J. Ojeda ; Robert M. Starke ; Ahmed Abdelsalam ; Frans van den Bergh ; Sylvie De Raedt ; Maxim Bester ; Fabian Flottmann ; Daniel Arvid Weiß ; Marius Kaschner ; Peter T. Kan ; Gautam Edhayan ; Michael R. Levitt ; Spencer L. Raub ; Mira Katan ; Urs Fischer ; Marios-Nikos Psychogios
Introduction: Thrombectomy complications remain poorly explored. This study aims to characterize periprocedural intracranial vessel perforation including the effect of thrombolysis on patient outcomes. - Patients and methods: In this multicenter retrospective cohort study, consecutive patients with vessel perforation during thrombectomy between January 2015 and April 2023 were included. Vessel perforation was defined as active extravasation on digital subtraction angiography. The primary outcome was modified Rankin Scale (mRS) at 90 days. Factors associated with the primary outcome were assessed using proportional odds models. - Results: 459 patients with vessel perforation were included (mean age 72.5 ± 13.6 years, 59% female, 41% received thrombolysis). Mortality at 90 days was 51.9% and 16.3% of patients reached mRS 0-2 at 90 days. Thrombolysis was not associated with worse outcome at 90 days. Perforation of a large vessel (LV) as opposed to medium/distal vessel perforation was independently associated with worse outcome at 90 days (aOR 1.709, p = 0.04) and LV perforation was associated with poorer survival probability (HR 1.389, p = 0.021). Patients with active bleeding >20 min had worse survival probability, too (HR 1.797, p = 0.009). Thrombolysis was not associated with longer bleeding duration. Bleeding cessation was achieved faster by permanent vessel occlusion compared to temporary measures (median difference: 4 min, p < 0.001). - Discussion and conclusion: Vessel perforation during thrombectomy is a severe and frequently fatal complication. This study does not suggest that thrombolysis significantly attributes to worse prognosis. Prompt cessation of active bleeding within 20 min is critical, emphasizing the need for interventionalists to be trained in complication management.
European stroke journal Oxford : Oxford University Press, 2016 10(2025), 1, Seite 63-73 Online-Ressource
von Paul Michael Haller ; Alina Goßling ; Christina Magnussen ; Hermann Brenner ; Ben Schöttker ; Licia Iacoviello ; Simona Costanzo ; Frank Kee ; Wolfgang Koenig ; Allan Linneberg ; Chaterina Sujana ; Barbara Thorand ; Veikko Salomaa ; Teemu J. Niiranen ; Stefan Söderberg ; Henry Völzke ; Marcus Dörr ; Susana Sans ; Teresa Padró ; Stephan Felix ; Matthias Nauck ; Astrid Petersmann ; Luigi Palmieri ; Chiara Donfrancesco ; Roberto De Ponti ; Giovanni Veronesi ; Marco M. Ferrario ; Kari Kuulasmaa ; Tanja Zeller ; Francisco Ojeda-Echevarria ; Stefan Blankenberg ; Dirk Westermann
