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Opt Express ; 30(7): 10833-10849, 2022 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-35473041


Daytime application of the pyramid wavefront sensor (PyWFS) is greatly challenged by a bright and fluctuating sky background, especially in the visible. A daytime-Py approach to apply visible pyramid wavefront sensing for real-time daylight AO is described in this paper. A field stop (FS) and a lenslet array are applied in the daylight AO system based on a visible PyWFS to separate the object signal from the background signal and improve the signal-to-noise ratio (SNR). A background elimination algorithm is proposed to extract the effective object signal. Closed-loop experiment using the daytime-Py approach is performed, which presents the first laboratory real-time daylight natural guide star AO correction of a faint object based on a visible PyWFS. SNR ranges for both the daytime-Py approach and PyWFS are reported. Furthermore, the correction results in different SNRs using both methods and with various pupil samplings using the daytime-Py approach are presented to prove that our proposal has the advantages over the PyWFS and Shack-Hartmann wavefront sensor (SHWFS) for daylight AO. This study demonstrates that the daytime-Py approach can realize the real-time object tracking and closed-loop correction in the daylight natural guide star adaptive optics (AO) system based on the visible PyWFS.

J Neurointerv Surg ; 2021 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-34857667


BACKGROUND: Mechanical thrombectomy is the standard treatment for acute ischemic stroke (AIS) with large vessel occlusion (LVO) in the anterior circulation. This trial aimed to indicate whether Skyflow, a new thrombectomy device, could achieve the same safety and efficacy as Solitaire FR in the treatment of AIS. METHODS: This study was a prospective, multicenter, randomized, single blind, parallel, positive controlled, non-inferiority clinical trial. Patients with intracranial anterior circulation LVO within 8 hours from onset were included to receive thrombectomy treatment with either the Skyflow or Solitaire FR stent retriever. The primary endpoint was the rate of successful reperfusion (modified Treatment In Cerebral Infarction (mTICI) ≥2b) after the operation. The safety endpoints were the rate of symptomatic intracranial hemorrhage (sICH) and subarachnoid hemorrhage (SAH) at 24 hours after operation. RESULTS: A total of 95 and 97 patients were involved in the Skyflow group and Solitaire FR group, respectively. A successful reperfusion (mTICI ≥2b) was finally achieved in 84 (88.4%) patients in the Skyflow group and 80 (82.5%) patients in the Solitaire FR group. Skyflow was non-inferior to Solitaire FR in regard to the primary outcome, with the criterion of a non-inferiority margin of 12.5% (p=0.0002) after being adjusted for the combined center effect and the National Institutes of Health Stroke Scale (NIHSS) score. The rate of periprocedural sICH and SAH did not differ significantly between the two groups. CONCLUSION: Endovascular thrombectomy with the Skyflow stent retriever was non-inferior to Solitaire FR with regard to successful reperfusion in AIS due to LVO (with a pre-specified non-inferiority margin of 12.5%).

BMJ Open ; 11(4): e043415, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33795300


OBJECTIVES: We aimed to determine predictors of mortality within 90 days and develop a simple score for patients with mechanical thrombectomy (MT). DESIGN: Analysis of a multicentre prospective registry. SETTING: In six participating centres, patients who had an acute ischaemic stroke (AIS) treated by MT between March 2017 and May 2018 were documented prospectively. PARTICIPANTS: 224 patients with AIS were treated by MT. RESULTS: Of 224 patients, 49 (21.9%) patients died, and 87 (38.8%) were independent. Variables associated with 90-day mortality were age, previous stroke, admission National Institutes of Health Stroke Scale (NIHSS), fasting blood glucose and occlusion site. Logistic regression identified four variables independently associated with 90-day mortality: age ≥80 years (OR 3.26, 95% CI 1.45 to 7.33), previous stroke (OR 2.33, 95% CI 1.04 to 5.21), admission NIHSS ≥18 (OR 2.37, 95% CI 1.13 to 4.99) and internal carotid artery or basilar artery occlusion (OR 2.92, 95% CI 1.34 to 6.40). Using these data, we developed predicting 90-day mortality of AIS with MT (PRACTICE) score ranging from 0 to 6 points. The receiver operator curve analysis found that PRACTICE score (area under the curve (AUC)=0.744, 95% CI 0.669 to 0.820) was numerically better than iScore (AUC=0.661, 95% CI 0.577 to 0.745) and Predicting Early Mortality of Ischemic Stroke score (AUC=0.638, 95% CI 0.551 to 0.725) for predicting 90-day mortality. CONCLUSIONS: We developed a simple score to estimate the 90-day mortality of patients who had an AIS treated with MT. But the score needs to be prospectively validated. TRIAL REGISTRATION NUMBER: Chinese Clinical Trial Registry (ChiCTR-OOC-17013052).

Isquemia Encefálica , AVC Isquêmico , Acidente Vascular Cerebral , Idoso de 80 Anos ou mais , Isquemia Encefálica/terapia , Humanos , Sistema de Registros , Estudos Retrospectivos , Acidente Vascular Cerebral/terapia , Trombectomia , Resultado do Tratamento
J Mol Neurosci ; 69(3): 478-484, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31325109


Although the symptoms of minor ischemic stroke are mild, poor prognosis may occur if left untreated. Therefore, it is particularly important to identify the predictors that associated with poor outcome in patients presenting minor ischemic stroke. The aim of this study was to elucidate the predictors of progression by using magnetic resonance imaging (MRI). A total of 516 patients diagnosed with minor ischemic stroke were enrolled in this study. They were divided into two groups, the progressive group and non-progressive group, according to the modified Rankin Scale (mRS) with the cutoff value of 2 points on day 90 after the stroke onset. We compared the results of MRI scan between the two groups to investigate the potential independent determinants of progression using multivariate logistic regression analysis. Ninety of 516 patients (17.44%) underwent progression. There were 9 factors that were independently associated with poor outcome, including age (OR = 1.045, 95% CI 1.017-1.074), heart disease (OR = 2.021, 95% CI 1.063-3.841), baseline NIHSS score (OR = 1.662, 95% CI 1.177-2.347), limb motor disturbance (OR = 2.430, 95% CI 1.010-5.850), ataxia (OR = 2.929, 95% CI 1.188-7.221), early neurological deterioration (OR = 50.994, 95% CI 17.659-147.258), diameter of infarction (OR = 1.279, 95% CI 1.075-1.521), non-responsible vessel size (OR = 2.518, 95% CI 1.145-5.536), and large-artery atherosclerosis (OR = 2.010, 95% CI 1.009-4.003). This study indicated that age, heart disease, motor disturbance of limb, ataxia, early neurological deterioration, diameter of infarction, size of non-responsible vessels, and large-artery atherosclerosis can be used to assess the prognosis of patients with minor ischemic stroke.

Dano Encefálico Crônico/etiologia , Isquemia Encefálica/diagnóstico por imagem , Imageamento por Ressonância Magnética , Neuroimagem , Fatores Etários , Idoso , Angiografia , Ataxia/etiologia , Aterosclerose/complicações , Vasos Sanguíneos/diagnóstico por imagem , Vasos Sanguíneos/patologia , Isquemia Encefálica/complicações , Isquemia Encefálica/mortalidade , Artérias Carótidas/diagnóstico por imagem , Comorbidade , Progressão da Doença , Feminino , Seguimentos , Humanos , Modelos Logísticos , Angiografia por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Transtornos dos Movimentos/etiologia , Análise Multivariada , Prognóstico , Estudos Prospectivos , Fatores de Risco , Índice de Gravidade de Doença , Resultado do Tratamento