Background:Real-world data on the impact of baseline disease severity on efficacy and safety of levodopa-carbidopa intestinal gel (LCIG) are limited. This analysis evaluates the effect of baseline disease severity on long-term effectiveness and safety of LCIG treatment in routine clinical practice.

Background: In clinical trials, levodopa-carbidopa intestinal gel (LCIG) reduced motor and non-motor symptoms in patients with advanced Parkinson's disease (PD). Prospective, long-term data on LCIG use in a real-world setting are limited. This analysis evaluates the long-term effectiveness and safety of LCIG during routine clinical practice in patients with advanced PD.

Background:Limited data on how age may impact levodopa-carbidopa intestinal gel (LCIG) effectiveness and safety exist. This analysis assess the real-world effect of age on the long-term effectiveness and safety of LCIG treatment in patients with advanced Parkinson's disease (PD).

BACKGROUND AND PURPOSE: Postprocedural dual-antiplatelet therapy is frequently withheld after emergent carotid stent placement during stroke thrombectomy. We aimed to assess whether antiplatelet regimen variations increase the risk of stent thrombosis beyond postprocedural day 1. MATERIALS AND METHODS: Retrospective review was undertaken of all consecutive thrombectomies for acute stroke with tandem lesions in the anterior circulation performed in a single comprehensive stroke center between January 9, 2011 and March 30, 2020. Patients were included if carotid stent patency was confirmed at day 1 postprocedure. The group of patients with continuous dual-antiplatelet therapy from day 1 was compared with the group of patients with absent/discontinued dual-antiplatelet therapy. RESULTS: Of a total of 109 tandem lesion thrombectomies, 96 patients had patent carotid stents at the end of the procedure. The early postprocedural stent thrombosis rate during the first 24?hours was 14/96 (14.5%). Of 82 patients with patent stents at day 1, in 28 (34.1%), dual-antiplatelet therapy was either not initiated at day 1 or was discontinued thereafter. After exclusion of cases without further controls of stent patency, there was no significant difference in the rate of subacute/late stent thrombosis between the 2 groups: 1/50 (2%) in patients with continuous dual-antiplatelet therapy versus 0/22 (0%) in patients with absent/discontinued dual-antiplatelet therapy (P?=?1.000). In total, we observed 88 patient days without any antiplatelet treatment and 471 patient days with single antiplatelet treatment. CONCLUSIONS: Discontinuation of dual-antiplatelet therapy was not associated with an increased risk of stent thrombosis beyond postprocedural day 1. Further studies are warranted to better assess the additional benefit and optimal duration of dual-antiplatelet therapy after tandem lesion stroke thrombectomy.

Aims The aim of this study was to assess the most frequent complication of the PEG procedure and device-related complication and also to analyze the management framework of the patients undergoing this maneuver.

Assess the long-term effectiveness of levodopa-carbidopa intestinal gel (LCIG) on motor fluctuations and dyskinesias in advanced Parkinson’s disease (PD) patients treated in routine clinical practice. DUOGLOBE is the first multinational observational routine care study of LCIG with 3 years follow-up. Primary outcome is mean change in patient-reported “Off” time; secondary outcomes include motor complications (dyskinesia duration/severity), as measured by the recently developed Unified Dyskinesia Rating Scale (UDysRS). Outcomes were collected at baseline, day (D) 1 and scheduled visits closest to months (M) 3, 6, and 12 (±14 days) in this interim analysis. 139 patients were included in the analysis (78% ≥ 65 years old; 51% ≥ 10 years’ disease duration. LCIG treatment significantly reduced patient-reported “Off” time (mean decrease from baseline to M12: −4.1 h) irrespective of sex, age, and disease duration. Dyskinesia assessed by UDysRS significantly improved at D1 and was maintained through M12 (mean decrease from baseline: −12.7). Improvements according to UPDRS part IV scores for duration of “Off” time (through M12), dyskinesia duration (through M6), dyskinesia-related disability (through M12), and dyskinesia-related pain (through M12) were also observed. Safety was consistent with LCIG’s known profile. This interim analysis confirms the marked improvement in “Off” time with LCIG in routine clinical practice. This first analysis using UDysRS, and supporting data from UPDRS part IV, showed that LCIG treatment was also associated with a marked reduction in dyskinesia duration and severity. These findings provide further evidence for the real-world effectiveness of LCIG on motor fluctuations and duration and severity of dyskinesia.

BACKGROUND AND PURPOSE: There are very few published data on the patency of carotid stents implanted during thrombectomies for tandem lesions in the anterior circulation. We aimed to communicate our experience of stenting in the acute setting with systematic follow-up of stent patency and discuss predictors and clinical repercussions of delayed stent thrombosis. MATERIALS AND METHODS: We performed a retrospective study of stroke thrombectomies in a single center between January 2009 and April 2018. Patient files were reviewed to extract patient characteristics, procedural details, imaging studies, and clinical information. Predictors of delayed stent thrombosis and clinical outcome at discharge were analyzed using univariate and multivariate analyses. RESULTS: We identified 81 patients treated for tandem lesions: 63 (77.7%) atheromas, 17 (20.9%) dissections, and 1 (1.2%) carotid web. TICI 2b-3 recanalization was achieved in 70 (86.4%) cases. Thirty-five patients (43.2%) were independent (mRS score <= 2) at discharge. Among 73 patients with intracranial recanalization and patent stents at the end of the procedure, delayed stent thrombosis was observed in 14 (19.1%). Among 59 patients with patent stents, 44 had further imaging controls (median, 105 days; range, 2-2407 days) and 1 (1.6%) had 50% in-stent stenosis with no retreatment. Stent occlusion rates were 11/39 (28.2%) for periprocedural aspirin treatment versus 3/34 (8.8%) for aspirin and clopidogrel (P = .04). Delayed stent thrombosis was independently associated with higher admission NIHSS scores (OR, 1.1; 95% CI, 1.01-1.28), diabetes (OR, 6.07; 95% CI, 1.2-30.6), and the presence of in-stent thrombus on the final angiographic run (OR, 6.2; 95% CI, 1.4-27.97). Delayed stent thrombosis (OR, 19.78; 95% CI, 2.78-296.83), higher admission NIHSS scores (OR, 1.27, 95% CI, 1.12-1.51), and symptomatic hemorrhagic transformation (OR, 23.65; 95% CI, 1.85-3478.94) were independent predictors of unfavorable clinical outcome at discharge. CONCLUSIONS: We observed a non-negligible rate of delayed stent thrombosis with significant negative impact on clinical outcome. Future studies should systematically measure and report stent patency rates.